Wednesday, 30 April 2014

Are You Destined to Get Your Parents' Illnesses?

WebMD Feature

Have you been told you've got your father's eye color or your mother's curly hair? These physical traits are a product of genes you inherited from your parents. If your mom has heart disease and your dad has colon cancer, you might also have inherited a greater chance of getting these diseases. But don't worry, it's not a sure thing.

With conditions like cancer, Alzheimer's, diabetes, and heart disease, your genes aren't always destiny. You can likely overcome your heredity and stay disease-free by making smarter health decisions.

Genes and Disease

Genes lead to disease in different ways. "With some diseases, it's almost certain that if you inherit that gene you'll inherit the disease. But for other diseases it's a matter of increased risk," says Soren Snitker, MD, PhD. He's an associate professor of medicine at the University of Maryland School of Medicine.

Some conditions, like Huntington's disease, are caused by a change to a single gene. If you have a parent with this disease, then you've got a 50-50 chance of getting it yourself.

Many other diseases, like type 2 diabetes or cancer, are caused by a combination of gene changes and lifestyle habits.

"A person can trump a lot of the inherited risk with very healthy behaviors," says Donald Lloyd-Jones, MD, ScM. He is chair of the department of preventive medicine at the Northwestern University Feinberg School of Medicine.

A good example of lifestyle trumping genes comes from a study of Amish people done by Snitker and other researchers. They looked at a gene called FTO, which contributes to obesity. Amish people with the gene who exercised didn't put on weight. They were able to overcome their gene by staying active.

Trump Your Genes

Not only can you override your genes by taking good care of yourself, you could even change how they function. A growing field of research is looking at how lifestyle choices affect our genetic makeup.

Behaviors don't change the genes themselves. They change the way the genetic information is used to make the proteins that control different body functions.

"The idea is that there are different ways that you can activate or inactivate genes based on what you do in your lifestyle," says Adam Rindfleisch, MD. He is an associate professor in family medicine and fellowship director of integrative medicine at the University of Wisconsin School of Medicine and Public Health.

No matter what your genetic makeup, you can avoid diseases like diabetes, cancer, and heart disease by adopting a few healthy habits:

Should You Get Tested?

Is it worth having a genetic test to learn your disease risk? In some cases seeing a genetic counselor and getting tested can be helpful.

source : Are You Destined to Get Your Parents' Illnesses?
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Can Low Cholesterol Keep Your Brain Healthy?

WebMD Feature

Most people think of heart disease when they hear the words "high cholesterol," but your brain's health may also be at stake.

The evidence is still limited, but studies show that high levels of cholesterol may be linked to Alzheimer's disease or other kinds of dementia.

The Role of Cholesterol

Researchers don't know exactly what causes Alzheimer's disease. But substances found in the brains of people with Alzheimer's, called amyloid plaques, may be part of it.

Amyloid plaques form in the brain when a protein called beta-amyloid builds up. That's where cholesterol may come in.

In a recent study, Charles DeCarli, MD, director of the University of California, Davis Alzheimer's Disease Research Center, and colleagues looked at levels of amyloid in the brains of 74 older adults.

They found that higher levels of LDL cholesterol and lower levels of HDL cholesterol both were linked to having more amyloid in the brain.

"Unhealthy patterns of cholesterol could be directly causing the higher levels of amyloid known to contribute to Alzheimer's, in the same way that such patterns promote heart disease," says Bruce Reed, MD, a study researcher and a co-director of the UC-Davis Alzheimer's Center.

The study, the first to link cholesterol to amyloid plaques in the brain, doesn'tdirectly say whether or not cholesterol is a risk for dementia, DeCarli says.

"We primarily looked at people who did not have dementia. There are still a lot of questions. But now that we have this amyloid imaging tool, we can actually ask those questions and identify relationships we couldn't see before."

Improving Your Cholesterol Numbers

One potential next step for researchers is to study whether or not changing a person's HDL or LDL cholesterol levels earlier in life can reduce amyloid levels in the brain later in life.

This could potentially make a big difference in reducing the number of people with Alzheimer's, Reed says.

What's clear, DeCarli says, is that if you're at risk for heart disease because your cholesterol levels aren't right, you have one more reason not to ignore the numbers.  Your risk of Alzheimer’s might be less after cholesterol treatment.

