If you consumed five or more standard measures of alcoholic drinks (4 or more for females) in a single sitting within the last 30 days, you are a binge drinker. According to the World Health Organization (WHO), alcohol causes 2.3 million premature deaths worldwide each year. This accounts for 3.7 % of global mortality. After tobacco and high blood pressure, drinking is the third-leading health risk factor in the development of cardiovascular diseases, cirrhosis of the liver and cancers for people living in industrial countries.

Since 1995, European surveys have shown an increasing number of binge drinkers among 15 -16 years old youths. In 2006 approximately 80 million Europeans aged 15 plus participated in binge drinking. Every year 2000 homicides in the European Union are related to heavy drinking (Adicciones 2007; 19: 33 – 339). In England, the number of people admitted to hospitals with alcohol-related illnesses has doubled in the last decade. In USA, alcohol-related motor vehicle accidents kill approximately 17,000 people annually and cost the country $51 billion in the year 2000.

A study from University College London looked at the drinking behaviour of 178 university students (Alcohol 2008 Apr 29, epub). The study showed that 39.6% of males and 35.9% of females reported binge drinking. The frequency of drinking and the drinking behaviour of friends predicted the intention to drink and binge drinking, respectively. Binge drinkers were influenced by their peers and social-situational factors. The pressure to drink was greater for male students. The size of the drinking group, ‘special offer’ prices and availability of alcohol influenced the drinking behaviour of the students. A recent study by the Centers for Disease Control and Prevention examined the drinking patterns of alcohol-impaired (AI) drivers in the United States (Alcohol Clin Exp Res 2008; 32: 639 – 644). The study found that 5% of drinkers had been engaged in AI driving during the preceding 30 days. Overall, 84% of AI drivers were binge drinkers and 88% of AI driving episodes involved binge drinkers. Researchers from the University of Southern Denmark studied 89,201 women who were enrolled in the Danish National Birth Cohort to see whether the frequency and timing of binge drinking episodes during the first 16 weeks of pregnancy would increase the risk of fetal death (Obstet Gynecol 2008; 111: 602 – 609). The study showed that neither the frequency nor the timing of the binge episodes was related to the risk of early or late spontaneous abortion. However, women who had had 3 or more binge episodes were 56% more likely to have stillbirth when compared to non-binge drinkers. In women with an average intake of 3 or more drinks per week and 2 or more binge drinking episodes, their risk of having a stillbirth was 220% higher.

Binge drinking is not confined to industrialized countries. It is a problem in developing countries as well. A study from Hanoi Medical University reported that weekly and daily binge drinking among men was 5.7% and 3.6%, respectively (Subst Use Misuse 2008; 43: 481 – 495). However, binge drinking among women was virtually non-existent. Binge drinking is not confined to young people either. A study of Brazilian men who are 60 or older living in the metropolitan areas of Belo Horizonte and Bambui City in Southeast Brazil, found that the prevalence of binge drinking was 27% and 13.7%, respectively (Rev Bras Psiquiatr 2008 Apr 28, epub).

Binge drinking is a worldwide problem. Apart from the health problems, harmful drinking is also linked to suicides, crime, violence, unemployment and absenteeism. It is no wonder that WHO has recently announced that it is going to draw up a global strategy to tackle youth binge drinking and other forms of harmful alcohol consumption. However, the blueprint is only going to be presented in two years time. Why wait? Parents can start now by educating their young children about the ill effects of alcohol.

Smoking is a common social habit especially in the developing countries. Previous studies have shown that the overall risk of dying among smokers is 87% higher than someone who never smoked. This risk is reduced to 29% for those who were former smokers. Despite the evidence that not smoking at all or giving up smoking is beneficial, many still smoke.

A recent Harvard study examined the relationship between cigarette smoking and smoking cessation on total and cause-specific mortality in women (JAMA 2008; 299: 2037 . 2047). A total of 104,519 women participating in the Nurses. Health Study were followed up from 1980 to 2004. When compared to non-smokers, current smokers are 7.25 times more likely to get smoking-related cancers and have a 58% increased risk of getting other cancers. In the case of colorectal cancer, smokers are 63% more likely to develop this cancer compared to non-smokers. This risk drops to 23% in former smokers. Compared to non-smokers, current smokers have an excess rate of 181% of dying from any causes. Current smokers have a higher risk of death associated with cancers of the bladder, cervix, esophagus, lip & mouth, pharynx, pancreas and stomach. The study also found that earlier initiation of smoking in life was associated with a higher risk of death, especially those related to lung disease and cancer. Women who started smoking before 15 years of age experienced the highest risk of mortality.

