A British scientist is criticizing doctors over the advice they give to pregnant women about drinking, saying that pregnant women are big girls who can make up their own minds about the risks.
In the United States, most medical advice on drinking during pregnancy centers on one word: "Don't." But the British have wrangled over the issue with considerable angst in recent years. In 2007, United Kingdom government officials recommended that women abstain from drinking any alcoholic beverages during pregnancy. The advice was controversial because, while excessive drinking in pregnancy is clearly harmful to a developing fetus and can result in fetal alcohol syndrome, there is debate over the harm of light or moderate drinking during pregnancy. In 2008, the U.K.'s National Institute for Health and Clinical Excellence reported that there was no evidence of harm if women drank no more than one or two drinks a week.
Studying the issue seems to be a favorite pastime in the U.K. One recent study suggested that even drinking small amounts of alcohol during pregnancy can affect maternal-child bonding and delay the mother's recovery from childbirth. Another study found that children born to mothers who drank one or two drinks per week during pregnancy were not at increased risk for behavioral or cognitive problems at age 3 compared with kids whose mothers did not drink.
In an article published today in the Journal of Medical Ethics, Colin Gavaghan warns doctors against telling women to abstain instead of a more truthful message. Women, he says, should be presented with the medical facts as they stand at the moment and trusted to make good decisions.
"The days where doctors routinely withheld information ... on the groups that patients would become confused and make bad decisions are, supposedly, consigned to history," he writes. "It is far from clear why a paternalistic exception is permitted in the case of pregnant women."
Gavaghan suggests that if a woman enjoys a drink or two and it helps her relax, that may be might be just as important to consider as the "interest of the future child."
Moreover, if doctors exaggerate the risk, he says, "their advice on genuine risks will carry less authority."
Paternalism has no place in medicine, but many doctors advise women to abstain from alcohol while pregnant or while trying to become pregnant because it's not really clear if there is any safe level of alcohol use. Women who drink at mild to moderate levels and then find out they are pregnant shouldn't panic, experts say, but they should stop drinking. The emerging field of epigenetics suggests that a fetus may be vulnerable to small and subtle changes in the mother's diet or environment that may alter its later risk for disease. It's not appropriate to frighten women unnecessarily. But it's wise to be prudent.
Pubs will soon be forced to offer patrons smaller glasses of wine, according to Britain's Daily Mail. It's part of the government's efforts to curb the cult of binge drinking and also to not encourage women to exceed a safe limit of alcohol.
The Mail article notes that, in the U.K., "a standard glass of wine used to be 125 ml -- around one unit of alcohol. But most pubs now serve wine in a 'small' 175 ml glass or a 'large' 250 ml glass -- as much as a third of a bottle of wine." And, the article further notes that "one in 10 bars use 250 ml as their standard size, which with certain strengths of wine can ... contain 3.5 units of alcohol -- enough to put a woman over the driving limit and exceed safe drinking limits."
I can speak for the mega-serving trend. Just two weeks ago, I was in the U.K. and went out with a sibling for a demure evening on the town involving a glass or two of wine at a pub or two. The glasses were behemoths! Filled to the brim! We surely had but a couple before popping round to visit my (practically teetotaler) brother and sister-in-law and treating them and our young nephew to an hour of witty banter and a knocked-over mug of coffee. If the mini-glass option had been available, I am sure this would not have happened.
The new, mandatory mini-servings would be offered in 125-milliliter glasses.
-- Rosie Mestel
PS: A number of reader comments make it clear that the tongue-in-cheek intention of my remark, "If the mini-glass option had been available, I am sure this would not have happened," may not have registered with all. For the record, it was tongue-in-cheek. But I don't think offering the option of a smaller glass of wine is a bad one, just as it's not a bad idea to offer people smaller servings of food in restaurants instead of the (also behemoth) portions so many places serve up.
Also for the record, re: a comment below, no driving was involved in the above-mentioned evening.
A drug to help people quit smoking appears to reduce the desire for alcohol as well, according to a study published online Monday in the journal Biological Psychiatry.
The drug, varenicline, is approved as a smoking cessation aid and is sold under the brand name Chantix. Researchers at Yale decided to test the drug on a small group of people who were heavy smokers and heavy drinkers because there was some evidence that the drug may reduce drinking in a similar manner to how it works for smoking. Drinking and smoking are behaviors that often go hand-in-hand. Smokers are four times more likely than nonsmokers to meet the criteria for alcohol-use disorders. Diseases related to tobacco use are the leading cause of death in alcoholics.
