Alcohol consumption, diet, coronary risk factors, and prevalent coronary heart disease in men and women in the Scottish heart health study.

STUDY OBJECTIVE--To measure the relationship between reported alcohol consumption and prevalent diagnosed and undiagnosed coronary heart disease (CHD) in men and women to see how much could be explained by covariation with diet, lifestyle, and biomedical factors. DESIGN AND SETTING--This was a cross sectional, random population survey covering 22 districts of Scotland and using general practitioner patient lists as the sampling frame. Odds ratios for prevalent CHD at different levels of alcohol consumption taken from a seven day recall were analysed. These ratios were then adjusted for lifestyle and biomedical factors. PARTICIPANTS--Male and female responders aged 40-59 years who completed the survey questionnaire and attended the survey clinic. MAIN RESULTS--The participation rate of those invited was 74%. Of the 10,359 responders, 658 were excluded because of missing alcohol data or ambiguous cardiovascular status. The questionnaire was used to designate 7058 drinkers and 2643 non-drinkers, who were then classified as having diagnosed or undiagnosed CHD, or who were controls. The prevalence of diagnosed CHD decreased with increasing alcohol consumption while undiagnosed CHD had a "U" shaped relationship. Patterns were similar in men and women if allowance was made for the lower alcohol consumption in women. Adjustment for several diet and lifestyle factors and for additional biomedical factors reduced the apparent protective effect of alcohol, leaving a modest but statistically insignificant (p > 0.05) reduction in CHD prevalence among light to moderate consumers compared with those who drank no alcohol. Wine drinkers seemed to be at lower risk than beer drinkers in both sexes. CONCLUSIONS--These results tend to confirm that intermediate alcohol consumption is a component and contributor to a low coronary risk lifestyle. Its effects are largely explained by adjusting for both confounding lifestyle associations and for biomedical effects but the remaining effect, and the lower risk with wine drinking compared with beer, are intriguing. Advice on alcohol habits should not be determined solely by the moderate apparent benefit to risk of CHD, however, as other disease risks cannot be ignored.     

Preference for wine is associated with lower hip fracture incidence in post-menopausal women

Background

Past studies of relationships between alcohol and hip fracture have generally focused on total alcohol consumed and not type of alcohol. Different types of alcohol consist of varying components which may affect risk of hip fracture differentially. This study seeks to examine the relationship between alcohol consumption, with a focus on type of alcohol consumed (e.g. beer, wine, or hard liquor) and hip fracture risk in post-menopausal women.

Methods

The longitudinal cohort consisted of U.S. post-menopausal women aged 50–79 years enrolled between 1993–1998 in the Women’s Health Initiative Clinical Trials and Observational Study (N=115,655).

Results

Women were categorized as non-drinkers, past drinkers, infrequent drinkers and drinkers by preference of alcohol type (i.e. those who preferred wine, beer, hard liquor, or who had no strong preference). Mean alcohol consumption among current drinkers was 3.3 servings per week; this was similar among those who preferred wine, beer and liquor. After adjustment for potential confounders, alcohol preference was strongly correlated with hip fracture risk (p = 0.0167); in particular, women who preferred wine were at lower risk than non-drinkers (OR=0.78; 95% CI 0.64-0.95), past drinkers (OR=0.85; 95% CI 0.72-1.00), infrequent drinkers (OR=0.73; 95% CI 0.61-0.88), hard liquor drinkers (OR=0.87; 95% CI 0.71-1.06), beer drinkers (OR=0.72; 95% CI 0.55-0.95) and those with no strong preference (OR=0.89; 95% CI 0.89; 95% CI 0.73-1.10).

Conclusions

Preference of alcohol type was associated with hip fracture; women who preferentially consumed wine had a lower risk of hip fracture compared to non-drinkers, past drinkers, and those with other alcohol preferences.

