Intake Of Alcoholic Beverages Research Articles

Abstract P071: Moderate Exposure to Inorganic Arsenic in Drinking Water is Associated with Elevated Pulse Pressure: Results from Chihuahua, Mexico

Background: Though levels of arsenic >100 μg/L in drinking water have been consistently associated with increased risk of cardiovascular disease (CVD), evidence of an association at lower levels of exposure is more inconsistent. We used data from a cohort from Chihuahua Mexico to examine whether relatively low levels of arsenic in drinking water were associated with elevated pulse pressure, a marker linked to arterial stiffening and CVD risk. Methods: We used concentrations of arsenic in household drinking water from 931 adults not taking hypertensive medication to examine the association between water arsenic categories as low as 25-50 μg/L and mean increases in systolic, diastolic and pulse pressure (systolic - diastolic pressure). We also examined the association between water arsenic categories and elevated pulse pressure, defined as >70 mm Hg. Associations between arsenic exposure and blood pressure measures were obtained from multivariable linear or logistic regression models that adjusted for age, gender, education level, ethnicity, BMI, waist circumference, smoking status and alcoholic beverage intake. Results: After multivariable adjustment, compared to lower levels, water arsenic concentrations of 25-50 μg/L and above were associated with statistically significant increases in systolic blood pressure (SBP) and pulse pressure, but were not associated with diastolic blood pressure (DBP). Multivariable-adjusted associations [β (95% confidence interval)] with water arsenic concentrations of 25-50 μg/L were: 4.3 (1.2-7.4) mm Hg for SBP; 3.3 (0.8-5.7) mm Hg for pulse pressure; and 1.3 (-0.6-3.3) mm Hg for DBP. For elevated pulse pressure (16.1% of the sample), the association [odds ratio (95% CI)] with water arsenic levels of 25-50 μg/dL was 2.5 (1.3-4.9). Conclusions: Results support potential adverse effects of exposure to moderate levels of arsenic in drinking water on CVD risk through pathways that may involve widening pulse pressure.

Validity and reliability of beverage intake questionnaire: evaluating hydration status.

The purpose of this investigation is to test the validity and reliability the assessment methods for the true beverage consumption of adults. This cross-sectional study was carried out 291 healthy volunteers. The beverage intake questionnaire (BIQ) was prepared in combination with a new one which is developed based on basic principles and the existing one developed for the beverages consumed the most with respect to frequency and amount by Turkish populations. During the initial visit the participants completed BIQ1 and then provided a urine sample to determine urinary specific gravity(USG). For validity, participants recorded the type and quantity of foods and beverages consumed on the same day and previous two days. Two weeks later, for reliability, participants completed the same beverage intake questionnaire (BIQ2). Mean daily total fluid intake was estimated at 1,773 ± 49.4mL using the dietary intake record (DIR), 2,120 ± 49.5 mL with BIQ1 and 1,990 ± 46.3 mL for BIQ2. The largest contribution to total fluid intake was plain water. The response on the two assessment tools (DIR and BIQ1) all beverage intakes were significantly correlated (p < 0.01) except for alcoholic beverage intake. One could see a significant correlation between BIQ1 and BIQ2 in relation to total fluid intakes (r = 0.838,p < 0.01). The USG measurement was negatively correlated with three assessment tools (DIR, BIQ1 and BIQ2), the amount of plain water and the amount of total fluid intake. The self-administered instrument described in this study may be useful for researchers interested in assessing habitual beverage consumption patterns or evaluating hydration status for adults.

Trends in Energy Intake from Alcoholic Beverages among US Adults by Sociodemographic Characteristics, 1989-2012

