> Seems to me that it is okay to have a drink a day
What's one drink?
One 125 ml glass of wine at 8% ABV would be 1 UK unit.
One 175 ml glass of wine at 12% ABV would be 2 UK units, nearly double the alcohol. One of those a day and you're drinking at the UK safe limit levels of 14 units a week.
> Healthwise, a drink or two every day is actually beneficial.
Please don't say this - it isn't supported by science.
A small amount of alcohol per week might be beneficial for some conditions, but might make others worse.
When you consider what many people see as "one drink" compared to the actual measure of alcohol we see that many people drink much more than a small amount of alcohol per week.
In the UK we use "units" as a simple public health measure. One unit of alcohol is given by serving size (in ml) * Alcohol by volume / 1000.
125 ml of wine at 8% ABV is one unit. It's hard to find wine at 8% ABV now. And if someone poured you a 125 ml serving you'd laugh and call them back.
People are much more likely to drink "a glass of wine", say 225 ml at 13.5% ABV. That's about 3 units.
UK recommendations for men are no more than 3 to 4 units per day, and not every day. For women the recommendations are no more than 2 to 3 units a day, and not every day. People should leave 48 hours clear if they have had a heavy drinking session.
Some people like drinking it. They'll have a glass or two after a long day at work. But that probably means half a bottle of wine.
This kind of long term, regular, drinking of not-excessive amounts is worrying, especially among women. They don't see it as harmful, when it probably is.
> Hospital consultants in north-east England have reported seeing an "epidemic" in the number of people in their early 30s with alcoholic liver disease.
I've done the maths on that and it comes out at 39.4 litres of 40% spirits a year, 750ml a week, or 108ml a day. In the UK that is basically two double spirit drinks.
Four UK units a day is above the recommended 14 per week and I'm sure isn't great for your health long term but most people wouldn't notice they are drinking at that level.
I appreciate this is the average so many will be way above that, but interesting to extrapolate it out.
Previous English advice was that men should drink less than 21 units per week. Current advice is less than 14 units per week.
Some people were asking what the evidence base was to reduce the limits, and papers like this address that.
> It is worth wondering if drinking 2 drinks a day, 3 days a week is better for you than drinking 1 drink 6 days in a row.
We know that it's better to leave some days drink free, and this is current alcohol advice in the UK and has been for some time now. (At least the past 20 years, I think.) This is because the liver needs time to recover.
> 1. Anecdotally, is anybody else having this reaction?
How do you define "one drink"? One serving? Or some measured amount of alcohol?
England has a public health measure of "units of alcohol" - 10 ml of pure alcohol.
With metric it's easy to convert. Serving size in litres * Alcohol by volume.
Thus, a 330 ml bottle of beer at 5% is about 1.65 units.
A bottle of wine at 12% would be 9 units (for a 0.75 l bottle)
A litre of vodka at 40% would be 40 units.
10 drinks a day seems high, even if we use this small "unit" figure for alcohol. That's EDIT 2 litres of alcohol per week; more than a bottle of wine every day; more than a lot of beer every day.
> At some point in there, it was not unusual for me to have two doubles with dinner -- the equivalent to four drinks. So I imagine I could have been classified as an alcoholic at that time. But when I got some answers and started getting healthier, I was happy to stop drinking.
2 glasses of whisky a day is not healthy but it's not alcoholism.
This is a bit tricky to describe but I'll do my best: let's assume you had two US doubles per day. Wikipedia says that 89 ml per drink. Let's round that up to 100 ml each drink. English public health has a concept of "units" to describe drinking amounts.
200 ml * 40 (the ABV of spirits) = 8 units per day.
Recommended safe limits are 3 to 4 units per day (without saving up to binge). You should try to have a couple of drink free days each week.
So, 8 units per day is over that level and increases the risks of harm.
> The definition of harmful alcohol use in this quality standard is that of the World Health Organisation (WHO) The International statistical classification of diseases and related health problems (ICD-10): "a pattern of psychoactive substance use that is causing damage to health. The damage may be physical (for example, hepatitis) or mental (for example, depressive episodes secondary to heavy alcohol intake). Harmful use commonly, but not invariably, has adverse social consequences; social consequences in themselves, however, are not sufficient to justify a diagnosis of harmful use".
> In ICD-10 the 'dependence syndrome' is defined as: "a cluster of behavioural, cognitive, and physiological phenomena that develop after repeated substance use and that typically include a strong desire to take the drug, difficulties in controlling its use, persisting in its use despite harmful consequences, a higher priority given to drug use than to other activities and obligations, increased tolerance, and sometimes a physical withdrawal state".
