Latest scientific news 25 January 2021

Not only how much you drink, but also how and what you drink matters

Evidence exists that not only the amount of alcohol but also other factors may influence the risk of adverse health effects. However, most drinking guidelines focus on average daily or weekly consumption of alcoholic beverages, without providing recommendations on the pattern or type of alcoholic beverage. The aim of this study was to examine the combined effect of various drinking patterns on the risk of health outcomes among regular consumers of alcoholic beverages.

More than 300,000 individuals participated in this prospective study in the UK. During the nine year follow-up period, major cardiovascular events such as heart attack and stroke, accidents, liver cirrhosis, all-cause and alcohol-related cancer incidence as well as mortality from all causes were monitored.

The results showed that in this large study of UK adults who consumed alcoholic beverages regularly, the majority of participants (52%) reported drinking more alcoholic beverages than the recommended amounts for low-risk consumption.

Type of alcoholic beverage

The highest absolute and relative risk of dying, experiencing a heart attack or stroke, liver cirrhosis and accidents/self-harm war observed among participants who were predominantly drinking spirits and beer/cider compared to red wine drinking (among regular drinkers).

With or without food

Similarly, those who reported drinking alcoholic beverages without food were at a higher risk compared to those consuming alcoholic drinks with food when the same amount was consumed overall.

Drinking pattern/frequency

Spreading the consumption of alcoholic beverages over 3 to 4 days in a week was related to a lower mortality, cardiovascular and cirrhosis risk than consuming alcohol daily or in a binge drinking manner.

Thus, among those who consume alcoholic beverages regularly, drinking red wine with the meals and spreading it over 3 to 4 days seems to be the best drinking pattern to lower the risk of dying from any disease and to prevent heart attacks and strokes.


  • Red wine consumption accounted for more than 50% of the total weekly units consumed = “red wine drinker”
  • Similar definitions were used for beer/cider, spirits, white wine/fortified wine/champagne and mixed

Drinking categories:

  • 1-14 units = low risk
  • 15-35 units for women and 15-50 units for men = increasing risk
  • > 35 units for women and > 50 unit for men = higher risk


Jani BD et al 2021, Association between patterns of alcohol consumption (beverage type, frequency and consumption with food) and risk of adverse health outcomes: a prospective cohort study, BMC Medicine 19:8,