November 05, 2017

Teen Alcohol and Marijuana Use Lessens Life Success

Young adults dependent on marijuana and alcohol are less likely to achieve adult life goals, according to new research by UConn Health scientists presented at the American Public Health Association 2017 Annual Meeting & Expo.

UConn Health researchers examined data from the Collaborative Study on the Genetics of Alcoholism (COGA) to track the effect teenage alcohol and marijuana use has on the achievement of life goals, defined as educational achievement, full time employment, marriage and social economic potential.

The study includes 1,165 young adults from across the United States whose habits were first assessed at age 12 and then at two-year intervals until they were between 25 and 34 years old. Most of the study participants had an alcoholic grandparent, parent, aunt or uncle.

Lower Economic Potential

Overall, individuals who were dependent on either marijuana or alcohol during their teen years achieved lower levels of education, were less likely to be employed full time, were less likely to get married and had lower social economic potential.

"This study found that chronic marijuana use in adolescence was negatively associated with achieving important developmental milestones in young adulthood. Awareness of marijuana's potentially deleterious effects will be important moving forward, given the current move in the US toward marijuana legalization for medicinal and possibly recreational use," said study author Elizabeth Harari.

Genders Affected Differently

The researchers also found that dependence may have a more severe effect on young men. Dependent young men achieved less across all four measures, while dependent women were less likely than non-dependent women to obtain a college degree and had lower social economic potential, but were equally likely to get married or obtain full time employment.

Previous research had shown that heavy use of alcohol or marijuana in adolescence affects people developmentally. This study followed up on that, to look at what happens after age 18. The life outcomes seem to show the differences are meaningful into adulthood.

The Research Continues

The study is ongoing.

"COGA investigators are following many subjects over the years and are using this extensive and growing database to examine several significant research topics," says Dr. Grace Chan, a statistician in the UConn Health department of psychiatry. Chan, Harari and UConn Health Alcohol Research Center Director Victor Hesselbrock are currently looking at whether there are different outcomes between young people dependent on alcohol versus marijuana, as well as why there were marked differences in outcomes between the sexes.

Posted by Webmaster at 11:35 PM

September 18, 2017

Young Binge Drinkers Show Altered Brain Activity

Researchers have studied the brain activity of young binge-drinking college students in Spain, and found distinctive changes in brain activity, which may indicate delayed brain development and be an early sign of brain damage.

For many students, college involves a lot of socializing at parties and at bars, and alcohol is a common factor in these social environments. Excessive alcohol use, in the form of binge drinking, is extremely common among college students, and one study has estimated that as many as one third of young North Americans and Europeans binge drink.

The National Institute of Alcohol Abuse and Alcoholism describes a binge as drinking five or more drinks for men and four or more for women within a two-hour period, and for many college students, these limits wouldn't equate to a particularly heavy night.

Alcohol Changes the Brain

Previous research has linked binge drinking to a variety of negative consequences including neurocognitive deficits, poor academic performance, and risky sexual behavior.

While numerous studies have shown that the brains of chronic alcoholics have altered brain activity, there is also evidence that bingeing can change adolescents' brains. Eduardo López-Caneda, of the University of Minho in Portugal, investigates this phenomenon.

"A number of studies have assessed the effects of binge drinking in young adults during different tasks involving cognitive processes such as attention or working memory," says López-Caneda. "However, there are hardly any studies assessing if the brains of binge drinkers show differences when they are at rest, and not focused on a task."

Binge-Drinking College Students

In a recent study published in Frontiers in Behavioral Neuroscience, López-Caneda and colleagues set out to see if the resting brains of binge-drinking college students showed any differences compared with those of their non-bingeing counterparts.

The researchers recruited first year college students from a university in Spain, and asked them to complete a questionnaire about their drinking habits. Students that had participated in at least one binge within the previous month were considered to be binge drinkers, whereas non-bingers had never binged before. By attaching electrodes to the students' scalps, the scientists could assess electrical activity in various brain regions.

Compared with the non-bingers, the binge drinkers demonstrated altered brain activity at rest. They showed significantly higher measurements of specific electrophysiological parameters, known as beta and theta oscillations, in brain regions called the right temporal lobe and bilateral occipital cortex.

Brains Similar to Chronic Alcoholics

Surprisingly, previous studies have found very similar alterations in the brains of adult chronic alcoholics. While the young bingers in this study might occasionally consume alcohol to excess, they did not fit the criteria for alcoholism. So, what does this mean?

The changes might indicate a decreased ability to respond to external stimuli and potential difficulties in information processing capacity in young binge drinkers, and may represent some of the first signs of alcohol-induced brain damage.

The brains of adolescents are still developing, meaning that they might be more vulnerable to the effects of alcohol abuse. "These features might be down to the particularly harmful effects of alcohol on young brains that are still in development, perhaps by delaying neuromaturational processes," says López-Caneda.

The results suggest that bingeing has tangible effects on the young brain, comparable with some of those seen in chronic alcoholics. "It would be a positive outcome if educational and health institutions used these results to try to reduce alcohol consumption in risky drinkers," says López-Caneda.

Posted by Webmaster at 07:01 AM

August 15, 2017

Intoxication Increases Risk of Domestic Violence

Intoxicated, heavy drinkers have a tendency to act rashly in response to negative emotions, which can intensify the risk for intimate partner aggression, according to a study by Georgia State University and Purdue University.

The researchers examined the link between risk-promoting factors, such as impulsivity and problematic drinking, and intimate partner aggression among intoxicated and non-intoxicated heavy drinkers.

Intimate Partner Aggression

To be considered a heavy drinker, participants had to report typically consuming at least five standard drinks for men or four standard drinks for women per drinking day at least twice per month during the past year.

The study suggests acute alcohol intoxication is a key facilitator of the association between problematic drinking patterns and intimate partner aggression. It's only under acute intoxication that problematic drinkers are more likely than non-problematic drinkers to perpetrate intimate partner aggression.

Olivia Subramani, first author of the study and a Ph.D. student in clinical psychology at Georgia State, offered an explanation for why alcohol intoxication exerts these effects.

Implusive Emotional Responses

"People who respond impulsively to their emotions likely do so because they tend to pay more attention to emotional cues in the situation (for example, a mean look from one's partner)," Subramani said. "This 'tunnel vision' for emotional cues is exacerbated when people are drunk, so they are focused almost exclusively on the aggression-promoting cues in the situation. This makes aggression an especially likely response."

The findings, published in the journal Alcoholism Clinical & Experimental Research, make important contributions about the conditions most likely to result in committing intimate partner aggression.

"Our findings shed light on one way that alcohol may cause intimate partner aggression, particularly among people who are already at high risk for perpetration," said Dr. Dominic Parrott, professor of psychology at Georgia State and co-author of the study. "These results suggest that interventions which aim to reduce alcohol use or help people to focus on cues that inhibit, rather than promote, aggression are most likely to be effective."

Aggression-Inhibiting Cues

Participants in this study, recruited from Atlanta and Indianapolis, were 249 heavy drinkers (148 men and 101 women) in heterosexual relationships with a recent history of psychological or physical intimate partner aggression toward their partner.

The study's results support alcohol use as an important target for the treatment of intimate partner aggression. When a person is acutely intoxicated, it could also be effective to distract them from aggression-promoting cues and redirect their attention onto aggression-inhibiting cues, such as peaceful images or themselves, the researchers said.

Posted by Webmaster at 12:02 AM

August 14, 2017

Alcohol Increases Risk of Digestive Cancers

Citizens across the EU are consuming an average of two alcoholic drinks per day, placing drinkers at a 21% increased risk of developing colorectal cancer, in addition to other digestive cancers, a report finds.

The report, launched today by United European Gastroenterology, revealed that the average daily intake of alcoholic drinks was 'moderate' (between 1 and 4 drinks per day) in all 28 EU states, placing these citizens at a heightened risk of both colorectal and oesophageal cancer.

3 Million Deaths Per Year

'Heavy' drinkers (people that consume more than 4 drinks per day) were found to be at an increased risk of pancreatic, liver and gastric cancer. These three cancers, coupled with colorectal and oesophageal cancer, are the five most common digestive cancers worldwide, causing almost three million deaths per year and contributing to over a third of global cancer deaths.

No countries within the EU were found to have 'light' alcohol consumption (on average, less than 1 alcoholic drink per day per capita).

The European Alcohol Endemic

Alcohol consumption across the European region is higher than in any other region in the world, with over one fifth of the European population over the age of 15 drinking heavily at least once a week. As a result, the continent suffers from the highest proportion of ill health and premature death directly linked to alcohol.

Despite high levels of consumption throughout Europe, research shows that as many as 90% of people are unaware on the link between alcohol and cancer.

In light of these alarming statistics, tackling the harmful use of alcohol is a main priority for the upcoming Estonian presidency of the Council of the European Union.

How to Tackle Europe's Alcohol Crisis

Consumers are provided with mixed-messages on recommended units, glasses and volumes of alcohol. UEG are therefore calling for a pan-European approach to the provision of clear and consistent information about the health risks of drinking alcohol to help eradicate confusion on appropriate levels of consumption.

Professor Markus Peck, leading digestive health expert, comments; "One of the main challenges in addressing high drinking levels is how deeply embedded alcohol consumption is within the European society, both socially and culturally. Political action like minimum pricing and reducing access to alcohol needs to be taken now to prevent many future casualties. Research then has to follow to help generate data and allow us to fine-tune future political activity".

