How Much Is Too Much?

Most experts agree that the safest amount of alcohol is none at all

IE161206APhoto: © Denis Tabler/Getty ImagesLike many Czechs, Lukáš Berný, 38, enjoys going out to the pub with his friends for conversation and a few beers. Berný, who has written books about the history of Czech pubs, points out that Czech people generally drink a lot of beer. “Czech beers—Pilsner Urquell especially—are world famous.”

“I don’t drink every day,” he adds. “I think about three times a week. When I go out, I usually have five to six beers at a time, about the same as my friends.” The beers are half-liters, or 500ml each.

Given that a half-liter of four-percent beer contains 16g of pure alcohol, Berný and his friends are drinking 80 to 96 grams of pure alcohol on each outing. The Czech Republic’s National Institute of Public Health, however, recommends that men consume fewer than 24g of pure alcohol per day; women, fewer than 16g.

Public health authorities are increasingly taking note of drinking habits and the harmful use of alcohol. According to a 2010 Eurobarometer study, the EU has the highest alcohol consumption in the world, and alcohol-related illnesses cost the EU an estimated 125 billion euros annually. The World Health Organization (WHO) paints a dire picture of the effects of alcohol on human health: worldwide, 3.3 million deaths every year result from the use of alcohol, and its harmful use is a causal factor in more than 200 disease and injury conditions. There is also, according to WHO, a causal relationship between harmful use of alcohol and a range of mental and behavioral disorders.

Motivated by a desire to improve heaalcohol-1 Photo: Reader's Digest Internationallth and safety, authorities in over 40 countries around the world have issued national safety guidelines. But, while authorities seem to agree that drinking “too much” can cause harm, what they can’t seem to agree upon is just how much is “too much.” National safety guidelines vary widely, ranging from a limit of 10g a day in the Netherlands up to Denmark’s 60g on any single occasion.

There are a number of reasons for the lack of agreement on safe levels. Dr. Larry Altshuler, an internal medicine physician and director of quality of life for the Cancer Treatment Centers in Tulsa, Oklahoma, explains that while everything is based on research, “Every group, race, and gender responds to alcohol differently.”

Also, researchers aren’t using the same models or methods, he says. “It can be like apples and oranges. How do you measure alcohol? Units, drinks, bottles, cans? What’s the alcohol content? Is it light or heavy?” While a half-liter of four per cent beer contains 16g of pure alcohol, a half-liter of five per cent lager contains 20g. And there’s a difference between average daily consumption and binge drinking. “Binge drinking does more damage to your liver,” Altshuler says. “You’re overloading your organs.”

Constance Scharff, a Senior Addiction Research Fellow and director of Addiction Research at Cliffside Malibu Treatment Center in California, says she believes the reason countries vary in their view on safe alcohol ingestion levels “is largely cultural.” “But the evidence is clear that the more you drink, both quantity and alcohol content, the more likely you are to develop alcohol-related health problems down the road.”

Last January, the UK revised its alcohol consumption guideline to just 16 grams a day for men and women, one of the lowest in Europe. And the Health Council of the Netherlands now recommends that people abstain from alcohol entirely or drink no more than one standard drink a day (WHO defines one standard drink as containing 10g of alcohol.)

Despite studies that claim a glass of wine can be good for you, most experts agree that the safest amount of alcohol is none at all. As Scharff says, “No amount of alcohol is good for you. The question is, how much is bad for you?”

alcohol-2 Photo: Reader's Digest InternationalSays Dr. Harold Urschel, author and chief medical strategist of Enterhealth, a drug and addiction company based in Dallas, Texas. “Scientifically, alcohol is a neurotoxin and a cardiotoxin. It trashes the immune system and increases your risk of cancers and injures your pancreas.” Plus, if you drink every day, he says, “you’re going to develop a tolerance and need more and more to get the same effect.”

Urschel endorses the Netherland’s recommendation to abstain but says he realizes that it is “unrealistic.” Various factors—culture, peer pressure, advertising, and just liking how it tastes—means that most people are going to drink. In many countries, alcohol is a part of social rituals and meals. If you’re going to “drink a neurotoxin,” he says, drink as little as possible, “one to two times a week, and one to two drinks at a time—preferably one.”

Says Scharff, “Anyone with a history of substance abuse, eating disorders, active mental illness, particularly depression, trauma, or anxiety, or physical issues like diabetes, liver or kidney disease—and this is not an exhaustive list—should abstain completely from alcohol use.”

There are some scenarios to avoid, says Altshuler. Don’t drink to intoxication. “And definitely don’t binge drink.”

Guidelines are useful only if people are paying attention to them. Ultimately of course, it comes down to personal choice. Lukas Berný says there is “no way” he will conform to his country’s recommendations. “I read that alcohol can be the cause of seven types of cancer,” he says, adding, “I think I read that just about everything on earth could cause cancer—from lemons to ladybugs!”

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