25 August 2020 In Drinking Patterns

BACKGROUND: Alcohol intake is widely assumed to contribute to excess body fatness, especially among young men; however, the evidence is inconsistent. We have addressed this research question by investigating associations between reported alcohol consumption and body composition from large representative national surveys in a high alcohol-consuming country with a high obesity prevalence.

METHODS: The present study comprised a secondary analysis of combined cross-sectional nationally representative Scottish Health Surveys (1995-2010). Reported alcohol-drinking frequency was divided into five groups: from 'nonfrequent drinking' (reference) to daily/'almost every day' among 35 837 representative adults [mean (SD) age: 42.7 (12.7) years (range 18-64 years)]. Quantitative alcohol consumption was categorised into seven groups: from '1-7 to >/=50 10 g units per week'. Regression models against measured body mass index (BMI) and waist circumference (WC) were adjusted for age, physical activity, income, smoking, deprivation category and economic status.

RESULTS: Among alcohol-consuming men, heavier drinking (21-28 units per week) was associated with a higher BMI by +1.4 kg m(-2) [95% confidence interval (CI) = 1.38-1.43] and higher WC by +3.4 cm (95% CI = 3.2-3.6) than drinking 1-7 units per week. However, those who reported daily drinking frequency were associated with a lower BMI by -2.45 kg m(-2) (95% CI = -2.4 to -2.5) and lower WC by -3.7 cm (95% CI = -3.3 to -4.0) than those who reported less-frequent drinking. Similar associations were found for women. Most of these associations were restricted to subjects aged >30 years. Unexplained variances in BMI and WC are large.

CONCLUSIONS: Quantitative alcohol consumption and frequency of consumption were positively and inversely associated, respectively, with both BMI and WC among alcohol-consuming adults. Surveys are needed that evaluate both the quantity and frequency of consumption. The lowest BMI and WC were associated with a 'Mediterranean' drinking style (i.e. relatively little, but more frequently)

25 August 2020 In Drinking Patterns

BACKGROUND: Some of the previously reported health benefits of low-to-moderate alcohol consumption may derive from health status influencing alcohol consumption rather than the opposite. We examined whether health status changes influence changes in alcohol consumption, cessation included.

METHODS: Data came from 571 current drinkers aged >/=60 years participating in the Seniors-ENRICA cohort in Spain. Participants were recruited in 2008-2010 and followed-up for 8.2 years, with four waves of data collection. We assessed health status using a 52-item deficit accumulation (DA) index with four domains: functional, self-rated health and vitality, mental health, and morbidity and health services use. To minimise reverse causation, we examined how changes in health status over a 3-year period (wave 0-wave 1) influenced changes in alcohol consumption over the subsequent 5 years (waves 1-3) using linear/logistic regression, as appropriate.

RESULTS: Compared with participants in the lowest tertile of DA change (mean absolute 4.3% health improvement), those in the highest tertile (7.8% worsening) showed a reduction in alcohol intake (beta: -4.32 g/day; 95% CI -7.00 to -1.62; p trend=0.002) and were more likely to quit alcohol (OR: 2.80; 95% CI 1.54 to 5.08; p trend=0.001). The main contributors to decreasing drinking were increased functional impairment and poorer self-rated health, whereas worsening self-rated health, onset of diabetes or stroke and increased prevalence of hospitalisation influenced cessation.

CONCLUSIONS: Health deterioration is related to a subsequent reduction and cessation of alcohol consumption contributing to the growing evidence challenging the protective health effect previously attributed to low-to-moderate alcohol consumption

25 August 2020 In Drinking Patterns

INTRODUCTION: A significant minority of Australians drink within the 2009 national guidelines. Despite encouragement of low-risk drinking as opposed to consumption patterns associated with greater harm, little is known about the drinking patterns of this group. This paper identifies subgroups of low-risk drinkers and their distinguishable characteristics.

METHODS: Data were sourced from the 2016 National Drug Strategy Household Survey, specifically 8492 adults (18+) who consumed 1-730 Australian standard drinks (ASD; 10 g ethanol) in the past year, and never 5+ ASD on a single occasion. Cluster analysis enabled identification of subgroups from drinking variables. Drinking patterns, socio-demographic characteristics, drinking context and alcohol-related perceptions of subgroups were examined.

RESULTS: Three subgroups were identified. Special occasion drinkers (64.6%) drank low to moderate amounts very infrequently. Regular moderates (19.6%) and Regular sippers (15.8%) drank 5-6 days a week on average, with the average number of ASD per day 1.2 and 0.5, respectively. Special occasion drinkers tended to be younger than members of more regular drinking subgroups. Perceptions of regular alcohol use also differed between Special occasion drinkers and members of the other subgroups.

DISCUSSION: Alcohol consumption patterns among low-risk drinkers are not homogeneous. Younger drinkers who consume at low-risk levels are more likely to report infrequent consumption than moderate regular consumption. A better understanding of low-risk drinkers may help increase the prominence and acceptability of this type of drinking, challenge the normativity of heavier drinking norms and help target campaigns as new information emerges on health risks associated with low-level drinking.

25 August 2020 In Diabetes

Health benefits of moderate wine consumption have been studied during the past decades, first in observational studies and more recently, in experimental settings and randomized controlled studies. Suggested biological pathways include antioxidant, lipid regulating, and anti-inflammatory effects. Both the alcoholic and polyphenolic components of wine are believed to contribute to these beneficial effects.

Although several of these studies demonstrated protective associations between moderate drinking and cardiovascular disease, atherosclerosis, hypertension, certain types of cancer, type 2 diabetes, neurological disorders, and the metabolic syndrome, no conclusive recommendations exist regarding moderate wine consumption. Yet, it is suggested that the physician and patient should discuss alcohol use. In the CASCADE (CArdiovaSCulAr Diabetes & Ethanol) trial, 224 abstainers with type 2 diabetes were randomized to consume red wine, white wine or mineral water for two years.

Here, we summarize our previous findings, offer new evidence concerning the differential effects of wine consumption among men and women, and further suggest that initiating moderate alcohol consumption among well-controlled persons with type 2 diabetes is apparently safe, in regard to changes in heart rate variability and carotid plaque formation

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