You Could Be Drinking More Than You Think, Without Even Knowing

“There are a number of reasons why drinking shortens lifespans, and one is that we have lost track of what a “drink” actually is.

Longstanding U.S. alcohol guidelines assume that a standard drink consists of just 0.6 ounce of alcohol. That is a 12-ounce beer with 5% alcohol, or a 5-ounce glass of wine with 12% alcohol. But over time, Americans are drinking larger and boozier beers and stronger wines, and getting heavy pours at bars, all of which deliver more alcohol than the standard drink.

This has troubling implications for health: We are drinking more alcohol, just as many epidemiologists are lowering what they think the safe level of alcohol is.

“One of the big challenges of alcohol research is how do we define the basic metric of ‘a drink,’ ” said Priscilla Martinez, deputy scientific director of the Alcohol Research Group, part of the nonprofit Public Health Institute. “How do we help people understand what that metric really means?”

A number of trends have contributed to the growing alcohol content of a drink.

Martinez has found that between 2003 and 2016 the average alcohol percentage of beer, wine and spirits all rose.

The climate might be partially to blame. The online wine database Liv-ex has found warmer growing seasons are producing grapes with more alcohol. The alcohol in the average Bordeaux red wine rose from 12.8% in the 1990s to 13.8% in the 2010s, with California reds increasing from 13.7% to 14.6% and reds from Tuscany up from 13.7% to 14.2%.

Blame generous bartenders, too. In one amusing study, researchers were dispatched across California bars to order beer, wine, shots, margaritas and mixed drinks such as rum and Coke. Each drink’s alcohol content was then “discreetly measured using graduated cylinders and beakers at a relatively private table or in the bathroom.”

Nearly every drink contained more alcohol than a “standard” drink, some nearly twice as much.

But this isn’t the only reason drinkers die sooner than nondrinkers.

The widespread notion that modest drinkers live longer than nondrinkers and heavy drinkers is what researchers call the “J-shaped” relationship between alcohol and health, which dates back to Johns Hopkins University research during Prohibition. The idea is that drinking a little bit might protect your health relative to not drinking at all, but as consumption goes toward excess, health outcomes get bad and then very bad.

In 2017 a team of researchers in the Journal of the American College of Cardiology found mortality risks are somewhat lower at as many as roughly six drinks a week, then get worse. By 13 drinks a week—about two drinks a day—risks are rising quickly.

The J-shaped curve remains controversial. People who abstain from alcohol entirely might be different than the general population: They might have illnesses or be on medications where they’re advised not to drink, for example. It might not be modest drinking that makes people healthier. Rather, people might drink modestly when they’re already healthy.

The disagreement over whether the J shape exists is only about the very start of the curve. Everyone agrees that risks start to rise quite quickly as drinking increases beyond modest amounts.”

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Why You Might Be Drinking Too Much Without Knowing It / The Wall Street Journal

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