Drinking over 14 units per week?

[TooManyUnits]

Obviously, there is no safe level from for example a perspective of breast cancer risk. I do understand this.

I've googled but not sure I am googling the right terms, because it's hard to find out what the risks are if you drink more than the cut off of 14 units, but not by a very large amount - like perhaps 18 units, on a regular basis?

I find that so easy to do! DP and I share a bottle of wine 2 nights a week. So 10 units. Then on a night out when friends were in town recently, I drank 4 beers in addition to the wine nights. Hence arriving at 18 units for an example. It's not the same ever week but that sort of amount is a pretty regular occurrence.

How do I gauge the risk from that level of drinking? Does anyone know of any studies that show what the risks actually are/ how it accelerates, beyond the black and white 14 units guideline, for example?

Well it used to be 21 units per week but this has been revised because even that increases risks, they didn’t reduce it down to 18 so presumably that still increases risk.

“No 'safe' drinking level”

If you drink less than 14 units a week, this is considered low-risk drinking.

It's called "low risk" rather than "safe" because there's no safe drinking level.

The type of illnesses you can develop after 10 to 20 years of regularly drinking more than 14 units a week include:

cancers of the mouth, throat and breast
stroke
heart disease
liver disease
brain damage
damage to the nervous system

www.nhs.uk/live-well/alcohol-advice/the-risks-of-drinking-too-much/

[quote Tasteslikeregret]Well it used to be 21 units per week but this has been revised because even that increases risks, they didn’t reduce it down to 18 so presumably that still increases risk.

“No 'safe' drinking level”

If you drink less than 14 units a week, this is considered low-risk drinking.

It's called "low risk" rather than "safe" because there's no safe drinking level.

The type of illnesses you can develop after 10 to 20 years of regularly drinking more than 14 units a week include:

cancers of the mouth, throat and breast
stroke
heart disease
liver disease
brain damage
damage to the nervous system

www.nhs.uk/live-well/alcohol-advice/the-risks-of-drinking-too-much/[/quote]
Yes, I thought I was quite clear in my post saying I know there is no 'safe' level.

Here's a list with a bit more detail:

Risks of heavy alcohol use

While moderate alcohol use may offer some health benefits, heavy drinking — including binge drinking — has no health benefits.

Heavy or high-risk drinking is defined as more than three drinks on any day or more than seven drinks a week for women and for men older than age 65, and more than four drinks on any day or more than 14 drinks a week for men age 65 and younger.

Binge drinking is defined as four or more drinks within two hours for women and five or more drinks within two hours for men.

Excessive drinking can increase your risk of serious health problems, including:

Certain cancers, including breast cancer and cancers of the mouth, throat, esophagus and liver
Pancreatitis
Sudden death if you already have cardiovascular disease
Heart muscle damage (alcoholic cardiomyopathy) leading to heart failure
Stroke
High blood pressure
Liver disease
Suicide
Accidental serious injury or death
Brain damage and other problems in an unborn child
Alcohol withdrawal syndrome

www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/alcohol/art-20044551

OP, I don't think you're going to find a study that says a 14% increase in alcohol consumption leads to a 23% increase in the risk of XXX. It's going to be confounded by age, comorbidities, activity level, etc. Keep in mind that we use the word intoxicated because alcohol is a toxin.

Yes, but if you read the quote from the nhs website it says the risks for regularly drinking more than 14 units.
More than 14 units includes 15, 16, 17, 18 or whatever 🤷🏼‍♀️

OP, I don't think you're going to find a study that says a 14% increase in alcohol consumption leads to a 23% increase in the risk of XXX. It's going to be confounded by age, comorbidities, activity level, etc. Keep in mind that we use the word intoxicated because alcohol is a toxin.

Yes, I agree and know there won't be anything that specific because there can't be.

I guess I just wondered if there was something along the lines of the smoking risk assessment 'pack years' approach. Not the same, of course.

