A Drink Is A Drink? Variation in the Amount of Alcohol Contained in Beer,Wine and Spirits Drinks in a US Methodological Sample

BACKGROUND: Empirically based estimates of the mean alcohol content of beer, wine and spirits drinks from a national sample of US drinkers are not currently available. METHODS: A sample of 310 drinkers from the 2000 National Alcohol Survey were re-contacted to participate in a telephone survey with specific questions about the drinks they consume. Subjects were instructed to prepare their usual drink of each beverage at home and to measure each alcoholic beverage and other ingredients with a provided beaker. Information on the brand or type of each beverage was used to specify the percentage of alcohol. RESULTS: The weighted mean alcohol content of respondents' drinks was 0.67 ounces overall, 0.56 ounces for beer, 0.66 ounces for wine and 0.89 ounces for spirits. Spirits and wine drink contents were particularly variable with many high-alcohol drinks observed. CONCLUSIONS: While the 0.6-ounce of alcohol drink standard appears to be a reasonable single standard, it cannot capture the substantial variation evident in this sample and it underestimates average wine and spirits ethanol content. Direct measurement or beverage-specific mean ethanol content estimates would improve the precision of survey alcohol assessment.     

Differences in the measured alcohol content of drinks between black, white and Hispanic men and women in a US national sample

Aims   To measure and describe drink alcohol content differences between Hispanic, non-Hispanic white and non-Hispanic black men and women in the United States.
Design   A telephone survey re-interview of 397 respondents who participated originally in the 2005 National Alcohol Survey, of whom 306 provided complete information on home drinks.
Setting   United States.
Participants   Adults aged 18 years and older from across the United States.
Measurements   Direct measurement by respondents of simulated drink pours in respondents' own glassware using a provided beaker and reported beverage brands were used to calculate drink alcohol content.
Findings   Black men were found to have the largest overall mean drink alcohol content at 0.79 oz (23 ml) of alcohol. This was significantly larger than the mean for white men or for black women and added 30% to black men's monthly alcohol intake when applied to their reported number of drinks. Spirits drinks were found to be particularly large for men. Multivariate models indicated that drink alcohol content differences are attributable more to income and family structure differences than to unmeasured cultural factors tied to race or ethnicity per se . Models predicting alcohol-related consequences and dependence indicate that adjusting drink alcohol content improves model fit and reduces differences between race/ethnicity defined groups.
Conclusions   Differences in drink alcohol content by gender, race/ethnicity and beverage type choice should be considered in comparisons of drinking patterns and alcohol-related outcomes. Observed differences can be explained partially by measured characteristics regarding family structure and income.     

Do College Students Drink More Than They Think? Use of a Free‐Pour Paradigm to Determine How College Students Define Standard Drinks

RATIONALE: Much of what is known about college drinking comes from self-report survey data. Such surveys typically ask students to indicate how many drinks they consume within a given period of time. It is currently unclear whether college students and researchers use similar operational definitions of a single drink. This information is critical given the widespread reliance on survey data for assessing the correlates and consequences of college drinking. OBJECTIVES: This study investigated whether college students define standard drink volumes in a way that is consistent with the operational definitions commonly used by researchers. METHODS: Students (n = 106) were administered an alcohol survey and then asked to perform three tasks. The tasks involved free-pouring fluid into empty cups of different sizes and estimating the volume of a single beer, a shot of liquor, or the amount of liquor in a mixed drink. The volumes poured by students then were compared with standards used in a well-known nationwide survey (i.e., 12 oz of beer and 1.25 oz of liquor in a shot or mixed drink). RESULTS: In every cup size of every task, students overestimated how much fluid they should pour to create a standard drink. In all three tasks, the magnitude of the discrepancy increased with cup size. Collapsed across cup sizes, students overpoured shots by 26%, mixed drinks by 80%, and beer by 25%. When a more liberal serving size of liquor (1.5 oz) was used as the standard, the results of the mixed drink task remained unchanged. However, the volumes poured by students during the shot free-pour task differed from the standard in only one cup size. CONCLUSIONS: The data suggest that college students drink more alcohol than indicated by their survey responses, raising questions about the validity of widely used alcohol surveys. Efforts to educate students about the alcohol content of standard drinks should be enhanced.     

