Benefits and hazards of alcohol-the J-shaped curve and public health

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Erik Skovenborg ◽  
Morten Grønbæk ◽  
R. Curtis Ellison
Keyword(s):  
Public Health ◽  
Alcohol Consumption ◽  
Alcohol Intake ◽  
Density Lipoprotein ◽  
Blood Lipid ◽  
Epidemiological Studies ◽  
Protective Effects ◽  
Content Type ◽  
All Cause Mortality ◽  
Moderate Alcohol Intake

Purpose The purpose of this paper is a review of updated evidence of a J-shaped association between alcohol consumption and the risk of coronary heart disease (CHD) and all-cause mortality in relation to public health issues to create a basis for sensible individual health deliberations. Design/methodology/approach A review of the evidence from the first observation of a J-shaped association between a moderate alcohol intake and CHD in 1926 to recent studies of the effect of healthy lifestyles (including moderate alcohol intake) on life expectancy free of cardiovascular disease (CVD), cancer and Type 2 diabetes. An update on the biological plausibility of the J-shaped association with focus on recent findings of the association of alcohol intake and blood lipid levels. Findings Plausible J-shaped relations between light to moderate alcohol consumption and the risk of CHD, CVD mortality and all-cause mortality have been found in a large number of robust epidemiological studies. Among the potential mechanisms underlying the proposed protective effects are higher levels of high-density lipoprotein lacking apolipoprotein C3, reduced platelet aggregability, increased level of endothelial cell fibrinolysis, increased insulin sensitivity and decreased inflammation. Originality/value The existence of a J-shaped association between alcohol consumption and the risk of CHD and all-cause mortality is based on observational evidence and accordingly challenged by a degree of uncertainty leading some public health circles to state: “there is no safe level of alcohol consumption.” The authors propose that communication on the pros and cons of alcohol intake should emphasize the nadir of a J-shaped curve as a healthy range for the general population while advice regarding the consumption of alcohol should be adjusted to factor in the risks and potential benefits for each individual patient considering age, sex, family history, personal drinking history and specific medical history.

scholarly journals Alcohol Consumption And Cardiovascular Mortality In Hypertensive Patients

Circulation ◽  
2001 ◽  
Vol 103 (suppl_1) ◽  
pp. 1367-1367
Author(s):  
Maciej K. Malinski ◽  
Howard D. Sesso ◽  
Francisco Lopez-Jimenez ◽  
Julie E. Buring ◽  
J. Michael Gaziano
Keyword(s):  
Alcohol Consumption ◽  
Cardiovascular Mortality ◽  
Alcohol Intake ◽  
Linear Trend ◽  
Health Study ◽  
Moderate Alcohol Consumption ◽  
Hypertensive Patients ◽  
All Cause Mortality ◽  
History Of ◽  
Moderate Alcohol Intake

P83 Background: Alcohol drinking is associated with a dose-dependent increase in blood pressure, and JNC VI advises limiting alcohol consumption in patients with hypertension. Data are sparse on relationship between alcohol consumption and mortality in hypertensive patients. We therefore assessed whether alcohol consumption is associated with decrease in total, and cardiovascular mortality among subjects with hypertension. Methods: From the enrollment cohort of 89,251 men from the Physicians’ Health Study who provided self-reported information on alcohol intake and were free of myocardial infarction, stroke, cancer or liver disease at baseline, we identified a group of 14,125 persons with a history of current or past treatment for hypertension. Results: During 75,710 person-years of follow up, there were 1,018 deaths including 579 from cardiovascular disease and 224 from cancer. In multivariate analyses that controlled for several potential confounders, moderate alcohol intake was associated with significant decrease in cardiovascular mortality (P<0.001 for linear trend). Compared with non-drinking men, those who drank 1 to 3 drinks per month had a RR for cardiovascular mortality of 0.86 (CI 0.63-1.18, P=0.35); for 1 to 6 drinks per week, the RR was 0.64 (CI 0.51-0.81, P<0.001); for >= 1 drink per day the RR was 0.57 (CI 0.44-0.72, P<0.001). RR values for all-cause mortality in the same groups were respectively 0.89 (CI 0.70-1.15, P=0.38); 0.73 (CI 0.60-0.88, P=0.001); and 0.73 (CI 0.61-0.89, P=0.0014)(P=0.0025 for linear trend). On the other hand, we found no significant association between moderate alcohol consumption and cancer mortality (P=0.68 for linear trend). Conclusion: These results suggest that light to moderate alcohol consumption is associated with a significant reduction in cardiovascular and all-cause mortality in patients with hypertension.

