title: Impact of alcohol intake on total mortality and mortality from major causes in Japan: a pooled analysis of six large-scale cohort studies.
abstract: OBJECTIVE
  Using common alcohol consumption categories, to conduct a pooled analysis of six ongoing large-scale cohort studies in Japan in order to produce concrete estimates of the quantitative contribution of alcohol consumption to all-cause and major causes of mortality in the Japanese population.
  
  
  METHODS
  Of the 309 082 subjects, there were 35 801 deaths during 3 832 285 person-years of follow-up. Using a random-effect model, we conducted a meta-analysis of the HRs of each alcohol consumption category in each study, thereby obtaining pooled estimates for the risk of total and major causes of mortality due to alcohol consumption.
  
  
  RESULTS
  There was a J- or U-shaped association for the risk of total and major causes of mortality in men, and the risk of total and heart disease mortality in women. Compared with non-drinkers, there was a significantly lower risk for total mortality at an alcohol consumption level of <69 g/day, cancer mortality at <46 g/day, heart disease mortality at <69 g/day and cerebrovascular disease mortality at <46 g/day in men, and for total mortality at <23 g/day in women. In addition, mortality risk increased linearly with rising alcohol dose among drinkers. It was estimated that 5% of total mortality, 3% of cancer mortality, 2% of heart disease mortality and 9% of cerebrovascular disease mortality in men, but only 0-1% of these risks in women, could be prevented by reducing alcohol consumption to <46 g/day in men and <23 g/day in women.
  
  
  CONCLUSIONS
  Maintaining alcohol consumption below 46 g/day in men and 23 g/day in women appears to minimise the risks of mortality in the Japanese population.
authors.affiliation: Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan. mnminoue@ncc.go.jp
authors.forename: Manami
authors.initials: M
authors.lastname: Inoue
authors.forename: Chisato
authors.initials: C
authors.lastname: Nagata
authors.forename: Ichiro
authors.initials: I
authors.lastname: Tsuji
authors.forename: Yumi
authors.initials: Y
authors.lastname: Sugawara
authors.forename: Kenji
authors.initials: K
authors.lastname: Wakai
authors.forename: Akiko
authors.initials: A
authors.lastname: Tamakoshi
authors.forename: Keitaro
authors.initials: K
authors.lastname: Matsuo
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Mizoue
authors.forename: Keitaro
authors.initials: K
authors.lastname: Tanaka
authors.forename: Shizuka
authors.initials: S
authors.lastname: Sasazuki
authors.forename: Shoichiro
authors.initials: S
authors.lastname: Tsugane
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000401:mortality*; D002423:Cause of Death; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality; D011446:Prospective Studies; D012306:Risk; D016019:Survival Analysis