Increased pressure on the alcohol industry to develop clear and responsible labeling, together with a tightening of regulations on the marketing of alcohol, are other important steps outlined within the report to help tackle the crisis. France is a country leading the way in this regard, where stricter marketing, coupled with regulations for drinking at work, has contributed to a decline in alcohol consumption and digestive cancer incidence as a result.

Posted by Webmaster at 03:29 AM

Binge Drinking Linked to High Glucose Levels

Regular high alcohol consumption and binge drinking from age 16 is associated with higher glucose concentrations in women's blood - an important risk factor for type 2 diabetes - later in life, according to a study published in the open access journal BMC Public Health.

This study is the first to assess alcohol consumption data, starting in adolescence, over a 27 year period in relation to their blood glucose levels taken when they were 43 years of age. In women, total alcohol consumption and binge drinking behavior throughout the 27 year period was significantly associated with higher blood glucose levels independent of BMI, hypertension and smoking status at age 43.

Men Affected in Other Ways

This association was not true for men, for whom only BMI and hypertension remained associated with increased blood glucose levels.

Dr Karina Nygren, lead author from Umea University, Sweden said: "Our findings show that high alcohol consumption from ages 16 to 43 is associated with higher blood glucose levels in women but not in men. Because higher blood glucose is a risk factor for the development of type 2 diabetes, our data suggest that informing people about the risk of high alcohol consumption at a young age could have positive health impacts further down the line."

Despite the association between alcohol, binge drinking and blood glucose only being significant in women, men still had higher blood glucose levels than women and consumed nearly 3 times as much alcohol between ages 16 and 43.

Alcohol Increases Insulin Resistance

Previous studies suggest possible mechanisms for the association between alcohol and elevated blood glucose. For example, human studies have shown that ethanol can increase insulin resistance, which in turn leads to accumulation of glucose in the blood. Studies in rats have also shown that binge drinking behavior alters the rat's metabolism in a way that negatively affects insulin.

Dr Nygren commented: "Although there are some biological explanations behind why alcohol can directly lead to increased levels of glucose in the blood, the difference between men and women in our study is more difficult to explain."

Data included in this study come from the Northern Swedish Cohort study which began in 1981. A total of 897 people from this study answered a questionnaire about alcohol consumption when they were 16, 18, 21, 30 and 43 years old. At age 43 a blood sample was taken from each person to assess blood glucose levels.

Long-Term Insight Into Drinking Behavior

The questionnaire involved eight questions about alcohol consumption including questions such as "how often do you drink alcohol?" and how much do you drink at each occasion?". Binge drinking was defined as drinking four or more standard drinks of beer, wine or spirits per occasion for women, and five or more for men, at least once per month. One standard drink was specified to contain 12g of ethanol, which is equivalent to 330ml of a 5-6% beer.

The study shows an association between alcohol consumption and higher blood glucose but cannot show cause and effect. The data is limited by the fact that information on alcohol consumption comes from self-reported questionnaires and could be subject to bias. However, the long term nature of the study, which includes multiple follow ups, offers a unique insight into the drinking behaviors of people throughout their life.

Posted by Webmaster at 03:25 AM

Alcohol's Health Benefits Overstated?

The benefits of light alcohol consumption, as well as the risks associated with not drinking at all, might not be as great as previously thought, according to Penn State researchers who examined the drinking habits of middle-aged adults.

The researchers analyzed information about more than 9,000 people across England, Scotland and Wales born in 1958 who are participating in the longitudinal National Child Development Study. The study, based at the University College London Centre for Longitudinal Studies, tracked changes in people's drinking and cigarette smoking habits from age 23 to 55, and linked these changes to mental and physical health.

About one third of men and women who reported drinking at the light-to-moderate level were very unlikely to smoke. While this group of light drinkers and non-smokers enjoyed the best health and quality of life in middle age, three other groups experienced more health problems. These groups were those who drank lightly to moderately but also smoked; those who both drank more heavily and smoked; and those who refrained from drinking alcohol or reduced their drinking over time.

Other Risk Factors Not Considered

Light-to-moderate drinkers were defined as adults who consumed no more than 14 units of alcohol, which is equivalent to roughly six pints of beer or six medium-sized glasses of wine, per week. This is the current maximum recommended for men and women by the United Kingdom's Department of Health, according to Jeremy Staff, professor of criminology and sociology at Penn State and the study's lead author.

While the supposed benefits of moderate drinking have been widely reported in the media, many reports have failed to take into account other risk factors. For example, light-to-moderate drinkers suffered poor health in midlife if they were former smokers or still had the occasional cigarette. This may be due to a direct effect of smoking or because of other lifestyle-related risks, such as lack of exercise or obesity. Many midlife abstainers also began their adult life in poorer physical or mental health than peers who had completely abstained from alcohol.

Is There Harm in Abstaining?

"Alcohol abstainers are a diverse group. They include former heavy drinkers who quit due to problems with alcohol, as well as those who quit drinking due to poor health, and not just lifetime abstainers," said Staff. "Medical professionals and public health officials should be wary of drawing conclusions about the so-called 'dangers' of never drinking without more robust evidence."

About 1-in-5 members of 55-year-olds who said they had never drunk alcohol in their lives had previously reported drinking when they were younger. This suggests that those who drink very little may tend to misremember or under-report previous drinking habits. When studies include this group as lifetime abstainers, apparent 'harms' of abstaining may be overestimated, said the researchers.

Alcohol Has Many Health Risks

While modest drinking habits also have been linked with higher levels of education, those with few or no educational qualifications were also among those who did not drink or drank modestly. On the other hand, men and women with the highest educational qualifications at age 23 were more likely than their peers to drink at light-to-moderate rates throughout their adult lives, and were unlikely to smoke.

Jennifer Maggs, professor of human development and family studies at Penn State and another of the study's authors, added, "Evidence continues to grow that alcohol has many health risks, including for cancer. Therefore, it is dangerous to report only benefits of moderate alcohol consumption. Drinking habits are also shaped by our education, health earlier in life, and related lifestyle factors including smoking. These other influences may be the real factors underlying the connection between drinking and midlife health."

According to Sir Ian Gilmore, Chair of the Alcohol Health Alliance in the UK, "This study provides yet more evidence that any benefits associated with drinking alcohol are smaller than previously thought. The most effective ways to reduce harms associated with alcohol consumption are to introduce pricing measures linked to alcohol sales, and enable more informed choices through public education efforts and mandatory labeling of alcohol products."

Posted by Webmaster at 03:23 AM

Binge Drinking Quickly Leads to Liver Disease

Alcohol consumed during just seven weeks of intermittent binge drinking harms the liver in ways that more moderate daily drinking does not, according to researchers at UC San Francisco. The scientists discovered that just 21 binge drinking sessions were enough to cause symptoms of early-stage liver disease.

Binge drinking produced fatty liver tissue and triggered early stages of inflammation, both indicators of alcohol-induced liver disease. Binging also increased the levels of alcohol-metabolizing enzymes, whose activity can produce oxidative damage and other forms of harm to the liver. Their work appears in the January 19, 2017 "EarlyView" online edition of the journal Alcoholism: Clinical and Experimental Research.

Binge Drinking as Dangerous as Long-Term Drinking

"We sometimes think of alcoholic liver damage as occurring after years of heavy drinking. However, we found that even a short period of what in humans would be considered excessive drinking resulted in liver dysfunction," said Frederic "Woody" Hopf, PhD, the study's senior researcher, an associate adjunct professor of neurology at UCSF, and a member of UCSF's Alcohol Center for Genes and Translation (ACGT). "It is important to intervene early to counter the dangers associated with binge drinking habits," said Hopf, also a member of UCSF's Wheeler Center for the Neurobiology of Addiction.

For a man, binge drinking is defined as consumption of five or more drinks within two hours, an amount equivalent to five bottles of beer, a bottle of wine, or five shots of hard liquor. For a woman, binge drinking involves consumption of four or more drinks in two hours.

88,000 Preventable Deaths Yearly

Reducing binge drinking is particularly important because many binge drinkers go on to develop an alcohol use disorder and associated health risks. Excessive alcohol use, which includes binge drinking, results in about 88,000 preventable deaths yearly in the United States and about 2.5 million years of lost life, according to the U.S. Centers for Disease Control and Prevention (CDC). Most people with an alcohol use disorder develop fatty liver, and of those, about one in five goes on to develop liver cirrhosis, which often is fatal.

In the UCSF study, liver triglycerides were almost 50 percent higher in binge drinkers' livers compared to mice that abstained from alcohol, and triglyceride levels in the blood were almost 75 percent higher. Fat droplets were clearly visible in liver slices from binge drinkers. In contrast, moderate-drinking mice and mice that completed just one binge drinking session did not have significantly elevated triglyceride levels compared to abstainers. "Our results strongly suggest that repeated, excessive alcohol drinking, even without alcohol dependence, can cause fatty liver, evidence of early alcohol-related liver dysfunction," Hopf said.

Binge Drinking Increases Enzyme Levels

The researchers also found that even a single episode of binge drinking elevated the levels of the liver enzyme CYP2E1, which metabolizes alcohol into toxic by-products that can cause oxidative damage and other forms of tissue injury. After seven weeks of binging, there was even more CYPE1 produced in response to binge drinking. Alcohol dehydrogenase, the major alcohol-metabolizing enzyme, was also more abundant in binge-drinking mice. These results suggest that repeated binging increases the levels of these enzymes, which could lead to greater cellular damage.

