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To Drink or Not to Drink? “Moderate” Alcohol Consumption in a Clinical Context

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Abstract

This chapter will focus on the narrower clinical context around counseling patients who don’t drink at all, or who drink at levels below thresholds used to delineate risky drinking. The topic of “moderate” drinking also has relevance for patients drinking risky amounts who might consider cutting back on their alcohol consumption. In this regard, there are two issues to address: The first is whether a non-drinker should consider beginning to drink for possible health benefits, and the second is what constitutes low-risk drinking for those who already consume alcohol. This approach may also save time and effort for those clinicians who might otherwise try to weigh complex, individualized decisions with their patients when that time might be better invested on other important aspects of patient care.

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References

  1. U.S. Department of Health and Human Services and U.S. Department of Agriculture. Dietary Guidelines for Americans, 2010. http://www.health.gov/dietaryguidelines/dga2010/DietaryGuidelines2010.pdf. Accessed 5 Nov 2011.

  2. Vinson DC, MacLure M, Reidinger C, et al. A population-based case-crossover and case-control study of alcohol and the risk of injury. J Stud Alcohol. 2003;64:358–366.

    PubMed  Google Scholar 

  3. Wechsler H, Nelson TF. Relationship between level of consumption and harms in assessing drink cut-points for alcohol research: commentary on Many college freshmen drink at levels far beyond the binge threshold by White et al. Alc Clin Exp Res. 2006;30:922–927.

    Article  Google Scholar 

  4. Weitzman ER, Nelson TF. College student binge drinking and the prevention paradox: implications for prevention and harm reduction. J Drug Education. 2004;34:247–266.

    Article  Google Scholar 

  5. Zador PL, Krawchuk SA, Voas RB. Alcohol-related relative risk of driver fatalities and driver involvement in fatal crashes in relation to driver age and gender: an update using 1996 data. J Stud Alcohol. 2000;61:387–395.

    PubMed  CAS  Google Scholar 

  6. National Toxicology Program, U.S. Department of Health and Human Services. Report on Carcinogens, 12th ed. 2011. http://ntp.niehs.nih.gov/ntp/roc/twelfth/roc12.pdf. Accessed 10 Nov 2011.

  7. Allen NE, Beral V, Casabonne D, et al. Moderate alcohol intake and cancer incidence in women. J Natl Cancer Inst. 2009;101:296–305.

    Article  PubMed  Google Scholar 

  8. Baan R, Straif K, Secretan B, al e. World Health Organization International Agency for Research no Cancer Monograph Working Group. Carcinogenicity of alcoholic beverages. Lancet Oncology. 2007;8:292–293.

    Article  PubMed  Google Scholar 

  9. Bagnardi V, Blangiardo M, La Vecchia C, et al. A meta-analysis of alcohol drinking and cancer risk. Br J Cancer. 2001;85:1700–1705.

    Article  PubMed  CAS  Google Scholar 

  10. Dawson DA, Grant BE. The gray area of consumption between moderate and risk drinking. J Stud Alc Drugs. 2011;72:453–458.

    Google Scholar 

  11. Ezzati M, Lopez AD, Rodgers A, et al. Selected major risk factors and global and regional burden of disease. Lancet. 2002;360:1347–1360.

    Article  PubMed  Google Scholar 

  12. National Institute on Alcohol Abuse and Alcoholism. Tenth Special Report to the U.S. Congress on Alcohol and Health. Bethesda: National Institutes of Health; 2000.

    Google Scholar 

  13. Mokdad AH, Stroup D, Marks JS, et al. Actual causes of death in the United States, 2000. JAMA. 2004;291:1238–1245.

    Article  PubMed  Google Scholar 

  14. Centers for Disease Control and Prevention. Alcohol-Related Disease Impact (ARDI). http://www.cdc.gov/alcohol/ardi.htm. Accessed 28 March 2008.

