Alcohol and stimulants dietary pattern is associated with haptoglobin blood levels, among apparently healthy individuals

  • Konstantinos M. Lampropoulos
  • Maria Bonou
  • Vassiliki Bountziouka
  • Angelos Evangelopoulos
  • Amalia Giotopoulou
  • Natalia Vallianou
  • Peter Avgerinos
  • Demosthenes Panagiotakos
  • John Barbetseas
Original Article


Studying dietary patterns and its relation to the development of various chronic diseases have received much interest during the past years, since they capture a holistic approach of true diet. Haptoglobin (Hp) has been associated with cardiovascular heart disease risk especially with acute myocardial infarction, coronary and peripheral artery disease, stroke, and heart failure. This study aimed to evaluate the relationship between dietary patterns and Hp blood levels among apparently healthy adults. During 2009, 490 volunteers (46 ± 16 years, 40 % male) were consecutively enrolled to the study (participation rate 85 %). Biochemical analyses were performed through established procedures, after 12 h fasting. Anthropometric, lifestyle and dietary characteristics were also recorded to account for potential confounders. Principal components analysis (PCA) was the data-driven technique to extract the dietary patterns. Pattern analysis revealed eight dietary patterns through the application of PCA; however, four of them were considered nutritionally important as they explained 35 % of total variance in food consumption (“Western diet”, “Mediterranean diet”, “Meat and bakery products” and “Alcohol and stimulants pattern”). The fourth pattern (alcohol and stimulants intake) has been characterised by intake of alcoholic drinks (wine, beer, and spirits) and stimulants (coffee and tea). Adherence to the latter pattern was associated with reduced Hp levels (b ± SE −5.9 ± 2.7, p = 0.03), adjusted for age, sex, body mass index, physical activity, and smoking habits. However, multi-adjusted analysis revealed that the individual effect of alcohol or stimulants on lowering Hp levels was not significant (p = 0.27 and p = 0.05, respectively). Moderate drinking of alcoholic drinks and stimulants seems to be associated with lower haptoglobin levels, suggesting another potential mechanism for the health benefits achieved through alcohol and stimulants drinking.


Haptoglobin Alcohol Dietary pattern Healthy individuals 



Body mass index


Coefficients of variation


Food frequency questionnaire




Principal components analysis


Conflict of interest

The authors declare that they have no competing interests.