Alcohol consumption and carotid atherosclerosis in China: the Cardiovascular Risk Survey

2011 ◽  
Vol 19 (3) ◽  
pp. 314-321 ◽  
Author(s):  
Xiang Xie ◽  
Yi-Tong Ma ◽  
Yi-Ning Yang ◽  
Zhen-Yan Fu ◽  
Xiang Ma ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
Alcohol Consumption ◽  
Carotid Artery ◽  
Alcohol Intake ◽  
Carotid Atherosclerosis ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Moderate Drinking ◽  
Carotid Plaques ◽  
Uygur Population

Aim: The relationship between alcohol consumption and carotid atherosclerosis has been reported in some epidemiological studies, but the results were conflicting. We investigated the association between alcohol intake and carotid atherosclerosis in the Han, Uygur, and Kazakh populations in Xinjiang in western China. Methods and results: The study population sample comprised 13,037 Chinese people (5277 Han, 4572 Uygur, and 3188 Kazakh) aged ≥35 years who participated in a cardiovascular risk survey between June 2007 and March 2010. Daily consumption of alcohol was determined by the number and frequency of alcoholic beverages consumed. Carotid-artery parameters, including common carotid artery intima–media thickness (CCA–IMT) and carotid plaques were measured using high-resolution B-mode ultrasonography. In the Han and Kazakh populations, CCA–IMT as a function of alcohol consumption was depicted as a J-shaped curve with a nadir for the alcohol-intake category of 20–29.9 g/day; In the Uygur population, a similar curve with a nadir of 30–49.9 g/day was observed. With respect to the prevalence of carotid plaques, we also observed similar curves in the Han and Kazakh populations, but not in the Uygur population. After adjustment for age, sex, blood pressure, body mass index, and smoking status, as well as levels of glucose, total cholesterol, high-density lipoprotein-cholesterol, and low-density lipoprotein-cholesterol, the J-shaped curves remained. Conclusions: Our results indicated that alcohol consumption was associated with carotid atherosclerosis and that moderate drinking had an inverse association with carotid atherosclerosis. However, the definition of moderate drinking could be different in Han, Uygur, and Kazakh populations.

Antiatherogenic potential of red wine: clinician update

2005 ◽  
Vol 288 (5) ◽  
pp. H2023-H2030 ◽  
Author(s):  
Paul E. Szmitko ◽  
Subodh Verma
Keyword(s):  
Large Scale ◽  
Alcohol Intake ◽  
Red Wine ◽  
Biological Effects ◽  
Epidemiological Studies ◽  
Alcoholic Beverages ◽  
Atherosclerotic Plaques ◽  
Industrialized Countries ◽  
Hemostatic Factors ◽  
Moderate Alcohol Intake

Complications of atherosclerosis remain the leading cause of morbidity and mortality in industrialized countries. Epidemiological studies have repeatedly demonstrated that moderate alcohol intake has a beneficial effect on cardiovascular disease. The purpose of this review is to examine the epidemiological and biological evidence supporting the intake of red wine as a means of reducing atherosclerosis. On the basis of epidemiological studies, moderate intake of alcoholic beverages, including red wine, reduces the risk of cardiovascular, cerebrovascular, and peripheral vascular disease in populations. In addition to the favorable biological effects of alcohol on the lipid profile, on hemostatic factors, and in reducing insulin resistance, the phenolic compounds in red wine appear to interfere with the molecular processes underlying the initiation, progression, and rupture of atherosclerotic plaques. Whether red wine is more beneficial than other types of alcohol remains unclear. Definitive data from a large-scale, randomized clinical end-point trial of red wine intake would be required before physicians can advise patients to use wine as part of preventative or medical therapies.

