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Introduction Methods Results Discussion and Conclusion Alcohol contributes significantly global disease burden. Over 50 countries, including Canada, have established low‐risk drinking guidelines to reduce alcohol‐related harm. Canada's Guidance on Alcohol and Health (CGAH) was released in 2023. This study examines the relationship between weekly alcohol consumption, CGAH risk zones and mortality patterns among Canadian drinkers aged 15 and older.A retrospective cohort study was conducted using data from three cycles of the national, population‐based Canadian Community Health Survey (2000–2006) linked to mortality data up to 2017. The sample included 145,760 respondents aged 15 and older who reported alcohol consumption in the past week. Average weekly alcohol consumption was assessed using the Timeline Followback method (i.e., 7‐day recall). Outcomes included all‐cause mortality, alcohol‐related mortality and mortality from conditions with an alcohol‐attributable fraction ≥15%.Alcohol consumption was significantly positively associated with increased risks of all‐cause (hazard ratio = 1.01, p < 0.001), alcohol‐related (hazard ratio = 1.01, p = 0.001) and alcohol‐attributable fraction‐related mortality (hazard ratio = 1.02, p < 0.001). Each additional standard drink per week raised mortality risk, with women experiencing a greater increase in risk compared to men.The findings support the CGAH recommendations, highlighting the importance of lower alcohol consumption limits to reduce health risks. Public health efforts should focus on increasing awareness and adherence to these guidelines, particularly among women who face greater mortality risks at higher consumption levels. Ongoing monitoring of alcohol consumption is critical for tracking and evaluating low‐risk drinking guideline effectiveness in reducing alcohol‐related harm. [ABSTRACT FROM AUTHOR]

Cardiovascular illnesses remain the primary cause of death, accounting for at least 17.9 million fatalities per year and posing a significant public health problem because of its extensive predominance and effect on healthcare systems. The etiology of cardiovascular disease is complex and involves several environmental and lifestyle factors. Alcohol use is a highly important determinant because of its dual-edged effect on cardiovascular health. Multiple studies indicate that moderate alcohol consumption may have certain advantages, such as slight enhancements in lipid profiles. Conversely, excessive alcohol intake is associated with serious negative consequences, including cardiomyopathy, hypertension, arrhythmias, and even mortality. The aim of this study is to provide a comprehensive analysis of the several effects of alcohol on cardiovascular health and their understanding within the medical field over time. It uses an interpretative narrative review methodology and analyzes studies that focus on genetic risk factors, gender differences, and shifts in paradigms in recent years. This article highlights the need for obtaining a thorough understanding of the effects of alcohol on cardiovascular health to support public health guidelines and clinical practice, and it underscores the significance of including alcohol consumption into the broader context of cardiovascular risk management and identifies important subjects for further study. [ABSTRACT FROM AUTHOR]

Studies that have examined young people's drinking behaviour, particularly how they abstain from alcohol or drink lightly and their motivations, have focused on Western contexts. Currently, studies on how and why young Africans abstain from alcohol or drink moderately are lacking. Therefore, there is a need to examine young people's drinking behaviours/practices on the continent to facilitate health promotion interventions. This study, which uses qualitative data elicited from 53 participants, explores how young Nigerian men and women who consume alcohol and drink heavily enact and negotiate abstinence and moderate drinking and the factors that motivate their choices. Some participants constructed situational abstinence, while others participated in temporary light drinking in their friendship networks, but these attracted some consequences. Peers pressured them, but some deployed the ability to offer 'valid' explanations and express self-determination and agency to ward off such pressures and negotiate situational abstinence or moderate drinking. Additionally, the fear of public embarrassment, negative publicity on social media due to intoxication and parental influences motivated some participants' occasional sobriety. Others relied on previous personal or friends' negative experiences of drunkenness or the consequences of heavy drinking represented in movies and books to construct occasional light drinking. The findings demonstrated how enacting and rejecting particular forms of masculinity and embodied gendered drinking practices, more generally, in some friendship groups, facilitated situational abstinence and moderation. Policymakers should partner with young people to design interventions that encourage abstinence or moderation and mitigate the current drinking practices in Nigeria, which will enhance health promotion. [ABSTRACT FROM AUTHOR]

Abstract Background Previous research has demonstrated that remissions from alcohol use disorders can occur without accessing treatment. The current study explored the prevalence of such untreated remissions in the UK and further, examined the extent to which people who resolved an alcohol use disorder regarded themselves as ever, or currently, being in recovery. Methods Participants were recruited using the Prolific online platform. Participants who met criteria for lifetime alcohol dependence (ICD-10) were asked about their drinking at its heaviest, use of treatment services, whether they identified as being in recovery, and their current alcohol consumption (to identify those who were abstinent or drinking in a moderate fashion). Results A total of 3,994 participants completed surveys to identify 166 participants with lifetime alcohol dependence who were currently abstinent (n = 67) or drinking in a moderate fashion (n = 99). Participants who were currently abstinent were more likely to have accessed treatment than those who were currently moderate drinkers (44.4% versus 16.0%; Fischer’s exact test = 0.001). Further, those who were abstinent were heavier drinkers prior to remission [Mean (SD) drinks per week = 53.6 (31.7) versus 29.1 (21.7); t-test = 5.6, 118.7 df, p

Clinicians worldwide continually have to respond to questions about the potential benefits on health from the moderate consumption of alcohol, and the “French paradox” has often been cited as supporting this premise. We wish to briefly comment on findings from the last several decades that provide evidence that moderate drinking may have some beneficial health effects, starting with a new analysis of the observation of “Unusually Low Incidence of Death From Myocardial Infarction” – a study of an Italian American community in Pennsylvania published in the Journal of the American Medical Association in 1964.

