PDF(Pubmed)
Abstract：
The objective of this scoping review is to evaluate the updated evidence on the consumption of alcohol and health outcomes regarded as relevant for the Nordic and Baltic countries, including cardiovascular disease, cancer, and all-cause mortality. It is based on the previous Nordic Nutrition Recommendations of 2012 and relevant papers published until 31 May 2021. Current evidence from mainly observational epidemiological studies suggests that regular, moderate alcohol consumption may confer protective effects against myocardial infarction (MI) and type 2 diabetes. Mendelian randomization analyses do not fully support these findings, possibly because these analyses may fail to identify low alcohol intake. For several cancers, it is not possible to set any safe limit. All-cause mortality is not increased with light to moderate alcohol intake in middle-aged and older adults who do not engage in binge drinking. Total abstinence is associated with the lowest risk of mortality in young adults. Observational studies on alcohol consumption are hampered by a number of inherent methodological issues such as ascertainment of alcohol intake, selection of appropriate exposure groups, and insufficient control of confounding variables, colliders, and mediators. It should also be emphasized that there is a socio-economic contribution to the alcohol-health axis with a stronger detrimental effect of alcohol in the lower social classes. The above issues contribute to the complexity of unravelling the causal web between alcohol, mediators, confounders, and health outcome.
摘要：
本次范围界定审查的目的是评估被认为与北欧和波罗的海国家相关的酒精消费和健康结果的最新证据，包括心血管疾病,癌症,和全因死亡率。它基于2012年之前的北欧营养建议和2021年5月31日之前发表的相关论文。目前主要来自观察性流行病学研究的证据表明，适度饮酒可能对心肌梗死(MI)和2型糖尿病具有保护作用.孟德尔随机化分析并不完全支持这些发现，可能是因为这些分析可能无法识别低酒精摄入量。对于几种癌症，不可能设置任何安全限制。在不暴饮暴食的中老年人中，轻度至中度饮酒不会增加全因死亡率。在年轻人中，完全禁欲与最低的死亡风险相关。关于饮酒的观察研究受到一些固有的方法论问题的阻碍，例如确定酒精摄入量，选择适当的暴露组，以及对混杂变量的控制不足，对撞机,和调解员。还应该强调的是，对酒精健康轴的社会经济贡献在较低的社会阶层中具有更强的酒精有害影响。上述问题导致了解开酒精之间因果网的复杂性，调解员,混杂因素，和健康结果。
