Session Title: Moderate Alcohol Use, Nutrition and Chronic Diseases: What We Know and Where to Go Next

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1 AMERICAN SOCIETY FOR NUTRITION 2015 SCIENTIFIC SESSIONS AND ANNUAL MEETING AT EB SYMPOSIUM APPLICATION (Applications due March 15, Please limit to 4 pages or less) Session Title: Moderate Alcohol Use, Nutrition and Chronic Diseases: What We Know and Where to Go Next Session Chair(s) and Organizer of Proposal Contact Information Session Chair Niyati Parekh, PhD, RD Assistant Professor of Nutrition and Public Health Organization Dept. of Nutrition, Food Studies and Public Health. New York University. Address 411 Lafayette Street, Room 542. New York. NY Niyati.parekh@nyu.edu Phone Number Session Co-Chair (if applicable) Mary Platek, PhD, RD, CDN, Assistant Professor of Clinical Nutrition Organization Dept. of Nutrition, Food Studies and Public Health. New York University. Address 411 Lafayette Street, Room 542. New York. NY niyati.parekh@nyu.edu Phone Number Should the organizer be copied on all planning s? NO General Description of Session Both dietary intake and alcohol consumption are complex behaviors that have the potential to interact on biologic and behavioral levels to impact health-related outcomes, including chronic diseases. There are numerous unanswered questions about the impact of moderate alcohol intake patterns and interactions between alcohol, diet, and body weight on chronic disease risk and outcomes and more research is warranted. New research supports an impact of moderate alcohol intake (1-2 drink per day) on food choices resulting in changes in energy intake. These changes may then result in an increased risk of obesity (or underweight) and overall poor diet quality due to inadequate intake of micronutrients (1). While much of the research to date demonstrates relationships between excessive alcohol intake and under-nutrition, research on the role of alcohol on obesity and on the double burden of overweight/obesity and micronutrient intake is much less well understood. A better understanding of the relationships between moderate alcohol consumption, nutrition and dietary patterns (2,3) will inform policy and chronic disease prevention programming. Virtually all large prospective studies performed since 1980 have shown that moderate alcohol intake reduces cardiovascular disease risk and mortality from the disease, (4-6) as well as diabetes risk (7-9). The session outlines research gaps on how alcohol and alcohol drinking patterns, modifies risk of based on body mass index and diet. Furthermore, little is known about particular subgroups (eg. gender) that are at an increased risk for specific drinking patterns (eg. binge) and disease risk (10). Finally, this session also addresses other potential underlying mechanisms of alcohol damage in the context of chronic disease etiology. Overview of talks (Speaker Biographies attached in Appendix 1): We have confirmed four distinguished speakers within the field of alcohol research for this session. Introduction: Dr. Parekh will provide an introduction to the topic and provide a brief overview of alcohol use (trends and prevalence) in the US. Dr. Platek (Co-Chair) will introduce the speakers and their talks. 1

