Heavy Alcohol Drinking Research Articles

P.735 Acute and chronic dose-response effects of cannabidiol on heavy alcohol drinking in male and female mice

Sodium selenite was added to basal diet at five levels (0.10, 0.42, 0.67, 1.06 and 1.46 mg Se/kg) and fed fish for 8 weeks. The dietary selenium requirement of juvenile blunt snout bream (Megalobrama amblycephala) was quantified. Dietaryseleniums at 0.67–1.06 mg Se/kg improved weight gain rate, specific growth rate and feed efficiency. The optimal amount was 0.96 mg/kg, for which the specific growth rate was 1.798%/day and the weight gain rate was 173.852% (p < 0.05). Se deposition in muscle was increased (p < 0.05) at ≥0.67 mg/kg, but moisture, protein, lipid and ash content were not affected. Physiological status and lipid metabolism were improved by 1.06–1.46 mg/kg dietary selenium based on total protein and albumin in plasma, and total cholesterol and triglycerides (p < 0.05). Activities of hepatic anti-oxidant enzymes catalase, total superoxide dismutase, glutathione peroxidase and reduced glutathione were enhanced at Se1.06 (p < 0.05). However, malondialdehyde content was lowered at Se1.06 (p < 0.05). Expression of anti-inflammatory cytokines, nuclear factor erythroid 2-related factor 2 (Nrf2) and kelch-like ECH-associated protein 1 (Keap-1) in liver were elevated at Se1.06 (p < 0.05), as were mRNA levels of glutathione peroxidase, copper zinc superoxide dismutase and catalase. Expression of pro-inflammatory cytokines, interleukin 8, tumour necrosis factor-α and transforming growth factor-β were inhibited at 0.67–1.46 mg/kg (p < 0.05). In general, 0.96 mg/kg was optimal, and optimal selenium enhanced antioxidant stress tolerance and anti-inflammatory ability.

Chronic heavy alcohol consumption influences the association between genetic variants of GCK or INSR and the development of diabetes in men: A 12-year follow-up study

Chronic heavy alcohol consumption is a risk factor for diabetes, which is characterized by impaired β-cell function and insulin resistance. We aimed to determine whether the longitudinal associations between genetic variants of glucokinase (GCK) and insulin receptor (INSR) and the risk of developing diabetes were influenced by chronic heavy alcohol consumption. Data were obtained from the Korean Genome and Epidemiology Study. To identify candidate variants, 1,520 subjects (726 non-drinkers and 794 heavy drinkers) were included in the baseline cross-sectional study. After excluding patients with diabetes at baseline and those with insufficient data on diabetes incidence, prospective analyses were conducted in 773 subjects (353 non-drinkers and 420 heavy drinkers). In the baseline cross-sectional study, one SNP (rs758989) in GCK and four SNPs (rs7245757, rs1035942, rs1035940, and rs2042901) in INSR were selected as candidate SNPs that interact with alcohol to affect prediabetes and diabetes. We identified that these GCK and INSR polymorphisms are affected by chronic heavy alcohol consumption and have an effect on the incidence of diabetes. The incidence of diabetes was increased in chronic heavy alcohol drinkers carrying the C allele of GCK compared with never-drinkers with the C allele (HR, 2.15; 95% CI 1.30–3.57), and was increased in chronic heavy alcohol drinkers who were not carrying the INSR haplotype (−/−) compared with never-drinkers carrying the AACT haplotype (HR, 1.98; 95% CI 1.24–3.18). Moreover, we observed that the aggravating effects on the late insulin secretion (I/G120 and I/G AUC 60–120) in individuals who were chronic heavy drinkers with C allele of GCK. In the INSR haplotype, chronic heavy drinkers not carrying AACT were associated with lower disposition index. These results potentially suggest that chronic heavy alcohol consumption induce β-cell dysfunction partially mediated by decreased GCK expression or decline of insulin sensitivity via inhibition of INSR, thereby contributing to the development of diabetes.

Heavy and binge alcohol drinking and parenting status in the United States from 2006 to 2018: An analysis of nationally representative cross-sectional surveys.

BackgroundBinge and heavy drinking are preventable causes of mortality and morbidity. Alcohol consumption by women who parent is damaging to child health, and it is concerning that women in the United States in their reproductive years have experienced increased drinking over the past decade. Although media attention has focused on the drinking status of women who are child-rearing, it remains unclear whether binge and heavy drinking vary by parenting status and sex.Methods and findingsWe examined national trends in binge drinking, defined as 5 or more drinks in a single day for men and 4 or more drinks for women, and heavy drinking, defined as 60 or more days with binge episodes in a year. We used survey-weighted logistic regression from the 2006–2018 waves of the cross-sectional National Health Interview Survey (NHIS, N = 239,944 eligible respondents) to study time trends in drinking outcomes by sex, age, and parenting status. Binge drinking increased for both sexes in nearly all age groups, with the largest increase among women ages 30–44 without children (from 21% reporting binge drinking in 2006 to 42% in 2018); the exception was young men (ages 18–29) with children, among whom binge drinking declined. By 2012, the prevalence of binge drinking among young men with children (38.5%) declined to below that of young women without children (39.2%) and stayed lower thereafter. Despite widespread increases in binge drinking, heavy drinking declined or remained stable for all groups except older women (ages 45–55) without children (odds ratio [OR] for heavy drinking each year = 1.06, 95% CI 1.02–1.10) and women ages 30–44, regardless of parenting status. For binge drinking outcomes only, we saw evidence of interaction in drinking trends by parenting status, but this was shown to be confounded by sex and age. Men and women with children reported consistently lower levels of drinking than those without children. Rates of abstention mirrored trends in binge outcomes for both sexes, limiting concerns about invariance. Study limitations include self-reported data and measurement invariance in binge drinking cutoffs across study years.ConclusionsThis study demonstrated that trends in binge and heavy drinking over time were not differential by parenting status for women; rather, declines and increases over time were mainly attributable to sex and age. Women both with and without children are increasing binge and heavy drinking; men, regardless of parenting status, and women without children consumed more alcohol than women with children. Regardless of impact on child health, increased drinking rates in the past decade are concerning for adult morbidity and mortality: binge drinking has increased among both sexes, and heavy drinking has increased among older women. Men and women of all ages and parenting status should be screened for heavy alcohol use and referred to specialty care as appropriate.

Exacerbation of Hangover Symptomology Significantly Corresponds with Heavy and Chronic Alcohol Drinking: A Pilot Study.

Alcohol hangover is a combination of mental, sympathetic, and physical symptoms experienced the day after a single period of heavy drinking, starting when blood alcohol concentration approaches zero. How individual measures/domains of hangover symptomology might differ with moderate to heavy alcohol consumption and how these symptoms correlate with the drinking markers is unclear. We investigated the amount/patterns of drinking and hangover symptomology by the categories of alcohol drinking. We studied males and females in three groups: 12 heavy drinkers (HD; >15 drinks/week, 34–63 years old (y.o.)); 17 moderate drinkers (MD; 5–14 drinks/week, 21–30 y.o.); and 12 healthy controls (social/light drinkers, SD; <5 drinks/week, 25–54 y.o.). Demographics, drinking measures (Timeline followback past 90 days (TLFB90), Alcohol Use Disorders Identification Test (AUDIT)), and alcohol hangover scale (AHS) were analyzed. Average drinks/day was 5.1-times greater in HD compared to MD. Average AHS score showed moderate incapacity, and individual measures and domains of the AHS were significantly elevated in HD compared to MD. Symptoms of three domains of the AHS (mental, gastrointestinal, and sympathetic) showed domain-specific significant increase in HD. A domain-specific relation was present between AUDIT and specific measures of AHS scores in HD, specifically with the dependence symptoms. Exacerbation in hangover symptomology could be a marker of more severe alcohol use disorder.

DISPARITIES IN HEALTH STATUS, HEALTH BEHAVIORS AND PREVENTIVE HEALTH SERVICES OF OLDER ADULTS WITH DIABETES

The prevalence of diabetes among older adults has increased substantially and health complications resulting from diabetes have significant adverse effects on health status of older adults. While diabetes cannot be cured, it can be managed successfully with healthy lifestyle choices. The purpose of this study is to examine the disparities in health status, health behaviors, and preventive health services for older adults with diabetes. This study used data from the 2018 Behavioral Risk Factor Surveillance System. The sample included older adults 50 and over. Health behaviors included exercise, smoking, and heavy alcohol drinking. Preventive health services included dental visit, flu shot, and colorectal cancer screening. Chi-Square analysis and weighted multivariate logistic regression was performed. Not surprisingly, older adults with diabetes were significantly more likely to be in poor health than those without diabetes. Compared to non-diabetic group, older adults with diabetes were more likely to have had no exercise in the previous month. Interestingly, more older adults with diabetes reported having visited dentist, had flu shot and colonoscopy than those without diabetes. In both groups, older adults who presented health behaviors and received preventive health services were more likely to report good health compared to those who did not. The results suggest that further efforts are needed to address the health disparities for older adults with diabetes. Given the risk of comorbidities and its complications for older adults with diabetes, further research should be directed toward designing better health promotion programs and policies for older adults with diabetes.

