Alcohol Use Disorders (33) Do people understand the harms of alcohol? (7) How can they be better informed? (3)

9 February, 2024

Yesterday I asked: "Perhaps people would be better informed if there were more consistency among healthcare information providers?" I pointed to potentially confusing differences between, for example, WHO advice ('there is no safe amount') and Mayo Clinic ('If you already have a glass of red wine with your evening meal, drinking it in limited amounts may improve your heart health').

Here is a related statement from the website of the Harvard TH Chan School of Public Health: 'More than 100 prospective studies show an inverse association between light to moderate drinking and risk of heart attack, ischemic (clot-caused) stroke, peripheral vascular disease, sudden cardiac death, and death from all cardiovascular causes... For a 60-year-old man, a drink a day may offer protection against heart disease that is likely to outweigh potential harm (assuming he isn’t prone to alcoholism)':

'The idea that moderate drinking protects against cardiovascular disease makes sense biologically and scientifically. Moderate amounts of alcohol raise levels of high-density lipoprotein (HDL, or “good” cholesterol), [37] and higher HDL levels are associated with greater protection against heart disease. Moderate alcohol consumption has also been linked with beneficial changes ranging from better sensitivity to insulin to improvements in factors that influence blood clotting, such as tissue type plasminogen activator, fibrinogen, clotting factor VII, and von Willebrand factor. Such changes would tend to prevent the formation of small blood clots that can block arteries in the heart, neck, and brain, the ultimate cause of many heart attacks and the most common kind of stroke.'

The inconsistency in information presents a challenge to health communicators and frontline healthcare providers who are trying to provide the best possible advice for the public and for patients.

By contrast there is consensus that excessive alcohol intake is harmful. The UK National Health Service recommends that men and women do not drink more than 14 units of alcohol per week (1 unit is equivalent to 10ml pure alcohol), spread across three days or more.

We come back to the question: Do people understand the harms of alcohol? Do they understand the potential benefits (if any) of 'light to moderate drinking'? Are people aware of the recommended maximums of weekly intake? Do they truly understand the potential consequences of exceeding those limits?

Best wishes, Neil

HIFA profile: Neil Pakenham-Walsh is coordinator of HIFA (Healthcare Information For All), a global health community that brings all stakeholders together around the shared goal of universal access to reliable healthcare information. HIFA has 20,000 members in 180 countries, interacting in four languages and representing all parts of the global evidence ecosystem. HIFA is administered by Global Healthcare Information Network, a UK-based nonprofit in official relations with the World Health Organization. Email: