Alcohol-drinking patterns and metabolic syndrome risk: the 2007 Korean National Health and Nutrition Examination Survey

Alcohol consumption has been known to be related to the prevalence of metabolic syndrome (MS). Although some studies have revealed that mild to moderate alcohol consumption reduces the risk of MS, most of these studies have focused the effect of alcohol consumption amount on MS. We examined the association between alcohol-drinking patterns and MS by using the alcohol use disorders identification test (AUDIT) questionnaire to study 1,768 alcohol drinkers (847 men, 921 women) aged 20-75 years from Korean National Health and Nutrition Examination Survey in 2007. When compared with the subjects in the reference group (AUDIT score ≤7), the odds ratios (ORs, 95% confidence intervals [CIs]) for MS of subjects in the highest group (AUDIT score ≥16) were 3.92 (2.40-6.22) in men and 2.27 (0.87-5.89) in women after adjusting for confounding variables. Among the items of the AUDIT score, several alcohol-drinking patterns, including “drinking frequency,” “usual drinking quantity,” “frequency of high-risk drinking,” “frequency of inability to stop drinking,” “frequency of feeling guilty after drinking,” and “frequency of inability to remember after drinking” were strongly associated with the prevalence of MS in men. In women, there were significant relationships between MS and “usual drinking quantity,” “frequency of feeling guilty after drinking,” and “frequency of inability to stop drinking.” In summary, AUDIT score was strongly associated with MS in Korean adults, particularly in men. Accordingly, in addition to the amount of daily alcohol consumption, alcohol-drinking patterns should be addressed in the prevention and treatment of MS.     

Alcohol consumption and increased mortality in Russian men and women: a cohort study based on the mortality of relatives

OBJECTIVE: To examine the relations between frequency of alcohol consumption and of binge drinking and adult mortality in Russian men and women. METHODS: Using modified indirect demographic techniques, a convenience cohort was constructed based on survey respondents' information about their close relatives. A random sample general population of the Russian Federation of 7172 respondents (response rate 61%) provided information on 10 475 male and 3129 female relatives, including age, vital status, and frequency of alcohol consumption and binge drinking. These relatives formed the cohort analysed in this report. The outcome measure was all-cause mortality after the age of 30 years. FINDINGS: There was a strong linear relation between frequency of drinking and of binge drinking and all-cause mortality in men; after controlling for smoking and calendar period of birth, the relative risk of death in daily drinkers compared to occasional drinkers was 1.52 (95% confidence interval (CI) 1.33-1.75). Male binge drinkers had higher mortality than drinkers who did not binge, which persisted after adjustment for drinking frequency (adjusted relative risk 1.09, 95% CI 1.00-1.19). In women, the increased mortality was confined to a small group of those who binged at least once a month (adjusted relative risk 2.68, 95% CI 1.54-4.66). CONCLUSION: The results suggest a positive association between alcohol and mortality in the Russian Federation. There was no evidence for the protective effect of drinking seen in western populations. Alcohol appears to have contributed to the high long-term mortality rates in Russian men, but it is unlikely to be a major cause of female mortality.     

Blood alcohol is the best indicator of hazardous alcohol drinking in young adults and working-age patients with trauma

AIMS: To determine the most effective marker of hazardous alcohol drinking in trauma patients. METHODS: A prospective study of 349 trauma patients aged 16-49 years admitted into a general hospital trauma centre. Information on the amount and pattern of alcohol drinking was obtained by interview. Blood or breath alcohol concentration (BAC), serum gammaglutamyl transferase (GGT), aspartate aminotransferase (AST), carbohydrate-deficient transferrin (CDT) and the mean corpuscular volume (MCV) of erythrocytes were measured as markers of alcohol consumption. RESULTS: In this series, 8% of all trauma patients were found to be dependent drinkers, while 61% were frequent binge drinkers, 17% infrequent binge drinkers, 8% light-to-moderate drinkers and 6% nondrinkers. On admission, the BAC test was positive in 68% of the hazardous drinkers (i.e. dependent drinkers or frequent binge drinkers). Using a cut-off level of >0 mg/dl, the sensitivity and specificity of the BAC test for identifying hazardous drinking were 68% (95% confidence intervals [CI], 61-73%) and 94% (95% CI, 87-97%), respectively, and the positive predictive value was 96% (95% CI, 92-98%). GGT, MCV, CDT and AST were less accurate indicators of hazardous drinking. BAC was the least expensive marker. CONCLUSIONS: Two-thirds of trauma patients were hazardous drinkers, and blood alcohol on admission was an accurate indicator of this. BAC should be systematically used in trauma centres if patients are to be selected for an alcohol intervention.     

