Alcohol responsible for one in 20 deaths worldwide: WHO

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Alcohol kills three million people worldwide each year—more than AIDS, violence and road accidents combined, the World Health Organization said Friday, adding that men are particularly at risk.
The UN health agency's latest report on alcohol and health pointed out that alcohol causes more than one in 20 deaths globally each year, including drink driving, alcohol-induced violence and abuse and a multitude of diseases and disorders.

22 sept 2018--Men account for more than three quarters of alcohol-related deaths, the nearly 500-page report found.
"Far too many people, their families and communities suffer the consequences of the harmful use of alcohol through violence, injuries, mental health problems and diseases like cancer and stroke," WHO chief Tedros Adhanom Ghebreyesus said in a statement.
Drinking is linked to more than 200 health conditions, including liver cirrhosis and some cancers.
Alcohol abuse also makes people more susceptible to infectious diseases such as tuberculosis, HIV and pneumonia, the report found.
The some three million alcohol-related deaths registered globally in 2016—the latest available statistics—account for 5.3 percent of all deaths that year.
For young people, the numbers are even more alarming, with a full 13.5 percent of all deaths among 20-29-year-olds considered to be alcohol-related, the study found.

'Unacceptably high'

In comparison, HIV/AIDS was responsible for 1.8 percent of global deaths in 2016, road injuries accounted for 2.5 percent and violence for 0.8 percent, it said.
The latest numbers are lower than those in WHO's last report on global alcohol consumption, published in 2014.
There are "some positive global trends", the agency said, noting shrinking prevalence of heavy episodic drinking and alcohol-related deaths since 2010.
But it warned that "the overall burden of disease and injuries caused by the harmful use of alcohol is unacceptably high," especially in Europe and the Americas.
Globally, an estimated 237 million men and 46 million women suffer from alcohol use disorders, WHO said.
Alcohol abuse affects nearly 15 percent of men and 3.5 percent of women in Europe, and 11.5 percent of men and 5.1 percent of women in the Americas, it pointed out.
Alcohol consumption overall is unevenly distributed around the globe, with well over half of the world's population over the age of 15 abstaining completely.
On average, the 2.3 billion people currently considered drinkers—meaning they have drunk alcohol at least once in the past year—consume 33 grammes of pure alcohol per day.

A beer a day

That is roughly equivalent to two glasses of wine, a large bottle of beer or two shots of spirits.
Europe clearly has the highest per capita consumption, which despite a more than 10-percent drop since 2010 still registered a per capita consumption of 10 litres of pure alcohol or more per year.
Alcohol consumption has dropped in three-quarters of European countries, with the biggest declines seen in Russia, Moldavia and Belarus.
In Russia, average annual alcohol consumption plunged from 18.7 litres of pure alcohol per person over 15 in 2005 to 11.7 litres in 2016, the report said.
This "dramatic decrease" is linked to a range of "positive policies" introduced by Moscow, Vladimir Poznyak, who coordinates WHO's substance abuse unit, told reporters.
He pointed to the introduction of a minimum price for vodka and an alcohol advertising ban.

Sport sponsorships

WHO however warned that outside of Europe, alcohol consumption has continued to rise, especially in Asia, with China and India registering significant hikes.
It urged countries to do more to counter harmful drinking and to reach a goal of cutting global consumption by 10 percent between 2010 and 2025.
"Based on all trends and predictions, we can expect an increase in overall alcohol consumption and alcohol-related harm in the next 10 years," Poznyak warned, stressing that "this will definitely result in increased number of deaths and suffering around the world."
WHO is urging countries to tax alcohol and ban advertising of such beverages to reduce consumption.
Poznyak said blocking alcohol companies from sponsoring big sporting events could make a big difference.
"These events are being watched by millions and sometimes billions of young people, and it's impossible to prevent exposure to this kind of advertising to those who are under the legal age," he said.

Individuals who drink heavily and smoke may show 'early aging' of the brain

Treatment for alcohol use disorders works best if the patient actively understands and incorporates the interventions provided in the clinic. Multiple factors can influence both the type and degree of neurocognitive abnormalities found during early abstinence, including chronic cigarette smoking and increasing age. A new study is the first to look at the interactive effects of smoking status and age on neurocognition in treatment-seeking alcohol dependent (AD) individuals. Findings show that AD individuals who currently smoke show more problems with memory, ability to think quickly and efficiently, and problem-solving skills than those who don't smoke, effects which seem to become exacerbated with age.

20 may 2013--Results will be published in the October 2013 issue of Alcoholism: Clinical & Experimental Research and are currently available at Early View.

"Several factors – nutrition, exercise, comorbid medical conditions such as hypertension and diabetes, psychiatric conditions such as depressive disorders and post-traumatic stress disorder, and genetic predispositions – may also influence cognitive functioning during earlyabstinence," explained Timothy C. Durazzo, assistant professor in the department of radiology and biomedical imaging at the University of California San Francisco, and corresponding author for the study. "We focused on the effects of chronic cigarette smoking and increasing age on cognition because previous research suggested that each has independent, adverse affects on multiple aspects of cognition and brain biology in people with and without alcohol use disorders. This previous research also indicated that the adverse effects of smoking on the brain accumulate over time. Therefore, we predicted that AD, active chronic smokers would show the greatest decline in cognitive abilities with increasing age."

