Study: Fathers-to-Be Should Avoid Alcohol for Months Before Conception

Both men and women hoping to become parents should avoid drinking alcohol prior to conception to protect their baby against congenital heart defects, according to a new study published in the European Journal of Preventive Cardiology.

Previous studies investigating the link between alcohol and congenital heart disease have focused on prospective mothers, with inconclusive results. This is the first meta-analysis to also examine the role of paternal alcohol drinking.

According to the findings, babies have a 44% increased risk of congenital heart disease when their father drank alcohol three months before conception, compared to babies whose dads did not drink. When the mothers drank during this time period or during the first trimester, babies had a 16% increased risk of disease.

The researchers suggest that when couples are trying for a baby, men should not consume alcohol for at least six months before conception while women should stop alcohol one year before and avoid it during pregnancy.

In addition, binge drinking — defined as five or more drinks per sitting — was related to a 52% higher likelihood of having a child with birth defects among men and 16% among women.

“Binge drinking by would-be parents is a high risk and dangerous behaviour that not only may increase the chance of their baby being born with a heart defect, but also greatly damages their own health,” said study author Dr. Jiabi Qin, of Xiangya School of Public Health, Central South University, Changsha, China.

The researchers compiled the best data published between 1991 and 2019, which amounted to 55 studies including 41,747 babies with congenital heart disease and 297,587 without. The analysis showed a relationship between parental alcohol drinking and congenital heart diseases.

‘We observed a gradually rising risk of congenital heart diseases as parental alcohol consumption increased. The relationship was not statistically significant at the lower quantities,” said Qin.

The authors noted that this was an observational study and does not prove a causal effect, nor does it prove that paternal drinking is more harmful to the fetal heart than maternal drinking. The data cannot be used to define a cut-off of alcohol consumption that might be considered safe.

Regarding specific defects, the researchers found that, compared to abstinence, maternal drinking was correlated to a 20% greater risk of tetralogy of Fallot, a combination of four abnormalities in the heart’s structure.

“The underlying mechanisms connecting parental alcohol and congenital heart diseases are uncertain and warrant further research. Although our analysis has limitations — for example the type of alcohol was not recorded — it does indicate that men and women planning a family should give up alcohol,” said Qin.

Alcohol is a known teratogen (causes malformation of an embryo) and has been connected with fetal alcohol spectrum disorder (FASD). Around one in four children with FASD have congenital heart disease.

Congenital heart diseases are the most common birth defects, with approximately 1.35 million infants affected every year. These conditions can increase the likelihood of cardiovascular disease later in life, even after surgical treatment, and are the main cause of perinatal death.

Source: European Society of Cardiology

Moderate Drinking in Pregnancy Can Alter Genes in Newborns, Mothers

Pregnant women who drink moderate to high levels of alcohol may be altering their babies’ DNA, according to a new study published in the journal Alcoholism: Clinical and Experimental Research.

The results also show that infants who were exposed to alcohol in the womb via the umbilical cord had increased levels of cortisol, a potentially harmful stress hormone that can suppress the immune system and lead to ongoing health issues.

Heavy drinking in women is defined as four or more drinks on at least five occasions in a month, and moderate drinking is around three drinks per occasion.

“Our findings may make it easier to test children for prenatal alcohol exposure, and enable early diagnosis and intervention that can help improve the children’s lives,” said lead author Dr. Dipak K. Sarkar, a distinguished professor and director of the Endocrine Program in the Department of Animal Sciences at Rutgers University-New Brunswick.

Building on an earlier Rutgers-led study that demonstrated how binge and heavy drinking may trigger long-lasting genetic changes in adults, the researchers wanted to investigate whether alcohol-induced DNA changes could occur in 30 pregnant women and 359 children.

In the new study, the research team discovered changes in two genes in women who drank moderate to high levels of alcohol during pregnancy and in children who had been exposed to those levels of alcohol in the womb. These genes were POMC, which regulates the stress-response system, and PER2, which influences the body’s biological clock.

