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Machine learning methods have been used in identifying omics markers for a variety of phenotypes. We aimed to examine whether a supervised machine learning algorithm can improve identification of alcohol-associated transcriptomic markers. In this study, we analysed array-based, whole-blood derived expression data for 17 873 gene transcripts in 5508 Framingham Heart Study participants. By using the Boruta algorithm, a supervised random forest (RF)-based feature selection method, we selected twenty-five alcohol-associated transcripts. In a testing set (30 % of entire study participants), AUC (area under the receiver operating characteristics curve) of these twenty-five transcripts were 0·73, 0·69 and 0·66 for non-drinkers v. moderate drinkers, non-drinkers v. heavy drinkers and moderate drinkers v. heavy drinkers, respectively. The AUC of the selected transcripts by the Boruta method were comparable to those identified using conventional linear regression models, for example, AUC of 1958 transcripts identified by conventional linear regression models (false discovery rate < 0·2) were 0·74, 0·66 and 0·65, respectively. With Bonferroni correction for the twenty-five Boruta method-selected transcripts and three CVD risk factors (i.e. at P < 6·7e-4), we observed thirteen transcripts were associated with obesity, three transcripts with type 2 diabetes and one transcript with hypertension. For example, we observed that alcohol consumption was inversely associated with the expression of DOCK4, IL4R, and SORT1, and DOCK4 and SORT1 were positively associated with obesity, and IL4R was inversely associated with hypertension. In conclusion, using a supervised machine learning method, the RF-based Boruta algorithm, we identified novel alcohol-associated gene transcripts.
Exploiting the fact that hypertension is diagnosed when a person’s blood pressure reading exceeds a medically specified threshold (90 mmHg for diastolic blood pressure or 140 mmHg for systolic blood pressure), this study estimates the effect of a first-ever hypertension diagnosis on Chinese adults’ alcohol consumption using a two-dimensional regression discontinuity design. Analyzing data on 10,787 adults from the China Health and Nutrition Survey, our estimation reveals that hypertension diagnoses based on diastolic blood pressure readings exert a number of desirable effects. Hypertensive adults’ drinking frequency and the incidence of excessive drinking among them were reduced by 1.2 times/week and 17.9 percentage points, respectively, about three years after the diagnosis. Meanwhile, their beer and Chinese spirits (Baijiu) intakes were reduced by 518.6 ml/week and 194.8 ml/week, respectively. Interestingly, we also found modest evidence that hypertension diagnoses based on diastolic blood pressure readings increase Chinese adults’ wine intake, suggesting a substitution pattern upon hypertension diagnoses. In contrast, based on systolic blood pressure readings, no significant effects of hypertension diagnoses on alcohol consumption were found.
Understanding the interplay between psychosocial factors and polygenic risk scores (PRS) may help elucidate the biopsychosocial etiology of high alcohol consumption (HAC). This study examined the psychosocial moderators of HAC, determined by polygenic risk in a 10-year longitudinal study of US military veterans. We hypothesized that positive psychosocial traits (e.g. social support, personality traits, optimism, gratitude) may buffer risk of HAC in veterans with greater polygenic liability for alcohol consumption (AC).
Methods
Data were analyzed from 1323 European-American US veterans who participated in the National Health and Resilience in Veterans Study, a 10-year, nationally representative longitudinal study of US military veterans. PRS reflecting genome-wide risk for AC (AUDIT-C) was derived from a Million Veteran Program genome-wide association study (N = 200 680).
Results
Among the total sample, 328 (weighted 24.8%) had persistent HAC, 131 (weighted 9.9%) had new-onset HAC, 44 (weighted 3.3%) had remitted HAC, and 820 (weighted 62.0%) had no/low AC over the 10-year study period. AUDIT-C PRS was positively associated with persistent HAC relative to no/low AC [relative risk ratio (RRR) = 1.43, 95% confidence interval (CI) = 1.23–1.67] and remitted HAC (RRR = 1.63, 95% CI = 1.07–2.50). Among veterans with higher AUDIT-C PRS, greater baseline levels of agreeableness and greater dispositional gratitude were inversely associated with persistent HAC.
