Alkoholin terveysvaikutukset hankkeen projektit

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Commentary on The role of alcohol consumption
in the health of ageing people Peter
Eriksson National Public Health
Institute Helsinki, Finland
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• Main aspects
• The role of beverage
• The role of the U-curve

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• The role of beverage
• General dogma
• The rank order of the frequency of mortality, CHD
  and dementia/Alzheimer is the following
• Liquor gt Beer gt Wine
• Confounding factors
• The question about whether it is the drink or the
  drinker

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• Conclusion by Morten Grønbæk 2007
• Potential confounders include better cognitive
  function, higher SES, better subjective health
  and healthier diet. Thus, the question of whether
  the beneficial effects of beverage types differ,
  with additional benefits for wine, remains
  unsolved

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• New results from a study on the role of beverage
  in association between childhood SES, alcohol
  consumption and CHD in middle-aged Finnish men
  (Pakarinen et al.)
• Exclusive liquor consumption in comparison other
  beverages was associated with lower SES, lower
  education level and less success in school and
  studies
• Also associated with less situational and overall
  alcohol drinking, less frequent drunkenness and
  hangover
• Also associated with more frequent heart attack,
  angina pectoris and cardiac insufficiency

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The dogma of the J/U shaped curve
CHD mortality
No
Moderate High alcohol drinking
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• Some recent conclusions 1
• Kaye Fillmore et al. 2006
• The majority of prospective studies on alcohol
  use and mortality risk indicates that abstainers
  are at increased risk of mortality from both all
  causes and coronary heart disease (CHD). This
  meta-analysis of 54 published studies tested the
  extent to which a systematic misclassification
  error was committed by including as 'abstainers'
  many people who had reduced or stopped drinking,
  a phenomenon associated with ageing and ill
  health. The studies judged to be error free found
  no significant all-cause or cardiac protection,
  suggesting that the cardiac protection afforded
  by alcohol may have been over-estimated.

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• Some recent conclusions 2
• Samuli Saarni et al. 2008
• Failure to separate former drinkers and other
  abstainers produces a significant bias favoring
  moderate drinkers. As the possible health utility
  benefits of moderate alcohol use were clinically
  insignificant, it suffices to investigate
  mortality, when estimating the public health
  impact of moderate alcohol consumption using
  quality-adjusted life years.

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Cancer risk (upper aerodigestive tract, breast,
colon)
No
Moderate High alcohol drinking
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• Overall conclusion
• Alcohol drinking cannot safely be recommended to
  elderly people