Consumption of alcoholic beverages and subjective health in Spain

STUDY OBJECTIVE: To examine the relation between alcohol and main alcoholic beverage consumption and subjective health in Spain. DESIGN: Logistic regression analysis using a cross sectional survey based on self reported data on alcohol and alcoholic beverage consumption, subjective health and the principal confounding factors (age, sex, civil status, educational level, job status, social support, region of residence, size of town or city, tobacco consumption, physical activity during leisure time and work hours, and chronic disease). SETTING: The 1993 Spanish National Health Survey. PARTICIPANTS: A 19 573 person sample, representative of the non-institutionalised Spanish population aged 16 years and over. MAIN RESULTS: Among Spaniards, 31.4% reported their health as suboptimal (fair, poor or very poor) and 56.9% consumed alcohol regularly, with the majority having a preference for wine. Light (1-2 drinks per day) or moderate consumption (3-4 drinks per day) was the most frequent pattern. After adjusting for confounding factors, a negative dose-response relation was observed between consumption of total alcohol, wine and beer, and prevalence of suboptimal health (linear trend: p<0.001 for total alcohol, p=0.023 for wine, and p=0.030 for beer). In contrast, for consumption of spirits the prevalence of ill health in moderate drinkers was lower than in non-drinkers, with no clear relation at higher consumption. While persons reporting a preference for wine had a lower frequency of suboptimal health than did abstainers, they showed no difference in frequency of subjective ill health with respect to persons with preference for other types of drink or no preference whatsoever. CONCLUSIONS: The higher the consumption of total alcohol, wine and beer, the lower the prevalence of suboptimal health. These results differ from those obtained in several Nordic countries, where a "J shaped" relation has been observed for total alcohol and wine, and suggest that the relation between alcohol consumption and subjective health may be different in Mediterranean countries.     

Alcohol use and the risk of prostate cancer: results from the VITAL cohort study

An association between alcohol consumption and prostate cancer risk remains uncertain. Although some studies have found that heavy alcohol consumption is associated with increased risk, a recent study reported that red wine consumption is associated with reduced risk. We examined the association between alcohol use and prostate cancer among 34,565 men, 50-76 yr old, in the Vitamins and Lifestyle (VITAL) cohort in Washington State. Alcohol consumption was ascertained by baseline questionnaire between October 2000 and December 2002. Incident prostate cancers (n = 816) as of December 31, 2004, were identified through the Surveillance, Epidemiology, and End Results cancer registry. Men who consumed more than one drink per month had a small increased risk of prostate cancer (hazard ratio, HR = 1.20; 95% confidence interval, CI = 1.02-1.40) compared with men who drank no alcohol or less than one drink per month. White wine consumption was associated with increased risk (HR for any vs. no white wine consumption = 1.27; CI = 1.08-1.49). Red wine, liquor, and beer were not associated with prostate cancer nor was total alcohol consumed at ages 18, 30, and 45. Associations of alcohol use with prostate cancer are modest and complex. More detailed assessment of specific alcoholic beverages is warranted in future studies.     

Alcohol consumption and risk of prostate cancer: The Harvard Alumni Health Study

BACKGROUND: Although many studies suggest that consumption of alcohol increases the risk of several site-specific cancers, the evidence remains unclear for prostate cancer. Few data exist on beverage-specific associations as well as lifetime patterns of alcohol consumption and prostate cancer risk. METHODS: We prospectively followed 7612 Harvard alumni (mean age 66.6 years) from 1988 through 1993, during which 366 cases of incident prostate cancer occurred. Self-reported alcohol consumption was assessed at baseline from wine, beer, and liquor intake. Previous assessments during college and in 1977 were also available. RESULTS: Overall, the mean total alcohol consumption in 1988 was 123.1 g/week, of which 28.6% was from wine, 15.8% from beer, and 55.6% from liquor. Compared to men reporting almost never drinking alcohol in 1988, the multivariate relative risks (95% CI) for 1 drink/month to < 3 drinks/week, 3 drinks/week to < 1 drink/ day, 1 to < 3 drinks/day, and > or = 3 drinks/day were 1.33 (0.88-2.01), 1.65 (1.12-2.44), 1.85 (1.29-2.64), and 1.33 (0.86-2.05), respectively. Wine or beer consumption was unassociated with prostate cancer; however, moderate liquor consumption was associated with a significant 61-67% increased risk of prostate cancer (P, non-linear trend < 0.001). Men initiating alcohol consumption between 1977 and 1988 had a twofold increased risk of prostate cancer compared to men with almost no alcohol consumption at both times. CONCLUSIONS: In contrast to the majority of previous studies, we found a positive association between moderate alcohol consumption and the risk of prostate cancer. Liquor, but not wine or beer, consumption was positively associated with prostate cancer.     

