Good practice principles low rik drinking EU RARHA

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consumers. The importance to avoid any confounding message will be stressed which could inducepatients to assume any alcoholic beverages could be beneficial for health in any quantity. This applies inparticular to wine, still considered less harmful than other alcoholic drinks.To provide consumers with adequate information, the idea is to develop drinking guidelines in theform of a “decalogue” identifying conditions under which lower-risk alcohol consumption could bepossible.References1Istituto Nazionale della Nutrizione. (1979) Indicazioni nutrizionali per la popolazione italiana. Roma: IstitutoNazionale della Nutrizione.2SINU. (1987) LARN – Livelli di Assunzione Raccomandati di Energia e Nutrienti: Revisione 1986-1987. Roma:Società Italiana di Nutrizione Umana (SINU).3FeSIN. (2010) Alimentazione e nutrizione in parole. Glossario di alimentazione e nutrizione umana. Firenze:Federazione delle Società italiane di Nutrizione (FeSIN).4Istituto Nazionale della Nutrizione. (1986) Linee Guida per una sana alimentazione italiana. Roma: IstitutoNazionale della Nutrizione.5Istituto Nazionale della Nutrizione. (1997) Linee Guida per una sana alimentazione italiana. Roma: IstitutoNazionale della Nutrizione.6SINU. (1996) LARN – Livelli di Assunzione Raccomandati di Energia e Nutrienti per la popolazione italiana. Roma:Società Italiana di Nutrizione Umana (SINU).7Istituto Nazionale della Nutrizione. (2003) Linee Guida per una sana alimentazione italiana. Roma: IstitutoNazionale della Nutrizione.8SINU. (2014) LARN – Livelli di Assunzione di Riferimento di Nutrienti ed Energia per la popolazione italiana.Milano: Società Italiana di Nutrizione Umana (SINU).9Anderson P et al. (2005) Alcohol and Primary Health Care: Clinical Guidelines on Identification and BriefInterventions. Barcelona: Department of Health of the Governement of Catalonia.10IARC. (2010) Alcohol consumption and ethyl carbamate. IARC Monographs on the evaluation of carcinogenicrisks to humans, Vol. 96. Lyon: International Agency for Research on Cancer (IARC).Core guidelinesTentative "decalogue" on lower-risk alcohol consumpotionIf you drink alcohol you should…… be adult;… be in good health;… have a complete and balanced diet;… have normal weight;… limit consumption to 2 units of alcohol if you are a man and 1 unit if you are a woman; c… drink only during the meal;… not be pregnant or lactating;… not be on medication;… not intend to drive or use and instrument that requires concentration;… not suffer for other dependencies.One unit equals 12 grams of pure alcohol.cTwo units = 24g of pure alcohol; one unit = 12g.68Good practice principles for low risk drinking guidelines
A quarter of a century of alcohol campaigns in DenmarkKit Broholm aIn Denmark, yearly alcohol campaigns have been carried out by health authorities since 1990. Thecampaigns have highlighted various aspects of alcohol related harm and disseminated informationon drinking guidelines to various target groups. In 2010, the focus of the drinking guidelines wasshifted from high risk to low risk. The national campaigns have served as an umbrella for activitiesat local level and, together with concrete guidance for municipal action, have been the backboneof a national health promotion strategy.Alcohol consumption has fallen in Denmark from 12,2 litres pure alcohol per capita (age 15+) in 1996 to9,3 litres in 2015 – a 23% reduction in less than 20 years [ 1 ]. Consumption is decreasing among bothmen and women and in all age groups, in particular among young men aged 16-24 years. The onlyexception is well-educated persons aged 65 years or more whose alcohol consumption shows anupward trend.[ 2 ]To explain this development it is necessary to look at Danish alcohol policy in terms of both controlmeasures and health promotion initiatives. Denmark has a tradition of liberal alcohol policy, with exciseduty and licensing of on-premise sale of alcoholic beverages as the main regulatory instruments. Thetrend has been toward further liberalization: restrictions on alcohol advertising have been lifted, theavailability of alcohol has increased including through internet retailing, and excise duties have beenlowered.As a consequence of the liberal policy, alcohol consumption among young people became a causefor concern in the 1990s. The first ESPAD survey report in 1995 showed vividly that young people inDenmark were drinking more than their European counterparts.