, Volume 48, Issue 3, pp 1105–1125 | Cite as

Moderate Alcohol Consumption and the Risk of Mortality

  • Theodore D. Fuller


There has been a growing consensus that moderate consumption of alcohol is associated with a lower risk of mortality and that this association is probably causal. However, a recent review article has raised a serious challenge to this consensus. In short, it determined that most prior research in this area committed serious misclassification errors; furthermore, among those studies that were free of these misclassification errors, no support for a protective role of alcohol consumption was found. This article reexamines the issue using prospective data for more than 124,000 persons interviewed in the U.S. National Health Interview Surveys of 1997 through 2000 with mortality follow-up through 2002 using the Linked Mortality File. The study involves about 488,000 person-years. Controlling for a variety of covariates, this study finds that compared with nondrinkers, those who consume a moderate amount of alcohol have lower all-cause and CHD mortality. The fact that the current study has taken care to avoid the pitfalls of some earlier studies and still finds that those who consume a moderate amount of alcohol have lower all-cause mortality and CHD mortality lends credence to the argument that the relationship is causal.


Alcohol consumption Mortality Coronary heart disease mortality Sex differences 



I would like to thank Margaret Gaines for computational assistance on this paper.


  1. Agarwal, D. P. (2002). Cardioprotective effects of light-moderate consumption of alcohol: A review of putative mechanisms. Alcohol & Alcoholism, 37, 409–415.CrossRefGoogle Scholar
  2. Benjamins, M. R., Hummer, R. A., Eberstein, I. W., & Nam, C. B. (2004). Self-reported health and adult mortality: An analysis of cause-specific mortality. Social Science and Medicine, 59, 1297–1306.CrossRefGoogle Scholar
  3. Bovet, P., & Paccaud, F. (2001). Commentary: Alcohol, coronary heart disease and public health: Which evidence-based policy? International Journal of Epidemiology, 30, 734–737.CrossRefGoogle Scholar
  4. Emberson, J. R., Shaper, A. G., Wannamethee, S. G., Morris, R. W., & Whincup, P. H. (2005). Alcohol intake in middle age and risk of cardiovascular disease and mortality: Accounting for intake variation over time. American Journal of Epidemiology, 161, 856–863.CrossRefGoogle Scholar
  5. Fillmore, K. M., Kerr, W. C., Stockwell, T., Chikritzhs, T., & Bostrom, A. (2006). Moderate alcohol use and reduced mortality risk: Systematic error in prospective studies. Addiction Research and Theory, 14, 101–132.CrossRefGoogle Scholar
  6. Fraser, G. E. (1999). Associations between diet and cancer, ischemic heart disease, and all-cause mortality in non-Hispanic white California Seventh-day Adventists. American Journal of Clinical Nutrition, 70(Suppl), 532S–538S.Google Scholar
  7. Hines, L. M., Stamper, M. J., Ma, J., Gaziano, J. M., Ridker, P. M., Hankinson, S. E.… Hunter, D. J. (2001). Genetic variation in alcohol dehydrogenase and the beneficial effect of moderate alcohol consumption on myocardial infarction. New England Journal of Medicine, 344, 549–555.Google Scholar
  8. Idler, E. L., & Benyamani, Y. (1997). Self-rated health and mortality: A review of twenty-seven community studies. Journal of Health and Social Behavior, 38, 21–37.CrossRefGoogle Scholar
  9. Kent, L. M., & Worsley, A. (2008). Does the prescriptive lifestyle of Seventh-day Adventists provide “immunity” from the secular effects of changes in BMI? Public Health Nutrition, 12(4), 472–480.CrossRefGoogle Scholar
