Age at menopause and mortality in Japan: the Jichi Medical School Cohort Study

BACKGROUND: Although several studies have reported increased mortality risk with early menopause, there were no studies examining the relationship between age at menopause and mortality in Japan. The goal of this analysis is to investigate the relationship between age at menopause and all-cause mortality among the Japanese. METHODS: Study subjects were 4,683 postmenopausal females in the Jichi Medical School Cohort Study, a population-based prospective study. Baseline data were obtained by questionnaire and health checkups between April 1992 and July 1995 in 12 rural areas in Japan. Main outcome measures were all-cause mortality derived from death certificates up to December 31, 2002. Cox's proportional hazard models were used to analyze the association of age at menopause with mortality. RESULTS: A total of 215 deaths were observed during the average of 9.2 year follow-up period. After adjusting for age, systolic blood pressure, serum total cholesterol level, serum high density lipoprotein cholesterol level, history of diabetes mellitus, body mass index, smoking habits, alcohol drinking habits, marital status, study area, and types of menopause, the hazard ratios (95% confidence intervals) of all-cause mortality were 2.10 (1.07-4.11), 0.68 (0.36-1.26), 0.94 (0.68-1.30), and 1.17 (0.63-2.20) for females with a menopause at ages younger than 40 years, 40-44, 50-54, and 55 or older, respectively, relative to those with menopause at age 45-49 years. CONCLUSIONS: Our data suggest that menopause aged younger than 40 years increases the risk of death from all causes among the Japanese.     

Alcohol Drinking and Blood Pressure Among Adolescents

The purpose of this study was to evaluate alcohol consumption among adolescents from Tucuman, Argentina, and to determine its possible relationship with increased levels of blood pressure. Three hundred fifty-six students aged 13–18 included in the study were asked to answer questionnaires anonymously. Two blood pressures measures were then taken. Differences between both sexes were found in quantity and frequency of alcohol consumption. Enjoyment was determined to be the main reason for drinking. There was an association between frequency and alcohol-related problems, and smoking habits. There were also differences in blood pressure among males and females. A weak, but significant, relationship between quantity/frequency index and diastolic blood pressure was found. A greater prevalence of hypertension in male heavy drinkers was noted as well. Because this addiction implies multiple social problems and it also accounts for a hypertension risk factor, the importance of aiming at developing prevention strategies for alcohol abuse among adolescents is stressed.     

Episodic heavy drinking,problem drinking and injuries – Results of the WHO/NIAAA collaborative emergency room study in South Korea

Alcohol is the 5th leading risk factor to the global disease burden and disability and about half of the global alcohol burden was attributable to injuries. Despite a large body of evidence documenting the associations between alcohol and injuries, data from Asian countries including South Korea are sparse. The aim of this study was to investigate the associations between episodic heavy past-year drinking, problem drinking symptomatic of alcohol dependence and alcohol-related and intentional injuries. Data from 1989 injured patients recruited for the WHO/NIAAA Collaborative Study on Alcohol and Injury in South Korea were analyzed with respect to the prevalence rates and associations between injuries and frequency of past-year episodic heavy drinking and problem drinking. In estimating the odds ratios (ORs) and the associated 95% confidence intervals between alcohol intake and injuries multivariable logistic models were employed to adjust for sociodemographic characteristics and selected drinking variables. All analyses were conducted using the SAS 9.2 software. Findings of this study were consistent with prior studies that the risk of alcohol-related or intentional injury was positively associated with the frequency of episodic heavy drinking. The magnitudes of the associations were larger with frequent consumption of 5+ drinks (OR = 4.0 approximately) than with frequent consumption of 12+ drinks (OR = 3.1). Strong associations were also noted between RAPS4-assessed alcohol dependence and alcohol-related and intentional injuries. Further, the prevalence of intentional injury and its association with alcohol increased sharply once the acute alcohol intake exceeded 90 ml. Our results were consistent with prior studies that episodic heavy consumption, acute intoxication and problem drinking are pervasive among emergency room patients. Results of our study also lent support for administering a single-item screener querying consumption of 5+ drinks at a sitting in the past 12 months as a triage tool in Korea.     

