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Britton A, Bell S. The protective effects of moderate drinking: lies, damned lies, and… selection biases? Addiction 2017; 112:218-219. [PMID: 27671900 DOI: 10.1111/add.13585] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 08/02/2016] [Accepted: 08/05/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Annie Britton
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Steven Bell
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
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Bell S, Mehta G, Moore K, Britton A. Ten-year alcohol consumption typologies and trajectories of C-reactive protein, interleukin-6 and interleukin-1 receptor antagonist over the following 12 years: a prospective cohort study. J Intern Med 2017; 281:75-85. [PMID: 27485145 PMCID: PMC5173424 DOI: 10.1111/joim.12544] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Moderate alcohol consumption is thought to confer cardiometabolic protective effects. Inflammatory pathways are hypothesized to partly underlie this association. OBJECTIVES The aim of this study was to examine the association between typologies of alcohol consumption and markers of inflammation, and their rate of change over time. METHODS Data were collected from 8209 participants [69% men; mean age, 50 years (SD 6.1)] of the British Whitehall II study. Alcohol consumption typologies were defined using up to three measures during an approximately 10-year period spanning from 1985 to 1994 as (i) stable nondrinkers, (ii) stable moderate drinkers (referent), (iii) stable heavy drinkers, (iv) nonstable drinkers and (v) former drinkers. C-reactive protein (CRP), interleukin (IL)-6 and IL-1 receptor antagonist (IL-1 RA) were measured up to three times in the following 12 years. RESULTS Stable moderate drinkers had lower levels of CRP than stable nondrinkers, stable heavy drinkers, former drinkers and nonstable drinkers, but there were no differences in the rate of change in CRP over time between groups. Stable nondrinkers had higher levels of IL-6 as did stable heavy drinkers; rates of change in IL-6 over time were also increased in the latter group. Stable nondrinkers also had higher levels of IL-1 RA. These associations were robust to adjustment for confounding factors. CONCLUSION Our novel investigation of 10-year drinking typologies shows that stable moderate alcohol consumption is associated with a long-term inflammatory marker profile that is consistent with conferring a reduced risk of developing coronary heart disease.
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Affiliation(s)
- S Bell
- Research Department of Epidemiology and Public Health, University College London, London, UK
| | - G Mehta
- UCL Institute of Liver and Digestive Health, Royal Free Campus, University College London, London, UK
| | - K Moore
- UCL Institute of Liver and Digestive Health, Royal Free Campus, University College London, London, UK
| | - A Britton
- Research Department of Epidemiology and Public Health, University College London, London, UK
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53
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Stockwell T, Zhao J, Panwar S, Roemer A, Naimi T, Chikritzhs T. Do "Moderate" Drinkers Have Reduced Mortality Risk? A Systematic Review and Meta-Analysis of Alcohol Consumption and All-Cause Mortality. J Stud Alcohol Drugs 2016; 77:185-98. [PMID: 26997174 DOI: 10.15288/jsad.2016.77.185] [Citation(s) in RCA: 341] [Impact Index Per Article: 42.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
OBJECTIVE Previous meta-analyses of cohort studies indicate a J-shaped relationship between alcohol consumption and allcause mortality, with reduced risk for low-volume drinkers. However, low-volume drinkers may appear healthy only because the "abstainers" with whom they are compared are biased toward ill health. The purpose of this study was to determine whether misclassifying former and occasional drinkers as abstainers and other potentially confounding study characteristics underlie observed positive health outcomes for lowvolume drinkers in prospective studies of all-cause mortality. METHOD A systematic review and meta-regression analysis of studies investigating alcohol use and mortality risk after controlling for quality-related study characteristics was conducted in a population of 3,998,626 individuals, among whom 367,103 deaths were recorded. RESULTS Without adjustment, meta-analysis of all 87 included studies replicated the classic J-shaped curve, with low-volume drinkers (1.3-24.9 g ethanol per day) having reduced mortality risk (RR = 0.86, 95% CI [0.83, 0.90]). Occasional drinkers (<1.3 g per day) had similar mortality risk (RR = 0.84, 95% CI [0.79, 0.89]), and former drinkers had elevated risk (RR = 1.22, 95% CI [1.14, 1.31]). After adjustment for abstainer biases and quality-related study characteristics, no significant reduction in mortality risk was observed for low-volume drinkers (RR = 0.97, 95% CI [0.88, 1.07]). Analyses of higher-quality bias-free studies also failed to find reduced mortality risk for low-volume alcohol drinkers. Risk estimates for occasional drinkers were similar to those for low- and medium-volume drinkers. CONCLUSIONS Estimates of mortality risk from alcohol are significantly altered by study design and characteristics. Meta-analyses adjusting for these factors find that low-volume alcohol consumption has no net mortality benefit compared with lifetime abstention or occasional drinking. These findings have implications for public policy, the formulation of low-risk drinking guidelines, and future research on alcohol and health.
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Affiliation(s)
- Tim Stockwell
- Centre for Addictions Research of BC, University of Victoria, Victoria, British Columbia, Canada.,National Drug Research Institute, Curtin University, Perth, WA 6845, Australia
| | - Jinhui Zhao
- Centre for Addictions Research of BC, University of Victoria, Victoria, British Columbia, Canada
| | - Sapna Panwar
- Institute for Scientific Analysis, San Francisco, California
| | - Audra Roemer
- Centre for Addictions Research of BC, University of Victoria, Victoria, British Columbia, Canada
| | - Timothy Naimi
- Boston University Schools of Medicine and Public Health, Boston, Massachusetts
| | - Tanya Chikritzhs
- Institute for Scientific Analysis, San Francisco, California.,National Drug Research Institute, Curtin University, Perth, WA 6845, Australia
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Abstract
In developed countries, the traditional gender gap in youth smoking and drinking is closing. As tobacco and alcohol are more harmful to women than to men, this is an alarming trend. As men are generally more short-term oriented in their sexuality than women, and given that cigarette and alcohol use are still considered masculine behaviors, we explored if female smoking and drinking can function as a short-term mating strategy. By means of a between-subjects experiment ( N = 218), men’s perceptions of female smoking and drinking were studied. The experiment showed that young men perceive women who use cigarettes and alcohol as being more sexually unrestricted. Furthermore, tobacco and (especially) alcohol use brought some short-term attractiveness benefits to women. In short-term mating contexts, drinking enhanced women’s attractiveness, whereas occasional smoking was found equally desirable as not smoking. However, in long-term mating contexts, frequent drinking and all smoking behavior harmed women’s desirability. A follow-up study ( N = 202) confirmed men’s perceptions, showing that female users of tobacco and alcohol are indeed more short-term oriented in their sexuality. Overall, results indicate that female smoking and drinking can operate as a short-term mating strategy.
