Doctors newspaper online, 13.04.2018
Thank you for your rating
A glass of wine or beer a day – does it hurt or not? A new analysis confirms that beyond 150 grams of alcohol per week, the risk of death increases significantly.
By Thomas Müller
Fun at the end of the day beer: Must the German alcohol guidelines be checked? © Syda Productions / stock.adobe.com
CAMBRIDGE. How much alcohol can it be? This issue has been a hot topic ever since when it comes to health effects. A great British analysis,
published in “Lancet” (2018; 392 :: 1513-23) , Now suggests that the risk of dying beyond 150 grams of alcohol per week increases dramatically – equivalent to 3.75 liters of beer – just over one-half a day or 1.34 liters of red wine with 14% alcohol – which is about one glass a day Wine with 0.2 l yields.
Below that, mortality is not significantly increased. On the other hand, anyone who consumes between 200 and 350 grams of alcohol per week has a life expectancy that is two years shorter at the age of 40, and even five years less than 350 g.
Death rate increased up to 45 percent
For the analysis, researchers have Dr. Angela Wood from the University of Cambridge evaluated 83 prospective observational studies with a total of 600,000 alcohol consumers. In all studies, the use of alcohol was quantified by questionnaire, and in some cases consumers had been questioned several times in the course of the studies.
On average, respondents were 57 years old, slightly more than half were men and around half said they consumed more than 100 grams per week.
The scientists around Woods analyzed eight different categories of consumption: less than 100 ml / week in 25 ml increments, moreover in 50 ml increments.
In the highest category with more than 350 g / week were at least 8.4 percent of the participants. People with high alcohol consumption were smokers and more often men, and they also displayed rather unfavorable blood pressure and lipid levels than participants with low consumption.
After an average of 7.5 years, around 40,300 of the participants had died, and 39,000 had cardiovascular disease for the first time.
Compared with the least alcohol-consuming participants (more than 0 but less than 25 g / week), all-cause mortality was significantly increased only in the top two categories: by about 45% in the group with more than 350 grams of alcohol per week and 20
Percent of participants with 200-350 g / week. Almost significantly at around five
According to these data, mortality is increased in the category with 150-200 g / week. For less than 150 g / week, no increased death rate was observed.
In the calculations, the researchers had age, sex, smoking status and diabetes included.
U-curve for cardiovascular diseases
The rate of new cardiovascular disease presented in a typical U-curve: it was the lowest in the category 100-150 grams of alcohol per week (about minus 8%) and reached the level of those with participants at 250-350 g / week again with the lowest alcohol consumption. This was mainly due to the lower myocardial infarction incidence at a dose of more than 100 g / week. Such persons suffered to 20
Percent less common heart attacks than those with the least consumption, regardless of how much more they drank.
However, strokes and congestive heart failure were significantly more frequent in heavy drinkers (over 200 g / week). Overall, the cardiovascular death rate was significantly increased in the two categories with over 200 g / week.
Interestingly enough, men and women showed a similar relationship, sowing doubts about the different limits.
If the researchers put a slightly coarser grid and formed 100-gram categories, even those with an alcohol consumption between 100 and 200 g / week showed an increased overall mortality: A 40-year-old would then live about six months shorter than someone who less than 100g / week drinks.
Perhaps the authors of the study around Wood therefore conclude that it would be better to drink less than 100 g / week and to base the guideline values for harmless alcohol consumption on this value, although their finer gridded data actually suggest that an increased risk of dying is only possible beyond 150 g / week is expected.
A major drawback of such studies is also that they are based on self-reports: In surveys, the participants notoriously assess their alcohol consumption too low – usually by a factor of two. Thus, the epidemiological addiction survey (ESA) came to an average alcohol consumption in Germany of 12 g / day. However, an amount that more than doubles is sold.
In this respect, those in Germany would apply Guide values (140 g / week for men, 84 g / week for women) still a good safety buffer.
The study coming soon
Objective: Where does critical drinking begin?
Answer: Beyond 150 g / week, the risk of death increases significantly
Importance: The alcohol consumption should not exceed a bottle of beer or a glass of wine per day.
restriction: The alcohol consumption was based on self-reports.
