Consumption of Total and Specific Alcoholic Beverages and Long-Term Risk of Gout Among Men and Women.

Importance: Previous studies on alcohol consumption and incident gout have mostly included men or combined both sexes, and the sex-specific associations between alcohol consumption and gout are poorly understood. Objective: To evaluate the consumption of total and specific alcoholic beverages in association with incident gout in men and women. Design, Setting, and Participants: This prospective cohort study included 401 128 participants in the UK Biobank aged 37 to 73 years who were free of gout at baseline (2006-2010). Participants were followed up through December 31, 2021, and data were analyzed between August 2023 and June 2024. Exposure: Questionnaire-based consumption of total alcohol and specific alcoholic beverages. Main Outcomes and Measures: The outcome was incident gout, identified using hospital records. Multivariable Cox proportional hazards regression models were used to estimate sex-specific hazard ratios (HRs) and 95% CIs of incident gout associated with alcohol consumption, with a particular consideration of reverse causation bias. Results: The main analysis included 179 828 men (mean [SD] age, 56.0 [8.2] years) and 221 300 women (mean [SD] age, 56.0 [8.0] years). Current drinkers showed a higher risk of gout than never drinkers among men (HR, 1.69; 95% CI, 1.30-2.18) but not among women (HR, 0.83; 95% CI, 0.67-1.03). Among current drinkers, higher total alcohol consumption was associated with a higher risk of gout among both sexes and more strongly among men than women (men: HR, 2.05 [95% CI, 1.84-2.30]; women: HR, 1.34 [95% CI, 1.12-1.61]). The most evident sex difference in the consumption of specific alcoholic beverages was observed for beer or cider (men: mean [SD], 4.2 [4.8] pints per week; women: mean [SD], 0.4 [1.1] pints per week). Consumption of champagne or white wine, beer or cider, and spirits each was associated with a higher risk of gout among both sexes, with beer or cider showing the strongest association per 1 pint per day (men: HR, 1.60 [95% CI, 1.53-1.67]; women: HR, 1.62 [95% CI, 1.02-2.57]). Some inverse associations between light to moderate consumption of specific alcoholic beverages and gout were eliminated after adjusting for other alcoholic beverages and excluding individuals who had reduced alcohol consumption for health reasons, self-reported poor health, or had cardiovascular disease, cancer, or kidney failure at baseline, or developed gout within the first 2 years of follow-up. Conclusions and Relevance: In this cohort study, higher consumption of several specific alcoholic beverages was associated with a higher risk of gout among both sexes. The sex-specific associations for total alcohol consumption may be associated with differences between men and women in the types of alcohol consumed.

[Health effects of alcohol: untangling the truth from the false!] / Effets de l'alcool sur la santé : démêler le vrai du faux !

HEALTH EFFECTS OF ALCOHOL: UNTANGLING THE TRUTH FROM THE FALSE! Daily alcohol consumption is associated with an increased risk of death, even at low doses. However, it remains high in France, where a large proportion of the population consumes alcohol in excess of reasonable limits. The most recent data invalidate the idea that a low dose could reduce cardiovascular risk. Santé publique France recommended in 2017 not to exceed the dose of 100 g of pure alcohol per week and not to drink alcohol every day. Harmonizing taxes on different types of alcoholic beverages upwards and indicating on each container: "Do not exceed 10 glasses per week" would be two good public health measures.

"EFFETS DE L'ALCOOL SUR LA SANTÉ : DÉMÊLER LE VRAI DU FAUX ! La consommation quotidienne d'alcool est associée à un risque augmenté de décès, et ce même si la dose d'alcool est faible. Elle reste toutefois élevée en France où une bonne partie de la population a une consommation dépassant les limites d'une consommation raisonnable. Les données les plus récentes infirment l'idée qu'une faible dose pourrait réduire le risque cardiovasculaire. Santé publique France a recommandé en 2017 de ne pas dépasser la dose de 100 g d'alcool pur par semaine et de ne pas boire d'alcool tous les jours. Harmoniser par le haut les taxes sur les différents types de boissons alcoolisées et indiquer sur chaque contenant : « Ne pas dépasser 10 verres par semaine ¼ seraient deux bonnes mesures de santé publique."

