Daily Drinking Is Associated with Increased Mortality.
paper
Primary
Public
- Authors
- Hartz, Sarah M; Oehlert, Mary; Horton, A C; Grucza, Richard A; Fisher, Sherri L; Culverhouse, Robert C; Nelson, Karl G; Sumerall, Scott W; Neal, Paul C; Regnier, Patrice; Chen, Guoqing; Williams, Alexander; Bhattarai, Jagriti; Evanoff, Bradley; Bierut, Laura J
- Year
- 2018
- Journal
- Alcoholism, clinical and experimental research
- PMID
- 30281161
- DOI
- 10.1111/acer.13886
- PMCID
- PMC6214719
BACKGROUND: There is evidence that low-level alcohol use, drinking 1 to 2 drinks on occasion, is protective for cardiovascular disease, but increases the risk of cancer. Synthesizing the overall impact of low-level alcohol use on health is therefore complex. The objective of this paper was to examine the association between frequency of low-level drinking and mortality. METHODS: Two data sets with self-reported alcohol use and mortality follow-up were analyzed: 340,668 individuals from the National Health Interview Survey (NHIS) and 93,653 individuals from the Veterans Health Administration (VA) outpatient medical records. Survival analyses were conducted to evaluate the association between low-level drinking frequency and mortality. RESULTS: The minimum risk drinking frequency among those who drink 1 to 2 drinks per occasion was found to be 3.2 times weekly in the NHIS data, based on a continuous measure of drinking frequency, and 2 to 3 times weekly in the VA data. Relative to these individuals with minimum risk, individuals who drink 7 times weekly had an adjusted hazard ratio (HR) of all-cause mortality of 1.23 (p < 0.0001) in the NHIS data, and individuals who drink 4 to 7 times weekly in the VA data also had an adjusted HR of 1.23 (p = 0.01). Secondary analyses in the NHIS data showed that the minimum risk was drinking 4 times weekly for cardiovascular mortality, and drinking monthly or less for cancer mortality. The associations were consistent in stratified analyses of men, women, and never smokers. CONCLUSIONS: The minimum risk of low-level drinking frequency for all-cause mortality appears to be approximately 3 occasions weekly. The robustness of this finding is highlighted in 2 distinctly different data sets: a large epidemiological data set and a data set of veterans sampled from an outpatient clinic. Daily drinking, even at low levels, is detrimental to one's health.
Patterns of alcohol use for each sample.
Adjusted hazard ratios* of all-cause mortality by drinking frequency for individuals who drink 1–2 drinks on occasion and never binge drink.2A. NHIS data, N=340,668; N deaths=30,498*NHIS hazard ratios are adjusted for birth cohort, gender, race, typical drinking quantity when not binge drinking, frequency of binge drinking, health and wellness factors (current smoking status, perceived health status, exercise level, and medical comorbidities), socioeconomic factors (educational attainment, employment status, and whether the household received food stamps in the last calendar year), region of country, and year of survey.2B. VA data, N=93,653; N deaths=8,322*VA hazard ratios are adjusted for birth cohort, gender, race, typical drinking quantity when not binge drinking, frequency of binge drinking, and medical comorbidities.
Estimated hazard ratios for mortality due to cardiovascular disease and cancer based on the frequency of non-binge drinking. Curves correspond to risk for individuals who typically drink 1–2 drinks per occasion and never binge in the NHIS dataset.*Hazard ratios are adjusted for birth cohort, gender, race, typical drinking quantity when not binge drinking, frequency of binge drinking, health and wellness factors (current smoking status, perceived health status, exercise level, and medical comorbidities), socioeconomic factors (educational attainment, employment status, and whether the household received food stamps in the last calendar year), region of country, and year of survey.
Gender-stratified hazard ratios for mortality based on frequency of non-binge drinking. Curves correspond to risk for individuals who typically drink 1–2 drinks per occasion and never binge in the NHIS dataset.*Hazard ratios are adjusted for birth cohort, gender, race, typical drinking quantity when not binge drinking, frequency of binge drinking, health and wellness factors (current smoking status, perceived health status, exercise level, and medical comorbidities), socioeconomic factors (educational attainment, employment status, and whether the household received food stamps in the last calendar year), region of country, and year of survey.