Alcohol use among entrants to a Hong Kong University

AIM: This study of first year entrants to one of the major universities in Hong Kong describes the pattern of their alcohol consumption, their binge drinking, alcohol abuse, and dependence. METHODS: A retrospective cross-sectional study was conducted. A representative sample of year 1 students 2630/2968 (89%) newly admitted to the Chinese University of Hong Kong in 2003 were recruited to participate in a structured self-administered questionnaire. RESULTS: First year university students in Hong Kong have low rates of ever drinking alcohol (62%), and the rates of binge drinking and alcohol-related problems were 7 and 0.8%, respectively. The pattern of binge drinking is more common than weekly drinking (2.3%). Binge drinkers are more likely to have experienced alcohol-related interpersonal problems or (95% CI) = 6.5 (1.7-24.5). Males were more likely to drink, to binge drink, and to drink frequently. CONCLUSIONS: In contrast with students in the west, the majority of first year university students in Hong Kong are not binge or regular drinkers. However, there is a subgroup who smoke, drink more, and use alcohol as a means of coping with stress. This group may be particularly in need of a brief intervention, such as providing counseling and referral services.     

Racial Disparities in Pregnancy-Related Drinking Reduction

Objective The purpose of this study was to investigate the likelihood that women of different racial and ethnic groups would reduce their alcohol consumption during pregnancy. Methods Data came from 22 states participating in the Pregnancy Risk Assessment Monitoring System from 2001 to 2005. After stratifying the sample by preconception drinking level, logistic regressions were used to predict drinking reduction and cessation by the third trimester by race, controlling for age, education, marital status, Medicaid status, pregnancy intention, smoking status, and state. Results Overall, Black, Asian/Pacific Islander and Hispanic women were all significantly less likely than White women to reduce their heavy drinking after becoming pregnant. American Indian/Alaskan Native women who were moderate drinkers before conception were over 2 times more likely than White women to reduce drinking after becoming pregnant (OR 2.19, CI 0.71, 6.76), although this difference was non-significant (P = .17). Among those who binge drank in the months before pregnancy, compared to White women, Black (OR 0.26, CI 0.17–0.39), Hispanic (OR 0.19, CI 0.12–0.29), American Indian/Alaskan Native (OR 0.44 CI 0.20, 0.96), and Asian/Pacific Islander women (OR 0.11, CI 0.06–0.22) were all less likely to quit binge drinking while pregnant. Conclusion Significant racial differences in pregnancy-related drinking reduction are evident, and may help explain racial disparities in FAS. Results suggest that more targeted efforts are needed to meet the national goals of preventing alcohol-exposed pregnancies.     

Patterns and Average Volume of Alcohol Use Among Women of Childbearing Age

Objectives: Maternal alcohol use is a leading preventable cause of neurobehavioral and developmental abnormalities in children. This study examines the patterns and average volume of alcohol use among U.S. women of childbearing age in order to identify subgroups of high-risk women for selective intervention. Methods: A sample of 188,290 women aged 18–44 years participated in the Centers for Disease Controls and Prevention (CDC)’s Behavioral Risk Factor Surveillance System (BRFSS) survey during the period of 2001–2003. Reported alcohol use patterns and average volume were examined for pregnant and nonpregnant women. Efforts were made to evaluate and characterize women who practiced various levels of binge drinking. Results: The results showed that approximately 2% of pregnant women and 13% of nonpregnant women in the United States engaged in binge drinking during the period of 2001–2003. Among the estimated average of 6.7 million women of childbearing age overall who engaged in binge drinking during the period, approximately 28.5% women also reported consuming an average of 5 drinks or more on typical drinking days, or about 21.4% women consumed at least 45 drinks on average in a month. Larger proportions of binge drinkers with high usual quantity of consumption were found among women of younger ages (18–24 years) or current smokers. Conclusions: Future prevention efforts should include strategies that combine health messages and encourage women of childbearing age, with particular emphasis on women 18–24 years, to avoid alcohol and tobacco use, and take multivitamins and folic acid daily for better pregnancy outcomes. Other efforts must also include broad-based implementation of screening and brief intervention for alcohol misuse in primary and women’s health care settings.     