Repeated binge drinking also increased activation of a gene that immune cells use to make an inflammatory cytokine protein called IL-1B, which is implicated in the liver inflammation seen in alcohol-induced liver disease. The scientists did not detect other alterations in the inflammatory system that are known to accompany later stages of liver cell damage.

Can Damage Be Undone?

"It's not yet clear whether the changes to the liver associated with binge drinking are completely reversible. It could even be that these changes sensitize and prime the liver, so that a subsequent return to binge drinking after long abstinence will more easily cause harm," Hopf said. "Those are experiments we are planning to do next."

For several decades, alcohol researchers have regarded mice as a validated model for learning about mechanisms that drive excessive drinking in humans, according to Hopf. In the newly published study, binge-drinking mice could drink 20 percent alcohol on just three nights per week. "On Monday, Wednesday and Friday nights, they got to drink all they wanted," Hopf said.

On the Road to Liver Damage

On the other hand, mice that had continuous access to alcohol drank more moderately, about half as much as binge drinkers. Alcohol binging in mice produces blood alcohol levels that are comparable to human binge drinking, Hopf said.

UCSF researchers at the ACGT are particularly interested in investigating whether changes in the brains of alcohol-binging mice might shed light on human binge drinking, especially the compulsive drives for alcohol associated with binge drinking that continues despite damaging consequences. The present studies suggest that even more limited alcohol binging is already sufficient to start one on the road to liver damage, Hopf said.

Posted by Webmaster at 03:10 AM

Alcohol Increases Risks of Heart Conditions

Alcohol abuse increases the risk of atrial fibrillation, heart attack and congestive heart failure as much as other well-established risk factors such as high blood pressure, diabetes, smoking and obesity, according to a study published in the Journal of the American College of Cardiology.

Despite advances in prevention and treatments, heart disease is the No. 1 killer of men and women in the US. Reducing alcohol abuse might result in meaningful reductions of heart disease, according to the researchers.

"We found that even if you have no underlying risk factors, abuse of alcohol still increases the risk of these heart conditions," said lead researcher Gregory M. Marcus, MD, director of clinical research in the Division of Cardiology at the University of California, San Francisco.

Double the Risk of Atrial Fibrillation

The researchers analyzed data from a database of all California residents ages 21 and older who received ambulatory surgery, emergency or inpatient medical care in California between 2005 and 2009. Among the 14.7 million patients in the database, 1.8 percent, or approximately 268,000, had been diagnosed with alcohol abuse.

The researchers found that after taking into account other risk factors, alcohol abuse was associated with a twofold increased risk of atrial fibrillation, a 1.4-fold increased risk of heart attack and a 2.3-fold increased risk of congestive heart failure. These increased risks were similar in magnitude to other well-recognized modifiable risk factors such as diabetes, high blood pressure and obesity.

Completely eradicating alcohol abuse would result in over 73,000 fewer atrial fibrillation cases, 34,000 fewer heart attacks, and 91,000 fewer patients with congestive heart failure in the United States alone, the researchers said.

Drinking Not Good for the Heart

"We were somewhat surprised to find those diagnosed with some form of alcohol abuse were at significantly higher risk of a heart attack," Marcus said. "We hope this data will temper the enthusiasm for drinking in excess and will avoid any justification for excessive drinking because people think it will be good for their heart. These data pretty clearly prove the opposite."

Previous research has suggested that moderate levels of alcohol consumption may help prevent heart attack and congestive heart failure, while even low to moderate levels of alcohol consumption have been shown to increase the incidence of atrial fibrillation.

Documented Alcohol Abuse

"The great majority of previous research relied exclusively on self-reports of alcohol abuse," Marcus said. "That can be an unreliable measure, especially in those who drink heavily. In our study, alcohol abuse was documented in patients' medical records." He said that the study did not quantify how much alcohol patients drank.

In an editorial accompanying the new study, Michael H. Criqui, MD, MPH, of the University of California San Diego, wrote that previous studies that found a benefit from alcohol consumption in protecting against heart attack and congestive heart failure were so-called cohort studies, which include defined populations. Such studies tend to recruit stable, cooperative and health-conscious participants who are more likely to be oriented toward a heathier lifestyle.

"Cohort studies have minimal participation by true alcohol abusers, so the current study likely presents a more valid picture of heavy drinking outcomes," Criqui said.

Posted by Webmaster at 03:04 AM

Alcohol Risks Increasing for Older Adults

Alcohol is the most commonly used psychoactive substance among older adults, and this group can have unique risks associated with alcohol consumption -- in even lower amounts -- compared to younger persons.

"Older adults have particular vulnerabilities to alcohol due to physiological changes during aging, including increasing chronic disease burden and medication use," said Benjamin Han, MD, MPH, a geriatrician and health services researcher at the Center for Drug Use and HIV Research (CDUHR) and in the Division of Geriatric Medicine and Palliative Care at NYU Langone Medical Center (NYU Langone). "However, no recent studies have estimated trends in alcohol use, including binge alcohol use and alcohol use disorders among older adults."

Significant Increases in Alcohol Use, Binge Drinking

To address the lack of research, Dr. Han and his team examined data from the National Survey on Drug Use and Health (years 2005 to 2014) in a paper published in the journal Drug and Alcohol Dependence. Trends of self-reported past-month binge alcohol use and alcohol use disorder were examined among adults age 50 and older.

The researchers found significant increases in past-year alcohol use, past-month alcohol use, past-month binge drinking, and alcohol use disorders. The paper, "Demographic trends of binge alcohol use and alcohol use disorders among older adults in the United States, 2005-2014." Published on-line 12 December 2016.

Binge Drinking Increased for Women

Results also suggest that while men had a higher prevalence of binge alcohol use and alcohol use disorders than women, binge alcohol use and alcohol use disorder increased among women in this nationally representative sample.

"As females age, they tend to experience a larger impact of physiological changes in lean body mass compared to men," commented Dr. Han. "Thus, they may experience the adverse effects associated with consuming alcohol even in lower amounts."

Risking Sexual Situations a Factor

"The increase in binge drinking among older women is particularly alarming" said Dr. Palamar, PhD, MPH, a CDUHR affiliated researcher and an assistant professor of Population Health at NYU Langone. "Both men and women are at risk for getting themselves into risky sexual situations while drinking, but women are at particularly high risk." Dr. Palamar also stated that "heavy drinking can not only have unintended health consequences, but it can also lead to socially embarrassing or regretful behavior."

For the researchers, the results also raise public health concerns, given the significant increases in binge alcohol use among older adults who reported "fair/poor" health and/or multiple chronic conditions. This population is particularly vulnerable to the negative effects of alcohol as it can impact chronic disease management or increase the risk of injury.

"Health care providers need to be made aware of this increasing trend of unhealthy alcohol use, particularly among older females, and ensure that screening for unhealthy alcohol use is part of regular medical care for this population" said Dr. Han.

Posted by Webmaster at 03:00 AM

August 13, 2017

Early Binge Drinking Linked to Hypertension

Having an occasional drink is fine, but "binge" drinking is a known health hazard and now high blood pressure may need to be added to the list of possible consequences. Young adults in their twenties who regularly binge drink have higher blood pressure which may increase the risk of developing hypertension, concludes a study conducted by researchers at the University of Montreal Hospital Research Centre (CRCHUM).

Binge drinking (i.e. consuming five or more alcoholic beverages in less than two hours), is quite prevalent: previous studies in Canada and the U.S. have shown that about four in ten young adults aged 18 to 24 are frequent binge drinkers.

Binge Drinking Affects Blood Pressure

Now researchers have demonstrated, for the first time, that binge drinking may have an effect on blood pressure, which can increase the risk of developing hypertension and chronic diseases related to hypertension.

"We found that the blood pressure of young adults aged 20 to 24 who binge drink was 2 to 4 millimetres of mercury higher than non-binge drinkers," says Jennifer O'Loughlin, senior author of a study published today in the Journal of Adolescent Health.

Data on alcohol consumption at age 20 were collected from 756 participants in the Nicotine Dependence in Teens study, which has followed 1294 young people from diverse social backgrounds in Montreal, Canada since 1999. Data were collected again at age 24, at which time participants' systolic blood pressure was also taken.

One in Four Affected, Study Shows

Systolic blood pressure measures the pressure in the arteries when the heart beats (i.e., when the heart muscle contracts), and it should be below 140 millimetres of mercury. A blood pressure reading of more than 140 over 90 indicates high blood pressure. The latter number, diastolic blood pressure, measures the pressure in the arteries between heartbeats (i.e., when the heart muscle is resting between beats and refilling with blood).

"Our findings show that more than one in four young adults who binge drink meet the criterion for pre-hypertension (i.e., a systolic blood pressure between 120 and 139 millimetres of mercury). This is worrisome because this condition can progress to hypertension, which in turn can cause heart disease and premature death," says O'Loughlin, a researcher at the CRCHUM and professor in the School of Public Health, University of Montreal.

Risk of Chronic Diseases

Health professionals and others may need to adopt a preventive approach, recommends O'Loughlin: "Poor diet, salt intake, and obesity are predictors of high blood pressure.

Since we know there is a link between higher blood pressure and the risk of developing chronic diseases, clinicians should ask young people about their alcohol consumption. A slight and continuous increase in systolic blood pressure may be an important warning sign."

The study also revealed that 85% of young adults who drink heavily at age 20 maintain this behaviour at age 24. But unlike our genetic make-up, risky behaviour can be changed.