Background and Aims: The relationship between moderate alcohol intake and health outcomes among individuals with metabolic dysfunction‐associated fatty liver disease (MAFLD) is complex. Our aim was to investigate the association of minimal alcohol consumption with all‐cause and cause‐specific mortality among MAFLD individuals of different genders. Methods: Our study included 2630 MAFLD individuals from the Third National Health and Nutrition Examination Survey. Cox regression analysis was performed to assess the association between alcohol use measures and all‐cause and cause‐specific mortality. Restricted cubic spline curves were used to evaluate the relationship between alcohol consumption per week and all‐cause mortality. Results: In the entire MAFLD cohort, we observed significant disparities in clinical characteristics between male and female individuals with MAFLD. Higher weekly alcohol consumption was significantly associated with all‐cause and cause‐specific mortality (male, hazard ratios [HRs]: 1.009, 95% CIs: 1.004–1.014; female, HRs: 1.032, 95% CIs: 1.022–1.042). In males with MAFLD, a linear association with all‐cause mortality was observed for weekly alcohol consumption (p for non‐linearity =.21). Conversely, in females with MAFLD, the risk of all‐cause mortality remained relatively stable until 2 drinks per week, after which it rapidly increased with each additional drink consumed, and the increase in mortality risk was higher than that observed in males (p for non‐linearity <.05). Conclusions: Our findings indicate that any increase in weekly alcohol consumption was associated with increased all‐cause mortality in men with MAFLD. Conversely, consuming less than 2 drinks per week had minimal impact on the risk of mortality among female. [ABSTRACT FROM AUTHOR]

Background: Previous research has demonstrated that remissions from alcohol use disorders can occur without accessing treatment. The current study explored the prevalence of such untreated remissions in the UK and further, examined the extent to which people who resolved an alcohol use disorder regarded themselves as ever, or currently, being in recovery. Methods: Participants were recruited using the Prolific online platform. Participants who met criteria for lifetime alcohol dependence (ICD-10) were asked about their drinking at its heaviest, use of treatment services, whether they identified as being in recovery, and their current alcohol consumption (to identify those who were abstinent or drinking in a moderate fashion). Results: A total of 3,994 participants completed surveys to identify 166 participants with lifetime alcohol dependence who were currently abstinent (n = 67) or drinking in a moderate fashion (n = 99). Participants who were currently abstinent were more likely to have accessed treatment than those who were currently moderate drinkers (44.4% versus 16.0%; Fischer's exact test = 0.001). Further, those who were abstinent were heavier drinkers prior to remission [Mean (SD) drinks per week = 53.6 (31.7) versus 29.1 (21.7); t-test = 5.6, 118.7 df, p <.001] and were more likely to have ever identified themselves as 'in recovery' (51.5% versus 18.9%; Fischer's exact test = 0.001) than current moderate drinkers. Conclusions: While participants with an abstinent remission were more likely than those currently drinking in a moderate fashion to have accessed treatment and to identify as being 'in recovery,' the majority of participants reduced their drinking without treatment (and did not regard themselves as in recovery). [ABSTRACT FROM AUTHOR]

Background: Chronic heavy alcohol consumption is known to harm health, while occasional light to moderate drinking may have potential benefits. However, it is unclear how modest alcohol intake affects brain structure. Aims & Objectives: This study aimed to examine the white matter integrity changes after a modest dose of acute alcohol consumption using diffusion tensor imaging (DTI). Method: Healthy individuals aged between 20 and 29, with ALDH2*1/*2 genotype, who understood the study and gave written informed consent were included in this study. They received an intravenous alcohol infusion using the alcohol clamp method to achieve a target blood alcohol concentration of 0.50 mg/mL. We acquired DTI data on a 3T MRI scanner at Kurihama Medical and Addiction Center and assessed self-reported clinical responses to alcohol administration (i.e., stimulus, physical, or sedative) using the visual analogue scale (VAS) at baseline (T0), 90 minutes after alcohol administration started (T1), and 90 minutes after alcohol administration ended (i.e., 180 minutes from baseline) (T2). We compared whole-brain fractional anisotropy (FA)/mean diffusivity (MD) values and FA/MD values for 48 regions of interest (ROI) extracted from the JHU-ICBM-DTI-81 white matter atlas across time using repeated-measure analysis of variance (ANOVA). Additional analyses were conducted to examine the correlation between baseline FA/MD value or FA/MD value changes and changes in behavioral VAS scores. Furthermore, we performed tract-based spatial statistics (TBSS) to compare white matter integrity between conditions (i.e., T0 vs T1, T0 vs T2, T1 vs T2). Results: The study consisted of 18 participants, with an average age of 25.1 years, of which 7 (38.9%) were male. Repeated measures ANOVA showed no significant differences in the whole FA/MD or FA/MD values in any DTI ROIs among the three time points. TBSS analysis revealed no significant differences in FA/MD between T1 and T0 or T2 and T1. However, there were significant increases in FA in the cerebral white matter voxel cluster at T2 compared to T0 (37,145 voxels, p=0.001, FWE-corrected), whereas no significant decreases were found. Moreover, there were significant decreases in MD in the voxel clusters, including right anterior corona radiata, right inferior fronto-occipital fasciculus, corticospinal tract, left uncinate fasciculus, anterior thalamic radiation at T2 compared to T0 (>1000 voxels, p<0.05, FWE-corrected) whereas no significant increases were found. The whole FA change from T0 to T1 showed a negative correlation with the change in the sedative score from T0 to T1 (r=-0.51, p=0.03), which did not survive after the multiple comparison correction. No other significant correlations were found between whole FA/MD changes and behavioral score changes from T0 to T1 or T0 to T2. No correlation was shown between baseline FA/MD value and the FA/MD value changes or behavioral score changes from T0 to T1 or T0 to T2. Discussion & Conclusion: This study indicates that a single, moderate alcohol consumption may increase the white matter integrity. However, the chronic effects of consistent moderate drinking on the brain's structure warrant further exploration. [ABSTRACT FROM AUTHOR]

Recent studies revealed that any amount of alcohol consumption is an overall health detriment to multiple populations, contrary to popular beliefs. In addition, very few alcohol use studies utilized machine learning methods to compare the biological health of moderate drinkers compared to those that abstain from alcohol consumption, opting instead to focus on binge drinking and heavy drinking. Using participant data of multiple factor types from the National Health and Nutrition Examination Survey, we created prediction models with stacked ensembles and gradient boosting models. Machine learning models were used to identify which factors most enabled the prediction of moderate drinking behaviors. Our combined factor runs produced a cross-validation area under the curve (AUC) of 0.929 and a validation area under the curve of 0.806. Runs that only included biochemical or demographical factors received cross-validation AUC values of 0.825 and 0.925, and validation AUC values of 0.757 and 0.783, respectively. The top predictive factors for our machine learning runs, including gamma glutamyl transferase, gender, iron levels, and cigarette and marijuana usage, corroborate past studies that link those factors to alcohol consumption. Our findings identified key differences in the biological health of moderate drinkers compared to those that abstain from drinking. These results reveal a need to further explore the health effects of moderate drinking, especially for vulnerable populations. • Recent studies concluded that any alcohol consumption is unhealthy for many groups. • These results refute previous research stating that healthy drinking levels exist. • There are biochemical differences found between abstinent and moderate drinkers. • Moderate drinking may have more effects upon bodily health than previously thought. [ABSTRACT FROM AUTHOR]