College students lack knowledge of standard drink volumes: implications for definitions of risky drinking based on survey data

BACKGROUND: College students tend to pour single servings of beer and liquor that are larger than commonly used standards. The reasons for this are unknown. Students might overpour because they lack knowledge of standard serving sizes. Alternatively, they might know how much alcohol to pour but simply have difficulty pouring the correct amounts. Misperceptions of standard serving sizes could lead to inaccuracies in self-reported consumption. If this is the case, then the validity of students' responses on alcohol surveys and the definitions of risky drinking that are based on them would be called into question. This study examined how college students define standard drinks, whether their definitions are similar to the definitions commonly used by alcohol researchers and government agencies, and whether their definitions of standard drinks are related to the sizes of the drinks that they pour. The study also examined whether feedback regarding the accuracy of their definitions of standard drinks leads students to alter their self-reported levels of consumption. METHODS: Students (N = 133) completed an alcohol survey and performed tasks that required them to free-pour a single beer, glass of wine, shot of liquor, or the amount of liquor in a mixed drink. Roughly half of the students received feedback regarding their definitions of standard drinks. All students then were resurveyed about their recent levels of consumption. RESULTS: With the exception of beer, students incorrectly defined the volumes of standard servings of alcohol, overestimating the appropriate volumes. They also overestimated appropriate volumes when asked to free-pour drinks. Positive relationships existed between students' definitions of standard drinks and the sizes of the drinks that they free-poured. Feedback regarding misperceptions of standard drink volumes led to an increase in levels of self-reported consumption, suggesting that students' original estimates of their alcohol consumption were too low. CONCLUSIONS: Despite the recent focus on alcohol education and prevention at the college level, college students have not been taught how to define standard drinks accurately. They tend to overstate the appropriate volumes, leading them to overpour drinks and underreport levels of consumption. Self-reported consumption levels are altered by feedback regarding the accuracy of students' definitions of standard drinks. The findings raise important questions about the validity of students' responses on alcohol surveys and the definitions of risky drinking that are based them.     

The Hispanic Americans Baseline Alcohol Survey: Alcoholic Beverage Preference Across Hispanic National Groups

Background: U.S. Hispanics come from many countries in Latin America, which can lead to different beverage preferences in the United States. This paper examines choice for drinking wine, beer, and liquor across 4 Hispanic national groups: Mexican Americans, Puerto Ricans, Cuban Americans, and South/Central Americans. Methods: A sample of 5,224 individuals 18 years of age and older was selected using multistage cluster procedures from the household population in 5 metropolitan areas of the United States: Miami, New York, Philadelphia, Houston, and Los Angeles. The survey weighted response rate was 76%. Face‐to‐face interviews lasting 1 hour on average were conducted in the respondents’ homes either in English or Spanish. Results: Among men, beer drinkers consume the highest mean number of drinks per week in all national groups. Among women, this is true only of Puerto Ricans and Mexican Americans. Among men who drink beer, beer drinking constitutes 52 to 72% of total alcohol consumption. Among women who drink beer, beer consumption is associated with 32 to 64% of total consumption. Beer is the beverage most associated with binge drinking among Puerto Rican and Mexican American women, while among Cuban Americans and South/Central Americans this is seen for wine. Regression analyses showed no significant differences by national group in the likelihood of drinking 2 or fewer drinks (vs. no drinks) of wine, beer, or liquor. Puerto Ricans were more likely (OR = 1.47; 95% CI = 1.00–2.14) than Cuban Americans to drink 3 or more drinks (compared with no drinks) of beer. There was no association between the likelihood of binge drinking and Hispanic national group. Conclusions: Beverage preference across Hispanic national groups is similar. Beer is the preferred beverage. Alcohol control policies such as taxation and control of sales availability should apply equally to beer, liquor, and wine. Prevention interventions directed at different Hispanic national groups in the United States can be relatively uniform in their focus on the dangers associated with drinking different types of alcoholic beverages.     

