Daily drinking associated with increased mortality risk

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The minimum risk of low-level drinking frequency for all-cause mortality appears to be approximately three occasions weekly, according to a US analysis of two large data sets.

The a study. Dr Sarah M. Hartz, from Washington University in St Louis, and colleagues examined the association between self-reported frequency of low-level drinking and mortality using data from 340,668 individuals participating in the National Health Interview Survey (NHIS) and 93,653 individuals from Veterans Health Administration (VA) outpatient medical records.

The researchers found that the drinking frequency with minimum risk among those who drink 1 to 2 drinks per occasion was 3.2 times weekly in the NHIS cohort and 2 to 3 times weekly with the VA data.

Compared with these individuals with minimum risk, individuals who drink 7 times weekly had an adjusted hazard ratio of all-cause mortality of 1.23 in the NHIS data, and individuals who drink 4 to 7 times weekly in the VA data also had an adjusted hazard ratio of 1.23. In the NHIS data, the minimum risk for cardiovascular mortality was drinking four times weekly and the minimum risk for cancer mortality was drinking monthly or less. After stratification of men, women, and never smokers, associations remained.

“The minimum risk of low-level drinking frequency for all-cause mortality appears to be approximately three occasions weekly,” the authors write.

One author is listed as an inventor on a patent covering the use of certain single-nucleotide polymorphisms in determining the diagnosis, prognosis, and treatment of addiction.

Abstract
Background: There is evidence that low‐level alcohol use, drinking 1 to 2 drinks on occasion, is protective for cardiovascular disease, but increases the risk of cancer. Synthesizing the overall impact of low‐level alcohol use on health is therefore complex. The objective of this paper was to examine the association between frequency of low‐level drinking and mortality.
Methods: Two data sets with self‐reported alcohol use and mortality follow‐up were analyzed: 340,668 individuals from the National Health Interview Survey (NHIS) and 93,653 individuals from the Veterans Health Administration (VA) outpatient medical records. Survival analyses were conducted to evaluate the association between low‐level drinking frequency and mortality.
Results: The minimum risk drinking frequency among those who drink 1 to 2 drinks per occasion was found to be 3.2 times weekly in the NHIS data, based on a continuous measure of drinking frequency, and 2 to 3 times weekly in the VA data. Relative to these individuals with minimum risk, individuals who drink 7 times weekly had an adjusted hazard ratio (HR) of all‐cause mortality of 1.23 (p < 0.0001) in the NHIS data, and individuals who drink 4 to 7 times weekly in the VA data also had an adjusted HR of 1.23 (p = 0.01). Secondary analyses in the NHIS data showed that the minimum risk was drinking 4 times weekly for cardiovascular mortality, and drinking monthly or less for cancer mortality. The associations were consistent in stratified analyses of men, women, and never smokers.
Conclusions: The minimum risk of low‐level drinking frequency for all‐cause mortality appears to be approximately 3 occasions weekly. The robustness of this finding is highlighted in 2 distinctly different data sets: a large epidemiological data set and a data set of veterans sampled from an outpatient clinic. Daily drinking, even at low levels, is detrimental to one’s health.

Authors
Sarah M Hartz, Mary Oehlert AC Horton Richard A Grucza, Sherri L. Fisher, Robert C Culverhouse, Karl G Nelson, Scott W Sumerall, Paul C Neal, Patrice Regnier, Guoqing Chen, Alexander Williams, Jagriti Bhattarai, Bradley Evanoff, Laura J Bierut

MPR material
Alcoholism: Clinical & Experimental Research abstract


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