On the evidence of a cardioprotective effect of alcohol consumption

Alcohol, cardiovascular disease and industry funding: A co-authorship network analysis of systematic reviews

BACKGROUND

Alcohol's effects on heart health is the site of a major scientific controversy. We conducted a co-authorship network analysis of systematic reviews on the impacts on alcohol on cardiovascular disease (CVD) in order to investigate patterns of co-authorship in the literature, with particular attention given to industry funding.

METHODS

We used Epistemonikos to identify systematic reviews. Review characteristics, influential authors, co-authorship subnetworks, prior histories of alcohol industry funding, study outcomes and citations were investigated.

RESULTS

60 systematic reviews with 231 unique authors met our inclusion criteria. 14 systematic reviews were undertaken by authors with histories of alcohol industry funding, including 5 that were funded directly by the alcohol industry itself. All 14 such reviews identified a cardioprotective effect of alcohol. These formed distinct co-authorship subnetworks within the literature. Of reviews by authors with no prior histories of alcohol industry funding, the findings were mixed, with 54% (25/46) concluding there was evidence of health protective effects. These two groups of reviews differed in other respects. Those with industry funding were more likely to study broader outcomes such as 'cardiovascular disease' or 'coronary heart disease' as opposed to specific CVD issues such as hypertension or stroke (93% [13/14] versus 41% [19/46]) (chi-squared 12.4, p < 0.001) and have more included studies (mean of 29 versus 20). They were also more widely cited by others. Over time the proportions of systematic reviews on CVD and alcohol undertaken by authors with no prior histories of alcohol industry funding has increased.

CONCLUSIONS

Systematic reviews undertaken by authors with histories of alcohol industry funding were more likely to study broader outcomes, and be cited more widely, and exclusively reported favorable conclusions.

Moderate alcohol consumption and lower total mortality risk: Justified doubts or established facts?

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.

Perceived determinants to alcohol consumption and misuse: a survey of university students

Aim:

Before an attempt is made to develop any population-specific behavioural change programme, it is important to know what the factors that influence behaviours are. The aim of this study was to identify what are the perceived determinants that attribute to young people’s choices to both consume and misuse alcohol.

Method:

Using a descriptive survey design, a web-based questionnaire based on the Theory of Triadic Influence was administered to students aged 18–29 years at one university in Northern Ireland.

Results:

Out of the total respondents ( n = 595), knowledge scores on alcohol consumption and the health risks associated with heavy episodic drinking were high (92.4%, n = 550). Over half (54.1%, n = 322) cited the Internet as their main source for alcohol-related information. The three most perceived influential factors of inclination to misuse alcohol were strains/conflict within the family home ( M = 2.98, standard deviation ( SD) = 0.18, 98.7%, n = 587), risk taking/curiosity behaviour ( M = 2.97, SD = 0.27, 97.3%, n = 579) and the desire not to be socially alienated ( M = 2.94, SD = 0.33, 96%, n = 571). Females were statistically significantly more likely to be influenced by desire not to be socially alienated than males (  p = .029). Religion and personal reasons were the most commonly cited reasons for not drinking.

Conclusion:

Future initiatives to reduce alcohol misuse and alcohol-related harms need to focus on changing social normative beliefs and attitudes around alcohol consumption and the family and environmental factors that influence the choice of young adult’s alcohol drinking behaviour. Investment in multi-component interventions may be a useful approach.