High Alcohol Intake Research Articles

Overview of Cancers

Cancer is a non-communicable disease that emerged without any definite cause [1]. According to [1] nearly 10 million deaths in 2020 due to cancer accounted for one in six deaths. There are several types of cancers, such as breast, lung, colon, rectum, and prostate cancers [1]. WHO (2022) had reported one-third of the causes of cancer are due to poor lifestyle choices such as tobacco smoking, high body mass index, alcohol intake, low fruit and vegetable intake, and lack of physical activity. The viral infections may cause cancer (Ho, 2016). For instance,[1] had also added that the human papillomavirus (HPV) and hepatitis viruses are the causative agents in 30% of cancer cases in low and lower-middle-income countries. Cancer is curable if treated in its early stages.

All-cause and liver-related mortality risk factors in excessive drinkers: Analysis of data from the UK biobank.

High alcohol intake is associated with increased mortality. We aimed to identify factors affecting mortality in people drinking extreme amounts of alcohol. We obtained information from the UK Biobank on approximately 500,000 participants aged 40-70 years at baseline assessment in 2006-2010. Habitual alcohol intake, lifestyle and physiological data, laboratory test results, and hospital diagnoses and death certificate data (to June 2020) for 5136 men (2.20% of male participants) and 1504 women (0.60%) who reported consuming ≥80 or ≥50 g/day, respectively, were used in survival analysis. Mortality hazard ratios for these excessive drinkers, compared to all other participants, were 2.02 (95% CI 1.89-2.17) for all causes, 1.89 (1.69-2.12) for any cancer, 1.87 (1.61-2.17) for any circulatory disease, and 9.40 (7.00-12.64) for any liver disease. Liver disease diagnosis or abnormal liver function tests predicted not only deaths attributed to liver disease but also those from cancers or circulatory diseases. Mortality among excessive drinkers was also associated with quantitative alcohol intake; diagnosed alcohol dependence, harmful use, or withdrawal syndrome; and current smoking at assessment. People with chronic excessive alcohol intake experience decreased average survival, but there is substantial variation in their mortality, with liver abnormality and alcohol dependence or other alcohol use disorders associated with a worse prognosis. Clinically, patients with these risk factors and high alcohol intake should be considered for early or intensive management. Research can usefully focus on the factors predisposing to dependence or liver abnormality.

A urinary peptidomics approach for early stages of cardiovascular disease risk: The African-PREDICT study.

Cardiovascular disease (CVD) affects individuals across the lifespan, with multiple cardiovascular (CV) risk factors increasingly present in young populations. The underlying mechanisms in early cardiovascular disease development are complex and still poorly understood. We therefore employed urinary proteomics as a novel approach to gain better insight into early CVD-related molecular pathways based on a CVD risk stratification approach. This study included 964 apparently healthy (no self-reported chronic illnesses, free from clinical symptoms of CVD) black and white men and women (aged 20-30 years old) from the African Prospective study on the Early Detection and Identification of Cardiovascular disease and Hypertension (African-PREDICT) study. Cardiovascular risk factors used for stratification included obesity, physical inactivity, tobacco use, high alcohol intake, hyperglycemia, dyslipidemia and hypertension. Participants were divided into low (0 risk factors), medium (1-2 risk factors) and high (≥3 risk factors) CV risk groups. We analyzed urinary peptidomics by capillary electrophoresis time-of-flight mass spectrometry. After adjusting for ethnicity, sex and age, 65 sequenced urinary peptides were differentially expressed between the CV risk groups (all q-values ≤ 0.01). These peptides included a lower abundance of collagen type I- and III-derived peptides in the high compared to the low CV risk group. With regard to noncollagen peptides, we found a lower abundance of alpha-1-antitrypsin fragments in the high compared to the low CV risk group (all q-values ≤ 0.01). Our findings indicate lower abundances of collagen types I and III in the high compared to the low CV risk group, suggesting potential early alterations in the CV extracellular matrix.

