Older adults who consume alcohol are at less risk of adverse health risk than younger people, and for healthy older people, low level alcohol consumption can actually have some health benefits, a new study reports.

This is the first study to report alcohol risk by geographical region, age, sex, and year. It suggests that global alcohol consumption recommendations should be based on age and location, with the strictest guidelines targeted toward males between ages 15-39, who are at the greatest risk of harmful alcohol consumption worldwide.

The research also indicates that adults aged 40 and older without underlying health conditions may see some benefits from small alcohol consumption (between one and two standard drinks per day), including a reduced risk in 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, the largest segment of the population drinking unsafe amounts of alcohol were males aged 15–39, and for this age group, drinking alcohol does not provide any health benefits and presents many health risks, with 60% of alcohol-related injuries occurring among people in this age group, including motor vehicle accidents, suicides, and homicides.

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

Age and Region Should Drive Alcohol Consumption Policies

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, the researchers were able to estimate the average daily intake of alcohol that minimises risk to a population.

The study also estimates another critical quantity – how much alcohol a person can drink before taking on excess risk to their health compared to someone who does not drink any alcohol.

The recommended amount of alcohol for people aged 15-39 before risking health loss was 0.136 standard drinks per day (a little more than one-tenth of a standard drink). That amount was slightly higher for females aged 15-39 years at 0.273 drinks (about a quarter of a standard drink per day).

One standard drink is defined as 10 grams of pure alcohol, which is equivalent to a small glass of red wine (100ml or 3.4 fluid ounces) at 13% alcohol by volume, a can or bottle of beer (375 ml or 12 fluid ounces) at 3.5% alcohol by volume, or a shot of whiskey or other spirits (30 ml or 1.0 fluid ounces) at 40% alcohol by volume.

In general, for individuals aged 40-64 years in 2020, safe alcohol consumption levels ranged from about half a standard drink per day (0.527 drinks for males and 0.562 standard drinks per day for females) to almost two standard drinks (1.69 standard drinks per day for males and 1.82 for females).

For individuals over 65 years in 2020, the risks of health loss from alcohol consumption were reached after consuming a little more than three standard drinks per day (3.19 drinks for males and 3.51 for females).

The estimates suggest that small amounts of alcohol consumption in populations over 40 without underlying conditions may be associated with improved health outcomes, particularly in populations that predominantly face a higher burden of cardiovascular diseases.

The distribution of disease burden for a given age group varied substantially across regions, resulting in variations in risks from alcohol consumption, particularly in individuals aged 40 years and older.

Overall, the recommended alcohol intake for adults remained low at between 0—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.”

“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,” says lead author Dana Bryazka, researcher at IHME.

Young Men Are At Greatest Risk Of Harmful Alcohol Consumption

Using these estimates, the proportion of the population consuming alcohol in amounts exceeding these thresholds by location, age, sex, and year, was also calculated, serving as a guide for targeting alcohol control efforts.

Harmful use of alcohol was particularly concentrated in young males in Australasia, western Europe, and central Europe.

“Although the risks associated with alcohol consumption are similar for males and females, young males stood out as the group with the highest level of harmful alcohol consumption. This is because a larger proportion of males compared to females consume alcohol and their average level of consumption is also significantly higher,” says Dr. Gakidou.

The authors acknowledge some limitations with this paper, including that patterns of drinking were not examined. Therefore, this study did not distinguish between individuals who infrequently engage in heavy episodic drinking and those who consume the same amount of alcohol over several days.

Alcohol consumption was also self-reported, which could have introduced bias, and the study could not include data on consumption during the COVID-19 pandemic due to pandemic-related delays with routine data collection, which could also have affected these estimates.