25 January 2023 In Drinking Patterns
Alcohol drinking patterns may determine the risk of hypertension and may also modify the detrimental effect of high alcohol intake. We prospectively evaluated the effect of the Mediterranean alcohol-drinking pattern and its interaction with the amount of alcohol consumed on the incidence of arterial hypertension. In the "Seguimiento Universidad de Navarra" (SUN) cohort, we followed-up 13,805 participants, all of them initially free of hypertension, during a maximum period of 16 years. Information about diet, chronic diseases, lifestyle and newly diagnosed hypertension was collected using validated questionnaires. We used a 7-item score (0 to 9 points) that jointly considered moderate alcohol consumption, distributed over the week, with meals, and a preference for red wine and avoidance of binge-drinking. During 142,404 person-years of follow-up, 1443 incident cases of hypertension were identified. Low adherence (score 7) category. Among alcohol consumers, a high adherence to the MADP is associated with a lower incidence of hypertension. Compared with abstinence, a high adherence did not seem to differ regarding its effect on hypertension risk.
27 October 2022 In Cancer

Importance: Although numerous studies have shown an association between alcohol consumption and cancer, how changes in drinking behavior increase or decrease the incidence of cancer is not well understood. Objective: To investigate the association between the reduction, cessation, or increase of alcohol consumption and the development of alcohol-related cancers and all cancers.

Design, Setting, and Participants: This population-based cohort study analyzed adult beneficiaries in the Korean National Health Insurance Service. Participants (aged >/=40 years) included those who underwent a national health screening in both 2009 and 2011 and had available data on their drinking status. Data were analyzed from April 16 to July 6, 2020. Exposures: Alcohol consumption level, which was self-reported by participants in health screening questionnaires, was categorized into none (0 g/d), mild (/=30 g/d) drinking. Based on changes in alcohol consumption level from 2009 to 2011, participants were categorized into the following groups: nondrinker, sustainer, increaser, quitter, and reducer. Main Outcomes and Measures: The primary outcome was newly diagnosed alcohol-related cancers (including cancers of the head and neck, esophagus, colorectum, liver, larynx, and female breast), and the secondary outcome was all newly diagnosed cancers (except for thyroid cancer).

Results: Among the 4513746 participants (mean [SD] age, 53.6 [9.6] years; 2324172 [51.5%] men), the incidence rate of cancer was 7.7 per 1000 person-years during a median (IQR) follow-up of 6.4 (6.1-6.6) years. Compared with the sustainer groups at each drinking level, the increaser groups had a higher risk of alcohol-related cancers and all cancers. The increased alcohol-related cancer incidence was associated with dose; those who changed from nondrinking to mild (adjusted hazard ratio [aHR], 1.03; 95% CI, 1.00-1.06), moderate (aHR, 1.10; 95% CI, 1.02-1.18), or heavy (aHR, 1.34; 95% CI, 1.23-1.45) drinking levels had an associated higher risk than those who did not drink. Those with mild drinking levels who quit drinking had a lower risk of alcohol-related cancer (aHR, 0.96; 95% CI, 0.92-0.99) than those who sustained their drinking levels. Those with moderate (aHR, 1.07; 95% CI, 1.03-1.12) or heavy (aHR, 1.07; 95% CI, 1.02-1.12) drinking levels who quit drinking had a higher all cancer incidence than those who sustained their levels, but when quitting was sustained, this increase in risk disappeared. Compared with sustained heavy drinking, reduced heavy drinking levels to moderate levels (alcohol-related cancer: aHR, 0.91 [95% CI, 0.86-0.97]; all cancers: aHR, 0.96 [95% CI, 0.92-0.99]) or mild levels (alcohol-related cancer: aHR, 0.92 [95% CI, 0.86-0.98]; all cancers: aHR, 0.92 [95% CI, 0.89-0.96]) were associated with decreased cancer risk.

Conclusions and Relevance: Results of this study showed that increased alcohol consumption was associated with higher risks for alcohol-related and all cancers, whereas sustained quitting and reduced drinking were associated with lower risks of alcohol-related and all cancers. Alcohol cessation and reduction should be reinforced for the prevention of cancer.

22 September 2022 In Cancer

IMPORTANCE: Although numerous studies have shown an association between alcohol consumption and cancer, how changes in drinking behavior increase or decrease the incidence of cancer is not well understood.

OBJECTIVE: To investigate the association between the reduction, cessation, or increase of alcohol consumption and the development of alcohol-related cancers and all cancers.