     

Type of alcohol and drinking pattern in 56, 970 Danish men and women

OBJECTIVE: To describe drinking patterns among individuals who prefer drinking wine, beer or spirits. DESIGN: Cross-sectional study obtaining detailed information on intake of wine, beer and spirits and on frequency of alcohol intake. Adjustment for gender, age, smoking habits, educational attainment and body mass index. SETTING: Denmark. SUBJECTS: 27, 151 men and 29, 819 women, randomly selected from Copenhagen and Aarhus, Denmark. MAIN OUTCOME MEASURES: Drinking pattern-steady or binge drinking. RESULTS: A vast majority (71%) of both men and women preferred wine or beer. At all levels of total alcohol intake, beer drinkers were most likely to be frequent drinkers. Thus, light drinkers of beer had an odds ratio for being frequent drinkers of 1.97 (95% confidence limits 1.50-2.58) as compared to light drinkers of wine (total alcohol intake 3-30 drinks per month), while people who preferred beer had an odds ratio of 1. 29 (1.19-1.40) compared with wine drinkers in the moderate drinking category (31-134 drinks per month). There were no significant differences in total alcohol intake between individuals preferring different alcoholic beverages. CONCLUSION: If binge drinking is less healthy than steady drinking, the relation between wine intake and coronary heart disease mortality could be subject to negative confounding, since beer drinkers seem to have the most sensible drinking pattern. SPONSORSHIP: Danish Cancer Society and the Danish National Board of Health. European Journal of Clinical Nutrition (2000) 54, 174-176     

Low prevalence of the metabolic syndrome in wine drinkers--is it the alcohol beverage or the lifestyle?

OBJECTIVE: To study how the intake of alcohol and the choice of wine, beer, and spirits is related to lifestyle factors and the metabolic syndrome in 60-y-old men and women. DESIGN: Cross-sectional population based study. SETTING: Stockholm County, Sweden. SUBJECTS: Sixty-year-old men and women (n=4232). RESULTS: Moderate intake of wine (10-30 g/day) was associated with a lifestyle characterized by being married, having a university education, being employed, being Swedish-born, having a good quality of life according to economy, leisure time and health, compared with a group with low alcohol intake. The opposite characteristics were seen among the non-drinkers. Drinkers of spirits were more often smokers and also reported higher intake of sausage and fried potatoes compared with a group with low alcohol intake. In women, the metabolic syndrome was significantly more common in non-drinkers (20%), P<0.05, and less common among wine drinkers (8%), P<0.01, compared with a group with low alcohol intake. After adjustments, a significant lower odds ratio for the metabolic syndrome were seen in wine drinkers in women (OR=0.60, P<0.05). CONCLUSIONS: Compared with low alcohol drinkers, moderate wine drinkers exhibited a more favorable pattern according to both lifestyle factors and metabolic parameters. The close link between alcohol drinking behaviour and lifestyle habits illustrate the complex relationship between alcohol and health.     

Beer, wine, spirits and subjective health

STUDY OBJECTIVE: To examine the association between intake of different types of alcoholic beverages and self reported subjective health. DESIGN: Cross sectional health survey with assessment of intake of beer, wine and spirits (at last non-weekend day), smoking habits, social networks, physical activity, body mass index, educational level, presence of chronic disease, and self reported health. SETTING: WHO Copenhagen Healthy City Survey, Denmark. PARTICIPANTS: 4113 men and 7926 women aged 18 to 100 years. MAIN RESULTS: Of the 12,039 subjects, 8680 reported their health as optimal, and 3359 reported a suboptimal health. After controlling for the covariates, the relation between total alcohol intake and the proportion reporting suboptimal health was J shaped. Heavy drinkers of any of the three types of alcoholic beverages had a higher prevalence of suboptimal health than non-drinkers. However, only light (1-2 glasses of wine yesterday) and moderate (3-5) wine drinkers had significantly lower odds ratios for suboptimal health--0.72 (95% confidence limits; 0.56 to 0.92) and 0.65 (0.49 to 0.87), respectively--when compared with non-wine drinkers. Moderate beer or spirits drinkers did not differ significantly from non-drinkers of these beverages with regard to prevalence of suboptimal health. Consistently, beer preference drinkers had an odds ratio of 1.50 (1.25 to 1.80) for suboptimal health compared with wine preference drinkers. CONCLUSIONS: A light to moderate wine intake is related to good self perceived health, whereas this is not the case for beer and spirits. The causal relations creating this association are unknown and should be considered when interpreting the relation between different types of alcoholic beverages and subsequent morbidity and mortality.     