[Hypothetical Alcohol Consumption Interventions and Hepatic Steatosis: A Longitudinal Study in a Large Cohort]. / æ¨¡æ‹Ÿé¥®é ’å¹²é¢„ä¸Žè‚è„‚è‚ªå˜æ€§ï¼šä¸€é¡¹å¤§åž‹é˜Ÿåˆ—çš„çºµå‘ç ”ç©¶.

Objective: Non-alcoholic fatty liver disease (NAFLD) and alcohol-associated fatty liver disease (ALD) are the most common chronic liver diseases. Hepatic steatosis is an early histological subtype of both NAFLD and ALD. Excessive alcohol consumption is widely known to lead to hepatic steatosis and subsequent liver damage. However, reported findings concerning the association between moderate alcohol consumption and hepatic steatosis remain inconsistent. Notably, alcohol consumption as a modifiable lifestyle behavior is likely to change over time, but most previous studies covered alcohol intake only once at baseline. These inconsistent findings from existing studies do not inform decision-making concerning policies and clinical guidelines, which are of greater interest to health policymakers and clinician-scientists. Additionally, recommendations on the types of alcoholic beverages are not available. Usually, assessing the effects of two or more hypothetical alcohol consumption interventions on hepatic steatosis provides answers to questions concerning the population risk of hepatic steatosis if everyone changes from heavy drinking to abstinence, or if everyone keeps on drinking moderately, or if everyone of the drinking population switches from red wine to beer? Thus, we simulated a target trial to estimate the effects of several hypothetical interventions, including changes in the amount of alcohol consumption or the types of alcoholic beverages consumed, on hepatic steatosis using longitudinal data, to inform decisions about alcohol-related policymaking and clinical care. Methods: This longitudinal study included 12687 participants from the UK Biobank (UKB), all of whom participated in both baseline and repeat surveys. We excluded participants with missing data related to components of alcohol consumption and fatty liver index (FLI) in the baseline and the repeat surveys, as well as those who had reported liver diseases or cancer at the baseline survey. We used FLI as an outcome indicator and divided the participants into non-, moderate, and heavy drinkers. The surrogate marker FLI has been endorsed by many international organizations' guidelines, such as the European Association for the Study of the Liver. The calculation of FLI was based on laboratory and anthropometric data, including triglyceride, gamma-glutamyl transferase, body mass index, and waist circumference. Participants responded to questions about the types of alcoholic beverages, which were defined in 5 categories, including red wine, white wine/fortified wine/champagne, beer or cider, spirits, and mixed liqueurs, along with the average weekly or monthly amounts of alcohol consumed. Alcohol consumption was defined as pure alcohol consumed per week and was calculated according to the amount of alcoholic beverages consumed per week and the average ethanol content by volume in each alcoholic beverage. Participants were categorized as non-drinkers, moderate drinkers, and heavy drinkers according to the amount of their alcohol consumption. Moderate drinking was defined as consuming no more than 210 g of alcohol per week for men and 140 g of alcohol per week for women. We defined the following hypothetical interventions for the amount of alcohol consumed: sustaining a certain level of alcohol consumption from baseline to the repeat survey (e.g., none to none, moderate to moderate, heavy to heavy) and changing from one alcohol consumption level to another (e.g., none to moderate, moderate to heavy). The hypothetical interventions for the types of alcoholic beverages were defined in a similar way to those for the amount of alcohol consumed (e.g., red wine to red wine, red wine to beer/cider). We applied the parametric g-formula to estimate the effect of each hypothetical alcohol consumption intervention on the FLI. To implement the parametric g-formula, we first modeled the probability of time-varying confounders and FLI conditional on covariates. We then used these conditional probabilities to estimate the FLI value if the alcohol consumption level of each participant was under a specific hypothetical intervention. The confidence interval was obtained by 200 bootstrap samples. Results: For the alcohol consumption from baseline to the repeat surveys, 6.65% of the participants were sustained non-drinkers, 63.68% were sustained moderate drinkers, and 14.74% were sustained heavy drinkers, while 8.39% changed from heavy drinking to moderate drinking. Regarding the types of alcoholic beverages from baseline to the repeat surveys, 27.06% of the drinkers sustained their intake of red wine. Whatever the baseline alcohol consumption level, the hypothetical interventions for increasing alcohol consumption from the baseline alcohol consumption were associated with a higher FLI than that of the sustained baseline alcohol consumption level. When comparing sustained non-drinking with the hypothetical intervention of changing from non-drinking to moderate drinking, the mean ratio of FLI was 1.027 (95% confidence interval [CI]: 0.997-1.057). When comparing sustained non-drinking with the hypothetical intervention of changing from non-drinking to heavy drinking, the mean ratio of FLI was 1.075 (95% CI: 1.042-1.108). When comparing sustained heavy drinking with the hypothetical intervention of changing from heavy drinking to moderate drinking, the mean ratio of FLI was 0.953 (95% CI: 0.938-0.968). The hypothetical intervention of changing to red wine in the UKB was associated with lower FLI levels, compared with sustained consumption of other types of alcoholic beverages. For example, when comparing sustaining spirits with the hypothetical intervention of changing from spirits to red wine, the mean ratio of FLI was 0.981 (95% CI: 0.948-1.014). Conclusions: Regardless of the current level of alcohol consumption, interventions that increase alcohol consumption could raise the risk of hepatic steatosis in Western populations. The findings of this study could inform the formulation of future practice guidelines and health policies. If quitting drinking is challenging, red wine may be a better option than other types of alcoholic beverages in Western populations.

