Changes In Alcohol Intake Research Articles

Health behaviors in survivors of aggressive NHL.

236 Background: Patients (pts) with aggressive lymphoma are generally treated with curative intent and many become long-term survivors. There is little data on health behaviors after lymphoma diagnosis and their effect on QOL and long-term outcomes. Methods: Lymphoma pts were prospectively enrolled within 9 months of diagnosis in the University of Iowa/Mayo Clinic SPORE Molecular Epidemiology Resource (MER) and systematically followed. We measured QOL (FACT-G) and health behaviors (tobacco/alcohol use; diet/exercise habits) 3 years after diagnosis. For this study, “survivor” was defined as alive at 3 years from diagnosis with no active disease or treatment within the previous year. Results: From 2002-2012, 671 patients with aggressive lymphoma were enrolled, met survivor definition, and completed 3-year QOL and health behavior questionnaires. At 3-years, 31% of female (F) and 48% of male (M) reported a history of tobacco use for 6+ months. Of these, 13% of F and 7% of M were still smoking; 52% reported decreased use from baseline. 66% reported no change in alcohol intake at 3-years while 25% of F and 34% of M reported decreased intake. 60% often chose whole grains and 65% get 2+ servings of vegetables daily. 42% of F and 38% of M “somewhat” believed diet could change the course of their lymphoma. Most pts endorsed no significant change in diet as a result of diagnosis. Those who made changes did so primarily out of concern for “health problems other than cancer”. Overweight/obese responders were 72% pre- and 66% post-treatment. A desire to lose weight was reported by 55% of pts. 14% of F and 23% of M often engaged in regular physical activity (PA). Nearly 50% reported a decrease in PA. Pts with advanced stage (p = 0.006), age > 60 (p = 0.001), ECOG PS > 2 (p = 0.04), and worse prognostic score (p = 0.006) were more likely to report decreased PA since diagnosis. 68% of F and 61% of M intend to become more active in the next months. Regular PA (p = < 0.0001) was associated with higher QOL, while increased alcohol intake was associated with lower QOL (p = 0.009) at 3 years. Conclusions: Many survivors of aggressive NHL strive to adopt healthy behaviors and these behaviors are associated with higher QOL. Interventions aimed at emphasizing these behaviors may have potential to improve long-term outcomes and QOL.

The relationship of alcohol use to weight loss in the context of behavioral weight loss treatment

Despite common wisdom that reducing alcohol intake will facilitate weight loss, little research has examined whether participants in behavioral weight loss treatments actually decrease their alcohol intake, or whether reduced alcohol intake relates to weight loss outcomes in this context. This study examined the relationship of alcohol use to energy intake excluding alcohol and to weight in 283 overweight and obese adults participating in a 26-session behavioral weight loss treatment. The majority of participants consumed low to moderate levels of alcohol at baseline. Participants who consumed alcohol at baseline meaningfully reduced their alcohol intake by end-of-treatment. Alcohol use did not relate to weight at baseline or end-of-treatment when controlling for relevant demographic variables, and change in alcohol use was unrelated to weight change in the overall sample during treatment. However, end-of-treatment alcohol intake did relate to end-of-treatment energy intake excluding alcohol. In addition, behavioral impulsivity and change in alcohol intake interacted to predict weight loss, such that decreases in alcohol intake were associated with greater percent weight loss at end-of-treatment for participants with higher levels of impulsivity. Alcohol consumption may lead to overeating episodes, and highly impulsive individuals may be at risk for increased energy intake during or after episodes of drinking. Therefore, the recommendation to reduce alcohol intake in the context of behavioral weight loss treatment seems warranted, particularly for individuals with high levels of impulsivity.

