Safe Level Of Alcohol Consumption Research Articles

Association between alcohol consumption and incidence of dementia in current drinkers: linear and non-linear mendelian randomization analysis

Previous conventional epidemiological studies found a J-shape relationship between alcohol consumption and dementia, but this result was subject to confounding biases and reverse causation. Therefore, we aimed to investigate the potential linear or non-linear causal association between alcohol consumption and the incident risk of dementia in current drinkers. This study used data from the UK Biobank to investigate the relationship between alcohol consumption and dementia risk. 313,958 White British current drinkers, who were free of dementia during 2006-2010, were followed up until 2021. Alcohol consumption was self-reported and calculated according to the National Health Service guideline. The primary outcome was all-cause dementia identified through hospital and mortality records. We used multivariable Cox models with restricted cubic splines for conventional analysis and both non-linear and linear Mendelian Randomization (MR) analyses to assess causal relationships, employing a genetic score based on 95 SNPs identified from a meta-genome-wide association study of 941,280 people from Europe. 313,958 current drinkers consumed an average of 13.6 [IQR: 7.1-25.2] units/week alcohol (men averaged 20.2 [11.1-33.9] units/week and women 9.5 [5.3-16.7] units/week). During a mean follow-up of 13.2 years, 5394 (1.7%) developed dementia. Multivariable Cox model with restricted cubic spline functions identified a J-shaped relationship between alcohol consumption and dementia risk, with the lowest risk at 12.2 units/week. The non-linear MR failed to identify a significant non-linear causal relationship (p=0.45). Both individual-level (HR: 2.22 95%CI [1.06-4.66]) and summary-level (1.89 [1.53-2.32]) linear MR analyses indicated that higher genetically predicted alcohol consumption increased dementia risk. This study identified a positive linear causal relationship between alcohol consumption and dementia among current drinkers. The J-shaped association found in conventional epidemiological analysis was not supported by non-linear MR analyses. Our findings suggested that there was no safe level of alcohol consumption for dementia. The Shenzhen Science and Technology Program and the Strategic Priority Research Program of Chinese Academy of Sciences.

Cancer risk based on alcohol consumption levels: a comprehensive systematic review and meta-analysis.

Alcohol consumption is a well-established risk factor for cancer. Despite extensive research into the relationship between alcohol consumption and cancer risk, the effect of light alcohol consumption on cancer risk remains a topic of debate. To contribute to this discourse, we conducted a comprehensive systematic review and meta-analysis. Our systematic review aimed to investigate the associations between different levels of alcohol consumption and the risk of several cancer types. We focused on analyzing prospective associations using data from 139 cohort studies. Among them, 106 studies were included in the meta-analysis after a quantitative synthesis. Our analysis did not find a significant association between light alcohol consumption and all-cause cancer risk (relative risk, 1.02; 95% confidence interval, 0.99 to 1.04), but we observed a dose-response relationship. Light alcohol consumption was significantly associated with higher risks of esophageal, colorectal, and breast cancers. Light to moderate drinking was associated with elevated risks of esophageal, colorectal, laryngeal, and breast cancers. Heavy drinking was also found to contribute to the risk of stomach, liver, pancreas, and prostate cancers, thereby increasing the risk of almost all types of cancer. Additionally, females generally had lower cancer risks compared to males. Our findings highlight that cancer risks extend beyond heavy alcohol consumption to include light alcohol consumption as well. These findings suggest that there is no safe level of alcohol consumption associated with cancer risk. Our results underscore the importance of public health interventions addressing alcohol consumption to mitigate cancer risks.

Should alcohol carry a warning label?

There is no safe level of alcohol consumption, according to updated guidelines from the Canadian Centre on Substance Use and Addiction (CCSA). The guidelines recommend consuming no more than two alcoholic drinks per week. That’s the equivalent of two bottles of beer, two glasses of wine, or two

High Clinical and Genetic Similarity Between Chronic Pancreatitis Associated With Light-to-Moderate Alcohol Consumption and Classical Alcoholic Chronic Pancreatitis.

