Lifetime alcohol use and overall and cause-specific mortality in the European Prospective Investigation into Cancer and nutrition (EPIC) study

Ferrari, Pietro; Licaj, Idlir; Muller, David C.; Andersen, Per Kragh; Johansson, Mattias; Boeing, Heiner; Weiderpass, Elisabete; Dossus, Laure; Dartois, Laureen; Fagherazzi, Guy; Bradbury, Kathryn E.; Khaw, Kay Tee; Wareham, Nick; Duell, Eric J.; Barricarte, Aurelio; Molina‐Montes, Esther; Navarro, Carmen; Arriola, Larraitz; Wallström, Peter; Tjønneland, Anne; Olsen, Anja; Trichopoulou, Antonia; Benetou, Vassiliki; Trichopoulos, Dimitrios; Tumino, Rosario; Agnoli, Claudia; Sacerdote, Carlotta; Palli, Domenico; Li, Kuanrong; Kaaks, Rudolf; Peeters, Petra H.M.; Beulens, Joline W.J.; Nunes, Luciana Neves; Gunter, Marc J.; Norat, Teresa; Overvad, Kim; Brennan, Paul; Riboli, Elio; Romieu, Isabelle

doi:10.1136/bmjopen-2014-005245

Cited by 86 publications

(79 citation statements)

References 30 publications

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“…For light-to-moderate alcohol consumption (up to 30 g/day), our results were similar to the EPIC study conducted by Ferrari et al ,3 which showed no association in any of the cause-specific mortalities studied (CVD, ARC, external causes of deaths) compared with 0.1–4.9 g/day of alcohol intake. In contrast with this EPIC study, we did not observe a statistically increased risk in any of the cause-specific mortalities studied among abstainers.…”

Section: Discussionsupporting

confidence: 91%

“…Alcohol-attributable deaths are highest in the European Region and particularly in high-income countries within Europe 2. In two recent studies, heavy alcohol consumption increased mortality from alcohol-related cancer (ARC), external causes and ‘other causes’ (external causes of deaths),3 4 while no association was observed for coronary heart disease (CHD) and other cardiovascular diseases (CVDs) 3. A J-shaped association between alcohol and all-cause mortality was been observed in two recent meta-analyses of prospective studies 5…”

Section: Introductionmentioning

confidence: 98%

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Alcohol consumption over time and mortality in the Swedish Women’s Lifestyle and Health cohort

et al. 2016

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BackgroundAlcohol consumption is steadily increasing in high-income countries but the harm and possible net benefits of light-to-moderate drinking remain controversial. We prospectively investigated the association between time-varying alcohol consumption and overall and cause-specific mortality among middle-aged women.MethodsAmong 48 249 women at baseline (33 404 at follow-up) in the prospective Swedish Women's Lifestyle and Health cohort, age 30–49 years at baseline, we used repeated information on alcohol consumption and combined this method with multiple imputation in order to maximise the number of participants and deaths included in the analyses. Multivariable Cox regression models were used to calculate HRs for overall and cause-specific mortality.ResultsDuring >900 000 person/years, a total of 2100 deaths were recorded through Swedish registries. The median alcohol consumption increased from 2.3 g/day in 1991/1992 (baseline) to 4.7 g/day in 2004 (follow-up). Compared with light drinkers (0.1–1.5 g/day), a null association was observed for all categories of alcohol consumption with the exception of never drinkers. The HR comparing never with light drinkers was 1.46 (95% CI 1.22 to 1.74). There was a statistically significant negative trend between increasing alcohol consumption and cardiovascular and ischaemic heart diseases mortality. The results were similar when women with prevalent conditions were excluded.ConclusionsIn conclusion, in a cohort of young women, light alcohol consumption was protective for cardiovascular and ischaemic heart disease mortality but not for cancer and overall mortality.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 98%

Alcohol consumption over time and mortality in the Swedish Women’s Lifestyle and Health cohort

et al. 2016

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“…The European Prospective Investigation on Cancer and nutrition (EPIC) study monitored 380,395 participants for 13 years (4,187 CVD deaths) (274). Female never-drinkers were at increased risk of CVD death (RR: 1.31; 95% CI: 1.13 to 1.53) compared with moderate drinkers (0.1 to 4.9 g/d); but the association was not significant for male never-drinkers (RR: 1.20; 95% CI: 0.89 to 1.62).…”

