The long-term nature of these kinds of studies means people drop out over time and population studies tend not to include extremely heavy drinkers. However, Dr Britton says the project’s attention is focused primarily on average drinkers. “Other researchers have focussed on clinical settings where people are treated for severe alcohol problems. We want to map out what’s happening in the typical drinker who is apparently functioning well in society,” she explains. The people that make up these cohorts grew up in very different social and economic climates, with varying dietary patterns, attitudes to alcohol, and exposure to behavioural factors like smoking. Dr Britton and her colleagues are also considering these issues in their
detrimental impact on health, both in terms of immediate risk and the likelihood of long-term harm. “It is thought that binge drinking leads to a heightened risk of coronary heart disease,” she says. Patterns of consumption change throughout life, which is another important consideration. “Average consumption shows a peak around adolescence, which sustains into early adult life, then it tails away and plateaus to older age, when it declines,” says Dr Britton. “But in terms of frequency, we found that quite a high proportion of older people – in one of the cohort studies it was about 50 percent of men – were drinking every day in older age. Often quite small amounts, but there’s a possibility it’s becoming a bit of a dependency.”
At a glance Full Project Title Alcohol Consumption across the Life-course: Determinants and Health Consequences (Alcohol Life-course) Project Objectives Research on the health consequences of alcohol needs to address the effects of changes in drinking behaviour over the life-course. The current evidence base lacks the consideration of the complexity of lifetime consumption patterns, the major predictors of change in drinking and the subsequent health risks. Project Funding Project funded by the European Research Council (2013-2016), UK Medical Research Council (2015-2017) and Alcohol Research UK (2015-2017). Project Team • Dr Annie Britton Principal Investigator • Dr Steven Bell Research Associate • Nadine Seward Research Associate • Craig Knott Doctoral Candidate • Melanie Lacey Doctoral Candidate • Ashley West Administrative Support
research. “We will take different socioeconomic positions in the cohorts into account. We’ll look to see whether there are trends over time. We also have data on national alcohol consumption trends which we can use to compare what’s happening in the background,” she says. The aim is to disentangle the health effects of alcohol consumption from other factors, such as exercise levels and diet. This could hold important insights into why alcohol seems to have a greater health impact on people at the lower end of the income scale. “This is sometimes referred to as the alcohol paradox. On average, people in lower socio-economic positions tend to have higher rates of alcohol-related problems, such as liver disease, despite drinking similar amounts to people in higher socioeconomic positions,” outlines Dr Britton.
Consumption patterns This is a complex area, and researchers continue to investigate the underlying issues behind these inequalities. One important consideration is whether people binge drink, which Dr Britton says has a
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The data from this research will enable scientists to draw stronger links between alcohol consumption patterns and specific health effects, which could be used to underpin health advice in the future. Dr Britton draws a parallel here with earlier research into the links between smoking behaviour and lung disease. “It has been shown that if you smoke until you are about 30 and then stop, the risk of developing lung disease falls dramatically. We really don’t know this kind of information for alcohol consumption. So if you drink a lot in your youth, then become a moderate drinker, does your risk of getting alcohol-related diseases fall to the same level as if you had never drunk?” she says. The evidence base needs to be extended if scientists are to answer this kind of question and investigate the links between alcohol consumption and health in more detail. “If we are able to look at trajectories of drinking, and how they map onto the development of disease, then we can disentangle the causal pathways between alcohol and harm,” continues Dr Britton.
Contact Details Project Coordinator, Dr Annie Britton PhD Senior Lecturer in Epidemiology Departmental Graduate Tutor, Department of Epidemiology and Public Health University College London, 1-19 Torrington Place London WC1E 6BT T: +44 (0)20 7679 5626 E: a.britton@ucl.ac.uk W: www.ucl.ac.uk/alcohol-lifecourse
Dr Annie Britton PhD
Dr Annie Britton PhD is a Senior Lecturer in Epidemiology at University College London (UCL) and has worked in alcohol epidemiology for 18 years. She has worked on several alcoholrelated projects, including research on heavy drinking in Eastern Europe and cardiovascular risk, estimates of alcohol-attributable mortality in England, and a meta-analysis of alcohol and risk of stroke.
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