Alcohol consumption and risk of cardiovascular disease, cancer and mortality: a prospective cohort study

Association between alcohol consumption and all-cause mortality, cardiovascular disease, and chronic kidney disease: A prospective cohort study

In recent years, significant progress has been achieved in comprehending the impact of alcohol consumption on adverse health outcomes. However, the quality of evidence remains limited. Our objective was to conduct a prospective study examining the relationship between different types of alcoholic beverages and the risk of all-cause mortality, cardiovascular disease (CVD), and chronic kidney disease (CKD), and identifying the thresholds of safe dose stratified by sex using data from the UK Biobank. 502,490 participants were enrolled. These participants were initially registered between 2006 and 2010, and underwent reassessment between 2012 and 2013. All participants completed a detailed questionnaire on their alcohol consumption, including total alcohol consumption yesterday, weekly consumption of red wine, champagne plus white wine, beer, spirits, and fortified wine. All-cause mortality and the incidence of CVD and CKD were considered as the primary outcomes. 2852 participants reported CKD during a median follow-up period of 11.94 years, while 79,958 participants reported CVD over a median follow-up period of 11.35 years. Additionally, 18,923 participants died over a median follow-up period of 11.89 years. After adjusting for variables such as age, sex, education level, smoking status, diet score, and exercise score, total alcohol consumption showed a U-shaped relationship with the risk of CVD and all-cause mortality, but showed an inverse association with the risk of CKD. Upon further classification of alcoholic beverages, our analysis revealed that red wine, champagne plus white wine, beer, spirits, and fortified wine presented a U-shaped relationship with the risk of all-cause mortality and CKD. However, spirits were positively associated with the risk of CVD, only red wine, champagne plus white wine, beer, and fortified wine showed a U-shaped relationship with the risk of CVD. The safe doses of total alcohol consumption should be < 11 g/d for males and < 10 for females, red wine consumption should be < 7 glasses/week for males and < 6 for females, champagne plus white wine consumption should be < 5 glasses/week, and fortified wine consumption should be < 4 glasses/week. Red wine, champagne plus white wine, beer, and fortified wine below the corresponding thresholds of safe dose in our analysis were significantly associated with a lower risk of all-cause mortality, CVD, and CKD. And these alcoholic beverages under safe doses exhibited a protective effect against conditions like diabetes, depression, dementia, epilepsy, liver cirrhosis, and other digestive diseases, while didn't increase the risk of cancer.

Sex differences in heart disease prevalence among individuals with spinal cord injury: A population-based study

CONTEXT/OBJECTIVE

The risk for cardiovascular disease is amplified following spinal cord injury, but whether risk differs between the sexes remains unknown. Here, we evaluated sex differences in the prevalence of heart disease among individuals with spinal cord injury, and compared sex differences with able-bodied individuals.

DESIGN

The design was a cross-sectional study. Multivariable logistic regression analysis was conducted, using inverse probability weighting to account for the sampling method and to adjust for confounders.

SETTING

Canada.

PARTICIPANTS

Individuals who participated in the national Canadian Community Health Survey.

INTERVENTIONS

Not applicable.

OUTCOME MEASURES

Self-reported heart disease.

RESULTS

Among 354 individuals with spinal cord injury, the weighted prevalence of self-reported heart disease was 22.9% in males and 8.7% in females, with an inverse-probability weighted odds ratio of 3.44 (95% CI 1.70-6.95) for males versus females. Among 60,605 able-bodied individuals, the prevalence of self-reported heart disease was 5.8% in males and 4.0% in females, with an inverse probability weighted odds ratio of 1.62 (95% CI 1.50-1.75) for males versus females. The effect of male sex on increasing heart disease prevalence was about two times higher among individuals with spinal cord injury than able-bodied individuals (relative difference in inverse probability weighted odds ratios = 2.12, 95% CI 1.08-4.51).

CONCLUSION

Males with spinal cord injury exhibit a significantly higher prevalence of heart disease, compared with females with spinal cord injury. Moreover, relative to able-bodied individuals, spinal cord injury amplifies sex-related differences in heart disease. Overall, this work will inform targeted cardiovascular prevention strategies, and may also inform a better understanding of cardiovascular disease progression in both able-bodied and individuals with spinal cord injury.

