Previous estimations of the associations between fruits and vegetables intake with diabetes markers showed mixed results, possibly partly because of the subjective assessment of dietary intake. We aimed to examine the relationship between the biomarkers (plasma carotenoids and α-tocopherol) as objective markers of fruit and vegetables (F/V) intake and fasting glucose in adults. This was a population-based cross-sectional study in 592 adults in Cameroon. Self-reported F/V intake was assessed using the WHO STEPS questionnaire and the biomarkers were analysed by high-performance liquid chromatography coupled with a photodiode array detector. The mean age of participants was 38.5±8.6 years (63.7% women). The median (IQR) number of times participants self-reported consuming fruits in a typical week was 2(1-5) times/week and vegetables was 4(2-7) times/week. Plasma total carotenoids was positively correlated with self-reported intake of fruits (r=0.13) and vegetables (r = 0.29), both p-value < 0.01. In unadjusted analysis, the difference in fasting glucose comparing the highest against the lowest tertile of the biomarkers concentrations was -0.28(95% CI -0.56 to -0.001) mmol/L for total carotenoids and -0.31(-0.59 to -0.03) mmol/L for plasma α-carotene. The inverse associations became stronger after adjusting for socio-demographics, smoking status, alcohol intake, season, physical activity, BMI and total cholesterol (-0.36(-0.73 to -0.002) mmol/L for total carotenoids and -0.41(-0.79 to -0.03) mmol/L for α-carotene). There was no evidence of an association between α-tocopherol and fasting glucose. We showed an inverse association of total carotenoids and α-carotene, objective indicators of F/V intake with fasting glucose. This suggests that a higher intake of F/V could be beneficial for diabetes prevention in African populations in whom the intake of F/V is low.

Lifestyle factors such as smoking, alcohol intake, physical activity, diet, and waist circumference are linked to kidney stone (KS) risk, but their combined effect is unclear. To examine the association between a composite lifestyle score and KS risk. We analyzed 2007–2016 NHANES data from 15,774 adults aged 20–80 years. A healthy lifestyle score (0–5) was derived from five factors: nonsmoking, moderate alcohol, adequate activity, healthy diet, and optimal waist circumference. KS was self-reported by questionnaire. Weighted multivariable logistic regression models were used to examine the association between the combined healthy lifestyle scores and KS risk. Restricted cubic spline models were employed to assess the dose-response relationship. The highest lifestyle score quartile had 51% lower KS risk (OR = 0.49; 95% CI: 0.41–0.63) versus the lowest quartile. Each 1-point increase reduced risk by 16% (OR = 0.84; 95% CI: 0.79–0.89). A linear dose-response relationship was observed (P-overall < 0.001; P-nonlinearity = 0.910). Sensitivity analyses supported robustness. Higher combined healthy lifestyle scores are associated with lower KS risk, highlighting the value of integrated lifestyle modification for prevention.

Rationale Disorders of arousal (DoA) constitute a class of related, heritable conditions that includes sleepwalking, sleep terrors, and confusional arousals. These disorders are defined by behavioral features which are shared with a separate phenomenon, alcohol-related blackout (ARB). Both ARB and DoA are characterized by full or partial amnesia and disinhibited behavior with maintenance of nearly normal motor function. While these disorders share phenomenology, to our knowledge no previous studies have examined the relationship between them. This is an important gap in the literature as the existence of a relationship between DoA and ARB would indicate potential shared underlying pathophysiology and genetic risk, possibly opening new pathways for research. Objectives The current study intended to probe the relationship between history of ARB and history of DoA among adults as a first step in determining whether they may be connected by shared neurophysiology, and whether there is a role of sex in that relationship. To control for alcohol intake, we examined whether DoA history interacted with alcohol use to predict ARB likelihood. Methods A demographically diverse sample ( n = 358) of adult (ages 18–72) United States citizens completed an online survey assessing self-reported drinking behaviors, lifetime history of ARB, and lifetime history of DoA episodes via the Munich Parasomnia Screening. Results Consistent with the literature, greater levels of past year alcohol misuse predicted higher likelihood of ARB in our sample. A novel finding is that history of DoA episodes also interacted with alcohol use to predict higher likelihood of ARB in females only. Conclusion Female individuals with a history of DoA may be more susceptible to experiencing ARB than individuals without such a history, suggesting that the two states may share a neurophysiological foundation.

