A new scientific study concludes there is no safe level of drinking alcohol.


The global study, which claims to be the most comprehensive of its kind, pours cold water on previous reports that espouse the protective effects of alcohol under some conditions.


The study, part of the annual Global Burden of Disease (GBD), assesses alcohol-related health outcomes and patterns between 1990 and 2016 for 195 countries and territories and by age and sex.


Researchers said that there is no safe level of alcohol as beneficial effects against ischemic heart disease are outweighed by the adverse effects on other areas of health, particularly cancers.


Alcohol use was ranked as the seventh leading risk factor for premature death and disability worldwide in 2016, the report added.


It found that alcohol led to 2.8 million deaths in 2016 and was the leading risk factor for premature mortality and disability among those ages 15 to 49, accounting for 10 percent of all deaths.


According to lead author Dr Max Griswold of the Institute for Health Metrics and Evaluation, University of Washington, USA, in people aged 15-95 years, drinking one alcoholic drink a day increases the risk of developing one of 23 alcohol-related health problems by 0.5 per cent in a year, compared with not drinking at all.


The greatest proportion of alcohol-related deaths among young people were from tuberculosis, road injuries and self-harm, the report found. Meanwhile, for those over age of 50, the biggest killer was cancer, particularly among women.


While researchers acknowledged that moderate drinking can protect against heart disease and diabetes, they said that the risks of cancer and other illnesses outweigh those benefits and have called for a change in medical guidance.


The majority of national guidelines suggest that one or two glasses of wine or beer per day are safe for an adult's health. However, the report's authors said, "Our results show that the safest level of drinking is none."


"The widely held view of the health benefits of alcohol needs revising," said the report published in The Lancet medical journal.


The study, which was carried out by researchers at the Institute of Health Metrics and Evaluation in Seattle, looked at levels of alcohol use and its health effects on those between the ages of 15 and 95 in 195 countries between 1990 and 2016.


The study shows that in 2016, nearly 3 million deaths globally were attributed to alcohol use, including 12 percent of deaths in males between the ages of 15 and 49.


“The health risks associated with alcohol are massive,” said Dr. Emmanuela Gakidou of the Institute for Health Metrics and Evaluation at the University of Washington and the senior author of the study which was published Aug. 23 in the international medical journal The Lancet.


She said the findings are consistent with other recent research that found “clear and convincing correlations” between drinking and premature death, cancer and cardiovascular problems. “Zero alcohol consumption minimizes the overall risk of health loss,” Gakidou said.


Current drinking habits pose "dire ramifications for future population health," the report's authors said, urging people to rethink their approach to drinking alcohol.

The study does not distinguish between beer, wine and liquor due to a lack of evidence when estimating the disease burden, Gakidou said. Researchers used data on all alcohol-related deaths generally and related health outcomes to determine their conclusions.


Alcohol use patterns vary widely by country and by sex, the average consumption per drinker, and the attributable disease burden. Globally, more than 2 billion people were current drinkers in 2016; 63 percent were male.


“With the largest collected evidence base to date, our study makes the relationship between health and alcohol clear – drinking causes substantial health loss, in myriad ways, all over the world,” Griswold said.


In 2016, eight of the leading 10 countries with lowest death rates attributable to alcohol use among 15- to 49-year-olds were in the Middle East: Kuwait, Iran, Palestine, Libya, Saudi Arabia, Yemen, Jordan, and Syria. The other two were Maldives and Singapore.


Conversely, seven of the leading 10 countries with highest death rates were in the Baltic, Eastern European, or Central Asian regions, specifically Russia, Ukraine, Lithuania, Belarus, Mongolia, Latvia, and Kazakhstan. The other three were Lesotho, Burundi, and Central African Republic.


Health officials in those nations, Gakidou said, would be well served by examining the study’s findings to inform their policies and programs to improve the health and well-being of their constituents.


“There is a compelling and urgent need to overhaul policies to encourage either lowering people’s levels of alcohol consumption or abstaining entirely,” she said. “The myth that one or two drinks a day are good for you is just that – a myth. This study shatters that myth.”


The risk of developing alcohol-related health problems increased to 7 per cent in people who drank two drinks a day for one year and 37 per cent in people who drank five drinks a day for one year.


Globally, one in three people (32.5 per cent) drink alcohol – equivalent to 2.4 billion people, including 25 per cent women (0.9 billion) and 39 per cent men (1.5 billion). On an average, a woman consumes 0.73 alcoholic drinks each day, while men have 1.7 drinks.

Drinking patterns vary globally. The highest number of alcohol drinkers is in Denmark (95.3 per cent women and 97.1 per cent men) while the lowest are in Pakistan for men (0.8 per cent) and Bangladesh for women (0.3 per cent). Men in Romania and women in Ukraine drink the most (8.2 and 4.2 drinks a day, respectively), whereas men in Pakistan and women in Iran drink the least (0.0007 and 0.0003 drinks a day, respectively).


In the study, a standard alcoholic drink is defined as 10g alcohol: examples include a small glass of red wine (100ml) at 13 per cent alcohol by volume, a can or bottle of beer (375 ml) at 3.5 per cent alcohol by volume; or a shot of whiskey or other spirits (30 ml) at 40 per cent alcohol by volume.



In India in 2016, the prevalence of female drinkers was 4.1 per cent and deaths attributed to alcohol consumption among women was 0.71 per cent (42,000 deaths). In males, the prevalence was 20 per cent and deaths attributed to alcohol drinking was 4.7 per cent (2.9 lakh deaths).


Dr Pankaj Chaturvedi, professor and surgeon at Tata Memorial Hospital, which is among the contributors to The Lancet report, said that the consumption of alcohol was steadily increasing in India.
Officially, Indians are still among the world’s lowest consumers of alcohol with more than 60 per cent adults completely abstaining from it, Dr Chaturvedi said, quoting national household surveys.


“However, studies have shown that India has a large number of heavy drinkers – more than 75 ml/day or almost every day of the week. The average age of initiation of alcohol use has also come down from 28 in the 1980s to 17 in 2007. It is sad that India does not have an overarching central policy to discourage alcohol use. There is no warning on alcohol packs though it is a confirmed cancer-causing substance,” he said.

According to Prof K Srinath Reddy, president of the Public Health Foundation of India, there is a need for more health literacy campaigns as drunken driving is the major cause of road accidents. There are multiple causes of death related to alcohol drinking and is associated with tuberculosis, road injuries, self harm and cancers.