Printed in U.S.A. DOI: 10.1093/aje/kwg184

A substantially increased risk for heavy drinkers and a slightly reduced risk for lighter drinkers results in the J-shaped alcohol-mortality curve. Limited data suggest a more favorable mortality experience for drinkers of wine than for drinkers of liquor or beer. To examine these relations, the authors performed a cohort study of participants in a large Northern California prepaid health care program. Demographic and history data were collected from 128,934 adults undergoing health evaluations in 1978–1985, with subsequent death ascertained by an automated linkage system. Cox proportional hazards models with eight covariates were used to determine relative risk estimates according to total alcohol intake and days per week of drinking wine, wine types, beer, or liquor. The J-shaped alcohol-mortality relation was stable for 20 years. Independently, frequency of wine drinking was associated with lower mortality risk (p < 0.001) largely because of lower coronary disease risk. Similar risk reductions were associated with red wine, white wine, other types of wine, and combinations of wine types. Much of the lower risk associated with light drinking was related to wine drinking. The authors conclude that drinkers of any type of wine have a lower mortality risk than do beer or liquor drinkers, but it remains unclear whether this reduced risk is due to nonalcoholic wine ingredients, drinking pattern, or associated traits. alcohol drinking; alcoholic beverages; beer; mortality; risk; wine Abbreviations: CI, confidence interval; ICD-9, International Classification of Diseases, Ninth Revision