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Who benefits most from the cardioprotective properties of alcohol consumption—health freaks or couch potatoes?
  1. A Britton,
  2. M G Marmot,
  3. M Shipley
  1. Department of Epidemiology and Public Health, University College London, London, UK
  1. Dr A Britton, Department of Epidemiology and Public Health, University College London, 1–19 Torrington Place, London WC1E 6BT, UK; a.britton{at}


Background: The cardioprotective properties of moderate alcohol consumption, compared with abstinence or heavy drinking, are widely reported, but whether the benefits are experienced equally by all moderate drinkers is less well known.

Aims: To examine the association between average alcohol intake per week and the incidence of fatal and non-fatal myocardial infarction during 17 years of follow-up for 9655 men and women without prevalent disease in the general population; and to test whether the level of cardioprotection differs according to subjects’ other health behaviours (healthy, moderately healthy, unhealthy) at entry to the study.

Method: A longitudinal, British civil service-based cohort study, baseline in 1985–8.

Results: A significant benefit of moderate drinking compared with abstinence or heavy drinking was found among those with poor health behaviours (little exercise, poor diet and smokers). No additional benefit from alcohol was found among those with the healthiest behaviour profile (⩾3 hours of vigorous exercise per week, daily fruit or vegetable consumption and non-smokers).

Conclusion: The cardioprotective benefit from moderate drinking does not apply equally to all drinkers, and this variability should be emphasised in public health messages.

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  • Funding: The Whitehall II study has been supported by grants from the Medical Research Council; Economic and Social Research Council; British Heart Foundation; Health and Safety Executive; Department of Health; National Heart Lung and Blood Institute (HL36310), US, NIH; National Institute on Aging (AG13196), US, NIH; Agency for Health Care Policy Research (HS06516); and the John D and Catherine T MacArthur Foundation Research Networks on Successful Midlife Development and Socio-economic Status and Health. MM is supported by an MRC Research Professorship. AB and MS are supported by the British Heart Foundation

  • Competing interests: None.

  • Ethics approval: The University College London ethics committee approved the study.

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