1–20 of 41
Next →
No entities extracted from this document yet.
No uploaded files.
Not in any collection.
| Citation | PMID | DOI | Status |
|---|---|---|---|
| AnstieFE (1870). On the use of wines in health and disease New York, J. S. Redfield. | — | — | — |
| BradleyKA, BushKR, (2003). “Two brief alcohol-screening tests From the Alcohol Use Disorders Identification Test (AUDIT): validation in a female Veterans Affairs patient population.” Arch Intern Med 163(7): 821–829.1269527310.1001/archinte.163.7.821 | — | — | — |
| BradleyKA, DeBenedettiAF, (2007). “AUDIT-C as a brief screen for alcohol misuse in primary care.” Alcohol Clin Exp Res 31(7): 1208–1217.1745139710.1111/j.1530-0277.2007.00403.x | — | — | — |
| BrittonA and BellS (2017). “The protective effects of moderate drinking: lies, damned lies, and… selection biases?” Addiction 112(2): 218–219.2767190010.1111/add.13585 | — | — | — |
| BrittonA and MarmotM (2004). “Different measures of alcohol consumption and risk of coronary heart disease and all-cause mortality: 11-year follow-up of the Whitehall II Cohort Study.” Addiction 99(1): 109–116.1467806910.1111/j.1360-0443.2004.00530.x | — | — | — |
| BushK, KivlahanDR, (1998). “The AUDIT alcohol consumption questions (AUDIT-C): an effective brief screening test for problem drinking. Ambulatory Care Quality Improvement Project (ACQUIP). Alcohol Use Disorders Identification Test.” Arch Intern Med 158(16): 1789–1795.973860810.1001/archinte.158.16.1789 | — | — | — |
| CaoY, WillettWC, (2015). “Light to moderate intake of alcohol, drinking patterns, and risk of cancer: results from two prospective US cohort studies.” Bmj 351: h4238.2628621610.1136/bmj.h4238PMC4540790 | — | — | — |
| ChenWY, RosnerB, (2011). “Moderate alcohol consumption during adult life, drinking patterns, and breast cancer risk.” JAMA : the journal of the American Medical Association 306(17): 1884–1890.2204576610.1001/jama.2011.1590PMC3292347 | — | — | — |
| ChikritzhsT, FillmoreK, (2009). “A healthy dose of scepticism: four good reasons to think again about protective effects of alcohol on coronary heart disease.” Drug Alcohol Rev 28(4): 441–444.1959479910.1111/j.1465-3362.2009.00052.x | — | — | — |
| ChikritzhsT, StockwellT, (2015). “Has the leaning tower of presumed health benefits from ‘moderate’ alcohol use finally collapsed?” Addiction 110(5): 726–727.2561320010.1111/add.12828 | — | — | — |
| CostanzoS, Di CastelnuovoA, (2010). “Alcohol consumption and mortality in patients with cardiovascular disease: a meta-analysis.” J Am Coll Cardiol 55(13): 1339–1347.2033849510.1016/j.jacc.2010.01.006 | — | — | — |
| CostanzoS, Di CastelnuovoA, (2010). “Cardiovascular and overall mortality risk in relation to alcohol consumption in patients with cardiovascular disease.” Circulation 121(17): 1951–1959.2043981110.1161/CIRCULATIONAHA.109.865840 | — | — | — |
| Del BocaFK and DarkesJ (2003). “The validity of self-reports of alcohol consumption: state of the science and challenges for research.” Addiction 98 Suppl 2: 1–12.10.1046/j.1359-6357.2003.00586.x14984237 | — | — | — |
| DeyoRA, CherkinDC, (1992). “Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases.” J Clin Epidemiol 45(6): 613–619.160790010.1016/0895-4356(92)90133-8 | — | — | — |
| Di CastelnuovoA, CostanzoS, (2006). “Alcohol dosing and total mortality in men and women: an updated meta-analysis of 34 prospective studies.” Arch Intern Med 166(22): 2437–2445.1715900810.1001/archinte.166.22.2437 | — | — | — |