BackgroundLong-term US trends in alcoholic beverage calorie intakes remain unexamined, particularly with respect to changes in population subgroup-specific patterns over time. ObjectiveThis study examined shifts in the consumption of alcoholic beverages, in total and by beverage type, on any given day among US adults in relation to sociodemographic characteristics. DesignThis study was a repeated cross-sectional analysis of data from the 1989-1991 and 1994-1996 Continuing Survey of Food Intakes by Individuals and the 2003-2006 and 2009-2012 National Health and Nutrition Examination Surveys. Participants and settingAdults aged ≥19 years (N=39,298) were targeted. A subset of alcoholic beverage consumers (n=7,081) were studied. Statistical analyses performedSurvey weighted mean per capita per day intakes (among all participants, both consumers of alcoholic beverages and nonconsumers) and contributions of beer, wine, and liquor/mixed drinks to total alcoholic beverage energy were determined. Multivariable regression models were used to examine trends in the proportion of alcoholic beverage consumers and the per consumer intakes (among consumers of alcoholic beverages only). ResultsPer capita intakes from alcoholic beverages increased from 49 kcal/capita/day in 1989-1991 to 109 kcal/capita/day in 2003-2006 (P<0.001). The proportion consuming alcoholic beverages on any given day increased significantly from 1989-1991 to 2009-2012 (P for overall increasing trend <0.0001) for most sociodemographic subgroups. Per consumer, alcoholic beverage calories increased between 1989-1991 and 1994-1996 (P<0.05) for many subpopulations. Adults with less than high school education were less likely to consume alcohol, yet had higher per consumer calorie intakes compared with adults with a college degree. Women and adults aged ≥60 years experienced a shift away from liquor/mixed drinks toward wine between 2003-2006 and 2009-2012. Beer contributed roughly 70% to total alcoholic beverage intake for less educated consumers across time. ConclusionsThese results indicate there has been an increase in the proportion of US adults who drink on any given day and an increase in calories consumed from alcoholic beverages when drinking occurs.

Healthy dietary pattern is inversely associated with non-alcoholic fatty liver disease in elderly.

The prevalence of non-alcoholic fatty liver disease (NAFLD) is rising, an increase that may be associated with changes in lifestyle such as unhealthy dietary patterns. Although advanced age is a risk factor for NAFLD, no studies reporting this association in the elderly population were found. In the present study, the association between dietary patterns and NAFLD in the elderly was assessed. A study including 229 older adults was conducted. NAFLD diagnosis was defined as individuals whose ultrasound examination disclosed hepatic steatosis at any stage, in the absence of excess intake of alcoholic beverages. Dietary patterns were obtained by principal components analysis. Mean scores and standard errors of each dietary pattern were calculated for the groups with and without NAFLD, and mean scores of the two groups were compared using the Mann-Whitney U test. The prevalence ratios and 95 % CI were estimated for each tertile of the dietary pattern adherence scores using Poisson multiple regression models with robust variance. A total of 103 (45 %) elderly with NAFLD and four dietary patterns were identified: traditional, regional snacks, energy dense and healthy. Mean scores for adherence to the healthy pattern in the groups with and without NAFLD differed. NAFLD was inversely associated with greater adherence to the healthy pattern and directly associated with the regional snacks, after adjustment for confounders. In conclusion, healthy dietary pattern is inversely associated with NAFLD in elderly.

Alcoholic beverage intake throughout the week and contribution to dietary energy intake in Australian adults.

To assess alcoholic beverage intake among Australian adults and its contribution to dietary energy intake. Secondary analysis of a national dietary survey using 24 h dietary recall. Australian National Nutrition and Physical Activity Survey (NNPAS) conducted from May 2011 to June 2012. Adults (n 9341) aged 19 years and over. On the day preceding the survey, 32·8% of Australian adults consumed one or more alcoholic drinks. The median contribution to total energy intake for consumers did not differ significantly between males and females (13·7% and 12·9%, respectively; P=0·10). The prevalence of consumption of alcoholic drinks on Friday, Saturday and Sunday was 38·8 (95% CI 37·1, 40·5)%, higher than the other days (28·6 (95% CI 27·5, 29·8)%). Consumers had a median daily intake of 4·0 standard drinks on the weekend compared with 3·0 standard drinks during the week (P<0·001). Beer was the most commonly consumed alcoholic beverage for men and white wine for women. The highest prevalence of alcoholic beverage intake occurred in the highest quintile of adjusted household income (42·7 (95% CI 40·4, 45·0)%) and the 'overweight' BMI category (40·3 (95% CI 38·5, 42·0)%). Alcoholic beverage intake among consumers was significantly different by household income quintile (median 3·84 (highest) v. 3·05 standard drinks (lowest); P<0·05) and by waist circumference category (median 4·09 standard drinks (highest)). Alcoholic drinks contribute substantially to the dietary energy intake of Australian adults. The type and pattern of consumption of alcoholic beverage intake should be considered in the development of strategies to improve dietary intake.