Alcohol use among older adults

2010 ◽  
Vol 20 (1) ◽  
pp. 56-68 ◽  
Author(s):  
Philip D St John ◽  
Wanda M Snow ◽  
Suzanne L Tyas
Keyword(s):  
Older Adults ◽  
Alcohol Consumption ◽  
Alcohol Use ◽  
Alcohol Intake ◽  
Alcohol Misuse ◽  
Heavy Episodic Drinking ◽  
Policy Makers ◽  
Alcohol Interventions ◽  
Screening Questionnaires ◽  
Moderate Alcohol Intake

SummaryAlcohol use is common in older adults and is associated with numerous health and social problems. Recent evidence suggests that in addition to level of alcohol consumption, drinking pattern may also be important. Moderate alcohol intake may confer some cardiac benefits, while heavy episodic drinking seems particularly problematic. Detecting alcohol misuse in older adults is difficult since clinical acumen is often poor, screening questionnaires have serious limitations and laboratory tests are not diagnostic. Brief alcohol interventions to reduce alcohol consumption appear useful in younger populations, but are less studied in older adults. While there is increasing research into the issue of alcohol use among older adults, clinicians and policy-makers must rely on limited evidence when making clinical decisions.

Biochemical and Haematological Response to Alcohol Intake

1985 ◽  
Vol 22 (1) ◽  
pp. 50-61 ◽  
Author(s):  
A G Shaper ◽  
S J Pocock ◽  
D Ashby ◽  
M Walker ◽  
T P Whitehead
Keyword(s):  
Alcohol Consumption ◽  
Alcohol Intake ◽  
Density Lipoprotein ◽  
Gamma Glutamyl Transferase ◽  
Haematological Response ◽  
Analysis Technique ◽  
Heavy Drinkers ◽  
Mean Corpuscular Haemoglobin ◽  
Glutamyl Transferase ◽  
Single Blood Sample

In a clinical survey of 7735 middle-aged men, alcohol consumption has been related to 25 biochemical and haematological measurements obtained from a single blood sample. Most measurements showed some association with alcohol consumption, gamma-glutamyl transferase (GGT) being the most strongly associated. Lead, mean corpuscular haemoglobin (MCH), mean corpuscular volume, high-density lipoprotein-cholesterol (HDL-C), urate and aspartate transaminase also showed substantial associations with alcohol intake. Using a discriminant analysis technique, a simple score based on five variables (GGT, HDL-C, urate, MCH and lead) provided the best discrimination between heavy drinkers (e.g. more than three pints of beer daily) and occasional drinkers, but still failed to identify more than half of the heavy drinkers. This combined score may prove a useful measure of an individual's biochemical/haematological response to alcohol consumption for use in epidemiological and clinical studies of alcohol-related disorders. The use of such indices should complement but not replace measures of alcohol intake derived from questionnaires.

scholarly journals Mechanisms of protective effects of moderate alcohol consumption on the cardiovascular system

2004 ◽  
Vol 132 (9-10) ◽  
pp. 334-339
Author(s):  
Branko Jakovljevic ◽  
Katarina Paunovic ◽  
Goran Belojevic ◽  
Vesna Stojanov
Keyword(s):  
Cardiovascular Diseases ◽  
Alcohol Consumption ◽  
Molecular Mechanisms ◽  
Blood Clot ◽  
Alcoholic Beverage ◽  
Significant Risk ◽  
Population Level ◽  
Epidemiological Studies ◽  
Alcoholic Beverages ◽  
Protective Effects

Consumption of alcoholic beverages has been known in many cultures since the ancient civilizations, so harmful consequences of excessive alcohol intake have been well explained. Many epidemiological studies confirmed lower morbidity and mortality rates of cardiovascular diseases in persons who drink alcohol "moderately" (1-2 drinks a day), independently of the kind of alcoholic beverage. This paper presents the review of molecular mechanisms that are believed to explain cardioprotective effect of moderate drinking-alcohol effects on lipoproteins, endothelial cells, blood clot formation and dissolution, as well as genetic and gender variances modifying the relation. A simple recommendation regarding the increase of alcohol consumption cannot be made on population level. The professionals must therefore concentrate on other preventive methods in order to reduce other significant risk factors of cardiovascular diseases.