'Responsible drinking' remains a poorly defined construct despite decades of use among diverse stakeholders including industry, academics, governmental agencies, and addiction advocacy groups. To move the field closer to a consensus definition of responsible drinking that is useful for educational and research purposes, we describe five primary barriers that discourage the construction of a shared definition of responsible drinking. These barriers include the lack of foundational empirical evidence, the social construction of the term, the possibility that different targets require different definitions, the political implications of responsible drinking, and the possibility that there is no safe level of alcohol consumption. We conclude this article by offering suggestions to overcome these barriers through further research. [ABSTRACT FROM AUTHOR]

Background. Oleanolic acid (OA) and moderate drinking have been reported to attenuate diabetes. However, the underlying mechanism of OA and moderate drinking alone or in combination on the islet β-cell deficiency induced diabetes is not fully elucidated. Methods. Male Sprague Dawley (SD) rats were intraperitoneally injected with 55 mg/kg streptozotocin (STZ) to induce β-cell deficiency. OA, 5% ethanol (EtOH), or a mixture of OA in 5% ethanol (OACEtOH) were applied to three treatment groups of hyperglycemia rats for 6 weeks. Results. STZ caused the increase of fast blood glucose (FBG) level.OA and EtOH treatment alone or in combination decreased the STZ increased FBG level during the 6 weeks of treatment. In addition, OA treatment also significantly increased the β-cell to total islet cell ratio. Both EtOH and OA+EtOH treatments promoted the increase of total islet cell number and α-cell to β-cell ratio when compared toOAgroup. STZ induced hyperglycemia dramatically reduced the glucagon-like peptide-1 receptor (GLP-1R) positive cells in islets, all the three treatments significantly increased the pancreatic GLP-1R positive cell number. In the meantime, STZ induced hyperglycemia suppressed the insulin mRNA expression and boosted the glucagon mRNA expression. EtOH and OA+EtOH treatments increased the insulin mRNA expression, but none of the 3 treatments altered the elevated glucagon level. Conclusion. GLP-1R positive cell ratio in islets is crucial for the blood glucose level of diabetes. OA and 5% ethanol alone or in combination suppresses the blood glucose level of β-cell deficiency induced diabetes by increasing islet GLP-1R expression. [ABSTRACT FROM AUTHOR]

Beer contains a variety of bioactive ingredients and trace elements that can regulate bodily functions, and moderate consumption of beer can enhance immune responses. This study aimed to investigate the potential benefits of moderate consumption of alcoholic or non-alcoholic beer on the gut microbiome, immunity, and intestinal barrier function in immunosuppressed BALB/c mice induced by cyclophosphamide (CTX). Model mice with CTX-induced immunosuppression were administered alcoholic or non-alcoholic beer or galacto-oligosaccharides (GOS) for 28 consecutive days. The GOS and beer intervention groups all showed alleviation of spleen tissue damage, an increased immune organ index, decreased gut inflammation, and reduced serum concentrations of D-lactic acid, lipopolysaccharide, and tumor necrosis factor α. High-throughput 16S rRNA gene sequencing revealed higher relative abundances of Firmicutes and Actinobacteriota, and lower relative abundances of Bacteroidota, Lactobacillus , and Bifidobacterium , in CTX mice than in normal control mice. In addition, Firmicutes showed lower abundance, while Desulfobacterota showed higher abundance in CTX mice with non-alcoholic beer intake than without it. Spearman correlation analysis indicated that Bacteroidota was negatively correlated with propionic acid and butyric acid, while Desulfobacterota was positively correlated with butyric acid. Proteobacteria was negatively correlated with acetic acid, propionic acid, isobutyric acid, and valeric acid. Helicobacter was positively correlated with valeric acid. In conclusion, this is one of the first studies to examine the modulatory effects of moderate alcohol consumption in immunocompromised mice. Our findings indicate that beer consumption can alter the gut microbiome and metabolites, enhancing immunity in mice., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could influence the work reported in this article., (©2025 BMFH Press.)

Background: Most of the available epidemiological evidence on alcohol and chronic disease agrees on recommending alcohol abstention to young people, but some controversy exists about the most appropriate recommendation for alcohol abstention for people of older ages. A growing body of evidence suggests that the pattern of alcohol consumption is likely to be a strong effect modifier. The Mediterranean Alcohol Drinking Pattern (MADP) represents a score integrating several dimensions of drinking patterns (moderation, preference for red wine, drinking with meals, and avoiding binge drinking). Our aim was to clarify this issue and provide more precise recommendations on alcohol consumption. Methods: We prospectively followed-up 2226 participants (men older than 50 years and women older than 55 years at baseline) in the Seguimiento Universidad de Navarra (SUN) cohort. We classified participants into three categories of adherence to the MADP score (low, moderate, and high), and we added a fourth category for abstainers. Cox regression models estimated multivariable-adjusted hazard ratios (HR) of all-cause death and 95% confidence intervals (CI) using low MADP adherence as the reference category. Results: The strongest reduction in risk of mortality was observed for those with high adherence to the MADP, with an HR of 0.54 (95% CI: 0.37–0.80). The moderate adherence group (HR = 0.65, 95% CI: 0.44–0.96) and the abstention group (HR = 0.60, 95% CI: 0.36–0.98) also exhibited lower risks of mortality than the low MADP adherence group. Conclusions: based on the available evidence, a public health message can be provided to people older than 50 years as follows: among those who drink alcohol, high adherence to the MADP score could substantially reduce their risk of all-cause mortality. [ABSTRACT FROM AUTHOR]

To mitigate alcohol-related harm, various stakeholders have advanced the construct of 'responsible drinking.' However, clarity regarding 'responsible drinking' in evaluation research is limited. Additionally, the alcohol industry often uses the term without any mention of clear limits or meaning. At this point it is unclear whether stakeholders are adopting a shared understanding of the 'responsible drinking' concept; such a shared understanding is essential for the development, implementation, and evaluation of consumer protection strategies that rest on individual responsibility. Therefore, we sought to describe 6 stakeholders' use of the construct. Stakeholder sectors included (1) academics, (2) government organizations, (3) alcohol industry, (4) alcohol treatment centers, (5) U.S. higher education institutions, and (6) addiction professionals' organizations. We searched a total of 133 sources representing these stakeholder sectors. Despite frequent use of the term 'responsible drinking' or a close derivative, only 17 sources provided an explicit definition. Coding revealed that the 'responsible drinking' message is still ambiguous, which means that consumers are not being provided clear harm avoidance guidance. Future research should create a shared conceptualization of responsible drinking to include all dimensions relevant to the construct. Furthermore, alternative phrases such as 'safe drinking' or 'moderate drinking' may be used to emphasize different dimensions of responsible drinking and may warrant further study. Like responsible drinking, other terms will require careful development, as well, but might benefit in terms of acceptability and reception from the absence of a positive connotation. [ABSTRACT FROM AUTHOR]

