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PubMed2001

Eating and drinking in labor: the influence of caregiver advice on women's behavior.

BACKGROUND: Although there is much debate about eating and drinking during labor, little scientific data about its influence on the course of labor exist. In The Netherlands, most midwives and obstetricians allow women to eat and drink during normal labor. The objective of this study was to examine whether or not women were actively advised to eat and drink and if this advice affected eating and drinking behavior. METHODS: A randomly selected group of midwives and obstetricians from across The Netherlands identified 211 consecutive nulliparous women to participate in the study. In a questionnaire with open-ended questions, women were asked after their delivery whether or not they were advised about eating and drinking during labor, and if so, about the nature of this advice and what they had consumed. Data were analyzed at the Leyenburg Hospital in The Hague. RESULTS: Sixty-six percent of the women were not given advice about eating and drinking during labor. Women who were given advice usually followed it. In the total group, 37 percent of the women had intake other than water and of these, 75 percent ate solid food. After adjusting for other prognostic factors, the incidence of an instrumental delivery due to a nonprogressing second stage was lower in women with caloric intake (13% vs 24%, p = 0.04). CONCLUSION: The study design did not enable us to draw conclusions about the cause and effect between caloric intake and labor progress. Scientific data with respect to the giving of evidence-based advice about eating and drinking during labor are lacking. Should such advice become available, women are likely to follow it.

Drinking↗
PubMed2001

Impaired drinking capacity in patients with functional dyspepsia: relationship with proximal stomach function.

BACKGROUND & AIMS: Impaired fundic accommodation to a meal and hypersensitivity to distention are increasingly recognized as important mechanisms underlying functional dyspepsia (FD). In the present study, we evaluated whether a drink test can predict such abnormalities and thus represent a noninvasive tool to study proximal stomach motor function. METHODS: Healthy volunteers (HV), nonconsulters with mild dyspeptic symptoms (MS), and patients with FD filled out a disease-specific questionnaire and underwent a drink test with either water or with a high calorie fluid. The maximal ingested volume and the subsequent symptoms were meticulously recorded. In addition, all subjects underwent a gastric barostat study assessing meal-induced relaxation and sensation to distention. RESULTS: Drinking capacity was not significantly related to any particular dyspeptic symptom. FD were able to consume less water (893 +/- 70 mL) and caloric liquid (767 +/- 50 mL) compared with HV (water, 1764 +/- 120 mL; caloric liquid, 1308 +/- 96 mL) or MS (water, 1645 +/- 120 mL; caloric liquid, 973 +/- 45 mL). Approximately half of the FD had an abnormal water or Nutridrink test compared with 9% of MS and 4% of HV. Furthermore, FD developed significantly more symptoms than MS or HV after both drink tests. The drinking capacity did not predict impaired fundic accommodation or visceral hypersensitivity. CONCLUSIONS: FD, but not MS, have an impaired drinking capacity to both water and a nutrient liquid. The drinking capacity is not related to a specific dyspeptic symptom and does not predict proximal stomach motor function.

Adult↗
PubMed1990

Gastric emptying with repeated drinking during running and bicycling.

The high prevalence of gastrointestinal complaints in long-distance runners makes the movements specific to this type of exercise suspected of causing a disruption of normal gastrointestinal function. Gastric emptying rate is one indicator thereof. In the present study trained volunteers performed similar repeated fluid ingestion tests while running and while bicycling for 80 min at 70% VO2max. Control tests at rest were also conducted. Two drinks containing carbohydrate were tested, one hypertonic, and one isotonic. Artificially sweetened water was used as a control. Gastric emptying rate of the isotonic drink, expressed as a percentage of the volume in the stomach at the beginning of each measurement period, did not differ between cycling and running during the first 40 min and was faster during cycling than during running between 40 and 80 min. With the hypertonic drink no differences between cycling and running were observed. In comparing gastric emptying rates after each sequential bolus, at rest, the isotonic drink was observed to maintain a high emptying rate, equal to that of water, whereas the hypertonic drink emptied more slowly after the first 20-min period. A similar pattern was observed during both running and cycling. The isotonic drink continued to empty quickly after the initial 20 min, whereas GE rate of the hypertonic drink decreased after the initial 20 min.

Adult↗
PubMed1995

The interactionist nature of drinking and driving: a structural model.

