Frequency of alcohol consumption and cardiovascular risk factors

November 20, 2012

Critique 096: Frequency of alcohol consumption and cardiovascular risk factors: implications for drinking guidelines 20 November 2012

Read the full critique here: http://www.bu.edu/alcohol-forum/critique-096-frequency-of-alcohol-consumption-and-cardiovascular-risk-factors-implications-for-drinking-guidelines-20-november-2012/

The purpose of this paper was to examine whether drinkers who consume lower-risk amounts on more frequent occasions have favourable risk factor profiles compared with those who drink more per occasion but less frequently. The authors also discuss implications for the larger debate about the limitations of non-randomized studies about 'moderate' drinking and the development of low-risk drinking guidelines. As stated by the authors, "many observational studies suggest that increased drinking frequency is associated with reduced mortality among those with low-dose alcohol consumption." Indeed, previous epidemiologic research has clearly shown that the healthiest outcomes occur among regular, moderate drinkers who do not binge drink. Further, almost all studies have adjusted for a large number of socio-economic factors that are known to be potentially confounding factors for evaluating the association of alcohol consumption with health outcomes.

As expected, the present study shows that regular drinkers tend to consume less alcohol per occasion, and are less likely to binge drink. Further, such individuals tend to have better socio-economic status and lower levels of most cardiovascular risk factors. Most previous researchers have interpreted the better educational status and economic levels of moderate drinkers to be important causes of their more moderate lifestyle factors (including avoiding abusive drinking). Further, most previous research, including many basic science interventions and limited trials in humans, have shown that the administration (intake) of moderate amounts of an alcoholic beverage leads to more favourable cardiovascular risk factors, and numerous mechanisms have been identified (higher HDL-cholesterol, improved vascular reactivity, improved platelet and other coagulation factors, etc.).

The authors of this paper take an unusual turn when it comes to discussing the implications of their results. They tend to down-play any potential health benefits that may be caused by alcohol or the pattern of drinking and infer instead that the favourable risk factors themselves may lead to the drinking pattern. Forum members disagreed with the implications of the authors on a number of factors: (1) the lack of randomized trials of low-dose alcohol consumption; (2) levels of evidence; (3) drinking frequency and alcohol intake; (4) clustering of lifestyle behaviours; (5) alcohol consumption and CVD-related biomarkers; (6) alcohol intake, cancer and total mortality. Further, Forum reviewers cite a large body of scientific research that refutes some of the conclusions of the authors, which imply that regular moderate alcohol intake does not relate to improved cardiovascular risk factors.

Forum reviewers agree with a concluding statement of the authors about using caution before recommending drinking to the general public. However, they believe that the arguments presented in this paper are not based on a balanced appraisal of available scientific data, and should not be used to support changes in guidelines for the public.
-end-
Reference: Naimi TS, Xuan Z, Brown DW, Saitz R. Confounding and studies of 'moderate' alcohol consumption: the case of drinking frequency and implications for low-risk drinking guidelines. Addiction 2012; pre-publication. doi:10.1111/j.1360-0443.2012.04074.x.

Comments on this paper have been provided by the following members of the International Scientific Forum on Alcohol Research:

Erik Skovenborg, MD, Scandinavian Medical Alcohol Board, Practitioner, Aarhus, Denmark

Creina Stockley, PhD, MBA, Clinical Pharmacology, Health and Regulatory Information Manager, AWRI, Australia

Arne Svilaas, MD, PhD, general practice and lipidology, Oslo University Hospital, Oslo, Norway

R. Curtis Ellison, MD, Section of Preventive Medicine & Epidemiology, Boston University School of Medicine, Boston, MA, USA

Giovanni de Gaetano, MD, PhD, Research Laboratories, Catholic University, Campobasso, Italy

Andrew L. Waterhouse, PhD, Marvin Sands Professor, University of California, Davis; Davis, CA, USA

Yuqing Zhang, MD, DSc, Epidemiology, Boston University School of Medicine, Boston, MA, USA

David Van Velden, MD, Dept. of Pathology, Stellenbosch University, Stellenbosch, South Africa

Dominique Lanzmann-Petithory, MD, PhD, Nutrition/Cardiology, Hopital Emile Roux, Paris, France

For the detailed critique of this paper by the International Scientific Forum on Alcohol Research and a listing of references, go to www.bu.edu/alcohol-forum or http://www.bu.edu/alcohol-forum/critique-096-frequency-of-alcohol-consumption-and-cardiovascular-risk-factors-implications-for-drinking-guidelines-20-november-2012/ The specialists who are members of the Forum are happy to respond to questions from Health Editors regarding emerging research on alcohol and health and will offer an independent opinion in context with other research on the subject

Boston University Medical Center

Related Alcohol Consumption Articles from Brightsurf:

Excessive alcohol consumption during the COVID-19 pandemic
The full impact of COVID-19 on alcohol use is not yet known, but rates have been rising during the first few months of the pandemic.

Alcohol consumption rises sharply during pandemic shutdown
Anecdotal information has suggested that people are buying and consuming more alcohol during the pandemic shutdown.

Associations of alcohol consumption, alcohol-induced passing out with risk of dementia
The risk of future dementia associated with overall alcohol consumption and alcohol-induced loss of consciousness in a population of current drinkers was examined in this observational study with more than 131,000 adults.

Sweet coolers a gateway to increased alcohol consumption
Sweetened alcoholic beverages can promote harmful alcohol consumption among teens, new University of Guelph research finds.

The influence of alcohol consumption among cohabitating partners
Research has linked a partner's or spouse's drinking with changes in alcohol-related behaviors, but few studies have considered only cohabiting relationships.

Does alcohol consumption have an effect on arthritis?
Several previous studies have demonstrated that moderate alcohol consumption is linked with less severe disease and better quality of life in patients with rheumatoid arthritis, but a new Arthritis Care & Research study suggests that this might not be because drinking alcohol is beneficial.

Is alcohol consumption more helpful than harmful? It depends on your age
Studies of health effects of alcohol consumption may underestimate the risks of imbibing, particularly for younger people, according to a new study in the Journal of Studies on Alcohol and Drugs.

Link between alcohol consumption and breast cancer ignored by women most at risk
Middle aged women in Australia aren't getting the message about the proven link between alcohol consumption and breast cancer, at a time when more are drinking while cancer rates in their age bracket are increasing, according to a new study.

How much is too much? Even moderate alcohol consumption is a risk factor for atrial fibrillation
Excessive alcohol consumption is an established risk factor for atrial fibrillation (AF), but what are the effects of moderate and mild consumption on AF?

Moderate consumption of alcohol is associated with fewer hospitalizations
A study of the Department of Epidemiology and Prevention of I.R.C.C.S.

Read More: Alcohol Consumption News and Alcohol Consumption Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.