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Research Summary

Safer Drinking Recommendations Should Vary By Age and Sex

Alcohol consumption has a U-shaped relationship with all-cause mortality; abstinence and heavy drinking increase risk. To quantify deaths attributable to and prevented by various levels of intake, researchers combined age- and sex-specific associations between alcohol consumption and mortality (from meta-analyses of observational studies) with population survey and national mortality data from England and Wales.

  • Over the lifespan, mortality attributable to and prevented by alcohol consumption was relatively balanced, with 0.8% of all deaths in men prevented by use (95% confidence interval, CI, 0.2% to 1.3%) and 0.1% of all deaths in women attributable to use (95% CI, -0.3% to 0.4%).
  • Deaths attributable to alcohol outweighed those prevented by use for men up to age 54 and for women up to age 64.
  • Among men, those aged 16–24 years were at greatest risk of alcohol-related mortality (22% of deaths attributable to alcohol use), while those aged 75–85 years were most likely to benefit from consumption (3% of deaths prevented by use).
  • Among women, those aged 35–44 years were at greatest risk (8% of deaths attributable to alcohol use), while those aged 85 and older were most likely to benefit (1% of deaths prevented by use).
Drinking Amounts that Produced the Lowest
Alcohol-Attributable Mortality
British Alcohol Units Per Week*
Age Men Women
16-34 0 0
35-44 2 0
45-54 5 1
55-64 7 2
65-85+ 8 3
*A British alcohol unit is 9 g of alcohol. An American standard drink is 12 g of alcohol.

Comments:

At least in England and Wales, mortality attributable to alcohol varies by age and sex. Recommendations of safest limits, which appear to be lower than the often cited “drink-a-day” for health, should vary as well. Abstinence is the safest choice for men up to age 34 and women up to age 44 because of their low risk of coronary heart disease and higher risk of alcohol-related traffic accidents. And although mortality benefits attributable to alcohol increase with age, a shift from abstinence to moderate consumption among elderly patients would only have a small effect on overall mortality.

Peter D. Friedmann, MD, MPH

Reference:

White IR, Altmann DR, Nanchalal K. Mortality in England and Wales attributable to any drinking, drinking above sensible limits and drinking above lowest-risk levels. Addiction. 2004;99(6):749–756.
(view abstract)


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