Trends in alcohol use and binge drinking, 1985-1999: results of a multi-state survey

Food environment index and preterm birth rate in the counties of the United States

OBJECTIVES

To determine the relationship between Food Environment Index (FEI) and Preterm Birth (PTB) rate at the county level of the United States of America (USA) (primary), while evaluating the interaction of multiple factors within a framework of sociodemographic, maternal health, maternal behavioral, and environmental factors.

METHODS

This is a population-based retrospective cohort ecological study from 2015-2018. The study compares the characteristics of the population of the counties of the USA. All counties with complete data on their PTB rate and the independent variables were included in the study. Independent variables with greater than 20% missing data were excluded from the study. Purposive sampling technique was applied. A total of 2983/3142 counties were included in the study.

RESULTS

The median PTB rate of all counties was 9.90%. The highest PTB rate (23.3%) was in Tallapoosa County, Alabama and the lowest (3.4%) in San Juan County, Washington State. After adjusting for variables, PTB rate had a significant association with FEI (coefficient of correlation - 0.36, p < 0.01, 95% CI - 0.19 to - 0.04). Increase in the rate of unemployment, African American race, adult smoking, obesity, uninsured rate, sexually transmitted diseases (STD), high school education and air pollution was associated with an increase in PTB rate, while an increase in FEI and alcohol abuse rates was associated with a decrease in PTB rate.

CONCLUSIONS

FEI can predict the PTB rate in USA counties after adjusting for sociodemographic, health, behavioral and environmental factors. Future studies are needed to confirm these associations and consider them when making policies to reduce PTBs.

Risk of cardiovascular disease in patients with alcohol use disorder: A population-based retrospective cohort study

The complex effects of alcohol consumption on the cardiovascular system vary with mean daily consumption and duration of intake. This population-based retrospective cohort study aimed to explore the risk of cardiovascular disease (CVD) in patients with alcohol use disorder (AUD). Data was collected from the Taiwan National Health Insurance Research Database from 2000 to 2013. A total of 7,420 patients with AUD were included in our study group, and 29,680 age- and sex-matched controls without AUD in the control group. Cox proportional hazard regression analysis was used to investigate the effects of AUD on the risk of CVD. Most patients were men aged 25–44 years. At the end of the follow-up period, the AUD group had a significantly higher incidence of CVD (27.39% vs. 19.97%, P<0.001) and more comorbidities than the control group. The AUD group also exhibited a significantly higher incidence of CVD than the control group based on the Cox regression analysis and Fine and Gray’s competing risk model (adjusted hazard ratio [AHR] = 1.447, 95% confidence interval [CI] = 1.372–1.52 5, P<0.001). Furthermore, male sex, diabetes mellitus, hypertension, hyperlipidemia, chronic kidney disease, chronic obstructive pulmonary disease, anxiety, depression, and a high Charlson Comorbidity Index were also associated with an increased risk of CVD. Patients with AUD in different CVD subgroups, such as those with CVD, ischemic heart disease (IHD), and stroke, were at a significantly higher risk of disease than those without AUD; CVD (AHR = 1.447, 95% CI = 1.372–1.525, P<0.001), IHD (AHR = 1.304, 95% CI = 1.214–1.401, P<0.001), and stroke (AHR = 1.640, 95% CI = 1.519–1.770, P<0.001). The risk also significantly differed among patients in the different CVD subgroups. We observed an association between AUD and development of CVD even after adjusting for several comorbidities and medications in our nationwide population cohort.

Leveraging change point detection to discover natural experiments in data

Change point detection has many practical applications, from anomaly detection in data to scene changes in robotics; however, finding changes in high dimensional data is an ongoing challenge. We describe a self-training model-agnostic framework to detect changes in arbitrarily complex data. The method consists of two steps. First, it labels data as before or after a candidate change point and trains a classifier to predict these labels. The accuracy of this classifier varies for different candidate change points. By modeling the accuracy change we can infer the true change point and fraction of data affected by the change (a proxy for detection confidence). We demonstrate how our framework can achieve low bias over a wide range of conditions and detect changes in high dimensional, noisy data more accurately than alternative methods. We use the framework to identify changes in real-world data and measure their effects using regression discontinuity designs, thereby uncovering potential natural experiments, such as the effect of pandemic lockdowns on air pollution and the effect of policy changes on performance and persistence in a learning platform. Our method opens new avenues for data-driven discovery due to its flexibility, accuracy and robustness in identifying changes in data.

Myriocin Treatment Reverses Alcohol-Induced Alterations in Polyunsaturated Fatty Acid-Containing Phospholipid Expression in the Liver

Chronic heavy alcohol exposure causes steatohepatitis manifested by abnormal intra-hepatocyte accumulation of lipid and parenchymal inflammation. Attendant alterations in polyunsaturated fatty acid (PUFA)-containing phospholipids could cause alcoholic liver disease (ALD) to progress by promoting oxidative stress, inflammation, and fibrogenesis. Previously we showed that myriocin, a serine palmitoyltransferase inhibitor, ameliorates experimental alcohol-induced steatohepatitis. However, the surprising overall therapeutic responses suggested that myriocin's targets may go beyond sphingolipids. To this end, the present study examines the effects of myriocin on hepatic composition of docosahexaenoic acid (DHA)- and arachidonic acid (AA)-containing phospholipids in an experimental model of ALD. A chronic+binge ethanol exposure model was generated by feeding Long Evans rats with ethanol-containing diets (24% caloric content) for 8 weeks and simultaneously binge gavage administering 2 g/kg ethanol on Tuesdays, Thursdays and Saturdays during Weeks 6-8. Myriocin was administered by i.p. injection on Mondays, Wednesdays, and Fridays of Weeks 3-8. Control rats were studied in parallel. Upon euthanasia, the livers were harvested to examine ethanol- and/or myriocin-modulation of hepatic lipids using matrix-assisted laser desorption/ionization imaging mass spectrometry (MALDI-IMS). Results were analyzed statistically by two-way analysis of variance and depicted with data bar plots and heatmaps. Chronic+binge ethanol exposures significantly increased hepatic expression of AA-containing phospholipids including PE(36:4) (P = .005), PE(38:4) (P = .03), and PI(38:4) (P = .04) and reduced DHA-containing phospholipids including PS(40:6) (P = .03) and PE(40:6) (P = .04) relative to control. Myriocin partially reversed ethanol's effects on hepatic PUFA expression by decreasing PE(36:4) (P = .004) and increasing PS(40:6) (P = .04) and PI(40:6) (P = .0003) relative to ethanol-exposed rats. Ethanol-mediated alterations in hepatic PUFA-containing phospholipids may contribute to hepatic oxidative and inflammatory injury by increasing AA and fibrogenesis by inhibiting DHA. The results suggest that Myriocin may help reduce or prevent long-term and progressive liver injury stemming from excessive chronic+binge ethanol consumption.