Effects of lifestyle risk behaviour clustering on cardiovascular disease among UK adults: latent class analysis with distal outcomes

Lifestyle risk behaviours such as smoking, physical inactivity, and unhealthy diet account for a considerable disease burden globally. These risk behaviours tend to cluster within an individual, which could have detrimental health effects. In this study, we aimed to examine the clustering effect of lifestyle risk behaviours on cardiovascular disease (CVD) and CVD risk among adults in the United Kingdom (UK). We performed a latent class (LC) analysis with distal outcomes using the UK Biobank baseline (2006–2010) data. First, we estimated LC measurement models, followed by an auxiliary model conditional on LC variables. We reported continuous (mean difference—MD) and binary (odds ratio—OR) outcomes with 95% confidence intervals. We included 283,172 and 174,030 UK adults who had data on CVD and CVD risk, respectively. Multiple lifestyle risk behaviour clustering (physically inactive, poor fruit & vegetable intake, high alcohol intake, and prolonged sitting) had a 3.29 mean increase in CVD risk compared to high alcohol intake. In addition, adults with three risk behaviours (physically inactive, poor fruit & vegetable intake, and high alcohol intake) had 25.18 higher odds of having CVD than those with two risk behaviours (physically inactive, and poor fruit and vegetable intake). Social deprivation, gender and age were also associated with CVD. Individuals' LC membership with two or more lifestyle risk behaviours negatively affects CVD. Interventions targeting multiple lifestyle behaviours and social circumstances should be prioritized to reduce the CVD burden.

S199 Excess Dietary Intake May Increase the Risk of Early Colon Cancer Pathogenesis

Introduction: Although non-modifiable factors such as age, sex, and race have been associated with increased risk of developing colon cancer, there are limited studies investigating modifiable factors. Some studies have shown fiber and calcium to be protective, while processed meats and alcohol to be risk factors. The data, however, remains controversial. The aims of this study are to 1) re-evaluate the epidemiology of colon cancer and 2) explore the nutritional status of those with early colon cancer diagnosis. Methods: The National Health and Nutrition Examination Survey (NHANES) is a survey designed to assess the health and nutritional status of adults and children across the United States (US). Nutritional information was collected via a 24-hour diet recall, and those with reliable recall were included in the study. We combined demographic and nutritional datasets from NHANES during 2007-2016 and identified patients who self-reported a diagnosis of colon cancer. The sample size was appropriately weighted and stratified into 2 cohorts: age < 45 years vs age ≥ 45 years. SPSS was used for analysis. Results: There were 5,767,593 self-reported cases of colon cancer in the US from 2007-2016 with reliable nutritional recall. Demographic data stratified by cohort is outlined in Table along with caloric and dietary intake. The average age of colon cancer diagnosis was 56.5 ± 15.3 years of which 19.4% were diagnosed early (age < 45). Univariate analysis showed those with early diagnosis had higher calorie (p< 0.001), fiber (p< 0.001), calcium (p< 0.001), caffeine (p< 0.001), and alcohol consumption (p< 0.001) than those diagnosed over 45. After controlling for BMI, race, sex, education, and income using logistic regression, we found that patients with higher caloric intake (≥ 2000 kcal) were more likely to be diagnosed with early onset colon cancer (OR: 3.81, 95% CI: 3.79-3.82). Conclusion: There were on average 576,759 reported cases of colon cancer per year in the US of which approximately 1/5th were diagnosed before 45. Females, non-Hispanic whites, and higher education/income were associated with early colon cancer diagnosis possibly due to earlier screening. Contrary to other studies, higher fiber and calcium intake did not appear to be protective. However, those with early diagnosis did have higher alcohol intake. Our data suggests those with high caloric intake, a modifiable risk factor, increases the odds of developing early cancer by over threefold, perhaps due to chronic underlying inflammation. Table 1. - Demographic and Dietary Breakdown in Patients Diagnosed with Colon Cancer Colon Cancer Diagnosis ≥ 45 years Colon Cancer Diagnosis < 45 years Average P-value Sex Male (%) 83.8% 16.2% - P< 0.001 Female (%) 78.2% 21.8% - Race Non-Hispanic White (%) 78.3% 21.7% - P< 0.001 Non-Hispanic Black (%) 89.5% 10.5% - Hispanic (%) 95.9% 4.1% - Other (%) 100% 0% - Education Level Less than 9th Grade (%) 80.6% 19.4% - P< 0.001 9-12th Grade (%) 87.0% 13.0% - High School Graduate (%) 89.8% 10.2% - AA Degree or Some College (%) 79.1% 20.9% - College Graduate (%) 72.4% 27.6% - Ratio of Family Income to Poverty Level (FIP) FIP ≥ 1 (%) 78.3% 21.7% - P< 0.001 FIP < 1 (%) 88.2% 11.8% - BMI (kg/m2) 29.9 31.4 30.2 P< 0.001 BMI BMI ≥ 25 79.7% 20.3% - P< 0.001 BMI < 25 83.6% 16.4% Total Caloric Intake (kcal) 1679.1 ± 654.1 2177.6 ± 1092.3 1775.6 ± 784.0 P< 0.001 Total Caloric Intake Kcal ≥ 2000 68.4% 31.6% - P< 0.001 Kcal < 2000 86.3% 13.7% Total Sugar (gm) 94.2 ± 69.7 122.9 ± 150.8 99.8 ± 91.9 P< 0.001 Total Fat (gm) 62.5 ± 28.8 90.7 ± 64.9 68.0 ± 40.1 P< 0.001 Dietary Fiber (gm) 14.3 ± 8.0 16.7 ± 10.5 14.7 ± 8.6 P< 0.001 Calcium (mg) 825.1 ± 537.5 980.1 ± 560.8 855.1 ± 545.6 P< 0.001 Caffeine (mg) 193.0 ± 177.4 284.0 ± 262.3 210.6 ± 200.0 P< 0.001 Alcohol (gm) 4.7 ± 14.3 9.0 ± 35.9 5.5 ± 20.4 P< 0.001