When to Intervene?

The researchers will now investigate whether this trend toward high blood pressure will continue when binge drinkers turn 30. With work and family obligations, binge drinking may become less frequent. Other questions that arise include: will the short-term effects of binge drinking disappear when binge drinking declines?

Is there a critical time period in which to intervene to prevent hypertension? While awaiting for answers to these questions, the old adage "moderation is always in good taste" may apply.

Posted by Webmaster at 07:58 PM

Alcohol Helps Bacteria Harm the Liver

End-stage liver disease or liver cirrhosis is the tenth leading cause of death in the United States, and approximately half of these cases are related to alcohol consumption. There's no refuting that alcohol itself harms the liver, but new research in mice and humans published February 10 in Cell Host & Microbe reveals that chronic drinking also promotes the growth of gut bacteria that can travel to the liver and exacerbate liver disease.

Gastroenterologist Bernd Schnabl of the University of California, San Diego School of Medicine and his colleagues found that chronic alcohol consumption suppresses the mouse antibacterial defense system in the intestine. It does so by blocking intestinal cells' ability to produce natural antibiotic proteins (called REG3B and REG3G).

Gut Bacteria Reaching the Liver

"Intestinal bacteria can now not only proliferate, but also slowly migrate through the intestinal wall," says Schnabl. "Since the liver encounters all the blood coming from the intestine, not only important nutrients but also bacteria can now reach the liver. The direct damage that is caused by alcohol to the liver is augmented by the arrival of these gut bacteria, through mechanisms that are currently unknown."

The team also found that mice genetically engineered to lack REG3G had more of these bacteria after consuming alcohol, and they developed more severe alcoholic liver disease than their littermates. However, restoring REG3G to the intestine reduced the levels of bacteria that traveled to the liver and protected against alcohol-induced liver damage.

Finally, the researchers found that humans with alcohol dependency had elevated levels of bacteria in their small intestines. The team's previous research showed that they also had lower levels of REG3G.

Probiotic Bacteria Needed

While it may be best for patients at risk of liver disease to stop drinking altogether, Schnabl notes that it can be difficult for some to do so. These latest findings indicate that it may be possible to help patients with alcoholic liver disease by boosting their intestinal defense against certain bacteria, for example by encouraging the growth of good (probiotic) bacteria or by stimulating the production of intestinal antibiotics such as REG3G.

The National Institute on Alcohol Abuse and Alcoholism states that "low-risk" drinking levels for men are no more than 4 drinks on any single day and no more than 14 drinks per week. For women, "low-risk" drinking levels are no more than three drinks on any single day and no more than 7 drinks per week.

Posted by Webmaster at 07:55 PM

Bariatric Surgery Can Lead to Alcohol Abuse

Among patients who underwent bariatric surgery, there was a higher prevalence of alcohol use disorders in the second year after surgery, and specifically after Roux-en-Y gastric bypass, compared with the years immediately before and following surgery, according to a study in JAMA.

"As the prevalence of severe obesity increases in the United States, it is becoming increasingly common for health care providers and their patients to consider bariatric surgery, which is the most effective and durable treatment for severe obesity. Although bariatric surgery may reduce long-term mortality, and it carries a low risk of short-term serious adverse outcomes, safety concerns remain. Anecdotal reports suggest that bariatric surgery may increase the risk for alcohol use disorders (AUD; i.e., alcohol abuse and dependence)," according to background information in the article.

Higher Alcohol Level Peak

The authors add that there is evidence that some bariatric surgical procedures (i.e., Roux-en-Y gastric bypass [RYGB] and sleeve gastrectomy) alter the pharmacokinetics of alcohol. "Given a standardized quantity of alcohol, patients reach a higher peak alcohol level after surgery compared with case-controls or their preoperative levels."

Wendy C. King, Ph.D., of the University of Pittsburgh, and colleagues conducted a study to determine whether the prevalence of AUD changed following bariatric surgery, comparing reported AUD in the year prior to surgery with the first and second years after surgery. The prospective study included 2,458 adults who underwent bariatric surgery at 10 U.S. hospitals. Of these participants, 1,945 (78.8 percent female; 87 percent white; median [midpoint] age, 47 years; median body mass index, 45.8) completed preoperative and postoperative (at 1 year and/or 2 years) assessments between 2006 and 2011. The primary outcome measure for the study was past year AUD symptoms determined with the Alcohol Use Disorders Identification Test (AUDIT) (indication of alcohol-related harm, alcohol dependence symptoms, or score 8 or greater).

Increases in 2nd Year

The researchers found that the prevalence of AUD symptoms did not significantly differ from 1 year before to 1 year after bariatric surgery (7.6 percent vs. 7.3 percent), but was significantly higher in the second postoperative year (9.6 percent). Frequency of alcohol consumption and AUD significantly increased in the second postoperative year compared with the year prior to surgery or the first postoperative year.

"More than half (66/106; 62.3 percent) of those reporting AUD at the preoperative assessment continued to have or had recurrent AUD within the first 2 postoperative years," the authors write. "In contrast, 7.9 percent (101/1,283) of participants not reporting AUD at the preoperative assessment had postoperative AUD. Nonetheless, more than half (101/167; 60.5 percent) of postoperative AUD was reported by those not reporting AUD at the preoperative assessment"

The researchers also found that male sex, younger age, smoking, regular alcohol consumption, AUD, recreational drug use, lower score on a measure of a sense of belonging at the preoperative assessment and undergoing a RYGB were independently related to an increased likelihood of AUD after surgery. RYGB accounted for 70 percent of surgeries and doubled the likelihood of postoperative AUD compared with laparoscopic adjustable gastric banding.

Significant Societal Costs

The authors note that although the 2 percent increase (7.6 percent to 9.6 percent) in prevalence of AUD from prior to surgery to the 2-year postoperative assessment may seem small, the increase potentially represents more than 2,000 additional people with AUD in the United States each year, with accompanying personal, financial, and societal costs.

"This study has important implications for the care of patients who undergo bariatric surgery. Regardless of alcohol history, patients should be educated about the potential effects of bariatric surgery, in particular RYGB, to increase the risk of AUD. In addition, alcohol screening and, if indicated, referral should be offered as part of routine preoperative and postoperative clinical care. Further research should examine the long-term effect of bariatric surgery on AUD, and the relationship of AUD to postoperative weight control."

Posted by Webmaster at 07:10 PM

Alcohol Greatly Increases Serious Injury Risk

Researchers know that alcohol impairs coordination and the ability to perceive and respond to hazards, and that hangovers impair neurocognitive performance and psychomotor vigilance. This study closely examined alcohol-related injuries admitted to hospital, finding that alcohol greatly increases risk for serious injury.

Results were published in Alcoholism: Clinical & Experimental Research.

"We know that alcohol is more heavily involved in fatalities than injuries," said Ted R. Miller, a senior research scientist at the Pacific Institute for Research and Evaluation and corresponding author for the study. "It is less clear whether and how heavily alcohol is involved in serious injury."

Alcohol and Injuries

"It is important to understand the proportion of injury attributable to alcohol for those injuries which are more severe and subsequently hospitalized, compared to those not needing hospitalization," said Cheryl J. Cherpitel, a senior scientist with the Alcohol Research Group. "Taken together, both are important for a more comprehensive understanding of the proportional decline in injury in the absence of alcohol."

The study authors combined national alcohol consumption data with alcohol metabolism rates to estimate hours that heavy drinkers versus other drinkers and non-drinkers spent as "alcohol positive" versus "alcohol negative" within one calendar year.

"If we know how much alcohol people drink, we can estimate how many hours per day people are alcohol-positive versus alcohol-negative," explained Miller. "Dividing the number of alcohol-positive injuries by the number of alcohol-positive hours indicates injury-risk when alcohol-positive. A similar calculation gives the alcohol-negative risk."

Results showed that alcohol consumption is a major cause of hospitalized injury. Even though heavy drinkers generally lead risky lifestyles, and even though they tolerate alcohol better than most drinkers, their injury risks still tripled when they drank.

4.5 Times Higher Risk

"Risk during hours that people were alcohol-positive was 4.5 times their risk when sober," said Miller. "Heavy drinkers claim they can handle their alcohol. Within limits, that's true. Alcohol raises a heavy drinker's injury risk less than an average person's risk. Still, a heavy drinker is three times more likely to be injured during an alcohol-positive than a sober hour. Possibly due to hangover effects, heavy drinkers also are 1.35 times as likely as other people to be injured when sober. Alcohol especially raises risk for assault, near drowning, non-elderly fall, and pedestrian injuries. An estimated 36 percent of hospitalized assaults and 21 percent of all injuries are attributable to alcohol use by the injured person."

"Non-heavy drinkers also seem to have a higher risk of injury-related hospitalization when alcohol positive compared to alcohol-positive heavy drinkers," said Cherpitel, "likely due to their not being accustomed to alcohol's effects, while heavier drinkers have developed a tolerance to alcohol and are therefore less affected by the same amount of alcohol. It is also possible that heavier drinkers may have consumed so much alcohol that they are unable to place themselves in risky situations that may result in injury; for example, they may become a passenger in a vehicle and sleep rather than attempt to drive. These findings are similar to those from our emergency-room studies."

