New alcohol guidelines recommending that Canadians limit themselves to just two drinks a week – and ideally cut alcohol altogether – have prompted intense debate over risk versus enjoyment in a country where most adults regularly drink alcohol.
The Canadian Centre on Substance Use and Addiction (CCSA) has called for a substantial reduction in consumption, warning that seemingly moderate drinking poses various serious health risks, including cancer, heart disease and stroke.
The new guidelines, funded by Health Canada, represent a dramatic shift from previous recommendations issued in 2011, when Canadians were told that low-risk consumption meant no more than 10 drinks a week for women and 15 drinks a week for men, reports The Guardian.
“We wanted to simply present the evidence to the public, so they could reflect on their drinking and make informed decisions,” said Peter Butt, a professor of family medicine at the University of Saskatchewan and a member of the panel that drafted the guidelines.
In its measurements, the CCSA considers a standard drink to be a 355ml serving of 5%-alcohol beer, a 148ml glass of 12%-alcohol wine or a shot glass of 40% spirits.
In the UK, the NHS recommends no more than six glasses of wine or six pints of 4% beer per week – ideally spread across three days or more. And in the US, health officials recommend no more than two drinks per day for men and only one for women.
But Canadian experts say that new research suggests three to six drinks a week should be considered moderate risk for both men and women, and seven or more drinks a week is high risk. In addition to elevated risk of colon and breast cancer, as well as heart disease and strokes, the CCSA also identified both injuries and violence as negative outcomes from drinking alcohol.
“This isn’t about prohibition. This is simply about reducing the amount one drinks,” said Butt.
The new guidelines were met with scepticism by some health experts.
“This type of research often marginalises other considerations of health and well-being from alcohol,” said Dan Malleck, a professor of health sciences at Brock University.
“With their job as the Canadian Centre on Substance Abuse and Addiction, there’s no space in there for considering there might be benefits. Their job is to find harm.” He described the guidelines as “irresponsible”, and said they risk creating “anxiety and stress” among Canadians who once saw themselves as moderate drinkers but now occupy a “high-risk” category.
“The research they’re using also ignores the enjoyment, pleasure, stress relief and collegiality associated with alcohol. None of those things is in the calculation whatsoever,” he said. “We aren’t just machines with inputs and output of chemicals or nutrition. We actually exist in a social space. That has a significant impact on our health.”
Others, however, see the guidelines as an attempt to help Canadians better understand the realities of alcohol consumption.
“Alcohol is a psychoactive drug. Occasional use isn’t going to have really significant effects. Even if you occasionally use something like heroin, you probably wouldn’t see significant effects on your life. But that’s the thing: people aren’t using alcohol occasionally – they’re using it every day,” said Taryn Grieder, a professor of psychology at the University of Toronto.
“The hope is that people will moderate their usage and not drink every day, because we’ve seen research that has shown that alcohol is a carcinogen.”
Grieder says that there are components in alcohol that can be beneficial, but are typically only found in certain drinks.
“A glass of red wine a day might have some benefits. But not beer, not a shot of hard alcohol. I think people took this idea of alcohol possibly having health benefits and really ran with it.”
The CCSA also suggested there could be benefits in mandatory labelling of alcoholic beverages – warning of possible health risks and including guidance on consumption standards.
“It might help change the perception for people, with labels showing cirrhosis of the liver and the possible long-term effects of drinking,” said Grieder. “Everyone is different and some people metabolise alcohol differently.
“But these guidelines are for the average person, and the hope is that people will recognise the risks associated with use – and especially long-term use.”
Canada's Guidance on Alcohol and Health Final Report
See more from MedicalBrief archives:
Alcohol consumption linked to 4% of global cancer cases – WHO study
Moderate alcohol use can be good for the heart if rich, fatal if poor
‘Safe’ levels of alcohol consumption challenged by Irish heart-failure study
No amount of alcohol is good for the heart – World Heart Federation
Red wine fights fat and improves memory
Alcohol consumption linked to 4% of global cancer cases – WHO study