How much is too much? A comparative look at recommended weekly alcohol intake across the world 

Alcohol limits vary greatly by country and by gender. David Morrison takes a fascinating look at the data.

Credit: Gerd Altmann on Pixabay
Credit: Gerd Altmann on Pixabay

There are arguments for and against the idea of consuming alcohol of any kind. Small amounts are often cited as being associated with health benefits - at least under certain circumstances. However, everyone has to recognize that there is an upper limit beyond which there are no health benefits at all. Drink too much and you die.

But what is this upper safe limit? Obviously, like anything else to do with the human body and brain, it varies from one person to the next – and between the sexes. So, to provide a recommended upper limit for any given time period, all that can be done is to make generalizations,. And this is precisely what the government health authorities in many countries have done. The generalized recommendations they have made differ quite dramatically, however, as do the way in which they are reported. Nobody consumes pure alcohol, so to make sense of advice that has to cover 2.5% ABV beer, wine with strengths ranging from 5-15% and a wide array of spirits, health authorities talk of standardized ‘units’ of alcohol (adopted by UK authorities) or ‘standard drink’ (the preferred term in US, Canada, Australia and New Zealand.) 

 

My unit is bigger than yours

Confusingly, whichever term is used, the amount of alcohol to which it refers is far from consistent. The UK and Iceland unit contains eight grams of pure alcohol. In Austria by contrast, it is 20g – two and a half times as much. Most other countries fall between, with most falling in line with the World Health Organisation (WHO)’s choice of 10g. The US and Hungary, however, are notable outliers at 14g and 17g respectively. Surprisingly, neighbouring countries differ too. A Canadian standard drink packs very slightly less of a punch at 13.5g than one on the other side of the US border. Likewise Germany and Portugal have more generous 11g units while France and Spain have 10g. Switzerland, for some reason, stands alongside the Scandinavians in agreeing that 12g is the correct amount of alcohol in a unit.

One way to look at units is that they represent the amount of alcohol an average human could metabolize in an hour, although health effects also accumulate through longer times. Obviously, this is a very rough estimate, given the different rate at which this might happen between larger and smaller individuals, males and females.

 

Source: Meininger's

 

Most countries acknowledge this last factor by making different recommendations for men and women. But here too, there is little consistency. The UK, Australia and the Netherlands - draw no distinction between the sexes. Indeed, in 2016 and 2020, respectively, the former pair of nations simply reduced the figure for males to match the female one. Some other countries simply presume that the male of the species can healthily consume twice as much as the female. 

Using a range of data, it is possible to compare these recommendations made by 25 countries and to map them on a graph, standardized so that it shows the recommended maximum weekly consumption of grams of pure alcohol, for males horizontally and females vertically. Each point represents a country; but note that there are only 18 points in the graph, because several countries have the same recommendations. (The data for all the nations is provided on a separate chart) 

The upper line indicates the situation where the recommendations are the same for both females and males, while the lower line represents female recommendations that are half that of the males. Some of the countries are labeled with their two-letter ISO codes.

 

Varying female limits

There are seven countries where the female recommendation is precisely half that of the males, including Portugal (PT), Romania (RO), the USA (US), Germany (DE) & Denmark (DK), and Poland (PL) & Sweden (SE). The latter two are among the lowest recommendations for both sexes, along with Korea (KR).

Almost all of the other countries (with one exception, discussed below) are half-way between these two limits, but with a huge international spread of recommendations for males. Note that the ones for Italy (IT), Norway (NO), Portugal and Romania exceed the other countries by quite some margin, with Portugal actually having the highest of all. Indeed, these four countries exceed the US recommendation by more than 70%, which represents quite a difference in assumed health effects.

 

 

 

Recommended maximum grams of pure alcohol per week: The Netherlands (NL), Australia (AU) and UK (UK) recommend the same consumption for men and women, but Britons of both sexes consume the most per head of these three countries. Portugal (PT) with the highest per-capita consumption on the chart, recommends that women drink half as much alcohol as men. Source: David Morrison/Meininger's 

 

In the next cluster, along with the USA, are Canada (CA), Switzerland (CH), Spain (ES), France (FR) and (Greece (GR). These male recommendations are still quite high, being 20% higher than for the next cluster (with Germany).

Explaining these differences is not immediately obvious. For example, it might be supposed that they could be related to total alcohol consumption among the respective populaces. However, testing this idea by comparing the average recommendations across both sexes for each country, with its reported per-capita alcohol consumption revealed almost no relationship. Italy has a weekly recommendation that is nearly twice that of the UK, despite its citizens consuming less alcohol than that more northern country.. 

There must be other factors at work. Indeed, even otherwise culturally similar countries  seem to differ in their recommendations. Most obviously,  Norway has a much higher set of recommendations than does Finland. In turn, Finland has almost the same recommendation for males as Denmark, but a 30% higher one for females. Sweden’s recommendations are notably lower than all of these..

Finally, note that there is no explicit recommendation for women in Japan — they are simply not mentioned at all in the documentation. How to interpret this is not at all clear. Should women not drink at all? Is their recommendation supposed to be the same as the 10g for the men?  Or indeed the 20g Japan used until 2011.

David Morrison
 

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