Conclusions
AUDIT-C PRS was prospectively associated with persistent HAC over a 10-year period, and agreeableness and dispositional gratitude moderated this association. Clinical interventions designed to target these modifiable psychological traits may help mitigate risk of persistent HAC in veterans with greater polygenic liability for persistent HAC.
Alcohol use is a leading risk factor for death and disability worldwide.
Aims
We conducted a systematic review on the cost-effectiveness evidence for interventions to prevent alcohol use across the lifespan.
Method
Electronic databases (EMBASE, Medline, PsycINFO, CINAHL and EconLit) were searched for full economic evaluations and return-on-investment studies of alcohol prevention interventions published up to May 2021. The methods and results of included studies were evaluated with narrative synthesis, and study quality was assessed by the Drummond ten-point checklist.
Results
A total of 69 studies met the inclusion criteria for a full economic evaluation or return-on-investment study. Most studies targeted adults or a combination of age groups, seven studies comprised children/adolescents and one involved older adults. Half of the studies found that alcohol prevention interventions are cost-saving (i.e. more effective and less costly than the comparator). This was especially true for universal prevention interventions designed to restrict exposure to alcohol through taxation or advertising bans; and selective/indicated prevention interventions, which involve screening with or without brief intervention for at-risk adults. School-based interventions combined with parent/carer interventions were cost-effective in preventing alcohol use among those aged under 18 years. No interventions were cost-effective for preventing alcohol use in older adults.
Conclusions
Alcohol prevention interventions show promising evidence of cost-effectiveness. Further economic analyses are needed to facilitate policy-making in low- and middle-income countries, and among child, adolescent and older adult populations.
Obesity and alcohol consumption are both important modifiable risk factors for cancer. We examined the joint association of adiposity and alcohol consumption with alcohol- and obesity-related cancer incidence. This prospective cohort study included cancer-free UK Biobank participants aged 40–69 years. Alcohol consumption was categorised based on current UK guidelines into four groups. We defined three markers of adiposity: body fat percentage (BF %), waist circumference and BMI and categorised each into three groups. We derived a joint alcohol consumption and adiposity marker variable with twelve mutually exclusive categories. Among 399 575 participants, 17 617 developed alcohol-related cancer and 20 214 developed obesity-related cancer over an average follow-up of 11·8 (SD 0·9) years. We found relatively weak evidence of independent associations of alcohol consumption with cancer outcomes. However, the joint association analyses showed that across all adiposity markers, above guideline drinkers who were in the top two adiposity groups had elevated cancer incidence risk (e.g. HR for alcohol-related cancer was 1·53 (95 % CI (1·24, 1·90)) for within guideline drinkers and 1·61 (95 % CI (1·30, 2·00)) for above guideline drinkers among participants who were in the top tertile BF %. Regardless of alcohol consumption status, the risk of obesity-related cancer increased with higher adiposity in a dose–response manner within alcohol consumption categories. Our study provides guidance for public health priorities aimed at lowering population cancer risk via two key modifiable risk factors.
Posttraumatic Stress Disorder (PTSD) tends to co-occur with greater alcohol consumption as well as alcohol use disorder (AUD). However, it is unknown whether the same etiologic factors that underlie PTSD-alcohol-related problems comorbidity also contribute to PTSD- alcohol consumption.
Methods
We used summary statistics from large-scale genome-wide association studies (GWAS) of European-ancestry (EA) and African-ancestry (AA) participants to estimate genetic correlations between PTSD and a range of alcohol consumption-related and alcohol-related problems phenotypes.
Results
In EAs, there were positive genetic correlations between PTSD phenotypes and alcohol-related problems phenotypes (e.g. Alcohol Use Disorders Identification Test (AUDIT) problem score) (rGs: 0.132−0.533, all FDR adjusted p < 0.05). However, the genetic correlations between PTSD phenotypes and alcohol consumption -related phenotypes (e.g. drinks per week) were negatively associated or non-significant (rGs: −0.417 to −0.042, FDR adjusted p: <0.05-NS). For AAs, the direction of correlations was sometimes consistent and sometimes inconsistent with that in EAs, and the ranges were larger (rGs for alcohol-related problems: −0.275 to 0.266, FDR adjusted p: NS, alcohol consumption-related: 0.145–0.699, FDR adjusted p: NS).
