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16 Alcohol
Pages 431-464

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From page 431...
... were alcohol abusers, defined by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) as drinkers who experienced at least one severe or moderately severe consequence of alcoho!
From page 432...
... Many alcoholics also reported consequences of alcohol abuse, and some counted as alcohol abusers may have had alcohol depender~ce. Alcohol consumption peaks in the 20- to 40-year age group; alcohol abuse is most frequent in youth and middle age.
From page 433...
... Black youths have higher abstention rates and lower rates of heavy drinking than white youths. Native Americans, on the average, are more likely to be heavy drinkers than the general population.
From page 434...
... Huss (~852) attributed the effects of chronic alcohol abuse to tissue damage and believed that alcohol's toxic effects were similar to those caused by intoxicating foocis.
From page 435...
... . North American Indians also vary widely in their reactions to alcoholic beverages and have changed their attitudes over time.
From page 436...
... Moderate alcohol intake (i.e., 16% of total calories) was associated with a slightly elevated energy intake (Gruchow et al., 1985a)
From page 437...
... Esophagus A high prevalence of alcoholism has been found among patients with esophageal cancer (Piques and Tison, 1937~. Furthermore, the incidence of esophageal cancer was greater among people employed in the production or distribution of alcoholic beverages than in the general population (Jensen, 1979~.
From page 438...
... (1982) reported that 19 of 51 subjects with various stages of alcoholic liver disease had one or more serologic markers of HBV in their serum.
From page 439...
... Adjustment for known breast cancer risk factors (e.g., parity, age at hrst birth, history of matemal breast cancer, prior breast disease, and relative weight) and a variety of nutritional variables (including estimated consumption of total calories, total fat, saturated fat, polyunsaturated fat, cholesterol, carotene, preformed vitamin A, and vitamin E)
From page 440...
... , chronic ethanol consumption enhanced the appearance of rectal tumors but not tumors in the distal or proximal colon (Seiez et al., 1984~. This effect did not relate to the cytochrome P450dependent oxidizing system in the liver or in the colonic mucosa or to changes in the fecal bile acids.
From page 441...
... For example, patients with alcoholic liver disease had very low hepatic vitamin A levels at all stages of their disease (Leo and Lieber, 1982~. Retinal can compete with DMN for its activation (presumably tO carcinogens)
From page 442...
... Thus, it is reasonable to expect that habitual alcohol consumption is associated with increased risk of stroke. In the Honolulu Heart Program a prospective study of 8,000 middIe-aged men of Japanese ancestry-alcohol consumption was positively associated with risk of hemorrhagic stroke but not of thromboembolic stroke (Donahue et al., 1986; Kagan et al., 1980, 1981~.
From page 443...
... In summary, the epidemiologic evidence is generally consistent with the hypothesis that chronic alcohol consumption is associated with increased blood pressure an] with increased risk of hemorrhagic stroke but not of cerebral infarction.
From page 444...
... , the association was highly significant and showed a dose response after adjustment for coronary risk factors such as cigarette smoking, serum cholesterol, and blood pressure. An especially important aspect of the Honolulu Heart Program is its large number of lifetime abstainers (2,744)
From page 445...
... A U-shaped association has been observed in many cohorts, e.g., the Honolulu Heart Program (Blackwelder et al., 1980) , the Whitehall Study of British civil servants (marmot et al., 1981)
From page 446...
... v , . ~ s , ~ Other Cardiovascular Diseases Alcohol intake was inversely associated with incidence of intermittent ciaudication in the Framingham Study, but was not associated with risk of congestive heart failure (Gordon and Kannel, 1983~.
From page 447...
... Hyperuricemia Excessive drinking of alcoholic beverages is as' sociated with acute gouty arthritis (Newcombe, 1972~. The hyperuricemia that accompanies bouts of intense alcohol intake occurs in patients with' out known disorders of uric acid metabolism or renal function (Lieber et al., 1962~.
From page 448...
... it has not been possible tO produce more advanced alcohol-induced liver injury in rats because of the short life and lower alcohol intake of the rat compared tO the baboon. Animal experiments and epidemiologic studies demonstrate that ethanol plays a major role in the pathogenesis of alcoholic liver disease.
From page 449...
... Furthermore, clinical data from patients with alcoholic liver disease as well as experiments in volunteers have shown the inert fectiveness of lipotropic factors in the prevention of alcohol-associated liver injury (Olson, 1964; Rubin and Lieber, 1968~. Diseases of the Nervous System Wernick - Korsakoff Syndrome The Wemick - Korsakoffsyndrome includes two diseases: Wemicke's encephalopathy, characterized by weakness of eye movements, gait disturbance, and confusion, and Korsakoff,s psychosis, a permanent brain disorder characterized by marked abnormalities in cognitive Unction, particularly the inability to team new information or tO remember recent events.
From page 450...
... , and triceps skinfolds were thinner (Mendenhall et al., 1984; Morgan, 1981; Simko et al., 1982~. Continued drinking was associated with weight loss, whereas abstinence was associated with weight gain (WorId et al., 1984a,b>, in patients with and without liver disease (Simko et al., 1962~.
From page 451...
... Vitamin A absorption is reduced even farther in the presence of fat malabsorption due to chronic alco' holic pancreatic. In humans with alcoholic liver disease, hepatic vitamin A levels progressively decreased with increasing severity of liver injury (Leo and Lieber, 1982~.
From page 452...
... Hepatic vitamin A stores are then depleted to a level precluding extensive mobilization; as a result, there is a general lack of vitamin A in hepatic and nonhepatic tissues. Epidemiologic studies associate chronic alcohol consumption with high blood pressure and increased risk of hemorrhagic stroke; acute consumption is linked with increased risk of stroke due to cerebral infarction and hemorrhage.
From page 453...
... 1979b. Interrelationship between coronary artery occlusion, high' density lipoprotein cholesterol, and alcohol intake.
From page 454...
... 1982. Evidence that hepatitis B virus has a role in liver-cell carcinoma in alcoholic liver disease.
From page 455...
... 1985a. The effects of chronic ethanol consumption on carcinogen metabolizing systems in rat upper alimentary tract.
From page 456...
... 1981. Hepatitis B infection in alcoholic liver disease and primary hepatocellular carcinoma in France.
From page 457...
... 1981. Serological markers of hepatitis B in patients 457 with alcoholic liver disease: a multi-centre survey.
From page 458...
... 1976. Epidemiology of alcoholic liver disease.
From page 459...
... 1982. Hepatic vitamin A depletion in alcoholic liver injury.
From page 460...
... 1970. Serum lipids and total fatty acids in chronic alcoholic liver disease at different stages of cell damage.
From page 461...
... and alcoholic liver disease. Hepatology 6:1391-1395.
From page 462...
... 1977. Abnormal plasma lipoproteins and lecithin-cholesterol acyltransferase deficiency in alcoholic liver disease.
From page 463...
... 1984. Enhancement of 1,2-dimethylhydrazine-induced rectal carcinogenesis following chronic ethanol consumption in the rat.
From page 464...
... 1984b. Differential effect of chronic alcohol intake and poor nutrition on body weight and fat stores.


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