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Chinese tea consumption and lower risk of Helicobacter infection.

BACKGROUND: Our first study had shown that Chinese tea has anti-Helicobacter activity. The present study investigated the relationship between patients'Helicobacter status and the history of Chinese tea consumption. METHODS: Chinese patients who had their first upper endoscopy were recruited. Before the procedure, patients completed questionnaires about their current Chinese tea consumption habits and those when they were around 10-25 years old. This information was used to calculate the tea consumption indices (TCI). Gastric biopsies (two from the antrum and two from the corpus) were taken for histological examination for Helicobacter. RESULTS: Eighty patients were recruited. Eight patients were rejected because of either an incomplete questionnaire, absence of gastric biopsy or a suspected history of treatment for Helicobacter infection. Of the 72 patients, 42 (58.3%) were Helicobacter positive. The age, sex ratio and indications for endoscopy were similar in both Helicobacter-positive and -negative groups. Classifying patients using either current, past or total TCI, patients with high tea consumption had significantly lower Helicobacter infection rate than those with low tea consumption (45% compared to 74%, 42% compared to 67% and 40% compared to 83%, respectively). Helicobacter-negative patients had higher overall TCI than Helicobacter-positive patients (28.2:17.3). When current and previous histories were analyzed separately, Helicobacter-negative patients also had a trend towards higher TCI currently (16.6:11.0) and in their 20s (11.6:6.1). CONCLUSIONS: There is a significant inverse relationship between Chinese tea consumption and Helicobacter infection. Chinese tea consumption may decrease the chance of Helicobacter infection.

Adult↗

Prevalence of antibiotic resistance of Helicobacter pylori isolates in Estonia during 1995-2000 in comparison to the consumption of antibiotics used in treatment regimens.

OBJECTIVE: To find a possible relation between the dynamics of antibiotic resistance of Helicobacter pylori isolates and the consumption of antibiotics during the last several years in Estonia. METHODS: Helicobacter pylori isolates were collected from the gastric mucosa of patients with peptic ulcer (153) and gastritis (68) and isolated on the Columbia Agar Base. From 1995 to 1997 the disk-diffusion method was used for testing of H. pylori susceptibility to metronidazole (115 isolates), erythromycin (119 isolates), tetracycline (119 isolates) and amoxicillin (119 isolates). From 1998 to 2000 the susceptibility of H. pylori to metronidazole (106 isolates), amoxicillin (30 isolates), clarithromycin (106 isolates) and ciprofloxacin (30 isolates) was assessed by E tests. Data from the Estonian State Agency of Medicines were used to determine the antibiotic consumption rate. RESULTS: Up to the year 2000 all the investigated H. pylori isolates were susceptible to ciprofloxacin; the resistance to clarithromycin, tetracycline, amoxicillin and erythromycin was 3%, 1.7%, 0.7% and 2.5%, respectively. Forty-six percent of H. pylori isolates were resistant to metronidazole. During 1995-2000 the consumption of amoxicillin, erythromycin and ciprofloxacin increased and the consumption of tetracycline decreased. The increasing consumption of amoxicillin reached a level 5.7 times than that of the consistent use of metronidazole. The resistance to amoxicillin appeared to be very low and resistance to metronidazole was continuously high. The increase of clarithromycin consumption (from 0.002 to 1.119 defined daily doses/1000) during three years was associated with the appearance of the first clarithromycin-resistant isolates in 2000. CONCLUSION: No relation was observed between the antibiotic consumption rate and the resistance pattern of H. pylori to metronidazole, amoxicillin, erythromycin, tetracycline and ciprofloxacin during recent years among the in population.

Adult↗

Plasma and lipoprotein levels of tea catechins following repeated tea consumption.

