Does the severity of hangovers decline with age? Survey of the incidence of hangover in different age groups

BACKGROUND

Alcohol hangover is a growing research area, but differences across the life span have not been assessed. Here, we test the hypothesis that the severity of hangovers depends on age.

METHODS

A cross-sectional study of 51,645 men and women aged 18 to 94 years old, who participated in the population-based Danish Health Examination Study (DANHES) in Denmark between 2007 and 2008, formed the database for our study.

RESULTS

The incidence of severe hangover was lower among older than younger participants. Odds ratios for experiencing severe hangover following an episode of binge drinking were 6.8, 4.8, 3.0, and 2.0 among the 18 to 29, 30 to 39, 40 to 49, and 50 to 59-year-old men, compared with those aged 60+ years. For women, similar results were obtained. This finding could not be explained by the usual amount of alcohol consumption, frequency of binge drinking, or the proportion of alcohol consumed with meals.

CONCLUSIONS

We found that hangover following engagement in binge drinking is much more common in the young than in the older age groups.

Smoking and risk of coronary heart disease in younger, middle-aged, and older adults

OBJECTIVES

We investigated associations of smoking and coronary heart disease (CHD) by age.

METHODS

Data came from the Pooling Project on Diet and Coronary Heart Disease (8 prospective studies, 1974-1996; n = 192,067 women and 74,720 men, aged 40-89 years).

RESULTS

During follow-up, 4326 cases of CHD were reported. Relative to never smokers, CHD risk among current smokers was highest in the youngest and lowest in the oldest participants. For example, among women aged 40 to 49 years the hazard ratio was 8.5 (95% confidence interval [CI] = 5.0, 14) and 3.1 (95% CI = 2.0, 4.9) among those aged 70 years or older. The largest absolute risk differences between current smokers and never smokers were observed among the oldest participants. Finally, the majority of CHD cases among smokers were attributable to smoking. For example, attributable proportions of CHD by age group were 88% (40-49 years), 81% (50-59 years), 71% for (60-69 years), and 68% (≥ 70 years) among women who smoked.

CONCLUSIONS

Among smokers, the majority of CHD cases are attributable to smoking in all age groups. Smoking prevention is important, irrespective of age.

Occupational heavy lifting and risk of ischemic heart disease and all-cause mortality

Background

Occupational heavy lifting is known to impose a high cardiovascular strain, but the risk of ischemic heart disease (IHD) from occupational heavy lifting is unknown. The objective was to investigate the association between occupational heavy lifting and risk of IHD and all-cause mortality, and the influence of occupational and leisure time physical activity on this association.

Methods

Data were analyzed from 1987, 1994, and 2000 from the Danish National Health Interview Surveys providing a sample of 6,692 working men and 5,921 working women aged 16–85 years without cardiovascular disease at baseline. Conventional risk factors for the outcomes IHD and all-cause mortality were controlled for in Cox analyses.

Results

Among men, heavy lifting was associated with increased risk for IHD (hazard ratio (HR): 1.52, 95% Confidence interval (95% CI): 1.15, 2.02), while a decreased risk was associated with occupational (HR: 0.50, 95% CI: 0.37, 0.68) and leisure time (HR: 0.73, 95% CI: 0.56, 0.95) physical activity. Referencing men with high occupational physical activity and no heavy lifting, men with high occupational physical activity and heavy lifting did not have an increased risk (HR: 1.11, 95% CI:0.68, 1.82), while men with low occupational physical activity and heavy lifting had a substantial increased risk (HR: 2.56, 95% CI:1.52, 4.32). No significant associations were found for all-cause mortality or for females.

Conclusion

These findings indicate an excessive risk for IHD from occupational heavy lifting among men, particularly among those with low occupational and leisure time physical activity.

Alcohol dehydrogenase and aldehyde dehydrogenase gene polymorphisms, alcohol intake and the risk of colorectal cancer in the European Prospective Investigation into Cancer and Nutrition study

BACKGROUND/OBJECTIVES

Heavy alcohol drinking is a risk factor of colorectal cancer (CRC), but little is known on the effect of polymorphisms in the alcohol-metabolizing enzymes, alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH) on the alcohol-related risk of CRC in Caucasian populations.

