Mukamal Kenneth J, Chiuve Stephanie E, Rimm Eric B
Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Arch Intern Med. 2006 Oct 23;166(19):2145-50. doi: 10.1001/archinte.166.19.2145.
Although moderate alcohol intake is associated with lower risk for myocardial infarction (MI), guidelines generally suggest that adults seek other lifestyle measures to reduce cardiovascular risk. We studied whether alcohol consumption is inversely associated with risk for coronary heart disease in men who report consistently favorable lifestyle behaviors.
From 51 529 male participants of the Health Professionals Follow-up Study who have reported diet and other lifestyle factors in biennial questionnaires since 1986, we defined a cohort of 8867 men free of major illness to participate in a prospective study. All participants reported 4 healthy lifestyle behaviors, including a body mass index (calculated as weight in kilograms divided by height in meters squared) of less than 25, moderate to vigorous activity for 30 minutes or more per day, abstention from smoking, and a summary diet score in the top 50% for men. High dietary scores reflected a high intake of vegetables, fruits, cereal fiber, fish, chicken, nuts, soy, and polyunsaturated fat; low consumption of trans-fat, and red and processed meats; and multivitamin use. We ascertained the incidence of nonfatal MI and fatal coronary heart disease according to reported intake of beer, wine, and liquor every 4 years.
During 16 years of follow-up, we documented 106 incident cases of MI. Compared with abstention, the hazard ratios for MI were 0.98 (95% confidence interval, 0.55-1.74) for alcohol intake of 0.1 to 4.9 g/d, 0.59 (95% confidence interval, 0.33-1.07) for alcohol intake of 5.0 to 14.9 g/d, 0.38 (95% confidence interval, 0.16-0.89) for alcohol intake of 15.0 to 29.9 g/d, and 0.86 (95% confidence interval, 0.36-2.05) for alcohol intake of 30.0 g/d or more. In men who met 3 criteria, the lower risk associated with alcohol intake of 5.0 to 29.9 g/d tended to be similar to the lower risk associated with the remaining healthy lifestyle behavior.
Even in men already at low risk on the basis of body mass index, physical activity, smoking, and diet, moderate alcohol intake is associated with lower risk for MI.
尽管适度饮酒与较低的心肌梗死（MI）风险相关，但指南通常建议成年人寻求其他生活方式措施来降低心血管风险。我们研究了在报告始终保持良好生活方式行为的男性中，饮酒是否与冠心病风险呈负相关。
从1986年起每两年通过问卷调查报告饮食和其他生活方式因素的51529名健康专业人员随访研究的男性参与者中，我们确定了8867名无重大疾病的男性队列，以参与一项前瞻性研究。所有参与者均报告了4种健康的生活方式行为，包括体重指数（以千克体重除以身高米数的平方计算）小于25、每天进行30分钟或更长时间的中度至剧烈运动、戒烟以及饮食综合评分在男性中处于前50%。高饮食评分反映了蔬菜、水果、谷物纤维、鱼类、鸡肉、坚果、大豆和多不饱和脂肪的高摄入量；反式脂肪、红肉和加工肉类的低消费量；以及多种维生素的使用。我们根据每4年报告的啤酒、葡萄酒和烈酒摄入量确定非致命性MI和致命性冠心病的发病率。
在16年的随访期间，我们记录了106例MI事件。与戒酒相比，每日饮酒量为0.1至4.9克时MI的风险比为0.98（95%置信区间，0.55 - 1.74），每日饮酒量为5.0至14.9克时为0.59（95%置信区间，0.33 - 1.07），每日饮酒量为15.0至29.9克时为0.38（95%置信区间，0.16 - 0.89），每日饮酒量为30.0克或更多时为0.86（95%置信区间, 0.36 - 2.05）。在符合3项标准的男性中，每日饮酒量为5.0至