  10. Klatsky, A. L. (2001). Commentary: Could abstinence from alcohol be hazardous to your health? International Journal of Epidemiology, 30, 739–742.CrossRefGoogle Scholar
  11. Lang, I., Guralnik, J., Wallace, R. B., & Melzer, D. (2006). What level of alcohol consumption is hazardous for older people? Functioning and mortality in U.S. and English national cohorts. Journal of the American Geriatric Society, 55, 49–57.CrossRefGoogle Scholar
  12. Liao, Y., McGee, D. L., Cao, G., & Cooper, R. S. (2000). Alcohol intake and mortality: Findings from the National Health Interview Surveys (1988 and 1990). American Journal of Epidemiology, 151, 651–659.Google Scholar
  13. Lochner, K. A., Hummer, R. A., & Cox, C. S. (2007). Comparative analysis of the public-use and restricted-use NHIS linked mortality files. Hyattsville, MD: National Center for Health Statistics.Google Scholar
  14. Marmot, M. G. (1984). Alcohol and coronary heart disease. International Journal of Epidemiology, 13, 160–167.CrossRefGoogle Scholar
  15. Marmot, M. G. (2001). Commentary: Reflections on alcohol and coronary heart disease. International Journal of Epidemiology, 30, 729–734.CrossRefGoogle Scholar
  16. Marmot, M. G., Rose, G., Shipley, M. J., & Thomas, B. J. (1981). Alcohol and mortality: The U-shaped curve. Lancet, 1, 580–583.CrossRefGoogle Scholar
  17. Minugh, P. A. (1998). Gender, health beliefs, health behaviors, and alcohol consumption. American Journal of Drug and Alcohol Abuse, 24, 483–497.CrossRefGoogle Scholar
  18. Mokdad, M. J., Marks, J. S., Stroup, D. F., & Gerberding, J. L. (2004). Actual causes of death in the United States, 2000. Journal of the American Medical Association, 291, 1238–1245.CrossRefGoogle Scholar
  19. Mossey, J. M., & Shapiro, E. (1982). Self-rated health: A predictor of mortality among the elderly. American Journal of Public Health, 72, 800–808.CrossRefGoogle Scholar
  20. National Center for Health Statistics (NCHS). (2003). 2002 National Health Interview Survey (NHIS). NHIS Survey Description. Hyattsville, MD: NCHS.Google Scholar
  21. Paganini-Hill, A., Kawas, C. H., & Corrada, M. M. (2007). Type of alcohol consumed, changes in intake over time and mortality: The Leisure World Cohort Study. Age and Ageing, 36, 203–209.CrossRefGoogle Scholar
  22. Pearl, R. (1926). Alcohol and longevity. New York: Alfred A Knopf.Google Scholar
  23. Rimm, E. (2001). Commentary: Alcohol and coronary heart disease–laying the foundation for future work. International Journal of Epidemiology, 30, 738–739.CrossRefGoogle Scholar
  24. Rimm, E. B., Klatsky, A., Grobbee, D., & Stampfer, M. J. (1996). Review of moderate alcohol consumption and reduced risk of coronary heart disease: Is the effect due to beer, wine or spirits. British Medical Journal, 312, 731–736.Google Scholar
  25. Rogers, R. G., Hummer, R. A., & Nam, C. B. (2000). Living and dying in the USA. New York: Academic Press.Google Scholar
  26. Shaper, A. G., Wannamethee, G., & Walker, M. (1988). Alcohol and mortality in British men: Explaining the U-shaped curve. Lancet, 2, 1267–1273.CrossRefGoogle Scholar
  27. Thun, M. J., Peto, R., Lopez, A. D., Monaco, J. H., Henley, S. J., Clark, J.… Doll, R. (1997). Alcohol consumption and mortality among middle-aged and elderly U.S. adults. New England Journal of Medicine, 337\, 1705–1714Google Scholar
  28. Yamaguchi, K. (1991). Event history analysis. Newbury Park, CA: Sage.Google Scholar

Copyright information

© Population Association of America 2011

Authors and Affiliations

  1. 1.Department of SociologyBlacksburgUSA

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