"The independent and interactive effects of smoking and other drug use on cognitive functioning among individuals with AD are largely unknown," added Alecia Dager, associate research scientist in the department of psychiatry at Yale University. "This is problematic because many heavy drinkers also smoke. Furthermore, in treatment programs for alcoholism, the issue of smoking may be largely ignored. This study provides evidence of greater cognitive difficulties in alcoholics who also smoke, which could offer important insights for treatment programs. First, individuals with AD who also smoke may have more difficulty remembering, integrating, and implementing treatment strategies. Second, there are clear benefits for thinking skills as a result of quitting both substances."

Durazzo and his colleagues compared the neurocognitive functioning of four groups of participants, all between the ages of 26 and 71 years of age: never-smoking healthy individuals or "controls" (n=39); and one-month abstinent, treatment-seeking AD individuals, who were never-smokers (n = 30), former-smokers (n = 21) and active-smokers (n = 68). Evaluated cognitive abilities included cognitive efficiency, executive functions, fine motor skills, general intelligence, learning and memory, processing speed, visuospatial functions, and working memory.

"We found that, at one month of abstinence, actively smoking AD [individuals] had greater-than-normal age effects on measures of learning, memory, processing speed, reasoning and problem-solving, and fine motor skills," said Durazzo. "AD never-smokers and former-smokers showed equivalent changes on all measures with increasing age as the never-smoking controls. These results indicate the combination of alcohol dependence and active chronic smoking was related to an abnormal decline in multiple cognitive functions with increasing age."

"These results indicate the combined effects of these drugs are especially harmful and become even more apparent in older age," said Dager. "In general, people show cognitive decline in older age. However, it seems that years of combined alcohol and cigarette use exacerbate this process, contributing to an even greater decline in thinking skills in later years."

Durazzo agreed. "Chronic cigarette smoking, excessive alcohol consumption, and increasing age are all associated with increased oxidative damage to brain tissue," he said. "Oxidative damage results from increased levels of free radicals and other compounds that directly injure neurons and other cells that make up the brain. Cigarette smoking and excessive alcohol consumption expose the brain to a tremendous amount of free radicals. We hypothesize that chronic, long-term exposure to cigarette smoke and excessive alcohol consumption interacts with the normal aging process to produce greater neurocognitive decline in the active-smoking AD group."

Cigarette smoking is a "modifiable health risk" that is directly associated with at least 440,000 deaths every year in the United States, Durazzo noted. "Chronic smoking, and to a lesser extent, alcohol use disorders are also associated with an increased risk for Alzheimer's disease," he said. "So, the combination of these modifiable health risks may place an individual at even greater risk for development of Alzheimer's disease. Given the above, in conjunction with the findings from our cognitive and neuroimaging research, we completely support programs that routinely offer smoking cessation programs to all individuals seeking treatment for alcohol/substance abuse disorders."

Older people may be at greater risk for alcohol impairment than teens, study says

An acute dose of alcohol may cause greater impairment in coordination, learning and memory in the elderly than in young people, according to a study by Baylor University.

15 april 2013--Researchers said the findings have profound significance for older people —a population that is aging worldwide at an unprecedented rate and that includes Baby Boomers as they become seniors.

"Health implications such as falls, accidents and poor medicine-taking are pretty easy to conclude," said Douglas B. Matthews, Ph.D., senior author of the paper, published online in the journal Alcoholism: Clinical and Experimental Research.

In the United States, as many as 13 percent of men and 8 percent of women over age 65 engage in risky drinking behavior, with an estimated 1 to 3 percent of those afflicted with an alcohol use disorder, according to prior research. Because of improvements in medicine and public health, nutrition and education, people 65 and older will account for nearly 20 percent of the U.S. population by the year 2030, according to U.S. Census Bureau estimates.

While previous data have indicated that aged people show significantly greater impairments than younger adults when alcohol is consumed, understanding the neurobiology underlying that increased sensitivity in the aged has been hampered by the lack of an adequate animal model, said Matthews, a research scientist in psychology and neuroscience in Baylor's College of Arts & Sciences and head of psychology at Nanyang Technological University in Singapore.

The Baylor research, the first of its kind, established a baseline of the acute effects of alcohol in aged populations, which can aid future research into neurobiology and in determining the effect of prolonged alcohol abuse.

The experiment included adult and aged rats (at least 18 months old), Matthews said. It showed a dramatic increase in ethanol-induced ataxia.

"We know a lot of neurobiological changes occur during aging which underlie age-related cognitive and behavioral deficits. It's reasonable to suspect a significant interaction exists between age-related and alcohol-induced effects in the brain," said Jim Diaz-Granados, Ph.D., a study co-author, chair of Baylor's department of psychology and neuroscience, and chair of the Council of Graduate Departments of Psychology, a national organization.

"Our hope would be that further findings in this area will serve as a basis to educate the public regarding the risks and provide insights in the clinic," Diaz-Granados said.