SUBJECTS/METHODS

A nested case-control study (1269 cases matched to 2107 controls by sex, age, study centre and date of blood collection) was conducted within the European Prospective Investigation into Cancer and Nutrition (EPIC) to evaluate the impact of rs1229984 (ADH1B), rs1573496 (ADH7) and rs441 (ALDH2) polymorphisms on CRC risk. Using the wild-type variant of each polymorphism as reference category, CRC risk estimates were calculated using conditional logistic regression, with adjustment for matching factors.

RESULTS

Individuals carrying one copy of the rs1229984(A) (ADH1B) allele (fast metabolizers) showed an average daily alcohol intake of 4.3 g per day lower than subjects with two copies of the rs1229984(G) allele (slow metabolizers) (P(diff)<0.01). None of the polymorphisms was associated with risk of CRC or cancers of the colon or rectum. Heavy alcohol intake was more strongly associated with CRC risk among carriers of the rs1573496(C) allele, with odds ratio equal to 2.13 (95% confidence interval: 1.26-3.59) compared with wild-type subjects with low alcohol consumption (P(interaction)=0.07).

CONCLUSIONS

The rs1229984(A) (ADH1B) allele was associated with a reduction in alcohol consumption. The rs1229984 (ADH1B), rs1573496 (ADH7) and rs441 (ALDH2) polymorphisms were not associated with CRC risk overall in Western-European populations. However, the relationship between alcohol and CRC risk might be modulated by the rs1573496 (ADH7) polymorphism.

Alcohol drinking habits, alcohol dehydrogenase genotypes and risk of acute coronary syndrome

Aims: The risk of myocardial infarction is lower among light-to-moderate drinkers compared with abstainers. Results from some previous studies, but not all, suggest that this association is modified by variations in genes coding for alcohol dehydrogenase (ADH). We aimed to test this hypothesis, including alcohol as both the amount of alcohol and the frequency of drinking. Methods: we conducted a nested case-cohort study within the Danish Diet, Cancer and Health study, including 1,645 men (770 incident cases of acute coronary syndrome from 1993—1997 through 2004 and 875 randomly selected controls). Results: Higher alcohol intake (measured as amount or drinking frequency) was associated with lower risk of acute coronary syndrome; however, there was no evidence that these finding were modified by ADH1B or ADH1C genotypes. Conclusions: The importance of functional variation in alcohol dehydrogenase for the association between alcohol drinking habits and the risk of developing acute coronary syndrome, if any, is very limited.

Alcohol intake and risk of coronary heart disease in younger, middle-aged, and older adults

BACKGROUND

Light to moderate alcohol consumption is associated with a reduced risk of coronary heart disease. This protective effect of alcohol, however, may be confined to middle-aged or older individuals. Coronary heart disease incidence is low in men <40 years of age and in women <50 years of age; for this reason, study cohorts rarely have the power to investigate the effects of alcohol on coronary heart disease risk in younger adults. This study examined whether the beneficial effect of alcohol on coronary heart disease depends on age.

METHODS AND RESULTS

In this pooled analysis of 8 prospective studies from North America and Europe including 192,067 women and 74,919 men free of cardiovascular diseases, diabetes, and cancers at baseline, average daily alcohol intake was assessed at baseline with a food frequency or diet history questionnaire. An inverse association between alcohol and risk of coronary heart disease was observed in all age groups; hazard ratios among moderately drinking men (5.0 to 29.9 g/d) 39 to 50, 50 to 59, and >or=60 years of age were 0.58 (95% confidence interval [CI], 0.36 to 0.93), 0.72 (95% CI, 0.60 to 0.86), and 0.85 (95% CI, 0.75 to 0.97) compared with abstainers. However, the analyses indicated a smaller incidence rate difference between abstainers and moderate consumers in younger adults (incidence rate difference, 45 per 100,000; 90% CI, 8 to 84) than in middle-aged (incidence rate difference, 64 per 100,000; 90% CI, 24 to 102) and older (incidence rate difference, 89 per 100,000; 90% CI, 44 to 140) adults. Similar results were observed in women.

