Health & Fitness

Alcohol is an accepted part of almost all societies. It is so engrained in socializing and entertainment, easy to obtain and relatively inexpensive that few think twice about taking a drink or two. Certainly, we know about alcoholism and recognize alcoholics, especially when they are on "skid row," but we don’t usually think of alcohol as a dangerous drug. But perhaps we should.

Scientific reports reveal that alcohol may be among the most dangerous drugs, illegal or legal, that exist. In the U.S., approximately 88,000 people die a year from alcohol-related causes — including more than 4,300 deaths among underage youth¹ — and in 2014, alcohol caused 9,967 driving fatalities in the U.S.² Worldwide, 5.9% of deaths are attributable to alcohol.³

Why is alcohol not demonized the way tobacco is? There are at least two reasons, say public health experts. One is that the alcohol lobby has bought favorable media coverage through donations and partnerships with public health groups and even government agencies. The other reason is that illegal drugs usually receive the brunt of bad publicity even when the legal drug, alcohol, may do more damage.

Alcohol Is More Harmful Than Many Realize

While most people are aware of drunk driving fatalities and the possible effects of excessive alcohol consumption on the liver, there are other serious consequences from drinking alcohol that are less well publicized. For example, alcohol is strongly linked to mouth cancers and cancers of the pharynx, larynx, esophagus, rectum, colon and breast. It is even linked to cancers of the pancreas and lung.⁴

The carcinogenic effect of alcohol "is unmistakably proportional to the daily/weekly dosage," according to research published in the Hungarian journal Magyar Onkologia.⁵ Alcohol, or ethanol as it is called in the medical profession, metabolizes into the known carcinogen acetaldehyde, which exerts negative actions:⁶

"Among other things chronic alcohol consumption promotes the production of endogen hormones, affects the insulin-like growth factor-1, alters several biological pathways, raises oxidative stress, and damages the genes. Even modest daily alcohol intake will increase the risk of breast cancer."

Further, alcohol can encourage colon cancer, according to a report in the journal Evidence Report/Technology Assessment:⁷

"One human tissue study, 19 animal studies … and 10 cell line studies indicate that ethanol and acetaldehyde may alter metabolic pathways and cell structures that increase the risk of developing colon cancer. Exposure of human colonic biopsies to acetaldehyde suggests that acetaldehyde disrupts epithelial tight junctions.

Among 19 animal studies the mechanisms considered included: Mucosal damage after ethanol consumption. Increased degradation of folate. Stimulation of rectal carcinogenesis. Increased cell proliferation. Increased effect of carcinogens."

Alcohol Can Contribute to Breast Cancer

The most common cancer in U.S. women is breast cancer and it is the second biggest cause of their cancer deaths. There is a strong correlation between the consumption of alcoholic beverages and breast cancer, according to a study published in the journal Alcohol:⁸

"Results of most epidemiologic studies, as well as of most experimental studies in animals, have shown that alcohol intake is associated with increased breast cancer risk.

Alcohol consumption may cause breast cancer through different mechanisms, including through mutagenesis by acetaldehyde, through perturbation of estrogen metabolism and response, and by inducing oxidative damage and/or by affecting folate and one-carbon metabolism pathways … Acetaldehyde is a known, although weak, mutagen."

Because of the oxidative damage alcohol causes and its effects on the insulin-like growth factor-1 and genes, "Even modest daily alcohol intake will increase the risk of breast cancer," concludes the journal Magyar Onkologia.⁹ The heightened breast cancer risk likely comes from alcohol's increase of estrogen, suggests research in Evidence Report/Technology Assessment:¹⁰

"Increased estrogen levels may increase the risk of breast cancer through increases in cell proliferation and alterations in estrogen receptors. Human studies have also suggested a connection with prolactin and with biomarkers of oxidative stress.

Of 15 animal studies, six reported increased mammary tumorigenesis … Other animal studies reported conversion of ethanol to acetaldehyde in mammary tissue as having a significant effect on the progression of tumor development."

Alcohol Is Often Linked to Violence

"Rape culture" and rapes on U.S. campuses are increasingly reported but their link to alcohol consumption is not always included. Social researchers do not think that alcohol, in and of itself, makes people violent or rapists but rather that it boosts the behavior in those with violent tendencies.¹¹ According to research in the Journal of Studies on Alcohol and Drugs:¹²

"College men's alcohol consumption is positively associated with sexual aggression perpetration … In the present study … heavy episodic drinking (HED) [was] … hypothesized to contribute to sexual aggression perpetration via more frequent attendance at drinking venues (parties, bars).

College men who more frequently attended drinking 'hot spots' were more likely to perpetrate subsequent sexual aggression, supporting a growing body of evidence on the importance of drinking venues in college sexual assault."

