New Year, new alcohol guidelines
Are you doing 'Dry January'? If so, chances are you made the choice to cut out alcohol to improve your health. Hurrah for you - unless your theory is that you can balance out drinking too much the rest of the year by giving up for a month. New guidelines on alcohol from the Chief Medical Officer, out today, recommend several key changes to drinking patterns to keep health risks low.
In short, the main messages are:
- Any regular alcohol can harm your health in the long term, increasing your risk of several cancers
- Men as well as women should stick to 14 units a week or less, spread over several days
- Pregnant women shouldn't drink at all
- Some people are at higher risk than others, and need to be particularly careful about their alcohol intake
- Taking a few days off alcohol each week is good for your health
One of the first changes is that we're back to recommending a weekly rather than daily limit. The idea of advising counting units to keep track of your drinking came about in the UK in 1987 - with a recommended limit of 14 units a week for women and 21 for men. In 1995, this was replaced with recommended daily limits (of two to three units for women and three to four for men) on the basis that many people were putting themselves at risk by saving up their weekly 'allowance' and blowing it all at once on a weekend binge.
Now the recommendation is to stick to no more than 14 units a week, whether you're a man or a woman, in order to keep health risks from alcohol low. That's because while very low levels of alcohol (not more than 1 unit a day) may offer some protection against heart attack or stroke for older men and women aged over 55, drinking above the recommended limits more than offsets these benefits. In fact, there's no level of regular alcohol drinking that doesn't increase your risks of a range of diseases in the long term. These include breast cancer (two units a day increases your risk by 16%, and five units a day increases it by 40%); cancer of the mouth and throat; and cirrhosis of the liver (two units a day for men increases your risk by 57% and five units a day by 207%).
But that doesn't mean you can go back to drinking all 14 units on a Friday night (probably on an empty stomach and followed by a very greasy curry and a whole weekend to recover). The guidelines also stress that if you do drink as much as 14 units a week, it's best to spread them out over three or more days. As well as short-term risks (like accidents and injuries - remember the Manchester Madness picture that went viral this New Year's eve?) from heavy drinking sessions, there are long-term health risks too.
There has also been clarification on the alcohol advice for women who are pregnant or trying to get pregnant - don't. It's a precautionary approach - drinking a small amount before you know you're pregnant carries a low risk to your baby. But it makes sense, because certainly in my consulting room the old guideline (avoiding alcohol especially in the first trimester but not more than one to two units once or twice a week if you 'had to') caused a lot of confusion. It's easy to underestimate how much you're drinking, and there's clear evidence that drinking more than one to two units a day can increase the risk of low birth weight and pre-term birth. Heavy drinking can cause terrible damage to the unborn child, with the multiple problems for body and brain seen in fetal alcohol syndrome.
Other groups who should pay special attention to their alcohol levels, because they may be at higher risk of harm, include:
- Young people (alcohol may have more of an effect on their still-developing brains and other organs)
- Older people (who process alcohol more slowly and are at higher risk of falls etc)
- People with low body weight (less body, same alcohol, higher levels in the bloodstream - you do the maths!)
- People taking other medicines (which might increase the side effects of alcohol)
- People with long-term medical conditions.
Most of this new advice isn't rocket science - but behind the simple message hide thousands of studies which have been trawled through to get it. So whether you're off the pop until February or not, do your body a favour - don't take them with a pinch of salt.