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CORK Bibliography: Alcohol, Beneficial Effects

33 citations. January 2010 to present

Prepared: March 2012

Boggs DA; Rosenberg L; Ruiz-Narvaez EA; Palmer JR. Coffee, tea, and alcohol intake in relation to risk of type 2 diabetes in African American women. American Journal of Clinical Nutrition 92(4): 960-966, 2010. (46 refs.)

Background: Numerous studies have reported inverse associations of coffee, tea, and alcohol intake with risk of type 2 diabetes, but none has reported results separately among African American women. Objective: We prospectively examined the relation of coffee, tea, and alcohol consumption to diabetes risk in African American women. Design: The study included 46,906 Black Women's Health Study participants aged 30-69 y at baseline in 1995. Dietary intake was assessed in 1995 and 2001 by using a validated food-frequency questionnaire. During 12 y of follow-up, there were 3671 incident eases of type 2 diabetes. Relative risks (RRs) and 95% CIs were estimated by using Cox proportional hazards models adjusted for diabetes risk factors. Results: Multivariable RRs for intakes of 0-1, 1, 2-3, and >= 4 cups of caffeinated coffee/d relative to no coffee intake were 0.94 (95% CI: 0.86, 1.04), 0.90 (95% CI: 0.81, 1.01), 0.82 (95% CI: 0.72, 0.93), and 0.83 (95% CI: 0.69, 1.01), respectively (P for trend =0.003). Multivariable RRs for intakes of 1-3, 4-6, 7-13, and >= 14 alcoholic drinks/wk relative to never consumption were 0.90 (95% CI: 0.82, 1.00), 0.68 (95% CI: 0.57, 0.81), 0.78 (95% CI: 0.63, 0.96), and 0.72 (95% CI: 0.53, 0.98), respectively (P for trend < 0.0001). Intakes of decaffeinated coffee and tea were not associated with risk of diabetes. Conclusion: Our results suggest that African American women who drink moderate amounts of caffeinated coffee or alcohol have a reduced risk of type 2 diabetes.

Carlsson AC; Theobald H; Wandell PE. Health factors and longevity in men and women: A 26-year follow-up study. European Journal of Epidemiology 25(8): 547-551, 2010. (26 refs.)

Health factors have the power to prevent and postpone diseases and death; however, studies using the same methodology in both men and women are sparse. We aimed to study the ability of health factors to prevent mortality in a population-based, 26-year follow-up of Swedish men and women. During 1969-70, a health-screening programme was offered to a stratified sample of 3,064 individuals aged 18-64 years to estimate health-care needs. Missing data (largely according to protocol) for physical fitness, BMI, and smoking habits left 935 subjects, 463 men and 472 women. Alcohol consumption in grams per week and BMI was calculated. Tobacco smoking was recorded as yes/no. Multivariate analysis was performed by Cox regression with age adjusted hazard ratios (HR) and 95% confidence interval (CI). Moderate alcohol consumption did not lead to any decrease in mortality. Having two health factors halved the mortality risk in men and women (hazard ratio (HR) 0.52, confidence interval (CI) 0.39-0.70). A further risk reduction was seen in men with three health factors (HR 0.17, CI 0.074-0.41). Men had about 70 per cent higher risk of mortality compared with women after adjustments for all health factors (HR 1.67, CI 1.26-2.23). Men compared to women had greater benefit of all three health factors. This in combination with the overall higher mortality risk in men makes a healthy lifestyle more important for them. The benefit of moderate alcohol consumption could not be detected in this study, and may be explained by an unhealthy drinking pattern in Sweden.

Chiuve SE; Rimm EB; Mukamal KJ; Rexrode KM; Stampfer MJ; Manson JE et al. Light-to-moderate alcohol consumption and risk of sudden cardiac death in women. Heart Rhythm 7(10): 1374-1380, 2010. (36 refs.)

BACKGROUND Moderate alcohol intake is associated with lower risk of coronary heart disease (CHD), but the association with sudden cardiac death (SCD) is less clear. In men, heavy alcohol consumption may increase risk of SCD, whereas light-to-moderate alcohol intake may lower risk. There are no parallel data among women. OBJECTIVE The purpose of this study was to assess the association between alcohol intake and risk of SCD among women and to investigate how this risk compared to other forms of CHD. METHODS We conducted a prospective cohort study among 85,067 women from the Nurses' Health Study who were free of chronic disease at baseline. Alcohol intake was assessed every 4 years through questionnaires. Primary endpoints included SCD, fatal CHD, and nonfatal myocardial infarction. RESULTS We found a U-shaped association between alcohol intake and risk of SCD, with the lowest risk among women who drank 5.0-14.9 g/day of alcohol (P for quadratic trend = 0.02). Compared to abstainers, the multivariate relative risk (95% confidence interval) for SCD was 0.79 (0.55-1.14) for former drinkers, 0.77 (0.57-1.06) for 0.1-4.9 g/day, 0.64 (0.43-0.95) for 5.0-14.9 g/day, 0.68 (0.38-1.23) for 15.0-29.9 g/day, and 1.15 (0.70-1.87) for >= 30.0 g/day. In contrast, the relationship of alcohol intake and nonfatal and fatal CHD was more linear (P for linear trend <.001). CONCLUSION: In this cohort of women, the relationship between light-to-moderate alcohol intake and SCD is U-shaped, with a nadir at 5.0-14.9 g/day. Low levels of alcohol intake do not raise the risk of SCD and may lower risk in women.

Corley J; Jia XL; Brett CE; Gow AJ; Starr JM; Kyle JAM et al. Alcohol intake and cognitive abilities in old age: The Lothian Birth Cohort 1936 study. Neuropsychology 25(2): 166-175, 2011. (58 refs.)

