The Tromsø heart study: alcoholic beverages and coronary risk factors

Healthy Choices in Midlife Predict Survival to Age 85 in Women: The Tromsø Study 1979-2019

The aim of this study is to examine the association between single risk factors and multiple risk factors in midlife and older ages (up to 64 years) and survival to the age of 85 years in women. The study sample comprised 857 women who attended the second survey of the population-based Tromsø Study (Tromsø2, 1979–1980) at the ages of 45–49 years and were followed for all-cause mortality until 85 years of age. Daily smoking, physical inactivity, being unmarried, obesity, high blood pressure, and high cholesterol in midlife were used as explanatory variables in survival analyses. In total, 56% of the women reached the age of 85. Daily smoking, physical inactivity, being unmarried, and obesity were significant single risk factors for death before the age of 85. None of the women had all six risk factors, but survival to age 85 did decrease gradually with increasing number of risk factors: from 67% survival for those with no risk factors to 28% survival for those with four or five risk factors. A subset of the study sample also attended the third and fourth surveys of the Tromsø Study (Tromsø3, 1986–1987 and Tromsø4, 1994–1995, respectively). Women who quit smoking and those who became physically active between Tromsø3 and Tromsø4 had higher survival when compared to those who continued to smoke and remained physically inactive, respectively. This study demonstrates the importance of having no or few risk factors in midlife with respect to longevity. We observed a substantial increase in the risk of death before the age of 85 among women who were daily smokers, physically inactive, unmarried, or obese in midlife. This risk may be mitigated by lifestyle changes, such as quitting smoking and becoming physically active later in life.

The Alcohol-High-Density Lipoprotein Athero-Protective Axis

Ingestion of alcohol is associated with numerous changes in human energy metabolism, especially that of plasma lipids and lipoproteins. Regular moderate alcohol consumption is associated with reduced atherosclerotic cardiovascular disease (ASCVD), an effect that has been attributed to the concurrent elevations of plasma high-density lipoprotein-cholesterol (HDL-C) concentrations. More recent evidence has accrued against the hypothesis that raising plasma HDL concentrations prevents ASCVD so that other metabolic processes associated with alcohol consumption have been considered. This review explored the roles of other metabolites induced by alcohol consumption-triglyceride-rich lipoproteins, non-esterified free fatty acids, and acetate, the terminal alcohol metabolite in athero-protection: Current evidence suggests that acetate has a key role in athero-protection but additional studies are needed.

Grape Pomace: Antioxidant Activity, Potential Effect Against Hypertension and Metabolites Characterization after Intake

Observational studies indicate that the intake of polyphenol-rich foods improves vascular health, thereby significantly reducing the risk of hypertension and cardiovascular disease (CVD). Therefore, the aim of this study was to analyse the remained potential of grape by-products from important Rhône Valley red wine cultivars: Grenache, Syrah, Carignan, Mourvèdre and Alicante. For that, six different extracts from grape pomaces, selected by their antioxidant activity, were studied in vivo during six weeks with spontaneously hypertensive rats (SHR). Extracts used in SHR1, SHR2 and SHR6 groups presented a « rebound effect » on systolic blood pressure, whereas the other extracts do not change it significantly. The bioavailability of Grenache (GRE1) (EA70) seed pomace extract (SHR1 group), Mouvendre (MOU) (EA70) skin pomace extract (SHR5 group) and Alicante (ALI) (EA70) skin pomace extract (SHR6 group) was studied by High Performance Liquid Chromatography with Photodiode Array detector and Electrospray Ionization Mass Spectrometer (HPLC-PDA-ESI-MSⁿ) in urine, plasma and tissues to search differences on the metabolism of the different extracts intake.

