EAL

DLM: Alcohol (2001)

Citation:

Study Design:

Class:

- Click here for explanation of classification scheme.

Quality Rating:

Research Purpose:

To summarize the current literature on wine intake and cardiovascular disease.

Inclusion Criteria:

Not described.

Exclusion Criteria:

Not described.

Description of Study Protocol:

Only population based descriptive studies and cohort studies have been used to evaluate the effect of alcohol on CHD
The majority of the studies were done in men.

Data Collection Summary:

Not described.

Description of Actual Data Sample:

Not described.

Summary of Results:

Possible benefits of alcohol use:

More than 60 prospective studies suggest an inverse relationship between moderate alcohol consumption (one to two drinks per day) and CHD
Most cohort studies do not support an association between type of alcoholic beverage and prevention of heart disease; a few have suggested that wine may be more beneficial than other alcohols
One to two drinks per day increase HDL by ~12% on average. However, no clinical trials have been done to verify the effect of alcohol on HDL.
Light to moderate consumption of any type of alcohol-containing beverage (60ml per day) appears to reduce platelet aggregation and provides an antithrombotic benefit similar to that of aspirin.

Possible adverse effects of alcohol use:

From the Nurses Health Study consumption of more than 20g alcohol per day in women 30 to 55 years of age is associated with a linear increase in the incidence of HTN
Intakes of more than 20g alcohol per day in men is also associated with HTN, but the relationship is less linear than in women
Long term consumption of alcohol (more than 60g per day) increases an individuals's risk for all stroke subtypes
Alcohol consumption can increase serum triglyceride and VLDL cholesterol
Alcohol consumption can increase can exacerbate pancreatitis.

Author Conclusion:

Moderate intake of alcoholic beverages (one to two drinks per day) is associated with a decreased risk of CHD in populations
Without a large-scale, randomized, clinical end-point trial of wine intake, there is little current justification to recommend alcohol (or wine specifically) as a cardioprotective strategy
The American Heart Association maintains its recommendations that alcohol use should be an item of discussion between physician and patient.

Funding Source:

Not-for-profit

Foundation associated with industry:

Reviewer Comments:

Criteria for article inclusion was not described
Search strategy was not described, nor was study quality assessed
For the most part, gender of study participants was not described.

Quality Criteria Checklist: Review Articles
Relevance Questions
	1.	Will the answer if true, have a direct bearing on the health of patients?	Yes
	2.	Is the outcome or topic something that patients/clients/population groups would care about?	Yes
	3.	Is the problem addressed in the review one that is relevant to dietetics practice?	Yes
	4.	Will the information, if true, require a change in practice?	Yes

Validity Questions
	1.	Was the question for the review clearly focused and appropriate?	Yes
	2.	Was the search strategy used to locate relevant studies comprehensive? Were the databases searched and the search termsused described?	No
	3.	Were explicit methods used to select studies to include in the review? Were inclusion/exclusion criteria specified andappropriate? Wereselectionmethods unbiased?	No
	4.	Was there an appraisal of the quality and validity of studies included in the review? Were appraisal methodsspecified,appropriate, andreproducible?	No
	5.	Were specific treatments/interventions/exposures described? Were treatments similar enough to be combined?	No
	6.	Was the outcome of interest clearly indicated? Were other potential harms and benefits considered?	Yes
	7.	Were processes for data abstraction, synthesis, and analysis described? Were they applied consistently acrossstudies and groups? Was thereappropriate use of qualitative and/or quantitative synthesis? Was variation in findings among studies analyzed? Were heterogeneity issued considered? If data from studies were aggregated for meta-analysis, was the procedure described?	No
	8.	Are the results clearly presented in narrative and/or quantitative terms? If summary statistics are used, are levels ofsignificance and/or confidence intervals included?	Yes
	9.	Are conclusions supported by results with biases and limitations taken into consideration? Are limitations ofthe review identified anddiscussed?	No
	10.	Was bias due to the review's funding or sponsorship unlikely?	Yes