This study of international drinking guidelines gives an analysis of the varying advice from governmental and medical bodies across the world. The report highlights the fact that although all such guidelines aim to offer the best advice to individuals for ‘safe’ drinking, there is considerable inconsistency in the actual levels of alcohol that are considered safe. These inconsistencies are explained from a historical and cultural perspective, and the report acknowledges that guidelines may also reflect the view of current governments as to how information on health and risk should be shared with the public, and the decision of some to err on the side of caution.
Most guidelines provide average recommendations which can be applied to the majority of the population. However, differences in physiology and the ability to metabolise alcohol between men and women has led to some countries such as the UK, France, Australia and US recommending different thresholds for men and women. In the Netherlands, women with a lower body weight are advised to drink less than the recommended daily limit. Other countries such as Italy, Spain, Switzerland and the Netherlands currently make no such distinction between recommendations for men and women.
Some countries offer specific advice for ‘special populations’ such as pregnant women, the elderly, or individuals who are alcohol dependent. Advice to pregnant women generally is to not drink, although some countries may only recommend caution and a decreased level of consumption.
Public guidelines are often presented in terms of ‘standard drinks’. The measurement of a ‘standard drink’ covers a broad range from 8g of ethanol (Ireland and the UK) up to 14g (USA and Portugal) and 19.7g in Japan. Other guidelines give daily thresholds directly in grams of ethanol. These vary for women from 10g in Poland to 50g in Catalonia, and for men from 20g in Poland to 70g in The Basque Country.
About a third of countries give an additional threshold for the week, which is less than 7 times the daily threshold, ranging for women from 50g in Poland to 140g in New Zealand, and for men from 100g in Poland to 252g in Denmark.
Some countries give only a weekly threshold. Knowing how many drinks per week may be ‘safe’ does not answer the question of how many drinks an individual can safely consume in a given day.
A minority of guidelines recommend one or two days free from alcohol per week. Further guidelines are situational suggesting that individuals should avoid alcohol in the workplace or during work time (Italy), when driving (Luxembourg, Norway, US), while operating machinery (The Netherlands, Switzerland), while engaging in sport (Switzerland), on an empty stomach or whilst in the company of young children (Norway).
Not all advice is discouraging drinking: The UK Sensible Drinking guidelines recommend that individuals who do not drink, drink very little, or are in an age group at high risk from CHD, might ‘consider the possibility that light drinking might benefit their health’. The Swedish Research Council also include recognition that ‘a moderate alcohol intake may have positive medical effects’.