Alcohol and coronary heart disease

Whole almond consumption is associated with better diet quality and cardiovascular disease risk factors in the UK adult population: National Diet and Nutrition Survey (NDNS) 2008-2017

PURPOSE

 This work aimed to estimate whole almond consumption in a nationally representative UK survey population and examine associations with diet quality and cardiovascular disease (CVD) risk.

METHODS

 Four-day food record data from the National Diet and Nutrition Survey (NDNS) 2008-2017 (n = 6802, age ≥ 19 year) were analyzed to investigate associations between whole almond consumption and diet quality, measured by the modified Mediterranean Diet Score (MDS) and modified Healthy Diet Score (HDS), and CVD risk markers, using survey-adjusted multivariable linear regression.

RESULTS

 Whole almond consumption was reported in 7.6% of the population. Median intake in whole almond consumers was 5.0 g/day (IQR 9.3). Consumers had higher diet quality scores relative to non-consumers; higher intakes of protein, total fat, monounsaturated, n-3 and n-6 polyunsaturated fats, fiber, folate, vitamin C, vitamin E, potassium, magnesium, phosphorus, and iron; and lower intakes of trans-fatty acids, total carbohydrate, sugar, and sodium. BMI and WC were lower in whole almond consumers compared to non-consumers: 25.5 kg/m2 (95% CI 24.9, 26.2) vs 26.3 kg/m2 (25.9, 26.7), and 88.0 cm (86.2, 89.8) vs 90.1 cm (89.1, 91.2), respectively. However, there were no dose-related fully adjusted significant associations between increasing almond intake (g per 1000 kcal energy intake) and lower CVD risk markers.

CONCLUSIONS

 Almond intake is low in the UK population, but consumption was associated with better dietary quality and lower CVD risk factors. Habitual consumption of whole almonds should be encouraged as part of a healthy diet.

Influence of alcohol consumption on blood coagulation in rotational thromboelastometry (ROTEM): an in-vivo study

Background

Twenty-five to 85% of trauma patients are under the influence of alcohol in addition to experiencing injury-related coagulation impairment. Viscoelastic point-of-care tests (thrombelastography [TEG], rotational thromboelastometry [ROTEM]) are popular tools for rapid hemostasis assessment and therapeutic decision-making in this and other settings. While alcohol affects these tests in-vitro, their specific effects in-vivo are unclear. Therefore, we evaluated the effects of alcohol ingestion on ROTEM parameters.

Methods

Twenty volunteers provided informed consent to drinking red wine, whisk(e)y, or vodka to a target blood alcohol concentration of 1‰ within one hour, calculated with the Widmark formula. Blood samples were collected before drinking, at a breath alcohol concentration of 0.5‰, and at 1.0‰, but no later than one hour. After each blood collection, ExTEM and FibTEM tests were performed directly "at the bedside."

Results

All participants had a blood alcohol concentration (BAC) of 0.00‰ at the beginning. The mean BACs at the second and third collection were 0.48 and 0.76‰, respectively. There were no significant differences in the ExTEM parameters. FibTEM measurements showed a significant difference at the A10 value (13.0 vs. 14.0 mm, P = 0.014) and a trend at the maximum amplitude (maximum clot firmness 13.7 vs. 16.2 mm, P = 0.075). We saw no significant differences in fibrinolysis parameters and no hyperfibrinolysis in our ROTEM measurements.

Conclusions

Ethanol ingestion can impair early fibrin polymerization. These results might be of special relevance in trauma and support routine application of ROTEM/TEG in such cases.

Prolonged Exposure to Alcohol Vapor Causes Change in Cardiovascular Function in Female but not in Male Rats

BACKGROUND

Alcohol abuse is a health concern worldwide. Studies have associated alcohol abuse with cardiovascular impairments. In this study, we investigated differences in the effects of chronic alcohol vapor exposure on cardiovascular function between male and female rats by using the alcohol vapor chamber method to induce alcohol addiction-like behaviors in rats.

METHODS

We exposed male and female Long-Evans rats to alcohol vapor for 14 hours, followed by ethanol withdrawal for 10 hours, for 30 consecutive days or room air (control groups). The animals underwent preparation for the surgical implantation of cannulas into femoral vessels, for allowing the assessment of the basal arterial pressure and heart rate values, baroreflex function, and autonomic activity.

RESULTS

Female control rats showed higher basal heart rate compared to male control rats. Chronic alcohol vapor inhalation reduced basal heart rate in females, but not in males; this effect was followed by an increase in the parasympathetic tone of the heart. Further, female rats subjected to alcohol vapor showed an increase in the baroreflex activity.

CONCLUSIONS

These findings suggest that females are more sensitive to chronic alcohol vapor exposure than males because they had a reduction in basal heart rate and changes in the baroreflex activity.

CONTROL OF ALCOHOL CONSUMPTION IN THE COUNTRIES OF NORTHERN DIMENSION PARTNERSHIP IN PUBLIC HEALTH ABD SOCIAL WELL­BEING

Alcohol consumption is one of the causes of premature death from the main non­communicable diseases (NCD), such as cardiovascular diseases, malignancies, diabetes. In the countries of Northern Dimension Partnership in Public Health and Social Well­being (NDPHW) alcohol consumption calculated for pure ethanol per person per year ranges from low ~8 L to high ≥12 L. In NDPHW countries where the inhabitants consume alcohol in low amounts, the probability of premature death from NCD is lower than in the countries with high consumption. It was shown that the events on alcohol approachability restriction were stricter in the countries with low consumption rate and hence with lower probability of premature NCD death. All NDPHW countries, except Germany and Estonia, are in the 20 of the countries with the highest score according to the politics of alcohol control that witness on effective implementation of the events for consumption control. Therefore acception and implementation of strict politics may facilitate the decrease of alcohol consumption and then, the rate of NCD premature death.

Lifestyle Habits among Adult Congenital Heart Disease Patients in Malta

OBJECTIVE

Adult congenital heart disease patients are prone to health risk behaviors like their peers. Such behaviors can have serious implications, particularly in patients with complex congenital lesions. We investigated patterns in tobacco smoking, alcohol consumption, substance misuse, dental reviews, and physical activity in Maltese patients.

DESIGN

A questionnaire modeled on the 2008 European Health Interview Survey was offered to consecutive adult congenital heart disease outpatients, aged 16 years and over, between May 2013 and May 2014. Foreigners and patients with learning difficulties or cognitive impairment were excluded. Data on these habits was compared with that from 372 age-matched and sex-matched 2008 survey responders (general population cohort).

