Association between alcohol intake pattern and metabolic syndrome components and simulated change by alcohol intake reduction: A cross-sectional study from the Japan Multi-Institutional Collaborative Cohort Study

Highlights

• High blood pressure prevalence increased with alcohol intake amount and frequency.

• The simulation of no heavy drinkers was associated with lower ORs for high blood pressure.

• Moderate reduction in the amount and frequency of alcohol intake similarly lowered blood pressure.

Abstract

To investigate the association between alcohol intake pattern in amount and frequency and metabolic syndrome (Mets) components, we simulated the change in the prevalence of Mets components by intake reduction. In order to manage Mets, alcohol intake reduction with moderation of intake pattern is required. However, evidence investigating the comparative impact of alcohol intake reduction in amount and frequency for Mets components is limited. We conducted a large-scale cross-sectional study in the general Japanese population. The study subjects included 37,371 non-drinkers and current drinkers recruited in the Japan Multi-Institutional Collaborative Cohort Study. Odds ratios (ORs) for Mets components according to alcohol intake amount and frequency were estimated using a multiple logistic regression model. The prevalence of Mets components was estimated after assumed alcohol intake reduction of a) none, b) 10 g/day (men) or 5 g/day (women), c) 20 g/day (men) or 10 g/day (women), d) less than 20 g/day (men) or 10 g/day (women) for moderate-to-heavy drinkers, e) 1–2 times/week, and f) 3–4 times/week. The ORs with alcohol intake amount and frequency increased with high blood pressure while decreasing with dyslipidemia. A J-shaped association was observed between intake amount and Mets. The estimated prevalence (%) of high blood pressure and dyslipidemia in men were a) 45.2, b) 43.0, c) 41.4, d) 40.4, e) 42.9, and f) 42.0; and a) 50.3, b) 51.8, c) 52.9, d) 50.2, e) 52.7, and f) 53.4 in women. The estimated prevalence of high blood pressure in women did not evidently decrease. Simulated alcohol intake reduction showed decreased prevalence for high blood pressure and increased prevalence for dyslipidemia in men after reduced intake amount and frequency. The largest decreased prevalence for high blood pressure was observed in men when all moderate-to-heavy drinkers reduced their alcohol intake amount to less than 20 g/day.

Introduction

Alcohol intake is the third leading risk factor for poor health worldwide and one of the four most common modifiable and preventable risk factors for noncommunicable diseases (GBD 2016 Alcohol Collaborators, 2018). A positive linear association was observed between alcohol intake and cancer (Bagnardi et al., 2015; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2010), while a J-shaped association was observed between alcohol intake and cardiovascular diseases (CVDs) (Inoue et al., 2012; Xi et al., 2017). When the effect of alcohol intake reduction for CVD risk and its related factors is evaluated, different associations between alcohol intake and metabolic syndrome (Mets) components as the major risk factors for CVDs should be taken into consideration, because alcohol intake is positively associated with hypertension and glucose intolerance and negatively associated with dyslipidemia (Freiberg, Cabral, Heeren, Vasan, & Curtis Ellison, 2004; Oh, Kim, Han, Park, & Jang, 2018; Ronksley, Brien, Turner, Mukamal, & Ghali, 2011; Suliga et al., 2019; Wakabayashi, 2010).

Intake amount and frequency are the major components of total alcohol consumption. Average consumption per period is usually used in the evaluation of alcohol-related risk in epidemiological studies (Dawson, 2003; Rehm, 1998), and average consumption per day is recommended for the moderation of alcohol intake in the management of alcohol-related diseases (Holman, English, Milne, & Winter, 1996; Ministry of Health, Labour, and Welfare, 2015; Tsugane, Fahey, Sasaki, & Baba, 1999). Drinkers have various alcohol drinking patterns; hence, moderation of intake patterns is required for the reduction management of alcohol intake. However, evidence investigating the comparative impact of alcohol intake reduction in amount and frequency for Mets and its components is limited. A previous study analyzed the association between drinking pattern and blood pressure and reported that intake frequency had greater impact on blood pressure than intake amount (Russell, Cooper, Frone, & Welte, 1991). An Eastern European cohort study reported lower risk of CVDs with less frequent intake of alcoholic beverages (Bobak et al., 2016). A Japanese cohort study revealed decreased risk of CVDs with liver holidays in male current drinkers (Saito et al., 2018). A United States population-based study reported the positive association of drinking frequency with blood pressure and negative association of drinking frequency with high-density lipoprotein cholesterol (HDL-C) levels (Fan et al., 2008).

To investigate the association between alcohol intake pattern in amount and frequency and Mets components and to simulate the change of the prevalence by alcohol intake reduction, we conducted a large-scale cross-sectional study in the general Japanese population.