The study was comprised of 20 adults who were daily smokers (smoking at least 10 cigarettes a day) and nonalcoholic heavy drinkers (consuming seven to 14 drinks per week and three or four drinks per episode at least once a week). The participants were given varenicline or a placebo for seven days. Then, in an experiment conducted in a laboratory, they were given one drink and then had the option of drinking more alcohol -- up to eight drinks -- in a two-hour period. The study found that varenicline reduced the desire to drink. Those people consumed one-half of one drink compared with the placebo group, which consumed an average of 2.6 drinks. Eighty percent of the participants receiving the drug did not take a drink at all compared with 30% of the placebo group. The drug reduced alcohol cravings and the feeling of being intoxicated.
Varenicline is thought to reduce the desire to smoke and drink by acting on receptors in the brain that stimulate the chemical dopamine. There were no adverse effects associated with taking varenicline and consuming alcohol.
The study was performed on heavy drinkers, and it's not known whether the drug would have any effect on people with alcohol dependence. But further studies should be conducted, said the lead author of the study, Sherry McKee, an associate professor of psychiatry at Yale School of Medicine. "A medication such as varenicline, which may target shared biological systems in alcohol and nicotine use, holds promise as a treatment for individuals with both disorders," McKee said in a news release.
Binge drinking among military personnel is common, according to a new study, and it may have serious health and social repercussions.
Among the 16,037 men and women surveyed in 2005, 43% reported binge drinking in the last month, resulting in almost 30 episodes per person per year. About 67% of binge drinking episodes were reported by military personnel ages 17 to 25, and that age group made up a little under half of all the active personnel surveyed. Researchers define binge drinking as consuming five or more drinks during a single occasion for men, and four or more for women.
Men were twice as likely to binge drink as women, but women weren't immune to the scenario — they averaged about 12 binge-drinking episodes per person per year.
Both genders who engaged in binge drinking were more likely to have adverse consequences such as getting into a fight, not being promoted, and drinking and driving, than those who drank but didn't binge drink. More than half of all binge drinkers said they experienced one or more undesirable results or engaged in high-risk behavior.
Researchers looked at data from the Department of Defense Survey of Health Related Behaviors Among Military Personnel, an anonymous health survey of active military in the U.S., overseas and on ships. The study was published in the March issue of the American Journal of Preventive Medicine.
In the general population, 22% of moderate drinkers in the U.S. reported binge drinking, according to a 2003 study in the Journal of the American Medical Assn. Researchers also found that people ages 18 to 25 had the highest rates of binge drinking, and that men were responsible for the vast majority of binge-drinking episodes.
Peer pressure may be a key cause of teen drinking, but it might not be the only factor.
A new study reveals that the closer teens live to where alcohol is sold, the greater the risk may be of binge drinking and driving under the influence.
Researchers from the Pardee RAND Graduate School in Santa Monica looked at the number and location of alcohol retailers in zones around homes in California to see what relationship existed between proximity to those stores and drinking in children ages 12 to 17. They found a significant association among homes within walking distance of places selling alcohol (about half a mile) and evidence of binge drinking and driving after drinking, and predict that moving those stores and restaurants farther away could reduce those numbers.
The study also noted that alcohol is more readily available in minority and lower-income areas. In predominantly white neighborhoods, within a half-mile there are an average 5.5 locations with active alcohol licenses. In predominantly African American neighborhoods it’s 6.4 locations; in predominantly Latino, 8.6; and in predominantly Asian, 9.5. Researchers point out that living in areas with higher alcohol sales could also mean more exposure to violent crime and drunk driving.
"Our study suggests that living in close proximity to alcohol outlets is a risk factor for youth," write the authors, whose study appears online this month in the American Journal of Public Health. "In California, retail licenses are not typically approved within 100 feet of a residence or within 600 feet of schools, public playgrounds and nonprofit youth facilities, but proximity by itself is not sufficient to deny a license. Our study suggests that more attention on the proximity rule is needed and environmental interventions need to curb opportunities for youth to get alcohol from commercial sources, whether being through tightening licensure or enforcing minimum age drinking laws."
"Drunk" is the oldest English-language synonym related to intoxication. But people who drink alcohol use a variety of words to describe their level of inebriation, and those descriptions are often at odds with the terms used by doctors and health professionals, say researchers from the University of Missouri.
Individuals do not perceive the word "drunk" in the same ways, says Ash Levitt, a graduate student in psychological science and a co-author of the study. The study of 290 college students found that "drunk" often reflected a level of intoxication between moderate and heavy. Intoxicated men tended to say they were "hammered" and women to say they were "tipsy."
