Relationships between alcoholic beverages and cardiovascular risk factor levels in middle-aged men, the PRIME Study. Prospective Epidemiological Study of Myocardial Infarction Study

Moderate alcohol consumption and lipoprotein subfractions: a systematic review of intervention and observational studies

CONTEXT

Moderate alcohol consumption is associated with decreased risk of cardiovascular disease (CVD) and improvement in cardiovascular risk markers, including lipoproteins and lipoprotein subfractions.

OBJECTIVE

To systematically review the relationship between moderate alcohol intake, lipoprotein subfractions, and related mechanisms.

DATA SOURCES

Following PRISMA, all human and ex vivo studies with an alcohol intake up to 60 g/d were included from 8 databases.

DATA EXTRACTION

A total of 17 478 studies were screened, and data were extracted from 37 intervention and 77 observational studies.

RESULTS

Alcohol intake was positively associated with all HDL subfractions. A few studies found lower levels of small LDLs, increased average LDL particle size, and nonlinear relationships to apolipoprotein B-containing lipoproteins. Cholesterol efflux capacity and paraoxonase activity were consistently increased. Several studies had unclear or high risk of bias, and heterogeneous laboratory methods restricted comparability between studies.

CONCLUSIONS

Up to 60 g/d alcohol can cause changes in lipoprotein subfractions and related mechanisms that could influence cardiovascular health.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO registration no. 98955.

Longitudinal study of alcohol consumption and HDL concentrations: a community-based study

Background: In cross-sectional studies and short-term clinical trials, it has been suggested that there is a positive dose-response relation between alcohol consumption and HDL concentrations. However, prospective data have been limited.Objective: We sought to determine the association between total alcohol intake, the type of alcohol-containing beverage, and the 6-y (2006-2012) longitudinal change in HDL-cholesterol concentrations in a community-based cohort.Design: A total of 71,379 Chinese adults (mean age: 50 y) who were free of cardiovascular diseases and cancer and did not use cholesterol-lowering agents during follow-up were included in the study. Alcohol intake was assessed via a questionnaire in 2006 (baseline), and participants were classified into the following categories of alcohol consumption: never, past, light (women: 0-0.4 servings/d; men: 0-0.9 servings/d), moderate (women: 0.5-1.0 servings/d; men: 1-2 servings/d), and heavy (women: >1.0 servings/d; men: >2 servings/d). HDL-cholesterol concentrations were measured in 2006, 2008, 2010, and 2012. We used generalized estimating equation models to examine the associations between baseline alcohol intake and the change in HDL-cholesterol concentrations with adjustment for age, sex, smoking, physical activity, obesity, hypertension, diabetes, liver function, and C-reactive protein concentrations.Results: An umbrella-shaped association was observed between total alcohol consumption and changes in HDL-cholesterol concentrations. Compared with never drinkers, past, light, moderate, and heavy drinkers experienced slower decreases in HDL cholesterol of 0.012 mmol · L^-1 · y^-1 (95% CI: 0.008, 0.016 mmol · L^-1 · y^-1), 0.013 mmol · L^-1 · y^-1 (95% CI: 0.010, 0.016 mmol · L^-1 · y^-1), 0.017 mmol · L^-1 · y^-1 (95% CI: 0.009, 0.025 mmol · L^-1 · y^-1), and 0.008 mmol · L^-1 · y^-1 (95% CI: 0.005, 0.011 mmol · L^-1 · y^-1), respectively (P < 0.0001 for all), after adjustment for potential confounders. Moderate alcohol consumption was associated with the slowest increase in total-cholesterol:HDL-cholesterol and triglyceride:HDL-cholesterol ratios. We observed a similar association between hard-liquor consumption and the HDL-cholesterol change. In contrast, greater beer consumption was associated with slower HDL-cholesterol decreases in a dose-response manner.Conclusion: Moderate alcohol consumption was associated with slower HDL-cholesterol decreases; however, the type of alcoholic beverage had differential effects on the change in the HDL-cholesterol concentration.

