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Galán I, Fontán J, Ortiz C, López-Cuadrado T, Téllez-Plaza M, García-Esquinas E. Volume of alcohol intake, heavy episodic drinking, and all-cause mortality in Spain: A longitudinal population-based study. Addict Behav 2024; 158:108108. [PMID: 39033565 DOI: 10.1016/j.addbeh.2024.108108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Revised: 06/13/2024] [Accepted: 07/16/2024] [Indexed: 07/23/2024]
Abstract
INTRODUCTION The impact of alcohol consumption on health, particularly in low quantities, remains controversial. Our objective was to assess the association between alcohol volume and heavy episodic drinking (HED) with all-cause mortality, while minimizing many of the known methodological issues. METHODOLOGY This longitudinal study used data from the 2011-2012 National Health Survey and the 2014 European Health Survey in Spain. Data from 43,071 participants aged ≥ 15 years were linked to mortality records as of December 2021. Alcohol consumption categories were defined based on intake volume and frequency: never-drinkers, former drinkers, infrequent occasional drinkers (≤once/month), frequent occasional drinkers ( once /month). Regular drinkers (≥once/week) were further classified by volume: >0-10 g/day, >10-20 g/day, >20-40 g/day, and > 40 g/day. Heavy Episodic Drinking (HED) was defined as ≥ 6 and ≥ 5 standard drinks (10 g) within 4-6 h for men and women, respectively. Hazard ratios (HR) were calculated using Cox regression, adjusting for sociodemographic variables, lifestyle factors, health status, and alcohol volume or HED. RESULTS Compared to infrequent occasional drinkers, HRs for never-drinkers and former drinkers were 1.30 (95 %CI:1.14-1.47) and 1.32 (95 %CI:1.15-1.50), respectively. No differences in mortality risk were observed for intakes up to 20 g/day, but it increased for consumptions > 20-40 g/day and > 40 g/day (HR = 1.29; 95 %CI:1.05-1.58 and HR = 1.57; 95 %CI:1.14-2.17, respectively). The HR of weekly HED vs. never was 1.31 (95 %CI:0.98-1.75). CONCLUSIONS Compared to infrequent occasional drinking, consuming low amounts of alcohol had no impact on mortality risk. However, never-drinkers, former drinkers, individuals with regular consumption > 20 g/day, and those engaging in weekly HED, experienced higher mortality risk.
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Affiliation(s)
- Iñaki Galán
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain; Department of Preventive Medicine and Public Health, Autonomous University of Madrid, Madrid, Spain.
| | - Julia Fontán
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain
| | - Cristina Ortiz
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain.
| | - Teresa López-Cuadrado
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain; Department of Preventive Medicine and Public Health, Autonomous University of Madrid, Madrid, Spain.
| | - María Téllez-Plaza
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain; Department of Preventive Medicine and Public Health, Autonomous University of Madrid, Madrid, Spain.
| | - Esther García-Esquinas
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Madrid, Spain.
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Ortolá R, Sotos-Prieto M, García-Esquinas E, Galán I, Rodríguez-Artalejo F. Alcohol Consumption Patterns and Mortality Among Older Adults With Health-Related or Socioeconomic Risk Factors. JAMA Netw Open 2024; 7:e2424495. [PMID: 39133491 PMCID: PMC11320169 DOI: 10.1001/jamanetworkopen.2024.24495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Accepted: 05/30/2024] [Indexed: 08/13/2024] Open
Abstract
Importance Alcohol consumption is a leading cause of morbidity and mortality that may be more important in older adults with socioeconomic or health-related risk factors. Objective To examine the association of alcohol consumption patterns with 12-year mortality and its modification by health-related or socioeconomic risk factors. Design, Setting, and Participants This prospective cohort study used data from the UK Biobank, a population-based cohort. Participants were current drinkers aged 60 years or older. Data were analyzed from September 2023 to May 2024. Exposure According to their mean alcohol intake in grams per day, participants' drinking patterns were classified as occasional: ≤2.86 g/d), low risk (men: >2.86-20.00 g/d; women: >2.86-10.00 g/d), moderate risk (men: >20.00-40.00 g/d; women: >10.00-20.00 g/d) and high risk (men: >40.00 g/d; women: >20.00 g/d). Main Outcomes and Measures Health-related risk factors were assessed with the frailty index, and socioeconomic risk factors were assessed with the Townsend deprivation index. All-cause and cause-specific mortality were obtained from death certificates held by the national registries. Analyses excluded deaths in the first 2 years of follow-up and adjusted for potential confounders, including drinking patterns and preferences. Results A total of 135 103 participants (median [IQR] age, 64.0 [62.0-67.0] years; 67 693 [50.1%] women) were included. In the total analytical sample, compared with occasional drinking, high-risk drinking was associated with higher all-cause (hazard ratio [HR], 1.33; 95% CI, 1.24-1.42), cancer (HR, 1.39; 95% CI, 1.26-1.53), and cardiovascular (HR, 1.21; 95% CI, 1.04-1.41) mortality; moderate-risk drinking was associated with higher all-cause (HR, 1.10; 95% CI, 1.03-1.18) and cancer (HR, 1.15; 95% CI, 1.05-1.27) mortality, and low-risk drinking was associated with higher cancer mortality (HR, 1.11; 95% CI, 1.01-1.22). While no associations were found for low- or moderate-risk drinking patterns vs occasional drinking among individuals without socioeconomic or health-related risk factors, low-risk drinking was associated with higher cancer mortality (HR, 1.15; 95% CI, 1.01-1.30) and moderate-risk drinking with higher all-cause (HR, 1.10; 95% CI, 1.01-1.19) and cancer (HR, 1.19; 95% CI, 1.05-1.35) mortality among those with health-related risk factors; low-risk and moderate-risk drinking patterns were associated with higher mortality from all causes (low risk: HR, 1.14; 95% CI, 1.01-1.28; moderate risk: HR, 1.17; 95% CI, 1.03-1.32) and cancer (low risk: HR, 1.25; 95% CI, 1.04-1.50; moderate risk: HR, 1.36; 95% CI, 1.13-1.63) among those with socioeconomic risk factors. Wine preference (>80% of alcohol from wine) and drinking with meals showed small protective associations with mortality, especially from cancer, but only in drinkers with socioeconomic or health-related risk factors and was associated with attenuating the excess mortality associated with high-, moderate- and even low-risk drinking. Conclusions and Relevance In this cohort study of older drinkers from the UK, even low-risk drinking was associated with higher mortality among older adults with health-related or socioeconomic risk factors. The attenuation of mortality observed for wine preference and drinking only during meals requires further investigation, as it may mostly reflect the effect of healthier lifestyles, slower alcohol absorption, or nonalcoholic components of beverages.
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Affiliation(s)
- Rosario Ortolá
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Madrid, Spain
- Center for Biomedical Research in Epidemiology and Public Health, Madrid, Spain
| | - Mercedes Sotos-Prieto
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Madrid, Spain
- Center for Biomedical Research in Epidemiology and Public Health, Madrid, Spain
- Department of Environmental Health and Nutrition, Harvard T.H. Chan School of Public Health. Boston, Massachusetts
- Madrid Institute for Advanced Studies Food Institute, Campus of International Excellence Universidad Autónoma de Madrid + Spanish National Research Council, Madrid, Spain
| | - Esther García-Esquinas
- Center for Biomedical Research in Epidemiology and Public Health, Madrid, Spain
- Department of Chronic Diseases, National Center for Epidemiology, Carlos III Health Institute, Madrid, Spain
| | - Iñaki Galán
- Center for Biomedical Research in Epidemiology and Public Health, Madrid, Spain
- Department of Chronic Diseases, National Center for Epidemiology, Carlos III Health Institute, Madrid, Spain
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Madrid, Spain
- Center for Biomedical Research in Epidemiology and Public Health, Madrid, Spain
- Madrid Institute for Advanced Studies Food Institute, Campus of International Excellence Universidad Autónoma de Madrid + Spanish National Research Council, Madrid, Spain
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Sarich P, Gao S, Zhu Y, Canfell K, Weber MF. The association between alcohol consumption and all-cause mortality: An umbrella review of systematic reviews using lifetime abstainers or low-volume drinkers as a reference group. Addiction 2024; 119:998-1012. [PMID: 38465993 DOI: 10.1111/add.16446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 01/07/2024] [Indexed: 03/12/2024]
Abstract
BACKGROUND AND AIMS Systematic reviews of the relationship between alcohol consumption and all-cause mortality have reported different relative risk (RR) curves, possibly due to the choice of reference group. Results have varied from 'J-shaped' curves, where low-volume consumption is associated with reduced risk, to monotonically increased risk with increasing consumption. We summarised the evidence on alcohol consumption and all-cause mortality exclusively from systematic reviews using lifetime abstainers or low-volume/occasional drinkers as the reference group. METHODS We conducted a systematic umbrella review of systematic reviews of the relationship between alcohol consumption and all-cause mortality in prospective cohort studies using a reference group of lifetime abstainers or low-volume/occasional drinkers. Several databases (PubMed/Medline/Embase/PsycINFO/Cochrane Library) were searched to March 2022. Reviews were assessed for risk of bias, and those with reference groups containing former drinkers were excluded. RESULTS From 2149 articles retrieved, 25 systematic reviews were identified, and five did not include former drinkers in the reference group. Four of the five included reviews had high risk of bias. Three reviews reported a J-shaped relationship between alcohol consumption and all-cause mortality with significant decreased risk for low-volume drinking (RR range 0.84 to 0.95), while two reviews did not. The one review at low risk of bias reported monotonically increased risk with greater consumption (RRs = 1.02, 1.13, 1.33 and 1.52 for low-, medium-, high- and higher-volume drinking, respectively, compared with occasional drinking). All five reviews reported significantly increased risk with higher levels of alcohol consumption (RR range 1.28 to 3.70). Sub-group analyses were reported by sex and age; however, there were evidence gaps for many important factors. Conversely, 17 of 20 excluded systematic reviews reported decreased mortality risk for low-volume drinking. CONCLUSIONS Over 70% of systematic reviews and meta-analyses published to March 2022 of all-cause mortality risk associated with alcohol consumption did not exclude former drinkers from the reference group and may therefore be biased by the 'sick-quitter effect'.
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Affiliation(s)
- Peter Sarich
- The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, Sydney, New South Wales, Australia
| | - Shuhan Gao
- Changzhou Center for Disease Control and Prevention, Changzhou, Jiangsu Province, China
| | - Yining Zhu
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Karen Canfell
- The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, Sydney, New South Wales, Australia
| | - Marianne F Weber
- The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, Sydney, New South Wales, Australia
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Thelle DS, Grønbæk M. Alcohol - a scoping review for Nordic Nutrition Recommendations 2023. Food Nutr Res 2024; 68:10540. [PMID: 38571916 PMCID: PMC10989238 DOI: 10.29219/fnr.v68.10540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 07/04/2022] [Accepted: 01/23/2024] [Indexed: 04/05/2024] Open
Abstract
The objective of this scoping review is to evaluate the updated evidence on the consumption of alcohol and health outcomes regarded as relevant for the Nordic and Baltic countries, including cardiovascular disease, cancer, and all-cause mortality. It is based on the previous Nordic Nutrition Recommendations of 2012 and relevant papers published until 31 May 2021. Current evidence from mainly observational epidemiological studies suggests that regular, moderate alcohol consumption may confer protective effects against myocardial infarction (MI) and type 2 diabetes. Mendelian randomization analyses do not fully support these findings, possibly because these analyses may fail to identify low alcohol intake. For several cancers, it is not possible to set any safe limit. All-cause mortality is not increased with light to moderate alcohol intake in middle-aged and older adults who do not engage in binge drinking. Total abstinence is associated with the lowest risk of mortality in young adults. Observational studies on alcohol consumption are hampered by a number of inherent methodological issues such as ascertainment of alcohol intake, selection of appropriate exposure groups, and insufficient control of confounding variables, colliders, and mediators. It should also be emphasized that there is a socio-economic contribution to the alcohol-health axis with a stronger detrimental effect of alcohol in the lower social classes. The above issues contribute to the complexity of unravelling the causal web between alcohol, mediators, confounders, and health outcome.
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Affiliation(s)
- Dag Steinar Thelle
- Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Morten Grønbæk
- National Institute of Public Health, Copenhagen, Denmark
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Yang Y, Hodge AM, Lynch BM, Dugué PA, Williamson EJ, Jayasekara H, Mishra G, English DR. Sustained Hypothetical Interventions on Midlife Alcohol Consumption in Relation to All-Cause and Cancer Mortality: The Australian Longitudinal Study on Women's Health. Am J Epidemiol 2024; 193:75-86. [PMID: 37489623 PMCID: PMC10773481 DOI: 10.1093/aje/kwad164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 05/14/2023] [Accepted: 07/20/2023] [Indexed: 07/26/2023] Open
Abstract
No randomized controlled trial has evaluated the effect of long-term alcohol interventions on mortality. Results reported in existing observational studies may be subject to selection bias and time-varying confounding. Using data from the Australian Longitudinal Study on Women's Health 1946-1951 birth cohort, collected regularly from 1996-2016, we estimated all-cause and cancer mortality had women been assigned various alcohol interventions (in categories ranging from 0 to >30 g/day ethanol, or reduced to ≤20 g/day if higher) at baseline, and had they maintained these levels of consumption. The cumulative risks for all-cause and cancer mortality were 5.6% (10,118 women followed for 20 years) and 2.9% (18 years), respectively. For all-cause and cancer mortality, baseline ethanol up to 30 g/day showed lower risk and >30 g/day showed higher risk relative to abstention. Had women sustainedly followed the interventions, a similar relationship was observed for all-cause mortality. However, the negative association observed for intakes ≤30 g/day and positive association for intakes >30 g/day was not evident for cancer mortality. Our findings suggest that all-cause mortality could have been lower than observed if this cohort of women had consumed some alcohol (no more than 30 g/day) rather than no consumption, but cancer mortality might not.
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Affiliation(s)
- Yi Yang
- Correspondence to Dr. Yi Yang, Level 4, Melbourne School of Population and Global Health 207 Bouverie Street, Carlton VIC 3053, Australia (e-mail: )
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Tian Y, Liu J, Zhao Y, Jiang N, Liu X, Zhao G, Wang X. Alcohol consumption and all-cause and cause-specific mortality among US adults: prospective cohort study. BMC Med 2023; 21:208. [PMID: 37286970 DOI: 10.1186/s12916-023-02907-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 05/24/2023] [Indexed: 06/09/2023] Open
Abstract
BACKGROUND Previous studies have shown inconsistent findings regarding the association of light to moderate alcohol consumption with cause-specific mortality. Therefore, this study sought to examine the prospective association of alcohol consumption with all-cause and cause-specific mortality in the US population. METHODS This was a population-based cohort study of adults aged 18 years or older in the National Health Interview Survey (1997 to 2014) with linkage to the National Death Index records through December 31, 2019. Self-reported alcohol consumption was categorized into seven groups (lifetime abstainers; former infrequent or regular drinkers; and current infrequent, light, moderate, or heavy drinkers). The main outcome was all-cause and cause-specific mortality. RESULTS During an average follow-up of 12.65 years, among the 918,529 participants (mean age 46.1 years; 48.0% male), 141,512 adults died from all causes, 43,979 from cardiovascular disease (CVD), 33,222 from cancer, 8246 from chronic lower respiratory tract diseases, 5572 from accidents (unintentional injuries), 4776 from Alzheimer's disease, 4845 from diabetes mellitus, 2815 from influenza and pneumonia, and 2692 from nephritis, nephrotic syndrome, or nephrosis. Compared with lifetime abstainers, current infrequent, light, or moderate drinkers were at a lower risk of mortality from all causes [infrequent-hazard ratio: 0.87; 95% confidence interval: 0.84 to 0.90; light: 0.77; 0.75 to 0.79; moderate 0.82; 0.80 to 0.85], CVD, chronic lower respiratory tract diseases, Alzheimer's disease, and influenza and pneumonia. Also, light or moderate drinkers were associated with lower risk of mortality from diabetes mellitus and nephritis, nephrotic syndrome, or nephrosis. In contrast, heavy drinkers had a significantly higher risk of mortality from all causes, cancer, and accidents (unintentional injuries). Furthermore, binge drinking ≥ 1 day/week was associated with a higher risk of mortality from all causes (1.15; 1.09 to 1.22), cancer (1.22; 1.10 to 1.35), and accidents (unintentional injuries) (1.39; 1.11 to 1.74). CONCLUSIONS Infrequent, light, and moderate alcohol consumption were inversely associated with mortality from all causes, CVD, chronic lower respiratory tract diseases, Alzheimer's disease, and influenza and pneumonia. Light or moderate alcohol consumption might also have a beneficial effect on mortality from diabetes mellitus and nephritis, nephrotic syndrome, or nephrosis. However, heavy or binge had a higher risk of all-cause, cancer, and accidents (unintentional injuries) mortality.
