scholarly journals Alcohol consumption: the good, the bad, and the indifferent

2008 ◽  
Vol 33 (1) ◽  
pp. 12-20 ◽  
Author(s):  
Maria Pontes Ferreira ◽  
Darryn Willoughby
Keyword(s):  
Alcohol Consumption ◽  
Disease Burden ◽  
Epidemiological Data ◽  
Consumption Patterns ◽  
Moderate Alcohol Consumption ◽  
Drinking Patterns ◽  
All Cause Mortality ◽  
System Functioning ◽  
Ethanol Ethanol ◽  
The Impact

Dietary ethanol (alcohol) is the most widely consumed drug worldwide. High levels of mortality, morbidity, and social malaise are associated with abuse of alcohol, and increasing numbers of women and youth are abusing alcohol. However, strong epidemiological data demonstrate a U- or J-shaped relationship between volume of alcohol consumed and all-cause mortality or disease burden. Moderate alcohol consumption is associated with a lower risk of all-cause mortality and disease burden than are abstinence and immoderate drinking. A brief review of the absorption, distribution, metabolism, and excretion of ethanol is provided with a discussion of the impact of gender differences. Potential mechanisms by which ethanol, ethanol metabolites, and (or) phytochemicals, as associated with different types of ethanol-containing beverages, are discussed in regards to the beneficial and detrimental impacts they may have on physiological system functioning and mortality or disease burden. Per capita consumption of ethanol-containing beverages varies across geo-political regions worldwide. A more recent research focus is the impact of consumption patterns on consumption volumes as they relate to disease and mortality. Certain drinking patterns moderate overall volume of ethanol consumption. Thus, an emerging approach to the study of alcohol consumption in populations is to consider both the volume and pattern of consumption as they relate to mortality and disease burden. Alcohol consumption patterns among athletes are discussed; physiological implications of alcohol abuse in this population are outlined. Current guidelines for the consumption of alcohol are reviewed. Alcohol consumption guidelines reflect the current scientific understanding of both the benefits of moderate alcohol consumption and the detriments of immoderate alcohol consumption.

Abstract P155: The Impact of Drinking Patterns on Differences in the Alcohol-Mortality Relationship between Blacks and Whites in the United States

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Chandra L Jackson ◽  
Frank B Hu ◽  
Ichiro Kawachi ◽  
David R Williams ◽  
Kenneth J Mukamal ◽  
...  
Keyword(s):  
Black Women ◽  
Alcohol Consumption ◽  
Black Men ◽  
Mortality Risk ◽  
White Men ◽  
The United States ◽  
Moderate Alcohol Consumption ◽  
Drinking Patterns ◽  
All Cause Mortality

Background: Moderate alcohol consumption appears to confer survival benefits, but previous studies suggest that blacks may not experience such benefits due to, for example, differences in genetic polymorphisms in ethanol metabolizing genes or societal/behavioral factors related to type and pattern of consumption. Investigating potential Black-White differences in the alcohol-mortality relationship may also help illuminate if apparent benefits of moderate alcohol consumption are confounded by lifestyle and socioeconomic characteristics. Few studies, however, have included a sufficient number of blacks. Objective: To investigate Black-White differences in the relationship between alcohol consumption and all-cause mortality. Methods: We pooled cross-sectional surveys of nationally representative samples of 145,143 adults in the National Health Interview Survey from 1997-2002 with mortality follow-up through 2006. Usual drinking days/week and level of alcohol consumed/day were based on self-report. Race-sex specific Cox regression analyses were used to adjust for marital status, education, physical activity, smoking status, and other potential confounders. Results: Over 9 years of follow-up, there were 13,366 deaths: 11,221 in whites and 2,145 in blacks. Participants who consumed 1 drink/day on 3-7 days/week had the lowest age-adjusted mortality rates (MR)/1,000 person years among white men (MR: 66.5 [95%CI: 57.7-75.3]) and women (MR: 34.3 [95%CI: 27.1-41.5]). Two drinks/day on ≤2 days/week in black men (MR: 101.9 [95%CI: 69.3-134.5]) and 1 drink/day ≤2 days/week in black women (MR: 60.0 [95%CI: 41.8-78.1]) was associated with the lowest MR. Compared to never drinkers after accounting for important covariates, the lowest relative risk of mortality for white men (HR=0.55 [95%CI: 0.42-0.74]) was found among those who consumed 2 drinks between 3 to 7 days/week, and white women (HR=0.39 [95%CI: 0.26-0.59]) consuming 1 drink/day on 3 to 7 days/week had the lowest mortality risk. Black women (HR=0.44 [95%CI: 0.27-0.72]) consuming 1 drink on ≤2 days/week had the lowest mortality risk, and black men (HR=0.52 [95%CI: 0.26-1.01]) who consumed 2 drinks ≤2 days/week had the lowest risk of total mortality. Conclusions: Light-to-moderate drinking patterns of alcohol consumption were associated with lowest all-cause mortality among white and black men and women although the apparent nadir varied by race and sex. Further research investigating racial differences in drinking patterns and health outcomes is warranted.