Warning Labels Needed

"Our estimates set the stage for injury-warning labels on alcohol bottles," said Miller. "They also suggest what percentage of public injury cost justifiably could be recovered through alcohol taxes. Moderate drinking has not traditionally been considered hazardous. Yet from an injury viewpoint, it appears to be more hazardous per drink than regular heavy drinking. Moderate drinkers who occasionally drink to excess suffer more injuries than heavy drinkers per alcohol-positive hour. Nonetheless, intervention rarely has been targeted to this group because its high risk was hidden."

"Certainly these findings point to the importance of screening and brief intervention in clinical practice," added Cherpitel, "as well as advancing public health knowledge regarding the potential effects of even small quantities of alcohol. Injury research needs to consider that even a small amount of alcohol in less experienced drinkers can be especially dangerous when undertaking potentially risky activities such as driving or using heavy equipment."

Posted by Webmaster at 06:40 PM

How Alcohol Interferes With Sleep

Large amounts of alcohol are known to shorten sleep latency, increase slow-wave sleep, and suppress rapid eye movement (REM) during the first half of sleep. During the second half of sleep, REM increases and sleep becomes shallower. A study of the acute effects of alcohol on the relationship between sleep and heart rate variability (HRV) during sleep has found that alcohol interferes with the restorative functions of sleep.

Results were published in Alcoholism: Clinical & Experimental Research.

Alcohol affects overall sleep architecture," said Yohei Sagawa, a medical doctor in the department of neuropsychiatry at the Akita University School of Medicine. "Normally, during physiologic nocturnal sleep in humans, the parasympathetic nervous system, responsible for 'rest-and-digest' activities, is dominant over the sympathetic nervous system, responsible for stimulating activities. We wanted to investigate how alcohol may change this complementary relationship."

Unique Sleep-Alcohol Study

"I believe that the approach used in this study is unique," added Seiji Nishino, director of the Sleep & Circadian Neurobiology Laboratory at Stanford University School of Medicine. "Although there are several studies monitoring HRV during sleep, as far as I know there is no report describing the effects of alcohol on autonomic nervous system during sleep using this parameter."

Sagawa and his colleagues gave 10 healthy, male university students with a mean age of 21.6 years three different alcohol beverages at three week intervals: 0g (control), 0.5g (low dose), or 1.0g (high dose) of pure ethanol/kg of body weight. On the day of the experiment, a Holter electrocardiogram was attached to the subject for a 24-hour period; the subject was instructed to drink one of the three alcoholic beverages 100 minutes before going to bed; and polysomnography was then performed for eight hours. Power spectral analysis of the HRV was performed using the maximum entropy method, and the low- and high-frequency components along with their ratios were calculated.

"Our study showed that alcohol suppresses the high-frequency power during sleep in a dosage-dependent manner," said Sagawa. "Although the first half of sleep after alcohol intake looks good on the EEG, the result of the assessment regarding the autonomic nerve system shows that drinking leads to insomnia rather than good sleep."

Heart Rate Increase

More specifically, as alcohol consumption increased, the heart rate increased and the spectral power of HRV measured at each frequency range decreased. Also, the low-frequency/high-frequency ratio that is considered an index of the balance between the sympathetic and parasympathetic systems was increased. This suggests that alcohol, in a dosage-dependent manner, suppresses the high-frequency component of HRV that is an indicator of parasympathetic nerve activity during sleep.

"The current study evaluates the acute effects after only a single dose of alcohol intake, and subsequently found a negative health consequence," observed Nishino. "Many subjects habitually drink alcohol, and if the reduction of parasympathetic nerve activity during sleep chronically occurred, negative health consequences may be much larger and may induce various diseases. It is reported that habitual drinkers with hypertension are often associated with reductions of parasympathetic nerve activities."

Many Alcoholics Have Insomnia

Sagawa agreed. "Many alcoholics and habitual drinkers suffer from insomnia," he said. "Suppressed parasympathetic nerve activity is the result of alcohol drinking. Thus, it is inferred that suppressed parasympathetic nerve activity is associated with insomnia, which includes difficulty getting to sleep, early-morning awakening, lack of a sense of deep sleep, and difficulty maintaining sleep."

"It is generally believed that having a nightcap may aid sleep, especially sleep initiation," said Nishino. "This may be true for some people who have small amounts of alcohol intake. However, it should be noted that large amounts of alcohol intake interfere with sleep quality and the restorative role of sleep and these negative consequences may be much larger during chronic alcohol intake."

Sagawa added that it is important for clinicians who are treating physical and psychological disorders related to alcohol to consider the disturbing effects on sleep's restorative effects that habitual drinking can have.

Posted by Webmaster at 06:19 PM

Brain Damage Seen in Young Binge-Drinkers

It's considered a rite of passage among young people – acting out their independence through heavy, episodic drinking. But a new University of Cincinnati study, the first of its kind nationally, is showing how binge drinking among adolescents and young adults could be causing serious damage to a brain that's still under development at this age.

Researcher Tim McQueeny, a doctoral student in the UC Department of Psychology, is presenting the findings this week at the 34th annual meeting of the Research Society on Alcoholism in Atlanta.

Binge Drinking and the Brain

High-resolution brain scans on a sample of 29 weekend binge drinkers, aged 18 to 25, found that binge-drinking – consuming four or more drinks in one incident for females and five or more drinks for males – was linked to cortical-thinning of the pre-frontal cortex, the section of the brain related to executive functioning such as paying attention, planning and making decisions, processing emotions and controlling impulses leading to irrational behavior.

McQueeny examined the brain's gray matter, the parts of brain cells that do the thinking, receiving and transmitting of messages. "We have seen evidence that binge drinking is associated with reduced integrity in the white matter, the brain's highways that communicate neuron messaging, but alcohol may affect the gray matter differently than the white matter," he says.

The pilot study examined whether the researchers could see a relationship between gray matter thickness and binge drinking among college-aged young adults. They found that greater number of drinks per binge is associated with cortical thinning. McQueeny is now interested in pursuing future research to examine whether binge drinking is affecting the brain's gray matter and white matter differently, or if they're both equally affected.

Brain Is Still Growing

"Alcohol might be neurotoxic to the neuron cells, or, since the brain is developing in one's 20s, it could be interacting with developmental factors and possibly altering the ways in which the brain is still growing," he says.

The findings affect a significant population. A publication from the National Institute on Drug Abuse reports that 42 percent of young American adults between 18 and 25 have engaged in binge drinking.

McQueeny adds that the depressant effects of alcohol emerge later in life, so for young adults, the effect of alcohol can be very stimulating and activate tolerance over time.

"In the past, in terms of what's known about the physical toll of alcohol, the focus on neurobiology has been in pathological populations and adult populations who were disproportionately male, so there was a significant gap in research in terms of when people started risky drinking. We're looking at developmental aspects at an age when binge drinking rates are highest, and we're also looking at gender effects," says McQueeny. "There might actually be indications of early micro-structural damage without the onset of pathological symptoms such as abuse, or dependence on alcohol."

Resonsible Drinking Suggested

McQueeny's advisor, UC Psychology Professor Krista Lisdahl Medina, served as senior author on the paper. She adds, "Our preliminary evidence has found a correlation between increased abstinence of binge drinking and recovery of gray matter volume in the cerebellum. Additional research examining brain recovery with abstinence is needed."

In terms of educating young adults about responsible drinking, Medina says there appear to be better efforts about communicating the dangers of drinking and driving. "However, people can still be doing damage to their brain as a result of the prevalence and acceptance of binge drinking. There is also evidence that drinking below the binge level may be less harmful," she says.

The high-resolution imaging was conducted at UC's Center for Imaging Research.

The research was supported by a $300,000 grant awarded to Medina's lab by the National Institute on Drug Abuse. McQueeny was also awarded a University Research Council Summer Graduate Fellowship.

Posted by Webmaster at 12:14 PM

Alcohol's Damaging Effects on the Brain

While alcohol has a wide range of pharmacological effects on the body, the brain is a primary target. However, the molecular mechanisms by which alcohol alters neuronal activity in the brain are poorly understood. Participants in a symposium at the annual meeting of the Research Society on Alcoholism in San Antonio, Texas addressed recent findings concerning the interactions of alcohol with prototype brain proteins thought to underlie alcohol actions in the brain.

Proceedings were published in Alcoholism: Clinical & Experimental Research.

Effects of Alcohol on the Brain

"Alcohol is the most common drug in the world, has been used by diverse human communities longer than recorded history, yet our understanding of its effects on the brain is limited when compared to other drugs," said Rebecca J. Howard, a postdoctoral fellow at The University of Texas at Austin Waggoner Center for Alcohol & Addiction Research and corresponding author for this study.

Howard explained that neuroscientists have discovered how marijuana, cocaine, and heroin each bind to a special type of protein on the surface of brain cells, fitting like a key into a lock to change that protein's normal function. Yet alcohol has special properties that make it difficult to characterize its lock-and-key binding in detail, for example, alcohol is much smaller than other drugs, and appears to interact with several different types of proteins.

"The adverse effects of alcohol abuse are devastating on a personal level and on a societal level," added Gregg Homanics, a professor of anesthesiology and pharmacology & chemical biology at the University of Pittsburgh. "Alcohol abuse costs our society more than the costs of all illegal drug abuse combined. For many years, most investigators thought that alcohol exerted nonspecific effects on the brain and simply perturbed neuronal function by dissolving in the membranes of nerve cells. However, our understanding of alcohol action has dramatically shifted in the last 10 to 15 years or so. There is now solid experimental evidence that alcohol binds in a very specific manner to key protein targets in the brain to cause the drug's well known behavioral effects. This review summarizes some of the most recent research."