Unhealthy behavior and risk of hypertension: the CONSTANCES population-based cohort.

We aimed to evaluate the individual and combined association between unhealthy behavior and hypertension (HTN). We conducted cross-sectional analysis using data from the population-based cohort study CONSTANCES. Blood pressure measurements were taken based on standardized operational procedures. Dietary adherence was done following the dietary approach to stop HTN diet. We considered heavy alcohol drinking, sedentary-level physical activity, low/medium dietary adherence and overweight/obesity as unhealthy behaviors. Participants' characteristics were compared according to the number of unhealthy behaviors and the association between HTN and unhealthy behaviors was estimated using logistic regression. A total of 86 448 volunteer participants were included and the prevalence of HTN was of 31.1%. Of those with HTN, 8.2, 33.0, 44.3 and 14.5% exhibited 0, 1, 2 or at least 3 unhealthy behaviors, respectively. In both sexes, the prevalence of HTN increased with low/medium dietary adherence compared with high (P < 0.01), in overweight/obese compared with normal BMI (P < 0.001), with heavy alcohol consumption compared with moderate or never (P < 0.05) and with sedentary physical activity level compared to high in women only (P = 0.049). Combination of several unhealthy behaviors was associated with increased odds of HTN (P trend <0.001); men reporting 2 or at least 3 unhealthy behaviors had an adjusted odds ratio of HTN of 1.77 and 2.29, respectively, while women had an adjusted odds ratio of 1.71 and 2.14, respectively. Individual and combined unhealthy lifestyle factors were strongly associated with HTN in this large population-based study.

Cigarette smoking, alcohol intake and the risk of diabetes mellitus in Gombe State, northeast Nigeria

Alcohol is consumed in almost all countries worldwide. Heavy drinking can reduce the body’s sensitivity to insulin, which can trigger type 2 diabetes mellitus. Diabetes can complicate chronic pancreatitis, which is overwhelmingly caused by heavy alcohol drinking. Alcohol is also high in calories, with heavy drinkers liable to obesity and a higher risk of type 2 diabetes mellitus. Similarly, cigarette smoking is associated with increased risk of type 2 diabetes mellitus among both middle-aged and elderly men and women. Nigeria is one of the three largest tobacco markets in Africa with a population of almost 13 million smokers. Northeast Nigeria ranks 3rd among the six geopolitical zones, with a smoking rate of 6.1%. In this study, we evaluated the risks of diabetes mellitus associated with alcohol consumption and cigarette smoking in Gombe State, Northeast Nigeria. This cross-sectional survey was conducted in a two-stage cluster sampling scheme based on existing administrative divisions. Study subjects were males and females aged 16 years and older who resided in the Jekadafari Ward of Gombe Metropolis. Subjects were excluded from this study if they were less than 16 years of age, pregnant women or suffered chronic conditions such as chronic kidney disease, chronic liver disease or chronic lung diseases based on clinical history and laboratory results. The calculated sample size was 1600 based on a 3.1% prevalence rate of DM, with a power of 85% and precision of 5%. We obtained complete data on 1302 subjects, of whom 50 (3.8%) had DM. (5.1% in males and 2.86% in females). Alcohol use was prevalent among 365 (28.03%) subjects, and was higher in males (49.4%) compared to females (11.4%). The risk of DM was significantly higher among alcoholusers compared to non-users, with an odds ratio of 4.1 (95%CI: 2.3- 7.3; P=0.0001). Eighty-eight subjects were cigarette smokers, of whom 87 were males and only one was female. We found no significant association between cigarette smoking and DM (OR=0.34, 95%CI 0.05-2.48; P=0.29). The overall prevalence of DM was 3.9%. Alcohol consumption, but not cigarette smoking, was associated with a higher risk of DM in this study.

Impact of Red Wine Consumption on Cardiovascular Health.

