Association between patterns of alcohol consumption (beverage type, frequency and consumption with food) and risk of adverse health outcomes: a prospective cohort study

Jani, B. D. , McQueenie, R., Nicholl, B. I. , Field, R. , Hanlon, P. , Gallacher, K. I. , Mair, F. S. and Lewsey, J. (2021) Association between patterns of alcohol consumption (beverage type, frequency and consumption with food) and risk of adverse health outcomes: a prospective cohort study. BMC Medicine, 19, 8. (doi: 10.1186/s12916-020-01878-2) (PMID:33430840) (PMCID:PMC7802201)

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Abstract

Background: Alcohol consumption is a leading contributor to death and disability worldwide, but previous research has not examined the effects of different patterns of alcohol consumption. The study objective was to understand the relationship between different alcohol consumption patterns and adverse health outcomes risk, adjusting for average amount consumed among regular drinkers. Methods: This was a prospective cohort study of UK Biobank (UKB) participants. Abstainers, infrequent alcohol consumers or those with previous cancer, myocardial infarction (MI), stroke or liver cirrhosis were excluded. We used beverage type, consumption with food and consumption frequency as exposures and adjusted for potential confounding. All-cause mortality, major cardiovascular events-MACE (MI/stroke/cardiovascular death), accidents/injuries, liver cirrhosis, all-cause and alcohol-related cancer incidence over 9-year median follow-up period were outcomes of interest. Results: The final sample size for analysis was N = 309,123 (61.5% of UKB sample). Spirit drinking was associated with higher adjusted mortality (hazard ratio (HR) 1.25; 95% confidence intervals (CI) 1.14–1.38), MACE (HR 1.31; 95% CI 1.15–1.50), cirrhosis (HR 1.48; 95% CI 1.08–2.03) and accident/injuries (HR 1.10; 95% CI 1.03–1.19) risk compared to red wine drinking, after adjusting for the average weekly alcohol consumption amounts. Beer/cider drinkers were also at a higher risk of mortality (HR 1.18; 95% CI 1.10–1.27), MACE (HR 1.16; 95% CI 1.05–1.27), cirrhosis (HR 1.36; 95% CI 1.06–1.74) and accidents/injuries (HR 1.11; 95% CI 1.06–1.17). Alcohol consumption without food was associated with higher adjusted mortality (HR 1.10; 95% CI 1.02–1.17) risk, compared to consumption with food. Alcohol consumption over 1–2 times/week had higher adjusted mortality (HR 1.09; 95% CI 1.03–1.16) and MACE (HR 1.14; 95% CI 1.06–1.23) risk, compared to 3–4 times/week, adjusting for the amount of alcohol consumed. Conclusion: Red wine drinking, consumption with food and spreading alcohol intake over 3–4 days were associated with lower risk of mortality and vascular events among regular alcohol drinkers, after adjusting for the effects of average amount consumed. Selection bias and residual confounding are important possible limitations. These findings, if replicated and validated, have the potential to influence policy and practice advice on less harmful patterns of alcohol consumption.

Item Type:Articles
Additional Information:BDJ received funding from NHS Research for Scotland Career Research Fellowship for some of his research time. This work was supported by the Medical Research Council [grant reference: MR/S021949/1].
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Nicholl, Dr Barbara and Jani, Dr Bhautesh and Gallacher, Dr Katie and Field, Ryan and Lewsey, Professor Jim and Mair, Professor Frances and McQueenie, Dr Ross and Hanlon, Dr Peter
Authors: Jani, B. D., McQueenie, R., Nicholl, B. I., Field, R., Hanlon, P., Gallacher, K. I., Mair, F. S., and Lewsey, J.
College/School:College of Medical Veterinary and Life Sciences
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > General Practice and Primary Care
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Health Economics and Health Technology Assessment
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:BMC Medicine
Publisher:BMC
ISSN:1741-7015
ISSN (Online):1741-7015
Copyright Holders:Copyright © 2021 The Authors
First Published:First published in BMC Medicine 19:8
Publisher Policy:Reproduced under a Creative Commons licence

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
305232Understanding prevalence and impact of frailty in chronic illness and implications for clinical managementFrances MairMedical Research Council (MRC)MR/S021949/1HW - General Practice and Primary Care