Harm from alcohol use may be greater for people in poorer health, research shows
Research shows that the harm associated with moderate or even low alcohol consumption may be greater in people who are poorer or in poorer health.
The research comes just weeks after another study found that alcohol’s benefits had been exaggerated and its harms downplayed in previous studies.
Dr. Rosario Ortolá, co-author of the study from the Autonomous University of Madrid, said that drinking small amounts of alcohol may have some benefits for older people at higher risk of cardiovascular disease. However, these benefits are small and can be achieved in other ways, such as through better diet or more exercise.
“Furthermore, it is clear that alcohol consumption is associated with a higher risk of cancer from the first drop, so we think medical advice should not recommend drinking alcohol to improve health,” she said.
Writing in the diary Jama Network OpenOrtolá and colleagues report how they used data provided to the UK Biobank health database by participants who enrolled between 2006 and 2010.
The researchers studied data from 135,103 participants aged 60 and older and placed each of them into one of four categories based on their average daily alcohol intake: occasional, low risk, moderate risk and high risk.
While the ‘occasional’ category equates to less than a quarter of a small glass of wine per day, ‘high risk’ equates to at least two pints of cider per day for men or one pint of cider per day for women.
The researchers then looked at which patients had died up to and including September 2021. In total, they arrived at 15,833 deaths.
After accounting for factors like participants’ age and gender, the team found that, compared with occasional drinking, risky drinking was associated with a 33 percent greater risk of dying from any cause during the study, as well as a greater risk of dying from cancer or cardiovascular disease.
Moderate-risk drinking was associated with a 10% greater risk of death from any cause compared with occasional drinking, and a 15% greater risk of death from cancer. Even low-risk drinking was associated with an 11% greater risk of death from cancer compared with occasional drinking.
However, when the team dug deeper, they found that moderate or low-risk drinking was worse for people who lived in deprived neighborhoods or who were already in poorer health.
“We believe that older people with poorer health are more susceptible to the harmful effects of alcohol because of their higher morbidity, higher use of alcohol-interacting medications and reduced tolerance to alcohol,” Ortolá said.
“There is also evidence that socioeconomically disadvantaged populations have higher rates of alcohol-related harm for equal or even lower amounts of alcohol, likely due to the coexistence of other health problems, including less healthy lifestyles and lower social support or access to health care,” she said.
Perhaps surprisingly, the team found that a strong preference for wine, or drinking only with meals, appeared to reduce the risk of death, regardless of the amount of alcohol consumed – although this only applied to those in poor health or experiencing significant deprivation.
Ortolá said these results need further investigation, but she suggested they may be related to factors such as the non-alcoholic components of wine or a slower absorption of alcohol with meals.
However, the study has limitations. For example, the data on alcohol consumption are based on self-reporting and the study cannot demonstrate cause and effect.
Colin Angus, a medical researcher from the University of Sheffield who was not involved in the work, said the study provided further confirmation that even low levels of drinking increase cancer risk. However, he said more research was needed to prove that links between low levels of drinking and higher mortality were stronger for people in poorer health or lower socioeconomic groups.
Angus also stressed that the finding that drinking wine can provide benefits should be viewed with extreme suspicion. “There is absolutely no biologically plausible evidence that wine consumption is better for you than other forms of alcohol,” he said. “It is almost certain that what they have actually found is that better off people drink more wine and are also less likely to die relatively young.”