DOCSLIB.ORG

THE FRENCH PARADOX: LESSONS for Heart: First Published As 10.1136/Heart.90.1.107 on 15 December 2003

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
THE FRENCH PARADOX: LESSONS for Heart: First Published As 10.1136/Heart.90.1.107 on 15 December 2003 Coronary disease THE FRENCH PARADOX: LESSONS FOR Heart: first published as 10.1136/heart.90.1.107 on 15 December 2003. Downloaded from OTHER COUNTRIES Jean Ferrie`res 107 Heart 2004;90:107–111 ‘‘Life is the art of drawing sufficient conclusions from insufficient premises’’ —Samuel Butler he French paradox is the observation of low coronary heart disease (CHD) death rates despite high intake of dietary cholesterol and saturated fat.12 The French paradox concept was Tformulated by French epidemiologists3 in the 1980s. France is actually a country with low CHD incidence and mortality (table 1). The mean energy supplied by fat was 38% in Belfast and 36% in Toulouse in 1985–86.4 More recently, in 1995–97, the percentage of energy from fat was 39% in Toulouse according to a representative population survey. c THE FRENCH PARADOX AND CAUSES OF DEATH The first source of error could come from an underestimated CHD mortality. According to this hypothesis, French physicians may not declare all the CHD deaths as CHD. If standardised data— for example those provided by the MONICA (monitoring of trends and determinants in cardiovascular disease) project—are used, the results concerning CHD attack and mortality rates show that France is at a low risk for CHD (table 1). Under certification of CHD deaths in France is a possible bias, but after correction, it remains a low bias. Thus, validated data on CHD mortality and incidence show that France is characterised by CHD risk, corroborating the first part of the French paradox definition. http://heart.bmj.com/ THE FRENCH PARADOX AND SATURATED FAT In correlation studies, measures that represent characteristics of an entire population (consumption of animal fat, daily milk, and alcohol) are used to describe disease (CHD mortality). Limitations of correlational studies are the inability to link exposure with disease in particular individuals, the lack of ability to control the effects of potential confounding factors, and the use of average exposure levels rather than actual individual values. Numerous correlation studies have been carried out in various countries concerning the relation between consumption on September 26, 2021 by guest. Protected copyright. of fat and CHD mortality.12 In one of the most interesting ones, Artaud-Wild and colleagues examined the relation of CHD mortality to the intake of foodstuffs and nutrients in 40 countries.2 After having defined a cholesterol–saturated fat index (CSI), they studied the relation between the CSI and CHD mortality (per 100 000 men aged 55–64 years) for all 40 countries (fig 1). France had a CSI of 24 per 1000 kcal and a CHD mortality rate of 198, whereas Finland had a CSI of 26 per 1000 kcal and a CHD mortality rate of 1031. In the seven countries study, 12 763 men from 16 cohorts in seven countries were examined for CHD risk factors in 1958. Information on diet was collected by use of seven day food records.5 The average consumption of animal food groups, with the exception of fish, was positively associated with 25 year CHD mortality rates. Furthermore, the average population intake of saturated fat was strongly related to 10 and 25 year CHD mortality rates. It is interesting to compare the World Health Organization dietary recommendations for saturated fat (, 10% of total energy) with actual intakes in France. In representative cross _________________________ sectional surveys of the French population performed in 1986–87 and 1995–97, the saturated fat Correspondence to: intake was 15% of the total energy intake in the first survey and 16% in the latter survey. This Professor Jean Ferrie`res, high consumption of saturated fatty acids is such that French subjects are exposed to a high risk Department of Epidemiology, INSERM U558, University of CHD. Why a high consumption of saturated fatty acids does not lead to a high CHD risk in School of Medicine, 37, alle´es France (and maybe elsewhere) is a central question behind the French paradox concept. The Jules Guesde, 31073 Toulouse cedex, France; [email protected] French paradox is a way of presenting provocative results from epidemiological studies and does _________________________ not take into account causality between risk factors and CHD mortality. www.heartjnl.com EDUCATIONINHEART Table 1 Age standardised coronary heart disease (CHD) mortality and event rate in selected European regions (men, aged 35–64 years) Heart: first published as 10.1136/heart.90.1.107 on 15 December 2003. Downloaded from Official CHD mortality CHD mortality per Coronary events Population rate per 100000* 100000À per 100 000` Glasgow (UK) 332 365 777 Belfast (UK) 280 279 695 108 Lille (northern France) 89 172 298 Strasbourg (north eastern France) 80 141 292 Toulouse (south western France) 53 91 233 Barcelona (north eastern Spain) 63 76 210 *Based on death certificate enumeration. ÀFatal events included definite, possible, and