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Association Between Daily Alcohol Intake and Risk of All-Cause Mortality: A Systematic Review and Meta-analyses
Systematic review and meta-analysis of 107 cohort studies (4.8M+ people, 425k+ deaths) modeling alcohol dose versus all-cause mortality: after adjustments for former-drinker bias and study-quality covariates, low-volume drinking was not significantly protective versus lifetime abstention, while risks rose significantly at 45–64 g/day and ≥65 g/day ethanol.
Design
- SR + MA of cohort studies (1980–July 2021)
- 107 studies; 724 adjusted RR estimates; ≈4,838,825 participants and ≈425,564 deaths
- Statistical approach: mixed linear regression with bias / quality covariates (incl. former-drinker bias)
Dose–mortality (fully adjusted model; abstract)
- Occasional drinkers (>0–<1.3 g/day): RR 0.96 (95% CI 0.86–1.06; P = .41)
- Low-volume (1.3–24.0 g/day): RR 0.93 (P = .07) — not significant protection
- 25–44 g/day: RR 1.05 (P = .28)
- 45–64 g/day: RR 1.19 (P < .001)
- ≥65 g/day: RR 1.35 (P < .001)
- Sex: larger mortality risks among female drinkers vs female lifetime abstainers (RR 1.22, P = .03)
Erratum / debate context
PubMed links an erratum on figures/supplements; expect post-publication replies—read updated materials.
Publication
Stockwell T, Zhao J, Panwar S, et al. JAMA Netw Open. 2023 Mar 31;6(3):e236185. PMID 37000449.
Outcomes
- All-Cause Mortality RiskEvents: /
- All-Cause Mortality RiskEvents: /