Drinking alcohol is believed to contribute to approximately 3 million deaths globally annually, with its prevalence growing notably in several low- and middle-income nations.

While the adverse effects of excessive drinking on specific illnesses such as liver cirrhosis, stroke, and various forms of cancer are widely acknowledged, there is a scarcity of comprehensive studies examining the overall impact of alcohol use on a wide spectrum of diseases within a given population.

A recent study conducted by researchers from Oxford Population Health and Peking University, published in Nature Medicine, has revealed that alcohol consumption escalates the susceptibility to more than 60 diseases in Chinese men. Remarkably, this research identified numerous diseases that were not previously associated with alcohol consumption.

The research found that alcohol usage increased the risk of 61 illnesses in Chinese males, including several non-fatal diseases that were previously thought to be alcohol-related owing to a lack of evidence. This study demonstrates the effect that alcohol consumption may have on disease risk in populations around the globe.

The researchers analyzed data from the China Kadoorie Biobank (CKB), a joint study of approximately 512,000 participants recruited from 10 different urban and rural sites throughout China between 2004 and 2008. Participants in the study were asked about their lifestyles and habits, including how often and how much they drank booze.

A third of males, but just 2% of women, consumed alcohol on a regular basis (at least once a week). Over a period of approximately 12 years, the researchers evaluated the health effects of alcohol consumption on more than 200 distinct maladies in men identified through hospital record linkage. Importantly, they also conducted a genetic investigation to determine whether or not drinking alcohol contributed to illness.

The study revealed:

• Self-reported alcohol use was linked to greater risks of 61 illnesses of the 207 diseases examined in males. This includes 33 illnesses not previously linked to alcohol, including gout, cataract, certain fractures, and stomach ulcers, as well as 28 illnesses previously linked to alcohol by the World Health Organization, including liver cirrhosis, stroke, and many gastrointestinal malignancies;
• In the research, which included over 1.1 million hospitalizations, males who had ever used alcohol on a daily basis had a noticeably greater chance of contracting any ailment and spent more time in the hospital than men who had only consumed alcohol on occasion;
• The odds of various illnesses, notably liver cirrhosis, were significantly raised by specific drinking habits, such as everyday drinking, heavy “binge” drinking episodes, or drinking outside of mealtimes;
• The genetic analyses revealed evidence of a dose-dependent causal relationship between the identified alcohol-related diseases, with every four drinks per day being linked to a 14% higher risk of those diseases already known to be related to alcohol, a 6% higher risk of those not yet known to be related to alcohol, and a more than two-fold higher risk of gout and liver cirrhosis;
• Although there was no evidence of an elevated risk of ischemic heart disease (IHD), greater alcohol consumption was substantially and dose-dependently linked to a higher risk of stroke in the genetic analysis. Furthermore, moderate drinking (one to two drinks per day) had no protective benefits against IHD.
• As few women in China consume alcohol (less than 2% of women in the study did so on a regular basis), the women in this study served as a useful control group for the genetic analyses, confirming that the excess disease risks in men were caused by alcohol consumption and not by other mechanisms related to genetic variants.

“Alcohol consumption is adversely related to a much wider range of diseases than has previously been established,” said Pek Kei Im, a Research Fellow at Oxford Population Health and the paper’s main author. “Our findings show these associations are likely to be causal.”

According to senior author and CKB co-PI Professor Liming Li of Peking University, alcohol use is on the rise in China, especially among males.

“This large collaborative study demonstrates a need to strengthen alcohol control policies in China.”

“It is becoming clear that the harmful use of alcohol is one of the most important risk factors for poor health, both in China and globally,” comments senior author Iona Millwood.

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