Individual and circumstantial vulnerabilities
These recommendations are intended for the general public. However, as the research shows with increasingly clarity, when it comes to alcohol, we are not all born equal.
The effects of alcohol can vary greatly from one person to the next, which means that these guidelines are not necessarily good for everyone.
Genetic heritage, weight and age are among the important factors we must all consider when figuring out what “moderate drinking” means for us.
Some genes – located in specific areas of the chromosomes – play an important role in determining how much alcohol it takes for a person to feel the effects. Recent studies show that as much as 50% of the risk of alcohol dependence is determined by genetic factors.
Slow response to alcohol. People who need a large quantity of alcohol in order to feel the effects are at greater risk of developing a dependence. Men and women who tend not to feel drunk should therefore pay closer attention and refrain from unlimited drinking.
Quick response to alcohol. Some people have to be careful for the opposite reason. These are the drinkers who feel drunk and lose control over their bodies sooner than the average person.
It is not uncommon for such people to have a family member with a serious drinking problem.
Like those who are slow to respond to alcohol, people who are quick to respond must be more careful than the average drinker. They should drink less than the amount recommended here in order to avoid social gaffes and accidents.
Our recommendations are for men and women of average weight and height. But we know that blood alcohol level is basically the amount of alcohol you absorb divided by the amount of water present in your body. Thus, the less water you have in your body, the higher your blood alcohol level will be.
People whose weight is below average and those with a high percentage of body fat must be very careful and drink less than the low-risk recommendations for the average person.
Low body weight. If your weight is below average, your body will also have a lower-than-average water content, which means that, all other things being equal, you will have a higher blood alcohol level than the average person who drinks the same amount. If this sounds like you, be careful!
High body fat. The same warning applies if you have a higher-than-average body fat percentage. Given two people who weigh the same, where one is well muscled and the other is overweight with a high body fat percentage, the one with the high body fat will feel the effects of alcohol more than the one with all the muscle. That’s because fatty tissue does not contain much water.
Young adults. The low-risk drinking guidelines are designed for adults. Teens who wish to drink should be careful and drink less than the recommended amounts.
In fact, teenagers can’t handle alcohol as well as adults. They often weigh less and have less water in their bodies to dilute the alcohol.
Also, compared to adults, young people have fewer of the enzymes that help the liver eliminate alcohol.
Furthermore, the adolescent brain is more vulnerable to damage by alcohol. Recent studies in neuroscience and child psychiatry show that the brain is not really fully developed until after the age of 20. Teens are therefore at greater risk when they drink because alcohol inhibits the development of some parts of the brain.
Older people. As people age, their kidneys, liver, cardiovascular system and brain undergo changes. Some of these changes make the elimination of alcohol less efficient, while others make people more sensitive to the effects of alcohol.
Older people tend to have a higher body fat percentage than younger adults and less water in their bodies. An older person will therefore have a higher blood alcohol level than a younger person who drinks the same amount.
Also, because of their increased physiological vulnerability and the fact that many of them take prescription drugs (see Medication), some older people should drink less than the low-risk guidelines for the general adult population.
The low-risk drinking guidelines may not be valid for someone who is taking medication. People on medication should be extra cautious and check with their doctor or pharmacist to see whether alcohol is contraindicated.
When taken in combination with certain medications, particularly those commonly prescribed for epilepsy, high blood pressure and the common cold, alcohol can cause dizziness and drowsiness.
Mixing alcohol with medication for rheumatism, arthritis, pain, infection and depression can cause serious physical and psychological problems.
Alcohol can also increase the sedative effect of benzodiazepines and other drugs, increasing the danger of falling.
- Hunger, fatigue and stress
When you are very hungry, tired or stressed, you should drink less than is recommended in the guidelines.
When you are hungry, your stomach is empty, so any alcohol you drink will be absorbed by the blood much more quickly. Consequently, you will feel the effects of the alcohol sooner and more intensely.
The same warning applies when you are very tired. Fatigue is a sign that your energy supplies are low, which means your liver will not eliminate alcohol as efficiently. The blood alcohol level of a tired person will be higher than that of a well rested person who drinks the same amount. Many symptoms of fatigue are similar to those of intoxication, and drinking will simply make them worse.
And since alcohol is a depressant, its negative effects will be felt more intensely by people who are stressed or depressed.
Official standards and how much you drink
The drinking guidelines proposed here have been established based on the standard drink. If you want to follow the guidelines and drink reasonably, you should make sure you know what a standard drink is in every form (beer, wine, cider, spirits, fortified wines, malt-based beverages and pre-mixed drinks, e.g. coolers).
Pay close attention to how much is poured – by you or anyone serving you – and know the alcohol content of what you’re drinking.
Studies show that many people, especially young people and women, underestimate the amount they drink because they do not know what constitutes a standard drink.
There has also been a recent trend among winemakers to increase the alcohol content of certain wines. Read all labels carefully and adjust your intake accordingly.
And remember that most people who drink spirits tend to have drinks containing more than the standard amount.