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Follow up study of moderate alcohol intake and mortality among middle aged men in Shanghai, China

BMJ 1997; 314 doi: (Published 04 January 1997) Cite this as: BMJ 1997;314:18
  1. Jian-Min Yuan, research fellowa,
  2. Ronald K Ross, professora,
  3. Yu-Tang Gao, professorb,
  4. Brian E Henderson, professora,
  5. Mimi C Yu, professora
  1. aDepartment of Preventive Medicine, USC/Norris Comprehensive Cancer Center, University of Southern California School of Medicine, Los Angeles, California 90033, USA
  2. bDepartment of Epidemiology, Shanghai Cancer Institute, Shanghai 200032, People's Republic of China,
  1. Correspondence to: Dr Yuan
  • Accepted 16 October 1996


Objective: To assess the risk of death associated with various patterns of alcohol intake.

Design: Prospective study of mortality in relation to alcohol consumption at recruitment, with active annual follow up.

Setting: Four small, geographically defined communities in Shanghai, China.

Subjects: 18 244 men aged 45-64 years enrolled in a prospective study of diet and cancer during January 1986 to September 1989.

Main outcome measure: All cause mortality.

Results: By 28 February 1995, 1198 deaths (including 498 from cancer, 269 from stroke, and 104 from ischaemic heart disease) had been identified. Compared with lifelong non-drinkers, those who consumed 1-14 drinks a week had a 19% reduction in overall mortality (relative risk 0.81; 95% confidence interval 0.70 to 0.94) after age, level of education, and cigarette smoking were adjusted for. This protective effect was not restricted to any specific type of alcoholic drink. Although light to moderate drinking (28 or fewer drinks per week) was associated with a 36% reduction in death from ischaemic heart disease (0.64; 0.41 to 0.998), it had no effect on death from stroke, which is the leading cause of death in this population. As expected, heavy drinking (29 or more drinks per week) was significantly associated with increased risks of death from cancer of the upper aerodigestive tract, hepatic cirrhosis, and stroke.

Conclusions: Regular consumption of small amounts of alcohol is associated with lower overall mortality including death from ischaemic heart disease in middle aged Chinese men. The type of alcoholic drink does not affect this association.

Key messages

  • Moderate alcohol consumption is associated with a reduced risk of death from all causes and ischaemic heart disease in Western populations

  • No data are available for Chinese people, who drink little grape wine and have a low rate of ischaemic heart disease

  • In this study of middle aged Chinese men regular drinkers of small amounts of alcohol had a 19% lower death rate than non-drinkers

  • Death rates among moderate drinkers were lower for cancer and non-cancer causes, and the type of alcohol made no difference

  • Relative to non-drinkers, heavy drinkers had a 30% increased risk of death


    • Accepted 16 October 1996
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