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Alcohol and its impact on health- how much is safe to drink?

Alcohol consumption is a well-known risk factor for more than 200 health conditions, such as arthritis, osteoporosis, cancer, cardiovascular disease, liver disease, and dementia. In addition, a staggering 3 million deaths worldwide can be attributed to alcohol consumption yearly. Therefore, the World Health Organisation has reduced the harmful use of alcohol, a public health imperative.

How much alcohol is safe?

Australia’s Alcohol Guidelines, developed by the National Health and Medical Research Council (NHMRC), our leading expert body in health and medical research, was recently revised. The guidelines advise reducing health risks from drinking alcohol so that Australians can make informed decisions about their alcohol intake for their health. The Guidelines have been developed using the most recent and best available evidence on the health effects of alcohol consumption.

While there’s no safe level of drinking, following the Guidelines keeps the risk of harm from alcohol low, but it does not remove all risks. For example, healthy adults who keep their drinking level within the guidelines have less than a 1 in 100 chance of dying from an alcohol-related condition.

What are the recommendations?

Guideline 1: Reducing the risk of alcohol-related harm for adults

To reduce the risk of harm from alcohol-related disease or injury, drink no more than ten standard drinks a week and no more than four standard drinks on any one day. The less you drink, the lower your risk of harm from alcohol. It is best to take 2-3 days off drinking each week to avoid dependence.

Guideline 2: Children and people under 18 years of age

People under 18 years of age should not drink alcohol to reduce the risk of injury and other harm to health.

Guideline 3: Women who are pregnant or breastfeeding

To prevent harm from alcohol to their unborn child, women who are pregnant or planning a pregnancy should not drink alcohol. For women who are breastfeeding, not drinking alcohol is safest for their baby.

How does the alcohol intake of Australians stack up when compared to the Guidelines?

In Australia in 2020-2021, one in four Australians (5 million people) aged 18 years and over exceeded these guidelines. So how does your intake compare to the Guidelines?

Alcohol and musculoskeletal diseases

A recent review of the research examined the impact of alcohol intake on musculoskeletal conditions. Alcohol intake was associated with more severe rheumatoid arthritis and increased risk of flares in gout.

A high alcohol intake has detrimental effects on bone mineral density, particularly amongst adolescents and children, and this is also a concern amongst those who already have osteopaenia (lower bone mineral density than normal but not yet to the extent of osteoporosis) or osteoporosis (low bone mineral density)

Alcohol and body weight

Alcohol increases the chance of weight gain for several reasons. Alcohol, also called ethanol, is high in energy (known as calories or kilojoules). Combine that with how alcohol is consumed – along with mixers such as juice, soft drink, and tonic water- and the energy goes up even more, which increases the risk of weight gain.

Alcohol also gives people “food cravings”. It acts on the brain to lower inhibitions, decreasing your defences regarding portion control and healthy eating choices. Research shows that people consume larger portions when drinking with a meal or have been drinking before.

Alcohol also influences the hormones that make us feel full and hormones that make us feel hungry. For example, alcohol inhibits the effects of leptin — a hormone that suppresses appetite.

Alcohol and cancer

The World Cancer Research Fund (WCRF) is the world’s leading authority in examining how diet, weight and physical activity affect the risk of developing and surviving cancer. For example, the WCRF states that alcohol intake (any amount) increases the risk of several types of cancer. Examples include breast cancer (both pre and post-menopause) and cancer of the mouth and throat. In addition, drinking two or more alcoholic drinks per day increases the risk of bowel cancer, and three or more drinks increase the chances of stomach and liver cancer.

There are multiple ways that alcohol increases the risk of cancer. One is that alcohol binds to our genes (our DNA), causes mutations (changes) in cancer-causing genes, and turns genes off, usually protecting us against cancer development. Another way that alcohol increases the risk of cancer is by changing our gut microbiota (the microorganisms that live in our gut and their genes).

Alcoholic drinks cause various cancers, irrespective of the type of alcoholic drink consumed. This is because all alcohol contains ethanol which is a cancer-causing compound.

To discuss making changes to your diet that are personalised and appropriate for your age, gender, and health conditions, reach out to your Accredited Practising Dietitian. Private Health Rebates to see a dietitian are usually available (depending on your coverage), and no referral is needed.

Written by Dr Emily Calton, Accredited Practising Dietitian, Accredited Sports Dietitian, Nutritionist, Director at The Nutrition Doctor

About the author:

Dr Emily Calton is an Accredited Practising Dietitian, Accredited Sports Dietitian and Nutritionist with a PhD in Public Health. Emily is a lecturer at Curtin University teaching into the Masters of Dietetics and Undergraduate Nutrition degree.  Her research interests include investigating the impact of diet on arthritis, body composition, inflammation, blood sugar and cholesterol. Through her telehealth practice The Nutrition Doctor, she helps clients around Australia make changes to their diets to improve their diet, manage health conditions such as osteoporosis, arthritis, type 2 diabetes, blood pressure, cholesterol, IBS, obesity, and fatty liver.

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