A new study done in countries of all income levels shows that alcohol use increases the risk of cancers and injury, with no reduction in risk of mortality or cardiovascular disease overall. The research, published in The Lancet, supports health strategies to reduce harmful alcohol use, especially in low-income countries (LICs).
Alcohol consumption is one of the top modifiable risk factor for death and disability. But alcohol consumption has been associated with both benefits and harm by studies conducted in the past, done mostly in high-income countries.
This new study investigated associations between alcohol consumption and clinical outcomes in a prospective cohort of countries at different economic levels in five continents.
The data came from 12 countries participating in the Prospective Urban Rural Epidemiological (PURE) study, a prospective cohort study of individuals aged 35–70 years. The high-income countries (HICs) were Sweden and Canada; upper-middle-income countries (UMICs) were Argentina, Brazil, Chile, Poland, South Africa, and Turkey; and lower-middle-income countries (LMICs) were China and Colombia; and lower income countries (LICs) were India and Zimbabwe.
The study included 114,970 adults, of whom 12904 (11%) were from HICs, 24408 (21%) were from UMICs, 48845 (43%) were from LMICs, and 28 813 (25%) were from LICs.
Although drinking was associated with a 24% reduced risk of heart attack, there was no reduction in risk of mortality or stroke, and current drinking was associated with a 51% increased risk of alcohol-related cancers—meaning those of the mouth, oesophagus, stomach, colorectum, liver, breast, ovary, and head and neck—and a 29% increased risk of injury in drinkers.
For a combination of all reported outcomes, there was no overall benefit from current alcohol use. High alcohol intake and heavy episodic drinking were both associated with significant increases in risk of overall mortality.
“Our data support the call to increase global awareness of the importance of harmful use of alcohol and the need to further identify and target the modifiable determinants of harmful alcohol use," said Andrew Smyth of the Population Health Research Institute (PHRI) at McMaster University in Canada.
Co-author Salim Yusuf, director of PHRI and president of the World Heart Federation, added: “Because alcohol consumption is increasing in many countries, especially in LICs/LMICs, the importance of alcohol as a risk factor for disease might be underestimated. Therefore, global strategies to reduce harmful use of alcohol are essential."