New alcohol guidelines that recommend Canadians limit themselves to just two drinks a week – and ideally abstain from alcohol altogether – have sparked intense debate about risk versus indulgence in a country where the vast majority of adults drink alcohol regularly.
The Canadian Center on Substance Use and Addiction (CCSA) this week called for significant reductions in consumption, warning that seemingly moderate drinking poses a number of serious health risks, including cancer, heart disease and stroke.
The new guidelines, funded by Health Canada, represent a dramatic change from previous recommendations made in 2011, when Canadians were told that safe drinking meant no more than 10 drinks per week for women and 15 drinks per week for men.
“We just wanted to present the evidence to the Canadian public so they can think about their alcohol consumption and make informed decisions,” said Peter Butt, a professor of family medicine at the University of Saskatchewan and a member of the panel that wrote the study’s guidelines. “It’s essentially based on the right to know.”
In its measurements, the CCSA considers a standard drink to be a 12oz (355ml) serving of beer at 5% alcohol, a 5oz (148ml) glass of wine at 12% alcohol, or a shot glass at 40% spirits.
In the UK, the NHS recommends no more than six 6oz glasses of wine or six pints of 4% beer per week – ideally spread over three days or more. Health authorities in the United States recommend no more than two drinks per day for men and only one for women.
But Canadian experts say new research suggests that three to six drinks a week should be considered moderate risk for both men and women, and seven or more drinks a week is high risk. In addition to an increased risk of colon and breast cancer, heart disease and stroke, the CCSA also identified injury and violence as negative consequences of alcohol consumption.
“This is not about bans. It’s just about reducing the amount you drink,” Butt said.
The guidelines also warn that no amount of alcohol is safe if you’re pregnant or trying to conceive. While abstinence while breastfeeding is the safest option, occasionally a standard drink does not significantly increase the risk.
The new guidelines were greeted with skepticism by some health experts.
“This type of research often marginalizes other considerations about alcohol-related health and well-being,” said Dan Malleck, professor of public health at Brock University.
“In their role as the Canadian Center on Substance Abuse and Addiction, there is no room there to think about whether there might be benefits. Your job is to find damage.”
Malleck described the guidelines as “irresponsible” and said they risked creating “anxiety and stress” among Canadians who once considered themselves moderate drinkers but now fall into a “high-risk” category.
“The research they use also ignores the indulgence and pleasure, stress relief and collegiality associated with alcohol. None of that is included in the calculation,” he said. “We are not just machines with inputs and outputs of chemicals or food. We actually exist in a social space. And that has a significant impact on our health.”
However, others see the guidelines as an attempt to help Canadians better understand the realities of alcohol use.
“Alcohol is a psychoactive drug. Occasional use won’t really have a significant impact. Even if you occasionally use something like heroin, you probably wouldn’t see any significant impact on your life. But that’s the thing: People don’t drink alcohol occasionally — they drink it every day,” said Taryn Grieder, a professor of psychology at the University of Toronto.
“The hope is that people will moderate their consumption and not drink every day because we’ve seen research showing that alcohol causes cancer.”
Grieder says there are components in alcohol that can be beneficial but are typically only found in certain beverages.
“A glass of red wine a day might have some benefits. But no beer, no schnapps. I think people have embraced this idea that alcohol has potential health benefits and they’ve really gone with it.”
The CCSA also suggested that mandatory labeling of alcoholic beverages could have benefits – warning of potential health risks and including guidance on consumption standards.
“It could help change people’s perceptions, as labels point to cirrhosis of the liver and the possible long-term effects of drinking,” Grieder said. “Everyone is different and some people metabolize alcohol differently.
“But these guidelines are for the average person, and the hope is that people realize the risks involved with use — and particularly with long-term use.”