Charles S. Fuchs, M.D., Meir J. Stampfer, M.D., Graham A. Colditz, M.B., B.S., Edward L. Giovannucci, M.D., JoAnn E. Manson, M.D., Ichiro Kawachi, M.B., Ch.B., David J. Hunter, M.B., B.S., Susan E. Hankinson, R.N., Sc.D., Charles H. Hennekens, M.D., Bernard Rosner, Ph.D., Frank E. Speizer, M.D., and Walter C. Willett, M.D.
Background Studies in men suggest that light-to-moderate alcoholintake is associated with a reduction in overall mortality,due primarily to a reduced risk of coronary heart disease. Amongwomen with similar levels of alcohol consumption, an increasedrisk of breast cancer has been noted that complicates the balanceof risks and benefits.
Methods We conducted a prospective study among 85,709 women,34 to 59 years of age and without a history of myocardial infarction,angina, stroke, or cancer, who completed a dietary questionnairein 1980. During the 12-year follow-up period, 2658 deaths weredocumented.
Results The relative risks of death in drinkers as comparedwith nondrinkers were 0.83 (95 percent confidence interval,0.74 to 0.93) for women who consumed 1.5 to 4.9 g of alcoholper day (one to three drinks per week), 0.88 (95 percent confidenceinterval, 0.80 to 0.98) for those who consumed 5.0 to 29.9 gper day, and 1.19 (95 percent confidence interval, 1.02 to 1.38)for those who consumed 30 g or more per day, after adjustmentfor other predictors of mortality. Light-to-moderate drinking(1.5 to 29.9 g per day) was associated with a decreased riskof death from cardiovascular disease; heavier drinking was associatedwith an increased risk of death from other causes, particularlybreast cancer and cirrhosis. The benefit associated with light-to-moderatedrinking was most apparent among women with risk factors forcoronary heart disease and those 50 years of age or older.
Conclusions Among women, light-to-moderate alcohol consumptionis associated with a reduced mortality rate, but this apparentsurvival benefit appears largely confined to women at greaterrisk for coronary heart disease.
In prospective cohort studies, conducted predominantly amongmen, light-to-moderate drinkers of alcoholic beverages havebeen found to have lower total mortality rates than either nondrinkersor heavier drinkers.1,2,3,4,5,6,7,8,9,10,11,12,13,14 This reducedmortality is due largely to a reduced risk of fatal coronaryheart disease. Studies among women have been fewer, and theresults have been conflicting.3,8,9,11,15,16
Whether the apparent overall benefit of light-to-moderate alcoholintake among men can be extrapolated to women is unclear. Ascompared with men, women have a lower risk of coronary heartdisease,17 attain higher blood alcohol concentrations for agiven amount of alcohol consumed,18 and are more susceptibleto alcoholic liver disease.19,20 Moreover, women who consumemoderate quantities of alcohol have an increased risk of breastcancer.21,22,23
We therefore examined prospectively the relation between alcoholintake and mortality in a large cohort of women. Furthermore,we specifically examined this relation among women at low riskfor coronary heart disease, for whom increased rates of breastcancer and other adverse events may outweigh the reduction incoronary heart disease.
Methods
Study Cohort
The Nurses' Health Study was established in 1976 when 121,700female registered nurses 30 to 55 years of age, residing inthe United States, completed a mailed questionnaire on knownor suspected risk factors for cancer22 and coronary heart disease.24Every two years since then, the participants have been sentfollow-up questionnaires to update information on potentialrisk factors and to identify newly diagnosed cases of cancer,coronary heart disease, and other diseases.
Semiquantitative Food-Frequency Questionnaire
In 1980, 1984, and 1986, the participants were asked to reporttheir average frequency of consumption of specified foods andbeverages during the previous 12 months. In 1980, we also askedwhether consumption of each item had greatly increased or greatlydecreased during the previous 10 years. The reproducibilityand validity of these questionnaires have been documented previously.25,26,27,28,29
Questions about the consumption of beer, wine, and spirits wereincluded as separate items. Total alcohol intake was the sumof the values for all three beverages; a 12-oz (360-ml) canor bottle of beer was assumed to contain 13.2 g of alcohol,a 4-oz (120-ml) glass of wine 10.8 g, and a standard drink ofspirits 15.1 g.30 The Spearman rank-correlation coefficientfor alcohol intake as measured by the questionnaire and as calculatedfrom the dietary records of participants was 0.90.22 Similarly,the correlation between the alcohol consumption reported inresponse to the 1984 questionnaire and that found in the 1980diet records was 0.84.29 In addition, alcohol intake as measuredby each of the methods was correlated with plasma concentrationsof high-density lipoprotein (r = 0.40, P<0.001).22,23,24,25,26,27,28,29
Population for Analysis
The dietary questionnaire was returned by 98,462 nurses in 1980.We excluded from our study women with 10 or more food itemsleft blank (4 percent) or with implausibly high or low scoresfor total food intake (2.7 percent). We also excluded womenwith a history of cancer (except nonmelanoma skin cancer), angina,myocardial infarction, or stroke. Because the group of womenwho now abstain from alcohol may include former heavy drinkersand women who stopped drinking because of illness, we excludedfrom our primary analysis 2957 women who reported no alcoholintake in 1980 but had greatly decreased their alcohol intakein the previous 10 years. This left 85,709 women in the analysis.
Identification of Deaths
Our primary end point was death from any cause. We made systematicsearches of the vital records of the states and the NationalDeath Index to discover deaths among women who did not respondduring each questionnaire cycle. This search was supplementedby reports from family members or from postal authorities. Weestimate that we were able to ascertain more than 98 percentof the deaths in the cohort by these methods.31
A physician, blinded to data on alcohol consumption and otherrisk factors, reviewed death certificates and medical recordsto classify the cause of death according to the InternationalClassification of Diseases, Eighth Revision (ICD-8).32 The followingsubgroups were analyzed: participants whose deaths were dueto any cardiovascular disease (ICD-8 codes 390 to 459 and 795);coronary heart disease (codes 410 to 414); stroke (codes 430to 437); any noncardiovascular cause (all codes except 390 to459 and 795); any cancer (codes 140 to 207); breast cancer (code174); cirrhosis of the liver (code 571); and any injury withan external cause (codes 800 to 999 and all "E" codes), whichincluded accidents and suicides.
