Less is Best When it Comes to Alcohol in those Over 60
Perhaps it’s time for a mocktail at your next happy hour? A new study published in JAMA discovered higher mortality in older drinkers even with “low-risk” (AKA moderate) alcohol intake. The study was done to evaluate the link between alcohol intake patterns and 12-year mortality and its modification by health-related or socioeconomic risk factors.
The cohort study included over 135,100 participants from the UK Biobank, a population-based cohort. Subjects were current drinkers aged 60 years or older. Data were evaluated from September 2023 to May 2024.
Subjects’ drinking habits were classified in grams per day as follows: occasional (<=2.86 g/d), low risk (men: >2.86-20.00 g/d; women: >2.86-10.00 g/d), moderate risk (men: >20.00-40.00 g/d; women: >10.00-20.00 g/d) and high risk (men: >40.00 g/d; women: >20.00 g/d).
Health risk factors were evaluated using the frailty index while socioeconomic risk factors were assessed with the Townsend deprivation index. Death certificates from national registries were used to obtain all-cause and cause-specific mortality information.
Deaths in the first 2 years of follow-up were not included in the analysis and adjusted for confounders such as drinking patterns and preferences. In the analytical sample which included 135,103 subjects, compared to occasional drinking, high-risk drinking was linked with higher all-cause cancer and cardiovascular mortality. Moderate-risk drinking was associated with higher all-cause and cancer mortality while low-risk drinking was linked with higher cancer mortality.
Despite no link being found for low-or moderate-risk drinking patterns compared to occasional drinking in individuals without socioeconomic or health-related risk factors, low-risk drinking was linked with higher cancer mortality and moderate-risk drinking with higher all-cause and cancer mortality in those with health-related risk factors.
Low-risk and moderate-risk drinking patterns were associated with higher mortality from all causes and cancer withing individuals with socioeconomic risk factors.
One upside; a preference for wine (>80% of alcohol from wine) and having alcohol with meals showed small protective associations with mortality, especially from cancer. However, this was seen only in drinkers with socioeconomic or health-related risk factors and was linked with enhancing the additional mortality linked with high-, moderate-- and even low-risk drinking.
Further studies are needed on mortality in wine drinkers and those who consume alcohol with meals. Protection from alcohol may be related to healthier lifestyles, reduced alcohol absorption with food, or beneficial components in beverages without alcohol.
What to tell your clients about alcohol and health:
· If you don’t drink, don’t start. Health benefits have not been observed in late adopters.
· Be moderate with alcohol when you do drink. One drink per day for women, two per day for men.
· Limit alcohol to 3 drinks per week for women with a risk of breast cancer. Or, avoid it altogether.
· Enjoy small amounts of alcohol with a meal or snack instead of an empty stomach.
· Get creative with mocktails. Flavored seltzer water and pomegranate or other juice is delightful.
· Avoid binge drinking. This is hard on several organs including your brain, heart, and liver.
· Space out your drinks with water. Limit how many drinks you allow yourself and stick with it.
· Try non-alcoholic beer or wine. They’re all the buzz!
· Limit alcohol intake to weekends only.
· Challenge yourself to Dry January or Sober October.
Lisa Andrews, MEd, RD, LD
Reference:
Rosario Ortolá, MD, PhD1,2; Mercedes Sotos-Prieto, PhD1,2,3,4; Esther García-Esquinas, PhD2,5; et alIñaki Galán, PhD2,5; Fernando Rodríguez-Artalejo, PhD1,2,4 Alcohol Consumption Patterns and Mortality Among Older Adults With Health-Related or Socioeconomic Risk Factors JAMA Netw Open. 2024;7(8):e2424495. doi:10.1001/jamanetworkopen.2024.24495
