Haveyou ever shared a bottle of 14.5% wine, say a Barossa Shiraz, over dinner? Maybe you had a gin and tonic or a white wine before that too. Many of us would regard that as civilised behaviour, a pastime enjoyed for hundreds or thousands of years.
The HSE considers that to be binge drinking, because it is consuming more than six units in one sitting.
Its website advises a sensible weekly maximum alcohol consumption for men of 17 units and for women 11; a unit being 10g of pure alcohol. In January, the UK reduced its recommended levels to 14 units for men and women, and their units are only 8g. It’s curious that we are neighbours and both in the EU but don’t share common unit sizes.
Across Europe, countries define units differently, and some merely refer to “standard drinks”. Total maximum weekly units vary, with the Dutch at a miserly 70g for men and women, the UK at 112g for both, Ireland at 170g for men and 110g for women, while the Basque region’s health department suggests a binge-worthy 70g per day.
Dr Richard Smith, chairman of the UK committee that came up with an original 21 units or 168g figure, admitted later that the numbers were “plucked out of the air”. Time moves on, and now the UK’s chief medical officer advises that “there is no level of regular drinking that can be considered safe”. Others beg to differ.
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There are consistent observations in western countries that moderate drinkers, of one to two drinks daily, live longer than non-drinkers and heavier drinkers. This is the so-called J curve. It isn’t based on merely a couple of studies. In 2011, the British Medical Journal published two papers by Dr William Ghali and colleagues, both a meta-analysis of research papers globally. One concluded that alcohol’s positive effect on HDL cholesterol is similar to how you’d hope a prescribed drug for cholesterol would act. The second concluded that 12.5-14g a day of alcohol reduced the risk of cardiovascular disease by 14-25% compared to abstainers.
No one doubts the seriousness of alcohol abuse, but the danger of such disparate advice from different countries undermines the credibility of the safety message. The evidence for damage above the lowest suggested levels can’t be compelling, or all countries would be recommending those levels.
There is no simple, one-size-fits-all message, but a little alcohol is probably good for you, a lot of it, bad. Defining safe patterns of consumption needs a lot more work.
If our health minister’s proposed warning on drink labels are introduced, maybe one day it might read: a drink a day may help you live longer.