Many people underestimate their alcohol consumption due to a lack of knowledge on how to accurately work out the unit content of alcoholic drinks. In addition, many deliberately under-report their weekly alcohol intake for a variety of reasons.
An article published by the Department of Health in 2013 stated that “the recent health survey for England highlighted underestimation in both the amount (by 40%) and frequency that people drink, raising major concerns about the nation’s knowledge of alcohol”.
Of those that drank too much, 80% acknowledged the health risks but considered themselves as only “moderate drinkers” and 60% had no intentions of cutting down. This is further compounded by the fact that this does not even include increased drinking at social events or on holiday as the questions about alcohol consumption normally ask about “average” or “typical drinking weeks”.
A significant number of individuals drink more than 5 units in a single sitting and some more than the weekly allowance in single sitting with the younger age group the biggest offenders!
Why shouldn’t we drink alcohol to excess?
The global implications of alcohol on health, weight, finances and crime are significant. There is also increasing evidence of alcohol being an important contributor to 7 types of cancer: mouth and upper throat, larynx, oesophagus, breast cancer in women, liver and bowel. In 2016 the UK Chief Medical Officers released new guidelines for alcohol consumption which warned that any level of alcohol increases the risk of a range of cancers. The original alcohol guidelines were produced in 1995 when the links between alcohol and cancer were not fully understood. Asking people to estimate their weekly alcohol intake based on “1 unit being ½ pint and one glass of wine being 1 unit” are outdated and incorrect dating back to decades ago when wine glasses were all uniformly small (125 ml) and alcohol was much weaker than many brands consumed today.
Liver disease is now the 5th biggest killer in the UK after heart, cancer, stroke and respiratory disease. It is the only major cause of death still increasing year on year and mortality from alcohol related liver disease has risen 41% from 1999 to 2005 – a 450% increase in 30 years! The process is silent but once liver disease has developed it presents as an acute illness with 25-50% immediate mortality.
So, what are the new guidelines?
Unit guidelines are now the SAME for men and women and both are advised not to regularly drink more than 14 units a week, a vast reduction on the old ‘recommendation’ of 21 units a week.
What do 14 units look like?
It is also recommended not to ‘save up’ the 14 units for 1 or 2 days, but to spread them over 3 or more days.
People who have 1 or 2 heavy drinking sessions each week increase the risk of death from long term illnesses such as liver disease and cancer, accidents and injuries.
Drinking during pregnancy
The guidelines for pregnant women have also been updated to clarify that no level of alcohol is safe to drink in pregnancy. Although the risk of harm to the baby is low if they have drunk small amounts of alcohol.
Previous research had suggested that small amounts of alcohol can have a protective effect on your heart. New evidence now shows that the benefits of alcohol for the heart only applies to women aged 55 and over.
Working out consumption
In the past, there has been some confusion about how to work out the unit content of an alcoholic drink. The percentage alcohol of a drink is the number of units in one litre.
- A bottle of wine with 13.5% of alcohol contains 13.5 unit in one litre or 10.12 units in a bottle (750ml).
- A bottle of wine with 11% of alcohol contains 11 units in one litre or 8.25 units.
- A pint of beer with a strength of 4.8% (Budweiser e.g.) is 4.8 units in one litre or 2.73 units in a pint (one pint = 0.568 l)
- 1 shot (=25 ml) of a 40% tequila is 1 unit (40% = 40 units/1 Litre or 1 unit in 25ml)
It is also interesting to compare the calorie content of different drinks. On the Drinkaware website, the Unit & Calorie Calculator gives us an insight into the varying calorie content of different alcohols and also showing how long it would take to run off these calories as well as the equivalent calories in burgers!
Underestimating the amount of alcohol consumed can result in a drink driving conviction and is certainly responsible for a large amount of excess weight individuals carry as well as increasing health risks. Here are some examples of the calculations from the Unit & Calorie Calculator that we did:
- 5 (175ml) glasses of wine at 13%:
- 4 pints of 4% beer:
- 8 (25ml) shots of tequila (38%):
Keeping the risks low
If and when you do drink, in order to keep the short-term health risks low, you should:
- Limit the total amount of alcohol drunk on any one occasion
- Drink more slowly, with food and alternate with water
The risk of getting some alcohol related cancers gradually reduces over time when people stop drinking, but can take many years before the risk falls to the levels found in people who have never drunk alcohol.
‘Liver disease has emerged as a key theme from international comparisons which show that this is the only major cause of mortality and morbidity which is on the increase in England whilst decreasing among our European neighbours… Equally important, service providers should continue to improve their efforts to detect early signs of liver disease… and use of appropriate tests to identify liver disease that can be reversed or treated.’ Professor Dame Sally Davies, Chief Medical Officer, from her annual report On the State of the Public’s Health
At Preventicum we take a full medical and alcohol history and scan the liver with ultrasound and MRI as well as performing a range of blood tests to look for any evidence of problems in the liver. Our commonest abnormal finding would be a fatty liver, which is nearly always reversible with weight loss.
Illustrations from drinkaware.co.uk