When pubs, bars and restaurants in England removed their largest size of wine sold by the glass, consumers drank less alcohol
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Alcohol consumption is the fifth largest contributor to premature death and disease globally. Many cues in physical and economic environments influence alcohol consumption across populations. One proposed intervention to excessive alcohol consumption is reducing the size of servings of alcoholic drinks sold by the glass, but there has been no real-world evidence for the effectiveness of this.
In the new study, researchers asked 21 licensed premises in England to remove from their menus their largest serving of wine by the glass – usually 250mL – for four weeks. The researchers then tracked the total volume of wine, beer and cider sold by each establishment.
Over the course of the four weeks, the total volume of wine sold by the licensed premises decreased by 7.6%, and there was no overall increase in beer and cider sales. There was an increase in the sales of smaller servings of wine by the glass – generally 125mL and 175mL – but no impact on sales of wine by the bottle or beer or cider sales.
“This suggests that this is a promising intervention for decreasing alcohol consumption across populations, which merits consideration as part of alcohol licensing regulations,” the authors say.
Marteau adds, “Removing the largest serving size of wine by the glass in 21 licensed premises reduced the volume of wine sold, in keeping with the wealth of research showing smaller serving sizes reduce how much we eat. This could become a novel intervention to improve population health by reducing how much we drink.”
Although past research has indicated that moderate alcohol consumption can reduce cardiovascular disease (CVD) risk, more recent studies suggest that moderate levels of drinking may be hazardous to heart health. A new analysis now sheds new insight on this complex relationship between alcohol consumption and the progression of CVD, showing that a few particular alcohol metabolites strongly influence its protective effects.
Published in the journal BMC Medicine, the study observed a total of 60 alcohol consumption-related metabolites, identifying seven circulating metabolites that link long-term moderate alcohol consumption with an increased risk of CVD, and three circulating metabolites that link this same drinking pattern with a lower risk of CVD.
The findings from the study led by Boston University School of Public Health and Friedman School of Nutrition Science and Policy at Tufts University (Friedman School) detail the molecular pathway of long-term alcohol consumption and show that further research on these metabolites is needed for targeted prevention and treatment of alcohol-related CVD.
“The study findings demonstrate that alcohol consumption may trigger changes of our metabolomic profiles, potentially yielding both beneficial and harmful outcomes,” says Dr Chunyu Liu, assistant professor of biostatistics at BUSPH and co-corresponding/co-senior author of the study along with Dr.Jiantao Ma, assistant professor in the Division of Nutrition Epidemiology and Data Science at the Friedman School.
“However, rather than definitively settling that debate, this study underscores the intricate effects of alcohol consumption on cardiovascular health and generates a useful hypothesis for future investigations,” Dr Liu says.
The researchers analysed blood samples to measure the association between the cumulative average consumption of beer, wine, and liquor and 211 metabolites among Framingham Heart Study Offspring Study participants, who are the children of participants in the long-running Boston University-based Framingham Heart Study, over 20 years.
Of the 2428 participants, 636 developed CVD over the study period. Among the 60 drinking-related metabolites, 13 metabolites had a stronger association with alcohol consumption in women than in men, perhaps due to higher blood alcohol levels from women’s generally smaller body size versus the same amount of alcohol.
Consuming different types of alcohol was also linked to different metabolomic responses, with beer consumption generating a slightly weaker association overall than wine and liquor.
In roughly two-thirds of the 60 metabolites, higher plasma levels were detected in participants who consumed greater amounts of alcohol. Branched-chain amino acids (BCAAs), were among the metabolites not associated with alcohol consumption.
The researchers then calculated two alcohol consumption-associated metabolite scores, which had opposite associations with the development of CVD.
“While our study presents intriguing findings, validation through state-of-the-art methods and large and diverse study populations is crucial,” Dr Ma says.
“To enhance reliability, we aim to conduct larger-scale research involving a more diverse racial and ethnic background, as the current study participants are all white. In addition, we will expand our study to integrate with other molecular markers such as genetic information to illustrate the complex relationships between alcohol consumption, metabolite features, and cardiovascular risk.”
A single glass of wine can rapidly increase the risk of atrial fibrillation, according to new research published in Annals of Internal Medicine.
The study provides the first evidence that alcohol consumption significantly increases the chance of the heart rhythm condition occurring within a few hours, and is contrary to the notion of a cardioprotective effect of alcohol.
