Binge drinking once a week raises the risk of alcohol problems almost fivefold - even if you are teetotal the rest of the time, according to new research.
Moderate consumers who down their units in one go are much more likely to develop health problems than those who get through the same amount - but spread it out.
The NHS advises a weekly limit of 14 - equivalent to six pints of beer or 10 small glasses of wine.
Lead author Professor Charles Holahan, a psychologist at the University of Texas in Austin, said: "What this means is an individual whose total consumption is seven drinks on Saturday night presents a greater risk profile than someone whose total consumption is a daily drink with dinner - even though their average drinking level is the same."
Professor Holahan and colleagues analyzed data on 1,229 people over 30 across the US who were tracked for nearly a decade.
They found moderate average drinkers with a pattern of binge drinking were almost five times as likely to experience multiple alcohol problems.
Their risk of suffering more related issues also doubled over the next nine years. Binge drinking is defined as consuming five or more drinks on the same occasion.
"This leaves many drinkers mistakenly assuming a moderate average level of consumption is safe - regardless of drinking pattern."
Previous studies have tended to focus on adolescents and college students but most binge drinking occurs among older individuals - with prevalence rising.
But research on adult alcohol consumption and its effects usually looks only on a person's average level - which masks heavy sessions.
As a result, the impact on low and moderate drinkers has not been well understood - until now.
Participants were members of the Midlife Development in the United States study carried out in two waves - shedding light on the long-term effects of drinking patterns.
The investigators said they were surprised by what they found. Most cases of binge drinking and multiple alcohol problems occurred among average moderate drinkers.
Professor Holahan and colleagues called for increased efforts to address it.
He said: "Much binge drinking among adults escapes public health scrutiny because it occurs among individuals who drink at a moderate average level.
"These findings point to a need for alcohol interventions targeting moderate average level drinkers in addition to conventional strategies focusing on the higher risk, but smaller, population of habitually high-level drinkers."
An earlier study found binge drinking doubled the risk of premature death in moderate drinkers. The same team followed hundreds of 55 to 65-year-olds for up to 20 years.
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