Statistical Analysis
In our primary analysis, we used incidence rates with person-yearsof follow-up as the denominators. For each woman, person-yearsof follow-up were counted from the date of return of the 1980questionnaire to May 31, 1992 or, for those who died, untilthe date of death. Because our focus was on mortality, and becausepeople tend to reduce alcohol consumption markedly or to discontinueconsumption after a major illness is diagnosed, levels of alcoholintake reported after 1980 were not taken into considerationin the primary analysis. For all other covariates, person-yearsof follow-up were assigned according to the risk-factor statusreported on the most recently completed questionnaire. Follow-upterminated at the date of death. If no questionnaire was returnedfor a follow-up cycle, the most recently recorded data wereused for the subsequent follow-up period.
We calculated relative risk as the incidence of death amongwomen with a given alcohol intake divided by the correspondingrate among women who did not consume alcohol. Relative riskswere adjusted for age, in five-year categories, and for thehistory and amount of cigarette smoking (participants were groupedinto those who never smoked, those who had formerly smoked,and those who smoked less than 15, 15 to 24, and more than 24cigarettes per day)33; 95 percent confidence intervals werecalculated.34 We used a proportional-hazards model to adjustfor multiple risk factors simultaneously.35 Any curvilinearassociation between alcohol intake and mortality was assessedby including both linear and quadratic terms (average alcoholintake and that value squared) in our model.36 Stratified analyseswere conducted to determine whether the effect of alcohol consumptionwas modified by age or coronary-risk-factor status. In boththese analyses, the value for the relevant variable, age orcoronary-risk-factor status, was updated biennially. Tests forinteraction were performed by entering into the proportional-hazardsmodel cross-product terms for alcohol consumption (as indicatorvariables for each level of intake) and either age or coronary-risk-factorstatus.36
To address the potential misclassification of alcohol intakedue to the passage of time, secondary analyses were performedon the basis of updated measurements of alcohol consumption,although these data were not used in the primary analysis.
Employing a model with separate continuous variables for alcoholintake according to type of beverage — beer, wine, orspirits — we used the Wald test to examine differencesbetween logistic-regression coefficients.36
Results
Among the 85,709 women eligible for analysis, 29.8 percent reportedno alcohol consumption in 1980, and the majority reported consumingonly low-to-moderate amounts (Table 1). Approximately 1 percentof the cohort drank more than 50 g per day. Most base-line characteristicswere distributed similarly among drinkers and nondrinkers, althoughdiabetes mellitus and obesity were more common among nondrinkersand regular aspirin use, oral-contraceptive use, and smokingwere more common among drinkers.
Table 1. Base-Line Characteristics of the Cohort, According to Alcohol Intake.
During the 12 years of follow-up (1,010,209 person-years), 2658of the women died. A total of 503 women died of cardiovasculardisorders; 1495 of any cancer, including 350 of breast cancer;203 of injury from external causes, including accidents andsuicides; 52 of cirrhosis of the liver; and 405 from other causes.
As compared with nondrinkers and heavy drinkers, light-to-moderatedrinkers (1.5 to 29.9 g of alcohol per day) had a significantlylower overall risk of death (Table 2). Even after we controlledfor several known or suspected predictors of mortality, thedata for mortality according to alcohol consumption fitted aU-shaped curve with a nadir at approximately 1.5 to 4.9 g perday (one to three drinks per week). The lower risk associatedwith light drinking was principally due to a lower risk of fatalcardiovascular disease. The higher death rate among women whoconsumed 30 g or more per day was largely due to a higher numberof deaths from noncardiovascular diseases, including breastcancer and cirrhosis. Furthermore, controlling for risk factorsfor breast cancer (age at menarche less than 13 years, one ormore pregnancies, age at first pregnancy less than 22 years,history of benign breast disease, or family history of breastcancer) did not materially affect the association of alcoholconsumption with mortality from all causes.
Table 2. Number of Deaths and Relative Risks of Death According to Cause and Alcohol Intake.
To assess the nonlinear relation between alcohol intake andmortality from all causes, we performed analyses in which alcoholconsumption, measured continuously, was entered into the multivariatemodel as both linear and quadratic terms (average alcohol intakeand that value squared). A negative regression coefficient forthe linear term ( = -1.3 x 10-2, P = 0.02) and a positive coefficientfor the quadratic term ( = 4.9x10-4, P = 0.001) were derived,results consistent with the observed U-shaped relation.
We excluded from our primary analysis former heavy drinkerswho reported current abstinence, but we examined the data onthese women separately. As compared with long-term nondrinkers,these former drinkers had a relative risk of death, after adjustmentfor age and smoking status, of 1.49 (95 percent confidence interval,1.27 to 1.74) as well as a significantly higher risk of deathfrom any cardiovascular cause (relative risk, 2.48; 95 percentconfidence interval, 1.88 to 3.25) and from any noncardiovascularcause (relative risk, 1.24; 95 percent confidence interval,1.02 to 1.50).
Age strongly affected the relation between alcohol intake andmortality from all causes. For women 34 to 39 years of age,the relative risk of death in all categories of drinkers wasslightly but not significantly increased (Table 3). Among womenin this age group who consumed 5.0 g or more of alcohol perday, external causes of injury accounted for 50 percent of thedeaths. In contrast, among women 50 or older, light-to-moderatedrinkers (1.5 to 29.9 g per day) had a significant reductionin mortality from all causes, which appeared to be the resultof a substantially lower risk of fatal cardiovascular disease.Among light-to-moderate drinkers, the relative risk of deathfrom a cardiovascular cause was 0.59 (95 percent confidenceinterval, 0.47 to 0.73) for women 50 years of age or older.To test whether age significantly affected the association betweenalcohol intake and total mortality, we added to the multivariatemodel the cross-product interaction terms of age (measured continuously)and each of the levels of alcohol consumption specified in Table 3.For light-to-moderate drinkers, the decrease in the relativerisk of death with increasing age was at the margin of statisticalsignificance (P for trend = 0.05).
Table 3. Number of Deaths and Relative Risk of Death According to Age and Alcohol Intake.
The apparent benefit associated with light-to-moderate alcoholconsumption was greatest among women with one or more risk factorsfor coronary heart disease (Table 4). Among women reportingat least one coronary risk factor (73.2 percent of the studypopulation in 1980), light-to-moderate drinkers had a significantlylower total mortality (P<0.001). In contrast, among womenwith no coronary risk factors (26.8 percent of the populationin 1980), light-to-moderate drinking was not associated withany appreciable reduction in total mortality (P = 0.70); consumptionof 30 g or more of alcohol per day by these women markedly increasedmortality. This higher total mortality among heavier drinkerswithout coronary risk factors was largely due to a higher riskof death from noncardiovascular disease (relative risk, 2.22;95 percent confidence interval, 1.31 to 3.72), most notablybreast cancer (relative risk, 3.43; 95 percent confidence interval,1.36 to 8.66). The result of a test for interaction betweenthe consumption of 1.5 to 29.9 g of alcohol per day and thepresence or absence of cardiac risk factors was not significantin a multivariate model (P = 0.09), although the relative risksassociated with the consumption of 30 g or more per day diddiffer significantly among women with and without cardiac riskfactors (P = 0.04).