2 Talk 1: Dr. Rosalind Breslow will discuss associations between alcohol consumption and diet quality. In particular, she will focus on intake of foods, nutrients, and diet quality in national populations. From her research, Dr. Breslow will discuss the associations she has found between increasing alcoholic beverage consumption and an overall decline in total diet quality (measured by the HEI-2005). Her research focuses on the broad implications of alcohol use on public health, chronic disease risk and has recently published peerreviewed articles that address a wide range of epidemiological and clinical studies to date in an attempt to find research gaps in this area and anticipate future directions. Talk 2: Dr. Susan Smith will describe how alcohol exposure affects organ functions including the brain, liver, pancreas, to influence nutrient dysregulation. The underlying mechanisms can involve the activation of cellular stress response systems including DNA repair, epigenetic reprogramming, oxidative stress, and cellular death, and how this damage may influence disease etiology. Importantly, she will discuss how nutritional behaviors can modify chronic disease risk in persons who consume alcohol. Talk 3: Dr. Eric Rimm will discuss his recent work investigating the associations of moderate alcohol consumption and risk of obesity and diabetes. In particular how drinking patterns, such as drinking light to moderate amounts most days of the week are associated with decreased risk of some disease risk factors. Talk 4: Dr. Kenneth Mukamal will discuss the associations of moderate alcohol use and cardiovascular disease and cancer. He will focus on the incidence and prognosis of these particular diseases and the role of alcohol consumption that he has learned from his research which incorporates epidemiological studies, hospital based clinical data and interventional studies. He will address the risks associated with binge drinking. Dr. Mukamal will bring a unique background to this session with his research in hospital-based and primary care settings. Talk 5: Dr. Rosalind Breslow will end the session by providing a short summary of current gaps in the literature and future directions to advance this research. She will also address new methodology for measuring alcohol intake in epidemiologic studies. Dr. Breslow is a key speaker in our session as she is an expert in this topic and will be able to further advance attendees understanding of the role of alcohol in chronic disease. How will this session be unique and useful to attendees? This symposium will examine a unique perspective on studying alcohol intake in relation to chronic disease outcomes. Specifically attendees will be exposed to methods for studying alcohol including assessment of alcohol drinking patterns, temporal aspects of alcohol intake, and interactions with nutrients and foods in relation to chronic disease. Attendees will also understand how moderate alcohol intake contributes to the double burden of overweight /obesity. Speakers will present new conceptualizations and methods for examining alcohol intake in the context of chronic diseases. At the end of this symposium the attendees will be able to understand the research gaps in this area to advance this field by using epidemiological designs to better understand the nutrient-alcohol interactions in chronic disease development and identifies new methodologies and research related to alcohol and nutritional chronic disease epidemiology. Please provide at least three learning objectives for this session: 1. Recognize the prevalence of moderate alcohol consumption and its potential role in the pathophysiology of chronic diseases 2. Understand the mechanisms underlying alcohol and chronic disease development 3. Identify key methodological issues in measuring alcohol in epidemiologic studies 4. Understand the interactions between nutrients, diet and alcohol in the context of chronic disease development 5. Identify gaps in alcohol research and learn about future research opportunities 2

3 Please select the ASN Research Priorities that this session relates to the most. Check all that apply. Select none if not applicable. The Role of Nutrition in Health Maintenance Nutrition-Related Behaviors Presentation Titles and Proposed Speakers (add additional speakers, as necessary): Speaker 1 (Introduction) Presentation Title A) Brief overview of importance of topic, alcohol use statistics B) Introduction of speakers (10 mins) Niyati Parekh, PhD, RD, & Mary Platek, PhD, RD, CDN Assistant Professors, Dept. of Nutrition, Food Studies and Public Health New York University Address 411, Lafayette Street, Room 542 niyati.parekh@nyu.edu Telephone Speaker 2 Presentation Title Alcohol use and association with dietary intake (25 mins) Rosalind Breslow, PhD, MPH, RD National Institute on Alcohol Abuse and Alcoholism (NIAAA) Address 31 Center Dr. MSC 2062 Building 31, Room B1-W30, Bethesda, Maryland rbreslow@mail.nih.gov Telephone Speaker 3 Presentation Title Mechanisms of alcohol pathogenesis (25 mins) Susan Smith, PhD Department of Nutritional Sciences. University of Wisconsin-Madison Address 1500 Highland Avenue, Madison, WI suesmith@nutrisci.wisc.edu Telephone Speaker 4 Presentation Title Moderate and light alcohol use, obesity and diabetes risk (25 mins) Eric Rimm, Sc.D. Dept. of Epidemiology, Harvard School of Public Health, Harvard Univ. Address 655 Huntington Ave, Building II Room 373a, Boston, MA eric.rimm@channing.harvard.edu Telephone Speaker 5 Presentation Title Moderate and light alcohol use, cardiovascular disease and cancer (25 min) Kenneth J. Mukamal, MD, MPH Harvard Medical School, Harvard University Address Beth Israel Deaconess Medical Center, General Medicine, CO-1309, 1309 Beacon Street, Brookline MA kmukamal@bidmc.harvard.edu 3

