August 14, 2017
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Light to moderate drinking may protect against all-cause, CVD mortality

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Moderate alcohol consumption appears to have a protective effect on all-cause and CVD-specific mortality in adults in the U.S., but heavy and binge drinking were linked to an increased risk for cancer-specific all-cause mortality, published data show.

Researchers aimed to clarify inconsistent findings from previous studies regarding light to moderate alcohol consumption and its relationship to CVD and cancer mortality.

“High alcohol consumption poses a significant health care and economic burden in the United States, and it has been linked to mortality due to injuries, violence, poisoning, liver cirrhosis and cancer, and to morbidity due to several chronic diseases,” Bo Xi, MD, from the department of epidemiology at the School of Public Health, Shandong University in Jinan, China, and colleagues wrote. “It is well-established that excessive alcohol consumption has an adverse effect on human health and mortality. However, evidence regarding risk of morbidity and mortality among light and moderate drinkers is inconsistent.”

Xi and colleagues used data from the National Health Interview Survey from 333,247 participants aged at least 18 years. Data from these participants were then linked to the National Death Index records using a probabilistic matching algorithm to determine mortality status.

Mortality and consumption

The researchers recognized six self-reported alcohol consumption patterns and separated them into the following categories: lifetime abstainers (fewer than 12 drinks per lifetime), lifetime infrequent drinkers (at least 12 drinks per lifetime but fewer than 12 drinks in any previous year), former drinkers (at least 12 drinks in a previous year), and current light (current use of fewer than three drinks per week), moderate (more than three drinks per week to 14 or fewer drinks per week for men; three drinks per week to seven or fewer drinks per week for women) or heavy drinkers (more than 14 drinks per week for men or more than seven drinks per week for women).

Xi and colleagues designated all-cause, cancer or CVD mortality as the main outcomes of the study.

The results showed that 34,754 participants died from any cause after a median follow-up of 8.3 years (8,947 CVD deaths; 8,427 cancer deaths).

Light or moderate alcohol consumers compared with lifetime abstainers were at a reduced risk for mortality from all causes (light, HR = 0.79; 95% CI, 0.76-0.82; moderate, HR = 0.78; 95% CI, 0.74-0.82) and CVD (light, HR = 0.74; 95% CI, 0.69-0.8; moderate, HR = 0.71; 95% CI, 0.64-0.78), according to the researchers.

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Adults categorized as heavy alcohol consumers had a significantly increased risk for mortality from all causes (HR = 1.11; 95% CI, 1.04-1.19) and cancer (HR = 1.27; 95% CI, 1.13-1.42).

There was also an increased mortality for all causes (HR = 1.13; 95% CI, 1.04-1.23) and cancer (HR = 1.22; 95% CI, 1.05-1.41) among participants who reported binge drinking more than 1 day per week.

Multiple effects on health

“The results by Xi et al supported previous studies that had shown a significant reduction in total mortality with light to moderate drinking vs. abstention or heavy drinking,” Giovanni de Gaetano, MD, PhD, from the department of epidemiology and prevention at the IRCCS Istituto Neurologico Mediterraneo NEUROMED in Pozzilli, Italy, and Simona Costanzo, MS, PhD, from the department of nutrition at Harvard T.H. Chan School of Public Health, wrote in an accompanying editorial. “Alcohol’s multiple effects on health not only depend on quantities but also on patterns of alcohol use (whether intake is concentrated — such as during weekends — or regularly dispensed during meals).” – by Dave Quaile

Disclosures: The authors, Costanzo and de Gaetano report no relevant financial disclosures.