RESULTS

There were 125 patient responders (65 males; mean age 30.64, SD 12.80 years). Adult congenital heart disease patients smoked less (patients 18.4%, general 32.0% P = .004) and had more regular dental reviews (patients 60.9%, general 45.2% P = .003) but were less physically active than the general population cohort (patients 30.6%, general 62.9% P < .001). The difference in smoking was only significant in patients born after the mid-1970s (younger) and females, while dental reviews were only better in younger and male patients. Male patients consumed alcohol more frequently (38.1%) than general population males (23.3%, P = .02). In the patient cohort, smoking was more likely with milder congenital lesions (OR 4.689, P = .007), substance misuse more likely in males (OR 5.703, P = .036) and with milder lesions (OR 5.405, P = .030) and alcohol consumption more likely in males (OR 11.697, P < .001).

CONCLUSIONS

Although there is an overall lower uptake of some unhealthy habits by Maltese adult congenital heart disease patients, this is not consistent between sexes or age groups. Male and older patients and those with milder lesions might need more reinforcement of the advice given regarding lifestyle habits. All patients need targeted exercise prescription to ensure better physical activity levels.

Genome-wide association analysis on five isolated populations identifies variants of the HLA-DOA gene associated with white wine liking

Wine is the most popular alcoholic beverage around the world and because of its importance in society has been widely studied. Understanding what drives its flavor has been a quest for decades but much is still unknown and will be determined at least in part by individual taste preferences. Recently studies in the genetics of taste have uncovered the role of different genes in the determination of food preferences giving new insight on its physiology. In this context we have performed a genome-wide association study on red and white wine liking using three isolated populations collected in Italy, and replicated our results on two additional populations coming from the Netherland and Central Asia for a total of 3885 samples. We have found a significant association (P=2.1 × 10(-8)) between white wine liking and rs9276975:C>T a polymorphism in the HLA-DOA gene encoding a non-canonical MHC II molecule, which regulates other MHC II molecules. The same association was also found with red wine liking (P=8.3 × 10(-6)). Sex-separated analysis have also revealed that the effect of HLA-DOA is twice as large in women as compared to men suggesting an interaction between this polymorphism and gender. Our results are one of the first examples of genome-wide association between liking of a commonly consumed food and gene variants. Moreover, our results suggest a role of the MHC system in the determination of food preferences opening new insight in this field in general.

Fatalism and short-termism as cultural barriers to cardiac rehabilitation among underprivileged men

Cardiovascular diseases are a leading cause of death and disability in Canada, and individuals of low socioeconomic status appear particularly vulnerable to such disorders. Although many health-related institutions have promoted cardiovascular health and have created cardiac rehabilitation programmes, they have not attained their desired outcomes, especially amongst socioeconomically deprived men. Drawing on Pierre Bourdieu's sociocultural theory, this qualitative study aims to understand the social mechanisms underpinning the lifestyles and health practices of men who had suffered a cardiovascular incident requiring hospitalisation. In all, 20 interviews were conducted with francophone men aged 40 to 65 years living in the province of Québec, Canada. The analysis strongly suggests that the respondents' living conditions and disease were significant obstacles to their adoption of a healthy lifestyle. Their despair and pessimism, apparently originating in the harshness of their financial realities, physical limitations and social networks, led them to believe that they could do little to control their lives, thereby limiting the fulfillment of any long-term ambitions. Therefore, the adoption of a habitus characterised by fatalistic and short-term perceptions of health influenced their lifestyle choices, leading them to maintain lives that were in stark contrast with the recommendations made by health promotion experts.

Alcohol consumption improves insulin signaling in the myocardium

BACKGROUND

In a previous study, we demonstrated that swine with metabolic syndrome treated with alcohol had improved insulin signaling. We developed a follow-up study to evaluate the effects of alcohol on ischemic myocardium in animals without metabolic syndrome.

METHODS

Fourteen Yorkshire swine underwent placement of an ameroid constrictor to induce chronic myocardial ischemia. Postoperatively, one group was supplemented with ethanol (ETOH), and one group was supplemented with sucrose (SUC) daily to normalize caloric intake. After 7 weeks, all animals underwent dextrose challenge and harvest of nonischemic and ischemic myocardium. Tissues were analyzed for protein expression and histologic analysis.

RESULTS

There was no difference in body mass index, serum glucose or insulin levels. However, ethanol supplementation up-regulated phosphoinostitide 3-kinase, phosphorylated protein kinase B, protein kinase B, and phosphorylated Forkhead Box 01 expression, which may promote insulin signaling, and down-regulated inhibitors of insulin signaling pIRS1 and pIRS2. There was no difference in intramyocardial glycogen but there was increased GLUT4 expression in the ETOH group, which may promote glucose use.

CONCLUSION

Despite similar serum glucose and insulin levels, alcohol consumption up-regulates the insulin signaling pathway in the absence of metabolic syndrome in both nonischemic and chronically ischemic myocardium. These results suggest that alcohol selectively up-regulates the insulin signaling pathway despite normoglycemia.

Nutritional recommendations for cardiovascular disease prevention

Lifestyle factors, including nutrition, play an important role in the etiology of Cardiovascular Disease (CVD). This position paper, written by collaboration between the Israel Heart Association and the Israel Dietetic Association, summarizes the current, preferably latest, literature on the association of nutrition and CVD with emphasis on the level of evidence and practical recommendations. The nutritional information is divided into three main sections: dietary patterns, individual food items, and nutritional supplements. The dietary patterns reviewed include low carbohydrate diet, low-fat diet, Mediterranean diet, and the DASH diet. Foods reviewed in the second section include: whole grains and dietary fiber, vegetables and fruits, nuts, soy, dairy products, alcoholic drinks, coffee and caffeine, tea, chocolate, garlic, and eggs. Supplements reviewed in the third section include salt and sodium, omega-3 and fish oil, phytosterols, antioxidants, vitamin D, magnesium, homocysteine-reducing agents, and coenzyme Q10.

Hormesis in aging and neurodegeneration-a prodigy awaiting dissection

Hormesis describes the drug action of low dose stimulation and high dose inhibition. The hormesis phenomenon has been observed in a wide range of biological systems. Although known in its descriptive context, the underlying mode-of-action of hormesis is largely unexplored. Recently, the hormesis concept has been receiving increasing attention in the field of aging research. It has been proposed that within a certain concentration window, reactive oxygen species (ROS) or reactive nitrogen species (RNS) could act as major mediators of anti-aging and neuroprotective processes. Such hormetic phenomena could have potential therapeutic applications, if properly employed. Here, we review the current theories of hormetic phenomena in regard to aging and neurodegeneration, with the focus on its underlying mechanism. Facilitated by a simple mathematical model, we show for the first time that ROS-mediated hormesis can be explained by the addition of different biomolecular reactions including oxidative damage, MAPK signaling and autophagy stimulation. Due to their divergent scales, the optimal hormetic window is sensitive to each kinetic parameter, which may vary between individuals. Therefore, therapeutic utilization of hormesis requires quantitative characterizations in order to access the optimal hormetic window for each individual. This calls for a personalized medicine approach for a longer human healthspan.