Heavy alcohol consumption and genetic factors represent the 2 major etiologies of chronic pancreatitis (CP). However, little is so far known about the clinical features and genetic basis of light-to-moderate alcohol consumption-related CP (LMA-CP). A cross-sectional analysis was performed on 1061 Chinese CP patients between 2010 and 2015. CP was classified as classical alcoholic CP (ACP; n= 206), LMA-CP (n= 154), and idiopathic CP (ICP; n= 701). Clinical features and genetic characteristics (PRSS1, SPINK1, CTRC, CFTR variant status) were compared between the different groups. Odds ratios (ORs) with 95% confidence intervals were calculated to ascertain the combinatorial effect of alcohol consumption and gene mutation. Compared with ICP, the clinical features of LMA-CP were characterized by higher rates of developing pancreatic stones, pseudocyst, diabetes, and steatorrhea, which were similar to those associated with ACP. The prevalence of CP-related gene variants in LMA-CP was 38.3%, similar to ACP (39.8%), although significantly lower than ICP (56.2%). Alcohol consumption enhanced the risk of a poor clinical outcome, whereas genetic factors amplified alcohol's effects. Compared with ICP, LMA-CP and ACP were associated with a high risk of pancreatic stones (patients without variants, OR= 2.01 and 2.54; patients with variants, OR= 2.17 and 1.07), pseudocyst (patients without variants, OR= 1.03 and 1.43; patients with variants, OR= 1.67 and 2.14), diabetes mellitus (patients without variants, OR= 0.86 and 1.31; patients with variants, OR= 2.05 and 1.55), and steatorrhea (patients without variants, OR= 1.56 and 2.10; patients with variants, OR= 2.11 and 1.60). Evidence was presented to show that LMA-CP was clinically and genetically similar to ACP but significantly different from ICP. Our findings provide support to the growing view that there is no safe level of alcohol consumption.

Five barriers to defining responsible drinking

‘Responsible drinking’ remains a poorly defined construct despite decades of use among diverse stakeholders including industry, academics, governmental agencies, and addiction advocacy groups. To move the field closer to a consensus definition of responsible drinking that is useful for educational and research purposes, we describe five primary barriers that discourage the construction of a shared definition of responsible drinking. These barriers include the lack of foundational empirical evidence, the social construction of the term, the possibility that different targets require different definitions, the political implications of responsible drinking, and the possibility that there is no safe level of alcohol consumption. We conclude this article by offering suggestions to overcome these barriers through further research.

Mechanisms and Therapeutic Opportunities in Atrial Fibrillation in Relationship to Alcohol Use and Abuse.

Excessive drinking has detrimental effects on the cardiovascular system. Atrial fibrillation (AF) after alcohol binge drinking, also named "holiday heart syndrome," is well established. However, chronic lower levels of alcohol intake also may increase AF risk. In this review, we aim to provide a comprehensive overview of the epidemiology and pathophysiology by which alcohol may be responsible for AF and discuss whether alcohol abstinence is required for optimal rhythm control as well as to maintain sinus rhythm in patients with AF. The pathophysiologic mechanisms responsible for the relationship between alcohol consumption and AF may include both direct and chronic effects increasing AF burden. Acute effects may include arrhythmogenic changes (such as shortening in atrial refractoriness, slowing in conduction velocity, and increased atrial ectopy) and an autonomic imbalance. Chronic changes contributing to the development of an arrhythmogenic substrate involve atrial structural and functional remodelling processes due to atrial dilation, elevated pressures, and fibrosis formation. In addition, alcohol consumption contributes to developing concomitant AF risk factors such as obesity, sleep-disordered breathing, and hypertension. Alcohol abstinence is associated with a reduction in AF recurrence and overall burden and moreover improves AF risk factor development such as obesity, hypertension, sleep apnea, and AF-related consequences such as stroke. In conclusion, alcohol consumption is associated with atrial arrhythmia and a wide range of cardiovascular comorbidities. Although further evidence is needed, current knowledge indicates that there might not be a safe level of alcohol consumption that does not increase AF risk.

Can slogans prevent gambling harm?

Can slogans prevent gambling harm?

New Australian guidelines for the treatment of alcohol problems: an overview of recommendations.