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Affiliation(s)
- Eveline Vincke
- Department of Communication Sciences, Ghent University, Gent, Belgium
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55
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Licaj I, Sandin S, Skeie G, Adami HO, Roswall N, Weiderpass E. Alcohol consumption over time and mortality in the Swedish Women's Lifestyle and Health cohort. BMJ Open 2016; 6:e012862. [PMID: 27807087 PMCID: PMC5129127 DOI: 10.1136/bmjopen-2016-012862] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Alcohol consumption is steadily increasing in high-income countries but the harm and possible net benefits of light-to-moderate drinking remain controversial. We prospectively investigated the association between time-varying alcohol consumption and overall and cause-specific mortality among middle-aged women. METHODS Among 48 249 women at baseline (33 404 at follow-up) in the prospective Swedish Women's Lifestyle and Health cohort, age 30-49 years at baseline, we used repeated information on alcohol consumption and combined this method with multiple imputation in order to maximise the number of participants and deaths included in the analyses. Multivariable Cox regression models were used to calculate HRs for overall and cause-specific mortality. RESULTS During >900 000 person/years, a total of 2100 deaths were recorded through Swedish registries. The median alcohol consumption increased from 2.3 g/day in 1991/1992 (baseline) to 4.7 g/day in 2004 (follow-up). Compared with light drinkers (0.1-1.5 g/day), a null association was observed for all categories of alcohol consumption with the exception of never drinkers. The HR comparing never with light drinkers was 1.46 (95% CI 1.22 to 1.74). There was a statistically significant negative trend between increasing alcohol consumption and cardiovascular and ischaemic heart diseases mortality. The results were similar when women with prevalent conditions were excluded. CONCLUSIONS In conclusion, in a cohort of young women, light alcohol consumption was protective for cardiovascular and ischaemic heart disease mortality but not for cancer and overall mortality.
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Affiliation(s)
- Idlir Licaj
- Department of Community Medicine, Faculty of Health Sciences, UiT—The Arctic University of Norway, Tromsø, Norway
| | - Sven Sandin
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Guri Skeie
- Department of Community Medicine, Faculty of Health Sciences, UiT—The Arctic University of Norway, Tromsø, Norway
| | - Hans-Olov Adami
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA
| | - Nina Roswall
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Elisabete Weiderpass
- Department of Community Medicine, Faculty of Health Sciences, UiT—The Arctic University of Norway, Tromsø, Norway
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Research, Cancer Registry of Norway, Institute of Population-based Cancer Research, Oslo, Norway
- Genetic Epidemiology Group, Folkhälsan Research Centre, Samfundet Folkhälsan, Helsinki, Finland
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56
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Oksanen A, Kokkonen H. Consumption of Wine with Meals and Subjective Well-being: A Finnish Population-Based Study. Alcohol Alcohol 2016; 51:716-722. [PMID: 27015691 DOI: 10.1093/alcalc/agw016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Accepted: 03/05/2016] [Indexed: 01/01/2023] Open
Abstract
AIMS To examine in the general population the association of regular consumption of wine with meals, subjective well-being and risky drinking. METHODS A random sample of Finnish people aged 18-69 ('Finnish Drinking Habits Survey 2008', n = 2591, response rate 74%) were interviewed regarding psychological distress, self-efficacy, self-perceived health, uncontrolled drinking, negative events during drinking, hazardous drinking and consumption of alcohol. The analysis focused on comparison of those who drank wine at least once a week versus more seldom. Regression models adjusted for social determinants, smoking and chronic illness. RESULTS Twelve percent of Finnish adults drank wine with meals at least once a week. Drinking wine with meals was an urban phenomenon and associated with higher socioeconomic status. Regular wine with meal drinkers reported better health, higher self-efficacy and less psychological distress than others even when various confounders were adjusted for. They also reported more risky drinking and higher yearly consumption than other alcohol consumers. Especially those who drank both wine and beer during meals had higher rates of risky drinking. Those restricting themselves to only wine with meals reported less hazardous drinking than the general population. CONCLUSION Consumption of wine with meals was associated with high socioeconomic status and high subjective well-being. Risky drinking was prevalent among wine with meal drinkers, but only among those who drank both wine and beer with meals. Potential unknown confounders may exist, but the results underline a link between subjective well-being and drinking wine with meals.