Nutritional therapy of gout

Nutrition and nutritional behaviours have been found to play a major role in the development of gout. Studies show that body mass index (BMI), as well as excessive intake of alcoholic beverages, meat, soft drinks and fruit juices increase the risk of developing gout. Similarly, dairy products and coffee have been seen to decrease the risk of hyperuricemia and gout, as they increase the excretion of uric acid. Flares of gout are often caused by large meals and high alcohol consumption. Each additional intake of meat portion per day increases the risk of gout by 21 %. Taking total alcohol consumption into account, the risk of gout increases after one to two standard drinks. In contrast to previous assumptions purine-rich plant foods like legumes and vegetables do not increase the risk of gout. The current dietary guidelines take into account nutritional factors, which not only consider purine intake, but also their endogenous production and their influence on renal excretion. A balanced diet based on the Swiss healthy eating guideline pyramid as well as the Mediterranean diet is appropriate for this patient population. The treatment of gout is multi-faceted, since this patient population presents other comorbidities such as obesity, diabetes mellitus, dyslipidemia and hypertension. Collectively, these risk factors are diet dependent and require a treatment strategy that is centered on modifying one's nutrition and nutritional behaviours. The aim of such therapy is to educate the patient as well as treat the accompanying comorbidities with the goal of decreasing serum uric acid values. Motivated patients require consultation and follow-up care in order to be able to actively decrease the serum uric acid.

Ethanol concentrations in the human gastrointestinal tract after intake of alcoholic beverages

IntroductionThe goal of this study was to monitor gastric and duodenal ethanol concentrations arising from the consumption of commonly used alcoholic beverages. Materials and methodsIn a cross-over study, five fasting volunteers were asked to drink two standard consumptions of commercially available alcoholic beverages, including beer (Stella Artois®, 500mL, 5.2% ethanol), wine (Blanc du Blanc®, 200mL, 11% ethanol) and whisky (Gallantry Whisky®, 80mL, 40% ethanol). The volunteers finished drinking beer within 10min and wine or whisky within 5min. Ethanol concentrations in gastric and duodenal fluids, aspirated as a function of time, were analyzed by headspace gas chromatography. ResultsIn all three conditions, the average gastric profile shows a maximum ethanol concentration (Cmax) at 7min, while the mean duodenal profiles have a Tmax at 20, 7 and 12min for beer, wine and whisky, respectively. The median gastric ethanol Cmax (min–max) for the beer, wine and whisky conditions amounts to 4.1% (3.1–4.1), 4.1% (2.6–7.3) and 11.4% (6.3–21.1), respectively. The mean duodenal profiles follow the same pattern as their corresponding gastric profiles, albeit with lower percentages of ethanol. Median duodenal ethanol Cmax (min–max) for beer, wine and whisky are 1.97% (0.89–4.3), 2.39% (2.02–5.63) and 5.94% (3.55–17.71), respectively. Intraluminal ethanol concentrations appear to decline relatively rapidly in fasting conditions: both stomach and duodenum contained less than 0.05% of ethanol after 120min. ConclusionsThis in vivo study is the first to present intraluminal ethanol concentrations in man after the intake of alcoholic beverages. Relatively low and fast declining gastric ethanol concentrations were observed, contrasting with the current Food and Drug Administration guidelines for the in vitro testing of formulations with respect to ethanol resistance. The presented gastric and duodenal ethanol concentrations and their variation may serve as reference data to design relevant models for predicting (i) ethanol resistance of drug formulations and (ii) ethanol effects on drug solubility and permeability.

Seasonality of food groups and total energy intake: a systematic review and meta-analysis

The aim of this systematic review and meta-analysis was to assess the effect of season on food intake from selected food groups and on energy intake in adults. The search process was based on selecting publications listed in the following: Medline, Scopus, Web of Science, Embase and Agris. Food frequency questionnaires, 24-h dietary recalls and food records as methods for assessment of dietary intake were used to assess changes in the consumption of 11 food groups and of energy intake across seasons. A meta-analysis was performed. Twenty-six studies were included. Articles were divided into those reporting data on four seasons (winter, spring, summer and autumn) or on two seasons (pre-and post-harvest). Four of the studies could be utilized for meta-analysis describing changes in food consumption across four season scheme: from winter to spring fruits decreased, whereas vegetables, eggs and alcoholic beverages increased; from spring to summer vegetable consumption further increased and cereals decreased; from summer to autumn fruits and cereals increased and vegetables, meat, eggs and alcoholic beverages decreased; from autumn to winter cereals decreased. A significant association was also found between energy intake and season, for 13 studies reporting energy intake across four seasons (favors winter) and for eight studies across pre- and post-harvest seasons (favors post-harvest). The winter or the post-harvest season is associated with increased energy intake. The intake of fruits, vegetables, eggs, meat, cereals and alcoholic beverages is following a seasonal consumption pattern and at least for these foods season is determinant of intake.