“Our research may help scientists identify biomarkers — measurable indicators such as altered genes or proteins — that predict the risks from prenatal alcohol exposure,” Sarkar said.

Prenatal alcohol exposure is a leading preventable cause of birth defects and neurodevelopmental abnormalities in the United States, according to the National Institute on Alcohol Abuse and Alcoholism.

Around 20 to 30 percent of women have reported drinking at some point during pregnancy, most typically during the first trimester. More than 8 percent of women have reported binge drinking at some point during pregnancy, primarily in the first trimester.

Fetal alcohol spectrum disorders (FASD) can include physical or intellectual disabilities as well as behavioral and learning problems. Children with FASD may have trouble learning and remembering, understanding and following directions, shifting attention, controlling emotions, and socializing.

While there is no cure, early intervention treatment services can improve a child’s development, according to the U.S. Centers for Disease Control and Prevention, which says there is no known safe amount of alcohol to drink while pregnant.

Source: Rutgers University


Marijuana Can Boost Risks of Drinking Alcohol

A new study has discovered that people who use alcohol and marijuana simultaneously were more likely to drink heavier and more often.

They were also more likely to experience alcohol-related problems, such as impulsive actions they later regretted, according to researchers at Penn State.

“The results suggest that individuals who simultaneously use alcohol and marijuana are at a disproportionately higher risk for heavy, frequent, and problematic substance use,” said Dr. Ashley Linden-Carmichael, assistant research professor at the Edna Bennett Pierce Prevention Research Center at Penn State.

The findings also suggest that prevention and intervention programs should take into account not just alcohol, but also if people are using additional substances, according to the researchers.

“Right now, a lot of campus programs focus on whether students are drinking, and while sometimes they are asked about other substances, it’s not necessarily whether they’re using these substances simultaneously,” Linden-Carmichael said. “I think we do need to be asking about whether they’re drinking in combination with other drugs and educating students about how that exacerbates their risk.”

According to the researchers, marijuana use is at an all-time high among young adults in the U.S., possibly leading to people using marijuana and alcohol simultaneously.

“The problem with simultaneous use is that it can affect people cognitively and perceptually, and also have an impact on motor impairment,” Linden-Carmichael said. “There is a burgeoning area of research that is examining why people are using marijuana and alcohol together and what those effects are.”

In the study, Linden-Carmichael said she and the other researchers were interested in learning more about how people use marijuana and alcohol together. They also wanted to explore whether personality traits — such as the tendency to pursue new and exciting experiences or “sensation seeking” — were associated with higher odds of using alcohol and marijuana at the same time.

The researchers recruited 1,017 participants from 49 states in the U.S. between the ages of 18 and 25 for the study. The participants provided information about how often they used alcohol, marijuana, and the two substances simultaneously. They also filled out questionnaires that measured their experiences with alcohol-related problems, whether they had a sensation-seeking personality, and how they perceived the drinking habits of their friends.

The findings revealed that individuals who used alcohol and marijuana simultaneously were at a greater risk than individuals using alcohol alone.

“Even after controlling for the number of drinks a person typically consumed, people who used alcohol and marijuana at the same time were at a greater risk for problems like blacking out, getting in an argument, or other concerns,” Linden-Carmichael said.

“Additionally, 70 percent of those who engaged in simultaneous use reported using at least weekly.”

The researchers found that among people who used alcohol and marijuana simultaneously, those who used more frequently were more likely to drink more alcohol, more often, and for longer periods of time. They were also associated with using more marijuana more often.

Additionally, they found that people who used alcohol and marijuana together were more likely to have higher levels of sensation-seeking characteristics and think their friends were drinking larger amounts of alcohol.

The study was published in the journal Substance Use and Misuse.

Source: Penn State

Study: One in 10 Seniors Binge Drinks

More than a tenth of U.S. adults 65 and older binge drink, putting them at risk for a range of health problems, according to a new study.