CONCLUSIONS

Alcohol is also associated with a decreased risk of coronary heart disease in younger adults; however, the absolute risk was small compared with middle-aged and older adults.

Alcohol Intake, Myocardial Infarction, Biochemical Risk Factors, and Alcohol Dehydrogenase Genotypes

Background— The risk of myocardial infarction is lower among light-to-moderate alcohol drinkers compared with abstainers. We tested associations between alcohol intake and risk of myocardial infarction and risk factors and whether these associations are modified by variations in alcohol dehydrogenases.

Methods and Results— We used information on 9584 men and women from the Danish general population in the Copenhagen City Heart Study. During follow-up, from 1991 to 2007, 663 incident cases of myocardial infarction occurred. We observed that increasing alcohol intake was associated with decreasing risk of myocardial infarction, decreasing low-density lipoprotein cholesterol and fibrinogen, increasing diastolic and systolic blood pressure and high-density lipoprotein cholesterol, and with U-shaped nonfasting triglycerides. In contrast, ADH1B and ADH1C genotypes were not associated with risk of myocardial infarction or with any of the cardiovascular biochemical risk factors, and there was no indication that associations between alcohol intake and myocardial infarction and between alcohol intake and risk factors were modified by genotypes.

Conclusions— Increasing alcohol intake is associated with decreasing risk of myocardial infarction, decreasing low-density lipoprotein cholesterol and fibrinogen, increasing diastolic and systolic blood pressure and high-density lipoprotein cholesterol, and U-shaped nonfasting triglycerides. These associations were not modified by ADH1B and ADH1C are genotypes.

Influence of smoking and alcohol consumption on admissions and duration of hospitalization

BACKGROUND

Previous studies have linked smoking and alcohol consumption to a considerable disease burden and large healthcare expenditures. However, findings from studies based on individual level data are sparse and inconclusive. Our objective was to assess the association between alcohol consumption, smoking and patterns of hospitalization, defined as admission and duration of hospitalization.

METHODS

The study was based on 12 698 men and women, aged 20 years or more, enrolled in the Copenhagen City Heart Study. We related smoking and alcohol to hospital admission from any cause, smoking- and alcohol-related diseases and duration of hospitalization in a two-part random effects model.

RESULTS

Smoking status was strongly associated with admission and duration of hospitalization. For smoking-related admissions, odds ratios (OR) of 2.77 (95% CI 2.13-3.59) in men and 6.30 (95% CI 4.80-8.26) in women were observed among smokers of >20 g/day compared to never-smokers. For any admission (excl. smoking-related causes), corresponding ORs were 1.32 (95% CI 1.15-1.51) and 1.80 (95% CI 1.58-2.06), respectively. In men, a U-shaped association between alcohol consumption and risk of admission was found, both regarding any admission and admissions due to alcohol-related diseases. Alcohol was associated with alcohol-related admissions in women but not with duration of hospitalization.

CONCLUSIONS

Smoking was associated with increased risk of hospital admission and duration of hospitalization. A U-shaped relation was observed for alcohol consumption and risk of hospitalization in men, but no effect on duration was observed. In women, however, alcohol consumption was only vaguely associated with admission and duration of hospitalization.

Alcohol intake, alcohol dehydrogenase genotypes, and liver damage and disease in the Danish general population

OBJECTIVES

We tested the hypothesis that alcohol, alone and in combination with alcohol dehydrogenase (ADH) 1B and ADH1C genotypes, affects liver damage and disease in the general population.

METHODS

Information on alcohol intake and on liver disease was obtained from 9,080 men and women from the Copenhagen City Heart Study. Biochemical tests for the detection of liver damage were specific for alanine aminotransferase (ALT), aspartate aminotransferase (AST)-to-ALT ratio (AST/ALT), gamma-glutamyl transpeptidase (gamma-GT), albumin, bilirubin, alkaline phosphatase, coagulation factors, and erythrocyte volume.

