***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Associations between modifiable exposures and disease seen in observational epidemiology are sometimes confounded and thus misleading , despite our best efforts to improve the design and analysis of studies . Mendelian r and omization-the r and om assortment of genes from parents to offspring that occurs during gamete formation and conception-provides one method for assessing the causal nature of some environmental exposures . The association between a disease and a polymorphism that mimics the biological link between a proposed exposure and disease is not generally susceptible to the reverse causation or confounding that may distort interpretations of conventional observational studies . Several examples where the phenotypic effects of polymorphisms are well documented provide encouraging evidence of the explanatory power of Mendelian r and omization and are described . The limitations of the approach include confounding by polymorphisms in linkage disequilibrium with the polymorphism under study , that polymorphisms may have several phenotypic effects associated with disease , the lack of suitable polymorphisms for study ing modifiable exposures of interest , and canalization-the buffering of the effects of genetic variation during development . Nevertheless , Mendelian r and omization provides new opportunities to test causality and demonstrates how investment in the human genome project may contribute to underst and ing and preventing the adverse effects on human health of modifiable exposures BACKGROUND Epidemiologic studies have shown alcohol consumption to be inversely as well as positively related to body weight and body fat . Metabolic studies have shown an increase in energy intake as well as compensation after alcohol consumption . OBJECTIVE Our objective was to assess the effects on energy intake of an apéritif compared with those of a water appetizer and 3 fruit juice appetizers . DESIGN Fifty-two men and women aged 20 - 45 y with a body mass index ( in kg/m2 ) between 20 and 32 were r and omly given 1 MJ ( 340 mL ) alcohol ( wine or beer ) , fat ( cream fruit juice ) , protein ( protein fruit juice ) , carbohydrate ( grape juice ) , or water , or no preload 30 min before an ad libitum lunch consumed from the universal eating monitor . RESULTS Energy intake ( 3.5+/-0.3 MJ compared with 2.7+/-0.2 MJ , P < 0.001 ) and eating rate were higher ( 44+/-3 g/min compared with 38+/-3 g/min , P < 0.01 ) , meal duration was longer ( 14 min compared with 12.0 min , P < 0.01 ) , satiation started to increase later ( 3.5 min compared with 1.5 min , P < 0.01 ) , and eating was prolonged after maximum satiation ( 2.5 min compared with 0.6 min , P < 0.01 ) after an apéritif than after a fat , protein , or carbohydrate appetizer , . Twenty-four-hour energy intake was higher on a day that an apéritif was consumed than after water or no preload . CONCLUSION Twenty-four-hour energy intake was elevated with a 1-MJ apéritif but not with a 1-MJ liquid carbohydrate , fat , or protein appetizer The vasodilation that follows acute alcohol intake is hard to conciliate with the high prevalence of hypertension detected in those persons who consume regular amounts of alcohol . In this experiment we examined early and late hemodynamic effects of acute administration of water and of 15 g , 30 g , and 60 g of alcohol in 40 normal men , aged 19 to 30 years , using 24-h ambulatory blood pressure monitoring ( ABPM ) .  Mean systolic and diastolic blood pressures were each approximately 4 mm Hg lower during the period immediately after ingestion of 60 g ( v 0 g ) of ethanol , and were 7 and 4 mm Hg higher , respectively , at night . The day minus night differences displayed a dose-response curve both for systolic ( P < .001 ) and diastolic blood pressure ( P = .045 ) . Three subjects in the 60-g group had more than 50 % of nightly blood pressure loads in the hypertensive range against none in the remaining groups ( P < .01 ) . In conclusion , our findings suggest that acute alcohol intake elicits a biphasic hemodynamic response , causing , first , vasodilatation and , later , a pressor effect . The higher prevalence of  hypertension  in alcohol abusers seen in epidemiological surveys may be , in part , a result of measurements done in the period of transiently increased blood pressure during ethanol washout Objective —Nitrates