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Affiliation(s)
- Atte Oksanen
- School of Social Sciences and Humanities, University of Tampere, Tampere, Finland
| | - Hanna Kokkonen
- Home Economics, Department of Teacher Education, University of Helsinki, Helsinki, Finland
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Genome-Wide Interaction Analyses between Genetic Variants and Alcohol Consumption and Smoking for Risk of Colorectal Cancer. PLoS Genet 2016; 12:e1006296. [PMID: 27723779 PMCID: PMC5065124 DOI: 10.1371/journal.pgen.1006296] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Accepted: 08/11/2016] [Indexed: 02/06/2023] Open
Abstract
Genome-wide association studies (GWAS) have identified many genetic susceptibility loci for colorectal cancer (CRC). However, variants in these loci explain only a small proportion of familial aggregation, and there are likely additional variants that are associated with CRC susceptibility. Genome-wide studies of gene-environment interactions may identify variants that are not detected in GWAS of marginal gene effects. To study this, we conducted a genome-wide analysis for interaction between genetic variants and alcohol consumption and cigarette smoking using data from the Colon Cancer Family Registry (CCFR) and the Genetics and Epidemiology of Colorectal Cancer Consortium (GECCO). Interactions were tested using logistic regression. We identified interaction between CRC risk and alcohol consumption and variants in the 9q22.32/HIATL1 (Pinteraction = 1.76×10−8; permuted p-value 3.51x10-8) region. Compared to non-/occasional drinking light to moderate alcohol consumption was associated with a lower risk of colorectal cancer among individuals with rs9409565 CT genotype (OR, 0.82 [95% CI, 0.74–0.91]; P = 2.1×10−4) and TT genotypes (OR,0.62 [95% CI, 0.51–0.75]; P = 1.3×10−6) but not associated among those with the CC genotype (p = 0.059). No genome-wide statistically significant interactions were observed for smoking. If replicated our suggestive finding of a genome-wide significant interaction between genetic variants and alcohol consumption might contribute to understanding colorectal cancer etiology and identifying subpopulations with differential susceptibility to the effect of alcohol on CRC risk. Alcohol consumption and smoking are associated with CRC risk. We performed a genome-wide analysis for interaction between genetic variants and alcohol consumption and cigarette smoking to identify potential new genetic regions associated with CRC. About 8,000 CRC cases and 8,800 controls were included in alcohol-related analysis and over 11,000 cases and 11,000 controls were involved in smoking-related analysis. We identified interaction between variants at 9q22.32/HIATL1 and alcohol consumption in relation to CRC risk (Pinteraction = 1.76×10−8). If replicated our suggested finding of the interaction between genetic variants and alcohol consumption might contribute to understanding colorectal cancer etiology and identifying subpopulations with differential susceptible to the effect of alcohol on CRC risk.
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Østby KA, Czajkowski N, Knudsen GP, Ystrøm E, Gjerde LC, Kendler KS, Ørstavik RE, Reichborn-Kjennerud T. Does low alcohol use increase the risk of sickness absence? A discordant twin study. BMC Public Health 2016; 16:825. [PMID: 27538396 PMCID: PMC4990980 DOI: 10.1186/s12889-016-3502-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Accepted: 08/12/2016] [Indexed: 11/29/2022] Open
Abstract
Background Results from observational studies suggest that people who drink little or no alcohol are less healthy than medium drinkers. This has been demonstrated for many different measures of health, including sick leave. However, whether these associations are causal or due to confounding remains to be clarified. The aim of this study was to use a discordant twin design to determine whether the increased level of sick leave associated with a low level of alcohol consumption, as compared to those with a medium level of consumption, reflects a causal mechanism or is due to genetic or environmental confounding. Methods Six thousand seven hundred thirty-four young adult twins from the Norwegian Institute of Public Health’s twin panel were in 1998 assessed for frequency of alcohol use and binge drinking. Data were linked to the Norwegian National Insurance Administration’s recordings of sick leave over a 10 year period. The associations between alcohol consumption and sick leave were first estimated in the total study population, and then within di- and monozygotic twin pairs discordant for alcohol use. Results Compared to medium consumption, both low and high alcohol consumption was associated with increased risk of sick leave. When low level drinkers were compared to medium level drinkers in a discordant twin design, the results were consistent with the association being due to genetic confounding rather than a causal effect. Conclusions The increased level of sick leave observed with low level drinkers seems to be mainly explained by confounding from genetic factors. In all observational studies of the relationship between alcohol consumption and health, one should be aware that important genetic confounders are likely to influence the results.
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Affiliation(s)
| | - Nikolai Czajkowski
- Department of Mental Health, Norwegian Institute of Public Health, Oslo, Norway.,Department of Psychology, University of Oslo, Oslo, Norway
| | - Gun Peggy Knudsen
- Department of Mental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Eivind Ystrøm
- Department of Mental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Line C Gjerde
- Department of Mental Health, Norwegian Institute of Public Health, Oslo, Norway.,Department of Psychology, University of Oslo, Oslo, Norway
| | - Kenneth S Kendler
- Virginia Institute for Psychiatric and Behavioral Genetics and Departments of Psychiatry and Human Genetics and Medical College of Virginia ⁄ Virginia Commonwealth University, Richmond, VA, USA
| | - Ragnhild E Ørstavik
- Department of Mental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Ted Reichborn-Kjennerud
- Department of Mental Health, Norwegian Institute of Public Health, Oslo, Norway.,Department of Psychology, University of Oslo, Oslo, Norway.,Department of Epidemiology, Columbia University, New York, NY, USA
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Evans-Polce RJ, Staff J, Maggs JL. Alcohol abstention in early adulthood and premature mortality: Do early life factors, social support, and health explain this association? Soc Sci Med 2016; 163:71-9. [PMID: 27404910 PMCID: PMC4970918 DOI: 10.1016/j.socscimed.2016.06.052] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Revised: 06/22/2016] [Accepted: 06/28/2016] [Indexed: 01/29/2023]
Abstract
OBJECTIVE Adult alcohol abstainers have a heightened risk of premature mortality compared to light-to-moderate drinkers. We examine three plausible explanations, other than lack of alcohol, for this observed difference: Abstainers 1) have early life disadvantages that undermine long-term health; 2) lack social support; 3) are less healthy. METHOD In the National Child Development Study, an ongoing national British cohort study of individuals born in 1958, we investigated whether early life disadvantages, lack of social support, and poor physical health reduce or eliminate the elevated risk of mortality through age 51 among those abstaining from alcohol at age 33. Using Cox proportional hazard models in a stepwise approach we examined whether the alcohol-mortality relationship changed when potential confounders were included. RESULTS The risk of mortality by age 51 was greater among age-33 abstainers compared to light drinkers (Hazard Ratio [HR] = 2.18; 95% CI = 1.40, 3.40). Including early life disadvantages and social support in the hazard models did not alter these associations (HR = 2.12; 95% CI = 1.27, 3.54). Including physical health in the model resulted in a 25% reduction in risk of death among abstainers, though the difference in risk remained statistically significant (HR = 1.75; 95% CI = 1.04, 2.94). CONCLUSIONS Abstaining from alcohol in early adulthood, in comparison to light drinking, predicts increased risk for premature mortality, even after accounting for numerous early and young adult confounders. Future research should examine potential moderators of this association.
