Mediterranean alcohol-drinking pattern and mortality in the SUN (Seguimiento Universidad de Navarra) Project: a prospective cohort study

Abstract

Moderate alcohol intake has been related to lower mortality. However, alcohol use includes other dimensions beyond the amount of alcohol consumed. These aspects have not been sufficiently studied as a comprehensive entity. We aimed to test the relationship between an overall alcohol-drinking pattern and all-cause mortality. In a Mediterranean cohort study, we followed 18 394 Spanish participants up to 12 years. A validated 136-item FFQ was used to assess baseline alcohol intake. We developed a score assessing simultaneously seven aspects of alcohol consumption to capture the conformity to a traditional Mediterranean alcohol-drinking pattern (MADP). It positively scored moderate alcohol intake, alcohol intake spread out over the week, low spirit consumption, wine preference, red wine consumption, wine consumed during meals and avoidance of binge drinking. During the follow-up, 206 deaths were identified. For each 2-point increment in a 0 -9 score of adherence to the MADP, we observed a 25 % relative risk reduction in mortality (95 % CI 11, 38 %). Within each category of alcohol intake, a higher adherence to the MADP was associated with lower mortality. Abstainers (excluded from the calculations of the MADP) exhibited higher mortality (hazard ratio 1·82, 95 % CI 1·14, 2·90) than participants highly adherent to the MADP. In conclusion, better adherence to an overall healthy alcohol-drinking pattern was associated with reduced mortality when compared with abstention or departure from this pattern. This reduction goes beyond the inverse association usually observed for moderate alcohol drinking. Even moderate drinkers can benefit from the advice to follow a traditional MADP.

Prevalence of severe esophagitis in Spain. Results of the PRESS study (Prevalence and Risk factors for Esophagitis in Spain: A cross‐sectional study)

“…29,30 It is known that consumption of large amounts of alcohol can promote regurgitation of acid into the esophagus and therefore cause GERD symptoms. Most individuals who experience alcohol-related health problems are not addicted to alcohol, but present with a hazardous pattern of alcohol consumption.…”

Empirically-derived food patterns and the risk of total mortality and cardiovascular events in the PREDIMED study

“…A suggested explanation is that 282 the "WDP" described in the U.S. [7] and the "WDP" in our study are not entirely equivalent 283 and may not produce the same potential adverse effects on health and longevity. Thus, the 284 consumption of foods known to be associated with lower mortality, such as fish and seafood 285 and alcohol in moderation [29], was included in the so-called WDP in our cohort. Besides, it 286 is possible that residual confounding may have affected our results.…”

Patterns of alcohol consumption and health-related quality of life in older adults

“…This pattern was used because there is recent evidence that adherence to the MDP is associated with a reduction in mortality that cannot be entirely explained by moderate drinking (Gea et al, 2014).…”

“…However, it may also have beneficial effects when consumed in small, regular amounts. Data from observational studies show that low-to-moderate alcohol consumption is associated with a reduced risk of cardiovascular disease (CVD), diabetes, frailty, and all-cause death among middle-aged and older adults (Gea et al, 2014;Mukamal et al, 2006;Ortolá et al,2015;Ronksley et al, 2011).…”