Children also experience violence as the result of alcohol consumption, a study published in the journal Child Abuse & Neglect found:¹³

"This study is a detailed examination of the association between parental alcohol abuse … and multiple forms of childhood abuse, neglect, and other household dysfunction, known as adverse childhood experiences (ACEs) …

Compared to persons who grew up with no parental alcohol abuse, the adjusted odds ratio for each category of ACE was approximately 2 to 13 times higher if either the mother, father, or both parents abused alcohol … exposure to parental alcohol abuse is highly associated with experiencing adverse childhood experiences."

Alcohol is also correlated with depressive effects in its users and problems in their daily lives, such as trouble in interpersonal relationships including marriage.¹⁴

Alcoholic Beverage Makers Have Spun a Good Image

As I mentioned before, alcohol has not been demonized like tobacco and street drugs. In fact, you do not have to look too far to see reports that alcohol is even healthful and that moderate drinkers live longer than non-drinkers. How has alcohol's positive image been created and maintained?

Two years after launching its Global Smart Drinking Goals campaign in 2015,¹⁵ Anheuser-Busch InBev, the world's largest beer brewer,¹⁶ debuted its Ab Inbev Foundation.¹⁷ "Built around the idea that partnerships can play an important role in reducing the harmful use of alcohol,” it "works through a collaborative model, with our staff, the City Pilot Steering Committees, and our partners," says the brewer.¹⁸

But, according to a commentary in the British journal The Lancet, the Ab Inbev Foundation is no different in intent and hypocrisy than Philip Morris International's Foundation for a Smoke-Free World.¹⁹

You could even add the hypocrisy of Juul Labs claiming to "transition the world’s billion adult smokers away from combustible cigarettes, eliminate their use, and combat underage usage of our products" while hooking children on vaping.²⁰ The Ab Inbev Foundation betrays unabashed conflicts of interest says the Lancet:²¹

"In fact, the foundation attracts senior UN and former US government officials to its board and funds and engages in policy making processes. Despite obvious conflicts of interest, the Anheuser-Busch InBev Foundation sponsors a US National Academies of Science forum on global violence prevention."

For example, a member of the Institute of Medicine's Forum on Global Violence Prevention in 2011 was Amie Gianino who was identified as "Senior Global Director, Beer & Better World, Anheuser-Busch InBev."²² Why is the alcohol industry considered a valid government presenter on these topics?

Anheuser-Busch InBev is not the only alcohol giant pretending to be concerned with global health while selling health-destroying products. The Carlsberg Foundation, one of the world's leading brewery groups,²³ created UNLEASH for young people working on "solutions to meet the United Nations Sustainable Development Goals."²⁴ It also works with government groups, says the Lancet commentary.²⁵

More Deception From Alcohol Beverage Manufacturers

How have alcohol beverage makers been able to minimize the considerable cancer links to their products? According to Drug and Alcohol Review:²⁶

"Three main industry strategies were identified: (i) denial/omission: denying, omitting or disputing the evidence that alcohol consumption increases cancer risk; (ii) distortion: mentioning cancer, but misrepresenting the risk; and (iii) distraction: focusing discussion away from the independent effects of alcohol on common cancers …

These activities have parallels with those of the tobacco industry. This finding is important because the industry is involved in developing alcohol policy in many countries, and in disseminating health information to the public, including schoolchildren."

At least one partnership between government and the alcohol industry was flagged as a conflict of interest. In 2018, Heineken, the world's second biggest brewer, and The Global Fund to Fight AIDS, Tuberculosis and Malaria announced a partnership to tackle infectious diseases in Africa. But, according to a Lancet editorial:²⁷

"The proposed partnership is a clear conflict of interest, offering the alcohol industry — already keen to tap into emerging markets such as in Africa — an opportunity to divert attention from the harms of its products, while also lending it an air of responsibility with policy makers and attracting further visibility and brand recognition."

Other public health groups such as the NCD (noncommunicable disease) Alliance concurred.²⁸

"'We have made it clear from the outset that we believe that the Global Fund´s partnership with an alcohol company such as Heineken is incompatible on the grounds of public health,' said Katie Dain, CEO of the NCD Alliance.

'It is unacceptable that a company whose core business is based on promoting products and choices that are of detriment to people´s health and wellbeing, should be seen as a viable partner by an organization like the Global Fund that is charged with bettering the health of so many millions of people around the world.'"

The partnership was suspended in 2018, not due to public health concerns but, rather, amid allegations that Heineken’s use of female beer promoters was sexually exploitative and unhealthy.²⁹

Other Alcohol Conflicts of Interest Exist

Public health organizations have seen the value in taxing tobacco and sugar-sweetened beverages because of the clear harm they do. Yet alcohol taxes and control strategies lag behind, says the Lancet. For example:³⁰

"Bloomberg Philanthropies, a worldwide leader in tobacco control, convened a high-level task force with former heads of state and finance ministers to consider fiscal policies for health.