I can't drink much anymore as I'm 37 and it causes huge issues with sleep, after years of not sleeping with small kids I can't do anything to mess up my sleep.
Thing is though it's like everything, alcohol is made from sugar, sugar is v v bad for the health so in excess can cause illnesses for some, being overweight is extremely bad for your health, having fat on your stomach is high risk for certain cancers . To be in optimum health you should regularly exercise , eat non processes food, avoid quite a lot of medication ( loads can affect the liver ) , most people should have no excess fat at all, you should be able to see your ribs, for breast cancer and other cancers you should breastfeed to lower your risk again and extended bf is more beneficial.

Thing I was trying to say is everyone has their vice usually. I drink too much coffee, I'm sure that's linked to some bad stuff. And yes too much alcohol is very bad for you but it's just as bad as being overweight. I think 14 units is enough if you are drinking every week but I also think a lot who are dogmatic about it on here may be overweight or have other habits that aren't super healthy. Alcohol is also a depressant and that is definitely a problem with it.

alcoholchange.org.uk/alcohol-facts/interactive-tools/check-your-drinking

You might find the “quick quiz” here interesting, but I don’t think it will give you the precise levels of “how unsafe is unsafe” you’re hoping for.

I agree that it’s very easy to go over the 14 units! The TryDry app lets you track your units, which I did after Dry January, and it was an eye-opener!

Just saw these replies. That quiz is interesting yes.

@Tasteslikeregret

Yes, but if you read the quote from the nhs website it says the risks for regularly drinking more than 14 units. More than 14 units includes 15, 16, 17, 18 or whatever 🤷🏼‍♀️

Very true. But does the unit guideline not vary across different European countries?

I suppose I'd like to see the meta analysis involved when public health sets guidance, explained for a lay person audience. At what point on the bell curve do the risks increase in a meaningful way?

I fully acknowledge there is no safe amount, I guess I just find it slightly odd that I can't seem to easily find this sort of info.

When with many other guidelines for health, it is readily available.

Bear in mind that when determing advice on these things, policy is not usually dictated purely by science, but also partially by psychology. They want you to drink less but not make it seem so unattainable that noone bothers to try - that is likely where the 14 units figure comes from, not from any study that specifies that is a particular cutoff level of drinking. Subsequent studies confirm the figure by continually comparing groups that drink over and above 14 units.

Yes, makes sense @Thatswhyimacat

Reading any of the studies about cancer or heart disease is making me too scared to have a glass of wine this weekend

Agree with @Thatswhyimacat also the psychology around individual drinking is partly influenced by culture eg the UK and other northern countries have a culture where drinking lots quickly is more acceptable than southern European countries. They all tackle it differently eg Finland makes booze expensive and less easy to get hold of, the UK doesn't do this so much, Russia lets people do what the fuck they want even if that means necking homebrewed moonshine and shooting at leaves on the tree because they look at you funny ...

I've always felt folk who are obsessive about alcohol units, and those who clog up supermarket aisles while they scour the minutiae on the back of food packaging must take years off their lives with their fretting.

The only consideration that ever enters my head when I'm pondering another drink is 'can I still walk/stand upright?'. If the answer is 'yes', then we're good to go.

@Owieeee

I can't drink much anymore as I'm 37 and it causes huge issues with sleep, after years of not sleeping with small kids I can't do anything to mess up my sleep. Thing is though it's like everything, alcohol is made from sugar, sugar is v v bad for the health so in excess can cause illnesses for some, being overweight is extremely bad for your health, having fat on your stomach is high risk for certain cancers . To be in optimum health you should regularly exercise , eat non processes food, avoid quite a lot of medication ( loads can affect the liver ) , most people should have no excess fat at all, you should be able to see your ribs, for breast cancer and other cancers you should breastfeed to lower your risk again and extended bf is more beneficial.

@Owieeee - what medication should we avoid? I've not heard this before. Can you suggest a reliable link to info on this please?

