EAT FOR HEALTH Australian Dietary Guidelines

EAT FOR HEALTH – AusTRALiAn diETARy guidELinEs

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Guideline 3

studies show that consuming two standard drinks or more per day during lactation is associated with deficits in

infant psychomotor development and disrupted infant sleep-wake behavioural patterns.^857 Although the extent

is unknown, a baby’s intake of alcohol from breast milk is not harmless.^857 Alcohol levels in breast milk parallel

blood alcohol levels and therefore the longer the time between drinking alcohol and breastfeeding, the safer for

the baby. The safest option for women who are breastfeeding is to abstain from alcohol.^794 For those who drink,

expressing milk before consuming alcohol is the next best option.^794

Children and adolescents

Alcohol use by younger people is associated with harmful effects on brain development. NHMRC recommends

that parents and carers should be advised that children under 15 years of age are at the greatest risk of harm from

drinking. For this age group, not drinking alcohol is especially important. For people aged 15−17 years, the safest

option is to delay drinking for as long as possible.^794

Older people

Older people are more susceptible than others to the toxic effects of alcohol due to changes in their body

composition, decreased metabolic capacity, the presence of co-morbid conditions and medications that regulate

these conditions.^859

Many older people take medications that may interact with alcohol. A combination of alcohol and medication

increases the risk of falls and injury.860-862

The NHMRC Alcohol Guidelines state that ‘cumulative alcohol-related harm is more evident among older people.

For some older adults, drinking alcohol increases the risk of falls and injuries, as well as some chronic conditions.

Older people are advised to consult their health professionals about the most appropriate level of drinking for

their health’.^794

Aboriginal and Torres Strait Islander peoples

Aboriginal or Torres Strait Islander peoples are more likely than other Australians to abstain from drinking alcohol

(23% compared to about 15%). However, those who do consume alcohol are more likely to do so at risky or

high-risk levels for short-term harm.^854 In response to severe problems related to excess alcohol consumption

in many Indigenous communities, including foetal alcohol syndrome863,864 initiatives have been introduced to

encourage non-harmful alcohol use, limit access to alcohol, and establish ‘dry’ areas and communities. As with

the general population, Aboriginal and Torres Strait Islander peoples should follow the alcohol guidelines

described above.^794

People from culturally and linguistically diverse groups

People from culturally and linguistically diverse groups are more likely than the general adult population in Australia

to abstain from alcohol (43% compared to 15%).^854 The possible protective health effect of moderate drinking

has not been demonstrated in Asian groups. Alcohol drinking customs vary in different cultures and typically

immigrant groups bring their drinking patterns from their country of origin.

People with diabetes

As alcohol and hypoglycaemia have independent but additive effects on cognitive function and behaviour, it is

recommended that people with type 1 or type 2 diabetes abstain from alcohol if they plan to drive.^865 Alcohol

worsens medical conditions associated with diabetes, such as liver disease, hypertension and advanced

neuropathy.850,866 People with type 1 or type 2 diabetes may need to take special precautions when drinking

and should discuss alcohol use with a health professional.

Interaction of alcohol with caffeine and other stimulants

A new category of alcoholic drinks is now available in Australia that have added caffeine and/or other stimulants.

There is concern that consuming stimulants such as caffeine, a central nervous system stimulant, and alcohol, a

depressant, at the same time will reduce subjective perceptions of alcohol-induced impairment in comparison

to alcohol alone.867-870

In the absence of any long-term research to quantify safe levels of concurrent consumption of alcohol and added

stimulants, this combination should be used with caution.