Moderate or low-risk alcohol consumption (defined by NIAAA as ?4 drinks on any single day AND ?14 drinks per week for men or ?3 drinks on any single day AND ?7 drinks per week for non-pregnant women) has been associated - despite its appellation - with a wide variety of health outcomes of the greatest import. Compared with abstainers or rare drinkers, moderate drinkers have been observed to have lower rates of coronary heart disease, congestive heart failure, ischemic stroke, diabetes, and cholelithiasis but higher rates of breast and possibly other cancers. Perhaps most compellingly, moderate alcohol intake has been associated with a lower risk of all-cause mortality, chiefly reflecting its inverse association with cardiovascular mortality. Important limitations affect this body of evidence, however. Although large and consistent epidemiological studies have been conducted, strong concerns about residual confounding by both health status and health- seeking behavior exist. The existing experimental studies of alcohol are small and short and, while demonstrating plausible mechanisms by which moderate drinking would lower cardiometabolic risk, the lack of correspondence between similar studies of postmenopausal estrogen treatment and the randomized Women's Health Initiative clinical trial only heightens this concern. Given the widespread use of alcohol, the clear risks and costs of its overuse, the uncertain balance of risks and benefits of moderate use, and the complete lack of definitive clinical trial data, the urgent is unmistakable. Our goal is to organize a satellite conference to he 2014 ISBRA/RSA meeting that brings together leaders in several domains, including experts in the conduct of feeding trials of moderate alcohol consumption, other complex nutritional interventions (such as low-fat or Mediterranean diet), and pharmaceutical interventions in individuals at high medical risk. Topics include: review of previous feeding studies of alcohol, existing recommendations from NIAAA and other agencies, effects of alcohol on biomarkers and outcomes in observational studies, lessons from nutritional and pharmaceutical Interventions, and future directions and recommendations. Participants from around the world will discuss these topics for an open audience of ISBRA/RSA attendees and other interested individuals, with plans to disseminate an overview of the conclusions and recommendations in the peer-reviewed literature.
Our goal is to organize an international conference that brings together leaders in several domains, including experts in the conduct of feeding trials of moderate alcohol consumption, other studies of dietary interventions, and drug trials in individuals at high medical risk. We aim to bring together alcohol investigators and experts in other, related fields to share methodological approaches and suggestions with an aim toward improving the long-term science base of the health effects of alcohol.
|Mukamal, Kenneth J; Clowry, Catherine M; Murray, Margaret M et al. (2016) Moderate Alcohol Consumption and Chronic Disease: The Case for a Long-Term Trial. Alcohol Clin Exp Res 40:2283-2291|