Alcohol-Harm Paradox Linked To Drinking Patterns Interview with:
“Alcohol” by Jorge Mejía peralta is licensed under CC BY 2.0Dr. Eirik Degerud, PhD

Norwegian Institute of Public Health What is the background for this study?

Response: Alcohol-related hospitalisations and deaths are more frequent among individuals with low socioeconomic position, despite that they tend to drink less on average. This is referred to as the alcohol-harm paradox. Alcohol is associated with both higher and lower risk of cardiovascular disease, depending on the drinking pattern. We wanted to assess if the paradox was relevant to these relationship also. What are the main findings?

Response: We found that binge drinking increased the risk of cardiovascular disease, but did not observe that risk estimates varied by socioeconomic position. We observed that moderately frequent drinking was associated with a lower risk of cardiovascular disease, and that this was more pronounced among individuals with a high socioeconomic position. Very frequent consumption was associated a higher risk of cardiovascular disease, but only among individuals with low socioeconomic position. What should readers take away from your report?

Response: If one choses to drink, try to avoid binge drinking, which means to limit the drinking per occasion to one, two or three drinks, not five, six or seven. One should also be aware that more recent studies using genetic instruments for alcohol consumption do not support a protective effect of alcohol on the risk of cardiovascular disease. This study suggest that the protective effect observed in many studies were likely overestimated by the lifestyle that accompanies alcohol consumption among individuals with higher socioeconomic position. Hence, they are able to incorporate a modest alcohol consumption into a healthy lifestyle, but alcohol is not what defines their healthy lifestyles. What recommendations do you have for future research as a result of this study?

Response: To take into consideration the possibility that the relationship between alcohol and health outcomes, and also other exposures such as marijuana, as well as for other health outcomes than cardiovascular disease, could vary by socioeconomic position. Is there anything else you would like to add?

Response: We have no disclosures.

Our study is financed in full by the Norwegian Research Council. The article is freely available to all readers at the non-profit journal Plos Medicine. We are grateful to all the Norwegians who participated in the population surveys in Norway in the past decades and who continuous to do so today. Thank you for your contribution to the community.


Life course socioeconomic position, alcohol drinking patterns in midlife, and cardiovascular mortality: Analysis of Norwegian population-based health surveys.

Degerud E1, Ariansen I1, Ystrom E1,2,3, Graff-Iversen S1, Høiseth G1,4, Mørland J1,5, Davey Smith G6, Næss Ø1,7.

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions. 

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Last Updated on January 5, 2018 by Marie Benz MD FAAD