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Journal of Epidemiology and Community Health logoLink to Journal of Epidemiology and Community Health
. 2001 Sep;55(9):648–652. doi: 10.1136/jech.55.9.648

Consumption of alcoholic beverages and subjective health in Spain

P Guallar-Castillon, F Rodriguez-Artalej, L Ganan, J Banegas, P Urdinguio, R Cabrera
PMCID: PMC1731972  PMID: 11511643

Abstract

STUDY OBJECTIVE—To examine the relation between alcohol and main alcoholic beverage consumption and subjective health in Spain.
DESIGN—Logistic regression analysis using a cross sectional survey based on self reported data on alcohol and alcoholic beverage consumption, subjective health and the principal confounding factors (age, sex, civil status, educational level, job status, social support, region of residence, size of town or city, tobacco consumption, physical activity during leisure time and work hours, and chronic disease).
SETTING—The 1993 Spanish National Health Survey.
PARTICIPANTS—A 19 573 person sample, representative of the non-institutionalised Spanish population aged 16 years and over.
MAIN RESULTS—Among Spaniards, 31.4% reported their health as suboptimal (fair, poor or very poor) and 56.9% consumed alcohol regularly, with the majority having a preference for wine. Light (1-2 drinks per day) or moderate consumption (3-4 drinks per day) was the most frequent pattern. After adjusting for confounding factors, a negative dose-response relation was observed between consumption of total alcohol, wine and beer, and prevalence of suboptimal health (linear trend: p<0.001 for total alcohol, p=0.023 for wine, and p=0.030 for beer). In contrast, for consumption of spirits the prevalence of ill health in moderate drinkers was lower than in non-drinkers, with no clear relation at higher consumption. While persons reporting a preference for wine had a lower frequency of suboptimal health than did abstainers, they showed no difference in frequency of subjective ill health with respect to persons with preference for other types of drink or no preference whatsoever.
CONCLUSIONS—The higher the consumption of total alcohol, wine and beer, the lower the prevalence of suboptimal health. These results differ from those obtained in several Nordic countries, where a "J shaped" relation has been observed for total alcohol and wine, and suggest that the relation between alcohol consumption and subjective health may be different in Mediterranean countries.


