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Kang DO, Lee DI, Roh SY, Na JO, Choi CU, Kim JW, Kim EJ, Rha SW, Park CG, Kim YS, Kim Y, You HS, Kang HT, Jo E, Kim J, Lee JW, Jung JM. Reduced Alcohol Consumption and Major Adverse Cardiovascular Events Among Individuals With Previously High Alcohol Consumption. JAMA Netw Open 2024; 7:e244013. [PMID: 38546645 PMCID: PMC10979316 DOI: 10.1001/jamanetworkopen.2024.4013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 01/22/2024] [Indexed: 04/01/2024] Open
Abstract
Importance Cardiovascular benefits of mild to moderate alcohol consumption need to be validated in the context of behavioral changes. The benefits of reduced alcohol consumption among people who drink heavily across different subtypes of cardiovascular disease (CVD) are unclear. Objective To investigate the association between reduced alcohol consumption and risk of major adverse cardiovascular events (MACEs) in individuals who drink heavily across different CVD subtypes. Design, Setting, and Participants This cohort study analyzed data from the Korean National Health Insurance Service-Health Screening database and self-reported questionnaires. The nationally representative cohort comprised Korean citizens aged 40 to 79 years who had national health insurance coverage on December 31, 2002, and were included in the 2002 to 2003 National Health Screening Program. People who drank heavily who underwent serial health examinations over 2 consecutive periods (first period: 2005-2008; second period: 2009-2012) were included and analyzed between February and May 2023. Heavy drinking was defined as more than 4 drinks (56 g) per day or more than 14 drinks (196 g) per week for males and more than 3 drinks (42 g) per day or more than 7 drinks (98 g) per week for females. Exposures Habitual change in heavy alcohol consumption during the second health examination period. People who drank heavily at baseline were categorized into 2 groups according to changes in alcohol consumption during the second health examination period as sustained heavy drinking or reduced drinking. Main Outcomes and Measures The primary outcome was the occurrence of MACEs, a composite of nonfatal myocardial infarction or angina undergoing revascularization, any stroke accompanied by hospitalization, and all-cause death. Results Of the 21 011 participants with heavy alcohol consumption at baseline (18 963 males [90.3%]; mean [SD] age, 56.08 [6.16] years) included in the study, 14 220 (67.7%) sustained heavy drinking, whereas 6791 (32.2%) shifted to mild to moderate drinking. During the follow-up of 162 378 person-years, the sustained heavy drinking group experienced a significantly higher incidence of MACEs than the reduced drinking group (817 vs 675 per 100 000 person-years; log-rank P = .003). Reduced alcohol consumption was associated with a 23% lower risk of MACEs compared with sustained heavy drinking (propensity score matching hazard ratio [PSM HR], 0.77; 95% CI, 0.67-0.88). These benefits were mostly accounted for by a significant reduction in the incidence of angina (PSM HR, 0.70; 95% CI, 0.51-0.97) and ischemic stroke (PSM HR, 0.66; 95% CI, 0.51-0.86). The preventive attributes of reduced alcohol intake were consistently observed across various subgroups of participants. Conclusions and Relevance Results of this cohort study suggest that reducing alcohol consumption is associated with a decreased risk of future CVD, with the most pronounced benefits expected for angina and ischemic stroke.
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Affiliation(s)
- Dong Oh Kang
- Cardiovascular Center, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Dae-In Lee
- Cardiovascular Center, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Seung-Young Roh
- Cardiovascular Center, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Jin Oh Na
- Cardiovascular Center, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Cheol Ung Choi
- Cardiovascular Center, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Jin Won Kim
- Cardiovascular Center, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Eung Ju Kim
- Cardiovascular Center, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Seung-Woon Rha
- Cardiovascular Center, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Chang Gyu Park
- Cardiovascular Center, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Ye-Seul Kim
- Department of Family Medicine, Chungbuk National University Hospital, Chungju, Republic of Korea
| | - Yonghwan Kim
- Department of Family Medicine, Chungbuk National University Hospital, Chungju, Republic of Korea
| | - Hyo-Sun You
- Department of Family Medicine, Chungbuk National University Hospital, Chungju, Republic of Korea
| | - Hee-Taik Kang
- Department of Family Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Eunseo Jo
- Department of Statistical Analysis, Zarathu Co Ltd, Seoul, Republic of Korea
| | - Jinseob Kim
- Department of Statistical Analysis, Zarathu Co Ltd, Seoul, Republic of Korea
| | - Jae-woo Lee
- Department of Family Medicine, Chungbuk National University Hospital, Chungju, Republic of Korea
- Department of Family Medicine, Chungbuk National University College of Medicine, Chungju, Republic of Korea
| | - Jin-Man Jung
- Department of Neurology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Republic of Korea
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Guan SP, Kumar SN, Fann DY, Kennedy BK. A mechanistic perspective on the health promoting effects of alcohol - A focus on epigenetics modification. Alcohol 2023; 107:91-96. [PMID: 35987314 DOI: 10.1016/j.alcohol.2022.07.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 07/25/2022] [Accepted: 07/27/2022] [Indexed: 01/23/2023]
Abstract
While the detrimental effects of binge drinking are well recognized, low-to-moderate alcohol consumption may be beneficial to health, although the underlying mechanism(s) remains elusive. In this opinion article, we will examine the effects of low dose alcohol consumption from the perspective of epigenetic modulation. Biochemically, alcohol is metabolized into acetate and subsequently to acetyl-coA, which can modulate histone acetylation levels. While elevated levels of acetyl-CoA are detrimental for longevity, we argue that diminished acetyl-CoA also negatively affects fatty acid biosynthesis and histone acetylation, which play a critical role in gene expression and, ultimately, health span. Since mitochondrial function and glucose metabolism, which provide the main source of nucleocytoplasmic acetyl-CoA, are compromised with age, alcohol-derived acetate could be an alternative source of acetyl-CoA to compensate. Hence, the health benefits of low ethanol consumption may be more pronounced after midlife, since mitochondrial function and/or glucose metabolism are diminished in this phase of the life course. Indeed, various clinical alcohol consumption studies concur with this notion, and have shown that a low dose of regular alcohol intake after midlife brings about various health and survival benefits. The requirement for regular alcohol intake may also reflect the transient nature of ethanol-induced histone acetylation. Conversely, ethanol may also stimulate carcinogenesis by inhibiting DNA methylation, as it was shown to reduce various pathways leading to DNA and histone methylation. However, unlike acetylation, where ethanol directly increases the substrate for acetylation, this effect was only observed in the high alcohol exposure cohort. While alcohol-derived acetate may be beneficial for health after midlife, various detrimental effects of alcohol consumption remain, and hence, we do not advocate excessive drinking to increase acetate. This opinion article establishes a possible role of ethanol-derived acetate in achieving homeostasis and sustaining an organism's health span.
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Affiliation(s)
- Shou Ping Guan
- Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Healthy Longevity Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Centre for Healthy Longevity, National University Health System, Singapore
| | - Shermila N Kumar
- Healthy Longevity Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Centre for Healthy Longevity, National University Health System, Singapore
| | - David Y Fann
- Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Healthy Longevity Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Centre for Healthy Longevity, National University Health System, Singapore
| | - Brian K Kennedy
- Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Healthy Longevity Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Centre for Healthy Longevity, National University Health System, Singapore; Singapore Institute of Clinical Sciences, Agency for Science, Technology and Research (A∗STAR), Singapore, Singapore.
