Relationship between body mass index, alcohol use, and alcohol misuse in a young adult female twin sample

Exploring the relationships between adolescent alcohol misuse and later life health outcomes

BACKGROUND

We sought to clarify the impact of adolescent alcohol misuse on adult physical health and subjective well-being. To do so, we investigated both the direct associations between adolescent alcohol misuse and early midlife physical health and life satisfaction and the indirect effects on these outcomes attributable to subsequent alcohol problems.

METHOD

The sample included 2733 twin pairs (32% monozygotic; 52% female) from the FinnTwin16 study. Adolescent alcohol misuse was a composite of frequency of drunkenness, frequency of alcohol use, and alcohol problems at ages 16, 17, and 18.5. The early midlife outcomes included somatic symptoms, self-rated health, and life satisfaction at age 34. The mediators examined as part of the indirect effect analyses included alcohol problems from the Rutgers Alcohol Problem Index at ages 24 and 34. Serial mediation and co-twin comparison models were applied and included covariates from adolescence and early midlife.

RESULTS

There were weak direct associations between adolescent alcohol misuse and early midlife physical health and life satisfaction. However, there was stronger evidence for indirect effects, whereby young adult and early midlife alcohol problems serially mediated the relationship between adolescent alcohol misuse and early midlife somatic symptoms (β = 0.03, 95% CI [0.03, 0.04]), self-rated health (β = -0.02, 95% CI [-0.03, -0.01]), and life satisfaction (β = -0.03, CI [-0.04, -0.02]). These serial mediation effects were robust in co-twin comparison analyses.

CONCLUSIONS

These results provide evidence that alcohol problems are a primary driver linking adolescent alcohol misuse and poor health outcomes across the lifespan.

Body mass index and serum levels of soluble leptin receptor are sex-specifically related to alcohol binge drinking behavior

OBJECTIVE

Binge drinking is a highly prevalent behavior in adolescents and young adults and a risk factor to develop alcohol use disorder. Body mass index (BMI) and blood levels of leptin peptide and its soluble receptor have been implicated in alcohol use disorder; however, their role in binge drinking remains to be investigated.

METHOD

We studied associations of BMI, serum levels of soluble leptin receptor (ObRe) and leptin as well as the free leptin index with binge drinking in 93 male and 99 female young adults.

RESULTS

In men, binge drinkers showed significantly higher BMI (kg/m²) than non-binge drinkers (23.67 vs. 22.08) and higher BMI correlated significantly with more severe binge drinking episodes (ρ = 0.251). In women, we found significantly higher ObRe (ng/ml) / BMI (kg/m²) values in binge drinkers than in non-binge drinkers (0.52 vs. 0.44) and ObRe/BMI values correlated significantly with more severe binge drinking episodes (ρ = 0.210).

CONCLUSION

This study confirms that higher BMI associates with binge drinking in men and shows for the first time a role of ObRe/BMI in binge drinking in women. Our data emphasize the importance of further research in the field of metabolic markers and implications in neurobiological processes of binge drinking.

Body mass index and craving predict 24-month hospital readmissions of alcohol-dependent in-patients following withdrawal

OBJECTIVE

Addictive alcohol drinking, craving, and overeating share common etiopathological mechanisms. We investigated whether body mass index (BMI) and craving predict outcome of alcohol-dependent in-patients.

METHOD

The prospective study included 101 male and 72 female early-abstinent alcohol-dependent in-patients. Craving was quantified by Obsessive-Compulsive Drinking Scale (OCDS) scores. We documented alcohol-related readmissions over 24 months.

RESULTS

In males, a higher BMI was associated with alcohol-related hospital readmission (median 26.1 vs. 23.1 kg/m², P = .007) and correlated with more (ρ = 0.286, P = .004) and earlier readmissions (ρ = -0.256, P = .010). These associations were stronger in the subgroup of active smokers (n = 79; median 25.9 vs. 22.3 kg/m², P = .005; ρ = 0.350, P = .002; ρ = -0.340, P = .002). BMI did not significantly predict outcome in females. Males with at least one readmission reported higher OCDS scores than those without (OCDS-total, OCDS-obsessive, OCDS-compulsive, P < .040), and the OCDS scores correlated with more readmissions (males: OCDS-total, OCDS-obsessive, OCDS-compulsive, ρ > 0.244, P < .014; females: OCDS-compulsive, ρ = 0.341, P = .003) and fewer days to first readmission (males: OCDS-total, OCDS-compulsive, ρ < -0.195, P < .050; females: OCDS-compulsive, ρ = -0.335, P = .004). The OCDS scores explained 9 to 19% of the relationship between BMI and outcome in males.

