Moderate Drinking and a Longer Life

To
examine the relationship between alcohol consumption and mortality
among older adults, researchers conducted a 23-year prospective
study of approximately 12,000 male British doctors aged 48–78
years. Mean daily alcohol intake was about 1.5–2 standard
drinks. During follow-up, 7364 deaths occurred. Analyses were adjusted
for age, smoking, and follow-up duration.

• Compared
  with nondrinkers (including ex-drinkers), current drinkers had
  significantly lower risks of death from ischemic heart disease
  (relative risk [RR] 0.7), other vascular diseases (RR 0.8), and
  respiratory disease (RR 0.8). Because these causes accounted for
  most deaths, current drinkers also had a lower risk of total mortality
  (RR 0.8).
• The
  relationship between alcohol consumption and mortality was U-shaped
  (i.e., nondrinkers and heavier drinkers had the highest rates)
  for all causes except alcohol-augmentable causes (i.e., those
  increased by heaving drinking, such as liver disease). Risk of
  death from alcohol-augmentable causes increased as consumption
  increased from <5 to >20 drinks per week.
• When recent ex-drinkers were grouped with current drinkers,
  the association between alcohol consumption and total
  mortality was attenuated (RR 0.9).

Comments:

This study from a leading epidemiologist confirms the relationship between moderate drinking and lowered risk of total and heart disease mortality. However, its finding of decreased risk of respiratory disease mortality is surprising. An editorialist notes that the main results may be due partially to a greater risk of death among ex-drinkers (e.g., those who stopped drinking because of illness) and/or insufficient adjustment for confounding factors.

R. Curtis Ellison, MD

Reference:

Doll R, Peto
R, Boreham J, et al. Mortality in relation to alcohol
consumption: a prospective study among male British doctors.
Int J Epidemiol. 2005;34(1):199–204.

Wannamethee SG. Commentary. Alcohol
and mortality: diminishing returns for benefits of alcohol.
Int J Epidemiol. 2005;34(1):205–206.