The devastating effects of heavy alcohol drinking have been long time recognized. In the last decades, potential benefits of modest red wine drinking were suggested. In European countries in which red wide intake is not negligible (such as France), the association between cholesterol and cardiovascular (CV) risk was less evident, suggesting the action of some protective molecules in red wine or other foods and drinks. This narrative review is based on the material searched for and obtained via PubMed up to May 2016. The search terms we used were: "red wine, cardiovascular, alcohol" in combination with "polyphenols, heart failure, infarction". Epidemiological and mechanistic evidence of a J-shaped relationship between red wine intake and CV risk further supported the "French paradox". Specific components of red wine both in vitro and in animal models were discovered. Polyphenols and especially resveratrol largely contribute to CV prevention mainly through antioxidant properties. They exert beneficial effects on endothelial dysfunction and hypertension, dyslipidemia, metabolic diseases, thus reducing the risk of adverse CV events such as myocardial infarction ischemic stroke and heart failure. Of interest, recent studies pointed out the role of ethanol itself as a potential cardioprotective agent, but a clear epidemiological evidence is still missing. The aim of this narrative review is to update current knowledge on the intracellular mechanism underlying the cardioprotective effects of polyphenols and ethanol. Furthermore, we summarized the results of epidemiological studies, emphasizing their methodological criticisms and the need for randomized clinical trials able to clarify the potential role of red wine consumption in reducing CV risk. Caution in avowing underestimation of the global burden of alcohol-related diseases was particularly used.

Raw Garlic Consumption and Risk of Liver Cancer: A Population-Based Case-Control Study in Eastern China.

Although the major risk factors for liver cancer have been established, preventive factors for liver cancer have not been fully explored. We evaluated the association between raw garlic consumption and liver cancer in a large population-based case-control study in Eastern China. The study was conducted in Jiangsu, China, from 2003 to 2010. A total of 2011 incident liver cancer cases and 7933 randomly selected population-controls were interviewed. Epidemiological data including raw garlic intake and other exposures were collected, and serum markers of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection were assayed. Overall, eating raw garlic twice or more per week was inversely associated with liver cancer, with an adjusted odds ratio (aOR) of 0.77 (95% confidence interval (CI): 0.62–0.96) compared to those ingesting no raw garlic or less than twice per week. In stratified analyses, high intake of raw garlic was inversely associated with liver cancer among Hepatitis B surface antigen (HBsAg) negative individuals, frequent alcohol drinkers, those having history of eating mold-contaminated food or drinking raw water, and those without family history of liver cancer. Marginal interactions on an additive scale were observed between low raw garlic intake and HBsAg positivity (attributable proportion due to interaction (AP) = 0.31, 95% CI: -0.01–0.62) and heavy alcohol drinking (AP = 0.28, 95% CI: 0.00–0.57). Raw garlic consumption is inversely associated with liver cancer. Such an association shed some light on the potential etiologic role of garlic intake on liver cancer, which in turn might provide a possible dietary intervention to reduce liver cancer in Chinese population.

Factors associated with isoniazid resistant tuberculosis among human immunodeficiency virus positive patients in Swaziland: a case-control study

BackgroundIsoniazid resistant tuberculosis is the most prevalent type of resistance in Swaziland and over two-thirds of the isoniazid resistant tuberculosis patients are tuberculosis and human immunodeficiency virus co-infected. The study aimed to determine risk factors associated with isoniazid resistant tuberculosis among human immunodeficiency virus positive patients in Swaziland.MethodsThis was a case-control study conducted in nine healthcare facilities across Swaziland. Cases were patients with isoniazid resistant tuberculosis (including 78 patients with isoniazid mono-resistant tuberculosis, 42 with polydrug-resistant tuberculosis, and 77 with multidrug-resistant tuberculosis). Controls were presumed drug-susceptible tuberculosis patients (n = 203). Multinomial logistic regression was used to determine related factors.ResultsThe median time lag from diagnosis to tuberculosis treatment initiation was 50 days for isoniazid mono or poly drug-resistant tuberculosis, 17 days for multidrug-resistant tuberculosis compared to 1 day for drug-susceptible tuberculosis patients. History of previous tuberculosis treatment was positively associated with either isoniazid mono or poly drug-resistant tuberculosis (OR = 7.91, 95% CI: 4.14–15.11) and multidrug-resistant tuberculosis (OR = 12.20, 95% CI: 6.07–24.54). Isoniazid mono or poly resistant tuberculosis patients were more likely to be from rural areas (OR = 2.05, 95% CI: 1.23–3.32) and current heavy alcohol drinkers compared to the drug-susceptible tuberculosis group. Multi drug-resistant tuberculosis patients were more likely to be non-adherent to tuberculosis treatment compared to drug-susceptible tuberculosis group (OR = 3.01, 95% CI: 1.56–5.82).ConclusionTo prevent and control isoniazid resistant tuberculosis among HIV-positive patients in Swaziland, the tuberculosis program should strengthen the use of rapid diagnostic tests, detect resistance early, promptly initiate supervised tuberculosis treatment and decentralize quality tuberculosis services to the rural areas. Adherence to tuberculosis treatment should be improved.

