The relationship between alcohol consumption, health indicators and mortality in the German population
Background. The patterns of total alcohol, beer and wine consumption were evaluated in the German National Health Surveys. The impact of these habits on cardiovascular and all-cause mortality as well as cardiovascular risk factors and liver disease parameters was estimated. Methods. Independent representative samples of the German population (15,400 people), and regional samples of the Berlin-Spandau population (2370 in total), aged 25-69 years, were analysed. The amount and frequency of alcohol consumption was assessed with standardized questionnaires. Biochemical analyses included serum lipids and gamma-glutamyl-transpeptidase (Gamma GT). Multiple analyses of variance were used to determine the relationship between alcohol intake and biochemical parameters. A mortality follow-up of about 7 years was conducted for the Berlin-Spandau population. Proportional hazard models were used to estimate hazard ratios (HR) for all-cause and cardiovascular mortality. Results. Over 80% of men and 55% of women in Germany drink alcohol on a regular base. The majority of the consumers (65% of men, 87% of women) are light (1-20 g/day) or moderate (21-40 g/day) drinkers. Higher serum high density lipoprotein (HDL)-cholesterol and Gamma GT levels were observed with increasing alcohol intake. In light and moderate drinkers no significant relationship was seen with non-HDL-cholesterol, triglycerides, blood pressure and body mass index, compared to teetotallers. Men who consumed 1-20 g alcohol/day had a significantly lower all-cause and cardiovascular mortality. As compared to non-drinkers, the risk was almost 50% lower. Conclusion. The results suggest that light (and possibly moderate) alcohol consumption reduces the risk of cardiovascular and total mortality risk and is favourably related to HDL-cholesterol.