Alcohol drinking and cardiac risk

Alcohol Drinking Impacts on Adiposity and Steatotic Liver Disease: Concurrent Effects on Metabolic Pathways and Cardiovascular Risks

PURPOSE OF REVIEW

This integrative search aimed to provide a scoping overview of the relationships between the benefits and harms of alcohol drinking with cardiovascular events as associated to body fat mass and fatty liver diseases, as well as offering critical insights for precision nutrition research and personalized medicine implementation concerning cardiovascular risk management associated to ethanol consumption.

RECENT FINDINGS

Frequent alcohol intake could contribute to a sustained rise in adiposity over time. Body fat distribution patterns (abdominal/gluteus-femoral) and intrahepatic accumulation of lipids have been linked to adverse cardiovascular clinical outcomes depending on ethanol intake. Therefore, there is a need to understand the complex interplay between alcohol consumption, adipose store distribution, metabolic dysfunction-associated steatotic liver disease (MASLD), and cardiovascular events in adult individuals. The current narrative review deals with underconsidered and apparently conflicting benefits concerning the amount of alcohol intake, ranging from abstention to moderation, and highlights the requirements for additional robust methodological studies and trials to interpret undertrained and existing controversies. The conclusion of this review emphasizes the need of newer multifaceted clinical approaches for precision medicine implementation, considering epidemiological strategies and pathophysiological mechanistic. Newer investigations and trials should be derived and performed particularly focusing both on alcohol's objective consequences as putatively mediated by fat deposition, including associated roles in fatty liver disease as well as to differentiate the impact of different levels of alcohol consumption (absence or moderation) concerning cardiovascular risks and accompanying clinical manifestations. Indeed, the threshold for the safe consumption of alcoholic drinks remains to be fully elucidated.

To beer or not to beer: A meta-analysis of the effects of beer consumption on cardiovascular health

A moderate alcohol consumption is demonstrated to exert a protective action in terms of cardiovascular risk. Although this property seems not to be beverage-specific, the various composition of alcoholic compounds could mediate peculiar effects in vivo. The aim of this study was to evaluate potential beer-mediated effects on the cardiovascular health in humans, using a meta-analytic approach (trial registration number: CRD42018118387). The literature search, comprising all English articles published until November, 30th 2019 in EMBASE, PubMed and Cochrane database included all controlled clinical trials evaluating the cardiovascular effects of beer assumption compared to alcohol-free beer, water, abstinence or placebo. Both sexes and all beer preparations were considered eligible. Outcome parameters were those entering in the cardiovascular risk charts and those related to endothelial dysfunction. Twenty-six trials were included in the analysis. Total cholesterol was significantly higher in beer drinkers compared to controls (14 studies, 3.52 mg/dL, 1.71–5.32 mg/dL). Similar increased levels were observed in high-density lipoprotein (HDL) cholesterol (18 studies, 3.63 mg/dL, 2.00–5.26 mg/dL) and in apolipoprotein A1 (5 studies, 0.16 mg/dL, 0.11–0.21 mg/dL), while no differences were detected in low density lipoprotein (LDL) cholesterol (12 studies, -2.85 mg/dL, -5.96–0.26 mg/dL) and triglycerides (14 studies, 0.40 mg/dL, -5.00–5.80 mg/dL) levels. Flow mediated dilation (FMD) resulted significantly higher in beer-consumers compared to controls (4 studies, 0.65%, 0.07–1.23%), while blood pressure and other biochemical markers of inflammation did not differ. In conclusion, the specific beer effect on human cardiovascular health was meta-analysed for the first time, highlighting an improvement of the vascular elasticity, detected by the increase of FMD (after acute intake), and of the lipid profile with a significant increase of HDL and apolipoprotein A1 serum levels. Although the long-term effects of beer consumption are not still understood, a beneficial effect of beer on endothelial function should be supposed.

Combined acute effects of red wine consumption and cigarette smoking on haemodynamics of young smokers

OBJECTIVE

Red wine seems to improve haemodynamic variables, while smoking provokes adverse effects. The haemodynamic effects of their combined use is unknown. The purpose of the present study was to examine the acute effects of red wine and its constituents, in combination with the smoking of one cigarette, on haemodynamic parameters, such as blood pressure and wave reflections, in a group of smokers.

METHODS

Twenty smokers (12 males, eight females) participated in a double-blind, crossover study comprised of 3 study days. All subjects either smoked one cigarette, or smoked and drank 250 ml of red wine, or 250 ml of de-alcoholized red wine (containing the same type and similar concentration of antioxidants). Applanation tonometry and generalized transfer functions were used to estimate aortic pressure waveforms at baseline and 30, 60 and 90 min after each trial. The augmentation index (AIx) was used to express wave reflections.

RESULTS

Smoking increased peripheral systolic blood pressure (P < 0.005) 30 min later, but simultaneous consumption of either type of red wine caused no such effect. Additionally, smoking caused no overall effect on AIx, while smoking and drinking either regular or de-alcoholized red wine reduced AIx (P < 0.001). The reduction of AIx after red wine consumption was significantly greater than the respective reduction after de-alcoholized red wine (P = 0.004).