Selected Psychosocial Factors, Nutritional Behavior, and the Analysis of Concentrations of Selected Vitamins in Patients with Cardiovascular Diseases

Cardiovascular diseases (CVD) are the leading cause of death worldwide, influenced by the interaction of factors, including age, sex, genetic conditions, overweight/obesity, hypertension, an abnormal lipid profile, vitamin deficiencies, diabetes, and psychological factors. This study aimed to assess the relationships between psychosocial and nutritional factors in a group of 61 patients with CVD (i.e., atherosclerosis, hypertension, ischemic heart disease, and myocardial infarction) and their possible impact on the course of the disease. The plasma concentrations of vitamins A, E, D, and β-carotene were determined using validated HPLC-MS/MS, while the lipid profile was analyzed enzymatically. Psychosocial factors and nutritional behaviors were assessed using author-designed questionnaires. Over 50% of patients had 25-OH-D3 and retinol deficiencies, while >85% of patients exhibited significant deficiencies in α-tocopherol and β-carotene. The lipid profile showed no specific relationship with any particular CVD. Dietary behavior minimally impacted biochemical parameters except for higher β-carotene concentrations in the group with higher fruit and vegetable intake. The negative impact of the CVD on selected parameters of quality of life was noticed. To increase the effectiveness of the prevention and treatment of CVD, the need for interdisciplinary cooperation observed between doctors, psychologists, and specialists in human nutrition seems to be justified.

Lifestyle-Related Risk Factors and Primary Prevention Strategies for Cardiovascular Diseases in a Middle-Income Country: A Scoping Review and Implication for Future Research

Cardiovascular diseases are the leading cause of death in middle-income countries such as Malaysia. There is a significant gap in knowledge between cardiovascular disease-related risk assessments and interventions in the Malaysian population. In this scoping review, we have determined the status of cardiovascular research in Malaysia by prioritising lifestyle-related risk assessments and interventions. We searched five electronic databases (Ovid MEDLINE, Cochrane Central Register of Controlled Trials, APA PsychINFO, Embase and Scopus) to identify relevant research articles that had been published. The Joanna Briggs Institute and the preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews served as a guide for the scoping review. Study selection was made using the Covidence platform, screened, and extracted. Thirty-one studies were included in this review. Studies reviewed reported a significant positive association between physical inactivity, smoking, poor dietary patterns, working hours, clustering of lifestyle risk, and cardiovascular disease risk. Most interventions focused on physical activity and a multimodal lifestyle approach, significantly improving primary and secondary cardiovascular disease-related outcomes. The findings suggest improving lifestyle-related risk assessments and interventions to prevent cardiovascular diseases in this population. It is unclear if these outcomes can translate to higher effectiveness in preventing cardiovascular disease. Nevertheless, intervention using the multifaceted lifestyle approach can improve cardiovascular disease-related outcomes.

The estimated 10-year risk of first-onset cardiovascular disease in Swedish-born and non-Swedish-born primary healthcare patients

BACKGROUND

SCORE2 has been introduced as an updated risk assessment tool for calculating the 10-year risk of first-onset cardiovascular disease (CVD). However, it does not account for ethnicity or socioeconomic status, known to affect CVD risk. This study investigated and compared SCORE2 estimates in Swedish-born and non-Swedish-born primary healthcare patients. The second aim was to examine if several risk factors could explain differences in CVD risk between the groups.

METHODS

This was an observational, cross-sectional study. Data were obtained from the 4D Diabetes Project study, providing a total of 444 participants aged between 40 and 69 years. All participants had complete risk variable data necessary for the SCORE2 tool and no history of previous CVD. Descriptive analysis was conducted to compare distributions of risk factors between Swedes and immigrants and odds ratios of risk factors amongst these two groups in correlation to elevated CVD risk were calculated using logistic regression.

RESULTS

Swedish-born patients showed a significantly higher risk of elevated CVD risk estimates (≥ 2.5% CVD risk increase for individuals < 50 years, respectively, ≥ 5% for individuals aged 51-69) than the non-Swedish-born population, even after adjustment for educational level (OR = 1.61, 95% CI 1.08-2.39). Weekly alcohol consumption implicated a risk of being classified as high risk of CVD risk, regardless of country of birth (OR = 1.93 CI 1.25-3.00). However, Swedes accounted for most of the alcohol consumption (62.6% vs. 19.6%). No other explanatory variable showed significance in association with elevated CVD risk.

CONCLUSIONS

Swedish-born patients were found to be at higher risk of an increased 10-year CVD risk. The association of alcohol consumption with elevated CVD risk needs to be further studied in longitudinal studies in representative populations, notably among Sweden's diverse ethnic groups.

Healthy Lifestyle and the Likelihood of Becoming a Centenarian

Importance

Previous studies have reported that lifestyle factors were associated with life expectancy and/or mortality, but most of them studied the middle-aged or older age groups (aged ≥60 years), and few focused on people aged 80 years or older.

Objectives

To examine healthy lifestyle and the likelihood of becoming centenarians among people aged 80 years or older in China.

Design, Settings, and Participants

Using data from the Chinese Longitudinal Healthy Longevity Survey, a nationally representative and one of the largest prospective cohorts targeting people aged 80 years or older established in 1998, a community-based, prospective nested case-control study was performed. Data were analyzed from December 1, 2022, to April 15, 2024.

Exposures

A healthy lifestyle score for 100 (HLS-100, ranging from 0 to 6), including smoking, exercise, and dietary diversity, was constructed, with higher scores indicating potentially better health outcomes.

