Critique 032: Comments on alcohol in newly released Dietary Guidelines for Americans, 2010 – (9 February 2010)

Dietary Guidelines for Americans, 2010

Chapter 3:  Comments on alcohol


In the United States, approximately 50 percent of adults are current regular drinkers and 14 percent are current infrequent drinkers. An estimated 9 percent of men consume an average of more than two drinks per day and 4 percent of women consume an average of more than one drink per day. Of those who drink, about 29 percent of U.S. adult drinkers report binge drinking within the past month, usually on multiple occasions. This results in about 1.5 billion episodes of binge drinking in the United States each year.

The consumption of alcohol can have beneficial or harmful effects, depending on the amount consumed, age, and other characteristics of the person consuming the alcohol. Alcohol consumption may have beneficial effects when consumed in moderation. Strong evidence from observational studies has shown that moderate alcohol consumption is associated with a lower risk of cardiovascular disease. Moderate alcohol consumption also is associated with reduced risk of all-cause mortality among middle-aged and older adults and may help to keep cognitive function intact with age. However, it is not recommended that anyone begin drinking or drink more frequently on the basis of potential health benefits because moderate alcohol intake also is associated with increased risk of breast cancer, violence, drowning, and injuries from falls and motor vehicle crashes.

Because of the substantial evidence clearly demonstrating the health benefits of breastfeeding, occasionally consuming an alcoholic drink does not warrant stopping breastfeeding. However, breastfeeding women should be very cautious about drinking alcohol, if they choose to drink at all. If the infant’s breastfeeding behavior is well established, consistent, and predictable (no earlier than at 3 months of age), a mother may consume a single alcoholic drink if she then waits at least 4 hours before breastfeeding. Alternatively, she may express breast milk before consuming the drink and feed the expressed milk to her infant later.

key definitions for alcohol

what is moderate alcohol consumption? Moderate alcohol consumption is defined as up to 1 drink per day for women and up to 2 drinks per day for men.

what is heavy or high-risk drinking? Heavy or high-risk drinking is the consumption of more than 3 drinks on any day or more than 7 per week for women and more than 4 drinks on any day or more than 14 per week for men.

what is binge drinking? Binge drinking is the consumption within 2 hours of 4 or more drinks for women and 5 or more drinks for men.

Excessive (i.e., heavy, high-risk, or binge) drinking has no benefits, and the hazards of heavy alcohol intake are well known. Excessive drinking increases the risk of cirrhosis of the liver, hypertension, stroke, type 2 diabetes, cancer of the upper gastrointestinal tract and colon, injury, and violence. Excessive drinking over time is associated with increased body weight and can impair short-and long-term cognitive function. For the growing percentage of the population with elevated blood pressure, reducing alcohol intake can effectively lower blood pressure, although this is most effective when paired with changes in diet and physical activity patterns. Excessive alcohol consumption is responsible for an average of 79,000 deaths in the United States each year. More than half of these deaths are due to binge drinking. Binge drinking also is associated with a wide range of other health and social problems, including sexually transmitted diseases, unintended pregnancy, and violent crime.

There are many circumstances in which people should not drink alcohol:

Individuals who cannot restrict their drinking to moderate levels.

Anyone younger than the legal drinking age. Besides being illegal, alcohol consumption increases the risk of drowning, car accidents, and traumatic injury, which are common causes of death in children and adolescents.

Women who are pregnant or who may be pregnant. Drinking during pregnancy, especially in the first few months of pregnancy, may result in negative behavioral or neurological consequences in the offspring. No safe level of alcohol consumption during pregnancy has been established.

Individuals taking prescription or over-the-counter medications that can interact with alcohol.

Individuals with certain specific medical conditions (e.g., liver disease, hypertriglyceridemia, pancreatitis).

Individuals who plan to drive, operate machinery, or take part in other activities that require attention, skill, or coordination or in situations where impaired judgment could cause injury or death (e.g., swimming).