Superior grey relational analysis on blood lipids and hematological parameters

2019 ◽  
Vol 9 (2) ◽  
pp. 207-212
Author(s):  
Jingyi Yan ◽  
Jin-Xiu Zhu ◽  
Nan Lu ◽  
Shanshan Gao ◽  
Jianfeng Ye ◽  
...  
Keyword(s):  
Grey Relational Analysis ◽  
Blood Lipids ◽  
White Cell Count ◽  
Hematological Parameters ◽  
Density Lipoprotein ◽  
Blood Lipid ◽  
Distribution Width ◽  
Content Type ◽  
Relational Analysis ◽  
Grey Relational

Purpose The purpose of this paper is to investigate the superior relationship between blood lipid- and cardiovascular disease (CVD)-related hematological parameters using superior grey relational analysis (GRA). Design/methodology/approach A total of 294 individuals who underwent simultaneous routine blood examination and blood lipid examination in the Physical Examination Center of the First Affiliated Hospital of Shantou University Medical College were included in this study. Superior GRA was performed to find out the superior factor in CVD-related hematological parameters and blood lipids. CVD-related hematological parameters included red blood cell distribution width, white cell count, and platelet count, platelet distribution width, mean platelet volume, as well as platelet crit. The indicators of blood lipids analyzed here consist of low-density lipoprotein, high-density lipoprotein, triglyceride and total cholesterol. Findings The results showed that all the grey relational degree of hematological parameters and blood lipids were over 0.8; the superior factor in hematological parameters was PLT, whereas TC was the superior factor in blood lipids. Practical implications Findings of this study suggested that hematological parameters are closely related to blood lipids and a potential role for hematological parameters in the prediction of dyslipidemia, which need further study; TC has the greatest influence on hematological parameters, whereas TG displays a minimal impact. Originality/value To the authors’ best knowledge, it was the first study to analyze the relationship between various CVD-related hematological parameters and blood lipids via superior GRA.

Abstract P043: Alcohol Consumption, Transferrin Saturation and Risk of All-Cause Mortality in The National Health and Nutrition Examination Surveys

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Laurence O James ◽  
James N Kiage ◽  
Loren Lipworth ◽  
Uchechukwu K Sampson ◽  
Edmond K Kabagambe
Keyword(s):  
Alcohol Consumption ◽  
National Health ◽  
Alcohol Intake ◽  
Iron Status ◽  
Transferrin Saturation ◽  
Moderate Alcohol Consumption ◽  
Health And Nutrition ◽  
Heavy Drinkers ◽  
All Cause Mortality ◽  
Reduced Risk

Background: Moderate alcohol consumers have a reduced risk for cardiovascular and all-cause mortality. Alcohol intake improves iron absorption and also has a profound effect on iron metabolism and thus could in part explain the observed inverse association between moderate alcohol intake and mortality. We sought to investigate whether moderate alcohol confers mortality benefits in part through improvement in iron status. Methods: Publicly available data from two consecutive National Health and Nutrition Examination Survey (NHANES) cycles (1999/2000 and 2001/2002) were obtained and linked to public data on all-cause mortality. Study participants were grouped as never, past, moderate (≤2 drinks/day for men, ≤ 1 drink/day for women) and heavy drinkers (>2 drinks/day for men, >1 drink/day for women). To assess the quality of alcohol data in NHANES, we tested whether self-reported alcohol consumption was associated with biomarkers of alcohol intake (HDL-C and γ-glutamyl transferase (GGT)). Cox-models, weighted using four-year sampling weights, were fitted to determine whether alcohol intake was associated with all-cause mortality. Measures of iron status, particularly serum ferritin, transferrin saturation, hemoglobin and free erythrocyte protoporphyrin were evaluated as potential mediators of the association between alcohol consumption and risk of all-cause mortality. Results: Among 7,532 men and women with complete data, 17% were never drinkers, 20% were past drinkers, 30% were moderate drinkers and 33% were heavy drinkers. We found an increase in HDL-C and GGT with increased alcohol intake, suggesting that self-reported alcohol intake is reliable in this population. In the weighted analysis, the hazard ratio (95% CI) for all-cause mortality among moderate alcohol users compared to never users was 0.56 (0.37-0.85), in models adjusted for age, race, smoking, statin use and history of diabetes, among other variables. Adjustment for transferrin saturation as a measure of iron status attenuated the benefit from moderate alcohol (HR = 0.69; 95% CI: 0.41-1.14), suggesting that moderate alcohol consumption may in part confer a benefit on mortality through improvement in iron status. These results warrant further evaluation in rigorous formal mediation analyses. Conclusions: Moderate alcohol consumption was associated with higher transferrin saturation and with reduced risk of mortality. Adjusting for iron status attenuated the association between moderate alcohol consumption and all-cause mortality suggesting that the effects of moderate alcohol on mortality may in part be via improvement in iron status.

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