New Australian guidelines for the treatment of alcohol problems: an overview of recommendations.

A safe level of alcohol consumption: the right answer demands the right question.

Alcohol has been produced by humans for nearly ten millennia, but gold-standard evidence by which to judge the health effects of limited alcohol consumption remains elusive, introducing serious difficulty in considering the safety of alcohol consumption. To do so, physicians and policymakers must consider the population, dose and context of alcohol consumption and the end-point, preferably a holistic composite, of interest. The limitations of new research trends, such as mega-cohorts, genetic instrumental variable analysis and modelling studies, must also be viewed against the much larger backdrop of existing evidence. Some existing guidelines, such as the 2015-2020 Dietary Guidelines for Americans, succeed remarkably in this task. Nonetheless, large-scale randomized trials are urgently needed if future generations are to enjoy any greater insight into the health effects of population-wide alcohol consumption than the current one has.

Systematic Review with Meta-Analysis: Low-Level Alcohol Consumption and the Risk of Liver Cancer.

Background/AimsMultiple meta-analyses and observational studies have reported that alcohol is a risk factor for liver cancer. However, whether there is a safe level of alcohol consumption remains unclear. We performed a systematic review and meta-analysis of the correlation between low-level alcohol consumption and the risk of liver cancer.MethodsNested case-control studies and cohort studies involving the general population published prior to July 2019 were searched. In total, 28 publications (31 cohorts) with 4,899 incident cases and 10,859 liver cancer-related deaths were included. The pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated.ResultsCompared with those with low levels of alcohol consumption, moderate and heavy drinkers (≥1 drink/day for females and ≥2 drinks/day for males) had pooled ORs of 1.418 (95% CI, 1.192 to 1.687; p<0.001) for liver cancer incidence and 1.167 (95% CI, 1.056 to 1.290; p=0.003) for liver cancer mortality. The pooled OR for liver disease-related mortality for those with more than low levels of alcohol consumption was 3.220 (95% CI, 2.116 to 4.898; p<0.001) and that for all-cause mortality was 1.166 (95% CI, 1.065 to 1.278; p=0.001). The sensitivity analysis showed that none of the studies had a strong effect on the pooled OR. The Egger test, Begg rank correlation test, and the funnel plot showed no overt indication of publication bias.ConclusionsContinuous consumption of more than a low-level of alcohol (≥1 drink/day for females and ≥2 drinks/day for males) is related to a higher risk of liver cancer.

Underappreciated Bias Created by Measurement Error in Risk Factor Assessment—A Case Study of No Safe Level of Alcohol Consumption

This quality improvement study assesses the potential consequences of systematic underreporting of alcohol use on the observed results in a recent, well-publicized study.

Abstract P185: Alcohol Consumption and Cardiovascular Disease Mortality in Adults With Hypertension Following the 2017 Blood Pressure Guidelines

