Commentary: Can Nonhazardous Limits of Drinking Be Defined?
Comentario: ¿Es posible definir los límites no nocivos del consumo de alcohol?
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"tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "457" "paginaFinal" => "459" ] ] "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "E Revuelta Muñoz, P Godoy García" "autores" => array:2 [ 0 => array:3 [ "Iniciales" => "E" "apellidos" => "Revuelta Muñoz" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] 1 => array:3 [ "Iniciales" => "P" "apellidos" => "Godoy García" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "affb" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Médico de Familia, ABS Pla d'Urgell, Lleida, Spain" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] 1 => array:3 [ "entidad" => "Facultad de Medicina, Universidad de Lleida, Lleida, Spain." "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "affb" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Comentario: ¿Es posible definir los límites no nocivos del consumo de alcohol?" ] ] "textoCompleto" => "<p class="elsevierStylePara">Drinking alcoholic beverages is widely permitted and tolerated in Spain. In industrialized countries, drink-related disorders have become an important health problem, and this in turn has generated a number of different areas of research, as well as increasing interest in the search for effective lines of action.</p><p class="elsevierStylePara">On a social level there is also interest in identifying health issues related with drinking--both its benefits and its drawbacks. Despite the widespread assumption that moderate drinking can have beneficial health effects, especially for the cardiovascular system,<span class="elsevierStyleSup">1,2</span> knowledge and awareness of the health risks of alcohol abuse are also increasing. This is consistent with reports of declining alcohol consumption in Spain (both in excess and day-to-day drinking) and decreasing rates of alcohol intoxication. Meanwhile moderate or light drinking appears to be on the increase.<span class="elsevierStyleSup">3</span></p><p class="elsevierStylePara">The perceived risk associated with drinking is lower in men, younger persons and risk drinkers.<span class="elsevierStyleSup">3</span> This is also consistent with the results of the study by Teruel et al<span class="elsevierStyleSup">4</span> of primary care center users, published in this issue of Atención Primaria. In general, the dangers of daily drinking appear to be greater and this type of drinking is seen as less desirable than weekend drinking, a behavior that the general public often tends to view with less concern.<span class="elsevierStyleSup">3</span></p><p class="elsevierStylePara">Studies that investigate the public's knowledge of harmful levels of alcohol consumption and the damage excess drinking can have on health are of interest to determine which preventive measures are most likely to work in primary care.</p><p class="elsevierStylePara">In addition, drinking habits (type, frequency and amount of alcohol consumed) have frequently been found to be underestimated or inaccurately noted in medical records, a fact that may be related with the still widespread acceptance (even among health professionals) of drinking as part of our culture and way of life. In this connection the findings of Teruel et al indicate that alcohol consumption is recorded more frequently in medical records at their center than in other parts of Spain, although the data may be incomplete or not up to date.