Adolescent Alcohol Use: Risks and Consequences

Adolescent Alcohol Use: Risks and Consequences
Alcohol and Alcoholism, Volume 49, Issue 2, 1 March 2014, Pages 160–164,
08 January 2014



Aims: The aim of the study was to summarize results of recent epidemiological research on adolescent alcohol use and its consequences, to outline the risk factors for drinking in adolescents and to consider effective treatment and preventative interventions. Methods: A literature review of relevant studies on adolescent alcohol use. Results: Alcohol use and other risk-taking behaviours such as smoking, substance use and risky sexual behaviour emerge in adolescence and tend to cluster together. Heavy alcohol consumption in late adolescence appears to persist into adulthood and is associated with alcohol problems, including dependence, premature death and diminished work capacity. Early identification of adolescent risk factors may be helpful in preventing and/or attenuating risk. Conclusion: There is a need for high-quality long-term prospective cohort studies to investigate the long-term consequences of adolescent drinking and further work is needed to identify the most effective intervention strategies.


The term ‘adolescent’ is an adjective describing a young person in the process of developing from a child into an adult and dates from the late 18th century (Oxford English Dictionary). It is derived from the Latin verb ‘adolescere’ which means ‘to grow up’. This short paper will review patterns of drinking in adolescence and the risk factors that are thought to predispose to the development of alcohol use and other co-morbid disorders in this age group.

Alcohol is the world’s third largest risk factor for disease and contributes to 4% of the global burden of disease (Rehm et al., 2009). It is estimated that ∼2.5 million deaths each year are directly attributable to alcohol, with 9% of deaths in the 15- to 29-year age group being alcohol-related (WHO, 2011).

When data from the World Health Organization’s Global Burden of Disease study were used to calculate cause-specific disability-adjusted life years (DALYs) for young people aged 10–24 years, the main risk factors were found to be alcohol (7% of DALYs), unsafe sex (4%), iron deficiency (3%), lack of contraception (2%) and illicit drug use (2%) (Gore et al., 2011). The contribution of other risk factors to disease, such as tobacco use, low physical activity and overweight/obesity only emerged in mid-to-late adulthood. These findings suggest that public health strategies should focus on child and adolescent health, and that adolescent drinking should be given priority (Gore et al., 2011).

Regular alcohol use, binge drinking and other risk-taking behaviours such as smoking, substance use and risky sexual behaviour emerge in adolescence and there is evidence that these behaviours tend to cluster together (Wiefferink et al., 2006). The adolescent brain, especially the hippocampus, may be particularly vulnerable to the effects of alcohol (Welch et al., 2013), thus predisposing the young drinker to alcohol, mental health and neuro-cognitive problems which can persist into adulthood (Hanson et al., 2011Welch et al., 2013). Young people who start to drink before the age of 15 years are reported to be four times more likely to meet criteria for alcohol dependence at some point in their lives (Grant and Dawson, 1997). Early alcohol use is associated not only with more regular and higher levels of alcohol use and dependence in adulthood, but also with more mental health and social harms (McCambridge et al., 2011).

In the US National Co-morbidity Study-AdolescentSupplement (NCA-S), over ¾ of adolescents (78.2%) had consumed alcohol by late adolescence, and 15.1% met criteria for DSM-IV lifetime alcohol abuse (Swendsen et al., 2012). The median age at onset was 14 years for alcohol abuse with or without dependence. This was a nationally representative survey in which over 10,000 young people between the ages of 13 and 18 were interviewed using a modified version of the Composite International Diagnostic Interview. Rates of alcohol use were lowest for black and other racial/ethnic groups compared with white or Hispanic adolescents. The increase in prevalence rates over the years from 13 to 18 indicates that this is a key period in the development of alcohol use disorders (AUDs). By the time they were 17–18 years of age male adolescents had higher rates of alcohol use than in early adolescence (use, regular use, abuse without dependence and abuse with dependence).

