Moderate Alcohol Consumption and Chronic Disease: The Case for a Long-Term Trial.
Drinking within recommended limits is highly prevalent in much of the world, and strong epidemiological associations exist between moderate alcohol consumption and risk of several major chronic diseases, including coronary heart disease, diabetes, and breast cancer. In many cases, plausible biological mediators for these associations have been identified in randomized trials, but gold standard evidence that moderate drinking causes or prevents any chronic disease remains elusive and important concerns about available evidence have been raised. Although long-term randomized trials to test the observed associations have been termed impossible, clinical investigators have now successfully completed randomized trials of complex nutritional interventions in a variety of settings, along with trials of alcohol consumption itself of up to 2 years duration. The successful completion of these trials suggests that objections to the execution of a full-scale, long-term clinical trial of moderate drinking on chronic disease are increasingly untenable. We present potential lessons learned for such a trial and discuss key features to maximize its feasibility and value.
Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts. kmukamal@bidmc.harvard.edu.
Kenneth J
KJ
Mukamal
Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
Catherine M
CM
Clowry
National Institute on Alcohol Abuse and Alcoholism, Rockville, Maryland.
Margaret M
MM
Murray
Hendriks Nutrition Support for Business, Zeist, the Netherlands.
Henk F J
HF
Hendriks
Departments of Nutrition and Epidemiology, Harvard TH Chan School of Public Health, Boston, Massachusetts.
Eric B
EB
Rimm
Section of Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina.
Kaycee M
KM
Sink
Department of Epidemiology & Public Health, University of Maryland School of Medicine, Baltimore, Maryland.
Clement A
CA
Adebamowo
Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark.
Lars O
LO
Dragsted
Countway Library of Medicine, Harvard University, Boston, Massachusetts.
P Scott
PS
Lapinski
Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Mariana
M
Lazo
Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut.
John H
JH
Krystal
D000428:Alcohol Drinking; D002908:Chronic Disease; D006801:Humans; D016032:Randomized Controlled Trials as Topic
Feeding Studies; Randomized Controlled Trial
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