“High informative value”
“This study has a high informative value due to its sample size”, says Privatdozent Dr. med. Hans-Jürgen Rumpf from the University of Lübeck, former President of the German Society for Addiction Research and Addiction Therapy.
Dr. Michael Roerecke of the University of Toronto, who, like Hull, was not involved in the study, points out that alcohol carries many health hazards: “All alcohol consumption carries a risk, and the negative influence far outweighs it all over the world.
Especially in women, every consumption is associated with an increased risk of breast cancer. The increased risk of cancer, not only for breast cancer, but also for oral and esophageal cancer, is unaware by many. ”
Dr. Cornelia Lange of the Robert Koch Institute (RKI) emphasizes that the study results should “serve as a stimulus to review the German recommendations and to revise them if necessary”.
After an analysis of the current yearbook Addiction German citizens over 15 years consume an average of 10.7 liters of pure alcohol per year. That’s about 165 grams per week.
More articles from this topic
[14.04.2018, 09:54:22] Dr. Thomas Georg Schätzler
Journalistic Scientific Declaration of Bankruptcy in the “Lancet”?
This study is a prime example of undisciplined, chaotic thinking, preconceived outcomes formulations, methodically misguided approaches, daring extrapolations, and scientific dishonesty. In “Risk thresholds for alcohol consumption: combined analysis of individual-participant data for 599 912 current drinkers in 83 prospective studies” by Angela M. Wood et al. Completely unproven claims are made because there are no peer groups. In order not to jeopardize the initial hypothesis: “To define thresholds associated with lowest risk for all-cause mortality and cardiovascular disease, 599 912 current drinkers without previous cardiovascular disease”, non-drinkers were identified as a potential comparison group ” current drinkers “, which, however, is extremely cryptic:” Of the 786,778 participants with sufficient information for inclusion in this consortium, 186,875 (19%) reported not drinking at baseline, leaving 599,912 current drinkers without a history of cardiovascular disease at baseline who were eligible for the prespecified principal analysis. ” Of these 599,912 “current drinkers”, however, only 152,640 serial alcohol measurements were made on just 71,011 participants in 37 studies: “… using 152,640 serial alcohol assessments obtained some years apart (median interval 5 · 6 years [5th-95th percentile 1 · 04-13 · 5]) from 71 011 participants from 37 studies. ” Spicy, the “some years apart” refers to 1964 to 2016! http://www.thelancet.com/action/showFullTableImage?tableId=tbl1&pii=S014067361830134X In the absence of morbidity and mortality base numbers without regular alcohol consumption or of any comparisons on general morbidity and mortality (“life endangers your health”), the present study et al. lifted to massive drinking habits up to chronic ethylism / alcohol dependence. Unsurprisingly, at the highest alcohol consumption level, life expectancy at the age of 40, with more than 350 g of pure alcohol per week (that’s more than 18.2 kilograms per year!), Has been shortened by 4-5 years: “In drinking> 0-≤100 g per week, those who reported drinking> 100-≤200 g per week,> 200-≤350 g per week, or> 350 g per week had lower life expectancy at age 40 6 months, 1-2 years, or 4-5 years, respectively. ” The inaccuracies and insecurities of the writing team in their “interpretations” (not conclusions!) Speak volumes: not only that the threshold of max. 100 g of pure alcohol per week was remarkably vaguely formulated. Myocardial infarction frequency was unaffected by any level of alcohol consumption. Similarly, for all other subgroups of cardiovascular disease, there was no significantly lower risk threshold below which lower alcohol consumption ceases to be associated with lower disease risk: “Interpretation – In current drinkers of alcohol in high-income countries, the threshold for lowest risk of all-cause mortality was about 100 g / week. For cardiovascular disease subtypes other than myocardial infarction, which lower alcohol consumption stopped being associated with lower disease risk. ” Evidence that the study data support lower limits on alcohol consumption than recommended in most current guidelines [“These data support limits for alcohol consumption are lower than those recommended in most current guidelines”] was m.E. not even rudimentary. Mf + kG, dr. med. Thomas G. Schätzler, FAfAM Dortmund to the article »