The 2011 European School Survey Project on Alcohol and Other Drugs (ESPAD) was carried out in 37 countries, and data are available for 36 countries (Hibell et al., 2012). The target population was students born in 1995 and the mean age at the time of data collection was 15.8 years. In all ESPAD countries except Iceland, 79% of students had consumed alcohol at least once in the past 12 months and 57% had consumed alcohol in the past 30 days. Figures were similar for boys and girls. The estimated average consumption on the most recent drinking day was a third higher for boys who were more likely to drink beer. Spirits were the most common beverage for girls in over half of countries. Rates of ‘heavy episodic drinking’, defined as more than five or more drinks on the same occasion in the past 30 days, were 43% for boys and 38% for girls. This was a slight decrease since 2007 when the figures were 45 and 41%, respectively. More boys than girls reported heavy episodic drinking in 22 countries. More girls than boys reported heavy episodic drinking in Sweden, and rates were the same for boys and girls in Finland, Iceland, Norway, Ireland and the UK, France, Monaco, Belgium, Estonia and the Russian Federation.

Analysis of 2011 data on smoking, drinking and drug use in 11–15 year olds in England showed that 12% had consumed alcohol in the past week, 8% had smoked over the same period and 6% had taken drugs in the past month (Health and Social Care Information Centre, 2012). Levels of alcohol consumption had decreased since 2001 when the figure was 26%. Mean alcohol consumption in 2011 was 10.7 units and the median 7 units. Drinking was associated with smoking and drug use, and having truanted from school.

A recent study of English students aged 13–14 years and 15–16 years found that most had had an alcoholic drink (70 and 89%, respectively), and that the first drink had most often been taken at about the age of 12–13 years, and usually in the company of an adult on a special occasion (Bremner et al., 2011). One fifth of 13–14 years olds who drank were drinking weekly, and the figure was 39% for the 15–16 year olds. One quarter of the older students had consumed six or more drinks on the last occasion they had taken a drink. The 13–14 year olds were more likely to have been drinking alcopops in the 7 days before the survey, whereas the 15–16 year olds were most likely to have been drinking beer, lager, spirits or liqueurs. By the age of 15–16 years, 79% of the students had been drunk and two-thirds of this group (66%) said they drank to get drunk at least once a month.

The Australian Secondary Students’ Alcohol and Drug Survey (ASSAD) is carried out every 3 years. The 2011 survey, the tenth in the series, included responses from just under 25,000 secondary students (White and Bariola, 2012). About three out of four students had tried alcohol at some point in their lives, 51% consuming alcohol in the 12 months before the survey. Just under one-fifth (17%) had consumed alcohol in the 7 days before the survey, 8% of 13 year olds and 37% of 17 year olds. About one-fifth (19%) of 17 year olds had consumed more than four drinks on at least one of the preceding 7 days. The proportion of students drinking in 2011 was less than that found in the 2008 and 2005 surveys.


What are the consequences in adulthood of late adolescent drinking? McCambridge et al. (2011) carried out the first systematic review of general population cohort studies where data on baseline alcohol consumption had been obtained from adolescents between the ages of 15 and 19 years, and follow-up data had been obtained from the same cohort at time points that were at least 3 years apart. The review included 54 studies, of which 35 were multiple reports from ten cohorts including 9 reports from the (all male) Swedish Conscript Study (SCS). Almost one half of studies (n = 26) were from the USA with the remainder coming from Sweden, Britain, New Zealand, Australia, Finland and the Netherlands (McCambridge et al., 2011). The main conclusion was that late adolescent alcohol consumption persisted into adulthood and was associated with alcohol problems, including dependence. Non-alcohol outcomes such as the mental health and social consequences of adolescent drinking could not be fully explored due to lack of evidence. The SCS evaluated the risk of premature death with late adolescent drinking after 15, 20 and 25 years and found that by the age of 34 years heavier drinkers were twice as likely as moderate drinkers to have died (Andreasson et al., 19881991Romelsjo et al., 1999). This finding was attenuated by the age of 39, but the main causes of death at both time points were car crashes (mainly at younger ages) and suicide (at older ages) (Andreasson et al., 1991). Good psychosocial adjustment did not protect heavier drinkers from an increased risk of premature mortality (Andreasson et al., 1991).

