No U-Shaped Curve for Alcohol and All-Cause Mortality in Younger Men

Most studies that support the benefits of moderate drinking have focused on middle-aged men. To examine whether younger men also experience these benefits, investigators assessed alcohol consumption, vital status, and all-cause mortality in 17,279 male construction workers (aged 25–64 years) in Germany. Subjects underwent an occupational health examination at baseline and were followed for an average of 10 years; during follow-up, 698 died.

• In analyses adjusted for age, nationality, and smoking, the relationship between alcohol consumption and all-cause mortality among men aged 35-64 years was J or U-shaped (i.e., higher risk among nondrinkers and heavier daily drinkers than in occasional drinkers).
• However, for men aged 25-34 years, the relationship was linear: mortality increased as consumption increased from 0 drinks per day (relative risk [RR] 0.9 compared with occasional drinking) to >=8 drinks per day (RR 2.5) (P for trend=0.02).
• Results did not change substantially when analyses were also adjusted for disorders at baseline that could influence drinking behavior and mortality (e.g., liver diseases, cancer).

Comments:

This study showed that moderate alcohol consumption may lower all-cause mortality in middle-aged and older men. This is likely due to the protective effects of moderate consumption on coronary heart disease. Any benefit from moderate drinking among younger people, who have a lower risk of heart disease, is not apparent. Thus, the "U-shaped" curve does not apply to the young.

R. Curtis Ellison, MD

Reference:

Arndt V, Rothenbacher D, Krauledat R, et al. Age, alcohol consumption, and all-cause mortality. Ann Epidemiol. 2004;14(10):750-753.