Alcohol consumption and the risk of tuberculosis: a systematic review and meta-analysis

OBJECTIVE: To perform a systematic review and meta-analysis of the association between alcohol consumption and tuberculosis risk.METHODS: Medline, EMBASE and Web of Science were searched for observational studies from 2005 to April 2018. Reference lists of included studies were screened.RESULTS: Forty nine studies were included. Compared to people with low or no alcohol intake, the risk of tuberculosis in people with high or any alcohol consumption was increased by a relative odds of 1.90 (95% CI: 1.-2.23). Substantial levels of heterogeneity were seen (I2=82%), but there was no evidence of publication bias (P=0.). Sensitivity analysis restricted to studies using no alcohol drinking as a reference group found a slightly lower but still increased risk (Odds Ratio= 1.59, 95%CI: 1.38-1.84). Subgroup analyses found no significant differences in relation to study design and quality, geographic location, publication year, and adjustment for confounders. A pooled analysis of a further four studies reporting hazard ratios, found nearly a tripling increase in risk of TB in relation to alcohol consumption during follow-up (HR=2.81, 95%CI: 2.12-3.74). An exposure-response analysis showed that for every 10-20 grams daily alcohol intake, there was 12% increase in TB risk.CONCLUSION: Alcohol consumption is an important risk factor for the development of TB

Regional alcohol consumption and alcohol-related mortality in Great Britain: novel insights using retail sales data

Background: Regional differences in population levels of alcohol-related harm exist across Great Britain, but these are not entirely consistent with differences in population levels of alcohol consumption. This incongruence may be due to the use of self-report surveys to estimate consumption. Survey data are subject to various biases and typically produce consumption estimates much lower than those based on objective alcohol sales data. However, sales data have never been used to estimate regional consumption within Great Britain (GB). This ecological study uses alcohol retail sales data to provide novel insights into regional alcohol consumption in GB, and to explore the relationship between alcohol consumption and alcohol-related mortality. Methods: Alcohol sales estimates derived from electronic sales, delivery records and retail outlet sampling were obtained. The volume of pure alcohol sold was used to estimate per adult consumption, by market sector and drink type, across eleven GB regions in 2010–11. Alcohol-related mortality rates were calculated for the same regions and a cross-sectional correlation analysis between consumption and mortality was performed. Results: Per adult consumption in northern England was above the GB average and characterised by high beer sales. A high level of consumption in South West England was driven by on-trade sales of cider and spirits and off-trade wine sales. Scottish regions had substantially higher spirits sales than elsewhere in GB, particularly through the off-trade. London had the lowest per adult consumption, attributable to lower off-trade sales across most drink types. Alcohol-related mortality was generally higher in regions with higher per adult consumption. The relationship was weakened by the South West and Central Scotland regions, which had the highest consumption levels, but discordantly low and very high alcohol-related mortality rates, respectively. Conclusions: This study provides support for the ecological relationship between alcohol-related mortality and alcohol consumption. The synthesis of knowledge from a combination of sales, survey and mortality data, as well as primary research studies, is key to ensuring that regional alcohol consumption, and its relationship with alcohol-related harms, is better understood

Alcohol consumption and lifetime change in cognitive ability:a gene × environment interaction study

Studies of the effect of alcohol consumption on cognitive ability are often confounded. One approach to avoid confounding is the Mendelian randomization design. Here, we used such a design to test the hypothesis that a genetic score for alcohol processing capacity moderates the association between alcohol consumption and lifetime change in cognitive ability. Members of the Lothian Birth Cohort 1936 completed the same test of intelligence at age 11 and 70 years. They were assessed for recent alcohol consumption in later life and genotyped for a set of four single-nucleotide polymorphisms in three alcohol dehydrogenase genes. These variants were unrelated to late-life cognition or to socioeconomic status. We found a significant gene × alcohol consumption interaction on lifetime cognitive change (p = 0.007). Individuals with higher genetic ability to process alcohol showed relative improvements in cognitive ability with more consumption, whereas those with low processing capacity showed a negative relationship between cognitive change and alcohol consumption with more consumption. The effect of alcohol consumption on cognitive change may thus depend on genetic differences in the ability to metabolize alcohol