Homer2 within the nucleus accumbens core bidirectionally regulates alcohol intake by both P and Wistar rats

In murine models of alcoholism, the glutamate receptor scaffolding protein Homer2 bidirectionally regulates alcohol intake. Although chronic alcohol drinking increases Homer2 expression within the core subregion of the nucleus accumbens (NAc) of alcohol-preferring P rats, the relevance of this neuroadaptation for alcohol intake has yet to be determined in rats. Thus, the present study employed an adeno-associated viral vector (AAV) strategy to over-express and knock down the major rodent isoform Homer2b within the NAc of both P and outbred Wistar rats to examine for changes in alcohol preference and intake (0–30% v/v) under continuous-access procedures. The generalization of AAV effects to non-drug, palatable, sweet solutions was also determined in tests of sucrose (0–5% w/v) and saccharin (0–0.125% w/v) intake/preference. No net-flux in vivo microdialysis was conducted for glutamate in the NAc to relate Homer2-dependent changes in alcohol intake to extracellular levels of glutamate. Line differences were noted for sweet solution preference and intake, but these variables were not affected by intra-NAc AAV infusion in either line. In contrast, Homer2b over-expression elevated, while Homer2b knock-down reduced, alcohol intake in both lines, and this effect was greatest at the highest concentration. Strikingly, in P rats there was a direct association between changes in Homer2b expression and NAc extracellular glutamate levels, but this effect was not seen in Wistar rats. These data indicate that NAc Homer2b expression actively regulates alcohol consumption by rats, paralleling this previous observation in mice. Overall, these findings underscore the importance of mesocorticolimbic glutamate activity in alcohol abuse/dependence and suggest that Homer2b and/or its constituents may serve as molecular targets for the treatment of these disorders.

The development of a brief self-report questionnaire to measure ‘recent’ Rash Impulsivity: A preliminary investigation of its validity and association with recent alcohol consumption

BackgroundTraditionally, impulsivity has been regarded as a stable trait. However, a series of longitudinal and behavioural laboratory studies has found that impulsivity can fluctuate within individuals, suggesting that it has a state as well as a trait manifestation. Whilst existing impulsivity questionnaires tap the former, there is no self-report instrument to assess recent fluctuations in impulsivity.Research aims and designThe present study set out to develop and undertake preliminary validation of a measure of ‘recent’ impulsivity, focusing in particular on Rash Impulsivity. Part of the construct validation of the resulting Recent Rash Impulsivity Scale (RRIS) entailed examining its association with recent alcohol intake, since there are well-documented reciprocal relationships between alcohol consumption and inhibitory control. In developing the RRIS, items from existing trait impulsivity questionnaires were converted into a ‘previous two weeks’ format. The pilot RRIS was then administered, along with a parallel trait version (Trait Rash Impulsivity Scale; TRIS) and a well-established trait impulsivity measure (the BIS-11; Patton, Stanford & Barratt, 1995), to two cohorts of first-year undergraduates aged 17 to 25 (N=240), on two occasions one month apart. Information about habitual and recent alcohol intake was also gathered. ResultsFactor analyses on both the RRIS and TRIS identified two factors: ‘Cognitive Impulsivity’ (CogImp) and ‘Motor Impulsivity’ (MotImp). Consistent with the RRIS being sensitive to fluctuations in impulsivity, it was found that, as predicted: i) the RRIS was somewhat less strongly correlated than the TRIS with an established trait measure (the BIS-11; Patton et al., 1995); ii) the test–retest stability of ‘Total’ scores (CogImp and MotImp) was weaker for the RRIS than the TRIS; iii) there was evidence that the RRIS MotImp and Total scales were more strongly predicted by recent alcohol intake than were their trait equivalents; and iv) the RRIS CogImp and Total scales correlated more strongly with their trait equivalents in participants whose alcohol consumption had remained stable recently (relative to their habitual intake), compared to those whose consumption had recently changed. ConclusionsThese data suggest that transient changes in impulsivity can be assessed via self-report, and that the RRIS is sensitive to recent changes in alcohol intake. Subject to a more intensive and detailed validation, it is thus promising as a tool for tapping and characterising fluctuations in behavioural control and for exploring a range of factors to which this might be associated.

Alcohol use among older adults: SABE cohort study, São Paulo, Brazil.

