Validity of Alcohol Intake

Reporting bias by high-intake or low-intake consumers could, to some extent, explain the apparent lower mortality among light to moderate drinkers. In the type of studies included in this review,- with an emphasis on prospective population studies, one obvious source of bias is misclassification of subjects according to their self-reported alcohol intake. Studies of the validity of self-reported total alcohol intake have mainly concentrated on validating total alcohol intake in suspected alcoholics, whereas intake validity among low-intake consumers in the general population is poorly studied. No reference of alcohol intake (sales reports, collateral information, biological markers, etc.) has been identified. Some biochemical markers of alcohol intake have been suggested, such as 7-glutamyl transferase, high-density lipoprotein, and carbohydrate-deficient transferrin, the latter being one of the most promising. However, in a study from Copenhagen, it was shown that carbohydrate-deficient transferrin was

1-7 7-14 14-21 >=21 Glasses of wine per week

Figure 7 Odds ratio for developing abdominal obesity (waist measure >102cm) among men. (Reproduced with permission from Vadstrup E et al. (2003) Waist circumference in relation to history of amount and type of alcohol: Results from the Copenhagen City Heart Study. International Journal of Obesity 27: 238-246.)

1-7 7-14 14-21 >=21 Glasses of wine per week

Figure 7 Odds ratio for developing abdominal obesity (waist measure >102cm) among men. (Reproduced with permission from Vadstrup E et al. (2003) Waist circumference in relation to history of amount and type of alcohol: Results from the Copenhagen City Heart Study. International Journal of Obesity 27: 238-246.)

an invalid marker of self-reported alcohol intake in a general population. With regard to information on alcohol intake from the general population, the need for any such marker can further be questioned. First, participants in prospective cohort studies sampled from the general population have less reason to underreport, or deny, their alcohol intake than alcoholics or insurance populations. Second, in a study on alcoholic cirrhosis, it was found that self-reported alcohol intake in the questionnaire used in most of the studies included in the overview was a reliable measure of 'true alcohol intake' since self-reported alcohol intake is a valid predictor of this outcome (Figure 2).

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