Average volume of alcohol consumed, type of beverage, drinking pattern and the risk of death from all causes

Background: The objective was to investigate associations between average volume of alcohol consumption, type of beverage and drinking pattern and all-cause mortality in the Melbourne Collaborative Cohort Study. Methods: Average consumption, including type of beverage, was estimated from beverage-specific questions on quantity and frequency of consumption. Pattern of consumption was estimated from a 7-day diary. During an average of 10.5 years of follow-up of 36 984 participants, 1971 deaths occurred. Results: For both men and women, mortality curves were J-shaped (nadir at 9-12 g/day of alcohol consumption; upper protective dose of 42-76 g/day). Wine consumption was associated with lower mortality (for men, minimum hazard ratio (HR) at 20/39 g/day of wine consumption: 0.69; 95% confidence interval (CI): 0.54/0.87; for women, minimum HR at 1-19 g/day: 0.82; 95% CI: 0.70-0.98). Beer was associated with an increased risk for men (test for trend, P = 0.05), but not for women. After adjustment for total amount of alcohol consumed, the number of drinking-days was inversely associated with the risk of dying in men (P-trend = 0.04). Conclusions: These results confirm previous findings about the effect of average volume of alcohol and type of beverage and suggest that drinking pattern is an independent risk factor for all-cause mortality.