Recent stressors may increase the risk of alcohol misuse. However, the number and duration of recent stress, whether social support (SS) moderates these effects, and whether this differs for men and women, are unclear. This cross-sectional study examined the effects of these factors on alcohol use severity, amount, and frequency in 462 community adult women and men. Linear regression (controlling for sex, age, and education) indicated that more stressful life events and longer stress duration were associated with a greater probability of any alcohol use and greater alcohol use severity as measured by the Alcohol Use Disorder Identification Test (AUDIT). More stressful events were associated with a greater amount of alcohol consumption. Longer stress duration also interacted with sex and SS to predict AUDIT scores, such that high SS, only for men, predicted a higher AUDIT score, but higher stress duration predicted AUDIT scores for women, regardless of SS score. More stress events with high social support predicted a greater alcohol use amount, only in men. Current findings demonstrate that significant impacts of the number and duration of recent stressors increase the risk of alcohol intake and severity. Furthermore, SS uniquely promotes drinking in men, suggesting male-specific increased alcohol risk. Future work would benefit from further disentangling whether these effects stem from certain types of SS (i.e., emotional, financial, practical) or if these effects were due to the nature of the social interactions (i.e., drinking buddies). Moreover, future work should continue to explore the multifaceted nature of stress as well as consider how sex and SS impact alcohol use.

Spinocerebellar ataxia type 6 (SCA6) is an autosomal dominant adult-onset neurodegenerative disorder. Cases may appear sporadic when the family history is uninformative or relatives' symptoms are unrecognized as disease-related. We herein report a 49-year-old male with no family history of ataxia but with excessive alcohol consumption, initially diagnosed with alcoholic cerebellar degeneration (ACD) and subsequently identified as having SCA6. Diagnosing ACD is difficult because reliable diagnostic markers and threshold levels of alcohol intake predicting cerebellar degeneration are lacking. Alternative diagnoses, including SCA6, should be considered when clinical or imaging findings are atypical and the family history is uninformative.

Atrial fibrillation (AF) risk is influenced by sex hormones and steatotic liver disease (SLD), but their interplay in women remains unclear. We aimed to evaluate the impact of various SLD statuses on AF risk among premenopausal and postmenopausal women. Total 2,181,691 women from the 2009 Korean National Health Insurance Service screenings were analyzed, excluding those with prior AF, hysterectomy, liver cancer, or transplantation. Participants were classified by menopausal status and SLD type: No SLD, metabolic dysfunction-associated steatotic liver disease (MASLD), MASLD with combined etiologies, MASLD and increased alcohol intake (MetALD), and alcohol-associated liver disease (ALD). Over 8.3 years of follow-up, postmenopausal women (n = 903,079) were older with higher body mass index and comorbidities, while premenopausal women (n = 1,278,613) more often smoked and consumed alcohol. In premenopausal women, AF incidence ranged from 0.65 per 1,000 person-years without SLD to 1.67 in ALD, with the highest hazard ratio in ALD (HR 2.16, 95% CI 1.27-3.67). Postmenopausal women showed higher absolute AF incidence (3.43-5.44) but attenuated hazard ratios, peaking at 1.66 in ALD. SLD is significantly associated with increased AF risk, peaking in premenopausal women with MASLD or ALD; these findings necessitate early cardiovascular risk assessment and AF screening, warranting further research into preventive strategies. These novel findings establish a significant association between SLD and increased AF risk across all menopausal stages, demonstrating that the highest relative risk is disproportionately concentrated in premenopausal women with MASLD or ALD, thus underscoring the urgent need for enhanced cardiovascular surveillance and status-specific primary prevention strategies in this overlooked younger population.