The philanthropic organization recognized that alcohol taxes were underused, and, if implemented, could indirectly save up to 22 million lives over the next 50 years. Yet, Bloomberg Philanthropies has not devoted resources to alcohol control programs."

Moreover, some research-based charities like the U.K.-based Wellcome Trust actually invest in alcohol beverage makers, says the Lancet commentary.³¹

"The Wellcome Trust, which announced a major commitment of £200 million to transform research and treatment for mental health, has also invested £171 million in Anheuser-Busch InBev as of 2017.

No global health charity has allocated substantial resources or prioritized investment in alcohol control, despite the fact that this neglected issue needs leadership."

We have long seen how junk food manufacturers like Coca-Cola have skewed research about the health effects of their products and tried to form partnerships that made them look health conscious. It is no surprise that alcoholic beverage makers would sink to the same dirty tricks. It’s important to take their messages with a grain of salt.

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COVID-19, the novel coronavirus identified in Wuhan City, China, in December 2019, is part of a family of viruses with a crown- or halo-like (corona) appearance.¹ As explained on the Virginia Department of Health website, seven human coronaviruses have currently been identified:²

Due to it being an enveloped virus (meaning its single-strand RNA is enveloped in a bubble of lipid or fatty molecules), COVID-19 (as all other coronaviruses) is highly susceptible to soap and disinfectants, which is good news. Some disinfectants are more effective than others, however, which is the focus of this article.

While there are many chemical disinfectants, I’ll focus on those that are most readily available for home use. You can learn more about other disinfectants and sterilizing agents used in health care settings on the CDC’s Chemical Disinfectants for Infection Control webpage.¹¹

Alcohol-Based Disinfectants

Alcohol-based disinfectants will contain either ethyl alcohol or isopropyl alcohol at various levels of strength (50% or greater). While alcohol primarily kills bacteria, it also has potent fungicidal and viricidal activity at concentrations above 60%.¹²

According to the U.S. Centers for Disease Control and Prevention,¹³ the microbial action of alcohol is thought to be due to its ability to denature proteins. Straight ethyl alcohol is less bactericidal than alcohol mixed with water, as the presence of water allows proteins to be denatured more rapidly.

When it comes to viruses, different alcohols are more or less effective depending on the type of virus in question.

• Ethyl alcohol — Provided the concentration is higher than 60%, ethyl alcohol effectively inactivates lipophilic viruses such as influenza viruses, coronaviruses and many (but not all) hydrophilic viruses
• Isopropyl alcohol — While killing lipid viruses such as coronavirus, isopropyl alcohol is ineffective against nonlipid enteroviruses

If using an alcohol-based disinfectant to inactivate and protect against coronaviruses on surfaces around your home, make sure it contains between 60% and 80% alcohol. According to the World Health Organization:¹⁴

"Alcohol solutions containing 60–80% alcohol are most effective, with higher concentrations being less potent. This paradox results from the fact that proteins are not denatured easily in the absence of water …"

What’s more, while alcohol-based disinfectants are highly effective against gram-positive and gram-negative bacteria, they can be more or less effective against viruses, depending on the type of virus.

They’re quite ineffective against nonenveloped (nonlipophilic) viruses, but tend to work better against enveloped viruses,^15,16 which is what COVID-19 is. Keep in mind that for hand sanitation, soap and warm water is the most effective. Only use alcohol-based hand sanitizers if soap and water are unavailable.

Chlorine Bleach

Chlorine disinfectants such as household bleach, which typically contains 5.25% to 6.15% sodium hypochlorite, have broad antimicrobial activity and effectively kills bacteria, fungi and viruses, including influenza viruses.^17,18 It has several major biological drawbacks, however. For example, bleach:¹⁹

Also make sure you dilute bleach with cold water, as hot water will inactivate it, rendering it ineffective for sterilization.²⁰ Ideally, use mask and gloves when using bleach. You should also dilute it before using. “Infection Prevention and Control of Epidemic- and Pandemic-Prone Acute Respiratory Infections in Health Care” recommends diluting bleach containing 5% sodium hypochlorite to 0.05% before using.²¹

Hydrogen Peroxide and Accelerated Hydrogen Peroxide

Hydrogen peroxide has the ability to kill or inactivate bacteria, viruses, spores, yeast and fungi. A list of brand name sterilants and disinfectants cleared by the U.S. Food and Drug Administration that contain 1% to 7.5% hydrogen peroxide can be found on the FDA’s website.²² As explained by the CDC:²³

“Hydrogen peroxide works by producing destructive hydroxyl free radicals that can attack membrane lipids, DNA, and other essential cell components.

Catalase, produced by aerobic organisms and facultative anaerobes that possess cytochrome systems, can protect cells from metabolically produced hydrogen peroxide by degrading hydrogen peroxide to water and oxygen. This defense is overwhelmed by the concentrations used for disinfection.”