“Contrary to a common belief that atrial fibrillation is associated with heavy alcohol consumption, it appears that even one alcohol drink may be enough to increase the risk,” said Gregory Marcus, MD, MAS, professor of medicine in the Division of Cardiology at UCSF.
“Our results show that the occurrence of atrial fibrillation might be neither random nor unpredictable,” he said. “Instead, there may be identifiable and modifiable ways of preventing an acute heart arrhythmia episode.”
Atrial fibrillation (AF) is the most common heart arrhythmia seen clinically, but until now research has largely focused on risk factors and treatments for the disease, rather than what can trigger episodes. Large studies have established that chronic alcohol consumption can be a predictor for AF, and Marcus and other scientists have demonstrated that it is linked to increased risk for a first diagnosis of atrial arrhythmias.
The research centered on 100 patients with documented AF who consumed at least one alcoholic drink a month, but without substance use disorders, certain allergies, or changing medications.
Each participant wore an electrocardiogram (ECG) monitor for roughly four weeks, pressing a button whenever they had a standard-size alcoholic drink. They were also all fitted with a continuously recording alcohol sensor. Blood tests reflecting alcohol consumption over the previous weeks were periodically administered. Participants consumed a median of one drink per day throughout the study period.
Researchers found that an AF episode was associated with two-fold higher odds with one alcoholic drink, and three-fold higher odds with two or more drinks within the preceding four hours. Increased blood alcohol concentration was also associated with AF episodes.
Study limitations included patients possibly forgetting to press their monitor buttons or minimising the number of button presses due to embarrassment, although these considerations would not have affected alcohol sensor readings. The study was also limited to those with established AF, not to the general population.
“The effects seem to be fairly linear: the more alcohol consumed, the higher the risk of an acute AF event,” said Prof Marcus. “These observations mirror what has been reported by patients for decades, but this is the first objective, measurable evidence that a modifiable exposure may acutely influence the chance that an AF episode will occur.”
A study from the UK has shown that people who drink up to 14 units of alcohol a week have a reduced risk of developing cataracts, with red wine having an even more pronounced effect.
Drinking less than 14 units of alcohol (or about six pints of beer, or six glasses of wine) is in line with the British Chief Medical Officer’s low risk drinking guidelines.
Cataracts are a major cause of impaired eyesight and blindness, mainly in older people. Cataract removal is simple, and is the most common surgery carried out by the UK’s National Health Service. The NHS considers drinking to be a risk factor for cataracts.
Researchers from Moorfields eye hospital in London and University College London’s institute of ophthalmology studied the medical and lifestyle history of nearly half a million participants in either the UK Biobank or Epic-Norfolk longitudinal health studies.
The results showed that people who drank within the 14 units a week guideline were less likely to have cataract surgery. Wine drinkers were even less likely to have it, compared to those who consumed beer or spirits. In the Epic-Norfolk study, drinking wine at least five times a week meant a 23% reduced chance of cataract removal than non-drinkers, while those in the UK Biobank study were 14% less likely.
“Cataract development may be due to gradual damage from oxidative stress during ageing. The fact that our findings were particularly evident in wine drinkers may suggest a protective role of polyphenol antioxidants, which are especially abundant in red wine,” said first author Dr Sharon Chua.
Research leader Dr Anthony Khawaja added: “We observed a dose-response with our findings – in other words, there was evidence for reducing chance of requiring future cataract surgery with progressively higher alcohol intake, but only up to moderate levels within current guidelines.”
The authors emphasised that there was still not a causal link between alcohol consumption and reduced cataract surgeries despite the association.
Dr Sadie Boniface, research head at the Institute of Alcohol Studies thinktank, cast doubt on the findings. She said that longitudinal studies such as UK Biobank may not accurately represent health across the nation because many volunteers were often in good health.
“Comparing the health of moderate drinkers with that of non-drinkers also carries problems. Non-drinkers are a diverse group, including people who have stopped drinking because of health problems. This means moderate drinking can artificially look like it carries health benefits, because the moderate drinkers are compared to people on average in poor health,” said Dr Boniface.
“The bigger effect seen among wine drinkers may be because of other characteristics of this group to do with their cataract risk which weren’t accounted for. If the amount of alcohol or number of units somebody drinks was having a direct effect, you’d expect this to be similar regardless of drink type.”
