21 September 2016 In Cancer

BACKGROUND: Breast cancer aetiology may differ by estrogen receptor (ER) status. Associations of alcohol and folate intakes with risk of breast cancer defined by ER status were examined in pooled analyses of the primary data from 20 cohorts.

METHODS: During a maximum of 6-18 years of follow-up of 1 089 273 women, 21 624 ER+ and 5113 ER- breast cancers were identified. Study-specific multivariable relative risks (RRs) were calculated using Cox proportional hazards regression models and then combined using a random-effects model.

RESULTS: Alcohol consumption was positively associated with risk of ER+ and ER- breast cancer. The pooled multivariable RRs (95% confidence intervals) comparing >/= 30 g/d with 0 g/day of alcohol consumption were 1.35 (1.23-1.48) for ER+ and 1.28 (1.10-1.49) for ER- breast cancer (Ptrend /= 0.26). Dietary (from foods only) and total folate intakes were not associated with risk of overall, ER+ and ER- breast cancer; pooled multivariable RRs ranged from 0.98 to 1.02 comparing extreme quintiles. Following-up US studies through only the period before mandatory folic acid fortification did not change the results. The alcohol and folate associations did not vary by tumour subtypes defined by progesterone receptor status.

CONCLUSIONS: Alcohol consumption was positively associated with risk of both ER+ and ER- breast cancer, even among women with high folate intake. Folate intake was not associated with breast cancer risk.

02 August 2016 In Social and Cultural Aspects

BACKGROUND: Changing trends demonstrate that women, in a number of economically-developed countries, are drinking at higher levels than ever before. Exploring key targets for intervention, this study examined the extent to which underlying beliefs in relation to alcohol consumption predicted intentions to drink in three different ways (i.e. low risk drinking, frequent drinking and binge drinking).

METHODS: Utilizing a prospective design survey, women (N = 1069), aged 18-87 years, completed a questionnaire measuring their beliefs and intentions regarding alcohol consumption. Then, two weeks later, 845 of the original sample, completed a follow-up questionnaire reporting their engagement in the drinking behaviors. A mixed design ANOVA was conducted to examine potential differences between women of different age groups (18-24, 25-34, 35-44, 45-54, 55 years and above) and their intentions to engage in the three different drinking behaviors. Based upon The Theory of Planned Behavior, critical beliefs analyses were carried out to identify key determinants underlying intentions to engage in the three different drinking behaviors.

RESULTS: Significant effects of age were found in relation to frequent and binge drinking. The critical beliefs analyses revealed that a number of behavioral, control and normative beliefs were significant predictors of intentions. These beliefs varied according to age group and drinking behavior.

CONCLUSIONS: Previously unidentified key factors that influence women's decisions to drink in certain ways have been established. Overall, future interventions and public policy may be better tailored so as to address specific age groups and drinking behaviors.

02 August 2016 In Drinking & Eating Patterns

BACKGROUND: Pre-drinking has been linked to subsequent heavy drinking and the engagement in multiple risky behaviors.

OBJECTIVES: The present study examined a group of adolescents who recently had a "big night out" to determine whether there were differences in their pre-drinking behavior based on age, gender, geographic location, and social setting.

METHODS: Participants (n = 351, aged 16-19) representing the heaviest 20-25% of drinkers in their age group were recruited using nonrandom sampling from metropolitan (Melbourne, Sydney, Perth) or regional (Bunbury) locations across Australia and administered a survey by a trained interviewer.

RESULTS: Almost half the sample pre-drank (n = 149), most commonly at a friend's house. Those aged 18-19 were more likely to pre-drink, and did so at higher quantities compared to their younger counterparts. Males and females reported similar pre-drinking duration, quantity and amount spent on alcohol. Compared to those in cities, regional participants consumed greater quantities over longer periods of time. Two-thirds of participants consumed alcohol in excess of national guidelines during their pre-drinking session. These participants were more likely to nominate price as a motivation to pre-drink and were less likely to report that someone else provided them alcohol.

CONCLUSIONS: This study sheds light on the pre-drinking habits of a population of young risky drinkers, and highlights the need for policy makers to address this form of drinking to reduce alcohol-related harm among young people.

28 June 2016 In General Health

Selection biases may lead to systematic overestimate of protective effects from 'moderate' alcohol consumption. Overall, most sources of selection bias favor low-volume drinkers in relation to non-drinkers. Studies that attempt to address these types of bias generally find attenuated or non-significant relationships between low-volume alcohol consumption and cardiovascular disease, which is the major source of possible protective effects on mortality from low-volume consumption. Furthermore, observed mortality effects among established low-volume consumers are of limited relevance to health-related decisions about whether to initiate consumption or to continue drinking purposefully into old age. Short of randomized trials with mortality end-points, there are a number of approaches that can minimize selection bias involving low-volume alcohol consumption.

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