Drinking less than the UK's recommended limit of 14 units of alcohol per week still increases the risk of cardiovascular issues such as heart and cerebrovascular disease, according to new research published in the journal Clinical Nutrition.
29 jan 2022--Academics from Anglia Ruskin University (ARU) examined hospitalisations related tocardiovascular eventsamong more than 350,000 UK residents aged between 40 and 69 from data obtained from the UK Biobank study.
The sample included 333,259 people who drank alcohol. Participants had been asked about their overall weekly alcohol intake and their intake of specific types of alcohol including beer, wine and spirits. Those participants were followed up for a median of approximately seven years, capturing all incidences where patients had been hospitalized through cardiovascular events.
Anyone who had suffered a previous cardiovascular event was excluded from the analysis, as were former drinkers or those who had not completed information on alcohol intake.
The analysis found that, for those participants that drank less than 14 units of alcohol per week—the limit recommended by the UK's Chief Medical Officers—each additional 1.5 pints of beer at 4 percent strength (alcohol by volume) is associated with a 23 percent increased risk of suffering a cardiovascular event.
The authors argue that biases in existing epidemiological evidence have resulted in the widespread acceptance of the "J-shaped curve" that wrongly suggests low to moderate alcohol consumption can be beneficial to cardiovascular health.
These biases include using non-drinkers as a reference group when many do not drink for reasons of existing poor health, pooling of all drink types when determining the alcohol intake of a study population, and embedding the lower risk observed of coronary artery disease among wine drinkers, potentially distorting the overall cardiovascular risk from the drink.
Lead author Dr. Rudolph Schutte, course leader for the BSc Hons Medical Science program and Associate Professor at ARU, said:
"The so-called J-shaped curve of the cardiovascular disease-alcohol consumption relationship suggesting health benefit from low to moderate alcohol consumption is the biggest myth since we were told smoking was good for us.
"Among drinkers of beer, cider and spirits in particular, even those consuming under 14 units a week had an increased risk of ending up in hospital through a cardiovascular event involving the heart or the blood vessels. While we hear much about wine drinkers having lower risk of coronary artery disease, our data shows their risk of other cardiovascular events is not reduced.
"Biases embedded in epidemiological evidence mask or underestimate the hazards associated with alcohol consumption. When these biases are accounted for, the adverse effects of even low-level alcohol consumption are revealed.
"Avoiding these biases in future research would mitigate current confusion and hopefully lead to a strengthening of the guidelines, seeing the current alcohol guidance reduced."
More information: Rudolph Schutte et al, Alcohol – The myth of cardiovascular protection, Clinical Nutrition (2021). DOI: 10.1016/j.clnu.2021.12.009
One drink per day? Limit on men's alcohol consumption may become official US guideline
by Simone Jasper, The News & Observer (Raleigh, N.c.)
Credit: CC0 Public Domain
Men should restrict alcohol consumption to one drink each day, a group recommending new U.S. dietary guidelines says.
21 august 2020--That would be stricter than current guidance, which limits men to two drinks daily, according to the Centers for Disease Control and Prevention. Under the proposed change, men would be urged to stick to the same one-drink cap recommended for women.
"The fact that most existing evidence indicates increased risk of all-cause mortality among men drinking 2 drinks per day compared to 1 drink per day, and the possibility that no protection exists for low volume drinking on (cardiovascular disease), changing recommended limits to 1 drink daily for men is justified and should be strongly considered," the 2020 Dietary Guidelines Advisory Committee report said.
The proposal is among the suggestions under consideration for official U.S. dietary guidelines, which the government says are designed to help people make nutrition decisions.
Several of the recommendations, which the committee compiled into its July report, address drinking in moderation.
"Do not begin to drink alcohol or purposefully continue to drink because you think it will make you healthier," the report said in one of its suggestions.
Another recommendation urges "drinking less is generally better for health than drinking more."
In the United States, one drink is considered a 12-ounce beer, 5 ounces of wine or 1.5 ounces of 80-proof liquor, according to the CDC.
Health officials last week said a public comment period about the advisory committee's report had ended. The document is expected to help the U.S. Departments of Agriculture and Health and Human Services develop 2020-2025 dietary guidelines by the end of the year, the government said.
The report comes as the CDC this month revealed about 5% of adults were heavy drinkers. That means they "consume an average of more than 14 alcoholic drinks per week for men or more than 7 drinks per week for women," according to a survey conducted in 2018.
Increased alcohol use has been recorded during the coronavirus pandemic. Researchers have said free time, stress and limited access to treatment could be behind the trend, McClatchy News reported.
But drinking more than recommended can come with risks, health officials warn.
"Heavy drinking is associated with an increased risk of alcohol use disorders, suicide, interpersonal violence, traffic injuries, liver disease, certain cancers and infectious diseases, and adverse birth outcomes in pregnant women," according to the CDC.
Tuesday, March 19, 2019
People who don't drink may still suffer harms from alcohol, study suggests
Harms to people resulting from alcohol consumption by others in Germany in 2014 are assessed in a study published in the open access journal BMC Medicine.