NONDRINKER MORTALITY RISK IN THE UNITED STATES

The literature has shown that people who do not drink alcohol are at greater risk for death than light to moderate drinkers, yet the reasons for this remain largely unexplained. We examine whether variation in people's reasons for nondrinking explains the increased mortality. Our data come from the 1988-2006 National Health Interview Survey Linked Mortality File (N= 41,076 individuals age 21 and above, of whom 10,421 died over the follow-up period). The results indicate that nondrinkers include several different groups that have unique mortality risks. Among abstainers and light drinkers the risk of mortality is the same as light drinkers for a subgroup who report that they do not drink because of their family upbringing, and moral/religious reasons. In contrast, the risk of mortality is higher than light drinkers for former drinkers who cite health problems or who report problematic drinking behaviors. Our findings address a notable gap in the literature and may inform social policies to reduce or prevent alcohol abuse, increase health, and lengthen life.

A diet pattern with more dairy and nuts, but less meat is related to lower risk of developing hypertension in middle-aged adults: the Atherosclerosis Risk in Communities (ARIC) study

Dietary intake among other lifestyle factors influence blood pressure. We examined the associations of an “a priori” diet score with incident high normal blood pressure (HNBP; systolic blood pressure (SBP) 120–139 mmHg, or diastolic blood pressure (DBP) 80–89 mmHg and no antihypertensive medications) and hypertension (SBP ≥ 140 mmHg, DBP ≥ 90 mmHg, or taking antihypertensive medication). We used proportional hazards regression to evaluate this score in quintiles (Q) and each food group making up the score relative to incident HNBP or hypertension over nine years in the Atherosclerosis Risk of Communities (ARIC) study of 9913 African-American and Caucasian adults aged 45–64 years and free of HNBP or hypertension at baseline. Incidence of HNBP varied from 42.5% in white women to 44.1% in black women; and incident hypertension from 26.1% in white women to 40.8% in black women. Adjusting for demographics and CVD risk factors, the “a priori” food score was inversely associated with incident hypertension; but not HNBP. Compared to Q1, the relative hazards of hypertension for the food score Q2–Q5 were 0.97 (0.87–1.09), 0.91 (0.81–1.02), 0.91 (0.80–1.03), and 0.86 (0.75–0.98); p_trend = 0.01. This inverse relation was largely attributable to greater intake of dairy products and nuts, and less meat. These findings support the 2010 Dietary Guidelines to consume more dairy products and nuts, but suggest a reduction in meat intake.

Alcohol and smoking consumption behaviours in older Australian adults: prevalence, period and socio-demographic differentials in the DYNOPTA sample

PURPOSE

Alcohol consumption and tobacco use are key risk factors for chronic disease and health burden across the adult lifespan. We estimate the prevalence of alcohol consumption and smoking by age and time period in adults from mid to old age.

METHODS

Participants (n = 50,652) were drawn from the Dynamic Analyses to Optimise Ageing (DYNOPTA) project and were compared with Australian National Health Survey data. Alcohol and smoking consumption DYNOPTA data were weighted to the estimated resident population of the sampling frame for each contributing study according to age and sex distributions within major statistical regions.

RESULTS

Comparisons in the rates of smoking and alcohol consumption between DYNOPTA and other national surveys were comparable. Males were more likely to be (RRR = 2.12) or have been smokers (RRR = 2.97), whilst females were more likely to be non-drinkers (RRR = 2.52). Period effects were also identified; higher prevalence rates in consumption of alcohol (RRR = 3.21) and smoking (RRR = 1.67) for those contributing studies from the early 1990's, in comparison with those studies from the latter half of the decade, were reported.

CONCLUSIONS

Over a decade, prevalence rates for high-risk consumption of alcohol and current smoking behaviour declined and suggest the possible impact of government health policy, with targeted-health policies, that included bans on public smoking, and a toughening of legislation against alcohol-related crime.

Vodka and wine consumption in a swine model of metabolic syndrome alters insulin signaling pathways in the liver and skeletal muscle

BACKGROUND

The purpose of this study was to examine the effects of alcohol in the context of metabolic syndrome on insulin signaling pathways in the liver and skeletal muscle.

METHODS

Twenty-six Yorkshire swine were fed a hypercaloric, high-fat diet for 4 weeks then split into 3 groups: hypercholesterolemic diet alone (HCC, n = 9), hypercholesterolemic diet with vodka (HCVOD, n = 9), and hypercholesterolemic diet with wine (HCW, n = 8) for 7 weeks. Animals underwent intravenous dextrose challenge before euthanasia and tissue collection.

RESULTS

HCC, HCVOD, and HCW groups had similar blood fasting glucose levels, liver function test, and body mass index. Thirty and 60 minutes after dextrose infusion, HCVOD and HCW groups had significantly increased blood glucose levels compared with the HCC group. The HCW group had significantly increased levels of insulin compared with the HCC group. Immunoblotting in skeletal muscle demonstrated that alcohol up-regulates p-IRS1, IRS2, AKT, AMPKα, PPARα, Fox01, and GLUT4. In the liver, HCW had up-regulation of AKT, AMPKα, and GLUT4 compared with HCC. Skeletal muscle immunohistochemistry demonstrated increased sarcolemmal expression of GLUT4 in both alcohol groups compared with HCC.

CONCLUSION

Moderate alcohol consumption in a swine model of metabolic syndrome worsens glucose metabolism by altering activation of the insulin signaling pathway in the liver and skeletal muscle.

The cardioprotective association of average alcohol consumption and ischaemic heart disease: a systematic review and meta-analysis

AIMS

  Most, but not all, epidemiological studies suggest a cardioprotective association for low to moderate average alcohol consumption. The objective was to quantify the dose-response relationship between average alcohol consumption and ischaemic heart disease (IHD) stratified by sex and IHD end-point (mortality versus morbidity).

METHODS

  A systematic search of published studies using electronic databases (1980-2010) identified 44 observational studies (case-control or cohort) reporting a relative risk measure for average alcohol intake in relation to IHD risk. Generalized least-squares trend models were used to derive the best-fitting dose-response curves in stratified continuous meta-analyses. Categorical meta-analyses were used to verify uncertainty for low to moderate levels of consumption in comparison to long-term abstainers.