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.     

Weekday distribution of head traumas in patients admitted to the emergency department of a city hospital: effects of age, gender and drinking pattern

AIMS: To define the alcohol-related risk for head traumas and to compare the weekly and monthly variations in alcohol consumption, and the occurrence of head traumas in a population with heavy episodic drinking as the prevailing drinking pattern. METHODS: All consecutive admissions due to head trauma into a Finnish city hospital during 1 year (1999) were recorded. 832 consecutive patients with data on alcohol consumption were covered. We compared the number of final diagnoses of head traumas per day and month to the anticipated frequency in the absence of any weekly or monthly variation. Official statistics on alcohol consumption in Finland are presented as reference. RESULTS: Alcohol-related head traumas were most common in young adults and people of working age. The occurrence of head traumas in sober subjects showed no temporal variations. By contrast, alcohol-related cases peaked on weekends and in the most popular vacation month (July). The alcohol-related risk from Friday to Sunday was 27.3% in women and 20.3% in men. The additional risk related to alcohol consumption in July was 16.1% in women and 5.3% in men. CONCLUSIONS: We found an excess of head traumas during weekends and the primary vacation month, and this excess was associated with heavy episodic drinking. Active measures are needed to prevent head traumas caused by this type of behaviour.     

2010年上海市15岁及以上居民饮酒行为研究

目的 研究2010年上海市15岁及以上居民饮酒行为现状.方法 采用分层多阶段整群随机抽样的方法,利用2010年“上海市慢性病及其危险因素监测”部分资料,研究上海市15岁及以上居民饮酒现状、饮酒频率、饮酒类型、每日酒精消费量及分级.结果 15岁及以上居民饮酒率为26.1％,男性为43.9％,女性为8.0％.饮酒者中酒精摄入量为34.3 g/d,男性为37.7 g/d,女性为14.9 g/d.不同年龄组中,男性45 ～ 59岁年龄组饮酒率和每日酒精摄入量最高（53.9％和42.6 g/d）,女性18～44岁年龄组饮酒率最高为9.6％,45 ～ 59岁年龄组酒精摄入量最高为16.5 g/d;中心城区和非中心城区的饮酒率分别为22.9％和28.5％,酒精摄入量分别为28.5g/d和37.8 g/d.男性饮酒者中,饮酒频率以几乎每天饮酒的比例最高（35.5％）,3～6d/周的比例最低（13.0％）;饮酒类型中,以饮黄酒、啤酒为主,比例为62.0％和42.8％,饮低度白酒的比例最低为9.8％;过量饮酒、危险饮酒和有害饮酒的比例分别为20.0％、9.2％和20.6％,单次大量饮酒比例为24.6％.结论 2010年上海地区15岁及以上居民饮酒率较高,不同性别、年龄和地区间饮酒行为存在差异.     

西藏拉萨地区世居成年藏族居民饮酒行为调查

目的 了解西藏拉萨地区成年居民饮酒行为现状。方法 于2009年6月-2010年8月,采用分层随机抽样方法在西藏拉萨地区抽取的2341名≥18岁世居藏族居民进行问卷调查、血常规和肝功能检测。结果 拉萨地区人群总饮酒率为48.95%,不同性别、职业、文化程度、月平均收入及是否吸烟者的饮酒率差异均有统计学意义(均P<0.05),多因素非条件logistic回归分析结果显示,男性、农牧民和干部、月平均收入>2000元和吸烟是拉萨地区世居成年藏族居民饮酒行为的危险因素。饮酒者日均饮酒量为4.55g(0.6,32.53),平均饮酒年限为17.00年(8.00,28.00),男性日均饮酒量和饮酒年限均分别高于女性;51~60岁年龄段的日均饮酒量最高,随着饮酒年限的延长,MCV和GLOB增高,ALB降低。结论 拉萨地区居民饮酒率高于全国平均水平,性别、职业、月均收入和是否吸烟是该地区居民饮酒行为的主要影响因素,应针对此类人群加大饮酒卫生的宣传。     

