Average volume of alcohol consumed, type of beverage, drinking pattern and the risk of death from all causes

BACKGROUND: The objective was to investigate associations between average volume of alcohol consumption, type of beverage and drinking pattern and all-cause mortality in the Melbourne Collaborative Cohort Study. METHODS: Average consumption, including type of beverage, was estimated from beverage-specific questions on quantity and frequency of consumption. Pattern of consumption was estimated from a 7-day diary. During an average of 10.5 years of follow-up of 36 984 participants, 1971 deaths occurred. RESULTS: For both men and women, mortality curves were J-shaped (nadir at 9-12 g/day of alcohol consumption; upper protective dose of 42-76 g/day). Wine consumption was associated with lower mortality (for men, minimum hazard ratio (HR) at 20-39 g/day of wine consumption: 0.69; 95% confidence interval (CI): 0.54-0.87; for women, minimum HR at 1-19 g/day: 0.82; 95% CI: 0.70-0.98). Beer was associated with an increased risk for men (test for trend, P = 0.05), but not for women. After adjustment for total amount of alcohol consumed, the number of drinking-days was inversely associated with the risk of dying in men (P-trend = 0.04). CONCLUSIONS: These results confirm previous findings about the effect of average volume of alcohol and type of beverage and suggest that drinking pattern is an independent risk factor for all-cause mortality.     

上海市男性饮酒与死亡关系的前瞻性研究

目的　探讨饮酒与上海市市区中老年男性死亡的关系。方法　自 1986年 1月～ 1989年 9月调查上海市区 4 5～ 6 4岁男性居民 182 4 4人 ,每年上门随访一次 ;用COX比例风险模型计算相对危险度。结果　至 2 0 0 2年度随访结束 ,全队列共随访 2 35 76 2人年 ,人均随访 12 .9年。在此期间共死亡 336 5人 ,其中恶性肿瘤死亡 1381人。在调整年龄、吸烟情况及教育程度后 ,相对于不饮酒者每天饮酒酒精量 <15 g和 15～ 2 9g者总死亡相对危险度 (RR)分别为 0 .80 (95 %CI:0 .72～ 0 .89)和 0 .87(95 %CI :0 .78～ 0 .97) ,每天饮酒酒精量 90 g及以上者RR为 1.2 5 (95 %CI:1.0 4～ 1.5 1)。少量饮酒者缺血性心脏病和慢性阻塞性肺部疾病死亡危险性显著降低。每天饮酒酒精量 70 g及以上者食管癌、结直肠癌、脑血管病死亡危险性显著升高 ,RR分别为 5 .0 8,2 .5 7和 1.5 7,肝硬化死亡危险性在每天饮酒酒精量 30 g及以上者中也显著上升 ,RR为 1.89。 结论　少量饮酒会降低中老年男性总死亡危险性 ,大量饮酒则会增加中老年男性食管癌、结直肠癌、脑血管病及肝硬化的死亡危险性。     

Alcohol consumption and 17-year mortality in the Chicago Western Electric Company study

The association between baseline alcohol intake and mortality from all causes and specific causes based on 17 years of follow-up experience was analyzed for 1,832 white males originally age 40–55 from the Chicago Western Electric Company study. Alcohol consumption was expressed as number of drinks per day for all intake combined, including hard liquor, beer, and wine, based on the maximum intake reported on three questionnaires. With mortality rates adjusted only for age, total intake was associated with increased risk of death from all causes, the cardiovascular diseases, coronary heart disease, cancer, and other causes at the level of six or more drinks per day. There was no increase in mortality with increasing alcohol consumption below this level. Only the associations between alcohol intake and death from the cardiovascular diseases and coronary heart disease failed to persist after adjustment for other risk factors, such as smoking and blood pressure. When the deaths were divided into those occurring within the first 10 years of follow-up and those occurring more than 10 years after entry, the association between baseline alcohol intake and mortality was generally stronger for those deaths occurring more than 10 years after entry.     