RESULTS

Increasing alcohol intake was associated with increasing erythrocyte volume, AST/ALT, and levels of ALT, gamma-GT, albumin, bilirubin, coagulation factors, and with decreasing levels of alkaline phosphatase. Multifactorially adjusted hazard ratios for alcoholic liver disease overall were 0.9 (95% confidence interval (CI), 0.6-1.4), 1.4 (0.8-2.5), 1.8 (0.9-3.5), and 4.1 (2.5-7.0) for an alcohol intake of 1-13, 14-20, 21-27, and > or = 28 drinks per week, respectively, compared with drinking <1 drink per week (P for trend<0.0001); the corresponding hazard ratios for alcoholic liver cirrhosis were 1.7 (0.6-4.7), 2.0 (0.8-7.1), 6.5 (2.0-21), and 13 (4.6-37) (P for trend<0.0001). ADH1B and ADH1C genotypes were not associated with and did not modify the effect of alcohol on biochemical tests or risk of liver disease.

CONCLUSIONS

Increasing alcohol intake from none to low (1-6 drinks per week) through to moderate (7-20 drinks per week) and excessive intake (> or = 21 drinks per week) leads to stepwise increases in signs of liver damage with no threshold effect, and to an increased risk of liver disease. The minor changes in biochemical tests for low alcohol intake may not account for subclinical liver disease.

[The occurrence of hangovers among Danish men and women]

We have examined the occurrence of hangovers i Danish men and women. Among 36,228 participants, the occurrence of a list of different hangover symptoms as well as of severe hangovers was higher in women than in men. For example, the odds ratio was 1.53 (95% CI: 1.41-1.66) for experiencing headache and 1.97 (95% CI: 1.75-2.21) for severe hangovers after an episode of binge-drinking in women compared with men. This finding could not be explained by weekly alcohol intake, type of alcohol ingested, frequency of binge drinking episodes or by the proportion of alcohol consumed with meals.

[Genetic variations in alcohol dehydrogenase, drinking habits and alcoholism]

Alcohol is degraded primarily by alcohol dehydrogenase (ADH), and genetic variation that affects the rate of alcohol degradation is found in ADH1B and ADH1C. By genotyping 9,080 white men and women from the general population, we found that men and women with ADH1B slow versus fast alcohol degradation drank approximately 30% more alcohol per week and had a higher risk of everyday and heavy drinking, and of alcoholism. Individuals with ADH1C slow versus fast alcohol degradation had a higher risk of heavy drinking.

Alcohol drinking frequency in relation to subsequent changes in waist circumference

BACKGROUND

Cross-sectional studies have reported a lower prevalence of abdominal obese persons among frequent drinkers than among nonfrequent drinkers.

OBJECTIVE

We tested the hypothesis that drinking frequency is associated with subsequent changes in waist circumference.

DESIGN

Data come from a prospective cohort study conducted in 1993-1997 (baseline) and 1999-2002 (follow-up) and included 43 543 men and women. Baseline information on alcohol drinking frequency was related to 1) change in waist circumference by linear regression and 2) major gain and major loss in waist circumference (defined as waist change in the lowest or highest quintile of waist changes) by polytomous logistic regression, also taking into account amount of alcohol intake.

RESULTS

Drinking frequency was inversely associated with changes in waist circumference in women and was unassociated with changes in waist circumference in men. Drinking frequency was unassociated with major waist loss but was inversely associated with major waist gain: odds ratios among men were 0.97 (95% CI: 0.73, 1.28), 0.95 (95% CI: 0.81, 1.12), 0.88 (95% CI: 0.77, 0.99), 0.82 (95% CI: 0.71, -0.95), and 0.79 (95% CI: 0.69, 0.9) for never drinking, drinking on 1, 2-4, 5-6, and 7 d/wk, respectively, compared with men who drank alcohol on <1 d/wk (P for trend < 0.0001). Results for women were similar. Adjustment for the amount of alcohol intake or total energy intake did not affect results considerably.

CONCLUSIONS

Drinking pattern may be associated with development of abdominal obesity; in this prospective study, drinking frequency was inversely associated with major waist gain and was unassociated with major waist loss.

Alcohol consumption and the risk of self-reported perennial and seasonal allergic rhinitis in young adult women in a population-based cohort study

BACKGROUND

Alcohol consumption has been suggested to be associated with the development of allergic rhinitis (AR), but there is limited data on the topic.