RESULTS

  The analyses used 38,627 IHD events (mortality or morbidity) among 957,684 participants. Differential risk curves were found by sex and end-point. Although some form of a cardioprotective association was confirmed in all strata, substantial heterogeneity across studies remained unexplained and confidence intervals were relatively wide, in particular for average consumption of one to two drinks/day.

CONCLUSIONS

  A cardioprotective association between alcohol use and ischaemic heart disease cannot be assumed for all drinkers, even at low levels of intake. More evidence on the overall benefit-risk ratio of average alcohol consumption in relation to ischaemic heart disease and other diseases is needed in order to inform the general public or physicians about safe or low-risk drinking levels.

Translating evidence into policy for cardiovascular disease control in India

Cardiovascular diseases (CVD) are leading causes of premature mortality in India. Evidence from developed countries shows that mortality from these can be substantially prevented using population-wide and individual-based strategies. Policy initiatives for control of CVD in India have been suggested but evidence of efficacy has emerged only recently. These initiatives can have immediate impact in reducing morbidity and mortality. Of the prevention strategies, primordial involve improvement in socioeconomic status and literacy, adequate healthcare financing and public health insurance, effective national CVD control programme, smoking control policies, legislative control of saturated fats, trans fats, salt and alcohol, and development of facilities for increasing physical activity through better urban planning and school-based and worksite interventions. Primary prevention entails change in medical educational curriculum and improved healthcare delivery for control of CVD risk factors-smoking, hypertension, dyslipidemia and diabetes. Secondary prevention involves creation of facilities and human resources for optimum acute CVD care and secondary prevention. There is need to integrate various policy makers, develop effective policies and modify healthcare systems for effective delivery of CVD preventive care.

Ischemic heart disease mortality and morbidity rates in former drinkers: a meta-analysis

Current abstainers from alcohol have been identified as an inadequate reference group in epidemiologic studies of the effects of alcohol, because inclusion of former drinkers might lead to overestimation of the protective effects and underestimation of the detrimental effects of drinking alcohol. The authors' objective in the current study was to quantify this association for ischemic heart disease (IHD). Electronic databases were systematically searched for relevant case-control or cohort studies published from 1980 to 2010. Thirty-eight articles fulfilled the inclusion criteria, contributing a total of 5,613 IHD events and 12,097 controls among case-control studies and 1,387 events with combined endpoints and 7,183 events stratified by endpoint among 232,621 persons at risk among cohort studies. Pooled estimates for the subset stratified by sex and endpoint showed a significantly increased risk among former drinkers compared with long-term abstainers for IHD mortality ( among men; relative risk = 1.25, 95% confidence interval: 1.15, 1.36; among women relative risk = 1.54, 95% confidence interval: 1.17, 2.03). For IHD morbidity, the estimates for both sexes were close to unity and not statistically significant. Results were robust in several sensitivity analyses. In future studies, researchers should separate former drinkers from the reference category to obtain unbiased effect estimates. Implications for the overall beneficial and detrimental effects of alcohol consumption on IHD are discussed below.

Mortality Differentials and Religion in the U.S.: Religious Affiliation and Attendance

Using data from the Health and Retirement Study, I examine the relationship between adult mortality and religious affiliation. I test whether mortality differences associated with religious affiliation can be attributed to differences in socioeconomic status (years of education and household wealth), attendance at religious services, or health behaviors, particularly cigarette and alcohol consumption. A baseline report of attendance at religious services is used to avoid confounding effects of deteriorating health. Socioeconomic status explains some but not all of the mortality difference. While Catholics, Evangelical Protestants, and Black Protestants benefit from favorable attendance patterns, attendance (or lack of) at services explains much of the higher mortality of those with no religious preference. Health behaviors do not mediate the relationship between mortality and religion, except among Evangelical Protestants. Not only does religion matter, but studies examining the effect of "religiosity" need to consider differences by religious affiliation.

Treatment Outcomes for Older Adults Who Abuse Substances

A Center for Substance Abuse Treatment Knowledge Application Program based on cognitive-behavioral and self-management treatment approaches and targeted to older adults with substance abuse was provided through a community behavioral health center. A sample of 199 adults aged 50 and above participated in the 18-session program. Observations were made at intake and 6 months after intake. Program completers versus noncompleters differed significantly over time, favoring completers with regard to decreased use of nonmedical prescription drugs, improved cognitive functioning, improved mental health, increased vitality, and lack of bodily pain. Significant time effects were noted in participants’ decreased use of alcohol and binge drinking, reduced stress, fewer emotional problems, a decrease in having to reduce important activities, and increased prescription of medication for psychological problems. Participants also reported significant improvement in their social functioning, and their physical health and emotional problems had less impact on what they were able to do.

Aldehyde dehydrogenase 2 knockout accentuates ethanol-induced cardiac depression: role of protein phosphatases

Alcohol consumption leads to myocardial contractile dysfunction possibly due to the toxicity of ethanol and its major metabolite acetaldehyde. This study was designed to examine the influence of mitochondrial aldehyde dehydrogenase-2 (ALDH2) knockout (KO) on acute ethanol exposure-induced cardiomyocyte dysfunction. Wild-type (WT) and ALDH2 KO mice were subjected to acute ethanol (3g/kg, i.p.) challenge and cardiomyocyte contractile function was assessed 24h later using an IonOptix edge detection system. Western blot analysis was performed to evaluate ALDH2, protein phosphatase 2A (PP2A), phosphorylation of Akt, and glycogen synthase kinase-3beta (GSK-3beta). ALDH2 KO accentuated ethanol-induced elevation in cardiac acetaldehyde levels. Ethanol exposure depressed cardiomyocyte contractile function including decreased cell shortening amplitude and maximal velocity of shortening/relengthening as well as prolonged relengthening duration and a greater decline in peak shortening in response to increasing stimulus frequency, the effect of which was significantly exaggerated by ALDH2 KO. ALDH2 KO also unmasked an ethanol-induced prolongation of shortening duration. In addition, short-term in vitro incubation of ethanol-induced cardiomyocyte mechanical defects was exacerbated by the ALDH inhibitor cyanamide. Ethanol treatment dampened phosphorylation of Akt and GSK-3beta associated with upregulated PP2A, which was accentuated by ALDH2 KO. ALDH2 KO aggravated ethanol-induced decrease in mitochondrial membrane potential. These results suggested that ALDH2 deficiency led to worsened ethanol-induced cardiomyocyte function, possibly due to upregulated expression of protein phosphatase, depressed Akt activation, and subsequently impaired mitochondrial function. These findings depict a critical role of ALDH2 in the pathogenesis of alcoholic cardiomyopathy.