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Affiliation(s)
- Yalan Tian
- Department of Maternal and Child Health, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wenhuaxi Road, Jinan, 250012, China
| | - Jiahui Liu
- Department of Maternal and Child Health, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wenhuaxi Road, Jinan, 250012, China
| | - Yue Zhao
- Department of Maternal and Child Health, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wenhuaxi Road, Jinan, 250012, China
| | - Nana Jiang
- Department of Maternal and Child Health, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wenhuaxi Road, Jinan, 250012, China
| | - Xiao Liu
- Department of Maternal and Child Health, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wenhuaxi Road, Jinan, 250012, China
| | - Gang Zhao
- Department of Cardiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Xia Wang
- Department of Maternal and Child Health, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wenhuaxi Road, Jinan, 250012, China.
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Kim M, Zhang H, Kim T, Mori Y, Okura T, Tanaka K, Isobe T, Sakae T, Oh S. Novel Approach for Glycemic Management Incorporating Vibration Stimulation of Skeletal Muscle in Obesity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4708. [PMID: 36981616 PMCID: PMC10048751 DOI: 10.3390/ijerph20064708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 03/03/2023] [Accepted: 03/05/2023] [Indexed: 06/18/2023]
Abstract
Because obesity is associated with impaired glucose tolerance and type 2 diabetes (T2D), it is important to manage the blood glucose level at an early stage. Nevertheless, people with obesity have significantly lower resistance to muscle fatigue after exercise and exercise adherence. Therefore, we developed a novel "Relaxing-Vibration Training (RVT)" consisting of 25 postures using vibration stimulation of skeletal muscle and determined the feasibility of RVT for glycemic management. Thirty-one participants with obesity were enrolled in a controlled trial (CT) and experimental trial (ET) based on a 75 g oral glucose tolerance test (OGTT). During the CT, participants were required to rest in a quiet room. During the ET, the RVT program (50 Hz, 4 mm), consisting of 25 postures of relaxation and stretching on the vibratory platform, was performed for 40 min. Subsequently, the participants rested as in the CT. Subjective fatigue and muscle stiffness measurements and blood collection were conducted before and after RVT. In both the CT and ET, interstitial fluid (ISF) glucose concentrations were measured every 15 min for 2 h. The incremental area under the curve value of real-time ISF glucose during an OGTT was significantly lower in the ET than in the CT (ET: 7476.5 ± 2974.9, CT: 8078.5 ± 3077.7, effect size r = 0.4). Additionally, the levels of metabolic glucose regulators associated with myokines, muscle stiffness, and subjective fatigue significantly improved after RVT. This novel RVT suggests that it is effective in glycemic management with great potential to improve impaired glucose tolerance and T2D with obesity in the future.
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Affiliation(s)
- Mijin Kim
- Institute of Food Research, National Agricultural and Food Research Organization, Tsukuba 305-8642, Japan
- R&D Center for Tailor-Made QOL, University of Tsukuba, Tsukuba 305-8550, Japan
| | - Hanlin Zhang
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba 305-8572, Japan
| | - Taeho Kim
- The Center for Sports Medicine and Health Sciences, Tsukuba University Hospital, Tsukuba 305-8576, Japan
| | - Yutaro Mori
- Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan
| | - Tomohiro Okura
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba 305-8572, Japan
| | - Kiyoji Tanaka
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba 305-8572, Japan
| | - Tomonori Isobe
- Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan
| | - Takeji Sakae
- Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan
| | - Sechang Oh
- Faculty of Rehabilitation, R Professional University of Rehabilitation, Tsuchiura 300-0032, Japan
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Hrelia S, Di Renzo L, Bavaresco L, Bernardi E, Malaguti M, Giacosa A. Moderate Wine Consumption and Health: A Narrative Review. Nutrients 2022; 15:175. [PMID: 36615832 PMCID: PMC9824172 DOI: 10.3390/nu15010175] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 12/21/2022] [Accepted: 12/28/2022] [Indexed: 12/31/2022] Open
Abstract
Although it is clearly established that the abuse of alcohol is seriously harmful to health, much epidemiological and clinical evidence seem to underline the protective role of moderate quantities of alcohol and in particular of wine on health. This narrative review aims to re-evaluate the relationship between the type and dose of alcoholic drink and reduced or increased risk of various diseases, in the light of the most current scientific evidence. In particular, in vitro studies on the modulation of biochemical pathways and gene expression of wine bioactive components were evaluated. Twenty-four studies were selected after PubMed, Scopus and Google Scholar searches for the evaluation of moderate alcohol/wine consumption and health effects: eight studies concerned cardiovascular diseases, three concerned type 2 diabetes, four concerned neurodegenerative diseases, five concerned cancer and four were related to longevity. A brief discussion on viticultural and enological practices potentially affecting the content of bioactive components in wine is included. The analysis clearly indicates that wine differs from other alcoholic beverages and its moderate consumption not only does not increase the risk of chronic degenerative diseases but is also associated with health benefits particularly when included in a Mediterranean diet model. Obviously, every effort must be made to promote behavioral education to prevent abuse, especially among young people.
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Affiliation(s)
- Silvana Hrelia
- Department for Life Quality Studies, University of Bologna, 47921 Rimini, Italy
| | - Laura Di Renzo
- Section of Clinical Nutrition and Nutrigenomics, Department of Biomedicine and Prevention, University of Tor Vergata, 00133 Rome, Italy
| | - Luigi Bavaresco
- Department of Sustainable Crop Production—Viticulture and Pomology Section, Università Cattolica del Sacro Cuore, 29122 Piacenza, Italy
| | - Elisabetta Bernardi
- Department of Biosciences, Biotechnologies and Biopharmaceutics, University of Bari “Aldo Moro”, 70121 Bari, Italy
| | - Marco Malaguti
- Department for Life Quality Studies, University of Bologna, 47921 Rimini, Italy
| | - Attilio Giacosa
- Department of Gastroenterology and Clinical Nutrition, Policlinico di Monza, 20900 Monza, Italy
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Cribb L, Hodge AM, Yu C, Li SX, English DR, Makalic E, Southey MC, Milne RL, Giles GG, Dugué PA. Inflammation and Epigenetic Aging Are Largely Independent Markers of Biological Aging and Mortality. J Gerontol A Biol Sci Med Sci 2022; 77:2378-2386. [PMID: 35926479 PMCID: PMC9799220 DOI: 10.1093/gerona/glac147] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Indexed: 01/20/2023] Open
Abstract
Limited evidence exists on the link between inflammation and epigenetic aging. We aimed to (a) assess the cross-sectional and prospective associations of 22 inflammation-related plasma markers and a signature of inflammaging with epigenetic aging and (b) determine whether epigenetic aging and inflammaging are independently associated with mortality. Blood samples from 940 participants in the Melbourne Collaborative Cohort Study collected at baseline (1990-1994) and follow-up (2003-2007) were assayed for DNA methylation and 22 inflammation-related markers, including well-established markers (eg, interleukins and C-reactive protein) and metabolites of the tryptophan-kynurenine pathway. Four measures of epigenetic aging (PhenoAge, GrimAge, DunedinPoAm, and Zhang) and a signature of inflammaging were considered, adjusted for age, and transformed to Z scores. Associations were assessed using linear regression, and mortality hazard ratios (HR) and 95% confidence intervals (95% CI) were estimated using Cox regression. Cross-sectionally, most inflammation-related markers were associated with epigenetic aging measures, although with generally modest effect sizes (regression coefficients per SD ≤ 0.26) and explaining altogether between 1% and 11% of their variation. Prospectively, baseline inflammation-related markers were not, or only weakly, associated with epigenetic aging after 11 years of follow-up. Epigenetic aging and inflammaging were strongly and independently associated with mortality, for example, inflammaging: HR = 1.41, 95% CI = 1.27-1.56, p = 2 × 10-10, which was only slightly attenuated after adjustment for 4 epigenetic aging measures: HR = 1.35, 95% CI = 1.22-1.51, p = 7 × 10-9). Although cross-sectionally associated with epigenetic aging, inflammation-related markers accounted for a modest proportion of its variation. Inflammaging and epigenetic aging are essentially nonoverlapping markers of biological aging and may be used jointly to predict mortality.
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Affiliation(s)
- Lachlan Cribb
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Allison M Hodge
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Chenglong Yu
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Sherly X Li
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Dallas R English
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Enes Makalic
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Melissa C Southey
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
- Department of Clinical Pathology, The University of Melbourne, Parkville, Victoria, Australia
| | - Roger L Milne
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Graham G Giles
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Pierre-Antoine Dugué
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
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10
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Prokopidis K, Witard OC. Understanding the role of smoking and chronic excess alcohol consumption on reduced caloric intake and the development of sarcopenia. Nutr Res Rev 2022; 35:197-206. [PMID: 34027849 DOI: 10.1017/s0954422421000135] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
This narrative review provides mechanistic insight into the biological link between smoking and/or chronic excess alcohol consumption, and increased risk of developing sarcopenia. Although the combination of excessive alcohol consumption and smoking is often associated with ectopic adipose deposition, this review is focused on the context of a reduced caloric intake (leading to energy deficit) that also may ensue due to either lifestyle habit. Smoking is a primary cause of periodontitis and chronic obstructive pulmonary disease that both induce swallowing difficulties, inhibit taste and mastication, and are associated with increased risk of muscle atrophy and mitochondrial dysfunction. Smoking may contribute to physical inactivity, energy deficit via reduced caloric intake, and increased systemic inflammation, all of which are factors known to suppress muscle protein synthesis rates. Moreover, chronic excess alcohol consumption may result in gut microbiota dysbiosis and autophagy-induced hyperammonemia, initiating the up-regulation of muscle protein breakdown and down-regulation of muscle protein synthesis via activation of myostatin, AMPK and REDD1, and deactivation of IGF-1. Future research is warranted to explore the link between oral healthcare management and personalised nutrition counselling in light of potential detrimental consequences of chronic smoking on musculoskeletal health outcomes in older adults. Experimental studies should investigate the impact of smoking and chronic excess alcohol consumption on the gut-brain axis, and explore biomarkers of smoking-induced oral disease progression. The implementation of behavioural change interventions and health policies regarding smoking and alcohol intake habits may mitigate the clinical and financial burden of sarcopenia on the healthcare system.
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Affiliation(s)
- Konstantinos Prokopidis
- Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, White City, London, UK
| | - Oliver C Witard
- Centre for Human and Applied Physiological Sciences, School of Basic and Medical Biosciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
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11
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The Sense of Coherence and Health Behavior of Men with Alcohol Addiction. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148650. [PMID: 35886502 PMCID: PMC9318652 DOI: 10.3390/ijerph19148650] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 07/13/2022] [Accepted: 07/14/2022] [Indexed: 02/01/2023]
Abstract
INTRODUCTION Alcohol dependence is one of the world's major health challenges. The salutogenic concept of health developed by Antonovsky focuses on the search for resources and factors supporting health. Its basic concept of the sense of coherence (SOC) focuses on strengthening the global orientation of the patient, and creating permanent internal resources that translate into the improvement of pro-health behavior, including the fight against alcoholism. OBJECTIVE The objective of this study was to determine the correlation between individual factors and the SOC as well as the influence of the SOC concept on pro-health behavior of people addicted to alcohol. MATERIALS AND METHODS The study group consisted of 110 men undergoing treatment in an addiction treatment ward. To check the level of the SOC, two standardized questionnaires, Antonovsky's "SOC-29 Life Orientation Questionnaire" and Juczyński's "Health Behaviour Inventory", were used. The correlation coefficient between the sociodemographic variables was checked using the Pearson's r test. RESULTS A positive correlation was found with the intensity of pro-health behaviors for three sociodemographic variables. In people aged 43-65 (r = 0.299; p = 0.030), people with primary/vocational education (r = 0.276; p = 0.015), and respondents living in rural areas (r = 0.303; p = 0.028) a greater SOC was associated with pro-health behaviors. CONCLUSIONS Individuals addicted to alcohol are characterized by a low SOC and a low level of pro-health behaviors. Strengthening the internal level of the SOC can constitute an element of addiction therapy when introducing health education to prepare the patient for independent life in sobriety.
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12
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Ding C, O'Neill D, Britton A. Trajectories of alcohol consumption in relation to all-cause mortality in patients with cardiovascular disease: a 35-year prospective cohort study. Addiction 2022; 117:1920-1930. [PMID: 35188300 PMCID: PMC9314067 DOI: 10.1111/add.15850] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 02/04/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND AND AIMS Research into alcohol consumption and cardiovascular disease (CVD) patients' prognosis has largely ignored the longitudinal dynamics in drinking behaviour. This study measured the association between alcohol consumption trajectories and mortality risk in CVD patients. DESIGN Prospective cohort study. SETTING UK-based Whitehall II Study. PARTICIPANTS A total of 1306 participants with incident non-fatal CVD (coronary heart disease/stroke) events. MEASUREMENTS Up to eight repeated measures of alcohol intake were available for each patient from the most recent assessment phase pre-incident CVD and all subsequent phases post-incident CVD, spanning up to three decades. Six trajectory groups of alcohol consumption were identified using group-based trajectory modelling and related to the risk of all-cause mortality, adjusting for demographics and changes in life-style and health status. FINDINGS Three hundred and eighty deaths were recorded during a median follow-up of 5 years after patients' last alcohol assessment. Compared with patients who consistently drank moderately (≤ 14 units/week), former drinkers had a greater risk of mortality (hazard ratio = 1.74, 95% confidence interval = 1.19-2.54) after adjustment for covariates. There was no significantly increased risk of mortality in long-term abstainers, reduced moderate drinkers, stable or unstable heavy drinkers. Cross-sectional analyses based only on drinking information at patients' last assessment found no significant differences in mortality risk for abstainers, former or heavy drinkers versus moderate drinkers. CONCLUSIONS Cardiovascular disease patients who consistently drink ≤ 14 units/week appear to have a similar risk of mortality to those who are long-term abstainers, which does not support a protective effect of moderate drinking on total mortality. Cardiovascular disease patients who stop drinking appear to have increased mortality risk compared with continuous moderate drinkers, but this may be linked to poor self-rated health before cardiovascular disease onset.