OBJECTIVES

The objective of this study was to investigate the association between alcohol consumption and the risk of developing AR among young women.

METHODS

Five thousand eight hundred and seventy Danish women aged 20-29 years participated in a prospective cohort study, and were free of seasonal and perennial AR at baseline (1991-1993). Alcohol consumption was assessed by a food frequency questionnaire. The main outcome measures were self-reported information on seasonal and perennial AR debuting during a mean follow-up period of 7.8 years.

RESULTS

During follow-up, 831 women developed seasonal AR and 523 women developed perennial AR, corresponding to 14% and 9%. Alcohol consumption was positively associated with the risk of developing perennial AR. The adjusted odds ratio (OR) for perennial AR was 1.78 (95% CI, 1.13-2.80) among women drinking more than 14 drinks/week compared with women drinking <1 drink/week. There was no association between alcohol consumption and seasonal AR. Having one or two parents with asthma was, after adjustment, significantly associated with the risk of developing seasonal (OR, 2.01; 95% CI, 1.65-2.45) and perennial AR (OR, 2.28; 95% CI, 1.70-2.74). Smoking was not associated with an increased risk of developing AR.

CONCLUSION

In this population of young adult women, alcohol consumption was associated with an increased risk of developing perennial AR.

[A prospective study of drinking habits and coronary heart disease in middle-aged Danish men and women - secondary publication]

Individuals with a moderate alcohol intake are at lower risk of heart disease than abstainers. In this study, we examined whether the frequency of alcohol intake plays a role in this association. Among men, we observed a low risk of coronary heart disease among frequent drinkers that was independent of the total weekly intake. Among women, we observed a low risk of coronary heart disease that was independent of the drinking frequency. These sex differences in the association of alcohol with coronary heart disease deserve more research.

Alcohol consumption and risk of atrial fibrillation in men and women: the Copenhagen City Heart Study

BACKGROUND

The relationship of the full range of alcohol consumption with risk of incident atrial fibrillation has been inconsistent in previous, mainly case-control studies.

METHODS AND RESULTS

In a prospective cohort study, we studied the association between self-reported alcohol use and incident atrial fibrillation among 16,415 women and men enrolled in the Copenhagen City Heart Study. We ascertained use of beer, wine, and spirits individually at up to 3 study visits with a structured questionnaire. We identified cases of atrial fibrillation by routine study ECGs and a validated nationwide registry of all hospitalizations. A total of 1071 cases occurred during follow-up. Among both women and men, alcohol consumption throughout the moderate range was not associated with risk of atrial fibrillation. However, consumption of 35 or more drinks per week among men was associated with a hazard ratio of 1.45 (95% CI 1.02 to 2.04); few women consumed this amount of alcohol. Approximately 5% of cases of atrial fibrillation among men were attributable to heavy alcohol use. Further adjustment for blood pressure and incident coronary heart disease and congestive heart failure did not attenuate the association (hazard ratio 1.63; 95% CI 1.15 to 2.31).

CONCLUSIONS

Heavy alcohol consumption is associated with a higher risk of atrial fibrillation, at least among men. This relationship does not appear to be related to the adverse effects of heavy drinking on coronary heart disease or blood pressure.

The relation between drinking pattern and body mass index and waist and hip circumference

OBJECTIVES

To study the association between alcohol drinking pattern and obesity.

DESIGN

Cross-sectional population study with assessment of quantity and frequency of alcohol intake, waist and hip circumference, height, weight, and lifestyle factors including diet.

SUBJECTS

In all, 25 325 men and 24 552 women aged 50-65 y from the Diet, Cancer and Health Study, Denmark, 1993-1997 participated in the study.

MEASUREMENTS

Drinking frequency, total alcohol intake, body mass index (BMI), and waist and hip circumference.

RESULTS

Among men, total alcohol intake was positively associated with high BMI (>/=30 kg/m(2)), large waist circumference (>/=102 cm) and inversely associated with small hip circumference (<100 cm). Among women, the total alcohol was associated with high BMI, large waist (>/=88 cm), and small hips only for the highest intake (28+ drinks/week). The most frequent drinkers had the lowest odds ratios (OR) for being obese. Among men, OR for having a high BMI were 1.39 (95% confidence interval: 1.36-1.64), 1.17 (1.02-1.34), 1.00 (reference), 0.87 (0.77-0.98), and 0.73 (0.65-0.82) for drinking 1-3 days/month, 1 day/week, 2-4 days/week, 5-6 days/week, and 7 days/week, respectively. Similar estimates were found for waist circumference. Corresponding results were found for women.