Declining Life Expectancy in the United States: Missing the Trees for the Forest

In recent years, life expectancy in the United States has stagnated, followed by three consecutive years of decline. The decline is small in absolute terms but is unprecedented and has generated considerable research interest and theorizing about potential causes. Recent trends show that the decline has affected nearly all race/ethnic and gender groups, and the proximate causes of the decline are increases in opioid overdose deaths, suicide, homicide, and Alzheimer's disease. A slowdown in the long-term decline in mortality from cardiovascular diseases has also prevented life expectancy from improving further. Although a popular explanation for the decline is the cumulative decline in living standards across generations, recent trends suggest that distinct mechanisms for specific causes of death are more plausible explanations. Interventions to stem the increase in overdose deaths, reduce access to mechanisms that contribute to violent deaths, and decrease cardiovascular risk over the life course are urgently needed to improve mortality in the United States.

Gender Difference in Longitudinal Social and Personal Factors Related to Frequency of Alcohol Consumption of South Korean Adults: A Fixed-Effects Model

The purpose of this study was to examine the longitudinal social and personal factors related to frequency of alcohol consumption by South Korean adults focused on comparisons between men and women. Data came from the 2005-2016 Korea Welfare Panel Study. A fixed-effects model was used to examine the longitudinal correlations between dependent and independent variables. According to the present results, first, life satisfaction except for health satisfaction and marital status were not associated with alcohol consumption patterns by men. On the other hand, higher frequency of alcohol consumption by women was negatively associated with various life satisfaction variables and being married. Second, income levels were positively associated with higher frequency of alcohol consumption by men, whereas income levels were not associated with alcohol consumption by women. Finally, being employed was positively associated with higher frequency of alcohol consumption by both men and women. In conclusion, there were gender differences in how alcohol consumption was influenced by various sociocultural and life satisfaction factors in South Korea.

Heterogeneity in educational pathways and the health behavior of U.S. young adults

An increasing number of U.S. adults are progressing through college in decidedly more complex ways. Little is known, however, about how this growing heterogeneity may be associated with the health behaviors and ultimately health of young adults. Using a life course perspective, we investigate whether and why different educational pathways - that is, variation in when people attend and complete school - are associated with daily smoking and binge drinking among U.S. young adults. We use 14 waves (1997-2011) of data from the National Longitudinal Survey of Youth 1997 cohort (n=7,359) that enable us to identify the most common educational pathways, as well as their association with young adult health behaviors. Bachelor's degree recipients who enrolled immediately after high school but did not attain their degree within 4 years were more likely to smoke daily in early adulthood (i.e., ages 26 to 32) than those who enrolled in college immediately after high school and attained a bachelor's degree within 4 years. Conversely, bachelor's degree recipients who delayed college enrollment were less likely to binge drink in early adulthood than individuals who enrolled in college immediately after high school and attained a bachelor's degree within 4 years. Marital status and household income in young adulthood accounted for some of the relationships between educational pathways and health behavior. These findings highlight the complexity of education's relationship to health behavior and strongly suggest that heterogeneity in educational pathways should be explicitly examined in population health research. Word Count: 241.

Ethanol-Induced White Matter Atrophy Is Associated with Impaired Expression of Aspartyl-Asparaginyl-β-Hydroxylase (ASPH) and Notch Signaling in an Experimental Rat Model

Alcohol-induced white matter (WM) degeneration is linked to cognitive-motor deficits and impairs insulin/insulin-like growth factor (IGF) and Notch networks regulating oligodendrocyte function. Ethanol downregulates Aspartyl-Asparaginyl-β-Hydroxylase (ASPH) which drives Notch. These experiments determined if alcohol-related WM degeneration was linked to inhibition of ASPH and Notch. Adult Long Evans rats were fed for 3, 6 or 8 weeks with liquid diets containing 26% ethanol (caloric) and in the last two weeks prior to each endpoint they were binged with 2 g/kg ethanol, 3×/week. Controls were studied in parallel. Histological sections of the frontal lobe and cerebellar vermis were used for image analysis. Frontal WM proteins were used for Western blotting and duplex ELISAs. The ethanol exposures caused progressive reductions in frontal and cerebellar WM. Ethanol-mediated frontal WM atrophy was associated with reduced expression of ASPH, Jagged 1, HES-1, and HIF-1α. These findings link ethanol-induced WM atrophy to inhibition of ASPH expression and signaling through Notch networks, including HIF-1α.

Trends in binge drinking in Canada from 1996 to 2013: a repeated cross-sectional analysis

BACKGROUND

Heavy drinking is a major factor in morbidity and mortality worldwide. Little information is available on trends in Canada regarding alcohol abuse. We sought to estimate abstinence, binge drinking and alcohol intake exceeding low-risk drinking guidelines in the Canadian population from 1996 to 2013.

METHODS

The data sources for this analysis were a series of cross-sectional national health surveys of the Canadian population carried out by Statistics Canada between 1996 and 2013. These were cross-sectional files from the National Population Health Surveys of 1996 and 1998, plus the Canadian Community Health Surveys from 2000 to 2013. Respondents were aged 18 years and older.

RESULTS

The proportion of binge drinkers increased steadily from 13.7% (95% confidence interval [CI] 13.2%-14.2%) in 1996 to 19.7% (95% CI 19.1%-20.3%) in 2013. The corresponding proportions for men were 20.8% (95% CI 19.9%-21.7%) in 1996, and 25.7% (95% CI 24.7%-26.6%) in 2013; for women, these proportions were 6.9% (95% CI 6.4%-7.5%) in 1996, and 13.8% (95% CI 13.1%-14.5%) in 2013. No significant increases were seen in the proportion of people who exceeded low-risk drinking guidelines or of abstainers during the same period.

INTERPRETATION

The rate of self-reported binge drinking in Canada has increased from 1996 to 2013, relatively more so among women than among men. No evidence of an increase in the proportion of people exceeding low-risk drinking guidelines or of abstainers was seen during the same period. These results suggest that binge drinking is of particular concern regarding intervention strategies aimed at improvement of public health.

Tobacco Smoke-Induced Hepatic Injury with Steatosis, Inflammation, and Impairments in Insulin and Insulin-Like Growth Factor Signaling

Background

Alcoholic liver disease (ALD) is associated with impairments in hepatic insulin and insulin-like growth factor (IGF) signaling through cell growth, survival, and metabolic pathways. Since not all heavy drinkers develop ALD, co-factors may be important. Epidemiologic data indicate that most heavy drinkers smoke tobacco and experimental data revealed that low-level nitrosamine exposures, including those from tobacco, can cause steatohepatitis with hepatic insulin/IGF resistance and exacerbate ALD. We hypothesize that cigarette smoke (CS) exposures also cause liver injury with impaired hepatic insulin/IGF signaling, and thereby contribute to ALD.

Methods

Adult male A/J mice were exposed to air for 8 weeks (A8), CS for 4 (CS4) or 8 (CS8) weeks, or CS for 8 weeks with 2 weeks recovery (CS8+R).

Results

CS exposures caused progressive liver injury with disruption of the normal hepatic chord architecture, lobular inflammation, apoptosis or necrosis, micro-steatosis, sinusoidal dilatation, and nuclear pleomorphism. Histopathological liver injury scores increased significantly from A8 to CS4 and then further to CS8 (P<0.0001). The mean histological grade was also higher in CS8+R relative to A8 (P<0.0001) but lower than in CS4, reflecting partial resolution of injury by CS withdrawal. CS exposures impaired insulin and IGF-1 signaling through IRS-1, Akt, GSK-3β, and PRAS40. Livers from CS8+R mice had normalized or elevated levels of insulin receptor, pYpY-Insulin-R, 312S-IRS-1, 473S-Akt, S9-GSK-3β, and pT246-PRAS40 relative to A8, CS4, or CS8, reflecting partial recovery.