Effects of the frequency of alcohol intake on risk factors for coronary heart disease

A cross-sectional study was conducted in 3660 male workers to examine whether the weekly frequency of alcohol intake affected serum lipids and blood pressure, which are risk factors for coronary heart disease, independently of the weekly alcohol consumption. Information regarding life-style habits and current medication was obtained by questionnaire. The effects of the frequency were examined using Tukey's test in the groups of drinkers divided according to their alcohol consumption. In moderate (189–377 ml/week) drinkers, a higher frequency of drinking was related to a higher level of HDL-cholesterol, and a lower level of triglycerides. In light (1–188 ml/week) and heavy (378–566 ml/week) drinkers, a higher frequency of drinking was also related to a higher level of HDL-cholesterol. There were no significant relations between the frequency of drinking and total cholesterol, or blood pressure in these three groups. Similar results were obtained when values were adjusted for age, body-mass index, smoking, physical activity and weekly alcohol consumption. Multiple regression analysis in the whole drinkers also showed that the weekly frequency of drinking was associated with HDL-cholesterol, but not with triglycerides (p = 0.052), total cholesterol, or blood pressure. The results suggest that the weekly frequency of drinking may affect the levels of HDL-cholesterol independently of the weekly alcohol consumption.     

Alcohol consumption profile by time in middle-aged men: a longitudinal study based on three different diagnostic instruments

This longitudinal study aimed at comparing aggregate measures of heavy or problem drinking and their variations across time among the same subjects. We examined middle-aged men participating in a health survey over a 5-year interval. Of the 133 consecutive men in the whole age group interviewed as 40-year-olds in 1989, 114 were reached and re-interviewed in 1994. Alcohol consumption was measured by self-report, Malmo-modified Michigan Alcoholism Screening Test (Mm-MAST), and serum carbohydrate-deficient transferrin (CDT). Self-reported alcohol consumption decreased with years (142 vs 105 g/week, P = 0.01), as did CDT (16.9 vs 14.4 U/l, P = 0.02), but there was no change in the Mm-MAST results. There was no significant difference in the number of heavy drinkers (either Mm-MAST score > or = 3, or by self-reported alcohol consumption > or = 280 g/week, or by CDT > or = 20 U/l) at 40 and 45 years of age (37 and 47% respectively). At the individual level, alcohol consumption both increased and decreased with age. At 45 years of age 5/114 (4%) of the men reported that they had increased their alcohol consumption by more than 80 g/week and 25/114 (22%) said that they had reduced their drinking by the same amount. The remaining 84 (74%) reported drinking the same amount as 5 years earlier (+/- 80 g/week). This indicates that alcohol drinking habits are not stable in middle age. Most heavy drinkers in both age groups were detected by Mm-MAST and this proportion increased with age while the proportion of positive self-reports and CDTs decreased. Thus, the social consequences, measured here by the Mm-MAST, may be more readily experienced with years even at smaller consumption levels.     

Nutrient intakes and blood pressure in normotensive males.

The association of dietary intakes with blood pressure levels was examined in a cross-sectional sample of 805 men aged 40-69 years free from clinical hypertension, coronary heart disease or cancer. After controlling for age, body habitus, and alcohol consumption, blood pressure levels were inversely associated with the intake of fruit (r = -0.09, p less than 0.05, for both systolic (SBP) and diastolic (DBP) blood pressure) and of fruit fibre (r = -0.07, p = 0.05 for SBP; r = -0.07, p = 0.07 for DBP). This association was independent of the intake of minerals and fibre from other sources. Calcium and magnesium intake were not significantly associated with blood pressure levels, but our results are statistically compatible with the modest inverse associations previously reported. These cross-sectional data suggest that some component of fruit has a blood pressure lowering effect.     

