Alcohol and survival in the Italian rural cohorts of the Seven Countries Study (original) (raw)

2000, International Journal of Epidemiology

Epidemiological studies repeatedly show that middle-aged men and women who regularly drink a moderate amount of alcohol have lower death mortality rates from all causes and particularly from coronary heart disease and thrombotic stroke, in comparison with abstainers and heavy drinkers. 1-14 In middle-aged people, these results are consistent across ecological, case-control, and prospective studies and for different types of alcoholic beverages, wherever they were carried out. Particularly meaningful are the results of the most recent cohort studies which involved several hundred thousand people. 1,2,13,14 Controlling for confounders seldom significantly modifies the results. Similarly most studies have found that alcohol drinkers experience higher mortality rates from cirrhosis, certain cancers, haemorrhagic stroke, violence, and accidents. The overall balance of risks and benefits depends on age and sex and is very different between, for example, a young woman and an adult man. This overall balance is summarized in total mortality. In a 1992 paper by some of the authors of this study, concerning a 20-year follow-up of an Italian rural cohort of men, aged 45-65 years at the entry examination in 1965, a U-shaped relation between alcohol consumption and mortality was shown. 4 In the present study, which applies to a 30-year followup of the same cohort, we examine the relation between survival and alcohol consumption, controlling for smoking habit and physical activity, and comparing groups in terms of life expectancy rather than in terms of mortality rates (30-year crude mortality rates are unlikely to differ much for different subgroups since in a few years the whole group will be deceased and the crude mortality rate will be 100% in each group). Subjects and Methods Study population The cohorts enrolled for this study consisted of all male subjects aged 40-59 years, resident in two small villages located in Northern (Crevalcore, CRV) and Central Italy (Montegiorgio,