Alcohol at the Familys Soul
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Where there had been laughter and jokes, a heavy silence hung. Paradise had become paradise lost. Strangely, the effect on my game was not immediate.
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I was on a winning streak, and the positive momentum carried me through for a couple of months. I felt no elation at my victories, but my body somehow kept going through the motions. My attitude was bad. I was depressed, lacking in enthusiasm. On the surface I remained a tennis-playing automaton, but the man inside had lost all love of life. My team members were at a loss as to how to react to the gloom that descended on me. I became a different person, distant and cold; short and sharp in conversation. And it did. First it was my knees that went.
I felt the first twinges in Miami, at the end of March.
Mind could no longer overcome matter and I took a break. I came back a couple of weeks later for the French Open. Maybe I should not have competed at Roland Garros, but I had won the championship the previous four years and I felt a duty to defend my crown, however unlikely the prospect of victory felt. Sure enough, I lost in the fourth round to Robin Soderling of Sweden, my first ever defeat in that tournament. This finally pushed me over the edge. Terribly sad, I pulled out of Wimbledon.
My knees were the immediate reason, but I knew that the root cause was my state of mind. Married: Died: 24 Dec Born: 25 May Died: 11 Nov Died: Married: 20 Jun , Winnipeg, Man. Died: 10 Jul , Montreal, Que. Born: 20 Dec , Plum Coulee, Man. Died: 6 Jul , Montreal, Que.
Married: , Paris, France. Born: Born Married: 28 Jun , Ottawa, Ont. Died: 26 Mar , Montreal, Que. All participants in both studies provided written informed consent, and all research was performed in accordance with relevant guidelines and regulations.
Individuals were excluded if they had a history of myocardial infarction in the past six months, reported being unable to walk one block, or were planning to relocate out of the area within three years. Between and , participants enrolled in the study. Of the participants at 5-year follow-up, 61 were excluded because they did not have both baseline and follow-up TL measurements, and an additional 2 were excluded because they did not have baseline alcohol data.
Baseline demographics, age, sex, race, ethnicity, smoking status, and comorbidities including diabetes mellitus, hypertension, heart failure, and history of previous myocardial infarction were determined by questionnaire. Weight and height were measured, and body mass index BMI was calculated as weight in kilograms divided by height in meters squared.
Waist and hip circumferences were measured with a flexible plastic measure to the nearest 0. Using DNA isolated from peripheral blood leukocytes, relative mean TL was measured from DNA by a quantitative polymerase chain reaction qPCR assay that compares mean telomere repeat sequence copy number T to a reference single-copy gene copy number S in each sample as previously described and validated Standard curves were derived from serially diluted reference DNA 36 — We observed an inter-assay coefficient of variation for telomere length measurement of 3.
In short, 5, individuals 65 years or older were recruited between and from a random sample of Medicare beneficiaries by four academic centers Johns Hopkins University, Wake Forest University, University of Pittsburgh, and University of California, Davis 41 — An additional black patients were recruited between and All participants had a medical history, physical exam, laboratory testing, and lead electrocardiogram ECG performed.
Participants were followed with annual clinic visits and semiannual telephone contact for ten years, with telephone contact continued every 6 months thereafter. Our analysis was restricted to the subset of participants randomly selected for TL measurement from participants who completed the —93 annual clinic examination considered baseline for the current analysis. Participants also reported whether they had changed their pattern of consumption during the past 5 years and whether they had ever regularly consumed five or more drinks daily Self-identified race, sex, income, and education level were obtained at baseline, while the rest of the covariates included in this analysis were obtained in — BMI was calculated from weight and height obtained at the yearly clinic visit.
Physical activity in kilocalories was calculated from the physical activity questionnaire. Medical comorbidities including diabetes mellitus, hypertension, coronary artery disease CAD , heart failure, and liver disease were assessed through a combination of clinic measurements, self-report, and medical record review. Events including myocardial infarction and stroke were individually adjudicated. Using DNA isolated from peripheral leukocytes, TL was measured using Southern blot analysis of terminal restriction fragment lengths and reported in kilobases 4 , 45 , Telomere measurements were performed in duplicate with each sample analyzed on two different gels on two different occasions , and the mean was used for statistical analyses.
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The laboratory conducting the TL measurements was blinded to all characteristics of participants. Specifically, for Heart and Soul, ideal drinking was defined as 1—2 drinks per day and no binge drinking the AUDIT-C did not differentiate between 1 and 2 drinks per day. For CHS, ideal drinking was defined as 1—7 drinks per week and no binge drinking for female participants and 1—14 drinks per week and no binge drinking for male participants.