Association between smoking and alcohol use in the general population: stable and unstable odds ratios across two years in two different countries

AIMS: The main objective of this article was to compare alcohol and tobacco consumption in the US and the Basque Country (the North of Spain) with particular attention to the association between alcohol and tobacco use. The consistency of findings was considered by analyzing data from two different years. These comparisons may provide a rational basis for exploring the associations between alcohol and cigarette use that are influenced by changes in use prevalences. METHODS: Two epidemiological samples from the US, obtained in 1992 and 1996, and two from the Basque Country, obtained in the same years, were used. Sampling methodologies were similar. Questionnaires were self-administrated with the help of interviewers, and were used to define ever smokers, ex-smokers, current smokers, heavy smokers, ever drinkers, ex-drinkers, current drinkers and weekly drinkers. The associations between smoking and alcohol drinking were explored through logistic regressions. RESULTS: The associations between current smoking and current drinking in the general population, and between ever smoking and weekly drinking among current drinkers appear very stable. In 1992 and 1996, US subjects who decided to try alcohol tended to try smoking and vice versa. In US Caucasians (particularly in 1996), heavy smoking was strongly associated with ever drinking among current smokers. In the Basque Country in 1992, there was a significant association between smoking cessation and drinking cessation among ever drinkers who also were ever smokers. CONCLUSIONS: Our analyses suggest that some associations between alcohol drinking and smoking behaviours are likely to be detected in Western countries where alcohol and nicotine are legal and easily available. On the other hand, other associations may be detected only in certain social contexts. These social contexts make the associations in subpopulations who are vulnerable to addiction, influence the results in the general population. In social contexts that exert considerable social pressure to quit smoking, such as in US Caucasians (particularly in 1996), heavy smoking was strongly associated with ever drinking among current smokers. When a social environment strongly discourages smoking and alcohol initiation (as in the US in 1992 and 1996), subjects who decide to try alcohol tend to try smoking and vice versa. The lack of social stigmatization of smoking and drinking in the Basque Country in 1992 may help to explain the significant association between smoking cessation and drinking cessation among ever drinkers who also were ever smokers.     

Spreading out or concentrating weekly consumption: alcohol problems and other consequences within a UK population sample

AIMS: To consider the consequences, within a UK population sample, of consuming a given amount of alcohol weekly in one or two sessions as against spreading it out over several sessions. METHODS: A new analysis of data from the UK components of the GENACIS survey of adults aged > or =18, was carried out. RESULTS: At low levels of weekly alcohol consumption those subjects whose usual drinking frequency was several times per week ('spreaders'), if anything, reported more alcohol problems than those who consumed alcohol only once or twice per week ('bingers'). As weekly consumption increased above approximately 11 units per week 'bingers' began to experience more problems than 'spreaders'. At the highest levels of consumption 'bingers' reported more positive experiences from drinking than did 'spreaders'. Subjects >54 years showed lower levels of weekly alcohol consumption than other subjects, and relationships between problems, drinking level, and drinking pattern were less in evidence. Females drank less alcohol and experienced fewer alcohol-related problems than did their male counterparts. However, at high-consumption levels, female 'bingers' experienced fewer problems than male 'bingers'. CONCLUSIONS: For most but not all the variables studied, both drinking level and drinking pattern are important determinants of problems experienced. Binge drinking for people who drink more than approximately 11 units per week is an obvious target for harm minimization.     

Riskanter Alkoholkonsum und Rauschtrinken unter Berücksichtigung von Verletzungen und der Inanspruchnahme alkoholspezifischer medizinischer Beratung

The German Health Interview and Examination Survey for Adults (DEGS1) was conducted from 2008–2011 and comprised interviews, examinations and tests. The target population was the resident population of Germany aged from 18–79 years (n?=?8,152). Data on alcohol consumption, at-risk drinking and heavy episodic drinking was collected in a self-administered questionnaire with the Alcohol Use Disorders Identification Test–Consumption (AUDIT-C). At-risk drinking is most common among young individuals aged from 19–29 years (men 54.9?%; women 36?%), becoming less common from an age of 65 years. With 41.6?%, at-risk drinking is more prevalent in men than in women (25.6?%). Men are three times more likely to be heavy episodic drinkers than women. Injuries are more common among individuals with at-risk or heavy episodic drinking. They receive advice on alcohol consumption during visits to general practitioners/specialists or outpatient departments more often than individuals without these drinking patterns. An English full-text version of this article is available at SpringerLink as supplemental.     