A structural model is described that examines the contributions of personal and situational determinants (interactionist theory) for the elicitation of previous self-reported drink-driving offending. Responses of 1011 UK driver's licence holders to 57 questions concerning demographics, driving experience/exposure, deterrence issues, attitudinal factors and situation specific drink-driving behaviour were subjected to a series of multiple regression analyses. Seven variables (five personal and two situational) accounting for 46% of the sample variance were shown to be significantly predictive of undetected offending behaviour. Of these age and safe driving consumption estimates were found to be best described in terms of their direct effects on offending behaviour. The relationships between general alcohol consumption and exposure to secondary level enforcement (breath test) with drink-driving behaviour have both direct and indirect effects. Two attitudinal factors referring to a belief of deterrence if random breath testing were introduced into the UK, and arranging alternative transport on a drinking occasion, as well as exposure to a drink-driving charge, show approximately proportional direct and spurious links with offending. Findings are discussed i n terms of the utility of an interactionist approach for the study of drink-driving behaviour, previous attempts at modelling drink-driving behaviour, and the implications that such results have for counter-measure development.

Adolescent↗
PubMed2006

Variations in drinking patterns in the rural South: joint effects of race, gender, and rural residence.

OBJECTIVES: To understand the relative contribution of gender, race (African-American vs. Caucasian), and rural residence on variations in drinking patterns, including past year abstinence, at-risk drinking, and recent drinking quantity and frequency for drinkers only. METHODS: A brief health survey was administered by telephone to a probability sample of 11,529 residents of six southern states, over-sampling rural inhabitants. RESULTS: Drinking patterns varied by gender, race, and rural residence in bivariate analysis. Gender effects were independent of rural residence, but race effects on abstinence and at-risk drinking were found only in urban residents and race differences in drinking quantity only in rural residents. Multivariate analysis, controlling for age and education, found gender and rural residence to be the strongest predictors, as well as being an African-American female. CONCLUSIONS: Female gender, African-American race, and rural residence appear protective for at-risk drinking but rural residence dominates racial differences.

Alcohol Drinking↗
PubMed2002

Underage college students' drinking behavior, access to alcohol, and the influence of deterrence policies. Findings from the Harvard School of Public Health College Alcohol Study.

Underage drinking is a major problem at American colleges, but little is known about the extent of alcohol use in different student groups, in different colleges, and in states with different control policies. We used data from the 2001 and 3 previous Harvard School of Public Health College Alcohol Studies that compared responses of underage students with those of their 21-23-year-old peers. Underage students drank alcohol less frequently but were more likely to drink to excess when they drank. College educational efforts and deterrent policies were limited in their outreach, and half of underage students obtained alcohol very easily. Underage students in states with extensive laws restricting underage and high-volume drinking were less likely to drink and to binge drink. A majority of underage students supported increasing efforts to control underage drinking. The results suggest that additional policy efforts to control underage drinking may be effective and feasible.

Adolescent↗
PubMed1996

Changing the perception of the norm: a strategy to decrease binge drinking among college students.

A reduction in college students' binge drinking associated with an intervention to change perceptions of drinking norms is described. The 5-year study was conducted at a public residential campus of 23,000 students. A traditional intervention proved unsuccessful, but a media campaign designed to change student perceptions of the amount of binge drinking showed an 18.5% drop in the number of students who perceived binge drinking as the norm (from 69.7% to 51.2%) and a corresponding reduction in self-reported binge drinking of 8.8% (from 43.0% to 34.2%). The apparent effectiveness of this prevention effort suggested that changing college students' perceptions of drinking norms may lower the proportion of students who engage in binge drinking.

Adult↗
PubMed1998

Changes in binge drinking and related problems among American college students between 1993 and 1997. Results of the Harvard School of Public Health College Alcohol Study.

In 1997, the Harvard School of Public Health College Alcohol Study resurveyed colleges that participated in a 1993 study. The findings revealed little change in binge drinking: a slight decrease in percentage of binge drinkers and slight increases in percentages of abstainers and frequent binge drinkers. Two of 5 students were binge drinkers (42.7%); 1 in 5 (19.0%) was an abstainer, and 1 in 5 was a frequent binge drinker (20.7%). As was true in 1993, 4 of 5 residents of fraternities or sororities were binge drinkers (81.1%). Asian students showed a greater increase and White students a greater decrease in binge drinking from 1993 to 1997, compared with all other students. Among students who drank alcohol, increases in frequency of drinking; drunkenness; drinking to get drunk; and alcohol-related problems, including drinking and driving, were reported. Binge drinkers in both 1993 and 1997 were at increased risk of alcohol-related problems, and nonbingers at colleges with high binge drinking rates had increased risks of encountering secondhand effects of binge drinking.