Table 4. Number of Deaths from All Causes and Relative Risk of Death According to Cardiac Risk Status and Alcohol Intake.
To determine whether the interaction between alcohol consumptionand coronary-risk-factor status was independent of age, we thenlimited our analysis to women 50 years of age or older. Amongthese older women, the reduction in mortality associated withlight-to-moderate drinking was again confined to women withone or more coronary risk factors. As was the case when youngerwomen were included, the interaction between the risk of deathassociated with the consumption of 1.5 to 29.9 g of alcoholper day and coronary-risk-factor status was not significant(P = 0.08).
Although we excluded women with serious illnesses at base line,the group of long-term nondrinkers could include women who refrainedfrom drinking because of early symptoms of disease. If so, thehigher mortality among nondrinkers might be due in part to undiagnosed,preexisting disease. Such an effect would account for higherrates of death in the earlier years of follow-up but would beexpected to diminish in later years of observation. To addressthis issue, we repeated our analyses after excluding deathsin the first four years of follow-up (Table 5). With the analysisrestricted to the final eight years of follow-up, a significantU-shaped relation remained between the average alcohol intakereported in 1980 and total mortality (P = 0.002 for the quadraticterm [average alcohol intake]2).
Because people may alter their drinking habits over time, longitudinalstudies that assess alcohol intake only at base line may resultin misclassification. Therefore, we repeated our analyses usingupdated measurements of alcohol consumption obtained in 1984and 1986, and still observed a significant U-shaped relationbetween alcohol consumption and mortality (P<0.001 for thequadratic term [average alcohol intake]2) (Table 5). In performinganalyses in which the data on alcohol intake were updated, weconsidered the possibility that a disproportionate number ofthe women who had recently stopped drinking did so because ofill health, which might have resulted in a misleading elevationof mortality among abstainers. Therefore, we performed furtheranalyses in which women were excluded from follow-up if theyreported nonfatal myocardial infarction, angina, stroke, orcancer during subsequent assessments of alcohol intake. With2043 deaths left in the analysis, we continued to observe asignificant U-shaped relation between alcohol intake and totalmortality (P = 0.001 for the quadratic term [average alcoholintake]2).
We examined separately the association between mortality andalcohol intake according to type of beverage — beer, wine,or spirits. In a regression model controlled for other predictorsof mortality, the associations between alcohol intake (measuredas a continuous variable) from beer, wine, or spirits and therisk of death did not differ significantly, although there wasa nonsignificant trend toward more protection with wine (datanot shown).
Discussion
Our results, from a large prospective study of women, providestrong evidence for a U-shaped relation between alcohol intakeand mortality in women. As compared with abstinence, light-to-moderatealcohol consumption was associated with a significantly reducedrisk of death due largely to a lower risk of fatal cardiovasculardisease. In contrast, heavier drinking was associated with increasedmortality, due largely to an increased risk of death from noncardiovasculardiseases, including breast cancer. In a manner consistent withthese competing effects, the apparent benefit of light-to-moderatealcohol consumption was mainly confined to women at greaterrisk for coronary heart disease, specifically older women andwomen with one or more coronary risk factors.
Bias is unlikely to explain the observed relations. The dietaryquestionnaires reliably measured alcohol intake.29 Moreover,our results remained unchanged even after we accounted for variationsin alcohol consumption over time. The prospective design precludedrecall bias. Differential follow-up is unlikely to have madea material contribution to these findings, since we estimatethat we accurately identified more than 98 percent of the deathsin this cohort.31
We observed a reduction in mortality for light-to-moderate drinkersonly among women 50 years of age or older, although our cohortdid not include women over 70. For women 34 to 39 years of age,we observed elevated risks of death for all levels of alcoholconsumption, but the number of deaths in this subgroup was small.Two previous studies have reported an increased mortality amongyounger drinkers, largely as a result of alcohol-related accidents.11,37Although a recent analysis of British physicians reported lowermortality for moderate drinkers at all ages, the study populationconsisted of men over the age of 50 who were predominantly formeror current smokers.5
The women in the Nurses' Health Study have patterns of alcoholconsumption that are quite similar to those found in a generalsurvey of U.S. women.38 Thus, our results may be applicableto the wider population of women. Since only a small percentageof our cohort consumed more than 50 g of alcohol per day, ourability to examine the health consequences of excessive drinkingis limited.
The relations between alcohol consumption and the risk of deathfrom breast cancer or cardiovascular disease reflect the previouslydescribed association of alcohol with the incidence of theseillnesses.21,22,23,39,40,41,42 In addition, several other diseaseshave been positively linked to alcohol consumption, includingcolorectal cancer, cancers of the upper aerodigestive tract(the oral cavity and esophagus), hemorrhagic stroke, cirrhosisof the liver, accidents, and suicide.2,11,43,44 Our mortalityanalysis does not address nonfatal disease and may thereforebe less useful in addressing causal relations. However, dataon mortality provide one measure of the overall balance of risksand benefits of alcohol consumption.
In conclusion, these findings indicate that for women as a grouplight-to-moderate alcohol consumption confers a significantoverall survival advantage. Among younger women and those withoutrisk factors for coronary heart disease, however, light-to-moderatealcohol consumption is not associated with a reduction in totalmortality and heavier drinking is associated with a substantialincrease in mortality. For older women and women with coronaryrisk factors, light-to-moderate alcohol consumption is associatedwith a reduction in total mortality, although with heavier intakemortality is increased.
Supported by grants (HL 34594 and CA 40356) from the NationalInstitutes of Health and by Faculty Research Awards from theAmerican Cancer Society (FRA-398 to Dr. Colditz and FRA-455to Dr. Hunter).
Source Information
From the Channing Laboratory (C.S.F., M.J.S., G.A.C., E.L.G., J.E.M., I.K., D.J.H., S.E.H., C.H.H., B.R., F.E.S., W.C.W.) and the Division of Preventive Medicine (J.E.M., C.H.H., B.R.), Brigham and Women's Hospital and Harvard Medical School; the Division of Medical Oncology, Dana–Farber Cancer Institute (C.S.F.); and the Departments of Epidemiology (M.J.S., G.A.C., D.J.H., S.E.H., C.H.H., W.C.W.), Nutrition (M.J.S., W.C.W.), Health and Social Behavior (I.K.), and Biostatistics (B.R.), Harvard School of Public Health — all in Boston.
