Do lipids contribute to the lack of cardio-protective effect of binge drinking: alcohol consumption and lipids in three eastern European countries.

AIMS: The cardio-protective effect of moderate alcohol consumption is partly mediated by HDL cholesterol. However, epidemiological studies suggest that binge drinking may not be associated with reduced risk of heart disease; a possible explanation is that the relationship of blood lipids with binge drinking is different from that with moderate intake. We investigated this hypothesis in a population study in three eastern European countries. METHODS: We conducted a cross-sectional study in random population samples in Novosibirsk (Russia), Krakow (Poland) and Karvina (Czech Republic). A sub-sample of 282 men aged 45-64 years who provided a fasting blood sample were analysed. Annual alcohol intake and the frequency of heavy binge drinking (> or =140 g of ethanol per session) were estimated from a graduated frequency questionnaire. RESULTS: Annual intake of alcohol was positively associated with total and HDL cholesterol. After controlling for annual intake, the frequency of heavy binge drinking was associated with increased concentrations of total and HDL cholesterol. By combining annual intake and drinking pattern, we found that men consuming >8 l of alcohol per year who had a heavy binge at least once a month had the mean total, HDL and LDL cholesterol 1.69 (SE 0.35), 0.61 (0.11) and 0.97 (0.34) mmol/l, respectively, higher than non-drinkers; this resulted in more favourable ratios of total and LDL cholesterol relative to HDL cholesterol in frequent heavy bingers. Triglycerides were not related to alcohol intake or binge drinking. CONCLUSIONS: Blood lipids do not seem to explain the apparent lack of the cardio-protective effect of binge drinking reported in epidemiological studies.

Trends in alcohol intake by education and marital status in urban population in Russia between the mid 1980s and the mid 1990s.

AIMS: We investigated changes in the distribution of alcohol consumption by education and marital status in Russia during the period of societal transformation after 1990. Such changes would indicate the potential role of alcohol in the rising social inequalities in mortality. METHODS: We analysed data from three surveys in random population samples conducted in Novosibirsk as part of the WHO MONICA project in 1985/86 (1533 men, 1292 women), 1988/89 (1700 men, no women) and 1994/95 (1526 men, 1510 women), coinciding with the period of societal transformation. Four measures of drinking were examined in relation to education and marital status: prevalence of drinking at least twice a week; the mean intake in the last week; the mean intake per drinking occasion; and the prevalence of binge drinking (>80 g ethanol for men and >60 g for women) at least once a month. RESULTS: Among men, those with university education had the lowest levels of all measures of drinking. Drinking indices increased over time in all educational groups but most sharply in men with high education, thus leading to a smaller education-related difference in the last survey. With respect to marital status, divorced and widowed men tended to drink most, but the pattern was inconsistent, and the difference between divorced and married men also narrowed over time. Among women, alcohol intake increased between the first and last survey. Differences by education and marital status in women were smaller than in men, and binge drinking was inversely related to education. CONCLUSIONS: All indices of alcohol consumption in men increased between the mid 1980s and the mid 1990s. The increase in alcohol intake among men was proportionally similar across categories of education and marital status but the absolute differences increased. The contribution of alcohol to the increase in social differentials in mortality in the 1990s was probably modest.

Relation between heavy and binge drinking and all-cause and cardiovascular mortality in Novosibirsk, Russia: a prospective cohort study.

BACKGROUND: Moderate alcohol consumption is associated with reduced cardiovascular mortality, but binge drinking is thought to be detrimental. We examined effects of heavy and binge drinking in a population with high rates of binge drinking. METHODS: We did a prospective cohort study in Novosibirsk, Russia, in 6502 men aged 25-64 years at baseline who were examined in WHO MONICA (monitoring trends and determinants in cardiovascular disease surveys) in 1985/86, 1988/89, and 1994/95, and in a pilot study in 1984. We assessed alcohol intake and drinking pattern by questionnaire; binge drinking was defined as consumption of 160 g or greater of pure alcohol on a typical occasion. Participants were followed-up for a median of 9.5 years (range 3.1-15.2). FINDINGS: There were 836 deaths in the cohort, 395 of which resulted from cardiovascular diseases. Prevalence of binge drinking at baseline was 16% (n=1005). Adjusted relative risks for binge drinking at least once a month (compared with consumption of <80 g pure alcohol) were 1.05 (95% CI 0.80-1.36) for deaths from all causes, 0.99 (0.66-1.50) for deaths from cardiovascular disease, 1.27 (0.81-1.99) for deaths from coronary heart disease, and 2.08 (1.08-3.99) for death from external causes. Risk of total and cardiovascular mortality was raised in a small group of frequent heavy drinkers (5% [264] of all drinkers); for this group, adjusted relative risks were 1.61 (1.04-2.50) for total mortality and 2.05 (1.09-3.86) for deaths from cardiovascular disease. INTERPRETATION: The risk of death from cardiovascular disease seems to be increased in frequent heavy drinkers, but is not necessarily associated with episodic binge drinking.