Abstract P055: Diet, Lifestyle And Blood Pressure of Non-alcohol Drinkers and Alcohol Drinkers in The Intermap Study

Abstract

Background: Non-drinkers and alcohol drinkers differ in social and cultural traits, lifestyle habits (e.g., smoking, exercise, diet) and blood pressure (BP). Objective: Assess whether differences in lifestyle traits, particularly food intake, among non-alcohol drinkers, moderate and heavy alcohol drinkers account for higher BP of heavy drinkers. Methods: The INTERMAP Study is a cross-sectional epidemiologic investigation of 4,680 men and women ages 40–59 years from 17 population samples in China, Japan, United Kingdom and United States. With standardized quality-controlled methods, four 24-hour dietary recalls, 2 timed 24-hour urine collections, 8 BP measurements and questionnaire data were accrued. Data on lifetime alcohol use and daily alcohol consumption over the previous 7 days were obtained at two visits (14 days total). Results: Heavy alcohol drinkers (>26 g alcohol/day for men; >13 g alcohol/day for women) were more likely to be cigarette smokers, and had lower age-sex-sample adjusted mean body mass index (BMI) and higher adjusted total energy intake than moderate and non-alcohol drinkers (P<0.001). Heavy alcohol drinkers had mean systolic and diastolic BP higher by 3.2/2.1 mm Hg (P<0.001) compared to non/moderate drinkers adjusted for sex, population sample, age, years of education, cigarette smoking, physical activity, employment, marital status, family history of hypertension, cardiovascular disease and diabetes mellitus diagnosis, supplement intake, and special diet. With additional adjustment for BMI, the BP differences between non/moderate drinkers and heavy drinkers increased 8% to 3.5 mm Hg for systolic and 2.3 mm Hg for diastolic (P<0.001). Heavy drinkers had significantly lower intakes of pasta and rice, bread, cereals, milk, ice-cream, table spread, vegetable oil, fresh fruits, fruit juices, raw vegetables, cooked vegetables, sweet snacks and non-alcoholic beverages, and higher intakes of meat, fish, shellfish and nuts compared to non-drinkers and moderate drinkers. Of 17 foods with significantly different intakes between heavy drinkers and non/moderate drinkers had little or no influence on the higher BP of heavy drinkers (range from 0.00 to 0.16 mm Hg, 0 to 5% changes). With adjustment for possible confounders and multiple foods, the adjusted mean BP differences between non/moderate drinkers and heavy drinkers were 3.2 mm Hg for systolic (P<0.001) and 2.1 mm Hg for diastolic (P<0.001). Results were similar for men and women analysed separately. Conclusions: Differences in food intake did not account for the significantly higher BP among heavy drinkers suggesting that other lifestyle traits may operate, and/or that heavy drinking per se is the responsible trait.