are used widely in clinical practice . However , the mechanism underlying the bioactivation of nitrates to release NO remains unclear . Recent animal data suggest that mitochondrial aldehyde dehydrogenase ( ALDH2 ) plays a central role in nitrate bioactivation , but its role in humans is not known . We investigated the role of ALDH2 in the vascular effects of nitroglycerin ( NTG ) in humans in vivo . Methods and Results —Forearm blood flow ( FBF ) responses to intra-arterial infusions of NTG , sodium nitroprusside ( SNP ) , and verapamil were measured in 12 healthy volunteers before and after ALDH2 inhibition by disulfiram . All drugs caused a dose-dependent vasodilatation . However , only the response to NTG was significantly reduced after disulfiram therapy ( 33 % reduction in area under the curve [ AUC ] ; P=0.002 ) . Separately , 11 subjects of East Asian origin , with the loss-of-function glu504lys mutation in the ALDH2 gene , received intra-arterial NTG , SNP , and verapamil . Only the FBF response to NTG was lower in the volunteers with the glu504lys mutation compared with East Asian and non-Asian wild-type control subjects ( 40 % reduction in AUC ; P=0.02 ) . Conclusions —The findings suggest that ALDH2 is involved in the bioactivation of NTG in humans in vivo but accounts for less than half of the total bioactivation . This may be of clinical importance in patients with mutations in the ALDH2 gene and in those taking drugs that inhibit ALDH2 Abstract Deficiencies in mitochondrial low-Km aldehyde dehydrogenase ( ALDH2 ) activity , and consequently high blood acetaldehyde levels , have been suggested to relate to various diseases in Japanese , including esophageal cancer . In the present study , 200 men aged 35 - 59 years r and omly selected from an occupational population were analyzed for the association of ALDH2 genotypes and cytochrome P450 - 2E1 ( CYP2E1 ) genotypes with the urinary excretion of acetaldehyde ( which is bound to some chemicals in the urine ) and with common alcohol-related health consequences . Urinary acetaldehyde excretion was increased , reflecting increased alcohol consumption even in this moderate alcohol-consuming population . Neither the ALDH2 nor the CYP2E1 genotypes showed significant influence on the elevation of urinary acetaldehyde excretion . Neither these genotypes nor urinary acetaldehyde concentration significantly affected blood pressure , serum aspartate aminotransferase and gamma-glutamyl transferase activities , or serum HDL-cholesterol and lipid peroxide concentrations . It was concluded that acetaldehyde accumulates in moderate alcohol consumers irrespective of ALDH2 and CYP2E1 genotype , and that the implication s of these genotypes and acetaldehyde accumulation in terms of common alcohol-related health consequences were obscure . The results also suggest that the carcinogenicity of acetaldehyde on esophageal mucosa depends greatly upon repeated exposure to high blood acetaldehyde , even through transient rather than chronic exposure Among older people , the detection and control of hypertension is particularly important to reduce cardiovascular disease risk . This cross-sectional survey aim ed to describe the detection , treatment and control of hypertension in older British adults . A total of 3059 women and 3007 men aged 60–79 years were r and omly selected from general practice age/sex registers in 24 British towns and examined from 1998 to 2001 . Of these , 52.6 % women and 47.9 % men had at least one indicator of hypertension ( high blood pressure on examination , or taking antihypertensive medication or recalled a doctor diagnosis of high blood pressure ) . Among women , 50 % of those with any indication of hypertension were on treatment and 29 % were well controlled , and among men 45 % were on treatment and 16 % were well controlled . With the exception of alcohol use in men ( adjusted odds ratio 0.67 ( 0.46 , 0.98 ) ) , socioeconomic factors , area of residence and behavioural risk factors were not associated with good control among those with hypertension in either sex . Of those on treatment , 20.7 % of women and 28 % of men were on two classes of antihypertensive medication and 3.5 and 4.9 % , respectively , were on three or more classes of antihypertensive medication . Among those with a doctor diagnosis of hypertension and taking antihypertensive medication , the proportion with well controlled