4 Telephone Speaker 6 Presentation Title Research Gaps and future directions (10 mins) Address Telephone Rosalind Breslow, PhD, MPH, RD Division of Epidemiology and Prevention Research, National Institute on Alcohol Abuse and Alcoholism (NIAAA) 31 Center Dr. MSC 2062 Building 31, Room B1-W30, Bethesda, Maryland rbreslow@mail.nih.gov Do you wish to have this considered as part of the Education Track? The Education Track is reserved for interactive, smaller group sessions (less than 200) that are focused on an educational or professional development topic. Yes X No Which ASN member groups (councils, RIS groups) and participating societies will be most interested in this session? [Please list the groups.] ASN Member Groups (Please mark all that apply) X Medical Nutrition Council (MNC) Global Nutrition Council (GNC) X Nutritional Sciences Council (NSC) X Aging and Chronic Disease RIS [CONFIRMED] CARIG RIS X Community and Public Health RIS X Diet & Cancer RIS Dietary Bioactive Components RIS Energy & Macronutrient Metabolism RIS Participating Societies: X ASN Physiology (APS) Pharmacology (ASPET) Experimental Animal Nutrition RIS Lactation RIS Nutrient-Gene Interactions RIS Nutrition Education RIS Nutrition Translation RIS Nutritional Epidemiology RIS Nutritional Immunology RIS X Obesity RIS [CONFIRMED] Vitamins and Minerals RIS Anatomy (AAA) Biochemistry and Molecular Biology (ASBMB) Session organizers are expected to assist with obtaining funding to cover expenses related to the presentation of accepted sessions. Do you have funding to support this activity? Yes (Please indicate the company and amount.) _X_ No (If no, please list potential funding sources.) Indicate which, if any, ASN RIS, Councils or Committees are endorsing and/or providing financial support for this session: Nutritional Epidemiology RIS. Describe any potential conflicts of interest. None Budget: We request a guest pass for two speaker (Dr. Mukamal and Dr. Rimm who are local and planning to come for the proposed session only to defray registration costs). We request program costs (including room space and audiovisual, estimated at $1500). Please include honoraria if funds are available. We will work with ASN to secure funding for the symposia and possible funding sources may be International Life Science Institute and the Alcoholic Beverage Medical Research Foundation. 4

5 Brief biography of the speakers and co-chairs: APPENDIX 1 Niyati Parekh, PhD, RD; New York University (Co-Chair and Speaker 1): Dr. Parekh is an Assistant Professor in the Department of Nutrition, Food Studies and Public Health and the PI of the American Cancer Society-funded Cancer, Insulin Resistance and Lifestyle (CIRCLE) Study that investigates insulin and cancer incidence across three familial generations of the Framingham Heart Study. She received her PhD in Nutritional Sciences from the University of Wisconsin-Madison and postdoctoral training from the Rutgers-Cancer Institute in cancer epidemiology. Mary Platek, PhD, RD, CDN (Co-Chair): Mary Platek, PhD, RD, CDN is an Assistant Professor of Clinical Nutrition at New York University. She completed a PhD in Epidemiology and an NIH fellowship in cancer prevention at Roswell Park Cancer Institute. Her research interests focus on cancer related malnutrition and cachexia in patients with alcohol-related cancer and the application of nutrition interventions in supportive oncology. Previously, she examined lifetime alcohol consumption and risk of breast cancer. Speaker 2 and 6: Rosalind Breslow, PhD, MPH, RD: Dr. Breslow is an epidemiologist in the Division of Epidemiology and Prevention Research at the National Institute on Alcohol Abuse and Alcoholism of the National Institutes of Health. Her work has focused on alcohol consumption and the significant impact it has on overall health and well-being. Dr. Breslow has published numerous peer reviewed articles in prestigious journals including American Journal of Clinical Nutrition, American Journal of Epidemiology and Journal of American Dietetics Association, using the NHANES datasets on the topic of alcohol consumption and diet. She also co-led a recent NIAAA expert Panel on Alcohol and Chronic Disease Epidemiology (with Dr. Mukakmal speaker 4) which resulted in a published review article which discusses current and future research trends on the topic. Speaker 3: Susan Smith, PhD: Dr. Smith is a professor of nutritional sciences at the University of Wisconsin-Madison. Her research focuses on the biochemical and molecular components of human nutrition. Her primary research interest is on the interactions between dietary agents and prenatal development. Dr. Smith is a leader in alcohol research and is past-chair of both the Neurotoxicology & Alcohol (NAL) NIH study section and past-president of the Fetal Alcohol Spectrum Disorders Study Group. She has published numerous peer-reviewed articles on alcohol and her research on alcohol s developmental mechanisms is supported by a MERIT Award from NIAAA. Speaker 4: Kenneth J. Mukamal, MD, MPH: Dr. Mukamal is an Associate Professor of Medicine at the Harvard Medical School. His main research interests include the investigation of dietary and lifestyle factors (in particular alcohol consumption) on the incidence and prognosis of cardiovascular disease and its risk factors. Dr. Mukamal is a general internist and a clinical investigator and his research combines various approaches including epidemiological studies, hospital based clinical data and interventional studies. He has been successful in receiving NIH RO1 research funds to extensively study alcohol consumption and measuring novel biomarkers in relation to alcohol consumption in adult populations. Speaker 5: Eric Rimm, Sc.D.: Dr. Rimm is an Associate Professor in the Department of Epidemiology at the Harvard School of Public Health. He has served as the Director of the Health Professionals Follow-Up Study for the past twenty years which is a prospective investigation of diet and chronic disease risk factors in an adult population of over 50,000 males. Dr. Rimm has also served on the 2010 USDA Dietary Guidelines for Americans Committee and the Institute of Medicine s Dietary Reference Intake committee. He is the Associate Editor of the American Journal of Epidemiology and the American Journal of Clinical Nutrition. His main research interests include studying associations between diet and other lifestyle characteristics in relation to risk of obesity, diabetes, heart disease and stroke and has over 500 peer-reviewed publications. 5