Epidemiological studies suggest that antioxidant flavonoids in tea may reduce the risk of cardiovascular disease, possibly via protection of low-density lipoproteins (LDL) against oxidation. However, the extent of absorption of tea flavonoids and their accumulation in LDL during regular consumption of tea is not clear. Therefore we investigated plasma and lipoprotein levels of catechins during tea consumption and the impact on LDL oxidizability ex vivo. Eighteen healthy adults consumed, in an incomplete balanced cross-over design, green tea, black tea, black tea with milk or water, one cup every 2 hr (eight cups/day) for three days. Blood samples were obtained in the mornings and evenings of each day. Plasma total catechin concentration was determined in all blood samples, and the distribution of catechins among lipoproteins was determined at the end of the third day (t = 60 hr). The resistance of LDL to copper-induced oxidation ex vivo was assessed before tea consumption and at t = 60 hr. Repeated tea consumption during the day rapidly increased plasma total catechin levels whereas they declined overnight when no tea was consumed. There was a gradual increase in plasma levels in the mornings (respectively, 0.08 microM vs. 0.20 microM on first and last day of black tea consumption) and evenings (respectively, 0.29 microM vs. 0.34 microM on first and last day of black tea consumption). Green tea catechins were mainly found in the protein-rich fraction of plasma (60%) and in high-density lipoproteins (23%). Although present in LDL, the concentration of catechins in LDL was not sufficient to enhance the resistance of LDL to oxidation ex vivo. Addition of milk to black tea did not affect any of the parameters measured. In conclusion, the present study shows that catechin levels in blood rapidly increase upon repeated tea consumption. The accumulation of catechins in LDL particles is not sufficient to improve the intrinsic resistance of LDL to oxidation ex vivo.

Adolescent↗

[Cannabis consumption and its psychosocial effects in a comparison of different cultures].

Cannabis consumption is a social and cultural phenomenon. It has a specific place in each society, therefore psychotropic effects are judged differently. In medieval Islam cannabis consumption showed connections with religious and mystic events and was basically formed through consuming sufis. The main risk of cannabis use was especially the induction of "madness" or psychotic states in case of high dosage and high frequency of consumption. Nevertheless there were no social sanctions. Today in western civilized countries cannabis consumption is connected with relaxed activity and is mainly consumed by adolescents. The main risk is seen in the ongoing consumption of illicit drugs, since cannabis consumption is widely held as the first step for such a career. On the other hand the induction of psychotic states or a schizophrenia-like psychosis is rarely named in public discussions. At all times self-reports of cannabis-users named creative aspects of cannabis-consumption, normally seen in the conscious translation into normal reality of astonishing and formerly unknown experiences made in an intoxicated state. This aspect of cannabis use is widely disregarded in scientific research. Various reasons therefore are discussed.

Cross-Cultural Comparison↗

[Health Risk drinking and problematic consumption of alcohol in Pomerania: comparative analysis of the Study of Health in Pomerania (SHIP) compared with the Federal German Health and Examination Survey in 1998].

PURPOSE: Epidemiological studies show a "North-South" gradient in drinking patterns in Germany, with the South-Eastern regions consuming more alcohol. Hence, patterns of alcohol consumption as well as at-risk drinking were evaluated in West Pomerania using a representative sample. In addition, the average daily quantities and the proportions of at-risk drinking were compared with representative data for Germany (Federal German Health and Examination Survey 1998 [FGHES]). METHODS: A representative random sample of the Pomeranian population (4,310 persons) was analysed. The response rate was 68.8 %. The amount and frequency of alcohol consumption was surveyed with a standardized questionnaire. Prevalence rates for at- risk drinking (> or = 30 g ethanol per day for men, > or = 20 g ethanol per day for woman), indications of abuse / dependence, and episodes of heavy drinking (number of days with 5 and more drinks consumed per day) are presented. To identify socio-economic correlates of high-risk drinking multiple logistic regression modelling was used. Alcohol consumption was evaluated via a frequency-quantity-measure and by using the "Luebeck Alcohol Dependence and Abuse Screening Test" (LAST). RESULTS: Average daily consumption of pure alcohol was about 11.8 g per day, 18.5 g per day for men and 5.8 g per day for women. The consumed quantities exceeded the levels calculated with the FGHES about 1.5 g, 1.8 g for men and 1.2 g for women. Prevalence of risk drinking and harmful alcohol use in Pomerania is higher than the FGHES as well. At-risk drinking was especially associated with age. In women, belonging to a higher social class at-risk drinking was higher, whereas in men of the lower social class consumption rates were higher. The highest alcohol consumption was observed among middle-aged men and women. CONCLUSIONS: The results suggest that alcohol consumption on a high level as well as high-risk drinking is a common phenomenon in the north-eastern part of Germany. Public health measures are indicated for this region. Such intervention projects should focus on population groups with higher alcohol intake.