19 mar 2019--Much of the research intoalcohol-associated harms investigates harm to the drinker, not to other individuals. Researchers at Institute for Therapy Research in Bayern, Germany, estimated the harms caused to others by alcohol during pregnancy, inroad traffic accidents, and as a result of interpersonal violence. The authors conclude that the harmful effects of alcohol on people other than the drinker need to be recognized as a public health problem, and effective ways of preventing such harms are required.
Dr. Ludwig Kraus, the corresponding author, said: "This study estimates some of the most severe harms that alcohol use may cause to other people than the drinker, namely fetal alcohol syndrome (FAS), fetal alcohol spectrum disorders (FASD), road traffic fatalities caused by drunk drivers, and deaths resulting from alcohol-attributable interpersonal violence."
The authors found that alcohol was responsible for 1,214 (45.1%) third-party road traffic deaths and 55 (14.9%) interpersonal violence deaths, and was implicated in 2,930 incidences of FAS and 12,650 cases of FASD. The authors note that FAS and FASD are not the only potential consequences of drinking alcohol during pregnancy. Overall, these results indicate that alcohol may not only cause harm to the drinker, but also substantial harm to third parties.
Dr. Kraus said: "Although the estimates across the three harm domains are not directly comparable, the results suggest that alcohol use in pregnancy followed by road traffic fatalities account for significantly more harm to others than alcohol-related violence."
To investigate the potential harm caused by alcohol to third parties, the authors examined survey data on the prevalence of alcohol use during pregnancy to estimate incidences of FAS and FASD in Germany. Cause-of-death statistics provided estimates of third party traffic deaths and interpersonal violence deaths thought to be caused by alcohol.
The authors caution that accurately assessing the prevalence and extent of alcohol use during pregnancy in Germany is challenging as the data are self-reported and so may be vulnerable to bias or misremembering.
Dr. Kraus said: "Although measures such as pricing policies or limiting the marketing of alcoholic beverages are unpopular, targeted measures addressing particular populations at risk, such as women of childbearing age or road users, may help to reduce harms to others as well as harms to the drinker."
More information: Quantifying harms to others due to alcohol consumption in Germany: a register-based study, Kraus et al. BMC Medicine 2019, DOI: 10.1186/s12916-019-1290-0
Provided by BioMed Central
Tuesday, July 17, 2018
Study finds potential link between alcohol and death rates
Credit: CC0 Public DomainDrinking heavily results in uncontrolled iron absorption into the body, putting strain on vital organs and increasing the risk of death, according to a new study published in the journal Clinical Nutrition. The study looked at health outcomes in 877 women in sub-Saharan Africa over a median follow-up time of nine years. The results of the study showed levels of ferritin, a blood marker of the extent of body iron loading, were higher in drinkers than non-drinkers.
17 july 2018--Iron loading is when the regulation of iron in the body is compromised by alcohol consumption, leading to more of it being absorbed. It is known to cause health issues such as heart attacks, liver disease and diabetes.
The study found that higher levels of ferritin and its statistical interaction with alcohol in these subjects predicted all-cause and cardiovascular mortality. This means that the prognostic significance of iron loading depends on alcohol consumption.
Dr. Rudolph Schutte, Course Leader of the BSc (Hons) Medical Science at Anglia Ruskin University, and lead author of the study, said: "Iron loading puts strain on especially the cardiovascular system through oxidisation, which can cause damage to cells, proteins and DNA.
"The link between iron and mortality has been disputed for around 30 years, but this study is the first to investigate the significance of the interaction between iron loading and alcohol intake.
"These findings may have health implications globally for people who consume large quantities of alcohol."
More information: Rudolph Schutte et al, Iron loading, alcohol and mortality: A prospective
study, Clinical Nutrition (2018). DOI: 10.1016/j.clnu.2018.05.008
Provided by Anglia Ruskin University
Thursday, May 17, 2018
Why alcohol health warning labels are a good idea: findings from the latest Global Drug Survey
Credit: lOvE lOvE/Shutterstock.comDrink-driving and drinking while pregnant are socially unacceptable in many countries, yet when it comes to other alcohol-related health risks, public awareness is low.
17 may 2018--Globally around 3.3m people die from causes directly related to alcohol consumption – the top ones being heart disease, cancer, liver disease and accidents. However, a 2016 survey of 2,100 adults in the UK found that just 13% of respondents identified cancer as a potential health risk of alcohol consumption.
It seems that the alcohol industry and governments aren't too bothered about changing this. In fact, mandatory health warnings for alcohol are rare. Across the EU, which boasts the highest per capita alcohol consumption in the world, there is no legislation requiring health warnings.
We know that the most effective strategies to change behaviour and reduce alcohol consumption are legislative. These include raising taxes, minimum unit pricing and lower drink-drive limits. But the alcohol industry lobbies hard against interventions that threaten profits, and most governments seem to defer to the industry's preferred alternative of self-regulation.
The industry and governments don't seem that keen on health warning labels either. One argument is that health messages don't change behaviour or that drinkers don't want to have their pleasure spoiled by uncomfortable truths. And it's true that information in isolation of other public health and health promotion strategies may be of limited value. But when it comes to motivating behaviour change, it can be helpful to raise awareness and challenge people's beliefs about their behaviour.
