Population-level risks of alcohol consumption by amount, geography, age, sex, and year: a systematic analysis for the Global Burden of Disease Study 2020

GBD 2020 Alcohol Collaborators

doi:10.1016/S0140-6736(22)00847-9

Population-level risks of alcohol consumption by amount, geography, age, sex, and year: a systematic analysis for the Global Burden of Disease Study 2020

GBD 2020 Alcohol Collaborators

Research output: Contribution to journal › Article › peer-review

234 Scopus citations

Abstract

Background: The health risks associated with moderate alcohol consumption continue to be debated. Small amounts of alcohol might lower the risk of some health outcomes but increase the risk of others, suggesting that the overall risk depends, in part, on background disease rates, which vary by region, age, sex, and year. Methods: For this analysis, we constructed burden-weighted dose–response relative risk curves across 22 health outcomes to estimate the theoretical minimum risk exposure level (TMREL) and non-drinker equivalence (NDE), the consumption level at which the health risk is equivalent to that of a non-drinker, using disease rates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2020 for 21 regions, including 204 countries and territories, by 5-year age group, sex, and year for individuals aged 15–95 years and older from 1990 to 2020. Based on the NDE, we quantified the population consuming harmful amounts of alcohol. Findings: The burden-weighted relative risk curves for alcohol use varied by region and age. Among individuals aged 15–39 years in 2020, the TMREL varied between 0 (95% uncertainty interval 0–0) and 0·603 (0·400–1·00) standard drinks per day, and the NDE varied between 0·002 (0–0) and 1·75 (0·698–4·30) standard drinks per day. Among individuals aged 40 years and older, the burden-weighted relative risk curve was J-shaped for all regions, with a 2020 TMREL that ranged from 0·114 (0–0·403) to 1·87 (0·500–3·30) standard drinks per day and an NDE that ranged between 0·193 (0–0·900) and 6·94 (3·40–8·30) standard drinks per day. Among individuals consuming harmful amounts of alcohol in 2020, 59·1% (54·3–65·4) were aged 15–39 years and 76·9% (73·0–81·3) were male. Interpretation: There is strong evidence to support recommendations on alcohol consumption varying by age and location. Stronger interventions, particularly those tailored towards younger individuals, are needed to reduce the substantial global health loss attributable to alcohol. Funding: Bill & Melinda Gates Foundation.

Original language	English
Pages (from-to)	185-235
Number of pages	51
Journal	The Lancet
Volume	400
Issue number	10347
DOIs	https://doi.org/10.1016/S0140-6736(22)00847-9
State	Published - Jul 16 2022

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10.1016/S0140-6736(22)00847-9

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@article{d95a236348de4c92a29fca26c59f62a3,

title = "Population-level risks of alcohol consumption by amount, geography, age, sex, and year: a systematic analysis for the Global Burden of Disease Study 2020",

abstract = "Background: The health risks associated with moderate alcohol consumption continue to be debated. Small amounts of alcohol might lower the risk of some health outcomes but increase the risk of others, suggesting that the overall risk depends, in part, on background disease rates, which vary by region, age, sex, and year. Methods: For this analysis, we constructed burden-weighted dose–response relative risk curves across 22 health outcomes to estimate the theoretical minimum risk exposure level (TMREL) and non-drinker equivalence (NDE), the consumption level at which the health risk is equivalent to that of a non-drinker, using disease rates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2020 for 21 regions, including 204 countries and territories, by 5-year age group, sex, and year for individuals aged 15–95 years and older from 1990 to 2020. Based on the NDE, we quantified the population consuming harmful amounts of alcohol. Findings: The burden-weighted relative risk curves for alcohol use varied by region and age. Among individuals aged 15–39 years in 2020, the TMREL varied between 0 (95% uncertainty interval 0–0) and 0·603 (0·400–1·00) standard drinks per day, and the NDE varied between 0·002 (0–0) and 1·75 (0·698–4·30) standard drinks per day. Among individuals aged 40 years and older, the burden-weighted relative risk curve was J-shaped for all regions, with a 2020 TMREL that ranged from 0·114 (0–0·403) to 1·87 (0·500–3·30) standard drinks per day and an NDE that ranged between 0·193 (0–0·900) and 6·94 (3·40–8·30) standard drinks per day. Among individuals consuming harmful amounts of alcohol in 2020, 59·1% (54·3–65·4) were aged 15–39 years and 76·9% (73·0–81·3) were male. Interpretation: There is strong evidence to support recommendations on alcohol consumption varying by age and location. Stronger interventions, particularly those tailored towards younger individuals, are needed to reduce the substantial global health loss attributable to alcohol. Funding: Bill & Melinda Gates Foundation.",

