Alcohol consumption and all-cause mortality

• Published in: International journal of epidemiology Vol. 24; no. 1; p. 100
• Main Author: Duffy, J C
• Format: Journal Article
• Language: English
• Published: England 01.02.1995
• Subjects: Adult; Age Factors; Aged; Alcohol Drinking; Australia; Chicago; Humans; Linear Models; Male; Meta-Analysis as Topic; Middle Aged; Mortality; Prospective Studies; Risk Factors; Sex Factors; United Kingdom; United States; Evaluation; Causes Of Death > men; Differential Mortality; Northern Europe; Europe; Mortality; Risk Factors; United Kingdom; Biology; Alcohol Drinking; Evaluation Methodology; Developed Countries; Population; Behavior; Demographic Factors; Population Dynamics
• ISSN: 0300-5771
• DOI: 10.1093/ije/24.1.100

Prospective studies of alcohol and mortality in middle-aged men almost universally find a U-shaped relationship between alcohol consumption and risk of mortality. This review demonstrates the extent to which different studies lead to different risk estimates, analyses the putative influence of abstention as a risk factor and uses available data to produce point and interval estimates of the consumption level apparently associated with minimum risk from two studies in the UK. Data from a number of studies are analysed by means of logistic-linear modelling, taking account of the possible influence of abstention as a special risk factor. Separate analysis of British data is performed. Logistic-linear modelling demonstrates large and highly significant differences between the studies considered in the relationship between alcohol consumption and all-cause mortality. The results support the identification of abstention as a special risk factor for mortality, but do not indicate that this alone explains the apparent U-shaped relationship. Separate analysis of two British studies indicates minimum risk of mortality in this population at a consumption level of about 26 (8.5 g) units of alcohol per week. The analysis supports the view that abstention may be a specific risk factor for all-cause mortality, but is not an adequate explanation of the apparent protective effect of alcohol consumption against all-cause mortality. Future analyses might better be performed on a case-by-case basis, using a change-point model to estimate the parameters of the relationship. The current misinterpretation of the sensible drinking level of 21 units per week for men in the UK as a limit is not justified, and the data suggest that alcohol consumption is a net preventive factor against premature death in this population.