Dose-Response Relationship Between Alcohol Consumption and Gout Risk: Do Subtypes of Alcoholic Beverages Make a Difference?

OBJECTIVE: Although previous studies have explored the association of drinking with gout risk, we sought to explore the dose-response relationship and the evidence between subtypes of alcoholic beverages and gout risk. METHODS: The weekly alcoholic beverage consumption of patients in the UK Biobank was collected and calculated. The Cox regression model was applied to assess the effects of drinking alcohol in general and its subtypes on gout risk by calculating the hazard ratio (HR) and 95% CIs. Additionally, the restricted cubic splines were used to estimate the dose-response relationship between alcohol consumption and gout risk. To evaluate the robustness, we performed subgroup analysis across various demographic characteristics. RESULTS: During a mean follow-up period of 11.7 years, a total of 5728 new incident gout cases were diagnosed among 331,865 participants. We found that light alcohol consumption was linked to a slight decrease in gout incidence among female individuals (HR 0.78, 95% CI 0.65-0.94, P = 0.01), whereas there was no significant association in male individuals. Moreover, the dose-response relationship showed that drinking light red wine and fortified wine could reduce the gout risk, whereas beer or cider, champagne or white wine, and spirits increased the gout risk at any dose. CONCLUSION: Our study suggested a J-shaped dose-response relationship between drinking and gout risk in female individuals, but not in male individuals. For specific alcoholic beverages, light consumption of red wine and fortified wine was associated with reduced gout risk. These findings offer new insights into the roles of alcoholic beverages in gout incidence risk, although further validation is warranted.

Evaluation of Color Stability and Translucency of Different Composite Resins Exposed to Alcohol.

BACKGROUND: As there is evidence showing the effects of alcohol on the surface properties of composite resins, it is of great importance to understand the effects of commonly consumed beverages on the discoloration of composite restorations in people who consume alcohol. AIM: The aim of this study was to investigate the changes in the color and translucency of composite resins immersed in different beverages after exposure to alcohol. METHODS: Disk-shaped samples from each composite resin (Filtek Z250 (Z250), Clearfil Majesty Esthetic (CME), and Esthelite Bulk Fill Flow (EBF), were prepared (n = 60) and randomly divided into two groups (exposed or unexposed to alcohol). The samples were immersed in distilled water, black tea, and coffee. The color parameter (∆E00) and translucency parameter (∆TP) were calculated after 24 h, 1 week, and 3 weeks. Four-way ANOVA and Tukey's post-hoc analysis were used for the statistical analysis (α = 0.05). RESULTS: Alcohol significantly increased the discoloration of Z250 and EBF in black tea. The discoloration of CME was not affected by alcohol exposure. Z250 and EBF showed clinically unacceptable discoloration (ΔE00 > 2.25) after immersion in black tea and coffee, whereas CME showed clinically unacceptable discoloration after immersion in black tea. Black tea caused the greatest color change in all composite materials regardless of alcohol exposure. EBF showed the lowest ΔTP values (∆TP = -1.82) at 3 weeks of immersion in black tea. CONCLUSIONS: The effect of alcohol on discoloration depended on the composite type used. The translucency of bulk-fill flowable composite decreased with alcohol exposure.

Characteristics, toxicology and major organ pathology of deaths due to acute alcohol toxicity in Australia, 2011-2022.