Adolescent↗
PubMed2003

Randomized controlled trial on the effects of a skills-based workshop on medical students' management of problem drinking and alcohol dependence.

The purpose of this study was to determine whether a skills-based workshop will improve medical students' management of problem drinking and alcohol dependence in simulated patients. Seventy-six 3rd and 4th year Ontario medical students were randomized to receive a 3-h workshop on either problem drinking and alcohol dependence or depression (control condition). Students then completed eight simulated office visits (OSCE stations) with simulated patients presenting with depression, problem drinking or alcohol dependence. Examiners completed a checklist of the questions asked and advice given by the student, and simulated patients and examiners completed a global rating scale. Four months later, students were sent a survey on their knowledge, attitudes, and behavior towards patients with alcohol problems. The alcohol group received significantly higher assessment and management checklist scores and global rating scores than did the depression group (p < 0.01) and performed better on almost all aspects of clinical management of both problem drinking and alcohol dependence. On the follow-up survey (n = 55) the alcohol group showed a significant increase in beliefs about self-efficacy in managing alcohol problems (p < 0.05) and had greater knowledge of reduced drinking strategies, but the two groups did not differ on other measures. A skills-based workshop causes marked short-term improvements in medical students' management of problem drinking and alcohol dependence, an increase from baseline to postworkshop in self-efficacy beliefs that was sustained through to follow-up, and greater knowledge of reduced drinking strategies. Repeated reinforcement of clinical skills may be required for a long-term impact on clinical behavior.

Alcohol Drinking↗
PubMed2006

The impact of adult roles on drinking among women in the United States.

This paper examines the impact of three adult roles-spouse, parent, and worker-on psychological distress and drinking among a national sample of 10,193 women in the United States, using the 1992 National Household Survey on Drug Abuse (NHSDA). We found that the spouse and worker roles are negatively associated with the level of psychological distress, and the parent role is positively correlated with it. Controlling for level of psychological distress, those workers generally are more likely to be drinkers, but, among drinkers, they do not consume alcoholic beverages more than non-workers. The family roles do not affect a woman's likelihood of being a drinker. However, among the drinkers, being a spouse or a parent is negatively related with level of alcohol consumption. Separating three aspects of drinking behavior-whether a woman drinks at all and, if she drinks, her levels of alcohol consumption and problem drinking-our findings suggest that drinking is not a unidimensional construct. A woman's roles influence various dimensions of her drinking differently.

Adult↗
PubMed2003

Prevalence of prenatal drinking assessed at an urban public hospital and a suburban private hospital.

BACKGROUND: Although the prevalence of fetal alcohol syndrome (FAS) varies within the population, few data are available concerning variation in the prevalence of prenatal drinking. METHODS: Postpartum women delivering singleton infants at two Atlanta hospitals in 1993 or 1994 were interviewed. Those delivering infants who were small for gestational age (SGA) (n = 638) were over-sampled relative to those delivering infants with birth weights that were appropriate for gestational age (AGA) (n = 247). The prevalence of prenatal drinking was estimated as a weighted average of reports from mothers of SGA and AGA infants. Estimates of the prevalence of FAS come from the Metropolitan Atlanta Congenital Defects Program (MACDP) of the Centers for Disease Control and Prevention. RESULTS: The prevalence of first-trimester drinking was half that reported for the three previous months (private hospital: 72% vs. 35%; public hospital: 52% vs. 28%). Most women (85%) reported abstaining throughout the second trimester. Fewer than 10% of women delivering at the public hospital (7.5%), but one-quarter of those delivering at the private hospital, reported third-trimester drinking. Binge, moderate and heavy drinking in pregnancy were more common among women delivering at the public hospital. Eight infants born at the public hospital during this period, but none of those born at the private hospital, were identified as possibly having FAS; four of the eight were identified as probably having FAS. CONCLUSIONS: These results have implications for health education programs. For example, obstetricians in private practice may wish to reaffirm their advice to abstain from drinking in the third trimester. They also suggest that prenatal abstinence programs be targeted at populations identified as most likely to engage in risky drinking.

Alcohol Drinking↗
PubMed2001

Binge drinking in pregnancy--frequency and methodology.