Main Outcomes and Measures

The primary outcome was survivorship to becoming a centenarian by 2018 (the end of follow-up). Information on sociodemographic characteristics, lifestyle factors, and other covariates was collected.

Results

The sample comprised 5222 individuals (61.7% women, mean [SD] age, 94.3 [3.3] years), including 1454 identified centenarians and 3768 controls (died before becoming centenarians) matched by age, sex, and year of entry. During a median follow-up of 5 (IQR, 3-7) years, 373 of 1486 individuals among the lowest HLS-100 (0-2) group and 276 of 851 individuals among the highest HLS-100 (5-6) group became centenarians. The adjusted odds ratio (AOR) comparing the highest vs the lowest HLS-100 groups was 1.61 (95% CI, 1.32-1.96; P < .001 for trend). An association was noted when we further treated centenarians with relatively healthy status as the outcome, as evaluated by self-reported chronic conditions, physical and cognitive function, and mental wellness (AOR, 1.54; 95% CI, 1.05-2.26). Similar results were observed in other sensitivity analyses.

Conclusions and Relevance

In this case-control study of Chinese older adults, adhering to a healthy lifestyle appears to be important even at late ages, suggesting that constructing strategic plans to improve lifestyle behaviors among all older adults may play a key role in promoting healthy aging and longevity.

Association analysis between an epigenetic risk score and blood pressure

Background

Epigenome-wide association studies have revealed multiple DNA methylation sites (CpGs) associated with alcohol consumption, an important lifestyle risk factor for cardiovascular diseases.

Results

We generated an alcohol consumption epigenetic risk score (ERS) based on previously reported 144 alcohol-associated CpGs and examined the association of the ERS with systolic blood pressure (SBP), diastolic blood pressure (DBP), and hypertension (HTN) in 3,898 Framingham Heart Study (FHS) participants. We found an association of alcohol intake with the ERS in the meta-analysis with 0.09 units higher ERS per drink consumed per day (p < 0.0001). Cross-sectional analyses in FHS revealed that a one-unit increment of the ERS was associated with 1.93 mm Hg higher SBP (p = 4.64E-07), 0.68 mm Hg higher DBP (p = 0.006), and an odds ratio of 1.78 for HTN (p < 2E-16). Meta-analysis of the cross-sectional association of the ERS with BP traits in eight independent external cohorts (n = 11,544) showed similar relationships with blood pressure levels, i.e., a one-unit increase in ERS was associated with 0.74 (p = 0.002) and 0.50 (p = 0.0006) mm Hg higher SBP and DBP, but could not confirm the association with hypertension. Longitudinal analyses in FHS (n = 3,260) and five independent external cohorts (n = 4,021) showed that the baseline ERS was not associated with a change in blood pressure over time or with incident HTN.

Conclusions

Our findings provide proof-of-concept that utilizing an ERS is a useful approach to capture the recent health consequences of lifestyle behaviors such as alcohol consumption.

Association analysis between an epigenetic alcohol risk score and blood pressure

Background

Epigenome-wide association studies have revealed multiple DNA methylation sites (CpGs) associated with alcohol consumption, an important lifestyle risk factor for cardiovascular diseases.

Results

We generated an alcohol consumption epigenetic risk score (ERS) based on previously reported 144 alcohol-associated CpGs and examined the association of the ERS with systolic blood pressure (SBP), diastolic blood pressure (DBP), and hypertension (HTN) in 3,898 Framingham Heart Study (FHS) participants. We found an association of alcohol intake with the ERS in the meta-analysis with 0.09 units higher ERS per drink consumed per day (p < 0.0001). Cross-sectional analyses in FHS revealed that a one-unit increment of the ERS was associated with 1.93 mm Hg higher SBP (p = 4.64E-07), 0.68 mm Hg higher DBP (p = 0.006), and an odds ratio of 1.78 for HTN (p < 2E-16). Meta-analysis of the cross-sectional association of the ERS with BP traits in eight independent external cohorts (n = 11,544) showed similar relationships with blood pressure levels, i.e., a one-unit increase in ERS was associated with 0.74 (p = 0.002) and 0.50 (p = 0.0006) mm Hg higher SBP and DBP, but could not confirm the association with hypertension. Longitudinal analyses in FHS (n = 3,260) and five independent external cohorts (n = 4,021) showed that the baseline ERS was not associated with a change in blood pressure over time or with incident HTN.

Conclusions

Our findings provide proof-of-concept that utilizing an ERS is a useful approach to capture the recent health consequences of lifestyle behaviors such as alcohol consumption.

