Alcohol consumption recommendations

Specific populations

Pregnant women

Excessive drinking during pregnancy, especially in the first eight to twelve weeks, is associated with fetal alcohol spectrum disorders such as abnormal appearance and behavioral problems. Most guidelines state that no safe amount of alcohol consumption has been established and recommend that pregnant women abstain entirely from alcohol. As there may be some weeks between conception and confirmation of pregnancy, most guidelines also recommend that women trying or likely to become pregnant should avoid alcohol as well.

• Australia: Total abstinence during pregnancy and if planning a pregnancy
• Canada: "Don't drink if you are pregnant or planning to become pregnant."
• France: Total abstinence
• Hong Kong: "Abstinence from alcohol during pregnancy is the safest choice."
• Iceland: Advise that pregnant women abstain from alcohol during pregnancy because no safe consumption level exists.
• Israel: Women should avoid consuming alcohol before and during pregnancy
• The Netherlands: Abstinence
• New Zealand: "Women who are pregnant or planning to become pregnant should avoid drinking alcohol."
• Norway: Abstinence
• Sweden: Abstinence.
• UK: Abstinence during pregnancy
• US: Total abstinence during pregnancy and while planning to become pregnant

Breastfeeding women

Moderate alcohol consumption by breastfeeding mothers can significantly affect infants. Even one or two drinks, including beer, may reduce milk intake by 20 to 23%, leading to increased agitation and poor sleep patterns. Regular heavy drinking (more than two drinks daily) can shorten breastfeeding duration and cause issues in infants, such as excessive sedation, fluid retention, and hormonal imbalances. Additionally, higher alcohol consumption may negatively impact children's academic achievement.

• Australia: Total abstinence advised
• Canada: "When breastfeeding, not drinking alcohol is safest."
• Hong Kong: "Avoid alcohol and alcoholic drinks."
• Iceland: Total abstinence advised because no safe consumption level exists.
• New Zealand: Abstinence recommended, especially in the first month of breastfeeding so that sound breastfeeding patterns can be established.
• United Kingdom: Total abstinence advised by some, such as the Royal College of Midwives; others advise to limit alcohol to occasional use in small amounts not exceeding the recommended maximums for non-breastfeeding woman as this is known to cause harm, and that daily or binge drinking be avoided.

Minors

Countries have different recommendations concerning the administration of alcohol to minors by adults.

• United Kingdom: An alcohol-free childhood is the healthiest option. Children aged under 15 should never be given alcohol, even in small quantities. Children aged 15–17 should not be given alcohol on more than one day a week – and then only under supervision from carers or parents.

• Singapore: A recurring message of the Get Your Sexy Back campaign is that consuming 5 or more units of alcohol (70 g pure ethanol) at a single sitting constitutes binge drinking.

Former alcoholics

• USA: According to the 2020-2025 Dietary Guidelines for Americans, alcohol consumption is not recommended for certain individuals. Specifically, those who are in recovery from Alcohol Use Disorder (AUD) or struggle to limit their alcohol intake should abstain from drinking entirely.

Elderly

• Italy: 12 g/day for men over 65.
• Japan: Less than 29 g/day for the elderly (and women).

Caveats

Risk factors

The recommended limits for daily or weekly consumption provided in the various countries' guidelines generally apply to the average healthy adult. However, many guidelines also set out numerous conditions under which alcohol intake should be further restricted or eliminated. They may stipulate that, among other things, people with liver, kidney, or other chronic disease, cancer risk factors, smaller body size, young or advanced age, those who have experienced issues with mental health, sleep disturbances, alcohol or drug dependency or who have a close family member who has, or who are taking medication that may interact with alcohol, or suffering or recovering from an illness or accident, are urged to consider, in consultation with their health professionals, a different level of alcohol use, including reduction or abstention.

Activities

Furthermore, the maximum amounts allowed do not apply to those involved with activities such as operating vehicles or machinery, risky sports or other activities, or those responsible for the safety of others.

Moreover, studies suggest even moderate alcohol consumption may significantly impair – neurobiologically beneficial and -demanding – exercise (possibly including the recovery and adaptation).

Drinking patterns

As of 2022, moderate consumption levels of alcoholic beverages are typically defined in terms of average consumption per day or week. However, drinking pattern (i.e. frequency, timing and dosage/intensity) is also significant. Although countries define binge drinking in different ways, the consensus recommendation is to avoid any form of binge drinking pattern, in addition to not exceeding the daily or weekly limit. Studies analyzing binge drinking have consistently found negative effects. Although there are few studies or guidelines on moderate consumption patterns, the general advice is that one should spread out consumption as evenly as possible, if one is consuming a fixed amount.

However, it is also easy, when drinking daily, to become habituated to alcohol's effects (consumption-induced tolerance). Most people cannot accurately judge how much alcohol they are consuming, particularly relative to the amounts specified in guidelines. Alcohol-free days provide a baseline and help people cut down on problematic drinking. One review showed that among drinkers (not limited to moderate consumption levels), daily drinking in comparison to non-daily drinking was associated with incidence of liver cirrhosis.

Alcohol promotion recommendations

Polymeal and most versions of the Mediterranean diet recommend a moderate amount of red wine, such as 150 mL (about one glass) every day, in combination with other several food items. Since about 2016, the American Heart Association and American Diabetes Association have recommended the Mediterranean diet as a healthy dietary pattern that may reduce the risk of cardiovascular diseases and type 2 diabetes, respectively. The United Kingdom's National Health Service also recommends a Mediterranean diet to reduce cardiovascular disease risk. The WHO has stated that there is currently no conclusive evidence that the potential benefits of moderate alcohol consumption for cardiovascular disease and type 2 diabetes outweigh the increased cancer risk associated with these drinking levels for individual consumers. A trial in Spain is expected to complete in 2028.

Units and standard drinks

Guidelines generally give recommended amounts measured in grams (g) of pure alcohol per day or week. Some guidelines also express alcohol intake in standard drinks or units of alcohol. The size of a standard drink varies widely among the various guidelines, from 8g to 20g, as does the recommended number of standard drinks per day or week. The standard drink size is not meant as recommendations for how much alcohol a drink should contain, but rather to give a common reference that people can use for measuring their intake, though they may or may not correspond to a typical serving size in their country.