Alcohol Consumption and Risk of Lung Cancer in the VITamins And Lifestyle Study

The effect of alcoholic beverage consumption on lung cancer risk was investigated in the VITamins And Lifestyle (VITAL) Study. The VITAL study is a prospective cohort of residents aged 50–76 yr in Washington state. Five hundred and eighty incident lung cancer cases diagnosed between study baseline (2000–2002) and 2007 were identified among 66,186 participants without previous cancer through the Washington Surveillance Epidemiology and End Result cancer registry. Multivariable Cox's regression was used to examine the effects of beer, red wine, white wine, liquor, combined alcoholic beverage intake at study baseline, and alcohol intake at age 30 and 45 on lung cancer risk, with careful adjustment for smoking. There was no clear association between lung cancer and consumption of beer, red wine, white wine, or liquor at ≥1 drink/day. Combined alcoholic beverage intake of up to ≥3 drink/day was not associated with elevated overall lung cancer risk. Heavy consumption of alcohol at study baseline and at age 45 was, however, associated with more than doubling of risk for squamous cell carcinoma (hazard ratio for ≥3 drink/day at study baseline = 2.54, 95% CI: 1.36–4.73, P value for linear trend = 0.002) but not for adenocarcinoma. Alcohol intake at age 30 was not associated with lung cancer risk.     

Alcohol consumption and risk of lung cancer in the VITamins And Lifestyle Study

The effect of alcoholic beverage consumption on lung cancer risk was investigated in the VITamins And Lifestyle (VITAL) Study. The VITAL study is a prospective cohort of residents aged 50-76 yr in Washington state. Five hundred and eighty incident lung cancer cases diagnosed between study baseline (2000-2002) and 2007 were identified among 66,186 participants without previous cancer through the Washington Surveillance Epidemiology and End Result cancer registry. Multivariable Cox's regression was used to examine the effects of beer, red wine, white wine, liquor, combined alcoholic beverage intake at study baseline, and alcohol intake at age 30 and 45 on lung cancer risk, with careful adjustment for smoking. There was no clear association between lung cancer and consumption of beer, red wine, white wine, or liquor at ≥1 drink/day. Combined alcoholic beverage intake of up to ≥3 drink/day was not associated with elevated overall lung cancer risk. Heavy consumption of alcohol at study baseline and at age 45 was, however, associated with more than doubling of risk for squamous cell carcinoma (hazard ratio for ≥3 drink/day at study baseline = 2.54, 95% CI: 1.36-4.73, P value for linear trend = 0.002) but not for adenocarcinoma. Alcohol intake at age 30 was not associated with lung cancer risk.     

A case-control study of alcoholic beverage consumption and breast cancer

In many studies, moderate alcohol consumption has been associated with increases in the risk of breast cancer of about 50-100%. The authors examined recent alcoholic beverage consumption in relation to the risk of breast cancer in a case-control study of women aged less than 70 years, conducted in Toronto, Ontario, Canada, from 1982 to 1986: 607 breast cancer cases identified in a cancer hospital were compared with 1,214 controls matched to the cases on neighborhood and decade of age. The subjects were interviewed at home. Confounding factors were controlled by conditional logistic regression. The relative risk estimates for women who consumed alcohol, relative to women who drank less than one alcoholic beverage (drink) per month, were close to 1.0: for women who drank at least one alcoholic beverage per day, the multivariate estimate was 0.9 (95% confidence interval 0.6-1.2). Among subgroups of women, including those at low baseline risk, there was also no association. For a subset of cases compared with hospital controls, once again there was no association. The relative risk (RR) estimate was elevated for women who drank at least one beer daily (RR = 1.7) and reduced for women who drank at least one glass of wine daily (RR = 0.7), but neither estimate was statistically significant. The results suggest that recent alcohol consumption does not influence the risk of breast cancer. Selection bias cannot be ruled out, however. In addition, because determinants of alcohol use are not well understood, control of confounding may have been incomplete in the present study and in other observational studies of alcohol and breast cancer.     

Patterns of alcohol consumption in the Seychelles Islands (Indian Ocean).

