OBJECTIVE: Research on late-middle-aged and older adults has focused primarily on average level of alcohol consumption, overlooking variability in underlying drinking patterns. The purpose of the present study was to examine the independent contributions of an episodic heavy pattern of drinking versus a high average level of drinking as prospective predictors of drinking problems.

METHOD: The sample comprised 1,107 adults ages 55-65 years at baseline. Alcohol consumption was assessed at baseline, and drinking problems were indexed across 20 years. We used prospective negative binomial regression analyses controlling for baseline drinking problems, as well as for demographic and health factors, to predict the number of drinking problems at each of four follow-up waves (1, 4, 10, and 20 years).

RESULTS: Across waves where the effects were significant, a high average level of drinking (coefficients of 1.56, 95% CI [1.24, 1.95]; 1.48, 95% CI [1.11, 1.98]; and 1.85, 95% CI [1.23, 2.79] at 1, 10, and 20 years) and an episodic heavy pattern of drinking (coefficients of 1.61, 95% CI [1.30, 1.99]; 1.61, 95% CI [1.28, 2.03]; and 1.43, 95% CI [1.08, 1.90] at 1, 4, and 10 years) each independently increased the number of drinking problems by more than 50%.

CONCLUSIONS: Information based only on average consumption underestimates the risk of drinking problems among older adults. Both a high average level of drinking and an episodic heavy pattern of drinking pose prospective risks of later drinking problems among older adults.

Published in Drinking Patterns

Alcohol and tobacco use during pregnancy are among the strongest and most preventable risk factors for adverse neonatal health outcomes, but few developmentally sensitive, population-based studies of this phenomenon have been conducted. To address this gap, the present study examined the prevalence and correlates of alcohol and tobacco use among pregnant adolescents (aged 12-17) and adults (aged 18-44) in the United States. Data were derived from the population-based National Survey of Drug Use and Health (80,498 adolescent and 152,043 adult women) between 2005 and 2014. Findings show disconcerting levels of past-month use among pregnant women with 11.5% of adolescent and 8.7% of adult women using alcohol, and 23.0% of adolescent and 14.9% of adult women using tobacco. Compared to their non-pregnant counterparts, pregnant adolescents were less likely to report past 30-day alcohol use (AOR=0.52, 95% CI=0.36-0.76), but more likely to report past 30-day tobacco use (AOR=2.20, 95% CI=1.53-3.18). Compared to their non-pregnant adult counterparts, pregnant adults were less likely to report using alcohol (AOR=0.06, 95% CI=0.05-0.07) and tobacco (AOR=0.47, 95% CI=0.43-0.52). Compared to pregnant abstainers, pregnant women reporting alcohol/tobacco use were more likely to have had a major depressive episode in the past 12 months, report criminal justice system involvement, and endorse comorbid alcohol/tobacco use. Given alcohol and tobacco's deleterious consequences during pregnancy, increased attention to reducing use is critical. Findings suggest that tobacco use is especially problematic for both adolescents and adults and is strongly linked with depression and criminal justice involvement, especially among adults.

Published in Pregnant Women

Alcohol consumption is associated with a modest increased risk of colon cancer, but its relationship with colon cancer survival has not been elucidated. Using data from a phase III randomized adjuvant trial, we assessed the association of alcohol consumption with colon cancer outcomes. Patients completed a risk factor questionnaire before randomization to FOLFOX or FOLFOX+cetuximab (N=1984). Information was collected on lifestyle factors, including smoking, physical activity, and consumption of different types of alcohol. Cox models assessed the association between alcohol consumption and outcomes of disease-free survival (DFS), time-to-recurrence (TTR) and overall survival (OS), adjusting for age, sex, study arm, body mass, smoking, physical activity, and performance status. No statistically significant difference in outcomes between ever and never drinkers were noted [hazard ratio (HR)DFS =0.86, HRTTR =0.87, HROS =0.86, p-values=0.11 to 0.17]. However, when considering alcohol type, ever consumers of red wine (n=628) had significantly better outcomes than never consumers (HRDFS =0.80, HRTTR =0.81, HROS =0.78, p-values=0.01 to 0.02). Favorable outcomes were confirmed in patients who consumed 1-30 glasses/month of red wine (n=601, HR=0.80 to 0.83, p-values=0.03 to 0.049); there was a suggestion of more favorable outcomes in patients who consumed >30 glasses/month of red wine (n=27, HR=0.33 to 0.38, p-values=0.05 to 0.06). Beer and liquor consumption were not associated with outcomes. Although alcohol consumption was not associated with colon cancer outcomes overall, mild to moderate red wine consumption was suggestively associated with longer OS, DFS, and TTR in stage III colon cancer patients. This article is protected by copyright.

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Published in Cancer

INTRODUCTION: Health benefits of low-to-moderate alcohol consumption may operate through an improved lipid profile. A Mendelian randomization (MR) approach was used to examine whether alcohol consumption causally affects lipid levels.

METHODS: This analysis involved 10,893 European Americans (EA) from the Atherosclerosis Risk in Communities (ARIC) study. Common and rare variants in alcohol dehydrogenase and acetaldehyde dehydrogenase genes were evaluated for MR assumptions. Five variants, residing in the ADH1B, ADH1C, and ADH4 genes, were selected as genetic instruments and were combined into an unweighted genetic score. Triglycerides (TG), total cholesterol, high-density lipoprotein cholesterol (HDL-c) and its subfractions (HDL2-c and HDL3-c), low-density lipoprotein cholesterol (LDL-c), small dense LDL-c (sdLDL-c), apolipoprotein B (apoB), and lipoprotein (a) (Lp(a)) levels were analyzed.

RESULTS: Alcohol consumption significantly increased HDL2-c and reduced TG, total cholesterol, LDL-c, sdLDL-c, and apoB levels. For each of these lipids a non-linear trend was observed. Compared to the first quartile of alcohol consumption, the third quartile had a 12.3% lower level of TG (p < 0.001), a 7.71 mg/dL lower level of total cholesterol (p = 0.007), a 10.3% higher level of HDL2-c (p = 0.007), a 6.87 mg/dL lower level of LDL-c (p = 0.012), a 7.4% lower level of sdLDL-c (p = 0.037), and a 3.5% lower level of apoB (p = 0.058, poverall = 0.022).

CONCLUSIONS: This study supports the causal role of regular low-to-moderate alcohol consumption in increasing HDL2-c, reducing TG, total cholesterol, and LDL-c, and provides evidence for the novel finding that low-to-moderate consumption of alcohol reduces apoB and sdLDL-c levels among EA. However, given the nonlinearity of the effect of alcohol consumption, even within the range of low-to-moderate drinking, increased consumption does not always result in a larger benefit.

Published in Cardiovascular System
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