Xinyuan Zhang1, Yan Liu2, Shanshan Li3, Alice H Lichtenstein4, Shuohua Chen2, Muzi Na1, Susan Veldheer5, Aijun Xing2, Yanxiu Wang2, Shouling Wu6, Xiang Gao7. 1. Department of Nutritional Sciences, The Pennsylvania State University, 109 Chandlee Lab, University Park, PA, 16802, USA. 2. Department of Cardiology, Kailuan General Hospital, 57 Xinhua East Rd, Tangshan, 063000, China. 3. Slone Epidemiology Center, Boston University School of Medicine, Boston, USA. 4. Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, USA. 5. Department of Family and Community Medicine and Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, USA. 6. Department of Cardiology, Kailuan General Hospital, 57 Xinhua East Rd, Tangshan, 063000, China. drwusl@163.com. 7. Department of Nutritional Sciences, The Pennsylvania State University, 109 Chandlee Lab, University Park, PA, 16802, USA. xxg14@psu.edu.
Abstract
BACKGROUND: Studies regarding whether light to moderate alcohol consumption is associated with a lower risk of cardiovascular diseases (CVD) have generated mixed results. Further, few studies have examined the potential impact of alcohol consumption on diverse disease outcomes simultaneously. We aimed to prospectively study the dose-response association between alcohol consumption and risk of CVD, cancer, and mortality. METHODS: This study included 83,732 adult Chinese participants, free of CVD and cancer at baseline. Participants were categorized into 6 groups based on self-report alcohol consumption: 0, 1-25, 26-150, 151-350, 351-750, and > 750 g alcohol/wk. Incident cases of CVD, cancers, and mortality were confirmed by medical records. Hazard ratios (HRs) for the composite risk of these three outcomes, and each individual outcome, were calculated using Cox proportional hazard model. RESULTS: During a median follow-up of 10.0 years, there were 6411 incident cases of CVD, 2947 cancers and 6646 deaths. We observed a J-shaped relation between alcohol intake and risk of CVD, cancer, and mortality, with the lowest risk at 25 g/wk., which is equivalent to ~ 2 servings/wk. Compared to consuming 1-25 g/wk., the adjusted HR for composite outcomes was 1.38 (95% confidence interval (CI):1.29-1.49) for non-drinker, 1.15 (95% CI: 1.04-1.27) for 26-150 g/wk., 1.22 (95% CI: 1.10-1.34) for 151-350 g/wk., 1.33 (95% CI: 1.21-1.46) for 351-750 g/wk., and 1.57 (95% CI: 1.30-1.90) for > 750 g/wk., after adjusting for age, sex, lifestyle, social economic status, and medication use. CONCLUSIONS: Light alcohol consumption at ~ 25 g/wk was associated with lower risk of CVD, cancer, and mortality than none or higher consumption in Chinese adults.
BACKGROUND: Studies regarding whether light to moderate alcohol consumption is associated with a lower risk of cardiovascular diseases (CVD) have generated mixed results. Further, few studies have examined the potential impact of alcohol consumption on diverse disease outcomes simultaneously. We aimed to prospectively study the dose-response association between alcohol consumption and risk of CVD, cancer, and mortality. METHODS: This study included 83,732 adult Chinese participants, free of CVD and cancer at baseline. Participants were categorized into 6 groups based on self-report alcohol consumption: 0, 1-25, 26-150, 151-350, 351-750, and > 750 g alcohol/wk. Incident cases of CVD, cancers, and mortality were confirmed by medical records. Hazard ratios (HRs) for the composite risk of these three outcomes, and each individual outcome, were calculated using Cox proportional hazard model. RESULTS: During a median follow-up of 10.0 years, there were 6411 incident cases of CVD, 2947 cancers and 6646 deaths. We observed a J-shaped relation between alcohol intake and risk of CVD, cancer, and mortality, with the lowest risk at 25 g/wk., which is equivalent to ~ 2 servings/wk. Compared to consuming 1-25 g/wk., the adjusted HR for composite outcomes was 1.38 (95% confidence interval (CI):1.29-1.49) for non-drinker, 1.15 (95% CI: 1.04-1.27) for 26-150 g/wk., 1.22 (95% CI: 1.10-1.34) for 151-350 g/wk., 1.33 (95% CI: 1.21-1.46) for 351-750 g/wk., and 1.57 (95% CI: 1.30-1.90) for > 750 g/wk., after adjusting for age, sex, lifestyle, social economic status, and medication use. CONCLUSIONS: Light alcohol consumption at ~ 25 g/wk was associated with lower risk of CVD, cancer, and mortality than none or higher consumption in Chinese adults.