Objective: Moderate alcohol consumption has been associated with better cognitive performance in late adulthood, possibly by improving vascular health. Few studies have examined the potentially confounding roles of prior cognitive ability and social class in this relationship. Method: Participants were 922 healthy adults about 70 years old in the Lothian Birth Cohort 1936 study, for whom there are IQ data from age 11. Alcohol consumption was obtained by self-report questionnaire. Cognitive outcome measures included general cognitive ability, speed of information processing, memory, and verbal ability. Results: Moderate to substantial drinking (> 2 units/day) was associated with better performance on cognitive tests than low-level drinking (<= 2 units/day) or nondrinking in men and women. After adjusting for childhood IQ and adult social class, most of these associations were removed or substantially attenuated. After full adjustment, a small, positive association remained between overall alcohol intake and memory (women and men) and verbal ability (women only). Women's overall alcohol intake was derived almost exclusively from wine. In men, effects differed according to beverage type: wine and sherry port consumption was associated with better verbal ability, but beer was associated with a poorer verbal ability and spirits intake was associated with better memory. Conclusions: Prior intelligence and socioeconomic status influence both amount and type of alcohol intake and may partly explain the link between alcohol intake and improved cognitive performance at age 70. Alcohol consumption was found to make a small, independent contribution to memory performance and verbal ability, but these findings' clinical significance is uncertain.

Di Castelnuovo A; Costanzo S; Donati MB; Iacoviello L; de Gaetano G. Prevention of cardiovascular risk by moderate alcohol consumption: Epidemiologic evidence and plausible mechanisms. (review). Internal and Emergency Medicine 5(4): 291-297, 2010. (65 refs.)

An inverse association between moderate alcohol intake and cardiovascular risk, in particular coronary disease and ischemic stroke, has been shown in many epidemiologic studies. In addition, several other diseases are also known to occur less frequently in moderate drinkers than in non-drinkers, whereas excess of drinking is invariably harmful. However, some concern has been recently raised about the possibility that at all dosages the harm of alcohol could overcome its beneficial effects. We present here the epidemiologic and mechanistic evidence to support the protective effect of moderate alcohol intake against cardiovascular disease and all-cause mortality.

Garia AM; Ramon-Bou N; Porta M. Isolated and joint effects of tobacco and alcohol consumption on risk of Alzheimer's disease. Journal of Alzheimer's Disease 20(2): 577-586, 2010. (32 refs.)

The roles of smoking and alcohol on the development of Alzheimer's disease (AD) remain unclear. We performed a case-control study on the effects of both exposures before the age of onset of the disease in the cases (and same reference age for their age-matched controls) on disease risk. Interviews were conducted with population controls (n = 246) and relatives of cases (n = 176) identified through local Alzheimer's Disease Associations. Logistic regression models were built adjusting by gender, age, residence, education, economic situation, employment, and history of dementia in close relatives. Risk of AD was unaffected by any measure of tobacco consumption. Alcohol consumers showed a lower risk of AD than never consumers (adjusted odds ratio, aOR = 0.53, 95% CI 0.32, 0.88), with differences by gender (women aOR = 0.48, 95% CI 0.27, 0.84; men aOR = 0.80, 95% CI 0.23, 2.80). Mean daily total consumption of alcohol and time consuming alcohol showed increasingly protective dose-response relationships in women. Lower AD risk was observed in alcohol drinkers of both genders who never smoked (aOR = 0.37, 95% CI 0.21, 0.65). All these associations were independent of the presence of apolipoprotein E4 allele(s) in the cases. Although the sample was small for some analyses addressing these interactions, our results suggest a protective effect of alcohol consumption, mostly in non-smokers, and the need to consider interactions between tobacco and alcohol consumption, as well as interactions with gender, when assessing the effects of smoking and/or drinking on the risk of AD.

Hansel B; Thomas F; Pannier B; Bean K; Kontush A; Chapman MJ et al. Relationship between alcohol intake, health and social status and cardiovascular risk factors in the urban Paris-Ile-De-France Cohort: is the cardioprotective action of alcohol a myth? European Journal of Clinical Nutrition 64(6): 561-568, 2010. (39 refs.)

Background/Objectives: Observational studies document the inverse relationship between cardiovascular disease (CVD) and moderate alcohol intake. However, the causal role for alcohol in cardioprotection remains uncertain as such protection may be caused by confounders and misclassification. The aim of our study was to evaluate potential confounders, which may contribute to putative cardioprotection by alcohol. Subjects/Methods: We evaluated clinical and biological characteristics, including cardiovascular (CV) risk factors and health status, of 149 773 subjects undergoing examination at our Center for CVD Prevention (The Urban Paris-Ile-de-France Cohort). The subjects were divided into four groups according to alcohol consumption: never, low (<= 10 g/day), moderate (10-30 g/day) and high (>30 g/day); former drinkers were analyzed as a separate group. Results: After adjustment for age, moderate male drinkers were more likely to display clinical and biological characteristics associated with lower CV risk, including low body mass index, heart rate, pulse pressure, fasting triglycerides, fasting glucose, stress and depression scores together with superior subjective health status, respiratory function, social status and physical activity. Moderate female drinkers equally displayed low waist circumference, blood pressure and fasting triglycerides and low-density lipoprotein-cholesterol. Alcohol intake was strongly associated with plasma high-density lipoprotein-cholesterol in both sexes. Multivariate analysis confirmed that moderate and low drinkers displayed better health status than did never drinkers. Importantly, few factors were causally related to alcohol intake. Conclusions: Moderate alcohol drinkers display a more favorable clinical and biological profile, consistent with lower CV risk as compared with nondrinkers and heavy drinkers. Therefore, moderate alcohol consumption may represent a marker of higher social level, superior health status and lower CV risk.

Holahan CJ; Schutte KK; Brennan PL; Holahan CK; Moos BS; Moos RH. Late-life alcohol consumption and 20-year mortality. Alcoholism: Clinical and Experimental Research 34(11): 1961-1971, 2010. (59 refs.)

