Journal of Epidemiology
Online ISSN : 1349-9092
Print ISSN : 0917-5040
ISSN-L : 0917-5040

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Impact of Alcohol Intake and Drinking Patterns on Mortality From All Causes and Major Causes of Death in a Japanese Population
Eiko SaitoManami InoueNorie SawadaHadrien CharvatTaichi ShimazuTaiki YamajiMotoki IwasakiShizuka SasazukiTetsuya MizoueHiroyasu IsoShoichiro Tsugane
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JOURNAL FREE ACCESS Advance online publication
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Article ID: JE20160200


Background: We examined the associations of alcohol consumption and liver holidays with all-cause mortality and with mortality due to cancer, heart disease, cerebrovascular disease, respiratory disease, and injury using a large-scale prospective study in Japan.

Methods: We followed 102,849 Japanese who were aged between 40 and 69 years at baseline for 18.2 years on average, during which 15,203 deaths were reported. Associations between alcohol intake and mortality risk were assessed using a Cox proportional hazards model, with analysis by the number of liver holidays (in which a person abstains from drinking for several days a week).

Results: A J-shaped association was observed between alcohol intake and total mortality in men (nondrinkers: reference; occasional drinkers: hazard ratio [HR] 0.74; 95% confidence interval [CI], 0.68–0.80; 1–149 g/week: HR 0.76; 95% CI, 0.71–0.81; 150–299 g/week: HR 0.75; 95% CI, 0.70–0.80; 300–449 g/week: HR 0.84; 95% CI, 0.78–0.91; 450–599 g/week: HR 0.92; 95% CI, 0.83–1.01; and ≥600 g/week: HR 1.19; 95% CI, 1.07–1.32) and in women (nondrinkers: reference; occasional: HR 0.75; 95% CI, 0.70–0.82; 1–149 g/week: HR 0.80; 95% CI, 0.73–0.88; 150–299 g/week: HR 0.91; 95% CI, 0.74–1.13; 300–449 g/week: HR 1.04; 95% CI, 0.73–1.48; and ≥450 g/week: HR 1.59; 95% CI, 1.07–2.38). In current drinkers, alcohol consumption was associated with a linear, positive increase in mortality risk from all causes, cancer, and cerebrovascular disease in both men and women, but not heart disease in men. Taking of liver holidays was associated with a lower risk of cancer and cerebrovascular disease mortality in men.

Conclusions: Alcohol intake showed J-shaped associations with the risk of total mortality and three leading causes of death. However, heavy drinking increases the risk of mortality, which highlights the necessity of drinking in moderation coupled with liver holidays.

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© 2017 Eiko Saito et al. This is an open access article distributed under the terms of Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.