INTRODUCTION: Acute alcohol toxicity is a significant component of alcohol-related mortality. The study aimed to: (i) determine the circumstances of death and characteristics of fatal alcohol toxicity cases, 2011-2022; (ii) determine their toxicological profile and major autopsy findings; and (iii) determine trends in population mortality rates. METHODS: Retrospective study of acute alcohol toxicity deaths in Australia, 2011-2022, retrieved from the National Coronial Information System. RESULTS: A total of 891 cases were identified, with a mean age of 49.2 years, 71.0% being male. Alcohol use problems were noted in 71.3%. In 57.5% death was attributed solely to acute alcohol toxicity, and combined acute alcohol toxicity/disease in 42.5%. There was evidence of sudden collapse in 24.9% of cases. The mean BAC was 0.331 g/100 mL (range 0.107-0.936), and spirits were the most commonly reported beverages (35.8%). Cases of combined toxicity/disease had significantly lower BACs than those attributed solely to alcohol toxicity (0.296 vs. 0.358 g/100 mL). Cardiomegaly was diagnosed in 32.5%, and severe coronary artery disease in 22.1%. Aspiration of vomitus was noted in 18.0%, and chronic obstructive pulmonary disease in 19.6%. Severe liver steatosis was present in 33.4% and 13.6% had cirrhosis. There was an average annual percentage increase in deaths of 7.90. DISCUSSION AND CONCLUSIONS: The 'typical' case was a long-standing, heavy spirits drinker. BACs showed enormous variation and no arbitrary concentration may be deemed lethal. Clinically significant disease was associated with death at a lower BAC and people with such disease may be at increased risk of alcohol poisoning.

Negative consequences associated with daily alcohol use as a nonlinear function of number of drinks in a daily diary study.

INTRODUCTION: Drinking intensity among young adults is associated with greater negative alcohol-related consequences, but often studied using categorical drinking thresholds. This study examined how alcohol-related consequences varied as a continuous function of number of drinks consumed, without imposing thresholds, to identify drink ranges for which risk is greatest. METHODS: Analyses included daily surveys from the Young Adult Daily Life study (2019-22) in which individuals reported drinking 1 or more alcoholic drinks (n=5219 days; 832 individuals). Time-varying effect models estimated total number of negative alcohol-related consequences and five individual consequences (hangover, drank more than planned, nausea/vomiting, did something embarrassing, blacked out) as a function of the number of drinks consumed among young adult males and females. RESULTS: Often, increases in the number and prevalence of negative consequences were a nonlinear function of the number of drinks consumed. Females reported few negative consequences on 1-to-3-drink occasions but steep increases in consequences on 4-to-9-drink occasions. Among females, the prevalence of blacking out increased six-fold from 4-drink (3.4%; 95% CI=2.6,4.7) to 9-drink occasions (20.6%; 95% CI=16.1,26.1). Among males, the prevalence of some consequences, while not linear, increased across the full drink range. Blacking out among males increased from 9.6% (95% CI=6.2,14.7) on 10-drink occasions to 23.9% (95% CI=15.0,35.8) on 15-drink occasions. CONCLUSIONS: Substantial heterogeneity is missed when typical drinking categories are used. In particular, variability in consequences across levels of the traditional binge drinking category suggests that important differences in risk may be missed when assessed as a uniform category.

The potential adverse effects of minors' exposure to alcohol-related stimuli via licenced venues: A narrative review.

ISSUES: Young people are particularly impressionable when it comes to forming expectations and attitudes around alcohol consumption. Any stimuli that normalise and foster positive expectations around alcohol use may increase the risk of underage alcohol consumption. Alcohol venues that market themselves as being appropriate 'family friendly' establishments for children risk exposing minors to environments that are saturated with alcohol-related stimuli. However, research examining how exposure to licenced venues affects underage people is very limited. The aim of this narrative review was to identify and synthesise relevant evidence to better understand how attending these venues might affect minors. APPROACH: A narrative review of research published between January 2016 and November 2022 was conducted to investigate the potential effects on underage people of exposure to licenced venues and stimuli encountered in/around these venues. Examined stimuli included alcohol advertising, people consuming alcohol and alcohol outlets. KEY FINDINGS: The reviewed literature indicates that the risk of alcohol-related harm among minors is likely to increase with greater exposure to alcohol venues due to the associated exposure to alcohol advertising, exposure to others consuming alcohol and higher outlet density. In combination, these factors are likely to normalise alcohol consumption for minors and create positive alcohol expectancies. IMPLICATIONS AND CONCLUSION: Venues serving alcohol should be discouraged from targeting families and parents should be warned about the risks associated with taking minors to venues where alcohol is sold and consumed.