History of Delirium Tremens in AUD Patients in Treatment: Relationship to AUD Severity and Other Factors.

IntroductionDelirium tremens (DT) occurs after stopping prolonged, high alcohol intake and may be life-threatening if untreated. We need to know about clinical correlates of DT in order to provide the best clinical care.MethodsAt admission to inpatient treatment a cohort of 114 alcohol use disorder (AUD) patients were interviewed and examined concerning psychiatric diagnosis and symptoms, trauma experiences and alcohol related measures and if they had experienced DT.ResultsTwenty-four percent of the patients reported a life-time experience of DT. These patients were predominantly males and had lower educational level. More of the patients in the DT than the non-DT group reported at least one suicide attempt, were diagnosed with PTSD, and dropped out of treatment. Also, having parents with alcohol problems was more common among these patients, and they reported a longer duration of problematic drinking and a higher number of drinks needed to feel an effect of drinking. In the multivariable adjusted analysis only a diagnosis of PTSD (OR=5.71; 95% confidence interval (CI): 1.34–24.31) and duration of problematic drinking with a 6% increase in risk for every year (OR=1.06; 95% CI: 1.01–1.11) remained significant risk factors for having DT experience.Discussion and conclusionHaving experienced DT was more prevalent in the current investigation than in earlier studies. Patients that had experienced DT seemed to have more serious AUD, especially signified by a longer duration of drinking. These patients seemed to have many clinical disadvantages including more drop-out and higher suicide rate. PTSD could be a risk factor for DT but may also follow the DT experience.

Assessing the influence of cannabis and alcohol use on different visual functions: A comparative study

This study aimed to assess and compare the influence of alcohol intake and cannabis smoking on different visual functions. A total of 64 young and healthy volunteers took part in the study. All undertook several randomised experimental sessions in which different visual functions, namely distance stereopsis, retinal straylight, visual discrimination capacity, and contrast sensitivity, were tested. Cannabis smokers (N = 30) took a baseline session and a session after smoking a cannabis cigarette, whereas alcohol users (N = 34) underwent a baseline session, a session after a low alcohol intake (Alcohol 1), and a session after a moderate to high alcohol intake (Alcohol 2). All visual functions were impaired by cannabis and alcohol use, particularly for the Cannabis and Alcohol 2 groups. The deterioration of all visual variables was higher for the Alcohol 2 than for the Alcohol 1 and Cannabis groups, except for retinal straylight, the deterioration of which was equal for the Cannabis group, and distant stereopsis, which was more impaired for the Cannabis group. The Alcohol 2 group experienced the most impairing conditions, although very similar to the cannabis group, and that factors other than the experimental conditions, such as sex and age, also influenced these visual changes. Alcohol and cannabis use clearly impair vision. The deterioration caused by cannabis is similar to, but slightly lower than, that produced by a moderate to high alcohol intake, with the experimental conditions, sex and age all having an impact on the variability of visual deterioration.

