4 Journal of Aging Research Table 1: Baseline demographics by alcohol consumption level, Aerobics Center for Longitudinal Study (ACLS), 1974–2002. Alcohol consumption (drinks/week) Nondrinkers (0) Quartile 1 (1–3) Quartile 2 (4–6) Quartile 3 (7–13) n 4870 6733 6150 6841 Age (years) 43.63 (9.65) 42.15 (9.15) 42.34 (9.07) 42.95 (9.23) Alcohol (drinks/week) 0 2.01 (0.76) 5.00 (0.87) 9.65 (1.93) Body mass index (kg/m2) 26.65 (4.29) 26.63 (4.02) 26.36 (3.65) 26.28 (3.45) Maximal treadmill time (min) 17.24 (5.15) 18.33 (4.89) 18.14 (4.90) 18.50 (4.84) Current smokers (%) 10.62 14.18 19.50 22.03 Systolic blood pressure (mmHg) 121 (13) 121 (13) 121 (13) 121 (13) Diastolic blood pressure (mmHg) 81 (10) 80.91 (9.47) 80.52 (9.35) 81.17 (9.41) Hypertension (%)a 30.86 28.32 28.10 30.35 Fasting glucose (mg/dL) 99.14 (18.92) 99.20 (16.52) 98.80 (14.50) 99.74 (14.50) Diabetes (%)b 4.58 4.92 4.70 4.37 Total cholesterol (mg/dL) 205.80 (38.56) 203.21 (39.88) 205.42 (38.29) 209.58 (39.16) Triglycerides (mg/dL) 141.09 (104.59) 137.20 (106.77) 132.02 (94.37) 134.63 (101.78) Hyperlipidemia (%)c 29.49 26.56 26.03 28.46 Unhealthy (%)d 49.63 46.81 45.69 48.68 Family history of CVD (%) 26.96 23.91 25.45 24.69 a Deﬁned as systolic or diastolic blood pressure ≥140/90 mmHg or history of physician diagnosis. bDeﬁned as fasting glucose ≥126 mg/dl or history of physician diagnosis. cDeﬁned as fasting total cholesterol ≥240 mg/dl or triglyceride ≥200 mg/dL. dDeﬁned as presence of one or more of following diseases: hypertension, diabetes, or hyperlipid. Quartile 4 (≥14) 7043 43.62 (9.13) 24.62 (13.64) 26.42 (3.35) 17.78 (4.83) 29.09 122 (13) 81.90 (9.53) 34.49 101.13 (14.19) 4.91 217 (40.42) 144.54 (105.24) 35.57 55.93 28.44 Table 2: Hazard ratios of all-cause mortality by alcohol consumption level in men, Aerobics Center for Longitudinal Study (ACLS), 1974– 2002. Alcohol consumption (drinks/week) Nondrinkers (0) Quartile 1 (1–3) Quartile 2 (4–6) Quartile 3 (7–13) Quartile 4 (≥14) Person-years 86,872 91,529 98,303 103,625 124,360 No. 4870 6733 6150 6841 7043 No. of Deaths 343 237 350 349 555 Death ratea 43.8 37.2 43.3 41.6 51.2 Basic modelb 1.00 (referent) 0.86 (0.73–1.01) 0.95 (0.82–1.10) 0.97 (0.83–1.12) 1.09 (0.95–1.25) Basic model plus Blood pressure factorsc 1.00 (referent) 0.86 (0.73–1.02) 0.94 (0.81–1.09) 0.97 (0.83–1.12) 1.06 (0.92–1.21) Fasting glucose factorsd 1.00 (referent) 0.84 (0.71–0.99) 0.95 (0.82–1.10) 0.96 (0.82–1.11) 1.07 (0.94–1.23) Lipid factorse 1.00 (referent) 0.86 (0.73–1.01) 0.95 (0.82–1.11) 0.96 (0.83–1.12) 1.09 (0.95–1.25) All intermediate factorscde 1.00 (referent) 0.84 (0.71–0.99) 0.94 (0.81–1.09) 0.96 (0.82–1.11) 1.05 (0.91–1.20) a Death rate per 10,000 person-years adjusted for age (in years). bAdjusted for age (in years), year of examination, BMI (kg/m2), smoking (current smoker or not), family history of CVD (yes or no), and maximal treadmill time (min). cSystolic blood pressure and reported hypertension (yes or no). dFasting glucose and reported diabetes (yes or no). eTotal cholesterol and triglyceride. their results and, through coronary angiography, Femia et al. [42] found the risk for atherosclerosis and cardiac mortality was independent of cholesterol, hypertension, and diabetes. More research is needed to study the potential mechanisms of alcohol intake on reduced CVD mortality risk. 4.3. Public Health Recommendations. Our results do not support the currently recommended intake of 1-2 drinks per day for men from the American Heart Association [43]. The lower alcohol consumption for risk reduction in our study may result from complete adjustment for confounders including ﬁtness and thorough screening resulting in exclu- sion of preclinical cases. There are large variations in results from prospective studies examining alcohol consumption and mortality making it diﬃcult to compare ﬁndings for universal alcohol recommendations. In Di Castelnuovo et al.’s [39] meta-analysis of all-cause mortality, they found diﬀerences among genders, countries of the study, and number of confounders. There has been large variation in methods of reporting and categorizing alcohol consumption.