CONCLUSION

BMI and craving are easily accessible outcome predictors of alcohol-related readmission following in-patient withdrawal treatment. They might be used to individualize relapse prevention in the future.

Phenotypic and Genetic Relationship Between BMI and Drinking in a Sample of UK Adults

The health impairments derived from both alcoholism and obesity are well known. However, reports that relate increased alcohol use with increased measures of obesity have been mixed in their findings, especially with respect to genetic factors that could potentially link these two behaviors. Here, using a large sample of adults from the UK (n ≈ 113,000), we report both the observed and genetic correlations between BMI (kg/m2) and two measures of alcohol use: reported quantity (drinks per week) and frequency of use (from never to daily). Overall, both observationally and genetically, alcohol intake is negatively correlated with BMI. Phenotypic correlations ranged from -0.01 to -0.17, and genetic correlations ranged from -0.1 to -0.4. Genetic correlations tended to be stronger than the phenotypic correlations, and these correlations were stronger in females and between BMI and, specifically, frequency of use. Though the mechanisms driving these relationships are yet to be identified, we can conclude that the genetic factors related to drinking both more and more often are shared with those responsible for lower BMI.

Impact of alcohol consumption and body mass index on mortality from nonneoplastic liver diseases, upper aerodigestive tract cancers, and alcohol use disorders in Korean older middle-aged men: Prospective cohort study

Alcohol use is a leading risk factor for the global disease burden including liver diseases. However, the combined effect of alcohol use and body mass index (BMI) on alcohol-related diseases has seldom been examined. We examined whether alcohol consumption and BMI could act together to increase mortality from nonneoplastic liver diseases, upper aero-digestive tract (UADT) cancers, and alcohol use disorders (AUD) in middle-aged Korean men.107,735 men (mean age, 58.8 years) participated in a postal survey in 2004 and were followed until 2010, by linkage to national death records. Hazard ratios (HRs) of cause-specific death were calculated after adjustment for confounders.Each 5-drink (approximately 45 g alcohol) higher weekly alcohol consumption was associated with increased mortality, by approximately 70% for nonneoplastic liver disease mortality (HR = 1.70, P < 0.001), approximately 60% for UADT cancer mortality (HR = 1.64, P < 0.001), and approximately 70% for AUD mortality (HR = 1.71, P < 0.001). Generally, BMI was inversely associated with these alcohol-related diseases (HR per each 5 kg/m higher BMI = 0.18-0.46, P < 0.001 for each cause), while, in participants with BMI ≥25 kg/m, each 5 kg/m higher BMI was also associated with an elevated mortality from nonneoplastic liver diseases of approximately 150% (HR = 2.52, P = 0.001). Men with BMI < 21 kg/m and weekly alcohol consumption ≥14 drinks showed markedly higher mortality from nonneoplastic liver diseases (HR = 5.7), alcoholic liver diseases (HR = 9.3), UADT cancers (HR = 10.5), and esophageal cancer (HR = 15.5), compared to men drinking less than 1 drink/wk with BMI ≥25 kg/m. The combined effect of low BMI and high weekly alcohol consumption was 2.25- to 3.29-fold greater than the additive effect of each factor for these alcohol-related diseases (P < 0.05 for each cause).Alcohol consumption and low BMI were related to deaths from nonneoplastic liver diseases, UADT cancers, and AUD, with evidence of a supra-additive combined effect of both factors. High BMI was also related to deaths from nonneoplastic liver diseases. Men with a low BMI (<23 kg/m) are suggested to be prone to the harmful effects of alcohol.

Childhood weight status and timing of first substance use in an ethnically diverse sample

BACKGROUND

We examined associations between weight status during childhood and timing of first cigarette, alcohol, and marijuana use in an ethnically diverse sample.

METHODS

Data were drawn from child respondents of the 1979 National Longitudinal Survey of Youth, including 1448 Hispanic, 2126 non-Hispanic Black, and 3304 non-Hispanic, non-Black (White) respondents aged 10 years and older as of last assessment. Cox proportional hazards regression was conducted predicting age at first use from weight status (obese, overweight, and underweight relative to healthy weight) assessed at ages 7/8, separately by substance class, sex, and race/ethnicity. Tests of interactions between weight status and respondent sex and race/ethnicity were also conducted.

