Young people face higher health risks from alcohol consumption than older adults, according to a new analysis published in the British medical journal The Lancet. 

The study – the first to report alcohol risk by geographical region, age, sex and year – suggests that global alcohol consumption recommendations should be based on age and location, with the strictest guidelines targeted toward males between ages 15-39, who are at the greatest risk of harmful alcohol consumption worldwide.

The research also indicates that adults aged 40 and older without underlying health conditions may see some benefits from small alcohol consumption (between one and two standard drinks per day), including a reduced risk in cardiovascular disease, stroke, and diabetes.

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Using estimates of alcohol use in 204 countries, researchers calculated that 1.34 billion people consumed harmful amounts in 2020. 

In every region, the largest segment of the population drinking unsafe amounts of alcohol were males aged 15-39 and for this age group, drinking alcohol does not provide any health benefits and presents many health risks, with 60 percent of alcohol-related injuries occurring among people in this age group, including motor vehicle accidents, suicides, and homicides.

"Our message is simple: young people should not drink, but older people may benefit from drinking small amounts," said senior author Emmanuela Gakidou, 

"While it may not be realistic to think young adults will abstain from drinking, we do think it's important to communicate the latest evidence so that everyone can make informed decisions about their health," continued Gakidou, a professor of health metrics sciences at the Institute for Health Metrics and Evalation (IHME) at the University of Washington's School of Medicine. 

How much alcohol can a person consume?

The study also estimates another critical quantity – how much alcohol a person can drink before taking on excess risk to their health compared to someone who does not drink any alcohol.

The recommended amount of alcohol for people aged 15-39 before risking health loss was 0.136 standard drinks per day – a little more than one-tenth of a standard drink.

That amount was slightly higher for females in the same age range, at 0.273 drinks – about a quarter of a standard drink per day. 

"Our estimates, based on currently available evidence, support guidelines that differ by age and region," said lead author Dana Bryazka, a researcher at IHME.

"Understanding the variation in the level of alcohol consumption that minimizes the risk of health loss for populations can aid in setting effective consumption guidelines, supporting alcohol control policies, monitoring progress in reducing harmful alcohol use, and designing public health risk messaging."

Among individuals consuming harmful amounts of alcohol in 2020, 59.1 percent were age 15-39 years, and 76.7 percent were male, with 1.03 billion males and 0.312 billion females drinking harmful amounts of alcohol. 

Varying patterns of drinking

Harmful use of alcohol was particularly concentrated in young males in Australasia, western Europe and central Europe.

"Although the risks associated with alcohol consumption are similar for males and females, young males stood out as the group with the highest level of harmful alcohol consumption," said Gakidou.

"This is because a larger proportion of males compared to females consume alcohol and their average level of consumption is also significantly higher."

The authors acknowledge some limitations with this paper, including that patterns of drinking were not examined. 

Therefore, this study did not distinguish between individuals who infrequently engage in heavy episodic drinking and those who consume the same amount of alcohol over several days. 

Alcohol consumption was also self-reported, which could have introduced bias, and the study could not include data on consumption during the COVID-19 pandemic due to pandemic-related delays with routine data collection, which could also have affected these estimates.