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Friday, September 9, 2011

QD: News Every Day--Women who drink moderately, regularly may age better

Middle-aged women who drink alcohol moderately yet regularly throughout the week may age more healthfully, according to data from the Nurses' Health Study.

Photo by  Sigfrid Lundberg via Flickr and a Creative Commons licenseAfter adjusting for variables such as smoking, women who drank light or moderate amounts of alcohol had a modestly increased chance of successful ageing compared to nondrinkers. For example, compared to nondrinkers, women who drank 5 to 15 g of alcohol per day (between one-third and one drink per day) at middle age had about a 20% higher chance of successful ageing, defined as being free of 11 major chronic diseases and having no major cognitive, physical or mental health limitations at age 70.

Independent of total alcohol intake, women who drank alcohol regularly had a better chance of successful ageing than occasional drinkers. Thus, compared to nondrinkers, women who drank five to seven days a week had nearly a 50% greater chance of successful ageing whereas women who drank only one or two days a week had a similar likelihood of successful ageing.

Researchers measured alcohol consumption at midlife using a validated food frequency questionnaire administered in 1980 and 1984 during the Nurses' Health Study among nearly 14,000 participants who survived to age 70, excluding nearly 2% who drank more than 45 g/d of alcohol at midlife. Results appeared Sept. 6 at PLoS Medicine.

Of all eligible study participants, 1,491 (10.7%) achieved successful aging. Light-to-moderate alcohol consumption at midlife (average age 58 years) was associated with modestly increased odds of successful aging. Compared to nondrinkers, those who imbibed were more likely to successfully age: less than 5 g/d (odds ratio [OR] 1.11; 95% confidence interval [CI] 0.96 to 1.29); 5.1 to 15.0 g/d (OR, 1.19; 95% CI, 1.01 to 1.40); 15.1 to 30.0 g/d (OR, 1.28; 95% CI, 1.03 to 1.58); and 30.1 to 45.0 g/d, (OR, 1.24; 0.87 to 1.76).

Independent of total alcohol consumption, those who drank alcohol throughout the week aged successfully more often than nondrinkers: 1 to 2 days per week, (OR, 1.10; 95% CI, 0.94 to 1.30) 3 to 4 days (OR, 1.29; 95% CI, 1.01 to 1.64) and 5 to 7 days (OR, 1.47; 95% CI, 1.14 to 1.90).

Also, when it came to the tipple of choice, wine, but not beer or liquor, was significantly associated with increased odds of successful ageing (and it was the preferred drink among the majority of women). Comparing more than one drink of wine per day vs. nondrinkers slightly attenuated successful aging: from OR, 1.43, 95% CI, 1.08 to 1.88 to OR, 1.35; 95% CI 1.01 to 1.80.

Researchers noted that this is an observational study, and that all the study participants were women and most had European ancestry. Still, they continued, the findings support 2010 U.S. Department of Agriculture dietary guidelines that up to one alcoholic drink per day for women and up to two alcoholic drinks per day for men may provide health benefits.

Previous research has borne out the association. Results of a study published in the Journal of the American Geriatrics Society in 2006 reported on a community-based, national random sample of 12,432 Australian women aged 70 to 75 at baseline concluded that nondrinking women were associated with greater risk of death and poorer health-related quality of life (nondrinkers' hazard ratio [HR], 1.94; 95% CI, 1.4 to 2.6; rare drinkers' HR, 1.58; 95% CI, 1.2 to 2.1) than women in the low-intake reference category (1 to 2 drinks per day, 3 to 6 days per week). If nondrinkers survived, they had lower health-related quality-of-life scores on surveys of general health, physical functioning, mental health and social functioning.

Study authors commented at the time that, "Alcohol use can be associated with psychological and social well-being which can be considered important health benefits in their own right. The social and pleasurable benefits of drinking, as well as the improved appetite and nutrition that may accompany modest alcohol intake, could also play a role. However, our study was not designed to provide evidence to suggest that non-drinkers should take up alcohol consumption in older age."

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Members of the American College of Physicians contribute posts from their own sites to ACP Internist and ACP Hospitalist. Contributors include:

Albert Fuchs, MD
Albert Fuchs, MD, FACP, graduated from the University of California, Los Angeles School of Medicine, where he also did his internal medicine training. Certified by the American Board of Internal Medicine, Dr. Fuchs spent three years as a full-time faculty member at UCLA School of Medicine before opening his private practice in Beverly Hills in 2000.

Zackary Berger
Zackary Berger, MD, ACP Member, is a primary care doctor and general internist in the Division of General Internal Medicine at Johns Hopkins. His research interests include doctor-patient communication, bioethics, and systematic reviews.

CasesBlog
Ves Dimov, MD, ACP Member, is an allergist/immunologist and Assistant Professor of Medicine and Pediatrics at the University of Chicago, where he evaluates and treats both pediatric and adult patients.

