1 / 44

Presented by: Megan Gawronski

The diuretic action of weak and strong alcoholic beverages in elderly men: A Randomized Diet-Controlled Crossover trial. Presented by: Megan Gawronski. Authors. Kristel C. M. M. Polhuis : PhD Candidate, Wageningen University & Research Annemarthe H. C. Wijnen : ??

hiroshi
Download Presentation

Presented by: Megan Gawronski

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. The diuretic action of weak and strong alcoholic beverages in elderly men: A Randomized Diet-Controlled Crossover trial Presented by: Megan Gawronski

  2. Authors • Kristel C. M. M. Polhuis: PhD Candidate, Wageningen University & Research • Annemarthe H. C. Wijnen: ?? • AafjeSierksma: Director of The Dutch Beer Institute • Wim Calame: PhD • Michael Tieland: Nutrition, Exercise and Aging Physiologist at Wageningen University

  3. Presentationoutline • Background and Current Research • Hypothesis • Purpose of the Study • Research Methods • Study Design • Results • Conclusion/Findings • Strength and Weaknesses • Conflicts of Interest

  4. Background

  5. Elderly • The ageing population in Europe/Northern America is increasing rapidly. • By 2030, more than 25% of the population will be over 60. • A large proportion of the elderly consume alcohol.

  6. Hydration • Older adults are at risk for dehydration. • Polypharmacy may influence hydration status. • Dehydration can lead to poor health outcomes.

  7. Alcohol • A standard drink is equal to 14.0 grams (0.6 ounces) of pure alcohol. This is generally found in: • 12 ounces of beer (5% alcohol content) • 5 ounces of wine (12% alcohol content) • 1.5 ounces or a “shot” of 80-proof (40% alcohol content) distilled spirits or liquor • Women- 1 drink/day • Men- 2 drinks/day

  8. Previous research • A study in rats in 1968 showed that the diuretic response is directly related to alcohol concentration. • In 2005, the Institute of Medicine concluded that there is only a brief relationship between alcohol consumption and fluid losses. • Studies on the effects of alcohol in the elderly are lacking.

  9. The purpose of the study

  10. Purpose • “The aim of the study is to examine the diuretic effect of moderate amounts of commercially available weak and strong alcoholic beverages and their non-alcoholic counterparts in elderly men in a normal-life situation.”

  11. Hypothesis NO HYPOTHESIS (from these researchers) Referenced hypothesis: “Strong (distilled) alcoholic beverages provoke more dehydration than weaker alcoholic beverages.”

  12. Research methods

  13. Participants • 20 Dutch men • Between the ages of 60-75 • Recruited around Wageningen, Netherlands

  14. Inclusion criteria • Occasional consumption of alcoholic beverages • <21 standard drinks per week, 10 grams of alcohol per drink • No family/personal history of alcoholism • No use of drugs or medication that could interfere with diuresis

  15. INCLUSION Criteria • Normal renal function • Creatinine: 60-110 mmol/L • Urea: 2.5-6.4 mmol/L • No exclusion criteria

  16. Participant flow • 45 assessed for eligibility • 25 excluded • 20 chosen and randomly distributed over 6 crossover interventions • Attrition = 1 • Due to loss of interest • Data from NAB, NAW and S trials have been used • One water trial was excluded due to incomplete data

  17. Types of beverages tested Alcoholic beer: • Pilsner, Heineken • 5% Non-alcoholic beer: • Amstel 0.0, Heineken • 0% Alcoholic wine: • Merlot • 13.5% Non-alcoholic wine: • Merlot • 0% Spirits: • BolsGenever (gin) • 35% Water: • 0%

  18. Study design • Randomized, diet-controlled crossover trial consisting of 6 interventions and a preliminary screening visit. • Each intervention separated by 7 days. • 30 grams of alcohol was supplied during each alcohol-related trial. • Equal volume of liquid supplied for other interventions.

  19. Study design • Urine collected for 24 hours • Testing: urine output, urine osmolality, urine sodium and potassium concentrations • Beverages consumed during lunch • In 3 equal portions over 30-minute period • 4-hour observation phase • Urine collected after every hour • After 4 hours, participants went home and continued collecting urine until the next morning.

  20. Study Design • Not blinded • Familiar tastes and odors of beverages • Block randomization done by an independent scientist not involved in the study.

  21. Diet controlled • Participants maintained normal dietary habits and exercise routines on days without interventions. • Refrained from alcoholic beverages and caffeinated foods and drinks after 6:00 PM the day before an intervention. • Drank 500 ml of water the night before to assume similar hydration prior to each intervention.

