Alcohol in the Elderly

Buja et al (2010 ) European Journal of Clinical Nutrition (2010) 64, 297–307;

Alcohol consumption and metabolic syndrome in the elderly: results from the Italian longitudinal study on aging

Although there is plenty of evidence of the association between metabolic syndrome (MS) and cardiovascular disease, the relationship between alcohol consumption and metabolic syndrome is still questioned. The few publications with respect to the elderly seem to indicate that alcohol consumption is unassociated with metabolic syndrome. The aim of this study was to assess the association between alcohol consumption and the prevalence and incidence of metabolic syndrome, as well as its components in a large sample of Italian elderly people.

This is a multicenter study on a population-based sample of Italian people aged 65–84 years. The Italian Longitudinal Study on Aging (ILSA) included a prevalence phase in 1992 and an incidence phase from 1995 to 1996. The median length of follow-up was 3.5 years. In the present study, the analysis included 1321 men grouped into five alcohol consumption classes: abstainers, and those consuming 12, 13–24, 25–47 or 48?g of alcohol in a day. Among the 1122 women considered, the last two of the above five categories were pooled together (>24?g/day). Metabolic syndrome was defined according to ATP III criteria. All statistical analyses were stratified by gender.


Adjusted odds ratios showed that categorized alcohol consumption was not significantly associated with the prevalence and incidence of metabolic syndrome when compared with abstainers in either gender. For the metabolic syndrome incidence survey, three of five components (systolic pressure, glycemia and waist circumference) proved to be significantly and harmfully affected by alcohol consumption in males, whereas no such significant association emerged in females.


These results suggest that alcohol can modify an individual’s metabolic condition and that, even among the elderly, men might be more sensitive to the effects of alcohol than women.

Alcohol Metabolism

Alcohol dehydrogenase (ADH) and mitochondria! aldehyde dehydrogenase (ALDH2) are responsible for metabolizing the bulk of consumed ethanol. These enzymes also affect the rate of ethanol elimination from the blood. They are expressed at highest levels in liver, but at lower levels in many tissues. This pathway probably evolved as a detoxification mechanism for environmental alcohols.

However, with the consumption of large amounts of ethanol. the oxidation of ethanol can become a major energy source and particularly in the liver, interferes with the metabolism of other nutrients. Polymorphic variants of the genes for these enzymes encode enzymes with altered kinetic properties.

The patho-physiological effects of these variants may be mediated by accumulation of acetaldehyde: High-activity ADH variants are predicted to increase the rate of acetaldehyde generation, while the low-activity ALDH2 variant is associated with an inability to metabolize this compound. The effects of acetaldehyde may be both in the cells, or by the acetaldehyde passing to various tissues by the bloodstream or even saliva.

Inheritance of the high-activity ADH β2. encoded by the ADH2*2 gene, and the inactive ALDH2*2 gene product have been conclusively associated with reduced risk of alcoholism. This association is influenced by gene-environment interactions, such as religion and national origin.

The variants have also been studied for association with alcoholic liver disease, cancer, foetal alcohol syndrome. CVD, gout, asthma and clearance of xenobiotics. The strongest correlations found to date have been those between the ALDH2*2 allele and cancers of the oro-pharynx and oesophagus.

Crabb et al 2004, Proceedings of the Nutrition Society (2004) vol 63, 49-63

History of Alcohol

This book by McGovern on a history of alcohol making suggested that the desire for alcohol is innate in human beings. The “ uniquely human traits “ of self-consciousness, innovation , the arts and religion have been encouraged by the consumption of alcohol

Alcohol has been made of thousands of #years.

Evidence of alcohol being made has been fond in the Zagros Mountains in Western Iran.

An alcoholic drink from fermented rice, honey and hawthorn fruit was produced in China inn 7000 BC.

McGoern PE 2009 Uncorking the past: the quest for wine, beer and other alcoholic beverages. University of California Press


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