Beer elicits vasculoprotective effects through Akt/eNOS activation

BACKGROUND

There is controversy regarding the effect of alcohol beverage intake in vascular vasodilatory function in peripheral arteries. The effects of beer intake in coronary vasodilation remain unknown. We investigated whether regular beer intake (alcohol and alcohol-free) protects against hypercholesterolaemia-induced coronary endothelial dysfunction and the mechanisms behind this effect.

MATERIALS AND METHODS

Pigs were fed 10 days: (i) a Western-type hypercholesterolaemic diet (WD); (ii) WD+low-dose beer (12·5 g alcohol/day); (iii) WD+moderate-dose beer (25 g alcohol/day); or (iv) WD+moderate-dose alcohol-free-beer (0·0 g alcohol/day). Coronary responses to endothelium-dependent vasoactive drugs (acetylcholine: receptor mediated; calcium ionophore-A23189: nonreceptor mediated), endothelium-independent vasoactive drug (SNP) and L-NMMA (NOS-antagonist) were evaluated in the LAD coronary artery by flow Doppler. Coronary Akt/eNOS activation, MCP-1 expression, oxidative DNA damage and superoxide production were assessed. Lipid profile, lipoproteins resistance to oxidation and urinary isoxanthohumol concentration were evaluated.

RESULTS

Alcoholic and nonalcoholic beer intake prevented WD-induced impairment of receptor- and non-receptor-operated endothelial-dependent coronary vasodilation. All animals displayed a similar vasodilatory response to SNP and L-NMMA blunted all endothelial-dependent vasorelaxation responses. Haemodynamic parameters remained unchanged. Coronary arteries showed lower DNA damage and increased Akt/eNOS axis activation in beer-fed animals. Animals taking beer showed HDL with higher antioxidant capacity, higher LDL resistance to oxidation and increased isoxanthohumol levels. Weight, lipids levels, liver enzymes and MCP-1 expression were not affected by beer intake.

CONCLUSIONS

Non-alcoholic-related beer components protect against hyperlipemia-induced coronary endothelial dysfunction by counteracting vascular oxidative damage and preserving the Akt/eNOS pathway. Light-to-moderate beer consumption prevents and/or reduces the endothelial dysfunction associated with cardiovascular risk factors.

Dietary (poly)phenolics in human health: structures, bioavailability, and evidence of protective effects against chronic diseases

Human intervention trials have provided evidence for protective effects of various (poly)phenol-rich foods against chronic disease, including cardiovascular disease, neurodegeneration, and cancer. While there are considerable data suggesting benefits of (poly)phenol intake, conclusions regarding their preventive potential remain unresolved due to several limitations in existing studies. Bioactivity investigations using cell lines have made an extensive use of both (poly)phenolic aglycones and sugar conjugates, these being the typical forms that exist in planta, at concentrations in the low-μM-to-mM range. However, after ingestion, dietary (poly)phenolics appear in the circulatory system not as the parent compounds, but as phase II metabolites, and their presence in plasma after dietary intake rarely exceeds nM concentrations. Substantial quantities of both the parent compounds and their metabolites pass to the colon where they are degraded by the action of the local microbiota, giving rise principally to small phenolic acid and aromatic catabolites that are absorbed into the circulatory system. This comprehensive review describes the different groups of compounds that have been reported to be involved in human nutrition, their fate in the body as they pass through the gastrointestinal tract and are absorbed into the circulatory system, the evidence of their impact on human chronic diseases, and the possible mechanisms of action through which (poly)phenol metabolites and catabolites may exert these protective actions. It is concluded that better performed in vivo intervention and in vitro mechanistic studies are needed to fully understand how these molecules interact with human physiological and pathological processes.

Adherence to the Mediterranean diet and risk of metabolic syndrome and its components

BACKGROUND AND AIMS

The role of diet in the aetiology of metabolic syndrome (MetS) is not well understood. The aim of the present study was to evaluate the relationship between adherence to the Mediterranean diet (MedDiet) and MetS.