Focus Groups in the Prevention of Teenagers’ Alcohol Misuse

ABSTRACTThe present study assessed the efficacy of focus groups (FGs) used as part of a prevention-action project targeting students in their first and second years of Italian high school (9th and 10th graders). A sample of 661 students was randomly divided into an experimental group participating in an FG activity and a control group only attending a brief informative meeting. Two questionnaires were administered to measure alcohol consumption and any psychopathological vulnerability, respectively, with test–retest modality. Among the most important results, 52.4% of students drank alcoholic beverages on Saturday evenings and this consumption increased with age; in addition, alcohol consumption was associated with psychobehavioral problems of the externalizing type. The FGs proved effective in reducing the known tendency for alcohol consumption to increase with age, in terms of both the frequency of ingestion of alcoholic beverages and the quantity of alcohol involved.

Knowledge and Lifestyle-Associated Prevalence of Obesity among Newly Diagnosed Type II Diabetes Mellitus Patients Attending Diabetic Clinic at Komfo Anokye Teaching Hospital, Kumasi, Ghana: A Hospital-Based Cross-Sectional Study.

This study aimed to determine the knowledge and prevalence of obesity among Ghanaian newly diagnosed type 2 diabetics. This cross-sectional study was conducted among diagnosed type 2 diabetics. Structured questionnaire was used to obtain data. Anthropometric measurements and fasting blood sugar levels were also assessed. Participants had adequate knowledge about the general concept of obesity (72.0%) and method of weight measurement (98.6%) but were less knowledgeable of ideal body weight (4.2%). The commonly known cause, complication, and management of obesity were poor diet (76.9%), hypertension (81.8%), and diet modification (86.7%), respectively. The anthropometric measures were higher among females compared to males. Prevalence of obesity was 61.3% according to WHR classification, 40.8% according to WHtR classification, 26.1% according to WC, and 14.8% according to BMI classification. Being female was significantly associated with high prevalence of obesity irrespective of the anthropometric measure used (p < 0.05). Taking of snacks in meals, eating meals late at night, physical inactivity, excessive fast food intake, and alcoholic beverage intake were associated with increased prevalence of obesity (p < 0.05). Prevalence of obesity is high among diabetic patient and thus increasing effort towards developing and making education programs by focusing on adjusting to lifestyle modifications is required.

Alcohol consumption in patients with cardiovascular diseases (results of the survey of cardiac patients in outpatient practice)

Aim. To study the frequency and characteristics of alcohol use in outpatients with cardiovascular diseases and to determine their preferences regarding the help in limiting alcohol consumption. Material and methods. Voluntary and anonymous survey using AUDIT-C and CAGE questionnaires was conducted in 199 patients. The data of 182 patients (82 women and 100 men, mean age 56.4±5.8 years) was included in the analysis. Results. Arterial hypertension (70%), heart rhythm disorders (25%), ischemic heart disease (20%), functional class I-II chronic heart failure (21%) predominated among all clinical entities. Positive AUDIT-C test was found in 30% of men and 7.3% of women. 17% of men and 23.2% of women did not use alcohol at all. Positive responses to all 4 questions of the CAGE test were given by 3% of men and none of women, positive answers to 3 questions – by 15% of men and none of women, to 2 questions - by 17% of men and 11% of women. Positive answer to the question about the need to reduce alcohol consumption was given by 36% of men and 13.4% of women. Conclusion . Simultaneous testing using AUDIT-C and CAGE questionnaires in outpatients with cardiovascular diseases allows identifying a subgroup of patients (more in men) who have a potential problem with an excessive alcohol consumption and need to reduce the intake of alcoholic beverages.

Beverages consumption and energy contribution from the ANIBES study.