Understanding drinking during pregnancy among urban American Indians and African Americans: health messages, risk beliefs, and how we measure consumption

BACKGROUND: Little is known about urban American Indian and African American women's drinking during pregnancy, or their beliefs about the risk of doing so. However, rates of fetal alcohol syndrome (FAS) are believed to be highest among those ethnic groups. METHODS: The Developing Effective Educational Resources (DEER) project recruited pregnant American Indian, African American, and white women from urban California areas (n = 321), to develop culturally appropriate consumption measures, to gather epidemiological data about drinking during pregnancy, and to assess exposure and reactions to health warnings intended to encourage abstinence during pregnancy. RESULTS: The study found high levels of exposure to health warnings among all ethnic groups, but many women were unclear about the actual consequences of FAS, about the risk of drinking even beer or wine or wine coolers, or about the value of reducing intake at any time during pregnancy. The majority of the women who drank malt liquor, fortified wine, wine, and spirits reported having larger than standard drinks, and daily drinkers had the highest levels of reporting error. When drink size was considered in the calculation of alcohol volume, average daily volume of consumption during pregnancy increased to the FAS risk level (average daily volume > or = 1) in the overall sample and among the African American and white subjects. CONCLUSIONS: Because some women, especially heavy drinkers, will continue drinking despite exposure to abstention-oriented health messages, it may be prudent to develop campaigns and interventions that provide factual information to help at-risk women reduce their drinking during pregnancy. Women could be advised of beverage equivalency, of standard drink sizes, and of how their own drinks compare with standard ones. Reliance on standard drink sizes in research can result in significant underreporting of consumption, especially among pregnant risk drinkers.     

The alcohol content of self-report and 'standard' drinks

A stubborn problem in alcohol epidemiology is that of standardization of unit of measurement. Consistent use of the ‘standard drink’ in research reports is hampered by difficulties in the assessment of the alcohol content of, particularly, self-reported drinks. Alcohol content of a drink depends on strength of the beverage and volume of the glass or container from which the beverage is taken. Both factors vary considerably between times, regions and individuals. Interview protocols and questionnaires rarely take into account the fact that people consume alcoholic beverages from a large variety of glasses and containers. In the present study the common presumption is tested of equality of alcohol content of standard and self-reported drinks. The test consisted of measuring the amount of wine, fortified wine and spirits people usually pour in the glass typical for the beverage type. The sample was drawn from the general Dutch population in 1985. The results show that on average self-reported drinks taken at home contained more than the presumed standard (10 g per drink). The deviation was highest for spirits (+26%), followed by fortified wines (+ 14%) and host for wine (+4%). There seemed to be a positive relationship between deviation from ‘standard’ and strength of the alcoholic beverage. This result is in line with data on the coverage of sales data: aggregate, survey-based spirits consumption shows the lowest coverage of sales. The effect of the difference between actual and presumed content of drinks on estimates of consumption is an overall increase of 7.5%, higher for women (+ 12%) than for men (+6%). Results are discussed with respect to the use of the concept of ‘standard unit’ in research protocols and health education campaigns.     

Alcohol sensitizes cerebral responses to the odors of alcoholic drinks: an fMRI study

Background:  Small, priming doses of alcohol enhance desire to drink, and thus play a role in the loss of control of alcohol consumption. Using functional magnetic resonance imaging (fMRI), we previously showed that alcoholic drink odors (AO; subjects' drinks of choice) induce greater nucleus accumbens (NAc) activity than non-appetitive odors (NApO; grass, leather) in subjects at risk for alcoholism. Here we hypothesized that priming exposure to alcohol would enhance responses to AO in the NAc and orbitofrontal cortex in comparison to NApO (grass, leather) and to the appetitive control odors (ApCO) of chocolate and grape.
Methods:  Ten hazardous drinkers (mean age = 22.7; SD = 2.9, average drinks per drinking day = 5.9, SD = 2.3; drinking days/90 days = 50.4, SD = 13.7) were scanned on a 1.5T GE Signa MR scanner during intravenous infusion of lactated Ringer's or 6% ethanol in lactated Ringer's that was pharmacokinetically modeled to achieve a constant breath alcohol concentration (BrAC) of 50 mg% throughout imaging. During scanning, subjects sniffed AO, NApO, and ApCO.
Results:  Alcohol infusion enhanced the contrast between AO and NApO in the NAc, and in orbitofrontal, medial frontal, and precuneus/posterior cingulate regions. The contrast between AO and appetitive control odors (ApCO; chocolate and grape) was similarly larger in the orbital, medial frontal, precuneus, and posterior cingulate/retrosplenial areas, with the most robust finding being a potentiated response in the posterior cingulate/retrosplenial area. The orbital region is similar to an area previously shown to manifest satiety-related decreases in activity induced by food cues.
Conclusions:  The results suggest that priming exposure to alcohol renders a limbic network more responsive to alcohol cues, potentially enhancing desire to drink.     

