Maintaining existing limits seems justified on current evidence

The complex relation between alcohol consumption and various diseases has been explored for centuries. Britain's Royal Colleges of Physicians, Psychiatrists, and General Practitioners recently reviewed the totality of evidence in order to readdress recommendations for “sensible limits” for the general public.1 2

We concur with the authors that the issue is complicated by several factors. Firstly, except for violent deaths attributable to acute intoxication, the risks and benefits of alcohol consumption are likely to accrue over years or even decades. Secondly, quantitative assessment of drinking is generally based on self reporting, which may lead to some misclassification. Thirdly, changes in drinking habits over time are rarely updated in prospective studies. Fourthly, consumption of alcoholic beverages tends to be embedded in cultural practices, which are in turn associated with several lifestyle factors. Fifthly, ethanol is a constituent of several different types of beverage, whose other constituents may also affect the risks of disease. Finally, the precise mechanisms by which alcohol affects coronary heart disease are still far from understood.

Despite these inherent …