METHODS AND RESULTS

A cross-sectional study was conducted with 808 high cardiovascular risk participants of the Reus PREDIMED Centre. MetS was defined by the updated National Cholesterol and Education Program Adult Treatment Panel III criteria. An inverse association between quartiles of adherence to the MedDiet (14-point score) and the prevalence of MetS (P for trend<0.001) was observed. After adjusting for age, sex, total energy intake, smoking status and physical activity, participants with the highest score of adherence to the MedDiet (>/=9 points) had the lowest odds ratio of having MetS (OR [95% CI] of 0.44 [0.27-0.70]) compared to those in the lowest quartile. Participants with the highest MedDiet adherence had 47 and 54% lower odds of having low HDL-c and hypertriglyceridemia MetS criteria, respectively, than those in the lowest quartile. Some components of the MedDiet, such as olive oil, legumes and red wine were associated with lower prevalence of MetS.

CONCLUSION

Higher adherence to a Mediterranean diet is associated with a significantly lower odds ratio of having MetS in a population with a high risk of cardiovascular disease.

Mediterranean diet and metabolic syndrome: the evidence

BACKGROUND

The Mediterranean diet has long been related to a lower cardiovascular disease risk; however, more recent evidences also indicate that it has a favourable effect on adiposity and type 2 diabetes.

DESIGN

Review of the available literature in relation to Mediterranean diet and metabolic syndrome.

RESULTS

Several components of Mediterranean diet patterns have been inversely related with body mass index. They are considered to be modulators of insulin resistance, can exert beneficial effects on blood pressure, improve atherogenic dyslipidemia or attenuate the inflammatory burden associated with metabolic syndrome. Furthermore, a lower prevalence of metabolic syndrome has been associated with dietary patterns rich in fruits and vegetables, nuts, olive oil, legumes and fish, moderate in alcohol and low in red meat, processed meat, refined carbohydrates and whole-fat dairy products.

CONCLUSIONS

There is much evidence suggesting that the Mediterranean diet could serve as an anti-inflammatory dietary pattern, which could help to fight diseases related to chronic inflammation, including metabolic syndrome.

The Tromsø Heart Study: coronary risk factor levels in treated and untreated hypertensives

Coronary risk factors are described in 288 medically treated hypertensives, 1293 untreated hypertensives and 15,029 normotensives. Cholesterol in untreated men and women was 0.37 mmol/l and 0.35 mmol/l higher than in normotensives (p less than 0.001). Non-significant differences were observed between those untreated and treated. Treated men and women had 0.16 mmol/l and 0.14 mmol/l lower HDL cholesterol than untreated (p less than 0.01). Between untreated and normotensives non-significant differences were found. Triglycerides were 0.27 mmol/l and 0.22 mmol/l higher in treated than in untreated men and women (p less than 0.01). Normotensive men and women had 0.33 mmol/l and 0.10 mmol/l lower triglycerides than untreated (p less than 0.01). The results suggest that the increased cholesterol in hypertensives was present originally, while the decreased HDL cholesterol and elevated triglycerides probably were evoked by drugs. The importance of consideration of the whole constellation of risk factors in order to reduce the mortality from coronary heart disease by antihypertensive drug treatment is emphasized.

Relationship of alcohol consumption and type of alcoholic beverage consumed with plasma lipid levels: differences between Whites and African Americans of the ARIC study

PURPOSE

Alcohol consumption has been shown to contribute to a favorable lipid profile, and most studies have reported a reduction in coronary heart disease risk with low-to-moderate consumption of alcohol that is generally attributed to the beneficial effects of alcohol on lipids. The influence of different types of alcoholic beverages on plasma lipid levels has been investigated to a lesser extent and in limited populations.

METHODS

We investigated the effect of overall alcohol consumption, as well as the type of alcoholic beverage consumed, on multiple lipid measures in the large bi-ethnic population of the Atherosclerosis Risk in Communities study.

