Background: The treatment of atrial fibrillation (AF) has made significant progress, but the prevention of AF has not received the attention it deserves. A few recent large-sized studies have conducted dose response analysis and reported different conclusions from previous studies on alcohol consumption and AF risk.
Objectives: The aim of this study is to examine the potential non-linear association between alcohol consumption and risk of AF and explore the potential differences of gender. Methods: In this updated dose-response meta-analysis, PubMed, Embase and Cochrane databases were searched until June 2022. Risk estimates were reported as relative risk (RR) with 95% confidence intervals (CIs). The random-effects restricted cubic spline models are used to evaluate the potential non-linear association between alcohol consumption and AF risk.
Results: A total of 10,151,366 participants with 214,365 cases of AF enrolled in 13 prospective studies. The overall meta-analysis showed that a 1 drink/day increase in alcohol consumption increased the risk of AF by 6% (RR: 1.06; 95% CI: 1.03-1.08). In gender subgroup analysis, pooled results were different between men (RR: 1.08; 95% CI: 1.05-1.11) and women (RR: 1.05; 95% CI: 0.96-1.14). A linear relationship between alcohol consumption and risk of AF was found in men (p = 0.87) while a J-shaped curve was observed in women (p = 0.00). Regional subgroup analysis yielded broadly comparable results in Americas (RR: 1.07; 95% CI: 1.03-1.12), Europe (RR: 1.04; 95% CI: 0.99-1.1) and Asia (RR: 1.07; 95% CI: 0.99-1.14).
Conclusion: The relationship between AF risk and alcohol consumption is linear in men, while a potential non-linear J-shaped relationship is shown in women. Condensed abstract: We conducted a dose-response meta-analysis on the relationship between alcohol consumption and risk of atrial fibrillation. We merged the data of over 10 million participants and found gender differences in the pattern of association with AF and alcohol consumption. The relationship between AF risk and alcohol consumption is linear in men, while a potential non-linear J-shaped relationship is shown in women. In summary, this research is vital in furthering our understanding of the role of alcohol consumption in new-onset AF, especially among different genders.
This review discusses the inconsistent recommendations on alcohol consumption and its association with chronic disease, highlighting the need for an evidence-based consensus. Alcohol is an addictive substance consumed worldwide, especially in European countries. Recommendations on alcohol consumption are controversial.
On one hand, many nonrandomized studies defend that moderate consumption has a beneficial cardiovascular effect or a lower risk of all-cause mortality. On the other hand, alcohol is associated with an increased risk of cancer, neurological diseases, or injuries, among others.
For years, efforts have been made to answer the question regarding the safe amount of alcohol intake, but controversies remain. Observational studies advocate moderate alcohol consumption following a Mediterranean pattern (red wine with meals avoiding binge drinking) as the best option for current drinkers.
However, agencies such as the IARC recommend abstention from alcohol as it is a potent carcinogen. In this context, more randomized trial with larger sample size and hard clinical endpoints should be conducted to clarify the available evidence and provide clinicians with support for their clinical practice.
This review discusses the inconsistent recommendations on alcohol consumption and its association with chronic disease, highlighting the need for an evidence-based consensus. Alcohol is an addictive substance consumed worldwide, especially in European countries. Recommendations on alcohol consumption are controversial. On one hand, many nonrandomized studies defend that moderate consumption has a beneficial cardiovascular effect or a lower risk of all-cause mortality. On the other hand, alcohol is associated with an increased risk of cancer, neurological diseases, or injuries, among others. For years, efforts have been made to answer the question regarding the safe amount of alcohol intake, but controversies remain. Observational studies advocate moderate alcohol consumption following a Mediterranean pattern (red wine with meals avoiding binge drinking) as the best option for current drinkers. However, agencies such as the IARC recommend abstention from alcohol as it is a potent carcinogen. In this context, more randomized trial with larger sample size and hard clinical endpoints should be conducted to clarify the available evidence and provide clinicians with support for their clinical practice.
PURPOSE: Previous meta-analyses assessed the association of adherence to the Mediterranean dietary pattern (MedDiet) with the risk of type 2 diabetes (T2D). Since then, new large-scale cohort studies have been published. In addition, dose-response relation was not previously investigated and the certainty of evidence was not assessed. We aimed to explore the dose-response relationship between adherence to the MedDiet and the risk of T2D.
METHODS: We did a systematic search using PubMed, Scopus, and ISI Web of Science up to April 2021 for prospective cohort studies of the relationship between adherence to the MedDiet and the risk of T2D in the general population. The summary relative risks (RR) and 95%CI were estimated by applying a random-effects model.
RESULTS: Fourteen prospective cohort studies (410,303 participants and 41,466 cases) were included. There was an inverse association for the highest versus lowest category of adherence to the MedDiet (RR: 0.79, 95%CI 0.72, 0.88; I(2) = 82%, n = 14; Risk difference: - 21 per 1000 person, 95%CI - 28, - 12; GRADE = moderate certainty), and for a 2-point increment in the MedDiet adherence score (RR: 0.86, 95%CI 0.82, 0.91; n = 13). The RR remained significant after controlling for important confounders and in almost all subgroups, especially subgroups defined by geographical region. We observed an inverse linear association between MedDiet adherence score and T2D incidence.
CONCLUSION: Adherence to the MedDiet was inversely related to T2D risk in a dose-response manner. Adherence to a Mediterranean-style diet may be a good advice for the primary prevention of T2D.
REGISTRY AND REGISTRY NUMBER: PROSPERO (CRD42021246589).