Alcohol and adiposity: effects of quantity and type of drink and time relation with meals

BACKGROUND: It has been suggested that the effects of alcohol on body weight and fat distribution may be influenced by the quantity and type of drink and may differ according to whether the alcohol is consumed with meals or not. OBJECTIVE: We have examined the cross-sectional association between alcohol intake, patterns of drinking and adiposity (body mass index (BMI), waist-to-hip ratio (WHR), waist circumference (WC) and percentage body fat (%BF)). METHODS: We studied 3327 men aged 60-79 y with no history of myocardial infarction, stroke or diabetes drawn from general practices in 24 British towns. RESULTS: BMI, WHR, WC and %BF increased significantly with increasing alcohol intake even after adjustment for potential confounders (all P < 0.0001), although the effects were stronger for WC and WHR (measures of central adiposity). Men who consumed > or = 21 units/week showed higher levels of central adiposity (WHR, WC) and general adiposity (BMI, %BF) than nondrinkers and lighter drinkers, irrespective of the predominant type of drink consumed (wine, beer, spirits or mixed). The positive association was most clearly seen in beer and spirit drinkers; positive but weaker associations were seen for wine. Among drinkers, a positive association was seen between alcohol intake and the adiposity variables irrespective of whether the alcohol was drunk with or separately from meals. CONCLUSION: Higher alcohol consumption (> or = 21 units/week) is positively associated with general and to a greater extent with central adiposity, irrespective of the type of drink and whether the alcohol is drunk with meals or not.     

Nutritional and health benefits of beer

Physicians should be aware of the growing evidence supporting the nutritional and health benefits of moderate consumption of alcohol as part of a healthy lifestyle. The recently approved voluntary label on wine ("the proud people who made this wine encourage you to consult your family doctor about the health effects of wine consumption") implies that physicians should promote wine as the preferred source of dietary alcohol. However, studies evaluating the relative benefits of wine versus beer versus spirits suggest that moderate consumption of any alcoholic beverage is associated with lower rates of cardiovascular disease. From a nutritional standpoint, beer contains more protein and B vitamins than wine. The antioxidant content of beer is equivalent to that of wine, but the specific antioxidants are different because the barley and hops used in the production of beer contain flavonoids different from those in the grapes used in the production of wine. The benefits of moderate alcohol consumption have not been generally endorsed by physicians for fear that heavy consumers may consider any message as a permissive license to drink in excess. Discussions with patients regarding alcohol consumption should be made in the context of a general medical examination. There is no evidence to support endorsement of one type of alcoholic beverage over another. The physician should define moderate drinking (1 drink per day for women and 2 drinks per day for men) for the patient and should review consumption patterns associated with high risk.     