unclassifiable (mainly sudden deaths with no available diagnostic information) coronary deaths. `Coronary events included non-fatal events (definite myocardial infarction) and fatal events. THE FRENCH PARADOX AND WINE DRINKING on all the studies dealing with the relations between alcohol Even if causality is not part of the French paradox, some and CHD.6 The only clear message is that moderate alcohol authors have put forward several hypotheses in order to drinking (two or three times a day) has a protective effect explain it. Debates have focused on alcohol consumption and, against CHD. Alcohol intake raises high density lipoprotein more specifically, on red wine. A superficial investigation of (HDL) cholesterol concentrations and approximately 50% of the lifestyles of south European countries, characterised by the risk reduction attributable to alcohol consumption is low CHD incidence, confirms wine as one of their common explained by changes in HDL cholesterol. However, the identifying elements. In a seminal paper,1 Renaud and De differential effects of wine, beer, and spirits have been Lorgeril compared age standardised annual mortality from examined. European research carried out in France and CHD and related risk factors in MONICA populations, Denmark has shown that wine consumption has been including the French centres. The mean serum total associated with a decrease of 24–31% in all cause mortality; cholesterol concentrations were similar in France, in the little to moderate wine drinking leads to lower mortality from USA, and the UK. After having performed a regression cardiovascular disease than an equivalent consumption of analysis between death rate from CHD and consumption of beer or spirits.7 dairy fat and wine, these authors concluded that the French Which mechanisms are responsible for the potential paradox may be caused by a high consumption of wine. Their different effects of the various types of alcohol? We have to article has started a long series of research studies analysing turn towards current theories on atherogenesis. The domi- the relation between wine and CHD. nant theory is the oxidative modification hypothesis. Final results do depend on the cultural background of the Oxidised lipids, especially phospholipids, generated during countries where they have been carried out. The most striking low density lipoprotein (LDL) oxidation or within oxidatively illustration is the classic contrast between cultures with stressed cells, are the triggers for many of the events seen in http://heart.bmj.com/ moderate and regular alcohol consumption and those where developing lesions.8 Flavonoids are components of a wide ‘‘binge’’ drinking is common. It would take too long to report variety of edible plants, fruit, and vegetables and of beverages such as tea, coffee, beer, and wine. In vitro, inhibition of LDL oxidation by flavonoids derived from red wine has been demonstrated. In men, consumption of red wine with meals reduces the susceptibility of human plasma and LDL to lipid peroxidation. Red wine contains a variety of polyphenols on September 26, 2021 by guest. Protected copyright. derived from grape skins. In free living subjects,9 concentra- tion of catechin in plasma was threefold higher in a diet with fruit and vegetables but without wine, than a diet without fruit, vegetables, and wine, and fourfold higher than in the latter in a diet with red wine but without vegetables and fruit. It seems that red wine and the Mediterranean diet may confer an additional protective effect. It is possible that, after adjustment for total alcohol intake, wine consumption might be associated with a more favourable lipid profile than beer consumption: higher HDL cholesterol, lower triglycerides and fibrinogen concentrations. Indeed, alcohol consumption and associated lifestyles may have an effect on CHD above and beyond their impact on lipids. The impact on haemostasis has also been debated.16In the Caerphilly prospective heart disease study, platelet aggrega- tion induced by adenosine diphosphate was inhibited in subjects who drank alcohol. Furthermore, in the Western Figure 1 Plot of death rate from coronary heart disease (1977) group of the Lyon diet heart study, there was an inverse correlated with daily dietary intake (from 1976 to 1978) of cholesterol relation between ethanol (wine represented 88% of total and saturated fat as expressed by the cholesterol fat index (CSI) per ethanol) and ex vivo platelet aggregation; this correlation 1000 kcal. Reproduced from Artaud-Wild et al,2 with permission. was absent in the Mediterranean group. Platelet aggregation www.heartjnl.com EDUCATIONINHEART was low and the same in both groups, suggesting that platelet rates reported by MONICA centres in Glasgow and Belfast aggregation was low in the Mediterranean group because of and similar to rates reported by MONICA centres in France Heart: first published as 10.1136/heart.90.1.107 on 15 December 2003. Downloaded from the diet (rich in a linolenic acid) and in the Western group and northern Italy. France has actually low CHD incidence (diet relatively rich in saturated fat) because of wine.
