In Sweden, alcohol abstention has increased over the last 20 years and consumption has recently decreased after a peak in 2004. To understand the dynamics of these trends the present study aims at estimating age, period and cohort (APC) effects on trends in alcohol use prevalence as well as overall and beverage-specific volume of drinking over the last three decades.
APC analysis of seven cross-sectional surveys from 1979 to 2011 was conducted using cross-classified random effects models (CCREMs) by gender. The nationally representative samples comprised 77,598 respondents aged 16-80 years. Outcome measures were 30-day prevalence of alcohol use and overall as well as beverage-specific alcohol volume.
Trends in prevalence, overall and beverage-specific volume were significantly affected by APC. The period effects of prevalence and overall volume show a small decline after an increase up to the year 2005. Mean beer and wine volume levelled off after a peak in 2005 and volume of spirits drinking decreased constantly. Predicted alcohol prevalence rates in male cohorts (1945-1985) remained generally at the same level, while they declined in post-World War II female generations. Results point to high overall and beverage-specific consumption among cohorts born in the 1940s, 1950s and 1980s.
High consuming cohorts of the 1940-1950s were key in rising consumption up to 2005. Progression through the life course of these cohorts, a decrease in prevalence and drinking volume in successive cohorts seem to have contributed to the recent downward trend in alcohol use in Sweden.
The association between alcohol intake and colorectal cancer was examined in a population-based case-control study performed in Stockholm in 1986-88. The study included 352 cases of colon cancer, 217 cases of rectal cancer, and 512 controls. Relative risks, with 95% confidence intervals, were calculated for total alcohol intake and for different alcoholic beverages. Total alcohol intake (> or = 30 g 100% ethanol per day) was not associated with colon cancer (relative risk = 0.9, confidence intervals = 0.4-1.8) or rectal cancer (1.0, 0.4-2.1). There was no evidence supporting beverage specificity (for colorectal cancer and > or = 10 g 100% ethanol per day: beer 1.1, 0.6-2.0, wine 1.0, 0.4-2.7, spirits 1.0, 0.6-1.6). The associations did not vary according to gender or site within the large bowel. These analyses were adjusted for year of birth and gender (when appropriate). Further adjustments for diet, body mass or physical activity had little or no influence on the results. The present study does not support the hypothesis that alcohol plays an important role in the aetiology of cancer of the colon and rectum in a population with a relatively low alcohol intake.
Moderate alcohol consumption has been shown to protect against cardiovascular diseases. The association between alcohol consumption, especially types of alcoholic beverages, and venous thromboembolism (VTE) is less well described. The aim of this study was to investigate the impact of alcohol consumption and different alcoholic beverages on risk of VTE. Information on alcohol consumption was collected by a self-administrated questionnaire in 26,662 subjects, aged 25-97 years, who participated in the Tromsø Study, in 1994-1995. Subjects were followed through September 1, 2007 with incident VTE as the primary outcome. There were 460 incident VTE-events during a median of 12.5 years of follow-up. Total alcohol consumption was not associated with risk of incident VTE. However, subjects consuming = 3 units of liquor per week had 53% increased risk of VTE compared to teetotalers in analyses adjusted for age, sex, body mass index, smoking, diabetes, cancer, previous cardiovascular disease, physical activity and higher education (HR: 1.53, 95% CI: 1.00-2.33). Contrary, subjects with a wine intake of = 3 units/week had 22% reduced risk of VTE (HR: 0.78, 95% CI: 0.47-1.30), further adjustment for liquor and beer intake strengthened the protective effect of wine (HR: 0.53, 95% CI: 0.30-1.00). Frequent binge drinkers (= 1/week) had a 17% increased risk of VTE compared to teetotallers (HR 1.17, 95% CI: 0.66-2.09), and a 47% increased risk compared to non-binge drinkers (HR 1.47, 95% CI: 0.85-2.54). In conclusion, liquor consumption and binge drinking was associated with increased risk of VTE, whereas wine consumption was possibly associated with reduced risk of VTE.
