Nutrients

Editorial

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3 pages, 184 KiB

Open AccessEditorial

The Impact of Alcoholic Beverages on Human Health

by Peter Anderson

Nutrients 2021, 13(12), 4417; https://doi.org/10.3390/nu13124417 - 10 Dec 2021

Cited by 15 | Viewed by 4829

Abstract

As summarized in the World Health Organization’s latest Global Status Report on Alcohol, the pleasure of alcohol is indicated by the fact that, worldwide, just over two-fifths of the population aged 15+ years drink alcohol; 2 [...] Full article

(This article belongs to the Special Issue The Impact of Alcoholic Beverages on Human Health)

Research

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13 pages, 2122 KiB

Open AccessArticle

The Global Impact of Alcohol Consumption on Premature Mortality and Health in 2016

by Ivneet Sohi, Ari Franklin, Bethany Chrystoja, Ashley Wettlaufer, Jürgen Rehm and Kevin Shield

Nutrients 2021, 13(9), 3145; https://doi.org/10.3390/nu13093145 - 9 Sep 2021

Cited by 19 | Viewed by 4678

Abstract

This study aimed to estimate the impact of alcohol use on mortality and health among people 69 years of age and younger in 2016. A comparative risk assessment approach was utilized, with population-attributable fractions being estimated by combining alcohol use data from the [...] Read more.

This study aimed to estimate the impact of alcohol use on mortality and health among people 69 years of age and younger in 2016. A comparative risk assessment approach was utilized, with population-attributable fractions being estimated by combining alcohol use data from the Global Information System on Alcohol and Health with corresponding relative risk estimates from meta-analyses. The mortality and health data were obtained from the Global Health Observatory. Among people 69 years of age and younger in 2016, 2.0 million deaths and 117.2 million Disability Adjusted Life Years (DALYs) lost were attributable to alcohol consumption, representing 7.1% and 5.5% of all deaths and DALYs lost in that year, respectively. The leading causes of the burden of alcohol-attributable deaths were cirrhosis of the liver (457,000 deaths), road injuries (338,000 deaths), and tuberculosis (190,000 deaths). The numbers of premature deaths per 100,000 people were highest in Eastern Europe (155.8 deaths per 100,000), Central Europe (52.3 deaths per 100,000 people), and Western sub-Saharan Africa (48.7 deaths per 100,000). A large portion of the burden of disease caused by alcohol among people 69 years of age and younger is preventable through the implementation of cost-effective alcohol policies such as increases in taxation. Full article

(This article belongs to the Special Issue The Impact of Alcoholic Beverages on Human Health)

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24 pages, 925 KiB

Open AccessArticle

Nature and Potential Impact of Alcohol Health Warning Labels: A Scoping Review

by Daša Kokole, Peter Anderson and Eva Jané-Llopis

Nutrients 2021, 13(9), 3065; https://doi.org/10.3390/nu13093065 - 31 Aug 2021

Cited by 28 | Viewed by 7319

Abstract

Alcohol is toxic to human health. In addition to providing nutritional information, labels on alcohol products can be used to communicate warnings on alcohol-related harms to consumers. This scoping review examined novel or enhanced health warning labels to assess the current state of [...] Read more.

Alcohol is toxic to human health. In addition to providing nutritional information, labels on alcohol products can be used to communicate warnings on alcohol-related harms to consumers. This scoping review examined novel or enhanced health warning labels to assess the current state of the research and the key studied characteristics of labels, along with their impact on the studied outcomes. Four databases (Web of Science, MEDLINE, PsycInfo, CINAHL) were searched between January 2010 and April 2021, and 27 papers were included in the review. The results found that most studies were undertaken in English-speaking populations, with the majority conducted online or in the laboratory setting as opposed to the real world. Seventy percent of the papers included at least one cancer-related message, in most instances referring either to cancer in general or to bowel cancer. Evidence from the only real-world long-term labelling intervention demonstrated that alcohol health warning labels designed to be visible and contain novel and specific information have the potential to be part of an effective labelling strategy. Alcohol health warning labels should be seen as tools to raise awareness on alcohol-related risks, being part of wider alcohol policy approaches. Full article