author = "{GBD 2020 Alcohol Collaborators} and Dana Bryazka and Reitsma, {Marissa B.} and Griswold, {Max G.} and Abate, {Kalkidan Hassen} and Cristiana Abbafati and Mohsen Abbasi-Kangevari and Zeinab Abbasi-Kangevari and Amir Abdoli and Mohammad Abdollahi and Abdullah, {Abu Yousuf Md} and Abhilash, {E. S.} and Eman Abu-Gharbieh and Acuna, {Juan Manuel} and Giovanni Addolorato and Adebayo, {Oladimeji M.} and Victor Adekanmbi and Kishor Adhikari and Sangeet Adhikari and Adnani, {Qorinah Estiningtyas Sakilah} and Saira Afzal and Agegnehu, {Wubetu Yimam} and Manik Aggarwal and Ahinkorah, {Bright Opoku} and Ahmad, {Araz Ramazan} and Sajjad Ahmad and Tauseef Ahmad and Ali Ahmadi and Sepideh Ahmadi and Haroon Ahmed and {Ahmed Rashid}, Tarik and Akunna, {Chisom Joyqueenet} and {Al Hamad}, Hanadi and Alam, {Md Zakiul} and Alem, {Dejene Tsegaye} and Alene, {Kefyalew Addis} and Yousef Alimohamadi and Atiyeh Alizadeh and Kasim Allel and Jordi Alonso and Saba Alvand and Nelson Alvis-Guzman and Firehiwot Amare and Ameyaw, {Edward Kwabena} and Sohrab Amiri and Robert Ancuceanu and Anderson, {Jason A.} and Andrei, {Catalina Liliana} and Tudorel Andrei and Jalal Arabloo and Muhammad Arshad and Artamonov, {Anton A.} and Zahra Aryan and Malke Asaad and Asemahagn, {Mulusew A.} and Thomas Astell-Burt and Athari, {Seyyed Shamsadin} and Atnafu, {Desta Debalkie} and Prince Atorkey and Alok Atreya and Floriane Ausloos and Marcel Ausloos and Getinet Ayano and Ayanore, {Martin Amogre} and Ayinde, {Olatunde O.} and Ayuso-Mateos, {Jose L.} and Sina Azadnajafabad and Azanaw, {Melkalem Mamuye} and Mohammadreza Azangou-Khyavy and {Azari Jafari}, Amirhossein and Azzam, {Ahmed Y.} and Badiye, {Ashish D.} and Nasser Bagheri and Sara Bagherieh and Mohan Bairwa and Bakkannavar, {Shankar M.} and Bakshi, {Ravleen Kaur} and Bilchut, {Awraris Hailu Balchut} and B{\"a}rnighausen, {T. W.} and Fabio Barra and Amadou Barrow and Pritish Baskaran and Luis Belo and Bennett, {Derrick A.} and Bensenor, {Isabela M.} and Bhagavathula, {Akshaya Srikanth} and Neeraj Bhala and Ashish Bhalla and Nikha Bhardwaj and Pankaj Bhardwaj and Sonu Bhaskar and Krittika Bhattacharyya and Bhojaraja, {Vijayalakshmi S.} and Bintoro, {Bagas Suryo} and Blokhina, {Elena A.Elena} and Bodicha, {Belay Boda Abule} and Archith Boloor and Cristina Bosetti and Dejana Braithwaite and Hermann Brenner and Briko, {Nikolay Ivanovich} and Brunoni, {Andre R.