Population-level risks of alcohol consumption by amount, geography, age, sex, and year: a systematic analysis for the Global Burden of Disease Study 2020

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Résumé

BACKGROUND: The health risks associated with moderate alcohol consumption continue to be debated. Small amounts of alcohol might lower the risk of some health outcomes but increase the risk of others, suggesting that the overall risk depends, in part, on background disease rates, which vary by region, age, sex, and year. METHODS: For this analysis, we constructed burden-weighted dose-response relative risk curves across 22 health outcomes to estimate the theoretical minimum risk exposure level (TMREL) and non-drinker equivalence (NDE), the consumption level at which the health risk is equivalent to that of a non-drinker, using disease rates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2020 for 21 regions, including 204 countries and territories, by 5-year age group, sex, and year for individuals aged 15-95 years and older from 1990 to 2020. Based on the NDE, we quantified the population consuming harmful amounts of alcohol. FINDINGS: The burden-weighted relative risk curves for alcohol use varied by region and age. Among individuals aged 15-39 years in 2020, the TMREL varied between 0 (95% uncertainty interval 0-0) and 0·603 (0·400-1·00) standard drinks per day, and the NDE varied between 0·002 (0-0) and 1·75 (0·698-4·30) standard drinks per day. Among individuals aged 40 years and older, the burden-weighted relative risk curve was J-shaped for all regions, with a 2020 TMREL that ranged from 0·114 (0-0·403) to 1·87 (0·500-3·30) standard drinks per day and an NDE that ranged between 0·193 (0-0·900) and 6·94 (3·40-8·30) standard drinks per day. Among individuals consuming harmful amounts of alcohol in 2020, 59·1% (54·3-65·4) were aged 15-39 years and 76·9% (73·0-81·3) were male. INTERPRETATION: There is strong evidence to support recommendations on alcohol consumption varying by age and location. Stronger interventions, particularly those tailored towards younger individuals, are needed to reduce the substantial global health loss attributable to alcohol. FUNDING: Bill & Melinda Gates Foundation.