A causal relationship between alcohol intake and type 2 diabetes mellitus: A two-sample Mendelian randomization study

Background and aimsWe investigated whether alcohol intake has a causal relationship with type 2 diabetes mellitus (T2DM) risk in adults of the Korean Genomic Epidemiology Study using two-sample Mendelian randomization (MR) analysis. Methods and resultsDaily alcohol intake was calculated based on the type, average amount, and frequency of alcohol consumption for six months before the interview. The participants were divided into low- and high-alcohol intake of 20 g/day. After adjusting for the covariates related to T2DM, the independent genetic variants (instrumental variables) related to alcohol intake were explored by GWAS analysis in a city hospital-based cohort (n = 58,701). SNPs with a significant level of p-value <5 × 10−8 and linkage disequilibrium of r2 < 0.001 were retrieved. MR methods were used to analyze the causality between alcohol intake and the T2DM risk, and the heterogeneity and leave-one-out sensitivity analyses were conducted in Ansan/Ansung plus rural cohorts (n = 13,598). High alcohol intake increased T2DM risk when the inverse-variance weighted (P = 0.012) and weighted median (P = 0.034) methods were used, but not when the MR-Egger method was used. No significant heterogeneity and horizontal pleiotropy between alcohol intake and T2DM were detected. A single genetic variant did not affect the causal association in a leave-one-out sensitivity analysis. ConclusionThis study supports that heavy alcohol intake appears to be causally associated with T2DM risk.

Possibility of falsely low levels of the alcohol marker phosphatidylethanol in patients with high alcohol consumption and hemolytic conditions

Although PEth is considered both a sensitive and specific marker of high alcohol intakes, false negative results are seen occasionally. Since the rate of PEth formation is a function of erythrocyte exposure to ethanol, short erythrocyte lifetime in hemolytic conditions may result in falsely lower or even negative PEth levels. Thus, our present study aimed to elucidate this hypothesis. PEth and CDT from 9893 serum and whole blood samples collected from 5746 patients were included along with markers of hemolysis (i.e. haptoglobin, HbA1c, reticulocytes, LD and Hb). Cases showing discrepancy between PEth and CDT, i.e. a low PEth value and a high CDT value, were considered to be possibly caused by falsely lowered PEth despite high alcohol consumption. These cases ( n = 233) were compared to the control group without PEth and CDT mismatch. The levels of haptoglobin were significantly lower in the cases showing low PEth and high CDT (estimate = −0.62, P = 0.002). The levels of HbA1c (estimate = −3.26, P = 0.001) and Hb (estimate = −0.507, P < 0.001) were also significantly lower in this group. These findings indicate hemolytic conditions in the low PEth/high CDT group. There were no significant differences for reticulocytes and LD concentrations between the low PEth/high CDT group and the control group. We also present a patient case with five samples illustrating the combination of low PEth and high CDT values combined with other findings indicative of hemolysis. These results indicate that PEth values could be falsely low in the presence of hemolytic conditions, although more research is needed to highlight this further. If high alcohol intake is suspected in the case of low PEth values, CDT should also be measured, and analysis of hemolytic biomarkers could be indicated.

Jeremiah Stamler, MD (1919-2022).

Jeremiah Stamler, MD (1919-2022).

Long-Term Dietary Patterns Are Reflected in the Plasma Inflammatory Proteome of Patients with Inflammatory Bowel Disease.

