Drinking Patterns

Drinking Patterns (15)

BACKGROUND: Alcohol consumption, even at low-levels, can not be guaranteed as safe or risk free. Specifically, the 2009 Australian National Health and Medical Research Council drinking guidelines recommend that adults should not drink more than two standard drinks on any day on average, and no more than four drinks on a single occasion. Nearly 40% of Australians aged 12 years and older drink alcohol but don't exceed these recommended limits, yet adult low-risk drinkers have been largely overlooked in Australian alcohol survey research, where they are usually grouped with abstainers. This paper examines the socio-demographic profile of low-risk drinking adults (18+ years old), compared to those who abstain.

METHODS: Data from the 2013 National Drug Strategy Household Survey were used. In the past 12 months, 4796 Australians had not consumed alcohol and 8734 had consumed alcohol at low-risk levels, accounting for both average volume and episodic drinking (hereafter low-risk).

RESULTS: Multivariate logistic regression results indicated that low-risk drinkers were more likely to be older, married, Australian-born, and reside in a less disadvantaged neighbourhood compared with abstainers. There was no significant difference by sex between low-risk drinkers and abstainers.

CONCLUSIONS: The socio-demographic profile of low-risk drinkers differed from that of abstainers. Combining low-risk drinkers and abstainers into a single group, which is often the practice in survey research, may mask important differences. The study may support improved targeting of health promotion initiatives that encourage low-risk drinkers not to increase consumption or, in view of increasing evidence that low-risk drinking is not risk free, to move towards abstinence.

The existence and potential level of cardioprotection from alcohol use is contested in alcohol studies. Assumptions regarding the risk relationship between alcohol use and ischaemic heart disease (IHD) are critical when providing advice for national drinking guidelines and for designing alcohol harm monitoring systems.

We use three meta-analyses regarding alcohol use and IHD risk to investigate how varying assumptions lead to differential estimates of alcohol-attributable (AA) deaths and weighted relative risk (RR) functions, in Australia and Canada. Alcohol exposure and mortality data were acquired from administrative sources and AA fractions were calculated using the International Model of Alcohol Harms and Policies.

We then customized a recent Global Burden of Disease (GBD) analysis to inform drinking guidelines internationally. Australians drink slightly more than Canadians, per person, but are also more likely to identify as lifetime abstainers.

Cardioprotective scenarios resulted in substantial differences in estimates of net AA deaths in Australia (between 2933 and 4570) and Canada (between 5179 and 8024), using GBD risk functions for all other alcohol-related conditions.

Country-specific weighted RR functions were analyzed to provide advice toward drinking guidelines: Minimum risk was achieved at or below alcohol use levels of 10 g/day ethanol, depending on scenario. Consumption levels resulting in 'no added' risk from drinking were found to be between 10 and 15 g/day, by country, gender, and scenario.

These recommendations are lower than current guidelines in Australia, Canada, and some other high-income countries: These guidelines may be in need of downward revision.

This review provides the first systematic and quantitative synthesis of the literature examining the relationship between binge drinking, cognition, brain structure and function in youth aged 10 to 24 years. PubMed, EMBASE, Medline, PsychINFO and ProQuest were searched for neuroimaging, neurophysiological, and neuropsychological studies.

A total of 58 studies (21 neuroimaging, 16 neurophysiological, 21 neuropsychological) met the eligibility criteria and were included in the review. Overall, abnormal or delayed development of key frontal executive-control regions may predispose youth to binge drink.

These abnormalities appear to be further exacerbated by the uptake of binge drinking, in addition to alcohol-related neural aberrations in reward-seeking and incentive salience regions, indexed by cognitive deficits and maladaptive alcohol associations.

A meta-analysis of neuropsychological correlates identified that binge drinking in youth was associated with a small overall neurocognitive deficit (g = -0.26) and specific deficits in decision-making (g = -1.70), and inhibition (g = -0.39). Using the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) Evidence Profile, the certainty in outcomes ranged from very low to low.

Future prospective longitudinal studies should address concomitant factors, exposure thresholds, and age-related vulnerabilities of binge drinking, as well as the degree of recovery following discontinuation of use.

Most epidemiological research on alcohol as a risk factor is based on the assumption that outcomes are linked to pattern and level of alcohol exposure, where different beverages are converted into grams of ethanol. This review examines this basic assumption, that alcohol has the same impact, independent of beverage type.

We conducted a systematic search on comparative research of beverage-specific alcohol exposure and consequences. Research was divided by methodology (survey, case-control, cohort, time-series analyses, interventional research). Overall, many studies showed higher risks for spirits compared to beer or wine; however, most research was not controlled adequately for confounders such as patterns of drinking. While there is no conclusive evidence for spirits being associated with more harm, given the same pattern and level of alcohol exposure, some evidence supports for certain outcomes such as injuries and poisonings, a potential excess risk with spirits consumption due to rapid ethanol intake and intoxication.