Health messages, if done well, could raise awareness and for some people might be the switch that gets them thinking about drinking less. Providing accurate information can also help to counter common myths and misunderstandings. For example, ambiguity about the potential health benefits of moderate drinking can be the "excuse" we need to resist changing our behaviour.
On the other hand, it is important to acknowledge evidence that health messages that try to induce fear often backfire – images of diseased lungs on cigarette packaging, being a case in point. Smokers don't want to be confronted by the negative consequences of their behaviour and they may smoke more to deal with the discomfort experienced. The same is likely to be true of alcohol health warnings.
Possible label. Author providedSome labels that might work
For the latest Global Drug Survey (GDS2018) – a survey of 130,000 people from more than 40 countries – we explored the potential of seven different health messages to change people's drinking habits. We chose a variety of health and social issues to focus on and used a mixture of positive messages, highlighting the benefits of reducing consumption, and negative messages, highlighting risks.
The results show that cancer remains the area that people least associate with alcohol use, and a message such as "drinking less can reduce your risk of seven different types of cancer" could get almost 40% of drinkers to think about drinking less.
The top two other messages that people reported would make them – or maybe make them – think about drinking less were: "Even people with heavy alcohol use can reduce their risk of liver disease by cutting down by even a small amount" (31%), and a label highlighting that a bottle of wine or six small beers has the same number of calories as a hamburger and fries (28%).
Our study also shows that different cultures may be more or less responsive to health warning labels, with Scandinavian countries, which certainly have high rates of alcohol-related harms, seemingly less concerned than those from South America and the Mediterranean.
Of particular interest was the relatively high rate of disbelief of the statement: "Most people get little or no health benefit from alcohol use, even at low levels of drinking". The subtle message that a little alcohol is good for your health is one the alcohol industry is fiercely protective of, and our results show that more work is required to diminish this falsehood.
Conversely, the label stating that alcohol increases the rate of violence and abuse was the one that was believed most by participants.
Globally, this was also rated as the most personally relevant label, closely followed by those about calories and the benefits of having two days off. This perhaps reflects that people are more concerned about the immediate effects of drinking.
Again, there were regional variations; our findings suggest that countries in South America and Eastern Europe may be more affected by the social impact of alcohol than other countries. Self-regulation doesn't work
Consumers of alcohol, like any other drug, need to be given the facts about the risks they expose themselves to when they drink. They need to know that risk is dependent on how much they drink and that drinking less reduces that risk. They need specific positive messages that allow people to feel OK about making decisions that may improve their health and well-being.
In the same way that plain packaging and health warnings on tobacco products were used as part of a broader public health approach to reducing consumption, appropriate and proportionate health messages on alcohol should be explored as a cheap, easy-to-implement strategy that could raise awareness of alcohol-related harms.
The latest Global Drug Survey supports the call for mandatory health warning labels on alcohol. An industry that makes profits from selling a product will never embrace anything that might lead to people drinking less. A self-regulated industry will always regulate to optimise profits not public health.
Largest study of its kind finds alcohol use biggest risk factor for dementia
Alcohol use disorders are the most important preventable risk factors for the onset of all types of dementia, especially early-onset dementia. This according to a nationwide observational study, published in The Lancet Public Health journal, of over one million adults diagnosed with dementia in France.
23 feb 2018--This study looked specifically at the effect of alcohol use disorders, and included people who had been diagnosed with mental and behavioural disorders or chronic diseases that were attributable to chronic harmful use of alcohol.
Of the 57,000 cases of early-onset dementia (before the age of 65), the majority (57%) were related to chronic heavy drinking.
The World Health Organization (WHO) defines chronic heavy drinking as consuming more than 60 grams pure alcohol on average per day for men (4-5 Canadian standard drinks) and 40 grams (about 3 standard drinks) per day for women.
As a result of the strong association found in this study, the authors suggest that screening, brief interventions for heavy drinking, and treatment for alcohol use disorders should be implemented to reduce the alcohol-attributable burden of dementia.
"The findings indicate that heavy drinking and alcohol use disorders are the most important risk factors for dementia, and especially important for those types of dementia which start before age 65, and which lead to premature deaths," says study co-author and Director of the CAMH Institute for Mental Health Policy Research Dr. Jürgen Rehm. "Alcohol-induced brain damage and dementia are preventable, and known-effective preventive and policy measures can make a dent into premature dementia deaths."
Dr. Rehm points out that on average, alcohol use disorders shorten life expectancy by more than 20 years, and dementia is one of the leading causes of death for these people.
For early-onset dementia, there was a significant gender split. While the overall majority of dementia patients were women, almost two-thirds of all early-onset dementia patients (64.9%) were men.
Alcohol use disorders were also associated with all other independent risk factors for dementia onset, such as tobacco smoking, high blood pressure, diabetes, lower education, depression, and hearing loss, among modifiable risk factors. It suggests that alcohol use disorders may contribute in many ways to the risk of dementia.