  1. 1.
    Knoops KT, de Groot LC, Kromhout D, Perrin AE, Moreiras-Varela O, Menotti A, van Staveren WA (2004) Mediterranean diet, lifestyle factors, and 10-year mortality in elderly European men and women: the HALE project. JAMA 292:1433–1439CrossRefGoogle Scholar
  2. 2.
    Keys A, Menotti A, Karvonen MJ, Aravanis C, Blackburn H, Buzina R, Djordjevic BS, Dontas AS, Fidanza F, Keys MH et al (1986) The diet and 15-year death rate in the seven countries study. Am J Epidemiol 124:903–915Google Scholar
  3. 3.
    Mitrou PN, Kipnis V, Thiébaut AC, Reedy J, Subar AF, Wirfält E, Flood A, Mouw T, Hollenbeck AR, Leitzmann MF, Schatzkin A (2007) Mediterranean dietary pattern and prediction of all-cause mortality in a US population: results from the NIH-AARP Diet and Health Study. Arch Intern Med 167:2461–2468CrossRefGoogle Scholar
  4. 4.
    Giugliano D, Ceriello A, Esposito K (2006) The effects of diet on inflammation: emphasis on the metabolic syndrome. J Am Coll Cardiol 48:677–685CrossRefGoogle Scholar
  5. 5.
    Dontas AS, Zerefos NS, Panagiotakos DB, Vlachou C, Valis DA (2007) Mediterranean diet and prevention of coronary heart disease in the elderly. Clin Interv Aging 2:109–115CrossRefGoogle Scholar
  6. 6.
    Sadrzadeh SM, Bozorgmehr J (2004) Haptoglobin phenotypes in health and disorders. Am J Clin Pathol 121(Suppl):S97–S104Google Scholar
  7. 7.
    Wassell J (2000) Haptoglobin: function and polymorphism. Clin Lab 46:547–552Google Scholar
  8. 8.
    Bountziouka V, Bathrellou E, Giotopoulou A, Katsagoni C, Bonou M, Vallianou N, Barbetseas J, Avgerinos PC, Panagiotakos DB (2011) Development, repeatability and validity regarding energy and macronutrient intake of a semi-quantitative food frequency questionnaire: methodological considerations. Nutr Metabol Cardiovasc Dis. doi: 10.1016/j.numecd.2010.10.015 Google Scholar
  9. 9.
    American Diabetes Association (2010) Diagnosis and classification of diabetes mellitus. Diabetes Care 33:S62–S69CrossRefGoogle Scholar
  10. 10.
    Anderson P, Cremona A, Paton A, Turner C, Wallace P (1993) The risk of alcohol. Addiction 88:1493–1508CrossRefGoogle Scholar
  11. 11.
    Marmot M, Brunner E (1991) Alcohol and cardiovascular disease: the status of the U shaped curve. BMJ 303:565–568CrossRefGoogle Scholar
  12. 12.
    Maclure M (1993) Demonstration of deductive meta-analysis: ethanol intake and risk of myocardial infarction. Epidemiol Rev 15:328–351Google Scholar
  13. 13.
    Klatsky AL (1994) Epidemiology of coronary heart disease—influence of alcohol. Alcohol Clin Exp Res 18:88–96CrossRefGoogle Scholar
  14. 14.
    Chick J (1998) Alcohol, health, and the heart: implications for clinicians. Alcohol Alcohol 33:576–591CrossRefGoogle Scholar
  15. 15.
    Beilin LJ, Puddey IB (2006) Alcohol and hypertension: an update. Hypertension 47:1035–1038CrossRefGoogle Scholar
  16. 16.
    Whelton PK, He J, Appel LJ, Cutler JA, Havas S, Kotchen TA, Roccella EJ, Stout R, Vallbona C, Winston MC, Karimbakas J (2002) Primary prevention of hypertension: clinical and public health advisory from the National High Blood Pressure Education Program. JAMA 288:1882–1888CrossRefGoogle Scholar
  17. 17.
    Appel LJ, Brands MW, Daniels SR, Karanja N, Elmer PJ, Sacks FM (2006) Dietary approaches to prevent and treat hypertension: a scientific statement from the American Heart Association. Hypertension 47:296–308CrossRefGoogle Scholar
  18. 18.
    O’Keefe JH, Bybee KA, Lavie CJ (2007) Alcohol and cardiovascular health: the razor-sharp double-edged sword. J Am Coll Cardiol 50:1009–1014CrossRefGoogle Scholar
  19. 19.
    Corrao G, Rubbiaty L, Bagnardi V, Zambon A, Poikolainen K (2000) Alcohol and coronary heart disease: a meta-analysis. Addiction 95:1505–1523CrossRefGoogle Scholar
  20. 20.
    Mukamal KJ, Conigrave KM, Mittleman MA, Camargo CA Jr, Stampfer MJ, Willett WC, Rimm EB (2003) Roles of drinking pattern and type of alcohol consumed in coronary heart disease in men. N Engl J Med 348:109–118CrossRefGoogle Scholar