Recent Alcohol Research

Some of the key points were:

Combining X-ray crystallography, structural modeling, and site-directed mutagenesis may be better suited to studying alcohol's low-affinity interactions than traditional techniques such as radioligand binding or spectroscopy.

"One major problem in studying alcohol binding to brain proteins is that the alcohol key does not fit very tightly into any particular protein lock," said Howard. "That is, alcohol has a 'low affinity' for proteins, compared to how other drugs interact with their own protein targets. We think this is one reason it takes such a large quantity of alcohol to affect the brain: whereas users of cocaine or heroin may consume just a few milligrams at a time, a person drinking a shot of strong liquor consumes about 1,000 times that much alcohol (several grams). The low affinity of alcohol for its protein targets [also] makes it difficult to study by traditional methods that rely on detecting stable drug-protein complexes over a long period of time."

Some common themes are beginning to emerge from a review of diverse proteins such as inwardly rectifying potassium, transient receptor potential, and neurotransmitter-gated ion channels, as well as protein kinase C epsilon.

Alcohol Targets in the Brain

"It is now very clear that hydrophobic pockets exist in the structure of various brain proteins and alcohols can enter those pockets," said Homanics. "Alcohols interact with specific amino acids that line those pockets in a very specific manner."

In particular, evidence is emerging that supports characteristic, discrete alcohol binding sites on protein targets.


"Different drugs bind to different types of proteins on the surface of brain cells, each fitting like a key, or drug, into a lock, or binding site, on a protein to change its normal function," explained Howard. "Understanding the exact shape of that lock and key helps us to understand how individuals with special mutations may be affected differently by drugs, and can help scientists design new medicines to help people with drug abuse or other problems."

The Brain's Binding Sites

"I feel that there is now overwhelming evidence that specific alcohol binding sites exist on a variety of brain protein targets," added Homanics. "This is significant because we can now focus on defining these sites in greater detail, ultimately at the level of each atom involved. This will allow for, one, a more complete understanding of the molecular pharmacology of alcohol action, two, the discovery of similar sites on other important brain proteins, and three, the rational design of drugs that can selectively target these binding sites."

"Our review summarizes very recent advances in understanding the molecular details of alcohol binding sites, which now include human brain targets, not just metabolic enzymes and receptors from other species," said Howard. "This information will give researchers new opportunities to characterize human mutations and design new medicines. Furthermore, common themes emerging about alcohol binding sites may help scientists identify important binding sites in other important brain proteins."

Highly Selective Targets

"In other words," said Homanics, "alcohol exerts its effects via binding sites on target molecules just like all other drugs we know about. There is now solid evidence from several different putative alcohol targets using several different techniques that alcohol interacts with specific brain targets in a highly selective manner. This is particularly important for more senior clinicians and researchers that were trained years ago when the predominant theory of alcohol action was via nonspecific effects on the nervous system." Both Howard and Homanics are hopeful that this research will aid the development of therapies and treatments for individuals with alcohol problems.

"Great progress is being made in understanding how alcohol exerts its effects on the brain at the molecular level," noted Homanics. "Understanding how alcohol affects brain proteins on a molecular level is essential if we are to effectively develop rational treatments to combat alcohol use disorders."

Posted by Webmaster at 12:10 PM

Binge Drinking Affects Ability to Learn

Binge drinking is prevalent among university students, especially in the United States. One brain structure particularly sensitive to alcohol's neurotoxicity during development is the hippocampus, which plays a key role in learning and memory. A study of the association between binge drinking and declarative memory – a form of long-term memory – in university students has found a link between binge drinking and poorer verbal declarative memory.

"In northern European countries, there is a strong tradition of a sporadic, drunkenness-orientated, drinking style," explained María Parada, a postdoctoral researcher at the Universidade de Santiago de Compostela, Spain and first author of the study. "In contrast, countries on the Mediterranean coast, such as Spain, have traditionally been characterized by a more regular consumption of low doses of alcohol. In recent years, the pattern of binge drinking among young people has become more widespread throughout Europe, hence the growing concern about this issue."

Binge Drinking and Memory

"I think it´s important to examine alcohol´s effects on the hippocampus because in animal studies, particularly in rats and monkeys, this region appears sensitive to the neurotoxic effects of alcohol, and this structure plays a main role in memory and learning," said Marina Rodríguez Álvarez, a senior researcher at the Universidad de Santiago de Compostela. "In other words, binge drinking could affect memory of young adults, which might affect their day-to day lives."

"Our interest in studying the effects of binge drinking patterns on declarative memory results from the well-established role of the hippocampus – a small seahorse-shaped brain structure located in the medial regions of the cerebral hemispheres – in this cognitive function," added Parada. "Both animal studies as well as some neuroimaging studies in humans have shown the hippocampus to be particularly vulnerable to the effects of alcohol, so we wondered whether hippocampus-dependent learning and memory could be affected by heavy episodic drinking."

Parada and her colleagues examined 122 Spanish university students between 18 and 20 years of age divided into two groups: those who engaged in binge drinking (n=62; 32 men, 30 women) and those who did not (n=60; 31 men, 29 women). All were administered a neuropsychological assessment that included the Rey Auditory Verbal Learning Test and the Wechsler Memory Scale-3rd ed. (WMS-III) Logical Memory subtest to measure verbal declarative memory, as well as the WMS-III Family Pictures subtest to measure visual declarative memory.

College Students Affected

"Our main finding was a clear association between binge drinking and a lower ability to learn new verbal information in healthy college students, even after controlling for other possible confounding variables such as intellectual levels, history of neurological or psychopathological disorders, other drug use, or family history of alcoholism," said Parada.

"Young adults with a binge drinking pattern of alcohol consumption who have poorer verbal declarative memory will need more neural resources to perform memory tasks and to learn new information, which probably would affect their academic performance," observed Rodríguez Álvarez.

Parada was a little more cautious. "Although it seems reasonable to expect that these differences in declarative memory affect academic performance – because it depends on the ability to learn new information – there are many other variables that may modulate and explain this relationship, for example, student effort or class attendance," she said. "We are currently carrying out a longitudinal study of these young people, and collecting information on their academic achievements, so we hope to be able to answer this question more definitively in the near future."

One of the strengths of this study, added Parada, is that it controlled for confounding variables such as psychiatric comorbidity, genetic vulnerability, or other drug use, such as marijuana. "This allowed us to establish a clearer association between binge drinking patterns and poorer performance on memory tasks," she said.

An additional strength, said Rodríguez Álvarez, was the finding that women are not more vulnerable than men to the neurotoxic effects of binge drinking.

Both Parada and Rodríguez Álvarez noted the importance of prevention programs and policies to address this issue.

Low Perception of Risk

"One of the factors that appear to be behind this pattern of consumption is the low perception of risk," said Parada. "Whereas most attention has focused on negative consequences such as traffic accidents, violence or public disorder, society and students themselves are unaware of the damaging effects binge drinking may have on the brain. Policies and prevention programs in Europe aimed at controlling this pattern of consumption on campus are still rare."

Yet the opposite should be occurring, added Rodríguez Álvarez. "These results should be taken into account by parents, clinicians, university administrators, and also governments because it is vital to address all that surrounds the brain's development in our adolescents and young adults."

Results were published in Alcoholism: Clinical & Experimental Research.

Posted by Webmaster at 12:04 PM

Alcohol Can Increase Risk of Atrial Fibrillation

A review of research studies indicate that alcohol consumption can increase the risk for developing atrial fibrillation. Atrial Fibrillation (AF) is the most common cardiac arrhythmia (abnormal heart rhythm). Its name comes from the fibrillating (i.e., quivering) of the heart muscles of the atria, instead of a coordinated contraction.

The result is an irregular heartbeat, which may occur in episodes lasting from minutes to weeks, or it could occur all the time for years. Atrial fibrillation alone is not in itself generally life-threatening, but it may result in palpitations, fainting, chest pain, or congestive heart failure.

There is no doubt that heavy alcohol intake and binge drinking can lead to cardiac arrhythmias, with the "Holiday Heart Syndrome" being known for more than three decades. This syndrome often includes atrial fibrillation; the syndrome is usually not associated with long-standing heart disease and the arrhythmia tends to resolve when drinking stops.

Heavy Drinking and Atrial Fibrillation

Members of The international Scientific Forum on Alcohol Research comment 'This paper, Alcohol consumption and risk of atrial fibrillation. A meta-analysis. J Am Coll Cardiol 2011;57:427-436. analyzing the results of 14 papers suggests that even moderate drinking can lead to this syndrome, but others find no effect for moderate alcohol intake, only for heavy drinking.

One of the best studies on alcohol consumption and risk of atrial fibrillation is a Danish cohort study (the Danish Diet, Cancer and Health Study) examining the issue among 22,528 men and 25,421 women followed over 6 years. The study included a large number of cases with atrial fibrillation, detailed information on potential confounding factors, and complete follow up through nationwide population-based registries.

The results included a modest increase in risk of atrial fibrillation in men drinking more that 2 drinks/day and no association between alcohol consumption and risk of atrial fibrillation in women.

Binge Drinking Dangers

There is much evidence that heavy alcohol consumption is associated with an increased incidence of atrial fibrillation, among other health risks. The pattern of consumption (speed, time frame and without food), not often addressed, affects risk too - we know that binge drinking is associated with a greater incidence of arrhythmias, especially atrial fibrillation.

