Drinking alcohol carries significant health risks and does not benefit young adults

A new study has found that young adults (under the age of 40) face greater health risks from alcohol consumption than older adults.

  • A new analysis of the global burden of disease estimates that 1.34 billion people consumed harmful amounts of alcohol (1.03 billion males and 0.312 billion females) in 2020.
  • The analysis indicates that for young adults between the ages of 15 and 39, there are no health benefits to drinking alcohol, only health risks. 59.1% of people who consumed unsafe amounts of alcohol in 2020 were 15-39 years old and 76.7% were male.
  • The authors note that given the complex relationship between alcohol and disease and the different background rates of disease worldwide, the risks of alcohol consumption vary with age and geographic location.
  • Health risks from alcohol consumption vary by age and region for adults over the age of 40. Consuming a small amount of alcohol (for example, drinking one to two 3.4-ounce glasses of red wine) can provide people in this age group with some health benefits, such as a reduced risk of cardiovascular disease, stroke, and diabetes.
  • The researchers call for a review of alcohol consumption guidelines to emphasize consumption levels by age. They stress that the level of alcohol consumption recommended by many of the current guidelines is too high for young people in all regions. They are also calling for policies targeting males under the age of 40, who are most likely to use alcohol harmfully.

According to a new analysis published in

Using estimates of alcohol use in 204 countries, researchers estimated that 1.34 billion people worldwide consumed harmful amounts in 2020. In each region, the largest share of the population who drank unsafe amounts of alcohol was males between the ages of 15 and 39 years old. For this age group, drinking alcohol does not provide any health benefits and also presents many health risks. Furthermore, 60% of alcohol-related injuries occur among people in this age group, including car accidents, suicides, and homicides.

Our message is simple: Young people should not drink, but older adults may benefit from drinking smaller amounts. While it may not be realistic to think that young people will abstain from drinking, we believe it is important to communicate the latest evidence so that everyone can make informed decisions about their health, says senior author Dr. and Evaluation (IHME) in University of WashingtonFaculty of medicine.[2]

Lancet alcohol consumption chart

Drinking alcohol has significant health risks for young adults, and small amounts may be beneficial for some older adults. A new analysis suggests that recommendations for how much one can drink should be based on age and local disease rates. credit: Lancet

Age and region should pay alcohol consumption policies

Researchers looked at the risks of alcohol consumption on 22 health outcomes, including injuries, cardiovascular disease, and cancers[3] Using GBD 2020 data for males and females aged 15-95 years and older between 1990 and 2020, for 204 countries and territories. From this, the researchers were able to estimate the average daily intake of alcohol that reduces the risk to the population. The study also estimates another critical quantity – the amount of alcohol a person can drink before putting themselves at increased risk to their health compared to someone who doesn’t drink any alcohol.

The recommended amount of alcohol for people ages 15 to 39 before the risk of losing health was 0.136 standard drinks per day (just over one-tenth of a standard drink). This amount was slightly higher for females aged 15 to 39 at 0.273 drinks (about a quarter of a standard drink per day). One standard drink is defined as 10 grams of pure alcohol, which is equivalent to a small glass of red wine (100 ml or 3.4 fl oz) at 13% alcohol by volume, or a can or bottle of beer (375 ml or 12 fl oz) at a concentration 3.5% alcohol by volume, or a shot of whiskey or other spirits (30 ml or 1.0 fluid ounce) at 40% alcohol by volume.[1]

The analysis also suggests that for adults age 40 or older who don’t have any underlying health conditions, drinking a small amount of alcohol may provide some benefits, such as a reduced risk of ischemic heart disease, stroke and diabetes. Overall, for individuals aged 40-64 years in 2020, levels of safe alcohol consumption ranged from about half a standard drink per day (0.527 standard drinks per day for males and 0.562 standard drinks per day for females) to approximately two standard drinks (1.69 standard drinks per day) day for males and 1.82 for females). For individuals over 65 years of age in 2020, the risk of health loss from alcohol consumption was reached after drinking just over three standard drinks per day (3.19 drinks for males and 3.51 for females). It is estimated that small amounts of alcohol consumption in populations over 40 years of age with no underlying conditions may be associated with improved health outcomes, particularly in populations that often face a greater burden of cardiovascular disease.

The distribution of disease burden for a given age group varied significantly across regions, resulting in differences in risk from alcohol consumption, particularly in individuals 40 years of age and older. For example, among individuals aged 55-59 years in North Africa and the Middle East, 30.7% of alcohol-related health risks were due to cardiovascular disease, 12.6% were due to cancer, and less than 1% were due to tuberculosis. By contrast, in this same age group in central sub-Saharan Africa, 20% of alcohol-related health risks were due to cardiovascular disease, 9.8% from cancers, and 10.1% from tuberculosis. As a result, consumption levels for this age group before risking health loss were 0.876 drinks (or approximately one standard drink per day) in North Africa and the Middle East and 0.596 drinks (about half a standard drink per day) in central sub-Saharan Africa.

