title: Three-year changes in drinking patterns in Spain: a prospective population-based cohort study.
abstract: BACKGROUND
  This study examined changes in alcohol drinking patterns (DP) and associated variables in a Mediterranean country.
  
  
  METHODS
  Changes in DP between baseline (2008-2010) and follow-up (2012-2013) were examined on a Spanish population-based cohort of 2254 adults (18-59 years) using multinomial logistic regression. Heavy consumption was defined as ≥40 g/day of alcohol in men (≥24 g/day in women) and binge drinking (BD) as the intake of ≥80 g of alcohol in men (≥60 g in women) on one occasion in the previous month. Six patterns were defined: (1) non-drinkers; (2) ex-drinkers; (3) moderate drinkers without BD (MNB); (4) moderate drinkers with BD (MB); (5) heavy drinkers without BD (HNB); and (6) heavy drinkers with BD (HB).
  
  
  RESULTS
  Overall, 45.2% of participants changed DP during follow-up. Over 24% of non-drinkers and 19.4% of ex-drinkers at baseline qualified as MNB at follow-up. The largest flow was from HNB to MNB (57.1%). Light-drinking patterns experienced the largest gains (ex-drinkers: 37.5% and MNB: 66.7%) by absorbing individuals lost by heavy-drinking patterns (MB: 50.8% and HNB: 48.4%). Men, younger individuals, and current smokers were more likely to report heavy-drinking patterns at one or both assessments. Being married or employed increased the likelihood of reporting light-drinking patterns at both surveys (p<0.05). Improving physical quality of life and exercise were associated with a shift from light- to heavy-drinking pattern during follow-up (p<0.05).
  
  
  CONCLUSIONS
  DP in Spain changed over 3 years with a tendency to "regress" toward moderate patterns. Repeated measures of alcohol intake may reduce classification errors and biased results when examining the impact of alcohol on health.
authors.affiliation: Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPAZ, C/Arzobispo Morcillo s/n, Madrid 28029, Spain; Department of Epidemiology and Public Health, Miller School of Medicine, University of Miami, Miami, FL 33136, USA.
authors.forename: Hosanna
authors.initials: H
authors.lastname: Soler-Vila
authors.affiliation: Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPAZ, C/Arzobispo Morcillo s/n, Madrid 28029, Spain; National Centre for Epidemiology, Instituto de Salud Carlos III, C/Sinesio Delgado, 4, Madrid 28029, Spain.
authors.forename: Iñaki
authors.initials: I
authors.lastname: Galán
authors.affiliation: Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPAZ, C/Arzobispo Morcillo s/n, Madrid 28029, Spain.
authors.forename: Juan
authors.initials: J
authors.lastname: Donado-Campos
authors.affiliation: Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPAZ, C/Arzobispo Morcillo s/n, Madrid 28029, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Sánchez-Alfonso
authors.affiliation: Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPAZ, C/Arzobispo Morcillo s/n, Madrid 28029, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Melchor Fernández Almagro, 3-5, Madrid 28029, Spain; Department of Preventive Medicine, Móstoles University Hospital, Calle Río Júcar, 1, Móstoles 28935, Spain.
authors.forename: José Lorenzo
authors.initials: JL
authors.lastname: Valencia-Martín
authors.affiliation: Department of Computer Science and Automatic Control, Universidad Nacional de Educación a Distancia (UNED), Calle Juan del Rosal 16, 28040 Madrid, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Morilla
authors.affiliation: Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPAZ, C/Arzobispo Morcillo s/n, Madrid 28029, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Melchor Fernández Almagro, 3-5, Madrid 28029, Spain.
authors.forename: Luz Ma
authors.initials: LM
authors.lastname: León-Muñoz
authors.affiliation: Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPAZ, C/Arzobispo Morcillo s/n, Madrid 28029, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Melchor Fernández Almagro, 3-5, Madrid 28029, Spain. Electronic address: fernando.artalejo@uam.es.
authors.forename: Fernando
authors.initials: F
authors.lastname: Rodríguez-Artalejo
mesh_terms: D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology* / Q000523:psychology; D000437:Alcoholism / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D012959:Socioeconomic Factors; D013030:Spain / Q000453:epidemiology; D055815:Young Adult
keywords: Alcohol; Drinking patterns; Prospective cohort study; Spain