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Affiliation(s)
- Rebecca J Evans-Polce
- The Methodology Center and Prevention Research Center, Pennsylvania State University, University Park, PA, USA.
| | - Jeremy Staff
- Department of Sociology and Criminology, Pennsylvania State University, University Park, PA, USA
| | - Jennifer L Maggs
- Department of Human Development and Family Studies and Prevention Research Center, Pennsylvania State University, University Park, PA, USA
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Is alcohol consumption related to likelihood of reporting chronic widespread pain in people with stable consumption? Results from UK biobank. Pain 2016; 157:2552-2560. [DOI: 10.1097/j.pain.0000000000000675] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Ng Fat L, Cable N, Shelton N. Worsening of health and a cessation or reduction in alcohol consumption to special occasion drinking across three decades of the life course. Alcohol Clin Exp Res 2016; 39:166-74. [PMID: 25623415 PMCID: PMC4329335 DOI: 10.1111/acer.12596] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Accepted: 10/04/2014] [Indexed: 11/29/2022]
Abstract
Background Ex-drinkers suffer from worse health than drinkers; however, whether a worsening of health is associated with a change in drinking status from early adulthood has not been previously investigated. We assess whether a worsening of health is associated with a cessation in consumption or reduction to special occasion drinking from early adulthood to middle age. Methods Multinomial logistic regression assessing whether a change in self-reported limiting longstanding illness (LLI) was associated with ceasing alcohol consumption, or a reduction to special occasion drinking compared with being a persistent drinker from age 23 in separate models at ages 33, 42, and 50. All models adjusted for sex, poor psychosocial health, education, marital status, and children in the household. Sample included participants from Great Britain followed longitudinally in the National Child Development Study from ages 23 to 33 (N = 5,529), 42 (N = 4,787), and 50 (N = 4,476). Results Developing an LLI from the previous wave was associated with ceasing alcohol consumption at ages 33 (odds ratio [ORs] = 2.71, 95% confidence interval [CI] = 1.16–4.93), 42 (OR = 2.44, 95%CI = 1.24–4.81), and 50 (OR = 3.33, 95%CI = 1.56–7.12) and a reduction to special occasion drinking at ages 42 (OR = 2.04, 95%CI = 1.40–2.99) and 50 (OR = 2.04, 95%CI = 1.18–3.53). Having a persistent LLI across 2 waves increased the odds of ceasing consumption at ages 42 (OR = 3.22, 95%CI = 1.06–9.77) and 50 (OR = 4.03, 95%CI = 1.72–9.44) and reducing consumption to special occasion drinking at ages 33 (OR = 3.27, 95%CI = 1.34–8.01) and 42 (OR = 2.25, 95%CI = 1.23–4.50). Persistent drinkers at older ages had the best overall health suffering less from previous poor health compared with those who reduced or ceased consumption at an earlier time point. Conclusions Developing an LLI was associated with a cessation in alcohol consumption and a reduction in consumption to special occasion drinking from early adulthood. Persistent drinkers who drank at least till 50 were the healthiest overall. Health selection is likely to influence nondrinking across the life course.
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Affiliation(s)
- Linda Ng Fat
- Department of Epidemiology and Public Health, UCL, London, United Kingdom
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62
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Osaki A, Okazaki Y, Kimoto A, Izu H, Kato N. Beneficial effect of a low dose of ethanol on liver function and serum urate in rats fed a high-fat diet. J Nutr Sci Vitaminol (Tokyo) 2016; 60:408-12. [PMID: 25866304 DOI: 10.3177/jnsv.60.408] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
This study investigated the effects of the consumption of 1% or 2% (v/v) ethanol in drinking water for 12 wk on rats fed a high-fat diet. Body weight gain, food intake, and fluid intake were unaffected by ethanol intake. Adipose tissue weight, and serum glucose and lipids were unaffected. Compared to the control (no ethanol), 1% ethanol intake significantly reduced serum levels of alanine aminotransferase (ALT), lactate dehydrogenase (LDH), and ammonia (p<0.05), whereas 2% ethanol intake did so to a lesser extent. Serum urate was significantly lower in both the 1% and 2% ethanol groups than that in the control group (p<0.05). The results suggest a low dose of ethanol has beneficial effects on liver function and serum urate in rats fed a high-fat diet.
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Affiliation(s)
- Aimi Osaki
- Graduate School of Biosphere Science, Hiroshima University
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63
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Hu Y, Pikhart H, Kubinova R, Malyutina S, Pajak A, Besala A, Bell S, Peasey A, Marmot M, Bobak M. Alcohol Consumption and Longitudinal Trajectories of Physical Functioning in Central and Eastern Europe: A 10-Year Follow-up of HAPIEE Study. J Gerontol A Biol Sci Med Sci 2016; 71:1063-8. [PMID: 26748094 PMCID: PMC4945885 DOI: 10.1093/gerona/glv233] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Accepted: 12/11/2015] [Indexed: 01/08/2023] Open
Abstract
Background: Physical functioning (PF) is an essential domain of older persons’ health and quality of life. Health behaviors are the main modifiable determinants of PF. Cross-sectionally, alcohol consumption appears to be linked to better PF, but longitudinal evidence is mixed and very little is known about alcohol consumption and longitudinal PF trajectories. Methods: We conducted longitudinal analyses of 28,783 men and women aged 45–69 years from Novosibirsk (Russia), Krakow (Poland), and seven towns of the Czech Republic. At baseline, alcohol consumption was measured by a graduated frequency questionnaire and problem drinking was evaluated using the CAGE questionnaire. PF was assessed using the Physical Functioning Subscale of the SF-36 instrument at baseline and three subsequent occasions. Growth curve modeling was used to estimate the associations between alcohol consumption and PF trajectories over 10-year follow-up. Results: PF scores declined during follow-up in all three cohorts. Faster decline in PF over time was found in Russian female frequent drinkers, Polish female moderate drinkers, and Polish male regular heavy drinkers, in comparison with regular and/or light-to-moderate drinkers. Nondrinking was associated with a faster decline compared with light drinking only in Russian men. Problem drinking and past drinking were not related to the decline rate of PF. Conclusions: This large longitudinal study in Central and Eastern European populations with relatively high alcohol intake does not strongly support the existence of a protective effect of alcohol on PF trajectories; if anything, it suggests that alcohol consumption is associated with greater deterioration in PF over time.