Purpose of Review: A clear link between excessive alcohol consumption and cardiovascular disease (CVD) has been established, but no consensus exists on the effects of moderate alcohol consumption on CVD. Recent Findings: A lower risk of coronary heart disease and myocardial infarction among moderate drinkers compared to abstainers has been consistently observed in epidemiological studies and meta-analyses of these studies. However, ambiguity remains on the effect of alcohol on other CVDs and all-cause mortality. Short-term randomized controlled trials (RCT) have identified potentially beneficial effects of alcohol consumption on cardiovascular risk factors, but studies investigating genetic polymorphisms that influence alcohol consumption (i.e., Mendelian randomization) have yielded inconclusive results. To date, a long-term RCT providing causal evidence is lacking but urgently needed. Summary: Triangulation of evidence from different study designs, including long-term RCTs, pragmatic trials and the evaluation of policy measures, combined will lead to the best available evidence. [ABSTRACT FROM AUTHOR]

Whether moderate alcohol intake is beneficial remains an unsolved issue. Recent studies have suggested that moderate alcohol consumption is associated with beneficial effects related to the prevention of cardiovascular diseases. Moderate alcohol consumption leads to a higher risk of hepatocellular carcinoma in patients with chronic viral liver diseases. However, the effects of moderate alcohol intake in patients with nonalcoholic fatty liver disease are unclear. In this review, we analyzed, from various perspectives, the effect of moderate alcohol consumption in patients with nonalcoholic fatty liver disease. We reviewed four cohort studies and seven cross-sectional studies. The results showed that moderate alcohol consumption was negatively related to the incidence of nonalcoholic steatohepatitis and liver fibrosis. However, moderate alcohol consumption was positively associated with the incidence of hepatocellular carcinoma in patients with nonalcoholic fatty liver disease. The results of the analysis of the relationship between moderate alcohol consumption and the levels of triglycerides, total cholesterol, high-density lipoprotein, and hypertension were diverse. More clinical data are needed to draw a conclusion about the effects of moderate alcohol consumption in patients with nonalcoholic fatty liver disease.

Compared to drinking abstinence, the encouragement of moderating drinking is a pragmatic and sensible approach to addressing excessive alcohol consumption. This study explores how students' perceptions of facilitators of moderate drinking vary between a wet (New Zealand) and dry drinking country (Vietnam). A qualitative survey was conducted with 227 and 278 respondents from New Zealand and Vietnam, respectively. Aligning with the behavioral ecological framework, the content analysis reveals that students perceive several factors to encourage moderate drinking at the individual (e.g., controllability and coping skills), social (e.g., peer influences), and environmental level (e.g., alternatives to drinking). The response variations between the two countries provided novel insights into cultural differences in students' perceptions, with internal factors exerting stronger influence in the dry culture and external influences being more prominent in the wet culture. The findings offer recommendations to inform nonprofit and social marketing in the areas of alcohol control. [ABSTRACT FROM AUTHOR]

Although it is known that APOE genotype is the strongest genetic risk factor for late-onset Alzheimer's disease, development is a multifactorial process. Alcohol use is a contributor to the epidemic of Alzheimer's disease and related dementias in the US and globally, yet mechanisms are not fully understood. Carriers of the APOE ε4 allele show elevated risk of dementia in relation to several lifestyle factors, including alcohol use. In this review, we describe how alcohol interacts with APOE genotype and aging with potential implications for Alzheimer's disease promotion. Age-related immune senescence and "inflammaging" (i.e., low-grade inflammation associated with aging) are increasingly recognized as contributors to age-related disease. We focus on three immune pathways that are likely contributors to Alzheimer's disease development, centering on alcohol and APOE genotype interactions, specifically: 1) microbial translocation and immune activation, 2) the senescence associated secretory phenotype, and 3) neuroinflammation. First, microbial translocation, the unphysiological movement of gut products into systemic circulation, elicits a proinflammatory response and increases with aging, with proposed links to Alzheimer's disease. Second, the senescence associated secretory phenotype is a set of intercellular signaling factors, e.g., proinflammatory cytokines and chemokines, growth regulators, and proteases, that drives cellular aging when senescent cells remain metabolically active. The senescence associated secretory phenotype can drive development of aging-diseases such as Alzheimer's disease. Third, neuroinflammation occurs via numerous mechanisms such as microglial activation and is gaining recognition as an etiological factor in the development of Alzheimer's disease. This review focuses on interactions of alcohol with APOE genotype and aging along these three pathways that may promote Alzheimer's disease. Further research on these processes may inform development of strategies to prevent onset and progression of Alzheimer's disease and to delay associated cognitive decline., Competing Interests: Conflict of Interest: None.

In order to establish a clear limit between protective and harmful effects of alcohol consumption, it is necessary to define patterns of consumption. However, there is no universally recognized quantitative classification for patterns of consumption by alcohol doses. This is because the pattern of alcohol consumption does not only describe how much alcohol was consumed, but also takes into account a number of boundary conditions. This review deals with variabilities in the definitions of standard alcohol doses and patterns of alcohol consumption. These terms are being discussed with respect to the benefits and harms associated with alcohol consumption as well as the risks intrinsic to studies of such a complex phenomenon as the effect of alcoholic beverages on human health.

Background: Moderate alcohol consumption is believed to be associated with reduced mortality from cardiovascular disease (CVD) in the general population. This cross-sectional study aimed to comprehensively examine the association between alcohol consumption and subclinical cardiovascular damage or hepatic fibrosis in non-alcoholic fatty liver disease (NAFLD).Methods: Subjects with NAFLD without a history of heart disease were extracted from 977 consecutive examinees who completed health checkups and optional cardiovascular examinations. Subclinical cardiovascular damage was assessed by coronary artery calcification (CAC), carotid artery ultrasound, and brachial-ankle pulse wave velocity (ba-PWV). CAC scores were classified into three grades (0, ≤100, and >100) by Agatston's method. Alcohol consumption was divided into three groups [Non-drinking (G0); Light (G1), 0.1-6.9 drinks/week; Moderate (G2), 7-20.9 drinks/week for men and 7-13.9 drinks/week for women]. Noninvasive markers (FIB-4, Fibrosis-4; NFS, NAFLD fibrosis score) were calculated for assessment of hepatic fibrosis and classified into low and intermediate-high grade.Results: The overall mean age was 60.2 years and males were 200 (74.6%) among 268 subjects with NAFLD. Number (%) of G0, G1, and G2 were 102 (38.1%), 103 (38.4%), and 63 (23.5%). Binary logistic regression analysis showed no significant difference between G0 and G1, or G0 and G2 in any of the above subclinical cardiovascular damages (CAC score >0, or CAC score >100, carotid plaque +, intima-media thickness ≥1.1 mm, and ba-PWV >1400 cm/s). However, only G2 had a significant association with intermediate-high grade of FIB-4 or NFS [odds ratio (95% confidence intervals), p value: 1.871 (1.209-2.893), p = 0.005; 2.910 (1.715-4.939), p = 0.000], compared to G0.Conclusions: Non-heavy drinking might not reduce the risk of CVD in NAFLD subjects. On the contrary, even moderate drinking could promote hepatic fibrosis. Thus, NAFLD drinkers should not be recommended for even a moderate amount of alcohol. [ABSTRACT FROM AUTHOR]

