Drinking pattern matters – a longer life with a Mediterranean drinking pattern?

It is long known that a Mediterranean dietary pattern with lots of fish, vegetables, nuts, and native olive oil is healthy. It is also known that alcoholic beverages are traditionally consumed in Mediterranean countries and contribute considerably to linked health benefits and a longer life expectancy. A Spanish study examined this phenomenon now more closely.

The Mediterranean diet is one of the healthiest eating patterns. It has been shown that adhering to such a diet is associated with a longer life expectancy. One component of the Mediterranean diet is the regular moderate consumption of wine. Wine is indeed one component of the scores that are used to help assess the adherence to a Mediterranean dietary pattern. However, a Mediterranean drinking patternThe Mediterranean diet, which includes moderate consumption of wine, is considered ... consists of more than just the type of alcoholic beverage and the amount consumed.

A Spanish research team developed their own score to assess the adherence to the traditional Mediterranean alcohol drinking pattern (MADP).

Mediterranean Alcohol Drinking Pattern (MADP)-Score: 0-9 points

The score for a Mediterranean drinking patternThe Mediterranean diet, which includes moderate consumption of wine, is considered ... includes the following criteria:

1. Moderate consumption: For women 5-25 g of alcohol/day and for men 10 – 50 g/day
   Preference for wine, at least 75% of the total amount of alcoholic beverages consumed
2. Preference for red wine, as it is customary in Spain (and many other Mediterranean countries), at least 75% of the total amount consumed
3. Consumption with the meals
4. Low consumption of spirits (less than 25% of the total amount consumed)
5. Consumption distributed throughout the week
6. Avoidance of “binge drinking”, which is more than 5 drinks per occasion

After analysing the questionnaires, the drinking pattern was evaluated:

• Score < 3: low adherence to MADP
• between 4-5: moderate adherence to MADP
• between 6-9: high adherence to MADP

Participants with a low adherence to MADP served as the control group.

Those who drink wine regular with meals live the longest

In this prospective study, the data of 2226 – mostly male (82%) – university graduates from the Spanish university of Navarra were analysed. At the start of the study, the men were at least 50 and the women at least 55 years old.

This so-called SUN cohort (Seguimiento Universidad de Navarra) consisted of educated and highly motivated study participants and is not representative of the general population. Nevertheless, the results can be generalized based on biological plausibility.

With regards to drinking pattern, the results showed that:

• Within 14 years, those who do not or hardly adhere to a MADP show the highest mortality rate, especially related to cancer.
• Both abstinence (mortality rate -40%) as well as a moderate MADP (-35%) perform better.
• The lowest mortality risk (-46%) was observed with a high adherence to a MADP.

Lower cancer risk with high adherence to MADP

• When only cancer deaths were considered in the analysis, a higher protective effect and a significant 62% reduction in the mortality risk was observed with high adherence to a MADP. The authors comment that theses results may seem contradictory to the available evidence on the harmful effects on cancer, however, these studies only consider the grams of alcohol consumed and not the drinking pattern as studied in this analysis. They further note that this result arises from comparison with the category of low adherence to the MADP and shows that moderate wine consumption with meals spread out over the week reduces the cancer mortality compared to both higher and occasional consumption.

The authors conclude that this publication reflects an important and applicable public health message: if you drink alcoholic beverages, follow the Mediterranean drinking patternThe Mediterranean diet, which includes moderate consumption of wine, is considered .... For a longer life, it seems to be ideal to regularly consume wine at meals which is spread throughout the week and avoiding binge drinking.