blood pressure did not differ between those on more than one antihypertensive and those on just one in either sex . We conclude that targets of good control are rarely met in older individuals , who would benefit from the associated reduction in cardiovascular disease risk OBJECTIVE Alcohol consumption may play a role in the development of obesity but the relationship between alcohol and weight is still unclear . The aim of our study was to assess the cross-sectional association of intakes of total alcohol and of specific alcoholic beverages ( wine , beer and spirits ) with waist-to-hip ratio ( WHR ) and body mass index ( BMI ) in a large sample of adults from all over France . DESIGN Cross-sectional . SETTING Participants were free-living healthy volunteers of the SU.VI.MAX study ( an intervention study on the effects of antioxidant supplementation on chronic diseases ) . SUBJECTS For 1481 women aged 35 - 60 years and 1210 men aged 45 - 60 years , intakes of total alcohol and specific alcoholic beverages were assessed by six 24-hour dietary records .  BMI and WHR were measured during a clinical examination the year after . RESULTS A J-shaped relationship was found between total alcohol consumption and WHR in both sexes and between total alcohol consumption and BMI in men only ( P<0.05 ) . The same relationships were observed with wine ( P<0.05 ) ; men and women consuming less than 100 g day(-1 ) had a lower BMI ( men only ) and WHR than non-drinkers or those consuming more . Spirits consumption was positively associated with BMI ( linear regression coefficient beta=0.21 , 95 % confidence interval ( CI ) : 0.09 - 0.34 and beta=0.22 , 95 % CI : 0.06 - 0.39 for men and women , respectively ) and WHR ( beta=0.003 , 95 % CI : 0.001 - 0.005 and beta=0.003 , 95%CI : 0.0002 - 0.006 ) in both sexes in a linear fashion . No relationship between beer consumption and BMI or WHR was found . CONCLUSION If confirmed in longitudinal studies , our results indicate that consumption of alcoholic beverages may be a risk factor for obesity BACKGROUND Extract of globe artichoke ( Cynara scolymus ) is promoted as a possible preventive or cure for alcohol-induced hangover symptoms . However , few rigorous clinical trials have assessed the effects of artichoke extract , and none has examined the effects in relation to hangovers . We undertook this study to test whether artichoke extract is effective in preventing the signs and symptoms of alcohol-induced hangover . METHODS We recruited healthy adult volunteers between 18 and 65 years of age to participate in a r and omized double-blind crossover trial . Participants received either 3 capsules of commercially available st and ardized artichoke extract or indistinguishable , inert placebo capsules immediately before and after alcohol exposure . After a 1-week washout period the volunteers received the opposite treatment . Participants predefined the type and amount of alcoholic beverage that would give them a hangover and ate the same meal before commencing alcohol consumption on the 2 study days . The primary outcome measure was the difference in hangover severity scores between the artichoke extract and placebo interventions . Secondary outcome measures were differences between the interventions in scores using a mood profile question naire and cognitive performance tests administered 1 hour before and 10 hours after alcohol exposure . RESULTS Fifteen volunteers participated in the study . The mean number ( and st and ard deviation ) of alcohol units ( each unit being 7.9 g , or 10 mL , of ethanol ) consumed during treatment with artichoke extract and placebo was 10.7 ( 3.1 ) and 10.5 ( 2.4 ) respectively , equivalent to 1.2 ( 0.3 ) and 1.2 ( 0.2 ) g of alcohol per kilogram body weight . The volume of nonalcoholic drink consumed and the duration of sleep were similar during the artichoke extract and placebo interventions . None of the outcome measures differed significantly between interventions . Adverse events were rare and were mild and transient . INTERPRETATION Our results suggest that artichoke extract is not effective in preventing the signs and symptoms of alcohol-induced hangover . Larger studies are required to confirm these findings Blood pressure , heart rate and responses to a 
    Output:
    
These findings support the hypothesis that alcohol intake has a marked effect on blood pressure and the risk of hypertension