In recent years, Brazil has demonstrated a new demographic pattern characterized by a reduction in both birth and mortality rates and a significant increase in the number of older adults. The purpose of the present study was to describe the frequency of alcohol intake in a representative sample community of older adults in the city of São Paulo, Brazil, followed over a six-year period. A prospective Saúde, Bem-Estar e Envelhecimento (SABE [Health, Wellbeing and Aging]) cohort study conducted in 2000 and 2006 in City of São Paulo, Brazil. 2,143 individuals aged 60 years or older selected through multi-stage sampling in the year 2000 (41.4% male and 58.6% women) and 1,115 individuals belonging to the follow-up cohort evaluated in 2006. The frequency of alcohol intake in the previous three months was obtained through self-reports of interviewees. The results demonstrate that in 2000, alcohol consumption was less than one day a week among 79.7% of the sample, one to three days a week among 13.0% and four or more days a week among 7.3%. In agreement with findings on other populations, consumption four or more days a week was more frequent among the male gender as well as those with greater schooling and income and good self-rated health (p<0.05). The longitudinal analysis demonstrated an increase in the frequency of alcohol consumption one to three times a week among the individuals in the 2006 follow-up study. In the present population-based sample, alcohol intake was low and the frequency of moderate alcohol consumption increased over the years. The present study can assist understanding the changes in alcohol intake among older adults throughout time and the ageing process.

Reduction of Alcohol Consumption and Subsequent Mortality in Alcohol Use Disorders

To determine whether a reduction in drinking in individuals with alcohol use disorders resulted in reduced mortality risk. Electronic searches were performed of MEDLINE, EMBASE, and ISI Web of Science and references of identified articles were searched up to May 2012 using these keywords: (alcohol dependence OR alcohol abuse) AND (mortality) AND (cohort OR follow-up). Only English-language articles were included. Sixteen cohort studies were identified that reported all-cause mortality risk by drinking groups measuring change in alcohol intake among people with alcohol use disorders. Numbers of participants and deaths in each group; odds ratios (ORs); and demographic, clinical, and methodological variables were extracted. In comparison to continued heavy drinking, a reduction below heavy levels of alcohol use (including abstention) was associated with a substantially reduced risk of mortality (random-effects pooled OR = 0.41; 95% CI, 0.34-0.50; P < .001). The OR was 0.35 (95% CI, 0.20-0.60; P < .001) for those who reached abstention and 0.61 (95% CI, 0.39-0.94; P = .026) for those who did not reach abstention but substantially reduced their consumption. The pooled OR for abstention compared to reduced consumption was 0.42 (95% CI, 0.19-0.92; P = .031). Meta-regression models did not reveal significant influences of study characteristics examined. Reduction of drinking in alcohol use disorders was associated with a marked reduction in mortality risk for those who reached abstinence or reduced drinking compared to continued heavy drinkers. Those who reached abstention showed the smallest mortality risk, lower than the risk for reduced consumption without abstinence.

Bifurcating effects of hope and support in short- and long-term health outcomes among primary care patients without mental illness

Adverse life events and stressors can lead to symptoms, increased alcohol intake, and impaired functional status, while hope and social support can mitigate such adverse effects. Yet, there is reason to question such simple, linear relationships among healthy adults. The purpose of this study was to assess whether short-term or long-term changes in alcohol intake, psychological symptoms or functional status were better modelled as cusp catastrophic or linear processes among primary care patients without mental illness. This secondary analysis of a study on the stability of psychological symptoms among primary care patients without mental disorders included 38 subjects who completed baseline, and 2-month and/or 6-month assessments of psychological symptoms, functional status and stressors as well as hope and social support. The analyses modelled short-term and long-term changes in alcohol intake, psychological symptoms and functional status using cusp catastrophe (CCM) and linear modelling. Overall, four of the nine 2-month analyses found CCM superior to linear models; however, only one 6-month analysis (alcohol intake) found that CCM was superior. The 2-month cusp phenomena included both symptomatology and functional status. The asymmetry variables were often not significant in the CCM models; in fact, only distress was significant at all. While hope was a significant bifurcation variable at both the 2-month and 6-month levels, social support was a significant bifurcation variable for three of the four 2-month CCMs. In conclusion, while 6-month outcomes were rarely explained through CCM, half of 2-month outcomes were. Hope and support demonstrated bifurcation effects.