<span class="elsevierStyleSup">5</span> The importance of correctly entering information about drinking in the patient's chart at primary care centers cannot be overemphasized, as this will help care providers to evaluate the extent of the problem in Spain and identify risk groups in need of specific interventions.</p><p class="elsevierStylePara">Members of the public appear to be aware of the limits for daily drinking, but downplay the risk of occasional abuse. They know excess alcohol is harmful, but their knowledge is partial and superficial. Perhaps lines of action should be directed toward defining the limits more clearly and communicating the real risks.</p><p class="elsevierStylePara">Unlike smoking and the use of other toxic substances, the problem with drinking may be that the message that we transmit regarding alcohol is not clear enough. On one hand there is a constant stream of contradictory information regarding the benefits of moderate drinking, whereas health professionals do not actively promote abstinence but instead recommend reducing alcohol consumption. This leaves the door open to subjective interpretation, self-deception and rationalization.</p><p class="elsevierStylePara">However, this may also be a result of health professionals' lack of a clear idea of what lines of action to use. Many studies have found larger numbers of excess drinkers in populations in which larger amounts of alcohol are habitually consumed.<span class="elsevierStyleSup">6</span> Other studies, in contrast, report moderate drinking to be more beneficial than abstinence with regard to cardiovascular disease.<span class="elsevierStyleSup">1,2</span> As health professionals, where should we focus our attention? Is it right to recommend abstinence when moderate drinkers may benefit from drinking? Nevertheless, if we recommend only that drinking be reduced, are we sending an unclear message about the importance of the problem and leaving the way open to subjectivity and rationalization? This issue is particularly important, as we know that for this type of problem the self-perceived threshold of risk is so low.</p><p class="elsevierStylePara">Within this context, studies of users' awareness of and attitudes regarding hazardous levels of drinking and the damage to health caused by excess drinking become increasingly relevant. The study by Teruel et al shows that up to 24% of the users at their health center (and often the younger users) are unaware of the limits of hazardous drinking, and that a large percentage of the population are still unclear about the potential consequences of this habit.</p><p class="elsevierStylePara">The efficacy of brief counseling as a preventive measure that can be provided through primary care has been clearly established.<span class="elsevierStyleSup">7</span> A profound awareness of our shortcomings and those of the population we serve is the way toward improving this type of intervention and making it more effective.</p><p class="elsevierStylePara">Key points</p><p class="elsevierStylePara">* Studies of the public's knowledge of nonhazardous limits of drinking and the damage this can cause can help to increase the efficacy of brief counseling.</p><p class="elsevierStylePara"> * It is important to increase and improve quality and update practices for recording alcohol consumption in primary care services.</p>" "pdfFichero" => "27v32n08a13054009pdf001.pdf" "tienePdf" => true "bibliografia" => array:2 [ "titulo" => "Bibliography" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:7 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Public opinion on the health benefits of moderate drinking: results from a Canadian National Population Health survey. 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| 2024 January | 29 | 6 | 35 |
| 2023 December | 20 | 4 | 24 |
| 2023 November | 24 | 8 | 32 |