Keywords: alcohol; subjective health

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Selected References

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  1. Bergner M., Bobbitt R. A., Pollard W. E., Martin D. P., Gilson B. S. The sickness impact profile: validation of a health status measure. Med Care. 1976 Jan;14(1):57–67. doi: 10.1097/00005650-197601000-00006. [DOI] [PubMed] [Google Scholar]
  2. Brazier J. E., Harper R., Jones N. M., O'Cathain A., Thomas K. J., Usherwood T., Westlake L. Validating the SF-36 health survey questionnaire: new outcome measure for primary care. BMJ. 1992 Jul 18;305(6846):160–164. doi: 10.1136/bmj.305.6846.160. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Engström G., Hedblad B., Janzon L. Subjective well-being associated with improved survival in smoking and hypertensive men. J Cardiovasc Risk. 1999 Aug;6(4):257–261. doi: 10.1177/204748739900600411. [DOI] [PubMed] [Google Scholar]
  4. Grønbaek M., Mortensen E. L., Mygind K., Andersen A. T., Becker U., Gluud C., Sørensen T. I. Beer, wine, spirits and subjective health. J Epidemiol Community Health. 1999 Nov;53(11):721–724. doi: 10.1136/jech.53.11.721. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Gutiérrez-Fisac J. L. Indicadores de consumo de alcohol en España. Med Clin (Barc) 1995 Apr 15;104(14):544–550. [PubMed] [Google Scholar]
  6. Idler E. L., Benyamini Y. Self-rated health and mortality: a review of twenty-seven community studies. J Health Soc Behav. 1997 Mar;38(1):21–37. [PubMed] [Google Scholar]
  7. Korn E. L., Graubard B. I. Epidemiologic studies utilizing surveys: accounting for the sampling design. Am J Public Health. 1991 Sep;81(9):1166–1173. doi: 10.2105/ajph.81.9.1166. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Laforge R. G., Williams G. D., Parker D. A., Harford T. C. Alcoholic beverage type, recall period effects and functional disability: evidence from the 1983 NHIS. Drug Alcohol Depend. 1990 Jun;25(3):257–272. doi: 10.1016/0376-8716(90)90151-4. [DOI] [PubMed] [Google Scholar]
  9. Mackenbach J. P., van den Bos J., Joung I. M., van de Mheen H., Stronks K. The determinants of excellent health: different from the determinants of ill-health? Int J Epidemiol. 1994 Dec;23(6):1273–1281. doi: 10.1093/ije/23.6.1273. [DOI] [PubMed] [Google Scholar]
  10. Manderbacka K., Lundberg O., Martikainen P. Do risk factors and health behaviours contribute to self-ratings of health? Soc Sci Med. 1999 Jun;48(12):1713–1720. doi: 10.1016/s0277-9536(99)00068-4. [DOI] [PubMed] [Google Scholar]
  11. Midanik L. The validity of self-reported alcohol consumption and alcohol problems: a literature review. Br J Addict. 1982 Dec;77(4):357–382. doi: 10.1111/j.1360-0443.1982.tb02469.x. [DOI] [PubMed] [Google Scholar]
  12. Mossey J. M., Shapiro E. Self-rated health: a predictor of mortality among the elderly. Am J Public Health. 1982 Aug;72(8):800–808. doi: 10.2105/ajph.72.8.800. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Poikolainen K., Vartiainen E., Korhonen H. J. Alcohol intake and subjective health. Am J Epidemiol. 1996 Aug 15;144(4):346–350. doi: 10.1093/oxfordjournals.aje.a008935. [DOI] [PubMed] [Google Scholar]
  14. Poikolainen K., Vartiainen E. Wine and good subjective health. Am J Epidemiol. 1999 Jul 1;150(1):47–50. doi: 10.1093/oxfordjournals.aje.a009917. [DOI] [PubMed] [Google Scholar]
  15. Prada Puentes C., del Río Gracia M. C., Yáez J. L., Alvarez González F. J. Mortalidad relacionada con el consumo de alcohol en España: 1981-1990. Gac Sanit. 1996 Jul-Aug;10(55):161–168. doi: 10.1016/s0213-9111(96)71891-5. [DOI] [PubMed] [Google Scholar]
  16. Rodríguez Artalejo F., Banegas J. R., García Colmenero C., del Rey Calero J. Lower consumption of wine and fish as a possible explanation for higher ischaemic heart disease mortality in Spain's Mediterranean region. Int J Epidemiol. 1996 Dec;25(6):1196–1201. doi: 10.1093/ije/25.6.1196. [DOI] [PubMed] [Google Scholar]
  17. Rodríguez Artalejo F., Guallar-Castillón P., Gutiérrez-Fisac J. L., Ramón Banegas J., del Rey Calero J. Socioeconomic level, sedentary lifestyle, and wine consumption as possible explanations for geographic distribution of cerebrovascular disease mortality in Spain. Stroke. 1997 May;28(5):922–928. doi: 10.1161/01.str.28.5.922. [DOI] [PubMed] [Google Scholar]
  18. Rodríguez Artalejo F., de Andrés Manzano B., Guallar-Castillón P., Puente Mendizabal M. T., González Enríquez J., del Rey Calero J. The association of tobacco and alcohol consumption with the use of health care services in Spain. Prev Med. 2000 Nov;31(5):554–561. doi: 10.1006/pmed.2000.0734. [DOI] [PubMed] [Google Scholar]
  19. Rodríguez-Artalejo F., de Andrés Manzano B., Guallar-Castillón P., Banegas Banegas J. R., del Rey Calero J. Association of moderate consumption of alcohol with rates of heavy drinking and abstinence in Spain. Alcohol Clin Exp Res. 1999 Sep;23(9):1502–1506. [PubMed] [Google Scholar]
  20. Rodríguez-Martos Dauer A., Gual Solé A., Llopis Llácer J. J. La "unidad de bebida estándar" como registro simplificado del consumo de bebidas alcohólicas y su determinación en España. Med Clin (Barc) 1999 Apr 10;112(12):446–450. [PubMed] [Google Scholar]
  21. Thun M. J., Peto R., Lopez A. D., Monaco J. H., Henley S. J., Heath C. W., Jr, Doll R. Alcohol consumption and mortality among middle-aged and elderly U.S. adults. N Engl J Med. 1997 Dec 11;337(24):1705–1714. doi: 10.1056/NEJM199712113372401. [DOI] [PubMed] [Google Scholar]
  22. Verkerk P. H., Buitendijk S. E., Verloove-Vanhorick S. P. Differential misclassification of alcohol and cigarette consumption by pregnancy outcome. Int J Epidemiol. 1994 Dec;23(6):1218–1225. doi: 10.1093/ije/23.6.1218. [DOI] [PubMed] [Google Scholar]
  23. Wannamethee G., Shaper A. G. Self-assessment of health status and mortality in middle-aged British men. Int J Epidemiol. 1991 Mar;20(1):239–245. doi: 10.1093/ije/20.1.239. [DOI] [PubMed] [Google Scholar]
  24. Yañez J. L., Del Rio M. C., Alvarez F. J. Alcohol-related mortality in Spain. Alcohol Clin Exp Res. 1993 Apr;17(2):253–255. doi: 10.1111/j.1530-0277.1993.tb00758.x. [DOI] [PubMed] [Google Scholar]

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