The relationship between moderate alcohol use and health is complex, as demonstrated in several studies. Alcohol consumption at any level is associated with loss of health due to several diseases, including liver cirrhosis, breast cancer and tuberculosis, as well as injuries. At the same time, some studies have found that drinking small amounts of alcohol can reduce the risk of cardiovascular disease and type 2 diabetes.
In principle, the amount of alcohol that minimizes the negative impact on health depends on a number of factors, mainly the profile of diseases present in a given population. Since this distribution varies widely by geography, age, sex and time, the level of alcohol consumption associated with the lowest health risk would depend on the age structure and the most common diseases of this population. In other words, alcohol consumption is associated with several health risks, but the causal relationships between its use and the risks of developing diseases and mortality are difficult to establish, as there are several variables, linked to lifestyle, place of residence, age, sex, socioeconomic status and most prevalent diseases that can interfere with the relationship, making it difficult to isolate the role of alcohol in health outcomes, although it is evident that this impact exists.
The study used the distribution of causes of disability-adjusted life years (DALYs) in each population, along with alcohol consumption patterns from the Global Burden of Disease, Injury and Risk Factors (GBD) 2020 Study, to estimate the theoretical minimum risk exposure level (TMREL), which represents the level of consumption that minimizes the health loss from alcohol for a population, and the non-drinker equivalence level (NDE), which measures the level of alcohol consumption where a drinker's risk of health loss is equivalent to that of a non-drinker for each region, age group, sex and year from 1990 to 2020.
Overall, results showed that TMREL remained low regardless of geography, age, sex, or time, ranging from 0 (95% IU 0–0) to 1.87 (0.500–3.30) standard doses per day. The TMREL and NDE did not vary significantly by sex or year, but rather by region and age, with younger age groups having much lower levels than older adults. This means that young people face greater health risks from alcohol consumption than older adults, and that the risks are also greater depending on where you live. In all macro-regions, among individuals aged 15 to 39 years, injuries accounted for the majority of alcohol-related DALYs in 2020. In individuals aged 40 to 64 years, health outcomes contributing to alcohol-related burden have shifted to chronic health conditions, including cardiovascular disease and cancer. For this reason, the research recommends that moderate consumption guidelines be differentiated according to age, being lower for the age group from 15 to 39 years old.
Overall, the study concludes that low-risk drinking recommendations are still high for younger populations and that there is no evidence to differentiate them by sex. Given the known difficulties associated with translating scientific evidence into changes in drinking behavior, clear messages about updates to drinking guidelines will be crucial to ensuring that improvements are made.
