Estudios científicos

Alcohol Intake and Total Mortality in 142,960 Individuals from the MORGAM Project: a population-based study.

Abstract:

Aim: To test the association of alcohol consumption with total and cause-specific mortality risk.

Design: Prospective observational multi-centre population-based study.

Setting: Sixteen cohorts (15 from Europe) in the MOnica Risk, Genetics, Archiving and Monograph (MORGAM) Project.

Participants: A total of 142 960 individuals (mean age 50 ± 13 years, 53.9% men).

Measurements: Average alcohol intake by food frequency questionnaire, total and cause-specific mortality.

Findings: In comparison with life-time abstainers, consumption of alcohol less than 10 g/day was associated with an average 11% [95% confidence interval (CI) = 7-14%] reduction in the risk of total mortality, while intake > 20 g/day was associated with a 13% (95% CI = 7-20%) increase in the risk of total mortality. Comparable findings were observed for cardiovascular (CV) deaths. With regard to cancer, drinking up to 10 g/day was not associated with either mortality risk reduction or increase, while alcohol intake > 20 g/day was associated with a 22% (95% CI = 10-35%) increased risk of mortality. The association of alcohol with fatal outcomes was similar in men and women, differed somewhat between countries and was more apparent in individuals preferring wine, suggesting that benefits may not be due to ethanol but other ingredients. Mediation analysis showed that high-density lipoprotein cholesterol explained 2.9 and 18.7% of the association between low alcohol intake and total as well as CV mortality, respectively.

Conclusions: In comparison with life-time abstainers, consuming less than one drink per day (nadir at 5 g/day) was associated with a reduced risk of total, cardiovascular and other causes mortality, except cancer. Intake of more than two drinks per day was associated with an increased risk of total, cardiovascular and especially cancer mortality.

Comentarios divulgativos:

En este estudio prospectivo, observacional y multicéntrico de base poblacional, se investigó la asociación entre la cantidad consumida (medida por un cuestionario de frecuencia de alimentos) con el riesgo de mortalidad por todas las causas y por causas específicas. El estudio incluyó dieciséis cohortes (15 de Europa, 1 de Australia) con un total de 142.960 individuos.

En comparación con los abstemios, el consumo ligero a moderado, menos de 10g/día, que equivale a menos de una bebida al día, se asoció con una reducción media del 11% del riesgo de mortalidad por todas las causas (con los mejores resultados encontrados en 5 g/día) y se observaron resultados similares para los fallecimientos por causas cardiovasculares.

Los países mediterráneos mostraron los mejores resultados, los autores sugieren que esto podría estar relacionado con el patrón de consumo habitual en estas regiones, así como con el tipo de bebida consumida. En estos países se suele consumir en las comidas principales y en gran parte en forma de vino.

En este estudio las asociaciones entre el consumo y un menor riesgo de mortalidad total se observaron a niveles bajos-moderados, en algunos casos inferiores a las directrices de consumo.