Commercially available 3% hydrogen peroxide is stable and effective for disinfecting a wide variety of surfaces. Contrary to bleach, hydrogen peroxide is molecularly very similar to water — it just has an additional oxygen atom — so it doesn’t produce any dangerous compounds when breaking down. Its inherent safety (provided you don’t drink it) makes it an excellent choice for home sanitation.

An even better alternative is accelerated hydrogen peroxide (AHP), sold under the brand name Rescue and some others. Compared to pharmaceutical grade 3% hydrogen peroxide, AHP works much faster, so you don’t need to wet the surface for as long. AHP can kill viruses in as little as 30 seconds.²⁴ According to Solutions Designed for Health Care:²⁵

“AHP® is composed of hydrogen peroxide, surface acting agents (surfactants), wetting agents (a substance that reduces the surface tension of a liquid, causing the liquid to spread across or penetrate more easily the surface of a solid) and chelating agents (a substance that helps to reduce metal content and/or hardness of water).

The ingredients are all listed on the EPA and Health Canada Inerts lists and the FDA Generally Regarded as Safe List (GRAS). All chemicals used in the formulation of AHP® are commonly found in commercial and industrial cleaners and disinfectants.”

According to Virox Technologies Inc. (a manufacturer of AHP), Health Canada named AHP the surface disinfectant of choice for health care facilities during the 2003 SARS outbreaks.²⁶ Overall, AHP appears to be one of the best and safest broad-spectrum viricidals available.

Malt Vinegar and Plain Soap Both Work

Another common household staple that can be used to disinfect viruses is 10% malt vinegar (made from malted barley grain, which is also used to make beer; a second fermentation turns the ale into vinegar²⁷).

As noted in the 2010 article, “Effectiveness of Common Household Cleaning Agents in Reducing the Viability of Human Influenza A/H1N1,” published in PLOS ONE:²⁸

“Our findings indicate that it is possible to use common, low-technology agents such as 1% bleach, 10% malt vinegar, or 0.01% washing-up liquid to rapidly and completely inactivate influenza virus.

Thus, in the context of the ongoing pandemic, and especially in low-resource settings, the public does not need to source specialized cleaning products, but can rapidly disinfect potentially contaminated surfaces with agents readily available in most homes …

The addition of any of 1% bleach, 50% and 10% malt vinegar and 1%, 0.1% and 0.01% washing up liquid were all effective at rapidly reducing viable virus below the limit of detection, while a low concentration of vinegar (1%) was no more effective than hot water alone …

While a strong oxidizing agent such as bleach is effective at reducing both genome detection and virus infectivity, low pH and detergent are equally efficacious virucidal agents.

These results also indicate that whilst vinegar and detergent disrupt the viral envelope proteins reducing infectivity, only bleach disrupts the viral genome.”

White Vinegar Is Not a Good Disinfectant

While 10% malt vinegar appears to be effective enough as a viral disinfectant, distilled white vinegar with an ascetic acid range of 4% to 8% is a rather poor choice, according to Talk CLEAN to Me, a blog by experts in chemical disinfection for infection prevention:²⁹

“… the various organic acid disinfectants … typically lack a broad spectrum of kill compared to higher level disinfectants such as bleach and hydrogen peroxide … You may be thinking ‘Hey, wait! Vinegar and acetic acid have been used for hundreds of years as methods of disinfection and sanitization.’

However, it is important to note that these only show strength against relatively easy to kill organisms such as pseudomonas. There is no current data that concludes that organic acids bolster a broad spectrum of kill.”

How to Safely Use Vinegar With Hydrogen Peroxide

In short, white vinegar has a low speed of disinfection (you’d have to leave it on for at least 10 minutes), and kills only the most easily destroyed microbes. That said, you could boost the effectiveness of white vinegar by using it in combination with hydrogen peroxide.

An important caveat here is that you must use them separately and not mixed together, as the chemical reaction will form a highly corrosive and unstable form of peracetic acid. A recipe by Susan Sumner, associate dean of College of Agriculture and Life Sciences at Virginia Tech, is offered by Cleaning Business Today:³⁰

1. Pour 3% hydrogen peroxide into one spray bottle and distilled white vinegar (5% ascetic acid) into a second bottle. Do NOT mix together in one bottle as they will create an unstable and highly corrosive form of peracetic acid
2. Clean the surface with soap and water. Dry with clean cloth or paper towel
3. Spray the surface with either the hydrogen peroxide or the vinegar. The order does not matter; just don’t spray them on at the same time as when mixed they will create an unstable form of peracetic acid
4. Let it set for at least five minutes before wiping off with a clean cloth or paper towel
5. Repeat with the second bottle

Clean First, Disinfect After

If your aim is to disinfect and sterilize, keep in mind that you need to clean the surface first. Soap and water is likely one of the best alternatives here, as the soap will effectively inactivate viruses.

