Safer Drinking Recommendations Should Vary By Age and Sex

Alcohol
consumption has a U-shaped relationship with all-cause mortality;
abstinence and heavy drinking increase risk. To quantify
deaths attributable to and prevented by various levels of intake,
researchers combined age- and sex-specific associations between
alcohol consumption and mortality (from meta-analyses of observational
studies) with population survey and national mortality data from
England and Wales.

• Over the lifespan, mortality attributable to and prevented
  by alcohol consumption was relatively balanced, with
  0.8% of all deaths in men prevented by use (95% confidence
  interval, CI, 0.2% to 1.3%) and 0.1% of all deaths in
  women attributable to use (95% CI, -0.3% to 0.4%).
• Deaths attributable to alcohol outweighed those prevented
  by use for men up to age 54 and for women up to age
  64.
• Among men, those aged 16–24 years were at greatest
  risk of alcohol-related mortality (22% of deaths attributable
  to alcohol use), while those aged 75–85 years
  were most likely to benefit from consumption (3% of
  deaths prevented by use).
• Among women, those aged 35–44 years were at
  greatest risk (8% of deaths attributable to alcohol
  use), while those aged 85 and older were most likely
  to benefit (1% of deaths prevented by use).

Comments:

At

least in England and Wales, mortality attributable to alcohol

varies by age and sex. Recommendations of safest
limits, which appear to be lower than the often cited “drink-a-day” for
health, should vary as well. Abstinence is the safest
choice for men up to age 34 and women up to age 44 because
of their low risk of coronary heart disease and higher
risk of alcohol-related traffic accidents. And although
mortality benefits attributable to alcohol increase with
age, a shift from abstinence to moderate consumption among
elderly patients would only have a small effect on overall
mortality.

Peter
D. Friedmann, MD, MPH

Reference:

White

IR, Altmann DR, Nanchalal K. Mortality in England
and Wales attributable to any drinking, drinking above
sensible limits and drinking above lowest-risk levels. Addiction. 2004;99(6):749–756.
(view
abstract)