26 August 2022 In General Health

Alcohol's impact on telomere length, a proposed marker of biological aging, is unclear. We performed the largest observational study to date (in n = 245,354 UK Biobank participants) and compared findings with Mendelian randomization (MR) estimates. Two-sample MR used data from 472,174 participants in a recent genome-wide association study (GWAS) of telomere length. Genetic variants were selected on the basis of associations with alcohol consumption (n = 941,280) and alcohol use disorder (AUD) (n = 57,564 cases).

Non-linear MR employed UK Biobank individual data. MR analyses suggested a causal relationship between alcohol traits, more strongly for AUD, and telomere length. Higher genetically-predicted AUD (inverse variance-weighted (IVW) beta = -0.06, 95% confidence interval (CI): -0.10 to -0.02, p = 0.001) was associated with shorter telomere length. There was a weaker association with genetically-predicted alcoholic drinks weekly (IVW beta = -0.07, CI: -0.14 to -0.01, p = 0.03).

Results were consistent across methods and independent from smoking. Non-linear analyses indicated a potential threshold relationship between alcohol and telomere length. Our findings indicate that alcohol consumption may shorten telomere length. There are implications for age-related diseases.

26 August 2022 In General Health

BACKGROUND: Gamma-glutamyltransferase (GGT) levels in the blood can be a sensitive marker of liver injury but the extent to which they give insight into risk across multiple outcomes in a clinically useful way remains uncertain.

METHODS: Using data from 293,667 UK Biobank participants, the relationship of GGT concentrations to self-reported alcohol intake and adiposity markers were investigated. We next investigated whether GGT predicted liver-related, cardiovascular (CV) or all-cause mortality, and potentially improved CV risk prediction.

FINDINGS: Higher alcohol intake and greater waist circumference (WC) were associated with higher GGT; the association was stronger for alcohol with evidence of a synergistic effect of WC. Higher GGT concentrations were associated with multiple outcomes. Compared to a GGT of 14.5 U/L (lowest decile), values of 48 U/L for women and 60 U/L for men (common upper limits of 'normal') had hazard ratios (HRs) for liver-related mortality of 1.83 (95% CI 1.60-2.11) and 3.25 (95% CI 2.38-4.42) respectively, for CV mortality of 1.21 (95% CI 1.14-1.28) and 1.43 (95% CI 1.27-1.60) and for all-cause mortality of 1.15 (95% CI 1.12-1.18) and 1.31 (95% CI 1.24-1.38). Adding GGT to a risk algorithm for CV mortality reclassified an additional 1.24% (95% CI 0.14-2.34) of participants across a binary 5% 10-year risk threshold.

INTERPRETATION: Our study suggests that a modest elevation in GGT levels should trigger a discussion with the individual to review diet and lifestyle including alcohol intake and consideration of formal liver disease and CV risk assessment if not previously done.

FUNDING: British Heart Foundation Centre of Research Excellence Grant (grant number RE/18/6/34217), NHS Research Scotland (grant number SCAF/15/02), the Medical Research Council (grant number MC_UU_00022/2); and the Scottish Government Chief Scientist Office (grant number SPHSU17).

26 August 2022 In General Health

The "drunken monkey" hypothesis posits that attraction to ethanol derives from an evolutionary linkage among the sugars of ripe fruit, associated alcoholic fermentation by yeast, and ensuing consumption by human ancestors. First proposed in 2000, this concept has received increasing attention from the fields of animal sensory biology, primate foraging behavior, and molecular evolution.

We undertook a review of English language citations subsequent to publication of the original paper and assessed research trends and future directions relative to natural dietary ethanol exposure in primates and other animals. Two major empirical themes emerge: attraction to and consumption of fermenting fruits (and nectar) by numerous vertebrates and invertebrates (e.g., Drosophila flies), and genomic evidence for natural selection consistent with sustained exposure to dietary ethanol in diverse taxa (including hominids and the genus Homo) over tens of millions of years.

We also describe our current field studies in Uganda of ethanol content within fruits consumed by free-ranging chimpanzees, which suggest chronic low-level exposure to this psychoactive molecule in our closest living relatives.

26 August 2022 In General Health

Literature highlights the need for adjustment for diet quality when the effect of alcohol consumption on health is investigated. We sought to define—a-posterior—dietary patterns according to various drinking preferences as well as to evaluate their combined effect against 10-year cardio-metabolic incidence.

During 2001–2002, 3042 CVD-free adults consented to participate in the ATTICA study; of them, 2583 completed the 10-year follow-up (85 % participation rate), but precise information about cardio-metabolic incidence was available in 2020 participants (overall retention rate 66 %). Intake per type of alcoholic beverage was assessed and “a posterior” dietary patterns were defined.

Results showed that among participants not drinking alcoholic beverages, women adhering more to a healthier dietary pattern had 25 % lower CVD risk within the 10-year study follow-up, while men adhering more to an unhealthy dietary pattern had almost two times higher CVD risk (p-values < 0.05). Among beer drinkers, both men and women adhering more to a healthier dietary pattern were found to have at least 26 % lower risk of developing hypertension and at least 15 % lower risk of developing hypercholesterolemia, while men adhering more to a healthier dietary pattern were also found to have 29 % lower CVD risk (all p-values < 0.05).

Similarly, among wine drinkers, women adhering more to a healthier dietary pattern were found to have a 16 % and 52 % lower risk of developing hypertension and diabetes mellitus, respectively, whereas men adhering more to a healthier dietary pattern had 22 % lower CVD risk (all p-values < 0.05). Finally, among spirit drinkers, higher adherence to an unhealthy dietary pattern in both genders had an aggravating effect on cardio-metabolic risk.

It seems that the quality of dietary pattern stands out as a critical confounding factor in studies assessing the effect of alcohol consumption on cardio-metabolic risk. A Phytochemical-Rich Dietary Pattern is suggested, particularly among drinkers.

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