Once the surface is clean of dirt and sticky grime, spray you chosen disinfectant on the surface and let it set for up to several minutes before wiping. The time required will depend on the disinfectant you use.

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The question of where and how to give birth is a relatively new one for women. Up until the early 20th century, fewer than 5% of women gave birth in a hospital. In the 1950s the birth of a baby, an event that had once been a family affair and attended by a midwife, became more medicalized.¹

Pregnancy and birth were seen more as a sickness than a natural part of life. One mom described the birth of her first child in the 1960s as occurring without pain medication, with minimal interaction from medical staff and a forced two-week hospital stay.²

Dads began attending births in the 1970s and by the 1990s childbirth was swinging back toward being a natural part of life. More women are now offered choices that are respectful of their wishes, without repeating the horror stories of past generations. This is an important factor in the future health of mother, child and family as recognized by the World Health Organization.³

The outcome not only affects the mother but may also be important in the development of the mother’s and child's relationship and mom’s future childbearing experiences. Researchers have found that a woman's positive and negative perceptions of birth are related more to her ability to control the situation and have a choice in her options, than specific details.

Low-Risk Home Birth as Safe as Hospital Birth

Evidence doesn’t back the long-held belief that low-risk deliveries are better served in the hospital where medical intervention may be used to speed delivery.

The safety debate surrounding home births is not a new one. Nearly 11 years ago data showed when a home birth was planned by a woman with a low-risk pregnancy and attended by a midwife, there were:⁴

" … very low and comparable rates of perinatal death and reduced rates of obstetric interventions and other adverse perinatal outcomes compared with planned hospital birth attended by a midwife or physician."

In 2008 the American College of Obstetricians and Gynecologists (ACOG) published a statement in opposition to home births, writing that “Choosing to deliver a baby at home, however, is to place the process of giving birth over the goal of having a healthy baby.”⁵

Despite evidence to the contrary, their statement published nearly 10 years later did not change: In 2017 they recommended women be informed of the risks, specifically that there are a lower number of risks to the woman but a higher rate of perinatal deaths.⁶

In another study of 530,000 births in the Netherlands,⁷ researchers found no differences in the rate of death in mother or baby between those born at home or in a hospital. The study was sparked by the suggestion that the high rate of infant mortality may be due to the high number of home births. The review of medical records did not bear out the hypothesis. Professor Simone Buitendijk commented to the BBC:⁸

"We found that for low-risk mothers at the start of their labour it is just as safe to deliver at home with a midwife as it is in hospital with a midwife. These results should strengthen policies that encourage low-risk women at the onset of labour to choose their own place of birth."

Safety Data Positive With Well-Educated Midwives

It should be noted data were published long before the 2017 policy statement from ACOG mentioned above. In 2014, a review of 16,924 home births recorded between 2004 and 2009 were examined. Researchers noted the rise of home births by 41% from 2004 to 2010, writing there is a⁹ “need for accurate assessment of the safety of planned home birth.”

The scientists found that of the participants who planned a home birth, 89.1% did in fact do so. Most of the transfers to the hospital during labor were for failure to progress. However, 93.6% went on to have a spontaneous vaginal delivery, and 86% of infants were breastfeeding exclusively by 6 weeks of age. The overwhelming majority — 87% — of 1,054 who attempted a vaginal delivery after cesarean section at home were successful.

Researchers recently conducted an international meta-analysis to evaluate the safety of home and hospital births with the primary outcome measurement of any perinatal or neonatal death. They chose 14 studies including approximately 500,000 intended home births attended by a midwife.¹⁰

The information was pulled from outcomes from eight Western countries, including the U.S., in studies published since 1990.¹¹ What they found fit many of the previous studies:¹² "The risk of perinatal or neonatal mortality was not different when birth was intended at home or in hospital." Eileen Hutton from McMaster University, one of the researchers, commented:¹³

"More women in well-resourced countries are choosing birth at home, but concerns have persisted about their safety. This research clearly demonstrates the risk is no different when the birth is intended to be at home or in hospital."

Conditions Best Addressed at the Hospital

Of course, there are high risk pregnancies better served inside a hospital environment. According to the U.S. Department of Health and Human Services, factors that potentially create a high-risk pregnancy include existing health conditions and lifestyle choices. While this list is not all-inclusive, these are factors your midwife or doctor will consider as you discuss your birth plan. Some include:¹⁴

High blood pressure — If this is the only risk factor and blood pressure is only slightly elevated, it may not be enough to stop a home delivery plan. However, uncontrolled blood pressure is dangerous to mother and baby.

Polycystic ovary syndrome (PCOS) — PCOS can increase the risk of gestational diabetes, cesarean section, preeclampsia and pregnancy loss before 20 weeks.

