Drink less alcohol, or none

Cost

Free, even saves money, and takes no time. The hard part is the small awkwardness when people push drinks at social occasions.

What you get

Pooling 83 studies that followed people forward in time (observational, not assigning groups), with 600,000 (60万) current drinkers, the lowest point of the risk of death is at up to 100 g of pure alcohol a week. That amount is about 2.5 L of 5% beer, or 300 mL of 40% baijiu (白酒). People who drink 100–200 g a week at age 40 have a life expectancy about 6 months shorter. Those who drink 200–350 g a week lose 1–2 years. Those who drink more than 350 g lose 4–5 years. These three figures are reported in years of life in the original. The Global Burden of Disease study (GBD 2016) added up all kinds of health loss, and the drinking level with the lowest risk was 0 drinks a week. Another pooled analysis corrected for biases in study design. Compared with lifelong abstainers, people who drank 1.3–24 g a day had about 7% lower risk of death (RR 0.93). But no statistically significant difference was seen for this one. Those who drank 45–64 g a day were about 19% higher (RR 1.19). Those who drank 65 g or more a day were about 35% higher (RR 1.35).

Notes

Disputed. The side that says “a little is beneficial” relies on a pooled analysis of 34 long-term follow-up studies. It reported that light drinkers had up to 17%–18% lower overall mortality. The amount it gave was no more than 4 drinks a day for men and 2 for women. Within that amount, those who drank more actually had lower mortality. The other side argues that the “non-drinker” group is mixed with people who quit drinking because of illness and people who were already in poor health. One pooled analysis specifically removed these distortions, and after doing so the protective effect disappeared. The Global Burden of Disease study also found 0 to be safest. The safe reading is that drinking a little does not clearly hurt your lifespan, and drinking a lot does. There is no basis for “starting to drink for your health.” For how to cut down, see §2.21 (count your drinks, then talk to a doctor). If you drink every day, don't force yourself to quit alone; see §2.20 (don't quit cold turkey on your own)

Evidence grade

A : Specific numbers from meta-analyses, large cohorts or randomized trials; for law and policy, the statute or official text.

Sources

1. Wood AM et al. (2018). Risk thresholds for alcohol consumption: combined analysis of individual-participant data for 599 912 current drinkers in 83 prospective studies. Lancet. https://doi.org/10.1016/S0140-6736(18)30134-X
2. GBD 2016 Alcohol Collaborators (2018). Alcohol use and burden for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. https://doi.org/10.1016/S0140-6736(18)31310-2
3. Zhao J et al. (2023). Association Between Daily Alcohol Intake and Risk of All-Cause Mortality: A Systematic Review and Meta-analyses. JAMA Network Open. https://doi.org/10.1001/jamanetworkopen.2023.6185
4. Di Castelnuovo A et al. (2006). Alcohol dosing and total mortality in men and women: an updated meta-analysis of 34 prospective studies. Archives of Internal Medicine. https://doi.org/10.1001/archinte.166.22.2437 (opposing view)

Translated from the Chinese original. Original book, section 2, tip 19. This section is about health and medicines. It is general information, not a substitute for a doctor’s diagnosis or prescription. Content may be out of date and rules differ by place. When you actually deal with an agency, a doctor or a court, follow what local officials, doctors and lawyers tell you. Disclaimer