Relationship of alcoholic beverage consumption to food habits in a Mediterranean population

PURPOSE: Wine consumption has been related to a reduced cardiovascular risk. This effect has been attributed partly to the healthier diet of wine drinkers. We compared food habits according to alcoholic beverage preference in a Mediterranean population. DESIGN: A cross-sectional study of a large sample of participants at high risk for cardiovascular disease. SETTING: Primary care centers in a Mediterranean country, Spain. PARTICIPANTS: A total of 1675 men aged 55 to 80 years old and 2150 women aged 60 to 80 years old who had no documented cardiovascular disease but had either diabetes or at least three major cardiovascular risk factors. MEASURES: A food frequency questionnaire, alcoholic beverage consumption, adherence to Mediterranean diet, age, family history of cardiovascular disease, smoking, body mass index, diabetes, dyslipidemia, and educational level were measured. ANALYSIS: We analyzed differences in food consumption according to the type of alcoholic beverage preferentially consumed and adjusted the estimates for age, body mass index, cholesterol level, and total energy intake. RESULTS: We found no substantial differences in adherence to the Mediterranean diet according to the main type of alcoholic beverage consumed, and we found no evidence that Mediterranean wine drinkers at high cardiovascular risk have a healthier diet than other drinkers. However, a better dietary pattern was found among nondrinkers than among drinkers. CONCLUSION: This large, Mediterranean study does not support an association between wine consumption and healthier dietary habits.     

Effect of lifestyle factors on plasma total homocysteine concentrations in relation to MTHFR(C677T) genotype. Inter99 (7)

OBJECTIVE: To examine the associations between various lifestyle factors--smoking habits, physical activity, dietary habits, coffee, tea, and alcohol consumption--and homocysteine (tHcy) in relation to MTHFR(C677T) genotype. DESIGN: Cross-sectional population-based study. SETTING: Residents of Copenhagen County, Denmark. SUBJECTS: A random sample of 6457 men and women aged 30-60 years drawn from the Civil Registration System and invited to a health examination in 1999-2001. A total of 2788 participants were included in the statistical analysis. MAIN OUTCOME MEASURES: tHcy was measured using a Fluorescent Polarization Immuno Assay. MTHFR-genotype was determined by PCR and RFLP analysis. Information about lifestyle factors was obtained from a self-administered questionnaire. RESULTS: Daily smoking, less healthy dietary habits, and coffee drinking were associated with elevated tHcy concentrations independent of other determinants. Wine consumption was related to tHcy in a J-shaped manner, whereas beer consumption was negatively associated with tHcy after multiple adjustments. Interaction was observed between smoking status and MTHFR-genotype, smoking status and sex, and beer consumption and age. The effect of smoking was more pronounced in persons with the TT genotype and in women. The effect of beer consumption was more pronounced at younger than at older ages. CONCLUSIONS: Smoking status, dietary habits, coffee intake, wine, and beer consumption were major lifestyle determinants of tHcy. Changes in these lifestyle factors may reduce tHcy concentrations, thereby lowering cardiovascular risk in the general population. SPONSORSHIP: Danish Medical Research Council, Danish Centre for Evaluation and Health Technology Assessment, and Danish Heart Foundation.     

'I drink spirits to get drunk and block out my problems...' beverage preference, drinking motives and alcohol use in adolescence

Aims: To investigate among adolescents whether (i) drinkingmotives are related to beverage preference; (ii) beverage preferenceis related to alcohol use (drinking levels and risky drinkingoccasions); (iii) the association between beverage preferenceand alcohol use is moderated or mediated by drinking motives.Method: Data from a national representative sample of 5379 8th–10thgraders in Switzerland (mean age 15.1, SD = 0.95) were analysedusing multiple regression analyses. Beverage preference wasbased on the proportion of a specific beverage in the totalamount of drinks consumed at the last drinking occasion. Drinkingmotives were assessed by the drinking motive questionnaire revised(DMQ-R). Results: A significant positive association was foundbetween enhancement motives and a preference for beer and spirits;the association was negative with regard to a preference forwine and alcopops. Conformity motives were positively relatedto a wine preference but negatively to a beer preference. Onlya preference for beer and spirits was significantly associatedwith alcohol use in models that exclude motives. However, theassociation between beer preference and adolescent alcohol usewas mediated by drinking motives. A preference for alcopopsand spirits was moderated by motives: social drinkers who preferredalcopops drank less than those who did not prefer alcopops.Coping drinkers who preferred spirits drank more than thosewho preferred other alcoholic drinks. Conclusions: Drinkingmotives are potential explanatory factors for the associationbetween beverage preference and alcohol use. Prevention approachesshould target coping motives, particularly for adolescents whoshow a preference for spirits.     

