Abstract
BackgroundHeavy alcohol consumption is an established risk factor for non-communicable diseases (NCDs) but few studies have investigated drinking and disease risk in middle income, non-western countries. We report on the relationship between alcohol consumption and NCDs in Thailand.MethodsA nationwide cross sectional survey was conducted of 87,151 Thai adult open university students aged 15 to 87 years (mean age 30.5 years) who were recruited into the Thai Cohort Study. Participants were categorized as never having drunk alcohol (n = 22,527), as being occasional drinkers who drank infrequently but heavily (4+ glasses/occasion - occasional heavy drinkers, n = 24,152) or drank infrequently and less heavily (<4 glasses/occasion - occasional light drinkers, n = 26,861). Current regular drinkers were subdivided into those who either drank heavily (4 + glasses per occasion - regular heavy drinkers, n = 3,675) or those who drank less (<4 glasses/occasion -regular light drinkers, n = 490). There were 7,548 ex-drinkers in the study. Outcomes were lifetime diagnoses of self-reported NCDs and obesity (body mass index ≥ 25).ResultsMost women were never drinkers (40 % among females) or occasional light drinkers (39 %), in contrast to men (11 % and 22 %, respectively). Alcohol consumption was associated with urban in-migration and other recognized risks for NCDs (sedentary lifestyle and poor diet). After adjustment for these factors the odds ratios (ORs) for several NCDs outcomes - high cholesterol, hypertension, and liver disease - were significantly elevated among both occasional heavy drinkers (1.2 to 1.5) and regular heavy drinkers (1.5 to 2.0) relative to never drinkers.ConclusionsHeavy alcohol consumption of 4 or more glasses per occasion, even if the occasions were infrequent, was associated with elevated risk of NCDs in Thailand. These results highlight the need for strategies in Thailand to reduce the quantity of alcohol consumed to prevent alcohol-related disease. Thailand is fortunate that most of the female population is culturally protected from drinking and this national public good should be endorsed and supported.
Highlights
Heavy alcohol consumption is an established risk factor for non-communicable diseases (NCDs) but few studies have investigated drinking and disease risk in middle income, non-western countries
Alcohol consumption was associated with urban in-migration and other recognized risks for NCDs
After adjustment for these factors the odds ratios (ORs) for several NCDs outcomes - high cholesterol, hypertension, and liver disease - were significantly elevated among both occasional heavy drinkers (1.2 to 1.5) and regular heavy drinkers (1.5 to 2.0) relative to never drinkers
Summary
Heavy alcohol consumption is an established risk factor for non-communicable diseases (NCDs) but few studies have investigated drinking and disease risk in middle income, non-western countries. Years (DALYs) in 2010 [1] It had a causal impact on the burden of non-communicable disease (NCDs), including several types of cancer, hypertension, ischemic heart disease, ischemic and haemorrhagic stroke and liver cirrhosis [2, 3]. Similar outcomes have been observed for ischemic stroke, but less is known about the relationship between binge drinking and other health outcomes, including those which may mediate the relationship between alcohol use and cardiovascular disease risk (e.g., hypertension, high cholesterol and obesity). Most research on alcohol and health has been conducted in Western countries [4], but concern is beginning to focus on emerging alcohol consumption in middle income countries such as Thailand [7]. Alcohol consumption in Thailand increased steadily from 1999 to 2008 and by 2008 was among the highest in Southeast
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