The negative associations between alcohol intake and total GMV and WMV are consistent with prior studies of early middle-aged46 and older adults28,47. Based on Figs. 2 and 3, which show that males consumed more alcohol units per day and had larger global GMV and WMV, we further examine the influence of sex in detail. We find negative associations between alcohol intake and the global IDPs for both sexes and weak evidence for interactive effects between alcohol intake and sex on the brain. These findings are similar to a recent study of early middle-aged adult moderate drinkers that showed smaller brain volumes associated with moderate alcohol consumption in men and women46. The weak sex-by-alcohol interactions also comport with the findings of an earlier longitudinal study in individuals with AUD38; however, other cross-sectional studies have reported greater volume changes in women than men48,49.