Traits of persons who drink decaffeinated coffee

PURPOSE: Little is known about the traits of decaffeinated coffee drinkers, who are sometimes used to ascertain whether the health effects of coffee intake are due to caffeine or some other coffee ingredient. METHODS: We studied these traits in 12,467 persons who reported type of coffee consumed at health examinations; 36% drank caffeinated only, 13% drank decaffeinated only, 27% drank both types and 24% drank no coffee. RESULTS: Odds ratios estimated from logistic regression analyses revealed that compared with regular (caffeinated) coffee drinkers or abstainers, decaffeinated coffee drinkers were less likely to be heavy coffee drinkers, smokers, alcohol drinkers, users of caffeinated soft drinks and medication and to be free of illness. Increased decaffeinated coffee drinking was associated with older age, female sex, African American ethnicity, use of special diets and cardiovascular, gastrointestinal, or neuropsychiatric symptoms. Persons on special diets were more likely to drink decaffeinated coffee whether they had heart disease or were free of any illness. CONCLUSION: These data suggest that decaffeinated coffee use is related to illness in some persons but to a healthy lifestyle in others. These potential and possibly conflicting confounding factors need to be considered when studying the health effects of coffee or caffeine.     

Selected diet and lifestyle factors are associated with estrogen metabolites in a multiracial/ethnic population of women

Diet and lifestyle factors, body size, and smoking behavior may influence estrogen metabolism, but the nature of these relations may vary according to race/ethnic groups. We evaluated the association of lifestyle factors with estrogen metabolites 2-hydroxyestrone (2-OHE1) and 16alpha-hydroxyestrone (16alpha-OHE1) in a racially diverse population. With a cross-sectional study design, urine samples from 1881 African-American, Caucasian, Chinese, Japanese, and Hispanic women, aged 42-52 y, from the Study of Women's Health Across the Nation (SWAN) were assayed by EIA for 2-OHE1 and 16alpha-OHE1. Dietary factors and beverages were measured using a modified Block FFQ. Dietary fiber, vegetable and fruit servings, Brassica vegetables, polyphenols, coffee, caffeine, green and black tea, and total alcohol and wine were related to metabolite values using multiple variable regression analyses. In adjusted analyses, 2-OHE1 concentrations were significantly associated with race/ethnicity, weight, smoking, and consumption of hydroxybenzoic acid, anthocyanidins, wine, and caffeine (P < 0.05). Regression models incorporating these variables explained 19-20% of the variation in 2-OHE1 concentrations. Regression models for 16alpha-OHE1, which explained 16-17% of the variability, included race/ethnicity, smoking, caffeine, total dietary fiber, and fiber from fruits and vegetables as variables. These associations may reflect why increased consumption of polyphenol-containing foods and fruit as well as decreased smoking, caffeine intake, and body size would be consistent with hypothesized benefits and risks for selected health outcomes.     

Alcoholic beverage preference and risk of becoming a heavy drinker

BACKGROUND: Studies have suggested that wine drinkers are at lower risk of death than beer or spirits drinkers. The aim of this study is to examine whether the risk of becoming a heavy or excessive drinker differs among individuals who prefer different types of alcoholic beverages. METHODS: In a longitudinal study of 10,330 moderate drinkers from Copenhagen, Denmark, we used logistic regression analyses to address the risk of becoming a heavy or excessive drinker (above 14 and 21 drinks per week, respectively, for women and above 21 and 35 drinks per week for men) according to preference of wine, beer, or spirits. RESULTS: Compared with those who preferred wine, those who preferred beer tended to have increased risk of becoming heavy and excessive drinkers. Women who preferred beer had odds ratios of 1.14 (95% CI = 0.87-1.50) for becoming heavy drinkers and 1.50 (95% CI = 0.93-2.43) for becoming excessive drinkers. For men who preferred beer the ORs were 1.16 (95% CI = 0.84-1.58) and 1.81 (95% CI = 0.85-3.82). CONCLUSION: The finding that moderate wine drinkers appear to be at lower risk of becoming heavy and excessive drinkers may add to the explanation of the reported beverage-specific differences in morbidity and mortality.     