RESULTS

Compared to healthy-weight females of the same race/ethnicity, overweight Hispanic females were at increased likelihood of alcohol and marijuana use and overweight White females were at increased likelihood of cigarette and marijuana use. Compared to healthy-weight males of the same race/ethnicity, obese White males were at decreased likelihood of cigarette and alcohol use and underweight Hispanic and Black males were at decreased likelihood of alcohol and marijuana use. Significant differences in associations by sex and race/ethnicity were observed in tests of interactions.

CONCLUSIONS

Findings highlight childhood weight status as a predictor of timing of first substance use among Hispanic and Non-Hispanic Black and White female and male youth. Results suggest that collapsing across sex and race/ethnicity, a common practice in prior research, may obscure important within-group patterns of associations and thus may be of limited utility for informing preventive and early intervention efforts.

Associations Between Body Weight Status and Substance Use Among African American Women in Baltimore, Maryland: The CHAT Study

BACKGROUND

Studies on associations between body weight status and specific substance use have provided conflicting findings.

OBJECTIVES

This paper investigated the association between substance use and body weight status among African American women.

METHODS

We analyzed the data from 328 African American women who were enrolled in a HIV prevention intervention in Baltimore, MD, USA, in order to investigate the association between substance use and their body weight status. Participants' anthropometry was measured by trained research staff. Substance use information was collected via self-administered and interviewer-administered questionnaires.

RESULTS

About 33.4% were classified as normal/underweight, 24.2% overweight, and 42.4% obese. Compared to overweight (38.5%) and obese (29.2%) participants, the normal/underweight women had significantly higher prevalence of drug use (52.8%) (χ(2)= 14.11, p < 0.05). BMI was significantly negatively associated with current heroin use (t = -2.21, p < 0.05). The risk of being overweight and obesity was lower among active marijuana (z = -2.05, p < 0.05) and heroin users (z = -1.91, p < 0.10) than among non-marijuana/non-heroin users. Heroin smokers had lower body weight (t = -3.02, p < 0.05) and BMI (t = -2.47, p < 0.05) than non-heroin smokers. The decrease in BMI appeared to be greater among more frequent (≥once/day) heroin users (t = -2.39, p <0.05) as compared to the less frequent heroin users (

CONCLUSIONS

The results are comparable to existing findings. Active marijuana and heroin users were less likely to be overweight and obese compared to their counterparts. The impact of substance use on body weight status differed by the frequency and route of administration.

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Key Words

• African American
• Obesity
• overweight
• substance use
• women

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MESH Headings

• Baltimore
• Body Mass Index
• Body Weight
• Female
• Humans
• Overweight
• United States

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Grants

• R01 MH066810 NIMH NIH HHS
• P30 AI094189 NIAID NIH HHS
• K99 AA020782 NIAAA NIH HHS
• K01 MH096611 NIMH NIH HHS
• R00 AA020782 NIAAA NIH HHS

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Affiliation(s)

Ji Li Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
Cui Yang Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
Melissa Davey-Rothwell Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
Carl Latkin Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA

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Evaluation of the influence of alcohol dehydrogenase polymorphisms on alcohol elimination rates in African Americans

INTRODUCTION

The relationship between alcohol dehydrogenase (ADH) polymorphisms and alcohol use disorders in populations of African descent has not been clearly established. This study examined the effect of ADH1B polymorphisms on alcohol metabolism and subjective response, following intravenous (IV) alcohol administration, and the influence of gender, recent drinking history, and family history of alcoholism (FHA), in nondependent African American drinkers.

MATERIALS

The sample included eighty-seven 21- to 35-year-old, light social drinkers of African descent. Participants included 39 sib pairs, 2 sibships with 3 siblings each, and 3 individuals who were not part of a sibship. Participants received infusions via the use of the clamp method that refers to the goal of controlling breath alcohol concentration in 2 randomized sessions at 0.06 g% ethanol and 0 mg% (placebo), and a battery of subjective scales at predefined time points. Dependent measures included alcohol elimination rates (AERs), alcohol disappearance rates (ADRs), subjective measures peak scores, and area under the curve. General linear model and mixed models were performed to examine the relationship between ADH1B genotype, dependent measures, and influence of covariates.

RESULTS

Participants with ADH1B1/1 genotypes showed higher number of drinks (p = 0.023) and drinks per drinking day (p = 0.009) compared with the persons with ADH1B1/3 genotype. AER (adjusted for body weight) was higher in ADH1B*1 homozygotes (p = 0.045) compared with ADH1B1/3 heterozygotes. ADR differed significantly between males and females (p = 0.002), regardless of body weight (p = 0.004) and lean body mass (p < 0.001) adjustments. Although a few subjective measures differed across genotype, all measures were higher in alcohol sessions compared with placebo sessions (p < 0.001). These observations were mediated by drinks per drinking day, gender, and FHA.