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Affiliation(s)
- Yaoyue Hu
- Research Department of Epidemiology and Public Health, University College London.
| | - Hynek Pikhart
- Research Department of Epidemiology and Public Health, University College London
| | | | - Sofia Malyutina
- Institute of Internal and Preventive Medicine, Novosibirsk, Russia. Novosibirsk State Medical University, Russia
| | - Andrzej Pajak
- Department of Epidemiology and Population Studies, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland
| | - Agnieszka Besala
- Department of Epidemiology and Population Studies, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland
| | - Steven Bell
- Research Department of Epidemiology and Public Health, University College London
| | - Anne Peasey
- Research Department of Epidemiology and Public Health, University College London
| | - Michael Marmot
- Research Department of Epidemiology and Public Health, University College London
| | - Martin Bobak
- Research Department of Epidemiology and Public Health, University College London
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Leung JPK, Britton A, Bell S. Adverse Childhood Experiences and Alcohol Consumption in Midlife and Early Old-Age. Alcohol Alcohol 2015; 51:331-8. [PMID: 26553290 DOI: 10.1093/alcalc/agv125] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Accepted: 10/20/2015] [Indexed: 11/14/2022] Open
Abstract
AIMS To examine the individual and cumulative effects of adverse childhood experiences (ACEs) on alcohol consumption in midlife and early old-age, and the role of ACEs in 10-year drinking trajectories across midlife. METHODS Data were from the Whitehall II study, a longitudinal British civil service-based cohort study (N = 7870, 69.5% male). Multinomial logistic regression was used to examine the individual and cumulative effects of ACEs on weekly alcohol consumption. Mixed-effect multilevel modelling was used to explore the relationship between ACEs and change in alcohol consumption longitudinally. RESULTS Participants who were exposed to parental arguments/fights in childhood were 1.24 (95% CI 1.06, 1.45) times more likely to drink at hazardous levels in midlife (mean age 56 years) after controlling for covariates and other ACEs. For each additional exposure to an ACE, the risk of hazardous drinking versus moderate drinking was increased by 1.12 (95% CI 1.03, 1.21) after adjusting for sex, age, adult socio-economic status, ethnicity and marital status. No associations between ACEs and increased risk of hazardous drinking in early old-age (mean age 66 years) were found. In longitudinal analyses, ACEs did not significantly influence 10-year drinking trajectories across midlife. CONCLUSION The effect of exposure to parental arguments on hazardous drinking persists into midlife.
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Affiliation(s)
- Jessica Pui Kei Leung
- Research Department of Epidemiology and Public Health, University College London, London, UK
| | - Annie Britton
- Research Department of Epidemiology and Public Health, University College London, London, UK
| | - Steven Bell
- Research Department of Epidemiology and Public Health, University College London, London, UK
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Bell S, Britton A. Drinking pattern during midlife and risk of developing depression during 28 years of follow-up: A prospective cohort study. Drug Alcohol Depend 2015; 155:111-7. [PMID: 26321670 DOI: 10.1016/j.drugalcdep.2015.08.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Revised: 08/03/2015] [Accepted: 08/10/2015] [Indexed: 12/19/2022]
Abstract
BACKGROUND The long-term impact of alcohol intake in midlife on developing depression is not clear. We aimed to investigate drinking pattern during midlife as a risk factor for developing depression during 28 years of follow-up. METHODS We used data from a well characterised prospective cohort study (the Whitehall II study) of 7478 men and women (70% male) aged 35 to 55 years, and free from depression in 1985-1988, followed up regularly until 2013. Drinking pattern was defined in terms of usual and maximum amounts consumed within a single drinking session, total weekly volume of alcohol consumed and drinking frequency. Depression was assessed using the General Health Questionnaire Depression Subscale at multiple follow-up occasions (up to eight times in total). Associations between different drinking pattern components during midlife and depression were estimated using flexible parametric survival models. RESULTS After adjustment for confounding factors only abstaining from alcohol during midlife was associated with an increased risk of developing depression during long-term observation. However, this association became non-significant after adjusting for baseline self-reported health. CONCLUSIONS In this community dwelling population, drinking pattern during midlife was not associated with an increased risk of developing depression.
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Affiliation(s)
- Steven Bell
- Research Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, UK.
| | - Annie Britton
- Research Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, UK
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Macfarlane GJ, Beasley M. Alcohol Consumption in Relation to Risk and Severity of Chronic Widespread Pain: Results From a UK Population-Based Study. Arthritis Care Res (Hoboken) 2015; 67:1297-1303. [PMID: 26212017 PMCID: PMC4855637 DOI: 10.1002/acr.22604] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Revised: 03/12/2015] [Accepted: 04/21/2015] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To determine whether the reported level of alcohol consumption is associated with the likelihood of reporting chronic widespread pain (CWP) and, among persons with CWP, the associated disability. METHODS In a population-based study in 2 areas of the UK, participants self-completed a postal questionnaire. They were classified according to whether they met the American College of Rheumatology definition of CWP and whether the pain was disabling (Chronic Pain Grade III or IV). They reported their usual level of alcohol consumption. Potential confounding factors on which information was available included age, sex, cigarette smoking, employment status, self-reported weight and height, and level of deprivation. RESULTS A total of 13,574 persons participated (mean age 55 years, 57% women) of whom 2,239 (16.5%) had CWP; 28% reported never regularly consuming alcohol, 28% reported consuming up to 5 units/week, 20% reported 6-10 units/week, and 24% reported >10 units/week. Among persons with CWP, disability was strongly linked to level of alcohol consumption. Prevalence of disability decreased with increasing alcohol consumption up to 35 units/week (odds ratio [OR]21-35 units alcohol/week versus never drinkers 0.33 [95% confidence interval (95% CI) 0.19-0.58]) adjusted for confounders. A similar relationship was found between reporting CWP and level of alcohol consumption (adjusted OR21-35 units alcohol/week versus never drinkers 0.76 [95% CI 0.61-0.94]). CONCLUSION This study has demonstrated strong associations between level of alcohol consumption and both CWP and related disabilities. However, the available evidence does not allow us to conclude that the association is causal. The strength of the associations means that specific studies to examine this potential relationship are warranted.
