Genetic screening and counseling slash young adults' excessive drinking, new study reveals

In a recent study published in the journal BMC Medicine, researchers conducted a randomized controlled trial (RCT) to investigate whether short-term interventions combining alcohol-metabolizing enzyme substances, alcohol dehydrogenase 1B (ADH1B) and aldehyde dehydrogenase 2 (ALDH2), with behavioral alterations in alcohol consumption could lower excessive alcohol intake.

Study: Effectiveness of genetic feedback on alcohol metabolism to reduce alcohol consumption in young adults: an open-label randomized controlled trial. Image Credit: Guayo Fuentes / ShutterstockStudy: Effectiveness of genetic feedback on alcohol metabolism to reduce alcohol consumption in young adults: an open-label randomized controlled trial. Image Credit: Guayo Fuentes / Shutterstock

Background

Excessive alcohol intake can cause health problems such as acute alcohol poisoning, risky conduct, injury, rape, and suicide. Young adulthood is a high-risk phase for alcohol misuse, and excessive consumption can lead to alcohol use problems later in life. Public health initiatives should aim to reduce high-risk alcohol intake among young individuals. 

Brief interventions, such as counseling sessions, have been tested to raise awareness about alcohol consumption and its repercussions. Studies demonstrate that intervention recipients' average daily alcohol intake significantly reduced six months later. Understanding an individual's alcohol-metabolizing enzyme genotype and following preventative practices can assist in solving alcohol-related health issues. 

About the study

In the present open-label RCT, researchers investigated the influence of short ADH1B and ALDH2 gene polymorphism screening treatments on alcohol intake among Japanese adults and the impacts on alcohol-use behavior changes.

The study comprised healthy undergraduate and postgraduate students, faculty, and staff of the University of Tsukuba, aged between 20 and 30 years, with excessive drinking habits (mean alcohol intake: at least four drinks daily for men and at least two drinks daily for women; one drink equivalent to 10 grams of 100% pure alcohol). Individuals participated in the study between July 2021 and October 2022, with enrolment completed by November 2022 and follow-up by June 2023.

The researchers randomized participants to the intervention [screening and brief intervention (SBI)] and control groups. Intervention recipients provided saliva samples for ADH1B and ALDH2 genotyping, and a month later, they received 30-minute offline or online instructional counseling based on their genotyping reports and alcohol intake data. Controls received conventional alcohol education.

The researchers calculated the mean daily alcohol intake based on alcohol consumption diaries recorded at study initiation and after three and six months. The primary outcome was the mean daily alcohol intake, and secondary outcomes included alcohol-use disorder identification test for consumption (AUDIT-C) scores and behavior modification phases evaluated using transtheoretical modeling (TTM). The researchers obtained data on age, gender, study field, living with or without family, job status, club participation, activities, hobbies, and outcomes using self-administered questionnaires and drinking calendars mailed to the participants. The five phases of drinking behavior modifications studied were pre-contemplation, contemplation, preparation, action, and maintenance.

The researchers found five categories of individuals with various degrees of alcohol breakdown. Type A exhibited low ADH1B and high ALDH2 activity, resulting in long-lasting effects and fast acetaldehyde breakdown. Type B possessed both ADH1B and ALDH2 activity, which made them prone to binge drinking. Type C exhibited delayed decomposition, Type D showed rapid alcohol breakdown and sluggish acetaldehyde decomposition, and Type E showed inactive ALDH2 and an increased risk of acute alcohol intoxication.

The intervention investigated the effect of alcohol-metabolizing enzyme genotyping on alcohol intake, absorption, and intake in nutrition, eating, and drinking, analyzing alcohol composition, illness risks, consumption planning, nutrition-based drinking, and slowing metabolism. It comprised drinking habit screening examinations, acceptable drinking and rest days, and guidance for improper drinking.

Results

The study comprised 100 intervention recipients and 96 controls. The researchers noted significantly lower mean alcohol intake after three and six months among intervention recipients but not among controls. The reduction in AUDIT-C scores and alcohol intake after three months was higher among intervention recipients than among controls.

Additionally, the study intervention significantly altered behavioral modification stages. The variations in the proportion of the distribution of behavioral modification phases between the control and intervention groups were significant at three months but showed slight significance at six months. The results showed a lower proportion of individuals in the pre-contemplation stage but a higher proportion in the action stage in the intervention group. As a result, these behavioral modifications may have contributed to the intervention group's lower alcohol consumption and AUDIT-C scores.

The study findings showed that genetic evaluation, including alcohol-metabolizing enzyme molecules and health advice on excessive drinking type, could lower long-term average alcohol intake in young individuals. The intervention group consumed much less alcohol and had lower AUDIT-C scores than the control group. The intervention also influenced the behavioral change phases of alcohol use. However, the intervention's impact did not last long. Future research should consider using electronic tools for quick alcohol intake conversion and comparing the efficiency of educational campaigns.

Journal reference:
Pooja Toshniwal Paharia

Written by

Pooja Toshniwal Paharia

Pooja Toshniwal Paharia is an oral and maxillofacial physician and radiologist based in Pune, India. Her academic background is in Oral Medicine and Radiology. She has extensive experience in research and evidence-based clinical-radiological diagnosis and management of oral lesions and conditions and associated maxillofacial disorders.

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