Self-reported drinking habits were examined in a random sample of 1067 persons aged 25-64 years in the Seychelles, a country in epidemiological transition where consumption of home-brewed, mostly unregistered beverages has been traditionally high. Alcohol consumption was calculated from respondents reporting at least one drink per week ('regular drinkers'). Among men, 51.1% were regular drinkers and had average intake of 112.1 ml alcohol a day. Among women, 5.9% were regular drinkers and had 49.7 ml alcohol a day. Frequency of drinking, but not amount per drinker, was slightly less in the 25-34-year than older-age categories. Home-brews (mostly palm toddy and fermented sugar cane juice) were consumed by 52% of regular drinkers and accounted for 54% of the total alcohol intake reported by all regular drinkers. Based on the reported consumption by regular drinkers only, the average annual alcohol consumption amounted respectively to 20.7 litres and 1.2 litres per man and woman aged 25-64 years, or, using extrapolation, 13.2 litres and 0.8 litres per man and woman respectively of the total population. These values may underestimate the true figures by half, since reported beer consumption accounted for 53% of beer sales. Socio-economic status was associated strongly and inversely with home-brew consumption, but slightly and positively with consumption of commercially marketed beverages. Alcohol intake was associated with smoking, high-density lipoprotein cholesterol, carbohydrate-deficient transferrin and blood pressure, but not with age and body mass index. In conclusion, these data show high alcohol consumption in the Seychelles with an important gender difference, a large proportion of alcohol derived from home-brews, and opposite tendencies for the relationships between socio-economic status and home-made or commercially marketed beverages.     

Wine drinking and risk of non-Hodgkin's lymphoma among men in the United States: a population-based case-control study

The relation between wine consumption and non-Hodgkin's lymphoma (NHL) was investigated using data from the Selected Cancers Study. Cases (n = 960) were men aged 32-60 years diagnosed with NHL from 1984 to 1988 and identified from eight US population-based cancer registries. Controls (n = 1,717) were men recruited by random digit dialing and frequency matched to cases by age and registry. Logistic regression was used to calculate odds ratios and 95% confidence intervals adjusted for age, registry, race/ethnicity, education, and smoking. Odds ratios for men who consumed less than one and those who consumed one or more wine drinks per day were 0.8 (95% confidence interval: 0.5, 1.3) and 0.4 (95% confidence interval: 0.2, 0.9) compared with nondrinkers, respectively (p for trend = 0.02). Among wine drinkers who consumed alcohol beverages from ages 16 years or less, odds ratios for intakes of less than one and one or more wine drinks per day were 0.4 (95% confidence interval: 0.2, 0.97) and 0.3 (95% confidence interval: 0.1, 0.8), respectively (p for trend = 0.004). No associations were evident for beer or spirits. These data show that consumption of wine, but not of beer or spirits, is associated with a reduced NHL risk.     

Consumption of different alcoholic beverages as predictors of local rates of night-time assault and acute alcohol-related morbidity

Objective: To determine whether population levels of consumption of some alcoholic beverages are more closely associated with levels of harm than others, particularly if consumption of cask wine is more strongly related to rates of acute alcohol problems than consumption of bottled wine as a consequence of the extremely low rates of federal tax levied on the former. Method: A database of alcohol consumption and related problems was established for 130 areas of Western Australia. Demographic and economic data for these areas were included from the 1991 census. Empirically derived assumptions regarding the mean wholesale price of cask and bottled wine were utilised. Regression analyses examined the extent to which the consumption of different alcoholic beverages predicted levels of major varieties of harm. Results: Only cask wine and high-strength beer consumption were significantly associated with rates of night-time assault; consumption of all beverage varieties except bottled wine was significantly associated with rates of acute alcohol-related morbidity. Further analyses, which included controls for an effect of total alcohol consumption, confirmed the pronounced contributions of cask wine and high-strength beer to rates of night assaults and acute alcohol-related morbidity. The proportion of all alcohol consumed as low-alcohol beer was significantly negatively associated with these harms. Conclusions: The beverages most associated with rates of night-time assaults and acute alcohol-related morbidity are those with the lowest federal taxation per standard drink, i.e. cask not bottled wine and regular-strength not low-alcohol beer.     