Introduction: Approximately half of adults have hypertension (HTN) under the 2017 blood pressure (BP) guidelines. The guidelines recommend lifestyle factors, such as limiting alcohol consumption, to manage BP, although safe levels of alcohol consumption have not been investigated for this new population with HTN. Objective: To examine the dose-response associations of alcohol consumption and cardiovascular disease (CVD) mortality in 29,499 adults (45±10 years) with HTN defined as systolic/diastolic BP ≥130/80 mmHg or physician diagnosis. Methods: Participants received a preventive medical examination during 1974-2003 and were without CVD, cancer, or abnormal electrocardiogram at baseline. Participants self-reported the number of standard alcoholic beverages they consumed per week on a medical history questionnaire. Participants were classified into 5 groups: non-drinkers and sex-stratified quartiles of weekly drinks based on no significant interaction by sex. Non-drinkers with a previous history of alcohol use problems were excluded to minimize a potential selection bias. Mortality follow-up was through 2003 using the National Death Index. Cox regression models included baseline age, sex, examination year, smoking status, body mass index, meeting the aerobic physical activity guidelines, and parental CVD. Models were further adjusted for cardiorespiratory fitness (CRF; in METs). Results: During a mean follow-up of 14.5 years, 672 CVD deaths occurred. Quartiles of alcohol consumption were 1-3, 4-7, 8-14, ≥15 drinks per week for men and 1-2, 3-4, 5-9, ≥10 drinks per week for women. Compared with non-drinkers (23%; 6,756 of 29,499), the hazard ratios (95% confidence intervals) for CVD mortality among quartiles of drinking were 0.71 (0.54-0.92), 0.73 (0.58-0.92), 0.76 (0.60-0.98), and 0.84 (0.67-1.05) after adjusting for potential confounders. After additional adjustment for CRF, the HRs were 0.75 (0.58-0.98), 0.79 (0.62-0.996), 0.82 (0.65-1.05) and 0.90 (0.72-1.13) for CVD mortality compared with non-drinkers. We found similar trends for CVD mortality after adjusting for fasting glucose, resting systolic and diastolic BP, total cholesterol, diabetes, and hyperlipidemia. We also found similar results in subgroups of men and women, young (&lt;60 years) and old (≥60 years), and normal weight (&lt;25 kg/m 2 ) and overweight/obese (≥25 kg/m 2 ) individuals. Similar trends were observed for all-cause mortality, although the associations were attenuated in all quartiles of drinking both before and after adjusting for CRF. Conclusions: The risk of CVD mortality was lower in light-to-moderate (quartiles 1-3) alcohol drinking in adults with HTN although these associations became weaker after adjusting for CRF. These results suggest a potential confounding effect of CRF on the association between alcohol consumption and CVD mortality that should be considered for future studies.

Fetal Alcohol Spectrum Disorder Information Dissemination by Health Care Professions

Fetal alcohol spectrum disorder (FASD) is the leading preventable intellectual and developmental disability. There is no safe level of alcohol consumption at any point during pregnancy. Findings of this study indicate that the information disseminated by health care professionals is not always in keeping with this understanding. Physicians and midwives appeared to be the least consistent in advocating to women that they abstain from alcohol consumption while pregnant. We explore ways in which social workers can support the medical profession to provide more consistent messaging of alcohol abstinence during pregnancy to lower the incidence of FASD.

Alcohol Consumption Levels and All-Cause Mortality Among Women Veterans and Non-Veterans Enrolled in the Women's Health Initiative.

To address research gaps regarding women Veterans' alcohol consumption and mortality risk as compared to non-Veterans, the current study evaluated whether alcohol consumption amounts differed between women Veterans and non-Veterans, whether Veterans and non-Veterans within alcohol consumption groups differed on all-cause mortality, and whether Veteran status modified the association between alcohol consumption and all-cause mortality. Six alcohol consumption groups were created using baseline data from the Women's Health Initiative Program (N = 145,521): lifelong abstainers, former drinkers, less than 1 drink/week (infrequent drinkers), 1-7 drinks/week (moderate drinkers), 8-14 drinks/week (moderately heavy drinkers), and 15 or more drinks/week (heavy drinkers). The proportions of Veteran and non-Veteran women within each alcohol consumption category were compared. Mortality rates within each alcohol consumption category were compared by Veteran status. Cox proportional hazard models, including a multiplicative interaction term for Veteran status, were fit to estimate adjusted mortality hazard (rate) ratios for each alcohol consumption category relative to a reference group of either lifelong abstainers or moderate drinkers. Women Veterans were less likely to be lifelong abstainers than non-Veterans. Women Veterans who were former or moderate drinkers had higher age-adjusted mortality rates than did non-Veterans within these alcohol consumption categories. In the fully adjusted multivariate models, Veteran status did not modify the association between alcohol consumption category and mortality with either lifelong abstainers or moderate drinkers as referents. The results suggest that healthcare providers may counsel Veteran and non-Veteran women in similar ways regarding safe and less safe levels of alcohol consumption.

Alcohol use and binge drinking among women of childbearing age - United States, 2011-2013.