Provided by Baylor University

First evidence from humans on how alcohol may boost risk of cancer

Almost 30 years after discovery of a link between alcohol consumption and certain forms of cancer, scientists are reporting the first evidence from research on people explaining how the popular beverage may be carcinogenic. The results, which have special implications for hundreds of millions of people of Asian descent, were reported here today at the 244^th National Meeting & Exposition of the American Chemical Society.

24 aug 2012--Silvia Balbo, Ph.D., who led the study, explained that the human body breaks down, or metabolizes, the alcohol in beer, wine and hard liquor. One of the substances formed in that breakdown is acetaldehyde, a substance with a chemical backbone that resembles formaldehyde. Formaldehyde is a known human carcinogen. Scientists also have known from laboratory experiments that acetaldehyde can cause DNA damage, trigger chromosomal abnormalities in cell cultures and act as an animal carcinogen.

"We now have the first evidence from living human volunteers that acetaldehyde formed after alcohol consumption damages DNA dramatically," Balbo said. She is a research associate in the laboratory of Stephen Hecht, Ph.D., a noted authority on cancer prevention at the University of Minnesota. "Acetaldehyde attaches to DNA in humans ― to the genetic material that makes up genes - in a way that results in the formation of a 'DNA adduct.' It's acetaldehyde that latches onto DNA and interferes with DNA activity in a way linked to an increased risk of cancer."

Balbo pointed out that people have a highly effective natural repair mechanism for correcting the damage from DNA adducts. Most people thus are unlikely to develop cancer from social drinking, although alcohol is associated with a risk of other health problems and accidents. In addition, most people have an enzyme called alcohol dehydrogenase, which quickly converts acetaldehyde to acetate, a relatively harmless substance.

However, about 30 percent of people of Asian descent ― almost 1.6 billion people ― have a variant of the alcohol dehydrogenase gene and are unable to metabolize alcohol to acetate. That genetic variant results in an elevated risk of esophageal cancer from alcohol drinking. Native Americans and native Alaskans have a deficiency in the production of that same enzyme.

To test the hypothesis that acetaldehyde causes DNA adducts to form in humans, Balbo and colleagues gave 10 volunteers increasing doses of vodka (comparable to one, two and three drinks) once a week for three weeks. They found that levels of a key DNA adduct increased up to 100-fold in the subjects' oral cells within hours after each dose, then declined about 24 hours later. Adduct levels in blood cells also rose.

"These findings tell us that alcohol, a lifestyle carcinogen, is metabolized into acetaldehyde in the mouth, and acetaldehyde is forming DNA adducts, which are known major players in carcinogenesis," said Balbo.

Provided by American Chemical Society

Alcohol consumption declining, according to results of new study

New York, 07 aug 2008- Overall alcohol use—particularly consumption of beer—is declining in the US, according to a new study published in the August 2008 issue of The American Journal of Medicine. Researchers examined 50 years of data and found several changes in alcohol intake but no change in alcohol use disorders. Americans are drinking significantly less beer and more wine, while hard liquor use has remained fairly constant. More people now report that they are non-drinkers. People born later in the 20th century drink more moderately than older people. As we age, our individual alcohol consumption goes down.
Researchers examined 8,000 records of the Framingham Heart Study, the longest population-based study of American adults ever conducted, to measure alcohol consumption over 50 years. Because the Framingham study recruited subjects that were born before 1900 until 1959, it gives insights into behavior and medical histories through most of the 20th Century. Subjects, both from the original cohort and from the children of the original cohort, have been interviewed every 4 years, from 1948 until 2003. Since each individual was followed directly, a set of histories of lifetime alcohol use could be captured.
While heavy alcohol use is associated with numerous bad outcomes, moderate consumption has been linked to improved cardiovascular health and to improved morbidity and mortality in the elderly. This study shows that, on the whole, the American population is moving in a healthier direction. Despite more favorable patterns of drinking, risk of alcohol dependence did not show a decrease. The proportion of people who developed alcohol-related disorders, such as alcoholic cardiomyopathy or alcoholic cirrhosis remained nearly constant across all age groups.
Writing in the article, Yuqing Zhang, DSc, Boston University School of Medicine, and his co-investigators state, "The findings in this study may be considered encouraging in many ways: the average amount of alcohol has decreased in more recently born cohorts, the percentage of the population exhibiting 'moderate' alcohol intake has been increasing steadily, and the percentage reporting 'heavy' drinking has decreased over time…While these data suggest the development of more favorable patterns of alcohol consumption over the latter part of the 20th century, that also show that, at the same time, the cumulative incidence of alcohol use disorders has not shown a decrease, and continuing efforts at preventing them are warranted."
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The article is "Secular Trends in Alcohol Consumption over 50 Years: The Framingham Study" by Yuqing Zhang, DSc, Xinxin Guo, MPH, Richard Saitz, MD, MPH, Daniel Levy, MD, MPH, Emily Sartini, MA, Jingbo Niu, DSc, and R. Curtis Ellison, MD. It appears in The American Journal of Medicine, Volume 121, Issue 8 (August 2008) published by Elsevier.