Exploring the contribution of lifestyle to the impact of education on the risk of cancer through Mendelian randomization analysis

Educational attainment (EA) has been linked to the risk of several types of cancer, despite having no expected direct biological connection. In this paper, we investigate the mediating role of alcohol consumption, smoking, vegetable consumption, fruit consumption and body mass index (BMI) in explaining the effect of EA on 7 cancer groupings. Large-scale genome wide association study (GWAS) results were used to construct the genetic instrument for EA and the lifestyle factors. We conducted GWAS in the UK Biobank sample in up to 335,024 individuals to obtain genetic association data for the cancer outcomes. Univariable and multivariable two-sample Mendelian randomization (MR) analyses and mediation analyses were then conducted to explore the causal effect and mediating proportions of these relations. MR mediation analysis revealed that reduced lifetime smoking index accounted for 81.7% (49.1% to 100%) of the protective effect of higher EA on lower respiratory cancer. Moreover, the effect of higher EA on lower respiratory cancer was mediated through vegetable consumption by 10.2% (4.4% to 15.9%). We found genetic evidence that the effect of EA on groups of cancer is due to behavioural changes in avoiding well established risk factors such as smoking and vegetable consuming.

Long-Term Consumption of 6 Different Beverages and Cardiovascular Disease-Related Mortality: A Systematic Review and Meta-Analysis of Prospective Cohort Studies

The relationship between beverage consumption and risk of cardiovascular disease has been extensively examined in cross-sectional studies. However, limited studies have investigated beverage consumption as a longer-term habitual behavior, which is important owing to potential cumulative harmful or beneficial cardiovascular effects. We examined the association between the long-term consumption of 6 types of beverages (sugar-sweetened or artificially sweetened beverages, tea, coffee, fruit juice, energy drinks, and alcohol) and cardiovascular mortality, by considering sex differences. We conducted a systematic search of MEDLINE, EMBASE, CINAHL, Web of Science, and Scopus databases from 2010 to December 2023. Of 8049 studies identified, 20 studies were included for meta-analysis. Summary hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated with the use of a random-effects model. We found that long-term coffee consumption was related to reduced cardiovascular disease-related mortality in males (pooled HR: 0.63; 95% CI: 0.46, 0.87; P = 0.005) but not in females (HR: 0.78; 95% CI: 0.60, 1.02; P = 0.07). Long-term higher intake of tea was associated with lower risk of cardiovascular disease-related mortality in all adults (pooled HR: 0.81; 95% CI: 0.72, 0.92; P ≤ 0.001). Higher alcohol intake was linked to higher stroke in both males (pooled HR: 1.44; 95% CI: 1.06, 1.94; P = 0.02) and females (pooled HR: 2.26; 95% CI: 1.34, 3.81; P = 0.002). Higher sugar-sweetened beverage intake was in relation to higher cardiovascular disease-related mortality (pooled HR: 1.31; 95% CI: 1.16, 1.46; P ≤ 0.0001). We concluded that long-term habitual coffee consumption is beneficial for males, and tea consumption is beneficial for all adults. Long-term high alcohol and sugar-sweetened beverage consumption increased risk of cardiovascular disease-related mortality for both males and females. However, we were unable to draw conclusions on the potential benefit or harm of the long-term consumption of fruit juice and energy drinks on cardiovascular disease-related mortality owing to the limited number of studies available. This review was registered at PROSPERO as CRD42020214679.

Life's essential 8 and risk of all-cause mortality in individuals with cardiovascular diseases: A prospective community-based study

BACKGROUND

Although risk factors for mortality in individuals with cardiovascular diseases (CVD) have been reported, little is known regarding the association between the comprehensive cardiovascular health (CVH) index assessed by life's essential 8 (LE8) and the risk of mortality.

HYPOTHESIS

The aim of this study was to evaluate the CVH assessed by LE8 and risk of mortality in individuals with CVD.

METHODS

A total of 1391 participants with CVD diagnosed before 2014 from the Kailuan cohort were included in the analysis. The CVH score ranged from 0 to 100 was assessed using the LE8 metrics (diet quality, physical activity, sleep health, cigarette smoking, body mass index, lipids, blood glucose, and blood pressure). Cox regression model was used to estimate the association between the CVH score and risk of all-cause mortality.

RESULTS

During a mean follow-up of 6.1 ± 1.5 years, 229 deaths occurred. The hazard ratio for all-cause mortality was 0.57 (95% confidence interval [CI]: 0.38, 0.84) in the highest quartiles compared with the lowest quartiles of CVH scores and 0.85 (95% CI: 0.75, 0.95) for each 10 points increment in CVH scores (ptrend  = .009), after adjustment for age, sex, CVD duration, social-economic status, alcohol consumption, inflammation, medicine use, and kidney function. We did not observe significant interactions between the CVH scores and age, sex, and duration of CVD diagnosis (pinteraction  > .05 for all).

CONCLUSIONS

The CVH assessed by the LE8 metrics was associated with a lower risk of all-cause mortality in individuals with CVD.