Diabetes — Moms who have diabetes are more likely to have babies that are larger than most; their babies may also have low blood sugar after being born.

Kidney disease — Depending upon the extent of the disease, it may impact fertility and the ability to carry a pregnancy to term. Nearly 20% of women with preeclampsia during pregnancy go on to be diagnosed with kidney disease.

Autoimmune disease — Medications used to treat autoimmune diseases may be harmful to the baby; such conditions also increase risks of pregnancy and delivery.

Thyroid disease — Uncontrolled disease may increase stress on the baby and cause poor weight gain, heart failure or problems with brain development.

Obesity — Obesity before becoming pregnant is associated with high risk and poor outcomes, including large for gestational age babies, difficult birth and a risk for heart defects.

Age — Teens and first-time moms over 35 fall into high-risk categories.

Lifestyle factors — Alcohol, tobacco and drug use increase the risks to mom and baby during the pregnancy and delivery.

Pregnancy conditions — Women carrying multiples, who have had a previous premature birth or who have gestational diabetes, preeclampsia or eclampsia are at high risk.

Comparing the Risks of Home and Hospital Births

The decision to give birth at home or in a hospital is a personal one. While ACOG claims the hospital is the safest place, research evidence shows low-risk pregnancies delivered at home or in a hospital with a qualified midwife have the same risks and outcome potential. Just as important are the risks for low-risk women who give birth inside a hospital setting.

For instance, while a home birth rarely if ever includes the use of drugs or interventions to speed delivery, many women who are hospitalized may receive Pitocin, a synthetic form of oxytocin. The drug is used to induce labor or start contractions and it may be used to intensify labor contractions to speed the process.

However, the use of the medication must be balanced against outcomes, such as a higher rate of analgesia and cesarean section,¹⁵ both of which affect mother and baby. In any pregnancy, oxytocin may also increase the risk of fever in the woman, low pH values in the umbilical cord and a shorter first stage of labor.¹⁶

Data from the CDC show the rate of cesarean sections in 2018 were 31.9% of all births.¹⁷ However, this includes a number of cesarean sections considered medically unnecessary. The rate for Nulliparous, Term, Singleton, Vertex (NTSV) Cesarean Birth Rate is 25.9%.¹⁸

This means that of all the women who had a cesarean section, 25.9% were having their first baby, beyond 39 weeks gestation and carrying one child who presented normally, in the vertex position with the head down.¹⁹

Having had a first cesarean section nearly guarantees the following births will also be a cesarean section as the repeat rate is 86.7%.²⁰ As explained by the American Pregnancy Association, cesarean section introduces multiple risks for mother and baby. For the mother, these include infection, hemorrhaging, injuries, lengthy stays in the hospital and emotional reactions as well as those related to medicine.

Moms can also have adhesions, or scar tissue that causes a blockage in the stomach area. Babies can have a low birth weight, a low APGAR score, breathing difficulties and even injuries.²¹

Type of Birth Influences Future Health

As you likely know, the gut microbiome is an intricate living foundation for your immune system that plays a role in your risk of chronic disease, weight management and how well your body absorbs nutrition. As you may imagine, during a vaginal birth a baby's microbiome is first “seeded” and developed.

During the process a baby is passed the mother's microbiome, which is why it's so important for the woman to have a healthy gut before, during and after pregnancy. The makeup of the mother's gut will influence how the baby's microbiome grows.

A cesarean section bypasses this important step, which may be compounded by bottle feeding, a lifetime of processed foods and an overuse of antibiotics. These factors all have led to a steep loss of biodiversity in the human gut making many vulnerable to disease. Skin-to-skin contact after birth and breastfeeding are two ways to pass along a healthy microbiome if you've had a cesarean section.

For more information about how to more effectively help seed your baby's gut microbiome see "How the Method of Birth Can Influence Lifelong Health."

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Being in the healthcare industry is demanding enough, but during a global pandemic it’s also risky. Here’s three health professionals on how they’re protecting themselves against infection from COVID-19.

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Busy mother-of-three, Adele Fiene adopted the CSIRO Total Wellbeing Diet and saw incredible results in just five months (going from her heaviest weight of 86.6kg to 66.6kg). Plus, it improved her eczema. 

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Using a recently developed fluorescent imaging technique, researchers in the United States have developed high-resolution maps of microbial communities on the human tongue. The images reveal that microbial biofilms on the surface of the tongue have a complex, highly structured spatial organization.

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In a new study, higher daily step counts were associated with lower mortality risk from all causes.

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From the age of 50, there is a decline not just in physical activity but also in cognitive abilities since the two are correlated. But which of them influences the other? Researchers used a database of over 100,000 people aged 50-90 whose physical and cognitive abilities were measured every two years for 12 years. The findings show that cognitive abilities ward off inactivity much more than physical activity prevents the decline in cognitive abilities.