RESULTS

We found both low-to-moderate and heavy alcohol consumption, regardless of the type of alcoholic beverage consumed, to result in significantly greater levels of high-density lipoprotein (HDL) cholesterol, HDL3 cholesterol, and apolipoprotein A-I in both white and African-American males and females. Associations with other lipid measures contrasted between whites and African Americans, with greater levels of alcohol consumption resulting in significantly greater triglyceride levels in African Americans.

CONCLUSIONS

Our results confirm previous studies associating alcohol consumption, regardless of beverage type, with greater HDL cholesterol levels, with additional consistent associations detected for the major HDL cholesterol density subfraction, HDL3 cholesterol, and the major HDL cholesterol structural apolipoprotein, apolipoprotein A-I.

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.

Non-linear models for the relation between cardiovascular risk factors and intake of wine, beer and spirits

It is generally accepted that moderate consumption of alcohol is associated with a reduced risk of coronary heart disease (CHD). It is not clear however whether this benefit is derived through the consumption of a specific beverage type, for example, wine. In this paper the associations between known CHD risk factors and different beverage types are investigated using a novel approach with non-linear modelling. Two types of model are proposed which are designed to detect differential effects of beverage type. These may be viewed as extensions of Box and Tidwell's power-linear model. The risk factors high density lipoprotein cholesterol, fibrinogen and systolic blood pressure are considered using data from a large longitudinal study of British civil servants (Whitehall II). The results for males suggest that gram for gram of alcohol, the effect of wine differs from that of beer and spirits, particularly for systolic blood pressure. In particular increasing wine consumption is associated with slightly more favourable levels of all three risk factors studied. For females there is evidence of a differential relationship only for systolic blood pressure. These findings are tentative but suggest that further research is required to clarify the similarities and differences between the results for males and females and to establish whether either of the models is the more appropriate. However, having clarified these issues, the apparent benefit of consuming wine instead of other alcoholic beverages may be relatively small.

Types of alcoholic beverages and blood lipids in a French population

STUDY OBJECTIVE

Prospective studies have shown a consistent relation between alcohol consumption and decreasing incidence of coronary artery disease. The protective effect of alcohol could be mediated through increased levels of HDL cholesterol (HDL-c). The aim of this study was to examine the relation between blood lipid levels and the consumption of different types of alcoholic beverages among 1581 men and 1535 women.

DESIGN

Data from representative cross sectional surveys (1994-1997) in three different regions of France were used. The consumption of the different types of alcohol was quantified using a recall method according to a typical weekly consumption.

MAIN RESULTS

The median daily alcohol intake was 24 g for men and 4 g for women. After adjustment for confounders, total alcohol showed a positive and significant association with HDL-c and triglycerides (TG) in both sexes. In multivariate analysis, wine was positively associated with HDL-c. Beer was positively associated with HDL-c in men and with triglycerides in men and women. When taking drinking patterns into account, wine drinkers had higher HDL-c levels than non-wine drinkers. Differences became non-significant after adjustment for confounders and particularly for socioeconomic parameters.

CONCLUSIONS

In a French population sample, total alcohol was positively associated with HDL-c and triglycerides. The specific influence of any particular alcoholic beverage on blood lipids was not clearly demonstrated but wine preference found in a group with higher lifestyle standards was associated with a more favourable blood lipid profile.

High-density-lipoprotein cholesterol and types of alcoholic beverages consumed among men and women

OBJECTIVES

Differences by sex in the relationship between high-density-lipoprotein (HDL) cholesterol and consumption of alcoholic beverages were examined in 1516 individuals.

METHODS

Questionnaires and blood-sample data from cross-sectional surveys were analyzed.

RESULTS

Both beer and liquor were independently associated with increased HDL cholesterol in the total group, in men, and in women after covariates were controlled for. Wine was associated with a significant increase in HDL cholesterol in women only.

CONCLUSIONS

Among women and men, amount may be more important than type of alcoholic beverage consumed. The independent effect of wine on HDL cholesterol among men remains unclear since few men in this population consumed wine exclusively or in large quantities.

