The controversy about vitamins in alcohol. The arguments against the compulsory addition of vitamin B-1 (thiamin) to alcoholic beverages

The aim of preventing alcohol related brain damage is very important, but if mass medication with a vitamin in a substance of drug abuse — alcoholic beverages — is to be undertaken as a public health preventive measure, there must be very sound scientific evidence to justify it. We have researched the matter thoroughly and cannot find sufficient sound scientific evidence to justify thiamin enrichment of beer and flagon and cask wines in Australia. In this matter there has been considerable controversy and debate for ten years, which indicates the complexity of the issue. While this controversy exists, the mandatory enrichment of some alcoholic beverages (not all have been included) with large quantities of thiamin should not go ahead. The addition of thiamin to alcoholic beverages has not been tested on the world stage, and it will be totally unacceptable to conduct this experiment on the Australian population.     

Dietary intake,nutrition, and fetal alcohol spectrum disorders in the Western Cape Province of South Africa

In this study, we describe the nutritional status of women from a South African community with very high rates of fetal alcohol spectrum disorders (FASD). Nutrient intake (24-h recall) of mothers of children with FASD was compared to mothers of normal controls. Nutrient adequacy was assessed using Dietary Reference Intakes (DRIs). More than 50% of all mothers were below the Estimated Average Requirement (EAR) for vitamins A, D, E, and C, thiamin, riboflavin, vitamin B₆, folate, calcium, magnesium, iron, and zinc. Mean intakes were below the Adequate Intake (AI) for vitamin K, potassium, and choline. Mothers of children with FASD reported significantly lower intake of calcium, docosapentaenoic acid (DPA), riboflavin, and choline than controls. Lower intake of multiple key nutrients correlates significantly with heavy drinking. Poor diet quality and multiple nutritional inadequacies coupled with prenatal alcohol exposure may increase the risk for FASD in this population.     

Changes in nutrient intake of hypertensives during a behavioral weight-control program

To evaluate the nutritional adequacy of the diets selected by hypertensive patients participating in a behavioral weight-control program, 26 patients were asked to complete 3-day food records at the start and end of the 8-week program. These records were analyzed using the United States Department of Agriculture (USDA) Handbook 456 data base. Patients decreased their overall caloric intake by 39% during the course of the program and decreased consumption of all nutrients, but only calcium intake decreased to unacceptable levels. There was, however, a significant increase in the number of individuals consuming less than two thirds of the Recommended Dietary Allowances (RDA) for thiamin, niacin, calcium, and iron, and a significant increase in the number of patients who were deficient in three or more nutrients. Thus, although average intake in the behavioral weight-control program was adequate, there was a sizeable number of individuals who were consuming poor diets. Inadequate intake occurred primarily in patients eating less than 1000 calories a day. The simple behavior change of adding a cup of skim milk to the unstructured calorie-counting diet would help restore calcium, thiamin, and niacin to adequate levels.     

The standard drink and alcohol consumption

The term 'standard drink' is commonly used when researchers collect alcohol consumption data and when educators create campaigns to encourage people to drink responsibly. However, little is known about community knowledge of the term 'standard drink' or what it represents in terms of what people are drinking in their own homes or on unlicensed premises. This study measured the amounts of a variety of alcoholic beverages that a sample of Perth metropolitan people use when drinking on unlicensed premises. The level of knowledge of the alcohol content of a variety of beverages and the knowledge of the term standard drink and what it represents in terms of commonly consumed beverages was also measured. The results showed that knowledge of the alcohol content of beverages was very poor. Knowledge of the term standard drink and what it represents in terms of absolute alcohol was also poor. Regarding the amounts of beverages poured, red and white wine, champagne and spirits are likely to be poured in amounts well in excess of a standard drink when people are drinking in their own homes. The results of this study have implications for the efficacy of educational campaigns designed to encourage safe and responsible drinking practices through the monitoring of personal intake. Before these can be effective, the terminology used must be familiar and well understood by the community towards which they are aimed. The results also discussed with respect to the design and administration of alcohol consumption questionnaires.     

