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The treatment and prevention of migraine within the last decade has become largely pharmacological. While there is little doubt that the advent of drugs (e.g. triptans) has helped many migraine sufferers to lead a normal life, there is still little knowledge with respect to the factors responsible for precipitating a migraine attack. Evidence from biochemical and behavioural studies from a number of disciplines is integrated to put forward the proposal that migraine is part of a cascade of events, which together act to protect the organism when confronted by a metabolic challenge.

Background: Psychosocial distress can contribute to avoidance, refusal, or discontinuation of cancer treatment, which could impact recovery and survival. Aims: The aim of the present study was to evaluate the effectiveness of a community based psychosocial program on alleviating mood disturbance in breast cancer survivors at different stages of their breast cancer journey. Method: A total of 37 women participated in an 8-week psychosocial program at their local community centre. The weekly 3-hour program was delivered in a small group format. Program components included health education, behavioural training, cognitive behavioural therapy, art therapy and stress-management. Questionnaires aimed at assessing psychiatric morbidity and mood adjustment were administered at the beginning of the program (Pre) and at the completion of the program (Post). Results: Group data revealed a significant reduction in psychiatric morbidity and improved psychological adjustment. When participants were divided into degree of psychiatric morbidity (mild, moderate, severe, very severe) a significant reduction in the reporting of anxiety symptoms in the mild, moderate, severe and very severe groups was reported; depression symptoms in the severe and very severe groups were noted, and anger, confusion and somatic symptoms in the mild group were noted. The level of activity was also significantly improved in the very severe group. Conclusions: A structured community based psychosocial program is beneficial to women struggling to come to terms with the emotional consequences of breast cancer at all stages of recovery.

Early work has highlighted that a large percentage of migraineurs may have an altered glucidic methabolis due to carbohydrate-induced hyperinsulinism. The aim of this study was to assess the effect of sucrose on biomarkers of energy metabolism and utilization in migraineous females. A total of 16 participants (8 = Migraine, 8 = Non-migraine) at the mid-point of their menstrual cycle underwent a 15-h fast prior to ingesting 75 g sucrose dissolved in 175 g water. Blood sampling for the assessment of serum insulin, serum cortisol and serum dehydroepiandrosterone sulfate (DHEAS) and plasma glucose was conducted upon arrival at 09:00 h and then at regular 15-min intervals across a 150-min experimental period. The results showed a significant alteration in serum insulin and plasma glucose following sucrose ingestion in the migraine and non-migraine groups. In addition, significant group differences were observed in the level of serum insulin, serum DHEAS, and the cortisol:DHEAS ratio with migraine participants on average recording a higher sucrose-induced serum insulin level and lower DHEAS level and cortisol:DHEAS ratio when group data was compared. It was concluded that while sucrose consumption may potentiate serum insulin in migraineurs this does not result in the development of sucrose-induced hypoglycemia in migraine or non-migraine participants.

There is an increasing evidence that long-term alcohol intake can promote damage to most of the body's major organs. However, regular consumption of a small-moderate amount of alcohol is often recommended as being beneficial to health and of concern is that the effect of ingesting commercially available alcohol products on steroid hormone synthesis under variable nutritional conditions has not been thoroughly investigated. Many individuals consume alcohol alone prior to a meal and the aim of the present study was to assess the effect of consuming a small-moderate amount of commercially available alcohol on the level of salivary cortisol and salivary dehydroepiandrosterone sulfate (DHEAS) before and after a meal. A total of 24 males aged 19–22 years participated in the current investigation. The experimental procedure required participants to fast for 6 h before being asked to ingest either 40 g alcohol in the form of red wine ( n = 8), low alcohol and high beer ( n = 8), white wine ( n = 8) or the equivalent amount of placebo over a 135-min period before consuming food for 45-min. The level of blood alcohol, salivary cortisol and salivary DHEAS was assessed upon arrival and then at regular 45-min intervals during the 180-min experimental period. The results showed that the consumption of alcohol and placebo can significantly lower the level of salivary cortisol. However, the effect of consuming a small-moderate amount of commercially available alcohol on the level of salivary DHEAS was dependent on the nutritional content of the beverage with red wine promoting no change, white wine promoting a significant decrease, and beer having a variable effect on salivary DHEAS concentration when compared to placebo. It was concluded that the effect of commercially available alcohol on the HPA axis is not the same for all alcohol products and both the nutritional status of participants and the nutritional content of the alcoholic beverage being administered should be taken into consideration when investigating the effect of alcohol on the HPA axis.

