Twenty‐Five‐Year Alcohol Consumption Trajectories and Their Association With Arterial Aging: A Prospective Cohort Study

O’Neill, Darragh; Britton, Annie; Brunner, Eric J.; Bell, Steven

doi:10.1161/jaha.116.005288

Cited by 44 publications

(58 citation statements)

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“…Although the number and frequency of repeated measures reported by existing studies are variable, and no study is yet to capture drinking behaviours throughout the whole adult life‐course , the use of repeated measures is important if differences in risk between heterogeneous consumption trajectories are to be understood more clearly and sensitive periods identified during which particular alcohol consumption behaviours may be most harmful, aiding the targeting of alcohol reduction interventions . To date, however, there is no consistent approach to handling such data, with some opting to restrict analyses to participant whose consumption was stable within pre‐defined limits , or else categorizing participants according to whether their drinking increased, decreased or remained stable over a given period of time . In addition, there is no clear agreement concerning the appropriate means of classifying drinkers who cease consumption prior to baseline measurement.…”

Section: Discussionmentioning

confidence: 99%

The stability of baseline‐defined categories of alcohol consumption during the adult life‐course: a 28‐year prospective cohort study

2017

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Background and aims Studies that report the relationship between alcohol consumption and disease risk have predominantly operationalised drinking according to a single baseline measure. The resulting assumption of longitudinal stability may be simplistic and complicate interpretation of risk estimates. This study aims to describe changes to the volume of consumption across the adult life course according to baseline categories of drinking. Design A prospective observational study. Setting United Kingdom. Participants A cohort of British civil servants totalling 6,838 men and 3,372 women aged 34–55 years at baseline, followed for a mean 19.1 (SD 9.5) years. Measurements The volume of weekly alcohol consumption was estimated from data concerning the frequency and number of drinks consumed. Baseline categories were defined: non-current drinkers, infrequent drinkers, 0.1–50.0 g/week, 50.1–100.0 g/week, 100.1–150.0 g/week and 150.1–250.0 g/week, and >250.0 g/week. For women, the highest category was defined as >100.0 g/week. Baseline frequency was derived as ‘daily or almost daily’ and ‘not daily or almost daily’. Trajectories were estimated within baseline categories using growth curve models. Findings Trajectories differed between men and women, but were relatively stable within light-to-moderate categories of baseline consumption. Drinking was least stable within the highest categories of baseline consumption (men: >250.0 g/week; women: >100.0 g/week), declining by 47.0 (95% CI [40.7, 53.2]) and 16.8 g/week (95% CI [12.6, 21.0]) respectively per 10-year increase in age. These declines were not a consequence of sudden transitions to complete abstention. Rates of decline appear greatest in older age, with trajectories converging toward moderate volumes. Conclusion Among UK civil servants, consumption within baseline drinking categories is generally stable across the life course, except among heavier baseline drinkers, for whom intakes decline with increasing age. This shift does not appear to be driven by transitions to non-drinking. Cohorts of older people may be at particular risk of misclassifying former heavy drinkers as moderate consumers of alcohol.

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Section: Discussionmentioning

confidence: 99%

The stability of baseline‐defined categories of alcohol consumption during the adult life‐course: a 28‐year prospective cohort study

2017

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“…(Sookoian et al, 2016) We found that, among women, the risks associated with heavy drinking in mid-life were only appreciable when considering a longitudinal drinking typology and not in cross-sectional analyses. This further emphasises the necessity of taking a life course approach when assessing the association between alcohol consumption and health outcomes (Bell and Britton, 2015b;O'Neill et al, 2017). There is a serious risk of misclassification if only one measure of alcohol is considered.…”

Section: Discussionmentioning

confidence: 99%

Association of thirty-year alcohol consumption typologies and fatty liver: Findings from a large population cohort study