Load more

Recommended publications
  • Can American Medicine Learn from Past Mistakes?
    COMMENTARY To Err is Human: Can American Medicine Learn from Past Mistakes? Jeffrey B Ritterman, MD Perm J 2017;21:16-181 E-pub: 06/14/2017 https://doi.org/10.7812/TPP/16-181 ABSTRACT seasoned researchers in overcoming a “set infants would be put to bed and found The history of medicine includes of well entrenched beliefs that conflicted dead in the morning. In 1830, patholo- many errors. Some persisted for decades with the new ideas.”3 gists noted that SIDS-affected infants had and caused great harm. Several are It took a generation for Marshall and enlarged thymus glands compared with highlighted in this article, including the Warren’s pioneering work to be recognized “normal” autopsy specimens.7 It seemed mythical thymic diseases: thymic asthma and acknowledged. They first published logical to conclude that these “enlarged” and status thymicolymphaticus. Some their findings onH pylori in 1984. More glands were in some way responsible for medical mistakes, such as the diet-heart than a decade later, in 1995, only 5% of the deaths. hypothesis of Ancel Keys, continue to American physicians were prescribing anti- In 1830, Kopp introduced the term cause harm. To avoid future errors and biotics for treatment of peptic ulcer disease.3 thymic asthma, suggesting that the “en- their associated harm, I suggest a cultural In 2005, Marshall and Warren received the larged” thymus occluded the trachea.8 The shift encouraging professional humil- Nobel Prize in Medicine for their discovery, existence of this fictitious disease became ity and greater questioning of medical 26 years after Warren discovered H pylori.2 widely and quickly accepted, and persisted dogma.
    [Show full text]
  • Cardiovascular Risk Is More Related to Drinking Pattern Than to the Type of Alcoholic Drinks
    rEViEW Cardiovascular risk is more related to drinking pattern than to the type of alcoholic drinks A. van de Wiel1*, D.W. de Lange2 1Department of Internal Medicine, Meander Medical Centre, Amersfoort, the Netherlands, 2Department of Clinical Toxicology, University Medical Centre and National Poisons Information Centre of the National Institute for Public Health and the Environment, Utrecht, the Netherlands, *corresponding author: e-mail: [email protected] ABsTract IntroductioN Many observational studies have shown an association Health aspects of alcohol have been debated for centuries. between moderate alcohol consumption and a lower Alcoholic drinks have been used as restoratives, stimulants, risk for cardiovascular morbidity and mortality. some appetizers, and even as analgesics for many of the body’s of these studies, whether or not inspired by the french aches. But alcohol consumption has also proven to be paradox, suggest a more favourable effect of wine than associated with liver disease, cardiomyopathy, trauma and of other alcoholic drinks. Certain polyphenols including injuries, the Wernicke-Korsakov syndrome and some forms the flavonoids, more abundant in red than in white wine, of cancer. are held responsible for this ‘bonus’ effect. However, this In ancient and medieval times, wine and beer were part of conclusion seems premature, since no significant bioactive everyday diet, because many places on earth lacked reliable effect of wine polyphenols has been shown in humans so sources of drinking water. Nowadays, they are mostly far. furthermore, wine drinking proves to be associated regarded as regular staples of modern day living and their with a healthier lifestyle profile than consumption of beer consumption parallels the increase in welfare.