Changes in Alcohol Intake and Their Relationship with Health Status over a 24‐Year Follow‐Up Period in Community‐Dwelling Older Adults

To determine whether alcohol use changes over time in older adults and whether alcohol intake is associated with common chronic diseases. Twenty-four-year longitudinal study. Southern California community. One thousand seventy-six members of the Rancho Bernardo cohort aged 50 to 89 at baseline. Participants completed two to six research visits at approximately 4-year intervals between 1984 and 2009. At each visit, participants completed standard questionnaires on alcohol use, chronic diseases, and behaviors. Mixed-effects linear models were used to examine changes in average weekly alcohol intake over time and in relationship to health status. Prevalence and frequency of alcohol use was high throughout the study, with more than 60% of participants reporting weekly alcohol intake. The average amount consumed declined with advancing age, regardless of the presence of any of the eight most common chronic diseases. Prevalence of drinking in excess of age- and sex-specific low-risk guidelines was high across all visits and did not vary according to disease burden. At the final visit, 29% of participants drank in excess of low-risk drinking guidelines, including 28% of those with hypertension and 31% with diabetes mellitus. Prevalence and frequency of alcohol intake remained stable over a 24 year follow-up in this cohort of educated, white, middle-class, older adults, although average amount consumed decreased with advancing age. Despite this decrease, a high proportion of older adults, including those with common chronic health conditions, drank in excess of current guidelines. Clinicians should provide more education on the importance of older adults moderating alcohol intake.

Roux en Y Gastric Bypass Increases Ethanol Intake in the Rat

Roux en Y gastric bypass (RYGB) surgery is currently the most effective therapy employed to treat obesity and its associated complications. In addition to weight loss and resolution of metabolic syndromes, such as diabetes, the RYGB procedure has been reported to increase alcohol consumption in humans. Using an outbred rodent model, we demonstrate that RYGB increases postsurgical ethanol consumption, that this effect cannot be explained solely by postsurgical weight loss and that it is independent of presurgical body weight or dietary composition. Altered ethanol metabolism and postsurgical shifts in release of ghrelin were also unable to account for changes in alcohol intake. Further investigation of the potential physiological factors underlying this behavioral effect identified altered patterns of gene expression in brain regions associated with reward following RYGB surgery. These findings have important clinical implications as they demonstrate that RYGB surgery leads directly to increased alcohol intake in otherwise alcohol nonpreferring rat and induces neurobiological changes in brain circuits that mediate a variety of appetitive behaviors.

The effect of sustained, long-term changes in alcohol intake on cardiovascular risk

Objective: To investigate whether sustained long-term changes in alcohol intake are predictive of cardiovascular risk. Methods: The study population was a subpopulation of the five-year intervention study, Inter99 study, (1999-2006), Copenhagen, Denmark (n = 2117; 30 - 60 years). Alcohol intake was assessed by questionnaires at baseline, one-, three- and five-year follow-up. The associations between sustained long-term changes in alcohol intake and cardiovascular risk factors (HDL and non-HDL cholesterol, systolic and diastolic blood pressure (BP); the absolute risk of ischemic heart disease (CRS)) at five-year follow-up were explored by linear regression models. The alcohol variables were tested for linear association with the response variable. Results: Sustained increased alcohol intake was significantly associated with increased CRS (β = 0.0028; P = 0.006) and a decreased HDL cholesterol (β = -0.0028; P = 0.005). Among participants with a moderate overall alcohol in-take at baseline increased alcohol intake was significantly associated with an increased plasma triglyceride (β = 0.0069; P = 0.04). No association with triglyceride was found for participants with a high alcohol intake. Change in wine intake was significantly negatively associated with changes in diastolic BP (β = 0.0015; P = 0.02). Conclusions: Sustained increase in the long-term intake of alcohol was a significant risk factor for an increased CRS, increased triglyceride level and decreased HDL cholesterol. Increased wine intake was associated with decreased diastolic BP.

Erratum: The Decreased Cyclic-AMP Dependent-Protein Kinase A Function in the Nucleus Accumbens: A Role in Alcohol Drinking but not in Anxiety-Like Behaviors in Rats