Conclusions
These findings illustrate that the genetic associations between consumption and problem alcohol phenotypes and PTSD differ in both strength and direction. Thus, the genetic factors that may lead someone to develop PTSD and high levels of alcohol consumption are not the same as those that lead someone to develop PTSD and alcohol-related problems. Discussion around needing improved methods to better estimate heritabilities and genetic correlations in diverse and admixed ancestry samples is provided.
Excessive alcohol consumption is a known risk factor for various mental health disorders and can exacerbate the already high burden of COVID-19 pandemic on mental health.On the other hand, the COVID-19 pandemic itself can adversely affect alcohol consumption and thus contribute to alcohol-related problems, including mental health problems.
Objectives
This study was aimed to assess changes in alcohol consumption that may have occurred as a result of the COVID-19pandemic and determine associated factors among population of Russian Federation.
Methods
By distributing a link to take part in an anonymous online survey,changes in volume and frequency of alcohol use,and frequency of heavy episodic drinking(6 or more servings of alcohol at a time)in the first months of COVID-19pandemic were assessed. 819respondents from Russia:321 men and 498women, submitted their responses during May-July,2020. Associations between changes in alcohol use were assessed in a univariate analysis with socio-demographic factors,alcohol use over the previous 12months,stress, individual perceptions of changes in daily and social life and other negative consequences of pandemic.The statistical significance of associations was assessed using the Pearson’sχ2 test.
Results
Individuals with initially higher alcohol consumption increased their alcohol use, while those who drank less, decreased alcohol use even more during pandemic (p<0.05). Severe restrictions of social/everyday life were associated with more frequent alcohol use and in larger volumes (p<0.001). Negative professional/financial consequences of pandemic and stress were associated with increase of typical drinking volume (p<0.001), more frequent alcohol use (p<0.001)and heavy episodic drinking (p<0.05).
Conclusions
The COVID-19 pandemic could have increased health inequalities in Russia through changes in alcohol consumption.
Despite the growing body of evidence suggesting that alcohol consumption is associated with an increased risk of and poorer treatment outcomes from pneumonia, little is known about the association between alcohol control policy and pneumonia mortality. As such, this study aimed to assess the impact of three alcohol control policies legislated in 2008, 2017 and 2018 in Lithuania on sex-specific pneumonia mortality rates among individuals 15+ years of age. An interrupted time-series analysis using a generalised additive mixed model was performed for each policy. Of the three policies, only the 2008 policy resulted in a significant slope change (i.e. decline) in pneumonia mortality rates among males; no significant slope change was observed among females. The low R2 values for all sex-specific models suggest that other external factors are likely also influencing the sex-specific pneumonia mortality rates in Lithuania. Overall, the findings from this study suggest alcohol control policy's targeting affordability may be an effective way to reduce pneumonia mortality rates, among males in particular. However, further research is needed to fully explore their impact.
Alcohol use disorder (AUD) has been described as a chronic relapsing condition, yet most individuals who develop AUD will reduce or resolve their problem, and many will “recover.” This chapter summarizes historical and contemporary definitions of recovery, including those developed by key stakeholder groups and definitions based on research with individuals who meet AUD criteria and resolve their problems with or without treatment. The literature supports an expanded definition of recovery as an ongoing dynamic behavior change process characterized by relatively stable improvements in biopsychosocial functioning and purpose in life. Definitions focused solely on abstinence and absence of AUD symptoms do not capture the multidimensional and heterogeneous pathways to recovery found in general population and clinical samples, and non-abstinent recovery is possible. The chapter discusses a shift away from a pathology-based model of recovery towards a strength-based, resilience-building model that recognizes many possible pathways to stable positive change.
On March, 2020, the World Health Organization (WHO) declared the COVID-19 outbreak a global pandemic. Social isolation, unemployment and financial difficulties can have an impact on mental health and trigger the use of alcohol as a form of coping. Since the beginning of this pandemic, the WHO had warned the general public of the potential risks of increased alcohol consumption, which might result in a higher incidence of alcohol use disorders (AUD) in future.
Objectives
The aim is to do a review of the literature of alcohol consumption during the COVID-19 pandemic.
Methods
Non-systematic review of the literature with selection of scientific articles published in the last 7 months; by searching the Pubmed databases, the following MeSH terms were used: COVID-19; alcohol consumption.