    [Show full text]
  • Drunk People – They Are out to Get to You
    Drunk people – They are out to get to you Abe Markin Dec 2014 TBL Outline • Physiology • They’re out to get you • Management of intoxication in ED – ABCs etc. – Do you have to check BAC? – Alcoholic Ketoacidosis • Wernicke’s • Korsakoff’s • 4 Phases of withdrawal • Holiday Heart Physiology • Absorbed primarily in stomach (70%) and duodenum (25%) • Distributed evenly throughout all organ systems • Traditionally thought to be zero order kinetics • First order kinetics for high levels, especially in heavy drinkers – 10% in gastric mucosa (first pass) – Remaining 90% in liver – Inducible CYP-450 enzymes in microsomal ethanol oxidizing system (MEOS; 8–10%) – Catalase (0–2%) • Respiratory depression, decreased airway responsiveness cause death Rosen’s 7th Edition; Vonghia et al. (Eur J Intern Med, 2008) How Drunks Might Get You • Other causes of AMS – Other toxins (toxic alcohols, benzos) – Head bleed – Infection (meningitis, sepsis), – Metabolic disturbances (AKA, DKA, hypoglycemia, hyponatremia, hepatic encephalopathy, uremia, hypoxia/CO2 narcosis) – Seizures (post-ictal / status) – Withdrawal syndromes • Missed injuries – Orthopedic, – C-spine – Intra-abdominal • Vomiting while supine in 4 points All drunks deserve… • ABC, fluids, nutrition, consider withdrawal • Benzos if needed • Volume depletion – Give IVF (D5 0.9 NS) • Nutrition – D5/food (No glycogen stores) – Thiamine (100mg) – Electrolytes: replace magnesium (1-2g/0-60min), potassium – MVI Slovis. (AAEM, 2007); Li et al. (Am J Emerg Med, 2008) Should we get a BAC? • Rosen: “Discharge (after excluding significant abnormal laboratory values or suspected head injury) can be considered when a patient is clinically sober and able to dress, walk, and function independently.” • Tintinalli: “Patients with no other medical reason for admission may be discharged when their clinical intoxication has resolved to the extent that they do not constitute a danger to themselves or others.
    [Show full text]
  • Beyond the French Paradox: the Impact of Moderate Beverage Alcohol and Wine Consumption in the Prevention of Cardiovascular Disease Tedd M
    Cardiol Clin 21 (2003) 449–457 Beyond the French paradox: the impact of moderate beverage alcohol and wine consumption in the prevention of cardiovascular disease Tedd M. Goldfinger, DO, FACCa,b,c,* aDesert Cardiology of Tucson Heart Center, 6080 N. La Cholla Boulevard, Tucson, AZ 85741, USA bDivision of Cardiology, University of Arizona School of Medicine, Tucson, AZ 85719, USA cWine & Heart Health Research Initiative Desert Heart Foundation, Tucson, AZ 85741, USA Cardiovascular disease (CVD) is the leading associated with moderate alcohol consumption. cause of death and disability in the United States Plausible biologic mechanisms for vascular pro- and is responsible for 53% of deaths in women and tection from beverage alcohol is discussed in this 46% of deaths in men. [1] CVD is a primary or article. The medical community has been cau- contributing cause in 60% of all deaths, and claims tioned not to expound the health benefits of as many lives as the next leading causes of death alcohol, and particularly wine. In a letter, Ellison including cancers, accidents, infections, and pul- countered that, ‘‘telling people to avoid any alco- monary disease. Coronary heart disease (CHD) hol consumption, because of the potential dan- affects 12 million people in the United States of gers of heavy use may not be in the best health which 1.1 million have a myocardial infarction interest of the public’’ [7]. Most agree that in the annually and about one third die. Worldwide, absence of a well-executed, randomized, double- CVD is the foremost cause of death, accounting blinded, intervention trial, controlled for con- for 57% of deaths among developing nations, and founding variables, the debate as to the health the second most cause of disability [2].