Background/Aims: The present study aims to investigate the contribution of alcohol toxicity to the development of malnutrition by assessing the effect of consuming a moderate amount of white wine on plasma insulin and serum IgA under fasting conditions. Methods: A total of 5 non-alcoholic males aged between 19 and 22 years participated in the current investigation. The experimental procedure required participants to undergo a 6-hour fast before ingesting 4 standard units of alcohol (40 g) in the form of white wine over a 120-min period. The level of blood alcohol, plasma insulin and serum IgA was assessed at 30-min intervals across the 120-min experimental period. Results: Consuming alcohol promotes a significant increase in serum IgA in the absence of any change in plasma insulin or ketone production in fasted individuals. Conclusion: White wine prior to a meal does not promote glucose metabolism and utilization and may increase the risk of developing a transient diabetic condition due to an alteration in energy metabolism.

The consumption of alcohol prior to food intake results in alcohol metabolism occurring in the liver, and the liver is often damaged in chronic alcoholics. This paper highlights the possibility that alcohol consumption in the absence of adequate nutrition after an extended period of time may lead to activation of the glyoxylate cycle, an energy pathway associated with the conversion of fat into carbohydrate which until recently was thought to only exist in plants and bacteria.

The nutritional status of the individual at the time of alcohol consumption may mediate the rate of alcohol absorption and metabolism, thus influencing the systemic effect of alcohol on the body. The aim in the present investigation was to assess the effect of moderate white wine consumption on the hypothalamic-pituitary-adrenal (HPA) axis under variable nutritional conditions. Seven males aged between 19 and 22 years participated in all aspects of the current investigation. The experimental procedure for the fasting trial required participants to ingest either 4 standard units of alcohol (40 g) or the equivalent amount of placebo over a 135-min period before consuming food for 45 min. Alternatively, in the feeding trial, food was consumed for 45 min prior to participants ingesting either 4 standard units of alcohol (40 g) or the equivalent amount of placebo over a 135-min period. Blood alcohol, salivary cortisol, and salivary dehydroepiandrosterone sulfate (DHEAS) levels were assessed at 45-min intervals during the 180-min experimental periods. The results demonstrated a significant alcohol-induced decrease in salivary cortisol irrespective of nutritional status and a significant decrease in salivary DHEAS when alcohol is consumed alone under fasting conditions only. It was concluded that moderate white wine consumption may promote a transient alteration in the functioning of the HPA axis.

The aim of this study was to clarify the effect of alcohol on cortisol prior to a meal by contrasting the effect of consuming a small-moderate amount of white wine on salivary cortisol and serum cortisol when sampled simultaneously, with salivary cortisol when sampled alone in fasted individuals. A total of 16 males aged 19-22 years participated in the investigation. The experimental procedure required all participants to fast for six hours and then ingest 40g alcohol in the form of white wine over a 135-min period. Participants were separated into two groups (serum+saliva, saliva only). In the saliva (only) trial (n=8) the level of blood alcohol and salivary cortisol was assessed upon arrival (0-min) and then again at 45-min, 90-min and 135-min.Similarly, in the serum+saliva trial (n=8) the level of blood alcohol, serum cortisol and salivary cortisol was assessed at regular intervals across the 135-min alcohol consumption period but serum cortisol and salivary cortisol was sampled simultaneously. The results showed that when white wine is consumed prior to food the level of: serum cortisol is significantly increased immediately; salivary cortisol is not significantly altered when measured during blood sampling; salivary cortisol is significantly decreased when measured in the absence of blood sampling. It was concluded that when assessing the effects of alcohol on the hypothalamic-pituitary-adrenal axis care should be taken to ensure that the experimental methodology does not inadvertently influence the final results. Cortisol is rapidly released in response to stress and the stress of the blood sampling procedure is a significant factor that if not controlled for could potentially obscure the true effects of alcohol on the hypothalamic-pituitary-adrenal axis.