Adult↗

Are survey measures of medical care utilisation misleading? A comparison of self-reported medical care consumption with actual medical care utilisation.

A substantial over-estimate of medical care consumption cost was found when estimates from self-report data from an epidemiological study were compared to actual cost data extracted from administrative records. Even though the few subjects who were actually provided with two or more services in the two-week self-report period substantially under-reported their medical care consumption, a large net over-estimate of medical care consumption was produced by the self-report data. This finding has important implications for use of self-report data from surveys such as the Australian Bureau of Statistics (ABS) National Health Survey for estimating health service consumption. By combining epidemiological survey data from the Australian Vietnam Veterans Health Study (AVVHS), with data on actual medical care for which the Health Insurance Commission (HIC) or the Department of Veterans' Affairs (DVA) paid benefits, we were able to directly compare self-reported medical care consumption with actual medical care utilisation. The comparison revealed that veterans' self-reports were a valid measure of relative medical care consumption because those who reported care over the past two weeks were much more likely to have been recent consumers than those who did not. This relationship became even stronger if the comparison of self-report was extended to data on benefits paid beyond the two-week self-report period. However, the HIC and DVA data confirmed only 51% of veterans self-reporting medical care consumption during the past two weeks actually received a service.

Health Care Surveys↗

Family food purchases and home food consumption: comparison of nutrient contents.

Estimates of nutrient intakes based on food purchasing records modelled on the National Food Survey (NFS) were compared with nutrient intakes calculated from food consumption records based on a semi-weighted method, a combination of weighing and household measurement techniques. Of eighty-two families in Cambridge who completed the study, thirty-two were volunteers and fifty were from a random sample in which the co-operation rate was 73%. The estimated energy and nutrient contents of the Cambridge food purchases were very similar to those reported by the NFS for families of similar composition and income. The energy intakes obtained by the semi-weighed method were compared with results from twenty-five studies of energy intake based on quantitative measurements of food consumption: there was no evidence to suggest that the semi-weighed method consistently under- or overestimated intakes in the Cambridge subjects. Purchases adjusted to allow for waste and consumption of food by visitors contained significantly more energy, protein, carbohydrate, calcium, iron and dietary fibre than measured home food consumption. There was no significant difference in the nutrient content of purchases and consumption per 4.184 MJ (1000 kcal), with the exception of Fe and ascorbic acid. Measured wastage of edible food in thirty-one families averaged 3.2% of purchases. Estimate of wastage in all eighty-two families was 3.8%, and consumption of food by visitors accounted for 3.0% of purchases. The excess of purchases over measured home food energy intake is probably accounted for by a net increase in larder stocks rather than wastage, consumption of food by visitors, or under-recording of intakes.

Adolescent↗

Concurrent validity of alcohol consumption measurement in a 'healthy' population; quantity-frequency questionnaire v. dietary history interview.

