Has the leaning tower of presumed health benefits from ‘moderate’ alcohol use finally collapsed?

Chikritzhs, Tanya; Stockwell, Tim; Naimi, Timothy S.; Andréasson, Sven; Dangardt, Frida; Liang, Wenbin

doi:10.1111/add.12828

Cited by 102 publications

(88 citation statements)

References 20 publications

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“…We found that only considering alcohol consumption at one point in time led to underestimation of the effect of heavy drinking on inflammatory markers. Furthermore, we observed that former drinkers had higher levels of cytokines than stable nondrinkers, in keeping with the idea that failing to exclude former drinkers from the group of stable nondrinkers will lead to overestimating the protective effect of moderate drinking 42. This group may consist of former heavy drinkers (including individuals with a history of alcohol use disorders) and those with illnesses that have led to alcohol cessation 60, both of which are likely to be associated with higher levels of inflammation 61, 62, 63.…”

Section: Discussionsupporting

confidence: 86%

“…Therefore, not accounting for long‐term drinking profiles or changes in alcohol consumption can introduce bias 38, 39, 40. A classic example of such bias is the failure to separate former drinkers from never drinkers which is known to in some cases substantially impact findings and subsequent conclusions that are drawn 41, 42. Levels of CRP, IL‐6 and IL‐1 RA also change over time and can similarly influence disease risk 25, 43, 44.…”

Section: Introductionmentioning

confidence: 99%

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Ten‐year alcohol consumption typologies and trajectories of C‐reactive protein, interleukin‐6 and interleukin‐1 receptor antagonist over the following 12 years: a prospective cohort study

et al. 2016

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BackgroundModerate alcohol consumption is thought to confer cardiometabolic protective effects. Inflammatory pathways are hypothesized to partly underlie this association.ObjectivesThe aim of this study was to examine the association between typologies of alcohol consumption and markers of inflammation, and their rate of change over time.MethodsData were collected from 8209 participants [69% men; mean age, 50 years (SD 6.1)] of the British Whitehall II study. Alcohol consumption typologies were defined using up to three measures during an approximately 10‐year period spanning from 1985 to 1994 as (i) stable nondrinkers, (ii) stable moderate drinkers (referent), (iii) stable heavy drinkers, (iv) nonstable drinkers and (v) former drinkers. C‐reactive protein (CRP), interleukin (IL)‐6 and IL‐1 receptor antagonist (IL‐1 RA) were measured up to three times in the following 12 years.ResultsStable moderate drinkers had lower levels of CRP than stable nondrinkers, stable heavy drinkers, former drinkers and nonstable drinkers, but there were no differences in the rate of change in CRP over time between groups. Stable nondrinkers had higher levels of IL‐6 as did stable heavy drinkers; rates of change in IL‐6 over time were also increased in the latter group. Stable nondrinkers also had higher levels of IL‐1 RA. These associations were robust to adjustment for confounding factors.ConclusionOur novel investigation of 10‐year drinking typologies shows that stable moderate alcohol consumption is associated with a long‐term inflammatory marker profile that is consistent with conferring a reduced risk of developing coronary heart disease.

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Section: Discussionsupporting

confidence: 86%

Section: Introductionmentioning

confidence: 99%

Ten‐year alcohol consumption typologies and trajectories of C‐reactive protein, interleukin‐6 and interleukin‐1 receptor antagonist over the following 12 years: a prospective cohort study

et al. 2016

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“…18,50-52 Flawed study designs have been implicated in earlier findings of "protective effects" 53-58 -however, a great deal of controversy on this topic remains. 51,55,[59][60][61][62] A large proportion of participants in this study reported light-moderate drinking (0.1 to 29.9 g of ethanol/day or < 1 to 2 drinks/day), and may be unaware of the potential harm associated with even small Continued on the following page but regular amounts of alcohol. Further investigation into the relationship between low-risk drinking and health outcomes is essential to better characterize the exact risk-benefit threshold for alcohol consumption among different population groups.…”

Section: Discussionmentioning

confidence: 90%

Alcohol consumption and low-risk drinking guidelines among adults: a cross-sectional analysis from Alberta’s Tomorrow Project

