Changes in Alcohol Intake and Subsequent Health Outcomes
To assess how changes in drinking over time may impact coronary heart disease (CHD), stroke, and all-cause mortality, investigators analyzed data from 6544 middle-aged, healthy British men who had participated in a 20-year prospective study on cardiovascular health. During follow-up, 922 men died from CHD or had a nonfatal myocardial infarction, 352 had a stroke, and 1552 died from all causes.
- The relationship between alcohol intake at study entry and the risks of CHD, stroke, and all-cause mortality was generally U-shaped, with the lowest risk for subjects who consumed 1-2 drinks per day or 1-6 drinks per day only on the weekends.
- In analyses that averaged consumption during follow-up (to account for intake over time), the benefits of lighter drinking and the risks of heavier drinking increased. Further, the risks of nondrinking decreased.
It is laudable to try to account for drinking, and changes in drinking, over time when assessing how alcohol use influences health outcomes. However, the results of this study are difficult to interpret for two major reasons. First, by using one value of "average" intake, investigators cannot accurately assess the effects of changes in drinking over time. Second, grouping subjects who drank small amounts regularly without bingeing with subjects who were weekend bingers is problematic. Researchers should be encouraged to study changes in alcohol intake over time, using appropriate methods, so we can better understand the effects of alcohol on CHD, stroke, and mortality.R. Curt Ellison, MD
Emberson JR, Shaper AG, Wannamethee SG, et al. Alcohol intake in middle age and risk of cardiovascular disease and mortality: accounting for intake variation over time. Am J Epidemiol. 2005;161(9):856-863.