Screening and brief intervention targeting risky drinkers in Danish general practice--a pragmatic controlled trial

AIMS: Recommendations for routine alcohol screening and brief counselling intervention in primary health care rest on results from intervention efficacy studies. By conducting a pragmatic controlled trial (PCT), we aimed at evaluating the effectiveness of the WHO recommendations for screening and brief intervention (SBI) in general practice. METHODS: A randomized PCT (brief counselling intervention vs no intervention) involving 39 Danish general practitioners (GPs). Systematic screening of 6897 adults led to inclusion of 906 risky drinkers, and research follow-up on 537 of these after 12-14 months. Outcome measures focused on patients' acceptance of screening and intervention and their self-reported alcohol consumption. RESULTS: Patient acceptance of screening and intervention -10.3% (N = 794) of the target population (N = 7, 691) explicitly refused screening. All intervention group subjects (N = 442) were exposed to an instant brief counselling session while only 17.9% of them (79/442) attended a follow-up consultation that was offered by their GP. Consumption Changes At one-year follow-up, average weekly consumption had increased by 0.7 drinks in both comparison groups. As secondary findings, we observed an indiscriminate absolute risk reduction (ARR = 0.08 (95% CI: -0.02; 0.18)) in male binge drinking, but adverse intervention effects for women on the secondary outcomes (binge drinking ARR = -0.30 (95% CI: -0.47; -0.09)). CONCLUSIONS: The results of brief interventions in everyday general practice performed on the basis of systematic questionnaire screening may fall short of theoretical expectations. When applied to non-selected groups in everyday general practice SBI may have little effect and engender diverse outcome. Women may be more susceptible to defensive reactions than men.     

Binge drinking: prevalence, patterns and policy

This paper presents analyses of the pattern of ‘bingedrinking’ in Wales, based on data drawn from a 1993 surveyof 12 167 (67%) 18–64 year olds resident in 15 212 householdsin Wales. Binge drinking, defined as drinking half the weeklyrecommended units of alcohol in a single drinking session, wasfound to be most prevalent among young adults, males, the manualsocial group, those who did not undertake any further educationafter secondary school, those who are single, divorced or separated,beer drinkers and those who concentrate most of their drinkingat weekends. 28.2% of men and 8.2% of women reported binge drinkingat least once a week, of whom about 42% felt that their levelof drinking was harmful to their health. About a quarter statedthat they would like to reduce their alcohol consumption butonly a small number had been advised to do so by their GeneralPractitioner. The public health impact of binge drinking isdiscussed. It is recommended that sensible drinking messagesshould emphasize the need to reduce binge drinking as well asto moderate overall weekly consumption and should be supportedby policies to create environments that support sensible alcoholuse.     

Absence of religious beliefs,unhealthy eating habits,illicit drug abuse,and self-rated health is associated with alcohol and tobacco use among college students — PADu study

Aim

Describing the factors associated with the alcohol consumption, tobacco use, binge drinking, and “binge drinking and tobacco use” by college students.

Subject and methods

Cross-sectional study carried out with 356 first-semester college students of a public educational institution at Minas Gerais, Brazil. Sociodemographic characteristics, lifestyle habits (alcohol consumption, tobacco and illicit drugs use, exposure time on screens, and eating habits), and health conditions (weight, height, self-rated health, symptoms of anxiety, and depression) were collected. Statistical analysis was performed using Stata® software version 13.0.

Results

The prevalence of alcohol consumption, tobacco use, binge drinking, and “binge drinking and tobacco use” were 73.9%, 17.4%, 43.5%, and 13.4%, respectively. Had no religious beliefs was associated with alcohol consumption (OR: 1.86 95% CI 1.06–3.27), tobacco use (OR: 2.00 95% CI 1.06–3.78), and “binge drinking and tobacco use” (OR: 2.33 95% CI 1.09–4.96). Unhealthy eating habits was associated with alcohol consumption (OR: 2.06 95% CI 1.06–3.97) and tobacco use (OR: 2.74 95% CI 1.33–5.68; OR: 0.75 95% CI 0.31–1.80). Illicit drugs was associated with alcohol consumption (OR: 8.55 95% CI 1.12–65.42) and tobacco use (OR: 3.19 95% CI 1.20–8.51). Self-rated health was associated with tobacco use, combined (OR: 2.93 95% CI 1.37–6.28) or not (OR: 2.46 95% CI 1.32–4.61) with binge drinking. Additionally, tobacco use was associated with white skin color (OR: 2.62 95% CI 1.35–5.07) and being homosexual (OR: 0.37 95% CI 0.18–0.75). Moreover, “binge drinking” was associated with being overweight (OR: 1.72 95% CI 1.03–2.84). Associations remained in the age and sex adjustment.