The long-term effects of alcohol consumption among stroke survivors are unclear. This study investigated the association between alcohol intake and all-cause and cardiovascular mortality, and whether inflammatory markers mediate this relationship. A total of 793 stroke survivors from the National Health and Nutrition Examination Survey 2005 to 2016 were classified by alcohol intake frequency. Mortality data were obtained from the National Death Index. Cox models estimated hazard ratios for mortality. Mediation analysis examined inflammatory biomarkers (neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, neutrophil-albumin ratio, white blood cell count). During follow-up, 313 participants died (86 cardiovascular deaths). Mild and moderate drinking were associated with reduced all-cause mortality compared to former drinkers (hazard ratio = 0.711 and 0.657, respectively; P < .05). No significant association was found with cardiovascular mortality. A J-shaped association was observed between alcohol use and all-cause death. Inflammatory markers showed minimal, nonsignificant mediation (≤8.2%). Light-to-moderate alcohol consumption was statistically associated with lower all-cause mortality among stroke survivors, while no significant association was observed for cardiovascular mortality. These findings represent observational associations based on the available data.

Hepatocellular carcinoma (HCC) remains a major health burden in Asia. Advances in antiviral therapies are reshaping the etiological landscape of HCC. This study evaluated temporal shifts in HCC etiology across Asian countries and their clinical implications. This multinational study analyzed 6,261 newly diagnosed HCC patients registered in the APASL Hepatology/Oncology Consortium (A-HOC) from 19 centers across seven Asian countries and regions between 2013 and 2023. Data on demographics, tumor characteristics, etiology, and treatment patterns were collected. Etiologies included hepatitis B virus (HBV), hepatitis C virus (HCV), alcoholic liver disease (ALD), metabolic dysfunction-associated fatty liver disease (MAFLD), MAFLD plus excess alcoholic intake (MAFLD + eAL), autoimmune liver disease, cryptogenic, and others. Temporal trends and regional variations were assessed. In many countries, HBV remained predominant (43.3%-69.5%) and relatively stable throughout the period, while HCV showed only modest reductions. In Japan, HCV was the leading cause of HCC (33.1%), with a significant decline over time, accompanied by a rise in MAFLD-related HCC. ALD-related HCC increased in South Korea, and MAFLD-related HCC rose in Turkey. Tumor size and stage at diagnosis varied by etiology and region, affecting treatment strategies. Early-stage diagnosis was more frequent in Japan and Taiwan, whereas advanced-stage HCC was common in China and Indonesia. Distinct regional patterns and temporal changes in HCC etiology across Asia highlight the need for tailored prevention and surveillance measures. The growing burden of MAFLD-related HCC emphasizes its emerging role in liver cancer development, particularly in regions with declining viral hepatitis.

The blackout rage gallon (BORG) is an excessive drinking trend popular at some colleges in the U.S and propelled by social media. Media reports depict harmful consequences of BORG use, but others view this trend as a strategy to reduce drink contamination, control alcohol intake, and minimize hangovers. This study provides the first detailed assessment of college students' perceptions and use of BORGs, including consequences and motivations for use and nonuse. Participants (age 18-25 years) were past-year college students (N=103) from both public and private U.S. institutions who reported weekly binge drinking and completed a survey assessing BORG use, motivations, and drinking-related outcomes. Participants were 20.4 years old, 62% female sex at birth, and their mean AUDIT score was 11.3±5.2. We oversampled college students reporting past-year BORG use (BORG+; n=63) relative to college students denying BORG use (BORG-; n=40). BORG+ participants consumed 9-10 standard alcohol drinks during a typical BORG event. Most reported getting buzzed or drunk (98%), nearly one-third (29%) experienced a blackout, 17% vomited, and 59% said/did something embarrassing. Regardless of these effects, two-thirds endorsed intending to engage in future BORG drinking. BORG- participants cited refraining from BORG use because it was not part of their college culture and was not effective for limiting alcohol intake. The BORG trend presents another challenge for harm reduction efforts focused on curbing excessive drinking in college students. The high intensity drinking of BORG use, paired with associated blackouts, vomiting, and behavioral disinhibition, render this phenomenon as living up to its name.

Disparities of Head and Neck Cancer in North India related to variability of Tobacco and Alcohol Intake: Policy consideration for Third World.