The nucleus accumbens (NAc) brain structures have been implicated in the reward and reinforcing properties of ethanol. The present study investigated the role of nucleus accumbal cyclic AMP (cAMP)-dependent protein kinase A (PKA) signaling in alcohol drinking and anxiety-like behaviors of rats. It was found that infusion of PKA inhibitor (Rp-cAMP) into the NAc shell significantly increased the alcohol but not the sucrose intake, without modulating the anxiety-like behaviors, as measured by elevated plus maze test in rats. PKA inhibitor infusion into the NAc shell significantly decreased the protein levels of alpha-catalytic subunit of PKA (PKA-Calpha) and phosphorylated cAMP response element-binding protein (p-CREB) as well as decreased the protein levels of neuropeptide Y (NPY) in the shell but not in the NAc core of rats. On the other hand, infusion of PKA activator (Sp-cAMP) or NPY alone into the NAc shell did not produce any changes in alcohol intake; however, when these agents were coinfused with PKA inhibitor, they significantly attenuated the increases in alcohol preference induced by pharmacological inhibition of PKA. Interestingly, PKA activator coinfusion with PKA inhibitor into the NAc shell significantly normalized the PKA inhibitor-induced decreases in the protein levels of PKA-Calpha and p-CREB as well as of NPY in the NAc shell of rats. Taken together, these results provide the first evidence that decreased PKA function in the NAc shell is involved in alcohol drinking but not in anxiety-like behaviors of rats. Furthermore, decreased function of PKA may regulate alcohol drinking behaviors via CREB-mediated decreased expression of NPY in the NAc shell of rats.

Changes in alcohol intake in response to transdiagnostic cognitive behaviour therapy for eating disorders

ObjectiveThe aim of this study was to examine how alcohol intake changes during and after transdiagnostic cognitive behaviour therapy for eating disorders (CBT-E). Additionally, the paper considers the relationship between alcohol consumption, eating disorder diagnosis and current major depressive episode at the time of first assessment. MethodOne hundred and forty nine outpatients with an eating disorder (body mass index over 17.5) were divided into high or low alcohol intake groups (HIG and LIG) according to their intake at pre-treatment assessment. Their alcohol intake and eating disorder psychopathology were examined over the course of treatment and follow-up. ResultsThere was no difference between the groups on response of the eating disorder to treatment. The HIG significantly reduced their alcohol intake following treatment whilst the intake of the LIG remained stable over the course of treatment and follow-up. There were no group differences in major depression and overall severity of eating disorder at baseline. ConclusionsThe response to CBT-E was not influenced by baseline level of alcohol use. The mean alcohol intake of the heavy drinking subjects decreased without being specifically addressed by the treatment.

Effect of Alcohol Intake Changes on Human Brain

Effect of Alcohol Intake Changes on Human Brain

Ethanol consumption in mice: relationships with circadian period and entrainment

A functional connection between the circadian timing system and alcohol consumption is suggested by multiple lines of converging evidence. Ethanol consumption perturbs physiological rhythms in hormone secretion, sleep, and body temperature; and conversely, genetic and environmental perturbations of the circadian system can alter alcohol intake. A fundamental property of the circadian pacemaker, the endogenous period of its cycle under free-running conditions, was previously shown to differ between selectively bred high- (HAP) and low- (LAP) alcohol preferring replicate 1 mice. To test whether there is a causal relationship between circadian period and ethanol intake, we induced experimental, rather than genetic, variations in free-running period. Male inbred C57Bl/6J mice and replicate 2 male and female HAP2 and LAP2 mice were entrained to light:dark cycles of 26 or 22 h or remained in a standard 24 h cycle. On discontinuation of the light:dark cycle, experimental animals exhibited longer and shorter free-running periods, respectively. Despite robust effects on circadian period and clear circadian rhythms in drinking, these manipulations failed to alter the daily ethanol intake of the inbred strain or selected lines. Likewise, driving the circadian system at long and short periods produced no change in alcohol intake. In contrast with replicate 1 HAP and LAP lines, there was no difference in free-running period between ethanol naïve HAP2 and LAP2 mice. HAP2 mice, however, were significantly more active than LAP2 mice as measured by general home–cage movement and wheel running, a motivated behavior implicating a selection effect on reward systems. Despite a marked circadian regulation of drinking behavior, the free-running and entrained period of the circadian clock does not determine daily ethanol intake.