Diet and blood pressure in 18-74-year-old adults: the French Nutrition and Health Survey (ENNS, 2006-2007)

OBJECTIVE

Dietary recommendations to reduce blood pressure (BP) have been widely disseminated. We investigated associations between dietary intake and BP in a national sample of adults living in France.

METHODS

The survey included 1968 18-74-year-old participants in the French Nutrition and Health Survey (Etude Nationale Nutrition Santé), a cross-sectional national multistage sampling study. Dietary intake and SBP and DBP were assessed using three 24-h recalls and three measurements, respectively. Mean dietary intake was compared across BP categories: previously diagnosed hypertensive and among undiagnosed optimal (SBP <120  mmHg and DBP <80  mmHg), intermediate and high (SBP ≥140  mmHg and/or DBP ≥90  mmHg) BP participants. After exclusion of previously diagnosed hypertensive participants, linear regressions were also carried out between dietary intake and SBP and DBP.

RESULTS

Eating habits of previously diagnosed hypertensive participants were not different from those of undiagnosed high BP participants, except higher milk consumption (P = 0.03) and lower seafood and alcohol intake (P < 0.03 and P = 0.002, respectively) in previously diagnosed hypertensive. After exclusion of them, dairy products (milk especially), fruit and vegetables, fiber and whole-grain food consumption were inversely and linearly associated with SBP (P < 0.04), whereas alcohol intake was positively associated with SBP (P < 10) and DBP (P = 0.005). Modification effect of sex was observed for saturated fatty acids intake (positive association with DPB in women) and calcium (negative association with SBP in men).

CONCLUSION

Adherence to nutritional recommendations still needs to be improved in hypertensive adults even if they are aware of their condition. In the rest of the population, proper habits regarding milk, fruit and vegetables, fiber and alcohol should decrease the risk of hypertension onset.

Is beer consumption related to measures of abdominal and general obesity? A systematic review and meta-analysis

A systematic review was conducted to assess the evidence linking beer consumption to abdominal and general obesity. Following a systematic search strategy, 35 eligible observational studies and 12 experimental studies were identified. Regarding abdominal obesity, most observational data pointed towards a positive association or no association between beer intake and waist circumference or waist-to-hip ratio in men, whereas results for women were inconsistent. Data from a subset of studies indicated that beer intake > 500 mL/day may be positively associated with abdominal obesity. Regarding general obesity, most observational studies pointed towards an inverse association or no association between beer intake and body weight in women and a positive association or no association in men. Data from six experimental studies in men, in which alcoholic beer was compared with low-alcoholic beer, suggested that consumption of alcoholic beer (for 21-126 days) results in weight gain (0.73 kg; P < 0.0001), but data from four studies comparing intake of alcoholic beer with intake of no alcohol did not support this finding. Generally, experimental studies had low-quality data. In conclusion, the available data provide inadequate scientific evidence to assess whether beer intake at moderate levels (<500 mL/day) is associated with general or abdominal obesity. Higher intake, however, may be positively associated with abdominal obesity.

Sex-specific differences in glycemic control and cardiovascular risk factors in older patients with insulin-treated type 2 diabetes mellitus

BACKGROUND

Because women have been excluded from many study populations in investigations of diabetes care, there is insufficient information on sex-specific differences in glycemic control.

OBJECTIVE

The aim of the present study was to assess whether treatment goals for glycemic and cardiovascular risk factor control are achieved equally in older, Central European, female and male patients with type 2 diabetes mellitus (T2DM).

METHODS

In a retrospective cross-sectional study, data were analyzed from consecutive older (aged ≥60 years) female and male patients with insulin-treated T2DM who attended a diabetes outpatient clinic between January 2007 and April 2008 at the Medical University of Vienna, Austria. Sex-specific differences in glycosylated hemoglobin (HbA₁(c)) levels were assessed as the primary outcome. LDL-C and HDL-C, as well as systolic and diastolic blood pressure (SBP and DBP, respectively), were assessed as secondary outcomes and were adjusted for age, duration of diabetes, duration of insulin treatment, body mass index, insulin units per kilogram per day, and secondary causes of diabetes. P values were adjusted using the Bonferroni correction.

