Suicidal behaviour among alcohol-dependent Danes attending outpatient treatment.

The association between alcohol dependence and suicidal behaviour is well established and patients with suicidal behaviour in treatment for alcohol dependence present a considerable challenge for clinical services. The aim of this study is to identify risk factors for suicide attempts and to evaluate the outcome of treatment in patients in treatment for alcohol dependence. Semi-structured, detailed interviews were administered at baseline and at three sequential follow-up interviews with a large sample of 1692 patients at an outpatient treatment centre in the county of Funen in Denmark. Characteristics of, predictors for and outcome among suicidal patients were studied. Alcohol-dependent patients with a history of suicide attempts were found to constitute a highly selected group in alcohol abuse treatment as they often had a more severe course of alcohol dependence, were unemployed, younger, were more often lowly educated, and had more physical and psychiatric problems. Traumatic childhood experience related to physical or sexual abuse was found as a major predictor for suicidal behaviour among alcohol-dependent patients. We found no significant difference in the effect of treatment in patients with and without suicidal behaviour. These results support the hypothesis that alcohol-dependent patients with a history of suicide attempts are a selected group in respect to a number of demographical and psychosocial factors, but we found no difference in the outcome of treatment. This may imply that suicidal patients in treatment for alcohol abuse are treated effectively within the present treatment settings.

Alcohol drinking frequency in relation to subsequent changes in waist circumference.

BACKGROUND: Cross-sectional studies have reported a lower prevalence of abdominal obese persons among frequent drinkers than among nonfrequent drinkers. OBJECTIVE: We tested the hypothesis that drinking frequency is associated with subsequent changes in waist circumference. DESIGN: Data come from a prospective cohort study conducted in 1993-1997 (baseline) and 1999-2002 (follow-up) and included 43 543 men and women. Baseline information on alcohol drinking frequency was related to 1) change in waist circumference by linear regression and 2) major gain and major loss in waist circumference (defined as waist change in the lowest or highest quintile of waist changes) by polytomous logistic regression, also taking into account amount of alcohol intake. RESULTS: Drinking frequency was inversely associated with changes in waist circumference in women and was unassociated with changes in waist circumference in men. Drinking frequency was unassociated with major waist loss but was inversely associated with major waist gain: odds ratios among men were 0.97 (95% CI: 0.73, 1.28), 0.95 (95% CI: 0.81, 1.12), 0.88 (95% CI: 0.77, 0.99), 0.82 (95% CI: 0.71, -0.95), and 0.79 (95% CI: 0.69, 0.9) for never drinking, drinking on 1, 2-4, 5-6, and 7 d/wk, respectively, compared with men who drank alcohol on <1 d/wk (P for trend < 0.0001). Results for women were similar. Adjustment for the amount of alcohol intake or total energy intake did not affect results considerably. CONCLUSIONS: Drinking pattern may be associated with development of abdominal obesity; in this prospective study, drinking frequency was inversely associated with major waist gain and was unassociated with major waist loss.

Time trends in heavy drinking among middle-aged and older adults in Denmark.

BACKGROUND: Studies have indicated an increasing proportion of heavy drinking among middle-aged and older Danes. Trends in consumption are often extremely sensitive to influence from various components of the time trends but only few have explored the age, period and cohort-related influences on late life alcohol consumption. By using age, period, and cohort modeling this study explores the time trends in heavy drinking. METHODS: Data derive from five National Health and Morbidity Surveys conducted by the Danish National Institute of Public Health in 1987, 1994, 2000, 2003, and 2005. A total of 15,144 randomly selected Danes between the age of 50 and 74 were interviewed about their alcohol intake on the last weekday and their alcohol intake in the last week. By applying the age-period-cohort model the probability of heavy alcohol drinking is estimated to separate the influence of age, period (calendar time) and cohort (year of birth). RESULTS: The unadjusted probability of heavy drinking declines by age and increases by calendar year and year of birth for both men and women. However, the negative effect of age is attenuated for women when adjusted for birth cohort, indicating that the proportion of heavy drinking women increases in younger birth cohorts. This trend is not observed for men as their drinking pattern mainly increase slightly by calendar year. CONCLUSIONS: Our Danish observations for older aged individuals correspond to the social and cultural changes in the 1960s and 1970s that possibly have affected the drinking behavior of the cohorts. Time trend analyses, such as this may serve as an excellent opportunity to extrapolate and forecast alcohol mortality and morbidity.

[Alcohol and lifestyle diseases]. / Alkohol og livsstilssygdomme.

The Danish Fitness and Nutrition Council evaluated the impact of moderate alcohol intake depending on drinking pattern, age, sex, and the type of beverage. A daily intake of approximately 1-3 units for men and approximately 1 unit for women is associated with the lowest risk of type 2-diabetes and cardiovascular diseases. Binge drinking is more detrimental than a more steady alcohol intake. No clear association is found between alcohol and obesity. In contrast, alcohol intake is associated with increased risk of various cancers, e.g. a linear increased risk of breast cancer with every unit of alcohol is present.