Changes in your lifestyle can improve your cholesterol numbers. A diet low in saturated fat may help reduce LDL "bad" cholesterol. Regular exercise may be helpful in boosting HDL "good" cholesterol.

source : Can Low Cholesterol Keep Your Brain Healthy?
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How to Stop a Binge Before It Starts


By Marianne Wait
WebMD Feature

Reviewed by Joseph Goldberg, MD

For someone with binge-eating disorder, the urge to overeat can be overwhelming. And while the first few bites can sometimes feel good, shame, guilt, and regret can quickly follow. But it’s possible to stop a binge before it starts, or even once it’s begun.

Long-Term Strategies

Follow a regular meal plan. “The most important thing to do is to get on a regular pattern of eating,” says Doug Bunnell, PhD, former president of the National Eating Disorders Association. Dietary restriction and under-eating -- often in an attempt to lose weight or “make up for” a binge -- drive people to feel hungry, then overeat or binge, he says.

Focus on health, not weight. The desire to lose weight can actually keep someone stuck in a bingeing cycle, Bunnell says. Focus on overall fitness and health rather than pounds.

Learn your triggers. “For me, a binge never really began with the first compulsive bite, but much earlier. It began with my not taking care of myself in some other way,” says Jenni Schaefer, co-author of Almost Anorexic: Is My (or My Loved One’s) Relationship with Food a Problem?

Learn what feelings, moods, interactions, and relationships drive your urge to binge, Bunnell says. A therapist can help you ID your triggers. Once you do, “you want to reframe the problem from being one of ‘I’m hungry’ to one of ‘I’m feeling ignored or unimportant’ or whatever it might be, and line up the solutions for that.”

Remove temptation. “Don’t keep foods that you like to binge on,” advises Leslie Anderson, PhD, training director at the Eating Disorders Center for Treatment and Research at University of California, San Diego.

Look for other ways to feel good. People with binge-eating disorder often have underlying depression, Bunnell says. He suggests seeking out non-food sources of pleasure. For example, try something you enjoyed as a kid -- perhaps an art class. And get more physical activity. “It’s actually one of the most powerful treatments we have for improving mood, and that’s often a critical part of helping people manage the binge eating,” Bunnell says.

When the Urge Strikes

Recognize you’re in the danger zone. “The first step is that you actually have to notice the urge” before you find yourself in front of a plate of food, Anderson says. Becoming very aware of your own moods and anxieties will help.

Change your mindset. Once you are good at noticing the urge, come up with ways to change gears. Anderson recommends keeping a list of your top goals and values on the fridge, and ask yourself whether bingeing would be consistent with them.

Distract to delay. “People often feel like they go from 0 to 60, right from urge to behavior,” Bunnell says. “Try to stretch out the time a little bit.” If you can delay bingeing long enough, you may be able to avoid it. Count your breaths, do yoga, take a walk, listen to music, or call a friend.

source : How to Stop a Binge Before It Starts
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HPV-Linked Oral Cancers May Not Be 'Contagious'


Kissing doesn't seem to raise rate of viral infection between committed partners, study finds

WebMD News from HealthDay

And more women getting pregnant while cohabiting.

By Dennis Thompson

HealthDay Reporter

TUESDAY, April 29, 2014 (HealthDay News) -- Romantic intimacy in long-term relationships often suffers when one partner gets a diagnosis of mouth or throat cancer caused by HPV, the sexually transmitted human papillomavirus. But new research suggests these couples can kiss as much and as deeply as they ever have, without worry.

Spouses and long-term partners of patients with HPV-related oral cancers appear to have no increased risk of oral HPV infections, according to the results of a new study led by Johns Hopkins investigators.

Saliva samples taken from the partners of oral cancer patients did not contain elevated levels of HPV DNA, the researchers reported online April 28 in the Journal of Clinical Oncology.

The prevalence of HPV among spouses and partners -- about 1.2 percent -- is comparable to the 1.3 percent prevalence of HPV among the general population of the same age, the researchers found.

Experts welcomed the findings.