| Division of Population Health. (7 25, 2016). “Alcohol Use and Your Health.” Retrieved September 20, 2016, from http://www.cdc.gov/alcohol/fact-sheets/alcohol-use.htm. | — | — | — |
| FillmoreKM, StockwellT, (2007). “Moderate alcohol use and reduced mortality risk: systematic error in prospective studies and new hypotheses.” Ann Epidemiol 17(5 Suppl): S16–23.1747832010.1016/j.annepidem.2007.01.005 | — | — | — |
| FosterRK and MarriottHE (2006). “Alcohol consumption in the new millennium - weighing up the risks and benefits for our health.” Nutrition Bulletin 31: 286–331. | — | — | — |
| FrankD, DeBenedettiAF, (2008). “Effectiveness of the AUDIT-C as a screening test for alcohol misuse in three race/ethnic groups.” J Gen Intern Med 23(6): 781–787.1842151110.1007/s11606-008-0594-0PMC2517893 | — | — | — |
| GBD 2016 Alcohol Collaborators (2018). “Alcohol use and burden for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016.” Lancet10.1016/S0140-6736(18)31310-2PMC614833330146330 | — | — | — |
| GouldenR (2016). “Moderate Alcohol Consumption Is Not Associated with Reduced All-cause Mortality.” Am J Med 129(2): 180–186 e184.2652470310.1016/j.amjmed.2015.10.013 | — | — | — |
| HolmesMV, DaleCE, (2014). “Association between alcohol and cardiovascular disease: Mendelian randomisation analysis based on individual participant data.” Bmj 349: g4164.2501145010.1136/bmj.g4164PMC4091648 | — | — | — |
| KerrWC, GreenfieldTK, (2011). “Racial and ethnic differences in all-cause mortality risk according to alcohol consumption patterns in the national alcohol surveys.” Am J Epidemiol 174(7): 769–778.2185664910.1093/aje/kwr147PMC3203376 | — | — | — |
| KlatskyAL and UdaltsovaN (2007). “Alcohol Drinking and Total Mortality Risk.” Ann Epidemiol 17(5, Supplement): S63–S67. | — | — | — |
| KlatskyAL and UdaltsovaN (2007). “Alcohol drinking and total mortality risk.” Ann Epidemiol 17: S63–S67. | — | — | — |
| KlatskyAL and UdaltsovaN (2013). “Abounding confounding: sick quitters and healthy drinkers.” Addiction 108(9): 1549–1552.2394772910.1111/add.12157 | — | — | — |
| LarssonSC, OrsiniN, (2015). “Alcohol consumption and risk of heart failure: a dose-response meta-analysis of prospective studies.” Eur J Heart Fail 17(4): 367–373.2559802110.1002/ejhf.228 | — | — | — |
| Minnesota Population Center and State Health Access Data Assistance Center (2016). Integrated Health Interview Series: Version 6.21 Minneapolis, University of Minnesota. | — | — | — |
| MostofskyE, MukamalKJ, (2016). “Key Findings on Alcohol Consumption and a Variety of Health Outcomes From the Nurses’ Health Study.” Am J Public Health 106(9): 1586–1591.2745945510.2105/AJPH.2016.303336PMC4981808 | — | — | — |
| MukamalKJ, ChenCM, (2010). “Alcohol consumption and cardiovascular mortality among U.S. adults, 1987 to 2002.” J Am Coll Cardiol 55(13): 1328–1335.2033849310.1016/j.jacc.2009.10.056PMC3865979 | — | — | — |
| MukamalKJ, ClowryCM, (2016). “Moderate Alcohol Consumption and Chronic Disease: The Case for a Long-Term Trial.” Alcohol Clin Exp Res 40(11): 2283–2291.2768800610.1111/acer.13231PMC5073014 | — | — | — |
| MukamalKJ, ConigraveKM, (2003). “Roles of drinking pattern and type of alcohol consumed in coronary heart disease in men.” N Engl J Med 348(2): 109–118.1251992110.1056/NEJMoa022095 | — | — | — |
| MukamalKJ, JensenMK, (2005). “Drinking Frequency, Mediating Biomarkers, and Risk of Myocardial Infarction in Women and Men.” Circulation 112(10): 1406–1413.1612979610.1161/CIRCULATIONAHA.105.537704 | — | — | — |