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Affiliation(s)
- Chengyi Ding
- Research Department of Epidemiology and Public HealthUniversity College LondonLondonUK
| | - Dara O'Neill
- CLOSER, UCL Social Research InstituteUniversity College LondonLondonUK
| | - Annie Britton
- Research Department of Epidemiology and Public HealthUniversity College LondonLondonUK
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13
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Ortolá R, García-Esquinas E, Buño-Soto A, Carballo-Casla A, Sotos-Prieto M, Banegas JR, Rodríguez-Artalejo F. Alcohol consumption patterns and growth differentiation factor 15 among life-time drinkers aged 65+ years in Spain: a cross-sectional study. Addiction 2022; 117:1647-1657. [PMID: 35072312 DOI: 10.1111/add.15809] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 01/10/2022] [Indexed: 12/18/2022]
Abstract
AIMS To examine the association of alcohol consumption patterns with growth differentiation factor 15 (GDF-15) in older drinkers, separately among individuals with cardiovascular disease (CVD)/diabetes and those without them, as GDF-15 is a strong biomarker of chronic disease burden. DESIGN Cross-sectional study. SETTING Population-based study in Madrid (Spain). PARTICIPANTS A total of 2051 life-time drinkers aged 65+ years included in the Seniors-ENRICA-2 study in 2015-17. Participants' mean age was 71.4 years and 55.4% were men. MEASUREMENTS According to their average life-time alcohol intake, participants were classified as occasional (≤ 1.43 g/day), low-risk (men: > 1.43-20 g/day; women: > 1.43-10 g/day), moderate-risk (men: > 20-40 g/day; women: > 10-20 g/day) and high-risk drinkers (men: > 40 g/day; women: > 20 g/day; or binge drinkers). We also ascertained wine preference (> 80% of alcohol derived from wine), drinking with meals and adherence to a Mediterranean drinking pattern (MDP) defined as low-risk drinking, wine preference and one of the following: drinking only with meals; higher adherence to the Mediterranean diet; or any of these. FINDINGS In participants without CVD/diabetes, GDF-15 increased by 0.27% [95% confidence interval (CI) = 0.06%, 0.48%] per 1 g/day increment in alcohol among high-risk drinkers, but there was no clear evidence of association in those with lower intakes or in the overall group, or across categories of alcohol consumption status. Conversely, among those with CVD/diabetes, GDF-15 rose by 0.19% (95% CI = 0.05%, 0.33%) per 1 g/day increment in the overall group and GDF-15 was 26.89% (95% CI = 12.93%, 42.58%) higher in high-risk versus low-risk drinkers. Drinking with meals did not appear to be related to GDF-15, but among those without CVD/diabetes, wine preference and adherence to the MDP were associated with lower GDF-15, especially when combined with high adherence to the Mediterranean diet. CONCLUSIONS Among older life-time drinkers in Madrid, Spain, high-risk drinking was positively associated with growth differentiation factor 15 (a biomarker of chronic disease burden). There was inconclusive evidence of a beneficial association for low-risk consumption.
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Affiliation(s)
- Rosario Ortolá
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid and Idipaz, Madrid, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Esther García-Esquinas
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid and Idipaz, Madrid, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Antonio Buño-Soto
- Department of Laboratory Medicine, La Paz University Hospital-IdiPaz, Madrid, Spain
| | - Adrián Carballo-Casla
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid and Idipaz, Madrid, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Mercedes Sotos-Prieto
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid and Idipaz, Madrid, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Department of Environmental Health and Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - José R Banegas
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid and Idipaz, Madrid, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid and Idipaz, Madrid, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.,IMDEA Food Institute. CEI UAM+CSIC, Madrid, Spain
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14
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Alcohol consumption patterns and unhealthy aging among older lifetime drinkers from Spain. Drug Alcohol Depend 2022; 235:109444. [PMID: 35421688 DOI: 10.1016/j.drugalcdep.2022.109444] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 04/01/2022] [Accepted: 04/02/2022] [Indexed: 12/18/2022]
Abstract
BACKGROUND The protective health effects of light alcohol consumption are debated due to potential selection biases, reverse causation and confounding. We examined cross-sectional and prospective associations of alcohol consumption patterns with unhealthy aging among older drinkers addressing these methodological issues. METHODS 2081 lifetime drinkers aged 65 + years from the Seniors-ENRICA-2 cohort followed-up for 2.4 years were classified as occasional (average lifetime alcohol intake [g/day] ≤1.43), low-risk (men: >1.43-20; women: >1.43-10), moderate-risk (men: >20-40; women: >10-20) and high-risk drinkers (men: >40; women: >20; or binge drinkers). A Mediterranean drinking pattern (MDP) was defined as occasional/low-risk drinking, wine preference and drinking only with meals. Unhealthy aging was measured with a 52-item health deficit accumulation index (DAI), with higher values indicating more health deficits. RESULTS A 10-g/day increment in lifetime average alcohol intake was cross-sectionally associated with a higher DAI among all drinkers (mean difference [95% confidence interval] = 0.35 [0.16, 0.53]) and moderate-/high-risk drinkers (0.41 [0.17, 0.65]), but not among occasional/low-risk drinkers. Also, the DAI was 1.35 (0.06, 2.65) points higher in high-risk versus low-risk drinkers and 2.07 (0.59, 3.60) points higher in non-adherers versus adherers to the MDP. Most associations strengthened when restricting analyses to individuals with lower disease burden and did not generally remain after 2.4 years. CONCLUSIONS We found no evidence of a beneficial association between low-risk alcohol consumption and unhealthy aging, but a detrimental one for high-risk drinking, which strengthened when accounting for reverse causation, although attenuated over the follow-up likely due to selective attrition of those less resilient to the harmful effects of alcohol.
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15
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Zhong L, Chen W, Wang T, Zeng Q, Lai L, Lai J, Lin J, Tang S. Alcohol and Health Outcomes: An Umbrella Review of Meta-Analyses Base on Prospective Cohort Studies. Front Public Health 2022; 10:859947. [PMID: 35602135 PMCID: PMC9115901 DOI: 10.3389/fpubh.2022.859947] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 04/06/2022] [Indexed: 12/18/2022] Open
Abstract
An umbrella review of meta-analyses was performed to summarize the evidence of associations between alcohol consumption and health outcomes and to assess its credibility. Meta-analyses of prospective cohort studies reporting the associations of alcohol consumption with health outcomes were identified. We recalculated the random-effects summary effect size and 95% confidence interval, heterogeneity, and small-study effect for each meta-analysis and graded the evidence. Fifty-nine publications reporting 224 meta-analyses of prospective cohort studies with 140 unique health outcomes were included, in which there were 49 beneficial associations and 25 harmful associations with nominally statistically significant summary results. But quality of evidence was rated high only for seven beneficial associations (renal cell carcinoma risk, dementia risk, colorectal cancer mortality, and all-cause mortality in patients with hypertension for low alcohol consumption; renal cell carcinoma risk, cardiovascular disease (CVD) risk in patients with hypertension and all-cause mortality in patients with hypertension for moderate consumption) and four harmful associations (cutaneous basal cell carcinoma risk for low alcohol consumption; cutaneous basal cell carcinoma risk and cutaneous squamous cell carcinoma risk for moderate alcohol consumption; hemorrhagic stroke risk for high alcohol consumption). In this umbrella review, only 11 health outcomes (5 in low alcohol consumption, 5 in moderate alcohol consumption and 1 in high alcohol consumption) with statistically significant showed high quality of epidemiologic evidence. More robust and larger prospective studies are needed to verify our results.
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Affiliation(s)
- Lixian Zhong
- Department of Gastroenterology, The First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Weiwei Chen
- Department of Gastroenterology, The First Affiliated Hospital, Jinan University, Guangzhou, China
- Department of Gastroenterology, The First People's Hospital of Zunyi (The Third Affiliated Hospital of Zunyi Medical University), Zunyi, China
| | - Tonghua Wang
- Department of Gastroenterology, Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China
| | - Qiuting Zeng
- Department of Gastroenterology, The First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Leizhen Lai
- Department of Gastroenterology, The First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Junlong Lai
- Department of Gastroenterology, The First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Junqin Lin
- Department of Gastroenterology, The First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Shaohui Tang
- Department of Gastroenterology, The First Affiliated Hospital, Jinan University, Guangzhou, China
- *Correspondence: Shaohui Tang
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16
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Swain CTV, Bassett JK, Hodge AM, Dunstan DW, Owen N, Yang Y, Jayasekara H, Hébert JR, Shivappa N, MacInnis RJ, Milne RL, English DR, Lynch BM. Television viewing time and all-cause mortality: interactions with BMI, physical activity, smoking, and dietary factors. Int J Behav Nutr Phys Act 2022; 19:30. [PMID: 35305675 PMCID: PMC8934515 DOI: 10.1186/s12966-022-01273-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 03/07/2022] [Indexed: 11/10/2022] Open
Abstract
Background Higher levels of time spent sitting (sedentary behavior) contribute to adverse health outcomes, including earlier death. This effect may be modified by other lifestyle factors. We examined the association of television viewing (TV), a common leisure-time sedentary behavior, with all-cause mortality, and whether this is modified by body mass index (BMI), physical activity, smoking, alcohol intake, soft drink consumption, or diet-associated inflammation. Methods Using data from participants in the Melbourne Collaborative Cohort Study, flexible parametric survival models assessed the time-dependent association of self-reported TV time (three categories: < 2 h/day, 2–3 h/day, > 3 h/day) with all-cause mortality. Interaction terms were fitted to test whether there was effect modification of TV time by the other risk factors. Results From 19,570 participants, 4,417 deaths were reported over a median follow up of 14.5 years. More TV time was associated with earlier mortality; however, this relationship diminished with increasing age. The hazard ratio (HR) and 95% confidence interval (95% CI) for > 3 h/day compared with < 2 h/day of TV time was 1.34 (1.16, 1.55) at 70 years, 1.14 (1.04, 1.23) at 80 years, and 0.95 (0.84, 1.06) at 90 years. The TV time/mortality relationship was more evident in participants who were physically inactive (compared with active; p for interaction < 0.01) or had a higher dietary inflammatory index score (compared with a lower score; p for interaction = 0.03). No interactions were detected between TV time and BMI, smoking, alcohol intake, nor soft-drink consumption (all p for interaction > 0.16). Conclusions The relationship between TV time and all-cause mortality may change with age. It may also be more pronounced in those who are otherwise inactive or who have a pro-inflammatory diet. Supplementary Information The online version contains supplementary material available at 10.1186/s12966-022-01273-5.
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17
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Di Castelnuovo A, Costanzo S, Bonaccio M, McElduff P, Linneberg A, Salomaa V, Männistö S, Moitry M, Ferrières J, Dallongeville J, Thorand B, Brenner H, Ferrario M, Veronesi G, Pettenuzzo E, Tamosiunas A, Njølstad I, Drygas W, Nikitin Y, Söderberg S, Kee F, Grassi G, Westermann D, Schrage B, Dabboura S, Zeller T, Kuulasmaa K, Blankenberg S, Donati MB, de Gaetano G, Iacoviello L. Alcohol intake and total mortality in 142 960 individuals from the MORGAM Project: a population-based study. Addiction 2022; 117:312-325. [PMID: 34105209 DOI: 10.1111/add.15593] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 11/02/2020] [Accepted: 05/26/2021] [Indexed: 12/12/2022]
Abstract
AIM To test the association of alcohol consumption with total and cause-specific mortality risk. DESIGN Prospective observational multi-centre population-based study. SETTING Sixteen cohorts (15 from Europe) in the MOnica Risk, Genetics, Archiving and Monograph (MORGAM) Project. PARTICIPANTS A total of 142 960 individuals (mean age 50 ± 13 years, 53.9% men). MEASUREMENTS Average alcohol intake by food frequency questionnaire, total and cause-specific mortality. FINDINGS In comparison with life-time abstainers, consumption of alcohol less than 10 g/day was associated with an average 11% [95% confidence interval (CI) = 7-14%] reduction in the risk of total mortality, while intake > 20 g/day was associated with a 13% (95% CI = 7-20%) increase in the risk of total mortality. Comparable findings were observed for cardiovascular (CV) deaths. With regard to cancer, drinking up to 10 g/day was not associated with either mortality risk reduction or increase, while alcohol intake > 20 g/day was associated with a 22% (95% CI = 10-35%) increased risk of mortality. The association of alcohol with fatal outcomes was similar in men and women, differed somewhat between countries and was more apparent in individuals preferring wine, suggesting that benefits may not be due to ethanol but other ingredients. Mediation analysis showed that high-density lipoprotein cholesterol explained 2.9 and 18.7% of the association between low alcohol intake and total as well as CV mortality, respectively. CONCLUSIONS In comparison with life-time abstainers, consuming less than one drink per day (nadir at 5 g/day) was associated with a reduced risk of total, cardiovascular and other causes mortality, except cancer. Intake of more than two drinks per day was associated with an increased risk of total, cardiovascular and especially cancer mortality.
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Affiliation(s)
| | - Simona Costanzo
- Department of Epidemiology and Prevention, IRCCS Neuromed, Pozzilli, Italy
| | | | - Patrick McElduff
- University of Newcastle & Hunter Medical Research Institute, Australia
| | - Allan Linneberg
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Veikko Salomaa
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Satu Männistö
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Marie Moitry
- Department of Public Health, University Hospital of Strasbourg and Department of Epidemiology and Public Health, University of Strasbourg, France
| | - Jean Ferrières
- Department of Cardiology and INSERM UMR 1295, Toulouse University Hospital, Toulouse, France
| | - Jean Dallongeville
- University of Lille, Inserm, CHU Lille, Institut Pasteur de Lille, Lille, France
| | - Barbara Thorand
- Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology, Neuherberg, Germany
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research and Division of Preventive Oncology, German Cancer Research Center, Heidelberg, Germany
| | - Marco Ferrario
- Research Center in Epidemiology and Preventive Medicine (EPIMED), Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Giovanni Veronesi
- Research Center in Epidemiology and Preventive Medicine (EPIMED), Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Emanuela Pettenuzzo
- Research Center in Epidemiology and Preventive Medicine (EPIMED), Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | | | - Inger Njølstad
- Department of community Medicine, University of Tromsø - the Arctic University of Norway, Norway
| | - Wojciech Drygas
- Department of Epidemiology CVD Prevention and Health Promotion, National Institute of Cardiology, Warsaw, Poland
| | - Yuri Nikitin
- The Institute of Internal and Preventive Medicine, Novosibirsk, Russia
| | - Stefan Söderberg
- Department of Public Health and Clinical Medicine, and Heart Centre, Umeå University, Sweden
| | - Frank Kee
- Centre for Public Health, Queens University of Belfast, Belfast, Northern Ireland
| | - Guido Grassi
- Clinica Medica, Università Milano-Bicocca, Milano, Italy
| | - Dirk Westermann
- Clinic of General and Interventional Cardiology, University Heart & Vascular Center Hamburg, Germany, and German Center for cardiovascular research, Partner Site Hamburg/Lübeck/Kiel, Hamburg, Germany
| | - Benedikt Schrage
- Clinic of General and Interventional Cardiology, University Heart & Vascular Center Hamburg, Germany, and German Center for cardiovascular research, Partner Site Hamburg/Lübeck/Kiel, Hamburg, Germany
| | - Salim Dabboura
- Clinic of General and Interventional Cardiology, University Heart & Vascular Center Hamburg, Germany, and German Center for cardiovascular research, Partner Site Hamburg/Lübeck/Kiel, Hamburg, Germany
| | - Tanja Zeller
- Clinic of General and Interventional Cardiology, University Heart & Vascular Center Hamburg, Germany, and German Center for cardiovascular research, Partner Site Hamburg/Lübeck/Kiel, Hamburg, Germany
| | - Kari Kuulasmaa
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Stefan Blankenberg
- Clinic of General and Interventional Cardiology, University Heart & Vascular Center Hamburg, Germany, and German Center for cardiovascular research, Partner Site Hamburg/Lübeck/Kiel, Hamburg, Germany
| | | | | | - Licia Iacoviello
- Department of Epidemiology and Prevention, IRCCS Neuromed, Pozzilli, Italy.,Research Center in Epidemiology and Preventive Medicine (EPIMED), Department of Medicine and Surgery, University of Insubria, Varese, Italy
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18
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Kim M, Isoda H, Okura T. Effect of Citrulline and Leucine Intake with Exercises on Body Composition, Physical Activity, and Amino Acid Concentration in Older Women: A Randomized Double-Blind Placebo-Controlled Study. Foods 2021; 10:foods10123117. [PMID: 34945668 PMCID: PMC8701161 DOI: 10.3390/foods10123117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 11/30/2021] [Accepted: 12/09/2021] [Indexed: 01/12/2023] Open
Abstract
The combined intake of citrulline (CIT) and leucine (LEU) can stimulate protein synthesis. Therefore, this study aimed to investigate the effect of combined intake of CIT and LEU accompanied by exercise for 20 weeks on body composition, physical activity (PA), and amino acid concentrations in older Japanese women with low body mass index (BMI) (16 to 21 kg/m2) using a randomized, double-blind, placebo-controlled design. The supplement was administered twice a day for 20 weeks (Ex (exercise) + CIT·LEU group, n = 10: mainly 0.8 g CIT and 1.6 g LEU; Ex + Placebo group, n = 13: mainly 3.5 g carbohydrate). Additionally, both groups exercised (weight-bearing exercise, square stepping exercise) once a week for 75 min. Body composition, PA, and amino acid concentrations in the plasma were measured. Body weight, BMI, body mass, household PA, total PA, and phenylalanine significantly increased in the Ex + CIT·LEU group (p < 0.05) post intervention. This study suggests that the combined intake of CIT and LEU accompanied by exercise can improve body weight, BMI, body mass, and PA in older women with low BMI, which may prevent sarcopenia and frailty.