Long-term alcohol intake can decrease the total amount of food consumed when food is freely available and over time this can promote the development of a severely malnourished state. Alcoholic beverages are high in calories but low in nutrients and how the body uses the energy contained in alcohol is complex and not well understood. Assessment of meal composition has highlighted that the alcohol-induced alteration in food intake may be highly specific and linked to impaired appetite for carbohydrate (in particular). The aim of this chapter is to explore this very specific alcohol effect (i.e. decrease in appetite for carbohydrate). We will begin by investigating whether alcohol is a food for the human body and then briefly look at the biochemical processes associated with regulation of appetite for carbohydrate. It is well accepted that appetite for carbohydrate is largely dependent on the efficient performance of cortisol, a steroid under the control of the hypothalamic-pituitary-adrenal axis, and insulin a pancreatic peptide hormone. In the last section we will look at data from a number of studies aimed at assessing the effect of alcohol on cortisol and insulin under variable nutritional conditions in order to conclude that a decreased appetite for carbohydrate may be a physiological consequence of alcohol consumption.

The aim in the present study was to assess the effect of small-moderate red wine ingestion on the level of serum insulin and plasma glucose when nutritional status is varied. Twenty nondiabetic males (19–22 years) participated in the study. In the fasting trial, all participants underwent a 6 h fast prior to consuming 4 standard units of red wine (40 g alcohol) or the equivalent amount of placebo as dealcoholized wine (containing

Despite the overwhelming evidence linking alcohol to the development of disease, the contribution of alcohol toxicity to ill health remains controversial. One of the major problems facing researchers is the fact that alcoholic beverages, which contribute little to the nutritional requirements of the body, are often substituted for food and nutritional deficiency alone can promote cell damage. Long-term alcohol intake can decrease the total amount of food consumed when food is freely available and the alcoholic individual is often held accountable for their irregular eating behaviour. Assessment of meal composition has highlighted that appetite for food-containing carbohydrate (in particular) is altered in moderate-heavy drinkers but at present there is insufficient biochemical evidence to confirm or deny this observation. The biochemical processes associated with appetite are many and it would be impossible to address all of these events in a single paper. Therefore, the aim of this review will be to focus on one of the major biochemical markers of appetite for carbohydrate in order to put forward the suggestion that a decreased appetite for food could be a physiological consequence of consuming some forms of alcohol.

Alcohol can have an effect on almost every cell in the human body and it is becoming increasingly clear that when alcohol is consumed the prior nutritional status of the individual may be an important factor for long-term health. The salt and water hypothesis integrates the biochemical findings from the current alcohol literature and proposes a mechanism by which alcohol consumption prior to food intake may cause a transient alteration in the functioning of the hypothalamic-pituitary-adrenal axis due to an alcohol-induced impairment in electrolyte regulation.

One hundred cases of individuals assessed for alcohol-related cognitive performance were examined. The assessment included demographic and alcohol consumption data, as well as performance on tests of auditory verbal learning, memory, motor skills, general intellectual functioning, and visuospatial functioning. All participants regularly drank in excess of 10 standard drinks/session. Fifty cases were binge drinkers who consumed alcohol on 2 days/week or less and 50 cases were individuals who consumed alcohol daily. The two groups of drinkers were statistically matched on a number of demographic and misuse factors. The results indicated similar performance for both the binge drinkers and the regular drinkers in visuo-motor speed, visuo-spatial organization and planning, learning, proactive interference, retroactive interference, and retrieval efficiency. However, performance differences were observed on tasks that required semantic organizational ability, with binge drinkers performing better than regular drinkers on these tasks. Due to the differences in the cognitive performance of the two groups, it was concluded that drinking pattern is an important factor in investigating cognitive performance in alcoholics.