An Epidemiological Study on Legionnaires' Disease in Gyeonggi Province, Korea: Occurrence, Infection Routes, and Risk Factors for Mortality (2016-2022)

Background and Objectives: Legionnaires' disease (LD) is an acute respiratory disease with increasing annual numbers of reported domestic and global cases. This study aimed to establish foundational data for the prevention and control of LD by investigating the occurrence and infection routes of reported and suspected cases of LD in Gyeonggi Province, Korea, from January 2016 to December 2022, and by and analyzing the risk factors for death. Materials and Methods: A sex-and-age standardization was performed on LD patients and suspected cases reported in Gyeonggi Province. The monthly average number of confirmed cases was visualized using graphs, and a survival analysis was performed using Kaplan-Meier survival curves. The mortality risk ratio was estimated using the Cox proportional hazards model. Results: The incidence of LD in Gyeonggi Province mirrored the national trend, peaking in July with the highest number of confirmed and suspected cases. While there was no significant difference in survival rates by age, the survival rate was higher for suspected cases when analyzed separately. Comparing the death ratio by infection route, nosocomial infections showed the highest death ratio, and intensive care unit (ICU) admission and the presence of coinfections were significantly correlated with mortality. Factors such as nosocomial infection, admission within 1 to 3 days following diagnosis, and the development of complications were factors contributing to a higher risk of death. Conclusions: The general characteristics of patients with LD were similar to those suggested by previous studies. The proportion of community-acquired infections was lower than in previous studies, but the length of hospital stay was similar for survivors and the deceased, and the mortality rate within 30 days after diagnosis was higher for nosocomial infections. In conclusion, nosocomial infection, a period of up to 3 days from admission to diagnosis, and complications were significantly related to the mortality rate of LD.

Solid herbal extract of Primula veris L. improves morphofunctional condition of rats’ myocardium in chronic alcohol intoxicat

Background and aim

Chronic alcohol intoxication (CAI) induces heart damage. One of the promising ways of its treatment involves the administration of herbal medicinal products. The purpose of this study was to explore the effect of solid herbal extract of Primula veris L. (PVSHE) on the morphofunctional changes in rats' myocardium after CAI.

Experimental procedure

CAI was simulated for 24 weeks. Loading testing was used to assess the functional condition of the heart, the functional assessment of mitochondria was based on the polarographic determination of oxygen consumption rate and determination of the indices of lipid peroxidation and antioxidant enzymes activity. We performed a microscopic examination of the left ventricle following the standard protocol of histological processing and h&e staining.

Results and conclusion

PVSHE restricts the toxic effects of ethanol on the heart which was indicated by a higher rise in the rates of myocardial contraction (by an average of 3.9 times, P < 0.05) and relaxation (2.6 times under volume load, P < 0.05), LVP (by an average of 1.7 times, P < 0.05) and MISP (by an average of 1.5 times, P < 0.05). PVSHE caused an improvement in the functional state of rats' cardiac mitochondria exposed to CAI, which was demonstrated by on average 1.3-1.4 times (P < 0.05) as high RCR as compared to the control group. The histological examination of the myocardium of the animals treated with PVSHE showed the increase in the volume fraction of cardiac myocytes, and a 31.2% (P < 0.05) decline in the interstitial volume. Therefore, PVSHE has a protective effect on the heart after CAI.

Association between triglyceride-glucose index and risk of cardiovascular disease among postmenopausal women

OBJECTIVE

We aimed to examine the association of triglyceride-glucose index (TyG) with risk for cardiovascular disease (CVD) among postmenopausal women.

METHODS

A total of 7741 participants met the inclusion criteria, and were included in the analysis. The TyG index was calculated as ln (triglyceride [mg/dL] × fasting blood glucose [mg/dL]/2). The participants were classified into four groups by the quartiles of TyG index, and the Q1 group was used as the reference group. The cumulative incidence of CVD for the groups were compared using the Kaplan-Meier curves. The association between the TyG index and risk of CVD among postmenopausal women was assessed by the Cox proportional hazards models (hazard ratio [HR], 95% confidence intervals [CI]).

RESULTS

During a median follow-up of 12 years, a total of 383 (4.95%) participants developed incident CVD. After adjusting for potential confounding factors, a high baseline TyG index (Q4 group) was associated with higher future risk of CVD, the HR (95% CI) of CVD risk was 1.70 (1.21-2.38) in Q4 group compared with the Q1 group. Subgroup analyses showed the Q4 group was significantly associated with the risk of CVD, regardless of age at menopause (younger than 50 years; 50 years and older) and obesity status.

CONCLUSIONS

Higher TyG index at baseline as a marker of insulin resistance (IR), is associated with higher risk of future CVD among postmenopausal women. The TyG index may serve as a simple and easy marker for early identification of high-risk individuals in the postmenopausal women.