  22. Diet controlled • During intervention periods, participants were not allowed to eat or drink anything except what was supplied. • Lasagna!!? • Diet and hydration protocol helped to eliminate cofounding variables

  23. Results

  24. Urine OUTPUT • First 4 hours: • Significant difference between wine and non-alcoholic wine (p < 0.03) • Significant difference between spirits and water (p < 0.001) • No significant difference between beer and non-alcoholic beer (p > 0.70) • At 24 hours: • No significant differences between alcoholic beverages and their non-alcoholic counterparts.

  25. Urine analysis

  26. Urine osmolality • Urine osmolality decreased during first 2 hours, then increased thereafter. • No significant differences between alcoholic beverages and their non-alcoholic counterparts. • Beer had lowest osmolality and highest urine output. • Indicates better hydration status • Larger fluid volume intake with beer

  27. Sodium concentration • Significant difference between alcoholic wine and non-alcoholic wine (p < 0.001) • Significant difference between spirits and water only up to hour 2 (p < 0.05) • No significant difference between beer and non-alcoholic beer (p > 0.10)

  28. Potassium concentration • Significant difference between wine and non-alcoholic wine (p < 0.001) • Significant difference between spirits and water (p < 0.001) • No significant difference between beer and non-alcoholic beer (p > 0.80)

  29. Conclusion

  30. Findings • Significant differences in urine output, sodium and potassium concentrations were only found between wine and non-alcoholic wine and between spirits and water.

  31. Findings • Moderate amounts of stronger alcoholic beverages (>13.5%) will provide a short-term diuretic effect. • Wine and spirits • Weaker alcoholic beverages (5%), do not provide a diuretic effect. • Beer

  32. Diuretic effect • Significant differences in urine appear only during first 4 hours. • Diuretic effect is relatively short-term. • Similar to caffeine

  33. Strengths and Limitations

  34. Strengths • Diet control and hydration protocol minimizes cofounding variables • Moderate amounts of alcohol used • Commercially available alcoholic products used • Real-life scenario • 24-hour urine testing • Previous studies were shorter

  35. weaknesses • Do people really only drink 30 grams (2 standard drinks) of alcohol in one sitting? • Incompliance with urine collection and dietary instruction at home (from hour 4-24) • Polypharmacy does influence most of the elderly • Lacks real-life scenario

  36. Weaknesses • Nutritional differences between alcoholic beverages and non-alcoholic counterparts • Rate of gastric emptying/hydration rate • Consuming alcohol in a fasting state vs. a fed state • No blood measurements were taken

  37. All In All The paper finishes with, “More research on this topic is needed.”

  38. Implications PUBLIC: • Information for family and friends who take care of elderly relatives. • These findings cannot be used for elderly women. CLINICAL: • Places such as nursing homes, comfort care, etc. will serve alcohol, these findings will give nurses an idea of what’s best for their patients. • Patient at risk for dehydration- offer beer instead of wine or spirits.

  39. Conflicts of interest

  40. Hmm.. Interesting.. • The study was funded by The Dutch Beer Institute. • Three of the authors (Polhuis, Wijnen and Sierksma) were employed by The Dutch Beer Institute during the execution of the study. • Winjnen and Sierksma were in charge of data collection. • Polhuis lead data interpretation.

  41. Citations • Polhuis, Kristel, et al. “The Diuretic Action of Weak and Strong Alcoholic Beverages in Elderly Men: A Randomized Diet-Controlled Crossover Trial.” Nutrients, vol. 9, no. 7, 2017, p. 660., doi:10.3390/nu9070660. • http://www.who.int/en/news-room/fact-sheets/detail/alcohol • https://www.cdc.gov/alcohol/faqs.htm • https://health.gov/dietaryguidelines/2015/guidelines/appendix-9/ • Population Division, Department of Economic and Social Affairs, United Nations. World Population Ageing 2015; United Nations: New York, NY, USA, 2015. • Faes, M.C. Spigt, M.G.; Olde Rikkert, M.G.M. Dehydration in Geriatrics. Geriatr. Aging, 2017, 10, 590-596. • Schols, J.M.; De Groot, C.P., van der Cammen, T.J.; Olde Rikkert, M.G. Preventing and treating dehydration in the elderly during periods of illness and warm weather. J. Nutr. Health Aging 2009, 13, 150-157. • http://www.kennisinstituutbier.nl/aboutus

  42. Photos • https://viddyad.com/linkedin-retiring-products-and-services-pages-and-launching-showcase-pages/stockvault-blue-water-texture116093/ • http://www.drinksguide.com.au/295?Page=2&Article=diageo-dominates-2018-top-100-spirits-brands • https://dinnerthendessert.com/ultimate-meat-lasagna/ • https://www.infocommshow.org/free-beer • http://static6.depositphotos.com/1004868/651/i/950/depositphotos_6515776-Doctor-with-thumbs-up.jpg

  43. QUESTIONS

More Related