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Light-to-moderate alcohol consumption and mortality in the Physicians' Health Study enrollment cohort
J M Gaziano1, T A Gaziano, R J Glynn
1Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02215-1204, USA. gaziano@maveric.org
Insights
Light-to-moderate alcohol consumption shows a U-shaped effect on total mortality in men. While beneficial for cardiovascular disease (CVD) mortality, it may increase risks for certain less common cancers.
Area of Science:
- Epidemiology
- Public Health
- Cardiovascular Research
Background:
- Previous research suggests a J-shaped curve for alcohol and total mortality in men.
- Light-to-moderate alcohol intake may reduce cardiovascular disease (CVD) mortality without increasing other causes of death.
Purpose of the Study:
- To investigate the association between light-to-moderate alcohol consumption and cause-specific mortality in men.
- To clarify the relationship between alcohol intake levels and risks of death from various causes.
Main Methods:
- Prospective cohort study of 89,299 U.S. men (Physicians' Health Study).
- Participants aged 40-84, free of major diseases at baseline (1982).
- Alcohol consumption assessed via food frequency questionnaire; follow-up for 5.5 years.
Main Results:
- A U-shaped relationship observed between alcohol consumption and total mortality.
- Significant risk reduction for death in consumers of 1-6 drinks/week and 1 drink/day.
- Inverse/L-shaped association with CVD mortality, with risk reduction even at >=2 drinks/day.
- No clear benefit or harm for common cancer sites; possible increased risk for other cancers at >=2 drinks/day.
Conclusions:
- Data support a U-shaped relation for alcohol and total mortality in light-to-moderate drinking men.
- The U-shaped curve may be influenced by inverse CVD mortality association and varying cancer risks.
- Findings highlight differential mortality risks based on alcohol consumption levels and cause of death.
Objectives:
This study examined the relationship between light-to-moderate alcohol consumption and cause-specific mortality.
Background:
Previous studies suggest a J-shaped relation between alcohol and total mortality in men. A decrease in cardiovascular disease (CVD) mortality without a significant increase in other causes of mortality may explain the overall risk reduction at light-to-moderate levels.
Methods:
We conducted a prospective cohort study of 89,299 U.S. men from the Physicians' Health Study enrollment cohort who were 40 to 84 years old in 1982 and free of known myocardial infarction, stroke, cancer or liver disease at baseline. Usual alcohol consumption was estimated by a limited food frequency questionnaire.
Results:
There were 3,216 deaths over 5.5 years of follow-up. We observed a U-shaped relationship between alcohol consumption and total mortality. Compared with rarely/never drinkers, consumers of 1, 2 to 4 and 5 to 6 drinks per week and 1 drink per day had significant reductions in risk of death (multivariate relative risks [RRs] of 0.74, 0.77, 0.78 and 0.82, respectively) with no overall benefit or harm detected at the > or =2 drinks per day level (RR = 0.95; 95% confidence interval (CI), 0.79 to 1.14). The relationship with CVD mortality was inverse or L-shaped with apparent risk reductions even in the highest category of > or =2 drinks per day (RR = 0.76; 95% CI, 0.57 to 1.01). We found no clear harm or benefit for total or common site-specific cancers. For remaining other cancers, there was a nonsignificant 28% increased risk for those consuming > or =2 drinks per day.
Conclusions:
These data support a U-shaped relation between alcohol and total mortality among light-to-moderate drinking men. The U-shaped curve may reflect an inverse association for CVD mortality, no association for common site-specific cancers and a possible positive association for less common cancers.