Journal of Aging Research After analyzing the overall eﬀect of alcohol on mortality, separate analyses were run for each type of alcohol (beer, wine, and liquor), because of the potential diﬀerential eﬀects from diﬀerent types of alcohol. As there were few men who consumed a single beverage type, analysis was conducted separately for quartiles of a single type of alcohol while adjusting for the remaining type of alcohol consumption [37, 38]. Alcohol consumption quartiles were created inde- pendently for each alcohol type and hazard ratios adjusted for age, year of examination, BMI, smoking, family history of CVD, maximal treadmill time, and remaining types of alcohol were calculated using nondrinkers as the reference group. 3. Results and Discussion A total of 31,637 men were included in the sample. The mean age of men at baseline was 42.9 (standard deviation (SD): 9.2) years. Baseline characteristics are presented in Table 1. Mean follow-up time was 16.0 (8.3) years for a total of 504,735 person-years. There were 1,834 total deaths and 588 CVD deaths. The rate of all-cause and CVD mortality was calculated for the ﬁve drinking categories: nondrinkers, quartile 1 (1–3 drinks/week), quartile 2 (4–6 drinks/week), quartile 3 (7–13 drinks/week), and quartile 4 (≥14 drinks/week). Alcohol consumption was linearly associated with both all-cause and CVD mortality rate (P = 0.002 and P = 0.02). 3.1. Primary Analysis. In the basic model adjusted for age, year of examination, BMI, smoking, family history of CVD, and ﬁtness, there were no signiﬁcant diﬀerences in all-cause mortality risks across alcohol intake groups (Table 2). There was a lower risk of CVD mortality in quartile 1 (HR = 0.71, 95% conﬁdence interval (CI): 0.53, 0.95) and quartile 2 (HR = 0.75, 95% CI: 0.58, 0.98) in the basic model which is less than 6 drinks per week (see Table 3). The addition of potential intermediate variables of glucose, lipids, and blood pressure, or the inclusion of all three, did not attenuate these relationships. The additional adjustment for psychological variables did not alter the observed associations and are not included in the results presented. 3.2. Stratiﬁed Analysis. The lower risk of all-cause mortality from light drinking (quartile 1) was attenuated when the results were stratiﬁed by BMI, health status, and ﬁtness (see Table 4). However, men younger than 60 years in quartile 1 exhibited a signiﬁcantly lower risk of all-cause mortality (HR = 0.80, 95% CI: 0.66, 0.96); whereas, men 60 or older did not. For CVD mortality, there were no signiﬁcant ﬁndings in men who were ≥60 years, had a BMI < 25 kg/m2, were healthy, or unﬁt (see Table 5). Younger men had lower risk of CVD mortality in quartile 1 (HR = 0.59, 95% CI: 0.43, 0.83) and quartile 2 (HR = 0.70, 95% CI: 0.52, 0.93). Men with a BMI >25 kg/m2 had lower CVD mortality risk in quartile 1 (HR = 0.67, 95% CI: 0.47, 0.94) and quartile 2 (HR = 0.71, 95% CI: 0.52, 0.97). Unhealthy men had a reduced risk in quartile 3 (HR = 0.74, 95% CI: 0.54, 0.998). When stratiﬁed 3 by ﬁtness, ﬁt men exhibited a lower risk in quartile 2 (HR = 0.69, 95% CI: 0.49, 0.96). 3.3. Type of Alcohol. The results of the sensitivity analysis are listed in Table 4. There were a total of 26,767 drinkers, of which 23,728 reported drinking beer, 21,997 reported drink- ing wine, and 20,416 reported drinking liquor. Therefore, for this analysis, the types of alcohol drinking are not exclusive. For all-cause mortality, there were no signiﬁcant diﬀerences in risk for any three of the alcohol types in comparison to nondrinkers (see Table 6). For CVD mortality, there was a lower risk with beer consumption in quartile 3 (HR = 0.72, 95% CI: 0.52, 0.995), wine consumption in quartile 2 (HR = 0.70, 95% CI: 0.53, 0.93) and liquor consumption in quartile 2 (HR = 0.71, 95% CI: 0.50, 0.93) and Q3 (HR = 0.69, 95% CI: 0.55, 0.93) (see Table 7). 4. Discussion 4.1. All-Cause Mortality. In the current study, the rela- tionship between risk of all-cause mortality with alcohol consumption appeared to evince a ﬂattened J-shaped curve pattern. However, the risk reductions were signiﬁcant only at the lowest levels of alcohol consumption. Other studies reporting on the association of alcohol consumption and all-cause mortality in men have found protective eﬀects up to three drinks per day [5]. In the Physicians Health Study, Gaziano et al [3], found a reduction in all-cause mortality with 5 to 6 drinks/week and reductions in CVD mortality with all levels of alcohol consumption. Gaziano’s results are consistent with a meta-analysis conducted by Di Castelnuovo [39] which found a reduced risk for all-cause mortality up to 4 drinks per day. 4.2. Cardiovascular Disease Mortality. It has been hypoth- esized that the lower CVD mortality risk associated with limited alcohol intake is due to the cardioprotective eﬀects of alcohol such as improved lipid proﬁles and decreased blood coagulation [11, 12]. CVD contributes to 34.3% of all deaths in the nation and is an important health outcome [40]; therefore, our results warrant consideration. In this sample, 32% of all deaths were attributed to CVD, similar to the nationwide estimates. There was a 29% and 25% reduction in risk for CVD mortality in the ﬁrst and second quartiles of alcohol consumption, respectively. This risk reduction was found for 1–6 drinks per week. The lower risk of CVD death may be balanced with an increase in other causes of death potentially due to alcohol consumption, again complicating public health recommendations. The lower CVD mortality risk we observed was not atten- uated when potential intermediate factors of blood pressure, lipids, and glucose were added to the model, suggesting the lower risks were not mediated by these factors. While Suh et al. [7] and Djousse´ et al. [41] found that the reduced risk of CVD mortality in women was mediated by lipids and insulin sensitivity, other authors have found the relationship to be independent of these risk factors. Arriola et al. [1] found that blood pressure, cholesterol, and diabetes did not alter