TY - JOUR
T1 - Drinking alcohol in moderation is associated with lower rate of all-cause mortality in individuals with higher rather than lower educational level
T2 - findings from the MORGAM project
AU - Di Castelnuovo, Augusto
AU - Bonaccio, Marialaura
AU - Costanzo, Simona
AU - McElduff, Patrick
AU - Linneberg, Allen
AU - Salomaa, Veikko
AU - Männistö, Satu
AU - Ferrières, Jean
AU - Dallongeville, Jean
AU - Thorand, Barbara
AU - Brenner, Hermann
AU - Ferrario, Marco
AU - Veronesi, Giovanni
AU - Tamosiunas, Abdonas
AU - Grimsgaard, Sameline
AU - Drygas, Wojciech
AU - Malyutina, Sofia
AU - Söderberg, Stefan
AU - Nordendahl, Maria
AU - Kee, Frank
AU - Grassi, Guido
AU - Dabboura, Salim
AU - Borchini, Rossana
AU - Westermann, Dirk
AU - Schrage, Benedikt
AU - Zeller, Tanja
AU - Kuulasmaa, Kari
AU - Blankenberg, Stefan
AU - Donati, Maria Benedetta
AU - Iacoviello, Licia
AU - de Gaetano, Giovanni
AU - MORGAM Study Investigators
N1 - © 2023. Springer Nature B.V.
PY - 2023/8
Y1 - 2023/8
N2 - 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.
AB - 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.
KW - Alcohol Drinking/adverse effects
KW - Educational Status
KW - Ethanol
KW - Female
KW - Humans
KW - Male
KW - Mortality
KW - Social Class
KW - Wine
UR - http://www.scopus.com/inward/record.url?scp=85163579302&partnerID=8YFLogxK
U2 - 10.1007/s10654-023-01022-3
DO - 10.1007/s10654-023-01022-3
M3 - Journal article
C2 - 37386255
SN - 0393-2990
VL - 38
SP - 869
EP - 881
JO - European Journal of Epidemiology
JF - European Journal of Epidemiology
IS - 8
ER -