Conclusion

CS-mediated liver injury and steatohepatitis with impairments in insulin/IGF signalling are reminiscent of the findings in ALD. Therefore, CS exposures (either first or second-hand) may serve as a co-factor in ALD. The persistence of several abnormalities following CS exposure cessation suggests that some aspects of CS-mediated hepatic metabolic dysfunction are not readily reversible.

Neighborhood Context and Binge Drinking by Race and Ethnicity in New York City

BACKGROUND

Neighborhood context is associated with binge drinking and has significant health, societal, and economic costs. Both binge drinking and neighborhood context vary by race and ethnicity. We examined the relations between neighborhood characteristics--neighborhood norms that are accepting of drunkenness, collective efficacy, and physical disorder--and binge drinking, with a focus on examining race and ethnic-specific relationships.

METHODS

Respondent data were collected through 2005 random digit-dial-telephone survey for a representative sample of New York City residents; neighborhood data were based on the 2005 New York City Housing and Vacancy Survey. Participants were 1,415 past-year drinkers; Whites (n = 877), Blacks (n = 292), and Hispanics (n = 246). Generalized estimating equations were used to estimate population average models.

RESULTS

For the overall sample, neighborhood norms that were more accepting of drunkenness were associated with greater binge drinking (odds ratio [OR] = 1.22; 95% confidence interval [CI] = 1.09, 1.37); collective efficacy and physical disorder were not significant. However, when examining this by race/ethnicity, greater collective efficacy (OR = 0.75; 95% CI = 0.62, 0.91) and greater physical disorder (OR = 0.76; 95% CI = 0.62, 0.93) were associated with less binge drinking for Whites only. Neighborhood norms that were more accepting of drunkenness were associated with binge drinking among Whites (OR = 1.20; 95% CI = 1.05, 1.38) and, while not significant (perhaps due to power), the associations were similar for Hispanics (OR = 1.18; 95% CI = 0.83, 1.68) and slightly lower for Blacks (OR = 1.11; 95% CI = 0.67, 1.84).

CONCLUSIONS

Overall, results suggest that neighborhood characteristics and binge drinking are shaped, in part, by factors that vary across race/ethnicity. Thus, disaggregating data by race/ethnicity is important in understanding binge drinking behaviors.

Perfil do consumo de álcool de usuários de uma unidade de Atenção Primária à Saúde

Objetivo Descrever o perfil de consumo de álcool de usuários adultos de uma unidade de Atenção Primária à Saúde, segundo características sociodemográficas. Métodos Inquérito domiciliar desenvolvido com usuários de uma unidade de Atenção Primária à Saúde na cidade do Rio de Janeiro, Brasil. Em 2010, amostra de 301 indivíduos respondeu a um instrumento de coleta que continha o Alcohol Use Disorders Identification Test e variáveis de caracterização sociodemográfica. Análises univariadas com distribuição de frequências simples e bivariadas com diferenças avaliadas pelo teste X2 e pelo teste exato de Fisher foram conduzidas, considerando-se um nível de significância de 0,05. Resultados O consumo de álcool de pessoas do sexo masculino, jovens, de baixa escolaridade, não casadas, empregadas e sem religião mostrou-se mais perigoso para a saúde. Conclusão Ações preventivas em saúde voltadas para o controle do consumo abusivo de álcool devem estar dirigidas para os grupos mais vulneráveis. É importante enfatizar ações de promoção à saúde de forma a evitar a iniciação e a manutenção de consumo perigoso de álcool, bem como sua evolução para casos de dependência.

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

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.

Test-retest reliability and validity of life-course alcohol consumption measures: the 2005 National Alcohol Survey follow-up

BACKGROUND

Few studies assess reliability and validity of lifetime alcohol measures. We undertook extended test-retest analyses of retrospective lifetime drinking measures and of incremental predictive ability of lifetime heavy drinking (days 5+ drinks) in teens, 20s, and 30s for current (12-month) alcohol use disorders (AUDs).

METHODS

A subset (31.4%; 962 men, 1,220 women) of the 2005 U.S. National Alcohol Survey (NAS; N11) completed a follow-up survey (N11T) by phone or mail (mean delay of 2.7 years). Both surveys assessed lifetime drinking.

RESULTS

In N11T, drinking status was reported consistently by 94.7% of N11 current drinkers, 85.5% of ex-drinkers, and 74.4% of lifetime abstainers (93.5% overall). Cumulative number of prior heavy drinking days (teens through 30s) were moderately consistent (Pearson's ρ = 0.6, p < 0.001, n = 1,636). Reliability was lower for younger respondents under 30 and higher for Whites versus Blacks and Hispanics (ρ = 0.68 vs. ρ = 0.56 vs. ρ = 0.56, both p = 0.01), but did not differ by gender. Heavy drinking days in teens correlated 0.63 (p < 0.001) for those aged 20 or older, higher for women than men and for Whites versus ethnic minorities. Heavy drinking days in the 20s and 30s reported by those 30 and older and 40 and older correlated at 0.63 and 0.67, respectively, being higher for Whites. Age of drinking onset and of lifetime maximum quantity reports were also consistent (0.65, 0.73), higher for women versus men, for those older than 29 versus younger, and for Whites versus Blacks and Hispanics. In N11, controlling for gender, age, ethnicity, and current 5+ frequency, cumulative prior 5+ days (teens to age 39) predicted current alcohol-related consequences and dependence (both p = 0.003).

CONCLUSIONS

Measurements of earlier heavy drinking are feasible, efficient, and reasonably reliable, albeit with some individual imprecision. Prior drinking data improve prediction of current AUDs, adjusting for demographics and current drinking.

The Relation Between Frequency of Binge Drinking and Psychological Distress Among Older Adult Drinkers

Objectives: The present study examined the relation between past year frequency of binge drinking and psychological distress among older adult drinkers. Method: Data were obtained from the 2009 California Health Interview Survey (CHIS). Adults aged 60 and older who had consumed alcohol in the past year ( n = 13,265) were analyzed. Psychological distress was assessed using the Kessler 6 (K6) scale. Multiple regression analyses were conducted. Results: A significant main effect of frequency of binge drinking was found in regression analyses, indicating that an increased frequency of binge drinking was significantly associated with increased psychological distress ( B = .10, p < .001). Results from additional analyses showed that binge drinking was related to increased psychological distress when individuals were binge drinking more than once in the past year. Discussion: The results suggest that binge drinking frequently may be related to increased experiences of psychological distress among older drinkers. Research and clinical implications are discussed.

