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Disturbing New Findings on Underage Binge Drinking

Underage drinking is among our most serious public health problems. Three out of four high school seniors and two of every five eighth graders have consumed alcohol.

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And when kids drink, they tend to drink heavily. Eleven percent of eighth graders and 29 percent of 12th graders have engaged in binge drinking within the past two weeks, according to the National Institute on Alcohol Abuse and Alcoholism.

The institute defines binge drinking as drinking enough to reach a blood alcohol concentration of 0.08 percent -- the legal limit for driving. This translates to roughly four or more drinks for a female or five or more drinks for a male during a two-hour period. Heavy binge drinkers can consume 10 to 15 drinks. Binge drinking typically begins around age 13 and peaks between 18 and 22, before gradually decreasing.

Each year, about 5,000 youths under age 21 die as a result of underage drinking, including 1,900 on the highways, 1,600 in homicides, 300 in suicides and hundreds in falls, burns, drownings, etc.

The more researchers study the effects of underage drinking, the more we are learning about the long-term health hazards. Underage drinking can have subtle effects on brains that are still developing, possibly affecting long-term thinking and memory skills. Underage drinking also can cause liver damage, especially among drinkers who are overweight.

Recently, my colleagues in Loyola's Stritch School of Medicine reported another potential health hazard: It appears binge-drinking teenagers may be putting themselves at risk for future osteoporosis and bone fractures.

A study by bone biologist John Callaci, PhD. in the July-August issue of the journal Alcohol and Alcoholism has found long-lasting disruptions in hundreds of genes involved in bone formation in rats.

"Lifestyle-related damage done to the skeleton during young adulthood may have repercussions lasting decades," Dr. Callaci and colleagues wrote.

Dr. Callaci cautioned that data from animals don't directly translate to people. But he believes the findings certainly suggest that this could be a problem with humans.

Bone mass is lost throughout adult life as part of the aging process. Thus, anything that inhibits the build up of bone mass during the critical years of adolescence and young adulthood could increase the risk of osteoporosis and fractures in later life.

A 2008 study by Dr. Callaci and colleagues found that adolescent rats exposed to alcohol in amounts comparable to that of binge drinkers had 15 percent less bone build-up than control rats exposed to saline solution.

The new study examined the effects of binge drinking on genes. Rats received injections of alcohol that resulted in a blood alcohol concentration of 0.28. (By comparison, a motorist with a blood alcohol concentration higher than 0.08 is legally drunk.) Rats were exposed to binge amounts of alcohol on either three consecutive days (acute binge) or three consecutive days for four weeks in a row (chronic binge). They were compared to control rats who received saline.

The researchers found that about 300 bone-related genes were disrupted in rats exposed to acute binge drinking and 180 bone-related genes were disrupted in rats exposed to chronic binge drinking. In the affected genes, alcohol either increased or decreased the amount of associated RNA. (RNA serves as the template for making proteins, the building blocks of bones and other tissue.) This change in how genes are expressed disrupted molecular pathways responsible for normal bone metabolism and maintenance of bone mass.
In one of the most disturbing findings, the researchers found that the gene disruption was long-lasting. Even after 30 days of sobriety, the genes still were being expressed differently. (Thirty days in a rat's lifespan is roughly equivalent to about three years in a human lifespan.)
The findings might help in the development of new drugs to minimize bone loss in alcohol abusers and in other people who are at risk for osteoporosis for other reasons.

Dr. Callaci believes that if we understand the mechanism of bone loss, eventually we will be able to figure out how to fix it.

But Dr. Callaci also is quick to point out that the best way to prevent alcohol-induced bone loss is to drink moderately or not at all.



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