"As a geriatric psychiatrist, I frequently see the effects of alcohol use disorder on dementia, when unfortunately alcohol treatment interventions may be too late to improve cognition," says CAMH Vice-President of Research Dr. Bruce Pollock. "Screening for and reduction of problem drinking, and treatment for alcohol use disorders need to start much earlier in primary care." The authors also noted that only the most severe cases of alcohol use disorder - ones involving hospitalization - were included in the study. This could mean that, because of ongoing stigma regarding the reporting of alcohol-use disorders, the association between chronic heavy drinking and dementia may be even stronger.
More information: Contribution of alcohol use disorders to the burden of dementia in France 2008–13: a nationwide retrospective cohort study, The Lancet Public Health (2018). dx.doi.org/10.1016/S2468-2667(18)30022-7
Provided by Centre for Addiction and Mental Health
Monday, September 11, 2017
Alcohol industry misleading the public about alcohol-related cancer risk
Led by the London School of Hygiene & Tropical Medicine with the Karolinska Institutet, Sweden, the team analysed the information relating to cancer which appears on the websites and documents of nearly 30 alcohol industry organisations around the world between September 2016 and December 2016.
11 sept 2017--Most of the organisational websites (24/26) showed some sort of distortion or misrepresentation of the evidence about alcohol-related cancer risk, with breast and colorectal cancers being the most common focus of misrepresentation.
The most common approach involves presenting the relationship between alcohol and cancer as highly complex, with the implication or statement that there is no evidence of a consistent or independent link. Others include denying that any relationship exists or claiming inaccurately that there is no risk for light or 'moderate' drinking, as well discussing a wide range of real and potential risk factors, thus presenting alcohol as just one risk among many.
According to the study, the researchers say policymakers and public health bodies should reconsider their relationships to these alcohol industry bodies, as the industry is involved in developing alcohol policy in many countries, and disseminates health information to the public.
Alcohol consumption is a well-established risk factor for a range of cancers, including oral cavity, liver, breast and colorectal cancers, and accounts for about 4% of new cancer cases annually in the UK1. There is limited evidence that alcohol consumptionprotects against some cancers, such as renal and ovary cancers, but in 2016 the UK's Committee on Carcinogenicity concluded that the evidence is inconsistent, and the increased risk of other cancers as a result of drinking alcohol far outweighs any possible decreased risk².
This new study analysed the information which is disseminated by 27 AI-funded organisations, most commonly 'social aspects and public relations organisations' (SAPROs), and similar bodies. The researchers aimed to determine the extent to which the alcohol industry fully and accurately communicates the scientific evidence on alcohol and cancer to consumers. They analysed information on cancer and alcohol consumption disseminated by alcohol industry bodies and related organisations from English speaking countries, or where the information was available in English.
Through qualitative analysis of this information they identified three main industry strategies. Denying, or disputing any link with cancer, or selective omission of the relationship, Distortion: mentioning some risk of cancer, but misrepresenting or obfuscating the nature or size of that risk and Distraction: focussing discussion away from the independent effects of alcohol on common cancers.
Mark Petticrew, Professor of Public Health at the London School of Hygiene & Tropical Medicine and lead author of the study, said: "The weight of scientific evidence is clear - drinking alcohol increases the risk of some of the most common forms of cancer, including several common cancers. Public awareness of this risk is low, and it has been argued that greater public awareness, particularly of the risk of breast cancer, poses a significant threat to the alcohol industry. Our analysis suggests that the major global alcohol producers may attempt to mitigate this by disseminating misleading information about cancer through their 'responsible drinking' bodies."
A common strategy was 'selective omission' - avoiding mention of cancer while discussing other health risks or appearing to selectively omit specific cancers. The researchers say that one of the most important findings is that AI materials appear to specifically omit or misrepresent the evidence on breast and colorectal cancer. One possible reason is that these are among the most common cancers, and therefore may be more well-known than oral and oesophageal cancers.
When breast cancer is mentioned the researchers found that 21 of the organisations present no, or misleading, information on breast cancer, such as presenting many alternative possible risk factors for breast cancer, without acknowledging the independent risk of alcohol consumption.
Professor Petticrew said: "Existing evidence of strategies employed by the alcohol industry suggests that this may not be a matter of simple error. This has obvious parallels with the global tobacco industry's decades-long campaign to mislead the public about the risk of cancer, which also used front organisations and corporate social activities."
The researchers say the results are important because the alcohol industry is involved in conveying health information to people around the world. The findings also suggest that major international alcohol companies may be misleading their shareholders about the risks of their products, potentially leaving the industry open to litigation in some countries.
Professor Petticrew said: "Some public health bodies liaise with the industry organisations that we analysed. Despite their undoubtedly good intentions, it is unethical for them to lend their expertise and legitimacy to industry campaigns which mislead the public about alcohol-related harms. Our findings are also a clear reminder of the risks of giving the AI the responsibility of informing the public about alcohol and health.
"It has often been assumed that, by and large, the AI, unlike the tobacco industry, has tended not to deny the harms of alcohol. However, through its provision of misleading information it can maintain what has been called 'the illusion of righteousness' in the eyes of policymakers, while negating any significant impact on alcohol consumption and profits.
"It's important to highlight that if people drink within the recommended guidelines they shouldn't be too concerned when it comes to cancer. For accurate and accessible information on the risks, the public can visit the NHS website."