Introduction: The purpose of this ANIBES study was to contribute to updating data of dietary energy intake and its main sources from food and beverages. Objective: To evaluate alcoholic and non-alcoholic beverages intake and percentage of energy input by beverages in The ANIBES study. Method: The sample was representative and composed of residents in Spain between 9 and 75 years old. Study participants were provided with a tablet device and trained in how to record information by taking photos of all food and drinks consumed during three days. Food records were returned from the field in real time by coders. VD-FEN2.1 software was used to calculate energy intake and food consumption records. Results: In The ANIBES study, the average consumption of non-alcoholic beverage was 851 g/person/day and alcohol beverage consumption was 99 g/person/day. Within the group of non-alcoholic beverages water is the most consumed beverage (570 g/d) followed by sugared soft drinks (88 g/d). For alcoholic beverages the low alcohol content drinks are largely the most consumed beverages (97 g/d). Energy contribution from non-alcoholic beverages was 3.9% and from alcoholic beverages 2.6% of the total energy intake. Juices and nectars provide 2.9% of the total energy intake in children. Sugared soft drinks represent 3.4% of total energy intake in adolescents. Low alcohol content beverages represent 2.6% and 3.3% of the total energy intake in adults and elderly respectively. Conclusion: The most consumed beverage group was the non-alcoholic beverages, representing 3.9% of the total energy intake. Acknowledgements: The study was financially supported by a grant from Coca-Cola Iberia through an agreement with the Spanish Nutrition Foundation (FEN).

Influence of alcohol consumption on hydration status in healthy adults.

Introduction: Both osmolality and water intake are considered key biomarkers of the hydration status, which is necessary for adequate cellular homeostasis and wellbeing. However, alcohol intake has been shown to affect the hydration status due to an elevated diuresis effect. Objective: To evaluate the influence of alcohol consumption on the hydration status of healthy adults. Method: This study was performed in 123 adults (25-45 y, 69% women). Blood samples were collected to analyze osmolality levels and a 72 h-recall food questionnaire was used to assess total water intake (TWI): drinking water, liquids (soft drinks, juices, milk, beer, wine and spirits) and solid foods, along with alcohol intake (grams). Mann-Whitney U test was performed to analyze sex differences and correlations were performed by the Spearman test adjusted by sex. Results: No significant differences were found for TWI in men (2.19 L/d) and women (2.21 L/d). Men consumed insufficient TWI according to EFSA recommendations (men=2.5 L/d). Osmolality and liquids intake were significantly higher in men (P<0.05), as well as the general intake of alcoholic beverages (P<0.05). A positive correlation between osmolality and alcohol consumption was found in men (P<0.05), but not in women. Conclusion: A shift in the liquid intake pattern in men, by decreasing alcohol intake and promoting water drinking might be advisable in order to lower osmolality levels and achieve a better hydration status.

Effect of type of alcoholic beverages on carbohydrate-deficient transferrin, sialic acid, and liver enzymes.

There are only limited data obtained under well controlled conditions on the effects of moderate drinking on markers of alcohol use disorders. The aim of this study was to investigate the effects of moderate intake of different alcoholic beverages on these markers, including carbohydrate-deficient transferrin (CDT), sialic acid (SA), and the liver enzymes gamma-glutamyltransferase, aspartate aminotransferase, and alanine aminotransferase. Eleven apparently healthy, nonsmoking middle-aged men were included in a 12-week randomized, diet-controlled crossover trial according to a 4 x 4 Latin-square design. Changes in CDT, SA, gamma-glutamyltransferase, aspartate aminotransferase, and alanine aminotransferase were analyzed after 3 weeks of daily intake of four glasses (40 g of alcohol) of red wine, beer, spirits (Dutch gin), or water (control). After 3 weeks' daily consumption of red wine, a significant decrease of serum CDT concentration was observed compared with water consumption. There was no effect of any alcoholic beverage on the other outcome measures. Daily consumption of 40 g of alcohol from different types of alcoholic beverages with dinner did not affect SA or liver enzymes. Further investigations to explore the mechanisms for the red wine-induced decreases of CDT, including changes in iron metabolism, are clearly needed.

Alcohol consumption and venous thromboembolism: friend or foe?