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Affiliation(s)
- Gary J. Macfarlane
- Gary J. Macfarlane, PhD, MD(Hons), Marcus Beasley, BSc, MSc: School of Medicine and DentistryUniversity of AberdeenAberdeenUK
| | - Marcus Beasley
- Gary J. Macfarlane, PhD, MD(Hons), Marcus Beasley, BSc, MSc: School of Medicine and DentistryUniversity of AberdeenAberdeenUK
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Bell S, Britton A. The Role of Alcohol Consumption in Regulating Circulating Levels of Adiponectin: A Prospective Cohort Study. J Clin Endocrinol Metab 2015; 100:2763-8. [PMID: 26000546 PMCID: PMC4490299 DOI: 10.1210/jc.2015-1845] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
CONTEXT The role of alcohol intake in influencing longitudinal trajectories of adiponectin is unclear. OBJECTIVE The objective of the study was to examine the association between alcohol intake and changes in the circulating levels of adiponectin over repeat measures. DESIGN, SETTING, AND PARTICIPANTS A prospective cohort study of 2855 men and women (74% men with a mean age of 50 y at baseline) drawn from the Whitehall II study. Data from study phases 3 (1991-1993), 5 (1997-1999), and 7 (2002-2004) were used. MAIN OUTCOME MEASURE Adiponectin serum concentrations (nanograms per milliliter) were measured, and alcohol intake was defined in terms of number of UK units (1 U = 8 g ethanol) consumed in the previous 7 days on three occasions. Cross-sectional associations between alcohol and adiponectin levels were calculated using linear regression. A bivariate dual-change score model was used to estimate the effect of alcohol intake on upcoming change in adiponectin. Models were adjusted for age, sex, ethnicity, and smoking status. RESULTS Alcohol consumption was cross-sectionally associated with (log transformed) adiponectin levels (β ranging from .001 to .004, depending on phase and level of adjustment) but was not associated with changes in adiponectin levels over time [γ = -0.002 (SE 0.002), P = 0.246]. CONCLUSION Alcohol intake is not associated with changes in circulating adiponectin levels in this cohort. This finding provides evidence that adiponectin levels are unlikely to mediate the relationship between moderate alcohol consumption and reduced risk of type 2 diabetes. It is important to consider dynamic longitudinal relationships rather than cross-sectional associations.
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Affiliation(s)
- Steven Bell
- Research Department of Epidemiology and Public Health, University College London, London WC1E 6BT, United Kingdom
| | - Annie Britton
- Research Department of Epidemiology and Public Health, University College London, London WC1E 6BT, United Kingdom
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Chikritzhs T, Stockwell T, Naimi T, Andreasson S, Dangardt F, Liang W. Has the leaning tower of presumed health benefits from 'moderate' alcohol use finally collapsed? Addiction 2015; 110:726-7. [PMID: 25613200 DOI: 10.1111/add.12828] [Citation(s) in RCA: 77] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2014] [Accepted: 12/08/2014] [Indexed: 11/29/2022]
Abstract
The evolving epidemiological literature, including improved methodology for assessing causality in observational studies, is raising doubts about whether moderate alcohol consumption has a protective effect on health.
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Affiliation(s)
- Tanya Chikritzhs
- Curtin University, National Drug Research Institute, Perth, Western Australia
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Bell S, Britton A. Protective effects of moderate alcohol consumption on fatty liver: a spurious association? J Hepatol 2015; 62:1209-11. [PMID: 25711419 DOI: 10.1016/j.jhep.2014.12.037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Accepted: 12/20/2014] [Indexed: 12/04/2022]
Affiliation(s)
- Steven Bell
- Research Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, UK.
| | - Annie Britton
- Research Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, UK
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Hu Y, Pikhart H, Malyutina S, Pajak A, Kubinova R, Nikitin Y, Peasey A, Marmot M, Bobak M. Alcohol consumption and physical functioning among middle-aged and older adults in Central and Eastern Europe: results from the HAPIEE study. Age Ageing 2015; 44:84-9. [PMID: 24982097 PMCID: PMC4255613 DOI: 10.1093/ageing/afu083] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Background: light-to-moderate drinking is apparently associated with a decreased risk of physical limitations in middle-aged and older adults. Objective: to investigate the association between alcohol consumption and physical limitations in Eastern European populations. Study design: a cross-sectional survey of 28,783 randomly selected residents (45–69 years) in Novosibirsk (Russia), Krakow (Poland) and seven towns of Czech Republic. Methods: physical limitations were defined as <75% of optimal physical functioning using the Physical Functioning (PF-10) Subscale of the Short-Form-36 questionnaire. Alcohol consumption was assessed by a graduated frequency questionnaire, and problem drinking was defined as ≥2 positive responses on the CAGE questionnaire. In the Russian sample, past drinking was also assessed. Results: the odds of physical limitations were highest among non-drinkers, decreased with increasing drinking frequency, annual consumption and average drinking quantity and were not associated with problem drinking. The adjusted odds ratio (OR) of physical limitations in non-drinkers versus regular moderate drinkers was 1.61 (95% confidence interval: 1.48–1.75). In the Russian sample with past drinking available, the adjusted OR in those who stopped drinking for health reasons versus continuing drinkers was 3.19 (2.58–3.95); ORs in lifetime abstainers, former drinkers for non-health reasons and reduced drinkers for health reasons were 1.27 (1.02–1.57), 1.48 (1.18–1.85) and 2.40 (2.05–2.81), respectively. Conclusion: this study found an inverse association between alcohol consumption and physical limitations. The high odds of physical limitations in non-drinkers can be largely explained by poor health of former drinkers. The apparently protective effect of heavier drinking was partly due to less healthy former heavy drinkers who moved to lower drinking categories.