Use of oral contraceptives in relation to dietary habits and alcohol consumption

The relationship between oral contraceptive (OC) use, dietary habits and alcohol consumption in young women was studied in Troms?, Norway. A total of 5,800 women aged 20-39 years answered a questionnaire in 1986/1987. Women with long-term duration of OC use reported more frequent intake of meat for dinner, preferred low-fat milk and drank less coffee. For other food items such as intake of fats, fish, fruit and vegetables, no differences were found. Strong associations were found for alcohol consumption, with increasing frequency of use among long-term users of OCs. These results are discussed in relation to the possible association between OC use and breast cancer in young women.     

Visual evoked potentials in rotogravure printers exposed to toluene.

Visual evoked potentials (VEPs) from stimulation by checkerboard pattern reversal were examined in 54 rotogravure printers exposed to toluene (all men, aged 22-64 years, duration of exposure 1-41 years). A control group consisted of 46 subjects (23 men and 23 women; aged 22-54 years). Compared with controls the exposed group showed more frequent responses with reduced reproducibility or absence of some waves, or both; the mean P1 wave latency was prolonged and mean amplitudes N1P1 and P1N2 were reduced. The VEPs were abnormal in 24% of workers. The frequency of abnormal VEPs correlated positively with the duration of exposure to toluene and also with the degree of alcohol drinking. No association was found between measurements of VEP and electroencephalogram (EEG) or electromyogram (EMG) examinations. A VEP measurement was made in 78% of the exposed workers two years after the first examination. No statistically significant difference between the two results was found. This suggests a marked stability of the observed VEP changes. These changes can be interpreted as a subclinical sign of dysfunction of the central nervous system (CNS) related to exposure to toluene and also to alcohol consumption.     

Visual evoked potentials in rotogravure printers exposed to toluene

Visual evoked potentials (VEPs) from stimulation by checkerboard pattern reversal were examined in 54 rotogravure printers exposed to toluene (all men, aged 22-64 years, duration of exposure 1-41 years). A control group consisted of 46 subjects (23 men and 23 women; aged 22-54 years). Compared with controls the exposed group showed more frequent responses with reduced reproducibility or absence of some waves, or both; the mean P1 wave latency was prolonged and mean amplitudes N1P1 and P1N2 were reduced. The VEPs were abnormal in 24% of workers. The frequency of abnormal VEPs correlated positively with the duration of exposure to toluene and also with the degree of alcohol drinking. No association was found between measurements of VEP and electroencephalogram (EEG) or electromyogram (EMG) examinations. A VEP measurement was made in 78% of the exposed workers two years after the first examination. No statistically significant difference between the two results was found. This suggests a marked stability of the observed VEP changes. These changes can be interpreted as a subclinical sign of dysfunction of the central nervous system (CNS) related to exposure to toluene and also to alcohol consumption.     

Relationships between childbearing and some food and alcohol habits: The Nordland health study

The aim of the study was to describe associations between childbearing pattern (parity and age at first and last birth) and food and alcohol habits in middle aged women. This was done in a cross-sectional survey of 3576 women aged 40–42 years living in a county in northern Norway, involving 71 percent of all women in the age bracket living in the county. Information about childbearing and food and alcohol habits was obtained from a self-administered questionnaire. High parity was positively related to indicators of a high intake of fat and low intake of fruits, vegetables and alcoholic beverages. High age at first birth was correlated with presumably healthy food habits and with a high wine and a low spirits consumption. High age at last birth was particularly related to relatively high vegetable and bread consumption and to low frequency of use of beer and spirits. As childbearing pattern and food and alcohol habits are correlated, they may be confounders for each other in analyses of risk factors for diseases with complex and multifactorial etiology (e.g. breast or colorectal cancer.)     