Self-reports of alcohol consumption account for approximately 50 % of the reported sales of alcohol. In the absence of a gold standard, it is not known how accurately different methods of measurement reflect actual consumption and whether under-reporting varies among different populations. The objective of the present study was to compare the consumption reported by the widely used quantity-frequency questionnaire (QFQ) with that reported in a cross-check dietary history interview (DHI), which has higher face validity. In 171 male and 197 female subjects of the Amsterdam Growth and Health Longitudinal Study (mean age 36 years), alcohol consumption was assessed by both the QFQ and the DHI. Most subjects reported a moderate consumption of alcohol by both measures. Spearman correlation coefficients were high (0.77 and 0.87 in men and women respectively). Overall, greater alcohol consumption was reported using the DHI. The difference between the DHI and QFQ reports was usually greater for wine than for beer. Backward stepwise regression analysis showed that the difference in reporting was positively related to a more irregular drinking pattern, and in wine drinkers to the square of the QFQ report. Sex, drinking alone or with others and the CAGE (acronym for four questions on drinking behaviour) score were not related to the difference in reporting. The precision of DHI estimation from QFQ reports and other factors was low. Serious questions arise as to the validity and precision of alcohol consumption measurements based on the QFQ alone. QFQ information may be improved by incorporating questions on the type of beverage and drinking patterns.

Adult↗

The consumption of rye bread and white bread as dimensions of health lifestyles in Finland.

OBJECTIVE: The aim of this research was to describe the variation in bread consumption within social classes and to link this consumption to health-related lifestyles in Finland from 1978 until 1998. DESIGN: A cross-sectional survey on health-related behaviour and socio-demographic factors has been conducted annually since 1978. SETTING: Mailed questionnaire. SUBJECTS: A random sample of 5000 Finns aged 15-64 years has been drawn annually. The response rate has varied from 84% to 68%. RESULTS: The consumption of rye bread decreased, but among the female population a slight increase appeared in the 1990s. The consumption of rye bread was associated with a low educational level and a rural place of residence. White bread was consumed less than was rye bread. White bread was consumed more frequently by the less educated in urban areas. Contrary to white bread, the consumption of rye bread was not associated with smoking, exercise or alcohol consumption. CONCLUSIONS: The traditional place of rye bread in the Finnish dietary pattern has remained rather constant. White bread consumption has been associated with an unhealthy lifestyle. As a result, those Finns who are concerned about their health avoid white bread but seem not to associate rye bread with a healthier lifestyle. In Finland, rye bread has a different image to the image of whole-grain or dark brown bread in many other western European countries.

Adolescent↗

Consumption of foods by young children with diagnosed campylobacter infection - a pilot case-control study.

OBJECTIVE: To determine whether parentally reported habitual intake of specific foods differed between children with diagnosed Campylobacter jejuni infection and children of a comparison group without diagnosed infection. DESIGN, SETTING AND SUBJECTS: Information was collected from the parents or primary caregivers of South Australian children aged 1-5 years with diagnosed C. jejuni (cases, n=172) and an age- and gender-matched group of uninfected children (controls, n=173). Frequency of consumption of 106 food and drink items was determined for the preceding two months by food-frequency questionnaire. Four children in the control group had recorded diarrhoeal episodes during the assessment period and were excluded, so 169 responses were evaluated for this group. Information was gathered on possible confounders including socio-economic status. Response frequencies were classified into three levels of consumption (rarely, weekly or daily) and statistical comparison was made by frequency of consumption of foods versus the 'rarely' classification for cases and controls, respectively. RESULTS: Frequency of consumption of most foods, including starchy foods and fruits and vegetables, did not differ between cases and controls. However, reported consumption of eight food items (block and processed cheese (slices and spread), salami/fritz (a form of processed sausage), chicken nuggets, pasteurised milk, fish (canned or fresh) and hot French fries) was significantly higher by controls. CONCLUSIONS: The hypothesis that reported consumption of starchy foods was lower by cases than by controls was not supported by the data. However, consumption of some processed and unprocessed foods was higher by controls. Some of these foods have established bactericidal actions in vitro that may indicate a possible mechanism for this apparent protection.

Campylobacter Infections↗

Demographic, familial and trait predictors of fruit and vegetable consumption by pre-school children.