Britton

Mehta

O’Neill

et al. 2019

Drug and Alcohol Dependence

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Objective: To evaluate the longitudinal relationship between repeated measures of alcohol consumption and risk of developing fatty liver. Patients and Methods-This study includes 5,407 men and women from a British population based cohort, the Whitehall II study of civil servants, who self-reported alcohol consumption by questionnaire over approximately 30 years (1985-1989 through to 2012-2013). Drinking typologies during midlife were linked to measures of fatty liver (the fatty liver index, FLI) when participants were in older age (age range 60-84 years) and adjusted for age, socioeconomic position, ethnicity, and smoking. Results-Those who consistently drank heavily had twofold higher odds of increased FLI compared to stable low-risk moderate drinkers after adjustment for covariates (men: OR=2.04, 95%CI=1.53-2.74; women: OR=2.24, 95%CI=1.08-4.55). Former drinkers also had an increased FLI compared to low-risk drinkers (men: OR=2.09, 95%CI=1.55-2.85; women: OR=1.68, 95%CI=1.08-2.67). There were non-significant differences in FLI between non-drinkers and stable low-risk drinkers. Among women, there was no increased risk for current heavy drinkers in cross sectional analyses. Conclusion-Drinking habits among adults during midlife affect the development of fatty liver and sustained heavy drinking is associated with an increased FLI compared to stable low-risk drinkers. After the exclusion of former drinkers, there was no difference between non-drinkers and low-risk drinkers, which does not support a protective effect on fatty liver from low-risk drinking. Cross-sectional analyses among women did not find an increased risk of heavy drinking compared to low-risk drinkers, thus highlighting the need to take a longitudinal approach.

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“…Notably, however, the importance of lifestyle modification irrespective of pharmacological treatment has been emphasized, particularly for diabetes mellitus given a lack of evidence that glycemic control alone improves macrovascular outcomes . Last, though low or moderate alcohol consumption has been associated with cardiovascular benefits, the link is complicated and the benefits of alcohol are offset by its well‐known potential harms, which may affect its perceived health impact. Differing interpretations or estimations of this balance of risk and benefit may account for the negative association between abstinence from alcohol and PNIPH as well as for the lack of association between excessive alcohol consumption and PNIPH.…”

Section: Discussionmentioning

confidence: 99%

Association Between Self‐Reported Potentially Modifiable Cardiac Risk Factors and Perceived Need to Improve Physical Health: A Population‐Based Study

Ramirez

Chen

Santo

et al. 2017

JAHA

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BackgroundAn individual's perceived need to improve their physical health (PNIPH) is an essential precursor to adopting healthy behaviors. Nine potentially modifiable risk factors (PMRFs) for myocardial infarction collectively account for ≥90% of the population attributable risk. Though widely recognized, their impact on individuals’ health perceptions is unclear.Methods and ResultsResidents from 6 provinces were administered a module on changes to improve health as part of the 2011–2012 Canadian Community Health Survey, yielding relevant data for 8 of the 9 PMRFs sought. The potential effects of PMRFs individually and cumulatively on PNIPH were examined using modified Poisson regression. In total, 45 443 respondents were included, representing 11 006 123 individuals and corresponding to 96.8% of the adult population of the sampled provinces. The sum of PMRFs was positively associated with PNIPH (adjusted prevalence ratio, 1.08; 95% CI, 1.07–1.09 per additional PMRF) with 82.3% of individuals with ≥5 PMRFs reporting this perception. Smoking, obesity, and low physical activity were most strongly associated with PNIPH, whereas hypertension and diabetes mellitus exhibited no association with this outcome after adjusting for potential confounders. Barriers to adopting healthy behaviors were reported by 55.9% of individuals endorsing PNIPH.ConclusionsThe cumulative burden of PMRFs is positively associated with PNIPH; however, individual PMRFs differentially contribute to this perception. Among those at highest cardiac risk, ≈1 in 5 denied PNIPH. A better understanding of factors underlying health perceptions and behaviors is needed to capitalize on cardiovascular preventive efforts.

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Twenty‐Five‐Year Alcohol Consumption Trajectories and Their Association With Arterial Aging: A Prospective Cohort Study

Cited by 44 publications

References 50 publications

The stability of baseline‐defined categories of alcohol consumption during the adult life‐course: a 28‐year prospective cohort study

The stability of baseline‐defined categories of alcohol consumption during the adult life‐course: a 28‐year prospective cohort study

Association of thirty-year alcohol consumption typologies and fatty liver: Findings from a large population cohort study

Association Between Self‐Reported Potentially Modifiable Cardiac Risk Factors and Perceived Need to Improve Physical Health: A Population‐Based Study

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