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Jeong SM, Lee HR, Han K, Jeon KH, Kim D, Yoo JE, Cho MH, Chun S, Lee SP, Nam KW, Shin DW. Association of Change in Alcohol Consumption With Risk of Ischemic Stroke. Stroke 2022; 53:2488-2496. [PMID: 35440171 DOI: 10.1161/strokeaha.121.037590] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The effect of serial change in alcohol consumption on stroke risk has been limitedly evaluated. We investigated the association of change in alcohol consumption with risk of stroke. METHODS This study is a population-based retrospective cohort study from National Health Insurance Service database of all Koreans. Four lakh five hundred thirteen thousand seven hundred forty-six participants aged ≥40 years who underwent 2 subsequent national health examinations in both 2009 and 2011. Alcohol consumption was assessed by average alcohol intake (g/day) based on self-questionnaires and categorized into non-, mild, moderate, and heavy drinking. Change in alcohol consumption was defined by shift of category from baseline. Cox proportional hazards model was used with adjustment for age, sex, smoking status, regular exercise, socioeconomic information, and comorbidities, Charlson Comorbidity Index, systolic blood pressure, and laboratory results. Subgroup analysis among those with the third examination was conducted to reflect further change in alcohol consumption. RESULTS During 28 424 497 person-years of follow-up, 74 923 ischemic stroke events were identified. Sustained mild drinking was associated with a decreased risk of ischemic stroke (adjusted hazard ratio, 0.88 [95% CI, 0.86-0.90]) compared with sustained nondrinking, whereas sustained heavy drinking was associated with an increased risk of ischemic stroke (adjusted hazard ratio, 1.06 [95% CI, 1.02-1.10]). Increasing alcohol consumption was associated with an increased risk of ischemic stroke (adjusted hazard ratio, 1.11 [95% CI, 1.06-1.17] from mild to moderate; adjusted hazard ratio, 1.28 [95% CI, 1.19-1.38] from mild to heavy) compared with sustained mild drinkers. Reduction of alcohol consumption from heavy to mild level was associated with 17% decreased risk of ischemic stroke through 3× of examinations. CONCLUSIONS Light-to-moderate alcohol consumption is associated with a decreased risk of ischemic stroke, although it might be not causal and could be impacted by sick people abstaining from drinking. Reduction of alcohol consumption from heavy drinking is associated with a decreased risk of ischemic stroke.
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Affiliation(s)
- Su-Min Jeong
- Department of Family Medicine/Supportive Care Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea (S.-M.J., H.R.L., D.W.S.)
| | - Han Rim Lee
- Department of Family Medicine/Supportive Care Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea (S.-M.J., H.R.L., D.W.S.)
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea (K.H.)
| | - Keun Hye Jeon
- Department of Family Medicine, CHA Gumi Medical Center, Gumi, Republic of Korea (K.H.J.)
| | - Dahye Kim
- Department of Medical Statistics, The Catholic University of Korea, Seoul, Republic of Korea (D.K.)
| | - Jung Eun Yoo
- Department of Family Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, Republic of Korea. (J.E.Y.)
| | - Mi Hee Cho
- Samsung C&T Medical Clinic, Kangbuk Samsung Hospital, Jongno-gu, Seoul, Republic of Korea (M.H.C.)
| | - Sohyun Chun
- International Healthcare Center, Samsung Medical Center, Seoul, Republic of Korea (S.C.)
| | - Seung Pyo Lee
- Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Republic f Korea. (S.P.L.)
| | - Ki-Woong Nam
- Department of Neurology, Seoul National University Hospital, Republic of Korea. (K.-W.N.)
| | - Dong Wook Shin
- Department of Family Medicine/Supportive Care Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea (S.-M.J., H.R.L., D.W.S.).,Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Science and Technology, Sungkyunkwan University, Seoul, Republic of Korea (D.W.S.)
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Lu H, Ni J, Yang Q, Qiu S, Lin Q, Liu J, Tu J, Ning X, Wang J. Alcohol Consumption and Stroke Risk in Men: A Population-Based Cohort Study in Rural Tianjin, China. Neuroepidemiology 2021; 55:266-274. [PMID: 34130285 DOI: 10.1159/000515036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 02/04/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Although the protective effects of alcohol consumption against future cardiovascular disease have been published, the effects of alcohol on stroke risk remain controversial. METHOD We assessed the effects of alcohol consumption on stroke risk in a poorly educated, low-income population in rural China. Between 1991 and 2018, a population-based cohort study was conducted in rural Tianjin, China, to examine stroke risk. All registered stroke events were clinically verified using available computed tomography or MRI scans. The stroke risk was analyzed, according to the extent of alcohol consumption, using Cox regression analyses. RESULTS We identified 352 incident stroke events among male participants during the study period. The stroke incidences (per 100,000 person-years) were 965.3 overall, 575.9 for ischemic stroke events, 208.4 for hemorrhagic stroke events, and 181.0 for undefined stroke events. Overall, alcohol consumption provided a 32% reduction in the total stroke risk. Low-dose alcohol consumption (≤12 g/day) showed a negative association with total (hazard ratio [HR], 0.64; 95% confidence interval [CI], 0.46-0.88; p = 0.008) and ischemic (HR, 0.66; 95% CI, 0.44-0.98; p = 0.039) strokes. Alcohol consumption was not significantly associated with hemorrhagic strokes. After age stratification, alcohol consumption was protective against total and ischemic strokes in men aged ≥55 years old, with the risk of each stroke type decreasing by 46 and 49%, respectively. Low-dose alcohol consumption was inversely associated with both total and ischemic stroke risks, with the risks decreasing by 56 and 65%, respectively. Alcohol consumption was not significantly associated with strokes among men aged <55 years old. CONCLUSIONS These findings suggest that low-dose alcohol consumption may decrease the risk of ischemic strokes among men. Even so, the adverse effects of alcohol on the liver and pancreas cannot be ignored. Additionally, the effects of alcohol consumption on stroke risk vary with age, protecting against ischemic and total strokes among males ≥55 years old. Nevertheless, recommending light drinking and its potential health benefits should not be generalized to men of all ages.
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Affiliation(s)
- Hongyan Lu
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
| | - Jingxian Ni
- Department of Neurology, Shenshan Central Hospital, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Shanwei, China
| | - Qiaoxia Yang
- Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Shujuan Qiu
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
| | - Qiuxing Lin
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China.,Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, China.,Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, China
| | - Jie Liu
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China.,Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, China.,Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, China
| | - Jun Tu
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China.,Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, China.,Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, China
| | - Xianjia Ning
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China.,Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, China.,Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, China
| | - Jinghua Wang
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China.,Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, China.,Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, China
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Åberg F, Puukka P, Salomaa V, Männistö S, Lundqvist A, Valsta L, Perola M, Färkkilä M, Jula A. Risks of Light and Moderate Alcohol Use in Fatty Liver Disease: Follow-Up of Population Cohorts. Hepatology 2020; 71:835-848. [PMID: 31323122 DOI: 10.1002/hep.30864] [Citation(s) in RCA: 100] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Accepted: 07/09/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND AIMS The effects of alcohol use in nonalcoholic fatty liver disease are unclear. We investigated the impact of alcohol use in fatty liver disease on incident liver, cardiovascular, and malignant disease, as well as death. APPROACH AND RESULTS Our study comprised 8,345 persons with hepatic steatosis (fatty liver index >60) who participated in health-examination surveys (FINRISK 1992-2012 or Health 2000), with available data on baseline alcohol intake. Main exclusions were baseline clinical liver disease, viral hepatitis, ethanol intake >50 g/day, and current abstainers. Data were linked with national registers for hospital admissions, malignancies, and death regarding liver, cardiovascular, and malignant disease, as well as all-cause death. Adjustment were for multiple confounders. Alcohol consumption showed a dose-dependent risk increase for incident advanced liver disease and malignancies. Consuming 10-19 g/day of alcohol in general or 0-9 g/day as nonwine beverages doubled the risk for advanced liver disease compared to lifetime abstainers. In contrast, alcohol intake up to 49 g/day was associated with a 22%-40% reduction of incident cardiovascular disease (CVD). We observed a J-shaped association between alcohol intake and all-cause death with a maximal risk reduction of 21% (95% confidence interval, 5%-34%) at alcohol intake of 0-9 g/day compared to lifetime abstainers. However, these benefits on CVD and mortality were only observed in never smokers. Alcohol intake >30 g/day yielded increased risk estimates for mortality compared to lifetime abstainers. In a subpopulation with longitudinal data, alcohol intake remained stable over time in >80% of subjects. CONCLUSIONS Even low alcohol intake in fatty liver disease is associated with increased risks for advanced liver disease and cancer. Low to moderate alcohol use is associated with reduced mortality and CVD risk but only among never smokers.