OBJECTIVE: To examine the contribution to fruit and vegetable eating in children of potential predictive variables within the domains of demographics, parental feeding practices and personality traits. DESIGN: Cross-sectional survey. SETTING: Questionnaires were distributed to parents through 22 London nursery schools. SUBJECTS: Questionnaires were completed and returned by 564 parents or principal caregivers of 2-6-year-old children. RESULTS: Significant predictors of children's fruit and vegetable intake emerged from all three domains examined. Demographic variables associated with child's vegetable consumption were mother's education and child's age and gender. Only ethnicity was significantly associated with fruit consumption. Parental consumption, breast-feeding and early introduction to fruit and vegetables were related to intake of both. Family meal times were associated with higher intake of vegetables, but not of fruit. Two characteristics of children themselves (food neophobia and enjoyment of food) were strongly related to the consumption of fruit and vegetables. Subsequent multivariate analyses revealed that parental intake and child food neophobia independently predicted intake of both foods. In the presence of these, fruit consumption was affected by breast-feeding and early introduction to fruit, whereas vegetable consumption was related only to child's gender and enjoyment of food. CONCLUSIONS: These findings may be used to inform future interventions aimed at increasing children's consumption of fruit and vegetables. Parents should be made aware of the possible impact of their own behaviour on the eating habits of their children.

Age Distribution↗

Food consumption patterns in an adult urban population in Beirut, Lebanon.

OBJECTIVES: To investigate, measure and assess the food consumption pattern of the adult population living in Beirut, Lebanon, and to identify inadequate or excessive intake of food groups particularly linked to non-communicable diseases. DESIGN: A cross-sectional food consumption survey was conducted in 2001. Dietary habits were assessed by means of a quantitative food-frequency questionnaire. SETTING: Dietary survey of the urban population (Beirut). SUBJECTS: Random sample of 444 adult subjects (aged 25-54 years) in Beirut. RESULTS: The mean consumption of food by the study population was estimated to be 3,030 g day(-1), providing an energy intake of 2,523.57 kcal day(-1). Fat contributed 38.9% to the average daily energy intake, protein 13.4% and carbohydrates 47.2%. Mean consumption of fruits and vegetables was approximately 367 g day(-1) and 45.3% of subjects consumed less than the recommended 400 g daily. Cereals contributed 324.5 g day(-1), providing 35.0% of daily energy intake, with bread being the most highly consumed (146.2 g day(-1)) in this food group. The mean intake of meat and poultry products was 91.7 g day(-1) and provided 8.8% of daily energy intake, with consumption of butchery products especially beef being the highest (47.6 g day(-1)) followed by poultry (36.1 g day(-1)). A low consumption of fish was noted (19.7 g day(-1)), with 73.6% of subjects consuming less than the recommended 2 servings of fish per week. Dairy products contributed 243.1 g day(-1) or 10.9% of daily energy intake, and milk was the least consumed dairy product (56.8% of consumers). The intake of added fats and oils, excluding those in cooked recipes, was 20.4 g day(-1); olive oil was not used in cooking but was added solely at the table and its mean intake was 5 g day(-1). The consumption of butter was low (0.86 g day(-1)) and vegetable oil was the type of fat mostly used in cooking. The average intake of alcoholic beverages was low (33.6 g day(-1)), accounting for 0.7% of total energy intake. Women had significantly higher intakes of milk, dairy products, vegetables and coffee than men (P < 0.05). The percentage of women who reported the use of low-fat items was significantly higher than that of men. Younger people (25-34 years) ate significantly more meat, sugar, alcoholic beverages and soft drinks, and consumed significantly less cooked vegetables and legumes, than older ones (P < 0.05). CONCLUSIONS: The rather high contribution of fat to daily energy intake, the low intake of fish and the relatively high percentage of people consuming less than the recommended amount of fruits and vegetables observed in this study suggest that the adult Lebanese population is at increased risk of cardiovascular diseases, obesity and other non-communicable diseases, which provides the basis for recommending increased intakes of fish, particularly fatty fish, and fruits and vegetables.

Adult↗

Antibiotic consumption, bacterial resistance and their correlation in a Swiss university hospital and its adult intensive care units.

