01 February 2017 In Cardiovascular System

BACKGROUND: We examined whether alcohol flushing could be used as an instrumental variable (IV) and investigated the effect of alcohol consumption on coronary calcification using alcohol flushing status as an IV.

METHODS: We analysed cross-sectional data from 24 681 Korean adults (20 696 men and 3985 women) who had been administered a questionnaire assessing alcohol consumption and alcohol flushing, as well as a coronary artery calcium (CAC) measurement. The associations of alcohol flushing status with potential confounders and alcohol consumption were examined. We employed two-stage predictor substitution methodology for the IV analysis.

RESULTS: The prevalence of alcohol flushing did not differ depending on gender, education, household income, cigarette smoking or physical activity. Balanced levels of confounders were observed between alcohol flushers and non-flushers. Alcohol flushing was closely related to alcohol consumption and levels of liver enzymes. In men, a doubling in alcohol consumption was associated with increased odds of coronary calcification in both the IV analysis [odds ratio (OR) of CAC scores of 1 or over = 1.11; 95% confidence interval (CI) = 1.03-1.20) and the multivariable regression analysis (OR = 1.04; 95% CI = 1.01-1.07). For cardiovascular risk factors, the IV analysis showed a positive association between alcohol consumption and blood pressure and high-density lipoprotein-cholesterol.

CONCLUSIONS: Alcohol flushing can be used as an IV in studies evaluating the health impact of alcohol consumption, especially in East Asian countries. Through such an analysis, we found that increased alcohol consumption was associated with an increased risk of subclinical coronary atherosclerosis.

15 December 2016 In Drinking & Eating Patterns

PURPOSE: We seek answers to three questions about adolescent risk of starting to drink alcoholic beverages: (1) in new United States (US) data, can we reproduce a recently discovered female excess risk? (2) has a female excess risk emerged in European countries? and (3) might the size of country-level female-male differences (FMD) be influenced by macro-level gender equality and development processes?

METHODS: Estimates are from US and European surveys of adolescents, 2010-2014. For US estimates, newly incident drinking refers to consuming the first full drink during the 12-month interval just prior to assessment. For all countries, lifetime cumulative incidence of drinking refers to any drinking before assessment of the sampled 15-16 years.

RESULTS: Cumulative meta-analysis summary estimates from the US show a highly reproducible female excess in newly incident drinking among 12-17 years (final estimated female-male difference in risk, FMD = 2.1%; 95% confidence interval = 1.5%, 2.7%). Several European countries show female excess risk, estimated as lifetime cumulative incidence of drinking onsets before age 17 years. At the country level, the observed magnitude of FMD in risk is positively associated with the Gender Development Index (especially facets related to education and life expectancy of females relative to males), and with residence in a higher income European country.

CONCLUSIONS: New FMD estimates support reproducibility of a female excess risk in the US. In Europe, evidence of a female excess is modest. Educational attainment, life expectancies, and income merit attention in future FMD research on suspected macro-level processes that influence drinking onsets.

25 October 2016 In Drinking & Eating Patterns

Young adult binge drinking prevalence has been widely researched. However, beverage-specific binge drinking rates for beer, liquor, wine, and wine coolers have not yet been documented for this age group. This study examines consumption of specific beverages (i.e., 5+ drinks in a row in the past two weeks) by young adults aged 19/20. Data from the national Monitoring the Future study were collected one or two years after high school from 2004 to 2014 (n=2004). Logistic regression was used to examine associations between beverage-specific 5+ drinking and gender, race/ethnicity, parent education, college status, and cohort year. Overall 5+ drinking in the past two weeks was reported by 31.4% of young adults. Beverage-specific 5+ drinking was most common with liquor (22.6%) and beer (22.4%), followed by wine (4.5%) and wine coolers (3.0%). Men were more likely than women to engage in 5+ drinking with beer and liquor; women were more likely than men to do so with wine and wine coolers. Beverage-specific patterns differed by college attendance. Compared to four-year college students, two-year college/votech students were less likely to have 5+ drinks of liquor or wine, and more likely to have 5+ wine coolers; those not in college were less likely to have 5+ drinks of liquor and more likely to have 5+ wine coolers. Differences in beverage-specific 5+ drinking by gender and college enrollment suggest that intervention efforts should focus on the beverages that are most commonly consumed at high levels within specific early young adult populations.

21 September 2016 In General Health

BACKGROUND: The association between alcohol consumption and metabolic syndrome (MetS) among Hispanic/Latino populations has not been studied in great detail. Our study examined the relationship between alcohol consumption and MetS among U.S. Hispanics/Latinos and explored whether this relationship varied by age, body mass index, gender, and Hispanic/Latino backgrounds.

METHODS: The Hispanic Community Health Study/Study of Latinos (HCHS/SOL) is a multisite, prospective, population-based, cohort study of Hispanics/Latinos, ages 18-74 years from four U.S. communities. Participants were categorized into never, former, occasional, low, moderate, and high alcohol consumption categories. A cross-sectional analysis of 15,905 participants with complete data was conducted. Survey design appropriate chi-squared and logistic regression models were run to detect significant associations between alcohol consumption categories and cases of MetS.

RESULTS: Almost half (47.4%) of the sample was classified as occasional, low, moderate, or heavy drinkers. Low and moderate alcohol consumers had lower odds of MetS than never drinkers. Low and heavy drinkers had higher odds of presenting with elevated central obesity, while occasional, low, moderate, and heavy drinkers had higher odds of having low high-density lipoprotein cholesterol levels compared to never drinkers. Low and moderate wine drinkers had lower odds of MetS compared to never drinkers. There were no significant findings among beer or liquor drinkers, or with binge drinking after model adjustments.

CONCLUSIONS: Our findings suggest that low and moderate alcohol consumption may lower the odds of MetS in a sample of Hispanic/Latino adults, but that the relationship of alcohol consumption varies with the individual components of MetS.

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