"This study does put the risk in perspective. It's not something you need to freak out about, or substantially alter your lifestyle. You can still smooch your sweetie," said Fred Wyand, spokesman for the American Sexual Health Association.

HPV-related oral cancers are increasing among white men in the United States, with the virus now associated with nearly three out of four cases of oropharyngeal cancer, according to a 2011 report in the Journal of Clinical Oncology. These include cancers of the base of the tongue, tonsils, soft palate and pharynx. Although sexual behavior is associated with oral HPV infection, it's not fully clear how the cancer-causing virus is transmitted or progresses, according to background information in the new report.

Once diagnosed, fear of HPV transmission can lead to anxiety, divorce and curtailing of sex and intimacy among couples, said the study's lead author, Gypsyamber D'Souza, associate professor of epidemiology at the Johns Hopkins Bloomberg School of Public Health.

New York City oncologist Dr. Dennis Kraus said it's normal for older couples in long-term relationships to become unsettled by the news that one of them has mouth and throat cancer caused by a sexually transmitted virus.

"They think, 'What kind of a relationship am I involved in? Who is this person?' Many of them have grandchildren and even great-grandchildren and now they have to be worried about their progeny being exposed to this disease," said Kraus, director of the Center for Head and Neck Oncology at Lenox Hill Hospital.

To confront these concerns, researchers took mouth-rinse samples from 164 patients with HPV-related oropharyngeal cancer and 93 partners. They then ran DNA tests for 36 strains of HPV.

Nine out of 10 of the oral cancer patients were men, and nearly all had performed oral sex in the past. They were in their 50s and early 60s.

source : HPV-Linked Oral Cancers May Not Be 'Contagious'
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4 New High-Tech Tools to Help Control Diabetes


WebMD Feature Archive

By Susan Bernstein
WebMD Feature

If you have diabetes, you’ll want to know about some new, high-tech gadgets and tools designed to help you keep track of what you eat, your blood sugar levels, how much you exercise, and how you feel each day. Some of these include:

  • Phone, tablet, or computer apps where you log your blood sugar or foods you eat
  • Devices that test your blood sugar every few minutes
  • Smart pumps that give you insulin as your body needs it
  • Texts, calls, or emails that remind you to test or take your medicine

Track Blood Sugar Patterns

Keeping track of patterns in your blood sugar levels can help you and your doctor better manage your diabetes.

To find out more, your doctor might use a machine called a continuous glucose monitor (CGM) that can test your blood sugar every 5 minutes all day long. It tests through tiny fibers on a patch stuck on your skin. Results are sent wirelessly to a small monitor that you can hold or clip on your belt. Some CGM devices even send your results to your doctor's office through a wireless signal. This can help you and your doctor spot spikes after you eat certain foods, work out, or while you sleep, says Robert Vigersky, MD. He is medical director of the Diabetes Institute of the Walter Reed Health Care System.

This gadget doesn’t take the place of old-school testing, though. The device’s maker says you need at least one finger-stick every 12 hours to set the device, and suggests regular testing three to four times a day to make sure the numbers match up.

New, smart insulin pumps that can sync with a CGM are great for people with type 1 diabetes, Vigersky says. “If your sugar goes too low, it will stop an insulin infusion for 2 hours.” Smart pumps can help you avoid dangerous dips in your blood sugar.

If you need insulin but not a pump, pre-filled pens may be easier to use than separate vials and needles, Vigersky adds. “Pens are so convenient and easy to use,” he says. And that makes people more likely to take their medication, which helps keep their blood sugar under better control.

Apps and Clips

New phone, tablet, or computer apps can be good if you don’t like writing things down in a journal, says Marisa Moore, a registered dietitian who works with type 2 diabetes patients in Atlanta.

Apps can help you track:

  • Calories, carbs, and other nutrition in your diet
  • Daily exercise and calories burned
  • Stress levels
  • Blood sugar test results

“Keeping a food diary can really help you manage your diabetes. With a phone app, you have it with you all the time, which makes it easier to keep up with,” she says. “People get tired of checking their blood sugar, too. So it’s helpful to have some way to track it that is easily uploaded.”

source : 4 New High-Tech Tools to Help Control Diabetes
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'Breast Milk Banks' Gain in Popularity


Experts say they're safer than online milk-sharing sources

WebMD News from HealthDay

By Dennis Thompson

HealthDay Reporter

TUESDAY, April 29, 2014 (HealthDay News) -- A wave of new nonprofit breast milk banks are opening across North America, driven by research that has promoted the use of donated mother's milk for healthy babies.