The relation between acculturation and alcohol consumption patterns among older Asian and Hispanic immigrants

This study examines the relation between acculturation and alcohol consumption patterns among older Asian and Hispanic immigrants in the state of California. Data were obtained from the 2009 California Health Interview Survey and included Asian (n = 1264) and Hispanic (n = 571) adults aged 60 and older who were born outside of the US. Outcome variables included presence of past year alcohol consumption, past year binge drinking, and number of binge drinking days. Acculturation was measured with items pertaining to English use and proficiency. Hierarchical multiple or logistic regression analyses were conducted separately for each racial/ethnic group and each dependent variable. Alcohol consumption was found in less than half of the sample for both Asians (43.2%) and Hispanics (39.2%). Binge drinking was found in 3.1% of Asians and 8.4% of Hispanics. Acculturation was significantly related to past year alcohol consumption for Hispanics, past year binge drinking for Asians, and binge drinking days for Asians, such that higher level of acculturation predicted a greater likelihood of alcohol consumption but decreased likelihood of binge drinking and fewer binge drinking days. The results indicate that acculturation may be related to alcohol consumption patterns for older immigrants. This suggests future needs to develop an in-depth understanding of the health behaviors of these immigrant elderly groups.

Drinking patterns among Korean adults: results of the 2009 Korean community health survey

Objectives

In Korea, the proportion of deaths due to alcohol is estimated at 8.9%, far exceeding the global estimate of 3.8%. Therefore, this study was performed to examine the factors associated with low-risk, moderate-risk, and high-risk drinking patterns in Korean adults and to identify target populations for prevention and control of alcohol-related diseases and deaths.

Methods

We analyzed data from 230 715 Korean adults aged 19 years and older who participated in the 2009 Korean Community Health Survey. Multinomial logistic regression analysis was used to examine associations between socio-demographic and health-related factors and patterns of alcohol use.

Results

A substantially larger proportion of men than women engaged in high risk (21.2% vs. 3.4%) and moderate-risk alcohol use (15.5% vs. 8.2%). In both sexes, moderate- and high-risk uses were associated with younger age, higher income, being currently employed, smoking, being overweight/obese, and good self-rated health.

Conclusions

Given the large proportion of the population that is engaging in moderate- and high-risk drinking and given the social norms that support this behavior, public health policies and campaigns to reduce alcohol consumption targeting the entire population are indicated.

Ethanol-resistant ethylcellulose/guar gum coatings--importance of formulation parameters

Recently, ethylcellulose/guar gum blends have been reported to provide ethanol-resistant drug release kinetics from coated dosage forms. This is because the ethanol insoluble guar gum effectively avoids undesired ethylcellulose dissolution in ethanol-rich bulk fluids. However, so far the importance of crucial formulation parameters, including the minimum amount of guar gum to be incorporated and the minimum required guar gum viscosity, remains unclear. The aim of this study was to identify the most important film coating properties, determining whether or not the resulting drug release kinetics is ethanol-resistant. Theophylline matrix cores were coated in a fluid bed with blends of the aqueous ethylcellulose dispersion "Aquacoat®ECD30" and guar gum. The polymer blend ratio, guar gum viscosity, and degree of dilution of the final coating dispersion were varied. Importantly, it was found that more than 5% guar gum (referred to the total polymer content) must be incorporated in the film coating and that the apparent viscosity of a 1% aqueous guar gum solution must be greater than 150 cP to provide ethanol-resistance. In contrast, the investigated degree of coating dispersion dilution was not found to be decisive for the ethanol sensitivity. Furthermore, all investigated formulations were long term stable, even upon open storage under stress conditions for 6 months.

Ethanol-resistant polymeric film coatings for controlled drug delivery

The sensitivity of controlled release dosage forms to the presence of ethanol in the gastro intestinal tract is critical, if the incorporated drug is potent and exhibits severe side effects. This is for instance the case for most opioid drugs. The co-ingestion of alcoholic beverages can lead to dose dumping and potentially fatal consequences. For these reasons the marketing of hydromorphone HCl extended release capsules (Palladone) was suspended. The aim of this study was to develop a novel type of controlled release film coatings, which are ethanol-resistant: even the presence of high ethanol concentrations in the surrounding bulk fluid (e.g., up to 40%) should not affect the resulting drug release kinetics. Interestingly, blends of ethylcellulose and medium or high viscosity guar gums provide such ethanol resistance. Theophylline release from pellets coated with the aqueous ethylcellulose dispersion Aquacoat® ECD 30 containing 10 or 15% medium and high viscosity guar gum was virtually unaffected by the addition of 40% ethanol to the release medium. Furthermore, drug release was shown to be long term stable from this type of dosage forms under ambient and stress conditions (without packaging material), upon appropriate curing.

Differences in the prevalence rates and correlates of alcohol use and binge alcohol use among five Asian American subpopulations

BACKGROUND

This study (1) estimated the prevalence of alcohol and binge alcohol use among adult Asian Americans by sub-ethnicity; (2) examined alcohol drinking patterns among these subpopulations; and (3) investigated sub-ethnic differences in characteristics associated with alcohol and binge alcohol use.

METHOD

Data from 8900 Asian Americans aged 18 or older who participated in the 2002-2008 National Surveys on Drug Use and Health (NSDUHs) were analyzed. Descriptive analyses and multivariate logistic regression modeling were applied.

RESULTS

Korean Americans (51.8%) and Japanese Americans (49.7%) reported higher rates of past-month alcohol use than Chinese Americans (42.0%), Filipino Americans (37.9%), and Asian Indian Americans (34.0%). Korean Americans (24.6%) reported the highest rate of past-month binge alcohol use, followed by Filipino Americans (14.5%), Japanese Americans (14.2%), Asian Indian Americans (10.1%), and Chinese Americans (8.1%). Among these examined Asian Americans, foreign-born Chinese, Filipino, and Asian Indian Americans were less likely to have past-month alcohol use than their corresponding U.S. born counterparts; and only foreign-born Asian Indian Americans were less likely to have past-month binge alcohol use than their U.S. born counterparts. Males were 3-5 times more likely to have binge alcohol use than females among examined Asian American subpopulations except for Korean Americans. Korean Americans were more likely to have binge alcohol use than the other examined sub-ethnic Asian Americans.

CONCLUSIONS

Adult Asian Americans are heterogeneous in sociodemographic characteristics and alcohol and binge alcohol use. These differences suggest the need for sub-ethnically specific prevention and treatment programs for alcohol use problems among Asian American subpopulations.

Sociodemographic characteristics associated with binge drinking among Brazilians

BACKGROUND

Binge drinking (BD) is a harmful pattern of alcohol use. This study describes this pattern of drinking and the sociodemographic variables associated with it in a representative sample of Brazilians.

METHODS

A cross-sectional survey of 3007 individuals using a multistage probabilistic sample was conducted in 143 Brazilian municipalities. The frequency of BD in the year preceding the study was assessed. BD was defined as the consumption of four drinks of alcohol within a two-hour period for women and five drinks in two hours for men. Weighted-ordered logit regression was used to assess the relationship between sociodemographic factors and BD.

RESULTS

Most respondents had not engaged in binge drinking (69.7%; 95% confidence interval (CI) 67.0-72.2%). Binge drinking was more common among participants who were male (odds ratio (OR) 2.9; 95% CI 2.3-3.6) or single (OR 1.5; 95% CI 1.1-2.1) or had higher family income (OR 2.3; 95% CI 1.3-3.8). Individuals between 18 and 44 years of age were four times more likely to engage in binge drinking than adolescents (OR 4.7; 95% CI 3.3-6.8). Evangelicals/Protestants were less likely to engage in binge drinking (OR 0.7; 95% CI 0.2-0.5).