Section: Macronutrients Foods and Cvd Risk Factorsmentioning

confidence: 99%

Food Consumption and its Impact on Cardiovascular Disease: Importance of Solutions Focused on the Globalized Food System

Anand

Hawkes

Souza

et al. 2015

Journal of the American College of Cardiology

416

267

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Major scholars in the field, based on a 3-day consensus, created an in-depth review of current knowledge on the role of diet in CVD, the changing global food system and global dietary patterns, and potential policy solutions. Evidence from different countries, age/race/ethnicity/socioeconomic groups suggest the health effects studies of foods, macronutrients, and dietary patterns on CVD appear to be far more consistent though regional knowledge gaps are highlighted. There are large gaps in knowledge about the association of macronutrients to CVD in low- and middle-income countries (LMIC), particularly linked with dietary patterns are reviewed. Our understanding of foods and macronutrients in relationship to CVD is broadly clear; however major gaps exist both in dietary pattern research and ways to change diets and food systems. Based on the current evidence, the traditional Mediterranean-type diet, including plant foods/emphasizing plant protein sources, provides a well-tested healthy dietary pattern to reduce CVD.

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“…Alcohol has been recognised as a major contributor to cancer mortality 5 42. The study of the links between PA and cancer is a recent field and current evidence shows that there is a robust decreased risk with increased PA for breast and colon cancers and perhaps several other cancer sites (eg, ovarian, lung and prostate cancers) 25 43 44.…”

Section: Discussionmentioning

confidence: 99%

Does physical activity moderate the association between alcohol drinking and all-cause, cancer and cardiovascular diseases mortality? A pooled analysis of eight British population cohorts

et al. 2016

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The objective of this study was to investigate associations between leisure-time physical activity, low high-density lipoprotein cholesterol (HDL-C) and mortality. Self-reported leisure-time physical activity, HDL-C concentration, and mortality were assessed in 37,059 adults in Health Survey for England and Scottish Health Survey. Meeting physical activity guidelines was defined as C150 min wk-1 of moderate-intensity activity, C75 min wk-1 of vigorous-intensity activity, or equivalent combinations. Low HDL-C was defined as \1.03 mmol L-1. Cox proportional hazard models were adjusted for age, sex, smoking, total cholesterol, systolic blood pressure, body mass index, longstanding illness, and socioeconomic status. There were 2250 deaths during 326,016 person-years of follow-up. Compared with those who met physical activity guidelines and whose HDL-C was normal (refer-ence group), all-cause mortality risk was not elevated in those who met physical activity guidelines and whose HDL-C concentration was low (hazard ratio: 1.07; 95% confidence interval: 0.75, 1.53). Compared with the reference group, all-cause mortality risk was elevated in those who did not meet physical activity guidelines and whose HDL-C was normal (1.37; 1.16, 1.61), and in those who did not meet physical activity guidelines and whose HDL-C was low (1.65; 1.37, 1.98). Cardiovascular disease mortality hazard ratios were similar, although confidence intervals were wider. There was no statistically significant evidence of biological interaction between physical inactivity and low HDL-C. This novel study supports the notion that leisure-time physical activity be recommended in those with low HDL-C concentration who may be resistant to the HDL-raising effect of exercise training.

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Lifetime alcohol use and overall and cause-specific mortality in the European Prospective Investigation into Cancer and nutrition (EPIC) study

Cited by 86 publications

References 30 publications

Alcohol consumption over time and mortality in the Swedish Women’s Lifestyle and Health cohort

Alcohol consumption over time and mortality in the Swedish Women’s Lifestyle and Health cohort

Food Consumption and its Impact on Cardiovascular Disease: Importance of Solutions Focused on the Globalized Food System

Does physical activity moderate the association between alcohol drinking and all-cause, cancer and cardiovascular diseases mortality? A pooled analysis of eight British population cohorts

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