The drink doctors who say that 21 units a week is far too much...
Published 06/01/2013 | 06:00
I like to think I'm a moderate drinker. I almost never get drunk. I have been hungover perhaps twice or three times in the past five years. I prefer to frequent coffee shops than pubs. And, more often than not, when I do go to the pub I am one of those mythic beasts who has "just the one".
So, it has come as quite a shock this week to discover that my alcohol consumption may be causing irreparable harm to my health.
It turns out that those long-standing guidelines for "low-risk drinking" – up to 21 units a week for men, and 14 for women according to the HSE – could be doing more harm than good.
UK-based physicians specialising in alcohol's impact on the body are now arguing that the truly "safe" level of alcohol per day is just quarter of a glass of wine. That's about 50mls – or, to put it another way – a few sips.
For years, I had laboured under the perception that my drinking was "safe". I enjoy a glass of wine with my dinner and the occasional port afterwards and I reckon I come well below the level the HSE deems to be low-risk.
But, like thousands of other people nationwide who consider their drinking to be moderate, I happen to drink a small amount practically every day. And – the experts say – that could be heightening my chances of contracting cancer or liver disease.
A BBC Radio 4 programme this week highlighted the sobering fact that the figure of 21 units a week for men (and its female equivalent) is not best on hard scientific research. Instead, it was essentially plucked out of thin air by British medics in the 1980s.
The guidelines – which were subsequently adopted by health promotion agencies in many countries, including Ireland – were produced by a working party from London's Royal College of Physicians in 1987. Richard Smith, a member of that group, has acknowledged that the numbers were made up. "Those limits weren't really based on any firm evidence at all," he has said. "It was a sort of intelligent guess by a committee."
The radio programme, You and Yours – presented by the well-known health campaigner, Dr Michael Mosley – dwelt on the stark new evidence that shows that even tiny amounts of alcohol increase your risk of cancer. According to a wide-ranging study commissioned by the British Heart Foundation last year, a woman's risk of breast cancer increases by 10pc if she gets through one bottle of wine per week. And the age-old "truism" about moderate alcohol protecting your heart has been called into question.
The Foundation's Dr Peter Scarborough believes that not only are the old guidelines misleading, but consuming just half a glass of wine per day amounts to "bingeing" – hence the recommendation not to consume more than about quarter of a very modest glass of wine per day.
Cliona Murphy, the policy development officer at lobby group Alcohol Action Ireland, believes "there is no such thing" as safe alcohol consumption.
"We're talking about low-risk guidelines," she says, "not 'safe' ones and people shouldn't lose sight of that. There is undeniable evidence that the consumption of alcohol – even small amounts – can increase the risk of developing liver disease or some cancers."
Murphy believes there is still widespread ignorance about what constitutes a standard unit, and the difficulty in understanding this measure is exacerbated by the fact that it is calibrated differently here than in the UK.
In Ireland, a unit has 10 grams of pure alcohol in it; in the UK, it has no more than 8g. "When we talk about low-risk drinking guidelines in this country," she says, "we mean up to 17 units for men and 11 for women. But that isn't reflected on much of the alcohol packaging, which refers to the British measure."
Those seeking concrete advice on the HSE website are likely to be confused. While it discusses the differences in Irish and UK standard units, it claims the low-risk weekly guidelines for adults are 21 and 14 units for men and women respectively and not the 17 and 11 indicated by Alcohol Action Ireland.
Cliona Murphy believes Ireland needs a "national strategy" to address our relationship with alcohol and has lobbied for health warnings on alcohol products – similar to those used in the tobacco industry – to become compulsory here. "Even moderate drinkers need to know the dangers."
The prospect of being permitted a few sips of wine or a half-glass of beer per day is a depressing thought for many – me included – but even this frugal approach to alcohol may be a step to far.
Sir Ian Gilmore, former president of the Royal College of Physicians, has a stark message for those concerned about how best to minimise the risk of alcohol on their health: "Taking into account all the risks and the potential benefits to older people, the best health option is not to drink at all."