Ecological surveys of high-antibiotic use areas in the hospital should be used to evaluate patterns and trends in order to optimise antibiotic consumption and minimise resistance. We conducted a retrospective cohort study with the aim to examine trends in antimicrobial consumption and bacterial susceptibility at the Geneva University Hospital and its adult ICUs between 1996 and 2000. The average annual consumption of antimicrobials was 400 d-defined doses (DDD)/1000 patient-d in the entire hospital, 462 in the surgical ICU and 683 in the medical ICU. In the medical ICU, we observed a steady decrease of intravenous antimicrobial use, whereas a 25% increase in the total antimicrobial consumption was noted in 1999 and 2000 for the entire hospital. The proportion of different bacterial species, resistance rates and antibiotic consumption rates differed between the entire hospital and the ICUs, with moderate variation between y. Possible relationships between antibiotic consumption and resistance rates, expressed as DDD and as number of resistant isolates per 1000 patient-d respectively, were calculated for of the most frequently isolated bacteria (total 71 correlations). Statistically significant positive correlations between antibiotic consumption and resistance were found in Escherichia coli for piperacillin, in Pseudomonas aeruginosa for piperacillin, cephalosporins and aminoglycosides, in Klebsiella spp. for cephalosporin, in coagulase-negative staphylococci for gentamicin and in Streptococcus pneumoniae for penicillin.

Anti-Bacterial Agents↗

Tea consumption and risk of cancer of the colon and rectum.

The association between tea consumption and risk of colon and rectal cancers was investigated in a population-based case-control study conducted in Iowa (United States). Colon (n = 685) and rectal (n = 655) cancer cases age 40-85 yr were identified through the Iowa Surveillance, Epidemiology, and End Results (SEER) Cancer Registry (86% response rate); controls (n = 2,434) were frequency matched by sex and 5-yr age group (80% response rate). The usual adult consumption of tea (hot and iced), along with other information including dietary data, was self-reported using a mailed questionnaire. Total tea consumption (cups/day) was categorized as none (reference category), low (< 3.1), medium (3.1-5.0), and high (> 5.0), with cut points for tea consumers based on the 75th and 90th percentiles of use among controls. Unconditional logistic regression was used to estimate the odds ratios (ORs) and 95% confidence intervals. There was no association between total tea consumption and colon cancer (ORs = 1.0, 1.1, 1.3, and 0.7) or rectal cancer (ORs = 1.0, 0.9, 1.4, and 1.0) after adjustment for age, sex, education, physical activity, smoking history, and intake of coffee, fiber, and fruits and vegetables. Results were similar when hot tea and iced tea were evaluated individually. Further adjustment for other colorectal cancer risk factors did not alter these results. There was no association with proximal or distal colon cancer. There was also no interaction between tea consumption and any of the dietary variables or total fluid on risk of colon or rectal cancer, with the exception of a suggestive positive association between an increasing frequency of tea consumption and colon cancer risk among current smokers (multivariate ORs = 1.0, 1.4, 2.0, and 1.8; P for trend = 0.1), but not among never smokers (multivariate ORs = 1.0, 1.0, 1.1, and 0.4; P for trend = 0.3). These data do not support an overall association, either positive or negative, between tea consumption and risk of colon or rectal cancer in this Mid-western US population.

Adult↗

UK consumption databases relevant to acute exposure assessment.

Consumption data can be expressed in different ways although it should be comparable to what is known about the toxicological property of the chemical in question and the likely pattern of consumer exposure. For example if the chemical has an acute toxic effect the consumption data should ideally be based on a single eating occasion or consumption over a single day and be based on the population of concern. This paper describes five UK dietary surveys and consumption data, specifically relevant to acute exposure assessment, from adult and pre-schoolchildren surveys. The acute consumption data are taken from the first day of the dietary regime. Closer examination of the dietary survey information suggests that either picking a random survey day or selecting all consuming days give 97.5 percentile values which are not significantly different. Consumption data are given for whole commodities and a few fruit juices. Examination of the dietary survey information shows that the consumption patterns are very different between whole commodities (e.g. apples), ingredients (e.g. apple in a dish or recipe) and juices and between adults and young children.