Young people and alcohol: an econometric analysis

Aims  To analyse the determinants of youth drinking behaviour within an economic –theoretical framework. The paper focuses especially on the effects of (a) having parents willing to supply alcohol, (b) living in a single-parent household, (c) having parents who are currently unemployed and (d) having received education about alcohol, narcotics and tobacco.
Design, setting and participants  A Swedish cross-sectional survey data on 833 individuals aged 12–18 years was used to analyse the effects of the above variables on participation in drinking, frequency of drinking, intensity of drinking and binge drinking. Separate analyses were conducted for beer, wine and spirits. Care was taken in using appropriate econometric methods for the questions posed (negative binomial regression, censored regression and probit regression).
Findings  Having parents willing to supply alcohol increased frequency ( P  < 0.05) of beer, wine and spirits consumption, intensity ( P  < 0.05) of wine, spirits and illicit alcohol consumption, and increased probabilities ( P  < 0.10) of binge drinking and participation in drinking ( P  < 0.05). No effects were seen from living in a single-parent household. Having received education about alcohol, narcotics and tobacco had a negative association only with intensity ( P  < 0.10) of beer consumption. Having a father who was currently unemployed was associated with an increased ( P  < 0.05) probability of binge drinking but a reduced ( P  < 0.05) frequency of wine consumption.
Conclusions  The positive effect of having parents willing to supply alcohol could reflect that these individuals face lower acquisition costs or lower psychological costs in consumption. It could also reflect a price effect, if the individual receives the alcohol free from his or her parents.     

Older adults' alcohol consumption and late-life drinking problems: a 20-year perspective

Aims   The aim of this study was to identify changes in patterns of alcohol consumption over a 20-year interval among older women and men, and to examine the associations between guideline-defined excessive drinking and late-life drinking problems.
Design, participants and measures   A community sample of 719 adults between 55 and 65 years of age who consumed alcohol at or prior to baseline participated in a survey of alcohol consumption and drinking problems and was followed 10 years and 20 years later.
Findings   The likelihood of excessive drinking declined over the 20-year interval as adults matured into their 70s and 80s. However, at ages 75–85, 27.1% of women and 48.6% of men consumed more than two drinks per day or seven drinks per week. At comparable guideline levels of alcohol consumption, older men were more likely to have drinking problems than were older women. Consumption of more than two drinks per day or seven drinks per week was identified as a potential conservative guideline for identifying excessive drinking associated with an elevated likelihood of drinking problems.
Conclusions   A substantial percentage of older adults who consume alcohol engage in guideline-defined excessive drinking and incur drinking problems. The finding that older men may be more likely than older women to experience problems when they drink beyond guideline levels suggests that alcohol guidelines for men should not be set higher than those for women.     

Alcohol dosing and the heart: updating clinical evidence

The consequences of heavy or irregular alcohol drinking have long been known. Recently, consistent information has been provided in support of an association between light/moderate alcohol consumption and protection from vascular and all-cause mortality, ischemic stroke, peripheral arterial disease, congestive heart failure, and recurrence of ischemic events. After reviewing the information with respect to major aspects of cardiovascular pathophysiology, to potential confounders and to underlying mechanisms, several concepts emerge. First, the recommended amounts of "safe alcohol drinking" in healthy individuals are up to two standard drinks (~20 g/d) for a man and up to one drink (10 g/d) for a nonpregnant woman. The overall balance for young premenopausal women, but not for older women, would be unfavorable for drinking. The risk of cancer would not outweigh potential benefits of alcohol on heart disease. Second, within the frame of a balanced pattern of dietary energy intake, patients with cardiovascular disease who drink alcohol should not exceed one or two standard drinks per day for women or up to two or three drinks per day for men. Third, the low rates of coronary heart disease among the Mediterranean people may be related to their pattern of drinking wine every day during meals. Regular drinking is associated with better outcomes than occasional (binge)/weekly drinking. Fourth, wine (ethanol with antioxidants) exhibits significantly higher anti-inflammatory effects than gin (ethanol without polyphenols), and thus in general wine should be preferred to liquor or beer.     

Beverage Effects on Patterns of Alcohol Consumption

In this paper an analysis is made of beverage preferences and their effect on alcohol consumption patterns. For this purpose we have used the 1993 Spanish National Household Health Survey conducted on members of the population aged 16 or over. Beer and spirits are consumed more frequently by young people and wine by older people. The most consumed daily drink is wine and beer on a weekly basis. Men always drank more frequently and consumed a greater number of drinks per occasion than women for the three types of drink analyzed. The study shows that beverage preference is an important factor in the characterization of alcohol use patterns.     

Is Pregnancy the Time to Change Alcohol Consumption Habits in France?