Overtime work and incident coronary heart disease: the Whitehall II prospective cohort study

AIMS

To examine the association between overtime work and incident coronary heart disease (CHD) among middle-aged employees.

METHODS AND RESULTS

Six thousand and fourteen British civil servants (4262 men and 1752 women), aged 39-61 years who were free from CHD and worked full time at baseline (1991-1994), were followed until 2002-2004, an average of 11 years. The outcome measure was incident fatal CHD, clinically verified incident non-fatal myocardial infarction (MI), or definite angina (a total of 369 events). Cox proportional hazard models adjusted for sociodemographic characteristics showed that 3-4 h overtime work per day was associated with 1.60-fold (95% CI 1.15-2.23) increased risk of incident CHD compared with employees with no overtime work. Adjustment for all 21 cardiovascular risk factors measured made little difference to these estimates (HR 1.56, 95% CI 1.11-2.19). This association was replicated in multivariate analysis with only fatal cardiovascular disease and incident non-fatal MI as the outcome (HR 1.67, 95% CI 1.02-2.76).

CONCLUSION

Overtime work is related to increased risk of incident CHD independently of conventional risk factors. These findings suggest that overtime work adversely affects coronary health.

Diverse effects of ethanol on Ca2+ entry and subsequent aggregation of platelets

Although alcohol is known to inhibit platelet aggregation, and transplasmalemmal Ca(2+) entry is profoundly involved in platelet aggregation, there has been limited knowledge about the relationship between alcohol and Ca(2+) entry. The purpose of this study was to determine whether and how ethanol in vitro affects Ca(2+) entry through different pathways and the subsequent aggregation of platelets. Thapsigargin, 1-oleoyl-2-acetyl-sn-glycerol (OAG), and thrombin were used to stimulate human platelets. Ca(2)(+) entry and the subsequent aggregatory responses of platelets were measured by spectrofluorometry using fura-2/AM as an indicator and the light transmission method, respectively. Thapsigargin-induced Ca(2+) entry and the following platelet aggregation were significantly inhibited by ethanol at concentrations of 0.5% or more. OAG-induced Ca(2+) entry was significantly augmented by ethanol at concentrations of 0.5% or more, whereas platelet aggregation by OAG was significantly inhibited by ethanol at concentrations of 0.5 % or more. Thrombin-induced Ca(2+) entry was not significantly affected by ethanol up to 2%, whereas platelet aggregation by thrombin was markedly inhibited by ethanol at concentrations of 0.5% or more. Thrombin-induced Ca(2+) entry in the presence of SKF-96365 was augmented by pretreatment with ethanol. Ethanol in vitro showed diverse effects on the different Ca(2+) entry pathways of platelets, whereas aggregatory responses induced by activation of the different Ca(2+) entry pathways of platelets were all inhibited by ethanol. These results suggest that ethanol inhibits platelet aggregation mainly via a mechanism(s) other than transplasmalemmal Ca(2+) entry.

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

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

Nutrition, hormetic stress and health

Hormesis defines an effect where exposure to a low dose of a toxic agent results in a beneficial response. It has been described in organisms exposed to low-dose radiation, heat stress, and chemicals. The effect is characterised by a J-shaped dose-response as opposed to a linear dose-response. Confirmation of the general phenomena of hormesis has proved difficult due to the lack of appropriate methodology and the absence of well-defined mechanisms to support the experimental observations. In the nutritional field there are few reports of its existence. The clearest illustration of the effect is seen in animals that are energy restricted when there is a clear benefit in the reduction of age-related disease, and an extension of maximum lifespan. DNA microarray experiments have shown that there is a down regulation of the stress-response genes that are up regulated through the ageing process. Electrophilic phytochemicals, that have been shown to have beneficial health effects at low doses, up regulate the antioxidant-electrophile response element. This probably occurs through an alteration in the redox state of the target cells which causes activation of protein kinases, the activation of the Nrf2 transcription factor and the up regulation of the phase II enzymes, similar to responses that occur under mild chemical stress. This situation might enable organisms to adapt to stress such that the effects of a subsequent exposure to a harmful challenge are reduced. There may be a permanent alteration in cellular homeostasis, or redox state, if the low level exposure is maintained. It remains to be proven if such a situation occurs in response to chronic low-dose exposure to dietary phytochemicals such that the target cells are better able to respond to a subsequent stress challenge.

Influence of body weight on the relationships of alcohol drinking with blood pressure and serum lipids in women

OBJECTIVE

To determine whether body weight influences the associations of habitual alcohol drinking with blood pressure and serum lipids in women.

METHODS

The subjects were 16,805 healthy women at ages of 35-54 years, and data were collected at work places of the subjects in Yamagata Prefecture in Japan from April 1999 to March 2000. The subjects were divided into three tertile groups of body weight and were further divided into three subgroups by average ethanol intake [non-, light (<15 g per day), and heavy (> or =15 g per day) drinkers].

RESULTS

In the first and second tertile groups of body weight, mean systolic and diastolic blood pressure and prevalence of high systolic or diastolic blood pressure were significantly higher in heavy drinkers than in non-drinkers, while these differences were not observed in the third tertile group of body weight. On the other hand, in all tertile groups of body weight, mean serum HDL and LDL cholesterol levels were higher and lower, respectively, in light and heavy drinkers than in non-drinkers, and prevalence of low HDL cholesterol or high LDL cholesterol was significantly lower in heavy drinkers than in non-drinkers.

CONCLUSIONS

The results suggest that body weight influences the association of alcohol drinking with blood pressure but not the associations of alcohol drinking with serum HDL and LDL cholesterol.

Measuring gambling participation

There are many parallels between research on gambling and research on alcohol use, but a striking difference is the emphasis in the former area on problem gambling rather than the use of participation measures. We outline five topics that are underdeveloped as a consequence: (i) gambling participation and future problems; (ii) moderate gambling; (iii) separate measurement of exposures and harms; (iv) predictors of participation; and (v) natural history of participation. Challenges to the future development of gambling participation measures are discussed by reference to comparable difficulties in the field of alcohol use and some examples are given as to how progress could be made. Further development of measures will necessarily occur in the context of broader scientific aims. Some recent studies are highlighted that provide hope of gains in this area. We urge further progress to yield conceptually and operationally distinct indices of exposures and harms.