Smoking and alcohol consumption are major risk factors for oral potentially malignant disorders (OPMDs), yet the extent to which an OPMD diagnosis prompts behavioral change remains unclear. This study aimed to describe the changes in smoking and alcohol consumption in patients after an OPMD diagnosis and explore the role of demographic and clinical factors in these behavioral changes. A retrospective cohort study was conducted in the Department of Oral and Maxillofacial Surgery at the McGill University Health Centre, including OPMD patients from 2018 to 2023. Eligible patients had a confirmed OPMD diagnosis, no prior history of head and neck cancer, and at least six months of follow-up. Those without smoking or alcohol data were excluded. Descriptive statistics, McNemar's and Wilcoxon signed-rank tests to assess behavioral changes, and logistic regression to identify factors associated with continued smoking and alcohol use were used. The sample composed of 82 patients, 30 (36.6%) were female, with a mean age at diagnosis of 64 years. Leukoplakia (82.9%) was the most common OPMD, and the tongue was the most affected site (42.7%). Median follow-up was 29 months. Most patients (76.8%) had a histologic diagnosis of either mild or moderate dysplasia. At the time of diagnosis, about one-third were active smokers or moderate-to-heavy drinkers. Smoking prevalence decreased from 30.5% at diagnosis to 22.5% post-diagnosis, although this reduction did not reach statistical significance (p = 0.06), while moderate-to-heavy alcohol use remained largely unchanged (31.7% vs. 30.5%, p = 1.00). Younger patients were less likely to change smoking habits (OR = 0.96, 95% CI 0.91-1.00; p = 0.042). Patients from lower socioeconomic backgrounds had lower odds of alcohol use post-diagnosis (OR = 0.26, 95% CI 0.08-0.82; p = 0.021). The findings suggest that smoking cessation is achievable post-diagnosis, whereas reducing alcohol intake may require more targeted interventions. Resistance to behavior change among younger patients may explain rising oral cancer rates in this population.

Lifelong APOB gene inactivation lowers LDL-C and cardiovascular risk, but impairs hepatic lipoprotein export, predisposing to chronic liver disease (CLD). The extent to which common steatogenic factors modulate this risk remains unclear. Moreover, the balance between long-term cardiovascular protection and CLD risk in APOB variant carriers has never been evaluated. Using UK Biobank data, we analysed 241 APOB loss-of-function (LoF) carriers and 410 721 non-carriers, stratified by steatogenic risk factors, including age, sex, diabetes, BMI, alcohol intake and the PNPLA3-rs738409 genotype. Associations with transaminase levels, CLD and cardiovascular (ASCVD) outcomes were assessed using Python and R packages. APOB carriers had ~35% lower LDL-C and apoB levels, along with reduced total triglycerides and Lp(a) (all p < 0.001). Baseline ALT and AST were higher in carriers than in non-carriers (Padj = 3.6 × 10-7), particularly among those with obesity (p ≤ 0.003). The prevalence and incidence of CLD were consistently higher in carriers across all risk factor categories (p ≤ 0.01), with the strongest association in those with diabetes and obesity over 15 years of follow-up (Padj = 0.03). In contrast, APOB carriers as a whole had a 57% lower ASCVD risk (Padj = 0.009), with a similar atheroprotective trend across all risk factor categories. This corresponded to an absolute risk reduction of 2.30 ASCVD events/1000 person-years (p = 0.002) and an absolute increase of 3.48 CLD events/1000 person-years (p = 0.003). Long-term exposure to low LDL-C levels due to APOB LoF variants has opposite consequences, reducing ASCVD risk but increasing CLD risk, especially in the presence of diabetes and obesity. These findings highlight the importance of balancing cardiovascular benefit with hepatic safety when considering apoB-targeting therapies.

Argument for the pharmacokinetically-informed preclinical researcher: A commentary for Alcohol.

Accelerometry-assessed sleep and liver health in adolescents and adults: Links to liver enzymes, MASLD, and MRI-derived liver fat.