OBJECTIVE: To assess whether amount or type of alcohol is associated with risk of dementia. Methods and subjects: Case-control nested in a cohort study among participants in the third Copenhagen City Heart Study (1991 to 1994), aged 65 years or more, who where screened using the Mini-Mental State Examination and subsequently examined for dementia. There were 83 subjects diagnosed with dementia and the remaining 1,626 nondemented subjects were included as controls. The two groups were compared with regard to alcohol intake and type of alcohol assessed 15 years before. RESULTS: Average weekly total alcohol intake had no significant effect on risk of dementia. Monthly and weekly intake of wine was significantly associated with a lower risk of dementia. For beer and spirits, only a monthly intake of beer was significantly associated with an increased risk of dementia. The effect of alcohol on risk of dementia did not differ between men and women. CONCLUSIONS: Monthly and weekly intake of wine is associated with a lower risk of dementia. The results do not indicate that people should start drinking or increase wine consumption to avoid dementia, but instead suggest that certain substances in wine may reduce the occurrence of dementia.
Comment In: Neurology. 2002 Nov 12;59(9):1300-112427873
To study if an association between total weekly intake of alcohol, type-specific weekly alcohol intake, alcoholic beverage preference, and the number of teeth among older people exists.
A cross-sectional study including a total of 783 community-dwelling men and women aged 65-95 years who were interviewed about alcohol drinking habits and underwent a clinical oral and dental examination. Multiple regression analyses were applied for studying the association between total weekly alcohol consumption, beverage-specific alcohol consumption, beverage preference (defined as the highest intake of one beverage type compared with two other types), and the number of remaining teeth (= 20 versus >20 remaining teeth).
The odds ratio (OR) of having a low number of teeth decreased with the total intake of alcohol in women, with ORs for a low number of teeth of 0.40 [95 percent confidence interval (CI) 0.22-0.76] in women drinking 1-14 drinks per week and 0.34 (95 percent CI 0.16-0.74) in women with an intake of more than 14 drinks per week compared with abstainers. Similar relations could also be obtained for type-specific alcohol intake of wine and for wine and spirits preference among women. Men who preferred beer showed a decreased risk for a low number of teeth compared with men with other alcohol preferences.
In this study, alcohol consumption, wine drinking, and wine and spirits preference among women were associated with a higher number of teeth compared with abstainers. Among men, those who preferred beer also had a higher number of teeth.
In Stockholm county, the incidences of hospitalizations for chronic pancreatitis, acute, nongallstone associated pancreatitis, and alcoholic liver disease peaked at 14.1, 40.1, and 24.3/100,000 population in 1974 for the first two conditions, and in 1979 for the last one. After the peaks, a steady decline was seen for each condition. Furthermore, the apparent national and Stockholm prevalence of chronic pancreatitis displayed a decline during 1971-1987. A concomitant decline in the Stockholm sales figures of distilled spirits from 9.2 to 5.4 1/person/yr was also observed, whereas the sales figures for wine and beer increased, leaving the overall alcohol purchase unchanged. Thus, the consumption of distilled spirits, but not that of wine and beer, appear as a risk factor for these diseases in Stockholm county.
STUDY OBJECTIVE: To examine the association between intake of different types of alcoholic beverages and self reported subjective health. DESIGN: Cross sectional health survey with assessment of intake of beer, wine and spirits (at last non-weekend day), smoking habits, social networks, physical activity, body mass index, educational level, presence of chronic disease, and self reported health. SETTING: WHO Copenhagen Healthy City Survey, Denmark. PARTICIPANTS: 4113 men and 7926 women aged 18 to 100 years. MAIN RESULTS: Of the 12,039 subjects, 8680 reported their health as optimal, and 3359 reported a suboptimal health. After controlling for the covariates, the relation between total alcohol intake and the proportion reporting suboptimal health was J shaped. Heavy drinkers of any of the three types of alcoholic beverages had a higher prevalence of suboptimal health than non-drinkers. However, only light (1-2 glasses of wine yesterday) and moderate (3-5) wine drinkers had significantly lower odds ratios for suboptimal health--0.72 (95% confidence limits; 0.56 to 0.92) and 0.65 (0.49 to 0.87), respectively--when compared with non-wine drinkers. Moderate beer or spirits drinkers did not differ significantly from non-drinkers of these beverages with regard to prevalence of suboptimal health. Consistently, beer preference drinkers had an odds ratio of 1.50 (1.25 to 1.80) for suboptimal health compared with wine preference drinkers. CONCLUSIONS: A light to moderate wine intake is related to good self perceived health, whereas this is not the case for beer and spirits. The causal relations creating this association are unknown and should be considered when interpreting the relation between different types of alcoholic beverages and subsequent morbidity and mortality.
