Ken
Mukamal
Ken Mukamal
EE.UU. - Boston, Massachusetts
Biografía
El Dr. Mukamal es Jefe Asociado de Investigación en Medicina General en el Centro Médico Beth Israel Deaconess, Profesor Asociado de Medicina en la Facultad de Medicina de Harvard y Asociado de Departamento de Nutrición en la Escuela Chan de Salud Pública de Harvard. Los principales intereses de investigación del Dr. Mukamal se centran en el papel de los factores dietéticos y de estilo de vida -con especial atención al consumo de alcohol- en la incidencia y el pronóstico de los trastornos neurocognitivos y cardiovasculares. Como internista general e investigador clínico, su investigación ha incorporado estudios epidemiológicos a gran escala, datos clínicos hospitalarios y estudios de intervención específicos. El Dr. Mukamal presidió en 2011 el Panel de Expertos en Epidemiología del Alcohol y las Enfermedades Crónicas para el Instituto Nacional de Salud. Sus proyectos más recientes incluyen la caracterización epidemiológica del papel de las especies de ácidos grasos libres en las enfermedades crónicas y pequeños ensayos centrados en los efectos de las antocianinas en los adultos mayores y el alcohol entre las mujeres que toman inhibidores de la aromatasa.
Filiaciones
- Facultad de Medicina de Harvard
Áreas de especialización
- Influencia de la dieta y el estilo de vida en la aparición y desarrollo de trastornos neurocognitivos y cardiovasculares.
Abstract
El Alcohol y la Carga Global de Enfermedades: Una Actualización para Profesionales de la Salud
Alcohol and the Global Burden of Disease: An Update for Health Professionals
Alcohol consumption remains a topic of enormous interest, uncertainty, and controversy worldwide. National guidelines on alcohol consumption have progressively lowered the upper limit of acceptable consumption, driven in part by several scientific trends. Among the foremost of these trends is the synthetic estimation of disability-adjusted life-years (DALYs) lost, nationally and globally. This synthesis integrates meta-analytic summary relative risks related to overall volumes of consumption for individual conditions with the morbidity and mortality of those conditions and nation-specific reports of alcohol consumption. As expected, this approach identifies a major signal of harm related to excessive alcohol consumption, but yields inconsistent estimates of benefit or harm from limited consumption. Important limitations of this approach include its sensitivity to accurate quantification of dose-response relationships, differential cross-nation baseline rates and selective inclusion of alcohol-sensitive conditions, inaccuracies in ascribed rates of limited and excessive drinking, inability to quantify scientific (versus statistical) uncertainty, and failure to account for drinking patterns. Consequently, differences in DALYs ascribed to limited drinking should be viewed with caution. With those caveats, results from 2022 suggested limited alcohol consumption might yield similar DALYs to abstention anywhere from 0 to 1.75 drinks per day among individuals aged 15–39 years. Among individuals aged 40 years and older, the curve was consistently J-shaped, with safe levels that ranged from 0.2 to 7 drinks per day.[1] The substantial variability in these estimates suggests that better evidence on the true health effects of alcohol consumption, ideally from high-quality clinical trials, is needed, evidence that cannot be replaced by even the most sophisticated modeling.
Keywords: alcohol consumption, meta-analysis, morbidity, mortality, disability-adjusted life years
Acknowledgements: Dr. Mukamal receives grant support from the US National Institutes of Health, American Heart Association, and US Highbush Blueberry Council, none of which had any role in this presentation.
Reference:
1) GBD 2020 Alcohol Collaborators. (2022) Population-level risks of alcohol consumption by amount, geography, age, sex, and year: a systematic analysis for the Global Burden of Disease Study 2020. Lancet: 400(10347):185-235. DOI: 10.1016/S0140-6736(22)00847-9.
Alcohol consumption remains a topic of enormous interest, uncertainty, and controversy worldwide. National guidelines on alcohol consumption have progressively lowered the upper limit of acceptable consumption, driven in part by several scientific trends. Among the foremost of these trends is the synthetic estimation of disability-adjusted life-years (DALYs) lost, nationally and globally. This synthesis integrates meta-analytic summary relative risks related to overall volumes of consumption for individual conditions with the morbidity and mortality of those conditions and nation-specific reports of alcohol consumption. As expected, this approach identifies a major signal of harm related to excessive alcohol consumption, but yields inconsistent estimates of benefit or harm from limited consumption. Important limitations of this approach include its sensitivity to accurate quantification of dose-response relationships, differential cross-nation baseline rates and selective inclusion of alcohol-sensitive conditions, inaccuracies in ascribed rates of limited and excessive drinking, inability to quantify scientific (versus statistical) uncertainty, and failure to account for drinking patterns. Consequently, differences in DALYs ascribed to limited drinking should be viewed with caution. With those caveats, results from 2022 suggested limited alcohol consumption might yield similar DALYs to abstention anywhere from 0 to 1.75 drinks per day among individuals aged 15–39 years. Among individuals aged 40 years and older, the curve was consistently J-shaped, with safe levels that ranged from 0.2 to 7 drinks per day.[1] The substantial variability in these estimates suggests that better evidence on the true health effects of alcohol consumption, ideally from high-quality clinical trials, is needed, evidence that cannot be replaced by even the most sophisticated modeling.
Keywords: alcohol consumption, meta-analysis, morbidity, mortality, disability-adjusted life years
Acknowledgements: Dr. Mukamal receives grant support from the US National Institutes of Health, American Heart Association, and US Highbush Blueberry Council, none of which had any role in this presentation.
Reference:
1) GBD 2020 Alcohol Collaborators. (2022) Population-level risks of alcohol consumption by amount, geography, age, sex, and year: a systematic analysis for the Global Burden of Disease Study 2020. Lancet: 400(10347):185-235. DOI: 10.1016/S0140-6736(22)00847-9.