老干部的营养及抗氧化营养素摄入与健康状况分析

目的了解宁波地区老干部的营养状况、抗氧化营养素摄人情况和营养相关疾病,为制定老年人营养改善措施提供依据。方法对511例宁波地区老干部进行询问调查、医学体检、实验室检测和膳食调查。结果其热能和蛋白质的摄入量稍高于推荐量,但脂肪、胆固醇和钠盐摄入过高;铁的摄入符合要求,钙、锌、维生素B,、维生素B：摄入不足;抗氧化营养素硒、维生素E、维生素C及维生素A（男）均摄入不足;肥胖、超重、高血压、糖尿病的患病率较高,分别为25．2％、30．0％、29．O％、10．6％。结论宁波地区部分老干部膳食结构不合理,营养过剩和营养不足并存,且抗氧化营养素普遍摄入不足。提示老干部因膳食失衡和不良生活方式导致的肥胖、高血压、糖尿病等慢性病不容忽视。     

One injection of estradiol valerate induces dramatic changes in rats' intake of alcoholic beverages

A series of experiments investigated the effects of a single injection of estradiol valerate (EV) on female rats' consumption of alcoholic beverages. EV provides sustained release of estradiol. Just after an injection of EV, rats' intake of a palatable alcoholic beverage, which had been taken regularly before, is reduced dramatically. Subsequently, rats' intake of alcoholic beverage returns to baseline levels. With continued opportunity to drink, rats take more ethanol than controls. When EV was given 15 and 31 days before the first opportunity to drink an alcoholic beverage, female rats markedly enhanced their intake of ethanol. Once enhanced intakes emerged, they were observed with different kinds of alcoholic beverages and endured for months.     

Estradiol valerate and alcohol intake: dose-response assessments

Background

An injection of estradiol valerate (EV) provides estradiol for a prolonged period. Recent research indicates that a single 2.0 mg injection of EV modifies a female rat's appetite for alcoholic beverages. This research extends the initial research by assessing 8 doses of EV (from.001 to 2.0 mg/female rat), as well assessing the effects of 2.0 mg EV in females with ovariectomies.

Results

With the administration of EV, there was a dose-related loss of bodyweight reaching the maximum loss, when it occurred, at about 4 days after injections. Subsequently, rats returned to gaining weight regularly. Of the doses tested, only the 2.0 mg dose produced a consistent increase in intake of ethanol during the time previous research indicated that the rats would show enhanced intakes. There was, however, a dose-related trend for smaller doses to enhance intakes. Rats with ovariectomies showed a similar pattern of effects, to intact rats, with the 2 mg dose. After extensive histories of intake of alcohol, both placebo and EV-treated females had estradiol levels below the average measured in females without a history of alcohol-intake.

Conclusion

The data support the conclusion that pharmacological doses of estradiol can produce enduring changes that are manifest as an enhanced appetite for alcoholic beverages. The effect can occur among females without ovaries.     

Wernicke's encephalopathy and Korsakoff's psychosis: to fortify or not to fortify?

The conventional wisdom suggests that Korsakoff's psychosis, an amnesic disorder associated with prolonged alcohol consumption, is the chronic outcome of a thiamin deficiency first exhibited as Wernicke's encephalopathy. The present paper describes the debate in Australia over whether flour and alcoholic beverages should be fortified with thiamin, in an attempt to prevent Wernicke's encephalopathy and thus Korsakoff's psychosis. We conclude that the scientific evidence linking Wernicke's encephalopathy and Korsakoff's psychosis is tenuous. Certainly, it is not sufficient to support what would amount to mass medication.     

Lifestyle, fibrinolysis and lipids.