(This article belongs to the Special Issue The Impact of Alcoholic Beverages on Human Health)

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12 pages, 618 KiB

Open AccessArticle

Government Options to Reduce the Impact of Alcohol on Human Health: Obstacles to Effective Policy Implementation

by Tim Stockwell, Norman Giesbrecht, Kate Vallance and Ashley Wettlaufer

Nutrients 2021, 13(8), 2846; https://doi.org/10.3390/nu13082846 - 19 Aug 2021

Cited by 14 | Viewed by 7698

Abstract

Evidence for effective government policies to reduce exposure to alcohol’s carcinogenic and hepatoxic effects has strengthened in recent decades. Policies with the strongest evidence involve reducing the affordability, availability and cultural acceptability of alcohol. However, policies that reduce population consumption compete with powerful [...] Read more.

Evidence for effective government policies to reduce exposure to alcohol’s carcinogenic and hepatoxic effects has strengthened in recent decades. Policies with the strongest evidence involve reducing the affordability, availability and cultural acceptability of alcohol. However, policies that reduce population consumption compete with powerful commercial vested interests. This paper draws on the Canadian Alcohol Policy Evaluation (CAPE), a formal assessment of effective government action on alcohol across Canadian jurisdictions. It also draws on alcohol policy case studies elsewhere involving attempts to introduce minimum unit pricing and cancer warning labels on alcohol containers. Canadian governments collectively received a failing grade (F) for alcohol policy implementation during the most recent CAPE assessment in 2017. However, had the best practices observed in any one jurisdiction been implemented consistently, Canada would have received an A grade. Resistance to effective alcohol policies is due to (1) lack of public awareness of both need and effectiveness, (2) a lack of government regulatory mechanisms to implement effective policies, (3) alcohol industry lobbying, and (4) a failure from the public health community to promote specific and feasible actions as opposed to general principles, e.g., ‘increased prices’ or ‘reduced affordability’. There is enormous untapped potential in most countries for the implementation of proven strategies to reduce alcohol-related harm. While alcohol policies have weakened in many countries during the COVID-19 pandemic, societies may now also be more accepting of public health-inspired policies with proven effectiveness and potential economic benefits. Full article

(This article belongs to the Special Issue The Impact of Alcoholic Beverages on Human Health)

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Review

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19 pages, 1388 KiB

Open AccessReview

Alcohol and the Brain

by David Nutt, Alexandra Hayes, Leon Fonville, Rayyan Zafar, Emily O.C. Palmer, Louise Paterson and Anne Lingford-Hughes

Nutrients 2021, 13(11), 3938; https://doi.org/10.3390/nu13113938 - 4 Nov 2021

Cited by 36 | Viewed by 17304

Abstract

Alcohol works on the brain to produce its desired effects, e.g., sociability and intoxication, and hence the brain is an important organ for exploring subsequent harms. These come in many different forms such as the consequences of damage during intoxication, e.g., from falls [...] Read more.

Alcohol works on the brain to produce its desired effects, e.g., sociability and intoxication, and hence the brain is an important organ for exploring subsequent harms. These come in many different forms such as the consequences of damage during intoxication, e.g., from falls and fights, damage from withdrawal, damage from the toxicity of alcohol and its metabolites and altered brain structure and function with implications for behavioral processes such as craving and addiction. On top of that are peripheral factors that compound brain damage such as poor diet, vitamin deficiencies leading to Wernicke-Korsakoff syndrome. Prenatal alcohol exposure can also have a profound impact on brain development and lead to irremediable changes of fetal alcohol syndrome. This chapter briefly reviews aspects of these with a particular focus on recent brain imaging results. Cardiovascular effects of alcohol that lead to brain pathology are not covered as they are dealt with elsewhere in the volume. Full article

(This article belongs to the Special Issue The Impact of Alcoholic Beverages on Human Health)

