Alcohol and survival in the Italian rural cohorts of the Seven Countries Study

Background Middle-aged men who regularly drink a moderate amount of alcohol have lower mortality rates from all causes in comparison with abstainers a nd heavy drinkers. This cohort study looks at the relationship between alco hol consumption and long-term survival, adjusting for smoking habit and phy sical activity. Methods In 1965, a total of 1536 Italian males aged 45-65 years underwent a n examination which included: a general questionnaire, anthropometric measu rements, an overall physical examination, ECG recording, blood pressure and serum cholesterol measurements and measurement of food consumption includi ng alcohol. The cohort was followed for total mortality from 1965 to 1995. Results During a period of 30 years 1096 deaths occurred. Age-adjusted life expectancy for men assuming a mean daily quantity of 63 g of alcohol (rang e 4-7 drinks per day) was 21.6 +/- 0.4 years, roughly 2 years more than men taking a mean quantity of 3.7 g (less than or equal to 1 drink) and men co nsuming >10 drinks per day. Taking smoking habit into account, the longest survival of 22.4 +/- 0.5 years was observed in non-smokers drinking 4-7 dri nks daily; the lowest, 18.5 +/- 0.7 years, in smokers drinking >10 drinks. Stratifying for physical activity, the longest survival (23.4 +/- 0.7 years ) was experienced by men engaged in heavy physical activity at work drinkin g 1-4 drinks per day. Conclusions The relationship between life expectancy and alcohol consumptio n (97% wine in this Italian cohort and mostly red wine) is confirmed to be non-linear. Men aged 45-64 at entry drinking about 5 drinks per day have a longer life expectancy than occasional and heavy drinkers.