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Affiliation(s)
- Mijin Kim
- R&D Center for Tailor-Made QOL, University of Tsukuba, Tsukuba 305-8550, Japan; (H.I.); (T.O.)
- Correspondence: ; Tel.: +81-29-859-1834
| | - Hiroko Isoda
- R&D Center for Tailor-Made QOL, University of Tsukuba, Tsukuba 305-8550, Japan; (H.I.); (T.O.)
- Alliance for Research on the Mediterranean and North Africa, University of Tsukuba, Tsukuba 305-8572, Japan
- Faculty of Life and Environmental Sciences, University of Tsukuba, Tsukuba 305-8572, Japan
| | - Tomohiro Okura
- R&D Center for Tailor-Made QOL, University of Tsukuba, Tsukuba 305-8550, Japan; (H.I.); (T.O.)
- Faculty of Health and Sport Science, University of Tsukuba, Tsukuba 305-8572, Japan
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19
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Estruch R, Hendriks HFJ. Associations between Low to Moderate Consumption of Alcoholic Beverage Types and Health Outcomes: A Systematic Review. Alcohol Alcohol 2021; 57:176-184. [PMID: 34897368 PMCID: PMC8919407 DOI: 10.1093/alcalc/agab082] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 11/19/2021] [Accepted: 11/20/2021] [Indexed: 11/24/2022] Open
Abstract
Aims There is limited research comparing light to moderate wine, beer and spirits consumption and their impact on long-term health. This systematic review aims to investigate the studies published in the past 10 years and qualitatively assess the similarities and differences between the three main beverages, when consumed at a low to moderate level, for their associations with various health outcomes. Methods A systematic search was conducted for comparative studies published in English language (2010 to mid-2021) of beverage-specific low to moderate alcohol consumption associated with all-cause mortality, cancer, cardiovascular disease and diabetes mellitus type II. Results The search yielded a total of 24 studies (8 meta-analyses; 15 prospective studies and 1 pooled analysis). Overall, most studies showed similar associations of different alcoholic beverages with chronic conditions, including all-cause mortality, many types of cancer, cardiovascular disease and diabetes mellitus type II. Not all data are consistent. Some studies show more beneficial or detrimental effects of wine than other beverage types, whereas other studies show such effects for other beverages. Conclusion Moderate consumption of one specific alcoholic beverage (wine, beer or spirits) may not be consistently associated with higher or lower risks for common health outcomes as compared with moderate consumption of any of the other alcoholic beverages.
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Affiliation(s)
- Ramon Estruch
- Department of Internal Medicine, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Villarroel, 170, 08036 Barcelona, Spain.,CIBER Fisiopatología de la Obesidad y la Nutrición (CIBER OBN), Instituto de Salud Carlos III, Montforte de Lemos 3-5, Pabellón 11, Planta O / 28029 Madrid, Spain
| | - Henk F J Hendriks
- Hendriks Nutrition Support for Business, Laan van Cattenbroeck 70, 3703 BP Zeist, The Netherlands
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20
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Ma H, Li X, Zhou T, Sun D, Shai I, Heianza Y, Rimm EB, Manson JE, Qi L. Alcohol Consumption Levels as Compared With Drinking Habits in Predicting All-Cause Mortality and Cause-Specific Mortality in Current Drinkers. Mayo Clin Proc 2021; 96:1758-1769. [PMID: 34218856 PMCID: PMC8262073 DOI: 10.1016/j.mayocp.2021.02.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 01/19/2021] [Accepted: 02/15/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To investigate the joint associations of amounts of alcohol consumed and drinking habits with the risks of all-cause mortality and cause-specific mortality. PATIENTS AND METHODS A total of 316,627 healthy current drinkers, with baseline measurements between March 13, 2006, and October 1, 2010, were included in this study. We newly created a drinking habit score (DHS) according to regular drinking (frequency of alcohol intake ≥3 times/wk) and whether consuming alcohol with meals (yes). RESULTS During a median follow-up of 8.9 years, we documented 8652 incident cases of all-cause death, including 1702 cases of cardiovascular disease death, 4960 cases of cancer death, and 1990 cases of other-cause death. After adjustment confounders and amount of alcohol consumed, higher DHS was significantly associated with a lower risk of all-cause mortality, cardiovascular disease mortality, cancer mortality, or other-cause mortality (Ptrend<.001, Ptrend=.03, Ptrend<.001, and Ptrend<.001, respectively). We observed that the amount of alcohol consumed have different relationships with the risks of all-cause mortality and cause-specific mortality among participants with distinct drinking habits, grouped by DHS. For example, in the joint analyses, a J-shaped association between the amount of alcohol consumed and all-cause mortality was observed in participants with unfavorable DHS (Pquadratictrend=.02) while the association appeared to be U-shaped in participants with favorable DHS (Pquadratictrend=.003), with lower risks in those consuming greater than or equal to 50 g/wk and less than 300 g/wk. CONCLUSION Our results indicate that alcohol consumption levels have different relationships with the risk of mortality among current drinkers, depending on their drinking habits.
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Affiliation(s)
- Hao Ma
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
| | - Xiang Li
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
| | - Tao Zhou
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
| | - Dianjianyi Sun
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
| | - Iris Shai
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Yoriko Heianza
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
| | - Eric B Rimm
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | - JoAnn E Manson
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Lu Qi
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA.
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21
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Calvo E, Allel K, Staudinger UM, Castillo-Carniglia A, Medina JT, Keyes KM. Cross-country differences in age trends in alcohol consumption among older adults: a cross-sectional study of individuals aged 50 years and older in 22 countries. Addiction 2021; 116:1399-1412. [PMID: 33241648 PMCID: PMC8131222 DOI: 10.1111/add.15292] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 06/01/2020] [Accepted: 10/02/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND AIMS Age-related changes in physiological, metabolic and medication profiles make alcohol consumption likely to be more harmful among older than younger adults. This study aimed to estimate cross-national variation in the quantity and patterns of drinking throughout older age, and to investigate country-level variables explaining cross-national variation in consumption for individuals aged 50 years and older. DESIGN Cross-sectional observational study using previously harmonized survey data. SETTING Twenty-two countries surveyed in 2010 or the closest available year. PARTICIPANTS A total of 106 180 adults aged 50 years and over. MEASUREMENTS Cross-national variation in age trends were estimated for two outcomes: weekly number of standard drink units (SDUs) and patterns of alcohol consumption (never, ever, occasional, moderate and heavy drinking). Human Development Index and average prices of vodka were used as country-level variables moderating age-related declines in drinking. FINDINGS Alcohol consumption was negatively associated with age (risk ratio = 0.98; 95% confidence interval = 0.97, 0.99; P-value < 0.001), but there was substantial cross-country variation in the age-related differences in alcohol consumption [likelihood ratio (LR) test P-value < 0.001], even after adjusting for the composition of populations. Countries' development level and alcohol prices explained 31% of cross-country variability in SDUs (LR test P-value < 0.001) but did not explain cross-country variability in the prevalence of heavy drinkers. CONCLUSIONS Use and harmful use of alcohol among older adults appears to vary widely across age and countries. This variation can be partly explained both by the country-specific composition of populations and country-level contextual factors such as development level and alcohol prices.
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Affiliation(s)
- Esteban Calvo
- Society and Health Research Center, School of Public Health, Universidad Mayor, Santiago, Chile
- Laboratory on Aging and Social Epidemiology, Facultad de Humanidades, Universidad Mayor, Santiago, Chile
- Department of Epidemiology, Mailman School of Public Health, Columbia University, NY, USA
- Robert N. Butler Columbia Aging Center, Mailman School of Public Health, Columbia University, NY, USA
| | - Kasim Allel
- Society and Health Research Center, School of Public Health, Universidad Mayor, Santiago, Chile
- Laboratory on Aging and Social Epidemiology, Facultad de Humanidades, Universidad Mayor, Santiago, Chile
- Institute for Global Health, University College London, London, UK
| | - Ursula M. Staudinger
- Robert N. Butler Columbia Aging Center, Mailman School of Public Health, Columbia University, NY, USA
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, NY, USA
| | - Alvaro Castillo-Carniglia
- Society and Health Research Center, School of Public Health, Universidad Mayor, Santiago, Chile
- Laboratory on Aging and Social Epidemiology, Facultad de Humanidades, Universidad Mayor, Santiago, Chile
- Department of Population Health, New York University School of Medicine, NY, USA
| | - José T. Medina
- Society and Health Research Center, School of Public Health, Universidad Mayor, Santiago, Chile
- Laboratory on Aging and Social Epidemiology, Facultad de Humanidades, Universidad Mayor, Santiago, Chile
| | - Katherine M. Keyes
- Society and Health Research Center, School of Public Health, Universidad Mayor, Santiago, Chile
- Department of Epidemiology, Mailman School of Public Health, Columbia University, NY, USA
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22
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Zatońska K, Psikus P, Basiak-Rasała A, Stępnicka Z, Wołyniec M, Wojtyła A, Szuba A, Połtyn-Zaradna K. Patterns of Alcohol Consumption in the PURE Poland Cohort Study and Their Relationship with Health Problems. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18084185. [PMID: 33920940 PMCID: PMC8071311 DOI: 10.3390/ijerph18084185] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 04/05/2021] [Accepted: 04/13/2021] [Indexed: 11/20/2022]
Abstract
(1) Background: Alcohol is a leading risk factor of premature morbidity and mortality. The objective of this study was to investigate the patterns of alcohol consumption in the PURE Poland cohort study baseline. (2) Methods: A Polish cohort was enrolled in the baseline study in 2007–2010. The study group consisted of 2021 adult participants of urban and rural areas from the Lower Silesia voivodeship in Poland (747 men and 1274 women). (3) Results: In the overall study population, 67.3% were current drinkers, 10.3% were former drinkers, and 22.4% were abstainers. Current use of alcohol products was more prevalent in men (77.2%), people living in urban areas (73.0%), and people with a higher level of education (78.0%). The percentage of current drinkers decreased with increasing age (from 73.4% in 30- to 44-year-olds to 48.8% in participants aged 64 and more). The majority of participants (89.2%) declared a low level of alcohol intake. The chance of high level of intake of alcohol was four times higher in men than in women (OR 4.17; CI 1.64–10.6). The majority of participants (54.6%) declared most frequent consumption of low-alcohol drinks (beer, wine) and 21% declared most frequent consumption of spirits. Current drinkers had almost 1.5-fold higher odds of diabetes and cardiovascular diseases (CVD) than never drinkers (OR 1.49, CI 1.03–2.17; OR 1.66, CI 1.27–2.18, respectively). Former drinkers had higher odds for hypertension and CVD than never drinkers (1.73, CI 1.05–2.85; OR 1.76, CI 1.22–2.53, respectively). (4) Conclusions: In our cohort study, we observed several socio-demographic factors differentiating the patterns of alcohol consumption. The preventive programs should focus predominantly on men, people aged <45 years, and those with a higher level of education.
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Affiliation(s)
- Katarzyna Zatońska
- Department of Social Medicine, Wroclaw Medical University, 50-345 Wrocław, Poland; (K.Z.); (Z.S.); (M.W.); (K.P.-Z.)
- Calisia University, 62-800 Kalisz, Poland; (P.P.); (A.W.)
| | - Piotr Psikus
- Calisia University, 62-800 Kalisz, Poland; (P.P.); (A.W.)
| | - Alicja Basiak-Rasała
- Department of Social Medicine, Wroclaw Medical University, 50-345 Wrocław, Poland; (K.Z.); (Z.S.); (M.W.); (K.P.-Z.)
- Correspondence: ; Tel./Fax: +48-71-328-21-45
| | - Zuzanna Stępnicka
- Department of Social Medicine, Wroclaw Medical University, 50-345 Wrocław, Poland; (K.Z.); (Z.S.); (M.W.); (K.P.-Z.)
| | - Maria Wołyniec
- Department of Social Medicine, Wroclaw Medical University, 50-345 Wrocław, Poland; (K.Z.); (Z.S.); (M.W.); (K.P.-Z.)
| | | | - Andrzej Szuba
- Department of Angiology, Hypertension and Diabetology, Wroclaw Medical University, 50-556 Wroclaw, Poland;
| | - Katarzyna Połtyn-Zaradna
- Department of Social Medicine, Wroclaw Medical University, 50-345 Wrocław, Poland; (K.Z.); (Z.S.); (M.W.); (K.P.-Z.)
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23
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Lee K. The Association between Alcohol Consumption and Grip Strength in a Nationwide Survey. J Bone Metab 2021; 28:41-50. [PMID: 33730782 PMCID: PMC7973402 DOI: 10.11005/jbm.2021.28.1.41] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Accepted: 01/12/2021] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Handgrip strength (HGS) is an important predictor of long-term health and physical function. Studies have associated alcohol consumption with HGS but based on inconsistent findings. The Korea National Health and Nutrition Examination Survey (KNHANES) data were analyzed to examine the association between alcohol consumption levels and HGS based on sociodemographic and health-related factors. METHODS Using the 2014 to 2018 KNHANES data, alcohol consumption levels (abstinence, moderate, binge, and heavy consumption) and HGS levels (normal vs. weak) were determined in 8,556 men and 10,054 women (age, 49±16 years). Logistic regression analyses were conducted after adjusting for sociodemographic and health-related factors and in subgroups of those factors. RESULTS Binge or heavy consumption was reported in 50.2% of men and 22.7% of women, and weak HGS was found in 4.6% of men and 9.9% of women. In the fully adjusted model, weak HGS was associated with binge consumption (odds ratio [OR], 0.51, 95% confidence interval [CI], 0.37-0.71) and heavy consumption (OR, 0.37, 95% CI, 0.22-0.63) in men, and moderate consumption (OR, 0.79, 95% CI, 0.67-0.93) and binge consumption (OR, 0.65, 95% CI, 0.52-0.83) in women. An association between consumption levels and weak HGS was found in both sexes regardless of age (<65 vs. ≥65 years), education/income level, exercise endurance level, presence/absence of co-morbid illness, weight, and the presence/absence of metabolic syndrome. CONCLUSIONS Alcohol consumption may be inversely associated with weak HGS, regardless of sociodemographic and health-related factors using the 2014 to 2018 KNHANES data. Further prospective studies are necessary to examine the causality of the association.