Risk factors for mortality from all causes and from coronary heart disease among persons with diabetes. Findings from the National Health and Nutrition Examination Survey I Epidemiologic Follow-up Study

Coronary heart disease is the leading cause of mortality among persons with diabetes mellitus, but the factors that account for this high coronary heart disease mortality remain unclear. In the National Health and Nutrition Examination Survey I Epidemiologic Follow-up Study, conducted from 1982 to 1984, 92 deaths from coronary heart disease were found to have occurred among 602 diabetic participants and 558 deaths from coronary heart disease were found to have occurred among 12,562 nondiabetic participants during the follow-up period (1971-1984; average follow-up, 10 years). Using proportional hazards analysis, the authors found age, male sex, severe overweight, and non-leisure-time physical inactivity to be significantly associated with coronary heart disease mortality among persons with diabetes. Age, male sex, current smoking, hypertension, and non-leisure-time physical inactivity were associated with all-cause mortality. Cholesterol showed a more complex relation to all-cause mortality. The strength of the associations between risk factors and all-cause and coronary heart disease mortality did not differ significantly among persons with and without diabetes. These results reinforce the importance of controlling coronary heart disease risk factors among persons with diabetes.     

The influence of duration of follow-up on the association between alcohol and cause-specific mortality in a prospective cohort study

PURPOSE: To investigate whether duration of follow-up influences the association between alcohol and cause-specific mortality in a prospective cohort study with only baseline assessment of alcohol intake. METHODS: In a cohort of 14,223 men and women participating in the first investigation of the Copenhagen City Heart Study between 1976 and 1978 and followed until 2001, we assessed whether the association between alcohol and mortality was modified by duration of follow-up. The 24 years of follow-up were divided into four intervals, and Cox survival analyses were conducted separately for these four succeeding 6-year periods of follow-up. RESULTS: The authors found differences in the predictive values of alcohol and beverage-specific types of alcohol depending on duration of follow-up both in terms of all-cause mortality and death from coronary heart disease and cancer. The apparent protective effect of a moderate alcohol consumption on coronary heart disease attenuated during prolonged follow-up, whereas high alcohol consumption became associated with higher risk of death from cancer with longer follow-up. CONCLUSIONS: This study accentuates the importance of taking duration of follow-up into consideration when interpreting risk estimates from prospective studies on the association between alcohol and mortality.     

Mortality attributable to drinking, drinking too much, or drinking too little: a comparison of methods

BACKGROUND: The existence of a U-shaped relationship between alcohol consumption and all-cause mortality complicates the calculation and interpretation of mortality attributable to alcohol consumption. METHODS: We used the relationships between all-cause mortality and alcohol consumption from four British cohort studies. For each study we defined a 'sensible drinking level' asthe level with lowest observed mortality. We estimated the fractions of deaths that were attributable to (1) any drinking (compared with not drinking), (2) drinking more than the 'sensible level', and (3) drinking less than the 'sensible level'. RESULTS: Data from the Doctors' study suggest that on balance 22.3 per cent of deaths are prevented by alcohol consumption, yet the fractions of deaths attributable to drinking more than 8-14 units per week and less than 8-14 units per week are nearly equal (6.5 per cent and 6.4 per cent, respectively). In a sensitivity analysis we show that it is possible for alcohol consumption to prevent deaths overall yet for more deaths to be attributable to drinking above a sensible level than are attributable to drinking below the sensible level. CONCLUSIONS: The balance of deaths attributable to or prevented by alcohol consumption provides no information about the deaths attributable to drinking above or below sensible levels. Using all-cause data in this way is likely to exaggerate the protective effect of alcohol consumption, so our results are only illustrative.     

