Thursday, December 16, 2010

Smoking 'causes a third of severe rheumatoid arthritis cases' (?)

I've got no time for smokers but the report below seems rubbish. Smoking is correlated with all indices of social disadvantage -- including low IQ -- and high IQ people are known to be healthier and live longer. So was IQ controlled for? I doubt it. Just mentioning IQ would probably be classed as hate speech in nutty Sweden. So I suspect that all we have here is yet another example of the most reliable finding in epidemiology: That lower social class goes with poorer health.

The journal article is: "Smoking is a major preventable risk factor for rheumatoid arthritis: estimations of risks after various exposures to cigarette smoke"

Smoking is responsible for a third of all cases of severe rheumatoid arthritis (RA), according to a study of more than 2,000 people. In people who are genetically predisposed towards the debilitating condition it accounts for more than a half of cases, the Swedish study found.

Rheumatoid arthritis is the painful swelling of the joints, thought to be caused by the body's own immune system attacking itself. It often begins to affect people between 40 and 60, and is three times more common in women than in men. About 400,000 people suffer from it in Britain.

Researchers at the Karolinska Institute in Stockholm asked 1,200 people with RA about their smoking habits, as well as almost 900 people without it. Both sets were matched for age, sex, and other factors.

They found people who had smoked heavily throughout their lives - at least 20 a day for at least 20 years - were more than two-and-a-half times as likely to test positive for a type of antibody, called the anticitrullinated protein/peptide antibody (ACPA), that is now closely associated with the most common and severe form of RA.

Based on this and other figures, they calculated that smoking accounted for 35 per cent of ACPA-positive cases of RA, and a fifth of cases of the disease overall.

Among people who were genetically susceptible to the disease, the researchers concluded that smoking was responsible for more than half (55 per cent) of ACPA-positive cases.

However, they found that in all but the heaviest smokers, the risk of developing RA diminished once a person stopped smoking.

The report is published today (TUES) online in the British Medical Journal's Annals of the Rheumatic Diseases.

Jane Tadman, from Arthritis Research UK, commented: "We’ve also known for some time that lifestyle factors such as smoking, and also eating a lot of red meat and drinking large amounts of caffeine may also affect the risk of developing the disease.

"As there is little you can do about changing your genetic make-up, it seems sensible to reduce the other risk factors that you actually have some control over. So stopping smoking would be one obvious way of doing this."


Why can't I enjoy a glass (or three) of wine without the pregnancy police telling me I'm evil?

A well-informed mother battles the myths

Now, what can I get you?’ asked my friend politely. ‘Tea? Coffee ­­— decaf, of course? Or a soft drink?’ ‘Actually, I’ll have a glass of the red, please,’ I replied and, instantly, the room took on a decidedly Arctic chill. After a long silence my friend looked at me quizzically, not sure if I was joking or not.

It wasn’t ten o’clock in the morning and neither was I a recovering alcoholic ­threatening to fall off the wagon. No, it was far worse than that… I was at a dinner party and I’m eight months pregnant.

And before I’m reviled, hated and ­condemned as being a selfish woman who doesn’t care about the health of her unborn child, let’s have a grown-up conversation about it, shall we? Because the reality is you’ll struggle to find anyone without a medical licence who knows more than me about drinking during pregnancy.

I’m a proud 31-year-old mother of two wonderfully healthy, happy, smart and ­mischievous boys — Eddie, six-and-three-quarters (he’d kill me if I didn’t include the three quarters), and Sammy, aged two.

I drank through each of their pregnancies, mostly one glass of wine in the evening after dinner but, sometimes — if it was a ­special occasion — I would have two or three over the course of a meal.

I’m not advocating that pregnant women get drunk, just that they be allowed to drink responsibly without any inciting hysteria.

I’ve read practically every piece of ­literature and study on the effects of ­drinking during pregnancy and have come to the educated ­conclusion that my alcohol intake during each of my three ­pregnancies has not adversely affected either of my two children and won’t affect my third, due next month. In fact (as I’ll explain later), it may even have contributed to them being so bright.

In 2006, the Royal College of Obstetricians and Gynaecologists concluded there was no ­convincing evidence of adverse affects of ­prenatal alcohol exposure at low to moderate levels of alcohol ­consumption — moderate being 10.5 units or seven small glasses of wine a week. Which means I can drink two glasses of wine with dinner at least three nights a week, or drink a glass or so a day, and do myself or my baby no harm.

Another study, carried out in October this year by University ­College London, monitored ­children over five years and ­concluded that light drinking in pregnancy does children ‘no long term harm’. So, if it’s OK with you, I’ll take the advice of medical experts rather than a bunch of hysterical ­housewives

Besides if we did­ ­everything to ‘be on the safe side’ we’d never leave the house in case we got hit by a bus. We’d never go on holiday in case the plane crashed and we’d never let our children play outside for fear of them being kidnapped.

The feeling of being collared by the self-appointed ‘pregnancy police’ will be familiar to Caroline Williams from Hove, Sussex. Last year, on a hot summer’s night, a six-months-pregnant ­Caroline thought she’d order a nice, cooling half pint of beer. The bar staff refused to serve her. When Caroline pointed out she was a paying customer and would like her beer, they threw her out. ‘I’m a respectable woman. I’ve never been thrown out of an ­establishment before in my life,’ said Caroline. ­‘I felt so humiliated.’

Every mother who’s ever thought about drinking ­during pregnancy is aware of Fetal ­Alcohol Syndrome — a mental and ­physical disorder which permanently affects the ­central nervous system of the ­developing foetus.

There’s no cure and it’s caused by excessive alcohol consumption d­uring pregnancy — meaning a large intake of ­alcohol over a sustained period of time. We’re talking a bottle a day, not a bottle a week. No study has ever found a ­correlation between the diagnosis of the condition and light to moderate alcohol ­consumption in expectant ­mothers.

I’ve been fortunate enough to have all three doctors I’ve seen through each of my pregnancies tell me the truth; the current UK ­medical advice to abstain entirely comes from the medical ­profession’s distrust for the public.

In short, pregnant women aren’t trusted to know when light to ­moderate drinking stops and heavy drinking begins.

I could pretend that I drink ­during pregnancy to give my kids a higher IQ — one study found the children of mothers who drank moderately during pregnancy had a higher one than those that abstained.

I find it depressing that Myleene Klass’s agent felt compelled to deny she was drinking after she was ­spotted at Piers Morgan’s CNN party recently with a wine glass in her hand at six months pregnant. The pregnancy police were assured ‘it was 100 per cent Diet Coke’. Phew. Cancel that call to social services.

And when Gwyneth Paltrow dared to admit she was drinking Guinness and was spotted sipping red wine in 2006 while pregnant with her second child, Moses, she was lambasted.

All this hysteria does is encourage the evangelists who make pregnant women feel guilty about so much as sniffing a ­barmaid’s apron.

But I’m not a one-woman-­campaign against the Temperance League, out to advise all expectant mums to crack open the Sancerre and put their feet up. Far from it. I’d just like every mum to do their own research and come to their own — informed — conclusion. So you may not feel like drinking during your pregnancy. That’s fine — I’m not standing in judgment. All I ask is that you afford me the same courtesy.


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