Conclusion

It was observed that some factors associated with alcohol consumption and tobacco use are modifiable risk factors. Therefore, we suggest strategic actions focusing on raising the population’s awareness to change these factors. Longitudinal studies are necessary to understand the causal relationship between studied variables and, thus, develop strategic actions to improve the life quality of this population group.

     

Adult outcomes of binge drinking in adolescence: findings from a UK national birth cohort

AIMS: The aim of the study was to determine outcomes in adult life of binge drinking in adolescence in a national birth cohort. DESIGN AND SETTING: Longitudinal birth cohort: 1970 British Birth Cohort Study surveys at 16 years (1986) and 30 years (2000). PARTICIPANTS: A total of 11 622 subjects participated at age 16 years and 11 261 subjects participated at age 30 years. MEASUREMENTS: At the age of 16 years, data on binge drinking (defined as two or more episodes of drinking four or more drinks in a row in the previous 2 weeks) and frequency of habitual drinking in the previous year were collected. Thirty-year outcomes recorded were alcohol dependence/abuse (CAGE questionnaire), regular weekly alcohol consumption (number of units), illicit drug use, psychological morbidity (Malaise Inventory) and educational, vocational and social history. FINDINGS: 17.7% of participants reported binge drinking in the previous 2 weeks at the age of 16 years. Adolescent binge drinking predicted an increased risk of adult alcohol dependence (OR 1.6, 95% CI 1.3 to 2.0), excessive regular consumption (OR 1.7, 95% CI 1.4 to 2.1), illicit drug use (OR 1.4, 95% CI 1.1 to 1.8), psychiatric morbidity (OR 1.4, 95% CI 1.1 to 1.9), homelessness (OR 1.6, 95% CI 1.1 to 2.4), convictions (1.9, 95% CI 1.4 to 2.5), school exclusion (OR 3.9, 95% CI 1.9 to 8.2), lack of qualifications (OR 1.3, 95% CI 1.1 to 1.6), accidents (OR 1.4, 95% CI 1.1 to 1.6) and lower adult social class, after adjustment for adolescent socioeconomic status and adolescent baseline status of the outcome under study. These findings were largely unchanged in models including both adolescent binge drinking and habitual frequent drinking as main effects. CONCLUSIONS: Adolescent binge drinking is a risk behaviour associated with significant later adversity and social exclusion. These associations appear to be distinct from those associated with habitual frequent alcohol use. Binge drinking may contribute to the development of health and social inequalities during the transition from adolescence to adulthood.     

PATTERNS OF ALCOHOL CONSUMPTION AMONG THE GENERAL POPULATION OF CASTILE AND LEON (SPAIN

A total of 2500 individuals, aged 14–70, who live in Castileand Leon (Spain), were surveyed in the spring of 1989 with regardto their alcohol consumption and its patterns. Among those surveyed26.2% were 'daily' drinkers and 66.0% ‘weekly’ drinkers.Differences of alcohol use (frequency) and intake were reviewedwith regard to sociodemographic factors such as gender, age,and marital status. Beer (52.6%) was the favourite drink, withwine (20.6%) the second most commonly consumed alcohol beverage.Most of those surveyed (54.6%) were ‘light’ drinkers(1–39 g/day of pure alcohol), while 3.0% had an intakeof over 80 g/day (‘heavy’ drinkers). The averageage at which they started drinking was 16 2 years The resultsallow a better understanding of the pattern of alcohol consumptionin Spain.     

