Search resultsModerate Alcohol Use and Reduced Mortality Risk: Systematic Error in Prospective Studies and New Hypotheses
Title
Moderate Alcohol Use and Reduced Mortality Risk: Systematic Error in Prospective Studies and New Hypotheses
Publication type
Journal Article
Year of Publication
2007
Authors
Journal
Annals of Epidemiology
Volume
17
Issue
5 SUPPL.
Pagination
S16 - S23
Date published
2007
ISBN
10472797 (ISSN)
Keywords
aging, alcohol abstinence, alcohol consumption, Alcohol Drinking, article, cardiovascular risk, Coronary Disease, Coronary heart disease, drinking behavior, Ethanol, human, Humans, hypothesis, ischemic heart disease, meta-analysis, mortality, population research, priority journal, Prospective Studies, risk assessment, Risk Factors, Selection Bias, Systematic Bias
Abstract
We have provided recent evidence suggesting that a systematic error may be operating in prospective epidemiological mortality studies that have reported "light" or "moderate" regular use of alcohol to be "protective" against coronary heart disease. Using meta-analysis as a research tool, a hypothesis first suggested by Shaper and colleagues was tested. Shaper et al suggested that people decrease their alcohol consumption as they age and become ill or frail or increase use of medications, some people abstaining from alcohol altogether. If these people are included in the abstainer category in prospective studies, it is reasoned that it is not the absence of alcohol elevating their risk for coronary heart disease (CHD) but, rather, their ill health. Our meta-analytic results indicate that the few studies without this error (i.e., those that did not contaminate the abstainer category with occasional or former drinkers) show abstainers and "light" or "moderate" drinkers to be at equal risk for all-cause and CHD mortality. We explore the history of this hypothesis, examine challenges to our meta-analysis, and discuss options for future research.