    [Show full text]
  • The Oxygen Paradox, the French Paradox, and Age-Related Diseases
    GeroScience (2017) 39:499–550 https://doi.org/10.1007/s11357-017-0002-y REVIEW ARTICLE The Oxygen Paradox, the French Paradox, and age-related diseases Joanna M. S. Davies & Josiane Cillard & Bertrand Friguet & Enrique Cadenas & Jean Cadet & Rachael Cayce & Andrew Fishmann & David Liao & Anne-Laure Bulteau & Frédéric Derbré & Amélie Rébillard & Steven Burstein & Etienne Hirsch & Robert A. Kloner & Michael Jakowec & Giselle Petzinger & Delphine Sauce & Florian Sennlaub & Isabelle Limon & Fulvio Ursini & Matilde Maiorino & Christina Economides & Christian J. Pike & Pinchas Cohen & Anne Negre Salvayre & Matthew R. Halliday & Adam J. Lundquist & Nicolaus A. Jakowec & Fatima Mechta-Grigoriou & Mathias Mericskay & Jean Mariani & Zhenlin Li & David Huang & Ellsworth Grant & Henry J. Forman & Caleb E. Finch & Patrick Y. Sun & Laura C. D. Pomatto & Onnik Agbulut & David Warburton & Christian Neri & Mustapha Rouis & Pierre Cillard & Jacqueline Capeau & Jean Rosenbaum & Kelvin J. A. Davies Received: 7 November 2017 /Accepted: 9 November 2017 /Published online: 21 December 2017 # The Author(s) 2017. This article is an open access publication Abstract A paradox is a seemingly absurd or impossi- 1997)?: the so-called Oxygen Paradox (Davies and ble concept, proposition, or theory that is often difficult Ursini 1995; Davies Biochem Soc Symp 61:1–31, to understand or explain, sometimes apparently self- 1995). How can French people apparently disregard contradictory, and yet ultimately correct or true. How the rule that high dietary intakes of cholesterol and is it possible, for example, that oxygen Ba toxic envi- saturated fats (e.g., cheese and paté) will result in an ronmental poison^ could be also indispensable for life early death from cardiovascular diseases (Renaud and (Beckman and Ames Physiol Rev 78(2):547–81, 1998; de Lorgeril Lancet 339(8808):1523–6, 1992; Catalgol Stadtman and Berlett Chem Res Toxicol 10(5):485–94, et al.