How effective are health messages/warnings in improving knowledge and awareness of alcohol-related harm? The Slovenian case on using a mobile app.

BACKGROUND: Consumers generally lack access to information on alcoholic beverages, in spite of it being readily available for food and non-alcoholic beverages. Given the rights of consumers, and as with other products harmful to the population, there have been increasing calls for health warnings to be placed on alcoholic beverages, similar to those implemented on tobacco products. The aim of our research was to assess whether knowledge and awareness of the risks and harms associated with alcohol can be improved with a mobile app. METHODS: Intervention was conducted using VKJ mobile app, which enables users to scan the barcode of an alcoholic beverage and receive feedback on its labelled alcohol content and estimated energy value. At each search, eleven different health messages/warnings about the risks and harms of alcohol are also displayed randomly, rotating on the screen. A survey was conducted before and after the intervention, to assess the knowledge and awareness of the risks and harms associated with drinking alcohol. RESULTS: Significant differences were found for eight of the twelve tested statements. The improvement was seen to a greater extent in the group of high-risk drinkers. The results also showed that the vast majority of participants (78%) who were exposed to the health messages supported mandatory labelling of alcoholic beverages with information on ingredient listing and energy value, and 72% would like to have health warnings on alcohol products. CONCLUSIONS: The use of a mobile app can be an option to improve knowledge and raise awareness of the risks and harms related to alcohol.

Association between alcoholic beverage intake and hyperuricemia in Chinese adults: Findings from the China Health and Nutrition Survey.

While prior research has shown that consuming alcohol may raise the risk of hyperuricemia, little is known about how individual types of alcohol are linked to levels of uric acid in China. Therefore, this study aimed to investigate the independent impact of beer, wine, and liquor on serum uric acid (SUA) levels in the serum of Chinese adults. This study analyzed data from the 2009 China Health and Nutrition Survey and included 7083 participants (3418 men and 3665 women, ≥18 years of age). Multivariable logistic regression was used to analyze the potential association between alcohol intake and hyperuricemia risk, while linear regression analysis and general linear model were performed to examine the impact of alcohol consumption on SUA levels. This study revealed that men who drank alcohol daily had a greater odds ratio (1.68, 95% confidence interval: 1.01, 2.81) of hyperuricemia than those who drank alcohol no more than once a month. SUA levels of men significantly increased by 0.001 mg/dL for per additional gram of liquor consumed weekly. But men who drank ≤ 90.6 g of liquor per week had lower SUA levels compared with those in nondrinkers. SUA levels were inversely associated with wine intake in women (P = .03, P for trend = .02). Overall, consumption of beer, wine, and liquor differentially affected SUA levels in adult Chinese men and women.

'A recipe for cultural disaster!'- a case study of Woolworths Group's proposal to build an alcohol megastore in Darwin, Northern Territory.

BACKGROUND: The health and wellbeing impacts of commercial activity on Indigenous populations is an emerging field of research. The alcohol industry is a key driver of health and social harms within Australia. In 2016 Woolworths, the largest food and beverage retailer in Australia, proposed to build a Dan Murphy's alcohol megastore in Darwin, near three 'dry' Aboriginal communities. This study examines the tactics used by Woolworths to advance the Dan Murphy's proposal and understand how civil society action can overcome powerful commercial interests to protect Aboriginal and Torres Strait Islander health and wellbeing. METHODS: Data from 11 interviews with Aboriginal and non-Aboriginal informants were combined with data extracted from media articles and government, non-government and industry documents. Thematic analysis was informed by an adapted corporate health impact assessment framework. RESULTS: Woolworths employed several strategies including lobbying, political pressure, litigation, and divisive public rhetoric, while ignoring the evidence suggesting the store would increase alcohol-related harm. The advocacy campaign against the proposal highlighted the importance of Aboriginal and non-Aboriginal groups working together to counter commercial interests and the need to champion Aboriginal leadership. Advocacy strategies included elevating the voices of community Elders in the media and corporate activism via Woolworths' investors. CONCLUSIONS: The strategies used by the coalition of Aboriginal and non-Aboriginal groups may be useful in future advocacy campaigns to safeguard Aboriginal and Torres Strait Islander health and wellbeing from commercial interests.