The effect of 'standard drink' labelling on the ability of drinkers to pour a 'standard drink'

Australia's National Health Policy on Alcohol has recommended that beverage containers be labelled so that alcohol content is 'readily understandable by the public'. Health promotion to increase the responsible use of alcohol now relies extensively on the concept of a standard drink--usually defined as 10 g of ethyl alcohol. Numerous difficulties confront a drinker who wishes to apply the standard drink system to monitor alcohol intake. This report describes a series of experimental tests of the proposal that these difficulties are minimised if alcohol containers have their alcohol content indicated in terms of standard drinks in addition to the usual percentage alcohol by volume method. Subjects were drinkers recruited from a Perth shopping mall and were tested only on beverage types they had consumed within the previous week. They were required to pour what they judged to be a single standard drink from a 750 ml bottle of either wine or beer. Beer drinkers achieved greater accuracy in this task when the bottles had standard drink labels, even when the glass size and beverage strength were varied. Wine drinkers had equal difficulty with this task whether standard drink or percentage labels were used. The addition of a 'ladder' up the side of a wine bottle with graduations in standard drinks would be necessary for wine drinkers to achieve a high level of accuracy. We conclude that labelling drink containers with their alcohol content in terms of standard drinks would better equip all drinkers to follow the advice of health educators.     

Alcohol consumption, abstaining, health utility, and quality of life--a general population survey in Finland

AIMS: To examine the associations between alcohol consumption and utility-based health-related quality of life (HRQoL), subjective quality of life (QoL), self-rated health (SRH), and mental distress. METHODS: Representative general population survey in Finland, with 5871 persons aged 30-64 years. HRQoL was measured with two health utility instruments (15D and EQ-5D), QoL and SRH were measured with RATING scales, and mental distress with a General Health Questionnaire (GHQ-12). Past alcohol problems were diagnosed with a structured psychiatric interview known as the composite international diagnostic interview (CIDI). Alcohol consumption was examined with a self-report questionnaire. RESULTS: Negative associations between alcohol and well-being were observed on several measures for women consuming more than 173 g and men more than 229 g per week. Former drinkers scored worst on most measures, even in comparison to the highest drinking decile. For men, all statistically significant associations between moderate drinking and well-being disappeared when sociodemographic factors and former drinkers were controlled for. For women, moderate alcohol use associated with better SRH and EQ-5D as compared to abstainers. However, the possible health utility benefits associated with moderate alcohol consumption were of clinically insignificant magnitude. CONCLUSIONS: Failure to separate former drinkers and other abstainers produces a significant bias favoring moderate drinkers. As the possible health utility benefits of moderate alcohol use were clinically insignificant, it suffices to investigate mortality, when estimating the public health impact of moderate alcohol consumption using quality-adjusted life years.     

Alcohol consumption and Mediterranean Diet adherence among health science students in Spain: the DiSA-UMH Study

ObjectiveTo describe the association between consumption of different alcoholic beverages and adherence to the Mediterranean diet.MethodsA cross-sectional analysis was conducted of the baseline data of the DiSA-UMH study, an ongoing cohort study with Spanish health science students (n = 1098) aged 17-35 years. Dietary information was collected by a validated 84-item food frequency questionnaire. Participants were grouped into non-drinkers, exclusive beer and/or wine drinkers and drinkers of all types of alcoholic beverages. Mediterranean diet adherence was determined by using a modification of the relative Mediterranean Diet Score (rMED; score range: 0-16) according to consumption of 8 dietary components. We performed multiple linear and multinomial regression analyses.ResultsThe mean alcohol consumption was 4.3 g/day (SD: 6.1). A total of 19.5%, 18.9% and 61.6% of the participants were non-drinkers, exclusive beer and/or wine drinkers and drinkers of all types of alcoholic beverages, respectively. Participants who consumed beer and/or wine exclusively had higher rMED scores than non-drinkers (β: 0.76, 95%CI: 0.25-1.27). Drinkers of all types of alcoholic beverages had similar rMED scores to non-drinkers. Non-drinkers consumed less fish and more meat, whereas drinkers of all types of alcoholic beverages consumed fewer fruits, vegetables and more meat than exclusive beer and/or wine drinkers.ConclusionsThe overall alcohol consumption among the students in our study was low-to-moderate. Exclusive beer and/or wine drinkers differed regarding the Mediterranean diet pattern from non-drinkers and drinkers of all types of alcohol. These results show the need to properly adjust for diet in studies of the effects of alcohol consumption.     

