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Thinking of trying Dry January? Steps for success

Let’s file this under unsurprising news: many American adults report drinking more since the pandemic began in March 2020, according to a survey on alcohol use in the time of COVID-19. If you’re among them, you might want to start 2022 on a healthy note by joining the millions who abstain from alcohol during Dry January. Your heart, liver, memory, and more could be the better for it.

What did this survey find?

The researchers asked 832 individuals across the US about their alcohol intake over a typical 30-day period. Participants reported drinking alcohol on 12.2 days and consuming almost 27 alcoholic drinks during that time. More than one-third reported engaging in binge drinking (consuming five or more drinks for men and four or more drinks for women in about two hours).

Moreover, nearly two-thirds of the participants said their drinking had increased compared to their consumption rates before COVID. Their reasons? Higher stress, more alcohol availability, and boredom.

But we can’t blame COVID entirely for the recent rise in alcohol consumption. Even before the pandemic, alcohol use among older adults had been trending upward.

Why try Dry January?

If you recognize your own behavior in this survey and wish to cut down on your alcohol intake, or simply want to begin the new year with a clean slate, join in the Dry January challenge by choosing not to drink beer, wine, or spirits for one month. Dry January began in 2012 as a public health initiative from Alcohol Change UK, a British charity. Now millions take part in this health challenge every year.

While drinking a moderate amount of alcohol is associated with health benefits for some people in observational studies, heavier drinking and long-term drinking can increase physical and mental problems, especially among older adults. Heart and liver damage, a higher cancer risk, a weakened immune system, memory issues, and mood disorders are common issues.

Yet, cutting out alcohol for even a month can make a noticeable difference in your health. Regular drinkers who abstained from alcohol for 30 days slept better, had more energy, and lost weight, according to a study in BMJ Open. They also lowered their blood pressure and cholesterol levels and reduced cancer-related proteins in their blood.

Tips for a successful Dry January

A month may seem like a long time, but most people can be successful. Still, you may need assistance to stay dry in January. Here are some tips:

  • Find a substitute non-alcoholic drink. For social situations, or when you crave a cocktail after a long day, reach for alcohol-free beverages like sparkling water, soda, or virgin beverages (non-alcoholic versions of alcoholic drinks.)

    Non-alcoholic beer or wine also is an option, but some brands still contain up to 0.5% alcohol by volume, so check the label. "Sugar is often added to these beverages to improve the taste, so try to choose ones that are low in sugar," says Dawn Sugarman, a research psychologist at Harvard-affiliated McLean Hospital in the division of alcohol, drugs, and addiction.

  • Avoid temptations. Keep alcohol out of your house. When you are invited to someone’s home, bring your non-alcoholic drinks with you.
  • Create a support group. Let friends and family know about your intentions and encourage them to keep you accountable. Better yet, enlist someone to do the challenge with you.
  • Use the Try Dry app. This free app helps you track your drinking, set personal goals, and offers motivational information like calories and money saved from not drinking. It’s aimed at cutting back on or cutting out alcohol, depending on your choices.
  • Don’t give up. If you slip up, don't feel guilty. Just begin again the next day.

Check your feelings

Sugarman recommends people also use Dry January to reflect on their drinking habits. It’s common for people to lose their alcohol cravings and realize drinking need not occupy such an ample space in their lives. If this is you, consider continuing for another 30 days, or just embrace your new attitude toward drinking where it’s an occasional indulgence.

If you struggle during the month, or give up after a week or so, you may need extra help cutting back. An excellent resource is the Rethinking Drinking site created by the National Institute on Alcohol Abuse and Alcoholism (NIAAA). For the record, NIAAA recommends limiting alcohol to two daily drinks or less for men and no more than one drink a day for women.

Be aware of problems that might crop up

Dry January can reveal potential alcohol problems, including symptoms of alcohol withdrawal ranging from mild to serious, depending on how much you usually drink. Mild symptoms include anxiety, shaky hands, headache, nausea, vomiting, sweating, and insomnia. Severe symptoms often kick in within two or three days after you stop drinking. They can include hallucinations, delirium, racing heart rate, and fever. "If you suffer alcohol withdrawal symptoms at any time, you should seek immediate medical help," says Sugarman.

