21 September 2016 In Drinking & Eating Patterns

BACKGROUND: While the efficacy and effectiveness of brief interventions for alcohol (ABI) have been demonstrated in primary care, there is weaker evidence in other settings and reviews do not consider differences in content. We conducted a systematic review to measure the effect of ABIs on alcohol consumption and how it differs by the setting, practitioner group and content of intervention.

METHODS: We searched MEDLINE, EMBASE, PsycINFO; CINAHL, Social Science Citation Index, Cochrane Library and Global Health up to January 2015 for randomised controlled trials that measured effectiveness of ABIs on alcohol consumption. We grouped outcomes into measures of quantity and frequency indices. We used multilevel meta-analysis to estimate pooled effect sizes and tested for the effect of moderators through a multiparameter Wald test. Stratified analysis of a subset of quantity and frequency outcomes was conducted as a sensitivity check.

RESULTS: 52 trials were included contributing data on 29 891 individuals. ABIs reduced the quantity of alcohol consumed by 0.15 SDs. While neither the setting nor content appeared to significantly moderate intervention effectiveness, the provider did in some analyses. Interventions delivered by nurses had the most effect in reducing quantity (d=-0.23, 95% CI (-0.33 to -0.13)) but not frequency of alcohol consumption. All content groups had statistically significant mean effects, brief advice was the most effective in reducing quantity consumed (d=-0.20, 95% CI (-0.30 to -0.09)). Effects were maintained in the stratified sensitivity analysis at the first and last assessment time.

CONCLUSIONS: ABIs play a small but significant role in reducing alcohol consumption. Findings show the positive role of nurses in delivering interventions. The lack of evidence on the impact of content of intervention reinforces advice that services should select the ABI tool that best suits their needs.

21 September 2016 In Drinking & Eating Patterns

Using data from the National Longitudinal Survey of Adolescent to Adult Health, we estimate the effect of peers' alcohol consumption and alcohol prices on the drinking habits of high-school-age youth. We use the two-stage residual inclusion method to account for the endogeneity of peer drinking in nonlinear models. For our sample of high school students, we find that peer effects are statistically and economically significant regarding the choice to participate in drinking but are not significant for the frequency of drinking, including binge drinking. Regarding alcohol prices, even though we have good price variation in our sample, alcohol prices are not found to be significant. The results are important for policymakers who are considering policies to reduce underage drinking, as we conclude that no significant impact on underage drinking will result from low-tax states' increasing excise taxes on alcohol so they are similar to those of high-tax states. Policymakers may choose to focus instead on the influence of peers and changing the social norm behavior.

21 September 2016 In Drinking & Eating Patterns

BACKGROUND: Parental drinking has been shown to be associated with offspring drinking. However, the relationship appears to be more complex than often assumed and few studies have tracked it over longer time periods. AIMS: To explore the long-term (10-year) transmission of familial drinking during adolescence to offspring drinking patterns in young adulthood.

DESIGN: Swedish longitudinal study, assessing the relationship between familial drinking in 2000 and offspring drinking in 2010 using simultaneous quantile regression analysis (n=744). DATA: Data on familial drinking was gathered from the Swedish level-of-living surveys (LNU) and from partner LNU in 2000 while data on offspring drinking in young adulthood was gathered from LNU 2010. Drinking among offspring, parents and potential stepparents was measured through identical quantity-frequency indices referring to the past 12 months in 2010 and 2000 respectively.

RESULTS: Young adults whose families were abstainers in 2000 drank substantially less across quintiles in 2010 than offspring of non-abstaining families. The difference, however, was not statistically significant between quintiles of the conditional distribution. Actual drinking levels in drinking families were not at all or weakly associated with drinking in offspring. Supplementary analyses confirmed these patterns.

CONCLUSION: The association between familial drinking and offspring drinking in young adulthood exhibits clear non-linear trends. Changes in the lower part of the familial drinking distribution are strongly related to drinking in young adults, but the actual levels of drinking in drinking families appear less important in shaping the drinking patterns of the offspring in young adulthood.

21 September 2016 In Diabetes

BACKGROUND: People with diabetes are told that drinking alcohol may increase their risk of hypoglycaemia. AIMS: To report the effects of alcohol consumption on glycaemic control in people with diabetes mellitus.

METHODS: Medline, EMBASE and the Cochrane library databases were searched in 2015 to identify randomized trials that compared alcohol consumption with no alcohol use, reporting glycaemic control in people with diabetes. Data on blood glucose, HbA1c and numbers of hypoglycaemic episodes were pooled using random effects meta-analysis.

RESULTS: Pooled data from nine short-term studies showed no difference in blood glucose concentrations between those who drank alcohol in doses of 16-80 g (median 20g, 2.5 units) compared with those who did not drink alcohol at 0.5, 2, 4 and 24 h after alcohol consumption. Pooled data from five medium-term studies showed that there was no difference in blood glucose or HbA1c concentrations at the end of the study between those who drank 11-18 g alcohol/day (median 13g/day, 1.5 units/day) for 4-104 weeks and those who did not. We found no evidence of a difference in number of hypoglycaemic episodes or in withdrawal rates between randomized groups.

CONCLUSIONS: Studies to date have not provided evidence that drinking light to moderate amounts of alcohol, with or without a meal, affects any measure of glycaemic control in people with Type 2 diabetes. These results suggest that current advice that people with diabetes do not need to refrain from drinking moderate quantities of alcohol does not need to be changed; risks to those with Type 1 diabetes remain uncertain. This article is protected by copyright. All rights reserved.

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