Drinking habits and health in Northern Italian and American men

BACKGROUND AND AIM

The aim of this study was to investigate alcohol drinking habits in two male cohorts, one Italian and one American, and to investigate whether cardiovascular disease risk factors are related to different drinking patterns. Furthermore, socio-demographic characteristics were taken into account.

METHODS

The Italian sample was drawn from the National Alpines Association. A dietary questionnaire was sent to the members of this association as an additional supplement to their monthly magazine. Eleven thousand one hundred and thirty-four men, 18-94 years, from Northern Italy were included in this analysis. The American sample is part of the Western New York Health Study (WNYHS) including 1927 male participants.

RESULTS

In both populations, those who drank more than 4 drinks/day were the least educated and showed the highest percentage of current smokers; the highest prevalence of hypertension occurred in heavier drinkers and those who mostly drank without food. By contrast, lifetime abstainers exhibited the lowest percentage of hypertension and the highest level of serum cholesterol; in both populations the highest prevalence of diabetes was present in lighter drinkers.

CONCLUSIONS

The current study shows that drinking habits are quite different in the two countries and are basically linked with socio-demographic and behavioral variables and support the notion that excess volume of alcohol consumed, and drinking without food, are associated with a higher risk of hypertension and hyperlipidaemia, particularly for Italians.

Sensitivity of thrombin-induced platelet aggregation to inhibition by ethanol

BACKGROUND

The purpose of this study was to determine the concentration of ethanol required for inhibition of thrombin-induced aggregation of human platelets in vitro.

METHODS

Three methods, light transmission method, particle counting method using light scattering and screen filtration pressure method using whole blood, were used for evaluation of platelet aggregation.

RESULTS

Thrombin (0.2 U/ml)-induced platelet aggregation was significantly inhibited by ethanol, and the threshold ethanol concentrations for inhibition determined by measurements using the light transmission method, particle counting method and screen filtration pressure method were 0.5%, 0.125% and 2%, respectively. Platelet aggregation induced by a lower concentration (0.05 U/ml) of thrombin was detected by the screen filtration pressure method but not by the light transmission method or particle counting method. The threshold ethanol concentration for the inhibition of thrombin (0.05 U/ml)-induced platelet aggregation was 0.125% according to results obtained by using the screen filtration pressure method.

CONCLUSIONS

Sensitivities for detection of thrombin-induced platelet aggregation and for detection of inhibition of platelet aggregation by ethanol were high in the screen filtration pressure method and the particle counting method, respectively. The threshold concentration of ethanol to inhibit thrombin-induced platelet aggregation is about 0.125% (approximately 21 mmol/l), which is easily attainable after drinking alcohol.

Influence of gender on the association of alcohol drinking with blood pressure

BACKGROUND

The purpose of this study was to determine whether gender influences the association of alcohol drinking with blood pressure.

METHODS

The subjects (43,810 healthy men and women at ages of 35-54 years) were divided into five groups by average daily ethanol intake (non-, very light (<10 g per day), light (> or =10 g and <20 g per day), moderate (> or =20 g and <30 g per day), and heavy (> or =30 g per day) drinkers). The means of each variable after adjustment for age, body weight, and history of smoking were compared among the groups.

RESULTS

Systolic blood pressure of men was significantly higher in moderate and heavy drinkers than in nondrinkers, and systolic blood pressure of women was significantly higher in heavy drinkers but not in moderate drinkers than in nondrinkers. Diastolic blood pressure of men and women was significantly higher in light, moderate and heavy drinkers than in nondrinkers. The differences in systolic and diastolic blood pressure between drinkers and nondrinkers were greater in men than in women. Both in men and women, serum HDL cholesterol was significantly higher in all four drinker groups than in the nondrinker group, and the difference between drinkers and nondrinkers was greater in women than in men. The above findings were not altered when age- and alcohol intake-matched groups of subjects were used.

CONCLUSIONS

The results suggest that blood pressure is more prone to be elevated by alcohol drinking in men than in women.

Self-reported chronic diseases and associated sociodemographic status and lifestyle risk factors among rural Vietnamese adults

AIMS

The fact that chronic diseases are leading causes of mortality and morbidity in hospitals in Vietnam was certified by yearly statistical information. However, population-based knowledge of chronic diseases is still largely lacking. This article examines the prevalence of major chronic diseases and their relationships with sociodemographic status and selected lifestyle risk factors among the adult population in a rural community in the north of Vietnam.

METHODS

A representative sample comprising 2500 adults aged 25-74 years was surveyed in 2005 using a structured questionnaire. Both descriptive and analytical statistical analyses were applied.

RESULTS

Thirty-nine per cent of the respondents had at least one of the studied chronic diseases. The prevalence of current smoking was 59% among men and 0.7% among women. The prevalence of at-risk alcohol drinking was 67% among men and 3% among women. Increasing age, low education and doing other jobs (small traders, temporary workers, housekeepers, handicraft makers and jobless), as well as tobacco use and at-risk alcohol drinking, were found to be associated with a higher probability of having at least one chronic disease of interest. Economic status was found to be inversely correlated with the probability of having at least one chronic disease among women only.

CONCLUSIONS

The findings from this study indicated that chronic conditions and lifestyle risk factors were very common among the adult population in rural Vietnam. There is an association between chronic diseases and lower socioeconomic status and unhealthy lifestyle risk factors.

Alcohol consumption and heart failure in hypertensive US male physicians

Although alcohol drinking increases blood pressure and heavy drinking has been associated with alcoholic cardiomyopathy, little is known about the association between light to moderate drinking and risk of heart failure (HF) in hypertensive subjects. Thus, the association between light to moderate drinking and incident HF in 5,153 hypertensive male physicians who were free of stroke, myocardial infarction, or major cancers at baseline was prospectively examined. Alcohol consumption was self-reported and classified as <1, 1 to 4, 5 to 7, and >or=8 drinks/week. HF was ascertained using follow-up questionnaires and validated using Framingham criteria. Average age was 58 years, and about 70% of subjects consumed 1 to 7 drinks/week. A total of 478 incident HF cases occurred in this cohort during follow-up. Compared with subjects consuming <1 drink/week, hazard ratios for HF were 0.89 (95% confidence interval [CI] 0.70 to 1.12), 0.72 (95% CI 0.57 to 0.91), and 0.38 (95% CI 0.20 to 0.72) for alcohol consumption of 1 to 4, 5 to 7, and >or=8 drinks/week after adjustment for age, body mass index, smoking, randomization group, use of multivitamins, vegetable consumption, breakfast cereal, exercise, and history of atrial fibrillation, respectively (p for trend <0.001). Similar results were obtained for subjects with HF with and without antecedent myocardial infarction and those without diabetes mellitus. In conclusion, our data suggested that light to moderate alcohol consumption was associated with a lower risk of HF in hypertensive male physicians.