Invisible Labor and Women’s Double Binds: Collusive Femininity and Masculine Drinking in Russia

The heavy drinking of alcohol remains primarily a hegemonically masculine ritual worldwide. Yet scholarship has undertheorized women’s practices in shaping the boundaries of masculine rituals, including drinking. Drawing on 12 months of ethnographic fieldwork and 151 interviews with single mothers, married mothers, nonresident fathers, and grandmothers from diverse class backgrounds, I demonstrate that Russian women perform extensive invisible management labor in attempting to produce responsible men. Constrained by a starkly unequal gender division of domestic labor, wives and mothers engage in varied “patriarchal bargains” as they shape men’s drinking practices, co-producing hegemonic masculinity. Whereas in the Soviet period women also managed men’s drinking, today new gender strategies have emerged. More women are held accountable to a collusive femininity involving both accommodation and resistance, upholding men’s drinking privileges only if breadwinning occurs. As women perform invisible labor, they end up reproducing the conditions that demand this labor from them in the first place. Some women embrace an alternative femininity by becoming single mothers and refusing to manage men’s drinking, especially when men fail as breadwinners. Theorizing collusive and alternative femininities, as well as women’s invisible labor, advances our knowledge of how multiple femininities shape, and may in time change, hegemonic masculinity.

Unhealthy behavior and risk of uncontrolled hypertension among treated individuals–The CONSTANCES cohort study

Poor lifestyle behaviors have been identified to contribute to poor blood pressure (BP) control. We aimed to examine the individual and combined associations of unhealthy behavior with uncontrolled hypertension (HTN) among treated hypertensive adults. We conducted cross-sectional analysis using data from the CONSTANCES cohort study. Volunteer participants who have been diagnosed with HTN and were taking antihypertensive medications were included. Uncontrolled BP was defined as mean systolic BP ≥ 140 mmHg and/or mean diastolic BP ≥ 90 mmHg. Lifestyle factors were assessed using validated questionnaires. Dietary adherence assessment was done using the modified National Program on Nutrition and Health (mPNNS) score and then categorized into low, medium and high. We considered heavy alcohol drinking, sedentary level PA, low/medium dietary adherence and overweight/obese (body mass index ≥ 25 kg/m 2 ) as unhealthy behaviors. Using logistic regression models we estimated the association between control of hypertension and unhealthy behaviors. Statistical analyses were stratified by sex and were performed with SAS 9.4 (SAS Institute). A total of 8,927 participants were analyzed. The prevalence of uncontrolled HTN was of 53.3% and it was more common in men than in women (66.3% vs. 42.6% respectively, P < 0.001). The odds of uncontrolled HTN increased with low dietary adherence in men only ( P = 0.038), overweight and obese men ( P < 0.001), heavy alcohol drinking in both men and women ( P < 0.05 for both) compared to moderate/light (never) drinking. However, there was no statistically significant association with physical activity in both genders. The frequency of uncontrolled HTN increased with the number of unhealthy behaviors in both sexes ( P < 0.001 for men and P = 0.008 for women). Men and women reporting three unhealthy behaviors had 1.53–fold and 1.73-fold increase of the odds of uncontrolled HTN, respectively. An unhealthy lifestyle including low/medium adherence to dietary recommendations, high alcohol consumption and overweight/obesity was associated with uncontrolled HTN among treated hypertensive individuals.

Unhealthy behavior and risk of hypertension–The CONSTANCES population based cohort

