27 February 2017 In Diabetes

AIMS/INTRODUCTION: Previous meta-analyses identified an inverse association of total alcohol consumption with the risk of type 2 diabetes. The current study further explored the relationship between specific types of alcoholic beverage and the incidence of type 2 diabetes.

MATERIALS AND METHODS: A search of PubMed, Embase and Cochrane Library databases from January 1966 to February 2016 was carried out for prospective cohort studies that assessed the effects of specific types of alcoholic beverage on the risk of type 2 diabetes. The pooled relative risks with 95% confidence interval were calculated using random- or fixed-effect models when appropriate.

RESULTS: A total of 13 prospective studies were included in this meta-analysis, with 397,296 study participants and 20,641 cases of type 2 diabetes. Relative to no or rare alcohol consumption, wine consumption was associated with a significant reduction of the risk of type 2 diabetes, with the pooled relative risks of 0.85, whereas beer or spirits consumption led to a slight trend of decreasing risk of type 2 diabetes (relative risk 0.96, 0.95, respectively). Further dose-response analysis showed a U-shaped relationship between all three alcohol types and type 2 diabetes. Additionally, the peak risk reduction emerged at 20-30 g/day for wine and beer, and at 7-15 g/day for spirits, with a decrease of 20, 9 and 5%, respectively.

CONCLUSIONS: Compared with beer or spirits, wine was associated with a more significant decreased risk of type 2 diabetes. The present study showed that wine might be more helpful for protection against type 2 diabetes than beer or spirits.

27 February 2017 In Cardiovascular System

BACKGROUND: Emerging evidence suggests that arterial stiffness, an important marker of cardiovascular health, is associated with alcohol consumption. However, the role of longer-term consumption patterns in the progression of arterial stiffness over time remains unclear. A longitudinal cohort design was used to evaluate the association between alcohol consumption over 25 years and subsequent changes in arterial stiffness.

METHODS AND RESULTS: Data (N=3869; 73% male) were drawn from the Whitehall II cohort study of British civil servants, in which participants completed repeat pulse wave velocity assessments of arterial stiffness across a 4- to 5-year interval. Repeated alcohol intake measurements were used to categorize participants into alcohol consumer types, accounting for longitudinal variability in consumption. Sex-stratified linear mixed-effects modeling was used to investigate whether drinker types differed in their relationship to pulse wave velocity and its progression over time. Males with consistent long-term heavy intake >112 g of ethanol/week had significantly higher baseline pulse wave velocity (b=0.26 m/s; P=0.045) than those who drank consistently moderately (1-112 g of ethanol/week). Male former drinkers showed significantly greater increases in arterial stiffness longitudinally compared to consistently moderate drinkers (b=0.11 m/s; P=0.009). All associations were nonsignificant for females after adjustment for body mass index, heart rate, mean arterial pressure, diabetes mellitus, high-density lipoprotein, and triglycerides.

CONCLUSIONS: This work demonstrates that consistently heavy alcohol consumption is associated with higher cardiovascular risk, especially among males, and also provides new insights into the potential impact of changes in drinking levels over time. It discusses the additional insights possible when capturing longitudinal consumption patterns in lieu of reliance on recent intake alone.

CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT02663791

01 February 2017 In Drinking & Eating Patterns
OBJECTIVE: Despite declines in Australian alcohol consumption, youth alcohol related harms remain prevalent. These alcohol-related consequences appear to be driven by a subset of risky drinkers who engage in 'high intensity' drinking episodes and are underrepresented in national health surveys. This project aims to investigate high risk drinking practices and alcohol-related harms amongst young people not otherwise recorded in existing data. METHODS: A community sample of the heaviest drinking 20-25% 16-19 year olds were surveyed across three Australian states (n=958; 80% metropolitan). We examined the context of their last risky drinking session through online and face-to-face surveys. RESULTS: Males consumed a mean of 17 and females 14 standard drinks, and 86% experienced at least one alcohol-related consequence during this session. More than a quarter of the face-to-face sample had Alcohol Use Disorders Identification Test (AUDIT) scores indicative of alcohol dependence. Indications of dependence were 2.3 times more likely among those who felt uncomfortable about seeking alcohol treatment, and less likely if harm reduction strategies were frequently used while drinking. CONCLUSIONS: It is clear this underrepresented population experiences substantial acute and potentially chronic consequences. IMPLICATIONS: Within the context of increasing alcohol-related harms among young Australians, the understanding of this group's drinking habits should be prioritised
01 February 2017 In Drinking & Eating Patterns

BACKGROUND: Alcohol contributes to approximately 30% of all serious crashes. While the majority of drivers acknowledge the risks associated with drink-driving, a significant proportion of the population continue to engage in this behaviour. Attitudes towards drink-driving as well as personal alcohol consumption patterns are likely to underpin a driver's decision to drink-drive. These associations were explored in the current study.

METHODS: A large (N=2994) cross-sectional online survey of a representative sample of drivers in Australia was conducted. Participants provided information about their own alcohol consumption patterns, drink-driving behaviour as well as attitudes towards drink-driving (own and others) and enforcement strategies.

RESULTS: Alcohol consumption patterns differed according to age, gender and work status. Drivers who reported drink-driving behaviour and had high risk alcohol consumption patterns were less likely to agree that drink-driving leads to increased crash risk and more likely to agree they drink and drive when they believed they could get away with it. In contrast, drivers who did not report drink-driving and had low risk consumption patterns were more likely to report that the enforcement strategies are too lenient. Binary logistic regression showed that high risk alcohol consumption patterns and agreement from drivers that they drink and drive when they believe they can get away with it had the strongest associations with drink-driving. These findings highlight the relationships between one's drinking patterns, drink-drive behaviour and attitudes towards drink-driving and drink-driving enforcement.

CONCLUSIONS AND IMPLICATIONS: The patterns of associations that emerged suggest that drink-driving is the expression of a broader health issue for the most "at-risk" cohort of drinkers. The decision to drink and drive may result from a need borne from an alcohol dependent lifestyle exacerbated by a social acceptability of the behaviour and positive attitudes towards one's ability to drink-drive with few adverse consequences. Therefore, the broader alcohol consumption patterns of drink-drivers needs to be considered when targeting drink-drive reductions.

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