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. 2021 Feb 1;20(1):13.
doi: 10.1186/s12937-021-00671-y.

Alcohol consumption and risk of cardiovascular disease, cancer and mortality: a prospective cohort study

Xinyuan Zhang  1 , Yan Liu  2 , Shanshan Li  3 , Alice H Lichtenstein  4 , Shuohua Chen  2 , Muzi Na  1 , Susan Veldheer  5 , Aijun Xing  2 , Yanxiu Wang  2 , Shouling Wu  6 , Xiang Gao  7
Affiliations

Alcohol consumption and risk of cardiovascular disease, cancer and mortality: a prospective cohort study

Xinyuan Zhang et al. Nutr J. .

Abstract

Background: Studies regarding whether light to moderate alcohol consumption is associated with a lower risk of cardiovascular diseases (CVD) have generated mixed results. Further, few studies have examined the potential impact of alcohol consumption on diverse disease outcomes simultaneously. We aimed to prospectively study the dose-response association between alcohol consumption and risk of CVD, cancer, and mortality.

Methods: This study included 83,732 adult Chinese participants, free of CVD and cancer at baseline. Participants were categorized into 6 groups based on self-report alcohol consumption: 0, 1-25, 26-150, 151-350, 351-750, and > 750 g alcohol/wk. Incident cases of CVD, cancers, and mortality were confirmed by medical records. Hazard ratios (HRs) for the composite risk of these three outcomes, and each individual outcome, were calculated using Cox proportional hazard model.

Results: During a median follow-up of 10.0 years, there were 6411 incident cases of CVD, 2947 cancers and 6646 deaths. We observed a J-shaped relation between alcohol intake and risk of CVD, cancer, and mortality, with the lowest risk at 25 g/wk., which is equivalent to ~ 2 servings/wk. Compared to consuming 1-25 g/wk., the adjusted HR for composite outcomes was 1.38 (95% confidence interval (CI):1.29-1.49) for non-drinker, 1.15 (95% CI: 1.04-1.27) for 26-150 g/wk., 1.22 (95% CI: 1.10-1.34) for 151-350 g/wk., 1.33 (95% CI: 1.21-1.46) for 351-750 g/wk., and 1.57 (95% CI: 1.30-1.90) for > 750 g/wk., after adjusting for age, sex, lifestyle, social economic status, and medication use.

Conclusions: Light alcohol consumption at ~ 25 g/wk was associated with lower risk of CVD, cancer, and mortality than none or higher consumption in Chinese adults.

Keywords: Alcohol consumption; Cancer; Cardiovascular disease; Mortality; Nutritional epidemiology.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Associations between alcohol consumption and cardiovascular disease, cancer, and all-cause mortality among 83,732 participants, adjusted for age, sex, marriage (single, first marriage, other), education (elementary school or below, middle or high school, college or above), household income per capita (≤500, 501–1000, > 1000 Chinese yuan/month), smoking status (never, past, current),moderate/vigorous physical activity (< 1, 1–3, ≥4 times/week), sodium intake (< 6, 6–9.9, ≥10 g/day), body mass index (kg/m2), fasting blood glucose (mmol/L), anti-hypertension drugs (yes, no), anti-diabetes drugs (yes, no), and lipid-lowering drugs (yes, no). The reference category is zero consumption. Diamonds represent hazard ratios (referenced to 1). Horizontal lines represent 95% confidence intervals. Incidence rate is calculated as per 1000 person-years. CVD, cardiovascular diseases
Fig. 2
Fig. 2
Associations between alcohol consumption and specific chronic diseases and cause-specific mortality among 83,732 participants, adjusted for age, sex, marriage (single, first marriage, other), education (elementary school or below, middle or high school, college or above), household income per capita (≤500, 501–1000, > 1000 Chinese yuan/month), smoking status (never, past, current), moderate/vigorous physical activity (< 1, 1–3, ≥4 times/week), sodium intake (< 6, 6–9.9, ≥10 g/day), body mass index (kg/m2), fasting blood glucose (mmol/L), anti-hypertension drugs (yes, no), anti-diabetes drugs (yes, no), and lipid-lowering drugs (yes, no). The reference category is zero consumption. Diamonds represent hazard ratios (referenced to 1). Horizontal lines represent 95% confidence intervals. Incidence rate is calculated as per 1000 person-years. CVD, cardiovascular diseases
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