The authors acknowledge limitations of their study including that there are many other mechanisms and organisations through which industry disseminates health-related information which they did not examine, although it is unlikely that the messages would be different.
The researchers also say there is an urgent need to examine other industry websites, documents, social media and other materials in order to assess the nature and extent of the distortion of evidence, and whether it extends to other health information, for example, in relation to cardiovascular disease.
More information: Mark Petticrew et al, How alcohol industry organisations mislead the public about alcohol and cancer, Drug and Alcohol Review (2017). DOI: 10.1111/dar.12596
Provided by London School of Hygiene & Tropical Medicin
Saturday, August 05, 2017
For white middle class, moderate drinking is linked to cognitive health in old age
Older adults who consume alcohol moderately on a regular basis are more likely to live to the age of 85 without dementia or other cognitive impairments than non-drinkers, according to a University of California San Diego School of Medicine-led study. The findings are published in the August issue of the Journal of Alzheimer's Disease.
05 aug 2017--Previous studies have found a correlation between moderate alcohol intake and longevity. "This study is unique because we considered men and women's cognitive health at late age and found that alcohol consumption is not only associated with reduced mortality, but with greater chances of remaining cognitively healthy into older age," said senior author Linda McEvoy, PhD, an associate professor at UC San Diego School of Medicine.
In particular, the researchers found that among men and women 85 and older, individuals who consumed "moderate to heavy" amounts of alcohol five to seven days a week were twice as likely to be cognitively healthy than non-drinkers. Cognitive health was assessed every four years over the course of the 29-year study, using a standard dementia screening test known as the Mini Mental State Examination.
Drinking was categorized as moderate, heavy or excessive using gender and age-specific guidelines established by the National Institute on Alcohol Abuse and Alcoholism. By its definition, moderate drinking involves consuming up to one alcoholic beverage a day for adult women of any age and men aged 65 and older; and up to two drinks a day for adult men under age 65. Heavy drinking is defined as up to three alcoholic beverages per day for women of any adult age and men 65 and older; and four drinks a day for adult men under 65. Drinking more than these amounts is categorized as excessive.
"It is important to point out that there were very few individuals in our study who drank to excess, so our study does not show how excessive or binge-type drinking may affect longevity and cognitive health in aging," McEvoy said. Long-term excessive alcohol intake is known to cause alcohol-related dementia.
The researchers said the study does not suggest drinking is responsible for increased longevity and cognitive health. Alcohol consumption, particularly of wine, is associated with higher incomes and education levels, which in turn are associated with lower rates of smoking, lower rates of mental illness and better access to health care.
The UC San Diego School of Medicine research team adjusted the statistical analyses to remove confounding variables, such as smoking or obesity, but noted the study is based only on statistical relationships between different demographic factors, behaviors and health outcomes. There remain on-going debates about whether and how alcohol impacts lifespan or potentially protects against cognitive impairments with age.
One of the study's advantages, however, is that the data derive from a relatively homogenous population in a geographically well-defined area. All of the 1,344 older adults (728 women; 616 men) who participated in the study are from Rancho Bernardo, a white-collar, middle-to-upper-middle-class suburb in San Diego County. More than 99 percent of the study participants, tracked from 1984 to 2013, are Caucasian with at least some college education.
"This study shows that moderate drinking may be part of a healthy lifestyle to maintain cognitive fitness in aging," said lead author Erin Richard, a graduate student in the Joint San Diego State University/UC San Diego Doctoral Program in Public Health. "However, it is not a recommendation for everyone to drink. Some people have health problems that are made worse by alcohol, and others cannot limit their drinking to only a glass or two per day. For these people, drinking can have negative consequences."
More information: Erin L. Richard et al, Alcohol Intake and Cognitively Healthy Longevity in Community-Dwelling Adults: The Rancho Bernardo Study, Journal of Alzheimer's Disease (2017). DOI: 10.3233/JAD-161153
Provided by University of California - San Diego
Sunday, July 31, 2016
New review concludes that evidence for alcohol causing cancer is strong
A new review of epidemiological evidence supports a causal association between alcohol consumption and cancers at seven sites in the body: oropharynx, larynx, oesophagus, liver, colon, rectum and female breast. This is a stronger statement than the long-recognised association between alcohol and cancer. An association means there is a relationship of some kind between the two variables. A causal association means there is evidence that alcohol consumption directly causes cancer.
31 july 2016--The causal link was supported by evidence for a dose-response relationship, at least partial reversal of risk when alcohol consumption is reduced, statistical adjustment for other factors that might explain the association, and specificity of the association with some cancers and not others.
The epidemiological evidence for these conclusions comes from comprehensive reviews undertaken in the last 10 years by the World Cancer Research Fund and American Institute for Cancer Research, the International Agency for Research on Cancer, the Global Burden of Disease Alcohol Group, and the most recent comprehensive meta-analysis undertaken by Bagnardi and colleagues*, building on meta-analyses of the effect of alcohol on single cancers.
The review cites evidence that alcohol caused approximately half a million deaths from cancer in 2012, 5.8% of cancer deaths worldwide. The highest risks are associated with the heaviest drinking, but a considerable burden is experienced by drinkers with low to moderate consumption.