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La notice

Revue

The Lancet

Thématique

Substance Abuse Treatment and Outcomes

Domaine

Medicine

Établissements canadiens

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Organismes subventionnaires

CilagEIT HealthDaiichi Sankyo EuropeDivision of Human Resource DevelopmentChinese University of Hong KongNational Institute on AgingLa Trobe UniversityFrankfurt University of Applied SciencesStudent Research Committee, Tabriz University of Medical SciencesFaculty of Medicine and Health, University of SydneyEuropean Regional Development FundNational Institute of Mental HealthVanderbilt UniversityGastrointestinal and Liver Diseases Research CenterQueensland Brain InstituteRobert Koch InstitutMedical Research CouncilSchool of Public Health and Family Medicine, University of Cape TownNovartis PharmaSamsungUniwersytet OpolskiDilla UniversityGeorge Institute for Global HealthAmelia Peabody Charitable FundUniversitat de BarcelonaAfrican UnionUniversity of HailUniversitatea SapientiaAutoritatea Natională pentru Cercetare StiintificăKermanshah University of Medical SciencesRajshahi UniversityImam Abdulrahman Bin Faisal UniversityPfizerHáskólinn í ReykjavíkHellenic Foundation for Research and InnovationSwedish Orphan BiovitrumUniversity of ColomboJawaharlal Institute Of Postgraduate Medical Education and ResearchUniversity of PennsylvaniaUniversity of Science and Technology of ChinaNSW Ministry of HealthDuke Global Health Institute, Duke UniversityPomorski Uniwersytet Medyczny W SzczecinieNational Heart, Lung, and Blood InstituteKhulna UniversityDire Dawa UniversityWestern Sydney UniversityTartu ÜlikoolNational Research University Higher School of EconomicsInstituto de Salud Carlos IIIArak University of Medical SciencesCentro de Investigación Biomédica en Red de Salud MentalUniversity of TabrizUnitatea Executiva pentru Finantarea Invatamantului Superior, a Cercetarii, Dezvoltarii si InovariiUniversity of TsukubaBritish Columbia Centre for Disease ControlCentre Hospitalier Universitaire VaudoisUniversity of LeedsNovo NordiskInstitut National Du CancerUniversità di BolognaShahid Beheshti University of Medical SciencesGöteborgs UniversitetAmerican Heart AssociationRafsanjan University of Medical SciencesNorwegian Institute of Public HealthBabol University of Medical SciencesTomsk Polytechnic UniversityUniversity of GhanaU.S. President’s Emergency Plan for AIDS ReliefMasarykova UniverzitaQazvin University of Medical SciencesSouth African Medical Research CouncilERAB: The European Foundation for Alcohol ResearchKoch Institute for Integrative Cancer Research, Massachusetts Institute of TechnologyGuilan University of Medical SciencesTehran Heart CenterNational and Kapodistrian University of AthensBirjand University of Medical SciencesYale UniversityJimma UniversityBanaras Hindu UniversityWollega UniversityNational University of SingaporeNational Institutes of HealthUniversity of Veterinary and Animal SciencesHamadan University of Medical SciencesInyuvesi Yakwazulu-NataliSouth Eastern Sydney Local Health DistrictTehran University of Medical Sciences and Health ServicesEuropean and Developing Countries Clinical Trials PartnershipUniversiti MalayaTabriz University of Medical SciencesUniversity of Cape TownUniversity of OttawaNational Authority for Scientific Research and InnovationKhalifa University of Science, Technology and ResearchMacquarie UniversityKashan University of Medical SciencesMadda Walabu UniversityUniversidade Federal de Juiz de ForaBill and Melinda Gates FoundationInstitució Catalana de Recerca i Estudis AvançatsPublic Health EnglandImperial College LondonLilly DeutschlandCentral South UniversityPirogov Russian National Research Medical UniversityAjou UniversityAmgenAmarin CorporationIslamic Azad UniversityGachon UniversityKyung Hee UniversityU.S. Department of Veterans AffairsKosin UniversityKing Saud UniversityRUDN UniversityShiraz University of Medical SciencesAin Shams UniversityNankai UniversityUniversiteit UtrechtCharles Sturt UniversityInstitut National de la Santé et de la Recherche MédicaleDeutsche ForschungsgemeinschaftAmity UniversityFriedrich-Schiller-Universität JenaQueensland University of TechnologyJahrom University of Medical SciencesLondon South Bank UniversityBaki Dövlət UniversitetiEuropean CommissionUniversité de BordeauxUniversitat de ValènciaSemmelweis EgyetemUniversity College LondonWorld Health OrganizationNational Institute on Drug AbuseUniversité de Versailles Saint-Quentin-en-YvelinesMinisterul Cercetării, Inovării şi DigitalizăriiEwha Womans UniversityShiraz UniversityKing's College LondonUniversity of QueenslandNational Institute for Health and Care ResearchWellcome TrustKorea UniversitySanjay Gandhi Postgraduate Institute of Medical SciencesBGI GroupKrishna Institute Of Medical Sciences Deemed To Be UniversityCentral University of KeralaNational Center of Neurology and PsychiatryMashhad University of Medical SciencesAlexander von Humboldt-StiftungTribhuvan UniversityUniversiteit StellenboschMahatma Gandhi UniversityJames Cook UniversityNord universitetInternational Centre for Diarrhoeal Disease Research, BangladeshMonash UniversityJohns Hopkins UniversityYazd UniversityUniversity of HullAksum UniversitySüleyman Demirel ÜniversitesiAnglia Ruskin UniversityUniversity of Engineering and Technology, LahoreBournemouth UniversityAlborz University of Medical SciencesNorthwestern UniversityEmory UniversityUniversità di CataniaMoscow Institute of Physics and TechnologyNational Institute of Mental Health and NeurosciencesUniversity of Central FloridaShanghai Jiao Tong UniversityAlberta Health ServicesUniversity of WashingtonDeakin UniversityUniversity of WaterlooTeva Pharmaceutical IndustriesHelsingin YliopistoAddis Ababa UniversityDanoneAmerican University of BeirutUniversidade de São PauloAhvaz Jundishapur University of Medical SciencesNew York University ShanghaiUniverzita Karlova v PrazeRajarata University of Sri LankaFlorida International UniversityAarhus UniversitetSanofiSocial Science Research CouncilMazandaran University of Medical SciencesAja University of Medical SciencesUniversidade de LisboaEli Lilly and CompanyGeorge Mason UniversityRussian Academy of SciencesUniversity of Rochester

Mots-clés

MedicineDemographyEnvironmental healthPopulationRelative riskConfidence intervalAlcohol consumptionBurden of diseaseGerontologyAlcoholInternal medicine

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