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Affiliation(s)
- Fredrik Åberg
- Transplantation and Liver Surgery Clinic, Helsinki University Hospital, Helsinki University, Helsinki, Finland.,The Transplant Institute, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Pauli Puukka
- National Institute for Health and Welfare, Helsinki University and Helsinki University Hospital, Helsinki, Finland
| | - Veikko Salomaa
- National Institute for Health and Welfare, Helsinki University and Helsinki University Hospital, Helsinki, Finland
| | - Satu Männistö
- National Institute for Health and Welfare, Helsinki University and Helsinki University Hospital, Helsinki, Finland
| | - Annamari Lundqvist
- National Institute for Health and Welfare, Helsinki University and Helsinki University Hospital, Helsinki, Finland
| | - Liisa Valsta
- National Institute for Health and Welfare, Helsinki University and Helsinki University Hospital, Helsinki, Finland
| | - Markus Perola
- National Institute for Health and Welfare, Helsinki University and Helsinki University Hospital, Helsinki, Finland
| | - Martti Färkkilä
- Clinic of Gastroenterology, Helsinki University and Helsinki University Hospital, Helsinki, Finland
| | - Antti Jula
- National Institute for Health and Welfare, Helsinki University and Helsinki University Hospital, Helsinki, Finland
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Yoon SJ, Jung JG, Lee S, Kim JS, Ahn SK, Shin ES, Jang JE, Lim SH. The protective effect of alcohol consumption on the incidence of cardiovascular diseases: is it real? A systematic review and meta-analysis of studies conducted in community settings. BMC Public Health 2020; 20:90. [PMID: 31964375 PMCID: PMC6971904 DOI: 10.1186/s12889-019-7820-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2019] [Accepted: 10/21/2019] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND This study investigated the dose-response relationship between alcohol consumption and CVD incidence, conducting a meta-analysis of studies focusing on residents from local communities. Further, we examined whether light to moderate alcohol consumption had a protective effect on CVD incidence through a sub-group analysis. METHODS This study conducted a meta-analysis of the relationship between alcohol consumption and CVD incidence, selecting journals published up to December 2017. The alcohol consumption level was classified into non-consumers, light (0.01-10.0 g/day), light to moderate (10.1-20.0 g/day), moderate (20.1-40.0 g/day), moderate to high (40.1-60.0 g/day), and high (> 60.0 g/day) groups. The sub-group analysis was conducted according to the number of comorbidities and age. RESULTS Seven articles were selected in total for the meta-analysis. The mean Newcastle-Ottawa scale score was 8.14 points, suggesting studies were of high quality. There was a J-shaped dose-response relationship between alcohol consumption level and CVD incidence only in men. In general, light to moderate and moderate consumption lowered CVD incidence (Relative risk (RR) [95% confidence interval (CI)] was 0.68 [0.57-0.81] and 0.72 [0.58-0.90], respectively). In men with 3-4 comorbidities, there were no protective effects of light to moderate and moderate consumption on CVD incidence. In either groups of only men or men and women there were protective effects of light to moderate and moderate consumption on CVD incidence only in those aged between 41 and 65. DISCUSSION We found that light to moderate and moderate alcohol consumption had a protective effect on CVD incidence, there was no protective effect either in those with at least three comorbidities or people aged 40 or younger. CONCLUSIONS We conclude that not all local community residents experience a protective effect of light to moderate consumption on CVD incidence. As such, it is necessary to recommend a moderate amount of drinking or less for each individual.
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Affiliation(s)
- Seok-Joon Yoon
- Department of Family Medicine, Chungnam National University Hospital, 282, Munhwa-ro, Jung-gu, Daejeon, Republic of Korea
| | - Jin-Gyu Jung
- Department of Family Medicine, Chungnam National University Hospital, 282, Munhwa-ro, Jung-gu, Daejeon, Republic of Korea.
| | - Sami Lee
- Department of Family Medicine, Chungnam National University Hospital, 282, Munhwa-ro, Jung-gu, Daejeon, Republic of Korea
| | - Jong-Sung Kim
- Department of Family Medicine, Chungnam National University Hospital, 282, Munhwa-ro, Jung-gu, Daejeon, Republic of Korea
| | - Soon-Ki Ahn
- Public Health and Medical Services Office, Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Ein-Soon Shin
- KAMS Research Center, Research Agency for Clinical Practice Guidelines, Korean Academy of Medical Sciences (KAMS), Seoul, Republic of Korea
| | - Ji-Eun Jang
- KAMS Research Center, Research Agency for Clinical Practice Guidelines, Korean Academy of Medical Sciences (KAMS), Seoul, Republic of Korea
| | - Sang-Hyun Lim
- Division of Cardiology, Department of Internal Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Tanaka R, Tsuji M, Tsuchiya T, Kawamoto T. Association Between Work-Related Factors and Diet: A Review of the Literature. Workplace Health Saf 2019; 67:137-145. [PMID: 30602349 DOI: 10.1177/2165079918812481] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The quality of workers' dietary intake could be influenced by their working conditions. This review aimed to summarize the published literature examining the association between work-related factors, such as work hours, shift work, physical strain, mental strain, job strain, support, and diet quality. The literature search, conducted in PubMed, was limited to articles published from 2000 to 2017, written in English, available online, and among workers employed in high-income countries. The search resulted in 16 articles that met the criteria. Although there was some evidence of unhealthy diet among shift workers, data on the diet quality in association with other work-related factors, such as number of hours worked, physical, mental, and job strain, and worksite support were scarce. Further studies are need for purposes better defining the association between work-related factors and quality of workers' diet.
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Affiliation(s)
- Rie Tanaka
- 1 University of Occupational and Environmental Health Japan
| | - Mayumi Tsuji
- 1 University of Occupational and Environmental Health Japan
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8
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Ilic M, Grujicic Sipetic S, Ristic B, Ilic I. Myocardial infarction and alcohol consumption: A case-control study. PLoS One 2018; 13:e0198129. [PMID: 29864160 PMCID: PMC5986147 DOI: 10.1371/journal.pone.0198129] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2017] [Accepted: 05/14/2018] [Indexed: 12/13/2022] Open
Abstract
Background Although epidemiological evidence for the beneficial effect of low alcohol consumption on myocardial infarction is strong, the impact of heavy drinking episodes is less clear. Objectives The aim of this study was to investigate a possible association between the risk for acute myocardial infarction occurrence and alcohol consumption. Methods Our hospital-based case-control study comprised 374 participants (187 newly diagnosed patients with myocardial infarction and 187 controls, individually matched by gender, age, and place of residence). This study was performed in Kragujevac (a city in Serbia) during 2010. Logistic regression analysis was used to determine odds ratio (OR) with 95% confidence intervals (95% CI). Results The history of alcohol consumption in patients with acute myocardial infarction and their controls did not differ significantly: the percentage of those that were consuming alcohol was slightly higher in cases (54.5%) than in controls (50.3%). The habit of binge drinking during the previous 12 months was significantly more common in cases (25.1%) than in controls (12.8%): adjusted OR = 2.2 (95%CI = 1.2–4.2, p = 0.017), p for trend = 0.015. Analysis of binge drinking by age, gender and place of residence revealed that the increase in risk for acute myocardial infarction was associated with older age (adjusted OR = 5.1, 95%CI = 1.7–15.1, p for trend = 0.010), male gender (adjusted OR = 2.3, 95%CI = 1.1–5.2, p for trend = 0.028) and rural place of residence (adjusted OR = 4.8, 95%CI = 1.3–18.5, p for trend = 0.033). Conclusion Our results suggest that binge drinking is associated with twice the risk for myocardial infarction compared to not drinking. Since consumption of alcohol is very common in the Serbian population, the effect of binge drinking on myocardial infarction should be considered an important public health issue.
