TUESDAY, Aug. 24 (HealthDay News) -- While the debate over the
possible health benefits of drinking continues to bubble, a new
study finds that abstainers and heavy drinkers have a higher
mortality risk than moderate drinkers.
"This fascinating, detailed and very meticulous study approached the well-established association between moderate alcohol intake and health benefits with a skeptical eye," said Dr. David L. Katz, director of the Prevention Research Center at Yale Medical School, who was not involved in the study.
"In essence, the authors asked, 'What if people who abstain from alcohol have a higher mortality risk than moderate drinkers not because they don't drink, but because they are sicker or are former problem drinkers?'" he said.
Their analysis shows this proposition to be partly true, but not
the whole truth, Katz said.
"Indeed, some of the mortality disadvantage seen in nondrinkers is explained by prior problem drinking, or established health problems. But even when all such factors are accounted for, moderate drinking still conferred a net survival advantage," he said.
The report is published in the Aug. 24 online edition of
Alcoholism: Clinical & Experimental Research.
For the study, a team led by Charles J. Holahan, a professor in
the department of psychology at the University of Texas at Austin,
collected data on 1,824 older adults, aged 55 and 65. They divided
the subjects into four groups -- light, moderate and heavy drinkers
and abstainers -- and did a 20-year follow-up analysis from the
"Although alcohol misuse is linked to many medical conditions, considerable epidemiological evidence indicates that moderate alcohol use is related to reduced total mortality," Holahan said in a statement.
The participants were asked about daily alcohol consumption,
problem drinking, and other questions about their health and social
"Controlling only for age and gender, mortality was highest among abstainers and heavy drinkers and lowest in moderate drinkers," Holahan said.
When the researchers took into account former problem drinking,
existing health problems, and key sociodemographic and
social-behavioral factors, they found a substantially reduced
mortality benefit among moderate drinkers compared to
Yet even after adjusting for all these factors, people who
didn't drink and heavy drinkers still had increased mortality risks
of 49 percent and 42 percent, respectively, compared with moderate
drinkers, researchers noted.
The slightly higher relative risk for light drinkers disappeared
when all the factors were taken into account, they added.
The health benefits of moderate drinking are complicated because
a number of health risks are associated with not drinking in later
life, the researchers said.
"Our findings demonstrate that abstainers were significantly more likely to have had prior drinking problems, to be obese, and to smoke cigarettes than moderate drinkers and scored significantly higher than moderate drinkers on health problems, depressive symptoms and avoidance coping," Holahan said. "In addition, abstainers were significantly lower than moderate drinkers on socioeconomic status, physical activity, number of close friends and quality of friend support, and significantly less likely to be married than moderate drinkers. Moreover, all of these factors that were associated with abstention significantly predicted mortality."
In the study, Holohan and colleagues noted several potential
limitations of their study: the findings were not experimental,
alcohol consumption was based on self-reports, and lifetime
abstainers were not included in the study, among other things.
The researchers also caution that any health benefits are linked
to moderate drinking only. Federal health agency guidelines
recommend no more than two drinks a day for men, and no more than
one a day for women.
"Older persons drinking alcohol should remember that consuming more than two drinks a day exceeds recommended alcohol consumption guidelines in the U.S. and is associated with increased falls, a higher risk of alcohol use problems, and potential adverse interactions with medications," Holahan said "Moreover, nondrinkers should not start drinking to try to enhance their health, and individuals who are or plan to become pregnant, or have alcohol problems or medical conditions that could be worsened by alcohol should not drink."
There are several take-away messages, Katz said. The first is
that moderate drinking does, indeed, confer a health benefit.
"The second is that benefit is probably somewhat smaller than most prior studies suggest; alcohol intake should not be anyone's primary health promotion strategy. And, the third is that alcohol is the quintessential double-edged sword. Some habitual intake -- that glass of wine with dinner, for instance -- is decisively good for most people, but an excess is decidedly bad," he said.
Other studies have also suggested that the benefits of moderate
drinking are due to other factors than the alcohol itself.
A recent major French study published in the May issue of the
European Journal of Clinical Nutrition links moderate
drinking to a lower risk for cardiovascular disease, but challenges
the notion that moderate drinking gets the credit.
Instead, the researchers say, people who drink moderately tend
to have a higher social status, exercise more, suffer less
depression and enjoy superior health overall compared to heavy
drinkers and lifetime abstainers.
For more information on drinking and health, visit the
U.S. National Library of Medicine.