What Is the Safest Amount of Alcohol to Drink?

You might have heard that a daily glass of wine is good for your health, but not every expert agrees. Here's what experts really think about alcohol consumption.

An occasional glass of wine or pint of beer is fine for most people, but unhealthy drinking habits and too much alcohol are clearly harmful for many. Worldwide, there are 3.3 million deaths every year from the use of alcohol, and it plays a role in more than 200 diseases and injury-related problems, according to the World Health Organization (WHO).

Alcohol abuse can lead to a range of mental and behavioral disorders, according to the WHO. So how much is too much alcohol?

Official recommendations vary based on where you live

Motivated by a desire to improve health and safety, authorities in over 40 countries around the world have issued national safety guidelines for alcohol intake. But, while authorities seem to agree that drinking “too much” can cause harm, what they can’t always agree on is just how much is “too much.” These guidelines vary widely, ranging from a limit of 10g a day in the Netherlands up to South Korea’s 40g a day, per the International Alliance for Responsible Drinking.

That’s one to four drinks a day if you consider that 10 grams of alcohol is one drink—meaning one beer; a small, 3.4 ounce glass of wine; or one ounce of spirits—in many countries.

The U.S. Dietary Guidelines for Americans recommends no more than one drink per day for women and two drinks per day for men, according to the Centers for Disease Control and Prevention (CDC).

In the U.S., one “standard drink” is larger, and has about 14 grams of alcohol. So one standard drink with 14 grams of alcohol is one 12-ounce regular beer with about 5 percent alcohol; 5 ounces of wine that’s about 12 percent alcohol; and 1.5 ounces of distilled spirits that’s about 40 percent alcohol, according to the National Institute of Alcohol Abuse and Alcoholism (NIAAA).

Why are recommendations different around the world?

There are a number of reasons for the lack of agreement on safe levels. Larry Altshuler, MD, an internal medicine physician, and the 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 to study, 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 percent beer contains 16g of pure alcohol, a half-liter of five percent lager contains 20g. And there’s a difference between average daily consumption and binge drinking. “Binge drinking does more damage to your liver. You’re overloading your organs,” says Dr. Altshuler.

In the U.S., binge drinking is defined as 4 or more drinks in one sitting (a roughly 2-hour period) for women and 5 or more drinks in one sitting for men on at least one day in the previous month. Since your body can generally process only one drink per hour, binge drinking can put you at risk for alcohol overdose. This can be potentially life threatening and cause symptoms like vomiting, seizures, a slow heart rate, and low body temperature.

Constance Scharff, PhD, co-author of Ending Addiction for Good, 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.”

That’s likely why in 2016, the U.K. revised its alcohol consumption guideline to just 14 units per week, which is 16 grams of alcohol a day (a unit is equal to 8 g of alcohol). That amount is for men and women, and at less than two drinks a day, is one of the lowest in Europe.

The real question might be how much alcohol is bad for you personally

Despite studies that claim a glass of wine can be good for you, many experts agree that the safest amount of alcohol is none at all. As Dr. Scharff says, “No amount of alcohol is good for you. The question is, how much is bad for you?” Plus, Harold Urschel, MD, author and chief medical strategist of Enterhealth, a drug and addiction company based in Dallas, Texas, adds, “scientifically, alcohol is a neurotoxin and a cardiotoxin. It trashes the immune system and increases your risk of cancers and injures your pancreas.” In particular, alcohol can increase the risk of breast cancer, in addition to other health problems. (Here’s what happens to your body when you drink one glass of wine a day.)

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.” (Here are some signs you should try a Dry January, or any other month.)

Dr. Urschel endorses the 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.” There are also some obvious scenarios to avoid, says Dr. Altshuler. “Definitely don’t binge drink,” he says.

“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,” says Dr. Scharff. (Here’s more on what doctors want you know about alcohol and diabetes.)

People in the U.S. are considered to have an alcohol use disorder if they meet two of 11 different criteria in a one-year time period, including drinking to the point where it interferes with relationships with family or friends, or trying to quit drinking and not being able to. Nearly 6 percent or more than 14 million people in the U.S. had an alcohol use disorder in 2018, according to the NIAAA.

Even if you don’t have a prior health condition, it may be worth following these simple tips to drink a little less and cut back on alcohol. This is especially true since experts agree that if you stop drinking alcohol, there are a number of positive health benefits.

Bottom line: Guidelines on alcohol are a starting point. And although alcohol consumption is ultimately a personal choice, there are plenty of reasons to practice moderation and mindful consumption.

Sources
Medically reviewed by Elisabetta Politi, CDE, MPH, RD, on July 02, 2020