Lifestyle including eating habits, physical training, smoking, drinking alcoholic beverages etc. can to a certain extent maintain or spoil our health. The physiological mechanisms of haemostasis and of lipoprotein metabolism play a role in acute cardiovascular diseases but also in a great number of chronic diseases in which vascular pathology is prominent. Impaired fibrinolysis and increased lipid levels are often incriminated in vascular disease. Lifestyle can modify fibrinolysis as well as lipid levels. Physical training, moderate eating habits, no smoking, moderate alcohol intake will be a beneficial influence on both fibrinolysis and lipid levels. The possibility that longterm pharmacological intervention may adversely affect fibrinolysis and lipid levels should always be considered.     

Dietary intake and bone status with aging

Osteoporosis and related fractures represent major public health problems that are expected to increase dramatically in importance as the population ages. Dietary risk factors are particularly important, as they are modifiable. However, most of the attention to dietary risk factors for osteoporosis has focused almost exclusively on calcium and vitamin D. Recently, there has been considerable interest in the effects of a variety of other nutrients on bone status. These include minerals--magnesium, potassium, copper, zinc, silicon, sodium; vitamins--vitamin C, vitamin K, vitamin B12, vitamin A; and macronutrients--protein, fatty acids, sugars. In addition, foods and food components, including milk, fruit and vegetables, soy products, carbonated beverages, mineral water, dietary fiber, alcohol and caffeine have recently been examined. Together the evidence clearly suggests that prevention of bone loss through diet is complex and involves many nutrients and other food constituents. For many, results remain inconclusive and in some cases contradictory. However, it is increasingly clear that our exposure to a complex of nutrients and food constituents interacts to affect bone status. In addition to identifying the role of individual components, there is a great need to understand the interactions of these factors within diets and, increasingly, in the presence of nutrient supplements. Furthermore, genetic factors are likely to interact with these dietary exposures, increasing the complexity of these effects. With advances in both genetics and nutrition, improved understanding of all these interactions will contribute to effective recommendations for prevention of bone loss and osteoporosis in the aging population.     

GENETIC AND ENVIRONMENTAL DETERMINANTS OF SUSCEPTIBILITY TO ALCOHOL-INDUCED LIVER DISEASE

Although there is an overall relationship between cumulative alcohol intake and the severity of alcohol-related liver damage, there is considerable variation in individual susceptibility to the hepatotoxic effects of alcohol. In this review I shall discuss what factors appear to influence susceptibility. Women develop liver disease after a shorter period of excessive drinking and at a lower alcohol intake than men. This is partly related to differences in body size and composition between the sexes which result in women having preportionately higher blood alcohol levels than men after a standard drink; this probably explains why women are more susceptible to a variety of alcohol-related problems. Other genetic determinants of susceptibility have until recently proved elusive, but certain HLA types, such as HLA-B8, have been shown to increase the risk of chronic liver damage by up to 50%. No genetic variations in the enzymes responsible for alcohol metabolism have been definitely associated with predisposition to liver damage. The more severe lesions — alcoholic hepatitis and cirrhosis — are more common in regular daily drinkers compared with intermittent or ‘qbinge’ drinkers and in moderately dependent patients compared with those who have severe alcohol-withdrawal symptoms. No exogenous agents such as hepatitis viruses of chemicals have yet been shown to contribute to the development of any of the morphological abnormalities of alcoholic liver disease. At the present time there is insufficient information for us to be able to tailor our advice about drinking to the individual patient. We recommend that men should on no account drink more than 80 g alcohol per day and that women should keep below half this amount. People whose intakes approach these amounts should have two alcohol-free days every week. In the future it may be possible to screen specifically for markers of susceptibility to liver damage in populations known to be at risk of alcohol problems.     