Stress-response hormesis and aging: "that which does not kill us makes us stronger"

Hormesis refers to the beneficial effects of a treatment that at a higher intensity is harmful. In one form of hormesis, sublethal exposure to stressors induces a response that results in stress resistance. The principle of stress-response hormesis is increasingly finding application in studies of aging, where hormetic increases in life span have been seen in several animal models.

Alcohol consumption and the risk of end-stage renal disease among Chinese men

We examined the relationship between alcohol consumption and incidence of end-stage renal disease (ESRD) in a prospective cohort of 65 601 Chinese men aged 40 years and older. Information on the amount and type of alcohol consumed was collected at a baseline examination with follow-up evaluations conducted 8-9 years later. During the 500 876 person-years of follow-up, 176 participants initiated renal replacement therapy or died from renal failure. Compared to non-drinkers, the relative risk of ESRD was 0.67 among men consuming less than 21 drinks per week and 0.52 among men consuming this amount or more after adjustment for age, geographic region, urbanization, education, body mass index, physical activity, and cigarette smoking. The inverse association between alcohol consumption and ESRD existed even after adjustment for systolic blood pressure, and history of diabetes and cardiovascular disease. Our results suggest an inverse relationship between alcohol consumption and risk of ESRD in Chinese men. Heavy alcohol consumption, however, may lead to increased risk of morbidity and mortality from other causes; therefore, the implications from these findings should be interpreted cautiously.

Myocardial infarction and alcohol consumption: a population-based case-control study

BACKGROUND AND AIM

Coronary heart disease (CHD) is the leading cause of death in industrialized societies. Identifying and characterizing modifiable variables associated with CHD is an important issue for health policy. The aim of the present study was to analyze the association of non-fatal myocardial infarction with total alcohol consumption and type of alcoholic beverage consumed. Preference of the subjects' consumption for beer, wine, or spirits was set at 80% or more of total alcoholic beverage consumption.

METHODS AND RESULTS

A population-based case-control study (244 subjects and 1270 controls) was conducted. Male patients aged 25 to 74 years with first myocardial infarction (MI) were recruited in the same region as the healthy male controls, who were taken from a random sample representative of the Gerona population. Alcoholic beverage consumption during the preceding week was recorded. Multiple logistic regression analysis was performed to determine the association of alcohol consumption and non-fatal MI. Total alcohol consumption up to 30 g per day, adjusted for lifestyle and cardiovascular risk factors, was inversely associated (Odds ratio 0.14; 95% confidence interval 0.06-0.36) with the risk of non-fatal MI. Drinking up to 20 g of alcohol through wine, beer and spirits significantly decreased the adjusted risk of MI. Higher alcohol intake did not substantially reduce the risk. A preference for spirits was correlated with a significantly increased risk of non-fatal MI (P<0.05).

CONCLUSION

Moderate alcohol consumption, independent of the type of alcoholic beverage, was associated with non-fatal MI risk reduction.

Blood HDL Cholesterol Levels Influence Association of Alcohol Intake With Blood Pressure in Young Men But Not in Middle-Aged Men

BACKGROUND

Both blood pressure and HDL cholesterol are affected by alcohol drinking. However, it has not been determined whether association of alcohol drinking with blood pressure varies depending on blood HDL level.

METHODS

The subjects were male workers aged 20 to 29 year and 50 to 59 year (n = 21,301), representing young and middle ages, respectively, who had received periodic health checkup examinations. The subjects were divided into tertile groups by serum HDL level, and they were further divided into 3 subgroups based on the average daily alcohol intake [nondrinkers, light drinkers (<30 g of ethanol per day) and heavy drinkers (30 g or more of ethanol per day)]. Blood pressure and incidence of high blood pressure were compared among the 3 alcohol subgroups in each age and HDL group.

RESULTS

In the lowest HDL tertile of 20 to 29-year-old subjects, systolic and diastolic blood pressure and incidences of high systolic and diastolic blood pressure were not significantly different among the 3 alcohol subgroups. In the middle and highest HDL tertiles of the twenties age group, systolic and diastolic blood pressure was significantly higher in heavy drinkers than in nondrinkers, and incidences of high systolic and diastolic blood pressure were significantly higher in drinkers than in nondrinkers. On the other hand, in all HDL tertile groups of 50 to 59-year-old subjects, blood pressure was significantly higher in light drinkers and heavy drinkers than in nondrinkers, and incidences of high systolic and diastolic blood pressure were significantly higher in drinkers than in nondrinkers.

CONCLUSIONS

The results suggest that blood pressure of middle-aged men is elevated by alcohol drinking independently of blood HDL level and is more sensitive to drinking than is blood pressure of young men.

Alcoholic beverage preference and dietary pattern in Spanish university graduates: the SUN cohort study

OBJECTIVE

To describe the association between alcohol beverage preference and dietary habits comparing wine drinkers with other alcoholic beverage drinkers and with nondrinkers in Spanish university graduates.

SUBJECTS

A total of 10 526 men and women, who were recruited using mailed questionnaires, participated in this study.

METHODS

A semiquantitative food frequency questionnaire previously validated in Spain was used together with other questionnaires designed to collect lifestyle characteristics.

RESULTS

Wine drinkers reported higher intake of fibre and olive oil, and lower consumption of fat (only men), dairy products, sugared soda drinks and fast food as compared with other alcoholic beverage groups and nondrinkers. Men nondrinkers were more likely to be physically active during their leisure time than wine drinkers. No relevant differences were found in adherence to the Mediterranean food pattern according to alcoholic beverage preference.

CONCLUSION

This similarity in dietary patterns between wine drinkers and other groups suggests that the positive cardiovascular effects reported for wine should not be attributed to an overall healthier dietary pattern of wine drinkers. .

