| Title: | Alcohol and mortality in Mexico: prospective study of 150 000 adults |
| Journal: | The Lancet Public Health |
| Published: | 1 Nov 2024 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/39486906/ |
| DOI: | https://doi.org/10.1016/s2468-2667(24)00228-7 |
Publication 32
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Abstract
BACKGROUND: Alcohol consumption is a leading cause of premature death globally, but there is no large-scale prospective evidence from Mexico.
METHODS: The Mexico City Prospective Study recruited 150000 adults aged 35 years or older between 1998 and 2004. Participants were followed up until Oct 1, 2022 for cause-specific mortality. Cox regression in those with no self-reported chronic disease at entry (adjusted for age, sex, district, education, physical activity, smoking, and diabetes) was used to relate baseline-reported alcohol consumption (never, former, occasional [less than monthly], and regular [at least monthly, split into <70, ≥70 to <140, ≥140 to <210, and ≥210 g/week]) to mortality at ages 35-74 from all causes, and from a pre-specified alcohol-related set of underlying causes. Heavy episodic drinking (normally consuming >5 [men] or >4 [women] drinks on a single occasion) and type of preferred drink were also examined.
FINDINGS: Among 138413 participants aged 35-74 years at recruitment, 21136 (15%) were regular alcohol drinkers (14863 [33%] men, 6273 [7%] women), of whom 13383 (63%) favoured spirits and 6580 (31%) favoured beer. During follow-up, there were 13889 deaths at ages 35-74 years, including 3067 deaths from the pre-specified alcohol-related causes. Overall, J-shaped associations with mortality were observed. Compared with occasional drinkers, those with baseline-reported consumption ≥210 g/week had 43% higher all-cause mortality (rate ratio [RR] 1.43 [95% CI 1.30-1.56]) and nearly three times the mortality from the pre-specified alcohol-related causes (2.77 [2.39-3.20]). Death from liver disease was strongly related to alcohol consumption; the RR comparing regular drinkers of ≥140 g/week with occasional drinkers was 4.03 (3.36-4.83). Compared with occasional light drinking, occasional heavy episodic drinking was associated with 20% higher alcohol-related mortality (1.20 [1.06-1.35]), and regular heavy episodic drinking was associated with 89% higher alcohol-related mortality (1.89 [1.67-2.15]). Drinks with alcohol percentages higher than spirits were associated with the greatest increased mortality risk, even after accounting for the total alcohol consumed.
INTERPRETATION: In this Mexican population, higher alcohol consumption, episodic drinking, and very high percentage alcoholic products were all associated with increased mortality.
FUNDING: Wellcome Trust, the Mexican Health Ministry, the National Council of Science and Technology for Mexico, Cancer Research UK, British Heart Foundation, and the UK Medical Research Council.
TRANSLATION: For the Spanish translation of the abstract see Supplementary Materials section.
18 Authors
- Eirini Trichia
- Jesus Alegre-Díaz
- Diego Aguilar-Ramirez
- Raúl Ramirez-Reyes
- Adrián Garcilazo-Ávila
- Carlos González-Carballo
- Fiona Bragg
- Louisa Gnatiuc Friedrichs
- William G Herrington
- Lisa Holland
- Jason Torres
- Rachel Wade
- Rory Collins
- Richard Peto
- Jaime Berumen
- Roberto Tapia-Conyer
- Pablo Kuri-Morales
- Jonathan R Emberson