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The sobering news on booze: more than two drinks a week increases health risk

Some sobering news released this week shows drinking even a small amount of alcohol can have serious health consequences, including raising the risk for several types of cancer.

As a result, Canadian guidelines have changed to define “low-risk” alcohol consumption as no more than two drinks per week.

That’s a significant change from the last set of guidelines, which came out a decade ago, and recommended a daily limit of three drinks for men and two drinks for women and a maximum weekly limit of 10 drinks for women and 15 drinks for men to be considered “low risk.”

“It’s a very big change,” said Dr. Alex Choi, the North Shore’s new medical health officer.

It’s also probably not what a lot of people want to hear.

But Choi said the new guidelines are based on an increased scientific understanding of how alcohol impacts the human body.

“These guidelines are not about creating strict rules,” adds Choi. They are meant to be transparent about the health risks of drinking, so people can make their own decisions about how much booze is reasonable to consume, he said.

For example, those who have two drinks a week have a one in 1,000 risk of premature death, while people who consume six alcoholic drinks a week have a one in 100 risk, Choi points out.

One of the more alarming findings of recent research is that alcohol is a “clear carcinogen,” causing an estimated 7,000 cases of cancer a year in Canada. The link is especially strong between breast and breast and colon cancer.

The idea that a glass of red wine is good for your heart has also been debunked, said Choi. On the contrary, alcohol has been linked to increased risk for heart failure, stroke and abnormal heart rhythms, she said. As well as liver disease, booze has also been linked to an increased risk for dementia.

Women are at higher risk for health impacts than men for the same amount of alcohol consumption – primarily because women’s body size and composition mean women reach higher blood alcohol levels faster.

New guidelines point to consumption of between two and six drinks a week as putting people at moderately increased health risk. Knocking back more than seven drinks a week is now considered to put Canadians at a higher risk for adverse health impacts.

How much of change would this mean if everyone followed the new guidelines?

“The good news is [there is] quite a large proportion of the Canadian population that drinks below the low-risk threshold,” said Choi. About 20 per cent of the population are teetotalers. Another 21 per cent drinks less than two drinks a week and about 17 per cent consumes between three and six drinks weekly. “That does mean we have about 40 per cent consuming at a high-risk level,” said Choi.

“One of the worrying things we’ve seen is an increase in alcohol consumption in BC”

In 2020 and 2021, during the first year of the COVID-19 pandemic, for example, BC recorded the highest ever level of alcohol consumption, since surveys began measuring it. (Researchers use a variety of data, including both population surveys and alcohol sales records to determine how much people are drinking.)

Between 20 and 30 per cent of North Shore residents reported drinking more during the pandemic, a statistic consistent with other communities in BC, said Choi.

That’s not a big surprise, said Choi. It was an “incredibly stressful time,” most people were stuck at home and there was a dramatic decrease in the social structures and activities that normally keep people healthy.

The increase was disproportionately high among middle-aged adults during the pandemic, Choi added.

Scientists and doctors who came up with the new guidelines are now recommending that warnings highlighting the connection between booze and cancer be added to alcohol packaging, in the same way as warnings about smoking and lung cancer. They’re also recommending labels letting people know how many standard drinks a bottle of alcoholic beverage contains.

Not everyone is convinced the booze-sodden sky is falling. Some critics of the new guidelines have pointed out only 16 scientific literature reviews or studies that were used as a basis for the changes. They also add that as no gold standard double-blind studies can be conducted ethically, all of the studies on health risks from alcohol are “observational” in nature and may fail to account for other important determinants of health.

For those who decide they want to cut down on their drinking, there is some good news.

Most of the increased harms of chronic disease connected to drinking “are reversible” when people quit or cut down, said Choi. Exactly how much any individual must cut down or for how long before they see those benefits is harder to quantify, he said. But “we can say with great certainty that if you decrease your alcohol intake, at any level, you will decrease your risk of alcohol-related health conditions.”

“Bodies are really resilient.”