Overall, recommended adult alcohol intake remained low between 0 – 1.87 standard drinks per day, regardless of geography, age, gender, or year.

“Even if a conservative approach is taken and the lowest level of safe consumption is used to make policy recommendations, this means that the recommended level of alcohol consumption is still too high for the younger population. Our estimates, based on the evidence currently available, support support guidelines that vary by age. Understanding the variance in the level of alcohol consumption that reduces the health risk of a population can help establish effective consumption guidelines, support alcohol control policies, monitor progress in reducing harmful alcohol use, and design public health risk messages, the author says. Principal Dana Pryazka, researcher at IHME.

Young people are most at risk of harmful alcohol consumption

Using these estimates, the proportion of the population consuming alcohol in amounts beyond these thresholds was also calculated by location, age, gender, and year, to serve as a guide for targeting alcohol control efforts.

Of the individuals who consumed harmful amounts of alcohol in 2020, 59.1% were aged 15-39 years, and 76.7% were male, with 1.03 billion males and 0.312 billion females who drank harmful amounts of alcohol. The harmful use of alcohol is particularly concentrated in young males in Australia, Western Europe and Central Europe.

“Although the risks associated with alcohol consumption are similar for males and females, young males have emerged as the group with the highest level of harmful alcohol consumption. This is because a greater proportion of males than females consume alcohol, and their average level of consumption is higher Significantly,” says Dr. Jacquido.

The authors acknowledge some limitations in this paper, including that drinking patterns were not examined. Therefore, this study did not distinguish between individuals who rarely engage in occasional heavy drinking and those who consume the same amount of alcohol over several days. Alcohol consumption was also self-reported, which may introduce bias, and the study could not include data on consumption during[{” attribute=””>COVID-19 pandemic due to pandemic-related delays with routine data collection, which could also have affected these estimates.

Writing in a linked Comment, Robyn Burton and Nick Sheron of King’s College London (who were not involved in the study) say, “These findings seemingly contradict a previous GBD estimate published in The Lancet, which emphasized that any alcohol use, regardless of amount, leads to health loss across populations. There are three main differences between the two GBD publications. First, the most recent study uses data from 2020 instead of 2016. Second, the relative risk curves for five alcohol-related outcomes have been updated. However, neither of these changes is driving the differences in results. Instead, the differences are due to the novel method of weighting relative risk curves according to levels of underlying disease, alongside the calculation of more disaggregated estimates by sex, age, and geographical region. The causes that contribute to all-cause mortality vary across groups, and this changes the proportional risk of alcohol on mortality. Across most geographical regions in this latest analysis, injuries accounted for most alcohol-related harm in younger age groups. This led to a minimum risk level of zero, or very close to zero, among individuals aged 15–39 years across all geographical regions. This is lower than the level estimated for older adults, due to a shift in alcohol-related disease burden toward cardiovascular disease and cancers. This highlights the need to consider existing rates of disease in a population when trying to determine the total harm posed by alcohol.”

Notes

This study was funded by the Bill and Melinda Gates Foundation. A full list of GBD 2020 Alcohol Collaborators is available in the paper.

[1] One standard drink is defined as 10 grams of pure alcohol. Examples include:

  • 1 small glass of red wine (100 ml or 3.4 fl oz) at 13% alcohol by volume;
  • can or bottle of beer (375 ml or 12 fl oz) of 3.5% alcohol by volume;
  • A dose of whiskey or other spirits (30 ml or 1.0 fl oz) at 40% alcohol by volume.

[2] A direct quote from the author and cannot be found in the text of the article.

[3] These health issues included:

  • Ischemic stroke, intracerebral hemorrhage, ischemic heart disease, hypertensive heart disease, atrial fibrillation and flutter.
  • Cancers, including: lip and oral cancer, nasopharyngeal cancer, other oropharyngeal cancer, esophageal cancer, laryngeal cancer, colorectal cancer, breast cancer, and liver cancer.
  • type 2 diabetes, cirrhosis of the liver and other chronic diseases of the liver, pancreatitis, idiopathic epilepsy, tuberculosis;
  • Transport injuries, unintentional injuries, self-harm and interpersonal violence.

Reference: “Population-level Alcohol Consumption Risks by Quantity, Geography, Age, Gender, and Year: A Systematic Analysis for the Global Burden of Disease Study 2020” By GBD 2020 Alcohol Collaborators, July 16, 2022, Available here. scalpel.
DOI: 10.1016 / S0140-6736 (22) 00847-9

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