[ 3 ] In 1998 a mimimum age of 15 yearswas introduced for retail purchasing of alcoholic beverages. In 2004 the age limit was raised to 16 years,and in 2011 to 18 years for beverages containing 16,5% alcohol or more. (For on-premise serving ofalcoholic beverages the age limit has been 18 years since 1924.) In parallel with raising the age limit,schools were recommended to agree on a school policy on alcohol and on common rules with parentsof pupils in the 5th to 9th grade. School-based work was supported through national campaigns andmaterials.The combination of measures has made an effect. Among boys, the share of those who had triedalcohol fell from 74% in 1998 to 49% in 2002 for 11 year olds, from 86% to 76% for 13 year olds, andfrom 95% to 92% for 15 year olds. The trend has been steadily falling. In 2014, the figures were 21% for11 year olds, 36% for 13 year olds and 77% for 15 year olds.[ 4 ]Regarding the population at large, health promotion has been the main strategy to reduce alcoholrelated harm, combining support for the development of municipal alcohol policy and action withnation-wide information campaigns including drinking guidelines.Health promotion in municipalitiesIn order to strengthen municipalities’ capacity and structures for health promotion, the Danish HealthAuthority has produced guidance materials on 11 different themes on which action should be steppedup, including alcohol, tobacco, physical exercise, diet and mental health. Each health promotionpackage lays out facts on the risk factor, presents evidence of effective interventions and describesgood practice. Evidence-informed recommendations for municipal health promotion are presentedregarding structural interventions, health promotion services, information and education and earlydetection. The recommended actions are indicated as basic level, suggested by current best evidence,and as developmental, that is, requiring a higher level of proactivity and new competencies. The aim isto assist municipal decision-makers and health planners in setting priorities, planning and organizinglocal health promotion and disease prevention.[ 5 ]aThe Danish Health Authority69Good practice principles for low risk drinking guidelines
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Good practice principlesfor low ris
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Table of contentsExecutive summary
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Executive summaryThe present public
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The Standard Drink concept and cons
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ForewordA recent flagship report by
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IntroductionThe present publication
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Chapter 1Joint Action on Reducing A
Page 17 and 18: Chapter 2Towards a common approach
Page 19 and 20: Graph 2. RARHA survey on low risk d
Page 21 and 22: replaced by daily guidelines in 199
Page 23 and 24: informed the UK 2016 review of drin
Page 25 and 26: Variability across population group
Page 27 and 28: the interpretation of low risk drin
Page 29 and 30: individual and public health, the r
Page 31 and 32: • Low risk drinking guidelines sh
Page 33 and 34: 35OECD (2015), Tackling Harmful Alc
Page 35 and 36: • A literature review into practi
Page 37 and 38: Graph 1. Uses of the Standard Drink
Page 39 and 40: link health messages to EU or natio
Page 41 and 42: warning in relation to consuming al
Page 43 and 44: in order to rduce risk of harm, the
Page 45 and 46: Chapter 4Guidance to reduce alcohol
Page 47 and 48: available in websites were mentione
Page 49 and 50: Restricting hours of sale and densi
Page 51 and 52: level of compliance with age limits
Page 53 and 54: Chapter 5Guidelines to support earl
Page 55 and 56: There is convincing evidence across
Page 57 and 58: standard routine health assessments
Page 59 and 60: Graph 3. Presence of multidisciplin
Page 61 and 62: 8Heather N. (2006) WHO Collaborativ
Page 63 and 64: ES Ministry of Health, Social Servi
Page 65 and 66: Annex 3Positive health effects of a
Page 67: Table 1. Changes in alcohol intake
Page 71 and 72: The percentages vary depending on t
Page 73 and 74: Review of adult drinking guidelines
Page 75 and 76: the addendum to the expert group re
Page 77 and 78: Guidance on alcohol consumption in
Page 79 and 80: Development of drinking guidelines
Page 81 and 82: 7Maa- ja metsätalousministeriö. (
Page 83 and 84: 83Title Report
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