Beyond HDL-cholesterol increase: phospholipid enrichment and shift from HDL3 to HDL2 in alcohol consumers

The reduction of cardiovascular mortality associated with moderate alcohol consumption is chiefly thought to be mediated by an increase of high density lipoprotein cholesterol (HDL-CH). This study highlights additional qualitative changes of HDL that might augment this antiatherogenic effect. In 279 healthy men, alcohol and nutrient consumption were evaluated. Groups 1 (n=62), 2 (n=172), and 3 (n=45) comprised subjects with alcohol consumption of 0-5.0, 5.1-30.0, and 30.1-75 g/day, respectively. Lipid analysis was performed in nonfractionated and fractionated plasma, including subfractions HDL(2a), HDL(2b), and HDL(3). No difference in LDL-cholesterol was observed. Compared with group 1, groups 2 and 3 exhibited significant increases of HDL-CH (group 1, 44 +/- 10 mg/dl; group 2, 51 +/- 11 mg/dl; group 3, 55 +/- 11 mg/dl; mean +/- SD, P<0.0005), accompanied by enhanced lipidation of HDL (increase of the HDL(2)-CH/HDL(3)-CH ratio). Moreover, phospholipid enrichment of HDL occurred in alcohol consumers, whereas the ratios between other HDL components remained constant. Multivariate analysis revealed alcohol to have the foremost statistical influence on changes of the HDL fraction, followed by body mass index and physical activity level. The increased lipidation of HDL found in alcohol consumers might augment the antiatherogenic effect of HDL-CH increase. In addition, the phospholipid enrichment of HDL might reduce the inflammatory response of atherogenesis.

Dietary patterns and survival of older Europeans: The EPIC-Elderly Study (European Prospective Investigation into Cancer and Nutrition)

Objective

To investigate the association of a posteriori dietary patterns with overall survival of older Europeans.

Design and setting

This is a multi-centre cohort study. Cox regression analysis was used to investigate the association of the prevailing, a posteriori-derived, plant-based dietary pattern with all-cause mortality in a population of subjects who were 60 years or older at recruitment to the European Prospective Investigation into Cancer and Nutrition (EPIC-Elderly cohort). Analyses controlled for all known potential risk factors.

Subjects

In total, 74 607 men and women, 60 years or older at enrolment and without previous coronary heart disease, stroke or cancer, with complete information about dietary intakes and potentially confounding variables, and with known survival status as of December 2003, were included in the analysis.

Results

An increase in the score which measures the adherence to the plant-based diet was associated with a lower overall mortality, a one standard deviation increment corresponding to a statistically significant reduction of 14% (95% confidence interval 5–23%). In country-specific analyses the apparent association was stronger in Greece, Spain, Denmark and The Netherlands, and absent in the UK and Germany.

Conclusions

Greater adherence to the plant-based diet that was defined a posteriori in this population of European elders is associated with lower all-cause mortality. This dietary score is moderately positively correlated with the Modified Mediterranean Diet Score that has been constructed a priori and was also shown to be beneficial for the survival of the same EPIC-Elderly cohort.

Moderate alcohol consumption in older adults is associated with better cognition and well-being than abstinence

BACKGROUND

There is evidence of a U-shaped association between alcohol consumption and physical health outcomes in older people, such that moderate drinking is associated with better outcomes than abstinence or heavy drinking, but whether moderate drinking in older people is associated with better cognition and mental health than non-drinking has not been explored.

OBJECTIVE

To assess the relationship between drinking and cognitive health in middle-aged and older people.

DESIGN

Prospective observational study.

SETTING/PARTICIPANTS

Six thousand and five individuals aged 50 and over who participated in Wave 1 of the English Longitudinal Study of Ageing (ELSA) and who were not problem drinkers. Exposure and outcome variables: we examined cognitive function, subjective well-being, and depressive symptoms, and compared the risks associated with having never drunk alcohol, having quit drinking, and drinking at <1, <2 and >2 drinks per day.

RESULTS

For both men and women, better cognition and subjective well-being, and fewer depressive symptoms, were associated with moderate levels of alcohol consumption than with never having drunk any.

CONCLUSIONS

In middle-aged and older men and women, moderate levels of alcohol consumption are associated with better cognitive health than abstinence.

A Glu487Lys polymorphism in the gene for mitochondrial aldehyde dehydrogenase 2 is associated with myocardial infarction in elderly Korean men

BACKGROUND

A homozygous mutant (ALDH2*2/*2) of the gene for mitochondrial aldehyde dehydrogenase 2 (ALDH2) at codon 487 was reported to be associated with myocardial infarction (MI) among Japanese men. However, such an association has never been studied in a Korean population.

METHOD

The subjects consisted of 122 men (60-81 y) with MI recruited randomly from Yonsei University Medical Center, Korea. A total of 439 men (60-84 y) without MI were selected as controls from the Ansan Geriatric Study. ALDH2 genotypes were determined using the TaqMan fluorogenic 5' nuclease polymerase chain reaction assay.

RESULTS

Genotypes carrying the mutant ALDH2 allele (ALDH2*1/*2 plus ALDH2*2/*2) were significantly more frequent in patients with MI than in the controls (42.6% vs. 30.5%, P=0.0163). Multiple logistic regression analysis revealed that ALDH2*1/*2 plus ALDH2*2/*2, together with abnormal high density lipoprotein cholesterol and elevated body mass index, was an independent risk factor for MI in elderly Korean men (odds ratio=1.976, 95% CI: 1.202-3.248).

CONCLUSIONS

ALDH2 polymorphisms may play an important role in the pathogenesis of MI in elderly Korean men.

Alcohol consumption and risk of leukemia: A multicenter case–control study

A population-based case-control study of 649 leukemia cases and 1771 controls carried out in 11 Italian areas, offered the opportunity to evaluate the relationship between alcohol consumption and leukemia risk. For all leukemias, acute lymphocytic leukemia (ALL), acute myeloid leukemia (AML), and chronic lymphocytic leukemia (CLL), we found a non-significantly inverse association for moderate levels of total alcohol and wine intake, but increased risks at high levels, with, in most cases, significant trend effects (odd ratios (OR) for all leukemias in the lowest quartile of total alcohol consumption [0.1-9.0 g/day of ethanol] versus never-drinker = 0.73; 95% confidence intervals (95% CI) = 0.51-1.03; OR in the highest quartile [> 31.7 g/day] = 1.15; 95% CI = 0.82-1.63; p of the linear trend test = 0.007). For chronic myeloid leukemia (CML), we found a non-significantly positive association for all levels of total alcohol and wine intake, and a significant positive linear trend effect (p = 0.03) for wine intake (OR for 0.1-9.0 g/day of ethanol intake from wine = 1.34; 95% CI = 0.61-2.94; OR in the highest quartile of wine intake [> 27.7 g/day] = 2.13; 95% CI = 1.01-4.50). No consistent dose-response was detected analysing duration of alcohol consumption for any leukemia subtypes. In conclusion, even though our study did not show a clear association between alcohol intake and leukemia risk, some of the patterns of the risk estimates (a possible J-shaped dose-response curve between alcohol intake and ALL, AML, and CLL risks, and the positive association between alcohol and CML), may be suggestive.