Five new milk banks are expected to open this year in the United States and Canada, joining four that opened in 2013 and bringing the total number of nonprofit milk banks up to 22, said Kim Updegrove, president of the Human Milk Banking Association of North America.

"There's an amazing resurgence of milk banks in North America," Updegrove said. "Every healthy lactating mother has the ability to save another baby's life if she is willing to go through a screening process and donate her milk through a nonprofit milk bank."

She said breast milk contains important nutrients, immune-system antibodies and growth factors that all contribute to a baby's health, particularly babies who are vulnerable because they are premature or underweight.

"It's now irrefutable that in absence of mom's own milk, donor milk increases survival rate and improves development of vulnerable infants," she said.

The milk banks are proliferating in response to mounting medical research that has shown donated breast milk can nurture babies just as well as their mother's own milk, Updegrove said.

Pediatricians hope that mothers will see the milk banks as a better, safer alternative to the growing practice of online breast milk sharing, said Dr. Susan Landers, a neonatologist in Austin, Texas, who sits on the American Academy of Pediatrics' section on breast-feeding.

Breast milk banks screen all donors, running tests to make sure they are not carrying an infectious disease that could be passed on through their milk, Landers said. In addition, the collected milk is pasteurized before being frozen and passed out to hospitals and families on a doctor's prescription.

Updegrove's group acts as a professional organization for the network of milk banks, laying out guidelines and certifying new banks as they come online.

"The AAP likes that set up," Landers said. "We like the milk to be pasteurized. We want the donor mothers to be screened. We want doctors to know it's a sterile product and prescribe it when donor milk is needed."

By comparison, there are no safety precautions in place for milk shared through online sites. A recent study found that nearly three-quarters of 101 breast milk samples purchased through a milk-sharing website contained bacteria that could make a baby sick -- including three batches that tested positive for salmonella.

Women who buy milk from these websites "don't know who's got hepatitis B and who's HIV-positive and who's got germs in their milk, and none of it's pasteurized," Landers said. The AAP is weighing a policy statement that would discourage mothers from participating in these online swapping sites.

source : 'Breast Milk Banks' Gain in Popularity
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Type 2 Diabetes May Shrink the Brain, Study Suggests


Loss of gray matter can lead to dementia, experts say

WebMD News from HealthDay

DNA changes appear to rise with more years of

By Steven Reinberg

HealthDay Reporter

TUESDAY, April 29, 2014 (HealthDay News) -- People with type 2 diabetes may lose more brain volume than is expected as they age, new research indicates.

Surprisingly, this shrinkage doesn't appear to be linked to the damaging effect of diabetes on tiny blood vessels in the brain, but instead by how the brain handles excess sugar, the researchers noted.

"We have known for a long time that diabetes is not good for the brain," said lead researcher Dr. R. Nick Bryan, a professor of radiology at the University of Pennsylvania's Perleman School of Medicine in Philadelphia.

Diabetes is associated with an increased risk for stroke and dementia, he said. Until now, doctors have thought these risks were likely related to blood vessel damage related to diabetes.

"But our study suggests that there is additional damage to the brain which may be more like a brain disorder such as Alzheimer's disease," Bryan said. "So there may be two ways diabetes affects the brain, damage to blood vessels and brain-cell degeneration."

The brain shrinkage seen in this study may be linked with how sugar is used by the brain, Bryan said.

"It is important that patients understand the adverse effect of their disease on their brains and cooperate with their doctors who are trying to treat their diabetes and prevent the effects of diabetes on the brain and other organs," he said.

Bryan cautioned, however, that what isn't known from this study is if treating diabetes will prevent or slow brain shrinkage.

Nearly 26 million people in the United States have diabetes, according to the American Diabetes Association. In type 2 diabetes, the body often doesn't use insulin efficiently, leading to an excess of both insulin and blood sugar, according to the association.

