Archive for January, 2016

Over 400 conditions co-occur with Fetal Alcohol Spectrum Disorders

Researchers at the Centre for Addiction and Mental Health (CAMH) have identified 428 distinct disease conditions that co-occur in people with Fetal Alcohol Spectrum Disorders (FASD), in the most comprehensive review of its kind.

The results were published today in The Lancet.

“We’ve systematically identified numerous disease conditions co-occurring with FASD, which underscores the fact that it isn’t safe to drink any amount or type of alcohol at any stage of pregnancy, despite the conflicting messages the public may hear,” says Dr. Lana Popova, Senior Scientist in Social and Epidemiological Research at CAMH, and lead author on the paper. “Alcohol can affect any organ or system in the developing fetus.”

Severity and Symptoms Vary

FASD is a broad term describing the range of disabilities that can occur in individuals as a result of alcohol exposure before birth. The severity and symptoms vary, based on how much and when alcohol was consumed, as well as other factors in the mother’s life such as stress levels, nutrition and environmental influences. The effects are also influenced by genetic factors and the body’s ability to break down alcohol, in both the mother and fetus.

Different Canadian surveys suggest that between six and 14 per cent of women drink during pregnancy.

428 Co-Occurring Conditions

The 428 co-occurring conditions were identified from 127 studies included in The Lancetreview. These disease conditions, coded in the International Classification of Disease (ICD-10), affected nearly every system of the body, including the central nervous system (brain), vision, hearing, cardiac, circulation, digestion, and musculoskeletal and respiratory systems, among others.

While some of these disorders are known to be caused by alcohol exposure – such as developmental and cognitive problems, and certain facial anomalies – for others, the association with FASD does not necessarily represent a cause-and-effect link.

Problems range from communications disorders to hearing loss

However, many disorders occurred more often among those with FASD than the general population. Based on 33 studies representing 1,728 individuals with Fetal Alcohol Syndrome (FAS), the most severe form of FASD, the researchers were able to conduct a series of meta-analyses to establish the frequency with which 183 disease conditions occurred.

More than 90 per cent of those with FAS had co-occurring problems with conduct. About eight in 10 had communications disorders, related to either understanding or expressing language. Seven in 10 had developmental/cognitive disorders, and more than half had problems with attention and hyperactivity.

Cause May Be Overlooked

Because most studies were from the U.S., the frequency of certain co-occurring conditions was compared with the general U.S. population. Among people with FAS, the frequency of hearing loss was estimated to be up to 129 times higher than the general U.S. population, and blindness and low vision were 31 and 71 times higher, respectively.

“Some of these other co-occurring problems may lead people to seek professional help,” says Dr. Popova. “The issue is that the underlying cause of the problem, alcohol exposure before birth, may be overlooked by the clinician and not addressed.”

The benefits of screening and diagnosis

Improving the screening and diagnosis of FASD has numerous benefits. Earlier access to programs or resources may prevent or reduce secondary outcomes that can occur among those with FASD, such as problems with relationships, schooling, employment, mental health and addictions, or with the law.

“We can prevent these issues at many stages,” says Dr. Popova. “Eliminating alcohol consumption during pregnancy or reducing it among alcohol-dependent women is extremely important. Newborns should be screened for prenatal alcohol exposure, especially among populations at high risk. And alerting clinicians to these co-occurring conditions should trigger questions about prenatal alcohol exposure.”

Stay Away From Alcohol If Pregnant

“It is important that the public receive a consistent and clear message – if you want to have a healthy child, stay away from alcohol when you’re planning a pregnancy and throughout your whole pregnancy,” she says.

It’s estimated that FASD costs $1.8 billion annually in Canada, due largely to productivity losses, corrections and health care costs, among others.

In addition to this review, Dr. Popova has been part of an expert group of leading FASD researchers and clinicians working with the Ontario Ministry of Children and Youth Services on its new FASD strategy. Her team is also undertaking a study to determine how common FASD is in Canada, as well as in other countries in Eastern and Central Europe and Africa.

January 13th, 2016  in Alcohol No Comments »

‘No-buy’ lists could cut kids’ exposure to alcohol ads

Young people’s exposure to alcohol advertisements on television could be greatly reduced if alcohol companies improved their use of so-called no-buy lists, according to a study in the January issue of the Journal of Studies on Alcohol and Drugs.

Alcohol manufacturers are self-regulated when it comes to advertising: In 2003, the industry set guidelines that limit advertising to media that have a primarily adult audience — with at least 71.6 percent of the audience being age 21 or older.

But as far back as 1999, the U.S. Federal Trade Commission (FTC) had suggested that the industry use no-buy lists to guide their ad placements. Such lists would put certain television shows or other media off-limits because a large chunk of the audience is likely to be underage.

FTC Says It’s ‘Best Practice’

“It’s been cited by the FTC as a ‘best practice,'” said Craig Ross, Ph.D., the lead researcher on the new study, president of Fiorente Media, Inc., in Boston, Mass, and Research Assistant Professor of Epidemiology at Boston University School of Public Health. Ross is also a consultant to the Center on Alcohol Marketing and Youth (CAMY) at the Johns Hopkins School of Public Health, which supported this research.

Some alcohol companies have been using no-buy lists to guide their ad placements, according to the FTC.

“Since 2005, kids have been exposed more than 15 billion times to alcohol advertisements that do not meet industry guidelines,” Ross said. “Regardless of how no-buy lists have been implemented in the past, there is clearly room for improvement.”

Non-Compliant Advertising

The goal of the new study, Ross explained, was to develop a “comprehensive” approach.

First, the researchers looked at how well the alcohol industry has been complying with its own guidelines when it comes to television ads. They found that between 2005 and 2012, approximately one of every eight alcohol advertisements seen by children under the legal drinking age was non-compliant with alcohol industry guidelines — with cable television accounting for most of it.

Next, Ross’s team tested the potential effectiveness of a set of new no-buy list criteria they’d designed. The criteria would recommend avoiding ad placements on programs that had fallen short of the industry’s own guidelines in the past year and during times of day when television audiences skew young (like late night). The criteria also recommend being more selective about ad placements on low-rated cable shows.

‘No-Buy’ Lists Should Not Be a Burden

The researchers found that, had their no-buy list been universally applied during the study period, it could have eliminated nearly all noncompliant advertising seen by children under the legal drinking age.

According to Ross, using the no-buy list should not be a burden to the industry.

“The programs that are problematic are actually small in number,” he said. “There would be still be a large universe of programs for advertisers to choose from.”

Limiting Underage Drinking

To get the no-buy list into the real world, Ross said the plan is to create quarterly reports that highlight the programs and times of day that alcohol advertisers should avoid.

The ultimate hope, of course, is to help limit underage drinking. And while restricting ads is not the whole answer, it is an important step, according to Ross — because advertising images can help set kids’ expectations regarding alcohol.

“There’s a growing body of research on the effects of alcohol advertising on underage drinking,” Ross said. “Ads can help create positive attitudes toward drinking, promoting drinking initiation and excessive drinking.”

January 13th, 2016  in Alcohol No Comments »