Approximately 64% of deaths in smokers were attributable to smoking. In former smokers, only 28% of deaths were attributable to smoking. Within 5 years of stopping, the risk of dying from all causes was decreased by 13%. After quitting for 20 years, the risk of death became comparable to those of non-smokers. Compared to other mortality risks, the risk of vascular disease death following smoking cessation declined more rapidly. Sixty one percent of the full potential benefit for coronary heart disease mortality was seen in the first 5 years of quitting smoking.

Although the study only examined the ill-effects of smoking in women, one would expect similar findings for men as well. While smoking may be considered as a cheap form of life.s pleasure, the subsequent price to pay for this enjoyment is indeed very high.

Peanut allergy is a significant problem for some people. It is especially so if you live in Asia or you are travelling through Asia. My nephew, who has a history of severe peanut allergy, found it difficult to find ‘safe’ hawker food (without peanut contamination) when he was backpacking through Thailand, Vietnam, Malaysia, Singapore and China. In the last 15 years, peanut allergy has been diagnosed in increasing numbers of children.

Peanut allergy affects approximately 1% of children under the age of 5 years. Food allergy affects 6 – 8% of children younger than 4 years and about 4% of the US population older than 10 years. While any food can potentially cause allergy, the common ones in children and adults include peanuts, tree nuts, fish and shellfish. Milk, eggs, wheat and soy are also common allergens for children. In Western Europe and the USA, food allergy is the leading cause of anaphylaxis treated in hospital emergency departments. Each year in the USA, food allergy accounts for about 30,000 anaphylactic reactions, 2000 hospital admissions and 200 deaths.

The increasing numbers of cases of peanut allergy worldwide has been well documented. In a population-based study of 3-year olds in UK, the prevalence of peanut sensitization rose from 1.3% to 3.2% between 1989 and 1995. In the USA, the rate of peanut allergy in young children increased from 0.4% to 0.8% between 1997 and 2002. In Canadian children, the estimated prevalence of peanut allergy was 1.34%. Even though peanut consumption levels in the USA and China are similar, it has long been thought that peanut allergy rate in China was much lower. However, recent data suggest that this is not the case.

The symptoms of peanut allergy develop within seconds but can occur up to 2 hours after eating peanuts. The allergic response can occur even after ingesting a few milligrams of peanut protein. (One peanut has about 300 mg of protein.) Allergic symptoms are normally not triggered by skin or air contact with the peanut protein. After ingesting the peanut protein, the symptoms are related to the skin, gastrointestinal (GI) and respiratory tracts. Skin symptoms include rash or angioedema. The GI symptoms include acute vomiting, abdominal pain or diarrhoea or both. The important chest symptoms are laryngeal oedema (swelling), repetitive coughing, voice changes and wheezing. When the allergic response is severe, the cardiovascular system is also involved and the symptoms include hypotension and dysrhythmia (abnormal heart rhythm). In one third of patients with fatal or near fatal anaphylactic reactions to peanut, there is a biphasic response. Initially, they get better and then a bit later (up to 4 hours later), they get a secondary late-phase allergic response.

Although you can test for peanut-specific IgE in the blood to diagnose peanut allergy, the most important method to diagnose peanut allergy is obtaining a good medical history indicating a temporal association between eating peanuts and the appearance of symptoms within seconds or minutes, but this can be up to 2 hours later. The treatment for anyone with peanut allergy is avoidance of ingesting peanut protein. In the event of an allergic reaction, the patient and family must be very well informed about the exact management plan. Treatment includes the use of antihistamines, epinephrine injections and steroids. At the present time there is no available immunotherapy for peanut allergy. Therefore, you can not desensitize someone in order to treat the peanut allergy.

If you want to read a more detailed paper on peanut allergy, go and have a look at the paper written by Professor Wesley Burks in the Lancet (2008; 371:1538 – 1546). Most informative, indeed.