Results
A recent article in The Lancet suggested that mental health and alcohol use during the pandemic, a major public health concern, are worthy of attention. Market research showed that alcohol sales increased in several countries compared to the same time last year. However, with the closure of several drinking places, sales are not in themselves reliable enough estimates of alcohol consumption. On the other hand, economic crises can lead to a reduction in alcohol consumption, due to financial problems or the risk of unemployment.
Conclusions
The present global circumstance is unique, and there is a need for further research on the relationship between alcohol consumption and COVID-19 to understand its long-term effects and develop specific prevention programs for this population.
The current SARS-CoV-2 pandemic has many implications, one of them being alcohol consumption. The impact of long-term distancing measures in terms of alcohol use and misuse is yet unknown. Any increase, would not only add to the usual disease burden associated with alcohol, but also add to the COVID-19 load, given that alcohol use may weaken the immune response.
Objectives
To characterize and compare the pattern of alcohol consumption throughout the pandemic in patients with the diagnosis of Alcohol Use Disorder; to identify factors considered as most relevant in the increase of alcohol consumption.
Methods
We conducted a observational study in an outpatient population in Centro Hospitalar Psiquiátrico de Lisboa (Portugal) with diagnosis of Alcohol Use Disorder, 6 months after the pandemic lockdown. We characterized our sample regarding social, demographic and clinical categories. We applied auto-filled questionnaires, particularly: Mental Health Inventory (MHI), Positive Mental Health Scale (PMHS) and Severity of Alcohol Dependence Questionnaire (SADQ-C).
Results
A total of 65 patients were included. More than 30% changed their drinking habits because of the pandemic. Nearly half of these increased consumption, and half decreased (16% vs 14%). The increase affected particularly men, and was related with the severity of alcohol dependence, stress-related coping strategies and psycopathology; on the other hand, a lowered level of consumption based on the decrease of alcohol accessability and affordability.
Conclusions
The current situation is unique in terms of mass physical distancing and may trigger different behaviours that should be monitored. Governments should give public health warning about excessive alcohol consumption to protect vulnerable individuals.
Darkness offered economically underprivileged and socially marginal groups livelihood and leisure opportunities that were hardly available during the day. These populations therefore figured prominently in the city’s nocturnal life. But the night offered cover also to the “respectable” residents of the city, and to its rulers. Darkness indeed had a blinding effect, but it also made it easier to turn a blind eye. Whereas infringements in broad daylight were a direct challenge to established order, it was often comfortable for all parties to pretend nighttime violations never happened. Both order and its alleged enemies, could more easily transgress their bounds at night, assuming that what happened in the dark remained in the dark. Throughout most of the eighteenth century, a huge nightlife scene was allowed to exist, as long as it remained out of sight and did not openly undermine diurnal order.
This chapter seeks to understand traditions of nocturnal conviviality, particular those that involved the consumption of alcohol, “from within,” that is, in the terms of those who partook in them. It begins with exploring the language and imagery of night and nocturnal devotion in contemporary poetry, which, as shown later in the chapter, also framed nocturnal sociability and invested it with meaning. Approached through this discourse, the night no longer appears as a mere a dark closet in which to hide while drinking, but rather as the ideal setting for cultivating intimacy and love, carnal, platonic, and divine. In fact, hiding in the night and investing it with spiritual significance were mutually dependent. By enveloping these traditions in darkness, the night allowed a space of “ambivalence and ambiguity” that would not directly challenge the unequivocal dictates of orthodoxy and authority. Social drinking, in short, and the wider cultural streams that legitimized it, found fertile soil in the nocturnal, and flourished in it, much like in a walled night garden.
In March 2020, concurrently with the outbreak of coronavirus disease 2019 (COVID-19) in Iran, the rate of alcohol poisoning was unexpectedly increased in the country. This study has attempted to make an overall description and analysis of this phenomenon by collecting credible data from the field, news, and reports published by the emergency centers and the Iranian Ministry of Health. The investigations showed that in May 20, 2020, more than 6150 people have been affected by methanol poisoning from whom 804 deaths have been reported. A major cause of the increased rate of alcohol poisoning in this period was actually the illusion that alcohol could eliminate the coronaviruses having entered the body. It is of utmost importance that all mass media try to dismiss the cultural, religious, and political considerations and prepare convincing programs to openly discuss the side-effects of forged alcohol consumption with the public, especially with the youth. It must be clearly specified that “consuming alcohol cannot help prevent COVID-19.”