RESULTS

Data were analyzed from 183 female and 209 male patients with insulin-treated T2DM. In multivariate linear regression models, women had significantly higher levels of LDL-C (P = 0.008), HDL-C (P < 0.001), SBP (P < 0.001), and DBP (P = 0.034), but not HbA₁(c) (P = NS). Multivariate logistic regression models revealed that women were significantly less likely to meet treatment goals for blood pressure (SBP, P = 0.044; DBP, P = 0.024), but not for cholesterol or HbA₁(c) levels (P = NS for LDL-C, HDL-C, and HbA₁(c)).

CONCLUSION

In this study of older patients with insulin-treated T2DM, whereas glycemic control was comparable between women and men, a more adverse cardiovascular risk factor profile was observed in female patients.

Metabolically healthy obesity: different prevalences using different criteria

OBJECTIVE

To estimate the prevalence of metabolically healthy obesity (MHO) according to different definitions.

METHODS

Population-based sample of 2803 women and 2557 men participated in the study. Metabolic abnormalities were defined using six sets of criteria, which included different combinations of the following: waist; blood pressure; total, high-density lipoprotein or low-density lipoprotein-cholesterol; triglycerides; fasting glucose; homeostasis model assessment; high-sensitivity C-reactive protein; personal history of cardiovascular, respiratory or metabolic diseases. For each set, prevalence of MHO was assessed for body mass index (BMI); waist or percent body fat.

RESULTS

Among obese (BMI 30 kg/m(2)) participants, prevalence of MHO ranged between 3.3 and 32.1% in men and between 11.4 and 43.3% in women according to the criteria used. Using abdominal obesity, prevalence of MHO ranged between 5.7 and 36.7% (men) and 12.2 and 57.5% (women). Using percent body fat led to a prevalence of MHO ranging between 6.4 and 43.1% (men) and 12.0 and 55.5% (women). MHO participants had a lower odd of presenting a family history of type 2 diabetes. After multivariate adjustment, the odds of presenting with MHO decreased with increasing age, whereas no relationship was found with gender, alcohol consumption or tobacco smoking using most sets of criteria. Physical activity was positively related, whereas increased waist was negatively related with BMI-defined MHO.

CONCLUSION

MHO prevalence varies considerably according to the criteria used, underscoring the need for a standard definition of this metabolic entity. Physical activity increases the likelihood of presenting with MHO, and MHO is associated with a lower prevalence of family history of type 2 diabetes.

No interaction between alcohol consumption and HDL-related genes on HDL cholesterol levels

OBJECTIVE

To assess the relationships and possible interactions between polymorphisms related to HDL levels and alcohol consumption.

METHODS

Cross-sectional population-based study including 2863 women and 2546 men aged 35-75 years (CoLaus study). Alcohol intake was assessed by the reported alcohol consumption of the last 7 days. Nineteen candidate genes known to influence HDL levels were studied.

RESULTS

Alcohol consumption increased HDL cholesterol levels in both genders. After multivariate adjustment for gender, age, body mass index, smoking, hypolipidaemic drug treatment, physical activity and alcohol consumption, APOA5, CETP, LIPC and LPL gene polymorphisms were significantly (10(-5) threshold) related with HDL cholesterol levels, while no genexalcohol intake interaction was found for all SNPs studied. ABCA1 polymorphisms were related to HDL cholesterol levels on bivariate analysis but the relationship was no longer significant after multivariate analysis.

CONCLUSION

Our data confirm the association of alcohol consumption and of APOA5, CETP, LIPC and LPL gene polymorphisms with HDL cholesterol levels. Conversely, no genexalcohol consumption interactions were found, suggesting that the effect of alcohol consumption on HDL cholesterol levels is not mediated via a modulation of HDL related genes.

Distribution of plasma levels of adiponectin and leptin in an adult Caucasian population

OBJECTIVES

Little is known regarding the distribution and the determinants of leptin and adiponectin levels in the general population.

DESIGN

Cross-sectional study.

PATIENTS

Women (3004) and men (2552) aged 35-74 living in Lausanne, Switzerland.

MEASUREMENTS

Plasma levels of leptin and adiponectin (ELISA measurement).