[Atherosclerotic cardiovascular diseases, dyslipidemia, hypertension, obesity, and diabetes mellitus in a population of the metropolitan area of southeastern Brazil. I--Research methodology]

An epidemiological study was carried out into the risk factors for the following atherosclerotic cardiovascular diseases: lipemic disorders, obesity, hypertension, diabetes mellitus as related to some factors which characterize life-style (sedentary, drinking, smoking and eating habits). The population studied belongs to the metropolitan area of S. Paulo. The research project had the following objectives: a) the development of an epidemiological baseline for the study of the risk factors for the atherosclerotics cardiovascular diseases represented by the lipimic disorders, obesity, hypertension and diabetes mellitus and their relationship with personal, family and social characteristics; b) the for clinical-educative treatment of patients or people at risk. In view of the objectives above it was decided that the project should in an integrated way with the local health centers and community associations in the field work phase. For this purpose, the methodology adopted was that of establishing small geographical areas, denominated "study areas", in accordance with socioeconomic criterion. Clinico-biochemical and eating surveys were carried out and interviews held with a view to obtaining data on socioeconomic and demographic and life-style characteristics. The clinical survey collected data on anthropometric measurements, arterial pressure, electrocardiogram and symptoms of heart disease. The biochemical survey consisted of the measurement of the following constituents of the blood: total cholesterol, HDL cholesterol, triglyceride, magnesium, glucose, sodium, potassium and phosphorous. The eating survey covered data of historic food consumption. By means of indicators such as income, schooling, occupation, position held in the occupation, ownership of property and respective size of property and employment of labour, the social classes were established. The clinico-educative intervention was carried out in the following way: a) the team made contact with the community associations and the health centers, that begin to participate in the project, permitting the use of their physical space for the carrying out of surveys and clinical exams and taking part in the work of publishing and explaining the project; b) those individuals with positive diagnosis or who are found at risk were referred to the health centers which then include assistance for the diseases in question in their permanent activities. After the end the project the team gave to the community a report on the prevalence of the morbidities researched in their population.

High-density lipoprotein cholesterol and alcohol consumption in US white and black adults: data from NHANES II

OBJECTIVES

High-density lipoprotein (HDL) cholesterol is known to be positively related to moderate alcohol consumption from studies in selected populations. This study describes the association in a representative sample of the US adult population.

METHODS

Stratification and multivariate regression analyses were used to examine HDL cholesterol levels and alcohol consumption.

RESULTS

Fewer women than men reported consumption of alcohol at any frequency. Similar percentages of Whites and Blacks reported alcohol consumption. Age-adjusted mean HDL cholesterol levels were higher among alcohol drinkers than among nondrinkers in all sex-race strata. Mean HDL cholesterol levels of Whites and Blacks of both sexes increased consistently with increased frequency of consumption of beer, wine, and liquor. With age, education, body mass index, smoking, and physical activity controlled for, there were higher age-adjusted HDL cholesterol levels with increasing reported quantities of alcohol consumed. Daily or weekly use of alcohol led to an increase of 5.1 mg/dL in mean HDL cholesterol level, whereas consumption of 1 g of alcohol led to an increase of 0.87 mg/dL.

CONCLUSION

Even if there is a causal association between alcohol consumption and higher HDL cholesterol levels, it is suggested that efforts to reduce coronary heart disease risks concentrate on the cessation of smoking and weight control.