| 2023 October | 27 | 4 | 31 |
| 2023 September | 19 | 1 | 20 |
| 2023 August | 8 | 6 | 14 |
| 2023 July | 13 | 2 | 15 |
| 2023 June | 20 | 2 | 22 |
| 2023 May | 14 | 6 | 20 |
| 2023 April | 10 | 1 | 11 |
| 2023 March | 6 | 0 | 6 |
| 2023 February | 10 | 0 | 10 |
| 2023 January | 6 | 0 | 6 |
| 2022 December | 17 | 3 | 20 |
| 2022 November | 18 | 4 | 22 |
| 2022 October | 19 | 6 | 25 |
| 2022 September | 30 | 4 | 34 |
| 2022 August | 27 | 11 | 38 |
| 2022 July | 16 | 7 | 23 |
| 2022 June | 13 | 6 | 19 |
| 2022 May | 14 | 8 | 22 |
| 2022 April | 25 | 12 | 37 |
| 2022 March | 16 | 10 | 26 |
| 2022 February | 8 | 4 | 12 |
| 2022 January | 10 | 10 | 20 |
| 2021 December | 16 | 6 | 22 |
| 2021 November | 14 | 8 | 22 |
| 2021 October | 20 | 10 | 30 |
| 2021 September | 10 | 8 | 18 |
| 2021 August | 12 | 6 | 18 |
| 2021 July | 8 | 5 | 13 |
| 2021 June | 21 | 7 | 28 |
| 2021 May | 14 | 4 | 18 |
| 2021 April | 16 | 31 | 47 |
| 2021 March | 19 | 7 | 26 |
| 2021 February | 16 | 6 | 22 |
| 2021 January | 15 | 11 | 26 |
| 2020 December | 9 | 12 | 21 |
| 2020 November | 6 | 6 | 12 |
| 2020 October | 10 | 8 | 18 |
| 2020 September | 6 | 9 | 15 |
| 2020 August | 7 | 7 | 14 |
| 2020 July | 7 | 12 | 19 |
| 2020 June | 5 | 9 | 14 |
| 2020 May | 12 | 4 | 16 |
| 2020 April | 9 | 1 | 10 |
| 2020 March | 12 | 7 | 19 |
| 2020 February | 13 | 3 | 16 |
| 2020 January | 9 | 4 | 13 |
| 2019 December | 21 | 9 | 30 |
| 2019 November | 6 | 7 | 13 |
| 2019 October | 5 | 2 | 7 |
| 2019 September | 6 | 5 | 11 |
| 2019 August | 6 | 3 | 9 |
| 2019 July | 7 | 4 | 11 |
| 2019 June | 32 | 18 | 50 |
| 2019 May | 60 | 15 | 75 |
| 2019 April | 5 | 7 | 12 |
| 2019 March | 4 | 5 | 9 |
| 2019 February | 2 | 4 | 6 |
| 2019 January | 5 | 2 | 7 |
| 2018 December | 8 | 6 | 14 |
| 2018 November | 8 | 4 | 12 |
| 2018 October | 6 | 5 | 11 |
| 2018 September | 4 | 6 | 10 |
| 2018 August | 1 | 0 | 1 |
| 2018 July | 6 | 2 | 8 |
| 2018 June | 4 | 0 | 4 |
| 2018 May | 6 | 0 | 6 |
| 2018 March | 2 | 0 | 2 |
| 2018 February | 3 | 1 | 4 |
| 2018 January | 2 | 0 | 2 |
| 2017 December | 4 | 1 | 5 |
| 2017 November | 4 | 0 | 4 |
| 2017 October | 6 | 1 | 7 |
| 2017 September | 4 | 1 | 5 |
| 2017 August | 3 | 0 | 3 |
| 2017 July | 7 | 2 | 9 |
| 2017 June | 18 | 0 | 18 |
| 2017 May | 13 | 0 | 13 |
| 2017 April | 12 | 2 | 14 |
| 2017 March | 19 | 2 | 21 |
| 2017 February | 19 | 0 | 19 |
| 2017 January | 2 | 3 | 5 |
| 2016 December | 11 | 2 | 13 |
| 2016 November | 15 | 2 | 17 |
| 2016 October | 33 | 3 | 36 |
| 2016 September | 17 | 1 | 18 |
| 2016 August | 19 | 2 | 21 |
| 2016 July | 13 | 7 | 20 |
| 2016 June | 20 | 12 | 32 |
| 2016 May | 10 | 5 | 15 |
| 2016 April | 14 | 1 | 15 |
| 2016 March | 16 | 3 | 19 |
| 2016 February | 13 | 6 | 19 |
| 2016 January | 17 | 1 | 18 |
| 2015 December | 17 | 3 | 20 |
| 2015 November | 9 | 2 | 11 |
| 2015 October | 14 | 2 | 16 |
| 2015 September | 13 | 1 | 14 |
| 2015 August | 11 | 3 | 14 |
| 2015 July | 7 | 0 | 7 |
| 2015 June | 2 | 1 | 3 |
| 2015 May | 3 | 7 | 10 |
| 2015 April | 5 | 7 | 12 |
| 2015 March | 8 | 1 | 9 |
| 2015 February | 5 | 3 | 8 |
| 2015 January | 20 | 0 | 20 |
| 2014 December | 27 | 3 | 30 |
| 2014 November | 15 | 0 | 15 |
| 2014 October | 25 | 1 | 26 |
| 2014 September | 29 | 0 | 29 |
| 2014 August | 26 | 1 | 27 |
| 2014 July | 16 | 3 | 19 |
| 2014 June | 21 | 1 | 22 |
| 2014 May | 15 | 0 | 15 |
| 2014 April | 14 | 1 | 15 |
| 2014 March | 8 | 0 | 8 |
| 2014 February | 12 | 0 | 12 |
| 2014 January | 9 | 2 | 11 |
| 2013 December | 19 | 1 | 20 |
| 2013 November | 9 | 1 | 10 |
| 2013 October | 25 | 2 | 27 |
| 2013 September | 10 | 3 | 13 |
| 2013 August | 16 | 2 | 18 |
| 2013 July | 12 | 1 | 13 |
| 2003 November | 394 | 0 | 394 |
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