RESULTS

Women had higher leptin and adiponectin levels than men. In both genders, leptin and adiponectin levels increased with age. After adjusting for fat mass, leptin levels were significantly and negatively associated with age in women: 18.1 +/- 0.3, 17.1 +/- 0.3, 16.7 +/- 0.3 and 15.5 +/- 0.4 ng/ml (adjusted mean +/- SE) for age groups [35-44], [45-54], [55-64] and [65-75], respectively, P < 0.001. A similar but nonsignificant trend was also found in men. Conversely, the age-related increase of adiponectin was unrelated to body fat in both genders. Post-menopausal women had higher leptin and adiponectin levels than premenopausal women, independently of hormone replacement therapy. Although body fat mass was associated with leptin and adiponectin, the associations were stronger with body mass index (BMI), waist and hip in both genders. Finally, after adjusting for age and anthropometry, no relationships were found between leptin or adiponectin levels with alcohol, caffeine consumption and physical activity, whereas smoking and diabetes decreased leptin and adiponectin levels in women only.

CONCLUSIONS

The age-related increase in leptin levels is attributable to changes in fat mass in women and probably also in men. Leptin and adiponectin levels are more related to BMI than to body fat mass. The effects of smoking and diabetes appear to be gender-specific.

Alcohol drinking and cardiovascular risk in a population with high mean alcohol consumption

Moderate alcohol consumption has been associated with lower coronary artery disease (CAD) risk. However, data on the CAD risk associated with high alcohol consumption are conflicting. The aim of this study was to examine the impact of heavier drinking on 10-year CAD risk in a population with high mean alcohol consumption. In a population-based study of 5,769 adults (aged 35 to 75 years) without cardiovascular disease in Switzerland, 1-week alcohol consumption was categorized as 0, 1 to 6, 7 to 13, 14 to 20, 21 to 27, 28 to 34, and > or =35 drinks/week or as nondrinkers (0 drinks/week), moderate (1 to 13 drinks/week), high (14 to 34 drinks/week), and very high (> or =35 drinks/week). Blood pressure and lipids were measured, and 10-year CAD risk was calculated according to the Framingham risk score. Seventy-three percent (n = 4,214) of the participants consumed alcohol; 16% (n = 909) were high drinkers and 2% (n = 119) very high drinkers. In multivariate analysis, increasing alcohol consumption was associated with higher high-density lipoprotein cholesterol (from a mean +/- SE of 1.57 +/- 0.01 mmol/L in nondrinkers to 1.88 +/- 0.03 mmol/L in very high drinkers); triglycerides (1.17 +/- 1.01 to 1.32 +/- 1.05 mmol/L), and systolic and diastolic blood pressure (127.4 +/- 0.4 to 132.2 +/- 1.4 mm Hg and 78.7 +/- 0.3 to 81.7 +/- 0.9 mm Hg, respectively) (all p values for trend <0.001). Ten-year CAD risk increased from 4.31 +/- 0.10% to 4.90 +/- 0.37% (p = 0.03) with alcohol use, with a J-shaped relation. Increasing wine consumption was more related to high-density lipoprotein cholesterol levels, whereas beer and spirits were related to increased triglyceride levels. In conclusion, as measured by 10-year CAD risk, the protective effect of alcohol consumption disappears in very high drinkers, because the beneficial increase in high-density lipoprotein cholesterol is offset by the increases in blood pressure levels.

Consumo de bebida alcoólica e adiposidade abdominal em doadores de sangue

OBJETIVO: Analisar a associação entre o consumo de bebidas alcoólicas e adiposidade abdominal. MÉTODOS: Estudo transversal com uma amostra de homens doadores de sangue (N=1.235), de 20 a 59 anos, em Cuiabá (MT), realizado de agosto/1999 a janeiro/2000. Os indicadores de adiposidade abdominal foram circunferência da cintura e relação cintura/quadril, ajustados pela adiposidade total. As medidas aferidas foram: peso, estatura, circunferências da cintura e do quadril. O consumo de álcool foi avaliado utilizando-se um questionário sobre tipo, freqüência e quantidade da bebida consumida. A associação entre o consumo de álcool e adiposidade abdominal foi analisada por regressão linear múltipla, com os modelos ajustados para idade, atividade física, tabagismo e adiposidade total. RESULTADOS: Após ajuste, a circunferência da cintura e a relação cintura quadril mantiveram-se associadas positivamente ao consumo de cerveja (p=0,02) e ao total de álcool consumido (p=0,01 e 0,03, respectivamente). O consumo de aguardente mostrou associação somente com a circunferência da cintura (p=0,04). CONCLUSÕES: O consumo de álcool, particularmente de cerveja, associou-se com a localização abdominal de gordura.