12 pages, 885 KiB

Open AccessReview

Margin of Exposure Analyses and Overall Toxic Effects of Alcohol with Special Consideration of Carcinogenicity

by Alex O. Okaru and Dirk W. Lachenmeier

Nutrients 2021, 13(11), 3785; https://doi.org/10.3390/nu13113785 - 25 Oct 2021

Cited by 18 | Viewed by 4456

Abstract

Quantitative assessments of the health risk of the constituents of alcoholic beverages including ethanol are reported in the literature, generally with hepatotoxic effects considered as the endpoint. Risk assessment studies on minor compounds such as mycotoxins, metals, and other contaminants are also available [...] Read more.

Quantitative assessments of the health risk of the constituents of alcoholic beverages including ethanol are reported in the literature, generally with hepatotoxic effects considered as the endpoint. Risk assessment studies on minor compounds such as mycotoxins, metals, and other contaminants are also available on carcinogenicity as the endpoint. This review seeks to highlight population cancer risks due to alcohol consumption using the margin of exposure methodology. The individual and cumulative health risk contribution of each component in alcoholic beverages is highlighted. Overall, the results obtained consistently show that the ethanol contributes the bulk of harmful effects of alcoholic beverages, while all other compounds only contribute in a minor fashion (less than 1% compared to ethanol). Our data provide compelling evidence that policy should be focused on reducing total alcohol intake (recorded and unrecorded), while measures on other compounds should be only secondary to this goal. Full article

(This article belongs to the Special Issue The Impact of Alcoholic Beverages on Human Health)

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16 pages, 343 KiB

Open AccessReview

Alcohol’s Impact on the Fetus

by Svetlana Popova, Danijela Dozet, Kevin Shield, Jürgen Rehm and Larry Burd

Nutrients 2021, 13(10), 3452; https://doi.org/10.3390/nu13103452 - 29 Sep 2021

Cited by 36 | Viewed by 11032

Abstract

Background: Alcohol is a teratogen and prenatal exposure may adversely impact the developing fetus, increasing risk for negative outcomes, including Fetal Alcohol Spectrum Disorder (FASD). Global trends of increasing alcohol use among women of childbearing age due to economic development, changing gender roles, [...] Read more.

Background: Alcohol is a teratogen and prenatal exposure may adversely impact the developing fetus, increasing risk for negative outcomes, including Fetal Alcohol Spectrum Disorder (FASD). Global trends of increasing alcohol use among women of childbearing age due to economic development, changing gender roles, increased availability of alcohol, peer pressure and social acceptability of women’s alcohol use may put an increasing number of pregnancies at risk for prenatal alcohol exposure (PAE). This risk has been exacerbated by the ongoing COVID-19 pandemic in some countries. Method: This literature review presents an overview on the epidemiology of alcohol use among childbearing age and pregnant women and FASD by World Health Organization regions; impact of PAE on fetal health, including FASD; associated comorbidities; and social outcomes. Results/Conclusion: The impact of alcohol on fetal health and social outcomes later in life is enormous, placing a huge economic burden on countries. Prevention of prenatal alcohol exposure and early identification of affected individuals should be a global public health priority. Full article

(This article belongs to the Special Issue The Impact of Alcoholic Beverages on Human Health)

10 pages, 273 KiB

Open AccessReview

Alcohol’s Impact on the Cardiovascular System

by Michael Roerecke

Nutrients 2021, 13(10), 3419; https://doi.org/10.3390/nu13103419 - 28 Sep 2021

Cited by 69 | Viewed by 13051

Abstract

Alcohol consumption has been shown to have complex, and sometimes paradoxical, associations with cardiovascular diseases (CVDs). Several hundred epidemiological studies on this topic have been published in recent decades. In this narrative review, the epidemiological evidence will be examined for the associations between [...] Read more.

