DRINK GUIDELINES: CUT LIMITS, SAVE LIVES
In March, the government announced a review of drinking guidelines for the first time in 15 years – since when the BBC and other media highlighted research showing that about 4,600 lives in England could be saved each year by reducing alcohol intake to half a unit a day.
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About 4,600 lives in England could be saved a year by reducing alcohol intake to just half a unit a day, revealed an Oxford University report, What is the optimal level of population alcohol consumption for chronic disease prevention in England? Modelling the impact of changes in average consumption levels. It warned that alcohol consumption is a risk factor for many chronic diseases. At the moment, ill health linked to alcohol is estimated to cost the NHS in England £3.3billion per year.
The government recommends that men drink no more than three to four units per day and women no more than two to three. But these guidelines are “not compatible with optimum protection of public health”, the researchers said. “Over 4,000 deaths from cancer, heart disease, stroke and liver disease in England could be prevented if drinkers reduced their average level of alcohol consumption to half a unit per person per day – a level much lower than current UK government recommendations,” Dr Melanie Nichols, lead author of the paper, concluded. “Half a unit of alcohol is as little as a quarter of a glass of wine, or a quarter of a pint.”
The Oxford University team used data from the 2006 General Household Survey looking at weekly drinking patterns of 15,000 adults in England. They used a mathematical model to study death rates from 11 illnesses known to be linked to long-term alcohol use. These included coronary heart disease, stroke, high blood pressure, diabetes, cirrhosis of the liver, epilepsy and five cancers.
In 2006, 170,558 people died from the 11 conditions at least partially associated with alcohol. Two thirds of the population drink and if they all consumed five grams of alcohol per day, there would be a 3% drop in deaths from the 11 conditions, the equivalent of 4,579 per year.
At this level of consumption, there would be 843 additional cardiovascular disease deaths because alcohol has a small protective effect on the heart, but this would be more than offset by 2,600 fewer cancer deaths (8% decrease), and almost 3,000 fewer liver cirrhosis deaths.
DRINKING GUIDELINES REVIEW
In March, the Department of Health stated that it will review drinking guidelines for the first time in 15 years. This was a response to the House of Commons’ Science and Technology Committee report, which declared the existing guidelines are “confusing” and called for further clarity.
Daily guidelines were advocated after 1995 research which suggested that moderate consumption could lower “bad” cholesterol and have a protective effect on coronary heart disease. The issue is contentious as, although daily guidelines might prevent people from assuming they could ‘save their units up’ for binge drinking, critics highlighted that they “appeared to endorse daily drinking” – so counterproductively increased possible interpretation of the advised amount by as much as 50%.
The STC report found that daily guidelines confused the general public, and further confidence is needed. The STC also urged the government to adapt the guidance to have two alcohol-free days per week, as is current in Scotland. And it suggested lower consumption levels for older people, who have lower tolerance.
The government insisted that guidelines are “consistent with scientific knowledge” but agreed the review is necessary. It will be led by Dame Sally Davies, its chief medical officer.
The NHS gives more information on cutting alcohol limit for public health. .
THE REPORT BY OXFORD UNIVERSITY
Below is a summary of the report published in the British Medical Journal.
Objective. To estimate the impact of achieving alternative average population alcohol consumption levels on chronic disease mortality in England.
Design. A macro-simulation model was built to simultaneously estimate the number of deaths from coronary heart disease, stroke, hypertensive disease, diabetes, liver cirrhosis, epilepsy and five cancers that would be averted or delayed annually as a result of changes in alcohol consumption among english adults. Counterfactual scenarios assessed the impact on alcohol-related mortalities of changing the median alcohol consumption of drinkers and the percentage of non-drinkers.
Data sources. Risk relationships were drawn from published meta-analyses. Age- and sex-specific distributions of alcohol consumption (grams per day) for the english population in 2006 were drawn from the General Household Survey 2006, and age-, sex- and cause-specific mortality data for 2006 were provided by the Office for National Statistics.
Results. The optimum median consumption level for drinkers in the model was 5grams/day – about half a unit – which would avert or delay 4,579 (2,544-6,590) deaths per year. About equal numbers of deaths from cancers and liver disease would be delayed or averted (-2,800 for each). There was a small increase in cardiovascular mortality.