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Affiliation(s)
- Milena Ilic
- Department of Epidemiology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
- * E-mail:
| | | | - Branko Ristic
- Clinic for Orthopedic Surgery and Traumatology, Clinical Center Kragujevac, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Irena Ilic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
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Raj R, Bhatti JS, Bhadada SK, Ramteke PW. Association of polymorphisms of peroxisome proliferator activated receptors in early and late onset of type 2 diabetes mellitus. Diabetes Metab Syndr 2017; 11 Suppl 1:S287-S293. [PMID: 28292576 DOI: 10.1016/j.dsx.2017.03.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Accepted: 03/03/2017] [Indexed: 12/06/2022]
Abstract
OBJECTIVE Genetic variation of disease susceptible genes is different in different ethnic groups and there is an evidence of association of polymorphisms of Peroxisome Proliferator Activated Receptors (PPARs) in Type 2 Diabetes Mellitus (T2DM). This research analyses the association of PPARs in early and late onset of T2DM in North Indian Population (NIP). METHODS Total of 703 subjects were recruited from north of India and subjects were further divided into subjects of early onset (less than 25 years of onset, 26 T2DM and 26 controls) and late onset (more than 25 years of onset, 326 T2DM and 325 controls). RESULT The onset of T2DM begins from 15 years and continues further to maximum T2DM subjects to the age of 50 (76% of T2DM). High BMI and WHR, high blood pressure leading to early onset of hypertension, early mortality due to T2DM (7% of T2DM is above 75 years and 3% of T2DM has 20 years duration of onset) and high hyperglycemic NIP were the few outcomes of this research. CONCLUSION There is a strong association of PPAR γ, PPAR α and PPAR δ genes on the susceptibility of T2DM in late onset but not with the early onset of T2DM subjects in North Indian Population: Dual association of PPAR γ was observed with its genotype G/G (Ala/Ala) favoring protection against T2DM and genotype C/C (Pro/Pro) favoring susceptibility to T2DM. Association of intron7 polymorphism of PPAR α and +T294C polymorphism of PPAR δ on the susceptibility to T2DM requires further analysis.
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Affiliation(s)
- Resal Raj
- Department of Computational Biology & Bioinformatics, Sam Higginbottom Institute of Agriculture, Technology and Sciences, Allahabad, UP, India.
| | - Jasvinder Singh Bhatti
- Department of Biotechnology & Bioinformatics, SGGS College, Sector L26 Chandigarh, India
| | | | - Pramod W Ramteke
- Department of Biological Sciences, Sam Higginbottom Institute of Agriculture, Technology and Sciences, Deemed to be University, Allahabad, India
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Dam MK, Hvidtfeldt UA, Tjønneland A, Overvad K, Grønbæk M, Tolstrup JS. Five year change in alcohol intake and risk of breast cancer and coronary heart disease among postmenopausal women: prospective cohort study. BMJ 2016; 353:i2314. [PMID: 27169583 PMCID: PMC5068920 DOI: 10.1136/bmj.i2314] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To test the hypothesis that postmenopausal women who increase their alcohol intake over a five year period have a higher risk of breast cancer and a lower risk of coronary heart disease compared with stable alcohol intake. DESIGN Prospective cohort study. SETTING Denmark, 1993-2012. PARTICIPANTS 21 523 postmenopausal women who participated in the Diet, Cancer, and Health Study in two consecutive examinations in 1993-98 and 1999-2003. Information on alcohol intake was obtained from questionnaires completed by participants. MAIN OUTCOME MEASURES Incidence of breast cancer, coronary heart disease, and all cause mortality during 11 years of follow-up. Information was obtained from the Danish Cancer Register, Danish Hospital Discharge Register, Danish Register of Causes of Death, and National Central Person Register. We estimated hazard ratios according to five year change in alcohol intake using Cox proportional hazards models. RESULTS During the study, 1054, 1750, and 2080 cases of breast cancer, coronary heart disease, and mortality occurred, respectively. Analyses modelling five year change in alcohol intake with cubic splines showed that women who increased their alcohol intake over the five year period had a higher risk of breast cancer and a lower risk of coronary heart disease than women with a stable alcohol intake. For instance, women who increased their alcohol intake by seven or 14 drinks per week (corresponding to one or two drinks more per day) had hazard ratios of breast cancer of 1.13 (95% confidence interval 1.03 to 1.23) and 1.29 (1.07 to 1.55), respectively, compared to women with stable intake, and adjusted for age, education, body mass index, smoking, Mediterranean diet score, parity, number of births, and hormone replacement therapy. For coronary heart disease, corresponding hazard ratios were 0.89 (0.81 to 0.97) and 0.78 (0.64 to 0.95), respectively, adjusted for age, education, body mass index, Mediterranean diet score, smoking, physical activity, hypertension, elevated cholesterol, and diabetes. Results among women who reduced their alcohol intake over the five year period were not significantly associated with risk of breast cancer or coronary heart disease. Analyses of all cause mortality showed that women who increased their alcohol intake from a high intake (≥14 drinks per week) to an even higher intake had a higher mortality risk that women with a stable high intake. CONCLUSION In this study of postmenopausal women over a five year period, results support the hypotheses that alcohol intake is associated with increased risk of breast cancer and decreased risk of coronary heart disease.
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Affiliation(s)
- Marie K Dam
- National Institute of Public Health, University of Southern Denmark, 1353 Copenhagen K, Denmark
| | - Ulla A Hvidtfeldt
- Social Medicine Section, Department of Public Health, University of Copenhagen, Copenhagen
| | | | - Kim Overvad
- Department of Public Health, Department of Epidemiology, Aarhus University, Aarhus, Denmark Department of Cardiology, Aalborg University Hospital, Hobrogade, Aalborg, Denmark
| | - Morten Grønbæk
- National Institute of Public Health, University of Southern Denmark, 1353 Copenhagen K, Denmark
| | - Janne S Tolstrup
- National Institute of Public Health, University of Southern Denmark, 1353 Copenhagen K, Denmark
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Machado MV, Cortez-Pinto H. Non-alcoholic fatty liver disease: what the clinician needs to know. World J Gastroenterol 2014; 20:12956-80. [PMID: 25278691 PMCID: PMC4177476 DOI: 10.3748/wjg.v20.i36.12956] [Citation(s) in RCA: 138] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Revised: 04/21/2014] [Accepted: 05/25/2014] [Indexed: 02/06/2023] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) is the most frequent cause of liver disease in the Western world. Furthermore, it is increasing worldwide, paralleling the obesity pandemic. Though highly frequent, only about one fifth of affected subjects are at risk of developing the progressive form of the disease, non-alcoholic steatohepatitis with fibrosis. Even in the latter, liver disease is slowly progressive, though, since it is so prevalent, it is already the third cause of liver transplantation in the United States, and it is predicted to get to the top of the ranking in few years. Of relevance, fatty liver is also associated with increased overall mortality and particularly increased cardiovascular mortality. The literature and amount of published papers on NAFLD is increasing as fast as its prevalence, which makes it difficult to keep updated in this topic. This review aims to summarize the latest knowledge on NAFLD, in order to help clinicians understanding its pathogenesis and advances on diagnosis and treatment.
