US Alcohol Guidelines Not Strict Enough
Upper limits of alcohol consumption specified in current US guidelines may not be low enough, according to new research.
These findings emerged from a study conducted by the Emerging Risk Factors Collaboration/EPIC-CVD/UK Biobank Alcohol Study Group. Their study included 599,912 current drinkers without cardiovascular disease (CVD) enrolled in 83 perspective studies.
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The researchers explored dose-response associations and determined hazard ratios (HRs) per 100 g per week of alcohol (about 7 servings). Findings were adjusted for study or center, age, sex, smoking, and diabetes.
Specifically, associations of alcohol consumption with all-cause mortality, total CVD, and several CVD subtypes were examined.
A total of 40,310 deaths and 39,018 CVD events occurred over 5.4 million person-years of follow-up. Results demonstrated a positive and curvilinear association with the level of alcohol consumption and a minimum mortality risk at or below 100 g per week.
The researchers observed rough linear associations of alcohol consumption with an increased risk of stroke (HR per 100 g per week higher consumption 1.14), coronary artery disease excluding myocardial infarction (1.06), heart failure (1.09), fatal hypertensive disease (1.24), and fatal aortic aneurysm (1.15).
However, they also found log-linear associations of alcohol consumption with a lower risk of myocardial infarction (HR 0.94).
Most notably, participants who reported consuming 100 to 200 g per week, 200 to 350 g per week, or more than 350 g per week had lower life expectancies at age 40 years of 6 months, 1 to 2, years, or 4 to 5 years, respectively, compared with those who consumed 100 g or less per week.
“In current drinkers of alcohol in high-income countries, the threshold for lowest risk of all-cause mortality was about 100 g/week,” the researchers wrote. “For [CVD] subtypes other than myocardial infarction, there were no clear risk thresholds below which lower alcohol consumption stopped being associated with lower disease risk.”
“These data support limits for alcohol consumption that are lower than those recommended in most current guidelines,” they concluded.
—Christina Vogt
Reference:
Wood AM, Kaptoge S, Butterworth AS, et al. Risk thresholds for alcohol consumption: combined analysis of individual-participant data for 599,912 current drinkers in 83 prospective studies. Lancet. 2018;391:1513-1523. https://doi.org/10.1016/S0140-6736(18)30134-X