Mortality associated with moderate intakes of wine, beer, or spirits

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Abstract
Objective: To examine the association between intake of different types of alcoholic drinks and mortality. Design: Prospective population study with base-line assessment of alcohol intake, smoking habit, income, education, and body mass index, and 10-12 years' follow up of mortality. Setting: Copenhagen city heart study, Denmark. Subjects: 6051 men and 7234 women aged 30-70 years. Main outcome measure: Number and time of cause-specific deaths from 1976 to 1988. Results: The risk of dying steadily decreased with an increasing intake of wine—from a relative risk of 1.00 for the subjects who never drank wine to 0.51 (95% confidence interval 0.32 to 0.81) for those who drank three to five glasses a day. Intake of neither beer nor spirits, however, was associated with reduced risk. For spirits intake the relative risk of dying increased from 1.00 for those who never drank to 1.34 (1.05 to 1.71) for those with an intake of three to five drinks a day. The effects of the three types of alcoholic drinks seemed to be independent of each other, and no significant interactions existed with sex, age, education, income, smoking, or body mass index. Wine drinking showed the same relation to risk of death from cardiovascular and cerebrovascular disease as to risk of death from all causes. Conclusion: Low to moderate intake of wine is associated with lower mortality from cardiovascular and cerebrovascular disease and other causes. Similar intake of spirits implied an increased risk, while beer drinking did not affect mortality. Key messages Alcohol in small doses is assumed to protect against ischaemic heart disease In this study drinkers of three to five glasses of wine a day had half the risk of dying as those who never drank wine Beer and spirit drinkers experienced no such advantages, and three to five drinks of spirits a day was associated with increased mortality The U shaped risk function may be a result of a combination of the risk functions of wine, beer, and spirits