Alcohol-related liver disease (ALD) and alcohol-related myopathy are consequences of chronic alcohol use. However, understanding of the associated molecular mechanisms and effective treatments remains limited. Multi-omics were employed to uncover molecular blueprints of liver versus skeletal muscle responses to chronic alcohol exposure, using a preclinical mouse model showing signs of alcohol-related liver dysregulation (diminished liver phosphatidylcholine-to-phosphatidylethanolamine lipid ratio) and alcohol-related myopathy (reduced muscle mass and strength). A greater proportion of transcriptomic, proteomic, and metabolomic features were altered by alcohol in liver than muscle, whereas similar proportions of lipid species were affected in both tissues. The liver was significantly enriched for a broad and diverse set of metabolic pathways across molecular layers, while muscle was associated with upregulated inflammatory and matrisome responses and impaired mitochondrial energetics. Lipidome analyses also revealed a novel potential role for altered phospholipid remodeling in the etiology of alcohol-related myopathy. Finally, computational drug repurposing identified several compounds for therapeutic targeting of alcohol-induced liver (e.g., saracatinib, GSK126) and muscle (e.g., metformin, trichostatin A) pathophysiology. Overall, this study provides a list of therapeutic targets and treatments to help expedite the understanding of and countermeasures against ALD and myopathy in humans.

HFE genetic variants, especially C282Y homozygosity (C282Y+/+), can increase systemic iron and cause hemochromatosis, though expression varies. Excess iron can lead to liver disease and liver cancer, yet factors influencing liver iron beyond HFE genotype remain unclear. We investigated genetic/environmental factors influencing liver iron, including HFE genotype and hemochromatosis diagnosis. We analyzed 37,287 European ancestry UK Biobank participants (mean age 64.1, SD: 7.6) with HFE genotypes and MRI-estimated liver iron concentrations (MRLIC). Linear regression assessed MRLIC associations with genetic and environmental factors, adjusting for age, sex, and genetic covariates. Mean MRLIC was highest in undiagnosed C282Y+/+ males and females (2.56 and 2.31mg/g) versus diagnosed (1.23 and 1.51mg/g, p=0.0001 and 0.0004). Other HFE genotypes had nominal increases versus those without HFE genetic variants. Higher MRLIC was associated with higher alcohol intake (β=0.11, 95% CI: 0.09-0.11, p=6.0×10-128; >30 vs. 1-14 units/wk), frequent red/processed meat consumption (β=0.08, 95% CI: 0.07-0.09, p=3.7×10-54; ≥3 times/week vs. none), high waist-height ratio (β=0.01, 95% CI: 0.006-0.02, p=6.4×10-5; although magnitude was weak) and genetically predicted transferrin saturation (β=0.22, 95% CI: 0.19-0.26, p=3.8×10-46). Lower MRLIC was associated with underweight body mass index (β=-0.06, 95% CI: -0.09 to -0.03, p=1.1×10-4) and proton pump inhibitor use (β=-0.03, 95% CI: -0.04 to -0.03, p=3.5×10-17). Undiagnosed C282Y+/+ individuals had excess liver iron versus diagnosed, likely due to treatment. Genetic and environmental factors influence liver iron beyond C282Y+/+. Tailored lifestyle advice could benefit those at risk of hemochromatosis.

Association of change in healthy lifestyle in early adulthood with steatotic liver disease risk in midlife.

