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Dietary Guidelines for Americans
Alcoholic Beverages

Overview

The consumption of alcohol can have beneficial or harmful effects depending on the amount consumed, age and other characteristics of the person consuming the alcohol, and specifics of the situation. In 2002, 55 percent of U.S. adults were current drinkers. Forty-five percent of U.S. adults do not drink any alcohol at all(15). Abstention is an important option. Fewer Americans consume alcohol today as compared to 50 to 100 years ago.

The hazards of heavy alcohol consumption are well known and include increased risk of liver cirrhosis, hypertension, cancers of the upper gastrointestinal tract, injury, violence, and death. Moreover, certain individuals who are more susceptible to the harmful effects of alcohol should not drink at all. In addition, alcohol should be avoided by those participating in activities that require attention, skill, and/or coordination.

Alcohol may have beneficial effects when consumed in moderation. The lowest all-cause mortality occurs at an intake of one to two drinks per day. The lowest coronary heart disease mortality also occurs at an intake of one to two drinks per day. Morbidity and mortality are highest among those drinking large amounts of alcohol.

KEY RECOMMENDATIONS

  • Those who choose to drink alcoholic beverages should do so sensibly and in moderation - defined as the consumption of up to one drink per day for women and up to two drinks per day for men.
  • Alcoholic beverages should not be consumed by some individuals, including those who cannot restrict their alcohol intake, women of childbearing age who may become pregnant, pregnant and lactating women, children and adolescents, individuals taking medications that can interact with alcohol, and those with specific medical conditions.

Alcoholic beverages should be avoided by individuals engaging in activities that require attention, skill, or coordination, such as driving or operating machinery.

Discussion

Alcoholic beverages supply calories but few essential nutrients (see table 16). As a result, excessive alcohol consumption makes it difficult to ingest sufficient nutrients within an individual's daily calorie allotment and to maintain a healthy weight. Although the consumption of one to two alcoholic beverages per day is not associated with macronutrient or micronutrient deficiencies or with overall dietary quality, heavy drinkers may be at risk of malnutrition if the calories derived from alcohol are substituted for those in nutritious foods.

The majority of American adults consume alcohol. Those who do so should drink alcoholic beverages in moderation. Moderation is defined as the consumption of up to one drink per day for women and up to two drinks per day for men. Twelve fluid ounces of regular beer, 5 fluid ounces of wine, or 1.5 fluid ounces of 80-proof distilled spirits count as one drink for purposes of explaining moderation. This definition of moderation is not intended as an average over several days but rather as the amount consumed on any single day.

The effect of alcohol consumption varies depending on the amount consumed and an individual's characteristics and circumstances. Alcoholic beverages are harmful when consumed in excess. Excess alcohol consumption alters judgment and can lead to dependency or addiction and other serious health problems such as cirrhosis of the liver, inflammation of the pancreas, and damage to the heart and brain. Even less than heavy consumption of alcohol is associated with significant risks. Consuming more than one drink per day for women and two drinks per day for men increases the risk for motor vehicle accidents, other injuries, high blood pressure, stroke, violence, some types of cancer, and suicide. Compared with women who do not drink, women who consume one drink per day appear to have a slightly higher risk of breast cancer.

Studies suggest adverse effects even at moderate alcohol consumption levels in specific situations and individuals. Individuals in some situations should avoid alcohol-those who plan to drive, operate machinery, or take part in other activities that require attention, skill, or coordination. Some people, including children and adolescents, women of childbearing age who may become pregnant, pregnant and lactating women, individuals who cannot restrict alcohol intake, individuals taking medications that can interact with alcohol, and individuals with specific medical conditions should not drink at all. Even moderate drinking during pregnancy may have behavioral or developmental consequences for the baby.

Heavy drinking during pregnancy can produce a range of behavioral and psychosocial problems, malformation, and mental retardation in the baby. Moderate alcohol consumption may have beneficial health effects in some individuals. In middle-aged and older adults, a daily intake of one to two alcoholic beverages per day is associated with the lowest all-cause mortality. More specifically, compared to non-drinkers, adults who consume one to two alcoholic beverages a day appear to have a lower risk of coronary heart disease. In contrast, among younger adults alcohol consumption appears to provide little, if any, health benefit, and alcohol use among young adults is associated with a higher risk of traumatic injury and death. As noted previously, a number of strategies reduce the risk of chronic disease, including a healthful diet, physical activity, avoidance of smoking, and maintenance of a healthy weight. Furthermore, it is not recommended that anyone begin drinking or drink more frequently on the basis of health considerations.

TABLE 16. Calories in Selected Alcoholic Beverages

This table is a guide to estimate the caloric intake from various alcoholic beverages. An example serving volume and the calories in that drink are shown for beer, wine, and distilled spirits. Higher alcohol content (higher percent alcohol or higher proof) and mixing alcohol with other beverages, such as calorically sweetened soft drinks, tonic water, fruit juice, or cream, increases the amount of calories in the beverage. Alcoholic beverages supply calories but provide few essential nutrients.

Beverage Approximate Calories Per 1 Fluid Oz (a) Example Serving Volume Approximate Total Calories (b)
Beer (regular) 12 12 oz 144
Beer (light) 9 12 oz 108
White wine 20 5 oz 100
Red wine 21 5 oz 105
Sweet dessert wine 47 3 oz 141
80 proof distilled spirits (gin, rum, vodka, whiskey) 64 1.5 oz 96

(a) Source: Agricultural Research Service (ARS) Nutrient Database for Standard Reference (SR), Release 17. http://www.nal.usda.gov/fnic/foodcomp/index.html
Calories are calculated to the nearest whole number per 1 fluid oz.
(b) The total calories and alcohol content vary depending on the brand. Moreover, adding mixers to an alcoholic beverage can contribute calories in addition to the calories from the alcohol itself.

(15) Behavioral Risk Factor Surveillance System, Surveillance for Certain Health Behaviors Among Selected Local Areas-United States, Behavioral Risk Factor Surveillance System, 2002, MMWR, 53, No SS-05. http://www.cdc.gov/brfss/.

Source: Dietary Guidelines for Americans, Chapter 9, Alcoholic Beverages, http://www.health.gov/DietaryGuidelines/

Adapted by Editorial Department, February 2007
Last update, August 2008

 


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