The effect of ‘standard drink’ labelling on the ability of drinkers to pour a ‘standard drink’

Abstract: Australia's National Health Policy on Alcohol has recommended that beverage containers be labelled so that alcohol content is ‘readily understandable by the public’. Health promotion to increase the responsible use of alcohol now relies extensively on the concept of a standard drink—usually defined as 10 g of ethyl alcohol. Numerous difficulties confront a drinker who wishes to apply the standard drink system to monitor alcohol intake. This report describes a series of experimental tests of the proposal that these difficulties are minimised if alcohol containers have their alcohol content indicated in terms of standard drinks in addition to the usual percentage alcohol by volume method. Subjects were drinkers recruited from a Perth shopping mall and were tested only on beverage types they had consumed within the previous week. They were required to pour what they judged to be a single standard drink from a 750 ml bottle of either wine or beer. Beer drinkers achieved greater accuracy in this task when the bottles had standard drink labels, even when the glass size and beverage strength were varied. Wine drinkers had equal difficulty with this task whether standard drink or percentage labels were used. The addition of a ‘ladder’ up the side of a wine bottle with graduations in standard drinks would be necessary for wine drinkers to achieve a high level of accuracy. We conclude that labelling drink containers with their alcohol content in terms of standard drinks would better equip all drinkers to follow the advice of health educators.     

Clustering of lifestyle behaviors: the relationship between cigarette smoking, alcohol consumption, and dietary intake

PURPOSE: To examine relationships between cigarette smoking, alcohol use, and dietary intake. DESIGN: Respondents to the U.S. Department of Agriculture's Continuing Survey of Food Intakes by Individuals, a nationwide probability sample conducted from January 1994 through January 1997 (n = 23,602; response rate = 80%), were selected. Adults ages 19 years and older were grouped according to their smoking and drinking habits. Selected demographic variables, food group servings, food energy, and densities of selected nutrients were compared. SETTING: In-home interviews were conducted in the 50 states and the District of Columbia. SUBJECTS: The selected sample (n = 6745) included 3229 nonsmokers, 1701 former smokers, and 1808 current smokers, and 2284 abstainers, 2713 occasional drinkers, 1000 moderate drinkers, and 748 liberal drinkers. MEASURES: Responses to standard questionnaires were examined by Student's t-test, chi 2, one-way analysis of variance, and univariate and multivariate analyses of covariance. RESULTS: Men were more likely than women to be current smokers and liberal drinkers (64% vs. 40% and 62% vs. 38%). For both, the use of cigarettes and alcohol was closely related. An additive relationship was observed between smoking/drinking classification and lower food group servings and nutrient intakes. Although cigarette and alcohol use may have been underreported, these findings support previous ones showing poor food choices along with lower nutrient intakes as smoking and drinking increase. CONCLUSIONS: Smoking and drinking habits may alter individuals' food selections and nutrient intakes. Future interventions for health promotion may achieve greater success by targeting multiple risk factors simultaneously or sequentially.     

Does food group consumption vary by differences in socioeconomic, demographic, and lifestyle factors in young adults? The Bogalusa Heart Study

OBJECTIVE: To examine if food group consumption varies by differences in socioeconomic, demographic, and lifestyle factors in young adults from a semirural setting in Louisiana. DESIGN: Cross-sectional. SUBJECTS: Young adults (n=1,266, 74% European American, 26% African American; 39% men, 61% women) aged 20 to 38 years, enrolled in the Bogalusa Heart Study. MEASURES: Food group consumption was assessed by a food frequency questionnaire. Socioeconomic (eg, income and education), demographic (eg, age, sex, and ethnicity), and lifestyle (eg, marital status and physical activity) information was obtained by a self-administered questionnaire and the subjects were stratified according to these groups. STATISTICAL ANALYSES: Analysis of covariance (adjusted for covariates) was used to detect differences in the mean servings of food groups consumed per day between the various socioeconomic, demographic, and lifestyle groups. RESULTS: Compared to income$45,000 had lower consumption of burgers/sandwiches (P<0.05) and those with income levels from $30,001 to $45,000 had lower consumption of mixed dishes (P<0.05). Intake of cereals/breads (P<0.05), dairy products (P<0.01), fruits/100% fruit juices (P<0.001), and vegetables (P<0.001) was higher in subjects with >12 years of education. European-American men consumed more servings of dairy products (P<0.05) and sweetened beverages (P<0.05) than African-American men. European-American women consumed more servings of dairy products (P<0.05), vegetables (P<0.05), and fats (P<0.05) than African-American women. African Americans (men and women) consumed more servings of fruits/100% fruit juices (P<0.0001) than European Americans (men and women), respectively. Married individuals consumed more servings of snacks/desserts (P<0.05), but fewer servings of alcoholic beverages (P<0.0001) than those who were unmarried. Active individuals consumed more servings of fruits/100% fruit juices (P<0.05) and fewer servings of burgers/sandwiches (P<0.05) than inactive individuals. CONCLUSIONS: These findings suggest that food group consumption varies by socioeconomic, demographic, and lifestyle factors in young adults from a semirural setting. Food and nutrition professionals who encounter diverse populations need to consider the influence of income, education, sex, ethnicity, marital status, and physical activity on food consumption patterns when planning diets, nutrition education programs, and interventions for young adults.     

