Alcohol has no benefits for people under the age of 40, but drinking a small amount of alcohol by healthy people over 40 might have some health benefits, according to a study conducted by the Global Burden of Disease study, published in The Lancet on Friday.

The study – the first to report alcohol risk by region, age and sex – suggests that the strictest drinking guidelines should be targeted at young men, who are at the greatest risk of harmful alcohol consumption worldwide.

Around 60% of alcohol-related injuries occur in people under 50, including motor vehicle crashes, suicides and homicides. 

For those over 40, consuming a small amount of alcohol (for example, less than two small glasses of red wine per day) can provide some health benefits, such as reducing the risk of cardiovascular disease, stroke, and diabetes.  

Using estimates of alcohol use in 204 countries, researchers calculated that 1.34 billion people consumed harmful amounts in 2020. In every region, and the group drinking the most unsafe amounts of alcohol were men aged 15–39.

Young men could only consume one-tenth of a standard drink and young women a quarter of a standard drink before incurring health risks, according to the study. It defines a standard drink as 10 grams of pure alcohol – the equivalent of a 100ml glass of red wine (13% alcohol by volume), a 375ml can of beer (3.5% alcohol volume), or a single 30ml shot of spirits (40% alcohol by volume).

“Our message is simple: young people should not drink, but older people may benefit from drinking small amounts,” said senior author Dr Emmanuela Gakidou, from the University of Washington’s Institute for Health Metrics and Evaluation (IHME).

“While it may not be realistic to think young adults will abstain from drinking, we do think it’s important to communicate the latest evidence so that everyone can make informed decisions about their health.”

Risk calculations from 204 countries

The researchers looked at the risk of alcohol consumption on 22 health outcomes, including injuries, cardiovascular diseases, and cancers using 2020 Global Burden of Disease data for males and females aged 15–95 years and older between 1990 and 2020, in 204 countries and territories. 

From this, they could estimate the average daily intake of alcohol that minimises risk to a population, as well as how much alcohol a person can drink before taking on excess risk to their health in comparison to someone who does not drink any alcohol.

There were substantial variations in risk across regions. For example, for people 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 cancers, and less than 1% were due to tuberculosis. 

In this same age group in central sub-Saharan Africa, 20% of alcohol-related health risks were due to cardiovascular disease, 9.8% to cancers, and 10.1% to tuberculosis. 

Overall, the recommended alcohol intake for adults remained low, at between zero and 1.87 standard drinks per day, regardless of geography, age, sex, or year.

“Even if a conservative approach is taken and the lowest level of safe consumption is used to set policy recommendations, this implies that the recommended level of alcohol consumption is still too high for younger populations,” said lead author Dana Bryazka, a researcher at IHME.

“Our estimates, based on currently available evidence, support guidelines that differ by age and region. Understanding the variation in the level of alcohol consumption that minimises the risk of health loss for populations can aid in setting effective consumption guidelines, supporting alcohol control policies, monitoring progress in reducing harmful alcohol use, and designing public health risk messaging.”

Image Credits: Taylor Brandon/ Unsplash.