    [Show full text]
  • Bar Le French Paradox
    Bar Le French Paradox Le French Paradox : constat américain de l’allongement de l’espérance de vie chez les Français qui consomment du vin rouge de façon raisonnable. A votre santé ! The French Paradox: Statistics and reports by American cardiologists showed the positive effects of red wine consumption with regard to fighting cardiovascular disease. Cheers! Prix Nets – Service compris – Net Prices - Service included Nos vins au verre Wines by the glass Champagne (15 cl) Deutz Brut Classique 15 € Deutz Brut Rosé 19 € Krug Grande Cuvée 45 € Vins blancs (15 cl) White wines Les Hauts de Smith, Pessac-Léognan 2017 13 € Château Olivier, Pessac-Léognan 2017 16 € Château Smith Haut Lafitte, Pessac-Léognan 2014 39 € Vins rouges (15 cl) Red wines Les Hauts de Smith, Pessac-Léognan 2016 13 € Château Carbonnieux, Pessac-Léognan 2014 18 € Château Smith Haut Lafitte, Pessac-Léognan 2012 37 € Vin Liquoreux Sweet wines Château Cyprès de Climens, Sauternes 2009 16 € Prix Nets – Service compris – Net Prices - Service included Apéritifs Aperitives (6 cl) Lillet blanc ou rouge / Lillet White or Red 10 € Pineau des Charentes Beaulon rouge / red 5 ans 10 € Pineau des Charentes Beaulon blanc / white 5 ans 10 € Pineau des Charentes Beaulon rouge / red 1981 15 € Pineau des Charentes Beaulon blanc /white 1982 15 € Pineau des Charentes Bourgoin blanc / white 15 € Pineau des Charentes Bourgoin 1979 50 € Apérol, Bitter Q, Campari (6 cl) 10 € Byrrh Grand Quinquina (6 cl) 10 € Kir (15 cl) 10 € Kir Royal (15 cl) 18 € Martini blanc ou rouge / white or red (4 cl) 10 €
    [Show full text]
  • 13 Years' Observations on Male British Doctors
    25 Medical Research Council. Tobacco smoking and cancer of the lung. BMJ 37 Doll R, Peto R, Hall E, Wheatley K, Gray R. Mortality in relation to 1957;i:1523. comsumption of alcohol: 13 years' observations on male British doctors. 26 Doll R, Forman D, La Vecchia C, Woutersen R. Alcoholic beverages and BM 1994;309:91 1-8. cancers of the digestive tract and larynx. In: Verschuren PM, ed. Health 38 Peto R, Lopez A, Boreham J, Thun M, Heath C. Mortality from tobacco in issues related to akoholconsumption. Washington, DC: ILSI Press, 1993. developed countries: indirect estimation from national vital statistics. Lancet 27 Key T. Diet and smoking related disease: lung cancer and coronary heart 1992;339: 1268-78. disease. journal ofTobacco-related Disease (in press). 39 Baron JA, Sandler RS. Cigarette smoking and cancer of the large bowel. In: 28 Stamler J, Wentworth D, Vaccaro 0, Neaton JD. Diabetes, other risk factors, Wald N, Baron J, eds. Smoking and hornone related disorders. Oxford: and 12-year cardiovascular mortality for men screened in the multiple risk Oxford University Press, 1990:167-80. factor intervention trial. Diabetes Care 1993;16:434-44. 40 Giovannucci E, Rimm EB, Stampfer MJ, Colditz GA, Aschero A, Keamey J, 29 National Research Council. Health risks of radon and other internally deposited et al. A prospective study of cigarette smoking and risk of colorectal alpha-emitters. BEIR IV. Washington, DC: National Academy Press, 1988. adenoma and colorectal cancer in US men. J Nad Cancer Inst 1994;86: 30 Bosch FX, Mufloz N, De Sanjose S, Izarzugaza I, Gili M, Viladiu P, et al.
    [Show full text]
  • Chemical Dependency CD440
    Drugs in American Society CHD 601 “Legal Drugs” Alcohol Unit 2 Last updated – April 12, 2017 Edward Pierce, LCSW Overview • From the last class – Counseling videos – Quiz 1 Process – Other items • Alcohol – Biochemical effects – Psychological effects – Assesment – Alcohol Use & Age, Gender, Ethnicity – Family effects – Social effects Effects of drug use • The effects of drug use are quite variable from one person to another. • Some people have fairly significant effects at low amounts, others seem to have little effect. • We have limited understanding of which people will have significant impacts and why. “Legal” Drugs • Alcohol and tobacco are legal, can be a physically destructive “drug” • 10 million Americans drink heavily Alcohol • Actually Ethanol is what is commonly consumed • 200 Proof is 100% ethanol • Beer is 4% ethanol • Wine 10 to 13% • 1 Mixed drink = glass of wine • Distilled spirits can be 50% ethanol or more Blood Alcohol Levels • .08 Legally Drunk in California and U.S. • .35 Death for half of all individuals – Also called (LD50) LD=lethal dose • .8 Death for all individuals (LD100) • Absorption faster for women • Healthy limits are two standard drinks for men, and one for women, in one hour • You can find the a Blood Alcohol Level chart at http://www.brad21.org/bac_charts.html Alcoholic Depression • Alcohol is a depressant, particularly with heavy or severe use. • One can be diagnosed as “Alcoholic Depression” which is a possible result of alcohol use. • Abstinence may relieve the symptoms and the person may not need anti-depressants
    [Show full text]
  • To Drink Or Not to Drink? That Is the Question
    To Drink or Not to Drink? That Is the Question Samer Kanaan, M.D. Goals Review Briefly my credentials and background Heart Disease – The Problem The French Paradox Review Heart-Health Benefits of Red Wine Biology Recommendations on Red Wine Consumption Heart Disease Estimated 80 million Americans have one or more type of Cardiovascular Disease 1 in 3 American Adults Cardiovascular Disease accounts for 35.3% of all deaths in 2005, or one of every 2.8 deaths in the United States. 2,400 Americans die of CVD each day one death every 37 seconds In every year since 1900 except 1918, CVD accounted for more deaths than any other cause. Cardiovascular Disease claims more lives each year than Cancer, Chronic Lower Respiratory Diseases, Accidents, and Diabetes Mellitus COMBINED! The French Paradox History of Alcohol and Health Hippocrates Illustrated the value of wine as a medicine and vital to a healthy diet. Paracelsus (German physician 16th century) “Whether wine is nourishment, medicine, or poison is a matter of dosage.” Thomas Jefferson “wine of long habit has become indispensable to my health” “I think it a great error to consider a heavy tax on wine as a tax on luxury. On the contrary, it is a tax on the health of our citizens.” Louis Pasteur “wine to be the most healthful and hygienic of beverages.” William Heberden – 1786 described angina pectoris “wines and spirituous liquors afford considerable relief” Renaud and DeLongeril Wine, alcohol, platelets, and the French paradox for coronary heart disease. Lancet 1992. Mortality rate for coronary heart disease in France was paradoxical and unexpectedly lower than other industrialized countries, such as the United States and the United Kingdom, despite similarly high dietary intake of saturated fat and the prevalence of other risk factors, such as smoking.
    [Show full text]
  • Role of Alcohol Drinking in Alzheimer's Disease, Parkinson's
    International Journal of Molecular Sciences Review Role of Alcohol Drinking in Alzheimer’s Disease, Parkinson’s Disease, and Amyotrophic Lateral Sclerosis Bin Peng 1, Qiang Yang 2, Rachna B Joshi 1,3, Yuancai Liu 2, Mohammed Akbar 4, Byoung-Joon Song 5 , Shuanhu Zhou 6,* and Xin Wang 1,* 1 Departments of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA; [email protected] (B.P.); [email protected] (R.B.J.) 2 Hubei Provincial Key Lab for Quality and Safety of Traditional Chinese Medicine Health Food, Jing Brand Research Institute, Daye 435100, China; [email protected] (Q.Y.); [email protected] (Y.L.) 3 Internal Medicine, Stafford Medical, PA. 1364 NJ-72, Manahawkin, NJ 08050, USA 4 Division of Neuroscience & Behavior, Laboratory of Membrane Biochemistry and Biophysics, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, MD 20852, USA; [email protected] 5 Section of Molecular Pharmacology and Toxicology, Laboratory of Membrane Biochemistry and Biophysics, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, MD 20892, USA; [email protected] 6 Departments of Orthopedic Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA * Correspondence: [email protected] (S.Z.); [email protected] (X.W.); Tel.: 1-617-732-5398 (S.Z.); 1-617-732-4186 (X.W.) Received: 25 February 2020; Accepted: 24 March 2020; Published: 27 March 2020 Abstract: Neurodegenerative diseases, including Alzheimer’s disease (AD), Parkinson’s disease (PD) and amyotrophic lateral sclerosis (ALS), increase as the population ages around the world.
