Original article
Drinking Pattern and Mortality:: The Italian Risk Factor and Life Expectancy Pooling Project

https://doi.org/10.1016/S1047-2797(00)00183-6Get rights and content

Abstract

PURPOSE: To analyze the relationship between an aspect of drinking pattern (i.e., drinking with or without meals) and risk of all-cause and specific-cause mortality.

METHODS: The Risk Factors and Life Expectancy Study, is a pooling of a series of epidemiological studies conducted in Italy. Eight-thousand six-hundred and forty-seven men and 6521 women, age 30–59 at baseline, and free of cardiovascular disease, were followed for mortality from all causes, cardiovascular and noncardiovascular, during an average follow-up of 7 years.

RESULTS: Drinkers of wine outside meals exhibited higher death rates from all causes, noncardiovascular diseases, and cancer, as compared to drinkers of wine with meals. This association was independent from the cardiovascular disease (CVD) risk factors measured at baseline and the amount of alcohol consumed and seemed to be stronger in women as compared to men.

CONCLUSIONS: The present results indicate that drinking patterns may have important health implications, and attention should be given to this aspect of alcohol use and its relationship to health outcomes. The relationship between alcohol consumption and disease has been the focus of intensive scientific investigation 1, 2, 3, 4, 5, 6, 7, 8, 9. Most studies to date, however, have limitations. A major drawback is that limited information has been collected regarding the complex issue of alcohol consumption. In many studies, ascertainment of alcohol consumption frequently focused only on quantity of alcohol consumed without considering the many different components of alcohol consumption, particularly drinking pattern 10, 11, 12. It has been hypothesized, and preliminary data support the notion, that drinking pattern could have important influences on determining the health effects of alcohol 13, 14. The present study examines the relationship between one aspect of drinking pattern (drinking wine outside meals) and mortality in a large cohort of men and women.

Section snippets

Materials and methods

The Risk Factors and Life Expectancy Project represents the pooling of nine different large-scale epidemiological studies focused on cardiovascular diseases conducted in Italy between 1978 and 1987; 47 population samples of men and women were included. Forty-five of the 47 samples were drawn from local electoral rolls in defined geographical or administrative areas, and two samples were drawn from occupational settings. A total of 62,285 men and women 20–69 years of age were included in the

Results

Table 1, Table 2 summarize the characteristics of participants free of CVD at baseline according to drinking pattern in the two sexes separately. Among the 8980 men eligible for the analyses, 959 (11.1%) reported no consumption of alcoholic beverages, 5650 (65.3%) report drinking wine at meals, 600 (6.9%) report drinking wine outside meals, and 1438 (16.7%) report drinking wine and liquors. Among the 6669 women, 2195 (33.7%) reported no consumption of alcoholic beverages, and 4090 (62.6%)

Discussion

In this large cohort of men and women, we found evidence for a potentially important effect of drinking pattern on health. Men and women drinking wine outside meals seemed to experience higher mortality rates as compared to drinkers of wine at meals; whereas, drinking wine with meals is associated with lower mortality from all causes, CVD, and CHD as compared to nondrinkers in men. In women, drinkers of wine with meals experience mortality rates from all and non-CVD causes similar to

Selected Abbreviations and Acronyms

CVD = cardiovascular disease

CHD = coronary heart disease

CVA = cerebrovascular accident

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