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Binge drinking cancels out benefits of moderate alcohol consumption

Am J Epidemiol 2010; Advance online publication

Irregular bouts of heavy drinking cancel out the cardioprotective benefits of light to moderate alcohol consumption, suggest meta-analysis findings.

The study found that people who occasionally drank the equivalent of five or more alcoholic drinks, or to intoxication, had around a 1.5-fold higher risk for ischemic heart disease than people who drank moderately on a regular basis.

Researchers Michael Roerecke (Centre for Addiction and Mental Health, Toronto, Ontario, Canada) and Jürgen Rehm call for guidelines on alcohol consumption for the general public to be re-examined and "tailored to the population at risk."

The study included four case–control and 10 cohort studies examining the relative risk for ischemic heart disease endpoints among people with irregular heavy drinking episodes, defined as consumption of 60 g or more alcohol per day at least 12 times per year but not more than 5 days per week, in comparison with drinkers with no heavy drinking episodes. The researchers calculated risk estimates stratified by or adjusted for total alcohol intake.
Reporting the findings in the American Journal of Epidemiology, Roerecke and Rehm say the results were relatively consistent across studies. Three studies found a nonsignificant association, the remainder yielding increased relative risks associated with irregular heavy drinking that ranged from 1.29 to 6.14. The overall pooled relative risk was 1.45, with moderate, but significant, heterogeneity among studies (p=0.008).

Indirect evidence from three further studies looking at associations between frequency of drinking days and ischemic heart disease risk, controlling for total alcohol consumption, appeared to support the meta-analysis result.

For example, one study of White men in the USA found a two-fold higher risk among those who drank at the weekends compared with people who drank at other times. Similarly, another study found a lower risk among men who reported drinking on 3–5 days or 6–7 days in the previous week than among those who drank on 1–2 days.

The authors conclude: "Low-risk drinking guidelines should be carefully re-evaluated based on the findings from this study to incorporate evidence for the difference in ischemic heart disease risk due to irregular heavy drinking occasions, not only for primary prevention of harmful effects due to alcohol consumption but also for considering requests for alcohol consumption as a secondary prevention measure that occur from time to time in the literature."

Read the abstract

MedWire ( is an independent clinical news service provided by Current Medicine Group, a part of Springer Science+Business Media. © Current Medicine Group Ltd; 2010