Looking at the English guidelines for treatment we see that medically supervised withdrawal starts when you're drinking 40 units per day - that would be a one liter bottle of 40% whisky every day.
> The problem is that when you get into the habit of drinking 2-3 drinks every night you’re bordering substance abuse
If you're drinking 3 bottles of beer a night, 7 days a week, you're likely consuming 6 units of alcohol a day, or 42 a week.
The NHS (UK health service) recommends less than 14 units a week, spread across at least 3 days (so less than 5 units a day, 3 days a week, tops).[0]
Drinking 3 beers a day 7 days a week results in you drinking more than 3 times the maximum weekly recommended allowance.
I think we're largely in agreement about how one can drink, but 2-3 drinks a day is not 'bordering' on substance abuse from a health perspective. Societally we've normalised drinking to this level, but it's not healthly, and is absolutely substance abuse.
It took me tracking my alcohol consumption daily before I realised that my 1-2 beers a weekday / 4-6 beers a weekendday was so far beyond what is healthy, that I stopped entirely for 6 months. I've since backslid back into 1-2 beers a day. I know it's wrong, but most of life is right now anyway that it doesn't seem like that big a deal anymore.
8 glasses of wine a week, at 250 ml per glass is 2 litres.
Weak 10% ABV wine would be 20 units. Normal 12.5% ABV would be 25 units. Strong 15% ABV wine would be 30 units.
UK advice is no more than 3 to 4 units per day for men, with a couple of days free of alcohol and no "saving up" of units for a binge. (The old advice was 21 units per week for men.)
Problem drinking has several definitions, but NICE recommend assisted withdrawal at 30 units per day. (15 to 20 per day if there are co morbid severe mental health problems).
I don't care if people use cannabis (and I am strongly in favour of legalisation) but I fucking hate the refusal of many cannabis users to even contemplate any negative effects of cannabis.
> I don't think the health effects are that much of a concern.
Very many people (especially in the UK) do not drink alcohol in moderation. Liver disease and cirrhosis is seen more commonly in young people than it used to be.
> and if you are drinking that much that you are getting worried about the state of your liver you should also worry how you are treating the people around you while continuously under the influence.
This appears to over-estimate the amount of alcohol needed to destroy a liver. A person does not need to be continuously drunk to severely damage their liver. Tolerance to alcohol would probably mean that they are not drunk all the time.
A woman drinking a glass of wine each evening, with an extra glass on Friday, Saturday, and Sunday is drinking (10 glasses of wine per week) is drinking something like 26 units a week, assuming a 200 ml serving size and a 13% ABV strength. WHO suggest that women drinking more than 14 units per week are at risk (although this is old advice) and men should drink less than 21 units per week. This woman will not see her drinking as anything extreme, and most people in the UK wouldn't see that as a worrying drinking pattern.
Current recommendations include some alcohol free days to allow the liver to repair itself.
> And one drink is probably much smaller than people realise: 125 ml wine at 8% ABV is one drink.
What is your source for this? The NIH defines a standard drink of wine as 5 oz or about 150ml at 12%. I agree that many people pour more than that since it's less than a cup of wine (about 250ml).
I agree with the general sentiment that you should be aware of how much you're drinking, but as the article points out, mortality rate from "alcohol-augmented conditions" is barely a blip until you hit 4-5 drinks daily. It is a U-shaped curve with the most deadly conditions being abstinence and seriously heavy drinking. Given that, I think just being roughly aware of your intake goes a long way.
I would love to know how the delta in mortality between 1 daily drink (the optimal) and 5 stacks up against mortality from other common behaviors. I'd hazard a guess that an extra 4 drinks a day is actually less dangerous than obesity or lack of exercise. And yet many people seem a lot more afraid of the effects of having two beers a day than they are of skipping the gym!
> It's easy to have a couple of beers or glasses of wine and have 3-4 drinks in the process.
Yes and even drinking that quantity of high ABV beer or large glasses of wine that you describe and you'd still have to do it every day of the week to hit 21 drinks a week.
It is, as suggested upthread, an incredible amount of alcohol to describe with “as little as”.
A unit is a UK public health thing. One unit is 10 ml of alcohol. For some time the safe drinking advice was 14 units a week for women, 21 units a week for men, with some days drink free and no saving up of the units for the weekend. You'll still see these limits on some shelf labels and on the back of some bottles, but they are out of date. The newer limits are 14 units per week for men and women.
Drinks in the UK come with an Alcohol by Volume number, as a percentage, printed on the bottle. To find the units in the drink you multiply the serving size in liters by the ABV.
People think a glass of wine is one unit. That was true a long time ago when serving sizes were smaller and wine was weaker.