Diet plays an important role in the development and progression of inflammatory bowel disease (IBD, comprising Crohn’s disease (CD) and ulcerative colitis (UC)). However, little is known about the extent to which different diets reflect inflammation in IBD beyond measures such as faecal calprotectin or C-reactive protein. In this study, we aimed to unravel associations between dietary patterns and circulating inflammatory proteins in patients with IBD. Plasma concentrations of 73 different inflammation-related proteins were measured in 454 patients with IBD by proximity extension assay (PEA) technology. Food frequency questionnaires (FFQ) were used to assess habitual diet. Principal component analysis (PCA) was performed to extract data-driven dietary patterns. To identify associations between dietary patterns and plasma proteins, we used general linear models adjusting for age, sex, BMI, plasma storage time, smoking, surgical history and medication use. Stratified analyses were performed for IBD type, disease activity and protein intake. A high-sugar diet was strongly inversely associated with fibroblast growth factor-19 (FGF-19) independent of IBD type, disease activity, surgical history and deviance from recommended protein intake (false discovery rate (FDR) < 0.05). Conversely, a Mediterranean-style pattern was associated with higher FGF-19 levels (FDR < 0.05). A pattern characterised by high alcohol and coffee intake was positively associated with CCL11 (eotaxin-1) levels and with lower levels of IL-12B (FDR < 0.05). All results were replicated in CD, whereas only the association with FGF-19 was significant in UC. Our study suggests that dietary habits influence distinct circulating inflammatory proteins implicated in IBD and supports the pro- and anti-inflammatory role of diet. Longitudinal measurements of inflammatory markers, also postprandial, are needed to further elucidate the diet–inflammation relationship.

Triglyceride-Associated Epigenetic Markers and Diet and Lifestyle Habits in the Framingham Heart Study

ObjectivesThe current evidence has shown that environmental and lifestyle factors (e.g., diet, physical activity, tobacco smoking, alcohol) are associated with DNA methylation patterns. However, the mechanisms underlying the relation between diet and other exposures and epigenetic profiles are not well understood. To reduce such knowledge gap, we investigated the links between lifestyle, including diet, and methylation marks with plasma triglyceride concentrations (TG).MethodsWe first conducted an epigenome-wide association study (EWAS) (Illumina HumanMethylation450 BeadChip) for TG in the Framingham Heart Study Offspring population (n = 2,178). We then examined the relationships between dietary and lifestyle-related variables, collected over 13 years, and differential DNA methylation marks associated with the last TG measures (exam 8). Second, we conducted a mediation analysis to examine the potential causal relationship between diet-related variables and TG.ResultsThe EWAS analyses revealed 28 TG-associated DNA methylation sites at 19 regions (e.g., ABCG1, CPT1A, DHCR24, PHGDH, SLC7A11, SLC43A1, SREBF1, TXNIP). Within those methylation sites, we identified 427 significant associations between these DNA methylation sites and one or more dietary and lifestyle-related variables after accounting for multiple testing. The two most significant and consistent associations between TG-associated DNA methylation markers and diet were alcohol (g/day) and carbohydrate intake (% total energy), with P-values ranging from 10^(−4) to 10^(−56). Mediation analyses demonstrated that alcohol and carbohydrate intake independently affect TG via DNA methylation markers as mediators. For seven of the 19 identified differential DNA-methylation regions, higher alcohol intake was associated with decreased methylation and higher TG. In contrast, increased carbohydrate intake was associated with higher DNA methylation at two epigenetic loci (CPT1A and SLC7A11) and lower TG.ConclusionsOur findings indicate that dietary factors (i.e., alcohol and carbohydrate) are associated with specific DNA methylation markers that could mediate some of the observed associations between diet and cardiometabolic risk factors.Funding SourcesThis work was funded by the US Department of Agriculture, under agreement no. 8050-51,000-107-000D.

Relationship of the Difficulty of Helicobacter pylori Eradication with Drinking Habits and Allergic Disease.

Eradication of Helicobacter pylori (H. pylori) is crucial to reduce the risk of developing gastric ulcers and gastric cancer. Although immunoglobulin E (IgE) levels and alcohol consumption have been shown to influence the failure of H. pylori eradication, the relationship between these factors and the mechanism of failure has not been clarified. Because high IgE levels are associated with eradication failure, the purpose of this study was to clarify the factors leading to high IgE levels. Completed questionnaires and blood test data were collected from patients who visited a university hospital for H. pylori eradication. Logistic regression analysis was per-formed to examine the relationship between high IgE levels and allergic diseases. We also examined the relationship between alcohol intake and high IgE levels. Linear regression analysis was performed on the relationship between the amount of alcohol consumed and IgE measurements. The results showed that patients with allergic diseases and those with high alcohol intake had significantly higher IgE levels. High IgE levels are a risk factor for failure of H. pylori eradication that is associated with drinking habits and alcohol consumption, and our results suggest that daily alcohol consumption should be avoided even in non-allergic patients.

Minor effect of patient education for alcohol cessation intervention on outcomes after acute fracture surgery: a randomized trial of 70 patients.