Address reprint requests to Dr. Fuchs at the Dana–Farber Cancer Institute, 44 Binney St., Boston, MA 02115.
References
Blackwelder WC, Yano K, Rhoads GG, Kagan A, Gordon T, Palesch Y. Alcohol and mortality: the Honolulu Heart Study. Am J Med 1980;68:164-169. [CrossRef][Medline]
Boffetta P, Garfinkel L. Alcohol drinking and mortality among men enrolled in an American Cancer Society prospective study. Epidemiology 1990;1:342-348. [Medline]
Cullen KJ, Knuiman MW, Ward NJ. Alcohol and mortality in Busselton, Western Australia. Am J Epidemiol 1993;137:242-248. [Free Full Text]
De Labry LO, Glynn RJ, Levenson MR, Hermos JA, LoCastro JS, Vokonas PS. Alcohol consumption and mortality in an American male population: recovering the U-shaped curve -- findings from the normative aging study. J Stud Alcohol 1992;53:25-32. [Medline]
Doll R, Peto R, Hall E, Wheatley K, Gray R. Mortality in relation to consumption of alcohol: 13 years' observations on male British doctors. BMJ 1994;309:911-918. [Free Full Text]
Dyer AR, Stamler J, Paul O, et al. Alcohol consumption, cardiovascular risk factors, and mortality in two Chicago epidemiologic studies. Circulation 1977;56:1067-1074. [Free Full Text]
Gordon T, Doyle JT. Drinking and mortality: the Albany Study. Am J Epidemiol 1987;125:263-270. [Free Full Text]
Gronbaek M, Deis A, Sorensen TI, et al. Influence of sex, age, body mass index, and smoking on alcohol intake and mortality. BMJ 1994;308:302-306. [Free Full Text]
Friedman LA, Kimball AW. Coronary heart disease mortality and alcohol consumption in Framingham. Am J Epidemiol 1986;124:481-489. [Free Full Text]
Kittner SJ, Garcia-Palmieri MR, Costas R Jr, Cruz-Vidal M, Abbott RD, Havlik RJ. Alcohol and coronary heart disease in Puerto Rico. Am J Epidemiol 1983;117:538-550. [Free Full Text]
Klatsky AL, Armstrong MA, Friedman GD. Alcohol and mortality. Ann Intern Med 1992;117:646-654.
Kono S, Ikeda M, Tokudome S, Nishizumi M, Kuratsune M. Alcohol and mortality: a cohort study of male Japanese physicians. Int J Epidemiol 1986;15:527-532. [Free Full Text]
Kozaraevic D, McGee D, Vojvodic N, et al. Frequency of alcohol consumption and morbidity and mortality: the Yugoslavia Cardiovascular Disease Study. Lancet 1980;1:613-616. [CrossRef][Medline]
Marmot MG, Rose G, Shipley M, Thomas B. Alcohol and mortality: a U-shaped curve. Lancet 1981;1:580-583. [Medline]
Garfinkel L, Boffetta P, Stellman S. Alcohol and breast cancer: a cohort study. Prev Med 1988;17:686-693. [CrossRef][Medline]
Camacho TC, Kaplan GA, Cohen RD. Alcohol consumption and mortality in Alameda County. J Chronic Dis 1987;40:229-236. [CrossRef][Medline]
National Center for Health Statistics. Vital statistics of the United States: mortality series. Washington, D.C.: Government Printing Office, 1968-1988.
Frezza M, di Padova C, Pozzato G, Terpin M, Baraona E, Lieber CS. High blood alcohol levels in women: the role of decreased gastric alcohol dehydrogenase activity and first-pass metabolism. N Engl J Med 1990;322:95-99. [Abstract]
Norton R, Batey R, Dwyer T, MacMahon S. Alcohol consumption and the risk of alcohol cirrhosis in women. BMJ 1987;295:80-82.
Saunders JB, Davis M, Williams R. Do women develop alcoholic liver disease more readily than men? BMJ 1981;282:1140-1143.
Longnecker MP. Alcoholic beverage consumption in relation to risk of breast cancer: meta-analysis and review. Cancer Causes Control 1994;5:73-82. [CrossRef][Medline]
Willett WC, Stampfer MJ, Colditz GA, Rosner BA, Hennekens CH, Speizer FE. Moderate alcohol consumption and the risk of breast cancer. N Engl J Med 1987;316:1174-1180. [Abstract]
Schatzkin A, Jones DY, Hoover RN, et al. Alcohol consumption and breast cancer in the Epidemiologic Follow-up Study of the first National Health and Nutrition Examination Survey. N Engl J Med 1987;316:1169-1173. [Abstract]
Stampfer MJ, Willett WC, Colditz GA, Rosner B, Speizer FE, Hennekens CH. A prospective study of postmenopausal estrogen therapy and coronary heart disease. N Engl J Med 1985;313:1044-1049. [Abstract]
Colditz GA, Willett WC, Stampfer MJ, et al. The influence of age, relative weight, smoking, and alcohol intake on the reproducibility of a dietary questionnaire. Int J Epidemiol 1987;16:392-398. [Free Full Text]
Colditz G, Martin P, Stampfer MJ, et al. Validation of questionnaire information on risk factors and disease outcomes in a prospective cohort study of women. Am J Epidemiol 1986;123:894-900. [Free Full Text]
Willett WC, Sampson L, Browne ML, et al. The use of a self-administered questionnaire to assess diet four years in the past. Am J Epidemiol 1988;127:188-199. [Free Full Text]
Willett WC, Sampson L, Stampfer MJ, et al. Reproducibility and validity of a semiquantitative food frequency questionnaire. Am J Epidemiol 1985;122:51-65. [Free Full Text]
Giovannucci E, Colditz G, Stampfer M, et al. The assessment of alcohol consumption by a simple self-administered questionnaire. Am J Epidemiol 1991;133:810-817. [Free Full Text]
Nutrition Information Service. Human provisional table on nutrient content of beverages. Washington, D.C.: Department of Agriculture, 1982.
