Overall, Forum members considered this to be a well-done paper that provides additional information on alcohol’s effects on CVD and mortality among a very large number of middle-aged or elderly women. Although women markedly increase their risk of CVD following menopause, this is a group of women for whom data are sparse. Weaknesses of the analysis include a lack of information on the pattern of drinking (binge versus regular), type of beverage, and drinking alcohol with or without food. It is of note that in some of the studies included in the meta-analysis, factors such as HDL-cholesterol and fibrinogen were adjusted for in the study; given that these are mechanisms of alcohol’s effects, overall results will surely underestimate the effects. Further, as the authors point out, this study provides little information on the physiologic mechanisms of alcohol’s effects on health.
Forum members praised the authors for this meta-analysis of a very large dataset. It strengthens previous analyses that show that each of the lifestyle factors considered – not smoking, not becoming obese, being physically active, and regularly consuming small to moderate amounts of alcohol – benefit health. The more healthy lifestyle factors a subject has, the greater the benefit.
It will be especially important that future research evaluates what happens if subjects change their lifestyle habits, as such results would help target specific behavioral changes. There are very limited data available on this at present, but such studies that have been done suggest that the onset of moderate drinking among non-drinkers, or a slight increase in alcohol consumption among light drinkers, have beneficial effects on health. Still, it is appreciated that moderate alcohol consumption is only one of a number of factors making up a “healthy lifestyle,” which is clearly associated with less cardiovascular and other diseases and a much lower risk of mortality.
Reference: Colpani V, Baena CP, Jaspers L, van Dijk GM, Farajzadegan Z, Dhana K, Tielemans MJ, Voortman T, Freak-Poli R, Veloso GGV, Chowdhury R, Kavousi M, Muka T. Franco OH. Lifestyle factors, cardiovascular disease and all-cause mortality in middle-aged and elderly women: a systematic review and metaanalysis. European Journal of Epidemiology 2018; pre-publication. https://doi.org/10.1007/s10654-018-0374-z