DESIGN, SETTING, AND PARTICIPANTS: This population-based cohort study analyzed adult beneficiaries in the Korean National Health Insurance Service. Participants (aged >/=40 years) included those who underwent a national health screening in both 2009 and 2011 and had available data on their drinking status. Data were analyzed from April 16 to July 6, 2020. Exposures: Alcohol consumption level, which was self-reported by participants in health screening questionnaires, was categorized into none (0 g/d), mild (/=30 g/d) drinking. Based on changes in alcohol consumption level from 2009 to 2011, participants were categorized into the following groups: nondrinker, sustainer, increaser, quitter, and reducer.

MAINS OUTCOMES AND MEASURES: The primary outcome was newly diagnosed alcohol-related cancers (including cancers of the head and neck, esophagus, colorectum, liver, larynx, and female breast), and the secondary outcome was all newly diagnosed cancers (except for thyroid cancer).

RESULTS: Among the 4513746 participants (mean [SD] age, 53.6 [9.6] years; 2324172 [51.5%] men), the incidence rate of cancer was 7.7 per 1000 person-years during a median (IQR) follow-up of 6.4 (6.1-6.6) years. Compared with the sustainer groups at each drinking level, the increaser groups had a higher risk of alcohol-related cancers and all cancers. The increased alcohol-related cancer incidence was associated with dose; those who changed from nondrinking to mild (adjusted hazard ratio [aHR], 1.03; 95% CI, 1.00-1.06), moderate (aHR, 1.10; 95% CI, 1.02-1.18), or heavy (aHR, 1.34; 95% CI, 1.23-1.45) drinking levels had an associated higher risk than those who did not drink. Those with mild drinking levels who quit drinking had a lower risk of alcohol-related cancer (aHR, 0.96; 95% CI, 0.92-0.99) than those who sustained their drinking levels. Those with moderate (aHR, 1.07; 95% CI, 1.03-1.12) or heavy (aHR, 1.07; 95% CI, 1.02-1.12) drinking levels who quit drinking had a higher all cancer incidence than those who sustained their levels, but when quitting was sustained, this increase in risk disappeared. Compared with sustained heavy drinking, reduced heavy drinking levels to moderate levels (alcohol-related cancer: aHR, 0.91 [95% CI, 0.86-0.97]; all cancers: aHR, 0.96 [95% CI, 0.92-0.99]) or mild levels (alcohol-related cancer: aHR, 0.92 [95% CI, 0.86-0.98]; all cancers: aHR, 0.92 [95% CI, 0.89-0.96]) were associated with decreased cancer risk.

CONCLUSIONS AND RELEVANCE: Results of this study showed that increased alcohol consumption was associated with higher risks for alcohol-related and all cancers, whereas sustained quitting and reduced drinking were associated with lower risks of alcohol-related and all cancers. Alcohol cessation and reduction should be reinforced for the prevention of cancer.

15 June 2022 In Diabetes

Despite earlier meta-analyses on the association between adherences to Mediterranean diet (MD) and risk of diabetes, there is no comprehensive and updated study assessing this issue. Furthermore, no earlier study has examined the nonlinear dose-response relationship between consumption of Mediterranean diet and risk of diabetes. The current systematic review and meta-analysis was done to investigate the linear and non-linear dose-response relationship between Mediterranean diet and incidence of diabetes. Using relevant keywords, electronic searches for prospective studies were conducted in ISI Web of Science, PubMed, and Scopus until January 2022. The reported hazard ratios or odds ratios in the primary studies were regarded as risk ratios (RRs). The overall effect was calculated using a random-effects model that accounts for between-study variability. The potential non-linear dose-response associations were tested using a two-stage hierarchical regression model. Based on 16 prospective studies (with 17 effect sizes), we found that the greatest adherence to the Mediterranean diet was significantly associated with a reduced risk of diabetes (Pooled RR: 0.83; 95% CI: 0.77-0.90; I2 =79%, P</= 0.001). Based on linear dose-response analysis, each 1-score rise in the Mediterranean diet score was associated with a 3% decreased risk of diabetes (HR = 0.97; 95% CI: 0.96-0.98, P< 0.001). A nonlinear relationship (P nonlinearity = 0.001) was also observed between Mediterranean diet score and risk of type 2 diabetes. Even modest adherence to the Mediterranean diet was linked to a decreased incidence of type 2 diabetes.

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