Alcohol consumption has been shown to have complex, and sometimes paradoxical, associations with cardiovascular diseases (CVDs). Several hundred epidemiological studies on this topic have been published in recent decades. In this narrative review, the epidemiological evidence will be examined for the associations between alcohol consumption, including average alcohol consumption, drinking patterns, and alcohol use disorders, and CVDs, including ischaemic heart disease, stroke, hypertension, atrial fibrillation, cardiomyopathy, and heart failure. Methodological shortcomings, such as exposure classification and measurement, reference groups, and confounding variables (measured or unmeasured) are discussed. Based on systematic reviews and meta-analyses, the evidence seems to indicate non-linear relationships with many CVDs. Large-scale longitudinal epidemiological studies with multiple detailed exposure and outcome measurements, and the extensive assessment of genetic and confounding variables, are necessary to elucidate these associations further. Conflicting associations depending on the exposure measurement and CVD outcome are hard to reconcile, and make clinical and public health recommendations difficult. Furthermore, the impact of alcohol on other health outcomes needs to be taken into account. For people who drink alcohol, the less alcohol consumed the better. Full article

(This article belongs to the Special Issue The Impact of Alcoholic Beverages on Human Health)

19 pages, 754 KiB

Open AccessReview

Alcohol Use and the Risk of Communicable Diseases

by Neo K. Morojele, Sheela V. Shenoi, Paul A. Shuper, Ronald Scott Braithwaite and Jürgen Rehm

Nutrients 2021, 13(10), 3317; https://doi.org/10.3390/nu13103317 - 23 Sep 2021

Cited by 31 | Viewed by 7363

Abstract

The body of knowledge on alcohol use and communicable diseases has been growing in recent years. Using a narrative review approach, this paper discusses alcohol’s role in the acquisition of and treatment outcomes from four different communicable diseases: these include three conditions included [...] Read more.

The body of knowledge on alcohol use and communicable diseases has been growing in recent years. Using a narrative review approach, this paper discusses alcohol’s role in the acquisition of and treatment outcomes from four different communicable diseases: these include three conditions included in comparative risk assessments to date—Human Immunodeficiency Virus (HIV)/AIDS, tuberculosis (TB), and lower respiratory infections/pneumonia—as well as Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) because of its recent and rapid ascension as a global health concern. Alcohol-attributable TB, HIV, and pneumonia combined were responsible for approximately 360,000 deaths and 13 million disability-adjusted life years lost (DALYs) in 2016, with alcohol-attributable TB deaths and DALYs predominating. There is strong evidence that alcohol is associated with increased incidence of and poorer treatment outcomes from HIV, TB, and pneumonia, via both behavioral and biological mechanisms. Preliminary studies suggest that heavy drinkers and those with alcohol use disorders are at increased risk of COVID-19 infection and severe illness. Aside from HIV research, limited research exists that can guide interventions for addressing alcohol-attributable TB and pneumonia or COVID-19. Implementation of effective individual-level interventions and alcohol control policies as a means of reducing the burden of communicable diseases is recommended. Full article

(This article belongs to the Special Issue The Impact of Alcoholic Beverages on Human Health)

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14 pages, 2263 KiB

Open AccessReview

Alcohol and Cancer: Epidemiology and Biological Mechanisms

by Harriet Rumgay, Neil Murphy, Pietro Ferrari and Isabelle Soerjomataram

Nutrients 2021, 13(9), 3173; https://doi.org/10.3390/nu13093173 - 11 Sep 2021

Cited by 160 | Viewed by 24342

Abstract

Approximately 4% of cancers worldwide are caused by alcohol consumption. Drinking alcohol increases the risk of several cancer types, including cancers of the upper aerodigestive tract, liver, colorectum, and breast. In this review, we summarise the epidemiological evidence on alcohol and cancer risk [...] Read more.