中国成年人饮茶与死亡风险的前瞻性关联研究

目的分析中国成年人饮茶与全因死亡和死因别死亡风险间的关联。方法本研究分析基于中国慢性病前瞻性研究项目。饮茶信息为基线自报。死亡信息主要通过链接死亡监测系统获取。使用Cox比例风险回归模型计算风险比(HR)及其95%CI。结果纳入分析的438 443例研究对象随访11.1年共发生死亡34 661例。与从不饮茶者相比, 当前非每日饮茶者和每日饮茶者全因死亡HR值(95%CI)依次为0.89(0.86～0.91)和0.92(0.88～0.95)。分性别分析显示, 饮茶对全因死亡风险的保护作用主要见于男性(交互P<0.05)。与从不饮茶者相比, 当前每日饮茶者死于缺血性心脏病、缺血性脑卒中、出血性脑卒中、恶性肿瘤、呼吸系统疾病及其他死因的HR值(95%CI)依次为0.83(0.76～0.92)、0.82(0.69～0.97)、0.86(0.78～0.94)、1.03(0.97～1.09)、1.00(0.87～1.16)、0.84(0.78～0.90)。在不吸烟且不过量饮酒者中, 每日饮茶与恶性肿瘤死亡风险间不存在有统计学显著性的关联, 但在吸烟或过量饮酒者中, 每日饮茶者死于恶性肿瘤的风...     

Daily variations in deaths in Lithuania: the possible contribution of binge drinking

BACKGROUND: During the early 1990s the countries of the Former Soviet Union experienced a dramatic rise in mortality, especially from cardiovascular diseases. Although still poorly understood there is evidence, particularly from Russia, that this mortality crisis is partly linked to alcohol consumption. In this paper we use data from Lithuania to explore the daily variations of deaths and the probable relationship with binge drinking. METHODS: Computerized death certificates for those aged 20-59 years were analysed according to the day of death, place of death, and cause of death for the years 1988-1997. RESULTS: There is a marked increase in deaths from accidents, violence, and alcohol poisoning at the weekend, suggesting a pattern of binge drinking in Lithuania. There is also a significant increase in ischaemic heart disease (IHD) deaths on Saturdays, Sundays and Mondays. If the analysis is performed separately according to place of death, the day of the week effect is strengthened for cardiovascular deaths outside of hospital; consistent with the idea of a sudden cardiac death. CONCLUSION: The increase in mortality from cardiovascular diseases observed at the weekend in Lithuania is similar to that observed in Moscow and other populations. The relationship with alcohol consumption is supported by the available physiological evidence. We propose that bingeing can be solely responsible for, or acts as a 'catalyst' for, pathophysiological events by increasing blood pressure, cardiac rhythm and coagulability. The increased IHD mortality observed throughout the weekend and on Monday in Lithuania may reflect the influence of alcohol consumption patterns in a population already subject to high psychosocial stress.     

Alcohol consumption and all-cause and cancer mortality among middle-aged Japanese men: seven-year follow-up of the JPHC study Cohort I. Japan Public Health Center

To examine the association between alcohol consumption and mortality in Japan, where mortality and lifestyle differ substantially from Western countries, a population-based prospective study was conducted in four public health center areas as part of the Japan Public Health Center-based prospective study on cancer and cardiovascular disease (JPHC). After excluding subjects with self-reported serious diseases at baseline, 19,231 men aged 40-59 years who reported their alcohol intake were followed from 1990 through 1996, and 548 deaths were documented. The association between all-cause mortality and alcohol consumption was J-shaped. The lowest risk was observed for men who consumed 1-149 g/week (relative risk (RR) = 0.64, 95% confidence interval (CI) 0.46, 0.88), while the highest risk was seen for men who consumed > or =450 g/week (RR = 1.32, 95% CI 1.00, 1.74), after adjustment for possible confounders. The association did not change after excluding deaths that occurred in the first 2 years of follow-up. However, the association was modified by smoking, and beneficial effects of moderate drinking were largely limited to nonsmokers. The risk of cancer death showed a similar trend, but increased more in heavy drinkers. The background characteristics of moderate drinkers were healthier than either nondrinkers or heavy drinkers. The authors conclude that moderate alcohol consumption was associated with the lowest risks of all-cause and cancer mortality, especially among nonsmokers.     