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Can ALS be caused by traumatic brain injury?

ALS, Amyotrophic Lateral Sclerosis acronym spelled out on sticky notes with stethoscope next to it.

Amyotrophic lateral sclerosis (ALS, or Lou Gehrig’s disease) is a neurologic disease that damages nerve cells in the spinal cord and brain, causing widespread muscle wasting and weakness. It strikes without warning, usually beginning between the ages of 55 and 75. As it worsens, ALS disables a person’s ability to move, speak, eat, or breathe. Although two FDA-approved medications can modestly slow its progress, death generally occurs within three to five years of diagnosis.

Decades of research have failed to come up with a definite cause. However, one new study supports a link between playing professional football and ALS.

Why is ALS called Lou Gehrig’s disease?

Since it was first described in the 19th century, much about ALS has remained mysterious. It’s quite rare, affecting about two in 100,000 people. It might have remained a disease you’d never heard of if not for Lou Gehrig, the Hall-of-Fame baseball player who played for the New York Yankees in the 1920s and 1930s. He developed ALS at age 36 and died of the disease two years later. Since then, ALS has often been called Lou Gehrig’s disease.

In recent years, widespread social media campaigns, such as the Ice Bucket Challenge, have raised awareness and funding for ALS research.

Searching for a cause of ALS

Some research suggests that risk factors for ALS include:

  • Genetics: Genes passed down through families contribute to about one in 10 cases
  • Smoking: In one study, the heaviest smokers had a 26% higher risk of developing ALS compared with those who had never smoked
  • Pesticide exposure, such as pesticides used on crops
  • Unusual infections with certain bacteria or viruses
  • Bodily injury severe enough to impair activities of daily living
  • High levels of physical exertion, as is common for elite athletes or members of the military
  • Head trauma, including concussions and repeated, less severe head injuries. While chronic traumatic encephalopathy (CTE) has been closely tied to head injuries, the role these injuries play in developing ALS is less certain.

New research links playing professional football with ALS

A new study published in JAMA Network Open might help us better understand the cause of at least some cases of ALS. It strongly suggests that playing professional football may be a risk factor for the disease.

  • Between 1960 and 2019, 19,423 men played in the National Football League (NFL). During that time period, 38 were diagnosed with ALS and 28 died of the disease.
  • Among these current and former football players, the risk of developing ALS and dying of the disease was nearly four times higher than that of men in the general population.
  • NFL players who developed ALS had a longer average football career (seven years) than those without the disease (4.5 years).
  • Many NFL players were in their mid-30s at the time of their ALS diagnosis. This is quite a bit younger than is typical for ALS.

Importantly, this study did not assess why there might be a relationship between ALS and playing professional football. The study authors speculate that traumatic brain injury might be to blame.

How certain are these findings?

This was an observational study. Observational research can identify a link between a possible risk factor (in this case, playing in the NFL) and a disease (ALS). However, it cannot prove that the risk factor caused the disease.

For studies like this, it’s always possible that a confounder — a factor not studied or accounted for — might explain the connection. For example, this study did not collect information about head injuries, pesticide exposure, smoking, or family history. This means it can’t provide insight into whether these factors played a role in ALS risk.

In addition, the study identified diagnoses of ALS among NFL players only through Google News reports and obituaries. The diagnoses weren’t confirmed by a review of the players’ medical records. Therefore, cases of ALS could have been missed or misdiagnosed.

It’s also possible that the study missed cases of ALS among less famous players whose health news or deaths might be overlooked by the media. To account for this, the researchers logged indicators of NFL fame (including selection to the NFL Pro Bowl and Hall of Fame). They found no difference in ALS risk among more famous and less famous players.

The bottom line

Public health experts and researchers are trying to sort out which sports harm brain health, and to recommend ways to protect against brain injuries. Expert recommendations for contact sports have evolved to include protective equipment, changes in game rules, limiting participation by younger players, and discouraging participation after a head injury until recovery is complete.

As noted, studies have strongly linked brain injury from concussions and repetitive head injuries. This latest study suggests some cases of ALS may also be caused by brain trauma.