[Do wine drinkers eat healthier than beer drinkers? A cross sectional study of 3(1/2) million purchases in Danish supermarkets--secondary publication]. / Spiser vindrikkere sundere end øldrikkere? En tvaersnitsundersøgelse af tre en halv millioner indkøb i danske supermarkeder.

In a cross sectional study based on information on the number, type of item and total charge of 3(1/2) million transactions over a period of 6 months in various supermarkets in Denmark we examined whether people who buy wine also buy healthier food items than those who buy beer. We found that wine buyers bought more olives, fruit and vegetables, poultry, cocking oil and low fat cheese, milk and meat than beer buyers who bought more ready cooked meals, sugar, cold cuts, chips, pork, butter or margarine, sausages, lamb and soft drinks than wine buyers.

[Alcohol consumption by middle-aged and elderly Danes from 1987 to 2003]. / Midaldrende og aeldre danskeres alkoholforbrug fra 1987 til 2003.

INTRODUCTION: The trend in alcohol consumption by middle-aged and elderly Danes has received little attention, but earlier studies indicated increased consumption. Social factors may influence the trend. Our objective was to investigate the trend in alcohol consumption by the middle-aged and elderly and inquire about significant trends among specific social subgroups. MATERIALS AND METHODS: In the Danish Health and Morbidity Survey carried out in 1987, 1994, 2000 and 2003, a total of 11,754 people aged 50 and older were asked about their alcohol consumption. The mean alcohol intake and the number of heavy drinkers were compared from year to year. RESULTS: The mean intake per day increased from 1.5 drinks in 1987 to 2.1 drinks in 2003 for men and from 0.5 drink in 1987 to 1.0 drink in 2003 for women. The percentage of elderly drinking above the sensible drinking limits increased from 15.2% to 20.4% for men and from 10.7% to 13.6% for women. The strongest increasing trend in the number of heavy drinkers was in the lowest socio-economic groups and among those married or cohabiting. CONCLUSION: The increased number of heavy drinkers among the middle-aged and elderly is of great importance to their general state of health. The increase has possibly been caused by a social and cultural development which has led to a generation of elderly who used to drink alcohol earlier in their lives and continue drinking in old age. More focus on alcohol consumption among the middle-aged and elderly in health policy initiatives is needed.

[Should the sensible drinking limits for adults be changed?]. / Er der grund til at aendre de kendte genstandsgraenser for voksne?

The sensible drinking limits may be too high depending on sex, age, genetic variation and other factors. Recent research on the alcohol-related risk of breast cancer and the impact of drinking patterns on health calls for an update of the literature. We focus on studies of the effect of alcohol on morbidity and mortality and conclude that the maximum of 21 drinks per week for men and 14 for women may be maintained. We emphasize that episodic intake of alcohol increases the risk of death and that the beneficial effect of alcohol is reached at an intake of one drink per day. We also specify groups for whom the drinking limits are not valid.

[The relation between life style, socioeconomic factors, social networks and suboptimal self-assessed health]. / Sammenhaengen mellem livsstil, socioøkonomiske faktorer, socialt netvaerk og suboptimalt selvvurderet helbred.

INTRODUCTION: The aim of the present study was to assess the relation between these life-style factors and suboptimal self-reported health. METHODS: A cross-sectional study was carried out on a random sample of 12,040 men and women from Copenhagen, who had answered a questionnaire regarding smoking, alcohol intake, physical activity, socio-economic status, social network, and self-perceived health. RESULTS: Smoking, high alcohol intake, and physical inactivity are strongly associated with a suboptimal self-reported health. DISCUSSION: The assumption of a correlation between a high quality of life and a shorter life cannot be confirmed by this study.

[Impact of a 10-year nation-wide campaign on knowledge of sensible drinking limits in Denmark]. / Betydningen af ti års landsdaekkende alkoholkampagne i Danmark for kendskabet til de anbefalede genstandsgraenser.

INTRODUCTION: In Great Britain and in Denmark, strong efforts have been made to influence knowledge on the upper threshold of hazardous drinking. In Denmark, a campaign has been repeated every week 40 from 1990 to 2001 with information on the sensible drinking limits of 21 drinks per week for men and 14 drinks per week for women. The aim of this study was to examine the effect of this ongoing campaign on the level of knowledge of sensible drinking limits for men and women. MATERIAL AND METHODS: Every year from 1994 to 1999, random representative samples of 1,030 adult Danes were interviewed on the telephone. RESULTS: Our main finding was that the level of knowledge of sensible drinking limits for own sex increased in all subsets of the population throughout the period. However, at the end of the study period (1999), a total of 80% of highly educated young (18-25 years of age) men knew sensible drinking limits for own sex, while only 35% of uneducated older (more than 65 years old) men had knowledge on sensible drinking limits. The proportions were similar among women: Subjects admitting an intake higher than sensible for own sex, i.e. 21 and 14 drinks per week, respectively, had the highest knowledge of these drinking limits. DISCUSSION: We conclude that public health campaigns, such as the sensible drinking limit campaign, certainly has an impact on the level of awareness in the general population. Furthermore, those drinking more than 21 and 14 drinks per week, respectively, are reached by these campaigns.