Designing Cancer Warning Labels for Alcoholic Beverages: Examining the Impact of Visual Elements.

Alcohol is a known carcinogen. However, public awareness of cancer risk associated with alcohol use is low. A promising approach to raising awareness is to include cancer warning labels on alcohol-containing products, but there is limited knowledge of the design and effect of such warnings. The present study investigated the impact of visual elements on the effectiveness of cancer warning labels. In a randomized online experiment, alcohol consumers (N = 1,190) were randomly assigned to one of three conditions: exposure to (a) text-only warning labels, (b) pictorial warning labels showing graphic health effects (e.g., diseased organs), and (c) pictorial warning labels showing lived experience (e.g., cancer patients in a medical setting). The results showed that whereas the three warning types did not differ significantly in behavioral intentions, pictorial warnings featuring health effects led to greater disgust and anger than text-only warnings and pictorial warnings featuring lived experience. Moreover, anger predicted lower intentions to reduce alcohol use and was a significant mediator of the effects of warning type on behavioral intentions. The findings highlight the role of emotions in responses to health warning labels with different visual elements and suggest that text-only warnings and pictorial warnings with lived experience may be useful in preventing boomerang effects.

Alcohol Consumption and Risk of Total Hip Replacement Due to Hip Osteoarthritis in Women.

OBJECTIVE: This study was undertaken to examine the relationship between alcohol consumption and hip osteoarthritis in women. Alcohol has been associated with both adverse and beneficial health effects generally; however, the relationship between alcohol consumption and hip osteoarthritis has been minimally studied. METHODS: Among women in the Nurses' Health Study cohort in the US, alcohol consumption was assessed every 4 years, starting in 1980. Intake was computed as cumulative averages and simple updates with latency periods of 0-4 through 20-24 years. We followed 83,383 women without diagnosed osteoarthritis in 1988 to June 2012. We identified 1,796 cases of total hip replacement due to hip osteoarthritis defined by self-report of osteoarthritis with hip replacement. RESULTS: Alcohol consumption was positively associated with hip osteoarthritis risk. Compared with nondrinkers, multivariable hazard ratios (HRs) and 95% confidence intervals (95% CIs) were HR 1.04 (95% CI 0.90, 1.19) for drinkers of >0 to <5 grams/day, HR 1.12 (95% CI 0.94, 1.33) for 5 to <10 grams/day, HR 1.31 (95% CI 1.10, 1.56) for 10 to <20 grams/day, and HR 1.34 (95% CI 1.09, 1.64) for ≥20 grams/day (P for trend < 0.0001). This association held in latency analyses of up to 16-20 years, and for alcohol consumption between 35-40 years of age. Independent of other alcoholic beverages, the multivariable HRs (per 10 grams of alcohol) were similar for individual types of alcohol intake (wine, liquor, and beer; P = 0.57 for heterogeneity among alcohol types). CONCLUSION: Higher alcohol consumption was associated with greater incidence of total hip replacement due to hip osteoarthritis in a dose-dependent manner in women.

Impact of alcohol taxes on violence in Hong Kong: a population-based interrupted time series analysis.

BACKGROUND: Interpersonal violence is a major public health concern with alcohol use a known risk factor. Despite alcohol taxation being an effective policy to reduce consumption; Hong Kong, contrary to most developed economies, embarked on an alcohol tax reduction and elimination policy. METHODS: To assess the impact of the alcohol tax reductions, we analysed population-based hospitalisation data for assault from the Hong Kong Hospital Authority, and violent and sexual crimes recorded by the Hong Kong Police Force (2004-2018). We conducted an interrupted time series using seasonal autoregressive integrated moving average models on monthly rates. Breakpoints in March 2007 and March 2008 were applied separately. RESULTS: The 2007 tax cut was associated with sustained increases in violence-related hospitalisation rates for 35-49 age group (female: 0.19%, p=0.007; male: 0.22%, p<0.001; overall: 0.16%, p=0.007); and an immediate increase of 51.3% (p=0.005) in the rate of sexual crimes reported. Results for the 35-49 age group after the 2008 tax cut were similar with sustained increases in hospitalisation rates (female: 0.21%, p=0.010; male: 0.23%, p<0.001; overall: 0.17%, p<0.001). The 2008 tax cut was also associated with immediate increases in hospitalisation rates in children (female: 33.1%, p=0.011; male: 49.2%, p<0.001, overall: 31.5%, p=0.007). For both tax cuts, results were insignificant in males and females for other age groups (15-34 and 50+ years). CONCLUSIONS: Both alcohol tax reductions in 2007 and 2008 were in some age groups associated with increases in violence-related hospitalisations and reports of sexual assault even in an environment of low crime.