Consumption of alcohol and cardiovascular disease mortality: a 16 year follow-up of 115,592 Norwegian men and women aged 40–44 years

We tested whether teetotalism explains the upturn in cardiovascular risk for non-drinkers and whether wine is a more favorable alcohol type. We studied 115,592 men and women aged 40–44 years who participated in the age 40 program in Norway in 1994–1999 and were followed for an average of 16 years with 550 cardiovascular deaths. Self-reported number of glasses of beer, wine and spirits during 14 days was transformed to alcohol units/day. One unit is approximately 8 grams of pure alcohol. The mean and median number of alcohol units/day were 0.70 and 0.46. Teetotallers had higher risk of dying from cardiovascular disease than alcohol consumers, multivariate adjusted hazard ratio (95% CI) 1.97 (1.52–2.56). The use of alcohol-related deaths as endpoint substantiated a selection of previous alcohol users to the teetotal group. Without teetotallers there was no association between alcohol consumption and cardiovascular disease mortality. However, the multivariate adjusted hazard ratio per one unit/day of wine was 0.76 (0.58–0.99). The corresponding figures for beer and spirits were 1.04 (0.94–1.15) and 0.98 (0.75–1.29). The upturn in risk for non-drinkers could be explained by a higher risk for teetotallers who likely included previous alcohol users or teetotalers who started to drink during follow-up. Wine gave the most favorable risk estimates.     

Alcoholic beverages and adenomatous polyps of the sigmoid colon: a study of male self-defence officials in Japan

The drinking habits of 86 men with adenomatous polyps of the sigmoid colon were compared to those of 1184 men with normal colonoscopy among middle-aged male self-defence officials. After adjustment for rank, smoking history and rice consumption, total ethanol intake was positively associated with the risk of adenomatous polyps. The odds ratio (OR) was 2.4 (95% confidence interval (CI) 1.0-5.5) for men consuming at least 60 ml of ethanol per day. Among five alcoholic beverages (shochu, beer, sake, whiskey and wine), both sake and beer showed a dose-response relationship with the risk of adenomatous polyps although the association with beer was less striking. Shochu was the largest source of ethanol intake in the study population, but there was virtually no association between shochu consumption and adenomatous polyps. Men drinking wine had a significantly increased risk, but these men were too few to examine the relation in detail. The findings suggest that the consumption of specific alcoholic beverages rather than ethanol itself is associated with an increased risk of adenomatous polyps of the sigmoid colon.     

Relation between rates of suicide in 15-24-year-olds and per capita consumption of alcohol beverages in European countries

Suicide in adolescents and young adults is a serious medical and social problem. One factor that has been consistently implicated in suicide is alcohol use. This study examined the relation between rates of suicide in 15-24-year-olds and per capita consumption of alcohol beverages in European countries. Data on suicide rates in 15-24-year-olds and per capita consumption of alcohol beverages were obtained from the World Health Organization databases. Correlations were computed to examine relationships between suicide rates in 15-24-year-old males and females and per capita consumption of beer, wine, and spirits in the general population in 34 European countries. Suicide rates in males and females were compared using t-test. There was a negative correlation between suicide rates in 15-24-year-old males and per capita consumption of wine. There was also a trend towards a negative correlation between suicide rates in 15-24-year-old females and per capita consumption of wine. No correlations between suicide rates in 15-24-year-olds and per capita consumption of beer or spirits were found. As expected, suicide rates in males were significantly higher than in females. Lower suicide rates in 15-24-year-olds are associated with higher per capita consumption of wine in the general population. It is possible that the observed relationship is a result of a third factor affecting both suicide rates in 15-24-year-olds and consumption of wine. Further studies are necessary to clarify the relation between suicide rates in different age groups and consumption of alcohol beverages.     

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     

Effect of beer drinking on ultrasound bone mass in women

ObjectiveTo study the effect of beer consumption on bone mass in a group of healthy women, by using phalangeal bone ultrasound to evaluate the amplitude-dependent speed of sound.MethodsThis was a cross-sectional study of 1697 healthy women (mean age 48.4 y, body mass index (BMI) 19.0–32.0 kg/m²), recruited in a clinical convenience sample and screened for the existence of disease and/or medication that would affect calcium metabolism. Of this total, 710 were premenopausal, 176 were perimenopausal, and 811 were postmenopausal. The women recruited completed a questionnaire that contained detailed sections on current cigarette, alcohol, caffeine, and nutrient consumption. In terms of current alcohol intake, the subjects were classified as moderate drinkers, light drinkers, and nondrinkers. Drinkers were also analyzed according to the kind of alcohol consumed: wine or beer.ResultsQuantitative bone ultrasound values were greater in the beer drinkers compared with the no beer and/or wine drinkers. Taking the amplitude-dependent speed of sound as a dependent variable, and age, BMI, gonadal status, intake of beer and wine, and number of cigarettes per day as independent variables, we found age (β = ?1.52), BMI (β = ?3.86), gonadal status (β = ?27.47), and beer intake (β = 1.06) to be significant.ConclusionThe greater bone density found in women beer drinkers might be a result of the phytoestrogen content of this alcoholic drink; this requires further investigation.     