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Affiliation(s)
- Yaoyue Hu
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Hynek Pikhart
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Sofia Malyutina
- Institute of Internal and Preventive Medicine, Siberian Branch of the Russian Academy of Medical Sciences, Novosibirsk, Russian Federation Novosibirsk State Medical University, Novosibirsk, Russian Federation
| | - Andrzej Pajak
- Collegium Medicum, Jagiellonian University, Krakow, Poland
| | | | - Yuri Nikitin
- Institute of Internal and Preventive Medicine, Siberian Branch of the Russian Academy of Medical Sciences, Novosibirsk, Russian Federation
| | - Anne Peasey
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Michael Marmot
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Martin Bobak
- Department of Epidemiology and Public Health, University College London, London, UK
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Bell S, Kivimäki M, Batty GD. Subgroup analysis as a source of spurious findings: an illustration using new data on alcohol intake and coronary heart disease. Addiction 2015; 110:183-4. [PMID: 25515832 PMCID: PMC4273867 DOI: 10.1111/add.12708] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- Steven Bell
- Research Department of Epidemiology and Public Health, University College London, London, UK.
| | - Mika Kivimäki
- Research Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, UK, WC1E 6BT
| | - G. David Batty
- Research Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, UK, WC1E 6BT,Centre for Cognitive Aging and Cognitive Epidemiology, University of Edinburgh, UK
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Abstract
Jim McCambridge and colleagues reflect on how the concept of harm reduction may be being usurped by the alcohol industry. Please see later in the article for the Editors' Summary.
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Affiliation(s)
- Jim McCambridge
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Kypros Kypri
- Centre for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
| | - Colin Drummond
- King's College London, National Addiction Centre, Institute of Psychiatry, London, United Kingdom
| | - John Strang
- King's College London, National Addiction Centre, Institute of Psychiatry, London, United Kingdom
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Diet and alcohol as risk factors for rheumatoid arthritis: a nested case-control study. Rheumatol Int 2014; 35:533-9. [PMID: 25428595 DOI: 10.1007/s00296-014-3185-x] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Accepted: 11/18/2014] [Indexed: 01/05/2023]
Abstract
The aim of this study was to investigate whether alcohol and diet, assessed as both macronutrients and dietary patterns, increased the risk of development of rheumatoid arthritis (RA) through a nested case-control design in the Västerbotten Intervention Program (VIP) cohort. Individuals in the VIP who had developed RA after the dietary survey were identified from medical records at the department of rheumatology at the University Hospital, Umeå (n = 386), and matched to 1,886 controls from the same database. Diet was assessed as food groups, as macronutrients and as scores of dietary patterns, namely the carbohydrate-restricted diet score, the Mediterranean diet score and the healthy diet indicator score. When analysing the dietary patterns, consumption of food groups and different macronutrients, a significant association was found in the highest tertile of carbohydrate-restricted diet among the cases with a subsequent anti-CCP-positive disease 1.40 (1.02-1.92), as well as in the highest tertile of protein consumption among smokers (OR = 1.80, 95% CI 1.09-2.95). However, after additional adjustment for sodium intake, these associations were no longer statistically significant. No association was observed between alcohol consumption and the risk of RA. To summarize, there were no significant associations between diet, or alcohol consumption, and the risk of development of RA within this cohort. The lack of any significant associations of alcohol consumption may be explained by a low consumption in the studied population overall or alternatively by methodological issues raised recently.
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Alcoholism risk reduction in France: a modernised approach related to alcohol misuse disorders. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:11664-75. [PMID: 25402563 PMCID: PMC4245636 DOI: 10.3390/ijerph111111664] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/11/2014] [Revised: 10/27/2014] [Accepted: 10/28/2014] [Indexed: 12/02/2022]
Abstract
During many years in France, risk reduction strategies for substance abuse concerned prevention strategies in the general population or interventions near users of illicit substances. In this spirit, the reduction of consumption only concerned opiate addicts. With regard to alcohol, the prevention messages relative to controlled consumption were difficult to transmit because of the importance of this product in the culture of the country. In addition, methods of treatment of alcoholism rested on the dogma of abstinence. Several factors have recently led to an evolution in the treatment of alcohol use disorders integrating the reduction of consumption in strategies. Strategies for reducing consumption should aim for consumption below recommended thresholds (two drinks per day for women, three for the men) or, at least, in that direction. It must also be supported by pharmacotherapy and psychotherapy, which offer possibilities. Failure to manage reduction will allow the goals to be revisited and to reconsider abstinence. Finally this evolution or revolution is a new paradigm carried in particular by a pragmatic approach of the disease and new treatments. The aims of this article are to give elements of comprehension relating to the evolution of the practices in France in prevention and treatment of alcohol use disorders and in particular with regard to the reduction of consumption.
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Roerecke M, Rehm J. Alcohol consumption, drinking patterns, and ischemic heart disease: a narrative review of meta-analyses and a systematic review and meta-analysis of the impact of heavy drinking occasions on risk for moderate drinkers. BMC Med 2014; 12:182. [PMID: 25567363 PMCID: PMC4203905 DOI: 10.1186/s12916-014-0182-6] [Citation(s) in RCA: 217] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Accepted: 09/10/2014] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Alcohol consumption is a major global risk factor for mortality and morbidity. Much discussion has revolved around the diverse findings on the complex relationship between alcohol consumption and the leading cause of death and disability, ischemic heart disease (IHD). METHODS We conducted a systematic search of the literature up to August 2014 using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to identify meta-analyses and observational studies examining the relationship between alcohol drinking, drinking patterns, and IHD risk, in comparison to lifetime abstainers. In a narrative review we have summarized the many meta-analyses published in the last 10 years, discussing the role of confounding and experimental evidence. We also conducted meta-analyses examining episodic heavy drinking among on average moderate drinkers. RESULTS The narrative review showed that the use of current abstainers as the reference group leads to systematic bias. With regard to average alcohol consumption in relation to lifetime abstainers, the relationship is clearly J-shaped, supported by short-term experimental evidence and similar associations within strata of potential confounders, except among smokers. Women experience slightly stronger beneficial associations and also a quicker upturn to a detrimental effect at lower levels of average alcohol consumption compared to men. There was no evidence that chronic or episodic heavy drinking confers a beneficial effect on IHD risk. People with alcohol use disorder have an elevated risk of IHD (1.5- to 2-fold). Results from our quantitative meta-analysis showed that drinkers with average intake of <30 g/day and no episodic heavy drinking had the lowest IHD risk (relative risk = 0.64, 95% confidence interval 0.53 to 0.71). Drinkers with episodic heavy drinking occasions had a risk similar to lifetime abstainers (relative risk = 1.12, 95% confidence interval 0.91 to 1.37). CONCLUSIONS Epidemiological evidence for a beneficial effect of low alcohol consumption without heavy drinking episodes is strong, corroborated by experimental evidence. However, episodic and chronic heavy drinking do not provide any beneficial effect on IHD. Thus, average alcohol consumption is not sufficient to describe the risk relation between alcohol consumption and IHD. Alcohol policy should try to reduce heavy drinking patterns.
