Background The use of alcohol-flavored beverages not containing alcohol (hereinafter referred to as non-alcoholic beverages) is recommended to reduce alcohol consumption. However, it is unclear if ...this reduces excessive drinking. Objective To verify whether non-alcoholic beverages impact the alcohol consumption of excessive drinkers. Study design Single-center, open-label, randomized, parallel-group study. Methods Participants aged 20 years or older who were not diagnosed with alcoholism, who drank at least four times a week, and whose alcohol consumption on those days was at least 40 g in males and 20 g in females, were recruited. Participants were randomized into the intervention or control group by simple randomization using a random number table. In the intervention group, free non-alcoholic beverages were provided once every 4 weeks for 12 weeks (three times in total), and thereafter, the number of alcoholic and non-alcoholic beverages consumed were recorded for up to 20 weeks. The consumption of alcoholic and non-alcoholic beverages was calculated based on a drinking diary submitted with the previous 4 weeks of data. The primary endpoint was the change from baseline in total alcohol consumption during past 4 weeks at week 12. The participants were not blinded to group allocations. Results Fifty-four participants (43.9%) were allocated to the intervention group and 69 (56.1%) to the control group. None of the participants in the intervention group dropped out, compared to two (1.6%) in the control group. The change in alcohol consumption was - 320.8 g (standard deviation SD, 283.6) in the intervention group and - 76.9 g (SD, 272.6) in the control group at Week 12, indicating a significant difference (p < 0.001). Even at Week 20 (8 weeks after the completion of the intervention), the change was - 276.9 g (SD, 39.1) in the intervention group, which was significantly greater than - 126.1 g (SD, 41.3) in the control group (p < 0.001). The Spearman rank correlation coefficient between the change in non-alcoholic beverage consumption and alcohol consumption at Week 12 was significantly negative only in the intervention group (rho = - 0.500, p < 0.001). There were no reports of adverse events during the study. Conclusions Providing non-alcoholic beverages significantly reduced alcohol consumption, an effect that persisted for 8 weeks after the intervention. Trial registration UMIN UMIN000047949. Registered 4 June 2022. Keywords: Non-alcoholic beverages, Reduced alcohol consumption, Randomized controlled study
We recently demonstrated that a 12-week intervention consisting of the provision of free non-alcoholic beverages reduced alcohol consumption in excessive drinkers for 8 weeks after the intervention. ...However, gender differences in this effect were not explored. Thus, this secondary analysis investigated gender differences in the influence of non-alcoholic beverage provision on alcohol consumption.
Individuals who frequently drank excessively (at least 40 g/day in men and 20 g/day in women) and who were not diagnosed with alcoholism were recruited. Participants were randomized into the intervention or control group by simple randomization using a random number table. In the intervention group, free non-alcoholic beverages were provided once every 4 weeks for 12 weeks (three times in total). The consumption of alcoholic and non-alcoholic beverages was calculated based on a drinking diary submitted with the previous 4 weeks' of data. In this study, we compared the longitudinal changes in alcohol consumption between genders in both groups.
The provision of non-alcoholic beverages significantly reduced alcohol consumption in both genders; however, significant differences in alcohol consumption between the control and intervention groups were observed only in men. The average alcohol consumption during the intervention fell below the level associated with a high risk of non-communicable diseases in men (32.7 g/day), but not in women (24.8 g/day). Correlation coefficient analysis showed that replacing alcoholic beverages with the provided non-alcoholic beverages resulted in different drinking patterns according to gender. The percent changes in the consumption of alcoholic and non-alcoholic beverages relative to baseline levels did not differ between genders.
Our results suggest that the provision of non-alcoholic beverages reduced alcohol consumption irrespective of gender. Of note, providing non-alcoholic beverages might be particularly useful for reducing high-risk alcohol consumption in male excessive drinkers.
UMIN UMIN000047949. Registered 4 June 2022.