Unhealthy behaviors may contribute to an increasing prevalence of hypertension (HTN). We aimed to evaluate the individual and combined association between unhealthy behavior and HTN. We conducted cross-sectional analysis on 48,346 volunteer participants from the CONSTANCES cohort study. Prevalent HTN was defined by a systolic blood pressure (BP) ≥ 140 mmHg and/or a diastolic BP ≥ 90 mmHg or by individuals receiving antihypertensive medications. Lifestyle behaviors were assessed through validated self-administered questionnaires. Dietary adherence assessment was done using the modified French National Program on Nutrition and Health (mPNNS) score. We considered heavy alcohol drinking, sedentary level PA, low/medium dietary adherence, and overweight/obese as unhealthy behaviors. Using logistic regression, we compared characteristics of subjects according to the number of unhealthy behaviors stratified by sex. After further adjustment, we estimated the association between HTN and unhealthy behaviors. The prevalence of HTN was of 31.6% and it was more common in men than in women (39.0% vs. 24.5%respectively, P < 0.001). Of those with HTN, 3.3%, 31.7%, 48.8% and 16.2% exhibited 0, 1, 2 or ≥ 3 unhealthy behaviors respectively. The prevalence of HTN increased with low/medium dietary adherence compared to high ( P < 0.01 for men and women), in overweight/obese compared to normal BMI ( P < 0.0001 in both sexes) and with heavy alcohol consumption compared to moderate or never ( P < 0.001 for men, P = 0.007 for women). On the other hand, the odds of HTN decreased with moderate/high PA compared to sedentary ( P < 0.01 for both genders). Combination of several unhealthy behaviors was associated with increased odds of HTN ( P trend < 0.001); men reporting 2 or ≥ 3 unhealthy behaviors had an adjusted odds ratio (ORa) of 2.08 and 2.93 respectively, while women had an ORa of 1.98 and 2.46, respectively. An unhealthy lifestyle including low/medium adherence to dietary recommendations, high alcohol consumption, low physical activity and overweight/obesity was associated with HTN in this large population-based study.

Predictors of uncontrolled blood pressure in hypertensive treated individuals–The CONSTANCES cohort study

A broad range of factors has been identified to contribute to poor blood pressure (BP) control. But further epidemiologic data in France are needed. We aimed to assess sociodemographic, clinical and behavioral predictors of uncontrolled BP among treated hypertensive individuals. We conducted cross-sectional analysis using data from the CONSTANCES cohort study. We included 11,159 participants previously diagnosed with hypertension and taking antihypertensive medications. Uncontrolled BP was defined as mean systolic BP ≥ 140 mm Hg and/or mean diastolic BP ≥ 90 mm Hg. Alcohol use disorder severity was defined according to the French version of the Alcohol Use Disorders Identification Test (AUDIT). Dietary assessment was done based on adherence to French dietary guidelines using the modified National Program on Nutrition and Health (mPNNS). Depressive symptoms were assessed with the Center of Epidemiologic Studies Depression scale (CES-D). Gender specific age-adjusted multivariable analyses were performed using logistic regression models. Adjusted mean systolic BP were studied across selected variables using the General Linear Model. The prevalence of uncontrolled BP was 60.2% and it was higher in men than in women (66.5% vs. 52.5%, P < 0.0001). A higher proportion of men had both SBP and DBP not at goal (42%) compared to women (34%). We found a significantly lower SBP with better dietary compliance ( P = 0.003 in men), high physical activity ( P = 0.048 in women) and low risk of alcohol use disorder ( P < 0.01, both sexes). There was no significant relationship with depression represented by CES-D. In both sexes, predictors of uncontrolled HTN were increasing age, history of CVD and dyslipidemia. In men, additional factors included diabetes (adjusted odds ratio 0.74; P = 0.036), increased BMI (ORa 1.26, P = 0.01), heavy alcohol drinking (ORa 1.59, P < 0.001) and high dietary adherence (ORa 0.69, P = 0.05) In this population-based study, clinical and behavioral characteristics were predictors of uncontrolled HTN. Modifiable risk factors such as weight, diet, alcohol use and physical activity influence the SBP and BP control.

Interactions of Behavioral Changes in Smoking, High-risk Drinking, and Weight Gain in a Population of 7.2 Million in Korea.

ObjectivesTo identify simultaneous behavioral changes in alcohol consumption, smoking, and weight using a fixed-effect model and to characterize their associations with disease status.MethodsThis study included 7 000 529 individuals who participated in the national biennial health-screening program every 2 years from 2009 to 2016 and were aged 40 or more. We reconstructed the data into an individual-level panel dataset with 4 waves. We used a fixed-effect model for smoking, heavy alcohol drinking, and overweight. The independent variables were sex, age, lifestyle factors, insurance contribution, employment status, and disease status.ResultsBecoming a high-risk drinker and losing weight were associated with initiation or resumption of smoking. Initiation or resumption of smoking and weight gain were associated with non-high-risk drinkers becoming high-risk drinkers. Smoking cessation and becoming a high-risk drinker were associated with normal-weight participants becoming overweight. Participants with newly acquired diabetes mellitus, ischemic heart disease, stroke, and cancer tended to stop smoking, discontinue high-risk drinking, and return to a normal weight.ConclusionsThese results obtained using a large-scale population-based database documented interactions among lifestyle factors over time.

