Alcohol consumption constitutes a significant risk to human life around the world. Worldwide, 3 million deaths every year result from harmful use of alcohol, representing 5.3% of all deaths. In the United States alone, there are approximately 261 alcohol-related deaths every day.
Many are calling it a public health crisis, with around 4 million people receiving alcohol addiction treatment, and many more in urgent need. As the state-level and global approach to alcohol harm is being questioned, new research has produced stark findings on the dangerous realities of alcohol consumption by age.
Everything in Moderation
Until now, the general approach to alcohol consumption has been that it is fine in moderation, with guidelines from the 2020-2025 Dietary Guidelines for Americans recommending that if alcohol is consumed, it should not be any more than one drink per day for women and two drinks per day for men, and only by adults over 21, the legal drinking age. One drink is generally referred to as 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of spirit, depending on the exact alcohol percentage content of the beverage.
However, a recent publication in the Lancet of research carried out by a group of collaborators across 204 countries has revealed that no amount of alcohol is safe for people under the age of 40. The study puts forward that while previous research shows potential benefits with the consumption of small amounts of alcohol lowering the risk of cardiovascular diseases and type 2 diabetes, the specific volume of alcohol that keeps health outcomes at the best level is likely to vary geographically, depending on the distribution of underlying causes of disease in populations in certain areas of the world. As a result one of the key proposals of the paper is that recommendations on alcohol consumption should vary by location and by age.
How Does Age Affect Safe Consumption?
At present, countries around the world have varying minimum age requirements for the purchase and consumption of alcohol. In the US it is 21, in the UK it is a little younger at 18, and in some parts of Europe and Africa, it is as low as 16. There are also countries where there is no minimum drinking age or where alcohol is prohibited altogether.
Research findings published by the CDC show that the minimum drinking age of 21 has saved lives. The question is, now that research has found no amount of alcohol to be safe for those under 40, will that become the new minimum drinking age? The answer is, that it is very unlikely. So what does this mean for the future of moderate alcohol use in the US, and around the world?
Background Research
Prior to the publication of this study, there was already a wealth of research on the topic, with the effect of moderate alcohol consumption on health outcomes being thoroughly studied and debated for a long time.
There have been a variety of approaches to studying the health impacts of alcohol consumption, ranging from analyzing the results on a particular disease, and observing multiple different health outcomes, to adopting all-cause mortality (ACM) – a term used to refer to death from any cause – as an outcome. The findings of such studies have produced varied results and hypotheses, contributing to the controversial nature of this topic and adding to the existing debate.
Researchers in the field often talk of the J-shaped relationship between alcohol and ACM. Meaning, that findings often suggest that at low consumption levels, alcohol actually decreases the risk of ACM; however, once this level has reached a certain threshold, it increases the risk of ACM.
Research Findings and Recommendations
The study found that 1.34 billion people drank harmful amounts of alcohol throughout 2020. Alcohol has dangerous short and long-term risks for physical and mental health, increasing the risk of:
- Dementia
- High blood pressure
- Heart disease
- Liver disease
- Dementia
- Cancers
In addition, heavy alcohol use can worsen mental illnesses that people often drink to self-medicate, causing a vicious cycle that can end in addiction.
In order to avoid or lessen such negative health outcomes, there have been calls to increase and improve education on alcohol consumption. Some campaigners suggest that the current approach of a ‘one size fits all national daily limit for all people over the age of 21 is ineffective.
The results of this study actually contradict the US recommendations by gender, finding that the safe daily limit is actually slightly higher for females aged 15 to 39. This is accompanied by the finding that in every region, males between the age of 15 and 39 years were the largest portion of the population found to be consuming unsafe levels of alcohol. It is actually the leading risk factor for mortality among males aged 15–49 years, yet it is not for females.
Take Away Message
The findings of this extensive study clearly show that people under 40 who drink more than one very small alcoholic beverage (0.136 of the current standard drink) a day are at an increased risk of developing diabetes, heart disease, and stroke.
For those over the age of 40 without underlying health conditions, there may be some health benefits when alcohol is consumed in small amounts. Drinking low quantities of alcohol has been linked to improved health outcomes in populations that experience a high degree of cardiovascular diseases. This strongly suggests that the traditional method of alcohol consumption messaging and guidelines need to be adapted, and brought in line with current findings on safe consumption, with adjustments by age rather than sex.
In a change from current popular discourse, this study concluded there are in fact no known health benefits gained from drinking alcohol. In contrast, even what was previously seen as ‘moderate’ or safe consumption brings considerable health risks to those under 40. This can be acutely demonstrated by the finding that 60% of alcohol-related injuries were found to affect individuals under 40.