Excessive alcohol use is risk factor for a wide range of health and social problems including liver cirrhosis, certain cancers, depression, motor vehicle crashes, and violence. Alcohol use during pregnancy can lead to fetal alcohol spectrum disorders (FASDs) and other adverse birth outcomes . Community studies estimate that as many as 2% to 5% of first grade students in the United States might have an FASD, which include physical, behavioral, or learning impairments. In 2005, the Surgeon General reissued an advisory urging women who are or might be pregnant to abstain from alcohol consumption to eliminate the risk for FASDs or other negative birth outcomes. To estimate current prevalences of any alcohol use and binge drinking (consuming four or more drinks on an occasion) among pregnant and nonpregnant women aged 18-44 years in the United States, CDC analyzed 2011-2013 Behavioral Risk Factor Surveillance System (BRFSS) data. Among pregnant women, the prevalences of any alcohol use and binge drinking in the past 30 days were 10.2% and 3.1%, respectively. Among nonpregnant women, the prevalences of any alcohol use and binge drinking in the past 30 days were 53.6% and 18.2%, respectively. Among binge drinkers, pregnant women reported a significantly higher frequency of binge drinking than nonpregnant women (4.6 and 3.1 episodes, respectively); the largest amount consumed during binge drinking was also higher among pregnant women than nonpregnant women (7.5 versus 6.0 drinks), although this difference was not statistically significant. Implementation of evidence-based clinical and community-level strategies would be expected to reduce binge drinking among pregnant women and women of childbearing age, and any alcohol consumption among women who are or might be pregnant. Healthcare professionals can support these efforts by implementing alcohol screening and brief interventions in their primary care practices, and informing women that there is no known safe level of alcohol consumption when they are pregnant or might be pregnant.

Maternal alcohol intake up to and during pregnancy and risk of adverse birth outcomes: evidence from a British cohort

BackgroundHigh maternal alcohol consumption has been linked to adverse birth outcomes such as small for gestational age and preterm birth, which in turn have been linked to increased risk of development of cardiovascular diseases and type 2 diabetes in adulthood. The UK Department of Health (DH) recommends that pregnant women and those trying to conceive should avoid alcohol and never drink more than 1–2 units once or twice a week. This study aimed to investigate the association between alcohol intake before and during different stages of pregnancy with both birthweight and gestational age. MethodsData were used from the Caffeine and Reproductive Health Study (CARE), a prospective birth cohort that included 1303 low-risk pregnant women aged 18–45 years, recruited from September, 2003, to June, 2006. Questionnaires administered in the first and second trimester and postpartum assessed alcohol consumption before pregnancy and for the three trimesters. Frequency of weekly alcohol consumption was analysed by categories of intake to accord with DH guidelines (≤2 units per week, >2 units per week, and a non-drinking category as the referent) and was related to preterm birth and size at birth, measured as grams and as customised birthweight centile, which takes into account maternal prepregnancy weight, height, parity, ethnicity, gestation, and baby's sex in multivariable linear and logistic regression models. We also adjusted for maternal age, caffeine intake, education, energy intake, and salivary cotinine as a biomarker of smoking status. Only participants with complete data for all variables were included in the analyses, which excluded just under 10% of the sample. All women provided informed consent and the study was approved by the Leeds West Local Research Ethics Committee (ref 03/054). Findings1153, 1135, 793, and 377 women, respectively, had data available for birth outcomes and alcohol consumption before pregnancy and during the three trimesters. 74% of women before pregnancy and 53% in the first trimester reported alcohol intakes above the DH recommendation. For intakes above 2 units per week compared with non-drinkers, the adjusted differences in birth centile were −7·7 (95% CI −12·8 to −2·6; ptrend=0·009), −8·2 (−12·6 to −3·7; ptrend=0·002), and −6·4 (−11·8 to −1·1, ptrend=0·06) before pregnancy and during trimesters 1 and 2, respectively. The association with small for gestational age and preterm birth was strongest in trimester 1, with adjusted odds ratios of 2·0 (95% CI 1·2–3·4; ptrend=0·03) and 3·5 (1·1–11·2, ptrend=0·04), respectively. Women who adhered to the recommendations in the first trimester of 2 units or fewer per week were also at a significantly higher risk of having babies born with lower birthweight (adjusted difference −98·5, 95% CI −170·9 to −26·1; ptrend=0·007), birth centile (−5·8, −10·8 to −0·7; ptrend=0·002), and preterm birth (adjusted odds ratio 4·6, 95% CI 1·4–14·7; ptrend=0·04) compared with non-drinkers. InterpretationThe first trimester was the most sensitive period for the association of alcohol with restricted fetal growth. However, this finding could be explained by under-reporting of alcohol intake. Our small sample size in the third trimester did not allow us to detect a change in birthweight, and larger prospective studies that take into account timing of exposure to alcohol are needed. We showed no evident safe level of alcohol consumption in pregnancy, and the safe advice should be to abstain from alcohol when planning to conceive and during pregnancy, particularly during its early stages. FundingThe CARE study was supported by a grant from the Food Standards Agency, UK (T01033).