The associations between the number of drinks of each alcohol type per week and TL were examined in CHS. Non-normally distributed continuous variables are presented as medians with interquartile ranges IQRs and were compared using the Kruskal—Wallis test. The association between categorical variables was determined using the chi-square test. Linear regression was used to examine the cross-sectional association between alcohol intake and TL in both cohorts.
Multivariable adjustment was made for potential demographic, medical, and biochemical confounders based on published associations and biological plausibility 4 , 9 , 47 — In addition to an age-adjusted model, 4 multivariate models were developed: Model 1included age, sex, and race; Model 2 included the Model 1 covariates plus BMI, waist-hip ratio, physical activity, smoking status, and number of pack years; Model 3 included Model 2 covariates plus diabetes, hypertension, coronary artery disease, prior myocardial infarction, heart failure, prior stroke, and liver disease; and Model 4 included Model 3 covariates plus inflammatory markers CRP, IL-6, fibrinogen and omega-3 fatty acid levels DHA, EPA.
Given that previous studies have demonstrated a strong relationship between baseline TL and subsequent change in TL 39 , we calculated a change score that is adjusted for baseline TL to use as our main outcome. Models were assessed for linearity using residual versus predicted plots and component plus residual plots.
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Normality was assessed using Q-Q plots of residuals. Constant variance across groups of alcohol consumption was verified. Influential points were assessed using boxplots of dfbeta statistics, which identified five potential outliers. When the models were re-fit excluding those potential outliers, our overall conclusions remained unchanged. We would like to acknowledge the participants, staff, and researchers of the Heart and Soul Study and the Cardiovascular Health Study for their contributions. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
All authors contributed to the interpretation of results and drafting of the manuscript. All authors read and approved the final manuscript.
Alcohol at the Family's Soul by Brian Davis - FictionDB
Supplementary information accompanies this paper at National Center for Biotechnology Information , U. Sci Rep.
Published online Feb 5. Shalini Dixit , 1 Mary A. Whooley , 1, 2, 3 Eric Vittinghoff , 3 Jason D.
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Roberts , 1 Susan R. Heckbert , 4, 5 Annette L. Mukamal , 9 and Gregory M. Marcus 1. Mary A. Jason D. Susan R. Annette L. Kenneth J. Gregory M. Author information Article notes Copyright and License information Disclaimer. Marcus, Email: ude. Corresponding author. Received Aug 21; Accepted Jan 9. Abstract The relationship between alcohol consumption and mortality generally exhibits a U-shaped curve.
Open in a separate window. Figure 1. Alcohol consumption was modeled continuously in drinks per week. Figure 2. Figure 3. Alcohol type and telomere length In CHS, no statistically significant relationships between amount of weekly wine, beer, or hard liquor consumption and TL were observed after multivariable adjustment. Discussion In an investigation of over Heart and Soul participants and over 1, CHS participants, we found no consistent relationship between alcohol consumption and either baseline TL or 5-year change in TL. Study cohort Between and , participants enrolled in the study.
Covariate ascertainment Baseline demographics, age, sex, race, ethnicity, smoking status, and comorbidities including diabetes mellitus, hypertension, heart failure, and history of previous myocardial infarction were determined by questionnaire. Measurement of telomere length Using DNA isolated from peripheral blood leukocytes, relative mean TL was measured from DNA by a quantitative polymerase chain reaction qPCR assay that compares mean telomere repeat sequence copy number T to a reference single-copy gene copy number S in each sample as previously described and validated The Cardiovascular Health Study Study design In short, 5, individuals 65 years or older were recruited between and from a random sample of Medicare beneficiaries by four academic centers Johns Hopkins University, Wake Forest University, University of Pittsburgh, and University of California, Davis 41 — Study cohort Our analysis was restricted to the subset of participants randomly selected for TL measurement from participants who completed the —93 annual clinic examination considered baseline for the current analysis.
Covariate ascertainment Self-identified race, sex, income, and education level were obtained at baseline, while the rest of the covariates included in this analysis were obtained in — Measurement of telomere length Using DNA isolated from peripheral leukocytes, TL was measured using Southern blot analysis of terminal restriction fragment lengths and reported in kilobases 4 , 45 , Supplementary information Supplementary Information 40K, docx.