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Abstract
Non-alcoholic fatty liver disease (NAFLD) is the liver disease of this century, increasing in parallel with obesity, insulin resistance and the metabolic syndrome. NAFLD can be seen as a component of the metabolic syndrome, and as such, contributing as a risk factor for cardiovascular disease. In fact, these patients die more often from cardiovascular disease than from direct consequences of liver disease. In this review, we will summarize the data that link NAFLD as a central player in this dysmetabolism, as well as the evidence for appropriate therapy, in order to improve not only liver disease prognosis, but also the overall prognosis and risk of mortality, with particular focus on cardiovascular risk.
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Affiliation(s)
- Mariana Verdelho Machado
- Departamento de Gastrenterologia, Hospital Santa Maria, CHLN, Unidade de Nutrição e Metabolismo, Faculdade de Medicina de Lisboa, IMM, Lisbon, Portugal
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Jayasekara H, English DR, Room R, MacInnis RJ. Alcohol consumption over time and risk of death: a systematic review and meta-analysis. Am J Epidemiol 2014; 179:1049-59. [PMID: 24670372 DOI: 10.1093/aje/kwu028] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
The results from the few cohort studies that have measured usual alcohol consumption over time have not been summarized. We therefore conducted a systematic review and meta-analysis to quantify mortality risk. Pertinent studies were identified by searching the Medline, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL) Plus, and Scopus databases through August 2012 using broad search criteria. Studies reporting relative mortality risks for quantitatively defined categories of alcohol consumption over time were eligible. Nine cohort studies published during 1991-2010 (comprising 62,950 participants and 10,490 deaths) met the inclusion criteria. For men, there was weak evidence of lower mortality risk with low levels of alcohol intake over time but higher mortality risk for those with intakes over 40 g/day compared with abstainers using a random-effects model (P for nonlinearity = 0.02). The pooled relative risks were 0.90 (95% confidence interval: 0.81, 0.99) for 1-29 g/day, 1.19 (95% confidence interval: 0.89, 1.58) for 30-59 g/day, and 1.52 (95% confidence interval: 0.78, 2.98) for 60 or more g/day compared with abstention. There was moderate between-study heterogeneity but no evidence of publication bias. Studies including women were extremely scarce. Our findings include a curvilinear association between drinking over time and mortality risk for men overall and widespread disparity in methods used to capture exposure and report results.
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Sinn DH, Gwak GY, Cho J, Son HJ, Paik YH, Choi MS, Lee JH, Koh KC, Paik SW, Yoo BC. Modest alcohol consumption and carotid plaques or carotid artery stenosis in men with non-alcoholic fatty liver disease. Atherosclerosis 2014; 234:270-5. [PMID: 24704629 DOI: 10.1016/j.atherosclerosis.2014.03.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2013] [Revised: 02/04/2014] [Accepted: 03/02/2014] [Indexed: 02/07/2023]
Abstract
BACKGROUND Favorable association between modest alcohol consumption and cardiovascular disease had been reported in general population, however, whether observed benefit extend to men with established fatty liver disease remains unknown. METHODS Cross-sectional study of 10,581 consecutive male participants aged 30 years or older undergoing abdominal ultrasonography and carotid artery ultrasonography were screened. Non-alcoholic fatty liver disease (NAFLD) was diagnosed with ultrasonography and exclusion of secondary causes for fat accumulation or other causes of chronic liver disease. Modest alcohol use was defined as consumption of less than 20 g of alcohol per day. RESULTS There were total 2280 men diagnosed with fatty liver, and the mean age was 51.8 years old. Among them, 1797 were modest alcohol drinkers. The prevalence of carotid plaques (55.3% vs. 43.4%, p < 0.001) and carotid artery stenosis (11.0% vs. 5.5%, p < 0.001) was higher in non-drinkers than modest drinkers. Modest alcohol consumption had the independent inverse association with carotid plaques [odd ratio (OR): 0.74, 95% confidence interval (CI): 0.60-0.92] and carotid artery stenosis (OR: 0.62, 95% CI: 0.43-0.90), adjusted for age, smoking and metabolic syndrome. CONCLUSIONS Modest alcohol consumption had a favorable association with carotid plaque or CAS in men with NAFLD.
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Affiliation(s)
- Dong Hyun Sinn
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, South Korea; Department of Internal Medicine, Sanggye Paik Hospital, Inje University School of Medicine, South Korea
| | - Geum-Youn Gwak
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, South Korea.
| | - Juhee Cho
- Department of Health Science and Technology, Samsung Advanced Institute for Health Science and Technology, Sunkyunkwan University, Seoul, South Korea; Department of Health, Behavior and Society and Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Hee Jung Son
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, South Korea; Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Yong-Han Paik
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, South Korea
| | - Moon Seok Choi
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, South Korea
| | - Joon Hyeok Lee
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, South Korea
| | - Kwang Cheol Koh
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, South Korea
| | - Seung Woon Paik
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, South Korea
| | - Byung Chul Yoo
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, South Korea
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Newcomb PA, Kampman E, Trentham-Dietz A, Egan KM, Titus LJ, Baron JA, Hampton JM, Passarelli MN, Willett WC. Alcohol consumption before and after breast cancer diagnosis: associations with survival from breast cancer, cardiovascular disease, and other causes. J Clin Oncol 2013; 31:1939-46. [PMID: 23569314 DOI: 10.1200/jco.2012.46.5765] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
PURPOSE Alcohol intake is associated with increased risk of breast cancer. In contrast, the relation between alcohol consumption and breast cancer survival is less clear. PATIENTS AND METHODS We assessed pre- and postdiagnostic alcohol intake in a cohort of 22,890 women with incident invasive breast cancer who were residents of Wisconsin, Massachusetts, or New Hampshire and diagnosed from 198 to 200 at ages 20 to 79 years. All women reported on prediagnostic intake; a subsample of 4,881 reported on postdiagnostic intake. RESULTS During a median follow-up of 11.3 years from diagnosis, 7,780 deaths occurred, including 3,484 resulting from breast cancer. Hazard ratios (HR) and 95% CIs were estimated. Based on a quadratic analysis, moderate alcohol consumption before diagnosis was modestly associated with disease-specific survival (compared with nondrinkers, HR = 0.93 [95% CI, 0.85 to 1.02], 0.85 [95% CI, 0.75 to 0.95], 0.88 [95% CI, 0.75 to 1.02], and 0.89 [95% CI, 0.77 to 1.04] for two or more, three to six, seven to nine, and ≥ 10 drinks/wk, respectively). Alcohol consumption after diagnosis was not associated with disease-specific survival (compared with nondrinkers, HR = 0.88 [95% CI, 0.61 to 1.27], 0.80 [95% CI, 0.49 to 1.32], 1.01 [95% CI, 0.55 to 1.87], and 0.83 [95% CI, 0.45 to 1.54] for two or more, three to six, seven to nine, and ≥ 10 drinks/wk, respectively). Results did not vary by beverage type. Women consuming moderate levels of alcohol, either before or after diagnosis, experienced better cardiovascular and overall survival than nondrinkers. CONCLUSION Overall alcohol consumption before diagnosis was not associated with disease-specific survival, but we found a suggestion favoring moderate consumption. There was no evidence for an association with postdiagnosis alcohol intake and breast cancer survival. This study, however, does provide support for a benefit of limited alcohol intake for cardiovascular and overall survival in women with breast cancer.