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Affiliation(s)
- Kayoung Lee
- Department of Family Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
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24
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Lahtinen S, Hietanen S, Herajärvi J, Käkelä R, Ala-Kokko T, Liisanantti J. Use of health care resources in relation to harmful alcohol use prior to intensive care unit admission. JOURNAL OF SUBSTANCE USE 2020. [DOI: 10.1080/14659891.2020.1838634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Sanna Lahtinen
- Department of Anesthesiology, Division of Intensive Care Medicine, Oulu University Hospital, Oulu, Finland
- Oulu University Medical Research Center, Research Group of Surgery, Anesthesiology and Intensive Care, University of Oulu, Oulu, Finland
| | - Siiri Hietanen
- Department of Anesthesiology, Division of Intensive Care Medicine, Oulu University Hospital, Oulu, Finland
- Oulu University Medical Research Center, Research Group of Surgery, Anesthesiology and Intensive Care, University of Oulu, Oulu, Finland
| | - Johanna Herajärvi
- Oulu University Medical Research Center, Research Group of Surgery, Anesthesiology and Intensive Care, University of Oulu, Oulu, Finland
| | - Riikka Käkelä
- Oulu University Medical Research Center, Research Group of Surgery, Anesthesiology and Intensive Care, University of Oulu, Oulu, Finland
| | - Tero Ala-Kokko
- Department of Anesthesiology, Division of Intensive Care Medicine, Oulu University Hospital, Oulu, Finland
- Oulu University Medical Research Center, Research Group of Surgery, Anesthesiology and Intensive Care, University of Oulu, Oulu, Finland
| | - Janne Liisanantti
- Department of Anesthesiology, Division of Intensive Care Medicine, Oulu University Hospital, Oulu, Finland
- Oulu University Medical Research Center, Research Group of Surgery, Anesthesiology and Intensive Care, University of Oulu, Oulu, Finland
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25
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Weisz D, Gusmano MK. Alcohol Consumption by Older New York City Residents: The Need for New Policies to Address Misuse. Alcohol Alcohol 2020; 55:448-454. [DOI: 10.1093/alcalc/agaa022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 03/04/2020] [Accepted: 03/05/2020] [Indexed: 11/14/2022] Open
Abstract
Abstract
Aims
The aim of this study is to assess risk factors for alcohol misuse among older New York City residents and examine the effect of local public health efforts to address alcohol misuse.
Methods
The Community Health Survey, a cross-sectional telephone survey of 8500 randomly selected adult New Yorkers, records the frequency of alcohol use. We examine these results among 65 and older subjects by sociodemographic status using logistic regression modeling and compare trends in smoking and alcohol consumption between 2002 and 2016.
Results
Those with unhealthy drinking habits, combining binge drinking and excessive consumption, constituted 5.7% of 65 plus population and were more likely to be White, US born, healthy, better educated and wealthier. The percentage of older smokers in New York City has decreased while unhealthy drinking is nearly flat since 2002.
Conclusions
Our findings reinforce the importance of screening geriatric populations for alcohol use disorders and support the development of new public health efforts to address alcohol misuse if the city is to achieve results similar to those obtained in decreasing tobacco consumption.
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Affiliation(s)
- Daniel Weisz
- World Cities Project, International Longevity Center, The Robert N. Butler Columbia Aging Center, Mailman School of Public Health, Columbia University, 722 W. 168th Street, New York, NY 10068, USA
| | - Michael Kelley Gusmano
- Health System and Policy, Rutgers School of Public Health, 683 Hoes Lane West, Room 311, Piscataway, NJ 08854, USA
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26
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Abstract
Alcohol consumption has long been a part of human culture. However, alcohol consumption levels and alcohol consumption patterns are associated with chronic diseases. Overall, light and moderate alcohol consumption (up to 14 g per day for women and up to 28 g per day for men) may be associated with reduced mortality risk, mainly due to reduced risks for cardiovascular disease and type-2 diabetes. However, chronic heavy alcohol consumption and alcohol abuse lead to alcohol-use disorder, which results in physical and mental diseases such as liver disease, pancreatitis, dementia, and various types of cancer. Risk factors for alcohol-use disorder are largely unknown. Alcohol-use disorder and frequent heavy drinking have detrimental effects on personal health.
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27
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Mravčík V, Chomynová P, Nechanská B, Černíková T, Csémy L. Alcohol use and its consequences in the Czech Republic. Cent Eur J Public Health 2020; 27 Suppl:S15-S28. [PMID: 31901189 DOI: 10.21101/cejph.a5728] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 07/10/2019] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Alcohol consumption is associated with substantial public health burden. This article summarises available information on the patterns and prevalence of alcohol use in the Czech Republic with a focus on the heavy alcohol use and its health and social consequences. METHODS A non-systematic literature review was conducted. The data sources included primarily 3 series of surveys in the adult population, 2 series of surveys in the school population, routine monitoring system of per capita alcohol consumption, routine statistics on alcohol-related morbidity and mortality, and alcohol-related crime. RESULTS In recent years the registered alcohol consumption in the Czech Republic has been very high; 9.8 litres of pure alcohol were consumed per capita in 2017. Recently, the prevalence of hazardous alcohol consumption in the adult population has reached 16.8-17.6% and harmful alcohol consumption 9.0-9.3%. From 12% to 17% of adult population and 12% of adolescent population were heavy episodic drinkers. Alcohol-related disorders are disproportionately higher (2-3 times) among men. Mortality for alcohol-related causes fully attributable to alcohol (AAF = 100%) and their proportion in overall mortality is on increase. CONCLUSIONS Alcohol consumption as well as the prevalence of heavy episodic drinking in the Czech Republic belongs among the highest globally. On the other hand, declines in alcohol use have been recently observed among children and adolescents. Available data on alcohol-related morbidity indicate stable situation, though alcohol-related mortality is increasing. Alcohol-related burden is rather underestimated and evidence-based alcohol policy should be increasingly implemented.
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Affiliation(s)
- Viktor Mravčík
- Department of Addictology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic.,National Monitoring Centre for Drugs and Addiction, Office of the Government, Prague, Czech Republic.,Centre for Epidemiological and Clinical Research on Addictions, National Institute of Mental Health, Klecany, Czech Republic
| | - Pavla Chomynová
- Department of Addictology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic.,National Monitoring Centre for Drugs and Addiction, Office of the Government, Prague, Czech Republic.,Centre for Epidemiological and Clinical Research on Addictions, National Institute of Mental Health, Klecany, Czech Republic
| | - Blanka Nechanská
- Department of Addictology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic.,Centre for Epidemiological and Clinical Research on Addictions, National Institute of Mental Health, Klecany, Czech Republic.,Institute of Health Information and Statistics of the Czech Republic, Prague, Czech Republic
| | - Tereza Černíková
- Department of Addictology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic.,National Monitoring Centre for Drugs and Addiction, Office of the Government, Prague, Czech Republic
| | - Ladislav Csémy
- Centre for Epidemiological and Clinical Research on Addictions, National Institute of Mental Health, Klecany, Czech Republic.,National Institute of Public Health, Prague, Czech Republic
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28
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Bataller R, Cabezas J, Aller R, Ventura-Cots M, Abad J, Albillos A, Altamirano J, Arias-Loste MT, Bañares R, Caballería J, Caballería L, Carrión JA, Diago M, Fernández Rodríguez C, Gallego R, García-Cortes M, García-Monzón C, Genescà J, Ginés P, Hernandez-Guerra M, Jorquera F, Lligoña A, Molina E, Pareja MJ, Planas R, Tomé S, Salmerón J, Romero-Gómez M. Alcohol-related liver disease. Clinical practice guidelines. Consensus document sponsored by AEEH. GASTROENTEROLOGIA Y HEPATOLOGIA 2019; 42:657-676. [PMID: 31771785 DOI: 10.1016/j.gastrohep.2019.09.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Accepted: 09/02/2019] [Indexed: 02/07/2023]
Abstract
Alcohol-related liver disease (ARLD) is the most prevalent cause of advanced liver disease and liver cirrhosis in Europe, including Spain. According to the World Health Organization the fraction of liver cirrhosis attributable to alcohol use in Spain is 73.8% among men and 56.3% among women. ARLD includes various stages such as steatohepatitis, cirrhosis and hepatocellular cancer. In addition, patients with underlying ARLD and heavy alcohol intake may develop alcoholic hepatitis, which is associated with high mortality. To date, the only effective treatment to treat ARLD is prolonged withdrawal. There are no specific treatments, and the only treatment that increases life expectancy in alcoholic hepatitis is prednisolone. For patients with alcoholic hepatitis who do not respond to treatment, some centres offer the possibility of an early transplant. These clinical practice guidelines aim to propose recommendations on ARLD taking into account their relevance as a cause of advanced chronic liver disease and liver cirrhosis in our setting. This paper aims to answer the key questions for the clinical practice of Gastroenterology, Hepatology, as well as Internal Medicine and Primary Health Centres, making the most up-to-date information regarding the management and treatment of ARLD available to health professionals. These guidelines provide evidence-based recommendations for the clinical management of this disease.
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Affiliation(s)
- Ramón Bataller
- Department of Medicine, Division of Gastroenterology, Hepatology and Nutrition, Center for Liver Diseases, University of Pittsburgh Medical Center, Pittsburgh, PA, Estados Unidos.
| | - Joaquín Cabezas
- Servicio de Aparato Digestivo, Hospital Universitario Marqués de Valdecilla, Instituto de investigación Sanitaria Valdecilla (IDIVAL), Santander, Cantabria, España; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, España
| | - Rocío Aller
- Servicio de Gastroenterología, Hospital Clínico Universitario de Valladolid, Valladolid, España; Facultad de Medicina, Universidad de Valladolid, Valladolid, España; Centro de Investigación de Endocrinología y Nutrición, Facultad de Medicina de Valladolid, Valladolid, España
| | - Meritxell Ventura-Cots
- Department of Medicine, Division of Gastroenterology, Hepatology and Nutrition, Center for Liver Diseases, University of Pittsburgh Medical Center, Pittsburgh, PA, Estados Unidos; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, España
| | - Javier Abad
- Servicio de Gastroenterología y Hepatología, Hospital Puerta de Hierro, Madrid, España
| | - Agustín Albillos
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, España; Servicio de Gastroenterología y Hepatología, Hospital Universitario Ramón y Cajal, Universidad de Alcalá, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, España
| | - José Altamirano
- Deparmento de Medicina Interna, Hospital Quironsalud, Barcelona, España
| | - María Teresa Arias-Loste
- Servicio de Aparato Digestivo, Hospital Universitario Marqués de Valdecilla, Instituto de investigación Sanitaria Valdecilla (IDIVAL), Santander, Cantabria, España; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, España
| | - Rafael Bañares
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, España; Servicio de Gastroenterología y Hepatología, Hospital Gregorio Marañón, Madrid, España
| | - Juan Caballería
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, España; Unidad de Hepatología, Hospital Clínic, IDIBAPS, Barcelona, España
| | - Llorenç Caballería
- Unidad de Apoyo a la Investigación de la Atención Primaria en la Metropolitana Norte, Barcelona, España
| | | | - Moisés Diago
- Servicio de Aparato Digestivo, Hospital General de Valencia, Valencia, España
| | - Conrado Fernández Rodríguez
- Servicio de Gastroenterología, Hospital Universitario Fundación Alcorcón. Facultad de Medicina, Universidad Rey Juan Carlos, Alcorcón, Madrid, España
| | - Rocío Gallego
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, España; UGC Aparato Digestivo, Instituto de Biomedicina de Sevilla. Hospital Universitario Virgen del Rocío, Universidad de Sevilla, Sevilla, España
| | | | | | - Joan Genescà
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, España; Servicio de Medicina Interna-Hepatología, Hospital Universitario Vall d'Hebron, Institut de Recerca Vall d'Hebron (VHIR), Universitat Autònoma de Barcelona, Barcelona, España
| | - Pere Ginés
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, España; Unidad de Apoyo a la Investigación de la Atención Primaria en la Metropolitana Norte, Barcelona, España
| | | | - Francisco Jorquera
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, España; Servicio de Aparato Digestivo, Complejo Asistencial Universitario de León, IBIOMED, León, España
| | - Anna Lligoña
- Unidad de Alcohologia, Departamento de Psiquiatría, Hospital Clínic. Barcelona, España
| | - Esther Molina
- Unidad de Hepatología, Servicio de Aparato Digestivo, Hospital Clínico-Xerencia de Xestión Integrada de Santiago de Compostela, Santiago de Compostela, La Coruña, España
| | | | - Ramón Planas
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, España; Departamento de Hepatología, Hospital Germans Trias i Pujol, Badalona, Barcelona, España
| | - Santiago Tomé
- Unidad de Trasplante Hepático, Hospital Clínico Universitario, Santiago de Compostela, La Coruña, España
| | - Javier Salmerón
- UGC de Aparato Digestivo, Hospital San Cecilio, Granada, España
| | - Manuel Romero-Gómez
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, España; UGC Aparato Digestivo, Instituto de Biomedicina de Sevilla. Hospital Universitario Virgen del Rocío, Universidad de Sevilla, Sevilla, España
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29
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Le Daré B, Lagente V, Gicquel T. Ethanol and its metabolites: update on toxicity, benefits, and focus on immunomodulatory effects. Drug Metab Rev 2019; 51:545-561. [PMID: 31646907 DOI: 10.1080/03602532.2019.1679169] [Citation(s) in RCA: 67] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
This article summarizes recent experimental and epidemiological data on the toxic and beneficial effects of ethanol and its metabolites (acetaldehyde), and focuses on their immunomodulatory effects. The section dealing with the toxic effects of alcohol focuses on its chronic toxicity (liver disorders, carcinogenic effects, cardiovascular disorders, neuropsychic disorders, addiction and withdrawal syndrome, hematologic disorders, reprotoxicity, osteoporosis) although acute toxicity is considered. The role of oxidative metabolism of ethanol by alcohol dehydrogenase, cytochrome P450 2E1, and aldehyde dehydrogenase, as well as the impact of genetic polymorphism in its physiopathology are also highlighted. The section dealing with the beneficial effects of low to moderate alcohol consumption (on cardiovascular system, diabetes, the nervous system and sensory organs, autoimmune diseases, and rheumatology) highlights the importance of anti-inflammatory and immunomodulatory effects in these observations. This knowledge, enriched by a focus on the immunomodulatory effects of ethanol and its metabolites, in particular on the NLRP3 inflammasome pathway, might facilitate the development of treatments that can reduce ethanol's harmful effects or accentuate its beneficial effects.
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Affiliation(s)
- Brendan Le Daré
- Univ Rennes, INSERM, INRA, Institut NuMeCan (Nutrition, Metabolisms and Cancer), Rennes, France.,Pharmacy Unit, Pontchaillou University Hospital, Rennes, France.,Forensic and Toxicology Laboratory, Pontchaillou University Hospital, Rennes, France
| | - Vincent Lagente
- Univ Rennes, INSERM, INRA, Institut NuMeCan (Nutrition, Metabolisms and Cancer), Rennes, France
| | - Thomas Gicquel
- Univ Rennes, INSERM, INRA, Institut NuMeCan (Nutrition, Metabolisms and Cancer), Rennes, France.,Forensic and Toxicology Laboratory, Pontchaillou University Hospital, Rennes, France
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30
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Costanzo S, de Gaetano G, Di Castelnuovo A, Djoussé L, Poli A, van Velden DP. Moderate alcohol consumption and lower total mortality risk: Justified doubts or established facts? Nutr Metab Cardiovasc Dis 2019; 29:1003-1008. [PMID: 31400826 DOI: 10.1016/j.numecd.2019.05.062] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 05/16/2019] [Accepted: 05/17/2019] [Indexed: 12/20/2022]
Abstract
For almost a century, the scientific community is aware of the J-shaped curve between alcohol consumption and all-cause mortality. Moderate drinkers seem to live longer than both abstainers and heavy drinkers. These epidemiological observations regarding moderate alcohol consumption and beneficial health effects have been incessantly scrutinised for confounding and bias. This viewpoint discusses previous and recent criticisms regarding the J-shaped curve between alcohol consumption and total mortality risk. The controversies regarding the J-shaped curve between alcohol consumption and mortality are ongoing, as well as the debate among scientists in this area of research, resulting in conflicting messages in media and in different alcohol guidelines. Although it appears quite difficult to come up with a position statement only based on the currently available scientific data, it is imperative to fairly inform the public, without creating confusion and, worst case, disbelief in science.
