Effects of Alcohol Drinking on Other Diseases

Effects of Alcohol Drinking on Other Diseases

Critique 275 – Recovery of neuropsychological function following abstinence from alcohol in adults diagnosed with an alcohol use disorder: Systematic review of longitudinal studies

Alcohol use disorder (AUD) commonly is associated with compromise in neurobiological and/or neurobehavioral processes. The severity of this compromise varies across individuals and outcomes, as does the degree to which recovery of function is achieved. Clinicians have commented that some of the greatest recoveries are in AUD, where a potentially life-threatening situation has been turned around by clinical intervention coupled with an individual’s determination and peer support. This paper provides clear evidence that alcohol’s compromising effects on neuropsychological function can be improved with abstinence.

For the detailed critique of this paper by the International Scientific Forum on Alcohol Research, please click here.

Critique 248:  Association of Alcohol Consumption with Cataract Surgery —  19 April 2021

This was a well-done analysis of a very large number of cases of cataract surgery in the UK; there were reasonable measures of the exposure (alcohol consumption), including the amount and type of beverage consumed, and appropriate potentially confounding factors were taken into consideration.  However, data on the consumption of alcohol with or without food were not available. The use of national registries of cataract surgery provide an appropriate approach for estimating the main outcome of the analyses, and the results probably reflect the incidence of clinically significant cataract occurrence in these populations.

The key results were that there was a small but highly significant lower risk of cataract surgery among moderate drinkers.  Red and white wine consumers showed more consistent and significantly lower risks of cataract surgery than consumers of other beverages.  (In one of the two studies included in the analysis, small amounts of beer and spirits also showed a lower risk than that of non-drinkers.) There were too few heavy drinkers in these studies to determine the extent to which such drinking might affect risk.  We appreciate that residual confounding, especially by factors that relate to subjects choosing to have surgical treatment of their cataracts, could still be present in these results.

Forum reviewers conclude that, in agreement with the investigators of this study, the data indicate a small but statistically and clinically significant decrease in the risk of cataract surgery for low-to-moderate drinkers, versus non-drinkers.  A lowering of risk was especially clear for wine drinkers, in comparison with consumers of beer and spirits.  There is an extensive literature regarding potential mechanisms by which constituents of the diet, especially those present in wine, may influence the development of cataracts.  Among these are antioxidants or ROS scavengers, aldose reductase inhibitors, antiglycating agents, and inhibitors of lens epithelial cell apoptosis.  However, the ultimate reason for the lower risk of cataract surgery associated with wine consumption found in this study has not been clearly delineated.

Reference:  Chua SYL, Luben RN, Hayat S, Broadway DC, Khaw K-T, Warwick A, et al, on behalf of The UK Biobank Eye and Vision Consortium.   Alcohol Consumption and Incident Cataract Surgery in Two Large UK Cohorts.  Ophthalmology 2021, pre-publication.

For the full critique of this paper by the International Scientific Forum on Alcohol Research, please click here.

Critique 225:  Moderate alcohol consumption may lower the risk of chronic kidney disease  —  8 April 2019

While numerous studies have found that moderate consumers of alcohol tend to be at a lower risk of developing chronic kidney disease (CKD), potential mechanisms for such an effect are unclear.  The present large prospective, population-based, multi-cultural study provides important additional data on the effects of alcohol intake on the initial diagnosis of CKD over many years.  It is based on data from the Atherosclerosis Risk in Communities Study and reports the relation of varying levels of alcohol consumption, versus non-drinking, to the incidence of CKD over a 24 year follow-up period.

Among the strengths of the study are the very large number of subjects (n=3,664) who developed CKD during follow up, using advanced methods for diagnosing the disease.  Only baseline alcohol intake was used as the exposure and type of beverage or pattern of drinking could not be assessed; however, the authors considered multiple appropriate potentially confounding variables in the analyses, including total energy intake, age, sex, race-center, income, education level, health insurance, smoking, and physical activity.  In comparison with the 25% of subjects in their analyses who were life-time abstainers, for subjects reporting all levels of alcohol consumption (≤1 drink per week, 2 to 7 drinks per week, 8 to 14 drinks per week, and ≥15 drinks per week), there was a statistically significant decrease in risk of incident CKD (from a 12% decrease in risk for the lowest category of alcohol intake to a 29% decrease for subjects reporting that they consumed 8-14 drinks/week).

The authors conclude:  “Consuming a low or moderate amount of alcohol may lower the risk of developing CKD.  Therefore, moderate consumption of alcohol may not likely be harmful to the kidneys.”  Forum members agree that this study supports much earlier research showing a protective effect of moderate drinking on the risk of kidney disease.  While mechanisms are not clear, effects of alcohol on renal vessels that are similar to those described for coronary and cerebrovascular arteries may play a role.

Reference:  Hu EA, Lazo M, Rosenberg SD, Grams ME, Steffen LM, Coresh J, Rebholz CM.  Alcohol Consumption and Incident Kidney Disease: Results From the Atherosclerosis Risk in Communities Study.  J of Renal Nutrition, 2019, in press.  DOI: https://doi.org/10.1053/j.jrn.2019.01.011

For the full critique of this paper by the International Scientific Forum on Alcohol Research, please click here.

Critique 021 .  Alcohol consumption affects risk of cataracts. 25 October 2010

Reference:  Kanthan GL, Mitchell P, Burlutsky G, Wang JJ.  Alcohol Consumption and the Long-Term Incidence of Cataract and Cataract Surgery: The Blue Mountains Study.  Am J Ophthalmol 2010;150:434–440.

A population-based prospective study from Australia utilized repeated lens photographs over a period of 5 to 10 years to diagnose cataracts among more than 2,500 subjects.  The investigators related the risk of their development, and the risk of cataract surgery, to the reported alcohol intake of subjects.  Previous research has provided some biological mechanisms that make an association between alcohol and cataracts plausible.

Overall, the present study showed few statistically significant relations between alcohol and cataracts, although adjusted results suggested a “U-shaped” association between total alcohol intake and development of cataracts (a lower risk for moderate drinkers, higher risk for both abstainers and heavier drinkers).  The U-shaped association with alcohol consumption was stronger for the risk of cataract surgery.  These results are consistent with previous cohort studies.  On inspection of the data presented, the potential reduction in risk of cataract was primarily for wine and beer.  While some types of cataract may be reduced by moderate drinking, larger intake of alcohol may be associated with increased risk.

Critique 005. Alcohol in young women may increase their risk of benign breast disease.

27 May 2010

Reference: Berkey CS; Willett WC; Lindsay Frazier A; Rosner B; Colditz GA; Rockett RH; Helaine RM.  Prospective study of adolescent alcohol consumption and risk of benign breast disease in young women.  Pediatrics 2010;125:e1081-e1087.

Among more than 6,000 young women being followed in a longitudinal study, 67 confirmed cases of benign breast disease (BBD) were diagnosed.  Alcohol consumption was reported on 57 women who developed BBD when they were 16 – 23 years of age, with all but 8 subjects being 18 or older when they reported alcohol intake, and no data were presented on potential exposures earlier following menarche.  A significant increase in the risk of BBD was associated with alcohol intake, although many key factors that have been shown to relate to BBD were not reported in the paper.  Hence, while the number of cases is small, and a number of potential risk factors are not included, this study suggests that BBD may be increased by alcohol consumption in young women.