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Affiliation(s)
- Michael Roerecke
- Social and Epidemiological Research Department, Centre for Addiction and Mental Health (CAMH), 33 Russell Street, Toronto, Ontario, M5S 2S1, Canada.
| | - Jürgen Rehm
- Social and Epidemiological Research Department, Centre for Addiction and Mental Health (CAMH), 33 Russell Street, Toronto, Ontario, M5S 2S1, Canada.
- Dalla Lana School of Public Health (DLSPH), University of Toronto, Toronto, Canada.
- Institute of Medical Science, University of Toronto, Toronto, Canada.
- Institute for Clinical Psychology and Psychotherapy, TU Dresden, Dresden, Germany.
- Department of Psychiatry, University of Toronto, Toronto, Canada.
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Zeisser C, Stockwell TR, Chikritzhs T. Methodological biases in estimating the relationship between alcohol consumption and breast cancer: the role of drinker misclassification errors in meta-analytic results. Alcohol Clin Exp Res 2014; 38:2297-306. [PMID: 25156617 PMCID: PMC4149760 DOI: 10.1111/acer.12479] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2013] [Accepted: 04/27/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND While alcohol consumption has been linked to breast cancer in women, few studies have controlled for possible biases created by including former or occasional drinkers in the abstainer reference group. We explored the potential for such misclassification errors as sources of bias in estimates of the alcohol-breast cancer relationship. METHODS Meta-analyses of population case-control, hospital case-control, and cohort studies to examine relationships between level of alcohol use and breast cancer morbidity and/or mortality in groups of studies with and without different misclassification errors. RESULTS Of 60 studies identified, only 6 were free of all misclassification errors. The abstainer reference group was biased by the inclusion of former drinkers in 49 studies, occasional drinkers (<10 g ethanol [EtOH] per week) in 22 and by both these groups in 18. Occasional drinkers were also mixed with light or hazardous-level drinkers in 22 studies. Unbiased estimates of the odds ratio (OR) for breast cancer were 1.011 (95% confidence interval [CI]: 0.891 to 1.148) among former drinkers (n = 11) and 1.034 (95% CI: 1.003 to 1.064) among occasional drinkers (n = 17). Hazardous-level drinking (>20 g < 41 g EtOH/d) was not significantly associated with breast cancer in studies with occasional drinker bias. However, in studies free from occasional drinker bias, the OR for breast cancer was 1.085 (95% CI: 1.015 to 1.160) for low-level (<21 g/d) drinkers (n = 17), 1.374 (95% CI: 1.319 to 1.431) for hazardous-level drinkers (n = 26), and 1.336 (95% CI: 1.228 to 1.454) for harmful-level (>40 g/d) drinkers (n = 9). CONCLUSIONS While the great majority of studies of the alcohol-breast cancer link include misclassification errors, only misclassification of occasional drinkers was found to bias risk estimates significantly. Estimates based on error-free studies confirmed that low, hazardous and harmful levels of alcohol use each significantly increase the risk of breast cancer.
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Affiliation(s)
- Cornelia Zeisser
- Centre for Addictions Research of British Columbia, University of Victoria, Victoria, British Columbia, Canada
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McCambridge J, Hartwell G. Has industry funding biased studies of the protective effects of alcohol on cardiovascular disease? A preliminary investigation of prospective cohort studies. Drug Alcohol Rev 2014; 34:58-66. [PMID: 24602075 PMCID: PMC4441279 DOI: 10.1111/dar.12125] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Accepted: 01/31/2014] [Indexed: 01/20/2023]
Abstract
INTRODUCTION AND AIMS There have been no previous quantitative analyses of the possible effects of industry funding on alcohol and health research. This study examines whether findings of alcohol's protective effects on cardiovascular disease may be biased by industry funding. DESIGN AND METHODS Findings from a recent systematic review of prospective cohort studies were combined with public domain data on alcohol industry funding. The six outcomes evaluated were alcohol's effects on cardiovascular disease mortality, incident coronary heart disease, coronary heart disease mortality, incident stroke, stroke mortality and mortality from all causes. RESULTS We find no evidence of possible funding effects for outcomes other than stroke. Whether studies find alcohol to be a risk factor or protective against incident stroke depends on whether or not there is possible industry funding [risk ratio (RR) 1.07 (0.97-1.17) for those without concern about industry funding compared with RR 0.88 (0.81-0.94)]. For stroke mortality, a similar difference is not statistically significant, most likely because there are too few studies. DISCUSSION AND CONCLUSIONS Dedicated high-quality studies of possible alcohol industry funding effects should be undertaken, and these should be broad in scope. They also need to investigate specific areas of concern, such as stroke, in greater depth.
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Fekjaer HO. Second-class evidence for causality, not second-class science. Addiction 2014; 109:164-5. [PMID: 24438117 DOI: 10.1111/add.12386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Bell S, Britton A. A second-class science? A defence of observational epidemiology to make causal inferences. Addiction 2014; 109:163-4. [PMID: 24438116 DOI: 10.1111/add.12379] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Affiliation(s)
- Steven Bell
- Research Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, UK.
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Affiliation(s)
- Jurgen Rehm
- Social and Epidemiological Research (SER) Department, Centre for Addiction and Mental Health (CAMH), 33 Russel Street, Toronto, ON, M5S 2S1, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada; Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada; PAHO/WHO Collaborating Centre for Mental Health & Addiction, Toronto, ON, Canada; Epidemiological Research Unit, Klinische Psychologie & Psychotherapie, Technische Universität Dresden, Dresden, Germany.
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82
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Affiliation(s)
- Sven Andréasson
- Department of Public Health Sciences, Karolinska institutet, Stockholm, 17177, Sweden.
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