CONCLUSIONS

ADH1B polymorphism had a marginal effect on alcohol pharmacokinetics following IV alcohol administration in nondependent drinkers of African descent. Session (alcohol vs. placebo) and ADH1B genotype did, however, influence subjective response to alcohol with some variation by gender, FHA, and drinks per drinking day.

Identification of POMC exonic variants associated with substance dependence and body mass index

Background

Risk of substance dependence (SD) and obesity has been linked to the function of melanocortin peptides encoded by the proopiomelanocortin gene (POMC).

Methods and Results

POMC exons were Sanger sequenced in 280 African Americans (AAs) and 308 European Americans (EAs). Among them, 311 (167 AAs and 114 EAs) were affected with substance (alcohol, cocaine, opioid and/or marijuana) dependence and 277 (113 AAs and164 EAs) were screened controls. We identified 23 variants, including two common polymorphisms (rs10654394 and rs1042571) and 21 rare variants; 12 of which were novel. We used logistic regression to analyze the association between the two common variants and SD or body mass index (BMI), with sex, age, and ancestry proportion as covariates. The common variant rs1042571 in the 3′UTR was significantly associated with BMI in EAs (Overweight: P_adj = 0.005; Obese: P_adj = 0.018; Overweight+Obese: P_adj = 0.002) but not in AAs. The common variant, rs10654394, was not associated with BMI and neither common variant was associated with SD in either population. To evaluate the association between the rare variants and SD or BMI, we collapsed rare variants and tested their prevalence using Fisher’s exact test. In AAs, rare variants were nominally associated with SD overall and with specific SD traits (SD: P_FET,1df = 0.026; alcohol dependence: P_FET,1df = 0.027; cocaine dependence: P_FET,1df = 0.007; marijuana dependence: P_FET,1df = 0.050) (the P-value from cocaine dependence analysis survived Bonferroni correction). There was no such effect in EAs. Although the frequency of the rare variants did not differ significantly between the normal-weight group and the overweight or obese group in either population, certain rare exonic variants occurred only in overweight or obese subjects without SD.

Conclusion

These findings suggest that POMC exonic variants may influence risk for both SD and elevated BMI, in a population-specific manner. However, common and rare variants in this gene may exert different effects on these two phenotypes.

Relationship between substance use and body mass index in young males

Recent findings in basic scientific research, such as neurobiological and neuroimaging studies, have suggested common pathways for food and drug intake. It was hypothesized that both compete for the same brain reward sites, and that a higher body mass index (BMI) may be associated with lower substance use. The aim of this study was to investigate the relationship between BMI and substance use in a large sample of young male adults. The sample consisted of 1,902 18-year-old males from a province of Austria in a naturalistic cross-sectional setting. Questionnaires were administered to assess alcohol abuse and dependence (CAGE) and nicotine dependence (Heavy Smoking Index). Urine samples were collected to assess the prevalence of recent illicit drug use. Associations between BMI and substance use were calculated by means of logistic regression analyses. An inverse relationship between BMI and recent illicit drug use was found. This relationship remained significant after adjusting for possible confounding factors such as level of education, nicotine dependence, breath carbon monoxide (CO) levels, and alcohol abuse and dependence. No significant association was found between BMI and nicotine and alcohol dependence. A higher BMI was associated with lower illicit drug use in our sample of young adult males. These results provide further evidence for the hypothesis that food and drugs may compete for the same brain reward sites. 

Weight perception, weight change intentions, and alcohol use among young adults

Obesity and binge drinking are important health issues for young adults in the United States. Several studies have investigated the relationship between these constructs with mixed results. One possible explanation to disentangle this relationship suggests that how people feel about their weight, regardless of their actual weight, may explain some variation in alcohol use. This study (n = 4497) investigated the relationship between two types of body weight concerns--weight perception and weight change intentions--and binge drinking. Controlling for measured body weight, we considered whether body weight concerns increase risk for binge drinking. Findings suggest that women who reported trying to lose weight had an increased risk of binge drinking. Conversely, men who perceived themselves overweight were significantly less likely to participate in binge drinking. We conclude with a discussion of the finding's implications.

Alcohol consumption and breast cancer recurrence and survival among women with early-stage breast cancer: the life after cancer epidemiology study

PURPOSE

To examine the association of alcohol consumption after breast cancer diagnosis with recurrence and mortality among early-stage breast cancer survivors.