Accordingly, encouraging people to opt for beverages with lower alcohol content via taxation strategies has the potential to reduce alcohol-attributable harm. This does not necessarily involve switching beverage type, but also can achieved within the same beverage category, by shifting from higher to lower concentration beverages.

BACKGROUND: Several studies have suggested a link between the type of alcoholic beverage consumption and body weight. However, results from longitudinal studies have been inconsistent, and the association between adolescent alcohol consumption long-term weight gain has generally not been examined.

METHODS: The study was based on data from 720 Danish adolescents aged between 15 to 19 years at baseline from the Danish Youth and Sports Study (YSS). Self-reported alcohol use, height, weight, smoking, social economic status (SES) and physical activity levels were assessed in baseline surveys conducted in 1983 and 1985, and in the follow up survey which was conducted in 2005. Multiple linear regression analyses were used to examine the association between alcohol consumption in adolescence and subsequent weight gain later in midlife.

RESULTS: There was no significant association between total alcohol consumption during adolescence and change in BMI into midlife (P = 0.079) (beta - 0.14; 95% CI -0.28, 0.005). Wine consumption was found to be inversely associated to subsequent BMI gain (P = 0.001) (beta - 0.46; 95% CI -0.82, - 0.09) while the results were not significant for beer and spirit. The relationship did not differ by gender, but smoking status was found to modify the relationship, and the inverse association between alcohol and BMI gain was seen only among non-smokers (P = 0.01) (beta - 0.24; 95% CI -0.41, - 0.06) while no association was found among smokers. Neither adolescent nor attained socioeconomic status in adulthood modified the relationship between alcohol intake and subsequent BMI gain.

CONCLUSION: Among non-smoking adolescents, consumption of alcohol, and in particular wine, seems to be associated with less weight gain until midlife.

TRIAL REGISTRATION: The YSS cohort was retrospectively registered on August 2017. (Study ID number: NCT03244150 ).

BACKGROUND: Adolescent drinking has declined across many developed countries from the turn of the century. The aim of this review is to explore existing evidence examining possible reasons for this decline.

METHODS: We conducted systematic searches across five databases: Medline, PsycINFO, CINAHL, Informit Health and Scopus. Studies were included if association between declining alcohol consumption and potential explanatory factors were measured over time. Narrative synthesis was undertaken due to substantial methodological heterogeneity in these studies.

RESULTS: 17 studies met the inclusion criteria. Five studies found moderate evidence for changes in parental practices as a potential cause for the decline. Five studies that examined whether alcohol policy changes influenced the decline found weak evidence of association. Three studies explored whether alcohol use has been substituted by illicit substances but no evidence was found. Two studies examined the effect of a weaker economy; both identified increase in adolescent alcohol use during times of economic crisis. One study indicated that changes in exposure to alcohol advertising were positively associated with the decline and another examined the role of immigration of non-drinking populations but found no evidence of association. One study tested participation in organised sports and party lifestyle as a potential cause but did not use robust analytical methods and therefore did not provide strong evidence of association for the decline.

CONCLUSIONS: The most robust and consistent evidence was identified for shifts in parental practices. Further research is required using robust analytical methods such as ARIMA modelling techniques and utilising cross-national data.

OBJECTIVES: To investigate how various alcohol-drinking behaviours are associated with sociodemographics, lifestyle factors and health status indicators in Brazil. STUDY DESIGN: This study is based on a household survey of 53,034 adults aged 18 + years from all 26 Brazilian capitals and the Federal District conducted in 2017.

METHODS: Sex-stratified relationships were modelled using logistic regressions and controlled for capital-specific effects. Main outcome measures included regular alcohol use, weekly alcohol use, heavy episodic drinking (HED), frequent HED and drinking and driving.

RESULTS: Overall (unadjusted) prevalence of regular alcohol consumption is 41%. Among drinkers, approximately 70% drink on a weekly basis, and 46% are heavy episodic drinkers. Among this latter group, close to 44% are frequent heavy episodic drinkers (i.e. at least four times in a month). Among regular drinkers who also are drivers, the prevalence of drinking and driving is 28%. These prevalences are considerably higher in men. The relationships investigated vary by drinking behaviour and sex, with some factors consistently associated with various behaviours, when present. Population (men or women) at greatest risk include (largely) younger individuals (up to 700% increase in odds) who are single or divorced, those who are less health conscious and watch television or use mobile devices during leisure time 4 + hours per day and do not have diabetes.

For drinking and driving, the additional risk factors include speeding behaviour, the use of mobile devices while driving and HED. Education, race/ethnicity and other health status indicators are differently associated with various drinking behaviours. For women, in particular, the results also show differences in odds of up to 360% and 1430% across cities for frequent HED and drinking and driving, respectively. Similarly, indigenous women are at greatest risk of weekly alcohol use and HED.

CONCLUSIONS: HED and drinking and driving are problematic, as the association with other factors suggests a clustering of risky behaviours that may exacerbate the consequences of drinking behaviours.

