When asked, "How many alcoholic beverages do you drink each week?," two people may honestly answer with the same number, but that doesn’t mean their behavior is even remotely similar. For example, one person may have one glass of wine each and every day of the week and another might drink seven glasses of wine every Saturday night. Now, researchers from the University of Texas at Austin and Boston University are challenging old ideas about what exactly moderate drinking means and how it affects people. Their new study finds that older adults who binge drink — even though their overall intake is moderate — have an increased risk of dying within 20 years when compared to moderate drinkers who do not binge.

"Binge drinking concentrates alcohol's toxicity and is linked to mortality by damaging body organs and increasing accident risk," said Dr. Charles J. Holahan, a professor of psychology at the University of Texas at Austin.

To investigate the possible link between what they describe as "episodic heavy drinking" and death, the team of researchers used data collected from a larger project examining patterns of alcohol consumption and drinking problems in people between the ages of 55 and 65. From 1,884 total respondents, the researchers pulled a sample population of just 446 adults (334 men, 112 women) who fit the bill as moderate drinkers: 74 were bingers, while 372 were non-bingers. Next, the researchers established a 20-year follow-up period, checking to see what happened to these 446 adults. “We predicted that moderate drinkers who were episodic heavy drinkers in comparison with regular moderate drinkers would show increased 20-year total mortality risk,” they wrote in their published paper.

So, what did happen to these moderate drinkers?

"We found that among older adults, those who engage in heavy episodic drinking — even when average consumption is moderate — show significantly increased total mortality risk compared to regular moderate drinkers," Holahan said. Specifically, 61 percent of the participants who were binge drinkers died during the 20-year follow-up period compared to only 37 percent of those who were so-called regular moderate drinkers. All told, the bingers had more than two times higher odds of dying within the 20-year period.

"Binge drinking is dangerous and many bad things have happened to drinkers or to others — car accidents, fights, injuries, domestic violence, sexual assaults — on the basis of binge drinking even if it is 'atypical' of how they drink and/or among those who are not alcoholic," said Dr. Timothy Naimi, a physician and alcohol researcher at Boston Medical Center at Boston University. "…Approximately a quarter of 'moderate' drinkers report binge drinking, and most folks in the U.S. don't typically drink in an 'average' way or on a daily basis.”

"The take-home message here for readers is that binge drinking is a significant public health problem that is frequent among middle-aged and older adults," Holahan stated in a press release. For doctors, the take-home message is that there's no real normal or average out there when it comes to moderate drinking. Patients who are modest drinkers on paper may actually be drinking in very risky ways.

Source: Holahan CJ, Naimi T, Schutte KK, Brennan PL, Holahan CK, Moos RH. Episodic Heavy Drinking and 20-Year Total Mortality Among Late-Life Moderate Drinkers. Alcoholism: Clinical & Experimental Research. 2014.