Alcohol consumption, gender and self-reported hypertension

This study examines the relationship of alcohol consumption and self-reported lifetime prevalence of hypertension among 19,284 non-institutionalized civilians in the United States. Cross-sectional data from the 1983 National Health Interview Survey, a national probability sample, were examined for each sex separately. Women who report hypertension consumed significantly less alcohol than women who did not report hypertension. Self-reported hypertensive men consumed equal or greater amounts of alcohol than self-reported normotensive men. Alcohol consumption was significantly associated with greater risk of hypertension among men, but not among women. After controlling for other risk factors significant effects for hypertension were found among males who on average consumed more than one drink/day. Beer consumption and spirits consumption above three drinks/day were significant predictors of male hypertension after adjustment for the confounding effects of other alcoholic beverage consumption and other risk factors. This study suggests that alcohol consumption by men who know that they are hypertensive is an important public health concern, with policy implications for targeting prevention efforts.

U-shaped dose-response curves: their occurrence and implications for risk assessment

A class of curvilinear dose-response relationships in toxicological and epidemiological studies may be roughly described by "U-shaped" curves. Such curves reflect an apparent reversal or inversion in the effect of an otherwise toxic agent at a low or intermediate region of the dose continuum. Several examples of U-shaped dose-response functions are presented to illustrate the variety of agents and end points that can follow this form. Such findings are not thought to represent a unitary phenomenon, but may be explained through numerous possible principles or mechanisms, some of which are illustrated and discussed in general terms. U-shaped dose-response curves raise important issues for toxicological and environmental health risk assessments, particularly in the identification of no-observed-effect levels and in the evaluation of multiple outcomes and the tradeoffs between potential risks and benefits of a given agent. It is especially important to avoid focusing exclusively on an apparent improvement in one end point and failing to consider other, possibly deleterious effects of the same agent.

[Dyslipidemia and some risk factors in the population outside of the metropolitan region of São Paulo, SP-Brazil. A pilot study]

A survey of the prevalence of lipemic disorders and some risk factors associated with them (obesity, hypertension and alcoholism), in a representative sample of the population of 20 years of age and over in a locality typical of the peripheral zone of the Greater S. Paulo Region, Brazil, both in terms of the poverty of the population and with regard to the lack of public sources such as sewage, transport and housing, is undertaken. The following results were obtained: a) the prevalence of one risk factor was about 55%, and of two or more associated risk factors was of approximately 9% in the age group from 20 to 39. There was found to be a prevalence of about 51% and 57%, respectively of two or more associated risk factors for the age groups from 40 to 59 and 60 years of age and over; b) the prevalence of lipemic disorders proper was of about 49%, 58% and 57% respectively, for the age groups of 20 to 39, 40 to 59 and 60 years of age and over. In these cases the most prevalent risk factors among men were alcoholism and hypertension, either isolatedly or associated with obesity, and among women the most prevalent was obesity, alone or associated with hypertension; c) the most prevalent lipemic disorder was due to HDL-cholesterol, mainly among the younger people. The prevalence lower-than-normal HDL-cholesterol, was of about 28% and of "other lipemic disorders" was of 22% in the age group between 20 and 39 years of age.(ABSTRACT TRUNCATED AT 250 WORDS)

Frequency of alcohol use and the level of education

The relationships between the length of education and the frequency of alcohol use were analysed in 12,000 men and women in Tromsø, Norway. Men drank beer and spirits more often than women, whereas the proportion of men and women who drank wine once a week, or more frequently, was the same (9%). Subjects with a high level of education drank all three types of alcohol more frequently than men and women with a low level of education. This was particularly true for wine (and beer for women). About 1% of men and women with less than 8 years of education stated that they drank wine at least once a week. In contrast, about one in four with more than 16 years of education drank wine weekly. The proportion of weekly beer drinkers in men with less than 8 years of education (23%) was less than half that for men with more than 16 years of education (53%). The relationship between the frequency of alcohol use and the level of education was not as strong for spirits as for wine.

Coffee, alcohol and coronary risk factors

In a number of studies coffee consumption has been shown to be related to total cholesterol levels. The finding is not consistent and the possibilities for a causal relationship is discussed. The U-shaped relation between risk of coronary heart disease and alcohol consumption is also reviewed as well as the possible relationship between some of the coronary risk factors and alcohol consumption.