} and Butt, {Zahid A.} and Chao Cao and Yin Cao and Rosario C{\'a}rdenas and Carvalho, {Andre F.} and M{\'a}rcia Carvalho and Castaldelli-Maia, {Joao Mauricio} and Giulio Castelpietra and Castro-De-Araujo, {Luis F.S.} and Cattaruzza, {Maria Sofia} and Chakraborty, {Promit Ananyo} and Jaykaran Charan and Chattu, {Vijay Kumar} and Akhilanand Chaurasia and Nicolas Cherbuin and Chu, {Dinh Toi} and Nandita Chudal and Chung, {Sheng Chia} and Chuchu Churko and Ciobanu, {Liliana G.} and Massimo Cirillo and Claro, {Rafael M.} and Simona Costanzo and Cowden, {Richard G.} and Criqui, {Michael H.} and Nat{\'a}lia Cruz-Martins and Culbreth, {Garland T.} and Dachew, {Berihun Assefa} and Omid Dadras and Xiaochen Dai and Giovanni Damiani and Lalit Dandona and Rakhi Dandona and Daniel, {Beniam Darge} and Anna Danielewicz and {Darega Gela}, Jiregna and Kairat Davletov and {de Araujo}, {Jacyra Azevedo Paiva} and {De S{\'a}}, {Antonio Reis} and Debela, {Sisay Abebe} and Azizallah Dehghan and Demetriades, {Andreas K.} and {Derbew Molla}, Meseret and Rupak Desai and Desta, {Abebaw Alemayehu} and {Dias da Silva}, Diana and Daniel Diaz and Digesa, {Lankamo Ena} and Mengistie Diress and Milad Dodangeh and Deepa Dongarwar and Fariba Dorostkar and Dsouza, {Haneil Larson} and Bereket Duko and Duncan, {Bruce B.} and Kristina Edvardsson and Michael Ekholuenetale and Elgar, {Frank J.} and Muhammed Elhadi and Elmonem, {Mohamed A.} and Endries, {Aman Yesuf} and Sharareh Eskandarieh and Azin Etemadimanesh and Fagbamigbe, {Adeniyi Francis} and Fakhradiyev, {Ildar Ravisovich} and Fatemeh Farahmand and {S{\'a} Farinha}, {Carla Sofia E.} and Andre Faro and Farshad Farzadfar and Ali Fatehizadeh and Fauk, {Nelsensius Klau} and Feigin, {Valery L.} and Rachel Feldman and Xiaoqi Feng and Zinabu Fentaw and Simone Ferrero and {Ferro Desideri}, Lorenzo and Irina Filip and Florian Fischer and Francis, {Joel Msafiri} and Franklin, {Richard Charles} and Gaal, {Peter Andras} and Gad, {Mohamed M.} and Silvano Gallus and Fabio Galvano and Balasankar Ganesan and Tushar Garg and Gebrehiwot, {Mesfin Gebrehiwot Damtew} and Gebremeskel, {Teferi Gebru} and Gebremichael, {Mathewos Alemu} and Gemechu, {Tadele Regasa} and Lemma Getacher and Getachew, {Motuma Erena} and {Getachew Obsa}, Abera and Asmare Getie and Amir Ghaderi and Mansour Ghafourifard and Alireza Ghajar and Ghamari, {Seyyed Hadi}",