Stampfer MJ, Willett WC, Speizer FE, et al. Test of the National Death Index. Am J Epidemiol 1984;119:837-839. [Free Full Text]
Department of Health, Education, and Welfare. International classification of diseases, 8th rev., adapted for use in the United States: ICDA. Vol. 1. Tabular list. Washington, D.C.: Government Printing Office, 1967. (DHEW publication no. (PHS) 1693.)
Rothman KJ. Modern epidemiology. Boston: Little, Brown, 1986.
Miettinen O. Estimability and estimation in case-referent studies. Am J Epidemiol 1976;103:226-235. [Free Full Text]
Cox D. Regression models and life-tables. J R Stat Soc [B] 1972;34:187-220.
Hosmer DW Jr, Lemeshow S. Applied logistic regression. New York: John Wiley, 1989.
Andreasson S, Allebeck P, Romelsjo A. Alcohol and mortality among young men: longitudinal study of Swedish conscripts. BMJ 1988;296:1021-1025.
Wilsnack R, Wilsnack S, Klassen A. Women's drinking and drinking problems: patterns from a 1981 national survey. Am J Public Health 1984;74:1231-1238. [Free Full Text]
Stampfer MJ, Colditz GA, Willett WC, Speizer FE, Hennekens CH. A prospective study of moderate alcohol consumption and the risk of coronary disease and stroke in women. N Engl J Med 1988;319:267-273. [Abstract]
Gaziano JM, Buring JR, Breslow JL, et al. Moderate alcohol intake, increased levels of high-density lipoprotein and its subfractions, and decreased risk of myocardial infarction. N Engl J Med 1993;329:1829-1834. [Free Full Text]
Rimm EB, Giovannucci EL, Willett WC, et al. Prospective study of alcohol consumption and risk of coronary disease in men. Lancet 1991;338:464-468. [CrossRef][Medline]
Klatsky AL, Armstrong MA, Friedman GD. Risk of cardiovascular mortality in alcohol drinkers, ex-drinkers and nondrinkers. Am J Cardiol 1990;66:1237-1242. [CrossRef][Medline]
Alcohol and cancer. Lancet 1990;335:634-635. [Medline]
McGinnis JM, Foege WH. Actual causes of death in the United States. JAMA 1993;270:2207-2212. [Free Full Text]
McKenzie, F., Jeffreys, M.
(2009). Do Lifestyle or Social Factors Explain Ethnic/Racial Inequalities in Breast Cancer Survival?. Epidemiol Rev
31: 52-66
[Abstract][Full Text]
Djousse, L., Lee, I-M., Buring, J. E., Gaziano, J. M.
(2009). Alcohol Consumption and Risk of Cardiovascular Disease and Death in Women: Potential Mediating Mechanisms. Circulation
120: 237-244
[Abstract][Full Text]
Laonigro, I., Correale, M., Di Biase, M., Altomare, E.
(2009). Alcohol abuse and heart failure. Eur J Heart Fail
11: 453-462
[Abstract][Full Text]
Lauer, M. S., Sorlie, P.
(2009). Alcohol, Cardiovascular Disease, and Cancer: Treat With Caution. JNCI J Natl Cancer Inst
101: 282-283
[Full Text]
Kerr, D., Penfold, S., Zouwail, S., Thomas, P., Begley, J.
(2009). The influence of liberal alcohol consumption on glucose metabolism in patients with type 1 diabetes: a pilot study. QJM
102: 169-174
[Abstract][Full Text]
Liu, B., Balkwill, A., Roddam, A., Brown, A., Beral, V., on behalf of the Million Women Study Collaborators,
(2009). Separate and Joint Effects of Alcohol and Smoking on the Risks of Cirrhosis and Gallbladder Disease in Middle-aged Women. Am J Epidemiol
169: 153-160
[Abstract][Full Text]
Ikehara, S., Iso, H., Toyoshima, H., Date, C., Yamamoto, A., Kikuchi, S., Kondo, T., Watanabe, Y., Koizumi, A., Wada, Y., Inaba, Y., Tamakoshi, A., Japan Collaborative Cohort Study Group,
(2008). Alcohol Consumption and Mortality From Stroke and Coronary Heart Disease Among Japanese Men and Women: The Japan Collaborative Cohort Study. Stroke
39: 2936-2942
[Abstract][Full Text]
Dam, R. M v., Li, T., Spiegelman, D., Franco, O. H, Hu, F. B
(2008). Combined impact of lifestyle factors on mortality: prospective cohort study in US women. BMJ
337: a1440-a1440
[Abstract][Full Text]
Reding, K. W., Daling, J. R., Doody, D. R., O'Brien, C. A., Porter, P. L., Malone, K. E.
(2008). Effect of Prediagnostic Alcohol Consumption on Survival after Breast Cancer in Young Women. Cancer Epidemiol. Biomarkers Prev.
17: 1988-1996
[Abstract][Full Text]
Colditz, G. A., Winn, D. M.
(2008). Criteria for the Evaluation of Large Cohort Studies: An Application to the Nurses' Health Study. JNCI J Natl Cancer Inst
100: 918-925
[Abstract][Full Text]
Kaneda, K., Miyamae, M., Sugioka, S., Okusa, C., Inamura, Y., Domae, N., Kotani, J., Figueredo, V. M.
(2008). Sevoflurane Enhances Ethanol-Induced Cardiac Preconditioning Through Modulation of Protein Kinase C, Mitochondrial KATP Channels, and Nitric Oxide Synthase, in Guinea Pig Hearts. Anesth. Analg.
106: 9-16
[Abstract][Full Text]
Inoue, M., Wakai, K., Nagata, C., Mizoue, T., Tanaka, K., Tsuji, I., Tsugane, S., for the Research Group for the Development and Eva,
(2007). Alcohol Drinking and Total Cancer Risk: An Evaluation Based on a Systematic Review of Epidemiologic Evidence among the Japanese Population. Jpn J Clin Oncol
37: 692-700
[Abstract][Full Text]
Opie, L. H., Lecour, S.
(2007). The red wine hypothesis: from concepts to protective signalling molecules. Eur Heart J
28: 1683-1693
[Abstract][Full Text]
Marugame, T., Yamamoto, S., Yoshimi, I., Sobue, T., Inoue, M., Tsugane, S., for the Japan Public Health Center-based Prospecti,
(2007). Patterns of Alcohol Drinking and All-Cause Mortality: Results from a Large-Scale Population-based Cohort Study in Japan. Am J Epidemiol
165: 1039-1046
[Abstract][Full Text]
Chan, A. T., Manson, J. E., Feskanich, D., Stampfer, M. J., Colditz, G. A., Fuchs, C. S.