A small glass of wine (125 ml) at 8% ABV = 1 unit.
A normal glass of wine (175 ml) at 12% ABV = 2 units.
Current UK advice for men is two to three units max per day with some days drink free and don't binge.
A 330ml bottle of beer five days a week is well within those levels and would not be seen by most people in the UK as heavy or problem drinking.
It does get a bit trickier when you talk about glasses of wine. People have less idea of how much alcohol is in their glass, and small errors mulity over a week.
One drink -- is that one glass of wine? Or is that one alcohol unit?
One glass of wine a day might seem fine to some, and outrageous to others.
With the amount of literature being written about how many units a week is still considered "ok", I wouldn't mind getting a clearer understand of how much is too much.
This article doesn't define what a "drink" is. It also says:
> Do you drink a glass of wine with dinner every night? That puts you in the top 30 percent of American adults in terms of per-capita alcohol consumption. If you drink two glasses, that would put you in the top 20 percent.
Which, in context, is weakly linking "glass of wine equals one drink".
England talks about alcohol units. One unit is, for example, 125 ml of wine with an ABV (alcohol by volume) of 8%. Even though wine is recently getting weaker it's tricky to find wine as weak as 8%. 13% is more typical. If someone poured you 125 ml of wine at a meal you might think they'd made a mistake. Try it yourself now to see how small it is. 175 ml or 200 ml are more normal serving sizes.
200 ml at 13% is 2.6 units. Two of those is 5.2 units.
So, really, people need to learn how much alcohol they're drinking. You get the health benefits from alcohol when you drink one unit per day; risks start to rise after that. Being teetotal appears to be as harmful as drinking maybe 5 to 6 units per day, even when corrected for people who are teetotal because of health history.
Less than one UK unit per day, with some days per week alcohol free. One unit is 10 ml of pure alcohol. Alcohol in the UK is sold with the percentage of alcohol by volume (ABV) listed. To find the units you multiply the serving size in litres by the ABV.
In the UK that's seen as "very low". Other countries have different cultures around alcohol.
> In 2015 in England, 55% of men said that they had drunk in the last year and that their average weekly alcohol consumption was no more than 14 units.
> 64% of women in England said that they had drunk in the last year and that their average weekly intake was no more than 14 units.
> In 2015, 11% of men and 7% of women in England said that their average weekly alcohol consumption was more than 14 units but no more than 21 units.
> In 2015 in England, 12% of men and 6% of women said that their average weekly alcohol consumption was more than 21 units but no more than 35 units.
> In 2015, 4% of men and 2% of women in England said that their average weekly alcohol consumption was more than 35 units but no more than 50 units.
This is important because there has been some publicity recently saying a drink a day is safe (mostly debunked now), or newspaper reports of the "benefits of red wine".
Here's one example of poor reporting: While we shouldn't increase the amount of pressure that pregnant women face (because they're already under considerable pressure) it's wrong to tell them that drinking wine daily is safe. https://news.ycombinator.com/item?id=6078575#6079665
You're right when you say that the quantity is important.
The UK talks about "units" of alcohol. One unit is 10ml of pure alcohol. Drinks in the UK are labled with their Alcohol by Volume (ABV) percentage. To work out how many units are in a drink you multiply the serving size in litres by the ABV number. Current UK guidelines are no alcohol at all if you're pregnant, and less than 14 units a week with some days alcohol free and don't save up the units for a binge.
In the past wine used to be weaker and serving sizes were smaller. One unit of wine is one glass at 125ml at 8%. In the UK by law everywhere selling glass by the wine has to offer a 125ml serving. That doesn't have to be a prominent offer though, it could be a footnote to the menu. UK serving sizes tend to be 175ml (for a small) or 250ml (for a large). This means there's huge variation in the quantity that people drink when they describe "5 glasses a week".
Five glasses * 125ml * 8%ABV is 5 units.
Five glasses * 175ml * 12.5%ABV is 11 units.
Five glasses * 250ml *12.5%ABV is 15.5 units.
15 units a week isn't hugely worrying, but it's a big difference. I guess we'd want people drinking 15 units a week to unwind after work to take up some exercise or mindfulness instead.
There's some cultural variation too. When a middle class couple in the UK talk about "a glass of wine" that could mean "half a bottle", and "a few times a week" could mean "most days". I used to work in a factory and people spoke about "going for a beer" after work, and that never meant one beer, it meant a drinking session where two or three beers are drunk.
What's one drink?
One 125 ml glass of wine at 8% ABV would be 1 UK unit.
One 175 ml glass of wine at 12% ABV would be 2 UK units, nearly double the alcohol. One of those a day and you're drinking at the UK safe limit levels of 14 units a week.
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