Harms associated with moderate or even low levels of drinking may be greater among people who are poorer or in worse health, research suggests. The study comes just weeks after another piece of research indicated the benefits of booze had been exaggerated and its harms downplayed by previous studies. Dr Rosario Ortolá, a co-author of the study from the Autonomous University of Madrid, said drinking low amounts of alcohol may have some benefits for older people at a higher risk of cardiovascular disease but that such benefits are small and may be achieved in other ways, for example with a better diet or more exercise. “Also, it is clear that alcohol consumption is related to a higher risk of cancer from the first drop, so we think that medical advice should not recommend consuming alcohol to improve health,” she said. Writing in the journal Jama Network Open, Ortolá and colleagues report how they used data provided to the UK Biobank health database by participants who signed up between 2006 and 2010. The researchers looked at data from 135,103 participants aged 60 and over and assigned each to one of four categories based on their average daily alcohol intake: occasional, low risk, moderate risk and high risk. While the “occasional” category works out at less than a quarter of a small glass of wine a day, “high risk” is equal to at least two pints of cider a day for men or one pint of cider a day for women. The researchers then looked at which patients died up to the end of September 2021, finding a total of 15,833 deaths. After taking into account factors like participants’ age and sex, the team found that, compared with occasional drinking, high-risk drinking was associated with a 33% greater risk of dying from any cause during the course of the study, as well as a higher risk of dying from cancer or cardiovascular disease. Moderate-risk drinking was associated with a 10% greater risk of death from any cause compared with occasional drinking, and a 15% greater risk of death from cancer. Even low-risk drinking was associated with a 11% greater risk of death from cancer compared with occasional drinking. However, when the team dug deeper they found moderate or low-risk drinking was worse for people who lived in more deprived areas or had poorer health to begin with. “We think that older adults with worse health are more susceptible to the harmful effects of alcohol owing to their greater morbidity, higher use of alcohol-interacting drugs and reduced tolerance to alcohol,” said Ortolá. “Also, there is evidence that socioeconomically disadvantaged populations have higher rates of alcohol-related harms for equivalent and even lower amounts of alcohol, probably owing to the coexistence of other health challenges, including less healthy lifestyles, and lower social support or access to health care,” she said. Perhaps surprisingly, the team found that a strong preference for wine, or only drinking with meals, appeared to reduce the risk of death independently of the amount of alcohol consumed – although this only held for those with poor health or high deprivation. While Ortolá said those results need further investigation, she suggested they could be down to factors such as the non-alcoholic components of wine or slower absorption of alcohol ingested with meals. However, the study has limitations, including that the drinking data was based on self-report, while the study cannot show cause and effect. Colin Angus, a medical research fellow from the University of Sheffield who was not involved in the work, said the study provides further confirmation that even low levels of drinking increases cancer risks. However, he said more research was needed to prove that associations between low levels of drinking and higher mortality were stronger for those in poorer health or lower socioeconomic groups. Angus also stressed the finding that drinking wine could bring benefits should be treated with extreme suspicion. “There is absolutely no biologically plausible evidence that wine consumption is better for you than other forms of alcohol,” he said. “It’s almost certain that what they have actually found is that better-off people drink more wine and are also less likely to die relatively young.”