Prevalence of problem drinking in a Venezuelan Native American population

This is the first study of alcohol-related problems among a Latin American indigenous population using the Alcohol Use Disorders Identification Test (AUDIT). A randomly selected community sample consisting of 3% of the adult population of the tribe completed oral interviews (n = 105 adults, completion rate 86%). The majority of both men (98%) and women (53%) had drunk alcohol at some time in their lives, with 94 and 26% respectively having consumed alcohol within the past 12 months. Using a cut-off score of 8 for the AUDIT, 86.5% of all men and 7.5% of all women were found to be problem drinkers. Focus group discussions revealed that traditional patterns of binge drinking of corn liquor had gradually been replaced by consumption of commercial beer and rum at more frequent intervals and with more negative social consequences. This male population demonstrates one of the highest prevalence rates for problem drinking reported in the world literature. Both the magnitude of problems detected and participants' concerns about them suggest that broad-scale interventions are warranted at the community level.     

Influence of Alcohol Consumption on the Development of Erosive Esophagitis in Both Sexes: A Longitudinal Study

The influence of changes in alcohol consumption on erosive esophagitis (EE) development in both sexes is unclear. This observational study investigated sex differences in the influence of alcohol consumption on EE development, and included 2582 patients without EE at baseline from 13,448 patients who underwent >2 health check-ups over >1 year. The rates of non-drinkers who started drinking, and drinkers who abstained from drinking, who increased, and who decreased their weekly alcohol consumption were 7.2%, 9.7%, 14.7%, and 24.1% and 7.3%, 17.8%, 12.8%, and 39.0% in men and women, respectively. In the final cohort, 211/1405 (15.0%) men and 79/1177 (6.7%) women newly developed EE. The odds ratio (OR) for drinking in EE development was 1.252 (95% confidence interval (CI), 0.907–1.726) among men and 1.078 (95% CI, 0.666–1.747) among women. Among men aged <50 years, the OR for drinking ≥70 g/week in EE development was 2.825 (95% CI, 1.427–5.592), whereas among women, the OR for drinking ≥140 g/week in EE development was 3.248 (95% CI, 1.646–6.410). Among participants aged <50 years, the OR for daily drinking in EE development was 2.692 (95% CI, 1.298–5.586) among men and 4.030 (95% CI, 1.404–11.57) among women. The influence of alcohol consumption on EE development differed between the sexes. We recommend no alcohol consumption for individuals aged <50 years to avoid EE development. Daily drinkers should be assessed for EE development.     

Effectiveness of medical advice for reducing excessive alcohol consumption. Meta-analysis of Spanish studies in primary care

INTRODUCTION: Former systematic reviews have backed the efficacy of medical counselling, a form of brief intervention, on the treatment of excessive drinkers detected in primary care settings. Nevertheless, these results cannot be applied without criticism to Mediterranean populations which, so far, have not been represented in the aforementioned studies. The aim of the present study was to update the results on the efficacy of brief interventions in primary care by pooling Spanish studies. METHODS: Studies were searched for by using appropriate databases and also by consulting to experts in the field to retrieve grey literature. Pooled estimations of effect sizes were calculated for two outcomes, the reduction in the amount of alcohol consumption and the decrease in the number of excessive drinkers. RESULTS: Two over the 5 retrieved studies were not included in a former review. The effect size regarding the decrease of alcohol consumption was medium (d = 0.46; 95% CI, 0.29 to 0.63; p < 0.0005; the intervention group outperformed the control by a 22%) and small for the decrease in the frequency of excessive drinkers (OR = 1.55; 95% CI, 1.06 to 2.26; p = 0.02; the intervention group outperformed the control by a 11%). The analysis by complimented protocols at the end of the study showed an effect size 1.5 times larger than the analysis performed on intention-to-treat basis. CONCLUSIONS: The results of this meta-analysis support the efficacy of brief intervention for excessive drinkers in primary care settings in Spain.     

Binge drinking

Binge' drinking is defined as episodic excessive drinking, but there is no worldwide consensus on how many drinks constitute a 'binge'. BEACH (Bettering the Evaluation and Care of Health) used three questions from the World Health Organization's Alcohol Use Disorders Identification Test (AUDIT) to gather information on alcohol consumption of patients aged 18 years or over from a subsample (40%) of participants. We defined regular binge drinkers as those who have six or more standard drinks on one occasion, either weekly or monthly.     

