Differing Health Effects Related to Quantity and Frequency of Drinking

There is increasing appreciation of the importance of drinking patterns as they relate to health effects. In this analysis, researchers assessed the relationship between quantity and frequency of alcohol consumption and mortality by linking data from the 1988 National Health Interview Survey with the National Death Index through 2002. The cohort included 20,765 current drinkers age ≥18 years. At 14-year follow up, 2547 had died.

• Men who consumed ≥5 drinks (compared with 1 drink) on drinking days had a relative risk (RR) of mortality of 1.30 for cardiovascular disease (nonsignificant), 1.53 for cancer, and 1.42 for other causes. Women who consumed ≥5 drinks on drinking days had an RR of mortality from other causes of 2.88.

• Men with the highest consumption frequency (compared with the lowest) had an RR of 0.79 for cardiovascular disease, 1.23 for cancer, and 1.30 for other causes (nonsignificant). Relative risk for cancer in women with the highest consumption frequency (≥3 days per week) was 1.65.

• Increasing frequency of drinking had no significant effect on total mortality risk for either men or women.

Comments:

The numbers of deaths in some of the higher alcohol-intake categories were rather small, especially for women, leading to less precise estimates of effect. But the findings are interesting and noteworthy; for example, for men, quantity and frequency effects trended in opposite directions for cardiovascular disease. In addition, frequency of drinking was associated with risk for cancer death, but I am not aware of studies other than this one that showed an increase in cancer risk from more frequent drinking when adjusted for total intake.

R. Curtis Ellison, MD

Reference:

Breslow RA, Graubard BI. Prospective study of alcohol consumption in the United States: Quantity, frequency, and cause-specific mortality. Alcohol Clin Exp Res. 2008; 32(3):513–521.