Big drinkers face newly appreciated massive health burden

Individuals who regularly consume alcohol in quantities defined by the World Health Organization as “very high risk” face a daunting and yet widely underappreciated health burden.

A study in which the investigators estimated the prevalence of what the WHO has defined as a “very-high-risk drinking level” among people aged 15-65 years in 13 EU countries. The researchers then went on to determine the associated annual risk of disease and injury, as well as the effects on life expectancy.

The numbers are so shocking that you have to take it seriously, nearly two decades ago, the WHO defined very-high-risk level of alcohol consumption as more than 100 g/day of ethanol for men and more than 60 g/day for women. That translates to a threshold of 7.1 and 4.3 standard drinks – a 12-ounce beer, 5-ounce glass of wine, or 1.5-ounce serving of liquor – on a daily basis.

This WHO categorization of drinking risk levels has been pretty much ignored in clinical trials and epidemiologic studies until three or four years ago, the study suggests this has been a serious mistake. By using data from the WHO’s Global Information System on Alcohol and Health, as well as from clinical trials, the investigators determined that the prevalence of this level of alcohol consumption was less than one percent overall across 13 European countries.

The investigators estimated that the risk of disease or injury associated with this very-high-risk drinking level was 13.5 percent per year. Life expectancy in the European Union stands at 80.6 years. The investigators calculated on the basis of comprehensive French national mortality data that very-high-risk level alcohol intake resulted in a 22-year reduction in life expectancy, compared with the general population. By comparison, all cancers considered together resulted in 10 years of life lost.