CONCLUSIONS

Our study, which is the first representative survey of BD in Brazil, showed that the age range of adults who engaged in BD is wider than the age range observed in other countries. These individuals are at increased risk for the adverse consequences of binge drinking, including addiction, car accidents, involvement in crime, absenteeism, and family violence.

Increased amplitude of P3 event-related potential in young binge drinkers

The aim of the present study was to determine how binge drinking (BD) affects brain functioning in male and female university students during the performance of a visual discrimination task. Thirty two binge drinkers and 53 controls (non binge drinkers), with no history of other drug use, personal or family history of alcoholism or psychopathological disorders, were selected. Event-related potentials (ERPs) were recorded during the performance of a visual oddball task. The latency and amplitude of the N2 and P3b components of the ERPs were analyzed. There were no differences between the groups in behavioral measures, but P3b amplitudes were significantly larger in binge drinkers than controls. This may suggest the presence of anomalies in neural processes mediating attention processing, or an imbalance (increased) of neuronal activity in P3b generators caused by the presence of BD pattern for a long time.

Acute oral ethanol exposure triggers asthma in cockroach allergen-sensitized mice

Asthma may be triggered by multiple mediators, including allergen-IgE cross-linking and non-IgE mechanisms. Several clinical studies have shown acute ethanol consumption exacerbates asthma, yet no animal model exists to study this process. We developed a model of ethanol-triggered asthma in allergen-sensitized mice to evaluate the mechanisms of ethanol inducing asthma-like responses. Outbred mice were exposed to cockroach allergens on Days 0 and 14; and on Day 21, mice received ethanol by oral gavage. Tracer studies confirmed alcohol aspiration did not occur. Within 30 minutes, alcohol induced degranulation of over 74% of mast cells, and multiple parameters of asthma-like pulmonary inflammation were triggered. Ethanol-gavaged mice had a fivefold increased production of eotaxin-2 (534 pg/mL) and a sevenfold increase in bronchoalveolar eosinophils (70,080 cells). Ethanol induced a 10-fold increase in IL-13, from 84 pg/mL in sensitized mice to 845 pg/mL in ethanol-gavaged sensitized mice. In cockroach allergen-sensitized mice, ethanol triggered asthma-like changes in respiratory physiology and a significant fivefold increase in airway mucin production. Importantly, none of these asthmatic exacerbations were observed in normal mice gavaged with ethanol. Cromolyn sodium effectively stabilized mast cells, yet increased mucin production and bronchoalveolar eosinophil recruitment. Together, these data show a single oral alcohol exposure will trigger asthma-like pulmonary inflammation in allergen-sensitized mice, providing a novel asthma model.

Intakes of alcohol and folate during adolescence and risk of proliferative benign breast disease

OBJECTIVES

To examine the combined effect of alcohol and folate intake during adolescence on the risk of proliferative benign breast disease (BBD).

METHODS

We used data from 29 117 women in the Nurses' Health Study II who completed both adolescent alcohol consumption questions in 1989 and an adolescent diet questionnaire in 1998. A total of 659 women with proliferative BBD diagnosed between 1991 and 2001 were confirmed by central pathology review. Cox proportional hazards models were used to estimate hazard ratios and 95% confidence intervals (CIs), adjusted for established risk factors of breast cancer.

RESULTS

Adolescent alcohol consumption was dose-dependently associated with an increased risk of proliferative BBD (hazard ratio = 1.15 per 10 g/day consumption; 95% CI, 1.03-1.28). There was no significant association between adolescent folate intake and the risk of proliferative BBD. Stratified analyses showed that each 10-g/day alcohol intake during adolescence was associated with a 21% (95% CI, 1.01-1.45) increase in the risk of proliferative BBD among women with low folate intake during adolescence, which was not significantly different from the alcohol-associated risk among women with moderate and high folate intake during adolescence (P for interaction = 0.18).

CONCLUSIONS

Adolescent alcohol consumption is associated with increased risk of proliferative BBD, which may not be reduced by increased folate intake during adolescence.

Losses of expected lifetime in the United States and other developed countries: methods and empirical analyses

Patterns of diversity in age at death are examined using e (†), a dispersion measure that equals the average expected lifetime lost at death. We apply two methods for decomposing differences in e (†). The first method estimates the contributions of average levels of mortality and mortality age structures. The second (and newly developed) method returns components produced by differences between age- and cause-specific mortality rates. The United States is close to England and Wales in mean life expectancy but has higher life expectancy losses and lacks mortality compression. The difference is determined by mortality age structures, whereas the role of mortality levels is minor. This is related to excess mortality at ages under 65 from various causes in the United States. Regression on 17 country-series suggests that e (†) correlates with income inequality across countries but not across time. This result can be attributed to dissimilarity between the age- and cause-of-death structures of temporal mortality reduction and intercountry mortality variation. It also suggests that factors affecting overall mortality decrease differ from those responsible for excess lifetime losses in the United States compared with other countries. The latter can be related to weaknesses of health system and other factors resulting in premature death from heart diseases, amenable causes, accidents and violence.

The epidemiology of alcohol consumption and misuse among Chinese college students

AIMS

To understand alcohol-related risk behaviours among Chinese college students.

METHODS

As part of the first China National Youth Risk Behaviour Survey, undertaken in 2009, 52,150 students at 119 colleges were randomly sampled. Information was obtained from self-administered questionnaires.

RESULTS

Prevalences were: lifetime drinkers 80.8%, current drinkers 49.3% (drank alcohol in past 30 days) and binge drinkers 23.5% ('binge drinkers' reporting at least five alcoholic drinks on a single occasion at least six times during the past 30 days). Multinomial logistic analysis revealed the contribution of sociodemographic factors to three high-risk drinking behaviours: odds ratio (95% confidence interval) = 3.64 (2.69-4.60) with frequent drinking; 3.27 (1.82-4.72) with binge drinking; and 5.48 (3.20-7.77) with heavy binge drinking. These three rates were greater among males than females, in the Western more than the Eastern region, among students living off-campus and among those whose mothers had higher education. Heavy drinking was linked to lower academic self-rating.

CONCLUSION

There is a trend towards risky drinking among Chinese college students. Measures such as a minimum drinking age, advertisement restrictions, taxation, drunk-driving penalties and campaigns to heighten public awareness of alcohol-related health risks should be instituted in order to improve the situation on college campuses where alcohol abuse is particularly prevalent.

Racial/ethnic differences in prevalence and correlates of binge drinking among older adults

OBJECTIVES

This study examines how the prevalence and correlates of binge drinking among older adults vary by race/ethnicity.

METHODS

Drawn from the 2007 California Health Interview Survey, adults aged 60 and older (n = 18,772) were selected. Binge drinking was measured dichotomously based on whether individuals reported consuming five or more drinks in a single day (four or more for females) in the previous year. Prevalence rates for binge drinking in the past year were calculated by race/ethnicity. A hierarchical logistic regression analysis was conducted using binge drinking in the past year as the dependent variable.