CONCLUSION

For a given level of total alcohol intake, obesity was inversely associated with drinking frequency, whereas the amount of alcohol intake was positively associated with obesity. These results indicate that frequent drinking of small amounts of alcohol is the optimal drinking pattern in this relation.

Does caffeine and alcohol intake before pregnancy predict the occurrence of spontaneous abortion?

BACKGROUND

Consumption of caffeine and alcohol is suspected to affect pregnancy outcome. Use of both stimulants is widespread and even minor effects on fetal viability are of public health interest.

METHODS

We performed a nested case-control study using prospective data from a population-based cohort comprising 11088 women aged 20-29 years. From this cohort, women who experienced either a spontaneous abortion (n = 303) or who gave birth (n = 1381) during follow-up [mean time: 2.1 years (range: 1.6-3.4)] were selected. Associations between self-reported exposures to caffeine and/or alcohol at enrolment and spontaneous abortion were analysed by means of logistic regression.

RESULTS

Compared with women with a pre-pregnancy intake of <75 mg caffeine per day, the adjusted odds ratio (95% confidence interval) for spontaneous abortion was 1.26 (0.77-2.06), 1.45 (0.87-2.41), 1.44 (0.87-2.37) and 1.72 (1.00-2.96) for a pre-pregnancy intake on 75-300, 301-500, 501-900 and >900 mg caffeine per day respectively (P = 0.05 for trend). A pre-pregnancy intake of alcohol was not a predictor for spontaneous abortion.

CONCLUSIONS

A high intake of caffeine prior to pregnancy seems to be associated with an increased risk of spontaneous abortion, whereas a low-to-moderate alcohol intake does not influence the risk.

Drinking pattern and mortality in middle-aged men and women

AIMS

To address the prospective association between alcohol drinking pattern and all-cause mortality.

DESIGN

Population-based cohort study conducted between 1993 and 2003.

SETTING

Denmark.

PARTICIPANTS

A total of 26 909 men and 29 626 women aged 55-65 years.

MEASUREMENTS

We obtained risk estimates for all-cause mortality for different levels of quantity and frequency of alcohol intake adjusted for life-style factors, including diet.

FINDINGS

During follow-up, 1528 men and 915 women died. For the same average consumption of alcohol, a non-frequent intake implied a higher risk of death than a frequent one.

CONCLUSIONS

Drinking pattern and not just the total amount of alcohol consumed is important for the association between alcohol intake and mortality. These results suggest that future public guidelines concerning sensible alcohol drinking should include messages about drinking pattern together with quantity of alcohol.

A prospective study of the association between smoking and later alcohol drinking in the general population

AIMS

To address the possible prospective association between smoking habits and risk of later heavy drinking in the adult population.

DESIGN

Pooled population-based long-term cohort studies with repeated assessments of smoking and alcohol habits.

SETTING

Copenhagen, Denmark.

PARTICIPANTS

A total of 14,130 non- to moderate drinkers at baseline, who attended re-examination.

MEASUREMENTS

Among the non- to moderate drinkers we addressed the relation between smoking habits at first examination and the risk of becoming a heavy and excessive drinker at follow-up.

FINDINGS

Level of tobacco consumption at first examination predicted an increased risk of becoming a heavy and excessive drinker in a dose-dependent manner. Men who smoked more than 25 g of tobacco per day had adjusted odds ratios of 2.12 (95% confidence interval (CI): 1.44-3.11) and 3.95 (95% CI: 1.93-8.95) for becoming heavy and excessive drinkers, compared to participants who had never smoked. Equivalent estimates among women were 1.76 (95% CI: 1.02-3.04) and 2.21 (95% CI: 1.00-4.58), respectively.

CONCLUSIONS

This study suggests that tobacco use is associated quantitatively with later risk of heavier drinking.