Wine, research and cardiovascular disease: Instructions for use

The results of studies on the role of appropriate wine consumption in the prevention of cardiovascular disease are inconsistent, suggesting that the general approach to the issue needs to be revisited before further research is conducted. A number of points for consideration are raised: (1) the necessity to characterize wine analytically, as the content in important components of wine, such as resveratrol, is influenced considerably by regional factors, such as climate and local oenological procedures; (2) the bioavailability of the components of wine, which appears to be adequate as a broad range of biological effects have been documented at low concentrations that can be achieved by moderate chronic wine consumption; (3) the lack of importance of wine color, as also white wine consumption affords benefit, thanks to its content in the antioxidants caffeic acid, tyrosol and hydroxytyrosol, which are also found in olive oil; (4) the recommendation by WHO to "investigate the possible protective effects of ingredients other than alcohol in alcoholic beverages".

ALCOHOL IS BAD FOR BLOOD PRESSURE

1. The regular consumption of alcohol elevates blood pressure, with global estimates that the attributable risk for hypertensive disease from alcohol is 16%. 2. The increase in blood pressure is approximately 1 mmHg for each 10 g alcohol consumed and is largely reversible within 2-4 weeks of abstinence or a substantial reduction in alcohol intake. 3. This increase in blood pressure occurs irrespective of the type of alcoholic beverage. In particular, the postulated effects of vasodilator flavonoid components of red wine to lessen or reverse alcohol-related hypertension have not been borne out in intervention studies. 4. Heavy drinking, especially a binge pattern of drinking, is linked to a higher incidence of cerebral thrombosis, cerebral haemorrhage and coronary artery disease deaths, although a role for alcohol-related hypertension in the causal pathway is not well defined. 5. In contrast, the light to moderate intake of alcohol has been consistently linked to a reduced risk of atherosclerotic vascular disease end-points. Such a protective effect may also extend to hypertensive subjects. 6. However, the magnitude of any protective effect appears to have been exaggerated because of unmeasured confounders, especially diet, lifestyle and patterns of drinking. Furthermore, a decrease in overall mortality with drinking appears confined to older subjects and to populations with a high background cardiovascular risk profile. 7. Any putative cardiovascular benefits from drinking need to be carefully considered against the effects of alcohol to elevate blood pressure, together with many other adverse health consequences from drinking. Maximum cardiovascular benefit occurs at relatively low levels of consumption (i.e. one to two standard drinks a day in men (10-20 g alcohol) and up to one a day in women (10 g alcohol)). In hypertensive subjects, consumption beyond these levels would be unwise.

Effect of Dealcoholized Beer (Bitburger Drive®) Consumption on Hemostasis in Humans

BACKGROUND

The beneficial effect of moderate alcohol consumption in lowering the risk of cardiovascular disease has been shown in several epidemiologic studies. Such studies have also shown, however, that the protective effect of alcoholic beverages like wine and beer is not only due to the ethanol content but also to the presence of nonalcoholic constituents. The positive effect of alcoholic beverages has been attributed to changes in lipoprotein metabolism, but there is substantial evidence that effects on hemostasis play an important role. Whether the effects of alcoholic beverages on hemostasis are due exclusively to ethanol or are due, in part, to nonalcoholic components, is still under debate.

METHODS

We have examined the hemostatic effects of 3 liters of beer, dealcoholized beer, and ethanol/water (v/v 4%), consumed over a period of 3 hr, in 12 young healthy volunteers. Platelet parameters CD62, PAC-1, and monocyte platelet aggregates were analyzed using flow cytometric measurements. The activity of factor VII was determined with a prothrombin time (PT) assay and plasminogen activator inhibitor activity using a chromogenic substrate. Thrombin generation was determined according to the method of Hemker.