Risk factors for extrahepatic cholangiocarcinoma: a case-control study in China.

To investigate risk factors for extrahepatic cholangiocarcinoma (ECC) in China. A total of 200 ECC cases and 200 matched control were included in the study. The presence of cigarette smoking, alcohol drinking, choledocholithiasis, primary sclerosing cholangitis, liver fluke infection (Clonorchis sinensis), diabetes mellitus, was investigated through clinical records. Blood from all cases was tested for hepatitis B surface antigen. Odds ratios (OR) and 95% confidence intervals (CIs) were estimated using conditional logistic regression. Compared with controls, ECC patients had a higher prevalence of cigarette smoking (61.0 vs. 47.0%, P=0.007), alcohol drinking (17.5 vs. 3.5%, P<0.000), and choledocholithiasis (6.0 vs. 1.0%, P=0.011). By multivariate analysis, the significant risk factors for the development of ECC were current smoking (OR=1.90, 95% CI=1.08-3.34), heavy alcohol drinking (OR=2.08, 95% CI=1.39-3.13), and choledocholithiasis (OR=6.68, 95% CI=1.48-30.27). The prevalence of hepatitis B virus infection, diabetes mellitus were not significantly different between cases and controls. These findings suggest that smoking, alcohol drinking, and choledocholithiasis are positive risk factors for the development of ECC in China.

Effect of differently worded messages about alcohol on intent to breastfeed among university women in South Korea

Background: There is concern that advice not to drink alcohol could discourage the initiation and particularly shorten the duration of breastfeeding. However, little research has explored the impact of variously worded messages about drinking while breastfeeding on women’s intentions to drink or to breastfeed. Methods: We haphazardly allocated a convenience sample of nulliparous (&gt;95%) Korean female university students to be exposed to three differently worded messages on alcohol use during breastfeeding in the body of a questionnaire. Translated to English, they were as follows: Liberal: “Breastfeeding is compatible with moderate but not heavy drinking of alcohol.” Moderate: “You can use alcohol while breastfeeding, but only on rare occasions and only 1-2 drinks at a time. Too much alcohol can harm the breastfeeding process. After each drink, you should wait 2 hours before breastfeeding to keep the child from being affected.” Strict: “You should never use alcohol while you are breastfeeding.” Results: Most of the 280 valid responses expressed an intention to breastfeed. Over 90% of sampled women drank alcohol currently; 91% of them intended to reduce consumption during breastfeeding. How strictly messages were worded did not affect intention to drink during breastfeeding. Neither strict nor liberal messages reduced intention to drink alcohol while breastfeeding. The strict message clearly told the students what to do, whereas the moderate and liberal messages left choices up to them. Receiving these messages that required women to decide for themselves reduced the women’s intention to breastfeed (p&lt;0.001). Conclusions: In this sample of largely nulliparous university women, a more strictly worded message regarding alcohol use during breastfeeding did not reduce breastfeeding intentions. Messages that left decisions up to the women did. The risk of harm associated with alcohol consumption during breastfeeding should we weighed against the risk that raising concerns about alcohol consumption might reduce the initiation or duration of breastfeeding. Research is needed to test such messages in different cultures and to follow up after delivery to see if indeed expressed intent correlates with actual practices. Until then, messages regarding breastfeeding and alcohol are likely to continue to be based only on the unexamined assumptions as to whether cautions about alcohol will affect women’s breastfeeding practices.

Dose-dependent effects of chronic alcohol drinking on peripheral immune responses

It is well established that chronic heavy alcohol drinking (CHD) results in significant organ damage, increased susceptibility to infections, and poor outcomes following injury. In contrast, chronic moderate drinking (CMD) has been associated with improved cardiovascular health and immunity. These differential outcomes have been linked to alterations in both innate and adaptive branches of the immune system; however, the mechanisms remain poorly understood. To address this question, we determined the impact of chronic drinking on the transcriptional and functional responses of peripheral blood mononuclear cells (PBMC) collected from male rhesus macaques classified as CMD or CHD after 12 months of voluntary ethanol self-administration. Our analysis suggests that chronic alcohol drinking, regardless of dose alters resting transcriptomes of PBMC, with the largest impact seen in innate immune cells. These transcriptional changes are partially explained by alterations in microRNA profiles. Additionally, chronic alcohol drinking is associated with a dose dependent heightened inflammatory profiled at resting and following LPS stimulation. Moreover, we observed a dose-dependent shift in the kinetics of transcriptional responses to LPS. These findings may explain the dichotomy in clinical and immunological outcomes observed with moderate versus heavy alcohol drinking.

