Fetal alcohol syndrome

Fetal alcohol syndrome is caused when alcohol consumed by the mother crosses the placental barrier into the fetus.  This causes the fetus’s blood alcohol levels to rise approximately to the level of the mother’s; however, some babies of mothers who drink are born normal (Nadakavukaren, 2011).   Health care professionals are not sure why this happens, but they do know there is a direct link between drinking alcohol while pregnant and fetal alcohol syndrome.  As fetal alcohol syndrome affects 1-3 out of every 1000 pregnancies, it is the top known leading cause of intellectual disabilities (Nadakavukaren, 2011). 

Diagnostic criteria have remained fairly broad and include selected facial malformations, central nervous system abnormalities, and mental retardation (CDC, 2004).  A fourth diagnostic criterion is the mother’s alcohol consumption during pregnancy.  As these criteria may differ from child to child in severity, it is sometimes difficult for the health care provider to diagnose fetal alcohol syndrome.  Also, some of the criteria may have other causes; for example, ADHD may be triggered by a food allergy or short stature may be genetic.  Diagnosis will remain difficult until there is a standard set of criteria for fetal alcohol syndrome.

Fetal alcohol syndrome is different from other birth defects in that it is directly related to the alcohol consumed by the mother during pregnancy.  No level of alcohol is deemed safe for women who are planning a pregnancy or who are already pregnant as any level of alcohol can cause fetal alcohol syndrome to one degree or another (Nadakavukaren, 2011).  In 1989, labels on alcoholic beverages began listing a warning to pregnant women.  Even though the dangers are known, approximately one in eight women admit to drinking during pregnancy, which means the warnings are not being taken seriously (Nadakavukaren, 2011).

The effects of fetal alcohol syndrome are irreversible; this is a life-long condition.  However, it is avoidable if the mother abstains from alcohol during pregnancy.  Also, the effects will vary in degree and type depending on when the mother is drinking alcohol, and even as little as one drink could cause some degree of fetal alcohol syndrome.  For this reason, it is important that women who may become pregnant abstain from drinking alcohol as well.

A public health official who wishes to reduce the incidences of fetal alcohol syndrome could begin by educating women that even one drink is dangerous.   Many women are under the assumption that one or two drinks will not harm the fetus; however, findings show that any amount of alcohol could be dangerous.  This needs to become common knowledge for women who are pregnant or who may become pregnant, and it needs to be given the same urgency as bug spray or toxic household cleaners. 

There are very few advertisements in print or on television that outline the dangers of alcohol on a developing fetus.  Most of the information is given by health care providers who may not be fully educated on the subject (CDC, 2004).  While these health care providers are becoming more educated as more information on the subject is discovered, there are still many misconceptions about alcohol and pregnancy.  Most pregnant women understand that they are to be out of the house when the exterminator is around or that they should not be changing the kitty litter during the pregnancy, but many of these same women will have a glass of wine with supper without thinking about the risk to the fetus.  Perhaps if there were a more public campaign on the dangers of even one drink while pregnant, fewer pregnant women would drink.

CDC (2004)  Fetal Alcohol Syndrome:  Guidelines for Referral and Diagnosis.  Retrieved on May 9, 2013, from http://www.cdc.gov/ncbddd/fasd/documents/fas_guidelines_accessible.pdf

Nadakavudaren, Anne (2011) Our Global Environment: A Health Perspective, 7^th edition  Waveland Press, Inc:  Illinois

Mercury in Fish

Mercury safety is a topic that floats in and out of the nightly news.  Generally, when there is a need to do a segment on healthy eating, the report will give a brief statement on how seafood is important to health, but that one should be careful to limit the amounts consumed each week.  What is not talked about it how industrialization and evaporation of paints have cased mercury concentrations to increase three-fold in modern times (Nadakavukaren, 2011).  The question then is why we should be concerned about mercury when it is such a footnote in our daily information.

Methylmercury, the type of mercury found in fish, binds to the red blood cells and destroys the cells that control coordination, affecting speech, walking, and other cognitive abilities (Nadakaukaren, 2011).  This property makes methylmercury harmful to the developing brains of fetuses, infants, and young children.  However, the FDA does not recommend avoiding seafood altogether.

There are many benefits to consuming seafood.  Seafood is high in Omega-3 fatty acids, is low in saturated fat, and is a good source of protein, which means seafood is beneficial to heart health (FDA, 2013).  The main con to seafood is it contains mercury to varying degrees.  

The FDA provides a short list of fish to avoid due to high mercury levels.  The NRDC goes more in-depth and divides seafood into four categories:  least mercury, moderate mercury, high mercury, and highest mercury.  Low mercury is less than 0.09 parts per million, moderate mercury is 0.09-0.29 parts per million, high mercury is 0.3-0.49 parts per million, and highest mercury is above 0.5 parts per million (NRDC, n.d.).  Essentially, the older and bigger the fish, the higher the concentration of mercury. 

The FDA recommends no more than 12-oz per week of low-level fish such as shrimp, canned light tuna, salmon, pollock, and catfish (FDA, 2013).  The fish to avoid include shark, swordfish, king mackerel, and tilefish (FDA, 2013).  Since these recommendations are based on 130lb woman, the portion sizes would need to be adjusted for smaller adults and children (NRDC, n.d.).

Grocery stores are beginning to list information on mercury in seafood to educate consumers and to steer consumers toward lower-mercury fish.  Whole Foods, for example, now have signs on their fish counters for each type of fish they sell.  These signs are color-coded for sustainability and risk factors.  The website also lists which seafood to avoid and advises consumers to focus on low-mercury fish or take Omega-3 supplements (Whole Foods, 2013).

There is a great deal of information about methylmercury in seafood and the dangers it poses; however, the consumer must be diligent about educating himself.  The FDA and other sources provide basic guidelines for safety, which, when followed, are helpful.  What is not addressed is how the public can help reduce mercury levels in the environment.  Congress has passed laws and created regulations like the 1995 EPA’s Clean Mercury Rule and the Mercury Export Ban of 2008, but there should be more education on how the average person can reduce mercury levels.  One suggestion would be for the FDA, Whole Foods, NRDC, and other organizations to include this information with the listing of mercury-safe seafood.  Perhaps this kind of awareness would help keep the mercury-safe seafood safe so future generations can enjoy the benefits of seafood.

FDA (2013) What You Need to Know About Mercury in Fish and Shellfish.  Retrieved on May 4, 2013, from www.fda.gov/Food/ResourcesForYou/Consumers/ucm110591.htm

Nadakavukaren, Anne (2011)  Our Global Environment:  A Health Perspective, 7^th edition  Waveland Press, Inc:  Illinois

NRDC (n.d.) Mercury Contamination in Fish.  Retrieved on May 4, 2013, from www.nrdc.org/health/effects/mercury/guide.asp

Whole Foods Market (2013) Methylmercury in Seafood.  Retrieved on May 4, 2013, from www.wholefoodmarket.com/about-our-products/food-safety/methylmercury-seafood