Canada’s New Guidelines for Alcohol Say ‘No Amount’ Is Healthy

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The guidance builds on growing evidence, after decades of sometimes conflicting research, that even small amounts of alcohol can have serious health consequences.

A hand holds a carafe from which wine is being poured into one of several wine glasses lined up on a table next to a bottle, with a view of mountains and water in the distance.
Drinking even small amounts of alcohol “is damaging to everyone, regardless of age, sex, gender, ethnicity, tolerance for alcohol or lifestyle,” the Canadian Centre on Substance Use and Addiction said in a report.Credit…Jen Osborne for The New York Times

Canadian health officials have overhauled their guidelines for alcohol consumption, warning that no amount is healthy and recommending that people reduce drinking as much as possible.

The new guidelines, issued Tuesday, represent a major shift from the previous ones introduced in 2011, which recommended that women consume no more than 10 drinks per week and that men limit themselves to 15.

The experts who developed the guidelines said the new approach builds on growing evidence, after decades of sometimes conflicting research, that even small amounts of alcohol can have serious health consequences.

Instead of recommending that people limit themselves to a specific number of drinks per week, the guidelines outline a “continuum of risk” associated with drinking even a few glasses of wine or beer over a seven-day period.

The risk is “low” for people who consume two standard drinks or fewer per week; “moderate” for those who consume between three and six standard drinks per week; and “increasingly high” for those who consume seven or more standard drinks per week, according to the guidelines, which were issued in a report by the Canadian Centre on Substance Use and Addiction.

The report defines a standard drink as a 12-ounce bottle of beer that is 5 percent alcohol, a five-ounce glass of wine that is 12 percent alcohol or a 1.5-ounce shot glass of a spirit that is 40 percent alcohol.

“Research shows that no amount or kind of alcohol is good for your health,” the report states. “It doesn’t matter what kind of alcohol it is — wine, beer, cider or spirits. Drinking alcohol, even a small amount, is damaging to everyone, regardless of age, sex, gender, ethnicity, tolerance for alcohol or lifestyle. That’s why if you drink, it’s better to drink less.”

Recent research has found that even low levels of drinking slightly increase the risk of high blood pressure and heart disease, and the risk goes up significantly for people who drink excessively.

Research published in November revealed that between 2015 and 2019, excessive alcohol use resulted in roughly 140,000 deaths per year in the United States. About 40 percent of those deaths had acute causes, like car crashes. But a majority were caused by chronic conditions attributed to alcohol, such as liver disease, cancer and heart disease.

Dr. Catherine Paradis, interim associate director of research at the Canadian Centre on Substance Use and Addiction, said that consumption of even two drinks per week has been associated with an elevated risk of seven types of cancer, including breast and colon cancer, as well as cardiovascular disease.

Dr. Paradis, who was a co-chairwoman of the panel that developed the new guidelines, noted that the World Health Organization had recently declared that the harms associated with drinking alcohol had been “systematically evaluated over the years and are well documented” and that “when it comes to alcohol consumption, there is no safe amount that does not affect health.”

The good news, the report said, is that any reduction in alcohol consumption is beneficial. This is true even for those who do not cut their drinking to low or moderate levels. In fact, those consuming high levels of alcohol have much to gain by reducing their consumption by as much as possible, the report states.

“We have this line: Drink less, live more,” said Dr. Alexander Caudarella, chief executive of the Canadian Centre on Substance Use and Addiction. “The idea is that any reduction of alcohol will significantly reduce your risk.”

The new guidelines depart from the specific drink limits called for in other Western countries.

Australia, for example, recommends no more than 10 drinks a week and no more than four drinks on any one day. Britain recommends drinking no more than six medium glasses of wine or six pints of beer per week. The guidelines in the United States call for two drinks or fewer a day for men and one drink or fewer per day for women.

Canadian health officials said they hoped their less prescriptive approach would encourage consumers to make healthier choices.

“The guidance is really a fundamentally different way of looking at alcohol and saying we need to be much more open and transparent about what are the risks associated with it and what the science has shown us,” Dr. Caudarella said. “It’s really putting it out there in a way that lets people assess their own risk level and work toward it.”

To encourage consumers to cut down on their drinking, the report recommended that all alcoholic beverages sold in Canada come with warning labels, similar to those on cigarettes. Evidence shows that adding health warnings to alcohol labels can increase public awareness of the link between alcohol consumption and cancer, the report states.

Beer Canada, a national trade group trade that represents than 50 Canadian brewing companies, said that it continued to support the 2011 guidelines and that the process of updating those guidelines “lacked full transparency and, to date, has not included the essential rigor of an expert technical peer review.”

“Beer Canada and Canadian brewers have a long history promoting moderation and responsible consumption,” the group said in a statement. “Beer Canada believes the decision whether to drink, and if so how much, is a personal one. Responsible, moderate consumption can be part of a balanced lifestyle for most adults of legal drinking age.”

Dan Paszkowski, president and chief executive of Wine Growers Canada, which represents the country’s wineries, said the group had introduced a campaign, “The Right Amount,” in 2021 to promote “responsible consumption of wine.”

“It’s essential for Canadians to have confidence in public health institutions and the messaging must be informative, not persuasive, and based on sound science,” Mr. Paszkowski wrote in wrote in an opinion piece published this week in The Hill Times, a news outlet focused on Canadian politics and government. “From some to none, the right amount is different for every person.”

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