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Affiliation(s)
- Simona Costanzo
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Pozzilli, IS, Italy.
| | - Giovanni de Gaetano
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Pozzilli, IS, Italy
| | | | - Luc Djoussé
- Division of Aging, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Massachusetts Veterans Epidemiology and Research Information Center (MAVERIC), Boston Veterans Affairs Healthcare System, Boston, MA, USA
| | - Andrea Poli
- NFI (Nutrition Foundation of Italy), Viale Tunisia 38, 20124, Milan, Italy
| | - David P van Velden
- Department of Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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31
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Saunders JB, Degenhardt L, Reed GM, Poznyak V. Alcohol Use Disorders in ICD‐11: Past, Present, and Future. Alcohol Clin Exp Res 2019; 43:1617-1631. [DOI: 10.1111/acer.14128] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Accepted: 05/31/2019] [Indexed: 01/16/2023]
Affiliation(s)
- John B. Saunders
- Centre for Youth Substance Abuse Research University of Queensland Brisbane QLD Australia
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre University of New South Wales Sydney NSW Australia
| | - Geoffrey M. Reed
- Department of Psychiatry Columbia University Vagelos College of Physicians and Surgeons New York NY USA
- Department of Mental Health and Substance Abuse World Health Organization Geneva Switzerland
| | - Vladimir Poznyak
- Department of Mental Health and Substance Abuse World Health Organization Geneva Switzerland
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32
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Abstract
Both acute intoxication and longer-term cumulative ingestion of alcohol negatively impact the metabolic phenotype of both skeletal and cardiac muscle, independent of overt protein calorie malnutrition, resulting in loss of skeletal muscle strength and cardiac contractility. In large part, these alcohol-induced changes are mediated by a decrease in protein synthesis that in turn is governed by impaired activity of a protein kinase, the mechanistic target of rapamycin (mTOR). Herein, we summarize recent advances in understanding mTOR signal transduction, similarities and differences between the effects of alcohol on this central metabolic controller in skeletal muscle and in the heart, and the effects of acute versus chronic alcohol intake. While alcohol-induced alterations in global proteolysis via activation of the ubiquitin-proteasome pathway are equivocal, emerging data suggest alcohol increases autophagy in muscle. Further studies are necessary to define the relative contributions of these bidirectional changes in protein synthesis and autophagy in the etiology of alcoholic myopathy in skeletal muscle and the heart.
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Affiliation(s)
- Scot R Kimball
- Department of Cellular and Molecular Physiology, Pennsylvania State University College of Medicine, Hershey, Pennsylvania 17033, USA; ,
| | - Charles H Lang
- Department of Cellular and Molecular Physiology, Pennsylvania State University College of Medicine, Hershey, Pennsylvania 17033, USA; ,
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33
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Gray CM, Carroll RJ, Lentjes MAH, Keogh RH. Correcting for measurement error in fractional polynomial models using Bayesian modelling and regression calibration, with an application to alcohol and mortality. Biom J 2019; 61:558-573. [PMID: 30892741 PMCID: PMC6511281 DOI: 10.1002/bimj.201700279] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 11/17/2018] [Accepted: 11/18/2018] [Indexed: 01/12/2023]
Abstract
Exposure measurement error can result in a biased estimate of the association between an exposure and outcome. When the exposure-outcome relationship is linear on the appropriate scale (e.g. linear, logistic) and the measurement error is classical, that is the result of random noise, the result is attenuation of the effect. When the relationship is non-linear, measurement error distorts the true shape of the association. Regression calibration is a commonly used method for correcting for measurement error, in which each individual's unknown true exposure in the outcome regression model is replaced by its expectation conditional on the error-prone measure and any fully measured covariates. Regression calibration is simple to execute when the exposure is untransformed in the linear predictor of the outcome regression model, but less straightforward when non-linear transformations of the exposure are used. We describe a method for applying regression calibration in models in which a non-linear association is modelled by transforming the exposure using a fractional polynomial model. It is shown that taking a Bayesian estimation approach is advantageous. By use of Markov chain Monte Carlo algorithms, one can sample from the distribution of the true exposure for each individual. Transformations of the sampled values can then be performed directly and used to find the expectation of the transformed exposure required for regression calibration. A simulation study shows that the proposed approach performs well. We apply the method to investigate the relationship between usual alcohol intake and subsequent all-cause mortality using an error model that adjusts for the episodic nature of alcohol consumption.
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Affiliation(s)
- Christen M. Gray
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Raymond J. Carroll
- Department of Statistics, Texas A&M University, College Station, TX, USA
| | - Marleen A. H. Lentjes
- Department of Public Health & Primary Care, University of Cambridge, Strangeways Research Laboratories, Cambridge, United Kingdom
| | - Ruth H. Keogh
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, United Kingdom
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Tevik K, Selbæk G, Engedal K, Seim A, Krokstad S, Helvik AS. Mortality in older adults with frequent alcohol consumption and use of drugs with addiction potential - The Nord Trøndelag Health Study 2006-2008 (HUNT3), Norway, a population-based study. PLoS One 2019; 14:e0214813. [PMID: 30990815 PMCID: PMC6467384 DOI: 10.1371/journal.pone.0214813] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 03/20/2019] [Indexed: 12/19/2022] Open
Abstract
Background The aim of this study was to investigate whether frequent drinking, use of drugs with addiction potential and the possible combination of frequent drinking and use of prescribed drugs with addiction potential were associated with all-cause mortality in older adults. Methods We used data from the Nord-Trøndelag Health Study (HUNT3 2006–08), a population-based study in Norway. A total of 11,545 (6,084 women) individuals 65 years and older at baseline participated. We assessed frequent drinking (≥ 4 days a week), occasional drinking (i.e. a few times a year), never drinking and non-drinking in the last year. Drugs with addiction potential were defined as at least one prescription of benzodiazepines, z-hypnotics or opioids during one year for a minimum of two consecutive years between 2005 and 2009. This information was drawn from the Norwegian Prescription Database. The main outcome was all-cause mortality with information drawn from the Norwegian Cause of Death Registry. Follow-up continued until death or latest at 31 December 2013. Logistic regression analyses were used to investigate all-cause mortality since date of study entry and exact age at time of death was unknown. Results The adjusted logistic regression analyses showed that frequent drinking was not associated with all-cause mortality compared to occasional drinking. Men who reported to be never drinkers and non-drinkers in the last year had higher odds of mortality compared to those who drank occasionally. Use of prescribed drugs with addiction potential was associated with increased mortality in men, but not in women. No association was found between the possible combination of frequent drinking and use of prescribed drugs with addiction potential and mortality. Conclusion Neither frequent drinking nor the possible combination of frequent drinking and use of prescribed drugs with addiction potential were associated with all-cause mortality in older women and men. Use of prescribed drugs with addiction potential was associated with higher odds of mortality in men. This finding should lead to more caution in prescribing drugs with addiction potential to this group.
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Affiliation(s)
- Kjerstin Tevik
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- General Practice Research Unit, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- * E-mail:
| | - Geir Selbæk
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- The Research Centre for Age-related Functional Decline and Disease, Innlandet Hospital Trust, Ottestad, Norway
- Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Knut Engedal
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - Arnfinn Seim
- General Practice Research Unit, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Steinar Krokstad
- HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, (NTNU), Levanger, Norway
- Psychiatric Department, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Anne-S Helvik
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- General Practice Research Unit, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- St. Olavs University Hospital, Sluppen, Trondheim, Norway
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35
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Ortolá R, García-Esquinas E, López-García E, León-Muñoz LM, Banegas JR, Rodríguez-Artalejo F. Alcohol consumption and all-cause mortality in older adults in Spain: an analysis accounting for the main methodological issues. Addiction 2019; 114:59-68. [PMID: 30063272 DOI: 10.1111/add.14402] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 04/23/2018] [Accepted: 07/24/2018] [Indexed: 12/23/2022]
Abstract
BACKGROUND AND AIMS Observational evidence that light-to-moderate alcohol consumption lowers mortality is questioned because of potential selection biases and residual confounding. We assess the association between alcohol intake and all-cause death in older adults after accounting for those methodological issues. METHODS Data came from 3045 individuals representative of the non-institutionalized population aged ≥ 60 years in Spain. Participants were recruited in 2008-10, when they reported current and life-time alcohol intake; drinkers were classified as occasional (< 1.43 g/day), light (≥ 1.43 but < 20 g/day for men and ≥ 1.43 but < 10 g/day for women), moderate (≥ 20 but < 40 g/day for men and ≥ 10 but < 20 g/day for women) or heavy (≥ 40 g/day for men and ≥ 24 g/day for women)/binge. Participants were followed-up to 2017 to assess vital status. In analyses, ex-drinkers were removed from the abstainer group and were classified according to their life-time intake to address the 'abstainer bias'. Moreover, analyses were replicated in individuals without functional limitations, and excluded deaths in the first year of follow-up, to address reverse causation. Also, occasional drinkers were used as reference in some analyses to reduce the 'healthy drinker/survivor' bias. Results were adjusted for many covariates to minimize residual confounding. RESULTS Compared with never-drinkers, the hazard ratio (95% confidence interval) of mortality for light drinkers was 1.05 (0.71-1.56) and 1.20 (0.72-2.02) in those without functional limitations. Corresponding values for moderate drinkers were 1.28 (0.81-2.02) and 1.55 (0.87-2.75) and for heavy/binge drinkers 1.85 (1.07-3.23) and 2.15 (1.09-4.22). Results were consistent when occasional drinkers were used as reference. Among drinkers without functional limitations, the hazard ratio (95% confidence interval) of mortality per 10 g/day of alcohol was 1.12 (1.02-1.23). CONCLUSION After accounting for potential biases, light-to-moderate drinking among people 60+ years of age appears to have no statistically significant benefit on mortality compared with abstention from alcohol. By contrast, heavy/binge drinking shows a higher death risk compared with abstention from alcohol. Alcohol intake appears to have a positive dose-response with mortality among drinkers.
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Affiliation(s)
- Rosario Ortolá
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid and Idipaz, Madrid, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Esther García-Esquinas
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid and Idipaz, Madrid, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Esther López-García
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid and Idipaz, Madrid, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.,IMDEA Food Institute. CEI UAM+CSIC, Madrid, Spain
| | - Luz M León-Muñoz
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid and Idipaz, Madrid, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - José R Banegas
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid and Idipaz, Madrid, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid and Idipaz, Madrid, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.,IMDEA Food Institute. CEI UAM+CSIC, Madrid, Spain
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36
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Mahli A, Erwin Thasler W, Hellerbrand C. Establishment of a p-nitrophenol oxidation-based assay for the analysis of CYP2E1 activity in intact hepatocytes in vitro. Toxicol Mech Methods 2018; 29:219-223. [PMID: 30380359 DOI: 10.1080/15376516.2018.1539800] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
CYP2E1 is a mammalian cytochrome P450 enzyme, which oxidizes a structurally diverse class of endogenous and exogenous (xenobiotic) compounds. Best studied is the role of CYP2E1 in phase I metabolism of xenobiotics including alcohol. CYP2E1 metabolizes ethanol and is active in generating reactive oxygen species (ROS) and subsequent oxidative stress in the hepatic tissues. Several studies have shown and discussed the importance of CYP2E1 in the hepatotoxic actions of alcohol. However, the vast majority assessed the CYP2E1 activity only in isolated microsomes. Here, we aimed to develop and optimize a fast and easy method to assess alcohol-induced CYP2E1 activity in hepatocytes in vitro applying oxidation of para-nitrophenol to para-nitrocatechol as specific substrate probe. Using hepatoma cells with and without stable CYP2E1 expression and primary human hepatocytes, we established specific methodology to assess CYP2E1 catalytic activity and its induction by ethanol in a small number of cells and in a very short time.
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Affiliation(s)
- Abdo Mahli
- a Institute of Biochemistry (Emil-Fischer Zentrum) , Friedrich-Alexander University Erlangen Nürnberg , Erlangen , Germany
| | - Wolfgang Erwin Thasler
- b Department of General Visceral- and Transplantation Surgery, Biobank o.b. HTCR , Ludwig-Maximilians-University Munich , Munich , Germany
| | - Claus Hellerbrand
- a Institute of Biochemistry (Emil-Fischer Zentrum) , Friedrich-Alexander University Erlangen Nürnberg , Erlangen , Germany
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37
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Newman IM, Qian L, Tamrakar N, Zhang BB. Chemical Composition and Safety of Unrecorded Grain Alcohol (Bai Jiu) Samples from Three Provinces in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15122710. [PMID: 30513745 PMCID: PMC6313741 DOI: 10.3390/ijerph15122710] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 11/15/2018] [Accepted: 11/24/2018] [Indexed: 12/14/2022]
Abstract
About 20% of spirits consumed in China are “unrecorded”, where these spirits are produced in small-scale distilleries and sold outside the systems of taxation and quality control. Researchers visited small distilleries in rural Yunnan, Hubei and Anhui and purchased 56 samples of unrecorded bai jiu. Seven samples of the recorded bai jiu were purchased as reference samples. An independent laboratory conducted a blind analysis of the samples. Results were compared to the standards for unrecorded alcohol adopted by the European Commission’s Alcohol Measures for Public Health Research Alliance (AMPHORA). No samples exceeded the AMPHORA guidelines for methanol, ethyl acetate, lead and cadmium; one sample exceeded 1000 g/hL of combined higher alcohols; one sample exceeded 100 mg/L of arsenic; and three samples exceeded 50g/hL of acetaldehyde, but only by relatively small amounts. Low-priced unrecorded bai jiu averaged 9.8 RMB/jin (500 mL), compared to 10.7 RMB/jin for inexpensive recorded bai jiu. The low-priced unrecorded bai jiu samples had a mean alcohol-by-volume of 51.8%, compared to 50.1% for the recorded bai jiu samples. The results did not raise any critical safety issues with unrecorded bai jiu, but there may be long-term health risks related to ethanol, acetaldehyde and arsenic. The social ties between the bai jiu makers and the people who consume their product are a deterrent to adulteration; but when bai jiu is sold outside of the social circle, the deterrent disappears.
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Affiliation(s)
- Ian M Newman
- Nebraska Prevention Center for Alcohol and Drug Abuse, Department of Educational Psychology, University of Nebraska-Lincoln, P.O. Box 880345, Lincoln, NE 68588, USA.
| | - Ling Qian
- National Center for Health Education, Beijing 100011, China.
| | - Niran Tamrakar
- Nebraska Prevention Center for Alcohol and Drug Abuse, Department of Educational Psychology, University of Nebraska-Lincoln, P.O. Box 880345, Lincoln, NE 68588, USA.
| | - Bo-Bo Zhang
- School of Biotechnology, Jiangnan University, Wuxi 214122, China.