A light to moderate consumption of certain types of alcoholic beverages may exert a favorable effect on cardiovascular risk, but no conclusive information is available on the putative relationship between alcohol intake and the risk of venous thromboembolism (VTE). We performed an electronic search on Medline and Scopus, using the keywords "venous thromboembolism", "venous thrombosis" and "alcohol", to identify clinical studies linking alcohol intake and VTE risk. The literature search generated 16 studies, 4 of which are case-control, 1 cross-sectional and 11 prospective. Significant reduction of VTE associated with alcohol intake is observed in only 4/16 studies, and in all these the association is only meaningful for a moderate amount of alcohol (i.e., 2-4 glasses). Unlike these trials, two other studies observe that alcohol intake is associated with an increased risk of VTE, whereas the association is insignificant in the remainder. Binge drinking increases the VTE risk in one study but not in another. The consumption of beer is associated with a decreased VTE risk in one study but not in two others. We hence conclude that the relationship between intake of alcoholic beverages and increased or decreased risk of VTE is largely elusive.

Impact of beverage intake on metabolic and cardiovascular health.

This review is based on a presentation that was made at a meeting concerning hydration. It summarizes the epidemiological evidence for selected beverages in relation to cardiovascular and/or metabolic health. The review focuses on tea, cocoa, milk, orange juice, alcohol, and beverages sweetened with sugars. These beverage types were chosen because of their widespread consumption, with tea, cocoa, orange juice, and milk being of potential benefit while alcohol and sugars may be detrimental. There is reasonably consistent evidence of reduced risk of cardiovascular disease (CVD) in association with high consumption of tea, with the tea flavonoids appearing to be responsible for these benefits. There is also a growing evidence base for cocoa flavanols to have beneficial cardiovascular effects. The bulk of the evidence supporting these conclusions is epidemiological and needs to be confirmed with randomized controlled trials. Milk is associated with reduced risk of CVD, particularly in relation to blood pressure, with certain milk tripeptides being implicated in having effects to reduce angiotensin action. Further work is needed to confirm these potentially beneficial effects. There is some evidence of potentially beneficial effects of orange juice on aspects of cardiovascular function, but this is by no means convincing, and further evidence is needed from randomized controlled trials, together with the elucidation of whether any benefits are linked to the citrus flavanones or simply to the vitamin C content. While there is some evidence that red wine may convey some health benefits, there is also clear evidence that alcoholic beverages can have undesirable effects on blood pressure and increase the risk of CVD. It is possible that low to moderate intakes of alcoholic beverages may be beneficial. There is some evidence that beverages sweetened with sugars may contribute to increased energy intake and weight gain, and there is also an indication from longitudinal cohort studies that they are associated with an increased risk of developing type 2 diabetes. The mechanism of this latter association has not been explained. In conclusion, there is a substantial amount of epidemiological evidence for benefits of tea and cocoa in relation to cardiovascular health. There is a growing literature describing randomized controlled trials, but more evidence is needed. Potential cardiovascular and metabolic health benefits of milk and orange juice needs further investigation. The associations of higher alcohol intakes and consumption of beverages sweetened with sugars and their increased health risks are of concern, and more attention should be focused on this area.

Association of dietary patterns with serum adipokines among Japanese: a cross-sectional study.

BackgroundDiet may influence disease risk by modulating adipokines. Although some foods and nutrients have been linked to circulating adipokine levels, little is known about the role of dietary patterns on adipokines. We investigated the association between major dietary patterns and circulating levels of adiponectin, leptin, resistin, visfatin, and plasminogen activator inhibitor-1 (PAI-1) in a working population.MethodsThe subjects were 509 employees (296 men and 213 women), aged 20 to 65 years, of two municipal offices. Serum adipokines were measured using a Luminex suspension bead-based multiplexed array. Dietary patterns were derived by using principal component analysis of the consumption of 52 food and beverage items, which were ascertained by a validated diet history questionnaire. Multiple regression analysis was performed to assess the association between dietary pattern scores and adipokine concentrations, with adjustment for potential confounders.ResultsThree major dietary patterns were extracted: a Japanese, a Westernized breakfast, and a meat food patterns. Of these, we found significant, inverse associations of the Westernized breakfast pattern, which was characterized by higher intake of confectioneries, bread, and milk and yogurt but lower intake of alcoholic beverages and rice, with serum leptin and PAI-1 concentrations in a fully adjusted model (P for trend = 0.04 for both leptin and PAI-1). The other adipokines were not significantly associated with any dietary pattern.ConclusionThe Westernized breakfast dietary pattern may be associated with lower circulating levels of leptin and PAI-1.