RESULTS

All three fluids administered, dealcoholized beer, beer, and ethanol, reduced the expression of activated fibrinogen receptor, the platelet activation marker CD62, and the formation of monocyte-platelet-aggregate. In addition, dealcoholized beer also showed significant inhibitory effects on thrombin generation, whereas beer and ethanol showed procoagulatory effects.

CONCLUSIONS

This study has shown that the acute consumption of dealcoholized beer inhibits thrombogenic activity in young adults. This action could have a beneficial effect on the development of coronary artery disease. Thus, the consumption of dealcoholized beer could provide cardiovascular benefit without the negative effects of alcohol.

Determining lifestyle correlates of body mass index using multilevel analyses: the Tromsø Study, 1979-2001

Increases in overweight and obesity have been observed globally in both developed and developing countries. The authors assessed the relation between lifestyle factors and body mass index (BMI) (weight (kg)/height (m)2) in a population-based longitudinal study, using BMI and its subsequent change as responses in a multilevel model. The authors included 11,115 men and women aged 20-61 years at baseline who were living in the municipality of Tromsø, Norway, and who participated in three or four consecutive health surveys between 1979-1980 and 2001. Baseline age, physical activity at work, coffee consumption, and desired BMI (i.e., the BMI that the subjects reported they would like to have) were positively associated with baseline BMI, whereas height, alcohol consumption, leisure-time physical activity, and level of education were inversely associated. Most relations were found to be stronger in women than in men. Clinically relevant effect sizes were observed for most of the significant associations, especially in women. For instance, on an ordinal scale, a one-category increase in educational level would decrease the mean baseline BMI among women by 0.30 kg/m2. Significant associations between several lifestyle factors and subsequent BMI change revealed that observed baseline associations were strengthened over time, especially in women.

[Is fibrinogen a predictor or a marker of the risk of cardiovascular events?]

Most cardiovascular events result from a thrombotic complication of an atherosclerotic lesion. Inflammation plays a central role in both the pathogenesis of atherosclerosis and the progression of its complications (especially plaque rupture). Fibrinogen, on the one hand a marker of inflammation and on the other a major determinant in thrombosis and haemorrheology, plays a central role in atherosclerosis and its thrombotic complications. The clinical data are in agreement with epidemiological data, and show that increased plasma fibrinogen levels (compared with values in paired controls) are predictive of the risk of cardiovascular events - both primary cardiovascular events in the general population and recurrence in patients. Determining the plasma fibrinogen level in terms of genetic predisposition and environmental factors provides a good example of the interrelationship between genes and the environment. It must be recognised that a minimal increase in the fibrinogen level (within the plasma reference values) is an indicator of a significantly increased risk. This shows why epidemiological data are not useful for determining cardiovascular risk in individual patients in daily clinical practice (with the exception of the very high levels that are infrequently observed).

Red Wine and Beer Elevate Blood Pressure in Normotensive Men

A positive relationship between alcohol consumption and blood pressure (BP) is well-established but the relative effect of specific alcoholic beverages is controversial. This study aimed to determine whether red wine may improve vascular function and have less of an impact on blood pressure because of its high content of antioxidant vasodilator polyphenolic compounds. Healthy normotensive men entered a 4-period crossover study comparing in random order 4 weeks of control–abstinence with similar periods of daily consumption of red wine (375 mL; 39 grams alcohol), de-alcoholized red wine (375 mL), or beer (1125 mL; 41 grams alcohol). Ambulatory systolic BP and diastolic BP and heart rate (HR) were measured together with vascular function as assessed by flow-mediated dilatation (FMD) and glyceryl trinitrate-mediated (GTNMD) dilatation of the brachial artery. The systolic and diastolic BP and HR were not different between control–abstinence and de-alcoholized red wine. However, compared with control–abstinence, both red wine and beer increased awake systolic BP (2.9 and 1.9 mm Hg, respectively; P <0.05) and asleep HR (5.0 and 4.4 bpm; P <0.05). There were no specific effects of red wine, de-alcoholized red wine, or beer on FMD or GTNMD. Daily consumption of ≈40 grams alcohol as either red wine or beer for 4 weeks results in similar increases in systolic BP and HR. De-alcoholized red wine did not lower BP, and neither red wine nor de-alcoholized red wine influenced vascular function, suggesting that red wine polyphenolics do not have a significant role in mitigating the blood pressure-elevating effects of alcohol in men.