Acquisition and Utilization of Information About Alcohol Use in Pregnancy Among Australian Pregnant Women and Service Providers.

Because of an unknown safe level of alcohol consumption during pregnancy and inconsistent alcohol guidelines for pregnant women, it is unclear what information is being circulated with regard to alcohol use and pregnancy. This study aimed to explore how pregnant women and service providers acquire and utilize information about alcohol use during pregnancy. This qualitative study involved 10-minute semistructured interviews with 74 mothers of young children and focus groups with 14 service providers in urban and rural areas of New South Wales in 2008 and 2009. Mothers were asked about their use of pregnancy-related services, social support, and their perceptions about advice they received about alcohol use during pregnancy. Service providers were asked about what they knew about recommended alcohol use during pregnancy, how they knew it, and how they communicated this information to pregnant clients. Women and service providers expressed uncertainty about what the alcohol recommendations were for pregnant women. Health care providers were inclined to discuss alcohol use with women they perceived to be high risk but not otherwise. Women felt pressure to both drink and not drink during their pregnancies. Those who drank discounted abstinence messages and reported a process of internal bargaining on issues such as the stage of their pregnancy and the type of beverages they consumed. Those who abstained did so mainly because they were afraid of being held responsible for any problems with their pregnancies or infants that might have occurred from drinking. Confusion surrounding the recommendations regarding alcohol use during pregnancy, inconsistency in addressing alcohol use with pregnant women, information overload, and a perceived culture of drinking appear to contribute to the high proportion of Australian women drinking during pregnancy.

Alcohol consumption in pregnancy: results from the general practice setting

There is no established safe level of alcohol consumption in pregnancy. Studies from Ireland have consistently shown lower abstention and higher binge drinking rates in pregnancy than other countries, indicating a high potential for foetal alcohol-related disorders. There has been little research on alcohol in pregnancy in primary care. To determine the prevalence of alcohol consumption amongst pregnant women attending their GP for antenatal care, and to compare this to use in the year prior to conception. Prospective cross-sectional study was carried out in fifteen teaching practices in the greater Dublin area. Women were recruited at their antenatal visits. Data were gathered by self-completed questionnaire in the practice, or researcher-administered telephone questionnaire. The questionnaire was based on the AUDIT, a WHO-validated data collection instrument designed for use in primary care. Two hundred and forty valid questionnaires were returned (80 % recruitment rate). Alcohol intake and binge drinking levels were much lower during pregnancy compared to the year prior to pregnancy (p < 0.001). There was a marked reduction in the prevalence of alcohol use in pregnancy compared to previous research. Over 97 % drink no more than once a week, including almost two-thirds of women who abstain totally from alcohol in pregnancy. Non-pregnant Irish women drink alcohol more frequently, and with higher rates of binge drinking, than women of other nationalities. Primary care is a suitable setting to research alcohol use in pregnancy. Alcohol use in pregnancy in Ireland has decreased markedly compared to previous research from this jurisdiction.

Editor’s Choice

Editor’s Choice

Fetal Central Nervous System Development and Alcohol — The Evidence So Far

Currently in the UK, there is no absolute guidance about alcohol consumption in pregnancy. The guidance for drinking during pregnancy is one or two units of alcohol one or two times weekly, but conservative advice is to abstain as a cautionary measure [1]. Despite the lack of consensus about the safe levels of alcohol consumption in pregnancy, there is increasing evidence of the impact of alcohol on the developing central nervous system. This article explores the evidence regarding alcohol consumption and its effects on the developing fetal central nervous system.