201O年某区城乡居民膳食营养状况的分析

目的了解北京市丰台区居民膳食营养状况,为开展营养改善和合理膳食指导工作提供科学依据。方法采用多阶段分层整群随机抽样的方法,2010年8月至2010年10月在丰台区抽取6个居委会180户居民共计595人,采用连续3天24小时膳食回顾法与调味品称重法相结合的方法进行膳食调查。计算每标准人日营养素摄入量,并与2002年的营养调查资料进行比较分析。结果2010年北京市丰台区居民蛋白质、脂肪,碳水化合物的供能比分别为12．7％,35．4％,51．9％,膳食结构不尽合理;居民每标准人日能量,蛋白质、脂肪摄入量分别为1954．4kcal、61．7g、77．4g,维生素A、硫胺素、核黄素、烟酸、维生素C、维生素E摄入量分别为415.3μgRE、0．8mg、0．8mg、12．8mg、74．3nag和31．5mg,钠、钙、铁和锌摄八量分别为5576．7、409．6、22．1和9．7mg;除维生素E、钠和铁的摄入量达到或超过RNIJAI推荐水平外,其他营养素摄入量均低于推荐水平。膳食营养素摄入状况较2002年有降低趋势。结论丰台区居民宏量营养素供能比例不合理,绝大部分维生素、矿物质摄入不足,应制定相应的干预措施,控制和预防营养相关疾病的发生。     

Alcoholic beverages in acute porphyria.

Alcohol consumption habits and the clinical consequences of intake of alcoholic beverages were examined in 254 individuals with a diagnosis of acute intermittent porphyria or variegate porphyria, using a questionnaire. The study failed to demonstrate a connection between the amount of ethanol consumed, or the frequency of ingestion, and the development of symptoms of acute porphyria, other than in extreme consumption patterns. It was concluded that agents in alcoholic beverages other than ethanol play important roles in precipitating the porphyric symptoms. A majority of the individuals were able to identify alcoholic beverages that were less well tolerated and those that were better tolerated. The results suggest that polyphenolic compounds and 3 to 5 carbon chain hydrophobic alcohols may be responsible for the induction of clinical symptoms in acute porphyria by some alcoholic beverages. On the basis of these findings advice is proposed on alcohol counseling in inducible porphyria.     

The genetics of human alcohol metabolism

1. The custom of drinking alcoholic beverages is a human behavior with serious social and medical consequences for a surprisingly large fraction of drinkers. 2. This review describes recent advances in our understanding of the genetic loci that control enzyme systems involved in the metabolism of alcohol. 3. These advances make possible new experimental programs that may lead to simple diagnostic tests for patients at risk of developing alcohol abuse behaviour.     

Relevance of the developmental toxicity of ethanol in the occupational setting: a review

Numerous studies have been conducted investigating the reproductive toxicology of ethanol, the overwhelming majority concerning the adverse effects of consuming alcohol in beverages during pregnancy. Because many of the in vivo studies were designed to model alcoholism, they used comparatively high doses and assessed relatively few endpoints. Outcomes may have been affected by disturbances of metabolism at such high exposures, giving rise to secondary effects on development. The available data on ethanol from "conventional" developmental toxicity study test methods of the type used for regulatory hazard assessment of chemicals are limited. It is in this context, however, i.e. the use of ethanol as an industrial chemical rather than as a component of beverages, that this review is based. Using the usual criteria applied for the purpose of hazard assessment of industrial chemicals, it is concluded that there is no evidence that industrial exposure to ethanol is a developmental toxicity hazard. Developmental toxicity may result from drinking alcoholic beverages, the threshold level for all aspects of which has yet to be de fi ned. This is not, however, considered relevant to the low blood alcohol concentrations resulting from any conceivable inhalation or dermal exposure in the workplace or through the directed use of any consumer product containing ethanol.     

Defining maximum levels of higher alcohols in alcoholic beverages and surrogate alcohol products

