Alcohol is physically bad for you in any quantity; and the more you drink, the worse its health effects. The gigantic report on the subject published last week is unequivocal and authoritative. It makes depressing reading – “sobering” would be the wrong word here, not least because few people are likely to change their behaviour as a result. But it is difficult to argue with the conclusions. The report was based on enormous amounts of data: 28 million people around the world were examined in 592 studies to estimate the health risks, while the prevalence of drinking was estimated using a further 694 studies. Some of the effects of large-scale drinking are really shocking. In Russia, after the failure of Gorbachev’s attempt to curtail the country’s vodka habit, alcohol caused 75% of the deaths of men under 55, at a time when life expectancy was actually falling. Around the world today, alcohol is responsible for 20% of the deaths in the 15 to 49 age group (the researchers include in this an estimate for the proportion of road traffic fatalities cause by drunk driving, though this is extrapolated from US data).
The variety of ways in which alcohol can kill or damage people comes as a shock. In the poorest countries, its primary means of damage is through TB; as countries grow more developed (and drink, on average, more) the damage shifts to cancer and heart disease. It is the trade-off between cancer and heart disease which leads the researchers to reject the notion that moderate drinking has health benefits compared with abstinence: they find that the increased risk of cancers outweighs the diminished risk of heart disease among middle-aged moderate drinkers.
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