ObjectivesThe objective was to clarify the relationship between alcohol consumption/alcohol use disorders and patient complexity.DesignCross-sectional study.SettingA clinic located on a remote island ...in Okinawa, Japan, providing general outpatient practices and round-the-clock emergency services.ParticipantsPatients who lived on the island, visited Tarama Clinic from 1 April 2018 to 30 June 2018, were aged ≥20 years and had decision-making capacity were judged to be eligible for this study.Main outcome measuresAlcohol consumption/alcohol use disorders as measured by the Alcohol Use Disorders Identification Test (AUDIT) and patient complexity as scored by the Patient Centered Assessment Method (PCAM).ResultsDuring the 3-month study period, 355 patients (163 women and 192 men) with mean (SD) age of 66.4 (13.6) years were included. Multiple regression analysis of PCAM scores showed that, after adjusting for age, sex, education, occupation, physical activity, smoking, annual medical expenses and number of family members living with the patient, AUDIT scores classified as ‘dependence likely’ were associated with PCAM scores (p value=0.040).ConclusionsAlcohol consumption and alcohol use disorders classified as dependence likely are associated with patient complexity.
Purpose
To conduct a retrospective multicenter study to investigate the accuracy of pedicle screw (PS) placement in the cervical spine by freehand technique and the related complications in various ...pathological conditions including trauma, rheumatoid arthritis, degenerative conditions and others.
Methods
283 patients with 1,065 PSs in the cervical spine who were treated at eight spine centers and finished postoperative CT scan were enrolled. The numbers of placed PSs were 608 for trauma, 180 for rheumatoid arthritis (RA), 199 for spondylosis, and 78 for others. Malposition grades on CT image in the axial plane were defined as grade 0 (G-0) correct placement, grade 1 (G-1): malposition by less than half screw diameter, grade 2 (G-2): malposition by more than half screw diameter. The direction of malposition was classified into four categories: medial, lateral, superior and inferior.
Results
Overall malposition rate was 14.8 % (9.6 % in G-1 and 5.3 % in G-2). The highest malposition rate was 26.7 % for RA, followed by 16.6 % for spondylosis, and 11.2 % for trauma. The malposition rate for RA was significantly higher than those for other pathologies. 79.7 % of the malpositioned screws were placed laterally. Though intraoperative vertebral artery injury was observed in two patients with RA, there were no serious complications during a minimal 2-year follow-up.
Conclusions
Malposition rate of PS placement in the cervical spine by freehand technique was high in rheumatoid patients even when being performed by experienced spine surgeons. Any guidance tools including navigation systems are recommended for placement of cervical PSs in patients with RA.
The development of allergic diseases is common in the young but rare in the elderly. We encountered an elderly patient with food-dependent exercise-induced anaphylaxis (FDEIA). An 82-year-old man was ...rushed to the hospital for symptoms of anaphylaxis. Because the symptoms occurred after ingestion of wheat products and exercise, we made a diagnosis of FDEIA based on a high ω5-gliadin IgE level and a positive exercise test. Based on our review of the existing literature, this was the oldest patient to ever be diagnosed with FDEIA in Japan. This case suggests that physicians should keep in mind that older adults can develop FDEIA.
Low sleep quality in adolescents is an important public health concern, as it relates to both their current and future physical and mental health. Furthermore, subjective happiness is also often ...regarded as a major life goal. Although Japan is an economically powerful country, the reported levels of subjective happiness among Japanese adolescents is low. Thus, this study aims to examine the relationship between subjective happiness and sleep problems in Japanese adolescents.
We conducted a nationally representative cross-sectional study of adolescents enrolled in junior and senior high schools in Japan. We used a questionnaire to determine the prevalence of sleep problems (eg, insomnia, short sleep duration (SSD) and poor sleep quality) and to evaluate the participants' reported levels of subjective happiness. Multivariable logistic regression analyses were used to examine the associations between subjective happiness and sleep problems. Adjusted variables were basic demographic characteristics (eg, gender and school grade), lifestyle behaviors, and mental health status.
Data from 64,329 students were analyzed (age range 12–18 years, mean age 15.7 years, 53.9% male). The results indicated that reported levels of subjective happiness were strongly associated with the prevalence of sleep problems. Linear relationships can be observed between sleep problems and subjective happiness scores. The multivariable logistic regression analysis showed that dose–response association of subjective happiness score was observed with all three sleep problems.