Assessment of heavy alcohol drinking among young Swiss men

There is a need of empirical evidence of the relationship between heavy alcohol use and alcohol markers. More precisely, associations of these markers with patterns of alcohol use, such as risky single occasion drinking (i.e., drinking 6 drinks or more on a single occasion) have been scarcely investigated. This study aimed to derive psychometric properties of alcohol markers in comparison with different measures of alcohol use and to test whether it allows detecting excessive alcohol use. Participants ( n = 233, male, around 20 years old) were recruited based on a stratified random selection of the Swiss Cohort Study on Substance Use and Risk Factors. Inclusion criterion was an Audit score ≥ 13. Assessments included a clinical interview based on the Diagnostic Interview for Genetic Studies (DIGS) and self-reported alcohol measures [1] . Hair ( n = 230) and capillary blood ( n = 233) on Hemaxis ® DBS device were collected for ethyl glucuronide (EtG) and phosphatidylethanol (PEth) determination, respectively. EtG was extracted from washed hair by micropulverized extraction and SPE purification. The extracts were submitted to LC-MS/MS analysis (6500 Qtrap Sciex). Chromatographic separation was achieved using a Merck Chromolith ® RP-C18e column (150 × 3 mm). The PEth homologs 16:0/18:1 and 16:0/18:2 concentrations were determined by LC-MS/MS (5000 Qtrap Sciex) according to a validated method [2] . For the interpretation, only the PEth homolog 16:0/18:1 were used. Statistical data treatment (ROC-analysis) was carried out using R software. EtG could be detected in 151 of 230 samples with concentrations ≥ 4.0 pg/mg (LOQ). The maximum measured concentration was 690 pg/mg. Twenty-five percent, 50% (median) and 75% percentiles were 6.8, 15, and 34 pg/mg, respectively. In 53 cases, EtG concentrations were ≥ 30 pg/mg, suggesting excessive alcohol consumption. The area under the ROC curve for EtG ≥ 30 pg/mg vs. PEth was 0.8322. In cases where PEth ≥ 210 ng/mL, more than 75% presented also EtG ≥ 30 pg/mg. PEth 16:0/18:1 detected in 218 of 233 samples with concentrations ≥ 10 ng/mL (LOQ). The maximum measured concentration was 1990 ng/mL. Twenty-five percent, 50% (median) and 75% percentiles were 71, 182, and 360 ng/ml, respectively. In 99 cases, PEth 16:0/18:1 concentrations ≥ 210 ng/mL, suggesting excessive alcohol consumption, were found. Compared to self-reported data (last week total alcohol intake diary), area under the ROC curve for PEth ≥ 210 ng/mL were 0.8174. For detecting a risky single occasion drinking (≥ 5 drinks at one occasion), the area under the ROC curve for PEth were 0.7955. EtG and PEth measurement allowed detecting excessive alcohol consumption with high specificity and sensitivity. Both marker are complementary and do not necessarily provide the same information because of their different detection window and change of consumption during the evaluation period. The results support the statement in the SoHT consensus for the use of alcohol markers: “It is not advisable to use the results of hair testing for alcohol markers in isolation” [3] .

Chronic heavy drinking drives distinct transcriptional and epigenetic changes in splenic macrophages.

BackgroundChronic heavy alcohol drinking (CHD) leads to significant organ damage, increased susceptibility to infections, and delayed wound healing. These adverse outcomes are believed to be mediated by alterations in the function of myeloid cells; however, the mechanisms underlying these changes are poorly understood.MethodsWe determined the impact of CHD on the phenotype of splenic macrophages using flow cytometry. Changes in functional responses to LPS were measured using luminex and RNA-Seq. Finally, alterations in chromatin accessibility were uncovered using ATAC-Seq.FindingsA history of CHD led to increased frequency of splenic macrophages that exhibited a heightened activation state at resting. Additionally, splenic macrophages from CHD animals generated a larger inflammatory response to LPS, both at protein and gene expression levels. Finally, CHD resulted in increased levels of H3K4me3, a histone mark of active promoters, as well as chromatin accessibility at promoters and intergenic regions that regulate inflammatory responses.InterpretationThese findings suggest that a history of CHD alters the immune fitness of tissue-resident macrophages via epigenetic mechanisms.FundNational Institute on Alcohol Abuse and Alcoholism (NIAAA), National Institutes of Health (NIH) - R24AA019431, U01 AA13641, U01 AA13510, R21AA021947, and R21AA025839.