Gender differences in the relationship between alcohol consumption and drink problems are largely accounted for by body water

It is widely reported that women drink less and have a lower prevalence of drink problems than men, but the gender differences in the relationship between level of drinking and drink problems have rarely been investigated quantitatively. This paper reports results from the Medical Research Council National Survey of Health and Development (the 1946 British Cohort) when the subjects were 43 years old. Using 7-day recall for alcohol consumption and CAGE scores of 2, 3 or 4 for drink problems, it was found that the prevalence of drink problems increased with level of alcohol consumption. Women were more likely than men to report drink problems at the same level of alcohol consumption. However, this gender difference was largely accounted for by individual differences in weight of body water. Beer accounted for the excess of men's drinking over women's and the proportion of alcohol consumed as beer was inversely related to drink problems. Eighty per cent of women and 52% of men who had drink problems in the past year reported drinking less than an average of 3 U (women) or 4 U (men) a day in the past week. As drinking levels in women begin to approach those in men, rates of drink problems in women are likely to overtake those in men because of women's greater physiological sensitivity to the effects of alcohol.