Moderate drinking apparently beneficial even after other factors accounted for

By Steve Tokar

Sei Lee, MD

Older adults who drink one to two glasses of alcohol per day are 25 percent less at risk of death from any cause than people who drink more than that and those who do not drink at all, according to a study by researchers at the San Francisco VA Medical Center and the University of California, San Francisco.

The study adjusted for income, wealth, education, and ability to carry out activities of daily living.

“The apparent protective effects of moderate drinking have been noted for many years in many previous studies, but most of those studies have not accounted for other factors that may influence health and life expectancy,” notes lead author Sei J. Lee, MD, MAS, a staff physician at SFVAMC and an assistant adjunct professor of medicine at UCSF.

The study authors analyzed the self-reported drinking habits of 12,519 participants age 55 or older who were interviewed in 2002 as part of the Health and Retirement Study, an ongoing national prospective study of health, income, and wealth sponsored by the National Institute on Aging. The authors then determined whether the participants were alive or dead in 2006.

For the study, a drink was defined as 12 ounces of beer, five ounces of wine, or 1.5 ounces of hard liquor.

Lee says that the study, which appears in online Early View section of the “Journal of the American Geriatrics Society,” was the first to control for functional limitation – the ability to carry out basic activities of daily living such as bathing, shopping, and walking. In a previous study, Lee demonstrated that degree of functional limitation is a powerful predictor of mortality.

“We also looked at educational level, income, and overall wealth – because older, retired people can have low incomes but substantial financial assets,” says Lee.

The moderate drinkers turned out to be less functionally limited, better educated, and have higher incomes and more wealth – all factors that decrease mortality – than either non-drinkers or heavier drinkers.

Based on drinking habits alone, the moderate drinkers were 50 percent less likely to have died from any cause at the end of the study. After adjustment for the other factors, the moderate drinkers were still 25 percent less likely to have died.

The study also discounted an observation made in some previous studies that extremely light drinking – around one drink per week – was associated with improved health and mortality. “Once we accounted for all the other factors, that benefit went away,” reports Lee.

Lee cautions that his results are open to question because it was a retrospective study based on self-reported behavior. He says a different type of study is needed to determine whether moderate drinking actually confers potential health benefits.

“What we call for in the paper is an intervention trial in which we randomly ask non-drinkers to either begin moderate drinking or continue to abstain, and then compare them over time,” says Lee.

“People have made the argument that such a study carries the risk of creating harm for the people we ask to drink, which is true. However, if we find that alcohol is as helpful as it appears to be, there is a substantial overall benefit to be gained. It’s really the only way to find out.”

Co-authors of the study are Rebecca L. Sudore, MD, and Brie A. Williams, MD, of SFVAMC and UCSF; Karla Lindquist, MS, of UCSF; and Helen L. Chen, MD, and Kenneth E. Covinsky, MD, MPH, of SFVAMC and UCSF.

The study was supported by funds from the National Institute on Aging, the National Institutes of Health, and the Hartford Geriatrics Health Outcomes Research Scholars Awards Program. Some of the funds were administered by the Northern California Institute for Research and Education.

NCIRE - the Veterans Health Research Institute - is the largest research institute associated with a VA medical center. Its mission is to improve the health and well-being of veterans and the general public by supporting a world-class biomedical research program conducted by the UCSF faculty at SFVAMC.

SFVAMC has the largest medical research program in the national VA system, with more than 200 research scientists, all of whom are faculty members at UCSF.

UCSF is a leading university dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care.