Low-volume, daily alcohol consumption not protective against death

Daily low or moderate alcohol intake is not significantly associated with all-cause mortality risk, but risk increased at higher consumption levels, particularly for women, according to a review published online March 31 in JAMA Network Open.

Jinhui Zhao, Ph.D., from University of Victoria in British Columbia, Canada, and colleagues conducted a systematic literature review to examine the association between alcohol use and all-cause mortality.

Based on 107 included cohort studies (4.8 million participants and 425,564 deaths available), the researchers found that when adjusting for potential confounding effects of sampling variation, former drinker bias, and other prespecified study-level quality criteria, there was no significant reduced risk for all-cause mortality among occasional (>0 to <1.3 g of ethanol per day; relative risk [RR], 0.96; 95 percent confidence interval [CI], 0.86 to 1.06; P = 0.41) or low-volume drinkers (1.3 to 24.0 g per day; RR, 0.93; 95 percent CI, 0.85 to 1.01; P = 0.07) versus lifetime nondrinkers.

There was a nonsignificantly increased risk for all-cause mortality seen among drinkers who drank 25 to 44 g per day (RR, 1.05; 95 percent CI, 0.96 to 1.14; P = 0.28) in fully adjusted models and a significantly increased risk for drinkers who drank 45 to 64 and ≥65 g per day (RRs, 1.19 [95 percent CI, 1.07 to 1.32; P < 0.001] and 1.35 [95 percent CI, 1.23 to 1.47; P < 0.001], respectively). Female drinkers had significantly larger risks for mortality than female lifetime nondrinkers (RR, 1.22; 95 percent CI, 1.02 to 1.46; P = 0.03).

"The importance of controlling for former drinker bias/misclassification is highlighted once more in our results which are consistent with prior studies showing that former drinkers have significantly elevated mortality risks compared with lifetime abstainers," the authors write.

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