Guidelines Dietary - Eat For Health

3.4 Limit intake of alcohol3.4.1 Setting the sceneFor many people, an alcoholic drink is a regular and enjoyable part of meals. In terms of nutrition, alcohol isuniquely the only substance that is both a food providing energy and a drug affecting brain function. For thesereasons, advice on alcohol is included in these Guidelines.Drinking alcohol has health, social and economic costs and benefits for both individuals and populations. There issome evidence that people who drink small quantities of alcohol may have better health outcomes than thosewho do not drink, 787 but such findings have been challenged. 788,789 Heavy drinking has no health benefits andstudies consistently report that abstainers have better health outcomes than heavy drinkers.In the Australian population, alcohol is responsible for 3.3% of the total disease burden and prevents 1% of the totaldisease burden. This equates to a net effect of 2.3%, equivalent to 61,091 disability-adjusted life years (DALYs) and0.8% (1,084) of all deaths. 10 Among Aboriginal and Torres Strait Islander peoples, alcohol is responsible for a net 5.4%of the total disease burden and 6.7% of all deaths. 790 Alcohol is second only to tobacco as a preventable cause ofdrug-related death and hospitalisation. 791The total social costs of alcohol were $15.3 billion in 2004–05, the majority (71%) being for tangible costs suchas reduction of the workforce, absenteeism, health care, law enforcement, alcohol education campaigns andresearch. 792,793The NHMRC 2009 Australian guidelines to reduce health risks from drinking alcohol (NHMRC AlcoholGuidelines) 794 provide guidance for Australians on reducing their risk of harm from drinking alcohol.Guideline 3The NHMRC Alcohol Guidelines are as follows.Guideline 1Guideline 2Guideline 3For healthy men and women, drinking no more than two standard drinks on any one dayreduces the lifetime risk of harm from alcohol-related disease or injury.For healthy men and women, drinking no more than four standard drinks on a single occasionreduces the risk of alcohol-related injury arising from that occasion.For children and young people under 18 years of age, not drinking alcohol is the safest option.a. Parents and carers should be advised that children under 15 years of age are at thegreatest risk of harm from drinking and that for this age group, not drinking alcohol isespecially important.b. For young people aged 15–17 years, the safest option is to delay the initiation of drinkingfor as long as possible.Guideline 4Maternal alcohol consumption can harm the developing foetus or breastfeeding baby.a. For women who are pregnant or planning a pregnancy, not drinking is the safest option.b. For women who are breastfeeding, not drinking is the safest option.Most recommendations on alcohol consumption are made on the basis of ‘standard’ drinks consumed. A standarddrink in Australia contains 10g of alcohol (equivalent to 12.5ml of alcohol). 794 The alcohol concentration of drinksis printed on the label in terms of percentage by volume. However in social situations serve sizes are greaterthan standard drinks – for example a typical glass of wine in Australia is 170ml 795 which, depending on the alcoholcontent of the wine, is more than one ‘standard’ drink and likely to be closer to two ‘standard’ drinks.For some groups, the contribution of alcohol to energy intake is significant. Median percentages of contribution ofalcohol to energy intake for age and sex groups and the energy content of common alcoholic drinks is included inAppendix K. For example, if a man with average energy intake consumed four standard drinks of beer, this wouldaccount for 13–15% of his energy intake. The proportion of energy obtained from alcohol for those who consumeit peaks at age 19–24 for women and 25–44 for men, and declines thereafter.If the consumption of other foods or drinks is reduced to adjust for the extra energy intake from alcohol, over timethis could lead to a deficiency of key nutrients. In view of the increasing prevalence of overweight and obesity,limiting alcohol intake is an important strategy for achieving energy balance.80EAT FOR HEALTH – australian dietary guidelinesNational Health and Medical Research Council