No amount of alcohol is safe for those under age 40, according to an international study funded by the Bill and Melinda Gates Foundation.

Some older adults may benefit slightly from drinking a small amount of alcohol, according to a study published this week in The Lancet

The global study estimates 1.34 billion people across 204 countries, most of them male, consumed harmful amounts of alcohol in 2020. The study said that 60% of alcohol-related injuries, including vehicle crashes, suicides and homicides, happen among those ages 15 to 39.

Further, 1.78 million deaths in 2020 were due to alcohol use, which is the leading risk factor for death in men between the ages of 15 and 49.

To estimate the risks, the researchers looked at 22 possible health outcomes from drinking booze, including the risk of being injured, cardiovascular disease, diabetes, cirrhosis, pancreatitis, epilepsy and a variety of cancers, among others. They got the data from the 2020 Global Burden of Disease study wave, which included both males and females ages 15 to 95.

They also compared how much alcohol an individual could drink with no excess health risk, compared to someone who didn’t imbibe at all.

The findings were sobering.

People ages 15 to 39 can only safely consume one-tenth of a standard drink. The study defines a standard drink as 3.4 fluid ounces of red wine at 13% alcohol by volume; a 12-ounce can or bottle of beer containing 3.5% alcohol by volume; or 1 ounce of spirits at 40% alcohol by volume.

“By definition, the study’s findings suggested that alcohol stops being ‘safe’ to consume for under 40s around two teaspoons of red wine or two-and-a-half tablespoons of beer,” Fortune reported.

The research is part of the foundation’s Global Burden of Disease study, which began in 1990, described by the Lancet as “the most comprehensive effort to date to understand the changing health challenges around the world.” 

Drafting guidelines

The report noted, however, that risks of consuming alcohol vary by age and by geographic location and those should be noted when drafting guidelines. Of all the factors they considered, age and sex proved most important.

Risks vary for those over 40. According to the report, consuming a small amount of alcohol might provide some health benefits for those who don’t have underlying health conditions. A little alcohol might reduce the risk of developing heart disease, stroke or diabetes, the study reported.

The study authors emphasize a need to create alcohol guidelines specifically for males younger than 40, since they are the most apt to be problem drinkers.

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Although the report found the risks to be similar for males and females, it noted that males are more prone to alcohol consumption: more of them drink and they drink considerably more than females in their age category.

“Our message is simple: Young people should not drink, but older people may benefit from drinking small amounts,” said Dr. Emmanuela Gakidou, senior study author and a professor at the University of Washington School of Medicine.

“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,” she said in a news release about the study. 

What they studied

The “disease burden” of any age group depended largely on differences across regions, so the risk from alcohol consumption was different, too — especially for those over 40. The health risk for alcohol consumption is different in areas where heart disease is more common, or where certain cancers are often found.

For example, the report determined that for those 55-59 in north Africa and the Middle East, health risks from alcohol occurred with a single standard drink. But in central sub-Saharan Africa, risks began at about half a standard drink.

“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,” Dana Bryazka, the study’s lead author and a researcher at the Institute for Health Metrics and Evaluation at the University of Washington, said in the news release.

The study had some limitations, the report said, including not looking at drinking patterns. That meant the researchers could not tell if the results were different for those who drink a lot on rare occasion compared to those who drink that same total amount spread over several days.

They also noted that alcohol use was self-reported and might not be entirely accurate.

Finally, the study didn’t include alcohol consumption during the COVID-19 pandemic “due to pandemic-related delays with routine data collection, which could also have affected these estimates,” the report said.

Dueling findings

Fortune noted a couple of past studies with similar findings:

  • An Oxford University study in 2021, that has not yet been peer-reviewed, that showed there is “no safe dose of alcohol” for brain health.
  • An Irish study in May that found alcohol may pose greater risks to the heart than previously believed.

But Newsweek’s report on the study noted “much debate about the health effects of consuming alcohol, with seemingly contradictory evidence published, leading to confusion among the general public, for example, about whether or not red wine is good or bad for them.”

The findings show “the importance of alcohol recommendations that are tailored to specific regions and populations,” Amanda Berger, vice president of science and health for the trade group Distilled Spirits Council of the United States, told CNN of the new report. “Importantly, no one should drink alcohol to obtain potential health benefits, and some individuals should not drink at all.”

Not everyone agreed there’s any health benefit to be found in alcohol consumption. CNN quoted a written statement from Dr. Tony Rao, visiting clinical research fellow at King’s College London: “We know that any purported health benefits from alcohol on the heart and circulation are balanced out by the increased risk from other conditions such as cancer, liver disease and mental disorders such as depression and dementia.”