Brenner

Haig

Poirier

et al. 2017

Health Promot Chronic Dis Prev Can

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Introduction Moderate to heavy alcohol consumption is a risk factor for all-cause mortality and cancer incidence. Although cross-sectional data are available through national surveys, data on alcohol consumption in Alberta from a large prospective cohort were not previously available. The goal of these analyses was to characterize the levels of alcohol consumption among adults from the Alberta’s Tomorrow Project in the context of cancer prevention guidelines. Furthermore, we conducted analyses to examine the relationships between alcohol consumption and other high-risk or risk-related behaviours. Methods Between 2001 and 2009, 31 072 men and women aged 35 to 69 years were enrolled into Alberta’s Tomorrow Project, a large provincial cohort study. Data concerning alcohol consumption in the past 12 months were obtained from 26 842 participants who completed self-administered health and lifestyle questionnaires. We conducted cross-sectional analyses on daily alcohol consumption and cancer prevention guidelines for alcohol use in relation to sociodemographic factors. We also examined the combined prevalence of alcohol consumption and tobacco use, obesity and comorbidities. Results Approximately 14% of men and 12% of women reported alcohol consumption exceeding recommendations for cancer prevention. Higher alcohol consumption was reported in younger age groups, urban dwellers, those with higher incomes and those who consumed more red meat. Moreover, volume of daily alcohol consumption was positively associated with current tobacco use in both men and women. Overall, men were more likely to fall in the moderate and high-risk behavioural profiles and show higher daily alcohol consumption patterns compared to women. Conclusion Despite public health messages concerning the adverse impact of alcohol consumption, a sizeable proportion of Alberta’s Tomorrow Project participants consumed alcohol in excess of cancer prevention recommendations. Continued strategies to promote low-risk drinking among those who choose to drink could impact future chronic disease risk in this population.

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“…A study of nonagenarians (90+) did not find the J-or U-shaped association between alcohol and mortality, but results did indicate a higher mortality risk among abstainers compared to drinkers (Nybo et al, 2003). However, the health benefits of moderate alcohol consumption -at any age -is not uncontroversial (for a recent editorial, see Chikritzhs et al, 2015), and alcohol abstinence, particularly in old age, is often due to underlying health problems that constrain alcohol consumption.…”

Section: Introductionmentioning

confidence: 99%

Alcohol consumption in very old age and its association with survival: A matter of health and physical function

Agahi

Kelfve

Lennartsson

et al. 2016

Drug and Alcohol Dependence

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Alcohol consumption in very old age and its association with survival: a matter of health and physical function. Dependence, http://dx.doi.org/10.1016/j. drugalcdep.2015.12.022 Access to the published version may require subscription. N.B. When citing this work, cite the original published paper. Results: Compared to light-to-moderate drinkers, abstainers had lower levels of education and more functional health problems, while heavy drinkers were more often men, had higher levels of education, and no serious health or functional problems. In models adjusted only for age and sex, abstainers died earlier than drinkers. Among light-to-moderate drinkers, each additional drink/month was associated with longer survival, while among heavy drinkers, each additional drink/month was associated with shorter survival. However, after adjusting for personal and health-related factors, estimates were lower and no longer statistically significant. Conclusions: The association between alcohol consumption and survival in very old age seems to have an inverse J-shape; abstention and heavy use is associated with shorter survival compared to light-tomoderate drinking. To a large extent, differences in survival are due to differences in baseline health and physical function. Drug And Alcohol

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Has the leaning tower of presumed health benefits from ‘moderate’ alcohol use finally collapsed?

Cited by 102 publications

References 20 publications

Ten‐year alcohol consumption typologies and trajectories of C‐reactive protein, interleukin‐6 and interleukin‐1 receptor antagonist over the following 12 years: a prospective cohort study

Ten‐year alcohol consumption typologies and trajectories of C‐reactive protein, interleukin‐6 and interleukin‐1 receptor antagonist over the following 12 years: a prospective cohort study

Alcohol consumption and low-risk drinking guidelines among adults: a cross-sectional analysis from Alberta’s Tomorrow Project

Alcohol consumption in very old age and its association with survival: A matter of health and physical function

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