(2007). Long-term Aspirin Use and Mortality in Women. Arch Intern Med
167: 562-572
[Abstract][Full Text]
Jonsson, I.-M., Verdrengh, M., Brisslert, M., Lindblad, S., Bokarewa, M., Islander, U., Carlsten, H., Ohlsson, C., Nandakumar, K. S., Holmdahl, R., Tarkowski, A.
(2007). From the Cover: Ethanol prevents development of destructive arthritis. Proc. Natl. Acad. Sci. USA
104: 258-263
[Abstract][Full Text]
Di Castelnuovo, A., Costanzo, S., Bagnardi, V., Donati, M. B., Iacoviello, L., de Gaetano, G.
(2006). Alcohol Dosing and Total Mortality in Men and Women: An Updated Meta-analysis of 34 Prospective Studies. Arch Intern Med
166: 2437-2445
[Abstract][Full Text]
BAGLIETTO, L., ENGLISH, D. R., HOPPER, J. L., POWLES, J., GILES, G. G.
(2006). AVERAGE VOLUME OF ALCOHOL CONSUMED, TYPE OF BEVERAGE, DRINKING PATTERN AND THE RISK OF DEATH FROM ALL CAUSES. Alcohol Alcohol
41: 664-671
[Abstract][Full Text]
Maraldi, C., Volpato, S., Kritchevsky, S. B., Cesari, M., Andresen, E., Leeuwenburgh, C., Harris, T. B., Newman, A. B., Kanaya, A., Johnson, K. C., Rodondi, N., Pahor, M.
(2006). Impact of inflammation on the relationship among alcohol consumption, mortality, and cardiac events: the health, aging, and body composition study.. Arch Intern Med
166: 1490-1497
[Abstract][Full Text]
Rosen, M.
(2006). Chapter 5.1: Major public health problems -- cardiovascular diseases. Scand J Public Health
34: 51-58
Tolstrup, J., Jensen, M. K, Tjonneland, A., Overvad, K., Mukamal, K. J, Gronbaek, M.
(2006). Prospective study of alcohol drinking patterns and coronary heart disease in women and men. BMJ
332: 1244-1248
[Abstract][Full Text]
Johansen, D., Friis, K., Skovenborg, E., Gronbaek, M.
(2006). Food buying habits of people who buy wine or beer: cross sectional study. BMJ
332: 519-522
[Abstract][Full Text]
Emberson, J. R., Shaper, A. G., Wannamethee, S. G., Morris, R. W., Whincup, P. H.
(2005). Alcohol Intake in Middle Age and Risk of Cardiovascular Disease and Mortality: Accounting for Intake Variation over Time. Am J Epidemiol
161: 856-863
[Abstract][Full Text]
Szmitko, P. E., Verma, S.
(2005). Antiatherogenic potential of red wine: clinician update. Am. J. Physiol. Heart Circ. Physiol.
288: H2023-H2030
[Abstract][Full Text]
Greenfield, J. R., Samaras, K., Hayward, C. S., Chisholm, D. J., Campbell, L. V.
(2005). Beneficial Postprandial Effect of a Small Amount of Alcohol on Diabetes and Cardiovascular Risk Factors: Modification by Insulin Resistance. J. Clin. Endocrinol. Metab.
90: 661-672
[Abstract][Full Text]
Freiberg, M. S., Cabral, H. J., Heeren, T. C., Vasan, R. S., Curtis Ellison, R.
(2004). Alcohol Consumption and the Prevalence of the Metabolic Syndrome in the U.S.: A cross-sectional analysis of data from the Third National Health and Nutrition Examination Survey. Diabetes Care
27: 2954-2959
[Abstract][Full Text]
Greenfield, J. R., Samaras, K., Jenkins, A. B., Kelly, P. J., Spector, T. D., Gallimore, J. R., Pepys, M. B., Campbell, L. V.
(2004). Obesity Is an Important Determinant of Baseline Serum C-Reactive Protein Concentration in Monozygotic Twins, Independent of Genetic Influences. Circulation
109: 3022-3028
[Abstract][Full Text]
Aguilar, D., Skali, H., Moye, L. A., Lewis, E. F., Gaziano, J. M., Rutherford, J. D., Hartley, L. H., Randall, O. S., Geltman, E. M., Lamas, G. A., Rouleau, J. L., Pfeffer, M. A., Solomon, S. D.
(2004). Alcohol consumption and prognosis in patients with left ventricular systolic dysfunction after a myocardial infarction. J Am Coll Cardiol
43: 2015-2021
[Abstract][Full Text]
Bagnardi, V., Zambon, A., Quatto, P., Corrao, G.
(2004). Flexible Meta-Regression Functions for Modeling Aggregate Dose-Response Data, with an Application to Alcohol and Mortality. Am J Epidemiol
159: 1077-1086
[Abstract][Full Text]
Lett, H. S., Blumenthal, J. A., Babyak, M. A., Sherwood, A., Strauman, T., Robins, C., Newman, M. F.
(2004). Depression as a Risk Factor for Coronary Artery Disease: Evidence, Mechanisms, and Treatment. Psychosom. Med.
66: 305-315
[Abstract][Full Text]
Masters, J. A., Stevenson, J. S., Schaal, S. F.
(2004). The Association Between Moderate Drinking and Heart Rate Variability in Healthy Community-Dwelling Older Women. Biol Res Nurs
5: 222-233
[Abstract]
Greenfield, J. R., Samaras, K., Jenkins, A. B., Kelly, P. J., Spector, T. D., Campbell, L. V.
(2003). Moderate Alcohol Consumption, Dietary Fat Composition, and Abdominal Obesity in Women: Evidence for Gene-Environment Interaction. J. Clin. Endocrinol. Metab.
88: 5381-5386
[Abstract][Full Text]
Fisher Wilson, J.
(2003). Should Doctors Prescribe Alcohol to Adults?. ANN INTERN MED
139: 711-714
[Full Text]
Jiang, R., Hu, F. B., Giovannucci, E. L., Rimm, E. B., Stampfer, M. J., Spiegelman, D., Rosner, B. A., Willett, W. C.
(2003). Joint Association of Alcohol and Folate Intake with Risk of Major Chronic Disease in Women. Am J Epidemiol
158: 760-771
[Abstract][Full Text]
Greenfield, J. R., Samaras, K., Jenkins, A. B., Kelly, P. J., Spector, T. D., Campbell, L. V.