The study, published in the Journal of the American Geriatrics Society, also finds certain factors, including using cannabis and being male, are associated with an increase in binge drinking.

Binge drinking is a risky behavior, particularly for older adults, due to aging-related physical changes, such as the increased risk of falling, and the likelihood of chronic health issues, said researchers at the New York University School of Medicine and the Center for Drug Use and HIV/HCV Research (CDUHR) at NYU College of Global Public Health.

“Binge drinking, even episodically or infrequently, may negatively affect other health conditions by exacerbating disease, interacting with prescribed medications, and complicating disease management,” said Benjamin Han, M.D., M.P.H., the study’s lead author and an assistant professor in the Department of Medicine’s Division of Geriatric Medicine and Palliative Care, and the Department of Population Health at NYU Langone Health.

For the study, the researchers examined data from 10,927 U.S. adults age 65 and older who participated in the National Survey on Drug Use and Health between 2015 and 2017.

They looked at the prevalence of binge drinking in the past month, defined by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) as five drinks or more on the same occasion for men and four drinks or more for women.

Researchers also compared demographic and health factors of past-month binge drinkers with people who drank within the past month, but below the binge drinking threshold.

The researchers estimate that 10.6 percent of older adults binge drank in the past month. In the decade leading up to the data used in this study (2005-2014), binge drinking among adults 65 and older was between 7.7 percent and 9 percent, they reported.

Binge drinkers were more likely to be male, current tobacco and/or cannabis users, African American, and have less than a high school education, the researchers discovered. They were also more likely to visit the emergency room in the past year.

Similar to previous studies, this study did not find a link between binge drinking and other mental health disorders.

“The association of binge drinking with cannabis use has important health implications,” said CDUHR researcher Joseph Palamar, Ph.D., M.P.H., the study’s senior author. “Using both may lead to higher impairment effects. This is particularly important as cannabis use is becoming more prevalent among older adults, and older adults may not be aware of the possible dangers of using cannabis with alcohol.” Palamar is an associate professor in the Department of Population Health at NYU Langone Health.

The researchers also examined the chronic disease profiles of older binge drinkers.

“Binge drinkers were less likely to have most chronic diseases compared to alcohol users who did not binge drink. This may be because some people stop or decrease their drinking when they have an illness or alcohol-related disease,” said Han.

“Clinicians must be aware that some older adults with chronic disease still engage in binge drinking behaviors, which can worsen their health issues. This may explain why binge drinkers were more likely to report visits to the emergency room.”

The most common chronic diseases among binge drinkers was hypertension (41.4 percent), followed by cardiovascular disease (23.1 percent) and diabetes (17.7 percent).

The researchers note that while the study uses the NIAAA’s recommended threshold for binge drinking, the same organization also suggests lower drinking limits for adults over 65 — no more than three drinks a day. Since the current analysis used the higher cutoff for binge drinking, the study may underestimate the prevalence of binge drinking among older adults, the researchers said.

“Our results underscore the importance of educating, screening, and intervening to prevent alcohol-related harms in older adults, who may not be aware of their heightened risk for injuries and how alcohol can exacerbate chronic diseases,” said Han.

Source: New York University

UK Study Suggests High Rates of Mental Illness, Drug Problems in Homeless Population

A new U.K. study finds alarming evidence of severe mental health problems, drug and alcohol dependence, and high rates of hepatitis C among those in the homeless population.

Researchers from the University of Birmingham analyzed routinely collected data from nearly 1,000 patients registered in the Birmingham Homeless Healthcare Centre.

The findings, published in the British Journal of General Practice, show that nearly one in eight homeless individuals had been offered support for substance dependence and one in five had been offered support for alcohol misuse. A high prevalence of infectious hepatitis C was also identified.

The researchers also found that nearly one in three homeless people attended an Accident and Emergency Department in the previous 12 months. This equates to nearly 60 times the rate of A&E visits in the general population.