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Ortolá R, García-Esquinas E, Soler-Vila H, Ordovas JM, López-García E, Rodríguez-Artalejo F. Changes in health status predict changes in alcohol consumption in older adults: the Seniors-ENRICA cohort. J Epidemiol Community Health 2018; 73:123-129. [DOI: 10.1136/jech-2018-211104] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 08/31/2018] [Accepted: 10/17/2018] [Indexed: 12/11/2022]
Abstract
BackgroundSome of the previously reported health benefits of low-to-moderate alcohol consumption may derive from health status influencing alcohol consumption rather than the opposite. We examined whether health status changes influence changes in alcohol consumption, cessation included.MethodsData came from 571 current drinkers aged ≥60 years participating in the Seniors-ENRICA cohort in Spain. Participants were recruited in 2008–2010 and followed-up for 8.2 years, with four waves of data collection. We assessed health status using a 52-item deficit accumulation (DA) index with four domains: functional, self-rated health and vitality, mental health, and morbidity and health services use. To minimise reverse causation, we examined how changes in health status over a 3-year period (wave 0–wave 1) influenced changes in alcohol consumption over the subsequent 5 years (waves 1–3) using linear/logistic regression, as appropriate.ResultsCompared with participants in the lowest tertile of DA change (mean absolute 4.3% health improvement), those in the highest tertile (7.8% worsening) showed a reduction in alcohol intake (β: –4.32 g/day; 95% CI –7.00 to –1.62; p trend=0.002) and were more likely to quit alcohol (OR: 2.80; 95% CI 1.54 to 5.08; p trend=0.001). The main contributors to decreasing drinking were increased functional impairment and poorer self-rated health, whereas worsening self-rated health, onset of diabetes or stroke and increased prevalence of hospitalisation influenced cessation.ConclusionsHealth deterioration is related to a subsequent reduction and cessation of alcohol consumption contributing to the growing evidence challenging the protective health effect previously attributed to low-to-moderate alcohol consumption.
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Zhu S, Zhao J, Chen Z, Wang Y. Influential factors on cognitive performance in middle-aged cohort: Third National Health and Nutrition Examination Survey-based study. Medicine (Baltimore) 2018; 97:e12033. [PMID: 30212932 PMCID: PMC6156020 DOI: 10.1097/md.0000000000012033] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Aging-associated cognitive decline is closely linked to illness, dementia, increased mortality, and is a major health and social issue. The purpose of this study was to determine modifiable factors associated with cognitive performance.We analyzed data from a random sample of participants of the Third National Health and Nutrition Examination Survey, which is a cross-sectional survey, of the US population, aged 20 to 59 years, who underwent computer-based neurocognitive testing. There were 5 outcome measures in 3 neurocognitive tests: the mean of simple reaction time test, the mean total latency of the symbol digit substitution test (SDST), the average number of errors of the SDST, the average trials to criterion of the serial digit learning test (SDLT), and the average total score of the SDLT.Socioeconomic status, including older age, black ethnicity, lower income ratio, and lower education level, were associated with poorer neurocognitive function in all analyzed tests. In addition, participants with poor health, nonsmokers, and nondrinkers performed worse in all administered tests compared with individuals with good health, smokers, and participants consuming alcoholic beverages. Dietary and biochemical characteristics of the blood were not consistently associated with neurocognitive performance.Our results indicate that socioeconomic factors, health-related and dietary habits, biochemical parameters of the blood, and job category were associated with neurocognitive performance in visual attention, learning, and concentration in a large, nationally representative sample of healthy, ethnically diverse 20 to 59-year-olds. Future studies are needed to understand the mechanisms of cognitive aging and the factors that contribute to its individual differences.
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Affiliation(s)
| | | | - Zhiming Chen
- Department of Emergency, HangZhou Red Cross Hospital, Hangzhou, Zhejiang, China
| | - Yanpeng Wang
- Department of Emergency, HangZhou Red Cross Hospital, Hangzhou, Zhejiang, China
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40
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Kunzmann AT, Coleman HG, Huang WY, Berndt SI. The association of lifetime alcohol use with mortality and cancer risk in older adults: A cohort study. PLoS Med 2018; 15:e1002585. [PMID: 29920516 PMCID: PMC6007830 DOI: 10.1371/journal.pmed.1002585] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 05/11/2018] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND While current research is largely consistent as to the harms of heavy drinking in terms of both cancer incidence and mortality, there are disparate messages regarding the safety of light-moderate alcohol consumption, which may confuse public health messages. We aimed to evaluate the association between average lifetime alcohol intakes and risk of both cancer incidence and mortality. METHODS AND FINDINGS We report a population-based cohort study using data from 99,654 adults (68.7% female), aged 55-74 years, participating in the U.S. Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial. Cox proportional hazards models assessed the risk of overall and cause-specific mortality, cancer incidence (excluding nonmelanoma skin cancer), and combined risk of cancer and death across categories of self-reported average lifetime alcohol intakes, with adjustment for potential confounders. During 836,740 person-years of follow-up (median 8.9 years), 9,599 deaths and 12,763 primary cancers occurred. Positive linear associations were observed between lifetime alcohol consumption and cancer-related mortality and total cancer incidence. J-shaped associations were observed between average lifetime alcohol consumption and overall mortality, cardiovascular-related mortality, and combined risk of death or cancer. In comparison to lifetime light alcohol drinkers (1-3 drinks per week), lifetime never or infrequent drinkers (<1 drink/week), as well as heavy (2-<3 drinks/day) and very heavy drinkers (3+ drinks/day) had increased overall mortality and combined risk of cancer or death. Corresponding hazard ratios (HRs) and 95% confidence intervals (CIs) for combined risk of cancer or death, respectively, were 1.09 (1.01-1.13) for never drinkers, 1.08 (1.03-1.13) for infrequent drinkers, 1.10 (1.02-1.18) for heavy drinkers, and 1.21 (1.13-1.30) for very heavy drinkers. This analysis is limited to older adults, and residual confounding by socioeconomic factors is possible. CONCLUSIONS The study supports a J-shaped association between alcohol and mortality in older adults, which remains after adjustment for cancer risk. The results indicate that intakes below 1 drink per day were associated with the lowest risk of death. TRIAL REGISTRATION NCT00339495 (ClinicalTrials.gov).
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Affiliation(s)
- Andrew T. Kunzmann
- Centre for Public Health, Queen’s University Belfast, Belfast, Northern Ireland, United Kingdom
- * E-mail:
| | - Helen G. Coleman
- Centre for Public Health, Queen’s University Belfast, Belfast, Northern Ireland, United Kingdom
| | - Wen-Yi Huang
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, United States of America
| | - Sonja I. Berndt
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, United States of America
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de Rezende LFM, Rey-López JP, de Sá TH, Chartres N, Fabbri A, Powell L, Stamatakis E, Bero L. Reporting bias in the literature on the associations of health-related behaviors and statins with cardiovascular disease and all-cause mortality. PLoS Biol 2018; 16:e2005761. [PMID: 29912869 PMCID: PMC6023226 DOI: 10.1371/journal.pbio.2005761] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 06/28/2018] [Accepted: 06/07/2018] [Indexed: 12/16/2022] Open
Abstract
Reporting bias in the literature occurs when there is selective revealing or suppression of results, influenced by the direction of findings. We assessed the risk of reporting bias in the epidemiological literature on health-related behavior (tobacco, alcohol, diet, physical activity, and sedentary behavior) and cardiovascular disease mortality and all-cause mortality and provided a comparative assessment of reporting bias between health-related behavior and statin (in primary prevention) meta-analyses. We searched Medline, Embase, Cochrane Methodology Register Database, and Web of Science for systematic reviews synthesizing the associations of health-related behavior and statins with cardiovascular disease mortality and all-cause mortality published between 2010 and 2016. Risk of bias in systematic reviews was assessed using the ROBIS tool. Reporting bias in the literature was evaluated via small-study effect and excess significance tests. We included 49 systematic reviews in our study. The majority of these reviews exhibited a high overall risk of bias, with a higher extent in health-related behavior reviews, relative to statins. We reperformed 111 meta-analyses conducted across these reviews, of which 65% had statistically significant results (P < 0.05). Around 22% of health-related behavior meta-analyses showed small-study effect, as compared to none of statin meta-analyses. Physical activity and the smoking research areas had more than 40% of meta-analyses with small-study effect. We found evidence of excess significance in 26% of health-related behavior meta-analyses, as compared to none of statin meta-analyses. Half of the meta-analyses from physical activity, 26% from diet, 18% from sedentary behavior, 14% for smoking, and 12% from alcohol showed evidence of excess significance bias. These biases may be distorting the body of evidence available by providing inaccurate estimates of preventive effects on cardiovascular and all-cause mortality.
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Affiliation(s)
| | - Juan Pablo Rey-López
- Prevention Research Collaboration, School of Public Health, The University of Sydney, Sydney, Australia
| | - Thiago Hérick de Sá
- Núcleo de Pesquisas Epidemiológicas em Nutrição e Saúde, Universidade de São Paulo, São Paulo, São Paulo, Brasil
| | - Nicholas Chartres
- Charles Perkins Centre, Faculty of Pharmacy, The University of Sydney, Sydney, New South Wales, Australia
| | - Alice Fabbri
- Charles Perkins Centre, Faculty of Pharmacy, The University of Sydney, Sydney, New South Wales, Australia
| | - Lauren Powell
- Prevention Research Collaboration, School of Public Health, The University of Sydney, Sydney, Australia
| | - Emmanuel Stamatakis
- Prevention Research Collaboration, School of Public Health, The University of Sydney, Sydney, Australia
- Charles Perkins Centre, Epidemiology Unit, The University of Sydney, Sydney, Australia
| | - Lisa Bero
- Charles Perkins Centre, Faculty of Pharmacy, The University of Sydney, Sydney, New South Wales, Australia
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Abstract
OBJECTIVE This paper aims to quantify the population-level associations between child injury deaths and adult (aged 15+ years) per capita alcohol consumption (PCC) and between child injury deaths and the impact of major alcohol and safety policy changes in Australia. METHODS All child deaths due to external causes during 1910-2013, and child deaths due specifically to road crashes, assaults, suicide and other external causes, were obtained from the Australian Institute of Health and Welfare. Child (0-14 year) mortality rates were analysed in relation to PCC using an Autoregressive Integrated Moving Average model. RESULTS A positive association between PCC and overall child external mortality was identified. The estimated coefficient was 0.326 (p = .002), indicating that a 10% decrease in PCC was associated with a 3.3% reduction in child injury mortality. A positive association was identified for road traffic and other child injury mortality, but not assault injuries. The introduction of compulsory seatbelt legislation in combination with random breath testing was associated with a reduction in overall injury and road traffic child mortality. Decreasing the legal drinking age was associated with an increase in the rate of other external-cause child mortality. CONCLUSION Reducing PCC in Australia is likely to result in a small but significant reduction in the injury mortality rate of children aged 0-14 years.
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Affiliation(s)
- Anne-Marie Laslett
- National Drug Research Institute, Curtin University, Bentley, Perth, 6002, Australia; Centre for Alcohol Policy Research, School of Psychology and Public Health, La Trobe University, 3086, Australia; School of Population and Global Health, University of Melbourne, 3000, Australia.
| | - Heng Jiang
- Centre for Alcohol Policy Research, School of Psychology and Public Health, La Trobe University, 3086, Australia; School of Population and Global Health, University of Melbourne, 3000, Australia
| | - Tanya Chikritzhs
- National Drug Research Institute, Curtin University, Bentley, Perth, 6002, Australia
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43
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Kojima G, Liljas A, Iliffe S, Jivraj S, Walters K. A systematic review and meta-analysis of prospective associations between alcohol consumption and incident frailty. Age Ageing 2018; 47:26-34. [PMID: 28541395 DOI: 10.1093/ageing/afx086] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 05/11/2017] [Indexed: 11/12/2022] Open
Abstract
Background light-to-moderate alcohol consumption is protective against all-cause mortality and cardiovascular diseases. There is limited evidence in the literature on how alcohol consumption is related to frailty. Methods five databases (Embase, Scopus, MEDLINE, CINAHL, PsycINFO) were systematically searched in July 2016 for prospective studies published between 2000 and 2016 examining baseline alcohol consumption and subsequent frailty risk among middle-aged or older community-dwelling population. Odds ratios (ORs) for incident frailty were pooled using a random-effects model. Heterogeneity, methodological quality and publication bias were assessed. Results of 926 studies identified by the systematic search, four studies were included (total n = 44,051, ≥55 years, 66.2% alcohol users). OR of incident frailty for the highest (at least 24 g of alcohol/day for men, 12g of alcohol/day for women) or the most frequent (≥5 days of drinking/week) alcohol consumption compared with no drinking were used for a meta-analysis. Pooled OR among three studies measuring alcohol consumption quantitatively showed that the highest alcohol consumption was associated with lower frailty risk (3 studies:pooled OR = 0.44, 95%CI = 0.19-1.00, P = 0.05). Adding the other study measuring frequency of alcohol consumption made little change (4 studies:pooled OR = 0.61, 95%CI = 0.44-0.77, P < 0.001). Two of the included studies suggested a possible U-shaped association with lowest risks for moderate drinkers. Heterogeneity was moderate in both analyses (I2 = 52-67%). There was no evidence of publication bias. Conclusions this systematic review and meta-analysis study provides the first pooled evidence suggesting that heavier alcohol consumption is associated with lower incident frailty compared with no alcohol consumption among community-dwelling middle-aged and older people. However, this association may be due to unadjusted effect measures, residual confounding, 'sick quitter' effect or survival bias.
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Affiliation(s)
- Gotaro Kojima
- Department of Primary Care and Population Health, University College London, London, UK
| | - Ann Liljas
- Department of Primary Care and Population Health, University College London, London, UK
| | - Steve Iliffe
- Department of Primary Care and Population Health, University College London, London, UK
| | - Stephen Jivraj
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Kate Walters
- Department of Primary Care and Population Health, University College London, London, UK
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Saito E, Inoue M, Sawada N, Charvat H, Shimazu T, Yamaji T, Iwasaki M, Sasazuki S, Mizoue T, Iso H, Tsugane S. Impact of Alcohol Intake and Drinking Patterns on Mortality From All Causes and Major Causes of Death in a Japanese Population. J Epidemiol 2017; 28:140-148. [PMID: 29129895 PMCID: PMC5821691 DOI: 10.2188/jea.je20160200] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND We examined the associations of alcohol consumption and liver holidays with all-cause mortality and with mortality due to cancer, heart disease, cerebrovascular disease, respiratory disease, and injury using a large-scale prospective study in Japan. METHODS We followed 102,849 Japanese who were aged between 40 and 69 years at baseline for 18.2 years on average, during which 15,203 deaths were reported. Associations between alcohol intake and mortality risk were assessed using a Cox proportional hazards model, with analysis by the number of liver holidays (in which a person abstains from drinking for several days a week). RESULTS A J-shaped association was observed between alcohol intake and total mortality in men (nondrinkers: reference; occasional drinkers: hazard ratio [HR] 0.74; 95% confidence interval [CI], 0.68-0.80; 1-149 g/week: HR 0.76; 95% CI, 0.71-0.81; 150-299 g/week: HR 0.75; 95% CI, 0.70-0.80; 300-449 g/week: HR 0.84; 95% CI, 0.78-0.91; 450-599 g/week: HR 0.92; 95% CI, 0.83-1.01; and ≥600 g/week: HR 1.19; 95% CI, 1.07-1.32) and in women (nondrinkers: reference; occasional: HR 0.75; 95% CI, 0.70-0.82; 1-149 g/week: HR 0.80; 95% CI, 0.73-0.88; 150-299 g/week: HR 0.91; 95% CI, 0.74-1.13; 300-449 g/week: HR 1.04; 95% CI, 0.73-1.48; and ≥450 g/week: HR 1.59; 95% CI, 1.07-2.38). In current drinkers, alcohol consumption was associated with a linear, positive increase in mortality risk from all causes, cancer, and cerebrovascular disease in both men and women, but not heart disease in men. Taking of liver holidays was associated with a lower risk of cancer and cerebrovascular disease mortality in men. CONCLUSIONS Alcohol intake showed J-shaped associations with the risk of total mortality and three leading causes of death. However, heavy drinking increases the risk of mortality, which highlights the necessity of drinking in moderation coupled with liver holidays.
