Division of Chronic Disease Epidemiology, Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland.
Nutrition Group, Health Department, Swiss Distance University of Applied Sciences, Zurich, Switzerland.
Eur J Nutr. 2023 Apr;62(3):1331-1344. doi: 10.1007/s00394-022-03073-w. Epub 2022 Dec 24.
Non-communicable diseases generate the largest number of avoidable deaths often caused by risk factors such as alcohol, smoking, and unhealthy diets. Our study investigates the association between amount and context of alcohol consumption and mortality from major non-communicable diseases in Switzerland.
Generalized linear regression models were fitted on data of the cross-sectional population-based National Nutrition Survey menuCH (2014-2015, n = 2057). Mortality rates based on the Swiss mortality data (2015-2018) were modeled by the alcohol consumption group considering the amount and context (i.e., during or outside mealtime) of alcohol consumption and potential confounders. The models were checked for spatial autocorrelation using Moran's I statistic. Integrated nested Laplace approximation (INLA) models were fitted when evidence for missing spatial information was found.
Higher mortality rates were detected among drinkers compared to non-drinkers for all-cancer (rate ratio (RR) ranging from 1.01 to 1.07) and upper aero-digestive tract cancer (RR ranging from 1.15 to 1.20) mortality. Global Moran's I statistic revealed spatial autocorrelation at the Swiss district level for all-cancer mortality. An INLA model led to the identification of three districts with a significant decrease and four districts with a significant increase in all-cancer mortality.
Significant associations of alcohol consumption with all-cancer and upper aero-digestive tract cancer mortality were detected. Our study results indicate the need for further studies to improve the next alcohol-prevention scheme and to lower the number of avoidable deaths in Switzerland.
非传染性疾病导致的可避免死亡人数最多,通常是由酒精、吸烟和不健康饮食等危险因素引起的。我们的研究调查了瑞士饮酒量和饮酒情境(即用餐时或用餐外)与主要非传染性疾病死亡率之间的关联。
我们使用基于人群的横断面国家营养调查菜单 CH(2014-2015 年,n=2057)的数据拟合广义线性回归模型。根据瑞士死亡率数据(2015-2018 年),通过考虑饮酒量和饮酒情境(即用餐时或用餐外)以及潜在混杂因素的饮酒组,对死亡率进行建模。使用 Moran's I 统计量检查模型的空间自相关。当发现存在缺失空间信息的证据时,拟合集成嵌套 Laplace 逼近(INLA)模型。
与非饮酒者相比,所有癌症(RR 范围为 1.01 至 1.07)和上呼吸道消化道癌症(RR 范围为 1.15 至 1.20)的死亡率均在饮酒者中检测到更高的死亡率。全局 Moran's I 统计量显示,所有癌症死亡率在瑞士地区层面存在空间自相关。INLA 模型确定了三个癌症死亡率显著下降的地区和四个癌症死亡率显著上升的地区。
饮酒与所有癌症和上呼吸道消化道癌症死亡率之间存在显著关联。我们的研究结果表明,需要进一步研究以改进下一个酒精预防计划,降低瑞士的可避免死亡人数。