The review also finds the current evidence that moderate drinking provides protection against cardiovascular disease is not strong.
The review is published online today by the scientific journal Addiction.
More information: Connor J (2016) Alcohol consumption as a cause of cancer. Addiction 111: DOI: 10.1111/add.13477
*Bagnardi V, Rota M, Botteri E, Tramacere I, Islami F, Fedirko V, et al. Alcohol consumption and site-specific cancer risk: a comprehensive dose-response meta-analysis. Br J Cancer. 2015;112(3):580-93.
Provided by Society for the Study of Addiction
Sunday, January 10, 2016
Questions and answers about new UK drinking guidelines
A man walks by a wines and spirits shop in central London. British health officials say that drinking any alcohol regularly increases the risk of cancer, in tough new guidelines that could be hard to swallow for a nation where having a pint is a hallowed tradition. In recommendations released on Friday, Jan. 8, 2016, Britain's Chief Medical Officer advised both men and women not to drink any more than 14 units of alcohol, or about six pints of beer a week—that still carries a low risk of liver disease or cancer.
British health officials say drinking any alcohol regularly increases the risk of cancer, and have issued tough new guidelines that could be hard to swallow in a nation where having a pint is a hallowed tradition.
10 jan 2016--In recommendations released Friday, Britain's Chief Medical Officer advised both men and women not to drink any more than 14 units of alcohol—about six pints of beer or about four large glasses of wine—a week and said even that still carries a low risk of liver disease or cancer.
Alcohol is a known carcinogen; in the U.S., experts estimate it causes about 3.5 percent of all cancer deaths. People who have more than about four drinks a day have up to a three-fold greater risk of cancers of the head and neck than non-drinkers.
Here are some questions and answers about the new guidelines and their likely effect:
WHAT'S NEW?
For women, the guidelines remain unchanged, recommending no more than 14 units of alcohol a week.
Men, however, had previously been told they could drink up to 21 units a week. That now drops to the same limit as for women. The original guidance was published in 1995, before much of the recent evidence about the link between alcohol and cancer was released.
The guidance clarifies advice to pregnant women, recommending they avoid alcohol "as a precaution." The recommendations say "the risk of harm to the baby is likely to be low if a woman has drunk only small amounts of alcohol before she knew she was pregnant or during pregnancy."
In the U.S., the Centers for Disease Control and Prevention says there is no known safe amount of alcohol use during pregnancy or while trying to get pregnant.
WILL BRITONS GO TEETOTAL?
Probably not. In a nation known for its ales and its pubs, Britons are unlikely to abandon drinking in droves. Lax control of retail sales and cheap alcohol have fueled a rise in binge-drinking, which was once declared a national scandal by Prime Minister David Cameron. Even the new guidance acknowledges people are unlikely to give up drinking and advises them not to regularly drink more than 14 units a week rather than calling for abstinence.
To help Britons avoid binge drinking, the government recommends people spread their drinking over at least three days a week. It warns that the risk of cancers of the mouth, throat and breast increases with any amount drunk on a regular basis.
"This is not a crackdown on alcohol," said Dr. Niamh Fitzgerald, a lecturer in alcohol studies at the University of Stirling, who was not involved in drafting the government guidelines. "It is about supporting people to make up their own minds." In a statement, she said the new advice reflects the scientific consensus on the risks from drinking.
HOW DOES THIS COMPARE WITH OTHER COUNTRIES?
Each country measures alcohol consumption slightly differently. The new guidelines are stricter than some other countries in Europe including Ireland and Spain, but roughly similar to what's recommended in the U.S. According to American dietary guidelines, women should drink no more than one drink a day and men should have no more than two.
WHAT ABOUT THOSE SUPPOSED BENEFITS OF ALCOHOL?
While some studies have suggested drinking moderate levels of red wine is good for the heart, British officials say that only applies to women over age 55, in whom the greatest benefit is seen when women drink no more than about two glasses a week. "The group concluded that there is no justification for drinking for health reasons," the government said.
WHAT'S THE VIEW DOWN AT THE PUB?
"This won't change a thing," said David Evans, an engineer enjoying a pint at a north London pub. He said he regularly exceeds the new limitation of about six pints of beer a week in a single day and has no intention of changing his drinking habits. "A lot of people will let their own body tell them what's right and what's wrong," he said.
U.K. Independence Party leader Nigel Farage said the advice was "over the top" and called for a mass protest against such "nannying."
"We all know there is a big problem with excessive alcohol consumption in this country," he told LBC radio. "But frankly, if we choose to enjoy a few drinks four or five nights a week after a hard day at work, whether it slightly shortens our lives or not, so what?"
Tuesday, January 20, 2015
Drinking moderate amounts of alcohol is linked to reduced risk of heart failure
Evidence already exists for the beneficial effects of drinking moderate amounts of alcohol on the risk of developing a number of heart conditions; however, the role it plays in the risk of developing heart failure has been under-researched with conflicting results.