“The study provides compelling evidence about the health problems faced by homeless people,” said lead Investigator Dr. Vibhu Paudyal, from the University of Birmingham’s School of Pharmacy.

“Participants, whose average age was 38 years old, had two or more serious chronic medical conditions, a rate comparable to people in their 60s. Substance abuse and alcohol dependency were common, as were mental health problems and hepatitis C.”

“This study reinforces the need to further expand and diversify specialist services available to the homeless population, particularly preventative services. Further work needs to be done to minimise fragmentation of services and to improve access and experiences around homeless use of mainstream general practices.”

Paudyal says the evidence suggests that retention in long-term treatment of hepatitis C infection is better when treatment of substance dependence is offered at the same time. Such a multi-disciplinary approach can effectively prevent disease and harm from risky behaviors, improve health outcomes and reduce demand on A&E departments, Paudyal said.

The study authors urge general practitioners to make the registration of homeless people easier and to put up signs for specialist homelessness services where they are available. They say mainstream health services should be flexible and tailored to ensure this population does not face challenges and barriers in accessing care.

“Ill health can be both the cause and consequences of homelessness. Hence, early and opportunistic prevention and treatment of mental health, substance and alcohol dependence can prevent ill health and, for many, the repeat cycle of homelessness,” said Paudyal.

“These services should be readily accessible and where possible to be offered under one roof, as many of these conditions are co-prevalent.”

Shelter estimates suggest that there are over 320,000 homeless people in the U.K., and the number continues to rise.

Source: University of Birmingham

Harm from ‘Secondhand Drinking’ Called A Significant Public Health Issue

Each year, one in five adults — an estimated 53 million people — experience harm because of another person’s drinking, according to a new analysis of U.S. national survey data.

These harms, affecting around 21% of women and 23% of men, may include threats or harassment, ruined property or vandalism, physical aggression, harms related to driving, or financial or family problems. The most common harm was threats or harassment, reported by 16% of survey respondents.

Writing in the Journal of Studies on Alcohol and Drugs, the study authors call alcohol’s harm to other people a “significant public health issue.” And they assert that, similar to how policymakers have addressed the effects of secondhand smoke in recent years, society also needs to combat the secondhand effects of alcohol.

“[T]he freedom to drink alcohol must be counterbalanced by the freedom from being afflicted by others’ drinking in ways manifested by homicide, alcohol-related sexual assault, car crashes, domestic abuse, lost household wages, and child neglect,” writes Timothy Naimi, M.D., M.P.H., of the Boston Medical Center in an accompanying commentary.

For the study, researchers from the Alcohol Research Group, a program of the Public Health Institute in Oakland, California, analyzed data of 8,750 respondents, ages 18 and older, from two telephone surveys conducted in 2015: the National Alcohol’s Harm to Others Survey and the National Alcohol Survey.

The findings show gender differences: Women were more likely to report financial and family problems, whereas ruined property, vandalism, and physical aggression were more likely to be reported by men. According to the authors, there is “considerable risk for women from heavy, often male, drinkers in the household and, for men, from drinkers outside their family.”

Additional factors, including age and the person’s own drinking habits, also made a difference. For example, individuals younger than age 25 had a higher risk of experiencing harm from someone else’s drinking.

Further, almost half of men and women who themselves were heavy drinkers said they had been harmed by someone else’s drinking. Even light or moderate drinkers faced two to three times the risk of harassment, threats, and driving-related harms compared with abstainers. Heavy drinking was defined as drinking five or more drinks at a time for men or four or more drinks for women at least monthly.

The findings provide support for alcohol control policies, such as taxation and pricing to reduce alcohol’s harm to persons other than the drinker.

“Control policies, such as alcohol pricing, taxation, reduced availability, and restricting advertising, may be the most effective ways to reduce not only alcohol consumption but also alcohol’s harm to persons other than the drinker,” said study leader Madhabika B. Nayak, Ph.D.

Source: Journal of Studies on Alcohol and Drugs