To analyse the association between alcohol intake and incidence of rheumatoid arthritis in women.
Prospective cohort study with repeated measurements.
The Swedish Mammography Cohort, a population based cohort from central Sweden.
34,141 women born between 1914 and 1948, followed up from 1 January 2003 to 31 December 2009.
Newly diagnosed cases of rheumatoid arthritis identified by linkage with two Swedish national registers. Data on alcohol consumption were collected in 1987 and 1997.
During the follow-up period (226,032 person years), 197 incident cases of rheumatoid arthritis were identified. There was a statistically significant 37% decrease in risk of rheumatoid arthritis among women who drank >4 glasses of alcohol (1 glass = 15 g of ethanol) per week compared with women who drank 3 glasses of alcohol per week in both 1987 and 1997 had a 52% decreased risk of rheumatoid arthritis compared with those who never drank (relative risk 0.48 (0.24 to 0.98)).
Moderate consumption of alcohol is associated with reduced risk of rheumatoid arthritis.
Cites: Eur Heart J. 2004 Dec;25(23):2092-10015571824
Cites: Am J Epidemiol. 1997 Jan 1;145(1):72-808982025
OBJECTIVE: To examine the relation between different types of alcoholic drinks and upper digestive tract cancers (oropharyngeal and oesophageal). DESIGN: Population based study with baseline assessment of intake of beer, wine, and spirits, smoking habits, educational level, and 2-19 years' follow up on risk of upper digestive tract cancer. SETTING: Denmark. SUBJECTS: 15 117 men and 13 063 women aged 20 to 98 years. Main outcome measure: Number and time of identification of incident upper digestive tract cancer during follow up. RESULTS: During a mean follow up of 13.5 years, 156 subjects developed upper digestive tract cancer. Compared with non-drinkers (drinkers of =30% of their intake had a risk of 0.5 (0.2 to 1.4). Drinkers of >21 beers and spirits but no wine had a relative risk of 5.2 (2.7 to 10.2) compared with non-drinkers, whereas those who drank the same amount, but included wine in their alcohol intake, had a relative risk of 1.7 (0.6 to 4. 4). CONCLUSION: A moderate intake of wine probably does not increase the risk of upper digestive tract cancer, whereas a moderate intake of beer or spirits increases the risk considerably.
Comment In: BMJ. 1998 Sep 26;317(7162):8279748168
Comment In: BMJ. 1999 May 8;318(7193):1289-90; author reply 129110231282
Comment In: BMJ. 1999 May 8;318(7193):1290; author reply 129110391706
Comment In: BMJ. 1999 May 8;318(7193):1290; author reply 219110391707
Comment In: BMJ. 1999 May 8;318(7193):129110391708
BACKGROUND: There may be a weak association between total alcohol intake and colorectal cancer but the effect of different types of alcohol and effect on colon subsites have not been investigated satisfactorily. AIMS: To investigate the relationship between amount and type of alcohol and the risk of colon and rectal cancer. SUBJECTS: A population based cohort study with baseline assessment of weekly intake of beer, wine, and spirits, smoking habits, body mass index, educational level, and leisure time physical activity in Copenhagen, Denmark. The study included a random sample of 15 491 men and 13 641 women, aged 23-95 years. Incident cases of colorectal cancer were identified in the nationwide Danish Cancer Register. RESULTS: During a mean follow up of 14.7 years, we observed 411 colon cancers and 202 rectal cancers. We observed a dose-response relationship between alcohol and rectal cancer. Drinkers of more than 41 drinks a week had a relative risk of rectal cancer of 2.2 (95% confidence limits 1.0-4.6) compared with non-drinkers. Drinkers of more than 14 drinks of beer and spirits a week, but not wine, had a risk of 3.5 (1.8-6.9) of rectal cancer compared with non-drinkers, while those who drank the same amount of alcohol but including more than 30% of wine had a risk of 1.8 (1.0-3.2) of rectal cancer. No relation between alcohol and colon cancer was found when investigating the effects of total alcohol, beer, wine, and spirits, and percentage of wine of total alcohol intake. CONCLUSION: Alcohol intake is associated with a significantly increased risk of rectal cancer but the risk seems to be reduced when wine is included in the alcohol intake.