20 jan 2015--Now, a large study of nearly 15,000 men and women, published online today (Tuesday) in the European Heart Journal, shows that drinking up to seven drinks a week in early to middle age is associated with a 20% lower risk of men developing heart failure in the future when compared to people who did not drink at all, and a more modest 16% reduced risk for women.
Heart failure is a condition in which the heart can no longer pump blood around the body as well as it used to. The most common reason is that the heart muscle has been damaged, for instance by a heart attack. High blood pressure, heart muscle disease (cardiomyopathy), heart valve problems, an irregular heart beat (arrhythmia), viral infections, drinking excessive amounts of alcohol, consuming recreational drugs and the side-effects of radiotherapy treatment for cancer can all contribute to heart failure developing. Heart failure is a major public health problem with over 23 million people living with it worldwide.
Dr Scott Solomon, Professor of Medicine at Harvard Medical School and Senior Physician at Brigham and Women's Hospital, Boston, USA, Dr Alexandra Gonçalves, a research fellow at Brigham and Women's Hospital, and colleagues analysed data from 14,629 people aged between 45-64 years who had been recruited to the Atherosclerosis Risk in Communities Study between 1987 and 1989 in four communities in the USA. They followed the participants for 24-25 years to the end of 2011, and they questioned them about their alcohol consumption at the start and at each of the three subsequent visits made at three-yearly intervals.
They defined a drink as one that contains 14g of alcohol, equivalent to approximately one small (125ml) glass of wine, just over half a pint or a third of a litre of beer, and less than one shot of liquor such as whisky or vodka. The study participants were divided into six categories: abstainers (people who recorded having drunk no alcohol at every visit by the researchers), former drinkers, people who drank up to seven drinks a week, or between 7-14 drinks, 14-21 drinks, or 21 or more drinks a week.
During the follow-up period 1271 men and 1237 women developed heart failure. The lowest rate of heart failures occurred in those drinking up to 7 drinks per week and the highest rate was seen among former drinkers.
After taking account of various factors that could affect the results such as age, diabetes, high blood pressure, heart disease or heart attacks, body mass index, cholesterol levels, physical activity, education and smoking, men who consumed up to seven drinks a week had a 20% reduced risk of developing heart failure compared to abstainers, while the risk was reduced by 16% in women consuming the same amount. Former drinkers had the highest risk of developing heart failure - a 19% and 17% increased risk among men and women respectively compared to abstainers. Interestingly, among both men and women consuming the most amount of alcohol (14 or more drinks a week), the risk of heart failure was not significantly different compared to the risk for abstainers. Drinking excessive amounts of alcohol over a long period of time is known to increase the risk of cardiomyopathy. However, the number of very heavy drinkers in the study was small, which could have limited its power to detect such an association.
However, when the researchers looked at death from any cause, there was an increased risk of death of 47% for men and 89% of women who reported consuming 21 or more drinks a week at the start of the study.
Professor Solomon said: "These findings suggest that drinking alcohol in moderation does not contribute to an increased risk of heart failure and may even be protective. No level of alcohol intake was associated with a higher risk of heart failure. However, heavy alcohol use is certainly a risk factor for deaths from any cause.
"The people who were classified as former drinkers at the start of the study had a higher risk of developing heart failure and of death from any cause when compared with abstainers. This could be related to the reasons why they had stopped drinking in the first place, for instance because they had already developed health problems that might have made them more likely to go on to develop heart failure."
The protective effect of moderate drinking were more marginal in women than in men and the authors think this may be due to the fact that women metabolise alcohol in a different way to men and it can affect them differently.
Overall, most participants were abstainers (42%) or former drinkers (19%), with 25% reporting up to seven drinks a week, eight percent reporting seven to 14 drinks a week, and three percent reporting drinking 14-21 and 21 or more drinks a week respectively. Most drinkers also drank more than one type of drink. This meant that the researchers were unable to assess the role of binge drinking or any differences between types of drink.
"It is important to bear in mind that our study shows there is an association between drinking moderate amounts of alcohol and a lower risk of heart failure but this does not necessarily mean that moderate alcohol consumption causes the lowered risk, although we did adjust our results to take account, as far as possible, for a variety of other lifestyle factors that could affect a person's risk," concluded Professor Solomon.
More information: "Alcohol consumption and risk of heart failure: the Atherosclerosis Risk in Communities Study", by Alexandra Gonçalves et al. European Heart Journal. DOI: 10.1093/eurheartj/ehu514
Provided by European Society of Cardiology
Sunday, December 23, 2012
Alcohol may trigger serious palpitations in heart patients
The term "holiday heart syndrome" was coined in a 1978 study to describe patients with atrial fibrillation who experienced a common and potentially dangerous form of heart palpitation after excessive drinking, which can be common during the winter holiday season. The symptoms usually went away when the revelers stopped drinking. Now, research from UCSF builds on that finding, establishing a stronger causal link between alcohol consumption and serious palpitations in patients with atrial fibrillation, the most common form of arrhythmia.
23 dec 2012--In a paper scheduled to be published August 1 in the American Journal of Cardiology, the UCSF researchers report that people with atrial fibrillation had almost a four and a half times greater chance of having an episode if they were consuming alcohol than if they were not.
