4,600 lives could be saved a year by cutting daily alcohol intake to half a unit (5g)

www.bmjopen.bmj.comMay 31 2012

Cutting daily alcohol intake to just over half a unit (5 g), could save 4,600 lives a year in England, say experts in the online journal BMJ Open.

Current government recommendations of between 24-32 g (3 to 4 units*) a day for men, and 16-24 g (2-3 units) for women may “not be compatible with optimum protection of public health,” suggest the authors.

They calculated what impact changing average alcohol consumption among regular drinkers and increasing the percentage of non-drinkers would have on the health of England’s population as a whole.

They used a mathematical model called the Preventable Risk Integrated ModEl for Alcohol (PRIME-Alcohol) to assess the impact on the death toll from 11 conditions known to be at least partially linked to long term alcohol consumption.

These included coronary heart disease, stroke, high blood pressure, diabetes, cirrhosis of the liver, epilepsy, and five cancers.

As part of their calculations, the authors gathered the results of analyses of published research (meta-analyses), which quantified chronic disease risk for differing levels of alcohol consumption.

And they used information from the 2006 General Household Survey, to ascertain weekly levels of alcohol consumption in grams among 15,000 adults in England.

In 2006, just under a third (29%) of adults in England were classified as non-drinkers (less than 1 g a day), and 170,558 people died from the 11 conditions at least partially associated with alcohol.

The results of their calculations showed that just over half a unit of alcohol a day (5 g) was the optimal level of consumption among current drinkers.

This would delay or prevent around 4,579 premature deaths, equivalent to 3% of all deaths from the 11 conditions.

At this level of consumption, there would be 843 additional cardiovascular disease deaths, but this would be more than offset by 2,600+ fewer cancer deaths (8% decrease), and almost 3,000 fewer liver cirrhosis deaths (49% decrease), the figures indicated.

A belief that alcohol protects against cardiovascular disease is widespread, say the authors.

“However, our modelling shows that when multiple conditions are considered simultaneously, the levels of alcohol that would actually be likely to be associated with reduced risk of chronic disease are much lower than is generally accepted or recommended by government,” they write.

And they suggest there is no reason for non-drinkers to start drinking for any health benefits, as there are safer ways of reducing cardiovascular disease risk. And encouraging abstainers to start drinking while encouraging drinkers to cut down “is a mixed message that may be difficult to communicate,” they say.

They conclude: “It is likely that government recommendations would need to be set at a much lower level than the current ‘low risk’ drinking guidelines in order to achieve [the best possible outcomes for public health].”