Background: Growing epidemiological evidence indicates that moderate alcohol consumption is associated with reduced total mortality among middle-aged and older adults. However, the salutary effect of moderate drinking may be overestimated owing to confounding factors. Abstainers may include former problem drinkers with existing health problems and may be atypical compared to drinkers in terms of sociodemographic and social-behavioral factors. The purpose of this study was to examine the association between alcohol consumption and all-cause mortality over 20 years among 1,824 older adults, controlling for a wide range of potential confounding factors associated with abstention. Methods: The sample at baseline included 1,824 individuals between the ages of 55 and 65. The database at baseline included information on daily alcohol consumption, sociodemographic factors, former problem drinking status, health factors, and social-behavioral factors. Abstention was defined as abstaining from alcohol at baseline. Death across a 20-year follow-up period was confirmed primarily by death certificate. Results: Controlling only for age and gender, compared to moderate drinkers, abstainers had a more than 2 times increased mortality risk, heavy drinkers had 70% increased risk, and light drinkers had 23% increased risk. A model controlling for former problem drinking status, existing health problems, and key sociodemographic and social-behavioral factors, as well as for age and gender, substantially reduced the mortality effect for abstainers compared to moderate drinkers. However, even after adjusting for all covariates, abstainers and heavy drinkers continued to show increased mortality risks of 51 and 45%, respectively, compared to moderate drinkers. Conclusions: Findings are consistent with an interpretation that the survival effect for moderate drinking compared to abstention among older adults reflects 2 processes. First, the effect of confounding factors associated with alcohol abstention is considerable. However, even after taking account of traditional and nontraditional covariates, moderate alcohol consumption continued to show a beneficial effect in predicting mortality risk.

Hvidtfeldt UA; Tolstrup JS; Jakobsen MU; Heitmann BL; Gronbaek M; O'Reilly E et al. Alcohol Intake and Risk of Coronary Heart Disease in Younger, Middle-Aged, and Older Adults. Circulation 121(14): 1589-1597, 2010. (42 refs.)

Background-Light to moderate alcohol consumption is associated with a reduced risk of coronary heart disease. This protective effect of alcohol, however, may be confined to middle-aged or older individuals. Coronary heart disease incidence is low in men <40 years of age and in women <50 years of age; for this reason, study cohorts rarely have the power to investigate the effects of alcohol on coronary heart disease risk in younger adults. This study examined whether the beneficial effect of alcohol on coronary heart disease depends on age. Methods: and Results-In this pooled analysis of 8 prospective studies from North America and Europe including 192 067 women and 74 919 men free of cardiovascular diseases, diabetes, and cancers at baseline, average daily alcohol intake was assessed at baseline with a food frequency or diet history questionnaire. An inverse association between alcohol and risk of coronary heart disease was observed in all age groups; hazard ratios among moderately drinking men (5.0 to 29.9 g/d) 39 to 50, 50 to 59, and >= 60 years of age were 0.58 (95% confidence interval [CI], 0.36 to 0.93), 0.72 (95% CI, 0.60 to 0.86), and 0.85 (95% CI, 0.75 to 0.97) compared with abstainers. However, the analyses indicated a smaller incidence rate difference between abstainers and moderate consumers in younger adults (incidence rate difference, 45 per 100 000; 90% CI, 8 to 84) than in middle-aged (incidence rate difference, 64 per 100 000; 90% CI, 24 to 102) and older (incidence rate difference, 89 per 100 000; 90% CI, 44 to 140) adults. Similar results were observed in women. Conclusion-Alcohol is also associated with a decreased risk of coronary heart disease in younger adults; however, the absolute risk was small compared with middle-aged and older adults.

Joosten MM; Chiuve SE; Mukamal KJ; Hu FB; Hendriks HFJ; Rimm EB. Changes in alcohol consumption and subsequent risk of type 2 diabetes in men. Diabetes 60(1): 74-79, 2011. (36 refs.)

OBJECTIVE The objective of this study was to investigate the association of 4-year changes in alcohol consumption with a subsequent risk of type 2 diabetes. RESEARCH DESIGN AND METHODS: We prospectively examined 38,031 men from the Health Professionals Follow-Up Study who were free of diagnosed diabetes or cancer in 1990. Alcohol consumption was reported on food frequency questionnaires and updated every 4 years. RESULTS: A total of 1,905 cases of type 2 diabetes occurred during 428,497 person-years of follow-up. A 7.5 g/day (approximately half a glass) increase in alcohol consumption over 4 years was associated with lower diabetes risk among initial nondrinkers (multivariable hazard ratio [HR] 0.78; 95% CI: 0.60-1.00) and drinkers initially consuming <15 g/day (HR 0.89; 95% CI: 0.83-0.96), but not among men initially drinking g/day (HR 0.99; 95% CI: 0.95-1.02; P-interaction < 0.01). A similar pattern was observed for levels of total adiponectin and hemoglobin Ale, with a better metabolic profile among abstainers and light drinkers who modestly increased their alcohol intake, compared with men who either drank less or among men who were already moderate drinkers and increased their intake. Likewise, compared with stable light drinkers (0-4.9 g/day), light drinkers who increased their intake to moderate levels (5.0-29.9 g/day) had a significantly lower risk of type 2 diabetes (HR 0.75; 95% CI: 0.62-0.90). CONCLUSIONS: Increases in alcohol consumption over time were associated with lower risk of type 2 diabetes among initially rare and light drinkers. This lower risk was evident within a 4-year period following increased alcohol intake.

Klatsky AL. Alcohol and cardiovascular mortality: Common sense and scientific truth. Journal of the American College of Cardiology 55(13): 1336-1338, 2010. (15 refs.)

Anstie, a prominent public health activist, promulgated Anstie's Rule of a "sensible limit" of 45 ml of ethyl alcohol/dray or approximately 3 standard-sized drinks. The use of "sensible" rather than "safe" acknowledges that no amount of alcohol is safe for everyone. The author reviews the growing scientific evidence, as well as the findings of a national trial confirming a U-shaped relationship between alcohol intake and CV mortality. As expected, most of the apparent benefit in light-moderate drinkers is due to lower risk of CAD death. However, it is noted that absolute proof that persons at CAD risk obtain benefits form light-moderate drinking will not appear soon. In the 21st century a universal sensible limit would not accommodate serious public health issues such as the increased risk of female breast cancer risk associated with even moderate drinking or the consequences of the mixture of youthful drinking with the motor vehicle. The risks of moderate drinking differ by sex, age, personal history, and family history. As is often the case in medical practice, advice about lifestyle must be based on something less than certainty. There is no substitute for balanced judgment by a knowledgeable, objective health professional. What is required is a synthesis of common sense and the best available scientific facts.

