Total and beverage-specific alcohol use at mid-life and all-cause and cause-specific mortality: a prospective cohort study
In brief
High alcohol intake linked to 24% higher overall mortality in UK cohort
4 years, high total alcohol intake was associated with 24% higher all-cause mortality and 36% higher cancer mortality than never or occasional drinking. Low to moderate spirits and beer or cider intake was also linked to higher mortality, while wine intake was linked to lower mortality; the observational findings cannot establish cause and effect, and high intake of every beverage type was linked to deaths from multiple cancers.
- Journal
- Nutrition journal (Q1)
- Published
- 22 July 2026
- Study design
- Prospective / inception cohort
- Evidence level
- Level 2, Moderate (CEBM 2b)
- Authors
- Ziyue Li, Bohao Tan, Clémence Desjardins, Lu Wang, Neha Khandpur, Yu Feng, et al.
- PMID
- 42902373
- DOI
- 10.1186/s12937-026-01361-3
Why clinicians should know about it
- Picked for Epidemiology (top studies of the week, 25 October 2026): Large prospective cohort examines alcohol exposure and cause-specific mortality
Abstract
BACKGROUND: While detrimental health impacts of excessive alcohol use are well-established, potential effects of low-to-moderate drinking remain controversial. We examined the associations between total and beverage-specific alcohol intake and mortality, including cardiovascular disease (CVD), cancer (e.g., 20 site-specific cancers), and other mortality. METHODS: We included 340,924 participants from UK Biobank (2006-2022). Alcohol use was categorized as: never or occasional alcohol consumption (≤ 20 g/week), low consumption (> 20 g/week to ≤ 20 g/d for men, > 20 g/week to ≤ 10 g/d for women), moderate consumption (> 20 to ≤ 40 g/d for men, > 10 to ≤ 20 g/d for women), and high consumption (> 40 g/d for men and > 20 g/d for women). We used Cox proportional hazard models to examine the associations of alcohol intake and mortality. RESULTS: During a mean follow-up of 13.4 years, we documented 22,381 deaths. Compared with never or occasional alcohol intake, high total alcohol intake was associated with higher mortality from all-causes (HR and 95%CI: 1.24 (1.17, 1.31)), CVD (1.14 (1.01, 1.28)), cancer (1.36 (1.26, 1.47)), and other causes (1.12 (1.02, 1.22)), whereas moderate alcohol use was associated with higher cancer mortality (1.11 (1.03, 1.20)) only. Alcohol consumption from spirits and beer/cider, even at low to moderate levels, was associated with higher mortality from all-causes, CVD, cancer, and other diseases (HRs ranging from 1.07 to 1.83). Yet, low and moderate alcohol intake from wine was associated with lower all-cause, CVD, cancer, or other mortality. Importantly, moderate to high intake of total alcohol and alcohol from beer/cider and spirits, and high wine use were particularly associated with higher mortality from multiple site-specific cancers, including mortality from head/neck, respiratory system, gastrointestinal, liver/gallbladder, hematological, female breast, and female/male genital cancers. CONCLUSIONS: The results suggested that low to moderate alcohol intake from spirits and beer/cider was associated with higher all-cause, CVD, cancer, and other mortality, whereas low to moderate alcohol use from wine was associated with lower all-cause, CVD, cancer, and other mortality. However, high alcohol use, regardless of beverage-type, mortality from various site-specific cancers was elevated.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.