Drinking alcohol in moderation is associated with lower rate of all-cause mortality in individuals with higher rather than lower educational level: findings from the MORGAM project
Research output: Contribution to journal › Journal article › Research › peer-review
The association between socioeconomic status (SES) and alcohol-related diseases has been widely explored. Less is known, however, on whether the association of moderate drinking with all-cause mortality is modified by educational level (EL). Using harmonized data from 16 cohorts in the MORGAM Project (N = 142,066) the association of pattern of alcohol intake with hazard of all-cause mortality across EL (lower = primary-school; middle = secondary-school; higher = university/college degree) was assessed using multivariable Cox-regression and spline curves. A total of 16,695 deaths occurred in 11.8 years (median). In comparison with life-long abstainers, participants drinking 0.1–10 g/d of ethanol had 13% (HR = 0.87; 95%CI: 0.74–1.02), 11% (HR = 0.89; 0.84–0.95) and 5% (HR = 0.95; 0.89–1.02) lower rate of death in higher, middle and lower EL, respectively. Conversely, drinkers > 20 g/d had 1% (HR = 1.01; 0.82–1.25), 10% (HR = 1.10; 1.02–1.19) and 17% (HR = 1.17; 1.09–1.26) higher rate of death. The association of alcohol consumption with all-cause mortality was nonlinear, with a different J-shape by EL levels. It was consistent across both sexes and in various approaches of measuring alcohol consumption, including combining quantity and frequency and it was more evident when the beverage of preference was wine. We observed that drinking in moderation (≤ 10 g/d) is associated with lower mortality rate more evidently in individuals with higher EL than in people with lower EL, while heavy drinking is associated with higher mortality rate more evidently in individuals with lower EL than in people with higher EL, suggesting that advice on reducing alcohol intake should especially target individuals of low EL.
| Original language | English |
|---|---|
| Journal | European Journal of Epidemiology |
| Volume | 38 |
| Issue number | 8 |
| Pages (from-to) | 869-881 |
| Number of pages | 13 |
| ISSN | 0393-2990 |
| DOIs | |
| Publication status | Published - Aug 2023 |
Bibliographical note
Funding Information:
ADC reports personal fees as member of the Organizing Committee for the 7th European Beer and Health Symposium (2014), Beer and Health Initiative (The Dutch Beer Institute foundation—The Brewers of Europe), outside the submitted work. SC reports personal fees as member of the Organizing Committee and speaker for the 9th European Beer and Health Symposium (Bruxelles 2019) and for given lecture at the 13th European Nutrition Conference FENS 2019 (Dublin), sponsored by the Beer and Health Initiative (The Dutch Beer Institute foundation—The Brewers of Europe) outside the submitted work. GdG is a member of the International Scientific Forum on Alcohol Research ( http://alcoholresearchforum.org ), an independent organization of scientists that prepares critiques of emerging research reports on alcohol and health. The members of the Forum donate their time and effort to the review of papers and receive no financial support for their contributions to critiques. The Forum itself receives no support from any organization or company in the alcoholic beverage industry. However, whether the support for individual members is from governmental agencies, universities, private foundations, or other groups, none of these organizations has any input into the conclusions presented in the critiques published on the forum web-site. A detailed disclosure statement signed by each member of the forum is available at: http://alcoholresearchforum.org/disclosure-statement . GdG is a corresponding member of the non-profit Accademia Italiana della Vite e del Vino. VS has received a honorarium from Sanofi for consulting. He also has had research collaboration with Bayer Ltd (all unrelated to the present study). SS reports speakers’ honoraria from Actelion Pharmaceuticals Ltd (unrelated to the present study). JF reports lectures fees from Amgen, MSD, Sanofi and Servier. SM is supported by RAS, #22031700094–5.
Funding Information:
The MORGAM Project has received funding from EU projects MORGAM (Biomed, BMH4-CT98-3183), GenomEUtwin (FP5, QLG2-CT-2002–01254), ENGAGE (FP7, HEALTH-F4-2007–201413), CHANCES (FP7, HEALTH-F3-2010–242244), BiomarCaRE (FP7, HEALTH-F2-2011–278913), euCanSHare (Horizon 2020, No. 825903) and AFFECT-EU (Horizon 2020, No. 847770); and Medical Research Council, London (G0601463, No. 80983: Biomarkers in the MORGAM Populations). This has supported central coordination, workshops and part of the activities of the MORGAM Data Centre, the MORGAM Laboratories and the MORGAM Participating Centres. The present analysis was partially supported by the Ministero della Salute, Italy. Bando Ricerca Finalizzata 2018 RF-2018–12,367,074. VS was supported by the Finnish Foundation for Cardiovascular Research and Juho Vainio Foundation. SS was supported by the County Council of Västerbotten (ALF, RV-967561), and Umeå University. BS is funded by the German Research Foundation. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript
Publisher Copyright:
© 2023, Springer Nature B.V.
- Alcohol, All-cause mortality, Educational levels, Social status
Research areas
ID: 387870601