Alcohol Consumption, Heavy Drinking, and Mortality: Rethinking the J-Shaped Curve

Plunk, Andrew D.; Syed-Mohammed, Husham; Cavazos‐Rehg, Patricia A.; Bierut, Laura J.; Grucza, Richard A.

doi:10.1111/acer.12250

Cited by 107 publications

(65 citation statements)

References 24 publications

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“…This highlights the so-called binge drinkers as a special public health concern population, which has been consistent across studies. [25][26][27] This current research is thus in agreement to the established evidence, showing that the frequency and amount of drinking are intertwined, perhaps forming a vicious cycle that demand professional intervention. 28 Investigating the reason of consuming alcohol in Minahasan college students is also necessary.…”

Section: Discussionsupporting

confidence: 89%

Alcohol consumption among college students in Minahasa, Indonesia: a cross-sectional study towards the formulation of intervention strategies

Supit¹,

Mamuaja²,

Pissu³

2017

Int J Community Med Public Health

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Background: College students are within the high-risk group to experience the full spectrum of alcohol-related psychopathologies, ranging from initial contact with alcohol to the severe problematic drinking. The prevalence, degree of severity, reasons of drinking, among other variables, however, have been inconsistent across studies. Therefore, it is crucial to replicate such studies in different socio-cultural settings to synthesize a broader understanding about alcohol-consuming behavior and formulating intervention strategies. This research aims to describe the pattern of alcohol drinking behavior among college students in Minahasa, Indonesia, and to analyze its correlation with academic performance. Methods: We conducted a questionnaire-based cross-sectional study to investigate the alcohol-consumption pattern and examined its association with the students' academic performance obtained from the campus database. A total-sampling technique was applied to draw the samples. Chi-square and Kendall's tau analyses were employed accordingly to measure the relationship significance. Results: From 417 samples (338 samples were females), 70.98% of them reported never had consumed alcohol of any amount. Male sex and local ethnicity are positively associated with consuming behavior. We found an association between alcohol consumption status with cumulative GPA but not with current GPA. Although alcohol consumers considered GPA as less important, the self-insight about their academic performance is intact. The consumed beverages were mostly beers, followed by traditional liquor and winepalms. Most of them consumed alcohol to "warm-up the body"—a common practice in this area, followed by social reasons. Only small number of them identified themselves as being addicted. Majority of the consumers realized the importance to reduce or quit consuming alcohol. The implications of these findings are then discussed. Conclusions: This study showed that most of the students have never consumed alcohol. However, among the consumers, male sex and local ethnicity are more prone to become alcohol users. The academic performance is also affected, and since most of the consumers consider to reduce their drinking behavior, professional interventions are necessary to facilitate recovery attempts.

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Section: Discussionsupporting

confidence: 89%

Alcohol consumption among college students in Minahasa, Indonesia: a cross-sectional study towards the formulation of intervention strategies

Supit¹,

Mamuaja²,

Pissu³

2017

Int J Community Med Public Health

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“…However, approximately 14% of study participants were classified into one of three heavy drinking trajectories, characterized by more than 26 HED days per six-month period (i.e., at least one HED day per week). Given that HED at a frequency of at least once per week has been shown to predict both increased morbidity and mortality among adults (Plunk et al, 2014, Room et al, 2005), participants within the heaviest drinking trajectories may be at risk of adverse alcohol-related health outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…This definition of HED has been well-validated among men (Wechsler and Nelson, 2001), has been shown to be a good indicator for alcohol-related problems (Jackson, 2008), is predictive of an increased risk of mortality (Plunk et al, 2014), and has been used previously to examine developmental HED trajectories among adolescents (Oesterle et al, 2004). …”

Section: Methodsmentioning

confidence: 99%

Heavy Drinking Trajectories Among Men Who Have Sex with Men: A Longitudinal, Group‐Based Analysis

Marshall

Shoveller

Kahler

et al. 2015

Alcoholism Clin & Exp Res

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Background Heavy episodic drinking (HED) is associated with sexual risk behavior and HIV seroconversion among men who have sex with men (MSM), yet few studies have examined heavy drinking typologies in this population. Methods We analyzed data from 4,075 HIV-uninfected MSM (aged 16 to 88) participating in EXPLORE, a 48-month behavioral intervention trial, to determine the patterns and predictors of HED trajectories. Heavy episodic drinking was defined as the number of days in which ≥5 alcohol drinks were consumed in the past 6 months. Longitudinal group-based mixture models were used to identify HED trajectories, and multinomial logistic regression was used to determine correlates of membership in each group. Results We identified five distinct HED trajectories: non-heavy drinkers (31.9%); infrequent heavy drinkers (i.e., <10 heavy drinking days per 6 month period, 54.3%); regular heavy drinkers (30-45 heavy drinking days per 6 months, 8.4%); drinkers who increased HED over time (average 33 days in the past six months to 77 days at end of follow-up, 3.6%); and very frequent heavy drinkers (>100 days per 6 months, 1.7%). Intervention arm did not predict drinking trajectory patterns. Younger age, self-identifying as white, lower educational attainment, depressive symptoms, and stimulant use were also associated with reporting heavier drinking trajectories. Compared to non-heavy drinkers, participants who increased HED more often experienced a history of childhood sexual abuse. Over the study period, depressive symptomatology increased significantly among very frequent heavy drinkers. Conclusions Socioeconomic factors, substance use, depression, and childhood sexual abuse were associated with heavier drinking patterns among MSM. Multi-component interventions to reduce HED should seek to mitigate the adverse impacts of low educational attainment, depression, and early traumatic life events on the initiation, continuation or escalation of frequent HED among MSM.

