High alcohol consumption in Germany: results of the German National Health Interview and Examination Survey 1998 Martina Burger* and Gert BM Mensink Robert Koch-Institute, Department of Epidemiology and Health Reporting, Seestraße 10, D-13353 Berlin, Germany Submitted 6 October 2003: Accepted 27 April 2004 Abstract Objective: To analyse the alcohol consumption behaviour of the German adult population, with a focus on the characteristics of persons drinking more than the tolerable upper alcohol intake level (TUAL) of 10–12 g day 21 for healthy adult women and 20–24 g day 21 for healthy adult men. Design and setting: For the German National Health Interview and Examination Survey 1998, a representative sample of free-living adults was drawn. A total of 7124 participants were interviewed comprehensively about their sociodemographic background, lifestyle and eating habits including alcohol consumption. Subjects: A sub-sample of 4030 women and men, 18 – 79 years old, who were involved in the integrated German Nutrition Survey. Results: About 16% of women and 31% of men had mean alcohol consumption above the TUAL. Among other factors, the inclination to exceed the TUAL was related to middle-age, high socio-economic status, smoking and use of soft drugs. Among both women and men, a high proportion of persons drinking above the TUAL was observed among those consuming low amounts of soft drinks, fruit, poultry, milk products, bread and cake/biscuits. Women preferred to drink wine, whereas men preferred to drink beer. Conclusions: Many Germans have an alcohol consumption level above the TUAL and thus are supposed to be at increased risk for alcohol-associated diseases. Keywords Alcohol consumption Diet Germany Lifestyle Sociodemographics Tolerable upper alcohol intake level Several decades of research have shown that alcohol consumption may lead to hazardous health and social consequences. Still, it took a long time to achieve knowledge about the alcohol intake level up to which adverse health effects become unlikely for the majority of the population. Only recently, a systematic review focused on obtaining such a tolerable upper alcohol intake level (TUAL) and established the limits of 10–12g alcohol day 21 for healthy adult women and 20–24 g alcohol day 21 for healthy adult men 1 . It is assumed that people drinking above the TUAL have an increased risk of, for instance, liver cirrhosis and cancer of the respiratory – digestive tract. The purpose of this study was to gain an overview of alcohol drinking in Germany with a focus on the TUAL. The analyses are based on cross-sectional data from the German National Health Interview and Examination Survey (GNHIES) 1998 and the integrated German Nutrition Survey (GeNuS) 1998, and give a first insight into the multitude of sociodemographic and other health- relevant characteristics that are associated with high alcohol consumption. Methods Study population In total, 7124 non-institutionalised women and men between 18 and 79 years of age participated in the representative GNHIES 1998. The study population was drawn from population registries stratified for age, gender, community size and federal state. The overall participation rate was 61.4%. Participants underwent a physical examination including measurement of height and weight, and completed a questionnaire on sociodemographic, lifestyle and other health-related issues. Regular checking ensured internal and external quality. The survey has been described in more detail elsewhere 2,3 . Dietary assessment A randomly selected sub-sample of 2267 women and 1763 men participated in the GeNuS 1998 4 . Participants were interviewed about their dietary behaviour by trained nutritionists using the validated dietary assessment soft- ware DISHES 98 (Dietary Interview Software for Health Examination Studies) 5 . The DISHES interview is a q The Authors 2004 *Corresponding author: Email BurgerM@rki.de Public Health Nutrition: 7(7), 879–884 DOI: 10.1079/PHN2004631 http://dx.doi.org/10.1079/PHN2004631 Downloaded from http:/www.cambridge.org/core. IP address: 54.237.39.103, on 21 Oct 2016 at 14:53:33, subject to the Cambridge Core terms of use, available at http:/www.cambridge.org/core/terms.