Abstract P255: Moderate Alcohol Consumption and the Risk of Acute Ischemic Stroke and All-Cause Mortality: The Million Veteran Program

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Rebecca Song ◽  
Hugo J Aparicio ◽  
Sudha Seshadri ◽  
Kelly Cho ◽  
Peter W Wilson ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Alcohol Consumption ◽  
Acute Ischemic Stroke ◽  
Lower Risk ◽  
Sensitivity Analyses ◽  
Dash Score ◽  
Moderate Alcohol Consumption ◽  
All Cause Mortality ◽  
The Impact

Introduction: Moderate alcohol consumption has been associated with lower risk of acute ischemic stroke (AIS) in the general population, but this relation has not been examined among U.S. Veterans. Furthermore, inconsistent data are available on the relation of alcohol and all-cause mortality. Methods: Million Veteran Program (MVP) participants who completed a lifestyle survey were eligible for analysis (n=335,754). We combined grams of ethanol in wine, beer, and spirits from the food frequency questionnaire to estimate grams/day (g/d). Participants were categorized into categories of: Never, former, or current drinkers of ≤6 g/d, >6-12 g/d, >12-24 g/d, >24-36 g/d, >36-48 g/d, and >48 g/d. We defined incident AIS as 1 inpatient or 2 outpatient codes (ICD-9 433-434.XX, 436.XX, 437.0, 437.6; ICD-10 codes I63.XX, I65-I66.XX, I67.2, I67.6, I67.8) using the VA electronic health record. Participants with prevalent CVD (n=93,496), missing alcohol data (n=24,871), no follow-up time (n=18,948) or missing age or sex (n=135) were excluded. We used a Cox Proportional Hazards model to relate alcohol consumption and AIS and mortality (separately) adjusting for age, sex, race, body mass index, smoking, education, exercise, DASH score, diabetes, and hypertension status. A sensitivity analysis using simulation reclassifying never drinkers with prevalent comorbidities assessed the impact of potential exposure misclassification on effect estimates. Results: Among 198,304 participants, the mean age was 64y (SD=12), and 10% were women. During a mean follow up of 3.3 years, 3,834 AIS and 7,020 deaths occurred. Using never drinkers as the reference group, we identified a 20-26% (95% CI range: 0.42-0.93) lower risk of AIS, and a 29-39% (95% CI range: 0.46-0.80) lower risk of mortality among drinkers of >0-36 g/d, respectively (Figure 1). In sensitivity analyses, HRs were attenuated but the effects remained robust. Conclusion: Our data show a lower risk of AIS and all-cause mortality with moderate alcohol consumption among MVP participants.

scholarly journals Drinking Patterns and Risk of Ischemic Stroke in Middle-Aged Adults