Lou Gehrig reportedly had multiple concussions over the course of his sports career. Regardless of whether he actually had Lou Gehrig’s disease or CTE with features of ALS, this new research raises the possibility that his demise might have been due to traumatic brain injury. And that should serve as a reminder that even as we cheer on those with inspiring athletic talent and win-at-all-costs determination, protecting the health of sports participants should be even more important.

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Are poinsettias, mistletoe, or holly plants dangerous?

Last winter, my wife shooed the dog and visiting toddlers away from our poinsettia plants, saying "they’re poisonous, you know."

I did not know. But it turns out that the belief that poinsettias are deadly is widespread. The same could be said for mistletoe and holly. But are their reputations for danger well-deserved? Since these plants are especially popular to brighten up homes or give as gifts during the holidays, I decided to look into it.

The risks of poinsettia

Could a plant so common and so well-liked in the winter holidays also be so dangerous? If it is dangerous, what problems does it cause? Must it be eaten to cause problems, or is it harmful to just be nearby? And if it’s not dangerous, why does the myth live on?

The answers to these questions are not easy to find. In fact, the bad reputation may have started in 1919, when an army officer’s child reportedly died after eating part of a poinsettia plant. It is unclear if the plant was responsible, though: many other reports describe mild symptoms, such as nausea or vomiting, but no deaths.

Decades ago, a study in the American Journal of Emergency Medicine analyzed nearly 23,000 cases of people eating poinsettia and found

  • no fatalities
  • nearly all cases (96%) required no treatment outside the home
  • most cases (92%) developed no symptoms at all.

According to one estimate, a 50-pound child would have to eat more than 500 poinsettia leaves to approach a dose that could cause trouble. Similarly, pets may develop gastrointestinal symptoms after eating poinsettia, but these plants pose no major threat to animals.

The risks of mistletoe

The story is much the same for mistletoe. It’s not particularly dangerous, but may cause an upset stomach if eaten. In fact, mistletoe has been used for centuries as a remedy for arthritis, high blood pressure, infertility, and headache. The evidence isn’t high-quality for any of these uses, though.

Interest also centers on this plant’s potential as an anticancer treatment. Some extracts of mistletoe contain chemicals shown to kill cancer cells in the laboratory and to stimulate human immune cells. For example, a substance called alkaloids has similar properties as certain chemotherapy drugs used in the past to fight leukemia and other forms of cancer. However, a two-part 2019 review found that adding mistletoe extracts to conventional cancer treatments did not improve survival or quality of life.

No one suggests it's a good idea to eat this plant, accidentally or otherwise. But eating one to three berries or one or two leaves is unlikely to cause serious illness, according to the authors of a 1986 review of multiple studies. And no significant symptoms or deaths were described in one report of more than 300 cases of eating mistletoe. However, some sources warn that serious problems or even death may occur if enough is ingested. The specific dose required to cause death is unknown but, fortunately, it appears to be so high that consuming enough to be lethal is extremely rare.

The risks of holly

This plant can be dangerous to people and pets. The berries of holly plants are poisonous. If eaten, they may cause crampy abdominal pain, drowsiness, vomiting, and diarrhea. While no one would recommend eating holly, it is unlikely to cause death. And for at least one type of holly, knowing the Latin name would be enough to discourage ingestion: the yaupon holly is also called Ilex vomitoria.

The bottom line

No one should eat poinsettias, mistletoe, and holly, but if small amounts are consumed, they are unlikely to cause serious illness. It seems to me that the dangers of these plants appear to be vastly overestimated.

Perhaps the most dangerous thing about mistletoe and poinsettias is the choking hazard the berries pose for young kids, although that risk is not unique to plants: any small object poses similar risks. Try to keep holiday plants out of the reach of small children and pets. And keep in mind that berries may fall from these plants and wind up on the floor.

If a child or pet eats leaves or berries from these holiday plants, or any other plants, check in with poison control, your pediatrician, or your veterinarian. But unless a particularly large "dose" is consumed, don’t be surprised if the recommendation is to simply watch and wait.

Still concerned even if you know the risks are low? You can always regift holiday plants you receive to friends with no children or pets, or find other ways to decorate your home for the holidays.