Lakshman R; Garige M; Gong M; Leckey L; Varatharajalu R; Zakhari S. Is alcohol beneficial or harmful for cardioprotection? (review). Genes and Nutrition 5(2, special issue): 111-120, 2010. (118 refs.)

While the effects of chronic ethanol consumption on liver have been well studied and documented, its effect on the cardiovascular system is bimodal. Thus, moderate drinking in many population studies is related to lower prevalence of coronary artery disease (CAD). In contrast, heavy drinking correlates with higher prevalence of CAD. In several other studies of cardiovascular mortalities, abstainers and heavy drinkers are at higher risk than light or moderate drinkers. The composite of this disparate relation in several population studies of cardiovascular mortality has been a "U-" or "J-" shaped curve. Apart from its ability to eliminate cholesterol from the intima of the arteries by reverse cholesterol transport, another major mechanism by which HDL may have this cardioprotective property is by virtue of the ability of its component enzyme paraoxonase1 (PON1) to inhibit LDL oxidation and/or inactivate OxLDL. Therefore, PON1 plays a central role in the disposal of OxLDL and thus is antiatherogenic. Furthermore, PON1 is a multifunctional antioxidant enzyme that can also detoxify the homocysteine metabolite, homocysteine thiolactone (HTL), which can pathologically cause protein damage by homocysteinylation of the lysine residues, thereby leading to atherosclerosis. We demonstrated that moderate alcohol up regulates liver PON1 gene expression and serum activity, whereas heavy alcohol consumption had the opposite effects in both animal models and in humans. The increase in PON1 activity in light drinkers was not due to preferential distribution of high PON1 genotype in this group. It is well known that wine consumption in several countries shows a remarkable inverse correlation to local rates of CAD mortality. Significantly, apart from its alcohol content, red wine also has polyphenols such as quercetin and resveratrol that are also known to have cardioprotective effects. We have shown that quercetin also up regulates PON1 gene in rats and in human liver cells. The action of quercetin seems to be mediated via the active form of the nuclear lipogenic transcription factor, sterol-regulatory element-binding protein 2 (SREBP2) that is translocated from endoplasmic reticulum to the nucleus. However, the mechanism of action of ethanol-mediated up-regulation of PON1 gene remains to be elucidated. We conclude that both moderate ethanol and quercetin, the two major components of red wine, exhibit cardioprotective properties via the up-regulation of the antiatherogenic gene PON1.

Lee MY; Kim MY; Kim SY; Kim JH; Kim BH; Shin JY et al. Association between alcohol intake amount and prevalence of metabolic syndrome in Korean rural male population. Diabetes Research and Clinical Practice 88(2): 196-202, 2010. (50 refs.)

Moderate alcohol consumption is known to be associated with a reduced risk of cardiovascular disease and mortality. However, few studies reported that long-term alcohol drinking may increase the prevalence of central obesity, and cardiovascular disease. We examined the association between metabolic syndrome, nutritional factors and alcohol intake amount in Korean male rural population. We performed a cross-sectional analysis on data from Korean Rural Genomic Cohort (KRGC) study. We used multiple logistic regression analysis to estimate the adjusted odds ratio of metabolic syndrome according to alcohol intake amount categories (never, 0-16 g/day, 16-40 g/day, and >40 g/day). The age adjusted odds ratio for the prevalence of metabolic syndrome was significantly increased in the quartile with the highest alcohol consumption compared to the non-alcohol drinking group (1.33; C.I., 1.11-1.59). These results were similar in the high energy intake group, but not in the low energy intake group. Waist circumference, blood pressure, and serum triglyceride levels were significantly higher in the quartile with the highest alcohol consumption compared to the non-alcohol drinking group. These results suggest that large alcohol consumption is associated with metabolic syndrome and may be a modifiable risk factor of metabolic syndrome especially in subjects with high calorie intake.

Lee Y; Back JH; Kim J; Kim SH; Na DL; Cheong HK et al. Systematic review of health behavioral risks and cognitive health in older adults. (review). International Psychogeriatrics 22(2): 174-187, 2010. (57 refs.)

Background: An increasing body of evidence suggests that health behaviors may protect against cognitive impairment and dementia. The purpose of this study was to summarize the current evidence on health behavioral factors predicting cognitive health through a systematic review of the published literature. Methods: PubMedicine, Embase, and PsycINFO databases were searched for studies on community representative samples aged 65 and older, with prospective cohort design and multivariate analysis. The outcome - cognitive health - was defined as a continuum of cognitive function ranging from cognitive decline to impairment and dementia, and health behaviors included physical activity, smoking, alcohol drinking, body mass index, and diet and nutrition. Results: Of 12,105 abstracts identified, 690 relevant full-texts were reviewed. The final yield amounted to 115 articles of which 37 studies were chosen that met the highest standards of quality. Leisure time physical activity, even of moderate level, showed protective effects against dementia, whereas smoking elevated the risk of Alzheimer's disease. Moderate alcohol consumption tended to be protective against cognitive decline and dementia, but nondrinkers and frequent drinkers exhibited a higher risk for dementia and cognitive impairment. Midlife obesity had an adverse effect on cognitive function in later life. Analysis showed vegetable and fish consumption to be of benefit, whereas, persons consuming a diet high in saturated fat had an increased dementia risk. Conclusion: The review demonstrates accumulating evidence supporting health behavioral effects in reducing the risk of cognitive decline and dementia. Results indicate potential benefits of healthy lifestyles in protecting cognitive health in later life.

Lesna IK; Suchanek P; Stavek P; Poledne R. May alcohol-induced increase of HDL be considered as atheroprotective? Physiological Research 59(3): 407-413, 2010. (29 refs.)

