22 March 2022 In Drinking Patterns

ISSUES: Numerous studies have examined the impact of the COVID-19 pandemic on alcohol use changes in Europe, with concerns raised regarding increased use and related harms.

APPROACH: We synthesised observational studies published between 1 January 2020 and 31 September 2021 on self-reported changes in alcohol use associated with COVID-19. Electronic databases were searched for studies evaluating individual data from European general and clinical populations. We identified 646 reports, of which 56 general population studies were suitable for random-effects meta-analyses of proportional differences in alcohol use changes. Variations by time, sub-region and study quality were assessed in subsequent meta-regressions. Additional 16 reports identified were summarised narratively.

KEY FINDINGS: Compiling reports measuring changes in overall alcohol use, slightly more individuals indicated a decrease than an increase in their alcohol use during the pandemic [3.8%, 95% confidence interval (CI) 0.00-7.6%]. Decreases were also reported more often than increases in drinking frequency (8.0%, 95% CI 2.7-13.2%), quantity consumed (12.2%, 95% CI 8.3-16.2%) and heavy episodic drinking (17.7%, 95% CI 13.6-21.8%). Among people with pre-existing high drinking levels/alcohol use disorder, high-level drinking patterns appear to have solidified or intensified.

IMPLICATIONS: Pandemic-related changes in alcohol use may be associated with pre-pandemic drinking levels. Increases among high-risk alcohol users are concerning, suggesting a need for ongoing monitoring and support from relevant health-care services.

CONCLUSION: Our findings suggest that more people reduced their alcohol use in Europe than increased it since the onset of the pandemic. However high-quality studies examining specific change mechanisms at the population level are lacking.

23 February 2022 In General Health

Adherence to the traditional Mediterranean diet has been customarily assessed with the Mediterranean diet score (MDS or Trichopolou Index), with values of 0 or 1 assigned to each of the nine elements, and with the use of the sex-specific median as the cutoff. The value of persons whose consumption of the six beneficial items (ratio of monounsaturated to saturated fatty acids, vegetables, legumes, fruits and nuts, cereal, and fish) is at or above the median and is assigned a value of 1. Otherwise they receive 0 points.

For detrimental elements (meats and dairy products) persons whose consumption is below the median are assigned a value of 1. An additional ninth point is assigned to moderate ethanol intake. We assessed the effect of each of the nine components of the MDS (replacing the fats ratio with olive oil, the main source of monounsaturated fats in the Mediterranean diet) on the risk of COVID-19 infection, symptomatic and severe COVID-19. From March to December 2020, 9,699 participants of the "Seguimiento Universidad de Navarra" (SUN) cohort answered a COVID-19 questionnaire.

After excluding doctors and nurses, 5,194 participants were included in the main statistical analyses. Among them, we observed 382 cases of COVID-19 based on symptoms and clinical diagnosis; 167 of them with test confirmation. For the two COVID-19 definitions used, we found a significant decrease in risk for a higher adherence to the Mediterranean diet (OR = 0.64, 95% CI: 0.42-0.98, p for trend = 0.040; and OR = 0.44, 95% CI: 0.22-0.88, p for trend = 0.020, for test-diagnosed cases).

A protective effect was also found for symptomatic COVID-19 (OR = 0.64, 95% CI: 0.41-1.00, p for trend = 0.050). Among the different individual food groups, only the consumption of whole dairy products showed a harmful direct association. The Mediterranean diet as a whole seems more important than each of its components in preventing the infection and symptoms of COVID-19.

26 January 2022 In Drinking Patterns

OBJECTIVES: To evaluate the associations of status, amount, and frequency of alcohol consumption across different alcoholic beverages with coronavirus disease 2019 (COVID-19) risk and associated mortality.

MANDATE: This study included 473,957 subjects, 16,559 of whom tested positive for COVID-19. Multivariate logistic regression analyses were used to evaluate the associations of alcohol consumption with COVID-19 risk and associated mortality. The non-linearity association between the amount of alcohol consumption and COVID-19 risk was evaluated by a generalized additive model.

RESULTS: Subjects who consumed alcohol double above the guidelines had a higher risk of COVID-19 (1.12 [1.00, 1.25]). Consumption of red wine above or double above the guidelines played protective effects against the COVID-19. Consumption of beer and cider increased the COVID-19 risk, regardless of the frequency and amount of alcohol intake. Low-frequency of consumption of fortified wine (1-2 glasses/week) within guidelines had a protective effect against the COVID-19. High frequency of consumption of spirits (>/=5 glasses/week) within guidelines increased the COVID-19 risk, whereas the high frequency of consumption of white wine and champagne above the guidelines decreased the COVID-19 risk. The generalized additive model showed an increased risk of COVID-19 with a greater number of alcohol consumption. Alcohol drinker status, frequency, amount, and subtypes of alcoholic beverages were not associated with COVID-19 associated mortality.

CONCLUSIONS: The COVID-19 risk appears to vary across different alcoholic beverage subtypes, frequency, and amount. Red wine, white wine, and champagne have chances to reduce the risk of COVID-19. Consumption of beer and cider and spirits and heavy drinking are not recommended during the epidemics. Public health guidance should focus on reducing the risk of COVID-19 by advocating healthy lifestyle habits and preferential policies among consumers of beer and cider and spirits.

22 October 2021 In Drinking Patterns

During the early months of 2020, the world experienced a novel, violent, and relentless pandemic era. By the end of the year more than seventy-seven million cases of COVID-19 had been reported around the globe. Due to it being a highly contagious disease, the recommended measures adopted by most nations to prevent infection include social distancing and quarantine. How did these measures affect people's relationship with alcohol consumption in cultures where alcohol plays an important social role? A questionnaire-based study, designed to follow the drinking behaviour of people before and during lockdown was applied to two different cultural groups impacted by the pandemic during the strict phase of lockdown. These are the British and Spanish populations (179 participants from each country were interviewed). Considering the frequency of consumption of the alcoholic beverages evaluated (wine, beer, cider, whisky and spirits), the results showed that a significant lockdown*country interaction was observed. Overall, Spanish participants consumed alcoholic beverages less frequently during lockdown than before, while British participants reported no change in their consumption habits. Spaniards' decrease in alcohol consumption is related to the absence of a social contexts while Britons seems to have adapted their consumption to the modified context. Results suggest that, alcohol consumption is a central core of the British culture, while for the Spanish, socialization is more a cultural characteristic than the alcohol itself.

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