Alcohol consumption and cognitive function in the Whitehall II Study

The authors investigated the relation between alcohol consumption and cognitive function in a United Kingdom cohort study (4,272 men, 1,761 women) with median follow-up of 11 years. Measures of alcohol consumption were obtained at baseline (1985-1988) and four subsequent phases of data collection. Cognitive function (memory test, AH4, Mill-Hill, phonemic and semantic fluency) was assessed at phase 5 (1997-1999), when participants were aged 46-68 years. Of people who reported drinking alcohol in the past year, those who consumed at least one drink in the past week, compared with those who did not, were significantly less likely to have poor cognitive function. The beneficial effect extended to those drinking more than 240 g per week (approximately 30 drinks). The effect was stronger for women than men and was not confined to those with evidence of vascular disease. Similar associations were found in cross-sectional and longitudinal analyses. The relations were not explained by confounding by smoking and by physical and mental health and, to a large extent, were not mediated by cholesterol or blood pressure. However, the relations were weakened when social position was added to the model. The authors concluded that for middle-aged subjects, increasing levels of alcohol consumption were associated with better function regarding some aspects of cognition. Nonetheless, it is not proposed that these findings be used to encourage increased alcohol consumption.     

Relationship of plasma renin activity with caffeine intake and physical training in mild hypertensive men

To study the relationship between plasma renin activity (PRA) and coffee consumption, cigarette smoking, alcohol intake and physical activity habits. Setting: The multicentre HARVEST trial, involving 17 Hospital Centres in Northeast Italy. Subjects: 351 borderline to mild hypertensive men (mean age ± SEM 22.7 ± 0.47 years), never treated for hypertension. Interventions: Office and 24-hour blood pressure measurement, supine and standing PRA levels, and urinary catecholamines output. Main outcome measures: PRA levels according to coffee intake and physical activity status. Results: Coffee intake showed a major effect on PRA. Supine PRA levels were 40% higher in the subjects abstaining from coffee (n = 94) than in the coffee drinkers and was similar in the moderate (n = 223) and heavy (n = 34) drinkers. A weaker negative association was found between coffee use and PRA on standing. Office and whole-day blood pressure and heart rate, and urinary catecholamines did not differ according to coffee intake. Supine PRA was lower in the subjects performing regular physical activity than in the inactive subjects. Office and whole-day diastolic blood pressure and heart rate, and urinary norepinephrine were lower in the active than in the sedentary men. No relationship was found between PRA measured either in the supine or the upright posture and tobacco or alcohol use. In a multiple linear regression model supine PRA was negatively correlated with age, coffee consumption and physical activity habits. Conclusions: Chronic coffee intake and physical training showed an inverse relationship with PRA in mild hypertensive men, while tobacco and alcohol use were unrelated to PRA.     

Alcohol consumption and insulin resistance syndrome parameters: associations and evolutions in a longitudinal analysis of the French DESIR cohort

PURPOSE: To determine the effects of average alcohol consumption and changes in alcohol intake on the insulin resistance syndrome parameters in a 3-year follow-up study. METHODS: Longitudinal study of 1856 and 1529 alcohol drinking men and women in the French DESIR study (Data from an Epidemiological Study on the Insulin Resistance syndrome), aged 30 to 64 years. RESULTS: In men, fasting glucose, body mass index, waist circumference, systolic blood pressure, and HDL-cholesterol were positively associated with average alcohol consumption while there was no association with insulin or triglycerides concentrations. A change in alcohol intake was positively associated with HDL-cholesterol concentration and systolic blood pressure at follow-up. These effects of alcohol could not be attributed specifically to the intake of wine. In women, while the alcohol HDL-cholesterol relation was similar to that found in the men, the only significant effect of average alcohol intake was an increase in systolic blood pressure, with a spurious decrease in blood pressure related to a 3-year increase in alcohol intake. CONCLUSIONS: Alcohol only provided a beneficial effect on HDL-cholesterol. The beneficial effect seen by other authors of moderate alcohol drinking on diabetes and cardiovascular risk may be due to effects on parameters other than those included in the current definitions of the insulin resistance syndrome.