Hard liquor, not beer or wine, may explain trends in cirrhosis...( Scientists have noted a new clue to a...),Health

Scientists have noted a new clue to an epidemiological mystery surrounding the link between alcohol and cirrhosis. Although cirrhosis has long been associated with heavy drinking, US cirrhosis mortality trends have not always corresponded well with the nation's total alcohol consumption including beer, wine, and hard liquor.

Now, UCSF researchers have reported that the trend of hard liquor consumption by itself closely follows the long-term pattern of cirrhosis mortality. Their paper is published in the current issue of the British Medical Journal. Cirrhosis mortality in the United States experienced a long-term increase after World War II, peaked in 1973, then steadily declined to half its peak rate by 1994. Total alcohol consumption - as measured by combining the alcohol (ethanol) contributions of beer, wine, and liquor - also increased over the post-war era. But consumption peaked and turned downward around 1980, a half dozen years after cirrhosis mortality started falling.

"Why cirrhosis peaked when it did and why it commenced its long-term decline is unknown and has been a long-standing mystery," said Ron Roizen, UCSF sociologist in the department of social and behavioral science and lead author of the study. "Excluding beer and wine and only looking at hard alcohol was a remarkably simple thing for us to have previously overlooked."

Looking at data between 1949 and 1994, the researchers found that the consumption pattern of hard liquor in the US showed a reasonably close match to cirrhosis deaths. They evaluated their observed long-term correlation against two sharp, short-term declines in hard liquor consumption. In 1942-43, when wartime needs diverted all ethanol production to the making of synthetic rubber and explosives, per capita consumption fell 22 percent. A similar drop occurred in 1946-47 when post-war consumption levels commenced.

These short-term "natural experiments" generated mixed results, said Roizen. The 1942-43 dr
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Contact: Rebecca Sladek Nowlis
rsnowlis@pubaff.ucsf.edu
415-476-2557
University of California - San Francisco
13-Sep-1999