Cancer mortality and lipid and lipoprotein levels. Lipid Research Clinics Program Mortality Follow-up Study

The associations of serum lipid and lipoprotein levels with the risk of cancer mortality were assessed in 2,753 men and 2,476 women aged 40-79 years at baseline (1972-1976) who participated in the Lipid Research Clinics Program Mortality Follow-up Study through 1984. Seventy-nine cancer deaths occurred in men and 65 occurred in women during an average follow-up time of 8.4 years. Total cholesterol and low-density lipoprotein (LDL) cholesterol were significantly inversely associated with overall cancer mortality in men, but no relation was observed in women. Neither high-density lipoprotein (HDL) cholesterol nor triglycerides were significantly related to total cancer mortality in either sex, although in women. HDL cholesterol was positively associated with risk of death from gynecologic cancers. Compared with men with higher cholesterol levels, the relative risk of death from colon cancer, adjusted for age, body mass, cigarette smoking, and alcohol consumption, was 5.20 (95 percent confidence interval (Cl) 1.61-16.8) in men with total cholesterol levels less than or equal to 187 mg/dl and 4.79 (95 percent CI 1.37-16.8) in those with LDL cholesterol levels less than or equal to 119 mg/dl. Death from smoking-related cancers was inversely related to baseline total cholesterol but not to LDL cholesterol. The absence of an association with HDL cholesterol, which has been shown to be lower in persons with clinically manifest malignancy, and evidence from survival curves suggest that the inverse relation in men is not due to preexisting disease.     

Coffee consumption, gender, and Parkinson's disease mortality in the cancer prevention study II cohort: the modifying effects of estrogen

Caffeine consumption is associated with a reduced risk of Parkinson's disease in men but not in women. This gender difference may be due to an interaction between caffeine and use of postmenopausal estrogens. The authors prospectively assessed the relation between coffee consumption and Parkinson's disease mortality among participants in the Cancer Prevention Study II, a cohort of over 1 million people enrolled in 1982. Causes of deaths were ascertained through death certificates from January 1, 1989, through 1998. Parkinson's disease was listed as a cause of death in 909 men and 340 women. After adjustment for age, smoking, and alcohol intake, coffee consumption was inversely associated with Parkinson's disease mortality in men (p(trend) = 0.01) but not in women (p = 0.6). In women, this association was dependent on postmenopausal estrogen use; the relative risk for women drinking 4 or more cups (600 ml) of coffee per day compared with nondrinkers was 0.47 (95% confidence interval: 0.27, 0.80; p = 0.006) among never users and 1.31 (95% confidence interval: 0.75, 2.30; p = 0.34) among users. These results suggest that caffeine reduces the risk of Parkinson's disease but that this hypothetical beneficial effect may be prevented by use of estrogen replacement therapy.     

Light to Moderate Alcohol Consumption and Disability: Variable Benefits by Health Status

In adults, light to moderate alcohol consumption is associatedwith lower risks for heart disease, diabetes, and mortality.This study examined whether light to moderate alcohol use isalso associated with lower risk of incident physical disabilityover two 5-year periods in 4,276 noninstitutionalized adultsin the United States, aged 50 years or older, by using datafrom 3 waves of the National Health and Nutrition ExaminationSurvey Epidemiologic Follow-up Study surveys from 1982 to 1992.Light/moderate drinking (<15 drinks per week and <5 perdrinking day or 4 per drinking day for women) was associatedwith reduced risk for incident disability or death over 5 years,compared with abstention (adjusted odds ratio = 0.77; P = 0.008).Among survivors, light/moderate drinking was associated withlower risk for incident disability, compared with abstention(adjusted odds ratio = 0.75; P = 0.009). In stratified analyses,disability risk decreased with light/moderate drinking in adose-dependent fashion in men and women with good or betterself-reported health but not in men or women with fair or worseself-reported health. Alcohol consumption in moderation mightreduce the risk of developing physical disability in older adultsin good health but not in those in poor health. activities of daily living; alcohol drinking; longitudinal studies     

