February 16, 2000
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H eart disease is a big problems for women
( O M H I B U tU S I O m
Heart Disease, not cancer, is the
leading killer o f women in the U.S.
“Most women do not experience heart
d ise a se u n til a fte r m e n o p au se
b ecau se the ho rm o n e estro g en
protects them up until that point,”
said Dr. Rebecca Reeves at The
DeBakey Heart Center at Baylor
College o f Medicine in Houston.
“Following menopause, estrogen
levels change. This is why many
doctors encourage women to go on
horm o n e rep lacem en t th erap y .”
S om e o f th e risk factors for heart
disease in w o m en in clu d e obesity,
high blood pressure, high cholesterol,
sm oking, a lack o f exercise, and a poor
diet. E ating a b lan ch e d d iet w h ere
less than 30 p ercen t o f ca lo rie s co m e
from fat is v ery im portant.
F eb ru ary is N atio n al H eart M onth,
o f e ar in fectio n in ch ild ren .
T he P ortland O bserve «
Kaiser Perm anente physicians
Robert Shneidman, MD, and Sean
Jones, MD, have received the
Distinguished Physician Award
from the HM O” 660-physician
group.
First given in 1979, this annual
aw ard h o n o rs p h y sician s for
quality o f service to patients,
excellence in clinical practice,
contributions to both the HMO
and the com m unity, personal
achievem ents and relationship
with peers.
Dr. Shneidman is board certified
in gastroenterology and internal
m e d ic in e
and
p ra c tic e s
g a stro e n te ro lo g y at K a ise r
Permanente’s Interstate Medical
Office South. He earned his medical
degree from the University ofTexas
Medical School in Houston. Dr.
Shneidman is the clinical assistant
professor at OHSU and is active in
the c lin ic a l g astro en tero lo g y
fellowship also at OHSU. He has
been involved in a two-year study
o f Helicobactor pylori, a bacteria
that causes stomach ulcers. Dr.
Shneidman is also involved in
anemia research.
Dr. Jones is a board-certified
internist practicing at the Interstate
Medical Office East. He received
his m edical degree from Yale
University School ofMedicine. Dr.
Jo n e s w o rk ed as th e c lin ic
coordinator for internal medicine
residents rotating in the Interstate
campus. He worked on writing and
d isse m in a tin g
d e p re ssio n
g u id e lin e s fo r p rim a ry care
physicians.
Underage drinking is strong
predictor of alcoholism, alcohol abuse
The National Institute on Alcohol Abuse
and A lcoholism (N IA A A ) now has hard
evidence to support what many prevention
specialists and parents have long assumed:
Youthful experim entation with alcohol is
not a benign rite o f passage. It is a risk-
filled practice that can have d isastro u s
results. The earlier a young person drinks
alcohol, the m ore likely he o r she is to
develop a clinically defined alcohol dis­
order at som e point in life.
A $ 1 2 -m illio n stu d y by N IA A A ,
released last January, offers scientific val­
id atio n th at y o u n g p eo p le w ho b egan
drinking before age 15 are four times more
likely to dev elo p alcoholism than those
w ho began drinking at age 21. M ore than
4 0 p e rc e n t o f resp o n d en ts w ho b eg an
drin k in g befo re age 15 w ere classified
w ith alcohol dependence at som e tim e in
th eir lives com pared w ith 24.5 percent
for respondents w ho began drin k in g at
age 17 and about 10 percent for those who
began drinking at age 21 and 22.
T he study also found that the risk o f
developing alcohol abuse (a m aladaptive
drin k in g pattern that repeatedly causes
life p ro b lem s) m o re th an d o u b le d for
persons w ho began drinking before age
15 compared with those who began drink­
ing at age 21.
T h e stu d y , w h ic h sa m p le d 4 3 ,0 0 0
people, documents that the risk for alcohol
dependence and alcohol abuse decreases
11m i free
----------HAZELDEN-----------
s te a d ily an d s ig n ific a n tly w ith e ach
increasing year o f age o f drinking onset.
T h e N IA A A stu d y has b e c o m e an
im portant teaching tool for people such
as Kay Provine, a prevention specialist at
H azelden and codeveloper o f a popular
parenting skills program called Roots and
W ings. “A s soon as the study cam e out, I
m ade a bar graph to show the correlation
betw een early drinking and alcoholism ,"
said Provine. “It is so effective for parents
to see something this concrete. Every year
you can delay kids from using alcohol
you are buying them time to develop phys­
ically, em otionally, spiritually and psy­
chologically.”
Parents often don 't think their kids listen
to th em , said P ro v in e. B ut th e annual
Minnesota Student Survey o f 9th and 12th
g ra d e rs co n d u c te d fo r the M in n e so ta
D ep artm en t o f C h ild ren , F am ilies and
Learning, consistently shows that young
people are listening. “Parental objection is
the second m ost im portant reason kids
give for not using alcohol,” said Provine.
(The first is “don’t ¡jke the taste.”) “Young
people are beginning to drink earlier and
earlier now— some as young as 9 or 10.
And drinking for them is about intoxica­
tion, about getting drunk. Each o f these
facts spells trouble. Parents can consider
it a victory o f sorts if they can see that
their kids delay onset o f use, whether it is
a m atter o f months or years. Every day
our youth choose not to use improves their
chances o f not developing alcohol use
problem s.”
Provine and other prevention special­
ists know that the most effective preven­
tion programs are ongoing, consistent and
involve all aspects of a child’s life: home,
school and community. O ne program that
has been proven to be effective is Project
N orthland, a com m unity-based preven­
tion program designed to delay the onset
o f alcohol use, reduce alco h o l use for
young people w ho have alread y tried
drinking, and limit the number o f alcohol-
related problems o f young people. Project
N o rth lan d began at th e U n iv e rsity o f
M in n e so ta in 1990 as a p re v e n tio n
research program funded by the NIAAA.
It is the largest random ized com m unity
trial ever conducted for the prevention of
adolescent alcohol use.
Project Northland, designed to be imple­
mented over a three-year period during
grades 6-8, involves students, parents,
teachers and the com m unity at large. The
p re v e n tio n c u rric u lu m , p u b lish e d by
H azelden, uses com ic book characters to
help young people talk with their parents
about alcohol (sixth grade), deal with peer
pressures to use alcohol (seventh grade),
and develop com m unityw ide changes in
alco h o l-related program s and policies
(eighth grade).
A m o n g 2 ,4 0 0 s tu d e n ts fo llo w e d in
northeastern Minnesota, monthly drinking
was 20 percent lower and weekly drinking
w as 30 percent low er for students w ho
engaged in Project N orthland activities
com pared with students in control groups
w ho did not.
"Parents have to let their kids know that
u n d erag e d rin k in g is not o kay,” said
Provine. ‘T hey need to talk about family
standards and expectations and talk about
them again and again. Hopefully, they’ll
wait to experiment with alcohol. It might not
stop the train, but it will put the brakes on.”
F o r in fo rm a tio n a b o u t P ro je c t
Northland, contact Hazelden Publishing at
(800) 328-0098.
Alive & Free is a chemical health column
provided by Hazelden, a nonprofit agency
that provides a wide range o f information and
services relating to alcohol and drug depen­
dence. Address questions to Alive & Free
Editor, B C 10, P.O. Box 11, Center City, MN
55012-0011. For more resources on substance
abuse, call Hazelden at (800) 257-7800 or
check its web site at www.hazelden.org.
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