Large differences in alcohol intake between Italy and The Netherlands
In the rural Italian cohorts and in Zutphen information on alcohol consumption was collected with the cross-check dietary history method among all men. In the 1960s the average alcohol intake in the rural Italian cohorts was more than 80 g/day, while less than 10 g/day in the Zutphen cohort.
Moderate alcohol use associated with low CVD risk
In rural Italian and in Zutphen men a J-shaped relation was observed between alcohol intake at entry and CHD mortality. In Italian men the lowest 15-year CHD risk was observed in the mid-range (third quintile) of alcohol intake. A 30% lower CHD risk among alcohol users compared to non-users was found throughout the range of use up to 80 g per day. Zutphen men using less than 20 g per day, compared to non-users, had 30% lower CVD mortality during 40 years of follow-up. Above 20g/day the CVD risk was greater.
These results are compatible with a protective effect of alcohol for CHD risk in Italy and CVD risk in The Netherlands in the low range of 1-20 g/day intake. The Italian data showed that the possible protective effect of alcohol on CHD keeps until very high levels of alcohol intake. Also, other studies in Mediterranean areas reported a higher protective effect of alcohol than countries outside the Mediterranean. This may be due to differences in consumption pattern. Northern European men used mainly beer and spirits outside meals and men in Mediterranean areas consumed mostly wine with meals.