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The need to protect young people Peter Anderson MD, MPH, PhD, FRCP Professor, Alcohol and Health, Maastricht University Netherlands Visiting Professor, Alcohol and Health, Newcastle University, England Brussels, 17 March 2011. A point about alcohol Why alcohol matters to young people - PowerPoint PPT Presentation
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The need to protect young people
Peter Anderson MD, MPH, PhD, FRCPProfessor, Alcohol and Health, Maastricht University NetherlandsVisiting Professor, Alcohol and Health, Newcastle University, England
Brussels, 17 March 2011
1. A point about alcohol 2. Why alcohol matters to young people 3. But, what about us?4. Alcohol’s impact on health5. And, what does this all mean
1. A point about alcohol 2. Why alcohol matters to young people 3. But, what about us?4. Alcohol’s impact on health5. And, what does this all mean
WHO: Disability adjusted life year (DALY)
Measures a combination of ill-health (adjusted for the severity of ill-health) or premature death).
It measures a gap between how healthy we are and how healthy we could be
WHO: Top 10 risk factors for DALYs (world)
1. A point about alcohol 2. Why alcohol matters to young people 3. But, what about us?4. Alcohol’s impact on health5. And, what does this all mean
1. Brain function 2. Problems in later life3. Death
1. Brain function 2. Problems in later life3. Death
As we know, adolescents are vulnerable to the effects of alcohol
Let, us look at the example of the hippocampus, a structure of the forebrain
involved in memory and spatial navigation
In fact, taxi drivers in London have increased hippocampal size
Source: DeBellis et al 2000
alcohol use disorders in adolescence and volume of the hippocampus
Source: DeBellis et al 2000
alcohol use disorders in adolescence lead to reduced volume of the hippocampus
10% reduction
1. Brain function 2. Problems in later life3. Death
Prevalence of past-year alcohol and substance use disorders (AUDs and SUDs), by minimum legal drinking age (MLDA) exposure in US.
Source: Norberg et al 2009
1. Brain function 2. Problems in later life3. Death
Male alcohol-related deaths by age group, England
1. A point about alcohol 2. Why alcohol matters to young people 3. But, what about us?4. Alcohol’s impact on health5. And, what does this all mean
WHO: Top 10 risk factors for DALYs (age group 25-59 years)
Female alcohol-related deaths by age group, England
1. A point about alcohol 2. Why alcohol matters to young people 3. But, what about us?4. Alcohol’s impact on health5. And, what does this all mean
1. Alcohol as an intoxicant 2. Alcohol as a teratogen3. Alcohol as a carcinogen4. Heart attacks and strokes5. How much do you need to drink to die
1. Alcohol as an intoxicant 2. Alcohol as a teratogen3. Alcohol as a carcinogen4. Heart attacks and strokes5. How much do you need to drink to die
The risk of a non-motor vehicle accident injury related to the amount of alcohol consumed during the last 3 hours.
Source: Taylor et al, 2009
The risk of a motor vehicle accident injury related to the amount of alcohol consumed during the last 3 hours.
1. Alcohol as an intoxicant 2. Alcohol as a teratogen3. Alcohol as a carcinogen4. Heart attacks and strokes5. How much do you need to drink to die
1. Alcohol as an intoxicant 2. Alcohol as a teratogen3. Alcohol as a carcinogen4. Heart attacks and strokes5. How much do you need to drink to die
Overall evaluationAlcoholic beverages are carcinogenic to humansEthanol in alcoholic beverages is carcinogenic to humans
As a carcinogen, alcohol increases the risk of cancers of the oral cavity and pharynx, oesophagus, stomach, colon, rectum, liver and female breast in a linear dose–response relationship
Risk of female breast cancer by alcohol consumption
Source: Allen et al, 2009
1. Alcohol as an intoxicant 2. Alcohol as a teratogen3. Alcohol as a carcinogen4. Heart attacks and strokes5. How much do you need to drink to die
The more you drink, the greater the risk of:
Hypertension Arial fibrillation Haemorrhagic stroke
Relation with cardiovascular disease
There is a J-shaped-relationship between alcohol and:
Ischaemic heart disease Ischaemic stroke
Compared with abstainers, light drinkers have reduced risk; beyond the bottom of the the risk increases with a dose-response relationship
Relation with cardiovascular disease
J
In young people, alcohol increases the risk of ischaemic events
In old people, the protection tapers off with age
Relation with cardiovascular disease
For the middle aged, the protective effect
Is no different between exclusively beer or wine drinkers
Disappears the more the abstaining comparison group includes ex-drinkers
Disappears when light drinkers report at least one heavy drinking occasion per month
Relation with cardiovascular disease
Most of the protective effect can be achieved by a consumption of 5g alcohol (half a drink) a day
More protection can be achieved by engaging in other healthier behaviours (e.g., healthy diet, more physical activity)
Relation with cardiovascular disease
1. Alcohol as an intoxicant 2. Alcohol as a teratogen3. Alcohol as a carcinogen4. Heart attacks and strokes5. How much do you need to drink to die
0.02.04.06.08.0
10.012.014.016.0
10 20 30 40 50 60 70 80
Life
time
risk
of a
n al
coho
l-re
late
d de
ath
(1/1
00)
Grams alcohol per day or per week
Men dailyWomen dailyMen weeklyWomen weekly
Lifetime risk of dying from alcohol-related death by gram alcohol/day or /week for Australian men and women.
Source: National Health and Medical Research Council, Australia, 2009
1. A point about alcohol 2. Why alcohol matters to young people 3. But, what about us?4. Alcohol’s impact on health5. And, what does this all mean
Alcohol damages the adolescent brain?
Did you know:
25% of male and 15% of female adolescent deaths are due to alcohol?
Did you know:
Amongst us, alcohol is the top cause of ill-health and premature death?
Did you know:
That alcohol in pregnancy increases the risk of early childhood acute myeloid leukaemia nearly three-fold?
Did you know:
That alcohol produces cancer in at least 8 major organs?
Did you know:
Drinking a bottle of wine a day means a 10% chance that your death is due to alcohol?
Did you know:
Shouldn’t we use every opportunity to inform them?
I do not think people know these facts
Shouldn’t we use every opportunity to warn people about this?
Alcohol produces cancer