"As social and cultural animals, humans have developed a rich and diverse vocabulary of intoxication-related slang to describe the subjective states they are experiencing while drinking," said Levitt in a news release. "However, alcohol researchers have largely ignored the language of intoxication."
Women's descriptions of alcohol use could have important public health implications, Levitt said. The study found that women's use of the word "tipsy" reflected an average of four drinks over two hours. That's a quantity that actually meets the criteria for binge drinking for women. When doctors and researchers ask about drinking, they should use terms that are personalized and relevant to the patient's gender, he said. The study is published online today in the journal Alcoholism: Clinical & Experimental Research.
Gov. Arnold Schwarzenegger has proposed a 5-cent excise tax increase per alcoholic drink as a way to ease the state's huge budget shortfall. According to a study published today, alcohol tax increases also save lives.
The study, published in the American Journal of Public Health, found that raising the alcohol tax in Alaska led to a significant decline in the number of people who died from alcohol-related diseases. In 1983, Alaska increased its beer tax, followed by another big tax hike in 2002. Researchers from the University of Florida tracked deaths from alcohol-related diseases and found that the 1983 tax was followed by a 29% reduction in deaths (23 per year) and the 2002 tax boost was followed by an 11% reduction in deaths (an additional 21 per year). The taxes had a two to four times larger effect on alcohol-related deaths than some other common alcohol prevention programs, such as school education programs or media campaigns.
Alaska is well-known for its high rate of alcoholism, noted the study's lead author, Alexander C. Wagenaar.
"Alaska was cognizant of its alcohol problems and decided to do something meaningful. We are now benefiting from the results of their unique experiment which shows what other states could gain if they were to implement a similar tax increase."
About 85,000 deaths per year nationwide are linked to drinking, including injuries, homicides, suicides and a range of diseases. Many studies have found that alcohol tax increases reduce vehicular deaths. But other research on the effect of tax increases has been mixed. Some studies suggest alcohol prices were linked to lower unintentional injury and homicide rates, but others dispute that connection.
It's also not clear from previous research whether alcohol prices or taxes are related to the rates of alcohol dependence. But the new study suggests that tax hikes affect drinking patterns over long periods of time.
Many red and white wines from Europe contain potentially toxic levels of heavy metals, according to researchers from Kingston University in London.
The study examined wines from 16 countries in Europe, South America and the Middle East for their Target Hazard Quotient, a measure designed by the U.S. Environmental Protection Agency to determine safe levels of frequent, long-term exposure to various chemicals. A THQ over one indicates a health risk.
The study, published today in the open access Chemistry Central Journal, found that typical wines had a THQ ranging from 50 to 200 a glass and some wines had a THQ of 300 a glass. In comparison, THQs for heavy metal contamination in seafood have typically ranged from one to five.
A single glass of wine with a high THQ isn't harmful, noted a co-author of the study, Declan P. Naughton. But drinking a glass or two a day for many years could be hazardous. The minerals with the highest impact were vanadium, copper and manganese, but high levels of lead, zinc, chromium and nickel were also found. An excess intake of metal ions is thought to contribute to some neurological disorders, such as Parkinson's disease, and some inflammatory diseases, such as cancer.
The only countries with safe wines that were examined in the study were Argentina, Brazil and Italy.
Though mild or moderate intake of red wine has been linked to health benefits (due to the antioxidants in wine), this finding suggests those advantages may be outweighed by potential harm from wines with heavy metals, the authors said.
"Levels of metal ions should appear on wine labels, along with the introduction of further steps to remove key hazardous metal ions during wine production," they said.
Drinking a glass or two of red wine each day may be a prescription for avoiding lung cancer, especially among high-risk people such as smokers.
A study from Kaiser Permanente researchers published today found a strong link between red wine consumption and a decreased risk of lung cancer in men. The researchers studied 84,170 men ages 45 to 69 who were part of the California Men's Health Study. They found lung cancer risk is lowered an average of 2% for each glass of red wine consumed per month. The greatest risk reduction was found among men who smoked and who drank one or two glasses of red wine per day. They had a whopping 60% reduced risk.
Red wine contains a chemical called resveratrol that is a powerful antioxidant and is associated with a variety of health benefits, both for heart health and for cancer prevention. Previous studies in lab animals suggest that resveratrol alters the activity of carcinogens in the body, inducing abnormal cells to die and retarding the growth of cancerous cells, says the lead author of the study, Chun Chao, a research scientist at Kaiser Permanente Department of Research and Evaluation in Pasadena. The study, published in the October issue of Cancer Epidemiology, Biomarkers & Prevention, did not find any clear links between lung cancer and consumption of white wine, beer or liquor.