A weakness of this paper, and of essentially all meta-analyses, is that there were varying definitions for categories of alcohol consumption, and the highest category of alcohol intake included alcoholics and 6 or more drinks/day for some studies, while the highest category of alcohol intake was = 1-2 drinks/day in other studies.

Inherent Health Risk

The consistent message is that there is a difference between heavy and moderate use of alcohol, between binge drinking and a healthy pattern of drinking, and inherent health risk. The most important question would be: Does light to moderate drinking increase the risk of AF? The conclusion of the authors of this paper seems to be yes, while many other studies find little effect of such drinking'.

Overall, the scientific evidence from many studies suggests that heavy drinking may increase the risk of atrial fibrillation, although whether light-to-moderate intake increases the risk seems unlikely. Previous basic scientific data of mechanisms of atrial fibrillation have suggested that alcohol has little effect on this arrhythmia.

Posted by Webmaster at 11:40 AM

Alcohol Damages Much More Than the Liver

Alcohol does much more harm to the body than just damaging the liver. Drinking also can weaken the immune system, slow healing, impair bone formation, increase the risk of HIV transmission and hinder recovery from burns, trauma, bleeding and surgery.

Researchers released the latest findings on such negative effects of alcohol during a meeting of the Alcohol and Immunology Research Interest Group, held at Loyola University Medical Center.

The Effects of Alcohol

At Loyola, about 50 faculty members, technicians, post-doctoral fellows and students are conducting alcohol research. Studies at Loyola and other centers could lead to therapies to boost the immune system or otherwise minimize the effects of alcohol, said Elizabeth J. Kovacs, PhD, director of Loyola's Alcohol Research Program and associate director of Loyola's Burn & Shock Trauma Institute.

"Of course, the best way to prevent the damaging effects of alcohol is to not drink in the first place," Kovacs said. "But it is very difficult to get people to do this."

Sessions at the conference included Alcohol and Infection, Alcohol and Oxidative Stress and Alcohol and Organ Inflammation. Findings were presented by researchers from centers around the country, including Loyola, Cleveland Clinic, University of Iowa, University of Colorado, University of Massachusetts, Mississippi State University, Chicago State University and the National Institute on Alcohol Abuse and Alcoholism (NIAAA).

Posted by Webmaster at 11:06 AM

Just 2 Drinks Can Impair Older Drinkers

Blood alcohol levels below the current legal limit for driving have a significant negative effect on a person's dexterity. Researchers writing in the open access journal BMC Research Notes found that just two single vodka and orange drinks were enough to make senior volunteers struggle at an obstacle avoidance test while walking.

Judith Hegeman worked with a team of researchers from Sint Maartenskliniek, Nijmegen, The Netherlands, to carry out the tests in 13 healthy men and women (average age 61.5yrs or 62yrs). She said, "The results clearly show that even with low blood alcohol concentrations, reactions to sudden gait perturbations are seriously affected. After ingestion of 2 alcoholic drinks, obstacles were hit twice as often, response times were delayed and response amplitudes were reduced. These changes were most obvious in situations with little available response time."

Alcohol Hampers Reaction Times

To carry out the test, the volunteers first started to walk on a treadmill. Once they had attained a steady walking pace, a thin wooden block was placed at the far end of the belt and allowed to move towards the volunteer. Hegeman and her colleagues measured the effects of alcohol on how capable the subjects were of stepping over this obstacle.

She said, "We found that alcohol levels, considered to be safe for driving, seriously hamper the ability to successfully avoid sudden obstacles in the travel path. A possible limitation of this study is the relatively small sample size, however even with the small number, it yielded an unequivocal outcome."

Posted by Webmaster at 10:43 AM

Alcoholic Liver Disease Becoming More Aggressive

Many diagnostic and treatment options have been developed for chronic liver disease during the last 40 years, yet their influence on survival remain unclear. A study of the prognosis for patients hospitalized for liver diseases between 1969 and 2006, and of differences in mortality and complications between patients with alcoholic and non-alcoholic liver diseases, has found that the general prognosis for patients hospitalized with chronic liver diseases has not improved.

"The most effective changes in treatment for chronic liver disease during the last 40 years are, in my opinion, combination treatment for hepatitis C and treatment with prednisolone and azathioprine for autoimmune hepatitis," said Knut Stokkeland, an instructor in the department of medicine at Visby Hospital in Sweden and corresponding author for the study. "In addition, new diagnostic tools such as endoscopic examinations, computed tomography, MRI, and ultrasound have probably increased our possibilities to detect early disease and the development of cirrhosis."

Alcohol Dependence Increases Risks

Stokkeland added that the key difference between alcoholic and non-alcoholic liver disease is alcohol dependence (AD), which almost all patients with alcoholic liver disease have. "AD increases the risks of social problems, being a smoker, and severe psychiatric diseases," he said. "It also inhibits staying sober, which may stop disease progression."

Stokkeland and his colleagues used data from the Swedish Hospital Discharge Register and Cause of Death Register between 1969 and 2006 to both identify and follow up with a cohort of 36,462 patients hospitalized with alcoholic liver diseases and 95,842 patients hospitalized with non-alcoholic liver diseases.

"The main finding of Dr. Stokkeland's study is the much increased mortality risk of having an alcohol- versus a non-alcohol-related liver disease," observed Johan Franck, a professor of clinical addiction research at Karolinska Institutet in Sweden. "Thus, patients with alcohol-induced liver diseases should receive more attention, and they should routinely be offered treatment for their alcohol-use disorder. Presumably, the various treatment systems involved – such as hepatology versus substance-abuse care – may not be very well coordinated and this may present an area for improvement."

Must Focus on Treating Alcoholism

Stokkeland agreed. "This may be caused by the fact that hospitalized patients with [alcoholic] liver disease have such a severe liver disease that no effort may change their prognosis," he said. "I hope this study will motivate clinicians and scientists in the field of hepatology and gastroenterology to design clinical studies to see if any changes in care-taking of our patients with alcoholic liver disease may change their severe prognosis. We must also focus on treating their AD so that they may stop drinking."

"Given that alcohol doubles the risk of having a serious liver disease," added Franck, "efforts to reduce alcohol drinking will likely have a positive impact on the disease's outcome."

Results were published in the journal Alcoholism: Clinical & Experimental Research.

Posted by Webmaster at 10:39 AM

Alcohol Use Linked to Faster HIV Progression

HIV disease tends to progress at a faster rate in infected individuals who consume two or more alcoholic drinks a day, according to an important paper in AIDS Research and Human Retroviruses, a peer-reviewed journal published by Mary Ann Liebert, Inc.

The article, entitled "Alcohol Use Accelerates HIV Disease Progression," clearly demonstrates that frequent alcohol use, defined as two or more drinks daily, is associated with declining CD4+ cell counts (which indicate a weakened immune system) in individuals with HIV disease who either are or are not receiving antiretroviral therapy (ART). Based on the results of a 30-month prospective study, the authors, Marianna Baum, Carlin Rafie, Sabrina Sales, and Adriana Campa, from Florida International University (Miami), Shenghan Lai, from Johns Hopkins University, and John Bryan Page, from University of Miami, Florida, conclude that alcohol has a direct effect on CD4 cells and that the accelerated decline in CD4+ cell counts in frequent alcohol users is not simply due to poorer adherence to ART in this population.

Alcohol Consumption and HIV


Another article by Natascha Ching, Karin Nielsen-Saines, Jaime Deville, Lian Wei, Eileen Garratty, and Yvonne Bryson, from the David Geffen School of Medicine at UCLA, Los Angeles, CA, demonstrated that children who were infected with HIV while in utero via maternal-fetal transmission, were subsequently given antiretroviral therapy, and had no detectable HIV in their blood, still produced neutralizing antibodies against HIV, suggesting that low levels of viral replication might still be occurring despite drug therapy. In the article "Autologous Neutralizing Antibody to Human Immunodeficiency Virus-1 and Replication-Competent Virus Recovered from CD4+ T-Cell Reservoirs in Pediatric HIV-1—Infected Patients on HAART," the authors present data to support their conclusion that the children's CD4 T-cells may contain latent HIV reservoirs that formed early in life before antiretroviral therapy was initiated.

"It is important that HIV infected individuals make informed decisions relating to alcohol consumption. This article will help to achieve that goal," says Thomas Hope, PhD, Editor-in-Chief of AIDS Research and Human Retroviruses and Professor of Cell and Molecular Biology at the Feinberg School of Medicine, Northwestern University, Chicago, IL.

Posted by Webmaster at 09:39 AM

Proteins May Provide New Alcohol Use Test

Measuring a set of protein changes in the blood linked to alcohol use may potentially lead to a more accurate diagnostic test than those previously available, according to Penn State College of Medicine researchers.

"The challenge in alcohol abuse as opposed to substance abuse -- things like cocaine or heroin or PCP -- is that alcohol is a perfectly legal substance for those over 21," said Willard M. Freeman, Ph.D., department of pharmacology and lead investigator. "Unlike routine testing for illicit drugs, you can't just look for a trace of alcohol because many people enjoy a drink in a responsible manner and alcohol is very quickly metabolized. Discriminating between excessive and responsible levels of drinking makes this a greater challenge."

Proteins Predict Alcohol Use

Penn State Hershey researchers, working for two-and-a-half years in cooperation with Kathleen A. Grant, Ph.D., at the Oregon National Primate Research Center, identified a set of 17 proteins in the blood that accurately predicted alcohol usage 90 percent of the time in non-human primates. Researchers were able to separate usage into three categories -- no alcohol use, drinking up to two drinks per day and drinking at least six drinks per day.

