Associations between beer, wine, and spirits consumption and major mortality outcomes in 187,294 Norwegian men and women, with a focus on low-level wine intake.

Abstract

Aims: To examine how consumption of wine, beer, and spirits-both individually and in combination-is associated with mortality. We also assessed the relationship between overall alcohol intake and mortality from cardiovascular disease, ischemic heart disease, cancer, and alcohol-related diseases.

Methods: A cohort of 187,294 men and women aged 16-99 years (10th percentile 36 years, 90th percentile 52 years), without cardiovascular disease or cancer, were followed for an average of 21 years, with 15,642 deaths. The participants completed a cardiovascular health survey and a questionnaire reporting their consumption of beer, wine, and spirits over the preceding 14 days. Mortality outcomes were assessed using absolute mortality rates, calculated with the direct method, and hazard ratios, adjusted for major cardiovascular risk factors, estimated with Cox proportional hazards models. Non-drinkers served as the reference group.

Results: For all-cause death in men and women combined, the hazard ratio was 0.91 (95% confidence interval: 0.88-0.94) for 1-9 glasses/14 days of alcohol, 1.01 (0.96-1.07) for 10-19 glasses, and 1.44 (1.32-1.57) for 20+ glasses versus non-drinkers. Corresponding hazard ratios for ischemic heart disease death were 0.86 (0.77-0.97), 0.82 (0.68-0.98), and 1.09 (0.83-1.43), and for alcohol-related deaths 1.63 (1.07-2.49), 4.47 (2.85-7.02), and 13.0 (8.11-20.8). Low wine consumption alone, or combined with low beer or spirits consumption, was associated with hazard ratios of 0.84 (0.78-0.89) to 0.90 (0.84-0.97). Combinations without wine showed hazard ratios ranging from 1.00 (0.95-1.06) to1.06 (1.00-1.13).

Conclusions: Low wine consumption was associated with lower mortality than no alcohol consumption, irrespective of low beer or spirits consumption.