Chao cautions that the best way for smokers to lower the risk of developing lung cancer is to stop smoking. Even smokers who drink one or two glasses of red wine per day have a higher lung cancer risk than nonsmokers.
More research should be conducted before people start knocking back a glass or two of red wine each day just for the health of it, Chao says. "We need more studies on whether people should drink red wine to reduce lung cancer risk," she says. "If people want to drink red wine for cardiovascular benefits, they should talk to their doctor about that. But they shouldn't drink for lung cancer prevention."
The issue of drinking alcohol for health benefits is controversial because of the harm associated with heavy drinking and alcohol addiction. In general, most health professionals advise people not to start drinking if they don't already drink. The National Cancer Institute takes this position:
"Some studies suggest that alcohol consumption is associated with a lower risk of some risk of some non-cancer health conditions. However, it is not recommended that anyone begin drinking or drink more frequently on the basis of health considerations."
Trying to limit your alcohol intake is tougher when you're drinking in a bar with loud music, according to a new study.
Researchers have already shown that listening to fast music can speed up the rate of drinking. But now they say loud music has the same effect. Both fast and loud music can heighten arousal, causing people to drink faster and order more drinks, say the authors of the study, published online today in the journal Alcoholism: Clinical & Experimental Research. And there's another reason why people drink more when the band is blasting: They can't converse.
"...loud music may have had a negative effect on social interaction in the bar, so that patrons drank more because they talked less."
The authors of the study suggest that bar owners tone it down a little so that people won't overindulge. Since we know that won't happen, you may have to monitor yourself. If your ears are ringing, slow down before the room starts spinning.
Tami Dennis, who takes the word "skeptic" to previously uncharted territory, is the Times' Health and Science editor. She's adamant that pitches promoting awareness days, weeks or months are, by their nature, non-stories. And, because she's an adult, she refuses to use words like "veggies," "tummy" and "yummy."
Rosie Mestel, deputy Health and Science editor, studied genetics before abandoning flies, fungi and DNA for health/medical writing. Her hero is the biologist Ernst Haeckel, whose jellyfish paintings inspired snazzy chandeliers. Her favorite toast-spread is Marmite, a British delicacy made of yeast extract. Her least-favorite word is "millenniums."
Melissa Healy is a staff writer for the Health section reporting from Washington D.C. Healy's a veteran of The Times' National staff, having covered the Pentagon, Congress, poverty and social welfare, the environment, and the White House before shifting to Health in 2003. She writes frequently about mental health and human behavior, about federal health policy, prescription medication and ethics in medicine. More wonk than wellness freak, Healy chooses to believe in the health benefits of coffee and wine, and considers water a better work-out medium than beverage.
Karen Kaplan covers genetics, stem cells and cloning. She and colleague Thomas H. Maugh II comprise about 25% of the unofficial MIT-Alumni-in-Journalism Club, and she is proud to have taken more math (5) than English (0) courses in college. Her contributions to Booster Shots will, she hopes, appear more frequently than postings to her mommy blog.
Thomas H. Maugh II has been a science and medical writer at the Times for 23 years. Before that, he was on the staff of the journal Science for 13 years.
He has bachelor's degrees in English and chemistry from MIT and a doctorate in chemistry from UC Santa Barbara.
After a brief stint as a sports writer, Shari Roan turned to health journalism and has covered the topic for The Times for 18 years. She is the author of three books and the mother of two daughters, both teenagers who refer to her as a "health freak." She likes to jog, watch baseball and is very happy that dark chocolate contains some health benefit.
Jeannine Stein writes about fitness, sports medicine and obesity for the Health section. She’s a gym rat from way back and never met an elliptical trainer she didn’t like. Well, maybe one or two. She tempers exercise with a steady diet of reality television because she believes it’s all about balance.
A drug to help people quit smoking appears to reduce the desire for alcohol as well, according to a study published online Monday in the journal 
A new study reveals that the closer teens live to where alcohol is sold, the greater the risk may be of binge drinking and driving under the influence.
"Drunk" is the oldest English-language synonym related to intoxication. But people who drink alcohol use a variety of words to describe their level of inebriation, and those descriptions are often at odds with the terms used by doctors and health professionals, say researchers from the University of Missouri.
Gov. Arnold Schwarzenegger has proposed a 5-cent excise tax increase per alcoholic drink as a way to ease the state's huge budget shortfall. According to a study published today, alcohol tax increases also save lives.
Many red and white wines from Europe contain potentially toxic levels of heavy metals, according to researchers from Kingston University in London.
Drinking a glass or two of red wine each day may be a prescription for avoiding lung cancer, especially among high-risk people such as smokers.
