Aerobic metabolism in biological systems produces reactive oxygen species, and defense against such prooxidants requires antioxidant activity, e.g., predominantly vitamins C and E in serum. Recently, flavonoids (polyphenols occurring widely in plants) have been investigated in vitro for their antioxidant activity; whether they are absorbed after ingestion is not clear. Using a chemiluminescent assay of serum antioxidant capacity (SAOC), we have studied the effects in normal individuals of ingesting red wine, white wine, and high doses of vitamin C. In nine subjects who ingested 300 mL of red wine, the mean SAOC was increased by 18% after 1 h and by 11% at 2 h. The same amount of white wine produced 4% and 7% increases, respectively. The ingestion of 1000 mg (5.7 mmol) of ascorbic acid by four subjects increased their mean SAOC by 22% at 1 h and by 29% at 2 h. An in vitro comparison of red wine, white wine, and various fruit juices showed the high antioxidant capacity of red wine in addition to its ability to increase the antioxidant capacity of serum in vivo. The antioxidant effects of various flavonoids and other polyphenols were also studied.

The separate and joint effects of cigarette smoking and alcohol consumption on serum concentrations of total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and triglycerides were investigated in 46 750 men attending the BUPA Health Screening Centre in London during the period 1983–1987, after allowing for differences in age, body mass index and exercise level. Drinking alcohol was found to raise both total cholesterol and HDL-C concentrations, in such a way that HDL-C as a percentage of total cholesterol increased with increasing alcohol consumption. LDL-C concentrations increased with increasing alcohol consumption in non-smokers, but decreased in those smoking over 10 cigarettes per day. Drinking had no significant effect on triglycerides except at high levels of consumption. Smoking raised total cholesterol, LDL-C and triglycerides, but lowered HDL-C concentrations. In particular, smoking even small amounts could negate any protective benefit in HDL-C concentrations gained from moderate consumption of alcohol. Assuming a desirable lipid profile to consist of low total cholesterol, LDL-C and triglycerides and a high HDL-C value, this is best achieved for men by being a non-smoking moderate drinker.

SUMMARY. The separate and joint effects of cigarette smoking and alcohol consumption on serum activities of the enzymes aspartate aminotransferase (AST), alanine aminotransferase (AL T) and y-glutamyl transferase (GGT) were investigated in 46775 men attending the BUPA Health Screening Centre in London during the period 1983-1987, after allowing for differences in age, body mass index and exercise level. As expected, all showed a significant positive correlation with alcohol consumption. Cigarette smoking produced a significant increase in GGT activity in all drinking categories bar teetotallers, particularly for those smoking more than 20 cigarettes per day. There were no changes of clinical significance in AST or ALT activities with smoking. We postulate that the combined effects of alcohol and smoking on GGT activity are a result of induction of the enzyme by both alcohol and nicotine. Smoking as well as drinking habits should be taken into account when assessing the significance of an individual's enzyme activities. Additional key phrases: aspartate aminotransferase; alanine aminotransferase; gamma glutamyl transferase; nicotineIn a previous study! of the separate but not combined effects of alcohol consumption, cigarette smoking, exercise and body mass on the liver enzymes gamma glutamyl transferase (GGT), alanine aminotransferase (AL T) and aspartate aminotransferase (AST), it was concluded that cigarette smoking had a significant effect on GGT activity, but only a weak effect on ALT and AST. Using multivariate analysis, the changes in the activities of the latter two enzymes with smoking were found to be nonsignificant. Along with alcohol consumption, body mass index was found to be a significant factor in producing an increase in the serum enzymes. The study involved 15740 men attending the BUPA Health Screening Centre in London in 1987.In the present study, using a larger number of men attending the same centre, the separate and combined efects of smoking and alcohol consumption on liver enzymes have been assessed in a dose-related manner.Correspondence: D Robinson. SUBJECTS AND METHODSA total of 46775 men attending the BUPA Health Screening Centre in London during the period 1983-1987 were studied. They were predominantly from socio-economic groups A, Band CI, and attended the Centre either of their own volition or as part of a corporate health care scheme.Each subject completed a questionnaire which included questions as to whether he was a lifelong non-smoker, an ex-smoker or a current smoker of cigarettes. All ex-smokers were grouped together in the same category, as information regarding how long an individual had given up smoking was not available. Current smokers were asked to state how many cigarettes they smoked each day, artd were then divided into four groups: those smoking 1~1O, 11-20,21-30 or 31 + cigarettes per day.Each subject was also asked whether he was teetotal, an occasional drinker or a regular drinker. If a regular drinker he was asked how many units of alcohol he consumed each day....

1. Laboratory studies have shown that cold exposure causes an increase in blood pressure, cholesterol and erythrocyte count. However, whether the mild cold exposures received during everyday life are sufficient to cause such changes is unclear. 2. To test this, outdoor temperatures in central London between 1986 and 1992 were related to both haematological and blood pressure data on 50-69-year-old men attending BUPA health screening examinations in London, and to mortality in South-East England. Since any association with temperature may be an artifact due to common, temperature-independent, annual rhythms in the parameters, these data were also analysed after removal of these circannual components by digital filtering. 3. It was found that short-term falls in temperature produced significant increases in Hb, erythrocyte count, packed cell volume, mean corpuscular Hb concentration, serum albumin, systolic and diastolic blood pressure, and significant decreases in mean corpuscular volume and erythrocyte sedimentation rate. Mean corpuscular Hb, leucocyte count, platelet count and serum cholesterol concentrations were unchanged. Time-series analysis showed that these changes occurred almost immediately in response to a fall in temperature, but persisted for longer intervals of up to 1-2 days. 4. Mortalities from ischaemic heart disease and cerebrovascular disease were also significantly increased by short-term falls in temperature. 5. These finding indicate that in the general population the cold exposures of normal life are sufficient to induce significant and prolonged haemoconcentration and hypertension, which may explain why deaths from arterial disease are more prevalent in the winter.

Computerized tomographic (CT) scanning of the liver was undertaken in 17 occasional and 19 heavy drinkers undergoing health screening. The median attenuation value of the liver (CT number) in occasional drinkers with normal liver function tests was 54.4 compared with 25.9 in the heavy drinkers (P less than 0.001). Fourteen of the heavy drinkers had a CT number below the lowest value observed in occasional drinkers with normal liver function, indicating reduced liver density due to fatty change. Serum gamma-glutamyl transpeptidase was normal in 36% of these individuals. A rise in CT number was observed in 4 out of 5 heavy drinkers who underwent a second scan after decreasing their alcohol consumption. These findings suggest that CT scanning provides a noninvasive and convenient method of screening for a fatty liver, which occurred to a variable degree in over 70% of the men who admitted to regularly taking 8 or more alcoholic drinks per day.