Do Beliefs about Alcohol and Cancer Risk Vary by Alcoholic Beverage Type and Heart Disease Risk Beliefs?

BACKGROUND: Alcohol is a leading risk factor for cancer, yet awareness of the alcohol-cancer link is low. Awareness may be influenced by perceptions of potential health benefits of alcohol consumption or certain alcoholic beverage types. The purpose of this study was to estimate awareness of the alcohol-cancer link by beverage type and to examine the relationship between this awareness and concomitant beliefs about alcohol and heart disease risk. METHODS: We analyzed data from the 2020 Health Information National Trends Survey 5 Cycle 4, a nationally representative survey of U.S. adults. RESULTS: Awareness of the alcohol-cancer link was highest for liquor (31.2%), followed by beer (24.9%) and wine (20.3%). More U.S. adults believed wine (10.3%) decreased cancer risk, compared with beer (2.2%) and liquor (1.7%). Most U.S. adults (>50%) reported not knowing how these beverages affected cancer risk. U.S. adults believing alcoholic beverages increased heart disease risk had higher adjusted predicted probabilities of being aware of the alcohol-cancer link (wine: 58.6%; beer: 52.4%; liquor: 59.4%) compared with those unsure (wine: 6.0%; beer: 8.6%; liquor: 13.2%), or believing alcoholic beverages reduced (wine: 16.2%; beer: 21.6%; liquor: 23.8%) or had no effect on heart disease risk (wine: 10.2%; beer: 12.0%; liquor: 16.9%). CONCLUSIONS: Awareness of the alcohol-cancer link was low, varied by beverage type, and was higher among those recognizing that alcohol use increased heart disease risk. IMPACT: These findings underscore the need to educate U.S. adults about the alcohol-cancer link, including raising awareness that drinking all alcoholic beverage types increases cancer risk. See related commentary by Hay et al., p. 9.

Alcohol Mixed with Energy Drinks (AmED) Use among University Students: A Systematic Review and Meta-Analysis.

In the last decades, there has been a huge increase in the consumption of both Energy Drinks (EDs) and alcohol and, concurrently, these two trends generated the additional practice of mixing ED with alcohol, known as Alcohol mixed with Energy Drink (AmED). One of the most important group of AmED consumers is represented by young. Indeed, the study population of the researches in this field are mainly represented by college students and the results evidence a great range of negative consequences for health. The purpose of the systematic review was to explore the prevalence of AmED consumption among undergraduate students, together with motivations to their use, adverse effects and health-related behaviors associated to AmEDs use. The review was conducted according to the PRISMA Statement and PubMed, Scopus and Web of Science were interrogated. 42 articles, published from 2008 to 2021, were included in the review. An overall prevalence rate of 37% was estimated for AmEDs use in undergraduates, with geographical differences. Although a decrease in consumption was observed throughout the studied period, a continuous monitoring on this phenomenon is needed for identifying those risk groups that could develop risky behaviors related to AmEDs consumption and provide them targeted educational interventions.

Alcohol Drinking Patterns and Laboratory Indices of Health: Does Type of Alcohol Preferred Make a Difference?

Although excessive alcohol consumption is a highly prevalent public health problem the data on the associations between alcohol consumption and health outcomes in individuals preferring different types of alcoholic beverages has remained unclear. We examined the relationships between the amounts and patterns of drinking with the data on laboratory indices of liver function, lipid status and inflammation in a national population-based health survey (FINRISK). Data on health status, alcohol drinking, types of alcoholic beverages preferred, body weight, smoking, coffee consumption and physical activity were recorded from 22,432 subjects (10,626 men, 11,806 women), age range 25-74 years. The participants were divided to subgroups based on the amounts of regular alcohol intake (abstainers, moderate and heavy drinkers), patterns of drinking (binge or regular) and the type of alcoholic beverage preferred (wine, beer, cider or long drink, hard liquor or mixed). Regular drinking was found to be more typical in wine drinkers whereas the subjects preferring beer or hard liquor were more often binge-type drinkers and cigarette smokers. Alcohol use in all forms was associated with increased frequencies of abnormalities in the markers of liver function, lipid status and inflammation even at rather low levels of consumption. The highest rates of abnormalities occurred, however, in the subgroups of binge-type drinkers preferring beer or hard liquor. These results demonstrate that adverse consequences of alcohol occur even at moderate average drinking levels especially in individuals who engage in binge drinking and in those preferring beer or hard liquor. Further emphasis should be placed on such patterns of drinking in policies aimed at preventing alcohol-induced adverse health outcomes.

