Drinking Patterns And Gender, Not Quantity, May Detirmine Alcohol's Effect On Health

BUFFALO, N.Y. -- A new study to be presented tomorrow will report that the effect of alcohol on long-term health may depend as much on the way it is consumed and on the gender of the drinker, as on how much is consumed.

An analysis of the drinking behavior of a large cohort of Italian men and women by researchers at the University at Buffalo has found that people who drank wine outside of meals, as well as at mealtime, had higher mortality rates than people who drank wine with meals only.

For women, the rates were significantly higher.

The results will be reported at 3 p.m. Wednesday, Nov. 15, in Toronto at a conference titled “Social and Health Effects of Different Drinking Patterns,” sponsored by the Addiction Research Foundation.

“This is one of the first studies to indicate that the way you drink is going to make a difference,” said Maurizio Trevisan, M.D., professor and chair of the UB Department of Social and Preventive Medicine and lead author on the study.

“Past studies on the effects of alcohol on health always have looked at the amount of alcohol consumed. They have never looked at the way people drink. We find that if you drink a certain way -- outside of meals -- women, especially, are at very high risk.”

The study also showed that men who drink had a lower risk of death from all causes, death from cardiovascular disease and death from non-cardiovascular disease causes, but women experienced no such benefit. Findings showed that women drinkers had similar mortality rates as women who didn’t drink for all causes of death, death from non-cardiovascular causes and death from cancer.

“It’s clear from this study that for women, the so-called small benefit derived from drinking alcohol is not there,” Trevisan said. He noted, however, that the number of women in the study population who died from heart disease is very low, so the effect on cardiovascular mortality couldn’t be assessed.

On the question of why drinking outside of meals appears to put this population at risk, Trevisan had several thoughts.

“It could be that a drinker of wine outside of meals in Italy may be a problem drinker,” he said. “It could be that drinking wine on an empty stomach allows more alcohol to be absorbed. Or maybe those people just drink more often.”

The findings were based on consumption of wine, the principal alcoholic beverage of this population. Trevisan said he believes the results could apply to consumption of other alcoholic beverages and to other populations.

The researchers looked at alcohol consumption, drinking patterns and mortality in 8,980 men and 6,669 women ages 30-59 who are part of an on-going epidemiology study in Italy called the Risk Factor and Life Expectancy (RIFLE) project .

At the 10-year follow-up, 594 men and 173 women had died. Trevisan and colleagues compared the drinking habits of those who died with the rest of the study population.

Analysis showed that 88.8 percent of the men in the total study population and 66.3 percent of the women drank alcoholic beverages. Of the drinkers:

• 73.5 percent of men and 94.5 percent of women reported drinking wine at mealtime only.

• 7.7 percent of men and 0.9 percent of women drank wine both with meals and outside of mealtime.

• 18.8 percent of men and 4.6 percent of women drank both wine and liquors with meals.

For men, drinking up to five drinks a day was associated with lower death rates from all causes and death from cardiovascular disease and non-cardiovascular disease causes. Women drinkers, however, derived no benefit.

When drinking patterns were analyzed, in both sexes, drinkers of wine outside of meals had higher rates of all cause, non-cardiovascular mortality and coronary heart disease mortality than drinkers of wine only at mealtime, and the effect was strongest in women.

The research was supported by a grant from the National Institute on Alcohol Abuse and Alcoholism, and was conducted through the Center for the Clinical and Medical Epidemiology of Alcohol, a joint venture of the University at Buffalo and the Research Institute on Addictions.

Additional researchers were Enrique Schisterman, UB doctoral student in the Department of Social and Preventive Medicine; Suzanne Conti, Ph.D., and Gino Farchi, Ph.D., from the Instituti Superior di Sanitá, Rome, Italy; Allesandro Menotti, Ph.D., from the Instituti Italiano di Medicina Sociale, Rome, Italy, and the RIFLE group.