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Type of Alcohol Consumed and Mortality from All Causes, Coronary Heart Disease, and Cancer

Morten Grønbæk, MD, DrMedSci; Ulrik Becker, MD, DrMedSci; Ditte Johansen, MSc; Adam Gottschau, MSc, PhD; Peter Schnohr, MD; Hans Ole Hein, MD; Gorm Jensen, MD, DrMedSci; and Thorkild I.A. Sørensen, MD, DrMedSci
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Copyright ©2004 by the American College of Physicians


Ann Intern Med. 2000;133(6):411-419. doi:10.7326/0003-4819-133-6-200009190-00008
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Background: Although the J-shaped relation between alcohol intake and mortality has been reproduced in many large cohort studies, the question of whether the effects of beer, wine, and spirits differ remains controversial.

Objective: To examine the relation between intake of different types of alcohol and death from all causes, coronary heart disease, and cancer.

Design: Pooled cohort studies in which intake of beer, wine, and spirits; smoking status; educational level; physical activity; and body mass index were assessed at baseline.

Setting: Copenhagen, Denmark.

Participants: 13 064 men and 11 459 women 20 to 98 years of age.

Measurements: Number of deaths and time to death from all causes, coronary heart disease, and cancer during follow-up.

Results: During 257 859 person-years of follow-up, 4833 participants died. J-shaped relations were found between total alcohol intake and mortality at various levels of wine intake. Compared with nondrinkers, light drinkers who avoided wine had a relative risk for death from all causes of 0.90 (95% CI, 0.82 to 0.99) and those who drank wine had a relative risk of 0.66 (CI, 0.55 to 0.77). Heavy drinkers who avoided wine were at higher risk for death from all causes than were heavy drinkers who included wine in their alcohol intake. Wine drinkers had significantly lower mortality from both coronary heart disease and cancer than did non–wine drinkers (P = 0.007 and P = 0.004, respectively).

Conclusion: Wine intake may have a beneficial effect on all-cause mortality that is additive to that of alcohol. This effect may be attributable to a reduction in death from both coronary heart disease and cancer.

Figures

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Figure 1.
Relative risk for death from all causes in relation to total alcohol intake.circlestrianglesdiamondssquares

Data pertain to non–wine drinkers ( ), wine drinkers ( ), drinkers for whom wine made up 1% to 30% of their total alcohol intake ( ), and drinkers for whom wine made up more than 30% wine of their total alcohol intake ( ). Relative risk is set at 1.00 among nondrinkers (<1 drink/wk). Estimates were adjusted for age, sex, educational level, smoking status, physical activity, and body mass index.

Grahic Jump Location
Grahic Jump Location
Figure 2.
Relative risk for death from coronary heart disease (CHD) (top) and cancer (bottom) in relation to intake of total alcohol.circlessquares

Data refer to non–wine drinkers ( ) and wine drinkers ( ). Relative risk is set at 1.00 among nondrinkers (<1 drink/wk). Estimates were adjusted for age, sex, educational level, smoking status, physical activity, and body mass index.

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