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Moderate Alcohol Consumption May Reduce Incident Depression

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Low-to-moderate alcohol drinking is associated with lower risk of depression.

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Most cultures include alcoholic beverages as part of their usual diet. Alcohol intake is different over world regions regarding the habitual type of beverage and the frequency and average intake. In general terms, the consumption of alcoholic beverages is increasing worldwide. Unipolar depression is the most prevalent mental disorder in the world and it is increasing steadily.

In the existing literature about non-problematic alcohol use and depression, longitudinal studies are inconsistent. However, none of them has investigated the specific role of each beverage. Neither have they used repeated measurements on alcohol intake during follow-up to update the information on exposure to alcohol. A recent study published in BMC Medicine evaluated the incidence of depression among light to moderate drinkers from an older Mediterranean cohort at high cardiovascular risk using repeated measurements of intake.

An interesting characteristic of this population is that wine was the most frequently consumed alcoholic beverage. The study also evaluated specifically the association of wine with incident depression, using repeated measurements of wine consumption.

Participants were men and women aged 55 to 80 and 60 to 80 years, respectively. They were free of cardiovascular disease at baseline and met at least one of the two following criteria: type 2 diabetes mellitus or the presence of three or more coronary heart disease risk factors.

Previous history of cardiovascular disease, any severe chronic illness, history of food allergy, drug addiction or chronic alcoholism were exclusion criteria for this trial. Finally, a subsample of 5,505 participants (2,683 males and 2,822 females) was included in the analyses of the present study

Participants were divided into four groups according to their alcohol intake: abstainers, those who reported drinking less than 5 g/day, those with an intake ranging from >5 to 15 g/day, and the fourth group with an intake higher than 15 g/day.

Higher alcohol intake was positively associated with being male (88% of participants drinking more than 15 g/day were male), practicing more leisure-time physical activity, being a current or former smoker, having higher total energy intake, being married, but it was inversely associated with educational level.

Low-to-moderate alcohol drinking (5 to 15 g/day) was associated with lower risk of depression. This association was stronger for low-to-moderate wine-drinkers (two to seven glasses/week).

These results seem paradoxical as previous studies found a direct association between alcohol in higher amounts, especially alcohol use disorders, and depressive symptoms. However, lower amounts of alcohol intake might exert a protection as it has been observed for coronary heart disease. In fact, it is believed that depression and coronary heart disease share common pathophysiological mechanisms.

Previous investigations suggest that the hippocampal complex may play a role in the development of major depression. This neuroprotection applied to the hippocampus may prevent moderate wine drinkers from developing depression.

In conclusion, low-to-moderate total alcohol intake and specifically wine consumption may reduce incident depression, while heavy drinkers seem to be at higher risk. Further cohort studies are needed to confirm these results.

Reference:

Gea A, Beunza JJ, Estruch R, Sánchez-Villegas A, Salas-Salvadó J, Buil-Cosiales P, Gómez-Gracia E, Covas MI, Corella D, Fiol M, Arós F, Lapetra J, Lamuela-Raventós RM, Wärnberg J, Pintó X, Serra-Majem L, Martínez-González MA, & PREDIMED GROUP (2013). Alcohol intake, wine consumption and the development of depression: the PREDIMED study. BMC medicine, 11 (1) PMID: 23988010

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