note = "Publisher Copyright: {\textcopyright} 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license",

year = "2022",

month = jul,

day = "16",

doi = "10.1016/S0140-6736(22)00847-9",

language = "English",

volume = "400",

pages = "185--235",

journal = "The Lancet",

issn = "0140-6736",

number = "10347",

}

TY - JOUR

T1 - Population-level risks of alcohol consumption by amount, geography, age, sex, and year

T2 - a systematic analysis for the Global Burden of Disease Study 2020

AU - GBD 2020 Alcohol Collaborators

AU - Bryazka, Dana

AU - Reitsma, Marissa B.

AU - Griswold, Max G.

AU - Abate, Kalkidan Hassen

AU - Abbafati, Cristiana

AU - Abbasi-Kangevari, Mohsen

AU - Abbasi-Kangevari, Zeinab

AU - Abdoli, Amir

AU - Abdollahi, Mohammad

AU - Abdullah, Abu Yousuf Md

AU - Abhilash, E. S.

AU - Abu-Gharbieh, Eman

AU - Acuna, Juan Manuel

AU - Addolorato, Giovanni

AU - Adebayo, Oladimeji M.

AU - Adekanmbi, Victor

AU - Adhikari, Kishor

AU - Adhikari, Sangeet

AU - Adnani, Qorinah Estiningtyas Sakilah

AU - Afzal, Saira

AU - Agegnehu, Wubetu Yimam

AU - Aggarwal, Manik

AU - Ahinkorah, Bright Opoku

AU - Ahmad, Araz Ramazan

AU - Ahmad, Sajjad

AU - Ahmad, Tauseef

AU - Ahmadi, Ali

AU - Ahmadi, Sepideh

AU - Ahmed, Haroon

AU - Ahmed Rashid, Tarik

AU - Akunna, Chisom Joyqueenet

AU - Al Hamad, Hanadi

AU - Alam, Md Zakiul

AU - Alem, Dejene Tsegaye

AU - Alene, Kefyalew Addis

AU - Alimohamadi, Yousef

AU - Alizadeh, Atiyeh

AU - Allel, Kasim

AU - Alonso, Jordi

AU - Alvand, Saba

AU - Alvis-Guzman, Nelson

AU - Amare, Firehiwot

AU - Ameyaw, Edward Kwabena

AU - Amiri, Sohrab

AU - Ancuceanu, Robert

AU - Anderson, Jason A.

AU - Andrei, Catalina Liliana

AU - Andrei, Tudorel

AU - Arabloo, Jalal

AU - Arshad, Muhammad

AU - Artamonov, Anton A.

AU - Aryan, Zahra

AU - Asaad, Malke

AU - Asemahagn, Mulusew A.

AU - Astell-Burt, Thomas

AU - Athari, Seyyed Shamsadin

AU - Atnafu, Desta Debalkie

AU - Atorkey, Prince

AU - Atreya, Alok

AU - Ausloos, Floriane

AU - Ausloos, Marcel

AU - Ayano, Getinet

AU - Ayanore, Martin Amogre

AU - Ayinde, Olatunde O.

AU - Ayuso-Mateos, Jose L.

AU - Azadnajafabad, Sina

AU - Azanaw, Melkalem Mamuye

AU - Azangou-Khyavy, Mohammadreza

AU - Azari Jafari, Amirhossein

AU - Azzam, Ahmed Y.

AU - Badiye, Ashish D.

AU - Bagheri, Nasser

AU - Bagherieh, Sara

AU - Bairwa, Mohan

AU - Bakkannavar, Shankar M.

AU - Bakshi, Ravleen Kaur

AU - Bilchut, Awraris Hailu Balchut

AU - Bärnighausen, T. W.

AU - Barra, Fabio

AU - Barrow, Amadou

AU - Baskaran, Pritish

AU - Belo, Luis

AU - Bennett, Derrick A.

AU - Bensenor, Isabela M.

AU - Bhagavathula, Akshaya Srikanth

AU - Bhala, Neeraj

AU - Bhalla, Ashish

AU - Bhardwaj, Nikha

AU - Bhardwaj, Pankaj

AU - Bhaskar, Sonu

AU - Bhattacharyya, Krittika

AU - Bhojaraja, Vijayalakshmi S.

AU - Bintoro, Bagas Suryo

AU - Blokhina, Elena A.Elena

AU - Bodicha, Belay Boda Abule

AU - Boloor, Archith

AU - Bosetti, Cristina

AU - Braithwaite, Dejana

AU - Brenner, Hermann

AU - Briko, Nikolay Ivanovich

AU - Brunoni, Andre R.

AU - Butt, Zahid A.

AU - Cao, Chao

AU - Cao, Yin

AU - Cárdenas, Rosario

AU - Carvalho, Andre F.

