Alcohol consumption and mortality: modelling risks for men and women at different ages

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http://bmj.com/cgi/content/abstract/325/7357/191

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Alcohol
Other nutrition and metabolism

BMJ 2002;325:191 ( 27 July )
 

Papers

Alcohol consumption and mortality: modelling risks for men and women at different ages

Ian R White, medical statistician,  Dan R Altmann, medical statistician,  Kiran Nanchahal, medical statistician. 

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.

 

What is already known on this topic
Non-drinkers and heavy drinkers have higher all cause mortality rates than light drinkers---the U shaped curve

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 the lowest mortality ranges from 0 in men and women aged under 35 to 3 units a week in women aged over 65 and 8 units a week in men aged over 65

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



 


 

© BMJ 2002

Rapid Responses:

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Drinking Patterns are important
Johannes G. Scholl
bmj.com, 28 Jul 2002 [Full text]
Alcohol and Life
michael j fitzpatrick
bmj.com, 29 Jul 2002 [Full text]
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Robert Patton
bmj.com, 30 Jul 2002 [Full text]
Re: Alcohol consumption and mortality: modelling risks for men and women at different ages
Moussa Sarr
bmj.com, 1 Aug 2002 [Full text]


 

 

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