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“…Risk profiles based only on average alcohol consumption incorrectly estimate mortality risk for many drinkers (Plunk et al, 2014). Heavy episodic drinking is frequent among middleaged and older adults (Blazer & Wu, 2009).…”

Section: Discussionmentioning

confidence: 99%

“…Further, among Norwegians ages 20-62 years, drinking five drinks or more per occasion, even when infrequent, was linked to increased 20-year total mortality (Graff-Iversen et al, 2013). Similarly, among U.S. adults 17 years of age and older followed for 9 years, drinking five or more drinks a day at any frequency predicted increased total mortality risk (Plunk et al, 2014). …”

Section: Heavy Episodic Drinking and Mortalitymentioning

confidence: 96%

Drinking Level, Drinking Pattern, and Twenty-Year Total Mortality Among Late-Life Drinkers

Schutte

Brennan

Holahan

et al. 2015

J. Stud. Alcohol Drugs

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ABSTRACT. Objective: Research on moderate drinking has focused on the average level of drinking. Recently, however, investigators have begun to consider the role of the pattern of drinking, particularly heavy episodic drinking, in mortality. The present study examined the combined roles of average drinking level (moderate vs. high) and drinking pattern (regular vs. heavy episodic) in 20-year total mortality among late-life drinkers. Method: The sample comprised 1,121 adults ages 55-65 years. Alcohol consumption was assessed at baseline, and total mortality was indexed across 20 years. We used multiple logistic regression analyses controlling for a broad set of sociodemographic, behavioral, and health status covariates. Results: Among individuals whose high level of drinking placed them at risk, a heavy episodic drinking pattern did not increase mortality odds compared with a regular drinking pattern. Conversely, among individuals who engage in a moderate level of drinking, prior findings showed that a heavy episodic drinking pattern did increase mortality risk compared with a regular drinking pattern. Correspondingly, a high compared with a moderate drinking level increased mortality risk among individuals maintaining a regular drinking pattern, but not among individuals engaging in a heavy episodic drinking pattern, whose pattern of consumption had already placed them at risk. Conclusions: Findings highlight that low-risk drinking requires that older adults drink low to moderate average levels of alcohol and avoid heavy episodic drinking. Heavy episodic drinking is frequent among late-middle-aged and older adults and needs to be addressed along with average consumption in understanding the health risks of late-life drinkers. (J. Stud. Alcohol Drugs, 76, 552-558, 2015) Received: January 15, 2015. Revision: March 12, 2015. This work was supported by National Institute on Alcohol Abuse and Alcoholism Grant AA15685 and by Department of Veterans Affairs Health Services Research and Development Service funds. The opinions expressed here are the authors' and do not necessarily represent the opinions of the Department of Veterans Affairs. *Correspondence may be sent to Charles J. Holahan at the Department of Psychology (A8000), University of Texas at Austin, Austin, TX 78712, or via email at: holahan@utexas.edu. E XCESSIVE ALCOHOL CONSUMPTION is a major risk factor for chronic disease and injury (Rehm et al., 2009), but moderate alcohol consumption has been associated with reduced total mortality (Di Castelnuovo et al., 2006). However, research on moderate drinking has focused on the average level of drinking, masking diverse underlying patterns of drinking (Naimi et al., 2013). Among individuals whose average consumption is moderate, drinking may vary from a regular pattern to occasions of heavy episodic drinking. Recently, investigators have begun to consider the role of drinking pattern in mortality (Roerecke et al., 2011;Wannamethee, 2013). Heavy episodic drinking and mortalityHeavy episodic drinking is linked t...

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Alcohol Consumption, Heavy Drinking, and Mortality: Rethinking the J-Shaped Curve

Cited by 107 publications

References 24 publications

Alcohol consumption among college students in Minahasa, Indonesia: a cross-sectional study towards the formulation of intervention strategies

Alcohol consumption among college students in Minahasa, Indonesia: a cross-sectional study towards the formulation of intervention strategies

Heavy Drinking Trajectories Among Men Who Have Sex with Men: A Longitudinal, Group‐Based Analysis

Drinking Level, Drinking Pattern, and Twenty-Year Total Mortality Among Late-Life Drinkers

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