Stroke ◽  
2021 ◽  
Vol 52 (1) ◽  
pp. 164-171
Author(s):  
Wookjin Yang ◽  
Dong-Wan Kang ◽  
Sue Young Ha ◽  
Seung-Hoon Lee
Keyword(s):  
Ischemic Stroke ◽  
Alcohol Consumption ◽  
National Sample ◽  
Hazard Ratio ◽  
Drinking Patterns ◽  
Middle Aged ◽  
Group Iii ◽  
Group I ◽  
Stroke Group ◽  
The Impact

Background and Purpose: Although it has been reported that the amount of alcohol consumption has a J-shaped association with ischemic stroke, it is unclear whether differences in drinking patterns affect this relationship. We aimed to clarify the impact of drinking patterns on ischemic stroke in midlife. Methods: We used data from the National Health Insurance Service-National Sample Cohort, which is a large-sized, standardized population cohort in Korea. Five different drinking patterns were defined by combining the frequency of alcohol consumption and quantity of alcohol consumed per occasion, that is, abstainers, not drinking alcohol; drinker group I, ≤30 g/d and <5 d/wk; drinker group II, ≤30 g/d and ≥5 d/wk; drinker group III, >30 g/d and <5 d/wk; and drinker group IV, >30 g/d and ≥5 d/wk. The association between the drinking patterns and ischemic stroke occurrence was analyzed using the Cox proportional hazard model. Results: A total of 152 469 middle-aged participants (mean age, 50.2 years; 72 285 men [47.4%]) were eligible for the analyses. The median follow-up time was 9.0 years. Compared with abstainers, those who drank <5 d/wk (drinker groups I and III) had a significantly lower risk of ischemic stroke (group I hazard ratio, 0.71 [95% CI, 0.59–0.85]; group III hazard ratio, 0.80 [95% CI, 0.68–0.93]) during the first 7 years from the baseline, while other drinker groups showed no such differences. However, the effect of drinking patterns on ischemic stroke risk was attenuated after the first 7 years. Conclusions: Reduced risk of ischemic stroke was observed in middle-aged participants with specific drinking patterns, but it was limited to the earlier period. Physicians should be cautious in educating patients on alcohol consumption, considering the long-term association between drinking patterns and ischemic stroke.

scholarly journals Neurological diseases in Peru: a systematic analysis of the global burden disease study

2020 ◽  
Vol 78 (5) ◽  
pp. 282-289
Author(s):  
Carlos ALVA-DÍAZ ◽  
Andrely HUERTA-ROSARIO ◽  
Kevin PACHECO-BARRIOS ◽  
Roberto A. MOLINA ◽  
Alba NAVARRO-FLORES ◽  
...  
Keyword(s):  
Disease Burden ◽  
Neurological Diseases ◽  
Age Groups ◽  
Epidemiological Data ◽  
Global Burden ◽  
Years Of Life Lost ◽  
Systematic Analysis ◽  
Life Years ◽  
Disease Study ◽  
The Impact

ABSTRACT Background: Disease burden indicators assess the impact of disease on a population. They integrate mortality and disability in a single indicator. This allows setting priorities for health services and focusing resources. Objective: To analyze the burden of neurological diseases in Peru from 1990-2015. Methods: A descriptive study that used the epidemiological data published by the Institute for Health Metrics and Evaluation of Global Burden of Diseases from 1990 to 2015. Disease burden was measured using disability-adjusted life years (DALY) and their corresponding 95% uncertainty intervals (UIs), which results from the addition of the years of life lost (YLL) and years lived with disability (YLD). Results: The burden of neurological diseases in Peru were 9.06 and 10.65%, in 1990 and 2015, respectively. In 2015, the main causes were migraine, cerebrovascular disease (CVD), neonatal encephalopathy (NE), and Alzheimer’s disease and other dementias (ADD). This last group and nervous system cancer (NSC) increased 157 and 183% of DALY compared to 1990, respectively. Young population (25 to 44 years old) and older (>85 years old) were the age groups with the highest DALY. The neurological diseases produced 11.06 and 10.02% of the national YLL (CVD as the leading cause) and YLD (migraine as the main cause), respectively. Conclusion: The burden of disease (BD) increased by 1.6% from 1990 to 2015. The main causes were migraine, CVD, and NE. ADD and NSC doubled the DALY in this period. These diseases represent a significant cause of disability attributable to the increase in the life expectancy of our population among other factors. Priority actions should be taken to prevent and treat these causes.