For the study, Bryan and his colleagues used MRI scans to look at the brains of 614 people with type 2 diabetes. The volunteers had diabetes for an average of about 10 years.

They found that the longer a patient had the disease, the more brain volume loss occurred, particularly in the gray matter. Gray matter includes areas of the brain involved in muscle control, seeing and hearing, memory, emotions, speech, decision-making and self-control.

In fact, for every 10 years someone had diabetes, it looked as if the brain was about two years older than the brain of someone without diabetes, according to Bryan.

It's important to note that this study only found an association between type 2 diabetes and greater and faster brain volume loss, and it wasn't able to prove that type 2 diabetes was the cause of the brain shrinkage.

The report was published in the April 29 online edition of Radiology.

Dr. Souhel Najjar, director of neuroscience and stroke at Staten Island University Hospital in New York City said, "Given the increasing public health burden of type 2 diabetes, the findings of this research are very important as they link diabetes directly to brain atrophy, underscoring the importance of primary prevention and early management of diabetes in reducing the burden of dementia, particularly in older population."

source : Type 2 Diabetes May Shrink the Brain, Study Suggests
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Complications Common, Costly With Some Kidney Stone Treatments


Study found 1 in 7 patients has problems after certain procedures

WebMD News from HealthDay

Studies found statins, different IV fluids made

By Robert Preidt

HealthDay Reporter

TUESDAY, April 29, 2014 (HealthDay News) -- Kidney stone treatments cause complications in about 14 percent of patients and can be costly, according to a large new study.

Researchers analyzed data from more than 93,000 privately insured patients in the United States who were treated for kidney stones.

One in seven of the patients experienced complications that required hospitalization or emergency care within 30 days of treatment the study found. The average cost of treating complications was $30,000 per patient.

The study looked at three methods of treatment, including shock-wave lithotripsy, ureteroscopy and percutaneous nephrolithotomy.

In shock-wave lithotripsy, a machine known as a lithotripter is used to crush the kidney stone, according to the U.S. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Ureteroscopy involves using a long, tube-like instrument to find or break up the stone. Percutaneous nephrolithotomy uses a wire-thin viewing instrument to locate and remove the stone.

All three procedures require anesthesia, according to the NIDDK.

In the new study, rates of complications were 12 percent for patients who had shock-wave lithotripsy and 15 percent for those who underwent ureteroscopy. The average cost of treating complications after nephrolithotomy was $47,000, compared with $32,000 for complications after shock-wave lithotripsy.

Patients treated at hospitals that performed large numbers of kidney stone procedures were much less likely to have complications, according to the study published April 28 in the journal Surgery.

"Our findings provide a good starting point to understand why these complications are happening and how they can be prevented, because the costs to patients who suffer complications and to the health care system are substantial," lead author Dr. Charles Scales Jr., an assistant professor of surgery at Duke University, said in a university news release.

Further research is needed to learn why the three kidney stone treatments had different complication rates and costs, the study authors noted.

"From the patient perspective, an unplanned emergency department visit or hospital admission after a low-risk ambulatory procedure is a significant event," Scales said. "Kidney stones are excruciatingly painful and primarily affect people who are of working age. These patients face not only the cost of treatment, but also the financial difficulties from time off work due to pain and treatment."

source : Complications Common, Costly With Some Kidney Stone Treatments
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Tuesday, 29 April 2014

4 New High-Tech Tools to Help Control Diabetes


WebMD Feature Archive

By Susan Bernstein
WebMD Feature

Diabetes can make huge demands on you. For many patients, the daily routine involves painful finger sticks, glucose tests, and insulin injections -- all in an effort to keep blood sugar and diabetes under control.

But newer devices, such as continuous glucose monitors, may make it easier for many of the nation's 21 million people with diabetes to control the disease, according to Aaron Kowalski, PhD. Director of strategic research projects at the Juvenile Diabetes Research Foundation. Kowalski is himself a type 1 diabetes patient. "We think there are some new technologies that hold tremendous promise," he says. "It's an exciting time."

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Not all new devices make it, though. Some have fizzled after the fanfare. The GlucoWatch was a wristwatch-like device that measured glucose from fluid through the skin. Many hoped it would replace the difficult finger stick. "The expectations were extremely high," says Kowalski. "But it was disappointing on many levels."