(2003). Moderate Alcohol Consumption, Estrogen Replacement Therapy, and Physical Activity Are Associated With Increased Insulin Sensitivity: Is abdominal adiposity the mediator?. Diabetes Care
26: 2734-2740
[Abstract][Full Text]
Klatsky, A. L., Friedman, G. D., Armstrong, M. A., Kipp, H.
(2003). Wine, Liquor, Beer, and Mortality. Am J Epidemiol
158: 585-595
[Abstract][Full Text]
Greenfield, J. R., Samaras, K., Campbell, L. V., Jenkins, A. B., Kelly, P. J., Spector, T. D., Hayward, C. S.
(2003). Physical activity reduces genetic susceptibility to increased central systolic pressure augmentation: a study of female twins. J Am Coll Cardiol
42: 264-270
[Abstract][Full Text]
Wannamethee, S. G., Camargo, C. A. Jr, Manson, J. E., Willett, W. C., Rimm, E. B.
(2003). Alcohol Drinking Patterns and Risk of Type 2 Diabetes Mellitus Among Younger Women. Arch Intern Med
163: 1329-1336
[Abstract][Full Text]
Zaretsky, M. D.
(2003). Communication Between Identical Twins: Health Behavior and Social Factors Are Associated With Longevity That Is Greater Among Identical Than Fraternal U.S. World War II Veteran Twins. J Gerontol A Biol Sci Med Sci
58: M566-M572
[Abstract][Full Text]
Bataille, V., Ruidavets, J.-B., Arveiler, D., Amouyel, P., Ducimetiere, P., Perret, B., Ferrieres, J.
(2003). JOINT USE OF CLINICAL PARAMETERS, BIOLOGICAL MARKERS AND CAGE QUESTIONNAIRE FOR THE IDENTIFICATION OF HEAVY DRINKERS IN A LARGE POPULATION-BASED SAMPLE. Alcohol Alcohol
38: 121-127
[Abstract][Full Text]
Albert, M. A., Glynn, R. J., Ridker, P. M
(2003). Alcohol Consumption and Plasma Concentration of C-Reactive Protein. Circulation
107: 443-447
[Abstract][Full Text]
Karoll, B. R.
(2002). Women and Alcohol-Use Disorders: A Review of Important Knowledge and Its Implications for Social Work Practitioners. Journal of Social Work
2: 337-356
[Abstract]
Chen, W. Y., Colditz, G. A., Rosner, B., Hankinson, S. E., Hunter, D. J., Manson, J. E., Stampfer, M. J., Willett, W. C., Speizer, F. E.
(2002). Use of Postmenopausal Hormones, Alcohol, and Risk for Invasive Breast Cancer. ANN INTERN MED
137: 798-804
[Abstract][Full Text]
John, U., Hanke, M.
(2002). ALCOHOL-ATTRIBUTABLE MORTALITY IN A HIGH PER CAPITA CONSUMPTION COUNTRY -- GERMANY. Alcohol Alcohol
37: 581-585
[Abstract][Full Text]
Yamaguchi, T., Dayton, C., Shigematsu, T., Carter, P., Yoshikawa, T., Gute, D. C., Korthuis, R. J.
(2002). Preconditioning with ethanol prevents postischemic leukocyte-endothelial cell adhesive interactions. Am. J. Physiol. Heart Circ. Physiol.
283: H1019-H1030
[Abstract][Full Text]
White, I. R, Altmann, D. R, Nanchahal, K.
(2002). Alcohol consumption and mortality: modelling risks for men and women at different ages. BMJ
325: 191-191
[Abstract][Full Text]
Rimm, E. B., Stampfer, M. J.
(2002). Wine, Beer, and Spirits: Are They Really Horses of a Different Color?. Circulation
105: 2806-2807
[Full Text]
Davies, M. J., Baer, D. J., Judd, J. T., Brown, E. D., Campbell, W. S., Taylor, P. R.
(2002). Effects of Moderate Alcohol Intake on Fasting Insulin and Glucose Concentrations and Insulin Sensitivity in Postmenopausal Women: A Randomized Controlled Trial. JAMA
287: 2559-2562
[Abstract][Full Text]
Walsh, C. R., Larson, M. G., Evans, J. C., Djousse, L., Ellison, R. C., Vasan, R. S., Levy, D.
(2002). Alcohol Consumption and Risk for Congestive Heart Failure in the Framingham Heart Study. ANN INTERN MED
136: 181-191
[Abstract][Full Text]
Tanasescu, M., Hu, F. B., Willett, W. C., Stampfer, M. J., Rimm, E. B.
(2001). Alcohol consumption and risk of coronary heart disease among men with type 2 diabetes mellitus. J Am Coll Cardiol
38: 1836-1842
[Abstract][Full Text]
Ellison, R. C., Zhang, Y., McLennan, C. E., Rothman, K. J.
(2001). Exploring the Relation of Alcohol Consumption to Risk of Breast Cancer. Am J Epidemiol
154: 740-747
[Abstract][Full Text]
Britton, A, McPherson, K
(2001). Mortality in England and Wales attributable to current alcohol consumption. J. Epidemiol. Community Health
55: 383-388
[Abstract][Full Text]
Eigenbrodt, M. L., Mosley, T. H. Jr., Hutchinson, R. G., Watson, R. L., Chambless, L. E., Szklo, M.
(2001). Alcohol Consumption with Age: A Cross-sectional and Longitudinal Study of the Atherosclerosis Risk in Communities (ARIC) Study, 1987-1995. Am J Epidemiol
153: 1102-1111
[Abstract][Full Text]
Dufour, M. C.
(2001). If You Drink Alcoholic Beverages Do So in Moderation: What Does This Mean?. J. Nutr.
131: 552S-561
[Abstract][Full Text]
Fiellin, D. A., Reid, M. C., O'Connor, P. G.
(2000). Outpatient Management of Patients with Alcohol Problems. ANN INTERN MED
133: 815-827
[Abstract][Full Text]
Diamant, A. L., Wold, C., Spritzer, K., Gelberg, L.
(2000). Health Behaviors, Health Status, and Access to and Use of Health Care: A Population-Based Study of Lesbian, Bisexual, and Heterosexual Women. Arch Fam Med
9: 1043-1051
[Abstract][Full Text]
Gronbaek, M., Becker, U., Johansen, D., Gottschau, A., Schnohr, P., Hein, H. O., Jensen, G., Sorensen, T. I.A.
(2000). Type of Alcohol Consumed and Mortality from All Causes, Coronary Heart Disease, and Cancer. ANN INTERN MED
133: 411-419
[Abstract][Full Text]
Weintraub, W. S.