A recent paper from the SCS series reported that alcohol use in adolescence, particularly ‘risky’ use, was associated with an increased risk of obtaining a future disability pension (Sidorchuk et al., 2012). The association was stronger for early disability, indicating that risky adolescent alcohol use is a risk factor for diminished work capacity.

McCambridge et al. (2011) noted that few studies had addressed family influences and only one had investigated genetic aspects (Viken et al., 2007). The Viken et al. (2007) study of Finnish twins suggested that genetic and environmental influences on the development of alcohol problems between the ages of 18 and 25 years were different for men and women, such that genetic influences remained stable over time for men, but declined for women.

A recent study from a prospective UK birth cohort reported on alcohol use at 10, 13 and 15 years and found that by the age of 15 over half of the boys and girls had consumed alcohol and one-fifth reported drinking in a binge fashion (MacArthur et al., 2012). There were no gender differences in drinking behaviour. Higher alcohol consumption at 15 was associated with a significantly higher prevalence of engagement in other risk behaviours at 16 years, in particular substance use and sexual risk behaviours. Those who met criteria for hazardous drinking at 16 were six times more likely to engage in substance use behaviours than those who did not meet these criteria.

Another study of the same birth cohort used longitudinal latent class analysis to categorize alcohol use in the 13–15 year olds as low, medium and high, in terms of frequency and quantity of alcohol consumption (Heron et al., 2013). When they were 16, the young people completed a postal alcohol use disorders identification test (AUDIT) questionnaire: 29% met criteria for hazardous alcohol use (AUDIT score 8–15) and 5.6% met criteria for harmful use (AUDIT score >16). Being in the high class for either drinking frequency or consumption was associated with an 8- to 10-fold increase in odds of harmful alcohol use at 16 years.

A systematic review of longitudinal studies that examined the association between childhood socio-economic status and alcohol use later in life found that there was little evidence to support the association (Wiles et al., 2007).

Alcohol use, and particularly binge drinking, is associated with sleep disorders in a dose–response relationship (Popovivi and French, 2013). These findings were reported from the National Longitudinal Study of Adolescent Health which examined a sample of just over 14,000 adolescents and young adults. Further work is needed to explore the association.

There is clearly a need for high-quality long-term prospective cohort studies to investigate the long-term consequences of adolescent drinking. There is already enough evidence in the literature to warrant interventions to reduce drinking in adolescents (McCambridge et al., 2011).


The adolescent brain undergoes profound neuro-developmental change, in turn influenced by genetic, environmental and sex hormonal factors (Arain et al., 2013). Glutamatergic neurotransmission is predominant and the maturation of neural circuits facilitates social-emotional development (Nelson et al., 2005). At the same time puberty manifests itself in outward bodily change.

The risk factors for adolescent AUDs can be divided into environmental, genetic and phenotypic. Genetic-environmental interaction determines individual alcohol use and AUDs.

Environmental factors

As adolescents become more autonomous so the influence of the peer group becomes more important and family influences wane (Bremner et al., 2011). Adolescence sees a clustering of risk-taking behaviours such as smoking, drinking, drug-taking and sexual activity. Peer effects on risk-taking are strong in this age group, and adolescents affiliated with substance-using peers are at greater risk of engaging in similar behaviours themselves (Gardner and Steinberg, 2005). Peer acceptance is a potent social reward for adolescents (Rubin et al., 2006Guyer et al., 2012) and is associated with high self-esteem and social competence. Having friends who drink increases the likelihood that young people will drink too. Young people are also influenced by how much their friends are drinking. Having older friends and spending more time with drinking friends are likely to promote excessive drinking (Bremner et al., 2011).