Waist circumference and waist-to-hip ratio as predictors of serum concentration of lipids in Brazilian men

OBJECTIVE

It is unknown whether waist circumference can predict a lipid profile beyond that predicted by body fatness alone, after adjustment for important confounding variables such as smoking, alcohol intake, and physical activity. The purpose of this non-clinical, healthy-subject study was to test this hypothesis.

METHODS

Data refer to 416 men, ages 20 to 58 y with a body mass index between 18.5 and 29.9 kg/m(2), who were blood donors living in a Brazilian city. Alcohol consumption, smoking, and physical activity were evaluated by interview; body fat was measured by electrical bioimpedance, and weight, height, and waist and hip circumferences were measured by trained anthropometrists. Multiple linear regression analysis was performed to quantify the association between measurements of fat distribution (waist circumference and waist-to-hip ratio) and the ratio of total cholesterol to high-density lipoprotein cholesterol and triacylglycerols independently of measurements of fatness and potentially confounding factors.

RESULTS

Waist circumference was strongly correlated with percentage of body fat (r = 0.90), whereas waist-to-hip ratio was less correlated (r = 0.55). After adjustment for age, percentage of body fat, smoking, alcohol intake, and physical activity, waist circumference was not significantly related to the ratio of total cholesterol high-density lipoprotein cholesterol, whereas the waist-to-hip ratio was strongly associated among the youngest subjects (beta = 3.51, P = 0.005).

CONCLUSION

Although several studies have analyzed the association between serum lipids with anthropometric markers, few, including the present one, support waist circumference as a good predictor of lipid profile.

Relationship of Alcohol Drinking Pattern to Risk of Hypertension

Epidemiological studies have demonstrated a positive relationship between heavy alcohol use and hypertension, but few studies have directly addressed the role of drinking pattern. This study was designed to investigate the association of current alcohol consumption and aspects of drinking pattern with hypertension risk in a sample of 2609 white men and women from western New York, aged 35 to 80 years, and free from other cardiovascular diseases. Hypertension was defined by systolic blood pressure > or =140 mm Hg or diastolic blood pressure > or =90 mm Hg or use of antihypertensive medication. Odds ratios (95% confidence intervals) were computed after adjustment for several covariates. Compared with lifetime abstainers, participants reporting drinking on a daily basis (1.75 [1.13 to 2.72]) or mostly without food (1.64 [1.08 to 2.51]) exhibited significantly higher risk of hypertension. When analyses were restricted to current drinkers, daily drinkers and participants consuming alcohol without food exhibited a significantly higher risk of hypertension compared with those drinking less than weekly (1.65 [1.18 to 2.30]) and those drinking mostly with food (1.49 [1.10 to 2.00]), respectively. After additional adjustment for the amount of alcohol consumed in the past 30 days, the results were follows: 0.90 (0.58 to 1.41) for daily drinkers and 1.41 (1.04 to 1.91) for drinkers without food. For predominant beverage preference, no consistent association with hypertension risk was found across the various types of beverages considered (beer, wine, and liquor). In conclusion, drinking outside meals appears to have a significant effect on hypertension risk independent of the amount of alcohol consumed.

