Alcohol Dosing and Total Mortality in Men and Women An Updated Meta-analysis of 34 Prospective Studies

25 Dec 2006Augusto Di Castelnuovo, ScD; Simona Costanzo, ScD; Vincenzo Bagnardi, ScD; et al

Low levels of alcohol intake (drinks per day for women and drinks per day for men) are inversely associated with total mortality in both men and women. Our findings, while confirming the hazards of excess drinking, indicate potential windows of alcohol intake that may confer a net beneficial effect of moderate drinking, at least in terms of survival.

An inverse association between moderate alcohol consumption and coronary heart disease has been shown in observational studies. Mechanisms supporting this association include increased high-density lipoprotein cholesterol level and fibrinolysis, decreased platelet aggregation and coagulation factors, and beneficial effects on endothelial function and inflammation. Nonetheless, abuse of alcohol is unquestionably harmful. As a consequence, strong interest exists about the possibility that at any dose, the benefit of alcohol can overcome its harmful effects.

The relationship between alcohol and mortality has been depicted as a J-shaped curve, attributed to a combination of beneficial and harmful effects. Indeed, if low alcohol intake is inversely related to coronary heart disease, the other side of the coin shows an increased risk of certain cancers, cirrhosis, and death from accidents associated with increased alcohol consumption.

Moreover, whether alcohol has a different role in men and women is still debated. In previous studies, a similar inverse association of low doses of alcohol with cardiovascular disease in men and women was noted, but a meta-analysis of total mortality revealed a J-shaped relation only for men older than 34 years or women older than 54 years. Herein, we perform an updated meta-analysis of prospective studies to investigate the relationship between alcohol dosing and all-cause mortality, separately in men and women.

Meta Analysis
1 effect
10 years
1 subjects

Reported Outcomes


Alcohol Beverage risk & protective factor

Mortality Musculoskeletal outcome
Minor increase risk of Mortality
Musculoskeletal system

High evidence