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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.
References
  1. Boffetta P, Garfinkel L. Alcohol drinking and mortality among men enrolled in an American cancer society prospective study. Epidemiology. 1990;5:342-348. doi: 10.1097/00001648-199009000-00003

 

  1. Klatsky AL, Armstrong MA, Friedman GD. Risk of cardiovascular mortality in alcohol drinkers, ex-drinkers and nondrinkers. Am J Cardiol. 1990;66:1237-1242.

 

  1. Rimm EB, Giovannucci EL, Willett WC. Prospective study of alcohol consumption and risk of coronary disease in men. Lancet. 1991;338:464-468. doi: 10.1016/0140-6736(91)90542-w

 

  1. Beagelhole R, Jackson R. Alcohol, cardiovascular diseases and all causes of death: A review of the epidemiological evidence. Drug Alcohol Rev. 1992;11:275-289. doi: 10.1080/09595239200185811

 

  1. Doll R, Peto R, Hall E, Wheatley K, Gray R. Mortality in relation to consumption of alcohol: 13 years’ Observations on male British doctors. BMJ. 1994;309:911-918. doi: 10.1136/bmj.309.6959.911

 

  1. Gronbaek M, Deis A, Sorensen TI, Becker U, Schnohor P, Jansen G. Mortality associated with moderate intakes of wine, beer and spirits. BMJ. 1995;310:1165-1169. doi: 10.1136/bmj.310.6988.1165

 

  1. Rimm EB, Klatsky A, Grobbee D, Stampfer MJ. Review of moderate alcohol consumption and reduced risk of coronary heart disease: Is the effect of due to beer, wine or spirits? Br Med J. 1996;312:731-736. doi: 10.1136/bmj.312.7033.731

 

  1. Thun MJ, Peto R, Lopez DI, et al. Alcohol consumption and mortality among middle-aged and elderly U.S. adults. N Engl J Med. 1997;337:1705-1714. doi: 10.1056/NEJM199712113372401

 

  1. Keil U, Chambless LE, Doring A, Filipiak B, Stieber J. The relation of alcohol intake to coronary heart disease and all-cause mortality in a beer-drinking population. Epidemiology. 1997;8:150-156.

 

  1. Renaud SC, Gueguen R, Schenker J, D’Houtaud A. Alcohol and mortality in middle-aged men from Eastern France. Epidemiology. 1998;9:184-188.

 

  1. Gmel JR, Sempos CT, Trevisan M. Alcohol-related morbidity and mortality. Alcohol Res Health. 2003;166:2437-2445.

 

  1. Di Castelnuovo A, Costanzo S, Bagnardi V, Donati MB, Iacoviello L, De Gaetano G. Alcohol dosing and total mortality in men and women: An updated meta-analysis of 34 prospective studies. Arch Intern Med. 2006;166:2437-2445. doi: 10.1001/archinte.166.22.2437

 

  1. Roerecke M, Jürgen Rehm J. Alcohol consumption, drinking patterns, and ischemic heart disease: A narrative review of meta-analyses and a systematic review and meta-analysis of the impact of heavy drinking occasions on risk for moderate drinkers. BMC Med. 2014;12:182.

 

  1. Jayasekara H, English DR, Room R, MacInnis RJ. Alcohol consumption over time and risk of death: A systematic review and meta-analysis. Am J Epidemiol. 2014;179:1049-1059. doi: 10.1093/aje/kwu028

 

  1. Park JE, Choi T, Ryu Y, Cho SI. The relationship between mild alcohol consumption and mortality in Koreans: A systematic review and meta-analysis. BMC Public Health. 2015;15:918. doi: 10.1186/s12889-015-2263-7

 

  1. Stockwell T, Zhao J, Panwar S, Roemer A, Naimi T, Chikritzhs T. Do “moderate” drinkers have reduced mortality risk? A systematic review and meta-analysis of alcohol consumption and all-cause mortality. J Stud Alcohol Drugs. 2016;77:185-198. doi: 10.15288/jsad.2016.77.185

 

  1. Kuitunen-Paul S, Michael Roerecke M. Alcohol use disorders identification test (AUDIT) and mortality risk: A systematic review and meta-analysis. J Epidemiol Community Health. 2018;72:856-863. doi: 10.1136/jech-2017-210078

 

  1. Schutte R, Papageorrgiou M, Najlah M, et al. Drink types unmask the health risks associated with alcohol intake-prospective evidence from the general population. Clin Nutr. 2020;39:3168-3174. doi: 10.1016/j.clnu.2020.02.009

