Approximately 170,000 people die from alcoholic cirrhosis of the liver in Europe every year. Although alcohol is the most important risk factor, less is known about the significance of different patterns of drinking. Currently scientists believe that cirrhosis is a function of the volume of alcohol consumed irrespective of patterns of drinking. Investigators have now established that alcohol drinking pattern has a significant influence on the risk of cirrhosis and that daily drinking increases that risk compared with drinking less frequently.
"For the first time, our study points to a risk difference between drinking daily and drinking five or six days a week in the general male population, since earlier studies were conducted on alcohol misusers and patients referred for liver disease and compared daily drinking to 'binge pattern' or 'episodic' drinking," observed lead investigator Dr Gro Askgaard, of the department of hepatology, Copenhagen University Hospital, Rigshospitalet, and the National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark. "Since the details of alcohol induced liver injury are unknown, we can only speculate that the reason may be that daily alcohol exposure worsens liver damage or inhibits liver regeneration."
To examine the patterns of drinking associated with alcoholic cirrhosis, researchers in Denmark investigated the risk of alcoholic cirrhosis among nearly 56,000 participants aged between 50 and 64 in the Danish Cancer, Diet, and Health study (1993-2011). All participants first completed a detailed food-frequency questionnaire along with a questionnaire regarding lifestyle and background factors (alcohol, smoking, physical activity, and years of education) as well as a brief physical examination including measurement of waist circumference. Amount of alcohol intake was reported as the average amount per week of specific types of alcohol: beer, wine, and liquor. Participants were also asked to report their average amount of alcohol intake when they were 20-29, 30-39, 40-49, and 50-59 years old. Follow-up information came from national registers.
The researchers calculated hazard ratios (HRs) for alcoholic cirrhosis in relation to drinking frequency, lifetime alcohol amount, and beverage type. Among the 55,917 participants, 257 men and 85 women developed alcoholic cirrhosis, corresponding to an incidence rate of 66 in men and 19 in women per 100,000 person-years. There were no cases of alcoholic cirrhosis among lifetime abstainers.
In men, the results showed that daily drinking increases the risk of alcoholic cirrhosis compared with drinking less frequently. The results also suggest that recent alcohol consumption, and not lifetime alcohol consumption, is the strongest predictor of alcoholic cirrhosis.
Compared with beer and liquor, wine seems to be associated with a lower risk of alcoholic cirrhosis up to a moderate level of weekly alcohol amount. Among women, researchers were unable to draw firm conclusions due to low statistical power, though in general they found the same trends.
"Earlier studies regarding lifetime alcohol consumption and risk of alcoholic cirrhosis reached opposite conclusions, for instance, whether a previous high level of alcohol amount predicted future risk, even after having cut down," commented Askgaard. "From a clinical point of view, this is relevant in order to execute evidence-based counselling, and from a public health perspective, it may guide health interventions for the general population."
"This is a timely contribution about one of the most important, if not the most important risk factor for liver cirrhosis globally, because our overall knowledge about drinking patterns and liver cirrhosis is sparse and in part contradictory," said noted expert Dr Jürgen Rehm, director of the social and epidemiological research department of the Centre for Addiction and Mental Health, Toronto. "The work of Askgaard and colleagues not only increases our knowledge, but also raises questions for future research. The question of binge drinking patterns and mortality is far from solved, and there may be genetic differences or other covariates not yet discovered, which play a role and could explain the different empirical findings."
Too much alcohol in middle age can increase your stroke risk as much as high blood pressure or diabetes, a new study suggests. Medicinenet reports that according to the findings, people who average more than two drinks a day have a 34% higher risk of stroke compared to those whose daily average amounts to less than half a drink. Researchers also found that people who drink heavily in their 50s and 60s tend to suffer strokes earlier in life than light drinkers or non-imbibers.
"Our study showed that drinking more than two drinks per day can shorten time to stroke by about five years," said lead author Pavla Kadlecova, a statistician at St Anne's University Hospital International Clinical Research Centre in the Czech Republic. The enhanced stroke risk created by heavy drinking rivals the risk posed by high blood pressure or diabetes, the researchers concluded. By age 75, however, blood pressure and diabetes became better predictors of stroke.
The study involved 11,644 middle-aged Swedish twins who were followed in an attempt to examine the effect of genetics and lifestyle factors on risk of stroke. Researchers analysed results from a Swedish registry of same-sex twins who answered questionnaires between 1967 and 1970. By 2010, the registry yielded 43 years of follow-up, including hospital records and cause-of-death data. Almost 30% of participants had a stroke. They were categorised as light, moderate, heavy or non-drinkers based on the questionnaires, and researchers compared the risk from alcohol and health risks such as high blood pressure, diabetes and smoking.