The impact of a population-based multi-factorial lifestyle intervention on alcohol intake: The Inter99 study

Purpose To investigate the effect of screening and five years of multi-factorial lifestyle intervention on changes in alcohol intake in a general population. Methods The study was a pre-randomized intervention study on lifestyle, Inter99 (1999–2006), Copenhagen, Denmark. Participants in the intervention group ( n = 6 091) had at baseline a medical health examination and a face-to-face lifestyle counselling. Individuals at high risk of ischemic heart disease were repeatedly offered both individual and group-based counselling. The control group ( n = 3 324) was followed by questionnaires. Alcohol intake was measured by questionnaires. Changes were analysed by multilevel analyses. Results Binge drinking decreased both in men and women at three and five-year follow-ups (men: five-year: net-change:− 0.13; p = 0.03; women: five-year: net-change:− 0.08; p = 0.04). Furthermore, in women the ratio between wine and total alcohol was increased compared with the control group at five-year follow-up (net-change: 0.04; p < 0.01). In men with a high intake of alcohol (> 21 drinks per week) the effect on total alcohol intake was maintained at five-year follow-up (net-change: − 3.7; p = 0.01). No significant effects were found in women on total alcohol intake. Conclusion Multi-factorial lifestyle intervention, including low intensity alcohol intervention, improved long-term alcohol habits in a general population.

Magnesium treatment in alcoholics: A randomized clinical trial

BackgroundMagnesium (Mg) deficiency is common among alcoholics. Earlier research suggests that Mg treatment may help to normalize elevated enzyme activities and some other clinically relevant parameters among alcoholics but the evidence is weak.MethodsThe effect of Mg was studied in a randomized, parallel group, double-blind trial. The patients were first treated for alcohol withdrawal symptoms and then received for 8 weeks either 500 mg of Mg divided into two tablets or matching placebo. Measurements were made at the beginning and in the end of the Mg treatment period. The primary outcome was serum gamma-glutamyltransferase (S-GGT) activity; secondary outcomes included aspartate-aminotransferase (S-AST) and alanine-aminotransferase (S-ALT) activity.ResultsThe number of randomized patients (completers) was 64 (27) in the treatment and 54 (31) in the control group. In intention-to-treat-analyses and in most analyses of study completers, there were no significant differences between the Mg-treated and placebo groups in the outcome variables. When baseline serum Mg level, coffee intake, and the number of unused Mg tablets were controlled for in a multivariate regression model, after-treatment serum Mg levels were found to be higher among the Mg-treated group than in the placebo group (t-test 3.334, df = 53, p = 0.002). After controlling for age, body weight, baseline alcohol intake, subsequent change in alcohol intake and baseline S-AST, the after-treatment S-AST levels were found to be lower among the Mg-treated group than in the placebo group (t-test 2.061, df = 49, p = 0.045).ConclusionMg treatment may speed up the S-AST decrease in compliant patients. This might decrease the risk of death from alcoholic liver disease.Trial RegistrationClinicalTrials.gov ID NCT00325299

Changes in alcohol intake and risk of upper digestive tract cancer

Introduction. Alcohol intake measured at one point in time is a strong predictor for later development of cancer of the oral cavity, pharynx, larynx and esophagus. In this prospective cohort study, we examined whether changes in individual alcohol intake resulted in subsequent altered risk of these cancers. Material and methods. In the Copenhagen City Heart Study we assessed alcohol intake among 4 896 men and 6 239 women who participated at both the first (1976–1978) and second (1981–1983) examination of the study. Alcohol intake changes on risk of upper digestive tract cancer 1981–2002 were examined by a Cox model adjusted for potential confounders. Results. Despite a small number of cases (n = 105), alcohol intake increase >14 drinks/week was associated with significantly elevated risk (hazard ratio = 2.5; 95% confidence interval, 1.1–5.3), while suggestively decreased risk was observed for persons lowering alcohol intake >7 drinks/week (0.5; 0.1–2.5). The trend test was highly significant (p < 0.0001). Conclusions. These findings support public health messages of not increasing alcohol intake and lowering consumption among people with high alcohol intake.