Perception of safety and consumption of alcoholic beverages during pregnancy.

This cross-sectional study of antenatal clinic attendees aimed to determine the proportions of pregnant women that consider different alcoholic beverages safe for their babies; and the proportions that took them in the index pregnancy. Five hundred and six women completed the questionnaires. Mean age was 30.07 ± 5.13 years. Mean parity was 1.44 ± 1.32. 478 (94.5%) were married. Three hundred and eighty-three (75.69%) had tertiary education. These proportions did not consider these alcoholic beverages harmful in pregnancy: palm wine 35.77%, stout 17.03%, beer 14.03%, alcoholic wine 13.83%, ogogoro (distilled fermented palm wine) 13.04% and gin/spirits 9.88%. The proportion that consumed different alcoholic beverages during pregnancy were: palm wine 17.20%, beer 5.33%, alcoholic wine 4.35%, stout 4.15%, ogogoro 1.58% and gin/spirits 0.59%. Pregnant women who considered various alcoholic beverages safe in pregnancy were significantly more likely to consume them during pregnancy. Healthcare providers should assess women's perception of the safety of different alcoholic beverages and offer counselling to discourage their consumption during pregnancy.Impact StatementWhat is already known on this subject? Babies exposed to alcohol in pregnancy are at increased risk of developing foetal alcohol spectrum disorders. No safe level of alcohol has been established for pregnancy. The level of alcohol consumption by pregnant women is still high in our practice environment.What do the results of this study add? The perception that a specific alcoholic beverage is safe and not harmful to the foetus, significantly increases the likelihood of the consumption of that alcoholic beverage by a pregnant woman.What are the implications of these findings for clinical practice and/or further research? Healthcare workers will need to enquire about specific alcoholic beverages especially those common within their practice environment. An enquiry should be made on the perception of safety and their consumption during pregnancy. Women who perceive certain alcoholic beverages are more likely to consume them during pregnancy and hence should receive specific counselling on the alcoholic content of these beverages and the risk to their babies to discourage the consumption of that alcoholic beverage during pregnancy.

Effect of intermittent access to alcohol mixed in energy drink during adolescence on alcohol self-administration, anxiety, and memory during adulthood in rats.

BACKGROUND: Mixing alcohol with caffeinated energy drinks is a common practice among young people. Consumption of alcohol mixed in energy drink is associated with increased risk of binge drinking and alcohol dependence. The purpose of this study was to determine whether voluntary intermittent access to alcohol mixed in energy drink in adolescent rats alters adult self-administration of alcohol, anxiety, and memory. METHODS: For 10 weeks in the home-cage, two groups of adolescent female Sprague-Dawley rats had intermittent access to energy drink (ED) or 10% alcohol mixed in energy drink (AmED) with water concurrently available. Other rat groups had daily continuous access to ED or AmED. Anxiety was measured with an open field test and memory was assessed with a novel place recognition test. For self-administration, rats pressed levers for 10% alcohol alone on a fixed ratio (FR1) and on a progressive ratio (PR). RESULTS: Intermittent access to AmED generated greater intake during the initial 30 min of access (AmED 1.70 ± 0.04 g/kg vs. ED 1.01 ± 0.06 g/kg) and during the subsequent 24 h (AmED 7.04 ± 0.25 g/kg vs. ED 5.60 ± 0.29 g/kg). Intermittent AmED caused a significant but small decrease in anxiety while neither ED nor AmED altered memory. During alcohol self-administration, group differences emerged only during PR testing during which intermittent AmED rats responded more than all other groups. CONCLUSIONS: These findings suggest that intermittent access to AmED generates binge-like consumption that supports human findings that AmED generates greater alcohol consumption. Furthermore, experience with AmED may alter the motivational properties of alcohol into adulthood without necessarily causing a major impact on anxiety or memory.