The researchers found that for heavy drinkers, alcohol produced a high risk of stroke in late middle age, starting at age 50. By comparison, light drinkers' or non-drinkers' stroke risk increased gradually with age. Among identical twins, siblings who had a stroke drank more than their siblings who hadn't had a stroke, suggesting that midlife drinking raises stroke risks regardless of genetics and early lifestyle, the researchers said.
Midlife heavy drinkers – those in their 50s and 60s – were likely to have a stroke five years earlier in life, irrespective of genetic and lifestyle factors, the study found.
For years, research has suggested that mixing alcohol and heavily-caffeinated energy drinks could have negative health effects. Combining the two seems to make you want to drink more and mask signs of inebriation, says a Time report. The combo’s potential negative consequences aren’t just a personal risk, but a public health one, suggests a new research.
"When people mix energy drinks with alcohol, people drink more than they would if they had just consumed alcohol, which is associated with a cascade of problems," says paper author Cecile Marczinski, associate professor of psychology at Northern Kentucky University. The increased likelihood of engaging in risky behaviour, particularly drunk driving, is chief among the public health concerns, Marczinski says. The caffeine rush in energy drinks makes a drinker look and feel more balanced and coordinated than their drinking would suggest, leading some drinkers to believe they’re not actually drunk.
In one study Marczinski cited, people who combined energy drinks and alcohol were four times more likely to think they could drive home than their counterparts who drank alcohol alone. The effects of the energy drink may also make it less obvious to police officers that a driver is drunk, making the officer less likely to breathalyse.
Other public health concerns that stem from mixing alcohol and energy drinks include adolescent brain damage, more emergency department visits and increased hospitalisations, the review says.
University of Connecticut Health Centre researcher Steven Meredith, who has studied the health effects of the mixed drinks but was not involved in the review, says that more research is needed to fully understand how energy drinks and alcohol interact with the body together. Still, taking a more active approach to public policy makes sense, he says, given the reported risks.
And a new study has found that young people who are more receptive to alcohol ads on TV may be at higher risk of problem drinking over the next few years. "If you compare low- to high-receptivity kids, their risk of transitioning to binge drinking was over four times higher," Dr James Sargent, the study’s senior author from the Geisel School of Medicine at Dartmouth College is quoted in Reuters Health as saying.
Sargent and his colleagues write about two thirds of US high school students reported drinking. About a third reported drinking in the past month, and about one in five reported recent binge drinking, that is, five or more drinks on one occasion.
Previous research tried to establish a link between TV alcohol advertisements and young people's drinking behaviours, but with conflicting results. For the new study, the researchers applied a method previously used to find a link between smoking shown in movies and people's smoking behaviour. The method involves showing people ads stripped of brands, to see what they can recall from having seen the ad on TV.
In 2010 and 2011, more than 3,000 people ages 15 to 23 answered a series of questions over the phone and then finished the image portion of the study online. Two years later, 1,596 participants completed follow-up surveys. The youngest participants were only slightly less likely than the oldest ones – about 23% versus 26% – to report having seen alcohol ads, to like the ads they saw and to identify the alcohol brands in the ads.
Liking and remembering ads was considered a sign of greater receptivity to the advertising message. And at the two-year follow-up, participants who had scored highest for receptivity were more likely to have transitioned to drinking, binge drinking and hazardous drinking. "This study suggests that alcohol marketing does affect subsequent drinking behaviours," Sargent said.
[link url="http://www.eurekalert.org/pub_releases/2015-01/ehs-ddi012315.php"]Elsevier Health Sciences press release[/link]
[link url="http://www.journal-of-hepatology.eu/article/S0168-8278(14)00923-4/abstract"]Journal of Hepatology abstract[/link]
[link url="http://www.medicinenet.com/script/main/art.asp?articlekey=186599"]Full Medicinenet report[/link]
[link url="http://stroke.ahajournals.org/content/early/2015/01/29/STROKEAHA.114.006724.abstract?sid=e4434187-ecb5-4435-8c32-f6c27990d7d1"]Stroke abstract[/link]
[link url="http://time.com/3677044/alcohol-energy-drinks/"]Full Time report[/link]
[link url="http://advances.nutrition.org/content/6/1/96.abstract"]Advances in Nutrition abstract[/link]
[link url="http://www.reuters.com/article/2015/01/21/us-alcohol-marketing-youth-idUSKBN0KU2QB20150121"]Full Reuters Health report[/link]
[link url="http://archpedi.jamanetwork.com/article.aspx?articleid=2089643"]JAMA Pediatrics abstract[/link]