Background/Objectives: Healthy aging, defined as reaching older age free from major chronic diseases, is a key public health goal. The relationship between different levels of alcohol consumption, including low-to-moderate intake, and healthy ageing remains controversial. We aimed to evaluate the association between alcohol consumption and the risk of major chronic diseases or death before age 60 in a Mediterranean cohort.

Methods: We analyzed data from 6,047 participants who reached age 60 with complete follow-up and were free of major chronic diseases at baseline in the SUN (Seguimiento Universidad de Navarra) Project, a prospective Mediterranean cohort. Baseline alcohol intake was assessed using a validated semi-quantitative FFQ in Spain. Alcohol consumption was categorized according to Spanish Ministry of Health sex-specific thresholds: abstainers (reference), low (0-10 g/day in women; 0-20 g/day in men), moderate (10-25 g/day in women; 20-49 g/day in men), and high (25 g/day in women, ≥ 50 g/day in men). The outcome was a composite of incident cardiovascular disease, cancer, diabetes, dementia, or all-cause mortality (any of them developed before age 60). Multivariable logistic regression models were adjusted for sex, marital status, education, lifetime smoking exposure, physical activity, Mediterranean diet adherence, body mass index, energy intake, hypertension, hypercholesterolemia, and hypertriglyceridemia.

Results: Compared to abstainers, low alcohol consumption was not associated with the outcome (OR = 1.01; 95%CI: 0.84-1.21, p = 0.910). However, moderate consumption was associated with lower odds of developing major chronic disease or dying before age 60 both when the reference was abstention (OR = 0.73; 95%CI: 0.58-0.92, p = 0.008) or low alcohol intake (OR = 0.72; 95%CI: 0.60-0.86, p < 0.001. No association was found for high intake in this highly educated cohort.

Conclusions/Recommendations: In the SUN cohort, moderate alcohol consumption was associated with a lower likelihood of developing chronic diseases or dying before the age of 60. Further research is needed to determine whether the associations observed vary according to the source or type of drink (wine, beer, or spirits) and contextual patterns of consumption, which may reflect different associations between lifestyle and social factors.

Funding: Spanish Government Instituto de Salud Carlos III, European Regional Development Fund (FEDER), Government of Navarra and the National Plan on Drugs.