Due to these findings, we recommend that policy makers and school officials educate adolescents on the importance of both subjective happiness and good sleep hygiene.
•This study examined happiness and sleep problems in Japanese adolescents.•Lower subjective happiness levels may be the result of sleep problems.•It is important to educate adolescents on subjective happiness and sleep hygiene.
It is unclear whether brief interventions using the combined classification of alcohol-metabolizing enzymes aldehyde dehydrogenase 2 (ALDH2) and alcohol dehydrogenase 1B (ADH1B) together with ...behavioral changes in alcohol use can reduce excessive alcohol consumption. This study aimed to examine the effects of a brief intervention based on the screening of ALDH2 and ADH1B gene polymorphisms on alcohol consumption in Japanese young adults.
In this open-label randomized controlled trial, we enrolled adults aged 20-30 years who had excessive drinking behavior (average amount of alcohol consumed: men, ≥ 4 drinks/per day and women, ≥ 2 drinks/per day; 1 drink = 10 g of pure alcohol equivalent). Participants were randomized into intervention or control group using a simple random number table. The intervention group underwent saliva-based genotyping of alcohol-metabolizing enzymes (ALDH2 and ADH1B), which were classified into five types. A 30-min in-person or online educational counseling was conducted approximately 1 month later based on genotyping test results and their own drinking records. The control group received traditional alcohol education. Average daily alcohol consumption was calculated based on the drinking diary, which was recorded at baseline and at 3 and 6 months of follow-up. The primary endpoint was average daily alcohol consumption, and the secondary endpoints were the alcohol-use disorder identification test for consumption (AUDIT-C) score and behavioral modification stages assessed using a transtheoretical model.
Participants were allocated to the intervention (n = 100) and control (n = 96) groups using simple randomization. Overall, 28 (29.2%) participants in the control group and 21 (21.0%) in the intervention group did not complete the follow-up. Average alcohol consumption decreased significantly from baseline to 3 and 6 months in the intervention group but not in the control group. The reduction from baseline alcohol consumption values and AUDIT-C score at 3 months were greater in the intervention group than in the control group (p < 0.001). In addition, the behavioral modification stages were significantly changed by the intervention (p < 0.001).
Genetic testing for alcohol-metabolizing enzymes and health guidance on type-specific excessive drinking may be useful for reducing sustained average alcohol consumption associated with behavioral modification.
R000050379, UMIN000044148, Registered on June 1, 2021.
From among the global public health concerns, smoking remains one of the most crucial challenges. Especially for adolescents, the increase in the use of electronic cigarettes is controversial, as its ...use may lead to established smoking. In Japan, where a unique tobacco regulation system exists, the heat-not-burn tobacco market has been growing. However, the prevalence and association of combustible cigarettes and new tobacco-related products have not yet been closely investigated among Japanese adolescents. This study aimed to clarify the prevalence of smoking among adolescents, including new types of tobacco-related products, and to compare the characteristics of their users.
The 2017 Lifestyle Survey of Adolescents is a nationally-representative survey collected in Japan. From the national school directory, 98 junior high schools and 86 high schools were randomly sampled throughout Japan. The students completed an anonymous questionnaire at school. We calculated the prevalence of use for each type of tobacco product. Then, the use of a combination of products and the characteristics of different types of products were examined.
In total, 64,152 students from 48 junior high schools and 55 high schools were included the analysis (school response rate = 56%, M
= 15.7 years, 53.9% boys). The age-adjusted rate of ever (current) use of electronic cigarettes was 2.1% (0.7%) in junior high school and 3.5% (1.0%) in high school; that of combustible cigarettes was 2.6% (0.6%) in junior high school and 5.1% (1.5%) in high school. The rate of heat-not-burn tobacco use was lower relative to other products: 1.1% (0.5%) in junior high school and 2.2% (0.9%) in high school. An examination of the combined use of the three products identified a high number of dual users. Comparisons between different types of users indicated different backgrounds for combustible cigarette users and new product users.
