http://bmj.com/cgi/content/abstract/325/7357/191
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 Collections under
which this article appears: Alcohol
Other
nutrition and metabolism |
Ian R White
Medical Statistics Unit, London School of Hygiene and Tropical Medicine, London WC1E 7HT
Correspondence to: I R White, Medical Research Council Biostatistics Unit,
Institute of Public Health, Cambridge CB2 2SR
ian.white@mrc-bsu.cam.ac.uk
Objective: To estimate the relation between alcohol consumption
and risk of death, the level of alcohol consumption at which risk
is least, and how these vary with age and sex.
Design: Analysis using published systematic reviews and
population data.
Setting: England and Wales in 1997.
Main outcome measures: Death from any of the following causes: cancer
of lip, oral cavity, pharynx, oesophagus, colon, rectum, liver,
larynx, and breast, essential hypertension, coronary heart disease,
stroke, cirrhosis, non-cirrhotic chronic liver disease, chronic
pancreatitis, and injuries.
Results: A direct dose-response relation exists between
alcohol consumption and risk of death in women aged 16-54 and in men
aged 16-34. At older ages the relation is U shaped. The level at
which the risk is lowest increases with age, reaching 3 units a week
in women aged over 65 and 8 units a week in men aged over 65. The
level at which the risk is increased by 5% above this minimum is
8 units a week in women aged 16-24 and 5 units a week in men aged
16-24, increasing to 20 and 34 units a week in women and men aged
over 65, respectively.
Conclusions: Substantially increased risks of all cause
mortality can occur even in people drinking lower than recommended
limits, and especially among younger people.
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What is already known on this topic The precise shape and location of the U are likely to depend on age and sex, but this has not been quantified What this study adds The level of alcohol consumption that carries a 5% increase in mortality increases with age from 8 to 20 units a week in women and from 5 to 34 units a week in men Our calculations were for England and Wales in 1997: nadirs are likely to be lower in the future and in countries with less ischaemic heart disease |
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the U
shaped curve