Prevalence of HIV Risk Behaviors Between Binge Drinkers and Non-Binge Drinkers Aged 18- to 64-Years in US, 2008

Using data from the 2008 Behavioral Risk Factor Surveillance System on 281,303 adults aged 18–64 years in the United States, we examined the relationship between HIV risk behaviors and binge drinking of alcoholic beverages and the frequency of binge drinking among a subgroup of 41,073 respondents who were acknowledged binge drinkers (bingers), based on reported drinking behavior in the year preceding survey. Our findings show that the weighted prevalence of HIV risk behaviors (including injection drug use, exchange of sex for money/drugs, and anal sex without a condom) among binge bingers [7.0%, 95% confidence interval (95% CI): 6.4–7.6%] is twice that among nonbingers (2.9%, 95% CI: 2.7–3.0%). The highest prevalence of HIV risk behaviors is among the bingers aged 18–20 years (14%, 95% CI: 11.2–18.2%). After adjusting for covariates, bingers are 1.77 (95% CI: 1.58–2.00) times more likely than nonbingers to report HIV risk behaviors. Risk increases in bingers with the number of episodes. Compared with bingers reporting 1–2 binge episodes in the month proceeding survey, the adjusted odds of reporting HIV risk behaviors among bingers are 1.27 (1.08–1.49), 1.68 (1.35–2.10), 1.67 (1.08–2.57), and 1.70 (1.34–2.16), respectively for bingers with 3–4, 5–6, 7–8, and ≥9 episodes in the same period. Our results suggest that HIV risk behaviors are strongly linked with binge drinking and its frequency. Effective measures to prevent binge drinking are essential to HIV prevention, especially among youth aged 18–20 years.     

Implementation of brief alcohol interventions by nurses in primary care: do non-clinical factors influence practice?

BACKGROUND: In the UK, GPs and practice nurses selectively provide brief alcohol interventions to risk drinkers. GPs' provision of a brief alcohol intervention can be predicted by patient characteristics, practitioner characteristics and structural factors such as the features of the practice and how it is organized. However, much less is known about possible modifiers of nurse practice. OBJECTIVE: Our aim was to investigate if patient characteristics, nurse characteristics and practice factors influence provision of a brief alcohol intervention by practice nurses in primary health care. METHODS: One hundred and twenty-eight practice nurses who had implemented a brief alcohol intervention programme in a previous trial based in the North of England were requested to screen adults presenting to their surgery and follow a structured protocol to give a brief intervention (5 min of advice plus an information booklet) to all 'risk' drinkers. Anonymized carbon copies of 5541 completed Alcohol Use Disorders Identification Test (AUDIT) screening questionnaires were collected after a 3-month implementation period and analysed by logistic regression analysis. RESULTS: Although AUDIT identified 1500 'risk' drinkers, only 926 (62%) received a brief intervention. Logistic regression modelling showed that patients' risk status as measured by AUDIT score was the most influential predictor of a brief intervention by practice nurses. However, risk drinkers who were most likely to receive a brief intervention were male. Patients' age or social class did not independently predict a brief intervention. The multilevel model was unable to identify any independent nurse characteristics that could predict a brief intervention, but indicated significant variation between nurses in their tendency to offer the intervention to patients. No structural factors were found to be positively associated with selective provision. CONCLUSIONS: Patient and nurse factors contributed to the selective provision of a brief intervention in primary care. If patients are to experience the beneficial effects of a brief alcohol intervention, then there is a need to improve the accuracy of delivery.     

Average Volume of Alcohol Consumed,Drinking Patterns,and Metabolic Syndrome in Older Korean Adults

Background

Controversial results have been reported on the relationship between alcohol intake and metabolic syndrome (MetS). We examined the association of average volume of alcohol consumed and drinking patterns with MetS and its components.

Methods

This study was conducted as a baseline survey for the Dong-gu Study of adults aged 50 years or older. Drinking patterns were assessed using a structured interview, and average volume of alcohol consumed was calculated. MetS was defined according to the updated version of the National Cholesterol Education Program.

Results

Compared with individuals who never drank, the adjusted odds ratio (OR) for the prevalence of MetS was significantly higher in men who consumed 2.1 to 4.0 drinks/day (OR, 1.53; 95% CI, 1.17–2.00) and greater than 4.0 drinks/day (OR, 1.63; 95% CI, 1.23–2.14), whereas no significant association was observed in women. Significant dose-response relationships between average volume of alcohol consumed and all metabolic components were observed in men. A usual quantity of 5 to 6 drinks/drinking day (OR, 1.57; 95% CI, 1.19–2.09), 7 or more drinks/drinking day (OR, 1.88; 95% CI, 1.45–2.44), and binge drinking on at least 1 occasion/week (OR, 1.33; 95% CI, 1.01–1.76) were associated with a significantly higher OR for prevalence of MetS in men; however, none of these drinking patterns were associated with MetS in women.

