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Beer binging and mortality: results from the kuopio ischaemic heart disease risk factor study, a prospective population based study

^a Research Institute of Public Health and Department of Public Health and General Practice, University of Kuopio, Kuopio, Finland, ^b Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI 48109-2029, USA, ^c Human Population Laboratory, Berkeley, CA 94704, USA

Correspondence to: Dr Jussi Kauhanen Department of Public Health and General Practice, University of Kuopio, Box 1627, FIN-70211 Kuopio, Finland, jussi.kauhanen@uku.fi

Objective: To examine the association between beer binging (regular sessions of heavy beer drinking) and mortality.
Design: Prospective population based study with the baseline assessment of level of alcohol intake (dose), by type of drink and drinking pattern, previous and existing diseases, socioeconomic background, occupational status, involvement in organisations during leisure time, physical activity in leisure time, body mass index, blood pressure, serum lipids and plasma fibrinogen concentration, during an average of 7.7 years' follow up of mortality.
Setting: Finland.
Subjects: A population sample of 1641 men who consumed beer who were aged 42, 48, 54, or 60 years at baseline.
Main outcome measures: All cause mortality, cardiovascular mortality, death due to external causes, fatal myocardial infarctions.
Results: The risk of death was substantially increased in men whose usual dose of beer was 6 or more bottles per session compared with men who usually consumed less than 3 bottles, after adjustment for age and total alcohol consumption (relative risk 3.01 (95% confidence interval 1.54 to 5.90) for all deaths; 7.10 (2.01 to 25.12) for external deaths; and 6.50 (2.05 to 20.61) for fatal myocardial infarction). The association changed only slightly when smoking, occupational status, previous diseases, systolic blood pressure, low density lipoprotein and high density lipoprotein cholesterol concentration, plasma fibrinogen concentration, body mass index, marital status, leisure time physical activity, and involvement in organisations were controlled for.
Conclusion: The pattern of beer binging is associated with increased risk of death, independently of the total average consumption of alcoholic drinks. The relation is not explained by known behavioural, psychosocial, or biological risk factors. Death due to injuries and other external causes is overrepresented among beer bingers, but a strong association with fatal myocardial infarction suggests that the pathway may also involve other acute triggers of severe health events.

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