It is well known that the consumption of moderate doses of alcohol leads to the increase of HDL-cholesterol (HDL-C). Atheroprotectivity of HDL particles is based primarily on their role in reverse cholesterol transport (RCT). In the study with a crossover design 13 male volunteers were studied in two different regimens: i) drinking of 36 g alcohol daily and ii) drinking only non-alcoholic beverages, to test whether alcohol-induced increase of HDL cholesterol can affect cholesterol efflux (CHE) from cell culture of labeled human macrophages. Alcohol consumption induced significant (p<0.05) increases of HDL cholesterol from 1.25+/-0.32 to 1.34+/-0.38 mmol/l and Apo A1 from 1.34+/-0.16 to 1.44+/-0.19 g/l. These changes were combined with a slight increase of cholesterol efflux from 13.8+/-2.15 to 14.9+/-1.85 % (p=0.059). There were significant correlations between individual changes of HDL-C and Apo A1 concentrations and individual changes of CHE (0.51 and 0.60, respectively). In conclusion, moderate alcohol consumption changes the capacity of plasma to induce CHE only at a border line significance.

Lin JC; Guerrieri JG; Moore AA. Drinking patterns and the development of functional limitations in older adults: Llongitudinal analyses of the Health and Retirement Survey. Journal of Aging and Health 23(5): 806-821, 2011. (37 refs.)

Objective: To examine whether consistent low-risk drinking is associated with lower risk of developing functional limitations among older adults. Method: Data were obtained from five waves of the Health and Retirement Study. Function was assessed by questions measuring four physical abilities and five instrumental activities of daily living. Five different drinking patterns were determined using data over two consecutive survey periods. Results: Over the follow-up periods, 38.6% of older adults developed functional limitations. Consistent low-risk drinkers had lower odds of developing functional limitations compared with consistent abstainers, and the effect of consistent low-risk drinking was greater among those aged 50 to 64 years compared with those aged >= 65 years. Other drinking patterns were not associated with lower odds of incident functional limitation. Discussion: Consistent low-risk drinking was associated with lower odds of developing functional limitations, and this association was greater among older middle-aged adults aged 50 to 64 years.

Lippi G; Franchini M; Favaloro EJ; Targher G. Moderate red wine consumption and cardiovascular disease risk: Beyond the "French Paradox". Seminars in Thrombosis and Hemostasis 36(1): 59-70, 2010. (85 refs.)

The term French paradox was coined in 1992 to describe the relatively low incidence of cardiovascular disease in the French population, despite a relatively high dietary intake of saturated fats, and potentially attributable to the consumption of red wine. After nearly 20 years, several studies have investigated the fascinating, overwhelmingly positive biological and clinical associations of red wine consumption with cardiovascular disease and mortality. Light to moderate intake of red wine produces a kaleidoscope of potentially beneficial effects that target all phases of the atherosclerotic process, from atherogenesis (early plaque development and growth) to vessel occlusion (flow-mediated dilatation, thrombosis). Such beneficial effects involve cellular signaling mechanisms, interactions at the genomic level, and biochemical modifications of cellular and plasma components. Red wine components, especially alcohol, resveratrol, and other polyphenolic compounds, may decrease oxidative stress, enhance cholesterol efflux from vessel walls (mainly by increasing levels of high-density lipoprotein cholesterol), and inhibit lipoproteins oxidation, macrophage cholesterol accumulation, and foam-cell formation. These components may also increase nitric oxide bioavailability, thereby antagonizing the development of endothelial dysfunction, decrease blood viscosity, improve insulin sensitivity, counteract platelet hyperactivity, inhibit platelet adhesion to fibrinogen-coated surfaces, and decrease plasma levels of von Willebrand factor, fibrinogen, and coagulation factor VII. Light to moderate red wine consumption is also associated with a favorable genetic modulation of fibrinolytic proteins, ultimately increasing the surface-localized endothelial cell fibrinolysis. Overall, therefore, the "French paradox'' may have its basis within a milieu containing several key molecules, so that favorable cardiovascular benefits might be primarily attributable to combined, additive, or perhaps synergistic effects of alcohol and other wine components on atherogenesis, coagulation, and fibrinolysis. Conversely, chronic heavy alcohol consumption and binge drinking are associated with increased risk of cardiovascular events. In conclusion, although mounting evidence strongly supports beneficial cardiovascular effects of moderate red wine consumption (one to two drinks per day; 10-30 g alcohol) in most populations, clinical advice to abstainers to initiate daily alcohol consumption has not yet been substantiated in the literature and must be considered with caution on an individual basis.

Liu C; Yu ZJ; Li HX; Wang J; Sun LA; Qi QB et al. Associations of alcohol consumption with diabetes mellitus and impaired fasting glycemia among middle-aged and elderly Chinese. BMC Public Health 10: e-article 713, 2010. (35 refs.)

Background: The U-shaped relationship between alcohol consumption and diabetes mellitus was observed among western populations. However, few studies have systematically evaluated the association in Chinese. We aimed to investigate the associations of alcohol consumption with diabetes mellitus and impaired fasting glycemia (IFG) among middle-aged and elderly Chinese. Methods: We examined 1,458 men and 1,831 women aged 50 to 70 from Beijing and Shanghai China in a cross-sectional survey. Fasting glucose, adipokines and markers of inflammation were measured. Macronutrients and alcohol consumption were assessed with standardized questionnaires. Results: Compared with abstainers, alcohol consumption was associated with a decreased risk of having diabetes mellitus in women (OR: 0.41, 95% CI: 0.22-0.78) after controlling for socio-demographic factors, physical activity, smoking, family income, family history of cardiovascular disease or diabetes, macronutrients intake, body mass index, and markers of inflammation and adipokines. In men, both low and high alcohol consumptions were associated with increased risks of having combined diabetes and IFG (ORs 1.36 [95% CI: 1.02-1.82] and 1.50 [95% CI: 1.04-2.15], respectively]. In the multivariable stratified analyses among men, moderate drinkers who had drinking days of >= 5 days/week had a deceased likelihood (OR: 0.61, 95% CI: 0.37-0.98) and liquor drinkers had an increased likelihood (OR: 1.47, 95% CI: 1.09-1.98) of having combined diabetes and IFG respectively, compared with the abstainers. Conclusions: An approximately J-shaped association was observed between alcohol consumption and combined diabetes and IFG among men compared with abstainers in Chinese. Whether moderate alcohol intake could help decrease diabetic risk among Chinese people warrants further investigation.