Energy adjustment methods applied to alcohol analyses.

When alcohol consumption is related to outcome, associations between alcohol type and health outcomes may occur simply because of the ethanol in the beverage type. When one analyzes the consequences of consumption of beer, wine, and spirits, the total alcohol intake must therefore be taken into account. However, owing to the linear dependency between total alcohol intake and the alcohol content of each beverage type, the effects cannot be separated from each other or from the effect of ethanol. In nutritional epidemiology, similar problems regarding intake of macronutrients and total energy intake have been addressed, and four methods have been proposed to solve the problem: energy partition, standard, density, and residual. The aim of this study was to evaluate the usefulness of the energy adjustment methods in alcohol analyses by using coronary heart disease as an example. Data obtained from the Copenhagen City Heart Study were used. The standard and energy partition methods yielded similar results for continuous, and almost similar results for categorical, alcohol variables. The results from the density method differed, but nevertheless were concordant with these. Beer and wine drinkers, in comparison with findings for nondrinkers, had lower risk of coronary heart disease. Except for the case of men drinking beer, the effect seemed to be associated with drinking one drink per week. The standard method derives influence of substituting alcohol types at constant total alcohol intake and complements the estimates of adding consumption of a particular alcohol type to the total intake. For most diseases, the effect of ethanol predominates over that of substances in the beverage type, which makes the density method less relevant in alcohol analyses.     

Gender differences in the relationship between alcohol consumption and drink problems are largely accounted for by body water

It is widely reported that women drink less and have a lower prevalence of drink problems than men, but the gender differences in the relationship between level of drinking and drink problems have rarely been investigated quantitatively. This paper reports results from the Medical Research Council National Survey of Health and Development (the 1946 British Cohort) when the subjects were 43 years old. Using 7-day recall for alcohol consumption and CAGE scores of 2, 3 or 4 for drink problems, it was found that the prevalence of drink problems increased with level of alcohol consumption. Women were more likely than men to report drink problems at the same level of alcohol consumption. However, this gender difference was largely accounted for by individual differences in weight of body water. Beer accounted for the excess of men's drinking over women's and the proportion of alcohol consumed as beer was inversely related to drink problems. Eighty per cent of women and 52% of men who had drink problems in the past year reported drinking less than an average of 3 U (women) or 4 U (men) a day in the past week. As drinking levels in women begin to approach those in men, rates of drink problems in women are likely to overtake those in men because of women's greater physiological sensitivity to the effects of alcohol.     

The Troms? heart study: alcoholic beverages and coronary risk factors.

Frequency of beer, wine, and spirits drinking and inebriation by alcohol were associated with serum lipids and blood pressure in 14,667 free-living men and women aged 20 to 54 years. Regression analysis including several background variables revealed that alcohol was more "favourably" associated with coronary risk factors than previously reported, due to the small consumption of alcohol in the population (only 2.0% of men and 0.3% of women reported drinking every day) or to unknown confounding factors: wine (p less than 0.05) and inebriation (p less than 0.01) were inversely related with total cholesterol in women; the strong positive relation with HDL-cholesterol in both sexes previously reported was confirmed; beer (p less than 0.05) and inebriation p(less than 0.05) in men and spirits (p less than 0.01) in women seemed to decrease triglycerides; and a new observation may be the negative association between wine and blood pressure (systolic p less than 0.01 in both sexes) as opposed to the positive relation with beer (p less than 0.01 both pressures in men) and spirits (p less than 0.05 systolic pressure and p less than 0.01 diastolic pressure in men and p less than 0.05 diastolic pressure in women). Women showed more "favourable effects" of alcohol than men, and one reason may be that they drank less often. Wine gave lower risk factor readings than beer, and especially lower than spirits.     