Moderate alcohol consumption is associated with lower chronic disease burden expressed in disability-adjusted life years: a prospective cohort study

The relation of alcohol consumption with disease burden remains debated partly due to opposite associations with cardiovascular disease (CVD) and cancer. The relation of alcohol consumption with disease burden expressed in disability-adjusted life years (DALYs) summarizes opposing associations of alcohol consumption on chronic diseases. This study aimed to investigate the association of alcohol consumption with chronic disease burden expressed in DALYs based on individual-participant data. The study was a prospective study among 33,066 men and women from the EPIC-NL cohort. At baseline, alcohol consumption was assessed with a validated food-frequency questionnaire. Participants were followed for occurrence of and mortality from chronic diseases and DALYs were calculated. After 12.4 years follow-up, 6647 disease incidences and 1482 deaths were documented, resulting in 68,225 healthy years of life lost (6225 DALYs). Moderate drinkers (women 5–14.9 g/day, men 5–29.9 g/day) had a lower chronic disease burden (mean DALYs ?0.27; 95% CI ?0.43; ?0.11) than light drinkers (0–4.9 g/day), driven by a lower disease burden due to CVD (?0.18: ?0.29; ?0.06) but not cancer (?0.05: ?0.16; 0.06). The associations were most pronounced among older participants (≥50 years; ?0.32; ?0.53; ?0.10) and not observed among younger women (?0.08; ?0.43; 0.35), albeit non-significant (p_interaction > 0.14). Substantial drinking (women 15–29.9 g/day, men 30–59.9 g/day) compared to light drinking was not associated with chronic disease burden. Our results show that moderate compared to light alcohol consumption was associated with living approximately 3 months longer in good health. These results were mainly observed among older participants and not seen among younger women.     

Mortality in relation to alcohol consumption: a prospective study among male British doctors

BACKGROUND: To relate alcohol consumption patterns to mortality in an elderly population. METHODS: We undertook a 23-year prospective study of 12 000 male British doctors aged 48-78 years in 1978, involving 7000 deaths. Questionnaires about drinking and smoking were completed in 1978 and once again in 1989-91. Mortality analyses are standardized for age, follow-up duration, and smoking, and (during the last decade of the study, 1991-2001) subdivide non-drinkers into never-drinkers and ex-drinkers. RESULTS: In this elderly population, with mean alcohol consumption per drinker of 2 to 3 units per day, the causes of death that are already known to be augmentable by alcohol accounted for only 5% of the deaths (1% liver disease, 2% cancer of the mouth, pharynx, larynx, or oesophagus, and 2% external causes of death) and were significantly elevated only among men consuming >2 units/day. Vascular disease and respiratory disease accounted for more than half of all the deaths and were both significantly less common among current than among non-drinkers; hence, overall mortality was also significantly lower (relative risk, RR 0.81, CI 0.76-0.87, P = 0.001). The non-drinkers, however, include the ex-drinkers, some of whom may have stopped recently because of illness, and during the last decade of the study (1991-2001) overall mortality was significantly higher in the few ex-drinkers who had been current drinkers in 1978 than in the never-drinkers or current drinkers. To avoid bias, these 239 ex-drinkers were considered together with the 6271 current drinkers and compared with the 750 men who had been non-drinkers in both questionnaires. Even so, ischaemic heart disease (RR 0.72, CI 0.58-0.88, P = 0.002), respiratory disease (RR 0.69, CI 0.52-0.92, P = 0.01), and all-cause (RR 0.88, CI 0.79-0.98, P = 0.02) mortality were significantly lower than in the non-drinkers. CONCLUSIONS: Although some of the apparently protective effect of alcohol against disease is artefactual, some of it is real.     

World War II-veteran male twins who are discordant for alcohol consumption: 24-year mortality.