Alcohol Consumption and Alcohol Advertising Bans

The purpose of this paper is to empirically examine the relationship between alcohol advertising bans and alcohol consumption. Most prior studies have found no effect of advertising on total alcohol consumption. A simple economic model is provided which explains these prior results. The data set used in this study is a pooled time series of data from 20 countries over 26 years. The empirical model is a simultaneous equations system which treats both alcohol consumption and alcohol advertising bans as endogenous. The primary conclusions of this study are that alcohol advertising bans decrease alcohol consumption and that alcohol consumption has a positive effect on the legislation of advertising bans. The results indicate that an increase of one ban could reduce alcohol consumption by five to eight percent. The alcohol price elasticity is estimated at about .2. The results suggest that recent exogenous decreases in alcohol consumption will decrease the probability of enactment of new bans and undermine the continuance of existing bans. Canada, Denmark, New Zealand and Finland have recently rescinded alcohol advertising bans. Alcohol consumption in these countries may increase or decrease at a slower rate than would have occurred had advertising bans remained in place.

Relationship between alcohol intake and dietary pattern: Findings from NHANES III

AIM: To examine the association between macronutrient dietary patterns and alcohol consumption using the Third National Health and Nutritional Examination Survey III. METHODS: A total of 9877 subjects (5144 males) constituted the study cohort. Dietary interviews were conducted with all examinees by a trained dietary interviewer in a mobile examination center (MEC). Subjects reported all foods and beverages consumed except plain drinking water for the previous 24-h time period. Physical examination and history of alcohol consumption were obtained. Pearson correlation coefficients were used to evaluate the association of the levels of alcohol consumption and the percentage of energy derived from macronutrients. Univariate and multivariate regression analyses were performed accounting for the study sampling weight to further explore the relationships between alcohol consumption and calories derived from each macronutrient. RESULTS: Subjects who drank were younger than non-drinker controls in both genders (P < 0.01). Alcohol intake was inversely associated with body mass index and body weight in women. Of all macronutrients, carbohydrate intake was the first to decrease with increasing alcohol consumption. In the multivariate analyses, the level of alcohol consumption was found to be an independent predictor associated with lower intake of other macronutrients. CONCLUSION: Our results show that there is an alteration in the daily dietary pattern with increasing alcohol consumption and that energy derived from alcoholic beverages substitutes that from other macronutrients such as carbohydrate, protein, and fat

Socioeconomic status as an effect modifier of alcohol consumption and harm: an analysis of linked cohort data

Background: Alcohol-related mortality and morbidity are higher in socioeconomically disadvantaged populations. It is unclear if elevated harm reflects differences in consumption, reverse causation or greater risk of harm following similar consumption. We investigated whether the harmful effects differed by socioeconomic status accounting for alcohol consumption and other health-related factors. Methods: Alcohol consumption (weekly units and binge drinking) data (n=50,236; 429,986 person-years of follow-up) were linked to deaths, hospitalisations and prescriptions. The primary outcome was alcohol-attributable hospitalisation/death. The relationship between alcohol attributable harm and socioeconomic status was investigated for four measures (education level, social class, household income and area-based deprivation) using Cox proportional hazards models. The potential for alcohol consumption and other risk factors mediating the social patterning was explored. Downward social selection for high-risk drinkers (reverse causation) was tested by comparing change in area deprivation over time. Findings: Low socioeconomic status was consistently associated with markedly elevated alcohol-attributable harms, including after adjustment for weekly consumption, binge drinking, body mass index and smoking. There was evidence of effect modification: for example, relative to light drinkers living in advantaged areas, the hazard ratio for excessive drinkers was 6.75 (95% CI 5.09-8.93) in advantaged and 11.06 (95% CI 8.53-14.35) in deprived areas. We found little support for downward social selection. Interpretation: Disadvantaged social groups experience greater alcohol-attributable harms compared to the advantaged for given levels of alcohol consumption, even after accounting for different drinking patterns, obesity and smoking status at the individual level

Alcohol consumption and leukocyte telomere length.

