22 June 2017 In Cancer

BACKGROUND: Ethanol in alcoholic beverages is a known carcinogen, but its association with aggressive prostate cancer (APC) is uncertain. Recent studies have shown a modest increase in risk of APC associated with heavy alcohol intake while association for beverage types remain inconsistent.

METHODS: Using a case-control design and self-administered questionnaire, we examined the association between APC (high grade and/or advanced stage) and frequency and quantity of alcohol intake 2 years prior to enrolment. Furthermore, we delineated the relationships for beverage-specific intakes of beer, red wine, white wine and spirits.

RESULTS: The study included 1282 APC cases and 951 controls. Beer intake frequency of 5 days per week was associated with increased risk compared with no beer intake (odds ratio=1.66, 95% confidence interval: 1.12-2.48) whereas wine was protective at all frequencies of consumption compared with those with no wine intake. For every 10 g per week ethanol intake from beer increase, the odds of advanced PC rose by 3% (OR=1.03, 95% CI: 1.02-1.05). No such increased risk was observed for red or white wine while a marginal dose-response relationship was found for spirits (OR=1.03, 95% CI: 0.99-1.07).

CONCLUSIONS: Heavy beer and possibly spirits consumption is associated with increased risk while no dose-response relationship was found for red or white wine. Wine drinkers at all frequencies have a decreased risk of APC compared with those who did not drink wine.Prostate Cancer and Prostatic Diseases advance online publication, 18 April 2017; doi:10.1038/pcan.2017.12

26 April 2017 In General Health

BACKGROUND: In cross-sectional studies and short-term clinical trials, it has been suggested that there is a positive dose-response relation between alcohol consumption and HDL concentrations. However, prospective data have been limited.

OBJECTIVE: We sought to determine the association between total alcohol intake, the type of alcohol-containing beverage, and the 6-y (2006-2012) longitudinal change in HDL-cholesterol concentrations in a community-based cohort.

DESIGN: A total of 71,379 Chinese adults (mean age: 50 y) who were free of cardiovascular diseases and cancer and did not use cholesterol-lowering agents during follow-up were included in the study. Alcohol intake was assessed via a questionnaire in 2006 (baseline), and participants were classified into the following categories of alcohol consumption: never, past, light (women: 0-0.4 servings/d; men: 0-0.9 servings/d), moderate (women: 0.5-1.0 servings/d; men: 1-2 servings/d), and heavy (women: >1.0 servings/d; men: >2 servings/d). HDL-cholesterol concentrations were measured in 2006, 2008, 2010, and 2012. We used generalized estimating equation models to examine the associations between baseline alcohol intake and the change in HDL-cholesterol concentrations with adjustment for age, sex, smoking, physical activity, obesity, hypertension, diabetes, liver function, and C-reactive protein concentrations.

RESULTS: An umbrella-shaped association was observed between total alcohol consumption and changes in HDL-cholesterol concentrations. Compared with never drinkers, past, light, moderate, and heavy drinkers experienced slower decreases in HDL cholesterol of 0.012 mmol . L-1 . y-1 (95% CI: 0.008, 0.016 mmol . L-1 . y-1), 0.013 mmol . L-1 . y-1 (95% CI: 0.010, 0.016 mmol . L-1 . y-1), 0.017 mmol . L-1 . y-1 (95% CI: 0.009, 0.025 mmol . L-1 . y-1), and 0.008 mmol . L-1 . y-1 (95% CI: 0.005, 0.011 mmol . L-1 . y-1), respectively (P < 0.0001 for all), after adjustment for potential confounders. Moderate alcohol consumption was associated with the slowest increase in total-cholesterol:HDL-cholesterol and triglyceride: HDL-cholesterol ratios. We observed a similar association between hard-liquor consumption and the HDL-cholesterol change. In contrast, greater beer consumption was associated with slower HDL-cholesterol decreases in a dose-response manner.

CONCLUSION: Moderate alcohol consumption was associated with slower HDL-cholesterol decreases; however, the type of alcoholic beverage had differential effects on the change in the HDL-cholesterol concentration.

26 April 2017 In Drinking & Eating Patterns

OBJECTIVE: Evidence on the impact of legislative changes on individual alcohol consumption is limited. Using an observational study design, we assessed trends in individual alcohol consumption of a Swiss adult population following the public policy changes that took place between 1993 and 2014, while considering individual characteristics and secular trends.

DESIGN: Cross-sectional study.

SETTING: Swiss general adult population.

PARTICIPANTS: Data from 18 963 participants were collected between 1993 and 2014 (aged 18-75 years).

OUTCOME MEASURES: We used data from the 'Bus Sante' study, an annual health survey conducted in random samples of the adult population in the State of Geneva, Switzerland. Individual alcohol intake was assessed using a validated food frequency questionnaire. Individual characteristics including education were self-reported. 7 policy changes (6 about alcohol and 1 about tobacco) that occurred between 1993 and 2014 defined 6 different periods. We predicted alcohol intake using quantile regression with multivariate analysis for each period adjusting for participants' characteristics and tested significance periods. Sensitivity analysis was performed including drinkers only, the 10th centile of highest drinkers and smoker's status.

RESULTS: Between 1993 and 2014, participants' individual alcohol intake decreased from 7.1 to 5.4 g/day (24% reduction, p<0.001). Men decreased their alcohol intake by 34% compared with 22% for women (p<0.001). The decrease in alcohol intake remained significant when considering drinkers only (28% decrease, p<0.001) and the 10th centile highest drinkers (24% decrease, p<0.001). Consumption of all alcoholic beverages decreased between 1993 and 2014 except for the moderate consumption of beer, which increased. After adjustment for participants' characteristics and secular trends, no independent association between alcohol legislative changes and individual alcohol intake was found.

CONCLUSIONS: Between 1993 and 2014, alcohol consumption decreased in the Swiss adult population independently of policy changes.

26 April 2017 In Drinking & Eating Patterns

The quantity and frequency of alcohol consumption are crucial both in risk assessment as well as epidemiological and clinical research. Using the Munich Composite International Diagnostic Interview (M-CIDI), drinking amounts have been assessed in numerous large-scale studies. However, the accuracy of this assessment has rarely been evaluated. This study evaluates the relevance of drink categories and pouring sizes, and the factors used to convert actual drinks into standard drinks. We compare the M-CIDI to alternative drink assessment instruments and empirically validate drink categories using a general population sample (n = 3165 from Germany), primary care samples (n = 322 from Italy, n = 1189 from Germany), and a non-representative set of k = 22503 alcoholic beverages sold in Germany in 2010-2016. The M-CIDI supplement sheet displays more categories than other instruments (AUDIT, TLFB, WHO-CIDI). Beer, wine, and spirits represent the most prevalent categories in the samples. The suggested standard drink conversion factors were inconsistent for different pouring sizes of the same drink and, to a smaller extent, across drink categories. For the use in Germany and Italy, we propose the limiting of drink categories and pouring sizes, and a revision of the proposed standard drinks. We further suggest corresponding examinations and revisions in other cultures.

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