Aims The objective of this paper was to examine 20-year trends of the socioeconomic status (SES) measures income and employment and their association with current alcohol use behaviors in Danish adults aged 60–70. Methods Data from The Danish National Health Survey 2013 and the baseline assessment of the Elderly Study (2013–2016) were combined to form four groups from the general population with various drinking patterns, but with no recent treatment for alcohol use disorder (AUD), and one group seeking treatment: Abstinent (n  = 691), low- (n  = 1978), moderate- (n  = 602), and high-risk (HR) drinkers (n  = 467), and DSM-5 AUD seeking treatment (n  = 262). For all groups, Danish national register data were linked at the individual level obtain find annual information on income and employment during the 20 years prior to interview. Mixed effects models were utilized to model trajectories of income and employment for the five groups. Results Lower income and employment status was observed from middle-aged adulthood when comparing 12-month abstinence or AUD to individuals with low or moderate alcohol consumption. At the end of the study period, moderate-risk drinkers experienced an increase, and HR drinkers a decrease, in income and rate of employment relative to the low-risk drinkers. Conclusions Alcohol use behaviors observed in older adults are related to distinct long-term trajectories regarding income and employment status, which are observable already in middle-aged adulthood. [ABSTRACT FROM AUTHOR]

Alcohol education must ensure that young people have appropriate information, motivation and skills. This article describes the fifth phase in a program of intervention development based on principles of social marketing and intervention mapping. The aim was to enhance drink refusal self-efficacy (DRSE) and help develop skills for non-drinking or moderate drinking. We conducted a mixed-methods feasibility trial that measured intervention effects among 277 UK secondary school students aged 14–16, and used qualitative methods to explore four teachers' experiences of delivering the intervention. The intervention did not produce the desired changes in DRSE or alcohol use, but nor did it increase alcohol use. In the qualitative process evaluation, time constraints, pressure to prioritize other topics, awkwardness and embarrassment were identified as barriers to fidelitous delivery. A more intense and/or more prolonged intervention delivered with greater fidelity may have produced the desired changes in DRSE and alcohol use. This study illustrates how principles of social marketing and intervention mapping can aid development of resilience-based education designed to help students develop skills to drink moderately, or not drink. It also highlights the need to consider the constraints of micro-social (school) and macro-social (societal) cultures when designing alcohol education. [ABSTRACT FROM AUTHOR]

Epidemiologic studies consistently report a U-shaped curve relationship between the amount of alcohol consumption and cardiovascular disease, with consumption of ≥ three alcoholic drinks being associated with an increased risk. However, the cardioprotective effect of light and moderate alcohol consumption has been recently questioned. In the absence of a randomized trial confirming the cardioprotective effect of light or moderate alcohol consumption, an alternative method to prove the causality is Mendelian randomization using a genetic variant serving as a proxy for alcohol consumption. A Mendelian randomization analysis by Holmes et al. suggests that a reduction in alcohol intake is beneficial for cardiovascular health also in light to moderate drinkers. In a recent analysis of 83 prospective studies, alcohol consumption was roughly linearly associated with a higher risk of stroke, coronary heart disease excluding myocardial infarction, heart failure and risk of death from aortic aneurysm dissection. By contrast, increased alcohol consumption was associated with a lower risk of myocardial infarction. "Low-risk" alcohol consumption recommended by the National Institute of Public Health, Czech Republic, should not exceed 16 g of 100% ethanol/day for women and 24 g/day for men; at least two days a week should be alcohol free, and the dose of ethanol during binge drinking should not exceed 40 g. In practice, this means one standard drink daily for five days at most and two standard drinks at most when binge drinking. These amounts should be considered the highest acceptable limits, but alcohol consumption in general should be discouraged. [ABSTRACT FROM AUTHOR]

This study addresses the dearth of literature into drinking moderation and demonstrates the value of a social ecological approach for identifying the influencers of students' intention to moderate drinking. In doing so, the study supports a promotion approach over an avoidance approach as a new opportunity for addressing heavy student drinking through social marketing. A quantitative survey is conducted within a sample of university students (n = 660) in Vietnam where drinking moderation is commonplace. This research context is arguably helpful to discover factors linked to drinking in moderation, which could inform interventions to reduce problematic drinking in heavy-drinking cultures. Findings suggest that there exist multiple levels of influence on students' intention to moderate drinking beyond individual factors, which makes drinking moderation a complex phenomenon. There also exist gender differences in how the factors affect moderate drinking intention. Females appear to moderate their drinking through both internal and external control mechanisms, while males tend to moderate their drinking mainly through internal control. These findings can be used to develop interventions aimed at fostering safe and sensible drinking cultures. By taking a comprehensive approach, the most necessary targets are identified to bring about the desired change. It is also suggested that the interventions should be tailored to different gender needs. [ABSTRACT FROM AUTHOR]