The relationship between alcohol consumption and mortality generally exhibits a U-shaped curve. The longevity observed with moderate alcohol consumption may be explained by other confounding factors, and, if such a relationship is present, the mechanism is not well understood. Indeed, the optimal amount of alcohol consumption for health has yet to be determined. Leukocyte telomere length is an emerging quantifiable marker of biological age and health, and a shorter telomere length is a predictor of increased mortality. Because leukocyte telomere length is a quantifiable and objectively measurable biomarker of aging, we sought to identify the amount of alcohol consumption associated with the longest telomere length and least telomere length attrition. Among over 2,000 participants from two distinct cohort studies, we found no pattern of alcohol consumption that was associated with longer telomere length or less telomere length attrition over time. Binge drinking may reduce telomere length. Using telomere length as a marker of age and health, these data fail to demonstrate any benefits of alcohol consumption, even when consumed in moderation

Linked randomised controlled trials of face-to-face and electronic brief intervention methods to prevent alcohol related harm in young people aged 14–17 years presenting to Emergency Departments (SIPS junior)

Background: Alcohol is a major global threat to public health. Although the main burden of chronic alcohol-related disease is in adults, its foundations often lie in adolescence. Alcohol consumption and related harm increase steeply from the age of 12 until 20 years. Several trials focusing upon young people have reported significant positive effects of brief interventions on a range of alcohol consumption outcomes. A recent review of reviews also suggests that electronic brief interventions (eBIs) using internet and smartphone technologies may markedly reduce alcohol consumption compared with minimal or no intervention controls. Interventions that target non-drinking youth are known to delay the onset of drinking behaviours. Web based alcohol interventions for adolescents also demonstrate significantly greater reductions in consumption and harm among ‘high-risk’ drinkers; however changes in risk status at follow-up for non-drinkers or low-risk drinkers have not been assessed in controlled trials of brief alcohol interventions

Impulsivity, Emotional Intelligence, and Alcohol Consumption in Young People: A Mediation Analysis

Alcohol consumption in young people is a public health problem. Due to the harmful consequences and the large population using alcoholic substances, it would be important to determine the biological, psychological, and social factors associated with alcohol use and abuse. The main object of this study is to explore which components of impulsivity, according to the main theoretical models, have predictive power regarding alcohol consumption in young people. A secondary objective is to determine if emotional intelligence has a mediating role between the components of impulsivity and alcohol consumption, and thus specifically contribute to the knowledge about the mediation processes between those variables that are involved in the initiation and maintenance of alcohol consumption. For this purpose, 384 participants were recruited (83.1% females, n = 319), with mean age of 20.46 years (SD = 1.90; range 18-25). All participants were alcohol consumers at the beginning of the study. Data collection was conducted via online survey; impulsivity was evaluated by several questionnaires (Sensation Seeking Scale Form V, Barratt Impulsivity Scales 11, and Sensitivity to Punishment and Sensitivity to Reward), and emotional intelligence was evaluated by the Trait Meta-Mood Scale. The results reveal that the dimension of disinhibition (a dimension of the sensation search scale) significantly has the highest predictive value on alcohol consumption. Moreover, our data show that the total effect and direct effect of disinhibition on frequency of alcohol consumption were both significant. The mediating role of emotional intelligence in this process was also significant. These findings show which variables should be considered to prevent alcohol consumption in young peopl

Cigarettes and Alcohol: Substitutes or Complements?

Taxation of cigarettes and alcohol can raise revenue and reduce consumption of goods with negative external effects. Despite medical and psychological evidence linking their consumption, little previous work has investigated the significance of cross-price effects in cigarette and alcohol consumption. We use individual-level data from the Behavioral Risk Factor Surveillance System to investigate cigarette and alcohol consumption in the US, estimating both own and cross-price elasticities. Results suggest significant cross-price effects. Specifically, we find that higher alcohol prices decrease both alcohol consumption and smoking participation (suggesting a complementarity in consumption), while higher cigarette prices tend to decrease smoking participation but increase drinking. The significance of these findings suggests that further work is warranted to better understand the social and economic relationship between cigarette and alcohol consumption.