Mason WA; Spoth RL. Longitudinal associations of alcohol involvement with subjective well-being in adolescence and prediction to alcohol problems in early adulthood. Journal of Youth and Adolescence 40(9): 1215-1224, 2011. (52 refs.)

Adolescent alcohol involvement is associated with numerous negative outcomes, but also appears to have positive correlates, including subjective well-being. Additional research is needed to understand these paradoxical findings. The current study examines alcohol use, adverse alcohol-related (and other substance-related) consequences, and subjective well being in adolescence, and prediction to problem alcohol use in early adulthood. Participants in this longitudinal study, which extended from age 11 to age 21, were 208 rural teens (109 girls) and their families. Covariates included early substance use, early conduct problems, early depressed mood, gender, and parent educational attainment. Structural equation modeling showed that subjective well-being at age 16 positively predicted increased alcohol use at age 18. Alcohol use was not a significant predictor of subjective well-being; however, alcohol use at age 18 positively predicted alcohol problems at age 21, even while controlling for earlier adverse consequences and other predictors. Results help to further elucidate both the negative and positive correlates of underage drinking, and support the value of delaying alcohol initiation.

McCaul KA; Almeida OP; Hankey GJ; Jamrozik K; Byles JE; Flicker L. Alcohol use and mortality in older men and women. Addiction 105(8): 1391-1400, 2010. (38 refs.)

Aims: To compare the effect of alcohol intake on 10-year mortality for men and women over the age of 65 years. Design, setting and participants: Two prospective cohorts of community-dwelling men aged 65-79 years at baseline in 1996 (n = 11 727) and women aged 70-75 years in 1996 (n = 12 432). Measurements: Alcohol was assessed according to frequency of use (number of days alcohol was consumed per week) and quantity consumed per day. Cox proportional hazards models were compared for men and women for all-cause and cause-specific mortality. Findings: Compared with older adults who did not consume alcohol every week, the risk of all-cause mortality was reduced in men reporting up to four standard drinks per day and in women who consumed one or two drinks per day. One or two alcohol-free days per week reduced this risk further in men, but not in women. Similar results were observed for deaths due to cardiovascular disease. Conclusions: In people over the age of 65 years, alcohol intake of four standard drinks per day for men and two standard drinks per day for women was associated with lower mortality risk. For men, the risk was reduced further if accompanied with 1 or 2 alcohol-free days per week.

Mochly-Rosen D; Zakhari S. Focus on: the cardiovascular system: What did we learn from the French (paradox)? Alcohol Research & Health 33(1-2): 76-86, 2010. (112 refs.)

Although heavy alcohol consumption has deleterious effects on heart health, moderate drinking is thought to have cardioprotective effects, reducing the risk of coronary artery disease and improving prognosis after a myocardial infarction. It still is unclear, however, if this effect can be achieved with all types of alcoholic beverages and results from the alcohol itself from other compounds found in alcoholic beverages, or both. For example, the polyphenolic compound resveratrol, which is found particularly in red wine, can reduce the risk of atherosclerosis; however, it is not clear if the resveratrol levels present in wine are sufficient to achieve this result. Alcohol itself contributes to cardioprotection through several mechanisms. For example, it can improve the cholesterol profile, increasing the levels of "good" cholesterol and reducing the levels of "bad" cholesterol Alcohol also may contribute to blood clot dissolution and may induce a phenomenon called pre-conditioning, whereby exposure to moderate alcohol levels (like short bouts of blood supply disruption [i.e., ischemia]), and result in reduced damage to the heart tissue after subsequent prolonged ischemia. Finally, the enzyme aldehyde dehydrogenase (ALDH) 2, which is involved in alcohol metabolism, also may contribute to alcohol-related cardioprotection by metabolizing other harmful aldehydes that could damage the heart muscle.

Mostile G; Jankovic J. Alcohol in essential tremor and other movement disorders. (review). Movement Disorders 25(14): 2274-2284, 2010. (149 refs.)

Many patients with essential tremor (ET) report transient improvement of symptoms after drinking alcohol. However, the brief duration of action, subsequent rebound, and the risk of developing alcohol addiction make the use of alcohol as a treatment for ET inappropriate. Whether excessive alcohol consumption is a risk for or a consequence of ET has been a subject of some controversy. In this review, we critically examine the mechanism of action of alcohol and its role in ET and other movement disorders.

Naimi T. Commentary on McCaul et al. (2010): Observational studies about average alcohol consumption and health - closing time for a limited evidence base. (commentary). Addiction 105(8): 1401-1402, 2010. (19 refs.)

Nicoll R; Henein MY. Alcohol and the heart. (commentary). Alcoholism: Clinical and Experimental Research 35(10): 1737-1738, 2011. (17 refs.)

Alcohol consumption and disease or mortality display a J-shaped curve, with moderate amounts of alcohol being more protective than abstention, binge drinking, or heavy drinking. Red wine appears to be particularly protective for cardiovascular disease and associated conditions such as type 2 diabetes. There are, however, controversies concerning the effect of red wine on hypertension, in which there may be significant gender and ethnic differences. Overall, it seems that both ethanol and the polyphenols in red wine may contribute to the protective effect.

Perissinotto E; Buja A; Maggi S; Enzi G; Manzato E; Scafato E et al. Alcohol consumption and cardiovascular risk factors in older lifelong wine drinkers: The Italian Longitudinal Study on Aging. Nutrition, Metabolism, and Cardiovascular Diseases 20(9): 647-655, 2010. (38 refs.)

