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Moderate
Alcohol Use: The Heterogeneity of Abstention
Principal
Investigator: Robert I. Lipton, Ph.D.
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This
project is designed to describe a relatively under-described
population, abstainers, in more depth. This is an important
population because differences in abstainer health may help
explain why moderate alcohol consumption seems to protect
against heart disease. In this research, I would like to determine
if abstainers have a higher prevalence of physical and mental
illness compared to light-to-moderate alcohol drinkers and,
among abstainers, determine if differences exist in regard
to prevalence of physical and mental illness. Socio-demographic
measures, lifestyle, and ethnic/cultural differences will
also be examined for abstainers and light-to-moderate alcohol
consumers.
To
this end, a nationally representative dataset, the National
Longitudinal Alcohol Epidemiologic Survey will be used to
(1) measure alcohol use in terms of frequency, quantity, and
binge drinking; (2) distinguish amongst those abstaining based
on differences in health, smoking, ethnicity, and socio-demographic
measures; (3) determine amongst those abstaining if there
are differences in risk of heart disease by type of abstainer-sick
never drinkers, healthy never drinkers, former light, moderate,
heavy drinkers, abusing drinkers; (4) determine among those
abstaining if there are differences in risk of depression
by type of abstainer; (5) determine if abstainers have higher
levels of depression/mood problems than those not abstaining
when controlling for socio-demographic variables, ethnicity,
and physical illness; and (6) determine if abstainers have
higher levels of heart disease, compared to those not abstaining.
Information
from these activities will serve two related purposes: (1)
to increase our understanding of the correlates of abstention,
particularly differences across age, gender, and ethnicity
and (2) to increase our ability to classify abstainers into
etiologically meaningful categories relevant to moderate alcohol
and health. Often moderate drinkers, who may also be moderate
in many different measures of lifestyle and health status,
are typically compared to abstainers who may have combinations
of measures that are considerably less moderate, or at the
least, very different. Thus, instead of measuring differences
in health outcomes based on alcohol consumption between moderate
and abstention categories, researchers frequently are comparing,
for example, sick former heavy drinkers with relatively healthy
moderate drinkers. Similarly, sick never drinkers might be
compared to moderate alcohol drinkers. In either case, the
possible beneficial effect of moderate alcohol use is obscured
by other factors that may be influencing health outcomes independently
from moderate alcohol use or abstention. Results from this
project will allow a more insightful examination of the role
of moderate alcohol in protecting against certain chronic
diseases.
Findings:
I found that former drinkers who smoke have much higher rates
of myocardial infarction than do either lifetime abstainers
(who smoke) or current drinkers (who smoke). Lifetime abstainers
have lower rates of clinical depression than current drinkers
and ex-drinkers. Further, I have found that people who are
never smokers and currently employed, regardless of alcohol
consumption (life-time abstainers, ex-drinkers, moderate drinkers,
current drinkers), are protected against ever having a (self-reported)
myocardial infarction.
Abstainers
are a heterogeneous group, with former drinkers being sicker
than lifetime abstainers or current drinkers. There could
be something like a healthy drinker effect in play, whereby
people who are simply too sick to continue drinking wind up
in the abstainer/ex-drinker category.
Proceed
to PRC CD Presentation featuring Dr. Robert I. Lipton
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