HARVARD GAZETTE ARCHIVES

Death Risk Changes with Alcohol Consumption

By William J. Cromie

Gazette Staff

Men who have two to six alcoholic drinks a week have a relatively lower risk of death from all causes than nondrinkers and those who consume less than two drinks a week.

Light drinking seems to provide some protection against heart attacks, but two or more drinks a day substantially raises the risk of death from cancer, according to a Harvard study published this week.

"The difference between consumption of small and large amounts of alcohol may mean the difference between preventing and causing excess [earlier] deaths," says Carlos Camargo, a researcher at the Medical School and Brigham and Women's Hospital.

For almost 11 years, Camargo and his colleagues tracked 22,071 men, aged 40 to 84 years, who participate in Harvard's Physicians' Health Study. During this time, 1,206 of them died, 394 from heart and blood vessel disease, 488 from cancer, and 324 from other causes.

Those who drank two to four alcoholic drinks a week had a 28 percent lower death risk than those who consumed less than one drink a week. Those who downed five or six drinks experienced a 21 percent lower risk. But men who drank two or more drinks a day had a 51 percent higher risk of death.

One drink is defined as 12 ounces of beer, 4-5 ounces of wine, or 1.5 ounces of whiskey, vodka, etc.

These results cannot be applied to women, Camargo notes, because of the unknown effects of alcohol on breast cancer.

Give and Take

Several other studies have also found that two to six drinks a week offer protection against heart attacks. The benefit seems to come from a reduction in cholesterol and the tendency of blood to clot. But for those who might believe that more is better, the present study saw no added protection when consumption rises to two or more drinks a day.

Individuals should not prescribe light drinking for themselves without checking with a physician. Depending on other risk factors, a drink or two a day can increase the risk of death from other causes.

"Observed benefits on coronary heart disease mortality were eventually offset by an increased risk of death from other heart and blood vessel conditions, as well as a significant increase in cancer deaths," Camargo says.

Two or more drinks a day was associated with a sharp rise in risk of fatal lung cancer compared to the lightest drinkers. And it raised the risk of death from others cancers, including cancer of the stomach, esophagus, pancreas, and urinary tract.

Last week, researchers at the University of Illinois announced that red wine contains a substance (resveratrol) that appears to be a potent inhibitor of the initiation and growth of cancer cells. Camargo counters that what happens in a test tube may not happen in a male or female body. He says that, while less than two drinks a day doesn't seem to raise a male's risk of death from cancer, some researchers believe that even one glass of wine a day can slightly raise the risk of breast cancer in women.

Contrary to what you might expect, Camargo and his colleagues found that moderate drinking had no significant association with risk of violent death and suicide. "Heavy drinking during a single night sharply raises the possibilities of car crashes, fights, and suicide, but this is not a problem for regular drinkers who keep their intake below six drinks a week or two drinks a day," he pointed out.

Men in the Physicians' Health Study, all health professionals, tended to be healthier than the general population, had more education, a higher living standard, and better access to medical care. The heavier drinkers were older, smoked more, and were more likely to have high blood pressure. However, Camargo doesn't think the relationship between alcohol and death would be much different in other groups of men.

Heavy drinking ranks as one of the leading causes of preventable death. To increase their chances of a longer life, Camargo suggests that heavy drinkers discuss their drinking habits with their doctors and other health providers.

As a physician himself, Camargo advises those who drink three or more drinks a day to cut back. "For those who drink less, I take a medical history, weigh the risks and benefits, and let them know how moderate drinking might affect their health. For nondrinkers, I tell them how alcohol might affect them and leave it at that.

"There are people who believe that alcohol in any amount is an evil substance, and everything about it is bad," Camargo adds. "Others thinks it's always great, a relaxant, a feel-good agent, and a traditional accompaniment for food. As in most things, the truth lies in-between."

In this case, it's less than two drinks a day.

Participating in the study with Camargo were Charles Hennekens, Michael Gaziano, Robert Glynn, JoAnn Manson, and Meir Stampfer, all members of various departments of the Medical School and School of Public Health.