A prospective study of moderate alcohol drinking and risk of diabetes in women

Several investigators have observed an association between alcohol consumption and elevated glucose levels, raising the possibility that alcohol may increase the risk of diabetes. This hypothesis was evaluated prospectively among 85,051 women participating in the Nurses' Health Study who were 34 to 59 years of age in 1980 and had no history of cancer, coronary heart disease, or diabetes. At baseline, participants completed an independently validated dietary questionnaire which included information on the consumption of beer, wine, and liquor. Incident cases of non-insulin-dependent diabetes were reported on follow-up questionnaires sent in 1982 and 1984 (98% response to at least one follow-up); 526 cases were confirmed by a supplementary questionnaire regarding symptoms, laboratory values, and treatment. The risk of diabetes decreased monotonically with increasing alcohol consumption (chi trend = -9.4, p less than 0.0001). Compared with nondrinkers, women consuming 5-14.9 g of alcohol per day (about 4-10 drinks per week) had an age-adjusted relative risk of diabetes of 0.4 (95% confidence interval (CI) 0.3-0.6); for 15 g or more per day, the relative risk was 0.3 (95% CI 0.2-0.4). However, a strong inverse association between alcohol drinking and body weight explained much of the apparent protective effect of alcohol. After simultaneous adjustment for Quetelet index (weight (kg)/height (m)2), family history of diabetes, total caloric intake, and age, the relative risk of diabetes for consumers of 5-14.9 g per day was 0.8 (95% CI 0.6-1.2), and for women who drank 15+ g per day, the relative risk was 0.6 (95% CI 0.3-0.9). These data provide no support for the hypothesis that moderate alcohol intake increases the risk of non-insulin-dependent diabetes.     

Patterns of alcohol consumption in middle-aged men from France and Northern Ireland. The PRIME study

OBJECTIVE: To assess the patterns of alcohol consumption in France and Northern Ireland. DESIGN: Four cross-sectional studies. SETTING: Sample of 50-59 y old men living in France and Northern Ireland, consuming at least one unit of alcoholic beverage per week. SUBJECTS: 5363 subjects from France and 1367 from Northern Ireland. INTERVENTIONS: None. RESULTS: Consumption of wine was higher in France whereas consumption of beer and spirits was higher in Northern Ireland. Alcohol drinking was rather homogeneous throughout the week in France, whereas Fridays and Saturdays accounted for 60% of total alcohol consumption in Northern Ireland. In both countries, current smokers had a higher consumption of all types of alcoholic beverages than non-smokers. Similarly, obese and hypertensive subjects had a higher total alcohol consumption than non-obese or normotensive subjects, but the type of alcoholic beverages differed between countries. In Northern Ireland, subjects which reported some physical activity consumed significantly less alcoholic beverages than sedentary subjects, whereas no differences were found in France. Conversely, subjects with dyslipidemia consumed more alcoholic beverages than normolipidemic subjects in France, whereas no differences were found in Northern Ireland. In France, total alcohol, wine and beer consumption was negatively related to socioeconomic status and educational level. In Northern Ireland, total alcohol, beer and spirits consumption was negatively related whereas wine consumption was positively related to socioeconomic status and educational level. CONCLUSIONS: Alcohol drinking patterns differ between France and Northern Ireland, and also according to cardiovascular risk factors, socioeconomic and educational levels. SPONSORSHIP: Merck, Sharp & Dohme-Chibret (France), the NICHSA and the Department of Health and Social Service (Northern Ireland).     

Alcohol consumption and the risk of type 2 diabetes mellitus: atherosclerosis risk in communities study

Evidence regarding the association between alcohol consumption and type 2 diabetes risk remains inconsistent, particularly with regard to male-female differences. The authors conducted a prospective study of type 2 diabetes risk associated with alcohol consumption in a cohort of 12,261 middle-aged participants of the Atherosclerosis Risk in Communities Study (1990-1998), who were followed between 3 and 6 years. Alcohol consumption at baseline was characterized into lifetime abstainers, former drinkers, and current drinkers of various levels. Incident diabetes was determined by blood glucose measurements and self-report. After adjustment for potential confounders, an increased risk of diabetes was found in men who drank >21 drinks/week when compared with men who drank < or =1 drink/week (odds ratio = 1.50, 95% confidence interval: 1.02, 2.20) while no significant association was found in women. This increased diabetes risk among men who drank >21 drinks/week was predominantly related to spirits rather than to beer or wine consumption. The relative odds of incident diabetes in a comparison of men who drank >14 drinks of spirits per week with men who were current drinkers but reported no regular use of spirits, beer, or wine were 1.82 (95% confidence interval: 1.14, 2.92). Results of this study support the hypothesis that high alcohol intake increases diabetes risk among middle-aged men. However, more moderate levels of alcohol consumption do not increase risk of type 2 diabetes in either middle-aged men or women.