AU - Carvalho, Márcia

AU - Castaldelli-Maia, Joao Mauricio

AU - Castelpietra, Giulio

AU - Castro-De-Araujo, Luis F.S.

AU - Cattaruzza, Maria Sofia

AU - Chakraborty, Promit Ananyo

AU - Charan, Jaykaran

AU - Chattu, Vijay Kumar

AU - Chaurasia, Akhilanand

AU - Cherbuin, Nicolas

AU - Chu, Dinh Toi

AU - Chudal, Nandita

AU - Chung, Sheng Chia

AU - Churko, Chuchu

AU - Ciobanu, Liliana G.

AU - Cirillo, Massimo

AU - Claro, Rafael M.

AU - Costanzo, Simona

AU - Cowden, Richard G.

AU - Criqui, Michael H.

AU - Cruz-Martins, Natália

AU - Culbreth, Garland T.

AU - Dachew, Berihun Assefa

AU - Dadras, Omid

AU - Dai, Xiaochen

AU - Damiani, Giovanni

AU - Dandona, Lalit

AU - Dandona, Rakhi

AU - Daniel, Beniam Darge

AU - Danielewicz, Anna

AU - Darega Gela, Jiregna

AU - Davletov, Kairat

AU - de Araujo, Jacyra Azevedo Paiva

AU - De Sá, Antonio Reis

AU - Debela, Sisay Abebe

AU - Dehghan, Azizallah

AU - Demetriades, Andreas K.

AU - Derbew Molla, Meseret

AU - Desai, Rupak

AU - Desta, Abebaw Alemayehu

AU - Dias da Silva, Diana

AU - Diaz, Daniel

AU - Digesa, Lankamo Ena

AU - Diress, Mengistie

AU - Dodangeh, Milad

AU - Dongarwar, Deepa

AU - Dorostkar, Fariba

AU - Dsouza, Haneil Larson

AU - Duko, Bereket

AU - Duncan, Bruce B.

AU - Edvardsson, Kristina

AU - Ekholuenetale, Michael

AU - Elgar, Frank J.

AU - Elhadi, Muhammed

AU - Elmonem, Mohamed A.

AU - Endries, Aman Yesuf

AU - Eskandarieh, Sharareh

AU - Etemadimanesh, Azin

AU - Fagbamigbe, Adeniyi Francis

AU - Fakhradiyev, Ildar Ravisovich

AU - Farahmand, Fatemeh

AU - Sá Farinha, Carla Sofia E.

AU - Faro, Andre

AU - Farzadfar, Farshad

AU - Fatehizadeh, Ali

AU - Fauk, Nelsensius Klau

AU - Feigin, Valery L.

AU - Feldman, Rachel

AU - Feng, Xiaoqi

AU - Fentaw, Zinabu

AU - Ferrero, Simone

AU - Ferro Desideri, Lorenzo

AU - Filip, Irina

AU - Fischer, Florian

AU - Francis, Joel Msafiri

AU - Franklin, Richard Charles

AU - Gaal, Peter Andras

AU - Gad, Mohamed M.

