Measurement of alcohol-related effects in man: chronic effects in relation to levels of alcohol consumption. Part A.

The effects of chronic alcohol ingestion are quantitatively related to intake, but little information is available on the topic. In part A of this review, intake-effect relationships are examined for chronic dysfunctions of the liver, pancreas, cardiovascular system, testis and fetus. Part B considers central nervous system effects such as the withdrawal syndrome, psychosis, brain damage, memory loss, alterations of attention, sleep disturbances and EEG changes. Alcohol and the elderly, evidence of favorable effects of alcohol and the question of alcoholism are also discussed. In the vast majority of studies the documented daily intake levels have been over 150 g of ethanol (the equivalent of one pint of 80-proof spirits), often in the range of 250-300 g. Other potential risk factors such as malnutrition are rarely considered, and little information is available on the effects of more moderate daily intake. The liver emerges as the most vulnerable organ to regular alcohol use with the hazardous range beginning at a daily intake of 80-100 g of ethanol. There is some evidence beneficial effects, especially in the elderly, of daily intakes of 15-30 g and epidemiological evidence of a lower incidence of myocardial infarction in those with a daily intake approximating 56 g. More information is needed on chronic intake-effect relationship, particulary at levels below 150 g.