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Affiliation(s)
- Eiko Saito
- Graduate School of Medicine, The University of Tokyo.,Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center
| | - Manami Inoue
- Graduate School of Medicine, The University of Tokyo.,Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center
| | - Norie Sawada
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center
| | - Hadrien Charvat
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center
| | - Taichi Shimazu
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center
| | - Taiki Yamaji
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center
| | - Motoki Iwasaki
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center
| | - Shizuka Sasazuki
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center
| | - Tetsuya Mizoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine
| | - Hiroyasu Iso
- Public Health, Department of Social and Environmental Medicine, Osaka University Graduate School of Medicine
| | - Shoichiro Tsugane
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center
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Hietanen S, Ala-Kokko T, Ohtonen P, Käkelä R, Niemelä S, Liisanantti JH. Treatment Profile and 1-Year Mortality Among Nontraumatic Intensive Care Unit Patients With Alcohol-Related Health Problems. J Intensive Care Med 2017; 35:244-250. [DOI: 10.1177/0885066617740071] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Long-term excessive use of alcohol leads to severe complications, which often require treatment in an intensive care unit (ICU). The aim of this study was to report on the associations between alcohol-related health problems and treatment profile, as well as 1-year mortality among patients with nontrauma-related ICU admissions. Methods: Information on the history of alcohol-related health problems or excessive alcohol use and ICU treatment was collected retrospectively from electronic medical records and ICU patient data management systems at Oulu University Hospital, Finland. Information on 1-year mortality was obtained from the Finnish Population Register Center. Results: According to the medical records, in a total of 899 admissions, 32.9% (n = 296) of patients had a history of alcohol-related problems. In the alcohol group, intoxications were more frequent and respiratory and cardiovascular causes were less frequent, compared to those without alcohol-related problems. Patients without alcohol-related problems had a higher rate of previous comorbidities compared with the alcohol group. There were no differences concerning age, severity of illness scores, length of stay, or intensive care outcome. Mortality during the 1-year follow-up was 32.8% in total: 35.1% among those without alcohol-related history and 28.0% in the alcohol group ( P = .041). The difference in mortality appeared during the first month following admission and remained throughout the follow-up period. The highest 1-year mortality (59.3%) was observed among patients with alcohol-related liver disease. Conclusion: Every third patient admitted to ICU used alcohol excessively or had alcohol-related diseases, and those patients with alcohol-related liver disease had the poorest 1-year survival rate. We found higher long-term mortality in nonalcohol-related admissions, which can be explained by the case mix, including a lower rate of chronic diseases, such as malignancies and coronary artery disease, and a higher rate of low-risk admission diagnoses in the alcohol group.
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Affiliation(s)
- Siiri Hietanen
- Division of Intensive Care Medicine, Department of Anesthesiology, Oulu University Hospital, Oulu, Finland
- Research Group of Surgery, Anesthesiology and Intensive Care, Medical Research Center Oulu, University of Oulu, Oulu, Finland
| | - Tero Ala-Kokko
- Division of Intensive Care Medicine, Department of Anesthesiology, Oulu University Hospital, Oulu, Finland
- Research Group of Surgery, Anesthesiology and Intensive Care, Medical Research Center Oulu, University of Oulu, Oulu, Finland
| | - Pasi Ohtonen
- Department of Operative Care, Oulu University Hospital, Oulu, Finland
| | - Riikka Käkelä
- Division of Intensive Care Medicine, Department of Anesthesiology, Oulu University Hospital, Oulu, Finland
- Research Group of Surgery, Anesthesiology and Intensive Care, Medical Research Center Oulu, University of Oulu, Oulu, Finland
| | - Solja Niemelä
- Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland
- Department of Psychiatry, Lapland Hospital District, Rovaniemi, Finland
| | - Janne H. Liisanantti
- Division of Intensive Care Medicine, Department of Anesthesiology, Oulu University Hospital, Oulu, Finland
- Research Group of Surgery, Anesthesiology and Intensive Care, Medical Research Center Oulu, University of Oulu, Oulu, Finland
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46
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Abstract
BACKGROUND We aimed to determine the prevalence of alcohol use among older Jamaicans as well as to explore among this population the relationships between alcohol use and: age, sex, depressive symptoms, and life satisfaction. Although the nature of these relationships among the proposed study population were uncertain, in other settings alcohol use has tended to decline with increasing age, occur more commonly among men than women, and show non-linear relationships with depressive symptoms and life satisfaction. METHODS Data gathered by two-stage cluster sampling for a nationally representative health and lifestyle survey of 2,943 community-dwelling older Jamaicans, aged 60 to 103 years, were subjected to secondary analysis using the Student's t-test and χ 2 test as appropriate. RESULTS Current alcohol use was reported by 21.4% of the participants. It steadily declined with age and was six times more prevalent among men (37.6%) than women (6.2%). These findings were statistically significant as were associations of current alcohol use with comparatively lower levels of depressive symptoms. Current alcohol use was also more prevalent among persons who were either highly satisfied or highly dissatisfied with their lives, compared to others who had levels of life satisfaction between these two extremes. CONCLUSIONS Current alcohol use among older Jamaicans occurs primarily among men, declines with increasing age, and is associated with a relatively low likelihood of depression. It is also associated with very high and very low levels of life satisfaction.
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47
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Almeida OP, McCaul K, Hankey GJ, Yeap BB, Golledge J, Flicker L. Excessive alcohol consumption increases mortality in later life: a genetic analysis of the health in men cohort study. Addict Biol 2017; 22:570-578. [PMID: 26644136 DOI: 10.1111/adb.12340] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Revised: 10/28/2015] [Accepted: 10/30/2015] [Indexed: 12/20/2022]
Abstract
We designed this cohort study of men aged 70-89 years to determine if excessive alcohol use increases mortality. They reported history of alcohol use (never, past, ≤ two daily drinks, two to four daily drinks, four to six daily drinks, > six daily drinks) and donated a blood sample in 2001-2004. We determined the ADH1B rs1229984 G>A polymorphism and retrieved mortality data from the Western Australian Data Linkage System. Other study measures included age, education, body mass index, smoking, and history of hypertension, diabetes, chronic respiratory diseases, coronary heart disease and stroke. Of the 3496 participants, 225 (6.4 percent) carried the ADH1B rs1229984 G>A polymorphism. Carriers consumed significantly less alcohol than non-carriers. The adjusted mortality hazard ratio (MHR, 95 percent confidence interval-95%CI) over 8.0 years (range: 10 weeks to 11.2 years) relative to never drinkers was 1.15 (95%CI = 0.86, 1.55) for past drinkers, 0.98 (95%CI = 0.76, 1.25) for men consuming ≤ two daily drinks, 1.13 (95%CI = 0.85, 1.49) for two to four drinks, 1.18 (95%CI = 0.81, 1.71) for four to six drinks and 1.87 (95%CI = 1.11, 3.12) for those consuming more than six daily drinks on a regular basis. The MHR associated with the ADH1B rs1229984 G>A polymorphism was 0.68 (95%CI = 0.54, 0.87). Excessive alcohol use in later life is associated with increased mortality, and this association is likely to be causal. We found no evidence that light to moderate alcohol use decreases the mortality of older men. Health messages regarding the safe use of alcohol in older age may benefit from taking these findings into account.
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Affiliation(s)
- Osvaldo P. Almeida
- School of Psychiatry and Clinical Neurosciences; University of Western Australia; Australia
- WA Centre for Health and Ageing, Centre for Medical Research; Australia
- Department of Psychiatry; Royal Perth Hospital; Australia
| | - Kieran McCaul
- WA Centre for Health and Ageing, Centre for Medical Research; Australia
| | - Graeme J. Hankey
- School of Medicine and Pharmacology; University of Western Australia; Australia
- Department of Neurology; Sir Charles Gairdner Hospital; Australia
| | - Bu B. Yeap
- School of Medicine and Pharmacology; University of Western Australia; Australia
- Department of Endocrinology; Fremantle and Fiona Stanley Hospitals; Australia
| | - Jonathan Golledge
- Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry; James Cook University; Australia
- Department of Vascular and Endovascular Surgery; The Townsville Hospital; Australia
| | - Leon Flicker
- WA Centre for Health and Ageing, Centre for Medical Research; Australia
- School of Medicine and Pharmacology; University of Western Australia; Australia
- Department of Geriatric Medicine; Royal Perth Hospital; Australia
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48
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Licaj I, Sandin S, Skeie G, Adami HO, Roswall N, Weiderpass E. Alcohol consumption over time and mortality in the Swedish Women's Lifestyle and Health cohort. BMJ Open 2016; 6:e012862. [PMID: 27807087 PMCID: PMC5129127 DOI: 10.1136/bmjopen-2016-012862] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Alcohol consumption is steadily increasing in high-income countries but the harm and possible net benefits of light-to-moderate drinking remain controversial. We prospectively investigated the association between time-varying alcohol consumption and overall and cause-specific mortality among middle-aged women. METHODS Among 48 249 women at baseline (33 404 at follow-up) in the prospective Swedish Women's Lifestyle and Health cohort, age 30-49 years at baseline, we used repeated information on alcohol consumption and combined this method with multiple imputation in order to maximise the number of participants and deaths included in the analyses. Multivariable Cox regression models were used to calculate HRs for overall and cause-specific mortality. RESULTS During >900 000 person/years, a total of 2100 deaths were recorded through Swedish registries. The median alcohol consumption increased from 2.3 g/day in 1991/1992 (baseline) to 4.7 g/day in 2004 (follow-up). Compared with light drinkers (0.1-1.5 g/day), a null association was observed for all categories of alcohol consumption with the exception of never drinkers. The HR comparing never with light drinkers was 1.46 (95% CI 1.22 to 1.74). There was a statistically significant negative trend between increasing alcohol consumption and cardiovascular and ischaemic heart diseases mortality. The results were similar when women with prevalent conditions were excluded. CONCLUSIONS In conclusion, in a cohort of young women, light alcohol consumption was protective for cardiovascular and ischaemic heart disease mortality but not for cancer and overall mortality.
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Affiliation(s)
- Idlir Licaj
- Department of Community Medicine, Faculty of Health Sciences, UiT—The Arctic University of Norway, Tromsø, Norway
| | - Sven Sandin
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Guri Skeie
- Department of Community Medicine, Faculty of Health Sciences, UiT—The Arctic University of Norway, Tromsø, Norway
| | - Hans-Olov Adami
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA
| | - Nina Roswall
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Elisabete Weiderpass
- Department of Community Medicine, Faculty of Health Sciences, UiT—The Arctic University of Norway, Tromsø, Norway
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Research, Cancer Registry of Norway, Institute of Population-based Cancer Research, Oslo, Norway
- Genetic Epidemiology Group, Folkhälsan Research Centre, Samfundet Folkhälsan, Helsinki, Finland
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49
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Canan CE, Lau B, McCaul ME, Keruly J, Moore RD, Chander G. Effect of alcohol consumption on all-cause and liver-related mortality among HIV-infected individuals. HIV Med 2016; 18:332-341. [PMID: 27679418 DOI: 10.1111/hiv.12433] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2016] [Indexed: 01/18/2023]
Abstract
OBJECTIVES The aim of the study was to examine the association between levels of past and current alcohol consumption and all-cause and liver-related mortality among people living with HIV (PLWH). METHODS A prospective cohort study of 1855 PLWH in Baltimore, MD was carried out from 2000 to 2013. We ascertained alcohol use by (1) self-report (SR) through a computer-assisted self interview, and (2) medical record abstraction of provider-documented (PD) alcohol use. SR alcohol consumption was categorized as heavy (men: > 4 drinks/day or > 14 drinks/week; women: > 3 drinks/day or > 7 drinks/week), moderate (any alcohol consumption less than heavy), and none. We calculated the cumulative incidence of liver-related mortality and fitted adjusted cause-specific regression models to account for competing risks. RESULTS All-cause and liver-related mortality rates (MRs) were 43.0 and 7.2 per 1000 person-years (PY), respectively. All-cause mortality was highest among SR nondrinkers with PD recent (< 6 months) heavy drinking (MR = 85.4 deaths/1000 PY) and lowest among SR moderate drinkers with no PD history of heavy drinking (MR = 23.0 deaths/1000 PY). Compared with SR moderate drinkers with no PD history of heavy drinking, SR nondrinkers and moderate drinkers with PD recent heavy drinking had higher liver-related mortality [hazard ratio (HR) = 7.28 and 3.52, respectively]. However, SR nondrinkers and moderate drinkers with a PD drinking history of > 6 months ago showed similar rates of liver-related mortality (HR = 1.06 and 2.00, respectively). CONCLUSIONS Any heavy alcohol consumption was associated with all-cause mortality among HIV-infected individuals, while only recent heavy consumption was associated with liver-related mortality. Because mortality risk among nondrinkers varies substantially by drinking history, current consumption alone is insufficient to assess risk.
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Affiliation(s)
- C E Canan
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - B Lau
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - M E McCaul
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - J Keruly
- Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - R D Moore
- Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - G Chander
- Johns Hopkins School of Medicine, Baltimore, MD, USA
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50
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Evans-Polce RJ, Staff J, Maggs JL. Alcohol abstention in early adulthood and premature mortality: Do early life factors, social support, and health explain this association? Soc Sci Med 2016; 163:71-9. [PMID: 27404910 PMCID: PMC4970918 DOI: 10.1016/j.socscimed.2016.06.052] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Revised: 06/22/2016] [Accepted: 06/28/2016] [Indexed: 01/29/2023]
Abstract
OBJECTIVE Adult alcohol abstainers have a heightened risk of premature mortality compared to light-to-moderate drinkers. We examine three plausible explanations, other than lack of alcohol, for this observed difference: Abstainers 1) have early life disadvantages that undermine long-term health; 2) lack social support; 3) are less healthy. METHOD In the National Child Development Study, an ongoing national British cohort study of individuals born in 1958, we investigated whether early life disadvantages, lack of social support, and poor physical health reduce or eliminate the elevated risk of mortality through age 51 among those abstaining from alcohol at age 33. Using Cox proportional hazard models in a stepwise approach we examined whether the alcohol-mortality relationship changed when potential confounders were included. RESULTS The risk of mortality by age 51 was greater among age-33 abstainers compared to light drinkers (Hazard Ratio [HR] = 2.18; 95% CI = 1.40, 3.40). Including early life disadvantages and social support in the hazard models did not alter these associations (HR = 2.12; 95% CI = 1.27, 3.54). Including physical health in the model resulted in a 25% reduction in risk of death among abstainers, though the difference in risk remained statistically significant (HR = 1.75; 95% CI = 1.04, 2.94). CONCLUSIONS Abstaining from alcohol in early adulthood, in comparison to light drinking, predicts increased risk for premature mortality, even after accounting for numerous early and young adult confounders. Future research should examine potential moderators of this association.
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Affiliation(s)
- Rebecca J Evans-Polce
- The Methodology Center and Prevention Research Center, Pennsylvania State University, University Park, PA, USA.
| | - Jeremy Staff
- Department of Sociology and Criminology, Pennsylvania State University, University Park, PA, USA
| | - Jennifer L Maggs
- Department of Human Development and Family Studies and Prevention Research Center, Pennsylvania State University, University Park, PA, USA
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