Trends in energy and macronutrient intakes in non‐under‐reporters vary with the method used to identify under‐reporters

To investigate effects of using different methods to identify under-reporters on trends in dietary intake and physical activity level (PAL) in non-under-reporters. Dietary intake and activity pattern were recorded by 887 female university students from 1988 to 2003. Energy expenditure (EE) and PAL were measured using a factorial method. Nine methods were used to identify under-reporters. Trends between 1988 and 2003 were determined from linear regression of median data for each year. Prevalence of under-reporting varied with the method used, ranging from 22.2% to 66.7%. Trends that were consistent using all methods were a decrease in per cent of energy from fat and no change in alcohol intake or PAL (P<0.05). Trends in energy and macronutrient intakes varied with the method used. Using the four methods that excluded the most under-reporters there were increases in energy and gram carbohydrate (CHO) intakes (P<0.05), but no change in gram fat intake. Using the four methods that excluded the fewest under-reporters there was no change in energy or gram CHO intake, but a decrease in gram fat intake (P<0.05). Trends in energy, fat and CHO intakes in non-under-reporters varied with the method used to identify under-reporters.

Ritanserin, a central 5-HT2 antagonist, in heavy social drinkers: desire to drink, alcohol intake and related effects

Ritanserin, a 5-HT2 receptor antagonist, decreased alcohol intake in some, but not all, animal studies and in an open clinical study. We tested the short-term effects of ritanserin in 39 (35 male, four female) heavy social drinkers (consuming at least 28 drinks/week), aged 19-63 years, who were not seeking treatment. After an intake assessment, they received placebo for 7 days in a single-blind baseline. They were then randomly assigned to one of three double-blind treatments for 14 days: ritanserin 5 mg/day (n = 12), ritanserin 10 mg/day (n = 13) or placebo (n = 14). Subjects recorded daily outpatient alcohol intake. Feelings of intoxication and interest, desire, craving and liking for alcohol were rated retrospectively at each weekly study visit. Experimental drinking sessions were conducted after baseline (EDS1) and treatment (EDS2); in each session subjects were offered 18 mini-drinks (total = six standard) and rated their desire to drink, intoxication and mood (POMS). Outpatient results: ritanserin 5 mg/day decreased desire and craving for alcohol (vs. baseline, p < 0.05) but not alcohol intake. Liking of alcohol decreased from baseline with ritanserin 10 mg/day (p = 0.01) and placebo (p = 0.05). Changes in alcohol intake from baseline with ritanserin 10 mg/day (increase, p > 0.05) and placebo (decrease, p > 0.05) were different (p < 0.05). EDS results: in EDS2, desire ratings for the first three mini-drinks were lower after ritanserin 5 mg/day than after ritanserin 10 mg/day (p < 0.05), but the decreases were not statistically significant when EDS1 desire ratings were controlled for. Ritanserin 10 mg/day increased alcohol-induced feelings of intoxication and friendliness, compared with placebo (p < 0.05). Both ritanserin 5 mg/day and 10 mg/day enhanced alcohol-induced decreases in fatigue, compared with placebo (p < 0.05). These results indicate that ritanserin may have differential effects on alcohol intake, desire, craving and liking, intoxication and some of alcohol's effects on mood. However, they suggest that ritanserin has limited efficacy in reducing alcohol intake in heavy drinkers.

Time trends in burdens of cadmium, lead, and mercury in the population of northern Sweden

The time trends of exposure to heavy metals are not adequately known. This is a worldwide problem with regard to the basis for preventive actions and evaluation of their effects. This study addresses time trends for the three toxic elements cadmium (Cd), mercury (Hg), and lead (Pb). Concentrations in erythrocytes (Ery) were determined in a subsample of the population-based MONICA surveys from 1990, 1994, and 1999 in a total of 600 men and women aged 25–74 years. The study took place in the two northernmost counties in Sweden. To assess the effect of changes in the environment, adjustments were made for life-style factors that are determinants of exposure. Annual decreases of 5–6% were seen for Ery-Pb levels (adjusted for age and changes in alcohol intake) and Ery-Hg levels (adjusted for age and changes in fish intake). Ery-Cd levels (adjusted for age) showed a similar significant decrease in smoking men. It is concluded that for Pb and maybe also Hg the actions against pollution during recent decades have caused a rapid decrease of exposure; for Hg the decreased use of dental amalgam may also have had an influence. For Cd, the decline in Ery-Cd was seen only in smokers, indicating that Cd exposure from tobacco has decreased, while other environmental sources of Cd have not changed significantly. To further improve the health status in Sweden, it is important to decrease the pollution of Cd, and actions against smoking in the community are important.