Adolescent↗

Brain aging and midlife tofu consumption.

OBJECTIVE: To examine associations of midlife tofu consumption with brain function and structural changes in late life. METHODS: The design utilized surviving participants of a longitudinal study established in 1965 for research on heart disease, stroke, and cancer. Information on consumption of selected foods was available from standardized interviews conducted 1965-1967 and 1971-1974. A 4-level composite intake index defined "low-low" consumption as fewer than two servings of tofu per week in 1965 and no tofu in the prior week in 1971. Men who reported two or more servings per week at both interviews were defined as "high-high" consumers. Intermediate or less consistent "low" and "high" consumption levels were also defined. Cognitive functioning was tested at the 1991-1993 examination, when participants were aged 71 to 93 years (n = 3734). Brain atrophy was assessed using neuroimage (n = 574) and autopsy (n = 290) information. Cognitive function data were also analyzed for wives of a sample of study participants (n = 502) who had been living with the participants at the time of their dietary interviews. RESULTS: Poor cognitive test performance, enlargement of ventricles and low brain weight were each significantly and independently associated with higher midlife tofu consumption. A similar association of midlife tofu intake with poor late life cognitive test scores was also observed among wives of cohort members, using the husband's answers to food frequency questions as proxy for the wife's consumption. Statistically significant associations were consistently demonstrated in linear and logistic multivariate regression models. Odds ratios comparing endpoints among "high-high" with "low-low" consumers were mostly in the range of 1.6 to 2.0. CONCLUSIONS: In this population, higher midlife tofu consumption was independently associated with indicators of cognitive impairment and brain atrophy in late life.

Aged↗

Alcohol Consumption Estimates in Surveys in Europe: Comparability and Sensitivity for Gender Differences.

The comparability of general population studies on alcohol from nine European countries is evaluated from three points of view: (1) methodologic aspects influencing alcohol estimates, (2) variation between countries in coverage of sales estimates of alcohol consumption, and (3) associations between type of question used to measure alcohol consumption and gender differences in alcohol consumption. With respect to methodologic aspects, it was found that the studies differed on most of the 10 points included in this comparison. The coverage of sales estimates by surveys varies between 39% (Germany) and 56% (France). With respect to type of question and gender differences, it was found that more elaborate sets of questions on alcohol consumption are associated with smaller gender differences in the prevalence of heavy drinking (>600 g 100% alc/mo). It is concluded that the methodologic differences between studies and the differences in sales coverage do not allow cross-national comparison of survey estimates of alcohol consumption of different European countries. Compared with more elaborate sets of questions on alcohol consumption, simple questions on alcohol consumption are likely to underestimate gender differences in the prevalence of heavier drinking.

Journal Article↗

Per capita alcohol consumption and all-cause mortality in 14 European countries.

AIMS: (1) To estimate the relationship between per capita alcohol consumption and male all-cause mortality in 14 European countries. (2) To compare the estimates with predictions from the U-shaped curve at the aggregate level. DATA AND METHOD: The outcome measures comprised annual data, after 1950, on male mortality (all-cause mortality and mortality from diseases) for the following age groups: 15+, 15-29, 30-49, 50-69 and 70+ years. Female mortality was included as a control variable. Alcohol sales were used as proxy for per capita consumption. The data were analysed using the Box-Jenkins technique. The estimated alcohol effects were pooled within low-, medium- and high-consumption countries. RESULTS: For all-cause mortality (15+), the effect estimates were significantly positive in eight of the 14 countries. The effect on mortality of a 1-litre increase in consumption tended to be stronger in low-consumption countries (3% per litre) than in medium- and high-consumption countries (1%). This pattern deviates from that predicted from the U-shaped curve. No significant impact of alcohol was found in the youngest age group when mortality from diseases was used as the outcome. CONCLUSIONS: Increases in overall consumption seem to be associated with increases in total mortality. Differences in drinking patterns are discussed as a possible explanation for the variation between country groups in alcohol effect.

Adolescent↗