| NaimiTS, BrownDW, (2005). “Cardiovascular risk factors and confounders among nondrinking and moderate-drinking U.S. adults.” Am J Prev Med 28(4): 369–373.1583134310.1016/j.amepre.2005.01.011 | — | — | — |
| NaimiTS, StockwellT, (2017). “Selection bias and relationships between alcohol consumption and mortality.” Addiction 112(2): 220–221.2807870310.1111/add.13709 | — | — | — |
| NaimiTS, StockwellT, (2017). “Selection biases in observational studies affect associations between ‘moderate’ alcohol consumption and mortality.” Addiction 112(2): 207–214.2731634610.1111/add.13451 | — | — | — |
| National Center for Health Statistics. Office of Analysis and Epidemiology (2015). Public-use Linked Mortality File Hyattsville, Maryland. | — | — | — |
| National Institute on Alcohol Abuse and Alcoholism (2016). Rethinking Drinking N. I. o. Health, U.S. Department of Health and Human Services NIH Publication Number 15–3770. | — | — | — |
| PolichJM (1982). “The validity of self-reports in alcoholism research.” Addict Behav 7(2): 123–132.710244310.1016/0306-4603(82)90037-5 | — | — | — |
| RabinRC (2018). N.I.H. Lobbied Industry to Fund Study of Alcohol’s Effect New York Times New York, NY. | — | — | — |
| RicciC, WoodA, (2018). “Alcohol intake in relation to non-fatal and fatal coronary heart disease and stroke: EPIC-CVD case-cohort study.” BMJ 361.10.1136/bmj.k934PMC597277929844013 | — | — | — |
| RonksleyPE, BrienSE, (2011). “Association of alcohol consumption with selected cardiovascular disease outcomes: a systematic review and meta-analysis.” Bmj 342: d671.2134320710.1136/bmj.d671PMC3043109 | — | — | — |
| SAS Institute Inc. ( (c) 2000–2008). SAS 9.4 Cary, NC. | — | — | — |
| SemposCT, RehmJ, (2003). “Average volume of alcohol consumption and all-cause mortality in African Americans: the NHEFS cohort.” Alcohol Clin Exp Res 27(1): 88–92.1254401110.1097/01.ALC.0000046597.92232.73 | — | — | — |
| StahreM, RoeberJ, (2014). “Contribution of excessive alcohol consumption to deaths and years of potential life lost in the United States.” Prev Chronic Dis 11: 130293.10.5888/pcd11.130293PMC407549224967831 | — | — | — |
| StockwellT and RoomR (2012). “Constructing and responding to low-risk drinking guidelines: conceptualisation, evidence and reception.” Drug Alcohol Rev 31(2): 121–125.2238513010.1111/j.1465-3362.2011.00416.x | — | — | — |
| StockwellT, ZhaoJ, (2016). “Do “Moderate” Drinkers Have Reduced Mortality Risk? A Systematic Review and Meta-Analysis of Alcohol Consumption and All-Cause Mortality.” J Stud Alcohol Drugs 77(2): 185–198.2699717410.15288/jsad.2016.77.185PMC4803651 | — | — | — |
| TolstrupJ, JensenMK, (2006). “Prospective study of alcohol drinking patterns and coronary heart disease in women and men.” Bmj 332(7552): 1244–1248.1667231210.1136/bmj.38831.503113.7CPMC1471902 | — | — | — |
| TrichopoulouA, BamiaC, (2010). “Conformity to traditional Mediterranean diet and breast cancer risk in the Greek EPIC (European Prospective Investigation into Cancer and Nutrition) cohort.” Am J Clin Nutr 92(3): 620–625.2063120410.3945/ajcn.2010.29619 | — | — | — |
| U.S. Department of Health and Human Services and U.S. Department of Agriculture (2015). 2015 – 2020 Dietary Guidelines for Americans | — | — | — |
| WoodAM, KaptogeS, (2018). “Risk thresholds for alcohol consumption: combined analysis of individual-participant data for 599 912 current drinkers in 83 prospective studies.” Lancet 391(10129): 1513–1523.2967628110.1016/S0140-6736(18)30134-XPMC5899998 | — | — | — |
