What is moderate drinking

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While it is generally agreed that we should do all things in moderation [58], there is less agreement about the precise definition of 'moderate' drinking. Use of different sets of drinking categories in different reports has resulted in different interpretations, and the number and boundaries of categories appears to be determined by the sample size available in the study. Classification of moderate alcohol consumption ranges from a half a drink per day (or less) in some studies, up to six drinks a day in others [59], Data from the National Health Interview Survey [52] demonstrated that people with different drinking habits perceived 'moderate' drinking differently. Only 25% of men who drink 3 or more drinks per day, in comparison to 56% of other men, considered 2 or fewer drinks per occasion as moderate. Likewise, only 6% of the women who drink at least 2 drinks per day (vs. 27% of other women) perceived moderate drinking as 1 drink or less per occasion. The National Health and Medical Research Council [60] in Australia has recommended responsible, hazardous and harmful levels of alcohol intake for the public. Not exceeding 4 standard drinks per day for men and 2 drinks for women is recommended as 'safe and responsible' drinking. In England, the Royal College ofPhysicians, Psychiatrists, and General Practitioners [61] advised a 'sensible' limit of alcohol intake of21 units per week (~16 drinks in the US) for men and 14 units (~11 drinks) for women. The US Dietary Guidelines Advisory Committee [62] on the Dietary Guidelines for Americans defined moderate drinking as no more than 2 drinks per day for men and no more than 1 drink per day for women. There is a very high correlation between the mean level of alcohol consumption in a community and the prevalence of heavy drinkers, such that an increase in consumption of only 15g per week might be associated with a 10% increase in the prevalence of heavy drinkers [63 ]. Hence, an appropriate definition of the optimal level of drinking has important public health implications.

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