Higher alcohols occur naturally in alcoholic beverages as by-products of alcoholic fermentation. Recently, concerns have been raised about the levels of higher alcohols in surrogate alcohol (i.e., illicit or home-produced alcoholic beverages) that might lead to an increased incidence of liver diseases in regions where there is a high consumption of such beverages. In contrast, higher alcohols are generally regarded as important flavour compounds, so that European legislation even demands minimum contents in certain spirits. In the current study we review the scientific literature on the toxicity of higher alcohols and estimate tolerable concentrations in alcoholic beverages. On the assumption that an adult consumes 4 x 25 ml of a drink containing 40% vol alcohol, the maximum tolerable concentrations of 1-propanol, 1-butanol, 2-butanol, isobutanol, isoamyl alcohol and 1-hexanol in such a drink would range between 228 and 3325 g/hl of pure alcohol. A reasonable preliminary guideline level would be 1000 g/hl of pure alcohol for the sum of all higher alcohols. This level is higher than the concentrations usually found in both legal alcoholic beverages and surrogate alcohols, so that we conclude that scientific data are lacking so far to consider higher alcohols as a likely cause for the adverse effects of surrogate alcohol. The limitations of our study include the inadequate toxicological data base leading to uncertainties during the extrapolation of toxicological data between the different alcohols, as well as unknown interactions between the different higher alcohols and ethanol.     

军队离退休疗养干部营养健康状况712例分析

目的综合评价军队离退休干部的营养健康状况.方法对712例军队离退休干部进行膳食调查和人体测量.结果其蛋白质、维生素A、烟酸、维生素C、维生素E、铁、硒的摄入量符合要求,但脂肪、胆固醇和钠盐摄入过高,钙、锌、维生素B1和维生素B2摄入不足,超重和肥胖者占55%,三头肌皮褶厚度(TSF)、上臂围(MAC)、上臂肌围(MAMC)测量值明显升高(P＜0.01或＜0.001).结论军队离退休干部膳食结构不合理,需加强营养卫生宣教.     

Nature of questionnaire options affects estimates of alcohol intake

To estimate the degree of underreporting of alcohol consumption caused by questionnaire options for the frequency and quantity of drinking, two questionnaires (one oriented toward light alcohol consumption and the other toward heavy consumption) were administered to each of 86 patients (13 women) admitted for withdrawal treatment. The estimated mean daily alcohol intake was 137 g of absolute alcohol as measured by the "light" questionnaire and 302 g as measured by the "heavy" one. The Spearman correlation coefficient between individual mean intakes recorded by the two questionnaires was .58, indicating some influence on the rank ordering of drinkers. The intake estimate based on the heavy questionnaire correlated better with the number of drinks needed to overcome the subjective feelings of hangover than did the estimate based on the light questionnaire. A good deal of the underreporting commonly found in general population surveys might be related to the nature of questionnaire options. More detailed options for heavy intake might reveal previously unnoticed correlations between alcohol intake and various health hazards.     

Peer influence in a micro-perspective: Imitation of alcoholic and non-alcoholic beverages

Ample experimental research has found evidence for imitation of alcohol consumption in social encounters. However, these studies cannot reveal whether imitation is specifically related to alcohol and not to consumption in general. We investigated whether imitation is more evident when peers drink alcohol compared to other beverages. We observed sipping behavior during a 30-minute interaction between same-sex confederates and participants in an ad lib semi-naturalistic drinking context (bar lab). We expected a stronger imitation effect when both participant and confederate drank alcoholic beverages. A random occasion multilevel analysis was conducted to take repeated measurements into account. Findings showed that participants imitated the sips of the confederates, but that the likelihood of participants imitating a sip was lower when confederates were drinking alcoholic beverages and participants non-alcoholic beverages compared to when both were consuming alcohol.     

Dietary choices of recovering alcoholics

Nutritional therapy can play an important role in the rehabilitation of an alcoholic. To teach these patients proper eating habits, we need to know what they eat and whether their dietary choices are nutritionally adequate compared to the recommended daily allowances (RDA). We investigated dietary choices of 70 recovering (abstinent) alcoholics who lived in a halfway house but who ate and worked elsewhere everyday. Diets were analyzed for calories, protein, B vitamins, vitamins A and C, calcium, phosphorous, magnesium, iron and zinc. We found that these recovering alcoholics ate adequate amounts of all nutrients except for vitamin B₆, magnesium, iron and zinc. With the exception of vitamin B₆, the other three nutrients are also found to be low in the diets of the average population. We cannot say at present whether recovering alcoholics need more than the RDA for recovery, but we conclude that their freely chosen diet resembles that of non-alcoholic adult Americans.