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Affiliation(s)
- Polly A Newcomb
- Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA.
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16
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Dunn W, Sanyal AJ, Brunt EM, Unalp-Arida A, Donohue M, McCullough AJ, Schwimmer JB. Modest alcohol consumption is associated with decreased prevalence of steatohepatitis in patients with non-alcoholic fatty liver disease (NAFLD). J Hepatol 2012; 57:384-91. [PMID: 22521357 PMCID: PMC3399018 DOI: 10.1016/j.jhep.2012.03.024] [Citation(s) in RCA: 195] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2012] [Revised: 03/08/2012] [Accepted: 03/12/2012] [Indexed: 12/25/2022]
Abstract
BACKGROUND & AIMS Non-alcoholic fatty liver disease (NAFLD) is a cardiovascular risk factor. Although modest alcohol consumption may reduce the risk for cardiovascular mortality, whether patients with NAFLD should be allowed modest alcohol consumption remains an important unaddressed issue. We aimed to evaluate the association between modest alcohol drinking and non-alcoholic steatohepatitis (NASH), among subjects with NAFLD. METHODS In a cross-sectional analysis of adult participants in the NIH NASH Clinical Research Network, only modest or non-drinkers were included: participants identified as (1) drinking >20 g/day, (2) binge drinkers, or (3) non-drinkers with previous alcohol consumption were excluded. The odds of having a histological diagnosis of NASH and other histological features of NAFLD were analyzed using multiple ordinal logistic regression. RESULTS The analysis included 251 lifetime non-drinkers and 331 modest drinkers. Modest drinkers compared to non-drinkers had lower odds of having a diagnosis of NASH (summary odds ratio 0.56, 95% CI 0.39-0.84, p=0.002). The odds of NASH decreased as the frequency of alcohol consumption increased within the range of modest consumption. Modest drinkers also had significantly lower odds for fibrosis (OR 0.56 95% CI 0.41-0.77) and ballooning hepatocellular injury (OR 0.66 95% CI 0.48-0.92) than lifetime non-drinkers. CONCLUSIONS In a large, well-characterized population with biopsy-proven NAFLD, modest alcohol consumption was associated with lesser degree of severity as determined by lower odds of the key features that comprise a diagnosis of steatohepatitis, as well as fibrosis. These findings demonstrate the need for prospective studies and a coordinated consensus on alcohol consumption recommendations in NAFLD.
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Affiliation(s)
- Winston Dunn
- Departments of Pediatrics and Medicine, University of California, San Diego, La Jolla, CA,Gastroenterology and Hepatology, Department of Medicine, University of Kansas Medical Center, Kansas City, KS
| | - Arun J. Sanyal
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Internal Medicine, Virginia Commonwealth University Medical Center, Richmond, VA
| | - Elizabeth M. Brunt
- John Cochran VA Medical Center, Saint Louis and Division of Gastroenterology, Saint Louis University School of Medicine, Saint Louis, MO
| | - Aynur Unalp-Arida
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Michael Donohue
- Division of Biostatics and Bioinformatics, Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, CA
| | | | - Jeffrey B. Schwimmer
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics University of California, San Diego, CA,Department of Gastroenterology, Rady Children’s Hospital, San Diego, CA
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Pai JK, Mukamal KJ, Rimm EB. Long-term alcohol consumption in relation to all-cause and cardiovascular mortality among survivors of myocardial infarction: the Health Professionals Follow-up Study. Eur Heart J 2012; 33:1598-605. [PMID: 22453658 PMCID: PMC3388015 DOI: 10.1093/eurheartj/ehs047] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2011] [Revised: 01/14/2012] [Accepted: 02/14/2012] [Indexed: 11/12/2022] Open
Abstract
AIMS The aim of this study was to examine the association between long-term alcohol consumption, alcohol consumption before and after myocardial infarction (MI), and all-cause and cardiovascular mortality among survivors of MI. METHODS AND RESULTS The Health Professionals Follow-up Study (HPFS) is a prospective cohort study of 51 529 US male health professionals. From 1986 to 2006, 1818 men were confirmed with incident non-fatal MI. Among MI survivors, 468 deaths were documented during up to 20 years of follow-up. Long-term average alcohol consumption was calculated beginning from the time period immediately before the first MI and updated every 4 years afterward. Cox proportional hazards were used to estimate the multivariable-adjusted hazard ratios (HR) and 95% confidence intervals (CI). Compared with non-drinkers, the multivariable-adjusted HRs for all-cause mortality were 0.78 (95% CI: 0.62-0.97) for 0.1-9.9 g/day, 0.66 (95% CI: 0.51-0.86) for 10.0-29.9 g/day, and 0.87 (95% CI: 0.61-1.25) for ≥30 g/day (P(quadratic)= 0.006). For cardiovascular mortality, the corresponding HRs were 0.74 (95% CI: 0.54-1.02), 0.58 (95% CI: 0.39-0.84), and 0.98 (95% CI: 0.60-1.60), P(quadratic)= 0.003. These findings were consistent when restricted to pre- and post-MI alcohol assessments. In subgroup analyses, moderate alcohol consumption was inversely associated with mortality among men with non-anterior infarcts, and among men with mildly diminished left ventricular function. CONCLUSION Long-term moderate alcohol consumption is inversely associated with all-cause and cardiovascular mortality among men who survived a first MI. This U-shaped association may be strongest among individuals with less impaired cardiac function after MI and should be examined further.
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Affiliation(s)
- Jennifer K Pai
- Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, USA.
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Newsom JT, Huguet N, McCarthy MJ, Ramage-Morin P, Kaplan MS, Bernier J, McFarland BH, Oderkirk J. Health behavior change following chronic illness in middle and later life. J Gerontol B Psychol Sci Soc Sci 2012; 67:279-88. [PMID: 21983040 PMCID: PMC3325087 DOI: 10.1093/geronb/gbr103] [Citation(s) in RCA: 109] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2010] [Accepted: 07/12/2011] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES Understanding lifestyle improvements among individuals with chronic illness is vital for targeting interventions that can increase longevity and improve quality of life. METHODS Data from the U.S. Health and Retirement Study were used to examine changes in smoking, alcohol use, and exercise 2-14 years after a diagnosis of heart disease, diabetes, cancer, stroke, or lung disease. RESULTS Patterns of behavior change following diagnosis indicated that the vast majority of individuals diagnosed with a new chronic condition did not adopt healthier behaviors. Smoking cessation among those with heart disease was the largest observed change, but only 40% of smokers quit. There were no significant increases in exercise for any health condition. Changes in alcohol consumption were small, with significant declines in excessive drinking and increases in abstention for a few health conditions. Over the long term, individuals who made changes appeared to maintain those changes. Latent growth curve analyses up to 14 years after diagnosis showed no average long-term improvement in health behaviors. DISCUSSION Results provide important new information on health behavior changes among those with chronic disease and suggest that intensive efforts are required to help initiate and maintain lifestyle improvements among this population.
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Affiliation(s)
- Jason T Newsom
- Institute on Aging, School of Community Health, Portland State University, Portland, OR 97207-0751, USA.
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King DE, Mainous AG, Matheson EM, Everett CJ. Impact of healthy lifestyle on mortality in people with normal blood pressure, LDL cholesterol, and C-reactive protein. Eur J Prev Cardiol 2011; 20:73-9. [DOI: 10.1177/1741826711425776] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Dana E King
- Medical University of South Carolina, Charleston, USA
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20
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Antillon D, Towfighi A. No Time to ‘Weight’: The Link between Obesity and Stroke in Women. WOMENS HEALTH 2011; 7:453-63. [DOI: 10.2217/whe.11.36] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The obesity epidemic in the USA threatens the gains that have been made in the prevention and treatment of stroke. Both obesity and stroke disproportionately affect women more than men. Understanding the effect of obesity on stroke risk in women may be a useful stepping stone to reducing the burden of stroke in this vulnerable population. This article reviews the association between stroke and general obesity, abdominal obesity and metabolic syndrome in women. All three factors have been shown to independently increase stroke risk in women.