RESULTS

Significant racial/ethnic differences were found in prevalence rates: the presence of binge drinking was most common among non-Hispanic Whites (11.9%), followed by Latinos (10.8%), American Indian/Alaska Natives (9.8%), Blacks (8.0%), and Asians (4.2%). Being a current smoker was found to be the strongest predictor of binge drinking and significant main effects were also found for being Black, being Asian, younger age, being male, being unemployed, having a higher poverty threshold, having better self-rated health, and having more psychological distress. Significant interactions between race/ethnicity and age, sex, employment status, educational attainment, smoking status, and self-rated health were found. These findings indicate that certain correlates of binge drinking vary significantly by race/ethnicity among older adults.

CONCLUSIONS

Apparent racial/ethnic differences existed in the prevalence and correlates of binge drinking among older adults. Identification of more racial/ethnic specific predictors may be important for the development of racial/ethnic appropriate intervention programs.

Whiners and deniers - what does self-rated health measure?

Self-rated health is a widely used measure of health typically obtained from a question, "How do you rate your health?" Despite the measure's popularity, debates continue as to what exactly self-rated health captures. This study augments the rich literature on the construct of self-rated health using a unique measurement approach. We conceptualize self-rated health as consisting of two components: latent health and reporting behaviour. We operationalize a preference-standardized health-related quality of life as a measure of latent health, and its systematic deviation from self-rated health as a measure of reporting behaviour. Using the 2005 Canadian Community Health Survey, we assess comparatively how the deviations between self-rated health and latent health, measured by the Health Utilities Index Mark 3, vary systematically by demographic, socioeconomic, and cultural factors. We present reporting behaviour by these factors in terms of pessimism and optimism relative to the assessment of the average Canadian. Our analysis shows reporting behaviour statistically and clinically significantly varies by age and socioeconomic status: those aged 80+ years and those with less income and education exhibit optimism about their health. In addition, our analysis indicates a tendency for persons with healthier lifestyles to be slightly pessimistic about their health. Our results imply that it may be misleading to take self-rated health at face value as a measure of health status for applications where preferences should be standardized. For this popular measure to continue to play an important role in population health research and policy development, its users must acknowledge and understand the determinants of self-rated health, including reporting behaviour.

Associations between binge and heavy drinking and health behaviors in a nationally representative sample

BACKGROUND

Binge and heavy drinking are noted in the literature for their relatively high prevalence and adverse health-related effects.

DESIGN AND PARTICIPANTS

We used data from the 2006 Behavioral Risk Factor Surveillance Survey (BRFSS) to determine the associations between binge and heavy drinking and a wide range of health-related variables, including positive and negative health behaviors, preventive care practices, and quality of life indices in a nationally representative sample of 344,793 adults.

RESULTS

Rates of binge and heavy drinking in the current sample were 15% and 5%, respectively. Binge and heavy drinking were more common among men, younger adults, and individuals with higher incomes and at least some college education. After controlling for relevant demographic variables, binge and heavy drinking were associated with a number of adverse health-related and preventive care behaviors (e.g., smoking, failing to receive a mammogram), as well as less life satisfaction and a greater number of poor mental health days than those who did not engage in these drinking behaviors. Interestingly, binge and heavy drinking were also associated with some positive health-related variables (e.g., recent physical activity, positive perceptions of one's own health).

CONCLUSIONS

The current study findings provide additional information regarding the relations between health-related attitudes and behaviors and binge and heavy drinking in the U.S. population. Implications of study findings are discussed.

Changes in the prevalence of child sexual abuse, its risk factors, and their associations as a function of age cohort in a Finnish population sample

OBJECTIVE

We examined (1) the prevalence of childhood sexual abuse (CSA) experiences as a function of cohort and gender, (2) the prevalence of factors associated with CSA as a function of cohort and whether the association of these factors with CSA remained the same irrespective of cohort, and (3) whether any cohort differences could be explainable by cohort differences in reporting bias.

METHOD

We used the responses of 4,561 men (M=29, SD=7 years) and 8,361 female (M=29, SD=7 years) Finnish participants who responded to the Childhood Trauma Questionnaire-Short Form as well as questions regarding family structure.

RESULTS

The prevalence of CSA experiences varied between 0.7-4.6% for men and 1.8-7.5% for women depending on the item. Younger cohorts reported less CSA as well as less of the risk factors (physical neglect and abuse, emotional neglect and abuse, parental substances abuse, not growing up with both biological parents) that were positively associated with the likelihood of CSA. The effects of these risk factors did not vary as a function of the cohort. Also, the declining trend was not explainable by social desirability being higher in the younger cohorts.

CONCLUSIONS

The results suggest that there is a real decline in the prevalence of CSA and it is associated with a simultaneous decline in factors associated with CSA.

Cohabitation, gender, and alcohol consumption in 19 countries: a multilevel analysis

We used an ecological paradigm and multilevel analytic techniques to analyze gender-specific relationships of cohabitation (versus marriage) to drinking in 19 countries (n = 32,922) and to "heavy episodic drinking" (HED) in 17 countries (n = 24,525) in surveys (1996-2004) from Gender, Alcohol, and Culture: An International Study. Cohabitation was associated with elevated risk of HED among drinkers of both genders, controlling for age, education, and societal characteristics. The association between cohabitation and HED tended to be stronger for female drinkers than for male drinkers. HED was more prevalent among younger drinkers, especially among younger women in countries with higher per capita gross domestic product. Cross-culturally, cohabiters deserve special attention in prevention efforts for hazardous drinking, considering both individual-level and societal factors.

Disparities in liver cancer incidence by nativity, acculturation, and socioeconomic status in California Hispanics and Asians

BACKGROUND

Asians and Hispanics have the highest incidence rates of liver cancer in the United States, but little is known about how incidence patterns in these largely immigrant populations vary by nativity, acculturation, and socioeconomic status (SES). Such variations can identify high-priority subgroups for prevention and monitoring.

METHODS

Incidence rates and rate ratios (IRR) by nativity among 5,400 Hispanics and 5,809 Asians diagnosed with liver cancer in 1988-2004 were calculated in the California Cancer Registry. Neighborhood ethnic enclave status and SES were classified using 2000 U.S. Census data for cases diagnosed in 1998-2002.

RESULTS

Foreign-born Hispanic males had significantly lower liver cancer incidence rates than U.S.-born Hispanic males in 1988-2004 (e.g., IRR = 0.54, 95% confidence interval [CI] = 0.50-0.59 in 1997-2004), whereas foreign-born Hispanic females had significantly higher rates in 1988-1996 (IRR = 1.42, 95% CI = 1.18-1.71), but not 1997-2004. Foreign-born Asian males and females had up to 5-fold higher rates than the U.S.-born. Among Hispanic females, incidence rates were elevated by 21% in higher-enclave versus lower-enclave neighborhoods, and by 24% in lower- versus higher-SES neighborhoods. Among Asian males, incidence rates were elevated by 23% in higher-enclave neighborhoods and by 21% in lower-SES neighborhoods. In both racial/ethnic populations, males and females in higher-enclave, lower-SES neighborhoods had higher incidence rates.

CONCLUSIONS

Nativity, residential enclave status, and neighborhood SES characterize Hispanics and Asians with significantly unequal incidence rates of liver cancer, implicating behavioral or environmental risk factors and revealing opportunities for prevention.

IMPACT

Liver cancer control efforts should especially target foreign-born Asians, U.S.-born Hispanic men, and residents of lower-SES ethnic enclaves.