Protein levels rose and declined depending on alcohol consumption.

"We observed that the levels of some proteins increased or decreased with as little as one or two drinks a day," Freeman said. "These same changes occurred with heavier levels of drinking. We also found other proteins that responded only to heavy levels of drinking. Combined, these proteins allow us to classify subjects into non-drinking, alcohol-using, and alcohol-abusing groups."

The researchers are continuing their work, first by determining whether the changes measured return to normal levels with cessation of drinking. Second, they are looking for additional proteins to both increase accuracy and provide alternates if some of the initial 17 do not work in humans.

Working with groups around the world, Penn State Hershey researchers -- led by Freeman and Kent Vrana, chair, department of pharmacology -- plan to collect blood from people undergoing inpatient treatment for alcohol abuse.

Testing for Abstinence


"We'll collect blood throughout their stay to see if the patients' protein pattern reverts from an excessive drinking pattern to a pattern that's indicative of alcohol abstinence," Freeman said.

The goal is to create a diagnostic test for alcohol consumption that may be used in areas of public safety like aviation or national security, for parole conditions and for helping physicians determine if a patient may have an alcohol abuse problem. Currently there are tests that try to address this issue, but Freeman said these tests are not sensitive and specific enough to serve as diagnostics.

"Many of these tests rely on just one protein," he said. "The limitation to this approach is that these tests often look at proteins produced by the liver. While these proteins increase with excessive alcohol intake, they also increase with any type of injury to the liver. For example, a lot of prescription drugs are hard on the liver. These tests let us know that the liver is being stressed but can't discriminate between excessive drinking and other conditions, which therefore reduces the utility of these tests.

"That's where we see the promise in this panel of proteins. The proteins are produced by a number of organs including the liver, the muscle, and the brain. This unique fingerprint that is indicative of alcohol abuse is less likely to be produced by unrelated conditions."

Freeman stresses, a diagnostic test would not be testing for alcoholism, but rather, alcohol intake.

Amount of Drinking Test


"In a strictest use of the words, alcoholism is a psychological diagnosis as opposed to a level of drinking," he said. "The Diagnostic and Statistical Manual really classifies alcohol abuse and alcoholism based on how alcohol is interfering with your life. Obviously we can't use a blood test to say yes, your drinking is interfering with your home life. But the amount of drinking and the amount of problems it causes in your life are tightly correlated.

"We envision, a number of years down the line if this becomes a diagnostic test, that if the test indicates that you're drinking a lot, it would prompt a referral to a specialist in alcohol abuse and alcoholism. This test could provide an objective indicator to help people begin addressing what may really be a problem in their lives."

Posted by Webmaster at 08:49 AM

More Alcohol Outlets Mean More Violence

More alcohol sales sites in a neighborhood equates to more violence, and the highest assault rates are associated with carry-out sites selling alcohol for off-premise consumption, according to new research released by two Indiana University professors.

Using crime statistics and alcohol outlet licensing data from Cincinnati, Ohio, to examine the spatial relationship between alcohol outlet density and assault density, Department of Criminal Justice professor William Alex Pridemore and Department of Geography professor Tony Grubesic found that off-premise outlets appeared to be responsible for about one in four simple assaults and one in three aggravated assaults.

Easier Alcohol Availability

The findings were released at the annual meeting of the American Association for the Advancement of Science in San Diego, Calif.

"A higher density of alcohol sales outlets in an area means closer proximity and easier availability to an intoxicating substance for residents," Pridemore said. "Perhaps just as importantly, alcohol outlets provide a greater number of potentially deviant places. Convenience stores licensed to sell alcohol may be especially troublesome in this regard, as they often serve not only as sources of alcohol but also as local gathering places with little formal social control."

Using different suites of spatial regression models, the researchers found that adding one off-premise alcohol sales site per square mile would create 2.3 more simple assaults and 0.6 more aggravated assaults per square mile. Increases in violence associated with restaurants and bars were smaller but still statistically significant, with 1.15 more simple assaults created when adding one restaurant per square mile, and 1.35 more simple assaults per square mile by adding one bar.

"We could expect a reduction of about one-quarter in simple assaults and nearly one-third in aggravated assaults in our sample of Cincinnati block groups were alcohol outlets removed entirely," Grubesic noted. "These represent substantial reductions and clearly reveal the impact of alcohol outlet density on assault density in our sample."

Alcohol Sales and Crime

The study examined 302 geographic block groups that encompassed all of Cincinnati, with each block group containing about 1,000 residents. Block groups are subdivisions of census tracks and represent the smallest unit available for socioeconomic analysis using data from the Census Bureau.

Crime statistics from January through June 2008 provided by the Cincinnati Police Department found 2,298 simple assaults and another 479 serious assaults had occurred in the study area during that time. The location of each of these criminal events was geocoded to show the precise location where they occurred. The researchers, using data from the Ohio Division of Liquor Control for Hamilton County, Ohio, then used the same geocoding techniques to spatially aggregate the city's 683 unique alcohol sales outlets into those block groups. The arithmetic mean, or average, density of assaults was 69 per square mile, while the average density of alcohol outlets per square mile was 20.

The researchers pointed to possible implications from the research on both public policy and on future research within the field of criminology. Pridemore said ecological studies of alcohol and violence similar to this one, while appearing more and more over the past 20 years in journals of disciplines like public health, geography and epidemiology, have been rare in criminology journals.

Alcohol and Violence

"We believe that alcohol outlets, as a source of community-level variation in levels of interpersonal violence, deserve greater attention in the criminological literature," he said. "The nature of our findings should encourage further investigation of the nature of the ecological association between alcohol, violence and other negative outcomes within communities."

Grubesic said explanations for crime ecological theories like collective efficacy, social disorganization and social cohesion rely on elements like poverty, ethnic heterogeneity, residential mobility, anonymity of community members and willingness to intervene on another's behalf, are difficult to remedy through public policy. That is not the case with alcohol outlet density, he said.

"Alcohol outlet density, on the other hand, is much more amenable to policy changes," Grubesic pointed out. "Unlike other negative neighborhood characteristics that often seem intractable, regulating the density of outlets, and to some extent their management, can be readily addressed with a mixture of policies by liquor licensing boards, the police and government agencies that regulate land use."

Posted by Webmaster at 03:03 AM

August 12, 2017

Social Factors Affect Alcohol Misuse Among Seniors

Social factors have consistently been implicated as a cause of vulnerability to alcohol use and abuse. The reverse is also true, in that individuals who engage in excessive drinking may alter their social context. New research on drinking among older adults has found that older adults who have more money, engage in more social activities, and whose friends approve more of drinking are more likely to engage in excessive or high-risk drinking.

"Ours is one of the first studies to focus longitudinally on high-risk drinking among older adults," said Rudolf H. Moos, senior research career scientist for the Department of Veterans Affairs Health Care System in Palo Alto, California, as well as corresponding author for the study, "and the first to have 10-year and 20-year follow-ups addressing this issue."

Social and Financial Influences


Moos and his colleagues examined 719 (399 men, 320 women) 55 to 65-year-old adults at baseline (between 1986-1988), and then again 10 and 20 years later. At each contact point, participants provided information regarding their drinking, as well as their social and financial resources.

"Our findings show that, one, certain social factors may enhance the chances of an individual engaging in high-risk drinking and, two, once high-risk drinking has developed, social choices may be made to facilitate continuing this behavior," said Moos.

More specifically, results showed that older adults who have more money, who engage in more social activities, and whose friends approve more of drinking are more likely to engage in what is considered high-risk drinking: more than three drinks per day or more than 14 drinks per week.

"These findings show that social contextual models of alcohol use apply to older drinkers," observed Charles J. Holahan, a professor in the department of psychology at The University of Texas at Austin. "The findings undercut the assumption of a solely dispositional view of drinking among older adults, whose alcohol use might easily be assumed to be outside the sway of social influences after a lifetime of drinking. They also provide a textured picture of two processes that link social context and alcohol misuse in a reciprocal way—social causation, whereby social context shapes alcohol use, and social selection, whereby alcohol use in turn shapes social context."

"Older adults who engage in high-risk alcohol consumption tend to select friends who are more likely to drink and to approve of drinking," said Moos. "They may also experience a decline in the quality of relationships with extended family members, that is, high-risk drinking may impair some family relationships. Compared to older women, older men may be more vulnerable or susceptible to some social influences on drinking. Specifically, having more money, and friends who approve more of drinking, seem to be more closely related to high-risk drinking among older men than among older women."

Alcohol Problems Don't Go Away


"The findings serve to undercut a solely person-blame approach to later life drinking," said Holahan. "They demonstrate that a spouse and friends can make a constructive difference in later life drinking. However, a spouse and friends can also unwittingly become caught up as facilitators in the process of later life drinking. The findings also encourage awareness that alcohol misuse does not go away with aging. Although alcohol consumption declined with aging, at the 20-year follow-up more than 20 percent of adults aged 75 to 85 still engaged in high-risk alcohol consumption."

"This information can be used to teach older adults, and family members and friends who care about and have some responsibility for them, about how to avoid or minimize 'triggers,' such as specific social activities or interactions with friends associated with heavy drinking," said Moos. "While this type of information might be useful for brief interventions for older adults in primary care or community settings, there is no inherent reason why family members and friends of older adults who engage in excessive drinking could not use it."

Posted by Webmaster at 10:48 PM