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Affiliation(s)
| | - Amytis Towfighi
- Department of Neurology, University of Southern California, CA, USA
- Department of Neurology, Rancho Los Amigos National Rehabilitation Center, 7601 E. Imperial Highway, HB145, Downey, CA 90242, USA
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Joosten MM, Chiuve SE, Mukamal KJ, Hu FB, Hendriks HFJ, Rimm EB. Changes in alcohol consumption and subsequent risk of type 2 diabetes in men. Diabetes 2011; 60:74-9. [PMID: 20876712 PMCID: PMC3012199 DOI: 10.2337/db10-1052] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The objective of this study was to investigate the association of 4-year changes in alcohol consumption with a subsequent risk of type 2 diabetes. RESEARCH DESIGN AND METHODS We prospectively examined 38,031 men from the Health Professionals Follow-Up Study who were free of diagnosed diabetes or cancer in 1990. Alcohol consumption was reported on food frequency questionnaires and updated every 4 years. RESULTS A total of 1,905 cases of type 2 diabetes occurred during 428,497 person-years of follow-up. A 7.5 g/day (approximately half a glass) increase in alcohol consumption over 4 years was associated with lower diabetes risk among initial nondrinkers (multivariable hazard ratio [HR] 0.78; 95% CI: 0.60-1.00) and drinkers initially consuming <15 g/day (HR 0.89; 95% CI: 0.83-0.96), but not among men initially drinking ≥15 g/day (HR 0.99; 95% CI: 0.95-1.02; P(interaction) < 0.01). A similar pattern was observed for levels of total adiponectin and hemoglobin A(1c), with a better metabolic profile among abstainers and light drinkers who modestly increased their alcohol intake, compared with men who either drank less or among men who were already moderate drinkers and increased their intake. Likewise, compared with stable light drinkers (0-4.9 g/day), light drinkers who increased their intake to moderate levels (5.0-29.9 g/day) had a significantly lower risk of type 2 diabetes (HR 0.75; 95% CI: 0.62-0.90). CONCLUSIONS Increases in alcohol consumption over time were associated with lower risk of type 2 diabetes among initially rare and light drinkers. This lower risk was evident within a 4-year period following increased alcohol intake.
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Affiliation(s)
- Michel M Joosten
- Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, USA.
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Yoo YJ, Saliba AJ, Prenzler PD. Should Red Wine Be Considered a Functional Food? Compr Rev Food Sci Food Saf 2010; 9:530-551. [PMID: 33467832 DOI: 10.1111/j.1541-4337.2010.00125.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Functional foods may be regarded as foods that have nutritional value, but in particular, they also have beneficial effects on one or more body functions. Thus, functional foods may improve health and/or reduce the risk of developing certain diseases when taken in amounts that can be consumed in a normal diet. Based on nearly 2 decades of research since the term "French paradox" was first coined in 1992, wine would appear to fit this definition. Yet there seems to be reluctance to consider wine as a functional food. In this review, we present an overview of the accumulated evidence for the health benefits of wine-and its key phenolic components such as resveratrol, quercetin, catechin-and show that these alone are not enough to firmly establish wine as a functional food. What is required is to create clearly defined products based on wine that are targeted to consumers' needs and expectations when it comes to purchasing functional foods. Moreover, the crucial question of alcohol and health also needs to be addressed by the functional food industry. Suggestions are presented for working through this issue, but in many regards, wine is like any other food-it should be consumed sensibly and in amounts that are beneficial to health. Overindulgence of any kind does not promote good health.
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Affiliation(s)
- Yung J Yoo
- Authors are with Natl. Wine and Grape Industry Centre, School of Agricultural and Wine Sciences, Charles Sturt Univ., Wagga Wagga New South Wales, Australia. Direct inquiries to author Saliba (E-mail: )
| | - Anthony J Saliba
- Authors are with Natl. Wine and Grape Industry Centre, School of Agricultural and Wine Sciences, Charles Sturt Univ., Wagga Wagga New South Wales, Australia. Direct inquiries to author Saliba (E-mail: )
| | - Paul D Prenzler
- Authors are with Natl. Wine and Grape Industry Centre, School of Agricultural and Wine Sciences, Charles Sturt Univ., Wagga Wagga New South Wales, Australia. Direct inquiries to author Saliba (E-mail: )
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Carter MD, Lee JH, Buchanan DM, Peterson ED, Tang F, Reid KJ, Spertus JA, Valtos J, O'Keefe JH. Comparison of outcomes among moderate alcohol drinkers before acute myocardial infarction to effect of continued versus discontinuing alcohol intake after the infarct. Am J Cardiol 2010; 105:1651-4. [PMID: 20538109 DOI: 10.1016/j.amjcard.2010.01.339] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2009] [Revised: 01/20/2010] [Accepted: 01/20/2010] [Indexed: 11/19/2022]
Abstract
Light-to-moderate alcohol consumption has been previously associated with a lower risk of acute myocardial infarction (AMI) and mortality. The association of changes in drinking behavior after an AMI with health status and long-term outcomes is unknown. Using a prospective cohort of patients with AMI evaluated with the World Health Organization's Alcohol Use Disorders Identification Test, we investigated changes in drinking patterns in 325 patients who reported moderate drinking at the time of their AMI. One-year alcohol consumption, disease-specific (angina pectoris and quality of life) and general (mental and physical) health status and rehospitalization outcomes, and 3-year mortality were assessed. Seattle Angina Questionnaire Angina Frequency and Quality of Life, Short Form-12 Mental and Physical Component Summary Scales were modeled using multivariable hierarchical linear models within site. Of the initial 325 moderate drinkers at baseline, 273 (84%) remained drinking and 52 (16%) quit. In fully adjusted models, Physical Component Scale scores (beta 6.47, 95% confidence interval 3.73 to 9.21, p <0.01) were significantly higher during follow-up in those who remained drinking. Persistent moderate drinkers had a trend toward less angina (relative risk 0.65, 95% confidence interval 0.39 to 1.10, p = 0.11), fewer rehospitalizations (hazard ratio 0.79, 95% confidence interval 0.44 to 1.41, p = 0.42), lower 3-year mortality (relative risk 0.75, 95% confidence interval 0.23 to 2.51, p = 0.64), and better disease-specific quality of life (Seattle Angina Questionnaire Quality of Life, beta 3.88, 95% confidence interval -0.79 to 8.55, p = 0.10) and mental health (Mental Component Scale, beta 0.83, 95% confidence interval -1.62 to 3.27, p = 0.51) than quitters. In conclusion, these data suggest that there are no adverse effects for moderate drinkers to continue consuming alcohol and that they may have better physical functioning compared to those who quit drinking after an AMI.