AIM: To present a comparison between the effects on health due to a reduction in binge drinking (BD) and health-related quality of life (HRQoL), as a result of ALERTA ALCOHOL, an intervention aimed at reducing BD in Spanish adolescents.

METHODS: A two-arm cluster randomized controlled trial was conducted with an intervention and a control group, randomized at the school level, following individuals over four months. The study population consisted of Andalusian adolescents aged 15 to 19 years who were enrolled in urban public high schools (n=1247). Participants were assigned randomly to receive the intervention. The main outcomes studied were the number of occasions of BD in the last 30 days, which was directly obtained from the answers given by the adolescents, and HRQoL measured with the EQ-5D-5L questionnaire. The model of estimation was the generalized estimating equations (GEE) approach.

RESULTS: The program showed a BD reduction at the 4-month follow-up, although it was not shown to significantly increase the HRQoL in adolescents who reduced the number of occasions of BD and had received the intervention. However, it was shown that those who would predictably reduce the number of occasions of BD controlled by several sociodemographic variables perceived a higher HRQoL, as did those who had a greater adherence to the program.

CONCLUSIONS: Higher adherence to a web-based computer-tailored intervention to prevent BD in adolescents has a positive effect on decreasing the number of occasions of BD in adolescents as well as on increasing participants' HRQoL, although this second effect is very small, which could be due to the short follow-up time. This fact is quite important and should be assessed extensively to corroborate the results and translate into health policy.

OBJECTIVES: Binge drinking is a risk factor for a range of harms. This study estimates the national prevalence of binge drinking and adds to our understanding of correlates of binge drinking among older adults in the United States.

DESIGN: Cross-sectional analysis.

SETTING/PARTICIPANTS: A total of 10 927 adults, aged 65 years or older, from the 2015 to 2017 administrations of the US National Survey on Drug Use and Health.

MEASUREMENTS: We estimated the prevalence of past-month binge alcohol use (five or more drinks on the same occasion for men and four or more drinks on the same occasion for women). Characteristics of past-month binge drinkers, including demographics, substance use, serious mental illness, mental health treatment utilization, chronic disease, and emergency department (ED) use, were compared to participants who reported past-month alcohol use without binge drinking. Comparisons were made using chi(2) tests. We then used multivariable generalized linear models using Poisson and log link to examine the association between covariates and binge drinking among all past-month alcohol users aged 65 years or older.

RESULTS: Of 10 927 respondents, 10.6% (95% CI = 9.9%-11.2%) were estimated to be current binge drinkers. Binge drinkers were more likely to be male, have a higher prevalence of current tobacco and/or cannabis use, and have a lower prevalence of two or more chronic diseases compared to nonbinge drinkers. In multivariable analysis, among past-month alcohol users, the prevalence of binge drinking was higher among non-Hispanic African Americans than whites (adjusted prevalence ratio [aPR] = 1.44; 95% CI = 1.16-1.80), tobacco users (aPR = 1.52; 95% CI = 1.33-1.74), cannabis users (aPR = 1.41; 95% CI = 1.11-1.80), and those who visited the ED in the past year (aPR = 1.16; 95% CI = 1.00-1.33).

CONCLUSION: Over a tenth of older adults in the United States are estimated to be current binge drinkers. Results confirm the importance of screening for binge drinking behaviors among older adults to minimize harms.

BACKGROUND: An investigation of the risk of high blood pressure (HBP) associated with heavy alcohol consumption in adolescence and early adulthood is lacking. Therefore, we aimed to investigate the association between binge drinking from adolescence to early adulthood and the risk of HBP in early adulthood.

METHODS: We applied logistic regression to publicly available, population-representative data from waves I (1994-1995; ages 12-18) and IV (2007-2008; ages 24-32) of the National Longitudinal Study of Adolescent to Adult Health (n=5114) to determine whether past 12-month binge drinking in adolescence (wave I) and early adulthood (wave IV) was associated with HBP in early adulthood after adjusting for covariates, including smoking and body mass index. HBP was defined according to both the former and new classifications.

RESULTS: HBP was significantly, positively associated with infrequent binge drinking (less than once a week) in adolescence based on the new classification (overall: OR 1.23, 95% CI 1.02 to 1.49; male: OR 1.35, 95% CI 1.00 to 1.81) and frequent binge drinking (heavy consumption) in adolescence based on the former classification (overall: OR= 1.64, 95% CI 1.22 to 2.22; male: OR= 1.79, 95% CI 1.23 to 2.60). The risk of HBP was high when participants engaged in frequent binge drinking in both adolescence and early adulthood, especially based on the former classification (overall: OR 2.43, 95% CI 1.13 to 5.20; female: OR 5.81, 95% CI 2.26 to 14.93).

CONCLUSION: Binge drinking in adolescence may increase risk of HBP in early adulthood. This association is independent of other important risk factors for HPB, such as smoking and obesity.

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