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While observational studies have suggested a possible protective effect of moderate drinking, particularly within Mediterranean patterns, concerns about confounding and selection bias persist. No randomized trial to date has definitively addressed whether alcohol cessation offers superior health benefits compared to sustained moderate drinking. In response to this evidence gap, the European Research Council has funded the University of Navarra Alumni Trialist Initiative (UNATI), a large, pragmatic, randomized controlled trial designed to assess the long-term effects of two behavioral interventions: complete alcohol cessation versus moderated consumption following a Mediterranean pattern. UNATI will enroll over 10,000 adults in Spain (men aged 50\u201370 and women aged 55\u201375) who currently consume alcohol regularly. Participants will be randomly assigned to one of the two interventions for four years, with annual clinical evaluations and lifestyle assessments. 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