"One of the remaining big unknowns is why or how this happens," said senior author Gregory Marcus, MD, assistant professor of medicine at the UCSF Division of Cardiology. "In a previous publication, we suggested that there was an effect on the electrical activity of the atrium that leads to these arrhythmias but we do need additional studies to prove that."
Alcohol and Heart Palpitations
In the study, conducted from September 2004 to March 2011, UCSF researchers interviewed 223 patients with documented cardiac arrhythmia, a term that encompasses both atrial fibrillation and supraventricular tachycardia (SVT), or rapid heart rate originating above the ventricles. Researchers asked patients, "Does alcohol trigger your heart palpitations?" Participants ranked their symptoms on a scale from one to five (i.e. never, rarely, sometimes, frequently, and always).
"We defined 'yes' as frequently or always versus the rest of the responses," Marcus said, "and found that, after adjusting for potential confounders, atrial fibrillation patients had statistically significant greater odds of reporting that alcohol would trigger their symptoms." Of those patients interviewed, 133 reported intermittent or paroxysmal atrial fibrillation, or irregular heart palpitations, when drinking, and 90 had SVT, without any atrial fibrillation. After adjusting for variables, the paroxysmal atrial fibrillation group had a 4.42 greater chance of reporting alcohol consumption as an arrhythmia trigger, compared to the SVT group. Patients' claims of atrial fibrillation were verified by surface electrocardiograms and invasive cardiac studies.
The mean age of the study participants was 59 years. Eighty percent were Caucasian; 11 percent were Asian; 5 percent Latino, and 4 percent declined to state their ethnicity in the atrial fibrillation group. All were referred to and studied at UCSF.
"We didn't find any clear associations between age and race as a trigger, but we probably had insufficient number of people in the study," Marcus said.
Studying the Effects of Alcohol
Other studies have suggested that alcohol could help decrease the chance of developing atherosclerosis, which clogs or narrows the arteries. One of the proposed sources of benefit is the antioxidant in red wine called resveratrol, which may help prevent heart disease by increasing the "good" cholesterol in a person's body.
"There may be some beneficial effects to alcohol, but it's important to look at actual heart outcomes, like stroke and death," Marcus said. "Keep in mind that we used to think estrogen was good for your heart based on observational studies, and now we know that's not exactly true."
He says there's insufficient information at this time to recommend any lifestyle changes related to alcohol and heart disease risk. Still he points out that this report and previous reports indicate alcohol can cause cardiomyopathy and worsen hypertension.
"If someone has heart palpitations or atrial fibrillation, I'm often asked, 'Can I drink at all?'" Marcus said. "And I don't know the answer, but it may be that certain people are susceptible.
"The clinical evidence suggests that some people are susceptible and other people aren't, but if they know that they're susceptible they should avoid alcohol," he said.
Provided by University of California, San Francisco
Friday, September 09, 2011
One drink a day may be related to good overall health in women when older
Women who drink 15 grams or less of alcohol a day (the equivalent of one drink of any alcoholic beverage) at midlife may be healthier when older than women who do not drink at all, who consume more than two drinks a day, or who consume four drinks or more at the one time.
09 sept 2011--A study led by Qi Sun from the Harvard School of Public Health and the Brigham and Women's Hospital in Boston, USA, and published in this week's PLoS Medicine suggests that in women, regular, moderate alcohol consumption during middle age (average age 58 years) is related to good overall health—that is, having no major chronic diseases, such as heart disease or diabetes, and no major cognitive and physical impairment, or mental health limitations—in those who live to 70 years and beyond. The authors define this good overall health as "successful ageing."
The authors used information from periodic food frequency questionnaires given to the 121,700 female nurses enrolled in the US Nurses' Health Study (which began in 1976) to assess the alcohol consumption of the nurses during middle age. The authors then included in their analysis the vast majority (98.1%) of participants who were not heavier drinkers (45 g/d) when middle-aged and examined the health status in the 13,984 women who lived to 70 years and over.
After discounting other factors, such as smoking, that might affect their health status, the authors found that women who drank 5 g of alcohol per day (between a 1/3 and 1 drink per day) had about a 20% higher chance of good overall health when older compared to non-drinkers. Furthermore, women who drank alcohol regularly had a better chance of good overall health when older than occasional drinkers: compared to women who didn't drink, women who drank five to seven days a week had almost 50% greater chance of good overall health when older.
The authors conclude: "These data suggest that regular, moderate consumption of alcohol at midlife may be related to a modest increase in overall health status among women who survive to older ages."
They add: "The 2010 US Department of Agriculture dietary guidelines note that moderate alcohol consumption of up to one drink per day for women and up to two drinks per day for men may provide health benefits in some people. Our data support this recommendation and provide novel evidence suggesting that light-to-moderate alcohol consumption at the levels of one to two drinks/day or slightly less at midlife may benefit overall health at older ages in US women."
More information: Sun Q, Townsend MK, Okereke OI, Rimm EB, Hu FB, et al. (2011) Alcohol Consumption at Midlife and Successful Ageing in Women: A Prospective Cohort Analysis in the Nurses' Health Study. PLoS Med 8(9): e1001090. doi:10.1371/journal.pmed.1001090