| WoodAM, KaptogeS, (2018). “Risk thresholds for alcohol consumption: combined analysis of individual-participant data for 599 912 current drinkers in 83 prospective studies.” The Lancet 391(10129): 1513–1523.10.1016/S0140-6736(18)30134-XPMC589999829676281 | — | — | — |
| World Cancer Research Fund and American Institute for Cancer Research (2018). Alcoholic drinks and the risk of cancer | — | — | — |
| XiB, VeerankiSP, (2017). “Relationship of Alcohol Consumption to All-Cause, Cardiovascular, and Cancer-Related Mortality in U.S. Adults.” J Am Coll Cardiol 70(8): 913–922.2881820010.1016/j.jacc.2017.06.054 | — | — | — |
| XiB, VeerankiSP, (2017). “Relationship of Alcohol Consumption to All-Cause, Cardiovascular, and Cancer-Related Mortality in U.S. Adults.” Journal of the American College of Cardiology 70(8): 913–922.2881820010.1016/j.jacc.2017.06.054 | — | — | — |
| ZhengJ, ErzurumluogluAM, (2017). “LD Hub: a centralized database and web interface to perform LD score regression that maximizes the potential of summary level GWAS data for SNP heritability and genetic correlation analysis.” Bioinformatics 33(2): 272–279.2766350210.1093/bioinformatics/btw613PMC5542030 | — | — | — |
| ZhengYL, LianF, (2015). “Alcohol intake and associated risk of major cardiovascular outcomes in women compared with men: a systematic review and meta-analysis of prospective observational studies.” BMC Public Health 15: 773.2626404010.1186/s12889-015-2081-yPMC4533962 | — | — | — |
No papers in this knowledge base cite this source.
External
| Title | Authors | Journal | Year | Link |
|---|---|---|---|---|
| Maturing out or in? Demographic determinants of young adult drinking trajectories and midlife alcohol use disorder risks. | McKetta S et al. | — | 2026 | → |
| Alcohol consumption reported on routine healthcare screenings is associated with all-cause mortality in primary care patients: A retrospective cohort study. | Matson TE et al. | — | 2025 | → |
| Alcohol in Daily Products: Health Risks, Cultural Considerations, and Economic Impacts. | Herdiana Y | — | 2025 | → |
| Differential Organ Ageing Is Associated With Age-Related Macular Degeneration. | Papadam A et al. | — | 2025 | → |
| Prevalence and Correlates of Fearing a Partner During the COVID-19 Pandemic in Britain: Findings from Natsal-COVID. | Willis M et al. | — | 2025 | → |
| A longitudinal study of the influence of work characteristics, work-family status, and social activities on problem drinking: the Japanese civil servants study. | Shigeno T et al. | — | 2024 | → |
| Drinking in despair: Unintended consequences of automation in China. | Lu W et al. | — | 2024 | → |
| Investigation of Uncovering Molecular Mechanisms of Alcohol-Induced Female Infertility-A Rational Approach. | Lubau NSA et al. | — | 2024 | → |
| Trends in binge drinking in the United States by LGBTQ+ identity, gender, and age, 2014-2022. | McKetta S et al. | — | 2024 | → |
| Adherence to a healthy lifestyle, genetic susceptibility to abdominal obesity, cardiometabolic risk markers, and risk of coronary heart disease. | Wang M et al. | — | 2023 | → |
| Alzheimer's disease and related dementias among aging veterans: Examining gene-by-environment interactions with post-traumatic stress disorder and traumatic brain injury. | Logue MW et al. | — | 2023 | → |
| Effect of provision of non-alcoholic beverages on alcohol consumption: a randomized controlled study. | Yoshimoto H et al. | — | 2023 | → |
| Genetics of Alzheimer's Disease in the African American Population. | Logue MW et al. | — | 2023 | → |