Age differences in long-term patterns of change in alcohol consumption among aging adults

OBJECTIVE

To estimate patterns of long-term, within-person, changes in alcohol consumption among adults of different ages and assess key predictors of alcohol-use patterns over time.

METHOD

Data came from 3,617 adults, interviewed up to four times between 1986 and 2002. Multilevel multinomial logit models estimated the odds of abstinence and heavy drinking relative to moderate drinking.

RESULTS

The odds of abstinence increased and the odds of heavy drinking decreased during the study period. Older adults experienced faster increases in abstinence than younger adults. However, data extrapolations suggest that current younger adults are more likely to be abstinent and less likely to be heavy drinkers during late life than current older adults. Time-varying health, social, and lifestyle factors account for some of these patterns.

DISCUSSION

Drinking behavior in our aging population appears to be on a relatively promising course, perhaps reflecting the effectiveness of public health efforts.

Relationship between alcohol drinking and aspartate aminotransferase:alanine aminotransferase (AST:ALT) ratio, mean corpuscular volume (MCV), gamma-glutamyl transpeptidase (GGT), and apolipoprotein A1 and B in the U.S. population

OBJECTIVE

The misuse of alcohol, even at levels just above two drinks per day, is a public health problem, but identifying patients with this potentially unhealthy drinking is hindered by the lack of tests. Several blood tests, such as those testing for gamma-glutamyl transpeptidase (GGT) or mean corpuscular volume (MCV), are among the commonly used markers to identify very heavy drinking, but combinations of these markers have rarely been tested in lighter drinkers. We examined the relationship between alcohol drinking and the levels of these markers in a national population-based study composed primarily of lighter drinkers.

METHOD

Data were analyzed from 8,708 adult participants in the third U.S. National Health and Nutrition Examination Survey after excluding subjects with iron overload; with hepatitis B and C; who were pregnant; and who were taking prescription drugs such as phenytoin (Dilantin), barbiturates, and hydroxyurea (Droxia and Hydrea). The relationship between the amount of alcohol drinking and GGT, aspartate aminotransferase:alanine aminotransferase ratio, MCV of erythrocytes, and apolipoprotein A1 and B were analyzed and adjusted for potential liver injury risk factors.

RESULTS

The prevalence of unhealthy alcohol drinking (defined as consumption of more than two standard drinks per day) was 6.7%. Heavier drinkers tended to be younger and reported an average of 4.2 drinks per day. When tested alone or in combination, the sensitivity and positive predictive values for these blood tests were too low to be clinically useful in identifying the subjects in the heavier drinking category.

CONCLUSIONS

In this large, national, population-based study, the markers of heavy drinking studied here, either alone or in combination, did not appear to be useful in identifying unhealthy drinking. More work is needed to find the novel marker(s) associated with risky alcohol drinking.

Heavy Episodic Alcohol Use in Emerging Adulthood: The Role of Early Risk Factors and Young Adult Social Roles

In this paper we examine the potential interdependence between early adolescent alcohol use and later role occupancy of such social roles as higher education attendance, parenthood, level of work intensity, and marriage. Data from a ten-year prospective study (1990–1993 & 2000–2003) were employed to examine these relationships among a sample of 523 young adult males who had previously attended a Miami-Dade County (Florida) middle or high school. Among the adult social roles considered, only being currently married was shown to be a significant predictor of having an inverse association with heavy alcohol use. However, an important conditional relationship was also observed: among those respondents who have a history of high early alcohol use, there is an association between work intensity and heavy alcohol use such that work intensity has a social amplification effect on young adult heavy alcohol use. The results presented here demonstrate that early risk factors need to be considered in conjunction with later social role occupancy when examining young problem drinking. The implications and limitations of these findings are discussed.

Irregular heavy drinking occasions and risk of ischemic heart disease: a systematic review and meta-analysis

Contrary to a cardioprotective effect of moderate regular alcohol consumption, accumulating evidence points to a detrimental effect of irregular heavy drinking occasions (>60 g of pure alcohol or > or =5 drinks per occasion at least monthly) on ischemic heart disease risk, even for drinkers whose average consumption is moderate. The authors systematically searched electronic databases from 1980 to 2009 for case-control or cohort studies examining the association of irregular heavy drinking occasions with ischemic heart disease risk. Studies were included if they reported either a relative risk estimate for intoxication or frequency of > or =5 drinks stratified by or adjusted for total average alcohol consumption. The search identified 14 studies (including 31 risk estimates) containing 4,718 ischemic heart disease events (morbidity and mortality). Using a standardized protocol, the authors extracted relative risk estimates and their variance, in addition to study characteristics. In a random-effects model, the pooled relative risk of irregular heavy drinking occasions compared with regular moderate drinking was 1.45 (95% confidence interval: 1.24, 1.70), with significant between-study heterogeneity (I(2) = 53.9%). Results were robust in several sensitivity analyses. The authors concluded that the cardioprotective effect of moderate alcohol consumption disappears when, on average, light to moderate drinking is mixed with irregular heavy drinking occasions.

Efficacy of physician-delivered brief counseling intervention for binge drinkers

BACKGROUND

Binge drinking is a common pattern of alcohol use in the US. However, no studies have evaluated the effectiveness of brief interventions targeting only binge drinkers.

METHODS

Randomized controlled clinical trial with a 12-month follow-up period conducted from March 1, 2003 to March 1, 2006 in Spain. Of a screened population of 15,325 patients seeking routine medical care from their primary care providers, patients who met inclusion criteria were randomized into an experimental group (n=371) or a control group (n=381). The primary outcome measures were the frequency of binge drinking episodes and weekly alcohol intake.

RESULTS

There were no significant differences at baseline between groups in alcohol use and demographic variables. At the end of the 12-month follow-up period, there were significant reductions in binge-drinking status (52.2% vs 67.2%, P <.001), number of episodes of binge drinking (1.14 vs 1.56, P <.001), number of drinks weekly (19.2 vs 22.4, P <.001), and frequency of excessive alcohol intake in 7 days (47.9% vs 66.6%, P >.001).

CONCLUSIONS

This study provided evidence that screening and brief counseling delivered by a primary care physician as part of regular health care significantly reduced binge drinking episodes in binge drinkers.

An interaction between DAT1 and having an alcoholic father predicts serious alcohol problems in a sample of males

The current study examines whether the dopamine transporter (DAT1) VNTR polymorphism and paternal alcoholism are related to serious alcohol problems. Using data from the National Longitudinal Study of Adolescent Health (Add Health), we found that the DAT1 polymorphism interacted with paternal alcoholism to predict serious alcohol problems among males. Specifically, the 10-repeat allele conferred an increase of alcohol problems only among males who also had an alcoholic father; the 10-repeat allele was unrelated to alcohol problems for males without an alcoholic father. Coefficient tests revealed that this interaction effect was stronger among African-American males. Females who possessed the 9-repeat allele were more likely to report serious alcohol problems, but this effect was not moderated by paternal alcoholism. These analyses suggest that additive and interactive effects of DAT1 and paternal alcoholism may operate differently across genders and races.