Introduction: The negative association between heavy alcohol use and likelihood of successful smoking cessation is well established. However, evidence on the effects of moderate alcohol consumption on smoking cessation is sparse. This analysis evaluated the association between alcohol use and smoking and the interaction of alcohol use and use of pharmacotherapy interventions in relation to smoking cessation.Methods: Data from adults (n = 923) recruited through a smoking cessation website between November 2011 and March 2012 were analyzed. Data on past-year alcohol use, tobacco use, and demographics were collected at baseline. Self-reported smoking abstinence and current alcohol use data were collected at 1 and 7 months posttreatment. Chi-square and multivariate logistic regression analyses were conducted.Results: At 1 month, adjusted odds of continued smoking were 1.54 times greater (95% confidence interval [CI] = 1.05% to 2.23%) for moderate drinkers and 2.59 times greater (95% CI = 1.33% to 4.28%) for heavy drinkers than nondrinkers. At 7 months, adjusted odds of continued smoking were not greater for moderate drinkers than nondrinkers, and were 2.32 times greater (95% CI = 1.35% to 3.96%) among heavy alcohol drinkers than nondrinkers. At 1 month, adjusted odds of smoking cessation were 2.33 times greater (95% CI = 1.04% to 3.09%) for alcohol users assigned to nicotine replacement therapy than for those not assigned to nicotine replacement therapy. This relationship was not observed at 7 months.Conclusions: Moderate and heavy drinking might impact smoking cessation efforts. Recent moderate drinking may be associated with short-term continued smoking and heavy drinking associated with relapse in the short and long term.Implications: This study suggests that moderate drinking may influence the process to quit smoking. Further study is needed to better understand the implications of moderate drinking for smoking cessation. Providing information alone may not be effective in helping people abstain from drinking during smoking cessation, especially if moderate drinkers do not perceive their behavior as reducing their chance for a successful quit attempt. Tailoring smoking cessation interventions to include strategies to reduce moderate-to-heavy alcohol consumption may improve smoking cessation outcomes among alcohol users attempting to quit smoking. [ABSTRACT FROM AUTHOR]

Background: Alcohol consumption in later life has increased in the past decade, and the relationship between alcohol consumption and mortality is controversial. Recent studies suggest little, if any, health benefit to alcohol. Yet most rely on single–time point consumption assessments and minimal confounder adjustments. Methods: We report on 16 years of follow‐up from the Health and Retirement Study (HRS) cohorts born 1931 to 1941 (N = 7,904, baseline mean age = 61, SD = 3.18). Respondents were queried about drinking frequency/quantity. Mortality was established via exit interviews and confirmed with the national death index. Time‐varying confounders included but were not limited to household assets, smoking, body mass index, health/functioning, depression, chronic disease; time‐invariant confounders included baseline age, education, sex, and race. Results: After adjustment, current abstainers had the highest risk of subsequent mortality, consistent with sick quitters, and moderate (men: HR = 0.74, 95% CI: 0.60 to 0.91; women: HR = 0.82, 95% CI: 0.63 to 1.07) drinking was associated with a lower mortality rate compared with occasional drinking, though smokers and men evidenced less of an inverse association. Quantitative bias analyses indicated that omitted confounders would need to be associated with ~4‐fold increases in mortality rates for men and ~9‐fold increases for women to change the results. Conclusions: There are consistent associations between moderate/occasional drinking and lower mortality, though residual confounding remains a threat to validity. Continued efforts to conduct large‐scale observational studies of alcohol consumption and mortality are needed to characterize the changing patterns of consumption in older age. [ABSTRACT FROM AUTHOR]

Focusing on problematic behavior can stigmatize the target audience for change campaigns, especially in the context of alcohol consumption. In previous studies, excessive drinking (the problematic behavior) has been the dominant focus. By contrast, this study empirically examines moderate drinking practices (the desired behavior) in an Australian adult population. An online survey was administered, and results were analyzed through structural equation modeling. Findings indicate moderate drinking practices were applied more frequently by females than males. Confidence enhancement and sexual enhancement expectancies were negatively associated with moderate drinking practices. This study indicates higher self-efficacy skills (i.e., refusing alcohol offered) were associated with more moderate alcohol consumption practices. Findings of this study can be used to guide intervention design to attract and retain moderate alcohol drinkers. By taking a positive behavioral approach, modifiable factors to effect the desired change are identified delivering actionable insights that can be implemented to achieve the desired change (e.g., increase moderate drinking practices). [ABSTRACT FROM AUTHOR]

Background Unhealthy behaviours increase cancer risk. However, lifestyle habits co-occur and their joint association with cancer is not known. Methods A survey among midlife employees included data on lifestyle habits and covariates (N = 8960, response rate 67%, 80% women). The joint variables of lifestyle habits were prospectively linked with register data on cancer diagnosis (mean follow-up time 12.1 years). Cox proportional hazard model was used to calculate hazard ratios (HR), and their 95% confidence intervals. Results Smoking was associated with subsequent cancer risk and the association was strengthened by inactivity (HR 1.94, 1.46–2.59) and unhealthy diet (HR 1.92, 1.43–2.57). Smoking combined with both low (HR 1.70, 1.19–2.41) and moderate (HR 1.68, 1.27–2.23) alcohol consumption was also associated with increased cancer risk, as was unhealthy diet combined with moderate alcohol consumption (HR 1.55, 1.17–2.06) and inactivity (HR 1.44, 1.10–1.88). Inactivity combined with either low (HR 1.44, 1.06–1.96) or moderate (HR 1.47, 1.11–1.95) alcohol use was associated with subsequent cancer risk. Conclusions Key unhealthy behaviours have additive effects. Preventive measures should be targeted to especially smokers and those having several adverse lifestyle habits. [ABSTRACT FROM AUTHOR]

Aim: To assess the causality between alcohol intake, diabetes risk and related traits. Design Mendelian randomization (MR) study. Subgroup analysis, standard instrumental variable analysis and local average treatment effect (LATE) methods were applied to assess linear and non‐linear causality. Setting: China. Participants: A total of 4536 participants, including 721 diabetes cases. Findings Carriage of an ALDH2 rs671 A allele reduced alcohol consumption by 44.63% [95% confidence interval (CI) = –49.44%, −39.37%]. In males, additional carriage of an A allele was significantly connected to decreased diabetes risk for the overall population [odds ratio (OR) = 0.716, 95% CI = 0.567–0.904, P = 0.005] or moderate drinkers (OR = 0.564, 95% CI = 0.355–0.894, P = 0.015). In instrumental variable (IV) analysis, increasing alcohol consumption by 1.7‐fold was associated with an incidence‐rate ratio of 1.32 (95% CI = 1.06–1.67, P = 0.014) for diabetes risk, and elevated alcohol intake was causally connected to natural log‐transformed fasting, 2‐hour post‐load plasma glucose (β = 0.036, 95% CI = 0.018–0.054; β = 0.072, 95% CI = 0.035–0.108) and insulin resistance [homeostatic model assessment for IR (HOMA‐IR] (β = 0.104, 95% CI = 0.039–0.169), but was not associated with beta‐cell function (HOMA‐beta). In addition, the LATE method did not identify significant U‐shaped causality between alcohol consumption and diabetes‐related traits. In females, the effects of alcohol intake on all the outcomes were non‐significant. Conclusion: Among men in China, higher alcohol intake appears to be causally associated with increased diabetes risk and worsened related traits, even for moderate drinkers. This study found no significant U‐shaped causality between alcohol consumption and diabetes‐related traits. [ABSTRACT FROM AUTHOR]