| Psychological distance intervention reminders reduce alcohol consumption frequency in daily life. | Jovanova M et al. | — | 2023 | → |
| Structural sexism moderates work and occupational risks for alcohol consumption and binge drinking among US women, 1989-2016. | McKetta S et al. | — | 2023 | → |
| Alcohol drinking patterns have a positive association with cognitive function among older people: a cross-sectional study. | Akagi Y et al. | — | 2022 | → |
| Cannabis Use in Adults Who Screen Positive for Attention Deficit/Hyperactivity Disorder: CANreduce 2.0 Randomized Controlled Trial Subgroup Analysis. | Ahlers J et al. | — | 2022 | → |
| Correlates of high phosphatidylethanol (PEth) levels and their concordance with self-reported heavy alcohol consumption among men who have sex with men who binge drink alcohol. | McLaughlin MF et al. | — | 2022 | → |
| Structural sexism and Women's alcohol use in the United States, 1988-2016. | McKetta S et al. | — | 2022 | → |
| Types of criminal legal system exposure and polysubstance use: Prevalence and correlates among U.S. adults in the National Survey on Drug Use and Health, 2015-2019. | Ford JA et al. | — | 2022 | → |
| Validation of age- and sex-dependent association of uric acid and incident hypertension in rural areas. | Kim IJ et al. | — | 2022 | → |
| Alcohol, health and cardiovascular disease. | Masip J et al. | — | 2021 | → |
| Alcohol, health and cardiovascular disease. | Masip J et al. | — | 2021 | → |
| Association between patterns of alcohol consumption (beverage type, frequency and consumption with food) and risk of adverse health outcomes: a prospective cohort study. | Jani BD et al. | — | 2021 | → |
| Cohort effects on gender differences in alcohol use in the United States: How much is explained by changing attitudes towards women and gendered roles? | Keyes KM et al. | — | 2021 | → |
| Improvement of patient stratification in human papilloma virus-associated oropharyngeal squamous cell carcinoma by defining a multivariable risk score. | Oberste M et al. | — | 2021 | → |
| Rates and predictors of brief intervention for women veterans returning from recent wars: Examining gaps in service delivery for unhealthy alcohol use. | Pugatch M et al. | — | 2021 | → |
| The moderating role of emotion dysregulation in the relation between potentially morally injurious experiences and alcohol misuse among military Veterans. | Forkus SR et al. | — | 2021 | → |
| Trends in US Alcohol Consumption Frequency During the First Wave of the SARS-CoV-2 Pandemic. | McKetta S et al. | — | 2021 | → |
| Ageing and Alcohol: Drinking Typologies among Older Adults. | Roche AM et al. | — | 2020 | → |
| Factors Affecting Painkillers, Sedatives/Hypnotics, Nicotine, and Unhealthy Alcohol Use Among Gay and Bisexual Men in Taiwan. | Li DJ et al. | — | 2020 | → |
| Informal and Formal Social Integration Shape Eating and Drinking of Older Black and White Americans. | Hauschildt K et al. | — | 2020 | → |
| Red Wine Grape Pomace Attenuates Atherosclerosis and Myocardial Damage and Increases Survival in Association with Improved Plasma Antioxidant Activity in a Murine Model of Lethal Ischemic Heart Disease. | Rivera K et al. | — | 2019 | → |
| Sexual Identity, Adverse Life Experiences, and Cardiovascular Health in Women. | Caceres BA et al. | — | 2019 | → |
| Technology-Based Alcohol Interventions in Primary Care: Systematic Review. | Ramsey AT et al. | — | 2019 | → |
| The Consumption of Alcoholic Beverages and the Prevalence of Cardiovascular Diseases in Men and Women: A Cross-Sectional Study. | Suliga E et al. | — | 2019 | → |