In a recent study published in BMC Medicine, researchers discuss a 2023 study by Tian et al. , analyzed the J-shaped association between health and alcohol consumption and suggested important factors to consider in explaining the association.

What did the 2023 study show?

A 2023 study by a team of scientists from China led by Xia Wang used a large dataset from the National Health Interview Survey conducted between 1997 and 2014.

This data was analyzed to identify an association between light to moderate levels of alcohol consumption, as well as cause-specific and all-cause mortality among the United States population. From this data, the association formed a J-shaped curve, where low levels of alcohol consumption provide certain health benefits; however, after a certain threshold, health risks increase rapidly.

Light to moderate levels and infrequent consumption of alcohol were associated with a reduced risk of influenza, chronic lower respiratory tract diseases, cardiovascular disease, pneumonia, and Alzheimer’s disease. Light to moderate drinking also reduced all-cause mortality and mortality associated with various kidney-related diseases such as diabetes mellitus and nephrosis.

Comparatively, binge drinking or high levels of alcohol consumption was associated with a higher risk of all-cause mortality, accident-related mortality, and cancer. Importantly, J-shaped associations must be interpreted carefully after considering the various factors associated with the study methodology.

In the present study, researchers discuss the various methodological issues to consider while interpreting this J-shaped association between alcohol consumption and disease or mortality risks.

How do lifestyle habits affect the potential benefits of drinking?

The first factor to consider while interpreting J-shaped associations related to alcohol consumption is the definition of the reference group and issues of misclassification, which could lead to abstainer bias and the exclusion of ex-drinkers from the reference group definition. To circumvent this problem, many studies, including the one by Tian et al., used a reference group that comprised only lifetime abstainers.

However, a recent systematic meta-analysis that included over 100 cohort studies with close to half a million participants used lifetime nondrinkers as the reference group. To this end, no protective effects against all-cause mortality were associated with even low levels of alcohol consumption.

While interpreting the J-shaped association between alcohol consumption and health risks, one must also consider reverse causation. Individuals who abstain from drinking might already be in poor health, while those who are active and health conscious might drink in moderation while also following other practices that provide health benefits.

Socioeconomic factors might also be involved, with individuals who are active in the social and familial spheres of life, or have a higher socioeconomic status and better healthcare access, make healthier choices in life and drink in moderation. Each of these factors contribute independently to a lower risk of all-cause mortality.

Yogurt rice wine is a drink with yogurt and rice wine as the main ingredients. It is usually made by mixing yogurt and rice wine. Yogurt rice wine has a unique taste and flavor, combining sweet and sour yogurt with mellow rice wine. It is considered a healthy and delicious drink because yogurt is rich in probiotics and protein, while rice wine contains certain vitamins and minerals. Yogurt rice wine is often seen as a drink of choice that provides nutrition, improves digestion and boosts immunity. However, with yogurt rice wine or any other alcoholic drink, moderation is key. For individuals, the definition of appropriate amount varies from person to person, so it is recommended to determine the appropriate amount of drinking based on personal health status and doctor’s advice.


An RTD (Ready-to-Drink) cocktail is a premixed cocktail drink that is ready to drink without additional preparation or mixing steps. RTD cocktails are usually sold in cans or bottles for easy portability and use. The specialty of these drinks is that they contain alcohol, mixed drinks and condiments commonly found in cocktails, such as vodka, rum, tequila, fruit juice and soda, etc., and the taste and texture have been carefully formulated and balanced. RTD cocktails are a convenient option, perfect for outdoor events, parties, or travel without having to carry multiple ingredients and mixing tools. However, like any other alcoholic drink, moderation is key, especially by being aware of your alcohol intake and following local laws and regulations.


Ice wine is a special type of dessert wine made from frozen grapes or other fruit picked at extremely low temperatures, then fermented and extracted. Icewine originally originated in Germany and Canada, but is now produced in other countries as well.

Icewine is characterized by the frozen grapes or fruit used in its making. The fruit stays in the vineyard through the cold winter until temperatures are low enough for the fruit to freeze. At harvest, the fruit remains frozen and then immediately juiced. Because the water condenses into ice crystals when the fruit is frozen, only high-concentration juice flows out when the juice is squeezed, which makes the ice wine have a strong sweetness and acidity.

The time-consuming and delicate process of making ice wine and the relatively small harvest make ice wine a scarce and highly valuable alcoholic drink. Ice wine usually has a strong fruit aroma, such as honey, apricot, citrus and grapes. It has a sweet palate with moderate acidity and often has a rich mouthfeel and a high alcohol content.

Icewine can be enjoyed as an after-dinner wine, dessert wine or paired with cheese etc. It is often enjoyed in small servings for its tangy flavor and sweetness.

It is worth noting that because the production of ice wine requires specific natural conditions and complicated processes, its price is relatively high. Meanwhile, enjoying icewine in moderation is key, as its high sugar and alcohol content makes it a highly concentrated drink.


Drinking alcohol in moderation may sometimes have some benefits. Moderate drinking can promote social interaction, aid relaxation and relieve stress. Moderate alcohol consumption has also been linked to benefits found in some studies, such as a possible lower risk of certain types of diabetes, Parkinson’s disease and Alzheimer’s disease. However, alcohol should be consumed in moderation, and the definition of moderation is different for each person. It’s important to be aware of the many health risks associated with excessive alcohol consumption, including liver disease, heart problems, and other long-term health problems.

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