ABSTRACT Background: Previous work demonstrated that administration of saikosaponin A (SSA), one of the major components of the roots of Bupleurum falcatum, reduced oral alcohol self-administration, a validated measure of the reinforcing and motivational properties of alcohol, in Sardinian alcohol-preferring (sP) rats. Objectives: To evaluate whether SSA ability to reduce the reinforcing and motivational properties of alcohol extends to well-established binge-like drinking paradigms, characterized by intoxicating drinking patterns, in sP rats and C57BL/6J mice. Methods: Male sP rats (n = 48) were exposed to the 4-bottle [10%, 20%, and 30% (v/v)] alcohol vs water choice regimen, with limited and unpredictable time to access to alcohol. Male C57BL/6J mice (n = 56) were subjected to a single-bottle, 20% alcohol “drinking in the dark” protocol, initiated 3 hours into the dark phase. In both experiments, SSA (0, 1, 2, or 4 mg/kg) was administered acutely and intraperitoneally 15 min before the start of the drinking session. SSA was also tested on spontaneous locomotor activity in alcohol-naive sP rats (n = 48) and C57BL/6J mice (n = 39). Results: Alcohol binge-like drinking was prevented by administration of 2 and 4 mg/kg SSA in sP rats (p < .05; p < .005) and C57BL/6J mice (p < .005; p < .0001). However, the results of the locomotor activity experiments indicated that specificity of the reducing effect of SSA on alcohol intake was limited to sP rats and observed only at the dose of 2 mg/kg (p > .05). Conclusion: Overall, our findings support the potential of SSA as a treatment for binge alcohol drinking.

Introduction: Cataract, a progressive and largely irreversible opacification of the lens, remains a leading cause of visual impairment and blindness globally, with significant medical, social, and economic consequences. While aging is the main risk factor, lifestyle and environmental factors also influence cataract development. Aim: This review examines current evidence on the role of lifestyle, diet, and environmental exposures in the onset and progression of cataract, with a focus on identifying modifiable determinants that may inform preventive strategies. Materials and methods: For this review, we searched databases such as PubMed and Google Scholar using “cataract”, “diet”, “triggers”, “relationship”, “solar radiation”, “smoking”, and “alcohol”. We cited twenty-three articles in this publication. The review covers studies from 1966 to 2025. Results: Epidemiological and clinical studies indicate that diet quality, smoking, alcohol consumption, ultraviolet (UV) exposure, and corticosteroid use affect cataract risk. Diets rich in fruits, vegetables, antioxidants, and healthy fats are protective, while smoking and alcohol intake consistently increase risk. Corticosteroid use is strongly associated with posterior subcapsular cataracts, and cumulative UV exposure, along with environmental stressors such as heat and low humidity, contributes to regional disparities in disease burden. Conclusions: Cataract is a multifactorial condition influenced by aging, lifestyle, environmental, and pharmacological factors. Targeting modifiable risk factors through diet, lifestyle interventions, UV protection, and cautious corticosteroid use represents a crucial public health strategy. Future longitudinal, interventional, and epidemiological studies are warranted to clarify causal pathways and interactions, providing a robust evidence base for effective preventive programs aimed at delaying cataract onset.

ABSTRACTBackground and AimsNonalcoholic fatty liver disease (NAFLD) is a condition of fat accumulation in hepatocytes, not because of excess alcohol intake and disease‐causing etiology. The disease occurrence is increased among patients with type 2 diabetes mellitus (T2DM) because of a strong pathophysiological link. Therefore, the aim of this study was to assess the NAFLD status and its associated factors among patients with T2DM in Adama Hospital Medical College, South Eastern Ethiopia, 2022.MethodsSystematic random sampling was used in an institution‐based cross‐sectional study design from March to June 2022. Sociodemographic, behavioral, and clinical data were assessed using a structured questionnaire. Fatty liver was diagnosed using ultrasonography. About 5 mL of blood sample was collected for testing liver enzyme, fasting blood glucose, and lipid profile tests using the Cobas C 311 analyzer. EpiData version 3.1 was used for data input, and Stata version 17 for analysis. Binary and multivariable logistic regression were used to show the association of sociodemographic and clinical variables, and one‐way ANOVA with post hoc Bonferroni test was used to show significant mean differences among different liver status grading. p < 0.05 was taken as statistically significant.ResultsThe prevalence of NAFLD among patients with T2DM was 85.57% (95% CI: 79.8–89.8). Being female and having a longer duration of diabetes had higher odds of having NAFLD. Fasting blood glucose, alanine transaminase, direct bilirubin, total cholesterol, and triglyceride showed a significant mean difference among different NAFLD status as compared to patients with T2DM without NAFLD.ConclusionThe prevalence of NAFLD was found high. T2DM patients with longer duration of the diabetes and females were found to have a greater risk for NAFLD.