A study presented at the American College of Cardiology’s Annual Scientific Sessions (ACC.26) found that heavy alcohol consumption is associated with worse health outcomes regardless of the type of alcohol consumed, but the potential effects of low to moderate alcohol consumption appear to vary by type of beverage.
The study of more than 340,000 UK adults adds to previous research showing that reducing alcohol intake is good for health, and provides new insight into the effects of drinking at low and moderate levels.
These results are from the general population, and the risk may be even higher in certain high-risk groups, such as people with chronic or cardiovascular disease. ”
Zhangling Chen, MD, PhD, Professor, Second Xiangya Hospital, Central South University, China, senior study author
Researchers analyzed alcohol consumption habits and mortality rates in 340,924 adults who took part in the UK Biobank study between 2006 and 2022. Each participant completed a dietary questionnaire upon study enrollment and was divided into four categories based on alcohol intake, measured in grams of pure alcohol per day and per week. For reference, a 12-ounce can of beer, a 5-ounce glass of wine, and a 1.5-ounce shot of spirits each contain about 14 grams of pure alcohol. Those who consumed less than 20 g (approximately 1.5 standard drinks) per week were classified as never or occasional drinkers. Men who consumed between 20 g per week and 20 g per day and women who consumed between 20 g per week and 10 g per day were considered to have lower alcohol consumption. The appropriate daily intake for men is 20g to 40g (about 1.5 to 3 standard drinks), and for women 10g to 20g. The daily intake is said to be more than 40g (about 3 cups) for men and more than 20g (about 1.5 cups) for women. Health status was followed on average for more than 13 years.
Compared to never or occasional drinkers, people who consumed heavy alcohol were 24% more likely to die from any cause, 36% more likely to die from cancer, and 14% more likely to die from heart disease. Differences in risk by type of alcohol appeared at low and moderate consumption levels, with drinking spirits, beer, or cider associated with a significantly higher risk of death, whereas consuming the same level of wine was associated with a significantly lower risk of death.
Looking specifically at deaths from cardiovascular disease, researchers found that moderate wine drinkers had a 21% lower risk of dying from cardiovascular disease than those who never drank wine or drank only occasionally. In contrast, even low consumption of spirits, beer, and cider was associated with a 9% higher risk of death from cardiovascular disease compared with never or occasional drinking.
“Our findings help clarify previously mixed evidence regarding low-to-moderate alcohol consumption,” Chen said. “These findings will help refine guidance and emphasize that the health risks of alcohol depend not only on the amount of alcohol consumed, but also on the type of drink. Even low to moderate consumption of spirits, beer and cider is associated with increased mortality, while low to moderate consumption of wine may have a lower risk.”
The researchers said there may be several factors contributing to the differences between types of alcohol. Certain compounds in red wine, such as polyphenols and antioxidants, may have benefits for cardiovascular health. Wine was also more likely to be consumed with meals and by people who generally had higher quality diets and healthier behaviors, whereas spirits, beer and cider were more likely to be consumed outside of meals and were associated with lower overall diet quality and other lifestyle risk factors.
“Taken together, these factors suggest that the type of alcohol, how it is consumed, and associated lifestyle behaviors all contribute to the observed differences in mortality risk,” Chen said.
In their analysis, researchers adjusted the data to account for demographic factors, socioeconomic status, lifestyle factors, cardiometabolic factors, and family history of diabetes, cardiovascular disease, and cancer. However, the researchers noted that the study had inherent limitations as an observational study and suggested that high-quality randomized trials could help better understand the effects of alcohol consumption. Alcohol consumption was assessed based on self-report at baseline, and changes in drinking patterns over time were not captured. Additionally, UK Biobank participants are generally healthier than the population as a whole, which may limit the generalizability of the study.
Despite these limitations, the sample size and length of follow-up period of this study strengthen its statistical power. The researchers said this study provides a more comprehensive and nuanced picture of the health effects of alcohol consumption than many previous studies, providing a high degree of granularity regarding the amount and type of alcohol consumed and the various mortality outcomes.
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American College of Cardiology