@TooManyUnits I don't have the data in front of me and don't want to encourage wild drinking but usually, when they speak of risk increase of cancer etc from x, you're talking about the difference between say 1 person in 1000 developing cancer vs 2 in 1000. The stats used make it sound like a very large effect when it's large effect ON very small risk, so still a small risk overall. So 2 is 100 percent bigger than 1, or 200 percent of 1, but it's still 1 and 2.

@gingerhills something that I've found quite a few people don't know is that you shouldn't take paracetamol with alcohol as it worsens the liver damage. I've stopped many people popping it for hangovers!

[quote Thatswhyimacat]@gingerhills something that I've found quite a few people don't know is that you shouldn't take paracetamol with alcohol as it worsens the liver damage. I've stopped many people popping it for hangovers![/quote]
Thank you. That is worth knowing.

Here’s a large recent study which quantifies some of the risks in the way you’re looking for. So 100-200g a week (12.5-25units) reduces life expectancy by about six months

www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)30134-X/fulltext

This is another classic paper with some quantification of risk jamanetwork.com/journals/jamainternalmedicine/fullarticle/769554

The decision making process for the guidelines is described here assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/545739/GDG_report-Jan2016.pdf

This isn't remotely scientific, but for me I think you have to consider your whole lifestyle. For example I know I drink too much wine, probably 2-3 bottles a week, but I genuinely enjoy it. I am fit and healthy, I cook mostly from scratch, loads of salads/veg, drink loads of water, do regular cardio, dont smoke, have low blood pressure, I'm a healthy weight.

So overall my risk of poor health will be slightly increased because of the wine. But I'm happy with my choices. But if I had a poor diet, smoker, drank sugary drinks on top of the wine, I'd probably be in trouble health wise sooner rather than later.

I was told by a doctor (friend) some time ago that the 14/21-unit thresholds are arbitrary guesses at what seems sensible or doable and are not based on any quantitative research. They know that heavy drinking is bad for you but at what point it becomes risky is really not easily quantifiable, so they picked some limits which seem within reach.

I'd be genuinely interested if anyone can point to any research which does back up the NHS limits.

@verytired42, I've just seen your post, which is really interesting, and does answer my question I think - thanks.

@TooManyUnits - Reading your original post - I'd say that is too much for a regular amount of drinking every week.

If you have the odd week like that, then I'd try and balance it by having a working week (Mon to Thursday evening,say) totally clear of any alcohol the following week.

It is meant to be very good for your health to have several clear days off drinking in a row.

[quote verytired42]Here’s a large recent study which quantifies some of the risks in the way you’re looking for. So 100-200g a week (12.5-25units) reduces life expectancy by about six months

www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)30134-X/fulltext

This is another classic paper with some quantification of risk jamanetwork.com/journals/jamainternalmedicine/fullarticle/769554

The decision making process for the guidelines is described here assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/545739/GDG_report-Jan2016.pdf[/quote]
@verytired42

I always think the problem with just stating a statistic like - it reduces your life by 6 months - is that doesn't sound much and one might well think (I would) that I'd prefer to only live to 90 years and not 90 plus 6 months if that's the difference between drinking for the next half a century or not....

What is more important to me is the health in your final decades of life.

If you said AND you will have a much higher chance of having dementia for the last ten years of that life, then that would really affect my likelihood of not drinking excessively

I know several GPs and the general medical opinion seems to be that all alcohol can be potentially harmful. The unit limit of 14 is an arbitrary limit because they know that people won’t just stop drinking so it is more a realistic maximum before serious harm may occur. It does not mean you are ok to drink up to that amount - some people are but there are still increased risks. It’s a bit like the 5 a day advice - 5 a day isn’t really enough according to much of the research, more like 10 portions fruit/ veg a day. But they know most people will look at that and think there’s no way they can eat that so won’t bother. So 5 a day is a much more realistic target that will still benefit peoples health