Background:  Although it is well known that France has a cultural history of alcohol use, no recent French data on alcohol consumption during pregnancy in a large sample are available.
Methods:  To determine the alcohol consumption patterns among pregnant women in France, we analyzed data from a 1-year multicenter self-survey. Sociodemographic profile, obstetrical history, neonatal data, and a self-report for assessing drinking patterns during pregnancy including AUDIT were recorded from women who delivered recently. Cases of fetal alcohol syndrome (FAS) were also reported.
Results:  A total of 837 pregnant women have described all parameters. The mean age at delivery of our sample was 29.7 years (SD = 4.8 years). A total of 52.2% of women indicated that they had consumed alcohol at least once during their pregnancy, and among abstainers 54.5% had a positive AUDIT score. Of the pregnant women who consumed alcohol, 13.7% reported at least one binge drinking episode (5 or more drinks on 1 occasion) during pregnancy. Binge drinking is significantly more frequent than regular alcohol consumption (at least 1 drink more than 1 time per week) during pregnancy. A prevalence rate of FAS of 1.8 per 1,000 live births was observed.
Conclusions:  There is a large population of women who still drink alcohol during pregnancy, particularly in binge drinking episodes. This underlines the need to clearly inform women of childbearing age about the dangers of alcohol during pregnancy as related to all types of consumption. Moreover, acting to prevent alcohol consumption prior to pregnancy may also greatly influence prenatal drinking.     

National and state estimates of the mean ethanol content of beer sold in the US and their impact on per capita consumption estimates: 1988 to 2001

BACKGROUND: The average ethanol content of the beer sold in the US is a key factor in determining the per capita consumption of ethanol, the standard measure of alcohol use in aggregate-level research. To address the lack of empirically based estimates of beer ethanol content, we have calculated national estimates for the years 1988 to 2001 and state-specific estimates for 1993 to 2001. METHODS: These estimates are based on the ethanol content by volume of leading brands in each year, the national market share of each leading brand by type, and state-specific market shares of each beer type. RESULTS: The national mean ethanol content of beer was higher than the 4.5% figure typically used, ranging from 4.58% in 1993 to 4.75% in 1996. State-specific mean ethanol content estimates were also found to vary by state and over time. Application of mean ethanol content estimates to the per capita consumption of beer led to higher consumption estimates than those with the 4.5% conversion. For example, in 2000, the national estimate indicates that nearly 10 more drinks (containing 0.6 oz of ethanol) were consumed per person aged 14 years and older during that year. CONCLUSIONS: This may indicate that a larger than previously estimated share of the alcohol consumed in the US is in the form of beer. However, the results also indicate that empirically based estimates of wine and spirits mean that ethanol content may modify their consumption estimates as well.     

Effects of five different alcoholic drinks on patients with Crohn's disease

OBJECTIVE: Many patients with Crohn's disease (CD) complain of abdominal discomfort after alcohol intake. The aim of the present study was to investigate the effect of ethanol and sugar content in five different alcoholic drinks on abdominal discomfort in patients with CD. MATERIAL AND METHODS: In a crossover study, two weeks apart, 12 healthy individuals and 20 patients with CD in remission consumed randomly red wine, white wine, Smirnoff Ice, Elephant Beer and pure ethanol. Blood samples were obtained for determination of serum ethanol and plasma glucose at 0, 30, 60, 90, 120 and 180 min. A self-reported pain symptom score was used. RESULTS: There was no difference between CD patients and healthy individuals in the area under the curve (AUC) for the ethanol concentration after intake of the five different drinks. The plasma AUC for glucose in the CD patients after intake of Smirnoff Ice and Elephant beer was significantly increased (p<0.05) in comparison with that in the remaining three alcoholic drinks. Abdominal pain manifestations were significantly more pronounced in CD patients following intake of Smirnoff Ice and Elephant beer, with their higher sugar concentration, compared with intake of the remaining three drinks (p<0.05). CONCLUSIONS: The present study shows no difference in alcohol absorption between CD patients and controls. The alcoholic drinks Smirnoff Ice and Elephant beer have an increased effect on self-reported abdominal pain in CD patients, probably due to the high sugar content in these drinks.     

