Alcohol use is a leading risk factor for global disease burden and causes substantial health loss. A new study has found that the risk of all-cause mortality, and of cancers specifically, rises with increasing levels of alcohol consumption, and the level of consumption that minimizes health loss is zero. The findings appear in The Lancet.
Scientists recognize alcohol use as a leading risk factor for disease burden, and studies link its consumption to 60 acute and chronic diseases. Image credit: Laura M.
“The health risks associated with alcohol are massive,” said study senior author Dr. Emmanuela Gakidou, a researcher in the Institute for Health Metrics and Evaluation at the University of Washington.
“Our findings are consistent with other recent research, which found clear and convincing correlations between drinking and premature death, cancer, and cardiovascular problems. Zero alcohol consumption minimizes the overall risk of health loss.”
“The study does not distinguish between beer, wine, and liquor due to a lack of evidence when estimating the disease burden,” she added.
“However, we used data on all alcohol-related deaths generally and related health outcomes to determine their conclusions.”
The study, part of the annual Global Burden of Disease, used data from 694 studies to estimate how common drinking alcohol is worldwide and used 592 studies including 28 million people worldwide to study the health risks associated with alcohol between 1990 to 2016 in 195 countries.
Globally, one in three people (32.5%) drink alcohol — equivalent to 2.4 billion people — including 25% of women (0.9 billion women) and 39% of men (1.5 billion men). On average, each day women consumed 0.73 alcoholic drinks, and men drank 1.7 drinks.
Drinking patterns varied globally, the highest number of current alcohol drinkers was in Denmark (95.3% of women, and 97.1% of men) while the lowest were in Pakistan for men (0.8%) and Bangladesh for women (0.3%).
Men in Romania and women in Ukraine drank the most (8.2 and 4.2 drinks a day respectively), whereas men in Pakistan and women in Iran drank the least (0.0007 and 0.0003 drinks a day respectively).
“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,” the researchers said.
“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 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,” Dr. Gakidou said.
“There is a compelling and urgent need to overhaul policies to encourage either lowering people’s levels of alcohol consumption or abstaining entirely.”
“The myth that one or two drinks a day are good for you is just that — a myth. This study shatters that myth.”
Globally, drinking alcohol was the seventh leading risk factor for premature death and disease in 2016, accounting for 2.2% of deaths in women and 6.8% of deaths in men. However, in people aged 15-49 years old, alcohol was the leading risk factor in 2016, with 3.8% of deaths in women and 12.2% of deaths in men attributable to alcohol.
The main causes of alcohol-related deaths in this age group were tuberculosis (1.4% of deaths), road injuries (1.2%), and self-harm (1.1%). For people aged 50 years and older, cancers were a leading cause of alcohol-related death, constituting 27.1% of deaths in women and 18.9% of deaths in men.
“We now understand that alcohol is one of the major causes of death in the world today. We need to act now. We need to act urgently to prevent these millions of deaths. And we can,” said Lancet Editor Richard Horton.
“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,” said study lead author Dr. Max Griswold, also from the Institute for Health Metrics and Evaluation at the University of Washington.
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GBD 2016 Alcohol Collaborators. Alcohol use and burden for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. The Lancet, published online August 23, 2018; doi: 10.1016/S0140-6736(18)31310-2