Background and aims: A protective effect of moderate alcohol consumption on the cardiovascular system has consistently been reported, but limited evidence has been produced on the association of alcohol with metabolic factors in the elderly. The aim of this study was to investigate the association between different levels of current alcohol consumption and cardiovascular risk factors in a representative sample of elderly Italian men, mainly wine drinkers. Methods: and results: This is a cross-sectional multi-centre study on a population-based sample of Italian men aged 65-84 years, drawn from the Italian Longitudinal Study on Aging (ILSA) cohort. The analyses included 1896 men. Almost all the drinkers (98%) drank wine as a lifelong habit. Adjusted ORs for risk levels for cardiovascular factors (BMI, waist circumference, fibrinogen, alpha 2 protein, white blood cells, HDL cholesterol, Apo A-I, total cholesterol, Apo B-I, triglycerides, LDL, glycated hemoglobin, insulin, fasting plasma glucose, HOMA IR, systolic and diastolic blood pressure) were estimated, comparing drinkers with teetotalers using multivariate logistic regression models. We found alcohol consumption in older age associated with healthier hematological values of fibrinogen, HDL cholesterol, Apo A-I lipoprotein and insulin, but it was also associated with a worse hematological picture of total, LDL cholesterol levels, and systolic pressure. Conclusion: Our results indicated in elderly moderate wine drinkers a noticeably safe metabolic, inflammatory and glycemic profile that might balance higher blood pressure, leading to a net benefit. These findings however need to be placed in relation to the known adverse social and health effects of heavy drinking.

Rehm J; Roerecke M. Alcohol, the heart and the cardiovascular system: What do we know and where should we go? (editorial). Drug and Alcohol Review 30(4): 335-337, 2011. (33 refs.)

Roerecke M; Rehm J. Ischemic heart disease mortality and morbidity rates in former drinkers: A meta-analysis. (review). American Journal of Epidemiology 173(3): 245-258, 2011. (88 refs.)

Current abstainers from alcohol have been identified as an inadequate reference group in epidemiologic studies of the effects of alcohol, because inclusion of former drinkers might lead to overestimation of the protective effects and underestimation of the detrimental effects of drinking alcohol. The authors' objective in the current study was to quantify this association for ischemic heart disease (IHD). Electronic databases were systematically searched for relevant case-control or cohort studies published from 1980 to 2010. Thirty-eight articles fulfilled the inclusion criteria, contributing a total of 5,613 IHD events and 12,097 controls among case-control studies and 1,387 events with combined endpoints and 7,183 events stratified by endpoint among 232,621 persons at risk among cohort studies. Pooled estimates for the subset stratified by sex and endpoint showed a significantly increased risk among former drinkers compared with long-term abstainers for IHD mortality ( among men; relative risk = 1.25, 95% confidence interval: 1.15, 1.36; among women relative risk = 1.54, 95% confidence interval: 1.17, 2.03). For IHD morbidity, the estimates for both sexes were close to unity and not statistically significant. Results were robust in several sensitivity analyses. In future studies, researchers should separate former drinkers from the reference category to obtain unbiased effect estimates. Implications for the overall beneficial and detrimental effects of alcohol consumption on IHD are discussed.

Saliba AJ; Moran CC. The influence of perceived healthiness on wine consumption patterns. Food Quality and Preference 21(7, Special Issue): 692-696, 2010. (34 refs.)

Consumers are increasingly sensitive to the health qualities of foods and beverages they consume. Evidence remains equivocal about wine's health affordance, but the media often present it as fact. It is difficult to predict how many consumers believe wine is healthy and the relationship between that belief and consumption. In the present study 1050 adult wine consumers were interviewed about their perception that wine is healthy, their demographic characteristics, and consumption patterns. Results indicated those most likely to perceive wine as healthy were older males with a higher income, but the strength of association was weak. Those perceiving wine as healthy had a higher frequency but not volume of consumption. CAGE (potential alcoholism) scores were independent of the perception that wine is healthy. Based on these results, there is no reason to suppose consumers' wellbeing will be threatened by their behavioural response to positive information on health benefits of wine.

Skogen JC; Mykletun A; Ferri CP; Bebbington P; Brugha T; Coid J et al. Mental and personality disorders and abstinence from alcohol: Results from a national household survey. Psychological Medicine 41(4): 809-818, 2011. (41 refs.)

Background. The beneficial outcomes associated with moderate compared with low alcohol intake or abstinence may be due to the inclusion of people as 'low consumers', who have stopped consumption because of poor health. We investigated the association between alcohol abstinence and symptoms of common mental disorder and personality disorder, distinguishing between lifelong abstinence and abstinence following previous consumption. Method. Analyses were based on the British National Survey of Psychiatric Morbidity 2000, which sampled 8580 residents aged 16-74 years. Hazardous drinking (Alcohol Use Disorders Identification Test) was excluded. Symptoms of common mental disorder (depression/anxiety) were identified by the Clinical Interview Schedule. The screening questionnaire of the Structured Clinical Interview for Axis II Personality Disorders was used to identify potential personality disorder. Self-reported alcohol abstinence was divided into lifelong abstinence and previous consumption. Previous consumers were asked why they had stopped. Covariates included socio-economic status, social activity and general health status. Results. After adjustment, alcohol abstinence was associated with both common mental disorder symptoms and any personality disorder, but only for previous consumers, in whom odds ratios were 1.69 (95% CI 1.23-2.32) and 1.45 (95% CI 1.09-1.94). Associations were non-specific, being apparent for most individual mental disorder symptoms and personality disorder categories. More detailed analysis indicated that associations were again limited to previous consumers who reported ceasing alcohol consumption for health reasons. Conclusions. Worse mental health in low alcohol consumers, particularly those who have previously ceased for health reasons, should be taken into account when interpreting associations between moderate (compared with low) alcohol consumption and beneficial health outcomes.

Virta JJ; Jarvenpaa T; Heikkila K; Perola M; Koskenvuo M; Raiha I et al. Midlife alcohol consumption and later risk of cognitive impairment: A twin follow-up study. Journal of Alzheimers Disease 22(3): 939-948, 2010. (34 refs.)