Sixteen-year trends in multiple lifestyle risk behaviours by socioeconomic status from 2004 to 2019 in New South Wales, Australia

Few studies have examined trends in inequalities related to lifestyle risk behaviours. This study examined 1) 16-year (2004-2019) trends of individual lifestyle risk factors and a combined lifestyle risk index and 2) trends in socioeconomic inequalities in these risk factors, in New South Wales (NSW; Australia) adults. Data was sourced from the NSW Adult Population Health Survey, an annual telephone survey of NSW residents aged ≥16 years, totalling 191,905 completed surveys. Excessive alcohol consumption, current smoking, insufficient physical activity, insufficient fruit and/or vegetable consumption, sugar-sweetened beverage [SSB] consumption, and a combined lifestyle risk index (overall high-risk lifestyle defined as total number of lifestyle risk behaviours ≥2) were examined. Socioeconomic status was assessed using education attainment, postal area-level disadvantage measured by Index of Relative Socioeconomic Disadvantage (IRSD), and remoteness based on Accessibility-Remoteness Index of Australia Plus (ARIA+). Socioeconomic inequalities were examined as prevalence difference for absolute inequalities and prevalence ratio for relative inequalities. The prevalence of lifestyle behaviours by levels of each socioeconomic status variable were estimated using predicted probabilities from logistic regression models. After adjusting for covariates, there was a decrease in prevalence over time for most lifestyle risk behaviours. Between 2004 and 2019, the prevalence decreased for current smoking from 21.8% to 17.1%, insufficient physical activity from 39.1% to 30.9%, excessive alcohol consumption from 15.4% to 13.7%, daily SSB consumption from 29.9% to 21.2%, and overall high-risk lifestyle from 50.4% to 43.7%. Socioeconomic inequalities, based on one or more of the socioeconomic variables, increased over time for current smoking, insufficient physical activity, daily SSB consumption, and an overall high-risk lifestyle. Overall, the health behaviours of the NSW population improved between 2004 and 2019. However, some socioeconomic inequalities increased during this time, highlighting the need for effective public health strategies that seek to improve health behaviours among the most socioeconomically disadvantaged.

Complete alcohol abstinence increases the risk of NAFLD but not severity. A population analysis with transient elastography

BACKGROUND & AIMS

As the global prevalence of non-alcoholic fatty liver disease (NAFLD) continues to rise, ubiquity of alcohol use has also prompted discussion regarding the potential interactions between the two. This study aims to examine the effects of modest alcohol consumption on the prevalence and complications of NAFLD in a multi-ethnic population.

METHODS

This study analyses the 2017-2018 cycles of NHANES that examined liver fibrosis and steatosis with vibration controlled transient elastography. A coarsened exact matching was conducted to reduce confounding. Logistic regression was done with a multivariate model to assess the relationship between alcohol consumption (modest drinkers and non-drinkers) and risk of NAFLD and its complications.

RESULTS

2,067 individuals were found to have NAFLD and 284 NAFLD patients had a total history of alcohol abstinence. After coarsened exact matching, the prevalence of NAFLD was 49% (CI: 0.41 - 0.58) in non-drinkers and 33% (CI: 0.26 - 0.41) in modest drinkers. Non-drinkers had twice the odds of NAFLD compared to modest drinkers (OR: 1.99, CI: 1.22 - 3.22, p<.01) after adjustment for confounders. There were no significant differences in the odds of significant fibrosis, advance fibrosis, cirrhosis, cardiovascular disease and stroke between non-drinkers and modest drinkers. The odds of malignancy in non-drinkers were almost significantly less than modest drinkers (OR: 0.28, CI:0.08 - 1.02, p=.053).

CONCLUSION

Interestingly, modest alcohol consumption is associated with decreased odds of NAFLD. Further investigations are required to examine the relationship between alcohol consumption and NAFLD and subsequently the potential impact on NAFLD management.

Diet Quality is Associated with Prodromal Parkinson's Disease Features in Chinese Adults

BACKGROUND

The prodromal phase of Parkinson's disease (PD) is a critical window for prevention by modifying lifestyle factors. However, there is limited knowledge on how diet quality is associated with prodromal PD symptoms in Asian populations.

OBJECTIVE

To examine the association between overall diet quality and prodromal PD features.

METHODS

A total of 71,640 Chinese participants who were free of PD were included in this cross-sectional study. Diet quality was assessed using the modified Alternative Healthy Eating Index (mAHEI) and alternate Mediterranean Diet (aMED). Five prodromal features including probable rapid eye movement sleep behavior disorder (pRBD), hyposmia, excessive daytime sleepiness, constipation, and depressive symptom were measured using validated questionnaires. Logistic regression was used to calculate the odds ratio (OR) for having a combination of prodromal PD symptoms (1 and 2+ symptoms vs. 0 symptoms), adjusting for age, sex, lifestyle factors, total energy intake, and other potential confounders.