  15. Rehm J, Mathess C, Popova S, et al, Global Burden of Disease and Injury and Economic cost Attributable to Alcohol use and Alcohol use Disorder, Lancet 2009; 373:2223–2233.

    Article  PubMed  Google Scholar 

  16. Anderson JL. Infection, antibiotics, and atherothrombosis—end of the road or new beginnings? N Eng J Med. 2005;352:1706–1709.

    Article  CAS  Google Scholar 

  17. Blacker D. Mild cognitive impairment—no benefit from vitamin E, little from donepezil. N Eng J Med. 2005;352:2439–2441.

    Article  CAS  Google Scholar 

  18. Greenberg ER. Antioxidant vitamins, cancer, and cardiovascular disease. N Eng J Med. 1996;334:1189–1190.

    Article  CAS  Google Scholar 

  19. Women’s Health Initiative Investigators. Risks and benefits of estrogen plus progestin in healthy postmenopausal women—principal results from the Women’s Health Initiative randomized controlled trial. JAMA. 2002;288:321–333.

    Article  Google Scholar 

  20. Yaffe K. Hormone therapy and the brain—deja vu all over again? JAMA. 2003;289:2717–2719.

    Article  PubMed  Google Scholar 

  21. Naimi TS, Brown DW, Brewer RD, et al. Cardiovascular risk factors and confounders among nondrinking and moderate-drinking U.S. adults. Am J Prev Med. 2005;28:369–373.

    Article  PubMed  Google Scholar 

  22. Wannamethee G, Shaper AG. Men who do not drink: a report from the British Regional Heart Study. Intl J Epidemiol. 1988;17:307–316.

    Article  CAS  Google Scholar 

  23. Hansel B, Thomas F, Pannier B, et al. Relationship between alcohol intake, health and social status and cardiovascular risk factors in the urban Paris-Ile-De-France Cohort: is the cardioprotective action of alcohol a myth? European J Clin Nutr. 2010;64:561–568.

    Article  CAS  Google Scholar 

  24. Marmot M. Social determinants of health inequalities. Lancet. 2005;365:1005–1006.

    Google Scholar 

  25. Liang W, Chkritzhs T. Reduction in alcohol consumption and health status. Addiction. 2011;106:75–81.

    Article  PubMed  Google Scholar 

  26. Fillmore KM, Kerr WC, Stockwell T, et al. Moderate alcohol use and reduced mortality risk: systematic error in prospective studies. Addiction Research and Theory. 2006;14:101–132.

    Article  Google Scholar 

  27. Shaper AG. Alcohol consumption decreases with the development of disease. Addiction. 2011;106:123–125.

    Article  Google Scholar 

  28. Jousilahti P, Veikko S, Kuulasmaa K, et al. Total and cause-specific mortality among participants and non-participants of population-based health surveys: a comprehensive followup of 54,372 Finnish men and women. J Epidemiol and Community Health. 2005;59:310–315.

    Article  Google Scholar 

  29. Rosengren A, Wilhelmsen L, Berglund G, et al. Non-participants in a general population study of men, with special reference to social and alcoholic problems. Acta Med Scand. 1987;221:243–251.

    Article  PubMed  CAS  Google Scholar 

  30. Naimi TS, Brewer RD, Mokdad AH, Denny C, Serdula M, Marks JS. Binge drinking among U.S. adults. JAMA. 2003;289:70–75.

    Article  PubMed  Google Scholar 

  31. McElduff P, Dobson AJ. How much alcohol and how often? Population based case-control study of alcohol consumption and risk of a major coronary event. British Medical Journal. 1997;314:1159–1164.

    Article  PubMed  CAS  Google Scholar 

  32. Roerecke M, Rehm J. Irregular heavy drinking occasions and risk of ishcemic heart disease: a systematic review and meta-analysis. Am J Epidemiol. 2010. doi: 10.1093/aje/kwp1451.

