Q: My sister is having her first child and still has the occasional glass of wine with dinner. She claims that there's no risk if she's moderate, but it worries me. What's the bottom line here? — George G., Kankakee, Ill.
A: There's been contradictory info on drinking and pregnancy lately. For years, the recommendation was no drinking at all. Then last year, because of a study with dubious conclusions, folks were saying moderate consumption was OK. But that study's rationalization (we kid you not) was: Since some moms who drank a lot didn't have kids with neurodevelopmental problems and some moms who didn't drink had kids with problems, then it must be OK to have three to seven drinks a week. Huh?
So here are the important facts about fetal alcohol spectrum disorders:
1. In a recent study of 2,000 first-graders, researchers found that fetal alcohol syndrome — the most severe condition on the spectrum — affected six to nine kids out of every 1,000. Partial fetal alcohol syndrome was diagnosed in 11-17 kids out of every 1,000. The Centers for Disease Control and Prevention's numbers for fetal alcohol syndrome range from 0.2 percent to 2 percent of U.S. children.
2. The CDC says 7.6 percent of pregnant women admit they had a drink in the past 30 days.
3. The risk of harm to the fetus is also influenced by the amount of alcohol a woman drank in the three months BEFORE she got pregnant, late recognition that she is pregnant (so that she doesn't stop drinking immediately) and how much the father drinks.
4. Fetal alcohol spectrum disorders can cause small head size and facial deformities, short stature, hyperactivity, poor coordination, poor memory, learning disabilities, speech and language delays, low IQ, and vision, hearing, heart, kidney and bone problems. 5. The alcohol a mother drinks ALWAYS passes through the umbilical cord directly to the fetus. The brain of a fetus is quite vulnerable to the neurotoxic effects of alcohol.
So show her this column, let her know that if she drinks she's putting her unborn child at risk and let her know your concern comes from love for her and excitement about being an uncle.
Q: A friend of mine is putting off her recommended gastric bypass surgery because she's afraid of the operation. I know she needs to get it before she gets really ill. Can you help me reassure her about its safety? — Vanessa W., Cincinnati
A: Gastric bypass surgery (Roux-en-Ygastric bypass) used to be higher risk, but today it's not much more risky than an appendectomy. The Cleveland Clinic just came out with a study showing the overall rate of mortality and complications has plummeted in the past several years. And there is a steady stream of studies that demonstrate how great the benefits are. Some have shown that the risk of an early death is 40 percent higher in extremely obese people who don't have the surgery compared to extremely obese folks who do get it.
Also on the plus side: Gastric bypass reduces the severity of Type 2 diabetes in lots of folks (95 percent), throws it into complete remission for others (85 percent), and prevents it for those who are obese but not yet diagnosed.
Gastric bypass surgery and subsequent weight loss often reduce high blood pressure (cutting cardiovascular disease risk), cure sleep apnea and ease asthma. They also can reduce the need for medications such as antidepressants, statins, beta-blockers and narcotic pain relievers.
As for the dangers, all surgery comes with risks, and when you are overweight or obese they increase. That said, the risk of death from a gastric bypass surgery is only about 0.3 percent, and the likelihood of major complications is around 3 percent. So tell your friend that gastric bypass surgery isn't high-risk anymore, and the benefits are life-changing.
Dr. Mehmet Oz is host of “The Dr. Oz Show,” and Dr. Michael Roizen is chief medical officer at the Cleveland Clinic Wellness Institute. For more information go to www.sharecare.com.