Dietary intakes among South Asian adults differ by length of residence in the USA.

To examine whether nutrient and food intakes among South Asian adult immigrants differ by length of residence in the USA. Cross-sectional analysis to examine differences in nutrient and food intakes by length of residence in the USA. Dietary data were collected using an interviewer-administered, culturally appropriate FFQ, while self-reported length of residence was assessed using a questionnaire and modelled as tertiles. The Mediators of Atherosclerosis in South Asians Living in America (MASALA) study. Eight hundred and seventy-four South Asians (mean age=55 (sd 9) years; 47 % women; range of length of residence in the USA=2-58 years), part of the baseline examination of the MASALA study. Intakes of fat, including saturated and trans fats, dietary cholesterol and n-6 fatty acids, were directly associated with length of residence, while intakes of energy, carbohydrate, glycaemic index and load, protein, dietary fibre, folate and K were inversely associated with length of residence (P trend <0·05). A longer length of residence in the USA was also associated with higher intakes of alcoholic beverages, mixed dishes including pizza and pasta, fats and oils, and lower intakes of beans and lentils, breads, grains and flour products, milk and dairy products, rice, starchy vegetables and sugar, candy and jam (P for differences across groups <0·05). Length of residence in the USA influences diet and nutrient intakes among South Asian adult immigrants and should be considered when investigating and planning dietary interventions to mitigate chronic disease risk.

An update on heart failure and peripheral arterial disease.

![Graphic][1] With cardiovascular disease still the most important cause of morbidity and mortality in Western countries, in particular in Europe,1,2 heart failure with preserved (HFpEF1) or reduced ejection fraction (HFrEF)3,4 remain at the centre of interest. Overall, there are many causes which can lead to a failing heart, such as genetic disposition, nutrition, age, hypertension,5 diabetes, coronary artery disease,6 and infarction,7,8 among others. An important dietary factor is alcohol, which is consumed in large amounts in various beverages all over the world. Initially considered a health hazard mainly due to its addictive potential and as a cause of liver cirrhosis and pancreatitis, it has recently been recognized that moderate alcohol consumption can actually protect against heart attacks. The protective effects of a low intake of certain alcoholic beverages against myocardial infarction have been documented in large registries,9 and more recently also in Mendelian randomization studies.10 This supported the concept of the French paradox11 in cardiovascular prevention. However, heart failure to date was considered a contraindication even for moderate alcohol consumption. Alcohol is a cardiac toxin and potentially a cause of dilated cardiomyopathy in addicts. Hence, many doctors have recommended abstinence for such patients. All the more surprising are the results of the first paper of this issue entitled ‘Alcohol consumption and risk of heart failure: the Atherosclerosis Risk in Communities Study’ by Scott Solomon from the Brigham and Women's Hospital in Boston.12 This is also pointed out by the comprehensive Editorial by David Conen from the University Hospital in Basel, Switzerland13 which has also been recorded as a podcast for our readers' convenience. The authors examined 14 629 participants of the Atherosclerosis Risk in Communities (ARIC) study without heart failure at baseline followed-up for … [1]: pending:yes

Nutritional profile and obesity: results from a random-sample population-based study in Córdoba, Argentina.

Obesity is a chronic, heterogeneous, multifactorial disease, which has sharply increased in prevalence in both developed and developing countries. This study aimed to estimate the prevalence of obesity and to identify socio-demographic risk factors associated with it, with special emphasis on diet. Nutritional status, demographic characteristics, lifestyle habits, and food consumption patterns derived from a Food Frequency Questionnaire were investigated. Exhaustive exploratory analyses were performed in order to describe dietary patterns, and logistic regression models were used for odds ratio estimation. The study included 4328 subjects, over 18 years old and resident in Cordoba city. The prevalence of overweight and obesity was 34 and 17 %, respectively, with 60 % in men and 45 % in women of BMI ≥ 25. Obesity risk factors were high intake of sodium, refined grains, starchy vegetables, and snacks. A lower risk of overweight and obesity was associated with an adequate, moderate intake of meats, eggs, alcoholic beverages, sugar and sweets, milk, yogurt, and pulses. A high intake of snacks, refined grains, starchy vegetables and sodium and low intake of yogurt, milk, pulses, and whole grains seem to be associated with the emergence and high prevalence of obesity in Cordoba, Argentina.