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    • This hypothesis also provides some insight into more

    2018-10-23

    This aa-utp also provides some insight into more pronounced beneficial effects of low alcohol consumption on the risk of AP in women compared to men. Specifically, women are more likely to develop biliary problems and gallstones (Shen et al., 2013; Russell et al., 1998) and therefore constitute a larger proportion of the cases of biliary AP, whereas men are more likely to consume larger amounts of alcohol on daily basis and to binge drink, and therefore represent the majority of cases of alcoholic AP. Thus, the proportion of women consuming alcohol at the levels of less than 40g per day, which reduces their risk of biliary AP, is higher compared to men, and the beneficial effect of low levels of alcohol consumption is therefore more pronounced. This can be illustrated by data from the study by Morton et al. (2004). The subset of cases of alcoholic pancreatitis demonstrated an exponential increase of the risk of pancreatitis with the increase of the daily alcohol consumption. At the same time, in the subset of gallstone pancreatitis cases, the risk of pancreatitis was lower in subjects consuming low amounts of alcohol, and increased with higher alcohol consumption. The data on the risk of pancreatitis in different populations are scarce. While the data on AP were not sufficient to draw any conclusions regarding the impact of ethnicity on the risk of pancreatitis we were able to conduct separate analyses for CP based on geographical area of the study and there are indications that the risk of CP in predominantly Asian populations is linear and higher than in non-Asians or mixed populations of Europe and US. These variations may be related to genetic factors (e.g. Brooks et al., 2009), different drinking patterns as well as dietary variations.
    Conclusions There are differential dose–response relationships between average volume of alcohol consumption and risk of different types of pancreatitis in men and women. The relationship was linear for CP and AP in men, but non-linear for AP in women. There was strong evidence supporting a threshold effect for AP in women at the level of alcohol consumption of up to 40g/day. Beyond 40g of pure alcohol/day, the risk of pancreatitis, both acute and chronic, regardless of sex, was higher than previously thought.
    Role of the Funding Source The sponsor of the study (NIAAA) had no role in study design, data collection, data analysis, data interpretation, or writing of the report. The authors collected the data, and had full access to all of the data in the study. The authors also had final responsibility for the decision to submit the study results for publication.
    Contributors
    Funding The work was financially supported by a grant from the National Institute on Alcohol Abuse and Alcoholism (R21AA023521) to MR.
    Declaration of Conflict of Interest MR and JR report grants from the National Institutes of Health (NIH), National Institute on Alcohol Abuse and Alcoholism (NIAAA, R21AA023521), during the conduct of the study. AVS has no conflict of interest.
    Acknowledgments
    Introduction Obesity is defined as the abnormal accumulation of body fat and has become a major clinical burden worldwide (Swinburn et al., 2011). In order to prevent weight gain, the combination of reduced energy intake and increased physical activity has been recommended. Exercise guidelines (Garber et al., 2011; The Office for Lifestyle-Related Disease Control et al., 2006) and recommendations (World Health Organization, 2010) do not specifically comment on the most beneficial time of day for exercise. As part of the growing lifestyle diversity in modern society, there is wide variation in the time of day individuals choose to exercise. Recent surveys in the US and Japan have reported that on weekdays, most people exercise in the evening, with fewer individuals exercising in the morning or afternoon (Sports and Exercise, 2015; Anon., 2013). The skewed distribution of habitual exercise times toward the evening in the general population is in contrast with experimental conditions used in exercise studies, which are typically performed in the morning or afternoon and rarely in the evening.