Authors: H W Goedde; D P Agarwal; S Harada; D Meier-Tackmann; D Ruofu; U Bienzle; A Kroeger; L Hussein Journal: Am J Hum Genet Date: 1983-07 Impact factor: 11.025
Authors: Andrew Smyth; Koon K Teo; Sumathy Rangarajan; Martin O'Donnell; Xiaohe Zhang; Punam Rana; Darryl P Leong; Gilles Dagenais; Pamela Seron; Annika Rosengren; Aletta E Schutte; Patricio Lopez-Jaramillo; Ayetkin Oguz; Jephat Chifamba; Rafael Diaz; Scott Lear; Alvaro Avezum; Rajesh Kumar; Viswanathan Mohan; Andrzej Szuba; Li Wei; Wang Yang; Bo Jian; Martin McKee; Salim Yusuf Journal: Lancet Date: 2015-09-17 Impact factor: 79.321
Authors: V Bagnardi; M Rota; E Botteri; I Tramacere; F Islami; V Fedirko; L Scotti; M Jenab; F Turati; E Pasquali; C Pelucchi; C Galeone; R Bellocco; E Negri; G Corrao; P Boffetta; C La Vecchia Journal: Br J Cancer Date: 2014-11-25 Impact factor: 7.640
Authors: Steven Bell; Marina Daskalopoulou; Eleni Rapsomaniki; Julie George; Annie Britton; Martin Bobak; Juan P Casas; Caroline E Dale; Spiros Denaxas; Anoop D Shah; Harry Hemingway Journal: BMJ Date: 2017-03-22
Authors: Angela M Wood; Stephen Kaptoge; Adam S Butterworth; Peter Willeit; Samantha Warnakula; Thomas Bolton; Ellie Paige; Dirk S Paul; Michael Sweeting; Stephen Burgess; Steven Bell; William Astle; David Stevens; Albert Koulman; Randi M Selmer; W M Monique Verschuren; Shinichi Sato; Inger Njølstad; Mark Woodward; Veikko Salomaa; Børge G Nordestgaard; Bu B Yeap; Astrid Fletcher; Olle Melander; Lewis H Kuller; Beverley Balkau; Michael Marmot; Wolfgang Koenig; Edoardo Casiglia; Cyrus Cooper; Volker Arndt; Oscar H Franco; Patrik Wennberg; John Gallacher; Agustín Gómez de la Cámara; Henry Völzke; Christina C Dahm; Caroline E Dale; Manuela M Bergmann; Carlos J Crespo; Yvonne T van der Schouw; Rudolf Kaaks; Leon A Simons; Pagona Lagiou; Josje D Schoufour; Jolanda M A Boer; Timothy J Key; Beatriz Rodriguez; Conchi Moreno-Iribas; Karina W Davidson; James O Taylor; Carlotta Sacerdote; Robert B Wallace; J Ramon Quiros; Rosario Tumino; Dan G Blazer; Allan Linneberg; Makoto Daimon; Salvatore Panico; Barbara Howard; Guri Skeie; Timo Strandberg; Elisabete Weiderpass; Paul J Nietert; Bruce M Psaty; Daan Kromhout; Elena Salamanca-Fernandez; Stefan Kiechl; Harlan M Krumholz; Sara Grioni; Domenico Palli; José M Huerta; Jackie Price; Johan Sundström; Larraitz Arriola; Hisatomi Arima; Ruth C Travis; Demosthenes B Panagiotakos; Anna Karakatsani; Antonia Trichopoulou; Tilman Kühn; Diederick E Grobbee; Elizabeth Barrett-Connor; Natasja van Schoor; Heiner Boeing; Kim Overvad; Jussi Kauhanen; Nick Wareham; Claudia Langenberg; Nita Forouhi; Maria Wennberg; Jean-Pierre Després; Mary Cushman; Jackie A Cooper; Carlos J Rodriguez; Masaru Sakurai; Jonathan E Shaw; Matthew Knuiman; Trudy Voortman; Christa Meisinger; Anne Tjønneland; Hermann Brenner; Luigi Palmieri; Jean Dallongeville; Eric J Brunner; Gerd Assmann; Maurizio Trevisan; Richard F Gillum; Ian Ford; Naveed Sattar; Mariana Lazo; Simon G Thompson; Pietro Ferrari; David A Leon; George Davey Smith; Richard Peto; Rod Jackson; Emily Banks; Emanuele Di Angelantonio; John Danesh Journal: Lancet Date: 2018-04-14 Impact factor: 202.731