6 References: 1. Breslow, RA, Guenther, PM, Juan, W, Graubard, BI. (2010). Alcoholic beverage consumption, nutrient intakes, and diet quality in the US adult population, Journal of the American Dietetic Association, 110(4), Breslow, RA, Chen, CM, Graubard, BI, Jacobovits, T, Kant, AK. (2013). Diets of drinkers on drinking and nondrinking days: NHANES The American journal of clinical nutrition, 97(5), Breslow, RA, Guenther, PM, Smothers, BA. (2006). Alcohol drinking patterns and diet quality: the National Health and Nutrition Examination Survey. American journal of epidemiology, 163(4), Corrao G, Rubbiati L, Bagnardi V, Zambon A, Poikolainen K. (2000). Alcohol and coronary heart disease: a meta-analysis. Addiction, 95(10), Mukamal KJ, Chen, CM, Rao, SR, Breslow RA. (2010). Alcohol consumption and cardiovascular mortality among US adults, 1987 to Journal of the American College of Cardiology, 55(13), Ronksley PE, Brien SE, Turner BJ, Mukamal KJ, Ghali WA. (2011). Association of alcohol consumption with selected cardiovascular disease outcomes: a systematic review and metaanalysis. BMJ: British Medical Journal, Conigrave, KM, Hu, BF, Camargo, CA, Stampfer, M J, Willett WC, & Rimm, EB. (2001). A prospective study of drinking patterns in relation to risk of type 2 diabetes among men. Diabetes, 50(10), Howard, AA, Arnsten, JH, & Gourevitch, MN. (2004). Effect of Alcohol Consumption on Diabetes Mellitus. A Systematic Review. Annals of Internal Medicine, 140(3), Baliunas, DO, Benjamin J, Taylor HI, Roerecke M, Patra J, Mohapatra S, and Rehm J. "Alcohol as a Risk Factor for Type 2 Diabetes A systematic review and meta-analysis." Diabetes care 32, no. 11 (2009): Kim, SY, Breslow, RA, Ahn, J, Salem, N. (2007). Alcohol consumption and fatty acid intakes in the National Health and Nutrition Examination Survey. Alcoholism: Clinical and Experimental Research, 31(8),

Alcohol Consumption and Mortality Risks in the U.S. Brian Rostron, Ph.D. Savet Hong, MPH

Alcohol Consumption and Mortality Risks in the U.S. Brian Rostron, Ph.D. Savet Hong, MPH 1 ABSTRACT This study presents relative mortality risks by alcohol consumption level for the U.S. population, using