Conclusions

Unhealthy drinking patterns such as high usual quantity and binge drinking were significantly associated with MetS, suggesting that the effect of alcohol consumption on MetS should be considered in the context of drinking pattern, particularly in men.Key words: metabolic syndrome, alcohol consumption, cross-sectional study     

Web-based screening and brief intervention for the spectrum of alcohol problems

CONTEXT: Many persons who drink excessively remain unidentified and do not receive interventions. Screening and intervention using the World Wide Web could make such services more accessible and therefore more widely used. OBJECTIVE: To evaluate the use of a novel alcohol screening and brief intervention Web site. DESIGN: A Web site was developed, posted, and its use was evaluated. We analyzed a sample of visitors who completed alcohol screening over a 14-month period to describe their alcohol use, and their use of portions of the Web site that provide information and referral resources. SETTING: The Internet. PATIENTS OR OTHER PARTICIPANTS: Web site visitors, with a focus on visitors who completed an alcohol-screening questionnaire about their own drinking. INTERVENTION: Brief intervention via the Web site, consisting mainly of feedback, advice, and a menu of change options and referral information. MAIN OUTCOME MEASURES: Self-reported drinking amounts and alcohol screening test scores, and utilization of Web site components. RESULTS: Visitors completed online alcohol screening questionnaires at a rate of 50,711/year of 115,925 visitors/year. In a 14-month period, 39,842 adults completed the questionnaire about their own drinking habits; 66% were men, 90% reported drinking hazardous amounts (per occasion or typical weekly amounts), 88% reported binge (per occasion) drinking, and 55% reported typically exceeding weekly risky drinking limits. Most (65%) had alcohol screening test results (AUDIT > or = 8) consistent with alcohol abuse or dependence; similar proportions of women and men were hazardous drinkers. One-fifth of visitors visited portions of the Web site that provided additional information about alcohol use and referrals. Visitors with possible alcohol abuse or dependence were more likely than those without these disorders to visit a part of the Web site designed for those seeking additional help (33% vs. 8%, P < 0.0001). CONCLUSIONS: A well-publicized, easily accessible, research-based screening and intervention Web site can attract many users, most of whom are drinking excessively, and many of whom avail themselves of referral information after receiving individualized feedback.     

Patterns of alcohol drinking in a population of young social drinkers: a comparison of questionnaire and diary measures

Studies of alcohol use often depend on self-reported alcohol intake measured by quantity/frequency questionnaires. Previous research has shown that alcohol consumption may be underestimated by this type of retrospective questionnaire. The primary aim of this study was to compare the accuracy of an Alcohol Use Questionnaire (AUQ) with a 4-week diary account. A further aim was to explore patterns of drinking in young social drinkers, with particular attention to binge drinking, which has been suggested as a factor in increasing the risk of alcohol dependency. University students completed the AUQ in the laboratory. They were then asked to keep a record of their alcohol, nicotine and caffeine consumption over a 4-week period (diary). The questionnaire and the diaries were compared on factors of alcohol intake (units per week) and patterns of drinking behaviour (speed of drinking, number of times being drunk and percentage of times getting drunk when drinking). The two measures (AUQ and diary) were highly correlated on alcohol consumption and the other questions relating to drinking behaviour. However, differences were found between the two measures on alcohol intake, speed of drinking (drinks per hour) and number of times being drunk. Alcohol consumption was underestimated by approximately 12% on the questionnaire, and, when the accuracy of estimation of drinking habits was examined, it was found that high drinkers tended to underestimate their drinking behaviour, whereas lower drinkers tended to overestimate. The results suggest that the AUQ can be used with a reasonable degree of confidence, bearing in mind the tendency for high drinkers to underestimate consumption and drinking behaviour. Relationships between 'binge scores', beverage specificity and alcohol consumption support the idea that the criteria for binge drinkers should be based on patterns of drinking rather than alcohol consumption.