Drink types unmask the health risks associated with alcohol intake – prospective evidence from the general population

Background & aims: Uncertainty still exists on the impact of low to moderate consumption of different drink types on population health. We therefore investigated the associations of different drink types in the form of beer/cider, champagne/white wine, red wine and spirits with various health outcomes. Methods: Over 500,000 participants were recruited to the UK Biobank cohort. Alcohol consumption was self-reported as pints beer/cider, glasses champagne/white wine, glasses of red wine, and measures of spirits per week. We followed health outcomes for a median of 7.02 years and reported all-cause mortality, cardiovascular events, ischemic heart disease, cerebrovascular events, and cancer. Results: In continuous analysis after excluding non-drinkers, beer/cider and spirits intake associated with an increased risk for all-cause mortality (beer/cider: hazard ratio, 1.56; 95% confidence interval, 1.45–1.68; spirits: 1.47;1.35–1.60), cardiovascular events (beer/cider: 1.25;1.17–1.33; spirits: 1.25;1.16–1.36), ischemic heart disease (beer/cider:1.12;0.99–1.26 [P=0.056]; spirits: 1.17;1.02–1.35), cerebrovascular disease (beer/cider: 1.63;1.32–2.02; spirits: 1.59;1.25–2.02) and cancer (beer/cider: 1.14;1.05–1.24; spirits: 1.14;1.03–1.26), while both champagne/white wine and red wine associated with a decreased risk for ischemic heart disease only (champagne/white wine: 0.84;0.72–0.98; red wine: 0.88;0.77–0.99). Conclusions: Our findings do not support the notion that alcohol from any drink type is beneficial to health. Consuming low levels of beer/cider and spirits already associated with an increased risk for all health outcomes, while wine showed opposite protective relationships only with ischemic heart disease.