scholarly journals Advancing alcohol research in low-income and middle-income countries: a global alcohol environment framework

2020 ◽  
Vol 5 (4) ◽  
pp. e001958 ◽  
Author(s):  
Helen Walls ◽  
Sarah Cook ◽  
Richard Matzopoulos ◽  
Leslie London
Keyword(s):  
Alcohol Consumption ◽  
Alcohol Use ◽  
Low Income ◽  
Drinking Behaviour ◽  
Drinking Patterns ◽  
Full Spectrum ◽  
Middle Income ◽  
Alcohol Industry ◽  
Systems Research ◽  
The Impact

Alcohol-related harm has gained increased attention in high-income countries (HICs) in recent years which, alongside government regulation, has effected a reduction in alcohol consumption. The alcohol industry has turned its attention to low-income and middle-income country (LMIC) markets as a new source of growth and profit, prompting increased consumption in LMICS. Alcohol use in LMICs is also increasing. There is a need to understand particularly in LMICs the impact of industry strategy in shaping local contexts of alcohol use. We draw on conceptualisations from food systems research, and research on the commercial determinants of health, to develop a new approach for framing alcohol research and discuss implications for alcohol research, particularly in LMICs, focusing on South Africa as an illustrative example. We propose a conceptualisation of the ‘alcohol environment’ as the system of alcohol provision, acquisition and consumption—including, critically, industry advertising and marketing—along with the political, economic and regulatory context of the alcohol industry that mediates people’s alcohol drinking patterns and behaviours. While each country and region is different in terms of its context of alcohol use, we contrast several broadly distinct features of alcohol environments in LMICs and HICs. Improving understanding of the full spectrum of influences on drinking behaviour, particularly in LMICs, is vital to inform the design of interventions and policies to facilitate healthier environments and reduce the harms associated with alcohol consumption. Our framework for undertaking alcohol research may be used to structure mixed methods empirical research examining the role of the alcohol environment particularly in LMICs.

scholarly journals Rotavirus disease burden pre-vaccine introduction in young children in Rural Southern Mozambique, an area of high HIV prevalence

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0249714
Author(s):  
Sozinho Acácio ◽  
Tacilta Nhampossa ◽  
Llorenç Quintò ◽  
Delfino Vubil ◽  
Marcelino Garrine ◽  
...  
Keyword(s):  
Risk Factors ◽  
Disease Burden ◽  
Conditional Logistic Regression ◽  
Epidemiological Data ◽  
Daily Basis ◽  
African Countries ◽  
Severe Diarrhea ◽  
Vaccine Introduction ◽  
Rotavirus Vaccines ◽  
The Impact