CONCLUSION

Antioxidant substances in red wine counteracted the smoking-induced increase in peripheral systolic blood pressure. Both alcohol and antioxidants in red wine decrease wave reflections in uncomplicated habitual smokers postprandially, indicating an additional favourable effect of red wine.

RECENT TRENDS IN INCIDENCE RATES FOR SELECTED ALCOHOL-RELATED CANCERS IN THE UNITED STATES

AIMS

To examine recent trends in incidence rates for cancer types most strongly associated with alcohol use, using data from US cancer registries.

METHODS

Age-standardized annual incidence rates (ASIRs) for squamous cell carcinomas of the oral cavity and pharynx, esophagus and larynx diagnosed in the most recent 10-year period (1992-2001) were examined for geographic areas included in the US National Cancer Institute's Surveillance, Epidemiology and End Results (SEER) program of high-quality cancer registries.

RESULTS

For all geographic areas combined, ASIRs for these cancers declined over time, with no evidence for a recent plateau or upturn. This also held true for ASIRs in younger adults (age 20-54 years at diagnosis). For white males, declines in ASIRs occurred in each of the 11 geographic areas, and were statistically significant in nine areas. The declines in ASIRs were consistent with temporal declines in apparent alcohol consumption by state, although the prevalence of binge and heavy drinking in adults increased in some states.

CONCLUSIONS

Although there was no evidence for a recent plateau in ASIRs, continued surveillance is needed, in view of recent increases in the prevalence of binge and heavy drinking among US adults.

The influence of beer with different antioxidant potential on plasma lipids, plasma antioxidant capacity, and bile excretion of rats fed cholesterol-containing and cholesterol-free diets

The aim of this investigation was to assess the influence of beers with different antioxidant potentials on plasma lipid metabolism, plasma antioxidant capacity, and bile excretion of rats fed cholesterol-containing and cholesterol-free diets. Four types of beers were investigated in vitro. Two of them (designated as BeerHigh and BeerLow) with the highest and lowest antioxidant potentials (34.5% and 21.4% and 2.07 mmol/L and 1.65 mmol/L according to beta-carotene assay and Trolox equivalent antioxidant coefficient, respectively), were chosen for the experiment on rats. A total of 60 male Wistar rats were divided into 6 dietary groups of 10 rats each; the groups were designated as Control, BeerA, BeerB, Chol, Chol/BeerA, and Chol/BeerB. The rats in the Control group were fed a basal diet (BD) only, which included wheat starch, casein, soybean oil, vitamin, and mineral mixtures. To the BD of the other five groups were added the following: BeerHigh (BeerA), BeerLow (BeerB), 1% of cholesterol (Chol), 1% of cholesterol and BeerHigh (Chol/BeerA), and 1% of cholesterol and BeerLow (Chol/BeerB). After 4 weeks of feeding, diets supplemented with BeerHigh and, to a lesser degree, with BeerLow (Chol/BeerA and Chol/BeerB groups) hindered a rise in plasma lipids and a decrease in plasma antioxidant capacity, and increased the bile excretion indices. Supplementation with BeerHigh and, to a lesser degree, with BeerLow in rats fed cholesterol-free diets increased their plasma antioxidant capacity. No significant changes in the plasma lipid levels, antioxidant capacity, and bile excretion indices were observed in the Control group. In conclusion, beer was found to have a positively effect on plasma lipid profile and plasma antioxidant capacity, and to increase the bile excretion indices in rats fed cholesterol-containing diets. The degree of this positive influence is directly connected to the contents of the bioactive components and the related antioxidant potential of beer. It is suggested that to achieve the best results, beer with the highest antioxidant potential must be consumed.

Plasma circulating fibrinogen stability and moderate beer consumption

MODERATE BEER CONSUMPTION (MBC) IS CARDIOPROTECTIVE: it positively influences plasma lipid levels and plasma antioxidant activity in beer-consuming individuals. The connection between MBC and blood coagulation is not clearly defined. Forty-two volunteers were equally divided into experimental (EG) and control (CG) groups following coronary bypass surgery. For 30 consecutive days, only patients of the EG consumed 330 mL of beer per day (about 20 g of alcohol). A comprehensive clinical investigation of 42 patients was done. Blood samples were collected before and after the investigation for a wide range of laboratory tests. The plasma fibrinogen was denatured with 8 M urea and intrinsic fluorescence (IF), hydrophobicity and differential scanning calorimetry (DSC) were used to reveal possible qualitative changes. After 30 days of moderate beer consumption, positive changes in the plasma lipid levels, plasma anticoagulant and plasma antioxidant activities were registered in patients of the EG group. In 17 out of 21 patients of the same group, differences in plasma circulating fibrinogen's (PCF), secondary and tertiary structures were found. The stability of fibrinogen, expressed in thermodynamic parameters, has shown that the loosening of the structure takes place under ethanol and urea denaturation. Also fluorescence stability of PCF was decreased. No changes in the lipid levels, anticoagulant and antioxidant activity or changes in PCF were detected in patients of CG. In conclusion, for the first time after a short term of moderate beer consumption some qualitative changes in the plasma circulating fibrinogen were detected: differences in the emission peak response, fluorescence intensity and all thermodynamic data. Together, with the decrease in the PCF concentration it may lead to an elevation of the blood anticoagulant activity.