AU - Gallus, Silvano

AU - Galvano, Fabio

AU - Ganesan, Balasankar

AU - Garg, Tushar

AU - Gebrehiwot, Mesfin Gebrehiwot Damtew

AU - Gebremeskel, Teferi Gebru

AU - Gebremichael, Mathewos Alemu

AU - Gemechu, Tadele Regasa

AU - Getacher, Lemma

AU - Getachew, Motuma Erena

AU - Getachew Obsa, Abera

AU - Getie, Asmare

AU - Ghaderi, Amir

AU - Ghafourifard, Mansour

AU - Ghajar, Alireza

AU - Ghamari, Seyyed Hadi

PY - 2022/7/16

Y1 - 2022/7/16

N2 - Background: The health risks associated with moderate alcohol consumption continue to be debated. Small amounts of alcohol might lower the risk of some health outcomes but increase the risk of others, suggesting that the overall risk depends, in part, on background disease rates, which vary by region, age, sex, and year. Methods: For this analysis, we constructed burden-weighted dose–response relative risk curves across 22 health outcomes to estimate the theoretical minimum risk exposure level (TMREL) and non-drinker equivalence (NDE), the consumption level at which the health risk is equivalent to that of a non-drinker, using disease rates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2020 for 21 regions, including 204 countries and territories, by 5-year age group, sex, and year for individuals aged 15–95 years and older from 1990 to 2020. Based on the NDE, we quantified the population consuming harmful amounts of alcohol. Findings: The burden-weighted relative risk curves for alcohol use varied by region and age. Among individuals aged 15–39 years in 2020, the TMREL varied between 0 (95% uncertainty interval 0–0) and 0·603 (0·400–1·00) standard drinks per day, and the NDE varied between 0·002 (0–0) and 1·75 (0·698–4·30) standard drinks per day. Among individuals aged 40 years and older, the burden-weighted relative risk curve was J-shaped for all regions, with a 2020 TMREL that ranged from 0·114 (0–0·403) to 1·87 (0·500–3·30) standard drinks per day and an NDE that ranged between 0·193 (0–0·900) and 6·94 (3·40–8·30) standard drinks per day. Among individuals consuming harmful amounts of alcohol in 2020, 59·1% (54·3–65·4) were aged 15–39 years and 76·9% (73·0–81·3) were male. Interpretation: There is strong evidence to support recommendations on alcohol consumption varying by age and location. Stronger interventions, particularly those tailored towards younger individuals, are needed to reduce the substantial global health loss attributable to alcohol. Funding: Bill & Melinda Gates Foundation.

AB - Background: The health risks associated with moderate alcohol consumption continue to be debated. Small amounts of alcohol might lower the risk of some health outcomes but increase the risk of others, suggesting that the overall risk depends, in part, on background disease rates, which vary by region, age, sex, and year. Methods: For this analysis, we constructed burden-weighted dose–response relative risk curves across 22 health outcomes to estimate the theoretical minimum risk exposure level (TMREL) and non-drinker equivalence (NDE), the consumption level at which the health risk is equivalent to that of a non-drinker, using disease rates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2020 for 21 regions, including 204 countries and territories, by 5-year age group, sex, and year for individuals aged 15–95 years and older from 1990 to 2020. Based on the NDE, we quantified the population consuming harmful amounts of alcohol. Findings: The burden-weighted relative risk curves for alcohol use varied by region and age. Among individuals aged 15–39 years in 2020, the TMREL varied between 0 (95% uncertainty interval 0–0) and 0·603 (0·400–1·00) standard drinks per day, and the NDE varied between 0·002 (0–0) and 1·75 (0·698–4·30) standard drinks per day. Among individuals aged 40 years and older, the burden-weighted relative risk curve was J-shaped for all regions, with a 2020 TMREL that ranged from 0·114 (0–0·403) to 1·87 (0·500–3·30) standard drinks per day and an NDE that ranged between 0·193 (0–0·900) and 6·94 (3·40–8·30) standard drinks per day. Among individuals consuming harmful amounts of alcohol in 2020, 59·1% (54·3–65·4) were aged 15–39 years and 76·9% (73·0–81·3) were male. Interpretation: There is strong evidence to support recommendations on alcohol consumption varying by age and location. Stronger interventions, particularly those tailored towards younger individuals, are needed to reduce the substantial global health loss attributable to alcohol. Funding: Bill & Melinda Gates Foundation.

UR - http://www.scopus.com/inward/record.url?scp=85134328270&partnerID=8YFLogxK

U2 - 10.1016/S0140-6736(22)00847-9

DO - 10.1016/S0140-6736(22)00847-9

M3 - Article

C2 - 35843246

AN - SCOPUS:85134328270

SN - 0140-6736

VL - 400

SP - 185

EP - 235

JO - The Lancet

JF - The Lancet

IS - 10347

ER -

Population-level risks of alcohol consumption by amount, geography, age, sex, and year: a systematic analysis for the Global Burden of Disease Study 2020

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