To assess the prevalence of metabolic syndrome (MetS) in Chinese adults living in Ningbo and to examine the association between alcohol consumption and MetS and its medical components.
Design:
A representative survey in Ningbo was conducted in 2015 covering socio-demography. A FFQ together with additional questionnaires was used to collect information on alcohol consumption, diet, demography, lifestyle and medical information. Multivariable logistic regression and generalised linear models were used to examine the association between alcohol consumption and both MetS and its medical components, respectively.
Setting:
Ningbo, China.
Participants:
A total of 2853 adults ≥ 20 years (44 % men) in this final analysis.
Results:
The prevalence of frequent alcohol drinkers and MetS was 29·9 % and 28·0 %, respectively. Significantly higher prevalence of MetS and mean values of medical components were found in the group of frequent alcohol drinkers with an exception for HDL-cholesterol, compared with less or non-alcohol drinkers. Frequent alcohol consumption was associated with higher odds of developing MetS and positively associated with medical components excepting waist circumference.
Conclusions:
Frequent alcohol consumption contributed to a higher prevalence of MetS and unfavourable influence on MetS and its medical components among Chinese adults. A public health intervention on alcohol restriction is necessary for the prevention and control of the ongoing epidemic MetS.
Excessive alcohol consumption during reproductive years may impact the integrity of developing eggs and sperm, potentially affecting the life-long health of future children. Inadequate diets could aggravate these preconception effects of alcohol. The aim of the present study was to assess the prevalence of excessive alcohol consumption and explore whether weekly alcohol intake is associated with energy and nutrient intake and adequacy of micronutrient intake among students.
Design:
Cross-sectional survey using a validated and reproducibility-tested FFQ.
Setting:
University of Agder, Norway, in 2018.
Participants:
622 students (71 % female).
Results:
More than 80 % reported having consumed alcoholic beverages the past 4 weeks. One-third of men and 13 % of women exceeded the upper recommended limit of 14 UK alcohol units/week. An inverse association between increasing alcohol intake and energy-adjusted micronutrient intake was evident for thiamine, phosphate, Fe, Zn and Se in men, and for vitamin A, β-carotene, vitamin E and C, thiamine, vitamin B6, folate, P, Mg, K, Fe, Zn and Cu in women. A substantial proportion had vitamin D, folate, Fe and I intakes below average requirement regardless of alcohol consumption level. The combination of prevalent alcohol use, decreasing micronutrient density of diet across alcohol consumption level and a high probability of micronutrient inadequacy indicate reason for concern in a preconception public health perspective.
Conclusions:
Our findings call for investigations into young adults’ knowledge, reflections and beliefs regarding diet and alcohol use to understand how these behaviours could be improved ahead of parenthood.
The prediction of alcohol consumption in youths and particularly biomarkers of resilience, is critical for early intervention to reduce the risk of subsequent harmful alcohol use.
Methods
At baseline, the longitudinal relaxation rate (R1), indexing grey matter myelination (i.e. myeloarchitecture), was assessed in 86 adolescents/young adults (mean age = 21.76, range: 15.75–26.67 years). The Alcohol Use Disorder Identification Test (AUDIT) was assessed at baseline, 1- and 2-year follow-ups (12- and 24-months post-baseline). We used a whole brain data-driven approach controlled for age, gender, impulsivity and other substance and behavioural addiction measures, such as problematic cannabis use, drug use-related problems, internet gaming, pornography use, binge eating, and levels of externalization, to predict the change in AUDIT scores from R1.
Results
Greater baseline bilateral anterior insular and subcallosal cingulate R1 (cluster-corrected family-wise error p < 0.05) predict a lower risk for harmful alcohol use (measured as a reduction in AUDIT scores) at 2-year follow-up. Control analyses show that other grey matter measures (local volume or fractional anisotropy) did not reveal such an association. An atlas-based machine learning approach further confirms the findings.
