In order to minimize health risks, the optimal amount of alcohol someone should consume is none. That’s the simple, surprising conclusion of a massive study, co-authored by 512 researchers from 243 institutions, published Thursday in the prestigious journal the Lancet.

The researchers built a database of more than a thousand alcohol studies and data sources, as well as death and disability records from 195 countries and territories between 1990 and 2016. The goal was to estimate how alcohol affects the risk of 23 health problems. The number that jumped out, in the end, was zero. Anything more than that was associated with health risks.

The report found that 2.8 million people across the globe died in 2016 of alcohol-related causes, which is about the same proportionally as the 2.0 million who died in 1990. For people ages 15 to 49, alcohol is the leading risk factor for experiencing a negative health outcome.

This is a sobering report for the roughly 2 billion human beings who drink alcohol. The report challenges the controversial hypothesis that moderate drinking provides a clear health benefit. That notion took hold in the 1990s after news reports on the “French paradox”: The French have relatively low rates of heart disease despite a fatty diet. Some researchers pointed to red wine consumption among the French as potentially protective.

Numerous peer-reviewed studies found evidence that people who have a drink or two a day are less likely to have heart disease than people who abstain or drink excessively.

But the new study, while noting the lower risks of heart disease from moderate drinking, as well as a dip in the diabetes rate in women, found that many other health risks offset and overwhelm the health benefits. That includes the risk of breast cancer, larynx cancer, stroke, cirrhosis, tuberculosis, interpersonal violence, self-harm and transportation accidents.

Drinkers may take some reassurance from the fact that the new Lancet report focuses not on individuals but on populations. It estimates risks of alcohol-related diseases and disabilities per 100,000 people as a function of alcohol consumption. The authors do not suggest that there is significant danger in having a sip of alcohol. The risks spike dramatically with heavy drinking.

The report’s authors suggest that public health officials across the planet need to pay more attention to alcohol. Any reduction in average consumption in a population should produce a health benefit.

The heaviest-drinking nation is Romania, where men on average consume 8.2 drinks a day. That’s followed by Portugal at 7.2. Luxembourg, Lithuania, and Ukraine all average 7.0 among men.

For women, the heaviest consumption is in Ukraine, with 4.2 drinks a day on average, followed by Andorra, Luxembourg, Belarus and Sweden.

By contrast, a number of Muslim-majority countries report almost no alcohol consumption. The average for women in Iran is essentially zero, registering at 0.0003 drinks a day, the lowest rate globally. The lowest for men is in Pakistan, with an average of 0.0007 drinks daily.