Alcohol Awareness Week

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This week is alcohol awareness week in the UK and the NHS is encouraging its patients/clients to look in the mirror and ask whether or not they are drinking too much. As part of the holistic management of MS and our marginal gains strategy for managing MS, we are encouraging all pwMS to do the same.

Excessive alcohol consumption is bad for MS in several ways. It disrupts your sleep pattern and may, therefore, make fatigue and other mental health issues worse. It can affect your balance and coordination and increase your risk of falls and fractures. Alcohol lowers your seizure threshold and increases your chances of having seizures. Longterm alcohol consumption is associated with accelerated brain volume loss and hence increases your chances of developing cognitive impairment and is likely to exacerbate MS-related cognitive impairment.

Alcohol is not good for bone health and is a known cause of osteopaenia. Alcohol is metabolised by the liver and can result in liver toxicity. Alcohol interacts with many drugs affecting their activity and metabolism and may interact with MS-related medication resulting in unpredictable side effects.

Alcohol is very calorific and may contribute to weight gain. In general, excessive alcohol consumption is bad for you.

Why don’t you log onto Drink Coach, or download the App, and take the alcohol test to see if you have a drinking problem?

CoI: multiple

About the author

Prof G

Professor of Neurology, Barts & The London. MS & Preventive Neurology thinker, blogger, runner, vegetable gardener, husband, father, cook and wine & food lover.

9 comments

    • Sometimes you have to state the obvious, for example, I got a text from my GP this morning telling me about the alcohol test 😉

  • If alcohol is bad for you then why do tea total people have lower life span? Alcohol is the best stress reducer. But like anything excess is bad for you, so is alcohol. Even too much water will kill you. You drown!

    • More recent studies don’t necessarily support this; in other words, there is no safe limit of alcohol consumption. But I agree with you water in excess is bad for you and even life is ultimately a fatal disease. The point the NHS is trying to make is to moderate your consumption; dare I say mindful consumption?

      Wood et al. Risk thresholds for alcohol consumption: combined analysis of individual-participant data for 599 912 current drinkers in 83 prospective studies. Lancet. 2018 Apr 14;391(10129):1513-1523.

      BACKGROUND: Low-risk limits recommended for alcohol consumption vary substantially across different national guidelines. To define thresholds associated with lowest risk for all-cause mortality and cardiovascular disease, we studied individual-participant data from 599 912 current drinkers without previous cardiovascular disease.

      METHODS: We did a combined analysis of individual-participant data from three large-scale data sources in 19 high-income countries (the Emerging Risk Factors Collaboration, EPIC-CVD, and the UK Biobank). We characterised dose-response associations and calculated hazard ratios (HRs) per 100 g per week of alcohol (12·5 units per week) across 83 prospective studies, adjusting at least for study or centre, age, sex, smoking, and diabetes. To be eligible for the analysis, participants had to have information recorded about their alcohol consumption amount and status (ie, non-drinker vs current drinker), plus age, sex, history of diabetes and smoking status, at least 1 year of follow-up after baseline, and no baseline history of cardiovascular disease. The main analyses focused on current drinkers, whose baseline alcohol consumption was categorised into eight predefined groups according to the amount in grams consumed per week. We assessed alcohol consumption in relation to all-cause mortality, total cardiovascular disease, and several cardiovascular disease subtypes. We corrected HRs for estimated long-term variability in alcohol consumption using 152 640 serial alcohol assessments obtained some years apart (median interval 5·6 years [5th-95th percentile 1·04-13·5]) from 71 011 participants from 37 studies.

      FINDINGS: In the 599 912 current drinkers included in the analysis, we recorded 40 310 deaths and 39 018 incident cardiovascular disease events during 5·4 million person-years of follow-up. For all-cause mortality, we recorded a positive and curvilinear association with the level of alcohol consumption, with the minimum mortality risk around or below 100 g per week. Alcohol consumption was roughly linearly associated with a higher risk of stroke (HR per 100 g per week higher consumption 1·14, 95% CI, 1·10-1·17), coronary disease excluding myocardial infarction (1·06, 1·00-1·11), heart failure (1·09, 1·03-1·15), fatal hypertensive disease (1·24, 1·15-1·33); and fatal aortic aneurysm (1·15, 1·03-1·28). By contrast, increased alcohol consumption was log-linearly associated with a lower risk of myocardial infarction (HR 0·94, 0·91-0·97). In comparison to those who reported drinking >0-≤100 g per week, those who reported drinking >100-≤200 g per week, >200-≤350 g per week, or >350 g per week had lower life expectancy at age 40 years of approximately 6 months, 1-2 years, or 4-5 years, respectively.

      INTERPRETATION: In current drinkers of alcohol in high-income countries, the threshold for lowest risk of all-cause mortality was about 100 g/week. For cardiovascular disease subtypes other than myocardial infarction, there were no clear risk thresholds below which lower alcohol consumption stopped being associated with lower disease risk. These data support limits for alcohol consumption that are lower than those recommended in most current guidelines.

  • Alcohol Consumption Linked to Lower MS Disability

    Multiple sclerosis patients who consumed larger amounts of alcohol had lower rates of disability per the Expanded Disability Status Score (EDSS) and Multiple Sclerosis Severity Score (MSSS), study findings indicate.

    Consumption of beer also affected EDSS scores positively; however consumption of wine had no association with EDSS score, according to Camilio Diaz-Cruz, MD, of Brigham and Women’s Hospital in Boston, who reported the findings at the American Academy of Neurology 2015 Annual Meeting.

    Those who had higher alcohol intake were significantly associated with lower EDSS

    https://www.neurologyadvisor.com/conference-highlights/aan-2015-coverage/alcohol-consumption-linked-to-lower-ms-disability/?fbclid=IwAR1JqUrDDnkWCOhi_HlZkCQS_-oAoqMX97WM-BY0H3ddYHZ2ndDdqsFJxnc

  • ” Longterm alcohol consumption is associated with accelerated brain volume loss”

    Causation?

    For years, researchers have observed that alcohol consumption is associated with reduced brain volume and concluded that drinking can literally shrink the brain.

    But new research turns that theory on its head, suggesting that reduced brain volume may represent a genetically-conferred predispositional risk factor for heavier alcohol consumption

    Our results suggest that associations between alcohol consumption and reduced brain volume are attributable to shared genetic factors,”

    These findings don’t discount the hypothesis that alcohol abuse may further reduce gray matter volumes, but it does suggest that brain volumes started out lower to begin with,”

    “As a result, brain volumes may also serve as useful biological markers for gene variations linked to increased vulnerability for alcohol consumption.

    Which came first: Brain size or drinking propensity?

    https://medicalxpress.com/news/2019-10-brain-size-propensity.html

By Prof G

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