Background and purposeHigh alcohol intake is associated with increased risk of postoperative complications. Alcohol cessation intervention is recommended prior to elective surgery. We investigated short- and long-term effects of perioperative intensive alcohol intervention in relation to acute ankle fracture surgery.Patients and methods70 patients requiring ankle fracture surgery and consuming ≥ 21 drinks weekly (1 drink = 12 g ethanol) were randomized to a manual-based 6-week intensive standardized alcohol cessation program, the Gold Standard Program (GSP-A), or treatment as usual (TAU), on the day of operation. GSP-A included 5 personal meetings, patient education, and motivational and pharmacological support (alcohol withdrawal prophylaxis, B vitamins, and low-dose disulfiram). Complications requiring treatment were measured after 6 weeks and 1 year. Alcohol intake was validated by biomarkers. Quality of life (QoL) was measured by the SF-36. Hospital costs were obtained from the National Hospital Costs Register.ResultsPostoperatively, complete alcohol cessation was higher in the GSP-A than in the TAU group (18/35 vs. 5/35, number needed to treat = 3, p ≤ 0.001), but not lowrisk consumption in the long term (10/35 vs. 7/33, p = 0.5). Number of complications in the short and long term (12/35 vs. 14/33, 16/35 vs. 18/33), the SF-36 score, or hospital costs in the short and long term (€6,294 vs. €8,024, €10,662 vs. €12,198), were similar between the groups.InterpretationDespite an effect on alcohol cessation and a positive tendency as regards the other outcomes, the postoperative complications, QoL, and costs were similar. Better perioperative strategies for acute surgical patients with high alcohol intake therefore need to be developed.

Are health behaviors associated with academic performance among tertiary education students? A systematic review of cohort studies

Objective To evaluate the association between health behaviors with academic performance among tertiary education students. Methods Six databases were searched until July 2020 for prospective cohort studies evaluating the association between health behavior(s) (dietary intake, physical activity, sedentary behavior, alcohol intake, sleep, smoking or illicit drug use) and academic performance. Results Thirty-four studies were included (18 assessed sleep, 16 alcohol intake, 12 illicit drug use, 10 physical activity, 8 diet, 4 smoking, 2 sedentary behavior). A consistent negative association with academic performance was demonstrated for sleep (12/18 studies), alcohol intake (13/16) and illicit drug use (9/12). Most (7/10) studies found no association between physical activity and academic performance. Conclusion Findings suggest interventions to mitigate the influence of poor sleep, high alcohol intake, and illicit drug use on academic performance may be needed. Further research of other health behaviors, along with their co-occurrence, with academic performance, is required.

Individual Barriers to an Active Lifestyle at Older Ages Among Whitehall II Study Participants After 20 Years of Follow-up

