It is proven that excessive alcohol consumption is very harmful to health. The feeling of drunkenness can cause immediate psychological and physical disorders. In addition, in the long term, alcohol is an aggravating factor, or even a trigger, for many pathologies (cancers, cirrhosis, hypertension, etc.). However, we are not all equal when it comes to these effects. A study led by the Autonomous University of Madrid reveals that alcohol consumption, even moderate, is more harmful to elderly people with fragile health or who are economically disadvantaged.
Alcohol consumption is one of the leading causes of morbidity and mortality. It accounts for approximately 5.1% of the global burden of disease and 5.3% of all deaths. Alcohol is a psychoactive product, which alters consciousness and perceptions. As such, consumed in excess, it can have several harmful effects in the short term. Reduced visual field, poor coordination of movements, decreased reflexes and alertness, etc. These effects are unfortunately the cause of many accidents.
In the longer term, alcohol can cause fatigue, sleep disorders and memory problems. It also influences the development of many chronic diseases: cancers, cardiovascular and digestive diseases, diseases of the nervous system, mental disorders, etc. And this is the case even with moderate consumption! It is thought that in some people, these harmful effects could be even more significant.
“Potentially beneficial” alcohol consumption patterns?
For example, older adults in poor health are more likely to experience the adverse effects of alcohol for several reasons. They have greater morbidity, they use more medications that interact with alcohol, and finally, age generally leads to a lower tolerance to alcohol.
Some studies have nevertheless observed beneficial effects of alcohol on this category of population. They have notably demonstrated that a light consumption of wine, accompanied by meals, could have a protective effectThis effect is generally attributed to wine’s high content of polyphenols – which are powerful antioxidants.
People who are socio-economically disadvantaged are also at higher risk of alcohol-related harm. This trend is likely due to the co-existence of other health problems, inherent to less healthy lifestyles. This is compounded by a lack of social support and more difficult access to care.
Based on these observations, a team from the Autonomous University of Madrid set out to examine whether health-related risk factors and socioeconomic status modified the associations between drinking habits and mortality. They focused in particular on “potentially beneficial” drinking patterns. Namely: low consumption, preferential consumption of wine, and drinking only with meals. They grouped the causes of mortality into three groups: all causes, cancers, and cardiovascular disease.
Increased risks for sick and disadvantaged people
This cohort study is based on data from the UK Biobank. It includes over 135,000 participants, aged 60 years or older. Their drinking habits (self-reported) were categorised as occasional (≤ 2.86 g/d), low risk (men: > 2.86-20.00 g/d; women: > 2.86-10.00 g/d), moderate risk (men: > 20.00-40.00 g/d; women: > 10.00-20.00 g/d) and high risk (men: > 40.00 g/d; women: > 20.00 g/d).
Health-related risk factors were assessed using the ‘frailty index’ (developed specifically for the UK Biobank) and socio-economic risk factors via the Townsend index (which assesses material deprivation).
Content of a standard glass of pure alcohol. Source: Public Health France
Data analysis shows that, compared to occasional drinking, high-risk drinking was associated with higher rates of all-cause mortality (+33%), cancer (+39%) and cardiovascular disease (+21%). Moderate-risk drinking was associated with higher all-cause and cancer mortality (+10% and +15% respectively). Finally, even low-risk drinking was associated with 11% higher cancer mortality!
Among people with health-related risk factors, the trends are more pronounced. Indeed, the team noted an association between low or moderate consumption and higher mortality from cancer (+15% and +19% respectively). Moderate consumption also led to higher mortality (+10%) from all causes.
The same observation was made among people with socio-economic risk factors. Low and moderate consumption appeared to lead to higher mortality, from all causes and from cancer.
A very weak protective effect, which can be obtained in other ways
The team found “small protective associations” between drinking mostly wine and drinking only with meals and mortality. This was regardless of the amount of alcohol consumed. The effect was strongest for cancer mortality, but only among people in poor health or very deprived conditions.
Alongside this effect, the researchers noted an attenuation of excess mortality linked to low to high alcohol consumption. However, further research is needed to further investigate this attenuation. According to the researchers, it would not be due to the alcohol itself. It could mainly reflect the effect of healthier lifestyles, slower absorption of alcohol, the non-alcoholic components of wine (antioxidants) or more spaced out drinking times.
It should be noted that there is no concrete evidence to date that wine is healthier than other types of alcohol! Dr. Rosario Ortolá, co-author of the study, also points out that the small benefits observed can be obtained much more healthily, through a better diet and more physical activity. It is clear that alcohol consumption is linked to a higher risk of cancer from the first drop, so we believe that medical advice should not recommend drinking alcohol to improve health. », she declared.
The results of this study confirm a harmful association, even at low doses, between alcohol consumption and people with socio-economic or health-related risk factors. At the same time, they highlight new inequalities in public health. They could have an impact on national guidelines on alcohol consumption.
Studies on alcohol and health often biased
A few weeks ago, another searchled by a Canadian team, concluded that the benefits of alcohol are often exaggerated. No, a daily glass of alcohol is not “good for your health.”
Researchers believe this misleading message is based on biased previous research. This is because it often compares daily drinkers to people who drink lightly or abstain but are sick. In many cases, illness is the very reason why these people cut back. At the same time, the authors of these studies have generally underestimated the harmful effects of alcohol. In this context, light to moderate drinkers appear to be healthier.
The fact is that studies of alcohol and health can be subject to several biases. Indeed, in addition to drinking habits, other factors come into play: smoking, socioeconomic status, etc. In addition, people often change their drinking habits in response to poor health. In this analysis, self-reported drinking corresponds to a point in time t and may have varied over the study period. A cause-and-effect link is therefore particularly difficult to establish. Despite this lack of precision, experts are clear: alcoholic beverages are harmful, even when consumed in moderation.