Among the problems? Skin irritation and inaccurate readings.

But Kowalski and other experts predict that newer technologies that aim to help people control their diabetes may fare much better. And controlling diabetes is very important. Over time, long-term, high blood sugar can lead to eye, heart, kidney, and nerve disease and other complications. Low blood sugar can also quickly trigger immediate emergencies, such as seizures, coma, and death.

Here's WebMD's roundup of some of the breakthroughs in diabetes control tools.

New Diabetes Control Tools: Continuous Glucose Monitors

Many people with diabetes lance their fingers 2 or more times a day to check glucose levels. But even with as many as 9 finger sticks a day, patients still spend less than 30 percent of the day in a normal range, Kowalski says. "It's often a teeter-totter that a person with diabetes stands on."

Now, imagine getting a glucose reading every 5 minutes. That's 288 readings in 24 hours -- or almost 100 times what one would get with 3 finger sticks a day.

Thanks to the continuous glucose monitors (CGMs), this is possible. With a CGM, the user inserts a disposable, needle-like sensor under abdominal skin. The sensor measures glucose in tissue fluid, not blood. The sensor then transmits the data every 5 minutes to a monitor.

"It shows graphically what the patient's glucose level is doing in real time 24 hours a day," says Steve Sabicer, spokesman for Medtronic. (This is the company that introduced the first CGM in 2005.)

When people can see glucose trends continuously, they can make "real-time" decisions, says David Klonoff MD, FACP, Medical Director of the Diabetes Research Institute at Mills-Peninsula Health Services in San Mateo, California. For example, it helps them know when to inject insulin or to eat. "They can take action right now. They spend less time with high blood sugar and less time with low blood sugar."

source : 4 New High-Tech Tools to Help Control Diabetes
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Your Child and Alcohol

WebMD Feature

At some point, most likely well before he turns 21, your child will have to make a choice about whether to drink alcohol. Your role as a parent is to prepare him. But first, prepare yourself by learning the facts.

Don’t Assume Your Child Won’t Try Alcohol

  • 10% of eighth graders say they drank alcohol in the past month.
  • 39% of high school seniors say they drank alcohol in the past month.

Young drinkers are more likely do risky things. When kids age 12 to 20 drink, they often binge (having five or more drinks in a row.) The earlier a young person starts, the more they tend to binge drink. That raises the chances they’ll hurt themselves or others.

Binge drinking can also slow down the development of the part of the brain that controls judgment. Normally, it keeps forming until we’re about 25 years old. That’s why teens so often act on impulse.

Can You Teach Your Child to Drink Responsibly?

If you’re right there with your child to supervise, it will be OK, right?

Not really. It may seem like a good idea, but research strongly indicates the longer you keep your kid from drinking, the better. 

There’s no evidence to show letting your underage child drink alcohol at home leads to responsible drinking. And indulging at an earlier age raises risks of alcohol problems, like alcoholism. Kids who drink before age 15 are four times more likely to have addiction problems as an adult than those who wait until they’re 21.

Talk to Your Kids About Alcohol

Building a trusting relationship is key to teaching kids about responsible drinking. That helps them refuse alcohol, gain confidence, resist peer pressure, and know your expectations.

  • Show your child she can talk to you about anything. She’ll listen. It may not always seem so, but parents have a lot of influence on kids’ behavior.
  • Get involved in your child’s life. Know his friends and his whereabouts. Spend time with him daily.
  • If you drink, model healthy behavior. Don’t say you need to after a bad day. Don’t do it excessively, and never drink and drive.
  • Show your child other ways to relax, like exercise or music.
  • Use natural opportunities to start conversations, like when a beer commercial comes on or when someone at a restaurant drinks.
  • Be clear that underage drinking is not OK. Getting that message from their parents is the main reason kids say no to it.
  • Have your child practice saying “no” through role-playing, brainstorming, or just chatting.
  • Give information fitting your child’s maturity. Talk about alcohol dangers. Use short, simple comments and repeat them.
  • Give an older kid more specifics about alcohol’s effects and how it impacts your decision-making.
  • Talk about peer pressure. Help her recognize that good friends don’t push you to drink.

source : Your Child and Alcohol
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