Identification of individual-level barriers associated with decreased activity in older age is essential to inform effective strategies for preventing the health outcomes associated with high sedentary behavior and lack of physical activity during aging. To assess cross-sectional and prospective associations of a large set of factors with objectively assessed sedentary time and physical activity at older age. This population-based cohort study was conducted among participants in the Whitehall II accelerometer substudy with accelerometer data assessed in 2012 to 2013. Among 4880 participants invited to the accelerometer substudy, 4006 individuals had valid accelerometer data. Among them, 3808 participants also had factors assessed in 1991 to 1993 (mean [SD] follow-up time, 20.3 [0.5] years), 3782 participants had factors assessed in 2002 to 2004 (mean [SD] follow-up time, 9.1 [0.3] years), and 3896 participants had factors assessed in 2012 to 2013 (mean follow up time, 0 years). Data were analyzed from May 2020 through July 2021. Sociodemographic factors (ie, age, sex, race and ethnicity, occupational position, and marital status), behavioral factors (ie, smoking, alcohol intake, and fruit and vegetable intake), and health-related factors (ie, body mass index, 36-Item Short Form Health Survey (SF-36) physical and mental component summary scores [PCS and MCS], and number of chronic conditions) were assessed among 3808 individuals in 1991 to 1993; 3782 individuals in 2002 to 2004; and 3896 individuals in 2012 to 2013. High alcohol intake was defined as more than 14 units of alcohol per week, and high fruit and vegetable intake was defined as twice daily or more. Accelerometer-assessed time spent in sedentary behavior, light-intensity physical activity (LIPA), and moderate to vigorous physical activity (MVPA) in 2012 to 2013 were analyzed in 2021 using multivariate linear regressions. A total of 3896 participants (986 [25.3%] women; age range, 60-83 years; mean [SD] age, 69.4 [5.7] years) had accelerometer data and exposure factors available in 2012 to 2013. Older age, not being married or cohabiting, having overweight, having obesity, more chronic conditions, and poorer SF-36 PCS, assessed in midlife or later life, were associated with increased sedentary time at the expense of time in physical activity. Mean time differences ranged from 9.8 min/d (95% CI, 4.1 to 15.6 min/d) of sedentary behavior per 10-point decrease in SF-36 PCS to 51.4 min/d (95% CI, 37.2 to65.7 min/d) of sedentary behavior for obesity vs reference range weight, from -6.2 min/d (95% CI, -8.4 to -4.1 min/d) of LIPA per 5 years of age to -28.0 min/d (95% CI, -38.6 to -17.4 min/d) of LIPA for obesity vs reference range weight, and from -5.3 min/d (95% CI, -8.2 to -2.4 min/d) of MVPA per new chronic condition to -23.4 min/d (95% CI, -29.2 to -17.6 min/d) of MVPA for obesity vs reference range weight in 20-year prospective analyses for men. There was also evidence of clustering of behavioral factors: high alcohol intake, high fruit and vegetable consumption, and no current smoking were associated with decreased sedentary time (mean time difference in cross-sectional analysis in men: -12.7 min/d [95% CI, -19.8 to -5.5 min/d]; -6.0 min/d [95% CI, -12.3 to -0.2]; and -37.4 min/d [95% CI, - 56.0 to -18.8 min/d], respectively) and more physical activity. This study found a large range of individual-level barriers associated with a less active lifestyle in older age, including sociodemographic, behavioral, and health-related factors. These barriers were already evident in midlife, suggesting the importance of early implementation of targeted interventions to promote physical activity and reduce sedentary time.

Central nervous system monoamine metabolite response to alcohol exposure is associated with future alcohol intake in a nonhuman primate model (Macaca mulatta).

It is widely held that the central monoamine neurotransmitters modulate alcohol intake. Few studies, however, directly assess the relationship between baseline and alcohol-induced monoamine turnover, as well as the change from baseline, as predictors of alcohol intake. Using a nonhuman primate model, this study investigates baseline, alcohol-induced and alcohol-induced change in monoamine activity and their relationship with alcohol intake. Alcohol-naïve, adolescent rhesus macaques (Macaca mulatta, N = 114) were administered a standardized intravenous bolus of alcohol solution (16.8%, v/v) on two occasions, approximately 1 month apart. One month prior to and 1 h following each alcohol infusion, cisternal cerebrospinal fluid (CSF) was obtained and assayed for monoamine metabolite concentrations. Approximately 6-7 months later, subjects were allowed unfettered access to an aspartame-sweetened alcohol solution (8.4%, v/v) for 1 h/day, 5 days/week, over 5-7 weeks. Results showed strong positive correlations between baseline and post-infusion CSF monoamine metabolite concentrations, indicating a trait-like response. Low baseline and post-infusion serotonin and dopamine metabolite concentrations and a smaller change in serotonin and dopamine metabolites from one infusion to the next were associated with higher alcohol intake. Low baseline and post-infusion norepinephrine metabolite concentrations predicted high alcohol intake, but unlike the other monoamines, a greater change in norepinephrine metabolite concentrations from one infusion to the next was associated with higher alcohol intake. These findings suggest that individual differences in naturally occurring and alcohol-induced monoamine activity, as well as the change between exposures, are important modulators of initial alcohol consumption and may play a role in the risk for excessive alcohol intake.

Visual impairment and depression in China: a 7-year follow-up study from national longitudinal surveys

ObjectivesTo explore the longitudinal association between visual impairment (VI) and depression among adults 45 years and older in China based on a nationally representative follow-up dataset.SettingParticipants in China from the...

Relationships among Alcohol Drinking Patterns, Macronutrient Composition, and Caloric Intake: National Health and Nutrition Examination Survey 2017-2018.

