Risk thresholds for alcohol consumption – Authors' reply

To define alcohol consumption thresholds associated with lowest risk for all-cause mortality and cardiovascular disease subtypes, we analysed individual-participant data from 599912 current drinkers without previous cardiovascular disease.1 Among current drinkers, the threshold for lowest risk of all-cause mortality was about 100 g per week. For cardiovascular disease subtypes other than myocardial infarction, there were no clear risk-based thresholds below which lower alcohol consumption stopped being associated with lower disease risk. These data challenge the concept that moderate alcohol consumption is universally associated with lower cardiovascular disease risk, and suggest implications for low-risk limits in guidelines.