The importance of drinking frequency in evaluating individuals' drinking patterns: implications for the development of national drinking guidelines

Aims   This paper examines the relationship between frequency of drinking, usual daily consumption and frequency of binge drinking, taking into consideration possible age and gender differences.
Participants and design   Subjects were 10 466 current drinkers (5743 women and 4723 men) aged between 18 and 76 years, who participated in the GENACIS Canada (GENder Alcohol and Culture: an International Study) study.
Setting   Canada.
Measurements   The independent variable was the annual drinking frequency. The dependent variables were the usual daily quantity consumed, annual, monthly and weekly frequency of binge drinking (five drinks or more on one occasion).
Findings   Logistic regressions show (i) that those who drink less than once a week are less likely than weekly drinkers to take more than two drinks when they do drink; (ii) that the usual daily quantity consumed by weekly drinkers is not related to their frequency of drinking; but that (iii) the risk and frequency of binge drinking increase with the frequency of drinking.
Conclusions   Given that risk and frequency of binge drinking among Canadians increases with their frequency of drinking, any public recommendation to drink moderately should be made with great caution.     

The contribution of a moderate intake of alcohol to the presence of hypertension

The relationship between blood pressure and alcohol intake was examined in 2434 male and 1608 female London civil servants. These subjects had been selected from 24,000 office workers on the basis of responses to a health questionnaire. The men had an average blood pressure of 134/80 mmHg and consumed a mean of 62 g alcohol/week as beer, 28 g/week as wine or fortified wine and 18 g/week as spirits (a total of 11.8 drinks/week). The women had an average blood pressure of 133/79 mmHg and consumed 7 g alcohol/week as beer, 25 g/week as wine and 11 g/week as spirits (a total of 4.4 drinks/week). Twenty-five per cent of men and 24% of women had a casual diastolic pressure equal to or greater than 90 mmHg and were considered to have diastolic hypertension on the one occasion. There was no increase in either systolic or diastolic pressure in men until total alcohol intake exceeded 50 drinks/week. However, 1% of all men had hypertension associated with drinking alcohol and in those with hypertension, alcohol may have been the cause in between 4 and 9%. Defining 'hypertension' as a diastolic blood pressure of 90 mmHg or above on one occasion, 12-14% of people drinking more than 50 drinks of alcohol per week had hypertension associated with this intake of alcohol, and similarly, of those with both 'hypertension' and this level of intake, 36% could attribute their high blood pressure to their alcohol consumption.(ABSTRACT TRUNCATED AT 250 WORDS)     

Randomized controlled trial of cognitive–behavioural therapy for coexisting depression and alcohol problems: short-term outcome

Aims   Alcohol use disorders and depression co-occur frequently and are associated with poorer outcomes than when either condition occurs alone. The present study (Depression and Alcohol Integrated and Single-focused Interventions; DAISI) aimed to compare the effectiveness of brief intervention, single-focused and integrated psychological interventions for treatment of coexisting depression and alcohol use problems.
Methods   Participants ( n  = 284) with current depressive symptoms and hazardous alcohol use were assessed and randomly allocated to one of four individually delivered interventions: (i) a brief intervention only (single 90-minute session) with an integrated focus on depression and alcohol, or followed by a further nine 1-hour sessions with (ii) an alcohol focus; (iii) a depression focus; or (iv) an integrated focus. Follow-up assessments occurred 18 weeks after baseline.
Results   Compared with the brief intervention, 10 sessions were associated with greater reductions in average drinks per week, average drinking days per week and maximum consumption on 1 day. No difference in duration of treatment was found for depression outcomes. Compared with single-focused interventions, integrated treatment was associated with a greater reduction in drinking days and level of depression. For men, the alcohol-focused rather than depression-focused intervention was associated with a greater reduction in average drinks per day and drinks per week and an increased level of general functioning. Women showed greater improvements on each of these variables when they received depression-focused rather than alcohol-focused treatment.
Conclusions   Integrated treatment may be superior to single-focused treatment for coexisting depression and alcohol problems, at least in the short term. Gender differences between single-focused depression and alcohol treatments warrant further study.