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Scientists have revealed an important mechanism in the repair of DNA double-strand breaks, according to new research.

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Engineers have created a tiny device that can rapidly detect harmful bacteria in blood, allowing health care professionals to pinpoint the cause of potentially deadly infections and fight them with drugs.

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Struggling to get a solid eight hours? Nutritionist Rick Hay has put together a nervous system-nourishing weekly meal plan to help you get the shut-eye you deserve. 

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Bacteria are increasingly becoming resistant to antibiotics. By combining antibiotics with the cannabis compound, cannabidiol, researchers have found a way to enhance the antibiotic effect.

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Men are more prone to competitive risk taking and violent behavior, so what happens when the number of men is greater than the number of women in a population? According to new research, the answers might not be what you expect.

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An international team of scientists found that, like humans, female wild animals tend to live longer than males.

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We humans are far from the first to exploit the benefits of CRISPR. Groundbreaking research has helped to redefine what CRISPR is. Researchers have discovered that primitive bacterial parasites weaponize CRISPR to engage in battle against one another. This discovery opens up the possibility to reprogram CRISPR to combat multi-drug resistant bacteria.

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Researchers found that individuals going to bed even 30 minutes later than their usual bedtime presented a significantly higher resting heart rate that lasted into the following day.

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Have you already eaten your way through all your quarantine snacks?

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Nobel Prize winner Professor Peter Doherty says we can control the spread of COVID-19 in upcoming weeks. If we stick to our social distancing guns. 

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A new project is an effort to combat the rise of coordinated social media campaigns to incite violence, sew discord and threaten the integrity of democratic elections.

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One of the last arrows in the quiver in the fight against dangerous bacteria is the reserve antibiotic daptomycin. It is used primarily when conventional drugs fail due to resistant bacteria. Although the antibiotic was developed around 30 years ago, its exact mode of action was previously unclear. Scientists have now deciphered the puzzle: Daptomycin blocks the integration of important building blocks into the cell wall of the pathogens.

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Researchers are producing in the lab a human protein tasked with removing triglycerides from the blood stream. Unlocking the secrets of human protein APOA 5 gives us a leg up in treating heart disease.

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Nearly three in ten New York City residents (29%) report that either they or someone in their household has lost their job as a result of coronavirus over the last two weeks. In addition, 80% of NYC residents said they experienced reduced ability to get the food they need, and two-thirds (66%) reported a loss of social connection in the past week, suggesting that compelled isolation is taking a toll on residents.

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Many of us are spending a lot of time looking at our hands lately and we think we know them pretty well. But research shows the way our brains perceive our hands is inaccurate.

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A new study suggests that the age of certain immune cells used in immunotherapy plays a role in how effective it is. These cells -- natural killer (NK) cells -- appear to be more effective the earlier they are in development, opening the door to the possibility of an immunotherapy that would not utilize cells from the patient or a matched donor. Instead, they could be developed from existing supplies of what are called human pluripotent stem cells.

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Researchers identified neurons that promote non-REM sleep in the brainstem in mice. These neurons commonly expressed the gene that encodes the neuropeptide neurotensin. Activation of these neurons induced non-REM sleep. Moreover, direct administration of neurotensin into the ventricle induced NREM sleep-like brain activity. These findings contribute to our understanding of sleep promotion and sleep disorders, and could tell us more about the evolution of sleep architecture in mammals.

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The law on keeping dangerous snakes as pets should be tightened up, animal welfare experts demand.

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A coronavirus envelope all-atom computer model is being developed. The coronavirus model builds on success of all-atom infuenza virus simulations. Molecular dynamics simulations for the coronavirus model tests ran on up to 4,000 nodes, or about 250,000 of Frontera's processing cores. Full model can help researchers design new drugs, vaccines to combat the coronavirus.

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Prolonged fear and anxiety brought on by major stressors, like the coronavirus pandemic, can not only take a toll on a person's mental health, but may also have a lasting impact on a man's sperm composition that could affect his future offspring.

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Autism spectrum disorder (ASD) is a lifelong condition that affects a person’s social and communication skills. People with ASD can have repetitive behaviors, a narrow range of interests, a strong preference for sameness, and sensory processing differences. The number of children diagnosed with ASD has increased dramatically over the past several decades. Because of this, growing numbers of youth with ASD are now making the developmental transition from adolescence to adulthood. This transition is marked by changes in many areas of life, including new healthcare providers, educational or occupational settings, and living arrangements.

What makes the transition to adulthood particularly challenging for youth with ASD?

There are several features of ASD that add challenges to the transitions of adulthood, including a strong preference for sameness and a difficulty tolerating change. Communication difficulties can also complicate expressing distress or asking for help. Young adults with ASD may also find it difficult to participate in more complex social relationships. Finally, many people with ASD are very detail-focused but have difficulty taking into consideration the larger context, which can affect planning and organizing.