The influence of beer with different antioxidant potential on plasma lipids, plasma antioxidant capacity, and bile excretion of rats fed cholesterol-containing and cholesterol-free diets

The aim of this investigation was to assess the influence of beers with different antioxidant potentials on plasma lipid metabolism, plasma antioxidant capacity, and bile excretion of rats fed cholesterol-containing and cholesterol-free diets. Four types of beers were investigated in vitro. Two of them (designated as BeerHigh and BeerLow) with the highest and lowest antioxidant potentials (34.5% and 21.4% and 2.07 mmol/L and 1.65 mmol/L according to beta-carotene assay and Trolox equivalent antioxidant coefficient, respectively), were chosen for the experiment on rats. A total of 60 male Wistar rats were divided into 6 dietary groups of 10 rats each; the groups were designated as Control, BeerA, BeerB, Chol, Chol/BeerA, and Chol/BeerB. The rats in the Control group were fed a basal diet (BD) only, which included wheat starch, casein, soybean oil, vitamin, and mineral mixtures. To the BD of the other five groups were added the following: BeerHigh (BeerA), BeerLow (BeerB), 1% of cholesterol (Chol), 1% of cholesterol and BeerHigh (Chol/BeerA), and 1% of cholesterol and BeerLow (Chol/BeerB). After 4 weeks of feeding, diets supplemented with BeerHigh and, to a lesser degree, with BeerLow (Chol/BeerA and Chol/BeerB groups) hindered a rise in plasma lipids and a decrease in plasma antioxidant capacity, and increased the bile excretion indices. Supplementation with BeerHigh and, to a lesser degree, with BeerLow in rats fed cholesterol-free diets increased their plasma antioxidant capacity. No significant changes in the plasma lipid levels, antioxidant capacity, and bile excretion indices were observed in the Control group. In conclusion, beer was found to have a positively effect on plasma lipid profile and plasma antioxidant capacity, and to increase the bile excretion indices in rats fed cholesterol-containing diets. The degree of this positive influence is directly connected to the contents of the bioactive components and the related antioxidant potential of beer. It is suggested that to achieve the best results, beer with the highest antioxidant potential must be consumed.

Acamprosate involvement in triacylglycerol hydrolysis and transacylation with cholesterol in chronically ethanol-drinking rats

Acamprosate (AC) is used as a drug for treating alcoholism. We evaluated the effect of AC on serum triacylglycerol hydrolysis (GEH, glycerol ester hydrolysis), triacylglycerol transacylation with cholesterol (GECAT, glycerol ester:cholesterol acyltransferase), and acylcholesterol hydrolysis (Cease, cholesterol ester hydrolysis) in an experimental model of alcoholism. Ethanol-preferring (PRF), non-preferring (NPF), and control (CR) male Wistar rats were treated with AC (500 mg/kg, p.o.) for 21 consecutive days. The beneficial effect of AC on lipid parameters of PRF rats included decreased triacylglycerol, total cholesterol, and LDL-cholesterol, and increased HDL-cholesterol levels. Acamprosate-compensated changes associated with ethanol consumption were observed. Acamprosate treatment decreased GECAT and increased Cease control rats, but increased GECAT and decreased CEase in PRF animals. In all groups of rats, AC treatment did not influence GEH. In conclusion, our results suggest that AC can influence triacylglycerol metabolism by its action on the balance between hydrolysis and transacylation in rats.

Effect of alcohol on lipids and lipoproteins in relation to atherosclerosis

Several studies indicate that light-to-moderate alcohol consumption is associated with a low prevalence of coronary heart disease. An increase in high-density lipoprotein (HDL) cholesterol is associated with alcohol intake and appears to account for approximately half of alcohol's cardioprotective effect. In addition to changes in the concentration and composition of lipoproteins, alcohol consumption may alter the activities of plasma proteins and enzymes involved in lipoprotein metabolism: cholesteryl ester transfer protein, phospholipid transfer protein, lecithin:cholesterol acyltransferase, lipoprotein lipase, hepatic lipase, paraoxonase-1 and phospholipases. Alcohol intake also results in modifications of lipoprotein particles: low sialic acid content in apolipoprotein components of lipoprotein particles (e.g., HDL apo E and apo J) and acetaldehyde modification of apolipoproteins. In addition, "abnormal" lipids, phosphatidylethanol, and fatty acid ethyl esters formed in the presence of ethanol are associated with lipoproteins in plasma. The effects of lipoproteins on the vascular wall cells (endothelial cells, smooth muscle cells, and monocyte/macrophages) may be modulated by ethanol and the alterations further enhanced by modified lipids. The present review discusses the effects of alcohol on lipoproteins in cholesterol transport, as well as the novel effects of lipoproteins on vascular wall cells.