David Katz, MD
David L. Katz, MD, MPH, FACP, is an internationally renowned authority on nutrition, weight management, and the prevention of chronic disease, and an internationally recognized leader in integrative medicine and patient-centered care.

db's Medical Rants
Robert M. Centor, MD, FACP, contributes short essays contemplating medicine and the health care system.

DrDialogue
Juliet K. Mavromatis, MD, FACP, provides a conversation about health topics for patients and health professionals.

Dr. Mintz' Blog
Matthew Mintz, MD, FACP, has practiced internal medicine for more than a decade and is an Associate Professor of Medicine at an academic medical center on the East Coast. His time is split between teaching medical students and residents, and caring for patients.

Everything Health
Toni Brayer, MD, FACP, blogs about the rapid changes in science, medicine, health and healing in the 21st century.

FutureDocs
Vineet Arora, MD, FACP, is Associate Program Director for the Internal Medicine Residency and Assistant Dean of Scholarship & Discovery at the Pritzker School of Medicine for the University of Chicago. Her education and research focus is on resident duty hours, patient handoffs, medical professionalism, and quality of hospital care. She is also an academic hospitalist.

Glass Hospital
John H. Schumann, MD, FACP, provides transparency on the workings of medical practice and the complexities of hospital care, illuminates the emotional and cognitive aspects of caregiving and decision-making from the perspective of an active primary care physician, and offers behind-the-scenes portraits of hospital sanctums and the people who inhabit them.

Gut Check
Ryan Madanick, MD, ACP Member, is a gastroenterologist at the University of North Carolina School of Medicine, and the Program Director for the GI & Hepatology Fellowship Program. He specializes in diseases of the esophagus, with a strong interest in the diagnosis and treatment of patients who have difficult-to-manage esophageal problems such as refractory GERD, heartburn, and chest pain.

I'm dok
ACP Member Mike Aref, MD, PhD, ACP Member, is an academic hospitalist with an interest in basic and clinical science and education, with interests in noninvasive monitoring and diagnostic testing using novel bedside imaging modalities, diagnostic reasoning, medical informatics, new medical education modalities, pre-code/code management, palliative care, patient-physician communication, quality improvement, and quantitative biomedical imaging.

Informatics Professor
William Hersh, MD, FACP, Professor and Chair, Department of Medical Informatics & Clinical Epidemiology, Oregon Health & Science University, posts his thoughts on various topics related to biomedical and health informatics.

Just Oncology
Richard Just, MD, ACP Member, has 36 years in clinical practice of hematology and medical oncology. His blog is a joint publication with Gregg Masters, MPH.

KevinMD
Kevin Pho, MD, ACP Member, offers one of the Web's definitive sites for influential health commentary.

MD Whistleblower
Michael Kirsch, MD, FACP, addresses the joys and challenges of medical practice, including controversies in the doctor-patient relationship, medical ethics and measuring medical quality. When he's not writing, he's performing colonoscopies.

Medical Lessons
Elaine Schattner, MD, ACP Member, shares her ideas on education, ethics in medicine, health care news and culture. Her views on medicine are informed by her past experiences in caring for patients, as a researcher in cancer immunology, and as a patient who's had breast cancer.

More Musings
Rob Lamberts, MD, ACP Member, a med-peds and general practice internist, returns with "volume 2" of his personal musings about medicine, life, armadillos and Sasquatch at More Musings (of a Distractible Kind).

Musing of an Internist
Justin Penn, MD, ACP Associate Member, attended medical school at the University of Washington School of Medicine and trained in internal medicine at the University of Rochester, where he is serving as Chief Resident.

Prescriptions
David M. Sack, MD, FACP, practices general gastroenterology at a small community hospital in Connecticut. His blog is a series of musings on medicine, medical care, the health care system and medical ethics, in no particular order.

Reflections of a Grady Doctor
Kimberly Manning, MD, FACP, reflects on the personal side of being a doctor in a community hospital in Atlanta.

Technology in (Medical) Education
Neil Mehta, MBBS, MS, FACP, is interested in use of technology in education, social media and networking, practice management and evidence-based medicine tools, personal information and knowledge management.

White Coat Underground
Peter A. Lipson, MD, ACP Member, is a practicing internist and teaching physician in Southeast Michigan. The blog, which has been around in various forms since 2007, offers musings on the intersection of science, medicine, and culture.

Other blogs of note:

American Journal of Medicine
Also known as the Green Journal, the American Journal of Medicine publishes original clinical articles of interest to physicians in internal medicine and its subspecialities, both in academia and community-based practice.

Clinical Correlations
A collaborative medical blog started by Neil Shapiro, MD, ACP Member, associate program director at New York University Medical Center's internal medicine residency program. Faculty, residents and students contribute case studies, mystery quizzes, news, commentary and more.

Interact MD
Michael Benjamin, MD, ACP member, doesn't accept industry money so he can create an independent, clinician-reviewed space on the Internet for physicians to report and comment on the medical news of the day.

PLoS Blog
The Public Library of Science's open access materials include a blog.

White Coat Rants
One of the most popular anonymous blogs written by an emergency room physician.

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