    Google Scholar 

  33. Kauhanen H, Kaplan GA, Goldberg DE, Salonen JT. Beer binging and mortality: results from the Kuopio ischaemic heart disease risk factor study, a prospective population-based study. British Medical Journal. 1997;315:846–851.

    Article  PubMed  CAS  Google Scholar 

  34. Mukamal KJ, Maclure M, Muller JE, et al. Binge drinking and mortality after acute myocardial infarction. Circulation. 2005;112:3839–3845.

    Article  PubMed  Google Scholar 

  35. Freiberg MS, Samet JH. Alcohol and coronary heart disease: the answer awaits a randomized controlled trial. Circulation. 2005;112:1379–1381.

    Article  PubMed  Google Scholar 

  36. U.S. Preventive Services Task Force. Screening and behavioral counseling interventions in primary care to reduce alcohol misuse. http://www.uspreventiveservicestaskforce.org/uspstf/uspsdrin.htm. Accessed 11 Nov 2011.

  37. Abel EL, Kruger ML. Hon v. Stroh Brewery Company: what do we mean by moderate and heavy drinking? Alcohol Clin Exp Res. 1995;19:1024–1031.

    Article  PubMed  CAS  Google Scholar 

  38. Kloner RA, Shereif RH. To drink or not to drink? That is the question. Circulation. 2007;116:1306–1317.

    Article  PubMed  Google Scholar 

  39. Fan AZ, Russell M, Naimi TS, et al. Patterns of alcohol consumption and the metabolic syndrome. J Clin Endocrinol Metab. 2008;93:3833–3838.

    Article  PubMed  CAS  Google Scholar 

  40. Rehm J, Stempos CT, Trevisan M. Alcohol and cardiovascular disease—more than one paradox to consider. Average volumes of alcohol consumption, patterns of drinking and risk of coronary heart disease—a review. J Cardiovasc Risk. 2003;10:15–20.

    Article  PubMed  CAS  Google Scholar 

  41. Rehm J, Baliunas D, Borges G, et al. The relationship between different dimensions of alcohol consumption adn burden of disease: an overview. Addiction. 2010;105:817–843.

    Article  PubMed  Google Scholar 

  42. DiCastelnuovo A, Costanzo S, Bagnardi V, et al. Alcohol dosing and total mortality in men and women: an updated meta-analysis of 34 prospective studies. Arch Intern Med. 2006;166:2437–2445.

    Article  Google Scholar 

  43. Rehm J, Room R, Graham K, et al. The relationship of average volume of alcohol consumption and patterns of drinking to burden of disease: an overview. Addiction. 2003;98:1209–1228.

    Article  PubMed  Google Scholar 

  44. Carrao G, Bagnardi V, Zambon A. A meta-analysis of alcohol consumption and the risk of 15 diseases. Prev Med. 2004;38:613–619.

    Article  Google Scholar 

  45. Corrao G, Rubbiati L, Bagnardi V, et al. Alcohol and coronary heart disease: a meta-analysis. Addiction. 2000;95:1505–1523.

    Article  PubMed  CAS  Google Scholar 

  46. Schutze M, Boeing H, Pischon T, et al. Alcohol attributable burden of incidence of cancer in eight European countries based on results from prospective cohort study. Br Med J. 2011;342:d1584.

    Article  Google Scholar 

  47. Carrao G, Bagnardi V, Zambon A. Exploring the dose-response relationship between alcohol consumption and the risk of several alcohol-related conditions: a meta-analysis. Addiction. 1999;94:1551–1573.

    Article  Google Scholar 

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Correspondence to Timothy S. Naimi .

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Naimi, T.S. (2013). To Drink or Not to Drink? “Moderate” Alcohol Consumption in a Clinical Context. In: Saitz, R. (eds) Addressing Unhealthy Alcohol Use in Primary Care. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-4779-5_13

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  • DOI: https://doi.org/10.1007/978-1-4614-4779-5_13

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