RESULTS

In the multivariable-adjusted model, the OR for having 2+ versus 0 prodromal PD features was 0.64 (95% confidence interval [CI]: 0.49, 0.85) comparing the highest versus the lowest mAHEI diet quality quartiles with a significant inverse trend (P-trend = 0.003). For individual prodromal PD features, better diet quality, as assessed by the mAHEI, was associated with lower odds of having excessive daytime sleepiness and constipation (P-trend < 0.05 for both). We observed a marginally significant association between aMED and prodromal PD features (adjusted OR comparing the extreme quartiles = 0.74; 95% CI: 0.55, 0.98; P-trend = 0.09).

CONCLUSION

Better diet quality, as assessed by the mAHEI and the aMED, was associated with lower probability of having prodromal PD features in Chinese adults. © 2022 International Parkinson and Movement Disorder Society.

Dietary Therapy in Prevention of Cardiovascular Disease (CVD)—Tradition or Modernity? A Review of the Latest Approaches to Nutrition in CVD

The development of cardiovascular diseases is undoubtedly influenced by improper dietary behavior. The most common mistakes include irregularity of meal consumption, high dietary atherogenicity: snacking on sweets between meals, low supply of dietary fiber, unsaturated fatty acids, legume seeds, and high supply of meat and meat products. Among many food components, some are characterized by a specific cardioprotective effect, which means that their supply of food may prevent the occurrence of cardiovascular disease or improve the health of the sick. Coenzyme Q10 (CoQ10) is one of the ingredients showing cardioprotective effects on the heart and blood vessels. Antioxidant and lipid profile-enhancing effects are also attributed to sitosterol which is one of the plant-derived sterols. A very important argument indicating the necessity of a varied diet rich in a variety of plant products is the beneficial effect of polyphenols, which are most abundant in multicolored vegetables and fruits. Numerous studies show their effectiveness in lowering blood pressure, improving lipid profile, and regeneration of vascular endothelium. The collected publications from the field of lifestyle medicine can be a source of knowledge for dieticians, physicians, and people associated with physical culture and human mental health to prevent the development of cardiovascular diseases and reduce the risk of death from this cause.

Red wine but not alcohol consumption improves cardiovascular function and oxidative stress of the hypertensive-SHR and diabetic-STZ rats

AIMS

This raised the issue of whether in vivo long-term red wine treatment can act as a modulator of these targets.

MAIN METHODS

We monitored SBP, glucose tolerance, oxidative stress, and cardiovascular function. Aortic and atrial tissues from normotensive-WKY, hypertensive-SHR, and diabetic-STZ animals, chronically exposed to red wine (3.715 ml/kg/v.o/day) or alcohol (12%) for 21-days, were used to measure contractile/relaxation responses by force transducers. Key findings: red wine, but not alcohol, prevented the increase of SBP and hyperglycemic peak. Additionally, was observed prevention of oxidative stress metabolites formation and an improvement in ROS scavenging antioxidant capacity of SHR. We also revealed that red wine intake enhances the endothelium-dependent relaxation, decreases the hypercontractile mediated by angiotensin-II in the aorta, and via β₁-adrenoceptors in the atrium.

SIGNIFICANCE

The long-term consumption of red wine can improve oxidative stress and the functionality of angiotensin-II and β₁-adrenoceptors, inspiring new pharmacologic and dietetic therapeutic approaches for the treatment of hypertension and diabetes.Abbreviation Acronyms and/or abbreviations: [Ca²⁺]_cyt = Cytosolic Ca²⁺ Concentration; ACh = Acetylcholine; ANG II = Angiotensin II; AT1 = ANG II type 1 receptor; AUC = Area Under the Curve; Ca²⁺ = Calcium; Endo + = Endothelium Intact; Fen = Phenylephrine (1 μM); GTT = Glucose Tolerance Test; ISO = Isoprenaline (isoproterenol); KHN = Krebs-Henseleit Nutrient; LA = Left Atria; LH = Lipid Hydroperoxide; NO = Nitric Oxide; RA = Right Atria; RAS = Renin-Angiotensin System; ROS = Reactive Oxygen Species; SBP = Systolic Blood Pressure; SHR = Spontaneously Hypertensive Rats; STZ = Streptozotocin; WKY = Normotensive Wistar Kyoto Rats.

Effects of Regular Low-Level Alcohol Consumption in Healthy Individuals: A Randomized, Double-Blind, Placebo-Controlled Crossover Study

The effects of alcohol consumption on health are suggested to depend on the amount of alcohol consumed. We investigated the objective and subjective health effects of the daily consumption of a small amount of alcohol in healthy individuals using a randomized, double-blind, placebo-controlled crossover study. Accordingly, 15 male and 27 female Japanese adults with average or lower general well-being schedule (GWBS) scores were asked to consume a beverage with 0.5% (v/v) alcohol (~4 g of alcohol a day; test beverage) and a placebo beverage two times daily for 4 weeks each. Regular low-level alcohol consumption significantly decreased the serum liver function indexes (aspartic aminotransferase, alanine aminotransferase, and lactate dehydrogenase) before and after consumption (p = 0.034, 0.033, and 0.013, respectively). The small amount of alcohol did not affect the participants’ GWBS scores; however, a stratified analysis with poor subjective well-being revealed that these changes differed significantly between low-level alcohol consumption and placebo-treated subjects (16.0 vs. 11.5, p = 0.041). In addition, changes in serum testosterone levels demonstrated a higher trend in the group that received the test beverage compared with the group that received the placebo beverage (p = 0.051). Daily low-level alcohol consumption may have positive effects on liver function and subjective well-being.