Plasma lipoprotein alterations in squirrel monkeys (Saimiri sciureus) during ethanol administration and abstinence

The time course of lipoprotein changes during ethanol (EtOH) consumption followed by abstinence was examined in 3 groups of male squirrel monkeys: 1) controls fed isocaloric liquid diet; 2) low EtOH monkeys given liquid diet with vodka substituted isocalorically for carbohydrate at 12% of calories; and 3) high EtOH animals fed diet plus vodka at 24% of calories. After 2 weeks, high EtOH monkeys showed significant elevations in total plasma cholesterol which continued to increase at 4 weeks and then declined at 8 weeks. These elevations were the result of increases in both low density (LDL)- and high density lipoprotein (HDL)-cholesterol. Low EtOH monkeys had a modest increase in total cholesterol throughout 8 weeks which was attributed to increments in HDL-cholesterol alone. During abstinence, total, HDL- and LDL-cholesterol concentrations decreased rapidly in the high EtOH group and were similar to control values after 4 days. HDL-cholesterol showed a more gradual decline in animals fed 12% EtOH while LDL-cholesterol remained low and not significantly different from controls. Liver function tests were normal for all animals. Our results indicate that low-dose EtOH favors a coronary protective lipoprotein profile (increases HDL, decreases LDL) in squirrel monkeys while the higher alcohol regimen causes both favorable and unfavorable alterations in plasma lipids which quickly revert to control levels during abstinence.

The Tromsø Heart Study: responders and non-responders to a health questionnaire, do they differ?

In 1979-80, 21,329 subjects, 20-54 years old, were invited to a screening for coronary heart disease risk factors in Tromsø. 16,621 (77%) attended the screening, the response rate was higher in women than in men, lower in single than married and lowest in young (20-29 years) men. At the screening, the men and women were given a second questionnaire which they were asked to fill in and return by mail. 14,667 (88.2%) of the subjects did so. Based on information obtained at the screening, the differences between these 14,667 subjects and the 1954 men and women who failed to return the questionnaire are presented. 10.9% of the women did not return the questionnaire, the corresponding figure for men was 12.6%. The differences in age, body mass index (kg/m2), blood lipids and blood pressure were minor or non-existent. The subjects who returned the questionnaire tended to be married, non-smokers and report respiratory symptoms less often than non-responders.

Effect of ethanol dose on low density lipoproteins and high density lipoprotein subfractions

Male squirrel monkeys were fed increasing caloric percentages (0, 12, 24, and 36%) of ethanol (ETOH) substituted isocalorically for carbohydrate as part of a chemically defined liquid diet to assess how alcohol dose modifies plasma lipoproteins and liver function. A separate group of primates was used to define the dose at which elevations in plasma apolipoprotein B first occurred and to measure plasma alcohol levels. ETOH caused a dose-related, linear increase in high density lipoprotein (HDL) cholesterol which was primarily the result of increments in coronary protective HDL2 cholesterol. HDL2 total mass (lipid + protein) followed the pattern of HDL2 cholesterol. Animals fed the 12% regimen had plasma ETOH levels of approximately 49 mg/dl, the lowest low density lipoprotein (LDL) cholesterol, and the highest HDL2/HDL3 cholesterol ratio. Significant elevations in apolipoprotein B first appeared at 18% ETOH while higher doses (24 and 36%) caused increases in LDL cholesterol and HDL3, reduced HDL2/HDL3 ratios, and plasma alcohol levels of 142 and 202 mg/dl, respectively. Liver function tests were normal for all animals. Our results indicate that while a moderate ETOH caloric intake (12%) produces an antiatherogenic lipoprotein profile (decreases LDL/HDL, increases HDL2/HDL3), any coronary protection afforded by continued increases in HDL2 at higher doses may be attenuated by concurrent atherogenic alterations (increases LDL cholesterol, increases apolipoprotein B).