INTRODUCTION: Understanding the concept of a standard drink (SD) is foundational knowledge to many public health policies aimed at reducing alcohol-related harms. These policies include adhering to low-risk drinking guidelines, screening brief intervention and referral activities, and counter alcohol-impaired driving initiatives. A lack of awareness of SDs might preclude the effectiveness of these interventions. A systematic review was conducted to review the evidence about how effective alcohol labels are in communicating SD information to the consumer.

METHODS: A systematic review was conducted to identify peer-reviewed articles and grey literature from relevant indexes from January 1990 to January 2016. Additionally, policy makers and researchers in countries where standard drink labels (SDLs) have been implemented were consulted to help identify relevant literature. The search strategy was focused on the impact of SDLs relative to a range of outcomes, including awareness of SDs, pouring behaviors, and consumption patterns.

RESULTS: Eleven records were eligible for inclusion. The evidence suggests that knowledge of the definition of an SD is low. However, SDLs can help individuals more accurately identify and pour an SD. SDLs need to be supported by educational initiatives to help the consumer understand the SD information provided on the beverage container. To date, there has been no comprehensive evaluation of the impact of SDLs.

CONCLUSIONS: SDLs have the potential to increase awareness of SDs and facilitate the monitoring of personal alcohol consumption in the context of a comprehensive alcohol strategy. However, their impact on drinking behaviors requires further exploration, especially among high-risk populations.

Published in General Health

BACKGROUND: Hazardous and harmful alcohol use and high blood pressure are central risk factors related to premature non-communicable disease (NCD) mortality worldwide. A reduction in the prevalence of both risk factors has been suggested as a route to reach the global NCD targets. This study aims to highlight that screening and interventions for hypertension and hazardous and harmful alcohol use in primary healthcare can contribute substantially to achieving the NCD targets.

METHODS: A consensus conference based on systematic reviews, meta-analyses, clinical guidelines, experimental studies, and statistical modelling which had been presented and discussed in five preparatory meetings, was undertaken. Specifically, we modelled changes in blood pressure distributions and potential lives saved for the five largest European countries if screening and appropriate intervention rates in primary healthcare settings were increased. Recommendations to handle alcohol-induced hypertension in primary healthcare settings were derived at the conference, and their degree of evidence was graded.

RESULTS: Screening and appropriate interventions for hazardous alcohol use and use disorders could lower blood pressure levels, but there is a lack in implementing these measures in European primary healthcare. Recommendations included (1) an increase in screening for hypertension (evidence grade: high), (2) an increase in screening and brief advice on hazardous and harmful drinking for people with newly detected hypertension by physicians, nurses, and other healthcare professionals (evidence grade: high), (3) the conduct of clinical management of less severe alcohol use disorders for incident people with hypertension in primary healthcare (evidence grade: moderate), and (4) screening for alcohol use in hypertension that is not well controlled (evidence grade: moderate). The first three measures were estimated to result in a decreased hypertension prevalence and hundreds of saved lives annually in the examined countries.

CONCLUSIONS: The implementation of the outlined recommendations could contribute to reducing the burden associated with hypertension and hazardous and harmful alcohol use and thus to achievement of the NCD targets. Implementation should be conducted in controlled settings with evaluation, including, but not limited to, economic evaluation.

Published in General Health

OBJECTIVE: The aim of this study was to prospectively investigate the potential effects of alcohol by subtype on reported long-term weight change.

METHODS: This study examined changes in alcohol intake (total, wine, light beer, regular beer, and liquor) and simultaneous changes in reported body weight within 4-year periods from 1986 to 2010 from US men in the Health Professionals Follow-Up Study. The study adjusted for age, changes in lifestyle and dietary covariates, and cardiovascular risk factors.

RESULTS: The study included observations of 44,603 four-year periods from 14,971 men. Total alcohol, total beer, regular beer, and liquor intakes, modeled as the increase in weight per increase in drinks per day, were each directly associated with moderate weight gain over the 4-year periods, in pounds: total alcohol: 0.23 (0.10 to 0.35); total beer: 0.29 (0.08 to 0.51); regular beer: 0.61 (0.22 to 1.00); and liquor: 0.28 (0.09 to 0.48). Results for wine and light beer were as follows: wine: 0.16 (-0.04 to 0.36) and light beer: -0.38 (-1.07 to 0.08). Results were strongest for men < 55 years old.

CONCLUSIONS: Increased alcohol consumption was associated with minor reported weight gain at levels unlikely to be clinically meaningful. Beverage-specific differences were not substantial enough to make dietary recommendations for weight loss or maintenance by beverage type. The greatest risk of weight gain was among men who increased consumption to levels well above moderation.

Published in General Health

BACKGROUND: There is little knowledge about the consumption of alcohol among Chinese and Norwegian older adults aged 65 years and over. The aim of this study was to investigate the prevalence and factors related to alcohol consumption among older adults in China and Norway.

METHODS: The Chinese Longitudinal Healthy Longevity Survey (CLHLS) data in 2008-2009 conducted in China and The Nord-Trondelag Health Study data in 2006-2008 (HUNT3) conducted in Norway were used. Mulitvariable logistic regression was used to test the factors related to alcohol consumption.

RESULTS: The prevalence of participants who drink alcohol in the Chinese and Norwegian sample were 19.88% and 46.2%, respectively. The weighted prevalence of participants with consumption of alcohol in the Chinese sample of women and men were 7.20% and 34.14%, respectively. In the Norwegian sample, the prevalence of consumption of alcohol were 43.31% and 65.35% for women and men, respectively. Factors such as younger age, higher level of education, living in urban areas, living with spouse or partner, and better health status were related to higher likelihood of alcohol consumption among Norwegian older women and men; while reported better health status and poorer life satisfaction were related to higher likelihood of alcohol consumption among Chinese. In addition, rural males and older females with higher level of education were more likely to consume alcohol.

CONCLUSION: The alcohol consumption patterns were quite different between China and Norway. Besides economic development levels and cultures in the two different countries, demographic characteristics, socioeconomic status, overall health status, and life satisfaction were associated with alcohol consumption as well.

Published in General Health

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