What is the optimal level of population alcohol consumption for chronic disease prevention in England? Modelling the impact of changes in average consumption levels
OBJECTIVE: To estimate the impact of achieving alternative average population alcohol consumption levels on chronicdisease mortality in England.
DESIGN: A macro-simulation model was built to simultaneously estimate the number of deaths from coronary heart disease, stroke, hypertensive disease, diabetes, liver cirrhosis, epilepsy and five cancers that would be averted or delayed annually as a result of changes in alcohol consumption among English adults. Counterfactual scenarios assessed the impact on alcohol-related mortalities of changing (1) the median alcohol consumption of drinkers and (2) the percentage of non-drinkers.
DATA SOURCES: Risk relationships were drawn from published meta-analyses. Age- and sex-specific distributions of alcohol consumption (grams per day) for the English population in 2006 were drawn from the General Household Survey 2006, and age-, sex- and cause-specific mortality data for 2006 were provided by the Office for National Statistics.
RESULTS: The optimum median consumption level for drinkers in the model was 5 g/day (about half a unit), which would avert or delay 4579 (2544 to 6590) deaths per year. Approximately equal numbers of deaths from cancers and liver disease would be delayed or averted (∼2800 for each), while there was a small increase in cardiovascular mortality. The model showed no benefit in terms of reduced mortality when the proportion of non-drinkers in the population was increased.
CONCLUSIONS: Current government recommendations for alcohol consumption are well above the level likely to minimise chronic disease. Public health targets should aim for a reduction in population alcohol consumption in order to reduce chronic disease mortality.
El consumo de alcohol es un factor de riesgo para muchas enfermedades crónicas, mientras que proporciona una protección frente a otras. Las evaluaciones del impacto del consumo de alcohol sobre las enfermedades crónicas individuales pueden resultar en consejos contradictorios sobre el nivel de consumo de alcohol que es óptimo para la salud. El objetivo de este estudio fue estimar el impacto de la consecución de los niveles de consumo de alcohol de la población alternativas sobre mortalidad por enfermedades crónicas en Inglaterra.
Alcohol consumption is a risk factor for many chronic diseases, while providing modest protection from others. Assessments of the impact of alcohol on individual chronic diseases can result in contradictory advice about the level of alcohol consumption that is optimal for health. The aim of this study was to estimate the impact of achieving alternative population alcohol consumption levels on chronic disease mortality in England.