(2000). Alcohol Consumption, Diabetes, and Coronary Disease : An Epidemiological Perspective. Circulation
102: 489-490
[Full Text]
Papadakis, J.A., Ganotakis, E.S., Mikhailidis, D.P.
(2000). Beneficial effect of moderate alcohol consumption on vascular disease: myth or reality?. The Journal of the Royal Society for the Promotion of Health
120: 11-15
[Abstract]
Nanchahal, K., Ashton, W D., Wood, D. A
(2000). Alcohol consumption, metabolic cardiovascular risk factors and hypertension in women. Int J Epidemiol
29: 57-64
[Abstract][Full Text]
Gaziano, J. M., Gaziano, T. A., Glynn, R. J., Sesso, H. D., Ajani, U. A., Stampfer, M. J., Manson, J. E., Hennekens, C. H., Buring, J. E.
(2000). Light-to-moderate alcohol consumption and mortality in the physicians' health study enrollment cohort. J Am Coll Cardiol
35: 96-105
[Abstract][Full Text]
Rimm, E. B, Williams, P., Fosher, K., Criqui, M., Stampfer, M. J
(1999). Moderate alcohol intake and lower risk of coronary heart disease: meta-analysis of effects on lipids and haemostatic factors. BMJ
319: 1523-1528
[Abstract][Full Text]
Feng, A.-N., Chen, Y.-L., Chen, Y.-T., Ding, Y.-Z., Lin, S.-J.
(1999). Red Wine Inhibits Monocyte Chemotactic Protein-1 Expression and Modestly Reduces Neointimal Hyperplasia After Balloon Injury in Cholesterol-Fed Rabbits. Circulation
100: 2254-2259
[Abstract][Full Text]
Reid, M. C., Fiellin, D. A., O'Connor, P. G.
(1999). Hazardous and Harmful Alcohol Consumption in Primary Care. Arch Intern Med
159: 1681-1689
[Abstract][Full Text]
Valmadrid, C. T., Klein, R., Moss, S. E., Klein, B. E. K., Cruickshanks, K. J.
(1999). Alcohol Intake and the Risk of Coronary Heart Disease Mortality in Persons With Older-Onset Diabetes Mellitus. JAMA
282: 239-246
[Abstract][Full Text]
Criqui, M. H., Golomb, B. A.
(1999). Should Patients With Diabetes Drink to Their Health?. JAMA
282: 279-280
[Full Text]
Marshall, J. R, Chen, Z.
(1999). Diet and health risk: risk patterns and disease-specific associations. Am. J. Clin. Nutr.
69
: 1351S-1356S
[Abstract][Full Text]
Miyamae, M., Rodriguez, M. M., Camacho, S. A., Diamond, I., Mochly-Rosen, D., Figueredo, V. M.
(1998). Activation of varepsilon protein kinase C correlates with a cardioprotective effect of regular ethanol consumption. Proc. Natl. Acad. Sci. USA
95: 8262-8267
[Abstract][Full Text]
Miyamae, M., Camacho, S. A., Zhou, H.-Z., Diamond, I., Figueredo, V. M.
(1998). Alcohol consumption reduces ischemia-reperfusion injury by species-specific signaling in guinea pigs and rats. Am. J. Physiol. Heart Circ. Physiol.
275: H50-H56
[Abstract][Full Text]
Tangney, C. C., Hankins, J. S., Murtaugh, M. A., Piccione, W. Jr
(1998). Plasma Vitamins E and C Concentrations of Adult Patients During Cardiopulmonary Bypass. J. Am. Coll. Nutr.
17: 162-170
[Abstract][Full Text]
O'Connor, P. G., Schottenfeld, R. S.
(1998). Patients with Alcohol Problems. NEJM
338: 592-602
[Full Text]
Smith-Warner, S. A., Spiegelman, D., Yaun, S.-S., van den Brandt, P. A., Folsom, A. R., Goldbohm, R. A., Graham, S., Holmberg, L., Howe, G. R., Marshall, J. R., Miller, A. B., Potter, J. D., Speizer, F. E., Willett, W. C., Wolk, A., Hunter, D. J.
(1998). Alcohol and Breast Cancer in Women: A Pooled Analysis of Cohort Studies. JAMA
279: 535-540
[Abstract][Full Text]
Thun, M. J., Peto, R., Lopez, A. D., Monaco, J. H., Henley, S. J., Heath, C. W., Doll, R.
(1997). Alcohol Consumption and Mortality among Middle-Aged and Elderly U.S. Adults. NEJM
337: 1705-1714
[Abstract][Full Text]
Taira, D. A., Safran, D. G., Seto, T. B., Rogers, W. H., Tarlov, A. R.
(1997). The Relationship Between Patient Income and Physician Discussion of Health Risk Behaviors. JAMA
278: 1412-1417
[Abstract]
Miyamae, M., Diamond, I., Weiner, M. W., Camacho, S. A., Figueredo, V. M.
(1997). Regular alcohol consumption mimics cardiac preconditioning by protecting against ischemia-reperfusion injury. Proc. Natl. Acad. Sci. USA
94: 3235-3239
[Abstract][Full Text]
Camargo, C. A. Jr, Hennekens, C. H., Gaziano, J. M., Glynn, R. J., Manson, J. E., Stampfer, M. J.
(1997). Prospective Study of Moderate Alcohol Consumption and Mortality in US Male Physicians. Arch Intern Med
157: 79-85
[Abstract]
Pearson, T. A.
(1996). Alcohol and Heart Disease. Circulation
94: 3023-3025
[Full Text]
Fink, A., Hays, R. D., Moore, A. A., Beck, J. C.
(1996). Alcohol-Related Problems in Older Persons: Determinants, Consequences, and Screening. Arch Intern Med
156: 1150-1156
[Abstract]
Brunoski, T., Powell, L. H., Blackman, J. A., Bush, T. L., Joseph, K.S., Dupont, W. D., Wigg, D.R., Bluming, A. Z., Colditz, G. A., Willett, W. C., Speizer, F. E.
(1995). Breast Cancer and Hormone-Replacement Therapy. NEJM
333: 1355-1358
[Full Text]
Sijbrands, E. J.G., Smelt, A. H.M., Westendorp, R. G.J., Lowenfels, A. B., Fuchs, C. S., Stampfer, M. J., Willett, W. C.
(1995). Alcohol Consumption and Mortality among Women. NEJM
333: 1081-1082
[Full Text]
A correction has been published: N Engl J Med 1997;336(7):523.
= -1.3 x 10-2, P = 0.02) and a positive coefficient for the quadratic term (