Physical activity time and lifestyle correlates of cardiovascular disease status in older adults in Accra

Aim

The maintenance of physical activity (PA) over the life course is considered a hallmark for ageing well, but individuals who practice PA also often pursue lifestyles (e.g., smoking) that may inhibit the medicinal impact of PA on them. PA is said to protect against cardiovascular diseases (CVDs), but the literature has little to say about the impact of PA on the risk of CVDs when it is associated with lifestyle factors, comorbidities, and personal characteristics. This study aimed to assess the association between PA time and CVDs, with relevant lifestyle factors, comorbidities, and personal characteristics treated as covariates.

Subject and methods

The study’s population was retired and working older people aged 60 years or more in Accra, Ghana. A total of 686 individuals responded to self-reported questionnaires. Pearson’s chi-square test and binary logistic regression were used to present findings.

Results

The study found that the risk of having one or more CVDs increases as time spent in moderate and vigorous PA increases, whereas individuals who drank alcohol a few days a week or most days a week are respectively 2 (OR = 2.415; p = 0.037) and 22 (OR = 21.933; p = 0.000) times more likely to have one or more CVDs compared to those who never drank alcohol.

Conclusion

Health education should not only encourage PA maintenance but should also make individuals aware of the need to avoid unhealthy behaviours to maximize the positive effect of PA on health.

Alcohol Consumption and Cardiovascular Disease Risk: Placing New Data in Context

Purpose of Review

A clear link between excessive alcohol consumption and cardiovascular disease (CVD) has been established, but no consensus exists on the effects of moderate alcohol consumption on CVD.

Recent Findings

A lower risk of coronary heart disease and myocardial infarction among moderate drinkers compared to abstainers has been consistently observed in epidemiological studies and meta-analyses of these studies. However, ambiguity remains on the effect of alcohol on other CVDs and all-cause mortality. Short-term randomized controlled trials (RCT) have identified potentially beneficial effects of alcohol consumption on cardiovascular risk factors, but studies investigating genetic polymorphisms that influence alcohol consumption (i.e., Mendelian randomization) have yielded inconclusive results. To date, a long-term RCT providing causal evidence is lacking but urgently needed.

Summary

Triangulation of evidence from different study designs, including long-term RCTs, pragmatic trials and the evaluation of policy measures, combined will lead to the best available evidence.

Alcohol and Metabolic-associated Fatty Liver Disease

The diagnosis of metabolic-associated fatty liver disease is based on the detection of liver steatosis together with the presence of metabolic dysfunction. According to this new definition, the diagnosis of metabolic-associated fatty liver disease is independent of the amount of alcohol consumed. Actually, alcohol and its metabolites have various effects on metabolic-associated abnormalities during the process of alcohol metabolism. Studies have shown improved metabolic function in light to moderate alcohol drinkers. There are several studies focusing on the role of light to moderate alcohol intake on metabolic dysfunction. However, the results from studies are diverse, and the conclusions are often controversial. This review systematically discusses the effects of alcohol consumption, focusing on light to moderate alcohol consumption, obesity, lipid and glucose metabolism, and blood pressure.

Co-Occurrence and Clustering of Sedentary Behaviors, Diet, Sugar-Sweetened Beverages, and Alcohol Intake among Adolescents and Adults: The Latin American Nutrition and Health Study (ELANS)

Poor diet, sedentary behaviors, sugar-sweetened beverages (SSB) and alcohol intake seem to co-exist in complex ways that are not well understood. The aim of this study was to provide an understanding of the extent to which unhealthy behaviors cluster in eight Latin America countries. A secondary aim was to identify socio-demographic characteristics associated with these behaviors by country. Data from adolescents and adults from the “Latin American Health and Nutrition Study” was used and the prevalence of screen-time, occupational and transportation–sedentary time, socializing with friends, poor diet, SSB and alcohol intake, alone and in combination, were identified. The eight Latin America (LA) countries added to analyses were: Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru, and Venezuela. Logistic regression was used to estimate associations between ≥2 behaviors clustering, socio-demographics and weight status. Among 9218 individuals, the most prevalent behaviors were transportation and occupation–sedentary time, SSB and alcohol intake. Younger, female, married/living with a partner, low and middle-income and obese individuals had higher chances for these clustering behaviors. These results provide a multi-country level of understanding of the extent to which behaviors co-occur in the LA population.