Independent of average alcohol intake, the effect of binge drinking on adverse pregnancy outcomes in humans is only sporadically reported, but most studies in humans have found little or no effect of binge drinking on several adverse pregnancy outcomes. In a representative sample of 371 pregnant Danish women, the agreement between two different measures of binge drinking during the first half of pregnancy obtained from interviews and questionnaires was assessed, and the frequency and pattern of binge drinking were described. The percentage of agreement between the methods ranged between 81% and 86%. The proportion of women who reported binge drinking depended on the definition of pregnancy, but the proportion peaked in week 3 measured from the last menstrual period and thereafter declined to approximately 1 percent in week 7. On the basis of this 1998 study, it is suggested that most human studies on binge drinking in pregnancy may have failed to find any association because of methodological problems. It is suggested that future studies should take into account the number of binge episodes as well as the time of binge drinking. This information may easily be obtained from most pregnant women by asking two questions in interviews or questionnaires.

Adult↗
PubMed1994

Drinking pattern and blood pressure.

Large amounts of alcohol are known to increase blood pressure. There is little evidence about the effect of binge drinking of alcohol on blood pressure, although this is the dominant style of alcohol drinking in several countries. The purpose of the present study was to examine the relationship between binge drinking and blood pressure using daily heavy drinkers as a reference group. We examined 260 consecutive nonalcoholic 40- and 45-year-old men participating in a health screening. There were 37 teetotalers, 147 social drinkers, 62 weekend heavy drinkers attending the health screening 2 to 7 days after binge drinking, and 14 men who drank heavily every day. Group division was made using self-reported alcohol consumption and a structured alcohol questionnaire. Blood pressure was measured manually by a mercury manometer. BMDP statistical software was used in the statistical analysis of the material. The diastolic blood pressure of weekend heavy drinkers (mean intake during the weekend, 289 g) did not differ from that found in teetotalers but systolic blood pressure was slightly higher (5 mm Hg, P = .04). In contrast, daily heavy drinkers (mean intake during the weekend [Friday to Saturday], 151 g) had significantly higher systolic (8 mm Hg, P = .04) and diastolic (6 mm Hg, P = .05) blood pressure values than teetotalers. We conclude that different drinking habits seem to have different effects on blood pressure, those of daily heavy drinking being more prominent than those of weekend heavy drinking.

Adult↗
PubMedDate not supplied

The influence of habitual alcohol intake on breath-alcohol concentrations following prolonged drinking.

Fifty-one healthy men aged 20-35 years kept daily drinking diaries for 4 weeks prior to a 90-min drinking session of 1 ml of ethanol/kg body weight, taken as 4% alcohol by volume lager, at a constant rate, whilst fasting. This was followed by repeat breath-alcohol measurements for 90 min. Habitually light drinkers had significantly lower breath-alcohol levels than heavier drinkers up to 10 min post-drinking. Variation in breath-alcohol level was independent of habitual intake 15-90 min post-drinking. However, habitually light drinkers still had significantly lower blood-alcohol levels than heavy drinkers 30 min post-drinking. Group mean post-drinking breath-alcohol levels peaked at 20 min in light and moderate drinkers, at 10 min in heavy drinkers and at 5 min in very heavy drinkers. Wide individual variation in peak and rate of decline of breath-alcohol levels occurred independently of habitual intake and despite experimental control for factors influential on alcohol kinetics. Algorithms for alcohol intake and breath concentrations have limited application if drinking is prolonged. We suggest that preabsorptive metabolism and/or delayed absorption of alcohol may contribute to lower breath-alcohol levels in habitually light drinkers for 10 min following alcohol intake under the conditions of this study.

Adult↗
PubMedDate not supplied

Regret is what you get: the effects of manipulating anticipated affect and time perspective on risky single-occasion drinking.