The role of genetic and shared environmental influences in the association of alcohol with mortality was studied by using the National Academy of Sciences-National Research Council World War II-veteran male twin registry. An epidemiologic questionnaire administered from 1967 through 1969 permitted identification of twin pairs discordant for alcohol consumption. The subsequent 24 years of mortality follow-up yielded data on time and cause of death. Analyzing the first or only death in drinking-discordant pairs, we observed 27 deaths in abstainer twins and 14 deaths in their light- to moderate-drinker cotwins (relative risk [RR] = 1.93). Excess mortality in twin abstainers was also indicated for deaths from cardiovascular diseases (RR = 2.0) and other causes of death excluding cancers (RR = 3.2). The protective effect, however, of light to moderate drinking did not persist in twins who were smokers at baseline.     

Alcohol and mortality: a cohort study of male Japanese physicians

The relationship between drinking habit surveyed in 1965 and cause-specific mortality over 19 years was investigated in 5135 male Japanese physicians taking into account smoking habit and separating ex-drinker from non-drinker. As compared with non-drinkers, daily drinkers with high consumption had a significantly increased mortality from all causes. Drinking was significantly related to the so-called alcohol-related causes of death; upper aerodigestive cancer, liver cancer and liver cirrhosis. Mortality from acute myocardial infarction was inversely related to drinking, whereas other coronary heart disease showed a somewhat higher mortality among men consuming a large amount of alcohol than among non-drinkers. There was a weak, but significant, association between stroke and drinking, and the relation did not differ between haemorrhagic stroke and other stroke. No obvious relationship with drinking was observed for cancers of the stomach, large bowel, pancreas and lung.     

UTILIZING CULTURE AND BEHAVIOUR IN EPIDEMIOLOGICAL MODELS OF ALCOHOL CONSUMPTION AND CONSEQUENCES FOR ESTERN NATIONS

Cultural differences in alcohol consumption are inescapable,but have been difficult to establish as predictor variablesin epidemiological models. With respect to dependent variables,the behavioural outcomes of alcohol use have not been operationalizedas successfully as the health outcomes. This study examinedcultural differences in drinking by employing Levine's distinctionbetween Temperance and non-Temperance cultures, along with othercultural, consumption, and policy predictor variables, among21 Western countries. Dependent variables included the prevalenceof Alcoholics Anonymous (AA) groups (as a measure of behaviouraland social problems) and a range of alcohol consumption andhealth measures. Level of consumption was an important determinantof the health consequences of drinking among Western nations,but not so important in determining behavioural outcomes. Culture,on the other hand, is largely determinative of behavioural outcomesand also quite critical for some health outcomes. An inverserelationship between alcohol consumption and AA membership stronglyindicated that consumption is modified by cultural styles inproducing drinking behaviours. Temperance cultures, which arelargely Protestant, have far more AA groups and higher ratesof coronary heart disease mortality, but lower cirrhosis mortality.Overall mortality does not vary according to national alcoholconsumption or cultural distinctions. The percentage of alcoholconsumed as wine is a strong inverse predictor of mortalityin the 55–64 year age group, but the change in absolutenational wine consumption is directly associated with overallall-age mortality. In conclusion, religious and cultural distinctionsamong Western nations strongly predict behavioural drinkingproblems and also enhance the prediction of death rates fromdiseases related to alcohol consumption. Social engineeringtechniques which attempt to modify well-established culturaldrinking practices can have counterproductive results.     