In this prospective follow-up study, we monitored the effects of midlife alcohol consumption and drinking patterns on cognitive impairment risks in late life. 1,486 subjects recruited from the Finnish Twin Cohort were included in the analyses. Alcohol consumption data was obtained with structured questionnaires in 1975 and 1981, and subjects were contacted between 1999 and 2007 to conduct a telephone interview evaluating cognitive function. The mean follow-up period was 22.8 years (standard deviation 2.1 years). Both abstainers and heavy drinkers were found to have an increased risk of cognitive impairment in comparison to light drinkers (relative risk ratios 1.44; 95% confidence interval: 1.02-2.10, and 1.94, 1.10-3.44, respectively). Also, binge drinking at least monthly in 1975 and 1981, as well as more than two pass-outs due to excess drinking in 1981 were associated with an increased risk of cognitive impairment (1.98, 1.08-3.64 and 3.85, 1.51-9.83, respectively), even when excluding abstainers and controlling for total alcohol consumption. Subgroup analyses based on apolipoprotein E epsilon 4 status suggest that the increased risk of cognitive impairment associated with being an abstainer is limited to subjects without an epsilon 4 allele. Our results add to the evidence that light to moderate alcohol use is associated with a lower risk of cognitive impairment compared with higher levels of consumption. In addition, binge drinking was found to be an independent risk factor for cognitive impairment.

Wu JM; Hsieh TC; Vang O; Das DK (editors). Resveratrol: A cardioprotective substance. Annals of the New York Academy of Sciences. Resveratrol and Health 1215: 16-21, 2011. (35 refs.)

Coronary heart disease (CHD) is a major and preventable cause of morbidity and death in the United States. Recently, significant research efforts have been directed at an epidemiological phenomenon known as the "French paradox." This observation refers to the coexistence of high risk factors with unanticipated low incidence of CHD, and is postulated to be associated with low-to-moderate consumption of red wine. In vivo studies have shown that red wine intake is more CHD-preventative in comparison to other alcoholic drinks; enhanced cardioprotection may be attributed to grape-derived polyphenols, e.g., resveratrol, in red wine. This review summarizes results of in vitro and animal studies showing that resveratrol exerts multifaceted cardioprotective activities, as well as evidence demonstrating the presence of proteins specifically targeted by resveratrol, as exemplified by N-ribosyldihydronicotinamide quinone oxidoreductase, NQO2. A mechanism encompassing nongenomic and genomic effects and a research roadmap is proposed as a framework for uncovering further insights on cardioprotection by resveratrol.

Yokoyama H. Beneficial effects of ethanol consumption on insulin resistance are only applicable to subjects without obesity or insulin resistance: Drinking is not necessarily a remedy for metabolic syndrome. International Journal of Environmental Research and Public Health 8(7): 3019-3031, 2011. (59 refs.)

Although moderate drinking has been shown to lower insulin resistance levels, it is still unclear whether alcoholic beverages could be remedies for insulin resistance. To elucidate this, the correlation between levels of ethanol consumption and insulin resistance were cross-sectionally examined in 371 non-diabetic male Japanese workers. Multiple regression analysis demonstrated that the ethanol consumption level was inversely correlated with the insulin resistance level assessed by homeostatic model assessment (HOMA-IR, p = 0.0014), the serum insulin level (p = 0.0007), and pancreatic beta-cell function, also assessed by HOMA (HOMA-beta, p = 0.0002), independently from age, body mass index (BMI), and blood pressure, liver function tests, and lipid profiles status, as well as serum adiponectin. The correlations were true in subjects with normal BMIs (up to 25.0 kg/m(2), n = 301) or normal HOMA-IR (up to 2.0 mu IU.mg/mu L.dL n = 337), whereas all of them were non-significant in those with excessive BMIs (n = 70) or in those with HOMA-IR of more than 2.0 (n = 34). Although it is still unclear whether the reductions of these parameters by ethanol consumption are truly due to the improvement of insulin resistance, at least, these effects are not applicable to subjects with obesity and/or insulin resistance. Thus, alcoholic beverages could not be remedies for insulin resistance or metabolic syndrome.

Zyriax BC; Lau K; Klahn T; Boeing H; Volzke H; Windler E. Association between alcohol consumption and carotid intima-media thickness in a healthy population: Data of the STRATEGY study (Stress, Atherosclerosis and ECG Study). European Journal of Clinical Nutrition 64(10): 1199-1206, 2010. (44 refs.)

Background/Objectives: Epidemiologic evidence suggests a protective effect of moderate alcohol consumption on cardiovascular events. However, studies assessing the association between alcohol intake and intima-media thickness (IMT) as a marker of subclinical atherosclerosis have provided inconsistent results. The aim of this analysis of the Stress Atherosclerosis and ECG Study (STRATEGY study) was to investigate the relation between alcohol intake and IMT in a selectively healthy population. Subjects/Methods: In a cross-sectional study, laboratory values, anthropometric data, nutrition habits and physical activity were assessed in 106 men and 107 women, evenly distributed between 30 and 70 years. Carotid IMT was determined by B-mode ultrasonography according to the standardized protocol of the Study of Health in Pomerania. Results: In men, a significant positive correlation between daily alcohol consumption and IMT was observed (P<0.0001), whereas in women the positive correlation was not significant. The type of beverage consumed did not affect this finding. The mean IMT was significantly higher in men with an alcohol intake above the upper limit of 20 g/day than in men with an alcohol intake <20 g/day (P<0.001). According to a stepwise linear regression model adjusted for age, conventional risk factors, nutrition and physical activity, the IMT increases by 0.0253 mm per 21.4 g/day intake of alcohol in men (P<0.05). Conclusions: The STRATEGY study revealed a positive association between alcohol consumption and carotid IMT in healthy men aged 30-70 years. This relationship remained significant after adjustment for nutrition, physical activity, anthropometry and conventional cardiovascular risk factors.