PATIENTS AND METHODS

Patients included 1,897 LACE study participants diagnosed with early-stage breast cancer between 1997 and 2000 and recruited on average 2 years postdiagnosis, primarily from the Kaiser Permanente Northern California Cancer Registry. Alcohol consumption (ie, wine, beer, and liquor) was assessed at cohort entry using a food frequency questionnaire. Cox proportional hazards models were used to estimate hazard ratios (HR) and 95% CI with adjustment for known prognostic factors.

RESULTS

Two hundred ninety-three breast cancer recurrences and 273 overall deaths were ascertained after an average follow-up of 7.4 years. Nine hundred fifty-eight women (51%) were considered drinkers (> 0.5 g/d of alcohol), and the majority drank wine (89%). Drinking ≥ 6 g/d of alcohol compared with no drinking was associated with an increased risk of breast cancer recurrence (HR, 1.35; 95% CI, 1.00 to 1.83) and death due to breast cancer (HR, 1.51; 95% CI, 1.00 to 2.29). The increased risk of recurrence appeared to be greater among postmenopausal (HR, 1.51; 95% CI, 1.05 to 2.19) and overweight and obese women (HR, 1.60; 95% CI, 1.08 to 2.38). Alcohol intake was not associated with all-cause death and possibly associated with decreased risk of non-breast cancer death.

CONCLUSION

Consuming three to four alcoholic drinks or more per week after a breast cancer diagnosis may increase risk of breast cancer recurrence, particularly among postmenopausal and overweight/obese women, yet the cardioprotective effects of alcohol on non-breast cancer death were suggested.

Low to moderate alcohol intake is not associated with increased mortality after breast cancer

BACKGROUND

Both alcohol consumption and obesity have been linked with breast cancer morbidity and mortality. An inverse association between alcohol intake and obesity suggests possible confounding between these variables (and perhaps other factors) with breast cancer outcomes.

METHODS

Alcohol intake (beer, wine, spirits, and total) was examined in 3,088 women previously diagnosed and treated for breast cancer within an intervention trial that targeted vegetables, fiber, and fat but not alcohol or weight loss. Factors associated with baseline alcohol intake were included in Cox proportional hazards models for recurrence and mortality.

RESULTS

Alcohol intake was significantly associated with higher education and physical activity levels. Neither light alcohol intake nor obesity was significantly associated with breast cancer recurrence, but moderate alcohol intake >300 g/mo was protective against all-cause mortality (hazard ratio, 0.69; 95% confidence intervals, 0.49-0.97) in a proportional hazards model adjusted for obesity. Obese women were 61% more likely to be nondrinkers than drinkers, and 76% more likely to be light drinkers than moderate/heavy drinkers. In nonobese women, alcohol intake >10 g/mo was associated with lower risk of all-cause mortality (hazard ratio, 0.68; 95% confidence intervals, 0.51-0.91).

CONCLUSION

Light alcohol intake, regardless of body weight, did not increase the risk of breast cancer recurrence or all-cause mortality in this cohort of middle-aged women previously diagnosed with breast cancer. Alcohol intake was associated with other favorable prognostic indicators, which may explain its apparent protective effect in nonobese women.

Prevalence and determinants of binge drinking in middle age in a transitional post-communist country: a population-based study in Tirana, Albania

AIMS

To assess the prevalence and determinants of binge drinking in the middle-age population of transitional post-communist Albania, for which data were previously unavailable.

METHODS

A population-based sample aged 35-74 years, interviewed and examined in Tirana in 2003-2006, included 450 men and 235 women for whom data on alcohol intake were collected (65.5% response). Multivariable-adjusted logistic regression was used to assess the association of drinking patterns with sociodemographic, socioeconomic and psychosocial characteristics and coronary risk factors.

RESULTS

Age-standardized to the 2005 census, 9.2% (95% confidence interval, CI = 6.5-11.9%) and 10.3% (95% CI = 7.4-13.1%) of men reported two to three or more annual episodes of drunkenness and hangovers, respectively. In women, the prevalence of both these markers of binging was 1.4% (95% CI = 0-3.1%). Among men, 8.9% (95% CI = 6.2-11.6%) reported drinking > or =60 g alcohol per session. In multivariable-adjusted models in men, binge drinking was related to low educational level (odds ratio, OR = 1.8, 95% CI = 1.0-3.3), financial loss in the pyramid collapse (OR = 1.6, 95% CI = 1.0-2.5) and religiosity (inversely) in both Muslims and Christians (OR = 0.2, 95% CI = 0.1-0.4).

CONCLUSIONS

Among men in this transitional Southeast European country, social disadvantage and financial stress appear to promote alcohol abuse (which is rare in women), and traditionalism may be protective.