This study tested anticipated affect as a potential strategy for reducing risky single-occasion drinking (RSOD). The hypothesis was that asking respondents to focus on their anticipated affect following RSOD would lead to higher ratings of negative affect than those obtained when asking respondents to focus on their feelings towards RSOD. In turn, these negative affect ratings were hypothesized as leading to safer behavioural estimates and reductions in RSOD. The study is based on a self-report questionnaire administered at two time points. At Time 1, measures of past drinking and demographic information were collected, along with affect ratings of drinking within safer single-occasion limits and affect ratings of RSOD (within-subjects condition). Time perspective was manipulated whereby the experimental group was asked to focus on affective reactions after RSOD and the control group to focus on affective reactions towards RSOD (between-subjects condition). Two weeks later, drinking behaviour was measured. The findings showed that the time perspective manipulation resulted in significantly higher negative affect ratings in the feeling after condition than in the feeling towards condition. Further, females reported lower negative affect than males. No other main or interaction effects were found. The time perspective manipulation, however, failed to produce safer behavioural estimates and RSOD reduction at follow-up. No significant differences were found between ratings of negative affect when drinking within safe limits as compared with ratings of affect when drinking above such limits. Despite greater negative affect 'after' rather than 'toward' the target behaviour, anticipated affect following RSOD did not yield safer behavioural estimates and subsequent drinking reduction at follow-up. These findings are interpreted in the context of risk perception associated with RSOD. The implications of this study for design of interventions aimed at reducing RSOD are discussed. In particular, ways of intensifying negative affect for RSOD are considered.

Adult↗
PubMedDate not supplied

Predictors of alcohol intake and heavy drinking in early adulthood: a 5-year follow-up of 15-19-year-old Finnish adolescents.

Relative contributions of earlier drinking and smoking vs mental health risk factors in predicting alcohol intake and heavy drinking in young adulthood were assessed. Higher average alcohol intake and heavy drinking (13 or more drinks on one occasion) in 1995 were significantly related to male gender and earlier high scores in 1990 of relief smoking, relief drinking, and their interaction. Parental alcohol problems, social group, perceived degree of social support, trait anxiety, number of negative life events, self-esteem, grade-point average, somatic symptoms score, or immature, neurotic, or mature defence style measured in 1990 did not predict alcohol intake or heavy drinking 5 years later. The findings suggest that alcohol intake and heavy drinking in young adulthood can be predicted by earlier self-reports on relief smoking and alcohol intake in adolescence.

Adolescent↗
PubMedDate not supplied

The role of anxiety in predicting drinking behaviour.

AIMS: We investigated whether reduced anxiety predicted improved drinking outcomes over and above age of onset and ondansetron treatment among alcoholics enrolled in a clinical trial. METHODS: Study design was a 2 (early onset alcoholics versus late onset alcoholics) x 4 (placebo and ondansetron 1, 4 and 16 micro g/kg twice daily) factorial randomized clinical trial during which all participants received weekly group cognitive behavioural therapy. Using weighted least squares regression, we examined the effects of ondansetron dose, age of onset, pre-treatment drinking and anxiety level (measured by Profile of Mood States) on end-state drinking behaviour. Our previous studies have demonstrated that ondansetron dose, age of onset and pre-treatment drinking influence end-state drinking behaviour. RESULTS: and conclusions: The present study added to our previous knowledge, indicating that when change in anxiety level was included as a predictor of end-state drinking, it also accounted for a significant proportion of the variance. Those who experienced decreases in anxiety during the treatment reported fewer drinks per day at their last visit compared with those who reported increases in anxiety.

Adult↗
PubMed2005

Should we consider an acceptable drinking level specifically for postmenopausal women? Preliminary findings from the postmenopausal health disparities study.

AIMS: There are substantial neuroendocrine differences between postmenopausal (PMP) women and women with cyclic ovarian function; thus there are differences in hormonal responses to 'acceptable' levels of drinking, i.e. 7 total weekly drinks (TWD). The aim is to evaluate whether alcoholic beverage consumption for PMP women should be the same for all women, as is currently the case, or different from that for women with cyclic ovarian function. METHODS: Carefully collected and cross-checked current drinking data in 318 PMP women from a spectrum of racial and ethnic groups have been analysed to determine if a plateau in estradiol (E2) levels at a particular alcohol consumption level other than 7 TWD can be identified as the drinking level above which no additional benefit in E2 levels occurs. RESULTS: Levels of E2 are significantly different among abstainers and among drinkers within all racial and ethnic groups, with the disturbing exception of black PMP women. Although there are significant differences among racial and ethnic groups in the proportions of women who drink, there are no differences in TWD consumed during the previous month. Between < or =5 TWD and < or =6 TWD, a plateau in the correlation of E2 with increasing drinks/week occurs, and the range of the unstandardized multiple regression coefficient +/- the standard error do not overlap between these same two drinking levels (P < 0.05). CONCLUSIONS: Consideration should be given to lowering the acceptable level of drinking for PMP women 5 TWD. Additional studies in which sample sizes for each minority racial and ethnic are larger need to be performed in the future.

Adult↗