Alcohol and cardiovascular mortality in Moscow; new evidence of a causal association

BACKGROUND: In explaining recent trends in Russian mortality, alcohol drinking has often been put forward as a major factor. However, cardiovascular disease remains the major cause of death in Russia and alcohol is currently viewed as having a protective effect on heart disease. This study explores this apparent paradox by examining daily trends in deaths from cardiovascular disease in Moscow. SUBJECTS: Those dying in Moscow in the years 1993-1995. METHODS: Analysis of daily variation in deaths based on data from Moscow City death certificates. RESULTS: There is a significant increase in deaths from alcohol poisoning, accidents, and violence and cardiovascular diseases on Saturdays, Sundays, and Mondays. This is especially marked for sudden deaths. This pattern is consistent with the known pattern of drinking in Russia, which is more likely to take place in binges than is the case in other countries. CONCLUSION: A possible causative role for alcohol in sudden cardiovascular death is suggested as there are no other obvious explanations for this pattern, which cannot be accounted for by daily variations in traditional risk factors such as smoking or lipids. Although this is inconsistent with the prevailing view in the West that alcohol is seen as cardioprotective, there is considerable supporting evidence from a necropsy study and from studies in other places with a similar pattern of drinking. In countries such as Russia, where patterns of drinking differ considerably from that in the West, binge drinking can be an important cause of sudden cardiac death. This has important implications for estimates of the amount of mortality worldwide attributable to specific risk factors and thus for national and international policy.     

Consumption of coffee is associated with reduced risk of death attributed to inflammatory and cardiovascular diseases in the Iowa Women's Health Study

BACKGROUND: Coffee is the major source of dietary antioxidants. The association between coffee consumption and risk of death from diseases associated with inflammatory or oxidative stress has not been studied. OBJECTIVE: We studied the relation of coffee drinking with total mortality and mortality attributed to cardiovascular disease, cancer, and other diseases with a major inflammatory component. DESIGN: A total of 41,836 postmenopausal women aged 55-69 y at baseline were followed for 15 y. After exclusions for cardiovascular disease, cancer, diabetes, colitis, and liver cirrhosis at baseline, 27,312 participants remained, resulting in 410,235 person-years of follow-up and 4265 deaths. The major outcome measure was disease-specific mortality. RESULTS: In the fully adjusted model, similar to the relation of coffee intake to total mortality, the hazard ratio of death attributed to cardiovascular disease was 0.76 (95% CI: 0.64, 0.91) for consumption of 1-3 cups/d, 0.81 (95% CI: 0.66, 0.99) for 4-5 cups/d, and 0.87 (95% CI: 0.69, 1.09) for > or =6 cups/d. The hazard ratio for death from other inflammatory diseases was 0.72 (95% CI: 0.55, 0.93) for consumption of 1-3 cups/d, 0.67 (95% CI: 0.50, 0.90) for 4-5 cups/d, and 0.68 (95% CI: 0.49, 0.94) for > or =6 cups/d. CONCLUSIONS: Consumption of coffee, a major source of dietary antioxidants, may inhibit inflammation and thereby reduce the risk of cardiovascular and other inflammatory diseases in postmenopausal women.     

Alcohol volume, drinking pattern, and cardiovascular disease morbidity and mortality: is there a U-shaped function?

The health effects of a binge pattern of alcohol consumption have not been widely investigated. The objective of this study was to evaluate the cardiovascular consequences of binge drinking (consumption of eight or more drinks at one sitting) and usual (nonbinge) drinking in a longitudinal, population-based study. Data obtained from 1,154 men and women aged 18-64 years interviewed in Winnipeg, Manitoba, Canada, in 1990 and 1991 were linked to health care utilization and mortality records. Using an 8-year follow-up period, the authors performed separate Cox proportional hazards regression analyses for men and women on time to first event for physician visits, hospitalizations, and deaths due to coronary heart disease, hypertension, and other cardiovascular disease. Binge drinking increased the risk of coronary heart disease in both men (hazard ratio (HR) = 2.26, 95% confidence interval (CI): 1.22, 4.20) and women (HR = 1.10, 95% CI: 1.02, 1.18). It increased the risk of hypertension in men (HR = 1.57, 95% CI: 1.04, 2.35) but not in women. Binge drinking had no effect on the risk of other cardiovascular disease. In contrast, usual drinking had significant cardioprotective effects in both men and women. Thus, the harmful effects of binge drinking on cardiovascular disease morbidity and mortality can be disaggregated from the protective effects of usual drinking at various levels of consumption.