Conclusions
The insula is critically involved in predictive coding of autonomic function relevant to subjective alcohol cue/craving states and risky decision-making processes. The subcallosal cingulate is an essential node underlying emotion regulation and involved in negative emotionality addiction theories. Our findings highlight insular and cingulate myeloarchitecture as a potential protective biomarker that predicts resilience to alcohol misuse in youths, providing novel identifiers for early intervention.
To investigate associations between alcohol consumption patterns and diet quality, nutrient intakes and biochemical profile of women of childbearing age.
Design:
Nutrient intake data from 24 h diet recalls, alcohol consumption data and diet quality from the Dietary Habits Questionnaire, and biochemical analyses from the cross-sectional 2008/09 Adult Nutrition Survey in New Zealand.
Setting:
New Zealand households.
Participants:
New Zealand women aged 18–45 years (n 1124).
Results:
All analyses were completed using Stata and survey weights were used to allow for the complex survey design to produce population estimates. Multinomial logistic regression models were used to examine the associations between drinking patterns and the variables of interest, with ‘infrequent moderate/light’ drinkers being the reference category. The findings indicate that alcohol-consuming women of childbearing age tend to replace food energy with alcohol energy (P = 0·022). ‘More frequent heavy’ and ‘more frequent moderate/light’ drinkers had higher intakes of total, mono- and polyunsaturated fats with the latter group also consuming higher levels of saturated fats (P < 0·05). Women who were ‘infrequent moderate/light’ drinkers had relatively better diet quality, nutrient intakes and adequate biochemical status in comparison to other drinkers and abstainers. ‘Infrequent heavy’ drinkers, who were predominantly younger in age, had lower serum vitamin B12 levels (P = 0·01) with a higher proportion of women in this category having below-recommended levels of serum folate (P < 0·05).
Conclusions:
Alcohol consumption, especially heavy drinking patterns, may compromise nutritional status of women of childbearing age.
Studies suggest that alcohol consumption and alcohol use disorders have distinct genetic backgrounds.
Methods
We examined whether polygenic risk scores (PRS) for consumption and problem subscales of the Alcohol Use Disorders Identification Test (AUDIT-C, AUDIT-P) in the UK Biobank (UKB; N = 121 630) correlate with alcohol outcomes in four independent samples: an ascertained cohort, the Collaborative Study on the Genetics of Alcoholism (COGA; N = 6850), and population-based cohorts: Avon Longitudinal Study of Parents and Children (ALSPAC; N = 5911), Generation Scotland (GS; N = 17 461), and an independent subset of UKB (N = 245 947). Regression models and survival analyses tested whether the PRS were associated with the alcohol-related outcomes.
Results
In COGA, AUDIT-P PRS was associated with alcohol dependence, AUD symptom count, maximum drinks (R2 = 0.47–0.68%, p = 2.0 × 10−8–1.0 × 10−10), and increased likelihood of onset of alcohol dependence (hazard ratio = 1.15, p = 4.7 × 10−8); AUDIT-C PRS was not an independent predictor of any phenotype. In ALSPAC, the AUDIT-C PRS was associated with alcohol dependence (R2 = 0.96%, p = 4.8 × 10−6). In GS, AUDIT-C PRS was a better predictor of weekly alcohol use (R2 = 0.27%, p = 5.5 × 10−11), while AUDIT-P PRS was more associated with problem drinking (R2 = 0.40%, p = 9.0 × 10−7). Lastly, AUDIT-P PRS was associated with ICD-based alcohol-related disorders in the UKB subset (R2 = 0.18%, p < 2.0 × 10−16).
Conclusions
AUDIT-P PRS was associated with a range of alcohol-related phenotypes across population-based and ascertained cohorts, while AUDIT-C PRS showed less utility in the ascertained cohort. We show that AUDIT-P is genetically correlated with both use and misuse and demonstrate the influence of ascertainment schemes on PRS analyses.
A recent study in the Journal of Wine Economics presented forecasts of future alcohol consumption derived using the ARIMA (Box–Jenkins) method. Alcohol consumption forecasts can be developed using many different methodologies. In this Note we highlight the value of using multiple methods to develop alcohol consumption forecasts, and demonstrate the capability of the R software platform as a general forecasting tool. (JEL Classifications: D12, C53)