Approximately 4% of cancers worldwide are caused by alcohol consumption. Drinking alcohol increases the risk of several cancer types, including cancers of the upper aerodigestive tract, liver, colorectum, and breast. In this review, we summarise the epidemiological evidence on alcohol and cancer risk and the mechanistic evidence of alcohol-mediated carcinogenesis. There are several mechanistic pathways by which the consumption of alcohol, as ethanol, is known to cause cancer, though some are still not fully understood. Ethanol’s metabolite acetaldehyde can cause DNA damage and block DNA synthesis and repair, whilst both ethanol and acetaldehyde can disrupt DNA methylation. Ethanol can also induce inflammation and oxidative stress leading to lipid peroxidation and further DNA damage. One-carbon metabolism and folate levels are also impaired by ethanol. Other known mechanisms are discussed. Further understanding of the carcinogenic properties of alcohol and its metabolites will inform future research, but there is already a need for comprehensive alcohol control and cancer prevention strategies to reduce the burden of cancer attributable to alcohol. Full article

(This article belongs to the Special Issue The Impact of Alcoholic Beverages on Human Health)

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14 pages, 2006 KiB

Open AccessReview

Alcohol’s Impact on the Gut and Liver

by Keith Pohl, Prebashan Moodley and Ashwin D. Dhanda

Nutrients 2021, 13(9), 3170; https://doi.org/10.3390/nu13093170 - 11 Sep 2021

Cited by 60 | Viewed by 11210

Abstract

Alcohol is inextricably linked with the digestive system. It is absorbed through the gut and metabolised by hepatocytes within the liver. Excessive alcohol use results in alterations to the gut microbiome and gut epithelial integrity. It contributes to important micronutrient deficiencies including short-chain [...] Read more.

Alcohol is inextricably linked with the digestive system. It is absorbed through the gut and metabolised by hepatocytes within the liver. Excessive alcohol use results in alterations to the gut microbiome and gut epithelial integrity. It contributes to important micronutrient deficiencies including short-chain fatty acids and trace elements that can influence immune function and lead to liver damage. In some people, long-term alcohol misuse results in liver disease progressing from fatty liver to cirrhosis and hepatocellular carcinoma, and results in over half of all deaths from chronic liver disease, over half a million globally per year. In this review, we will describe the effect of alcohol on the gut, the gut microbiome and liver function and structure, with a specific focus on micronutrients and areas for future research. Full article

(This article belongs to the Special Issue The Impact of Alcoholic Beverages on Human Health)

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14 pages, 680 KiB

Open AccessReview

Production, Consumption, and Potential Public Health Impact of Low- and No-Alcohol Products: Results of a Scoping Review

by Peter Anderson, Daša Kokole and Eva Jane Llopis

Nutrients 2021, 13(9), 3153; https://doi.org/10.3390/nu13093153 - 10 Sep 2021

Cited by 27 | Viewed by 6599

Abstract

Switching from higher strength to low- and no-alcohol products could result in consumers buying and drinking fewer grams of ethanol. We undertook a scoping review with systematic searches of English language publications between 1 January 2010 and 17 January 2021 using PubMed and [...] Read more.

Switching from higher strength to low- and no-alcohol products could result in consumers buying and drinking fewer grams of ethanol. We undertook a scoping review with systematic searches of English language publications between 1 January 2010 and 17 January 2021 using PubMed and Web of Science, covering production, consumption, and policy drivers related to low- and no-alcohol products. Seventy publications were included in our review. We found no publications comparing a life cycle assessment of health and environmental impacts between alcohol-free and regular-strength products. Three publications of low- and no-alcohol beers found only limited penetration of sales compared with higher strength beers. Two publications from only one jurisdiction (Great Britain) suggested that sales of no- and low-alcohol beers replaced rather than added to sales of higher strength beers. Eight publications indicated that taste, prior experiences, brand, health and wellbeing issues, price differentials, and overall decreases in the social stigma associated with drinking alcohol-free beverages were drivers of the purchase and consumption of low- and no-alcohol beers and wines. Three papers indicated confusion amongst consumers with respect to the labelling of low- and no-alcohol products. One paper indicated that the introduction of a minimum unit price in both Scotland and Wales favoured shifts in purchases from higher- to lower-strength beers. The evidence base for the potential beneficial health impact of low- and no-alcohol products is very limited and needs considerable expansion. At present, the evidence base could be considered inadequate to inform policy. Full article

