Trends in alcohol consumption in relation to cause-specific and all-cause mortality in the US: A report from the National Health and Nutrition Examination Survey linked to the U.S. mortality registry

Background. Excessive alcohol use is the third leading cause of mortality in the USA where alcohol use consistently increased over the last decades. This trend is currently maintained, despite regulatory policies aimed to counteract it. While the increased health risks resulting from alcohol use is evident, some open questions regarding alcohol use and its consequences in the US population remain. Objective. The current work aims to evaluate the relationship between alcohol consumption trends over a period of 15 years with all-cause and cause-specific mortality. In addition, we evaluate the adequacy of the current alcohol use recommendation according to the 2015-2020 US Dietary Guidelines for Americans (USDGA). Design. Prospective population based study defined by the NHANES surveys conducted over the period 1999-2014 linked to US mortality registry in 2015. Results. The sample, composed of 34,672 participants, was observed for a median period of 7.8 years totalling 282,855 person-years. In the present sample 4,303 deaths were observed. Alcohol use increased during the period 1999-2014. Alcohol use above the current US recommendations was associated with increased all-cause and cause-specific mortality risk, ranging from 39% to 126%. A proportion of these deaths, ranging from 19 to 26%, could be theoretically be prevented if US citizens followed current guidelines, and 13% of all-cause deaths in men could be avoided if the current US guidelines for women (one standard drink for day) were applied to them. Conclusions. The present study provides evidence in support of limiting alcohol intake in adherence with the USDGA recommendations.