What are some ASD-specific transitional needs?

Youth with ASD also have some specific transitional needs in terms of healthcare, education, employment, and independent living. They are more likely to have active medical needs and require a healthcare team that is familiar with ASD. Unfortunately, many adult healthcare providers receive very little ASD-specific training regarding common medical and psychiatric comorbidities, as well as the pragmatics of working with adults with ASD.

Helpful strategies for healthcare providers include adjusting the lighting in the examination room, being flexible as to where the patient sits, scheduling “practice visits,” minimizing wait times, and booking patients with ASD for either the first or last appointment of the day. Also, many young adults with ASD transition from their parents’ private health insurance plan to a public insurance plan, which can limit access to certain providers. Finally, many youth with ASD feel anxious about managing their own medical conditions. Parents also express concern about whether their adult child is capable of making their own medical decisions, and in some cases seek guardianship (a court-ordered arrangement in which a person is given authority to make decisions on behalf of another person), particularly when there is significant comorbid intellectual disability.

The transition to adulthood also marks an important change in the educational setting. The Individuals with Disabilities Education Act (IDEA) mandates that public education be available from ages 3 to 21. When an adult with ASD turns 22, he or she is expected to transition out of the school environment. This may result in loss of services, since many of these supports, including speech, behavioral, and occupational therapy, are provided through school. Leaving school can also result in loss of established social connections. Furthermore, young adults can have difficulty finding and accessing appropriate vocational or post-secondary educational environments that provide sufficient supports while also allowing the young adult to develop new skills.

How can caregivers and healthcare providers ease the transitions?

Although the transition to adulthood can seem daunting, there are several strategies that can be helpful. First, it is important to have a clear sense of a young person’s strengths, challenges, skills, and interests in order to develop realistic long-term goals and seek out educational and vocational settings that are a good fit. The person with ASD should be as involved in this process as possible. Smaller, intermediate goals can be developed with the long-term goal in mind. Progress should be assessed regularly, and the development of long-term goals can be a flexible and iterative process.

Second, since the transition to adulthood is complex, early preparation and a series of conversations is needed. Healthcare providers should initiate these conversations several years in advance to allow patients and families to prepare and seek additional resources. Caregivers may want to seek additional information about funding and services from their local state and federal agencies, including the state’s department of developmental services, the state’s vocational rehabilitation program, and the Social Security Administration. In some cases, legal counsel regarding guardianship may also be helpful. Further information on the transition to adulthood can be accessed through the Autism Speaks Resources Guide. Healthcare providers can also help ease the transition from pediatric to adult healthcare providers by creating written medical summaries, developing lists of adult healthcare providers familiar with ASD, and scheduling transition-specific appointments.

Finally, since independent living requires a range of self-care skills including personal hygiene, dressing, meal preparation, household chores, money management, self-advocacy, and community safety, it is important for caregivers and healthcare providers to gradually teach and assess acquisition of independent living skills throughout childhood, rather than waiting until an adolescent is on the cusp of adulthood. These skills can be developed through education, therapeutic supports such as occupational therapy, and positive reinforcement.

Seeking solutions to a public health issue via advocacy for people with ASD

The transition to adulthood can be challenging for adolescents with ASD, because of the nature of their condition and because of the many gaps in systems of care, limited public funds, and the need to coordinate among multiple agencies. These challenges are increasingly recognized as a major public health issue, and both patient advocates and medical providers who specialize in ASD are working to find solutions to these issues, by preparing people entering the healthcare field to become aware of the needs of people with ASD through life’s transitions. Successful navigation of the transition to adulthood can help set the stage for a young person with ASD to be able to tolerate, navigate, and seek support during future periods of change throughout adulthood.

References

Examining Primary Care Health Encounters for Adults With Autism Spectrum Disorder. The American Journal of Occupational Therapy, September-October 2019.

The Massachusetts General Hospital Guide to Medical Care in Patients with Autism Spectrum Disorder (Eric P. Hazen and Christopher J. McDougle, editors).

Autism Speaks Resource Guide

The post Opportunities for growth: Transitions for youth with autism spectrum disorder appeared first on Harvard Health Blog.

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A comprehensive review of US social policies evaluated for their health outcomes found suggestive evidence that early life, income, and health insurance interventions have the potential to improve health. Scientists have long known that 'social' risk factors, like poverty, are correlated with health. However, until this study, there was little research carried out to understand whether it was actually possible to improve population health by addressing these risk factors with social policies.

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In a time where many are practicing 'social distancing' from the outside world, people are relying on their immediate social circles more than usual. Does a sense of obligation -- from checking on parents to running an errand for an elderly neighbor -- benefit or harm a relationship? A study found the sweet spot between keeping people together and dooming a relationship.

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A new raft of stricter social distancing measures will come into effect as of midnight, on Wednesday 25th of March.  

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