The prevalence of new tobacco-alternative products is growing in popularity among Japanese adolescents. Dual use is common, and many adolescents use new products only. Moreover, e-cigarettes might attract a broader range of groups to smoking. Continuous monitoring and research are needed to investigate their influence as a possible gateway to tobacco smoking.
ObjectivesThe primary objective was to describe the characteristics of Otōri, a regionally specific drinking custom in the Miyakojima region of Okinawa, Japan, and its participants. The secondary ...objective was to clarify the distribution of alcohol consumption/alcohol use disorders as measured by the Alcohol Use Disorders Identification Test (AUDIT) and its association with the frequency of engagement in Otōri per month.DesignCross-sectional study.SettingTarama Island, a remote island in Okinawa, Japan.ParticipantsIndividuals who lived on Tarama Island, participated in a mass general health check or mass influenza vaccination programme, were aged ≥20 years and had decision-making capacity were eligible to participate.Primary outcome measuresAlcohol consumption/alcohol use disorders as measured by the AUDIT, frequency of engagement in Otōri per month, settings in which people engage in Otōri and attitudes toward Otōri.ResultsAmong 478 eligible participants, 401 answered the questionnaire. Approximately 15% reported attitudes toward Otōri of ‘like’ or ‘somewhat like’; around 80% of these participants were middle-aged to older adult men. Compared with the national average, a higher percentage of people (9.2% and 40.9% of women and men, respectively) had AUDIT scores indicating ‘hazardous drinking or more’, which was associated with ‘low or intermediate frequency’ and ‘high frequency’ of engagement in Otōri per month (ORs of 7.626 and 20.321, respectively).ConclusionsSocial obligation generated by some community members could pressure most of the population into participating in Otōri, possibly leading to a higher percentage of people engaging in hazardous/harmful alcohol consumption and alcohol dependence. However, healthcare professionals should carefully consider the beneficial and detrimental effects of the custom on biomedical and social conditions and avoid advocating to promote or abolish the custom by only highlighting one aspect.
Abstract
Background
The alcohol-metabolizing enzyme aldehyde dehydrogenase 2 (
ALDH2
) is a carcinogenic acetaldehyde-degrading enzyme, and its low activity is a genetic constitution peculiar to East ...Asians. People with low alcohol dehydrogenase 1B activity (
ADH1B*1/*1
genotype) have a high risk of developing head and neck cancer and alcoholism. The study aims to evaluate the effectiveness of brief interventions for excessive drinking among college students and adults in their 20s, including information on five constitutions that combine the
ALDH2
and
ADH1B
genotypes.
Methods
Participants comprised university students and staff aged 20–30 years who had consumed ≥40 g (males) or ≥20 g (females) of pure alcohol; they were classified into intervention and control groups using a simple randomization method. Participants anonymously filled out questionnaires linked to identification numbers and recorded the drinking days and amounts on the drinking calendar. The intervention group will then be tested for genotype testing using saliva (5 types of combinations of
ALDH2
and
ADH1B
enzyme activities); the result report will arrive approximately 1 month later. We will conduct a 30-min face-to-face or online intervention. The control group will be merely given the conventional materials, and genetic testing will be performed voluntarily after 6 months (end of study). The intervention group will undergo questionnaire surveys 1 month after the intervention and 3 and 6 months after baseline. Questionnaire surveys will be conducted 1, 3, and 6 months after baseline for the control group. The average amount of drinking before and after the intervention, attribute/baseline data between the two groups, and time-series data were compared using various analysis tools. For interventions, we engaged in dialog based on intervention materials that added genotyping content to the existing materials, result reports, baseline data, and drinking calendar records. Participants’ ingenuity is respected to support their drinking behavior and goal setting.
Discussion
Individual information on the genetic makeup of alcohol-metabolizing enzymes provided during the intervention is more personal and objective than general health information, especially in Japan, where the
ALDH2
low activity rate is high. This information may be useful for health care and precautionary measures.
Trial registration
R000050379, UMIN000044148, Registered on June 1, 2021.
Scientific Title: Examination of simple intervention using genetic polymorphism information for excessive drinking.
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