Dietary habits of smokers, people who never smoked, and exsmokers

A large database on hospital patients with illnesses not related to tobacco or alcohol was used to investigate the dietary habits of males and females who never smoked, who were exsmokers, and who currently smoked. Smoking was positively related to meat consumption and negatively related to cereal consumption in males. Both male and female smokers consumed fewer vegetables and fruits but more alcohol and coffee than did people who never smoked. Exsmokers' diets were similar to those of people who never smoked. These results emphasize the importance of ruling out potential confounders or effect modifiers when studying the role of meat, milk, fruits, vegetables, cereal, coffee, or alcohol intake in the etiology of tobacco-related diseases.     

Healthy Eating Index scores among adults, 60 years of age and over, by sociodemographic and health characteristics: United States, 1999-2002

OBJECTIVE: This report presents Healthy Eating Index (HEI) scores for adults, 60 years of age and over, from the National Health and Nutrition Examination Survey (NHANES), 1999-2002, and examines the association between the HEI scores and sex, age, race and ethnicity, education, smoking status, tooth retention, self-reported health, and body mass index (BMI). METHODS: The percentage of older adults meeting the recommendations for the HEI components and dietary quality based on the overall score were estimated. Means and standard errors were calculated for selected sociodemographic and health characteristics for the total population and stratified by sex. A two-tailed t-test or analysis of variance was used to test the effects of the sociodemographic and health characteristics on the HEI scores. When a characteristic consisted of three levels, the Bonferroni method of adjustment was used to assess significant differences in the mean scores. RESULTS: Seventy-two percent of older adults met the guidelines for cholesterol intake and 56% met the recommendation for diet variety, but less than one-third met the recommendations for HEI's five food groups. Only 17% of older adults consumed a "good" quality diet. Males had higher scores for some components, but females had higher scores for others. Age significantly influenced several HEI components, but not in a consistent fashion. Non-Hispanic white persons usually had the highest scores and non-Hispanic black persons had the lowest scores. Adults with more years of education usually had higher scores but smokers usually had lower scores. Edentulous persons and those who rated their health as fair or poor generally ate fewer servings of fruits and vegetables, ate a less varied diet, and had a poorer quality diet than persons with teeth or who rated their health higher. Females with a BMI of 30 or higher ate fewer servings of dairy products, consumed a higher percentage of calories from total and saturated fat, and had a lower quality diet than those whose BMI was less than 30. CONCLUSIONS: This research demonstrates that many older adults' diets need improvement, and that many sociodemographic and health characteristics were associated with their intake of food and nutrient groups and overall dietary quality.     

Wine drinking and diet in Italy

OBJECTIVE: To investigate the relation between wine drinking and intake of selected indicator foods, which may vary in various populations. DESIGN: Cross-sectional analysis of the comparison group of a case- control study. SETTING: A network of teaching and general hospitals from six Italian areas. SUBJECTS: 5642 control subjects (3261 females and 2381 males) aged 20-74 y (median age 58 y), admitted for acute, non-neoplastic conditions unrelated to alcohol consumption. Participation rate was over 95%. INTERVENTION: Trained interviewers collected information using a structured and validated questionnaire. The average intakes of selected food items were computed, together with the multivariate odds ratios (OR) of eating above the median of each food. RESULTS: No appreciable difference in either sex for any food indicator considered (fruit, raw vegetables, cooked vegetables, salad and fish) was observed between abstainers, wine, and other alcoholic beverage drinkers. If anything, female wine drinkers reported less frequently high consumption of salad (OR=0.8) and raw vegetables (OR=0.8), both estimates being of borderline significance. CONCLUSIONS: In no instance did wine drinkers or mixed drinkers (who include a large proportion of wine drinkers, too) show an association with indicators of healthy diet. SPONSORSHIP: Italian Association for Cancer Research, Milan, Italy. European Journal of Clinical Nutrition (2000) 54, 177-179