For Your Health, No Amount of Alcohol Is Safe

Alcohol use is a leading health risk factor. Its impact is complex and includes purported benefits at low levels for certain health conditions. Using data from 694 individual and population-level studies in 195 countries and territories, researchers evaluated the global impact of alcohol use and estimated the levels of consumption that minimize an individual’s total attributable risk on health.

• In 2016, alcohol was the seventh leading risk factor for death and disability worldwide.
• Among those aged 15–49, alcohol use was the leading risk factor, accounting for 2.3% of disability-adjusted life-years (DALYs) and 3.8% of deaths among women, and 8.9% of DALYs and 12.2% of deaths among men.
• The burden changed over the lifespan: tuberculosis, road injuries, and self-harm were leading causes of death attributable to alcohol among 15-49 year-olds, while cancer was the leading cause among people over 50.
• A J-shaped curve showing positive effects for lower levels of alcohol use was found only for ischemic heart disease, with a minimum relative risk at 0.9 standard drinks (10g ethanol) per day. For all other outcomes (including all cancers), risk increased with any alcohol consumption.
• Protective effects were offset by cancer risks. Consuming zero standard drinks a day minimized the overall risk for all health outcomes.

Comments: This analysis provides a global view; the exact distribution of each alcohol-attributable illness will vary by locale. Nonetheless, Alcohol use contributes largely to global death and disability, particularly among men. These results indicate that the safest level of drinking is none, which should encourage health agencies to revise current recommendations. We should not drink alcohol because we think that it is good for our health.

Nicolas Bertholet, MD, MSc

Reference: GBD 2016 Alcohol Collaborators. Alcohol use and burden for 195 countries and territories, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2018;392(10152):1015–1035.