Researchers analyzing more than 340,000 adults uncovered an intriguing pattern linking alcohol type with long-term health outcomes.
For decades, scientists have debated whether some alcoholic drinks are “healthier” than others. While heavy drinking is widely known to raise the risk of serious diseases and early death, the effects of lighter drinking have remained far less clear — especially when it comes to wine, beer, cider, and spirits.
Now, a major study involving more than 340,000 adults in the United Kingdom suggests that the type of alcohol people drink may influence long-term health outcomes at low to moderate levels of consumption. The findings, presented at the American College of Cardiology’s Annual Scientific Session (ACC.26), add new nuance to growing evidence that when it comes to alcohol and health, both quantity and beverage choice may matter.
“These results come from the general population, and in certain high-risk groups, such as people with chronic diseases or cardiovascular conditions, the risks could be even higher,” said Zhangling Chen, MD, PhD, a professor at the Second Xiangya Hospital, Central South University in China and the study’s senior author.
Beverage type changed the picture
Researchers examined drinking patterns and mortality outcomes for 340,924 adults who took part in the UK Biobank study from 2006 to 2022. When participants joined the study, they completed a dietary questionnaire and were assigned to one of four alcohol intake groups based on grams of pure alcohol consumed per day and per week.
For comparison, a 12 ounce beer, a 5 ounce glass of wine, and a 1.5 ounce serving of spirits each contain roughly 14 grams of pure alcohol. People who drank less than 20 g (about 1.5 standard drinks) per week were categorized as never or occasional drinkers.
Men who consumed between 20 g per week and 20 g per day, and women who consumed between 20 g per week and 10 g per day, were placed in the low alcohol group. Moderate intake was defined as 20 g to 40 g (about 1.5 to three standard drinks) per day for men and 10 g to 20 g per day for women. High intake was defined as more than 40 g (about three drinks) per day for men and more than 20 g (about 1.5 drinks) per day for women. Participants’ health outcomes were followed for an average of more than 13 years.
Wine diverged at lower intake
Compared with people who never drank or drank only occasionally, high intake drinkers had a 24% higher risk of death from any cause, a 36% higher risk of death from cancer, and a 14% higher risk of death from heart disease. At low and moderate intake levels, the pattern differed by drink type. Spirits, beer, and cider were associated with a significantly higher risk of death, while similar levels of wine intake were associated with a significantly lower risk of death.
For cardiovascular disease deaths specifically, moderate wine drinkers had a 21% lower risk of dying from cardiovascular disease than never or occasional drinkers. In contrast, even low consumption of spirits, beer, or cider was linked to a 9% higher risk of cardiovascular death compared with never or occasional drinking.
“Our findings help clarify previously mixed evidence on low to moderate alcohol consumption,” Chen said. “These findings can help refine guidance, emphasizing that the health risks of alcohol depend not only on the amount of alcohol consumed, but also on the type of beverage. Even low to moderate intake of spirits, beer, or cider is linked to higher mortality, while low to moderate intake of wine may carry lower risk.”
Lifestyle may shape the signal
Researchers said several explanations could help account for the different patterns seen by beverage type. Red wine contains compounds such as polyphenols and antioxidants, which may support cardiovascular health. Wine is also more often consumed with meals and by people who tend to have higher-quality diets and healthier overall habits. Spirits, beer, and cider are more often consumed outside meals and were linked with lower overall diet quality and other lifestyle risk factors.
“Taken together, these factors suggest that the type of alcohol, how it is consumed, and the associated lifestyle behaviors all contribute to the observed differences in mortality risk,” Chen said.
Caution remains despite scale
The researchers adjusted their analyses for demographic factors, socioeconomic status, lifestyle factors, cardiometabolic factors, and family history of diabetes, cardiovascular disease, and cancer. Still, they noted that the work has built-in limitations because it is observational.
They said high-quality randomized trials would be useful for better understanding the effects of alcohol intake. Drinking habits were self-reported at the beginning of the study, and the analysis did not capture changes in alcohol consumption over time. UK Biobank participants also tend to be healthier than the broader population, which may limit how widely the findings apply.
Even with those limitations, the large number of participants and long follow-up period give the study substantial statistical strength. Researchers said the analysis offers a more detailed view of alcohol’s health effects than many earlier studies, with finer distinctions by drinking amount, beverage type, and different mortality outcomes.
Meeting: American College of Cardiology’s Annual Scientific Session
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