 

  1. Fragopoulou E, Antonopoulo S. The French paradox three decades later: Role of inflammation and thrombosis. Clin Chim Acta. 2022;510:160-169. doi: 10.1016/j.cca.2020.07.013

 

  1. Zatonska K, Psikus P, Basiak-Rasala A, et al. Patterns of alcohol consumption in the PURE Poland cohort study and their relationship with health problems. Int J Environ Res Public Health. 2021;18:4185. doi: 10.3390/ijerph18084185

 

  1. Di Castelnuovo A, Costanzo S, Bonaccio M, et al. Alcohol intake and total mortality in 142 960 individuals from the MORGAM project: A population-based study. Addiction. 2021;117:312-325. doi: 10.1111/add.15593

 

  1. Chudzinska M, Wolowiec L, Banach J, Rogowicz D, Grzeisk G. Alcohol and cardiovascular diseases-do the consumption pattern and dose make the difference? J Cardiovasc Dev Dis 2022;9:317. doi: 10.3390/jcdd9100317

 

  1. Lucas-Torres ML, Saz Lara L, Diewz-Ferdandez A, et al. Association between wine consumption with cardiovascular disease and cardiovascular mortality: A systematic review and meta-analysis. Nutrients. 2023;15:2785. doi: 10.3390/nu15122785

 

  1. Serio F, Imbriani G, Acito M, et al. Moderate red wine intake and cardiovascular health protection: A literature review. Food Funct. 2023;14:6346-6362. doi: 10.1039/D3FO01004J

 

  1. Surma S, Gajos G. Alcohol, health loss, and mortality: Can wine really save the good name of moderate alcohol consumption? Pol Arch Intern Med. 2024;20:16708. doi: 10.20452/pamw.16708

 

  1. Farchi G, Fidanza F, Mariotti S, Menotti A. Alcohol and mortality in the Italian rural cohorts of the seven countries study. Int J Epidemiol. 1992;21:74-82.

 

  1. Farchi G, Fidanza F, Giampaoli S, Mariotti S, Menotti A. Alcohol and survival in the Italian rural cohorts of the seven countries study. Int J Epidemiol. 2000;29:667-671. doi: 10.1093/ije/29.4.667

 

  1. Menotti A, Puddu PE. How the seven countries study contributed to the launch and development of cardiovascular epidemiology in Italy. A historical perspective. Nutr Metab Cardiovasc Dis. 2020;30:368-383. doi: 10.1016/j.numecd.2019.11.010

 

  1. Rose G, Blackburn H. Cardiovascular Survey Methods. Geneva: World Health Organization; 1968.

 

  1. Fidanza-Alberti A, Seccareccia F, Torsello S, Fidanza F. Diet of two rural population groups of middle-aged men in Italy. Int J Vitam Nutr Res. 1988;58:442-451.

 

  1. Menotti A, Puddu V. Ten-year mortality from coronary heart disease among 172,000 men classified by occupational physical activity. Scand J Work Environ Health. 1979;5:100-108. doi: 10.5271/sjweh.s2663

 

  1. Menotti A, Seccareccia F. Physical activity at work and job responsibility as risk factors for fatal coronary heart disease and other causes of death. J Epidemiol Comm Health. 1985;39:325-329. doi: 10.1136/jech.39.4.325

 

  1. Fidanza F, Alberti A, Lanti M, Menotti A. Mediterranean adequacy index: Correlation with 25-year mortality from coronary heart disease in the seven countries study. Nutr Metab Cardiovasc Dis. 2004;14:254-258. doi: 10.1016/s0939-4753(04)80052-8

 

  1. Menotti A, Kromhout D, Puddu PE, et al. Baseline fatty acids, food groups, a diet score and 50-year all-cause mortality rates. An ecological analysis of the seven countries study. Ann Med. 2017;49:718-727. doi: 10.1080/07853890.2017.1372622

 

  1. Kromhout D, Menotti A, Alberti-Fidanza A, et al. Comparative ecologic relationships of saturated fat, sucrose, food groups, and a Mediterranean food pattern score to 50-year coronary heart disease mortality rates among 16 cohorts of the seven countries study. Eur J Clin Nutr. 2018;72:1103-1110. doi: 10.1038/s41430-018-0183-1

 

  1. World Health Organization. WHO International Classification of Diseases. 8th Revision. Geneva: World Health Organization; 1965.
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Brain & Heart, Electronic ISSN: 2972-4139 Published by AccScience Publishing
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