(This article belongs to the Special Issue The Impact of Alcoholic Beverages on Human Health)

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19 pages, 772 KiB

Open AccessReview

‘Joining the Dots’: Individual, Sociocultural and Environmental Links between Alcohol Consumption, Dietary Intake and Body Weight—A Narrative Review

by Mackenzie Fong, Stephanie Scott, Viviana Albani, Ashley Adamson and Eileen Kaner

Nutrients 2021, 13(9), 2927; https://doi.org/10.3390/nu13092927 - 24 Aug 2021

Cited by 10 | Viewed by 6497

Abstract

Alcohol is energy-dense, elicits weak satiety responses relative to solid food, inhibits dietary fat oxidation, and may stimulate food intake. It has, therefore, been proposed as a contributor to weight gain and obesity. The aim of this narrative review was to consolidate and [...] Read more.

Alcohol is energy-dense, elicits weak satiety responses relative to solid food, inhibits dietary fat oxidation, and may stimulate food intake. It has, therefore, been proposed as a contributor to weight gain and obesity. The aim of this narrative review was to consolidate and critically appraise the evidence on the relationship of alcohol consumption with dietary intake and body weight, within mainstream (non-treatment) populations. Publications were identified from a PubMed keyword search using the terms ‘alcohol’, ‘food’, ‘eating’, ‘weight’, ‘body mass index’, ‘obesity’, ‘food reward’, ‘inhibition’, ‘attentional bias’, ‘appetite’, ‘culture’, ‘social’. A snowball method and citation searches were used to identify additional relevant publications. Reference lists of relevant publications were also consulted. While limited by statistical heterogeneity, pooled results of experimental studies showed a relatively robust association between acute alcohol intake and greater food and total energy intake. This appears to occur via metabolic and psychological mechanisms that have not yet been fully elucidated. Evidence on the relationship between alcohol intake and weight is equivocal. Most evidence was derived from cross-sectional survey data which does not allow for a cause-effect relationship to be established. Observational research evidence was limited by heterogeneity and methodological issues, reducing the certainty of the evidence. We found very little qualitative work regarding the social, cultural, and environmental links between concurrent alcohol intake and eating behaviours. That the evidence of alcohol intake and body weight remains uncertain despite no shortage of research over the years, indicates that more innovative research methodologies and nuanced analyses are needed to capture what is clearly a complex and dynamic relationship. Also, given synergies between ‘Big Food’ and ‘Big Alcohol’ industries, effective policy solutions are likely to overlap and a unified approach to policy change may be more effective than isolated efforts. However, joint action may not occur until stronger evidence on the relationship between alcohol intake, food intake and weight is established. Full article

(This article belongs to the Special Issue The Impact of Alcoholic Beverages on Human Health)

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15 pages, 739 KiB

Open AccessReview

Alcohol and the Risk of Injury

by Tanya Chikritzhs and Michael Livingston

Nutrients 2021, 13(8), 2777; https://doi.org/10.3390/nu13082777 - 13 Aug 2021

Cited by 73 | Viewed by 13251

Abstract

Globally, almost four and a half million people died from injury in 2019. Alcohol’s contribution to injury-related premature loss of life, disability and ill-health is pervasive, touching individuals, families and societies throughout the world. We conducted a review of research evidence for alcohol’s [...] Read more.