Authors: Cristian Ricci; Angela Wood; David Muller; Marc J Gunter; Antonio Agudo; Heiner Boeing; Yvonne T van der Schouw; Samantha Warnakula; Calogero Saieva; Annemieke Spijkerman; Ivonne Sluijs; Anne Tjønneland; Cecilie Kyrø; Elisabete Weiderpass; Tilman Kühn; Rudolf Kaaks; Maria-Jose Sánchez; Salvatore Panico; Claudia Agnoli; Domenico Palli; Rosario Tumino; Gunnar Engström; Olle Melander; Fabrice Bonnet; Jolanda M A Boer; Timothy J Key; Ruth C Travis; Kim Overvad; W M Monique Verschuren; J Ramón Quirós; Antonia Trichopoulou; Eleni-Maria Papatesta; Eleni Peppa; Conchi Moreno Iribas; Diana Gavrila; Ann-Sofie Forslund; Jan-Håkan Jansson; Giuseppe Matullo; Larraitz Arriola; Heinz Freisling; Camille Lassale; Ioanna Tzoulaki; Stephen J Sharp; Nita G Forouhi; Claudia Langenberg; Rodolfo Saracci; Michael Sweeting; Paul Brennan; Adam S Butterworth; Elio Riboli; Nick J Wareham; John Danesh; Pietro Ferrari Journal: BMJ Date: 2018-05-29
Authors: Iona Y Millwood; Robin G Walters; Xue W Mei; Yu Guo; Ling Yang; Zheng Bian; Derrick A Bennett; Yiping Chen; Caixia Dong; Ruying Hu; Gang Zhou; Bo Yu; Weifang Jia; Sarah Parish; Robert Clarke; George Davey Smith; Rory Collins; Michael V Holmes; Liming Li; Richard Peto; Zhengming Chen Journal: Lancet Date: 2019-04-04 Impact factor: 202.731
Authors: Michael V Holmes; Caroline E Dale; Luisa Zuccolo; Richard J Silverwood; Yiran Guo; Zheng Ye; David Prieto-Merino; Abbas Dehghan; Stella Trompet; Andrew Wong; Alana Cavadino; Dagmar Drogan; Sandosh Padmanabhan; Shanshan Li; Ajay Yesupriya; Maarten Leusink; Johan Sundstrom; Jaroslav A Hubacek; Hynek Pikhart; Daniel I Swerdlow; Andrie G Panayiotou; Svetlana A Borinskaya; Chris Finan; Sonia Shah; Karoline B Kuchenbaecker; Tina Shah; Jorgen Engmann; Lasse Folkersen; Per Eriksson; Fulvio Ricceri; Olle Melander; Carlotta Sacerdote; Dale M Gamble; Sruti Rayaprolu; Owen A Ross; Stela McLachlan; Olga Vikhireva; Ivonne Sluijs; Robert A Scott; Vera Adamkova; Leon Flicker; Frank M van Bockxmeer; Christine Power; Pedro Marques-Vidal; Tom Meade; Michael G Marmot; Jose M Ferro; Sofia Paulos-Pinheiro; Steve E Humphries; Philippa J Talmud; Irene Mateo Leach; Niek Verweij; Allan Linneberg; Tea Skaaby; Pieter A Doevendans; Maarten J Cramer; Pim van der Harst; Olaf H Klungel; Nicole F Dowling; Anna F Dominiczak; Meena Kumari; Andrew N Nicolaides; Cornelia Weikert; Heiner Boeing; Shah Ebrahim; Tom R Gaunt; Jackie F Price; Lars Lannfelt; Anne Peasey; Ruzena Kubinova; Andrzej Pajak; Sofia Malyutina; Mikhail I Voevoda; Abdonas Tamosiunas; Anke H Maitland-van der Zee; Paul E Norman; Graeme J Hankey; Manuela M Bergmann; Albert Hofman; Oscar H Franco; Jackie Cooper; Jutta Palmen; Wilko Spiering; Pim A de Jong; Diana Kuh; Rebecca Hardy; Andre G Uitterlinden; M Arfan Ikram; Ian Ford; Elina Hyppönen; Osvaldo P Almeida; Nicholas J Wareham; Kay-Tee Khaw; Anders Hamsten; Lise Lotte N Husemoen; Anne Tjønneland; Janne S Tolstrup; Eric Rimm; Joline W J Beulens; W M Monique Verschuren; N Charlotte Onland-Moret; Marten H Hofker; S Goya Wannamethee; Peter H Whincup; Richard Morris; Astrid M Vicente; Hugh Watkins; Martin Farrall; J Wouter Jukema; James Meschia; L Adrienne Cupples; Stephen J Sharp; Myriam Fornage; Charles Kooperberg; Andrea Z LaCroix; James Y Dai; Matthew B Lanktree; David S Siscovick; Eric Jorgenson; Bonnie Spring; Josef Coresh; Yun R Li; Sarah G Buxbaum; Pamela J Schreiner; R Curtis Ellison; Michael Y Tsai; Sanjay R Patel; Susan Redline; Andrew D Johnson; Ron C Hoogeveen; Hakon Hakonarson; Jerome I Rotter; Eric Boerwinkle; Paul I W de Bakker; Mika Kivimaki; Folkert W Asselbergs; Naveed Sattar; Debbie A Lawlor; John Whittaker; George Davey Smith; Kenneth Mukamal; Bruce M Psaty; James G Wilson; Leslie A Lange; Ajna Hamidovic; Aroon D Hingorani; Børge G Nordestgaard; Martin Bobak; David A Leon; Claudia Langenberg; Tom M Palmer; Alex P Reiner; Brendan J Keating; Frank Dudbridge; Juan P Casas Journal: BMJ Date: 2014-07-10