Alcohol consumption, finasteride, and prostate cancer risk: results from the Prostate Cancer Prevention Trial

BACKGROUND

Current research is inconclusive regarding the relation between alcohol consumption and prostate cancer risk. In this study, the authors examined the associations of total alcohol, type of alcoholic beverage, and drinking pattern with the risk of total, low-grade, and high-grade prostate cancer.

METHODS

Data for this study came from the 2129 participants in the Prostate Cancer Prevention Trial (PCPT) who had cancer detected during the 7-year trial and 8791 men who were determined by biopsy to be free of cancer at the trial end. Poisson regression was used to calculate relative risks (RRs) and 95% confidence intervals (95% CIs) for associations of alcohol intake with prostate cancer risk.

RESULTS

Associations of drinking with high-grade disease did not differ by treatment arm. In combined arms, heavy alcohol consumption (> or =50 g of alcohol daily) and regular heavy drinking (> or =4 drinks daily on > or =5 days per week) were associated with increased risks of high-grade prostate cancer (RR, 2.01 [95% CI, 1.33-3.05] and 2.17 [95% CI, 1.42-3.30], respectively); less heavy drinking was not associated with risk. Associations of drinking with low-grade cancer differed by treatment arm. In the placebo arm, there was no association of drinking with risk of low-grade cancer. In the finasteride arm, drinking > or =50 g of alcohol daily was associated with an increased risk of low-grade disease (RR, 1.89; 95% CI, 1.39-2.56); this finding was because of a 43% reduction in the risk of low-grade cancer attributable to finasteride treatment in men who drank <50 g of alcohol daily and the lack of an effect of finasteride in men who drank > or =50 g of alcohol daily (P(interaction) = .03).

CONCLUSIONS

Heavy, daily drinking increased the risk of high-grade prostate cancer. Heavy drinking made finasteride ineffective for reducing prostate cancer risk.

Longitudinal patterns of binge drinking among first year college students with a history of tobacco use

BACKGROUND

Underage heavy episodic drinking is a major contributor to alcohol-related morbidity/mortality. Reports indicate underage binge drinking among college students is widespread and has remained stable over the past decade. This study describes individual characteristics and calendar-specific events associated with binge drinking episodes over the course of freshman college academic year (2002-2003).

METHODS

Students (N=827, age 18 years), with a prior history of tobacco use, attending a large Midwest university completed weekly web-based surveys on the number of drinks consumed for each of the past 7 days over the duration of 35 consecutive weeks (avg. number of weeks reported 16.0+/-10.5).

RESULTS

Average prevalence of binge episodes across the academic year was 17.2+/-14.4%, 23.6+/-8.3%, and 66.3+/-11.2% for weekdays, Thursdays, and weekend days, respectively. Two-level random effects logit survival models for repeated events indicated the prevalence of weekday and Thursday binge drinking was associated with specific university/community events (Local festival odds ratio [OR] 6.03, 95% confidence interval [CI] 4.34-8.36), holidays (New Year's Eve OR 18.48, CI 12.83-26.63), and academic breaks (Spring Break OR 6.45, CI 4.57-9.08). Expected associations of younger age of first heavy drinking, past 12-month drinking, and experiencing negative consequences from heavy drinking were observed.

CONCLUSIONS

Although individual characteristics were related to engaging in a binge episode, binge episodes were strongly associated with time-specific calendar events. Effective interventions to prevent immediate and long-term health consequences associated with binge drinking should consider environmental and institutional policy-level controls to reduce high levels of binge drinking on college campuses connected with holidays and university/community events.

Binge drinking among youths and young adults in the United States: 1979-2006

OBJECTIVE

To evaluate trends in the past 30-day prevalence of binge drinking by age, sex, and student status, among youths and young adults in the United States between 1979 and 2006, a period that encompasses the federally mandated transition to a uniform legal drinking age of 21 years, and other policy changes aimed at curbing underage drinking.

METHOD

Data were analyzed from 20 administrations of the National Survey on Drug Use and Health, yielding a pooled sample of more than 500,000 subjects. Trends in relative risk for four different age groups, stratified by sex, relative to the 24- to 34-year-old reference group were calculated. We also examined trends in risk for binge drinking associated with student status (among college-age students) and race/ethnicity.

RESULTS

Significant reductions in relative risk for binge drinking over time were observed for 12- to 20-year-old males, but no changes were observed for females in this age range, and binge drinking among minority females increased. Risk for binge drinking increased among 21- to 23-year-old women, with college women outpacing nonstudents in this age range. Trends also indicate that no reduction in binge drinking occurred for college men.

CONCLUSIONS

Although the overall trend is toward lower rates of binge drinking among youths, likely a result of a higher legal drinking age and other changes in alcohol policy, little improvement has occurred for college students, and increases in binge drinking among women has offset improvements among youths. Understanding these specific demographic trends will help inform prevention efforts.

Binge drinking and its detection among middle-aged men using AUDIT, AUDIT-C and AUDIT-3

Binge (heavy episodic) drinking is common, but there is little knowledge on how this drinking pattern could be detected. This study compares three structured questionnaires among binge drinking middle-aged men. All 45-year-old men in the city of Tampere, Finland, were asked to fill in the Alcohol Use Disorders Identification Test (AUDIT). Based on the interview on their drinking the men were divided into non-binging moderate drinkers (n = 352), binging moderate drinkers (n = 130), non-binging heavy drinkers (n = 10) and binging heavy drinkers (n = 63). The complete AUDIT, AUDIT-C (first three AUDIT questions inquiring quantity-frequency) and AUDIT-3 (the third binging-frequency question of AUDIT) in detecting binge drinking were compared. The complete AUDIT was effective in detecting binge drinkers by a cut-off score of >or=8 or >or=7. The optimal cut-off score for AUDIT-C was >or= 6 and that for AUDIT-3 >or=2. The area under the curve (AUC) among all risky drinkers (binging moderate and binging heavy and non-binging heavy drinkers) for AUDIT was 0.824 (95% CI 0.789 - 0.859), for AUDIT-C 0.829 (95% CI 0.795 - 0.864) and for AUDIT-3 0.779 (0.739 - 0.818). The complete AUDIT and its short versions are applicable in populations where binging is the dominant drinking pattern, but the cut-off scores should be tailored to individual cultures.

Hostility and trajectories of body mass index over 19 years: the Whitehall II Study

The authors examined the associations of hostility measured in adulthood with subsequent body mass index (BMI; weight (kg)/height (m)(2)) assessed at 4 time points over a 19-year period (1985-2004) in a United Kingdom cohort study. A total of 6,484 participants (4,494 men and 1,990 women) aged 35-55 years at baseline (1985-1988) completed the Cook-Medley Hostility Scale. BMI was assessed upon medical examination in phases 1 (1985-1988), 3 (1991-1993), 5 (1997-1999), and 7 (2002-2004). Mixed-models analyses of repeated measures showed clear evidence of increasing BMI over follow-up in both sexes. In women, higher levels of hostility were associated with higher BMI at baseline, and this effect remained constant throughout the follow-up period. In men, hostility levels were also strongly associated with BMI at baseline, but results for the interaction between time and hostility also suggested that this association increased over time, with persons in the highest quartile of hostility gaining an excess of 0.016 units (P = 0.023) annually over the follow-up period as compared with persons in the lowest quartile. The authors conclude that the difference in BMI as a function of hostility levels in men is not stable over time.