Annie Britton1, Michael Marmot. 1. Department of Epidemiology and Public Health, University College London, UK. a.britton@public-health.ucl.ac.uk
Abstract
AIMS: To investigate the relationship between three measures of alcohol consumption obtained simultaneously in a large cohort and the validated risk of coronary heart disease and all-cause mortality during follow-up. DESIGN: Prospective cohort study with median follow-up of 11 years. SETTING: The Whitehall II Cohort Study: London-based civil service. PARTICIPANTS: A total of 10,308 (33% female) civil servants aged 35-55 years at baseline (1985-88). MEASUREMENTS: Self-reported volume of alcohol consumed during past week, frequency of drinking over past year, usual amount consumed per drinking session. MAIN OUTCOME MEASURES: Coronary heart disease and all-cause mortality until 1999. FINDINGS: A U-shaped relationship was found between volume of alcohol consumed per week and outcome. Compared to those who drank moderately (10-80 g alcohol per week), non-drinkers and those drinking more than 248 g per week had approximately a twofold increased risk of mortality. The optimal frequency of drinking was between once or twice a week and daily, after adjustment for average volume consumed per week. Those drinking twice a day or more had an increased risk of mortality (male hazard ratio 2.44 95% CI 1.31-4.52) compared to those drinking once or twice a week. Drinking only once a month or only on special occasions had a 50% increased risk of mortality. The usual amount consumed per drinking session was not indicative of increased health risk in this cohort. CONCLUSIONS: Epidemiological studies should collect information on frequency of drinking in addition to average volume consumed in order to inform sensible drinking advice.
AIMS: To investigate the relationship between three measures of alcohol consumption obtained simultaneously in a large cohort and the validated risk of coronary heart disease and all-cause mortality during follow-up. DESIGN: Prospective cohort study with median follow-up of 11 years. SETTING: The Whitehall II Cohort Study: London-based civil service. PARTICIPANTS: A total of 10,308 (33% female) civil servants aged 35-55 years at baseline (1985-88). MEASUREMENTS: Self-reported volume of alcohol consumed during past week, frequency of drinking over past year, usual amount consumed per drinking session. MAIN OUTCOME MEASURES: Coronary heart disease and all-cause mortality until 1999. FINDINGS: A U-shaped relationship was found between volume of alcohol consumed per week and outcome. Compared to those who drank moderately (10-80 g alcohol per week), non-drinkers and those drinking more than 248 g per week had approximately a twofold increased risk of mortality. The optimal frequency of drinking was between once or twice a week and daily, after adjustment for average volume consumed per week. Those drinking twice a day or more had an increased risk of mortality (male hazard ratio 2.44 95% CI 1.31-4.52) compared to those drinking once or twice a week. Drinking only once a month or only on special occasions had a 50% increased risk of mortality. The usual amount consumed per drinking session was not indicative of increased health risk in this cohort. CONCLUSIONS: Epidemiological studies should collect information on frequency of drinking in addition to average volume consumed in order to inform sensible drinking advice.
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