Aims Epidemiological studies and experimental data from rodent models have reported a non-linear relationship between consumption of alcohol and cardiovascular disease (CVD) risk that suggests that light-to-moderate drinking as opposed to excessive consumption may provide some cardiovascular benefits. The present study examined potential mechanisms by which moderate alcohol consumption may provide a protective effect against CVD. Short summary Wistar rats exposed for 3 months to a 20% ethanol intermittent-access voluntary drinking paradigm displayed a reduction in epididymal fat, blood glucose and non-HDL and total cholesterol. These effects were accompanied by decreased expression of Hmgcr, Srebp-2, Cox-2 and RelA, indicating downregulation of genes involved in cholesterol synthesis and inflammation. Methods Twenty-four male Wistar rats voluntarily consumed a 20% v / v ethanol solution on alternate days for 13 weeks (ethanol-treated) or were given access to water alone (non-ethanol-exposed control). Results There was no difference in body weight gain between the two groups, however, epididymal fat weight was lower in ethanol-fed rats (P = 0.030). Blood glucose, total cholesterol, non-high-density lipoprotein (HDL) and oxidized low-density lipoprotein (LDL) levels were lower in the ethanol group compared to controls (P < 0.05). There was a significant reduction in the expression of hydroxymethylglutaryl-coenzyme A reductase and sterol regulatory element-binding protein-2 in ethanol-treated rats (P < 0.05), suggesting that ethanol may have lowered cholesterol levels via downregulation of genes involved in cholesterol synthesis. Paraoxonase-1, which is associated with inhibition of LDL cholesterol oxidation, was upregulated in the ethanol group (P = 0.029). Ethanol-treated rats exhibited significantly lower levels of high-mobility box group protein 1 (P ≤ 0.05). Cyclooxygenase-2 and RelA gene expression were significantly lower in ethanol-treated rats (P < 0.05), indicating possible anti-inflammatory effects. Conclusions These findings suggest that moderate ethanol consumption may potentially contribute to improved cardiovascular outcomes by reducing body fat, improving blood cholesterol and blood glucose, and modulation of gene expression involved in inflammation and/or cholesterol synthesis. [ABSTRACT FROM AUTHOR]

In order to establish a clear limit between protective and harmful effects of alcohol consumption, it is necessary to define patterns of consumption. However, there is no universally recognized quantitative classification for patterns of consumption by alcohol doses. This is because the pattern of alcohol consumption does not only describe how much alcohol was consumed, but also takes into account a number of boundary conditions. This review deals with variabilities in the definitions of standard alcohol doses and patterns of alcohol consumption. These terms are being discussed with respect to the benefits and harms associated with alcohol consumption as well as the risks intrinsic to studies of such a complex phenomenon as the effect of alcoholic beverages on human health. [ABSTRACT FROM AUTHOR]

Aims: The US state of Washington's 333 state-run liquor stores were privatized on 1 June 2012 and purchases began in ~1500 licensed stores of a variety of types. A regime of taxes and fees was implemented to replace the revenues generated by the state stores and, 1 year later, the beer tax was reduced by two thirds. This study evaluates the impact of these changes on total alcohol and spirits consumption in a retrospective pre-test design. Methods: The study sample consists of 2289 adults recruited in three cross-sectional surveys during 2014 and 2015. Retrospective typical past month quantity--frequency measures for before privatization drinking and current past month quantity--frequency measures were compared within subjects, for all alcohol and for spirits only. Results: No change in alcohol volume was seen across privatization while spirits volume was found to decrease, suggesting a shift from spirits to beer. This decline in spirits volume came from a reduction in drinking days while overall drinking days were found to increase. This was offset by a reduction in drinks per drinking day and in heavy occasions. Conclusions: These findings accurately mirror the overall flat trend in per capita alcohol sales but seem to exaggerate the very small shift towards beer seen in sales data. Effects of increased spirits availability appear to have been countered by increased spirits prices and a decreased beer tax, leading to a shift to beer consumption. Short summary: Survey-based analyses of alcohol use across Washington's spirits privatization, beer tax reduction and marijuana legalization found no change in alcohol volume, a reduction in spirits volume and a shift to more moderate drinking patterns. Reductions in drinking occurred among marijuana users and those with lower educational attainment reduced spirits volume. [ABSTRACT FROM AUTHOR]

Objectives: To assess whether a relationship between alcohol use and health exists for older adults before and after controlling for proxy and full indicators of socioeconomic status (SES). Method: Secondary analysis of data from 2,908 participants in the New Zealand Longitudinal Study of Ageing (2012) completing measures of alcohol use, health, SES proxies (income, education) and SES. Sample mean age was 65, 52% were female, more than 80% were drinkers, and more than 75% had educational qualifications. Results: Moderate drinkers had better health and SES than heavier or nondrinkers. The positive influence of moderate alcohol consumption on health was observed for men and women when controlling for SES proxies, but was substantially reduced in women and completely disappeared for men when controlling for full SES. Discussion: SES plays a key role in presumed "heath benefits" of moderate alcohol consumption for older adults. It accounts for any alcohol-health relationship in a sample of men of whom 45% consume at least one drink daily, and substantially attenuates the association between alcohol and health in a sample of women who are not frequent drinkers. Prior research may have missed the influence of SES on this alcohol--health relationship due to the use of incomplete SES measures. [ABSTRACT FROM AUTHOR]