Background Rotavirus vaccines have been adopted in African countries since 2009, including Mozambique (2015). Disease burden data are needed to evaluate the impact of rotavirus vaccine. We report the burden of rotavirus-associated diarrhea in Mozambique from the Global Enteric Multicenter Study (GEMS) before vaccine introduction. Methods A case-control study (GEMS), was conducted in Manhiça district, recruiting children aged 0–59 months with moderate-to-severe diarrhea (MSD) and less-severe-diarrhea (LSD) between December 2007 and November 2012; including 1–3 matched (age, sex and neighborhood) healthy community controls. Clinical and epidemiological data and stool samples (for laboratory investigation) were collected. Association of rotavirus with MSD or LSD was determined by conditional logistic regression and adjusted attributable fractions (AF) calculated, and risk factors for rotavirus diarrhea assessed. Results Overall 915 cases and 1,977 controls for MSD, and 431 cases and 430 controls for LSD were enrolled. Rotavirus positivity was 44% (217/495) for cases and 15% (160/1046) of controls, with AF = 34.9% (95% CI: 32.85–37.06) and adjusted Odds Ratio (aOR) of 6.4 p< 0.0001 in infants with MSD compared to 30% (46/155) in cases and 14% (22/154) in controls yielding AF = 18.7%, (95% CI: 12.02–25.39) and aOR = 2.8, p = 0.0011 in infants with LSD. The proportion of children with rotavirus was 32% (21/66) among HIV-positive children and 23% (128/566) among HIV-negative ones for MSD. Presence of animals in the compound (OR = 1.9; p = 0.0151) and giving stored water to the child (OR = 2.0, p = 0.0483) were risk factors for MSD; while animals in the compound (OR = 2.37, p = 0.007); not having routine access to water on a daily basis (OR = 1.53, p = 0.015) and washing hands before cooking (OR = 1.76, p = 0.0197) were risk factors for LSD. Conclusion The implementation of vaccination against rotavirus may likely result in a significant reduction of rotavirus-associated diarrhea, suggesting the need for monitoring of vaccine impact.

Abstract P043: Alcohol Consumption, Transferrin Saturation and Risk of All-Cause Mortality in The National Health and Nutrition Examination Surveys

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Laurence O James ◽  
James N Kiage ◽  
Loren Lipworth ◽  
Uchechukwu K Sampson ◽  
Edmond K Kabagambe
Keyword(s):  
Alcohol Consumption ◽  
National Health ◽  
Alcohol Intake ◽  
Iron Status ◽  
Transferrin Saturation ◽  
Moderate Alcohol Consumption ◽  
Health And Nutrition ◽  
Heavy Drinkers ◽  
All Cause Mortality ◽  
Reduced Risk

Background: Moderate alcohol consumers have a reduced risk for cardiovascular and all-cause mortality. Alcohol intake improves iron absorption and also has a profound effect on iron metabolism and thus could in part explain the observed inverse association between moderate alcohol intake and mortality. We sought to investigate whether moderate alcohol confers mortality benefits in part through improvement in iron status. Methods: Publicly available data from two consecutive National Health and Nutrition Examination Survey (NHANES) cycles (1999/2000 and 2001/2002) were obtained and linked to public data on all-cause mortality. Study participants were grouped as never, past, moderate (≤2 drinks/day for men, ≤ 1 drink/day for women) and heavy drinkers (>2 drinks/day for men, >1 drink/day for women). To assess the quality of alcohol data in NHANES, we tested whether self-reported alcohol consumption was associated with biomarkers of alcohol intake (HDL-C and γ-glutamyl transferase (GGT)). Cox-models, weighted using four-year sampling weights, were fitted to determine whether alcohol intake was associated with all-cause mortality. Measures of iron status, particularly serum ferritin, transferrin saturation, hemoglobin and free erythrocyte protoporphyrin were evaluated as potential mediators of the association between alcohol consumption and risk of all-cause mortality. Results: Among 7,532 men and women with complete data, 17% were never drinkers, 20% were past drinkers, 30% were moderate drinkers and 33% were heavy drinkers. We found an increase in HDL-C and GGT with increased alcohol intake, suggesting that self-reported alcohol intake is reliable in this population. In the weighted analysis, the hazard ratio (95% CI) for all-cause mortality among moderate alcohol users compared to never users was 0.56 (0.37-0.85), in models adjusted for age, race, smoking, statin use and history of diabetes, among other variables. Adjustment for transferrin saturation as a measure of iron status attenuated the benefit from moderate alcohol (HR = 0.69; 95% CI: 0.41-1.14), suggesting that moderate alcohol consumption may in part confer a benefit on mortality through improvement in iron status. These results warrant further evaluation in rigorous formal mediation analyses. Conclusions: Moderate alcohol consumption was associated with higher transferrin saturation and with reduced risk of mortality. Adjusting for iron status attenuated the association between moderate alcohol consumption and all-cause mortality suggesting that the effects of moderate alcohol on mortality may in part be via improvement in iron status.

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