    [Show full text]
  • Moderate Alcohol Intake in Non-Alcoholic Fatty Liver Disease: to Drink Or Not to Drink?
    nutrients Review Moderate Alcohol Intake in Non-Alcoholic Fatty Liver Disease: To Drink or Not to Drink? Maria L. Petroni * , Lucia Brodosi, Francesca Marchignoli, Alessandra Musio and Giulio Marchesini * Department of Medical and Surgical Sciences, “Alma Mater” University, Sant’Orsola-Malpighi Hospital, Via Massarenti 9, 1-40135 Bologna, Italy; [email protected] (L.B.); [email protected] (F.M.); [email protected] (A.M.) * Correspondence: [email protected] (M.L.P.); [email protected] (G.M.) Received: 31 October 2019; Accepted: 10 December 2019; Published: 13 December 2019 Abstract: Nonalcoholic fatty liver disease (NAFLD) is defined by hepatic steatosis in the presence of alcohol intake within safe limits, defined by guidelines of scientific associations (usually 20 g or 2 units/day in women, 30 g or 3 units in men). The diagnosis is usually followed by medical counseling of total abstinence, in order to prevent disease progression. This policy has been challenged by epidemiological studies, suggesting that the risk of liver disease and disease progression is lower in modest drinkers than in total abstainers. We revised the literature on the effects of modest alcohol intake on disease burden. Epidemiological data may suffer from several potential biases (recall bias for retrospective analyses, difficulties in the calculation of g/day), limiting their validity. Prospective data suggest that NAFLD patients with regular alcohol intake, although within the safe thresholds, are at higher risk of liver disease progression, including hepatocellular carcinoma; a detrimental effect of modest alcohol drinking is similarly observed in liver disease of viral etiology. Alcohol intake is also a risk factor for extrahepatic cancers, particularly breast, oral, and pharyngeal cancers, with gender difference and no floor effect, which outweigh the possible beneficial effects on cardiovascular system, also derived from retrospective studies.
    [Show full text]
  • Alcohol Withdrawal Syndrome Sharon F
    Gardner-Webb University Digital Commons @ Gardner-Webb University Nursing Theses and Capstone Projects Hunt School of Nursing 7-2016 Alcohol Withdrawal Syndrome Sharon F. Ali Gardner-Webb University Follow this and additional works at: https://digitalcommons.gardner-webb.edu/nursing_etd Part of the Psychiatric and Mental Health Nursing Commons, and the Public Health and Community Nursing Commons Recommended Citation Ali, Sharon F., "Alcohol Withdrawal Syndrome" (2016). Nursing Theses and Capstone Projects. 251. https://digitalcommons.gardner-webb.edu/nursing_etd/251 This Thesis is brought to you for free and open access by the Hunt School of Nursing at Digital Commons @ Gardner-Webb University. It has been accepted for inclusion in Nursing Theses and Capstone Projects by an authorized administrator of Digital Commons @ Gardner-Webb University. For more information, please see Copyright and Publishing Info. Alcohol Withdrawal Syndrome by Sharon F. Ali A thesis submitted to the faculty of Gardner-Webb University Hunt School of Nursing in partial fulfillment of the requirements for the Master of Science in Nursing Degree Boiling Springs, North Carolina 2016 Submitted by: Approved by: _______________________ ______________________ Sharon F. Ali Dr. Gayle Casterline _______________________ ______________________ Date Date Abstract Alcohol withdrawal syndrome (AWS) is a very serious problem that may affect the patient when admitted inpatient for a traumatic or non-traumatic diagnosis. Chronic Alcohol consumption in moderation may put the patient at risk for delirium tremens which is the most severe form of alcohol withdrawal. Management of alcohol withdrawal in acutely ill hospitalized patients is challenging for healthcare providers (Riddle, Bush, Tittle, & Dilkhush, 2010). Signs and symptoms of AWS are caused primarily by neurophysiologic changes in the brain, which may be mild to severe, and may develop within 6-72 hours after abstaining from alcohol.
    [Show full text]