The authors of this paper use very questionable data to suggest that drinking guidelines for all countries should be lowered to no more than 1 drink/day. In their analyses, they make a very large number of assumptions, including adding 80% to reported amounts of alcohol for all subjects to make up for alcohol disappearance data, and do not modify this according to their individual likelihood of being an under-reporter of intake. Further, they are not able to adjust for the pattern of drinking or type of beverage consumed, and it is considered bizarre that they grouped ex-drinkers (many of whom were apparently heavy drinkers) with current drinkers who report consuming within the guidelines to state that such subjects have a high risk of adverse effects. From the numbers presented in the tables in this paper, the risk of alcohol-attributable death for consumers of alcohol within-guidelines was fifty times lower than for those consuming above the guidelines. Such deficiencies in methodology, and especially possibly deliberate combinations of groups to support their premise, make it impossible to utilize their conclusions for setting guidelines for “low-risk” drinking.
Further, their conclusions do not reflect what the vast majority of well-done epidemiologic studies have shown for decades that light-to-moderate alcohol consumption (when defined as up to 1 drink/day for women and up to 2 drinks/day for men and not consumed in binges) is associated with a significant decrease in the risk of cardiovascular mortality as well as total mortality. The results of the current paper are not sufficient to warrant changing drinking guidelines.
Reference: Sherk A, Thomas G, Churchill S, Stockwell T. Does Drinking Within Low-Risk Guidelines Prevent Harm? Implications for High-Income Countries Using the International Model of Alcohol Harms and Policies. J Stud Alcohol Drugs 2020;81:352–361.