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ORIGINAL RESEARCH ARTICLE

Wine intake and 45-year mortality in middle-aged men with high alcohol consumption: The Italian rural areas of the Seven Countries Study

Paolo Emilio Puddu1,2†* ,  Alessandro Menotti1†
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1 Association for Cardiac Research, Rome, Italy
2 Signalisation, électrophysiologie et imagerie des lésions d’ischémie reperfusion myocardique, UNICAEN, Caen, France
Brain & Heart 2024, 2(3), 3016 https://doi.org/10.36922/bh.3016
Submitted: 26 February 2024 | Accepted: 24 April 2024 | Published: 26 July 2024
© 2024 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
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Abstract

Research into the relationship between alcohol consumption and health has a long-standing history. Previous studies have revealed the beneficial effects of moderate alcohol consumption on cardiovascular disease (CVD) and all-cause mortality compared to abstainers and heavy drinkers. To study the long-term impact of wine intake on mortality, we conducted a study involving 1284 men aged 45 – 64 years in 1965, followed over a period of 45 years. We analyzed their wine-drinking habits in relation to all-cause mortality and specific causes using the Cox model. In addition, we utilized a multiple regression model with age at death as the dependent variable adjusted for age, smoking habits, body mass index, physical activity, dietary score, and comorbidity index. At baseline, 97.7% of participants were drinkers, consuming alcohol at an average of 77.4 g/day (mostly from wine). After 45 years, 98.4% of men had passed away. Our findings revealed a J-shaped relationship between alcohol intake and mortality from major CVD and all causes, while the relationship was roughly linear for cancer and liver cirrhosis. The relationship with CVD and all-cause mortality remained J-shaped, even when abstainers were excluded from the analysis, indicating potential health benefits for those consuming an average of 52 g/day (range: 47 – 70 g) and a 34% excess in mortality for those consuming an average of 176 g/day (range: 142 – 570 g). The average age at death for the reference class was 3.5 years higher compared to abstainers and 3.8 years higher compared to the upper class (average: 176 g/day). Reducing alcohol intake during the first 20 years of follow-up was beneficial in terms of life expectancy. In a lifetime follow-up, the relationship between alcohol consumption and mortality formed a J-shaped curve for CVD and all-cause mortality, even when excluding abstainers. Thus, relatively high wine consumption is more beneficial than lower intakes, especially when associated with vigorous physical activity at work – a common practice among rural men in the 1960s.

Keywords
Alcohol intake
Wine consumption
Cardiovascular disease mortality
All-cause mortality
Long-term follow-up
Funding
For the initiation of the Italian section of the SCS of CVDs, funds were received from Prof. Ancel Keys, University of Minnesota, USA, obtained as research grants from the National Heart Institute (later NHLBI) and the American Heart Association. Other funds obtained at the national level came from the Association for Cardiac Research, Rome; the Centre of Cardiovascular Disease, S. Camillo Hospital, Rome; the City of Naples; the National Institute of Public Health (ISS); the National Research Council (CNR); the European Union; and the Centre for the Fight against Infarction, Rome. The analysis and writing of this manuscript were not covered by the above funds.
Conflict of interest
The authors declare that they have no competing interests.
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Brain & Heart, Electronic ISSN: 2972-4139 Published by AccScience Publishing
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