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Affiliation(s)
- Maia D Carter
- Mid America Heart Institute of Saint Luke's Hospital, Kansas City, Missouri, USA
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24
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Moderate alcohol intake is associated with decreased risk of insulin resistance among individuals with vitamin D insufficiency. Nutrition 2010; 26:100-5. [DOI: 10.1016/j.nut.2009.03.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2008] [Revised: 03/25/2009] [Accepted: 03/26/2009] [Indexed: 11/24/2022]
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Sull JW, Yi SW, Nam CM, Ohrr H. Binge Drinking and Mortality From All Causes and Cerebrovascular Diseases in Korean Men and Women. Stroke 2009; 40:2953-8. [DOI: 10.1161/strokeaha.109.556027] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Jae Woong Sull
- From the Institute for Health Promotion (J.W.S., H.O.), Graduate School of Public Health, Yonsei University, Seoul, Korea; the Department of Preventive Medicine and Public Health (S.-W.Y.), Kwandong University College of Medicine, Gangneung, Korea; and the Department of Preventive Medicine (C.M.N., H.O.), Yonsei University College of Medicine, Seoul, Korea
| | - Sang-Wook Yi
- From the Institute for Health Promotion (J.W.S., H.O.), Graduate School of Public Health, Yonsei University, Seoul, Korea; the Department of Preventive Medicine and Public Health (S.-W.Y.), Kwandong University College of Medicine, Gangneung, Korea; and the Department of Preventive Medicine (C.M.N., H.O.), Yonsei University College of Medicine, Seoul, Korea
| | - Chung Mo Nam
- From the Institute for Health Promotion (J.W.S., H.O.), Graduate School of Public Health, Yonsei University, Seoul, Korea; the Department of Preventive Medicine and Public Health (S.-W.Y.), Kwandong University College of Medicine, Gangneung, Korea; and the Department of Preventive Medicine (C.M.N., H.O.), Yonsei University College of Medicine, Seoul, Korea
| | - Heechoul Ohrr
- From the Institute for Health Promotion (J.W.S., H.O.), Graduate School of Public Health, Yonsei University, Seoul, Korea; the Department of Preventive Medicine and Public Health (S.-W.Y.), Kwandong University College of Medicine, Gangneung, Korea; and the Department of Preventive Medicine (C.M.N., H.O.), Yonsei University College of Medicine, Seoul, Korea
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King DE, Mainous AG, Carnemolla M, Everett CJ. Adherence to healthy lifestyle habits in US adults, 1988-2006. Am J Med 2009; 122:528-34. [PMID: 19486715 DOI: 10.1016/j.amjmed.2008.11.013] [Citation(s) in RCA: 210] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2008] [Revised: 11/21/2008] [Accepted: 11/25/2008] [Indexed: 11/29/2022]
Abstract
BACKGROUND Lifestyle choices are associated with cardiovascular disease and mortality. The purpose of this study was to compare adherence to healthy lifestyle habits in adults between 1988 and 2006. METHODS Analysis of adherence to 5 healthy lifestyle trends (>or=5 fruits and vegetables/day, regular exercise >12 times/month, maintaining healthy weight [body mass index 18.5-29.9 kg/m(2)], moderate alcohol consumption [up to 1 drink/day for women, 2/day for men] and not smoking) in the National Health and Nutrition Examination Survey 1988-1994 were compared with results from the National Health and Nutrition Examination Survey 2001-2006 among adults aged 40-74 years. RESULTS Over the last 18 years, the percent of adults aged 40-74 years with a body mass index >or=30 kg/m(2) has increased from 28% to 36% (P <.05); physical activity 12 times a month or more has decreased from 53% to 43% (P <.05); smoking rates have not changed (26.9% to 26.1%); eating 5 or more fruits and vegetables a day has decreased from 42% to 26% (P <.05), and moderate alcohol use has increased from 40% to 51% (P <.05). Adherence to all 5 healthy habits has gone from 15% to 8% (P <.05). Although adherence to a healthy lifestyle was lower among minorities, adherence decreased more among non-Hispanic Whites over the period. Individuals with a history of hypertension/diabetes/cardiovascular disease were no more likely to be adherent to a healthy lifestyle than people without these conditions. CONCLUSIONS Generally, adherence to a healthy lifestyle pattern has decreased during the last 18 years, with decreases documented in 3 of 5 healthy lifestyle habits. These findings have broad implications for the future risk of cardiovascular disease in adults.
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Affiliation(s)
- Dana E King
- Department of Family Medicine, Medical University of South Carolina, Charleston, SC 29425, USA.
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Gilbertson R, Ceballos NA, Prather R, Nixon SJ. Effects of acute alcohol consumption in older and younger adults: perceived impairment versus psychomotor performance. J Stud Alcohol Drugs 2009; 70:242-52. [PMID: 19261236 DOI: 10.15288/jsad.2009.70.242] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Perceived impairment and psychomotor performance following acute alcohol administration in older (ages 50-74, n=42; 22 male) and younger (ages 25-35, n=26; 12 male) adults were investigated in this study. METHOD Double-blind, placebo-controlled alcohol administration techniques were designed to produce peak levels of breath alcohol concentration consistent with an episode of social drinking (40 mg/100 ml). Behavioral measures (Trail Making Test, Forms A and B), as well as measures of self-reported perceived intoxication and impairment, were administered on the ascending and descending limbs at common time points after beverage ingestion. RESULTS Results indicated that psychomotor performance differences did not parallel self-reported levels of perceived impairment. Relative to younger adults, older adults exhibited performance deficits on the ascending limb while simultaneously reporting less perceived impairment. Conversely, on the descending limb, older adults who received alcohol reported more perceived impairment than did those who received placebo, although psychomotor performance between these two groups of older drinkers did not differ. For younger participants, a moderate dose of alcohol facilitated performance on the ascending limb; however, these differences were not reflected on the descending limb. CONCLUSIONS These results reinforce the common knowledge that self-reported measures may not provide an accurate reflection of performance outcomes and, importantly, that older adults may be impaired even under a moderate dose of alcohol, although they may not be aware (i.e., report) of this impairment.
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Affiliation(s)
- Rebecca Gilbertson
- Neurocognitive Laboratory, Department of Psychology, University of Kentucky, Lexington, Kentucky 40506-0044, USA.
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Health behaviour patterns in relation to hypertension: the English Longitudinal Study of Ageing. J Hypertens 2009; 27:224-30. [PMID: 19155779 DOI: 10.1097/hjh.0b013e3283193e6e] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Clinical guidelines emphasize that hypertensive individuals should be encouraged to maintain healthy lifestyles with respect to smoking, physical activity, alcohol consumption and diet. We assessed health behaviours in a large sample of older hypertensive individuals, and tested whether medication for hypertension leads to compensatory increases in cardiovascular risk behaviours. METHODS Analysis of wave 1 of the English Longitudinal Study of Ageing, involving 5231 men and 6292 women aged at least 50 years. We analysed the prevalence of smoking, heavy drinking, sedentary behaviour and vigorous physical activity in relation to self-reported hypertension, controlling for age, sex, socioeconomic status, comorbidity (coronary heart disease, diabetes, arthritis), impairments of mobility, activities of daily living and depression. RESULTS The prevalence of self-reported hypertension was 37.8%, and 77% of hypertensive participants were prescribed medication. Hypertensive participants were less likely to smoke than normotensive ones (14.8 vs. 19.7%), with reduced odds of smoking [odds ratio (OR) 0.72, 95% confidence intervals (CI) 0.56-0.83] after adjusting for covariates. Hypertensive individuals were more likely to be heavy drinkers (OR 1.34, CI 1.10-1.62), to be sedentary (OR 1.14, CI 1.02-1.27), and not engage in vigorous physical activity (OR 0.84, CI 0.75-0.94). There was no evidence for risk compensation in medicated hypertensive individuals compared with unmedicated ones. CONCLUSION Smoking rates are low among hypertensive individuals, but the patterns of alcohol consumption and physical activity are suboptimal. Compensatory increases in risky behaviours appear not to be present in medicated individuals. There is considerable scope for advice and counselling to older hypertensive individuals to improve patterns of health behaviour.
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Middle-age initiation of alcohol consumption unlikely to cause addiction. Am J Med 2008; 121:e9. [PMID: 18724956 DOI: 10.1016/j.amjmed.2008.03.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2008] [Accepted: 03/18/2008] [Indexed: 11/22/2022]
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