Alcohol preference and health behaviors in patients with cardiometabolic diseases: insights from the multi-center iact cross-sectional study

Abstract

Recognizing the influence of alcohol preference on health behaviors is essential for developing tailored interventions that effectively promote healthier lifestyles and optimize disease management strategies in the vulnerable population of patients with cardiometabolic diseases (CMD). The present study aims to provide valuable insights into how alcohol preference relates to dietary habits and medication adherence among patients with CMD diseases. A total of 1,988 patients diagnosed with CMD diseases (e.g., cardiovascular disease including coronary heart disease and stroke, hypertension, Type 1 and Type 2 diabetes, hypercholesterolemia, elevated triglycerides, obesity, and non-alcoholic fatty liver disease) participated in the IACT study, with 1,180 being females and an average age of 64 years. Participants completed validated questionnaires covering socioeconomic and demographic characteristics, alcohol consumption patterns, adherence to the Mediterranean diet (Meddietscore), and adherence to prescribed medication (4-Item Morisky Medication Scale). Based on the median value of the Meddietscore, patients were categorized as low and high adherers to the Mediterranean diet, while based on their score in the 4-Item Morisky Scale, patients were categorized as non-adherers and perfect adherers to the prescribed medication. Additionally, utilizing the FFQ employed, patients were also classified into four groups: (i) abstainers (no alcohol consumption); (ii) those who predominantly consumed beer (> 50% of alcohol intake from beer); (iii) those who predominantly consumed wine (> 50% of alcohol intake from red/white wine); and (iv) consumers of other spirits. Multivariable logistic regression analysis was employed to explore the relationship between alcohol preference and adherence to the Mediterranean diet, medication adherence. The outcomes of this investigation unveiled that 40.5% of patients (n=805) diagnosed with CMD conditions disclosed alcohol consumption, with a notable portion (n=411) opting to consume alcohol alongside meals. Regarding their weekly alcohol intake, 49.2% of alcohol consumers favored wine, 29.9% favored beer, while the remaining 20.9% favored other spirits such as ouzo, and tsipouro. In addition, among alcohol consumers, 57.1% of women and 42.9% of men indicated a preference for wine, whereas 26.6% of women and 32.6% of men favored beer (P< 0.001). It is also worth noting the fact that the majority of the patients living in rural areas preferred wine (59.2%) followed by ouzo/tsipouro (32.8%), while among patients living in urban areas, the highest proportion preferred beer (48.0%) followed by wine (41.0%) (P<0.001). Notably, individuals favoring wine were significantly older compared to those favoring beer and other alcoholic beverages (P< 0.05 in both genders). Among both men and women, beer consumers exhibited the highest socioeconomic status, evidenced by their higher educational attainment (P< 0.05 in both genders) and income level (P< 0.05 in both genders) compared to consumers of other alcoholic beverages. Following adjustments for demographic, socioeconomic, and clinical variables, wine consumers were approximately 10% and 26% more likely to adhere to the Mediterranean diet compared to beer consumers and consumers of other alcoholic beverages, respectively (P< 0.05 in both instances). Conversely, beer consumers were 1.4 times more likely to adhere to medication than wine consumers (OR= 1.4; 95% CI= 1.1-1.8) and 1.5 times more likely than consumers of other alcoholic spirits (OR= 1.5; 95% CI= 1.1-2.0). Overall, the study contributes valuable insights into the intricate relationships between alcohol preference, dietary habits, medication adherence, and socioeconomic factors among individuals with CMDs in Greece, yet further research is warranted to explore the underlying mechanisms.

Alkoholpräferenz und gesundheitsverhalten bei patienten mit kardiometabolischen erkrankungen: einblicke aus der multizentrischen iact-querschnittsstudie.

Preferencia de alcohol y comportamientos de salud en pacientes con enfermedades cardiometabólicas: perspectivas del estudio transversal multicéntrico iact.