title: Alcohol and self-rated health in a Mediterranean country: the role of average volume, drinking pattern, and alcohol dependence.
abstract: BACKGROUND
  The association between average alcohol consumption and self-rated ill-health is "J-shaped" in Scandinavian and Anglo-Saxon countries, but it has shown an inverse linear relationship in the few studies conducted in Mediterranean countries, based on average volume solely.
  
  
  OBJECTIVE
  To examine the relationship between alcohol and self-rated health in the general population of a Mediterranean country, by simultaneously taking into account average volume, drinking pattern, and alcohol abuse.
  
  
  METHODS
  From 2000 to 2005, we conducted telephone interviews on 12,037 persons, representative of the population aged 18 to 64 years in Madrid, Spain. The drinking pattern encompassed binge drinking, beverage preference, and drinking at mealtimes. Alcohol abuse was estimated by the CAGE test. The association between each alcohol-related variable and self-rated suboptimal (fair, poor, or very poor) health was estimated from logistic regression, with adjustment for the remaining alcohol-related variables and other potential confounders.
  
  
  RESULTS
  In comparison with never-drinkers, suboptimal health was less frequent among occasional drinkers [odds ratio (OR) 0.72; 95% confidence interval (CI): 0.61 to 0.86], average moderate drinkers (OR 0.57; 95% CI: 0.48 to 0.69), and excessive drinkers (OR 0.51; 95% CI: 0.36 to 0.72), but more frequent among former drinkers with > or =1 year of abstinence (OR 1.30; 95% CI: 1.03 to 1.64). Frequency of suboptimal health was likewise higher in subjects with > or =3 episodes of binge drinking (OR 1.55; 95% CI: 1.12 to 2.14) or alcohol abuse (OR 1.47; 95% CI: 1.22 to 1.76). No differences were observed in suboptimal health according to beverage preference or drinking at mealtimes. RESULTS in each gender were similar to those for total study participants.
  
  
  CONCLUSIONS
  Occasional, moderate, and excessive consumption of alcohol are associated with better self-rated health, even after adjustment for drinking pattern and alcohol abuse. In contrast, former-drinking, frequent binge drinking, and alcohol abuse are all associated with suboptimal self-rated health.
authors.affiliation: CIBER en Epidemiología y Salud Pública (CIBERESP), Universidad Autónoma de Madrid, C/Arzobispo Morcillo 4, Madrid, Spain. jose.valencia@uam.es
authors.forename: José Lorenzo
authors.initials: JL
authors.lastname: Valencia-Martín
authors.forename: Iñaki
authors.initials: I
authors.lastname: Galán
authors.forename: Fernando
authors.initials: F
authors.lastname: Rodríguez-Artalejo
mesh_terms: D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology* / Q000523:psychology; D000434:Alcoholic Beverages; D000437:Alcoholism / Q000453:epidemiology* / Q000503:physiopathology / Q000523:psychology; D001515:Beer; D004435:Eating; D005260:Female; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014920:Wine; D055815:Young Adult