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      Associations between Low to Moderate Consumption of Alcoholic Beverage Types and Health Outcomes: A Systematic Review

      review-article
      ,
      Alcohol and Alcoholism (Oxford, Oxfordshire)
      Oxford University Press

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          Abstract

          Aims

          There is limited research comparing light to moderate wine, beer and spirits consumption and their impact on long-term health. This systematic review aims to investigate the studies published in the past 10 years and qualitatively assess the similarities and differences between the three main beverages, when consumed at a low to moderate level, for their associations with various health outcomes.

          Methods

          A systematic search was conducted for comparative studies published in English language (2010 to mid-2021) of beverage-specific low to moderate alcohol consumption associated with all-cause mortality, cancer, cardiovascular disease and diabetes mellitus type II.

          Results

          The search yielded a total of 24 studies (8 meta-analyses; 15 prospective studies and 1 pooled analysis). Overall, most studies showed similar associations of different alcoholic beverages with chronic conditions, including all-cause mortality, many types of cancer, cardiovascular disease and diabetes mellitus type II. Not all data are consistent. Some studies show more beneficial or detrimental effects of wine than other beverage types, whereas other studies show such effects for other beverages.

          Conclusion

          Moderate consumption of one specific alcoholic beverage (wine, beer or spirits) may not be consistently associated with higher or lower risks for common health outcomes as compared with moderate consumption of any of the other alcoholic beverages.

          Abstract

          Short Summary: A systematic review of 24 prospective studies and meta-analyses showed that moderate consumption of one specific alcoholic beverage (wine, beer or spirits) may not be consistently associated with higher or lower risks for common health outcomes as compared with moderate consumption of any of the other alcoholic beverages.

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          Most cited references47

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          Primary Prevention of Cardiovascular Disease with a Mediterranean Diet Supplemented with Extra-Virgin Olive Oil or Nuts

          Observational cohort studies and a secondary prevention trial have shown inverse associations between adherence to the Mediterranean diet and cardiovascular risk.
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            Association of alcohol consumption with selected cardiovascular disease outcomes: a systematic review and meta-analysis

            Objective To conduct a comprehensive systematic review and meta-analysis of studies assessing the effect of alcohol consumption on multiple cardiovascular outcomes. Design Systematic review and meta-analysis. Data sources A search of Medline (1950 through September 2009) and Embase (1980 through September 2009) supplemented by manual searches of bibliographies and conference proceedings. Inclusion criteria Prospective cohort studies on the association between alcohol consumption and overall mortality from cardiovascular disease, incidence of and mortality from coronary heart disease, and incidence of and mortality from stroke. Studies reviewed Of 4235 studies reviewed for eligibility, quality, and data extraction, 84 were included in the final analysis. Results The pooled adjusted relative risks for alcohol drinkers relative to non-drinkers in random effects models for the outcomes of interest were 0.75 (95% confidence interval 0.70 to 0.80) for cardiovascular disease mortality (21 studies), 0.71 (0.66 to 0.77) for incident coronary heart disease (29 studies), 0.75 (0.68 to 0.81) for coronary heart disease mortality (31 studies), 0.98 (0.91 to 1.06) for incident stroke (17 studies), and 1.06 (0.91 to 1.23) for stroke mortality (10 studies). Dose-response analysis revealed that the lowest risk of coronary heart disease mortality occurred with 1–2 drinks a day, but for stroke mortality it occurred with ≤1 drink per day. Secondary analysis of mortality from all causes showed lower risk for drinkers compared with non-drinkers (relative risk 0.87 (0.83 to 0.92)). Conclusions Light to moderate alcohol consumption is associated with a reduced risk of multiple cardiovascular outcomes.
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              Alcohol consumption and mortality among middle-aged and elderly U.S. adults.

              Alcohol consumption has both adverse and beneficial effects on survival. We examined the balance of these in a large prospective study of mortality among U.S. adults. Of 490,000 men and women (mean age, 56 years; range, 30 to 104) who reported their alcohol and tobacco use in 1982, 46,000 died during nine years of follow-up. We compared cause-specific and rates of death from all causes across categories of base-line alcohol consumption, adjusting for other risk factors, and related drinking and smoking habits to the cumulative probability of dying between the ages of 35 and 69 years. Causes of death associated with drinking were cirrhosis and alcoholism; cancers of the mouth, esophagus, pharynx, larynx, and liver combined; breast cancer in women; and injuries and other external causes in men. The mortality from breast cancer was 30 percent higher among women reporting at least one drink daily than among nondrinkers (relative risk, 1.3; 95 percent confidence interval, 1.1 to 1.6). The rates of death from all cardiovascular diseases were 30 to 40 percent lower among men (relative risk, 0.7; 95 percent confidence interval, 0.7 to 0.8) and women (relative risk, 0.6; 95 percent confidence interval, 0.6 to 0.7) reporting at least one drink daily than among nondrinkers, with little relation to the level of consumption. The overall death rates were lowest among men and women reporting about one drink daily. Mortality from all causes increased with heavier drinking, particularly among adults under age 60 with lower risk of cardiovascular disease. Alcohol consumption was associated with a small reduction in the overall risk of death in middle age (ages 35 to 69), whereas smoking approximately doubled this risk. In this middle-aged and elderly population, moderate alcohol consumption slightly reduced overall mortality. The benefit depended in part on age and background cardiovascular risk and was far smaller than the large increase in risk produced by tobacco.
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                Author and article information

                Contributors
                Journal
                Alcohol Alcohol
                Alcohol Alcohol
                alcalc
                Alcohol and Alcoholism (Oxford, Oxfordshire)
                Oxford University Press
                0735-0414
                1464-3502
                March 2022
                11 December 2021
                11 December 2021
                : 57
                : 2
                : 176-184
                Affiliations
                Department of Internal Medicine , Hospital Clinic, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona , Villarroel, 170, 08036 Barcelona, Spain
                CIBER Fisiopatología de la Obesidad y la Nutrición (CIBER OBN), Instituto de Salud Carlos III , Montforte de Lemos 3-5, Pabellón 11, Planta O / 28029 Madrid, Spain
                Hendriks Nutrition Support for Business , Laan van Cattenbroeck 70, 3703 BP Zeist, The Netherlands
                Author notes
                Corresponding author: Department of Internal Medicine, Hospital Clinic, University of Barcelona, Villarroel, 170, Barcelona 08036, Spain. Tel.: +34 93 2275539; Fax: +34 93 2279236; E-mail: restruch@ 123456clinic.cat
                Article
                agab082
                10.1093/alcalc/agab082
                8919407
                34897368
                2b3adfd6-d25f-4f0c-86d6-123db3e6120a
                © The Author(s) 2021. Medical Council on Alcohol and Oxford University Press.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 4 October 2021
                : 19 November 2021
                : 20 November 2021
                : 20 November 2021
                Page count
                Pages: 9
                Funding
                Funded by: Diageo plc;
                Award ID: 4800295861
                Categories
                Review
                AcademicSubjects/MED00860

                Health & Social care
                Health & Social care

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