  21. 21.
    White IR, Altmann DR, Nanchahal K (2002) Alcohol consumption and mortality: modelling risks for men and women at different ages. BMJ 325:191–198CrossRefGoogle Scholar
  22. 22.
    Liao Y, McGee DL, Cao G, Cooper RS (2000) Alcohol intake and mortality: findings from the National Health Interview Surveys (1988 and 1990). Am J Epidemiol 151:651–659CrossRefGoogle Scholar
  23. 23.
    Lippi G, Franchini M, Favaloro EJ, Targher G (2010) Moderate red wine consumption and cardiovascular disease risk: beyond the “French paradox”. Semin Thromb Hemost 36:59–70CrossRefGoogle Scholar
  24. 24.
    Rimm EB, Giovannucci EL, Willett WC, Colditz GA, Ascherio A, Rosner B, Stampfer MJ (1991) Prospective study of alcohol consumption and risk of coronary disease in men. Lancet 338:464–468CrossRefGoogle Scholar
  25. 25.
    Movva R, Figueredo VM (2012) Alcohol and the heart: to abstain or not to abstain? Int J Cardiol.
  26. 26.
    Centers for Disease Control and Prevention (CDC) (2004) Alcohol-attributable deaths and years of potential life lost—United States, 2001. MMWR Morb Mortal Wkly Rep. 53:866–870Google Scholar
  27. 27.
    Kastorini CM, Milionis HJ, Esposito K, Giugliano D, Goudevenos JA, Panagiotakos DB (2011) The effect of Mediterranean diet on metabolic syndrome and its components a meta-analysis of 50 studies and 534, 906 individuals. J Am Coll Cardiol 57:1299–1313CrossRefGoogle Scholar
  28. 28.
    Rissanen TH, Voutilainen S, Virtanen JK, Venho B, Vanharanta M, Mursu J, Salonen JT (2003) Low intake of fruits, berries, and vegetables is associated with excess mortality in men: the Kuopio Ischaemic Heart Disease Risk Factor (KIHD) Study. J Nutr 133:199–204Google Scholar
  29. 29.
    Parikh P, McDaniel MC, Ashen MD, Miller JI, Sorrentino M, Chan V, Blumenthal RS, Sperling LS (2005) Diets and cardiovascular disease: an evidence-based assessment. J Am Coll Cardiol 45:1379–1387CrossRefGoogle Scholar
  30. 30.
    Nettleton JA, Steffen LM, Mayer-Davis EJ, Jenny NS, Jiang R, Herrington DM, Jacobs DR Jr (2006) Dietary patterns are associated with biochemical markers of inflammation and endothelial activation in the Multi-ethnic Study of Atherosclerosis (MESA). Am J Clin Nutr 83:1369–1379Google Scholar
  31. 31.
    Levy AP (2004) Haptoglobin: a major susceptibility gene for diabetic cardiovascular disease. Isr Med Assoc J 6:308–310Google Scholar
  32. 32.
    Levy AP, Hochberg I, Jablonski K, Resnick HE, Lee ET, Best L, Howard BV (2002) Strong Heart Study. Haptoglobin phenotype is an independent risk factor for cardiovascular disease in individuals with diabetes: the Strong Heart Study. J Am Coll Cardiol 40:1984–1990CrossRefGoogle Scholar
  33. 33.
    Lioupis C, Barbatis C, Drougou A, Koliaraki V, Mamalaki A, Klonaris C, Georgopoulos S, Andrikopoulos V, Bastounis E (2011) Association of haptoglobin genotype and common cardiovascular risk factors with the amount of iron in atherosclerotic carotid plaques. Atherosclerosis 216:131–138CrossRefGoogle Scholar
  34. 34.
    Pan JP, Cheng TM, Shih CC, Chiang SC, Chou SC, Mao SJ, Lai ST (2011) Haptoglobin phenotypes and plasma haptoglobin levels in patients with abdominal aortic aneurysm. J Vasc Surg 53:1189–1194CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 2013

Authors and Affiliations

  • Konstantinos M. Lampropoulos
    • 1
  • Maria Bonou
    • 1
  • Vassiliki Bountziouka
    • 2
  • Angelos Evangelopoulos
    • 3
  • Amalia Giotopoulou
    • 2
  • Natalia Vallianou
    • 4
  • Peter Avgerinos
    • 1
  • Demosthenes Panagiotakos
    • 2
  • John Barbetseas
    • 1
  1. 1.“Polyclinic” General HospitalAthensGreece
  2. 2.Department of Nutrition and DieteticsHarokopio University of AthensAthensGreece
  3. 3.Roche Diagnostics (Hellas) SAAthensGreece
  4. 4.“Evangelismos”, General Hospital AthensAthensGreece

Personalised recommendations