Putting the ‘risks’ of alcohol consumption into context

16/04/2019

A number of recent academic studies have received media coverage with headlines warning consumers that ‘even one drink a day increases stroke risk’, that there is ‘no safe level of alcohol consumption’, or even comparing alcohol consumption to smoking.

While, in isolation, these studies are alarming, they should be viewed in the context of existing scientific research over the last 30 years, the bulk of which suggests a J-shaped curve of risk for cardiovascular disease and diabetes.

While findings vary across studies, eight out of nine meta-analyses published since 2008 have found that total cardiovascular disease or coronary heart disease risk is lower for individuals who are light or moderate drinkers than for those who do not drink at all and those who drink heavily.

To take one study as an example, Wood et al (April 2018), showed that, compared to moderate drinkers, ‘never-drinkers’ experience 30% more heart disease and strokes, and 20% higher overall death rate. 

Indeed, the study on stroke risk cited above also found evidence using conventional epidemiology to reinforce the existence of a ‘J-curve’, suggesting moderate alcohol intake “was associated with a risk of stroke lower than that in non-drinkers or, particularly, ex-drinkers”, although its use of genetic epidemiology suggested no protective effects.

Furthermore, consumers should take a sensible and measured approach to risk and, whilst we realise that everyone’s circumstances are different, in general drinking moderately represents a very low level of risk.

Putting the concept of ‘risk’ into perspective is important. An Institute for Health Metrics and Evaluation co-ordinated study (August 2018) alleged ‘no safe level of alcohol consumption’, suggesting that any beneficial effects of alcohol on heart disease are outweighed by the adverse effects on other areas of health, particularly cancers, with a 0.5% increase in relative risk at low levels of drinking compared to non-drinkers.

However, commenting on the study, Ian Hamilton, Senior Lecturer in Addiction at York University, called on readers to put the study findings into context, saying that “There’s no safe level for a lot of things in life - riding a bike or driving a car for example; they all carry risks. This research appears to show an alarming risk to health, including cancer and liver problems, throughout your life, but you have to put that risk in proportion to everything else. If 25,000 moderate drinkers were to have a bottle of gin a month, for example, one of them would suffer a serious health problem throughout their life.” 

It is important to remember that science is a living body of evidence that is constantly subject to updates. We base our view on the existing body of high-quality evidence, and are fully prepared to change our view when the body of evidence changes.

Based on the existing evidence, we believe that moderate alcohol consumption can form part of a well-balanced healthy lifestyle for those who choose to drink.

However, we also believe that alcohol producers should not market their products utilising any purported ‘health’ angle. Indeed, our Code explicitly excludes products suggesting a ‘therapeutic quality’ or which can ‘enhance mental or physical capabilities’, and as a responsible regulator we encourage the public to report any products they see which may breach this code.

Overall, we want consumers to have a balanced understanding of the relative risks of alcohol consumption and to drink responsibly.