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Do "Moderate" Drinkers Have Reduced Mortality Risk? A Systematic Review and Meta-Analysis of Alcohol Consumption and All-Cause Mortality - PubMed Skip to main page content
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Review
. 2016 Mar;77(2):185-98.
doi: 10.15288/jsad.2016.77.185.

Do "Moderate" Drinkers Have Reduced Mortality Risk? A Systematic Review and Meta-Analysis of Alcohol Consumption and All-Cause Mortality

Tim Stockwell  1   2 , Jinhui Zhao  1 , Sapna Panwar  3 , Audra Roemer  1 , Timothy Naimi  4 , Tanya Chikritzhs  3   2
Affiliations
Review

Do "Moderate" Drinkers Have Reduced Mortality Risk? A Systematic Review and Meta-Analysis of Alcohol Consumption and All-Cause Mortality

Tim Stockwell et al. J Stud Alcohol Drugs. 2016 Mar.

Abstract

Objective: Previous meta-analyses of cohort studies indicate a J-shaped relationship between alcohol consumption and allcause mortality, with reduced risk for low-volume drinkers. However, low-volume drinkers may appear healthy only because the "abstainers" with whom they are compared are biased toward ill health. The purpose of this study was to determine whether misclassifying former and occasional drinkers as abstainers and other potentially confounding study characteristics underlie observed positive health outcomes for lowvolume drinkers in prospective studies of all-cause mortality.

Method: A systematic review and meta-regression analysis of studies investigating alcohol use and mortality risk after controlling for quality-related study characteristics was conducted in a population of 3,998,626 individuals, among whom 367,103 deaths were recorded.

Results: Without adjustment, meta-analysis of all 87 included studies replicated the classic J-shaped curve, with low-volume drinkers (1.3-24.9 g ethanol per day) having reduced mortality risk (RR = 0.86, 95% CI [0.83, 0.90]). Occasional drinkers (<1.3 g per day) had similar mortality risk (RR = 0.84, 95% CI [0.79, 0.89]), and former drinkers had elevated risk (RR = 1.22, 95% CI [1.14, 1.31]). After adjustment for abstainer biases and quality-related study characteristics, no significant reduction in mortality risk was observed for low-volume drinkers (RR = 0.97, 95% CI [0.88, 1.07]). Analyses of higher-quality bias-free studies also failed to find reduced mortality risk for low-volume alcohol drinkers. Risk estimates for occasional drinkers were similar to those for low- and medium-volume drinkers.

Conclusions: Estimates of mortality risk from alcohol are significantly altered by study design and characteristics. Meta-analyses adjusting for these factors find that low-volume alcohol consumption has no net mortality benefit compared with lifetime abstention or occasional drinking. These findings have implications for public policy, the formulation of low-risk drinking guidelines, and future research on alcohol and health.

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Figures

Figure 1.
Figure 1.
Flow chart of systematic search process for studies of alcohol consumption and risk of all-cause mortality. CHD = coronary heart disease.
Figure 2.
Figure 2.
Estimates of the relative risk of all-cause mortality associated with low-volume drinking in 81 studies. CI = confidence interval.
Figure 3.
Figure 3.
All-cause mortality relative-risk estimates for low-volume alcohol consumers versus lifetime abstainers with and without influential covariates (n = 81 studies, 229 risk estimates). CI = confidence interval.
Figure 4.
Figure 4.
All-cause mortality relative risk for low-volume drinkers versus lifetime abstainers after controlling for design characteristics by study selection in adjusted models. CI = confidence interval.
See this image and copyright information in PMC

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References

    1. Acuna E., Rodrigues C. A meta-analysis study of outlier detection methods in classification. Mayaguez, Puerto Rico: University of Puerto Rico at Mayaguez; 2014. Retrieved from http://academic.uprm.edu/eacuna/paperout.pdf.
    1. Austin P. C., Steyerberg E. W. The number of subjects per variable required in linear regression analyses. Journal of Clinical Epidemiology. 2015;68:627–636. doi:10.1016/j.jclinepi.2014.12.014. - PubMed
    1. Babor T. F., Caetano R., Casswell S., Edwards G., Giesbrecht N., Graham K., Rossow I. Alcohol: No ordinary commodity: Research and public policy. 2nd ed. Oxford, England: Oxford University Press; 2010. doi:10.1093/acprof:oso/9780199551149.001.0001.
    1. Bergmann M. M., Rehm J., Klipstein-Grobusch K., Boeing H., Schütze M., Drogan D., Ferrari P. The association of pattern of lifetime alcohol use and cause of death in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. International Journal of Epidemiology. 2013;42:1772–1790. doi:10.1093/ije/dyt154. - PMC - PubMed
    1. Brien S. E., Ronksley P. E., Turner B. J., Mukamal K. J., Ghali W. A. Effect of alcohol consumption on biological markers associated with risk of coronary heart disease: Systematic review and meta-analysis of interventional studies. BMJ. 2011;342:d636. doi:10.1136/bmj.d636. - PMC - PubMed