Background: Alcohol misuse is a major social and public health issue in Australia, with an estimated cost to the community of Aus $30 billion per annum. Until recently, a major barrier in addressing this significant public health issue is the fact that the majority of individuals with alcohol use disorders and alcohol misuse are not receiving treatment.Objective: This study aimed to assess whether alcohol consumption changes are associated with participation in Hello Sunday Morning's blog platform, an online forum discussing experiences in abstaining from alcohol.Methods: The study reports on Hello Sunday Morning participants who signed up for a 3-month period of abstinence from November 2009 to November 2016. The sample comprised 1917 participants (female: 1227/1917, 64.01%; male: 690/1917, 35.99%). Main outcome measures were Alcohol Use Disorders Identification Test (AUDIT) scores, mood, program engagement metrics, and slip-ups.Results: Individuals who reported hazardous (preprogram AUDIT mean 11.92, SD 2.25) and harmful consumption levels (preprogram AUDIT mean 17.52, SD 1.08) and who engaged in the Hello Sunday Morning program reported a significant decrease in alcohol consumption, moving to lower risk consumption levels (hazardous, mean 7.59, SD 5.70 and harmful, mean 10.38, SD 7.43), 4 months following program commencement (P<.001). Those who reported high-risk or dependent consumption levels experienced the biggest reduction (preprogram mean 25.38, SD 4.20), moving to risky consumption (mean 15.83, SD 11.11), 4 months following program commencement (P<.001). These reductions in risk were maintained by participants in each group, 7 months following program commencement. Furthermore, those who engaged in the program more (as defined by more sign-ins, blogs posted, check-ins completed, and engagement with the community through likes and following) had lower alcohol consumption. Finally, those who experienced more slip-ups had lower alcohol consumption.Conclusions: Participation in an online forum can support long-term behavior change in individuals wishing to change their drinking behavior. Importantly, reductions in AUDIT scores appeared larger for those drinking at high-risk and hazardous levels before program commencement. This has promising implications for future models of alcohol reduction treatment, as online forums are an anonymous, accessible, and cost-effective alternative or adjunct to treatment-as-usual. Further research is needed into the specific mechanisms of change within a Web-based supportive community, as well as the role of specific mood states in predicting risky drinking behavior. [ABSTRACT FROM AUTHOR]

Background No prospective study of maternal alcohol use has focused on age at transition to motherhood as a predictor of trajectories of risky drinking. The goal of this study was to examine the impact of maternal age at first birth on trajectories of alcohol use beyond recommended levels over a 17-year span. Methods Pregnant women ( N = 456) were recruited at an urban prenatal clinic. The women (13 to 42 years old; 64% African American, 36% White) were interviewed about alcohol use during pregnancy and at 6, 10, 14, and 16 years postpartum. Growth mixture modeling (GMM) was used to identify trajectories of risky drinking. Maternal age at first birth was then regressed onto trajectory class membership. Results The GMM on maternal alcohol use identified 3 groups of mothers as a function of alcohol use before, during, and after the pregnancy. The majority of mothers (66%) were identified as having low-risk trajectories of alcohol use over the 17-year span. However, 2 groups were in the higher-risk categories, with 23% identified as being in a long-term high-risk trajectory, and 11% in a short-term high-risk trajectory group. Maternal age at first birth predicted membership in a high-risk group: Younger mothers were more likely to be classified into a long-term high-risk alcohol use group. Conclusions Younger mothers were more likely to engage in risky drinking early in pregnancy, continuing 6 to 14 years postpartum. These results can help physicians target mothers who are likely to exceed current NIAAA guidelines of abstinence during pregnancy, and no more than 7 drinks per week in the postpartum. [ABSTRACT FROM AUTHOR]

In addition to monitoring problematic or harmful alcohol consumption, drinking experiments indicated the potential of phosphatidylethanols (PEth) in abstinence monitoring. To date, no profound evaluation of thresholds for the differentiation of abstinence from moderate drinking and for detection of excessive consumption based on PEth homologues exists. Investigations with a large group of healthy volunteers (n=300) were performed to establish PEth reference values reflecting different drinking habits. Blood samples were analyzed for PEth 16:0/18:1 and 16:0/18:2 by online-SPE-LC-MS/MS method. Results were compared to AUDIT-C questionnaires, to the amounts of alcohol consumed during the two-weeks prior to blood sampling, and were statistically evaluated. PEth concentrations were significantly correlated with self-reported alcohol consumption (r>0.69) and with AUDIT-C scores (r>0.65). 4.0% of 300 volunteers reported abstinence (AUDIT-C score: 0), no PEth was detectable in their blood. PEth 16:0/18:1 concentrations below the limit of detection of 10.0ng/mL match with abstinence and light drinking habits (≤10g pure alcohol/day). However, some volunteers classified as "excessive alcohol consumers" had negative PEth results. In the group of volunteers classified as "moderate drinkers" (AUDIT-C score: 1-3 (women) and 1-4 (men)), 95% of the test persons had PEth 16:0/18:1 ranging from not detected to 112ng/mL, and PEth 16:0/18:2 ranging from not detected to 67.0ng/mL. Combination of self-reported alcohol consumption and AUDIT-C score showed that negative PEth results match with abstinence or light drinking. Moderate alcohol consumption resulted in PEth 16:0/18:1 from 0 to 112ng/mL and for PEth 16:0/18:2 ranged from 0 to 67.0ng/mL. Higher PEth concentrations indicated excessive alcohol consumption. [ABSTRACT FROM AUTHOR]

Background: Previous studies have revealed inconsistent findings regarding the association of light to moderate alcohol consumption with cardiovascular disease (CVD) and cancer mortality.Objectives: The aim of this study was to examine the association between alcohol consumption and risk of mortality from all causes, cancer, and CVD in U.S. adults.Methods: Data were obtained by linking 13 waves of the National Health Interview Surveys (1997 to 2009) to the National Death Index records through December 31, 2011. A total of 333,247 participants ≥18 years of age were included. Self-reported alcohol consumption patterns were categorized into 6 groups: lifetime abstainers; lifetime infrequent drinkers; former drinkers; and current light, moderate, or heavy drinkers. Secondary exposure included participants' binge-drinking status. The main outcome was all-cause, cancer, or CVD mortality.Results: After a median follow-up of 8.2 years (2.7 million person-years), 34,754 participants died of all causes (including 8,947 CVD deaths and 8,427 cancer deaths). Compared with lifetime abstainers, those who were light or moderate alcohol consumers were at a reduced risk of mortality for all causes (light-hazard ratio [HR]: 0.79; 95% confidence interval [CI]: 0.76 to 0.82; moderate-HR: 0.78; 95% CI: 0.74 to 0.82) and CVD (light-HR: 0.74; 95% CI: 0.69 to 0.80; moderate-HR: 0.71; 95% CI: 0.64 to 0.78), respectively. In contrast, there was a significantly increased risk of mortality for all causes (HR: 1.11; 95% CI: 1.04 to 1.19) and cancer (HR: 1.27; 95% CI: 1.13 to 1.42) in adults with heavy alcohol consumption. Binge drinking ≥1 d/week was also associated with an increased risk of mortality for all causes (HR: 1.13; 95% CI: 1.04 to 1.23) and cancer (HR: 1.22; 95% CI: 1.05 to 1.41).Conclusions: Light and moderate alcohol intake might have a protective effect on all-cause and CVD-specific mortality in U.S. adults. Heavy or binge drinking was associated with increased risk of all-cause and cancer-specific mortality. [ABSTRACT FROM AUTHOR]