Globally, almost four and a half million people died from injury in 2019. Alcohol’s contribution to injury-related premature loss of life, disability and ill-health is pervasive, touching individuals, families and societies throughout the world. We conducted a review of research evidence for alcohol’s causal role in injury by focusing on previously published systematic reviews, meta-analyses and where indicated, key studies. The review summarises evidence for pharmacological and physiological effects that support postulated causal pathways, highlights findings and knowledge gaps relevant to specific forms of injury (i.e., violence, suicide and self-harm, road injury, falls, burns, workplace injuries) and lays out options for evidence-based prevention. Full article

(This article belongs to the Special Issue The Impact of Alcoholic Beverages on Human Health)

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11 pages, 797 KiB

Open AccessReview

Dose–Response Relationships between Levels of Alcohol Use and Risks of Mortality or Disease, for All People, by Age, Sex, and Specific Risk Factors

by Jürgen Rehm, Pol Rovira, Laura Llamosas-Falcón and Kevin D. Shield

Nutrients 2021, 13(8), 2652; https://doi.org/10.3390/nu13082652 - 30 Jul 2021

Cited by 55 | Viewed by 8149

Abstract

Alcohol use has been causally linked to more than 200 disease and injury conditions, as defined by three-digit ICD-10 codes. The understanding of how alcohol use is related to these conditions is essential to public health and policy research. Accordingly, this study presents [...] Read more.

Alcohol use has been causally linked to more than 200 disease and injury conditions, as defined by three-digit ICD-10 codes. The understanding of how alcohol use is related to these conditions is essential to public health and policy research. Accordingly, this study presents a narrative review of different dose–response relationships for alcohol use. Relative-risk (RR) functions were obtained from various comparative risk assessments. Two main dimensions of alcohol consumption are used to assess disease and injury risk: (1) volume of consumption, and (2) patterns of drinking, operationalized via frequency of heavy drinking occasions. Lifetime abstention was used as the reference group. Most dose–response relationships between alcohol and outcomes are monotonic, but for diabetes type 2 and ischemic diseases, there are indications of a curvilinear relationship, where light to moderate drinking is associated with lower risk compared with not drinking (i.e., RR < 1). In general, women experience a greater increase in RR per gram of alcohol consumed than men. The RR per gram of alcohol consumed was lower for people of older ages. RRs indicated that alcohol use may interact synergistically with other risk factors, in particular with socioeconomic status and other behavioural risk factors, such as smoking, obesity, or physical inactivity. The literature on the impact of genetic constitution on dose–response curves is underdeveloped, but certain genetic variants are linked to an increased RR per gram of alcohol consumed for some diseases. When developing alcohol policy measures, including low-risk drinking guidelines, dose–response relationships must be taken into consideration. Full article

(This article belongs to the Special Issue The Impact of Alcoholic Beverages on Human Health)

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9 pages, 259 KiB

Open AccessReview

Human Evolution and Dietary Ethanol

by Robert Dudley and Aleksey Maro

Nutrients 2021, 13(7), 2419; https://doi.org/10.3390/nu13072419 - 15 Jul 2021

Cited by 17 | Viewed by 8624

Abstract

The “drunken monkey” hypothesis posits that attraction to ethanol derives from an evolutionary linkage among the sugars of ripe fruit, associated alcoholic fermentation by yeast, and ensuing consumption by human ancestors. First proposed in 2000, this concept has received increasing attention from the [...] Read more.

The “drunken monkey” hypothesis posits that attraction to ethanol derives from an evolutionary linkage among the sugars of ripe fruit, associated alcoholic fermentation by yeast, and ensuing consumption by human ancestors. First proposed in 2000, this concept has received increasing attention from the fields of animal sensory biology, primate foraging behavior, and molecular evolution. We undertook a review of English language citations subsequent to publication of the original paper and assessed research trends and future directions relative to natural dietary ethanol exposure in primates and other animals. Two major empirical themes emerge: attraction to and consumption of fermenting fruits (and nectar) by numerous vertebrates and invertebrates (e.g., Drosophila flies), and genomic evidence for natural selection consistent with sustained exposure to dietary ethanol in diverse taxa (including hominids and the genus Homo) over tens of millions of years. We also describe our current field studies in Uganda of ethanol content within fruits consumed by free-ranging chimpanzees, which suggest chronic low-level exposure to this psychoactive molecule in our closest living relatives. Full article

(This article belongs to the Special Issue The Impact of Alcoholic Beverages on Human Health)

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