It’s no wonder if Australians are confused about how much to drink, given the conflicting advice on offer.

The National Health and Medical Research Council’s 2001 document on alcohol’s health effects says that to minimise risk and gain benefits, men should drink an average of no more than four standard drinks daily, and women should have no more than two.

But the Council’s 2003 dietary guidelines took a tougher stance because they also considered alcohol’s contribution to energy intake, and these advise that men have an average of no more than two standard drinks a day, and that women should have no more than one.

Perhaps the discrepancy doesn’t really matter so much, given that many people haven’t a clue what makes a standard drink (it’s equivalent to a 100ml glass of wine, or one can of mid-strength beer or a 30ml nip of spirits — more examples here).

Meanwhile, pregnant women wondering whether it is safe to drink are given quite different advice according to who they ask, according to a recent review of the various guidelines and policies on offer. Some health departments and professional groups recommend abstinence, but others do not.

However, we can expect some resolution of this mess soon, say the experts currently updating the NHMRC’s 2001 guidelines. Their draft review, expected to be released for public comment in August, is expected to take a tougher line on drinking in pregnancy, warning that its safety cannot be guaranteed.

The revised guidelines are also likely to highlight concerns about alcohol’s impact on young people’s development and predisposition to later mental health problems and addictions, and to make recommendations specific to children, teenagers and young adults. They will probably also acknowledge concerns that older people may also be particularly vulnerable to alcohol’s harmful effects.

But the guidelines will likely also highlight the many uncertainties surrounding alcohol’s impact on health. Professor Jon Currie, director of addiction medicine at St Vincent’s Hospital in Melbourne and chair of the review, says plenty of accepted wisdoms are not backed by reliable evidence.

He is particularly worried by the notion that it’s a good idea to introduce children to watered-down wine as part of a so-called Mediterranean diet. “It’s very worrying when you realise how popular that mythology is out there,” he says.

Meanwhile, mounting evidence about alcohol’s adverse impact on young bodies has prompted Professor Steve Allsop, Director of the National Drug Research Institute in Perth, to rethink his own parenting behaviour.

“I personally as a father have become more conservative in my views about young people and drinking because of recent research looking at the impact of alcohol on the developing mind and body,” he says. “It’s not conclusive from a scientific point of view, but from a parental point of view it’s making me a bit more conservative about my 16-year-old drinking — I’m delaying it as long as possible.”
Of course, the guidelines in themselves are unlikely to have any impact on hazardous drinking. What really counts is whether there will be the political will and funding to see their recommendations promoted and implemented. Watch this space…

Tomorrow: A spin doctor’s advice to the alcohol industry