Since my 20s, I have drunk on average a bottle of wine a day. I鈥檓 57. That鈥檚 49 UK alcohol units a week. The UK鈥檚 recommended weekly limit for a man is 28 units. I recently had a health check at my local clinic, and I鈥檓 in perfect health. Specifically, my liver function tests are entirely normal. Am I exceptional or are the government limits spurious? I rarely drink spirits and occasionally substitute beer for wine. I play football and squash. I walk 3 kilometres to and from work. I lead a normal life and, probably due to regular consumption, I never feel drunk, but presumably I am considered a binge drinker. I don鈥檛 want advice from a government minister or associated medic. I want objective information. Am I lucky? Or is my consumption relatively harmless? What鈥檚 the truth?
A is 10 millilitres (8 grams) of alcohol 鈥� Ed
鈥� The questioner may not be getting away with his alcohol consumption as lightly as he thinks. The liver has a remarkable ability to carry on working, and liver function tests may remain normal even when the organ is quite badly damaged. The test is more sensitive than other enzyme tests at detecting damage, but it is often not offered to National Health Service patients in the UK because of its cost.
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I also think the writer has underestimated his consumption. If he really drinks a bottle of wine a day then, given the strength of typical popular wines, I would estimate that he could be drinking more than 60 units a week. In more than 30 years of general practice, almost everyone I encountered drinking more than 40 units a week was damaging his or her health in some way, through addiction, hypertension, liver or gastric problems, or mental problems.
鈥淎nyone drinking more than 40 units of alcohol a week is damaging their health in some way鈥�
That said, government advice on alcohol consumption is necessarily arbitrary, as there is great genetic variation in the way that people metabolise and tolerate alcohol.
Anthony Daniel, General practitioner, Sevenoaks, Kent, UK
鈥� The short answer is that, like a 90-year-old smoker, you are just lucky. The government limits of 2 or 3 units per day for women and 3 or 4 units per day for men are based on epidemiological evidence. The complex mix of factors influencing our health makes it impossible to issue cast-iron predictions of what will happen to a particular individual at a given level of consumption.
One bottle of wine typically contains 10 UK units or about 80 grams of alcohol. Drinking a bottle a day has been shown to increase the risk of liver cirrhosis 18-fold. You are also five times as likely to get cancer of the mouth, and two to three times as likely to get laryngeal or oesophageal cancer, to have a stroke, or to suffer from essential hypertension or chronic pancreatitis.
These are relative risks. What they are relative to will depend on a number of factors, including genetics. The liver is vulnerable to excess fat, so an active lifestyle and low-fat diet will reduce the risk of liver disease.
Rachel Seabrook, Institute of Alcohol Studies, St Ives, Cambridgeshire, UK