26 February 2019 In Drinking & Eating Patterns

Background: Alcohol-induced hangover constitutes a significant, yet understudied, global hazard and a large socio-economic burden. Old folk wisdoms such as "Beer before wine and you'll feel fine; wine before beer and you'll feel queer" exist in many languages. However, whether these concepts in fact reduce hangover severity is unclear.

Objectives: The aim of this study was to investigate the influence of the combination and order of beer and wine consumption on hangover intensity. Methods: In this multiarm, parallel randomized controlled matched-triplet crossover open-label interventional trial, participants were matched into triplets and randomly assigned according to age, gender, body composition, alcohol drinking habits, and hangover frequency. Study group 1 consumed beer up to a breath alcohol concentration (BrAC) >/=0.05% and then wine to BrAC >/=0.11% (vice versa for study group 2). Control group subjects consumed either only beer or only wine. On a second intervention day (crossover) >/=1 wk later, study-group subjects were switched to the opposite drinking order. Control-group subjects who drank only beer on the first intervention received only wine on the second study day (and vice versa). Primary endpoint was hangover severity assessed by Acute Hangover Scale rating on the day following each intervention. Secondary endpoints were factors associated with hangover intensity.

Results: Ninety participants aged 19-40 y (mean age 23.9), 50% female, were included (study group 1 n = 31, study group 2 n = 31, controls n = 28). Neither type nor order of consumed alcoholic beverages significantly affected hangover intensity (P > 0.05). Multivariate regression analyses revealed perceived drunkenness and vomiting as the strongest predictors for hangover intensity.

Conclusions: Our findings dispel the traditional myths "Grape or grain but never the twain" and "Beer before wine and you'll feel fine; wine before beer and you'll feel queer" regarding moderate-to-severe alcohol intoxication, whereas subjective signs of progressive intoxication were confirmed as accurate predictors of hangover severity. This trial was prospectively registered at the Witten/Herdecke University Ethics Committee as 140/2016 and retrospectively registered at the German Clinical Trials Register as DRKS00015285



Kochling,J.; Geis,B.; Wirth,S.; Hensel,K.O.

Grape or grain but never the twain? A randomized controlled multiarm matched-triplet crossover trial of beer and wine

Am.J Clin.Nutr, 2019, 109,2: 345-352.

22 February 2019 In Liver Disease

OBJECTIVE: To evaluate the longitudinal relationship between repeated measures of alcohol consumption and risk of developing fatty liver.

PATIENTS AND METHODS: This study includes 5407 men and women from a British population-based cohort, the Whitehall II study of civil servants, who self-reported alcohol consumption by questionnaire over approximately 30 years (1985-1989 through to 2012-2013). Drinking typologies during midlife were linked to measures of fatty liver (the fatty liver index, FLI) when participants were in older age (age range 60-84 years) and adjusted for age, socio-economic position, ethnicity, and smoking.

RESULTS: Those who consistently drank heavily had two-fold higher odds of increased FLI compared to stable low-risk moderate drinkers after adjustment for covariates (men: OR = 2.04, 95%CI = 1.53-2.74; women: OR = 2.24, 95%CI = 1.08-4.55). Former drinkers also had an increased FLI compared to low-risk drinkers (men: OR = 2.09, 95%CI = 1.55-2.85; women: OR = 1.68, 95%CI = 1.08-2.67). There were non-significant differences in FLI between non-drinkers and stable low-risk drinkers. Among women, there was no increased risk for current heavy drinkers in cross sectional analyses.

CONCLUSION: Drinking habits among adults during midlife affect the development of fatty liver, and sustained heavy drinking is associated with an increased FLI compared to stable low-risk drinkers. After the exclusion of former drinkers, there was no difference between non-drinkers and low-risk drinkers, which does not support a protective effect on fatty liver from low-risk drinking. Cross-sectional analyses among women did not find an increased risk of heavy drinking compared to low-risk drinkers, thus highlighting the need to take a longitudinal approach.

05 December 2018 In General Health

BACKGROUND: Problem drinking carries significant health burdens, including an increased risk of hypertension. The effect of chronic alcohol intake on blood pressure (BP) in women is understudied and poorly understood.

OBJECTIVES: We sought to examine the relationships between drinking habits and BP in hypertensive women.

METHODS: We analyzed drinking habits in 113 women followed in the Brigham and Women's Hospital Hypertension Clinic for at least one year.

RESULTS: Among these women with well-controlled hypertension, baseline diastolic BP was significantly lower in moderate drinkers compared with women who rarely or never drank. Changes in both systolic and diastolic BP over 12 months showed a significant negative association with changes in percent drinking days. In contrast, there was a trend toward higher baseline systolic BP among those women who consumed more drinks per drinking day.

CONCLUSIONS: Among these women with controlled hypertension, our data failed to demonstrate an association between drinking beyond recommended limits and higher disease burden. These findings parallel the widely reported difference between drinking frequency, associated with a host of positive health outcomes, and drinking intensity, associated with negative outcomes. Novel to this report is an observed reduction in blood pressure over the one-year follow-up period accompanying an increased drinking frequency in treated hypertensive women. Cautions include the suggestion that a greater number of drinks per drinking day was associated with higher baseline pressure. These data imply that drinking within sensible limits has no negative impact on chronic hypertension. In fact, for women with well-controlled hypertension, such a habit may impart benefit.

29 October 2018 In Cardiovascular System

BACKGROUND: Alcohol-induced cardiotoxicity is incompletely understood. Specifically, the long-term impact of alcohol use on ventricular remodeling or dysfunction, its modulators, and effect thresholds among young adults remain controversial.

OBJECTIVES: The authors sought to evaluate a potential relationship between alcohol intake and cardiac remodeling, assessed by echocardiography, over 20 years of follow-up.

METHODS: Among the CARDIA (Coronary Artery Risk Development in Young Adults) study cohort, the authors studied all subjects without baseline heart disorders who provided adequate information on their drinking habits and underwent echocardiographic evaluation at years 5 and 25 of the study. The echocardiographic outcomes were left ventricular (LV) ejection fraction, indexed LV end-diastolic volume and LV mass, and left atrial diameter. Participants were grouped according to their weighted-average weekly drinking habits. An additional analysis used the estimated cumulative alcohol consumption. Regression models and multivariable fractional polynomials were used to evaluate the association between alcohol consumption and the outcomes.

RESULTS: Among the 2,368 participants, alcohol consumption was an independent predictor of higher indexed LV mass (p = 0.014) and indexed LV end-diastolic volume (p = 0.037), regardless of sex. No significant relationship between alcohol intake and LV ejection fraction was found. Drinking predominantly wine was associated with less cardiac remodeling and there was a nonsignificant trend for a harmful effect of binge drinking.

CONCLUSIONS: After 20 years of follow-up, alcohol intake was associated with adverse cardiac remodeling, although it was not related with LV systolic dysfunction in this initially healthy young cohort. Our results also suggest that drinking predominantly wine associates with less deleterious findings in cardiac structure.

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