Excessive alcohol consumption is associated with poor diet. Mixed reports in literature, so far, emphasize on the detailed understanding of relationships between diet composition and binge drinking at different drinking thresholds. We examined the association of alcohol consumption thresholds with macronutrient composition, caloric intake and anthropometric measures from the NHANES 2017-2018 dataset. A total of 2320 participants' data were analyzed. Energy and nutrient content from daily food and beverage intake were assessed via two dietary recall interviews. Physical examination and Alcohol Use Questionnaire including details about lifetime and current usage patterns were obtained. Correlations were evaluated using the Rao-Scott F Adjusted Chi-square statistic and Wald F-test. Sample-weighted multiple linear regression models were built to analyze the associations among volume of alcohol consumed, weight history and macronutrient intake. Waist circumference was significantly higher in 0- < 4 drinks/episode (low-quantity) drinkers than 4-7 drinks/episode (medium-quantity) and 8-11 drinks/episode (high-quantity) drinkers. High-quantity drinkers consumed significantly more kilocalories (2569.91) compared with low-quantity drinkers (2106.73). Low-quantity drinkers consumed more energy from carbohydrate and fat than medium and high-quantity drinkers. Very high-quantity drinkers (12+ drinks/episode) consumed less fiber (12.81g) than low-quantity drinkers (16.67g). We observed an association between high alcohol intake and differences in eating habits and body composition. The findings suggest a need to compare more specific drinking patterns and their impact on nutrient intake. Although some results conflicted with previous studies, the mechanisms underlying alcohol's effect on ingestive and digestive metabolic pathways are still unclear and require further investigation.

Associations of Alcohol Consumption and Smoking With Disease Risk and Neurodegeneration in Individuals With Multiple Sclerosis in the United Kingdom

Understanding the effects of modifiable risk factors on risk for multiple sclerosis (MS) and associated neurodegeneration is important to guide clinical counseling. To investigate associations of alcohol use, smoking, and obesity with odds of MS diagnosis and macular ganglion cell layer and inner plexiform layer (mGCIPL) thickness. This cross-sectional study analyzed data from the community-based UK Biobank study on health behaviors and retinal thickness (measured by optical coherence tomography in both eyes) in individuals aged 40 to 69 years examined from December 1, 2009, to December 31, 2010. Risk factors were identified with multivariable logistic regression analyses. To adjust for intereye correlations, multivariable generalized estimating equations were used to explore associations of alcohol use and smoking with mGCIPL thickness. Finally, interaction models explored whether the correlations of alcohol and smoking with mGCIPL thickness differed for individuals with MS. Data were analyzed from February 1 to July 1, 2021. Smoking status (never, previous, or current), alcohol intake (never or special occasions only [low], once per month to ≤4 times per week [moderate], or daily/almost daily [high]), and body mass index. Multiple sclerosis case status and mGCIPL thickness. A total of 71 981 individuals (38 685 women [53.7%] and 33 296 men [46.3%]; mean [SD] age, 56.7 [8.0] years) were included in the analysis (20 065 healthy control individuals, 51 737 control individuals with comorbidities, and 179 individuals with MS). Modifiable risk factors significantly associated with MS case status were current smoking (odds ratio [OR], 3.05 [95% CI, 1.95-4.64]), moderate alcohol intake (OR, 0.62 [95% CI, 0.43-0.91]), and obesity (OR, 1.72 [95% CI, 1.15-2.56]) compared with healthy control individuals. Compared with the control individuals with comorbidities, only smoking was associated with case status (OR, 2.30 [95% CI, 1.48-3.51]). High alcohol intake was associated with a thinner mGCIPL in individuals with MS (adjusted β = -3.09 [95% CI, -5.70 to -0.48] μm; P = .02). In the alcohol interaction model, high alcohol intake was associated with thinner mGCIPL in control individuals (β = -0.93 [95% CI, -1.07 to -0.79] μm; P < .001), but there was no statistically significant association in individuals with MS (β = -2.27 [95% CI, -4.76 to 0.22] μm; P = .07). Smoking was not associated with mGCIPL thickness in MS. However, smoking was associated with greater mGCIPL thickness in control individuals (β = 0.89 [95% CI, 0.74-1.05 μm]; P < .001). These findings suggest that high alcohol intake was associated with retinal features indicative of more severe neurodegeneration, whereas smoking was associated with higher odds of being diagnosed with MS.