Parental expectation and involvement in social activities has been shown to moderate alcohol use (Nash et al., 2005Wichers et al., 2013) and religious affiliation also shows a protective effect. Factors that influence drinking, drinking frequently and drinking to excess include lower levels of parental supervision, exposure to a close family member who drinks or becomes intoxicated, easy access to alcohol and positive expectations of alcohol (Bremner et al., 2011).

Genetic factors

Genetic predisposition accounts for about half of the risk in the development of alcohol dependence. Adolescents with a positive family history of alcohol problems are at greater risk of developing an alcohol problem, and at a younger age, than their peers with negative family histories. Genetic factors may have more influence on drinking behaviour in late than in earlier adolescence (Rose et al., 2001).

Certain childhood characteristics are thought to increase the risk of adolescent AUDs and early identification of these characteristics can be helpful in preventing or attenuating the risk (Thatcher and Clark, 2008). For instance childhood psychological dysregulation is a behavioural phenotype that reflects an individual’s vulnerability to developing an AUD in adolescence (Tarter et al., 2003Thatcher and Clark, 2008). Other characteristics that have been identified and can be measured, but cannot be seen, are known as endophenotypes. Endophenotypes are not an element of the disorder but are associated with it, contribute to individual vulnerability and are seen in the families of affected individuals (Laucht et al., 2007). A range of endophenotypes has been identified as markers for AUDs in young people, including behavioural sensitivity to alcohol and event-related potentials (e.g. P300). Schuckit and colleagues have shown that a low level of response (LR) to alcohol is associated with heavier drinking and alcohol problems (Schuckit et al., 20052008). Adolescent children of alcoholics have been shown to have an abnormal P300 response and abnormalities in brain structure and function (Hill and Steinhauer, 1993Iacono et al., 2002Yoon et al., 2006).

Sensation seeking and behavioural disinhibition are associated with an increased risk of developing substance use disorders in adolescence and may mediate genetic risk (Laucht et al., 2007Iacono et al., 2008).

Externalizing problems in childhood, in particular conduct disorder, have been shown to predict adolescent alcohol and substance use disorders (White et al., 2001King et al., 2004Fergusson et al., 2007Young et al., 2008). A longitudinal study from the West of Scotland (N = 2586 pupils) explored the causal effects of alcohol (mis)use and antisocial behaviour in pupils followed up between the ages of 11 and 15 years (Young et al., 2008) and the findings suggested that antisocial behaviour was the main predictor of alcohol misuse and alcohol-related trouble in this under-age cohort. An American study of 429 rural youths found that delinquency at the age of 11 was a positive predictor of alcohol use at 16 for both boys and girls (Mason et al. (2007). However other studies have reported a reciprocal relationship (D’Amico et al., 2008) and Iacono et al. (2008)propose that a common genetic liability to behavioural disinhibition underlies the co-occurrence of early onset substance use disorders and these other disorders. A recent study of male twins found that genetic risk of externalizing disorder and peer deviance predicted the greatest risks of unfavourable alcohol trajectories (Wichers et al., 2013).

Adolescents with attention deficit hyperactivity disorder appear to have an increased risk of drug use disorders but the evidence for an association with AUDs is mixed (Molina and Pelham, 2003Molina et al., 20072012). Parental knowledge may confer a protective effect in relation to alcohol use in adolescents with ADHD (Walther et al., 2012).

Of internalizing disorders, only depression at the age of 11 years was shown to have a significant relationship with substance use at the age of 14 years (King et al., 2004).

Adolescents with poor affect regulation and depression or who are experiencing high levels of environmental stress may drink or use drugs to self-medicate as a maladaptive coping mechanism. The association between low mood and alcohol use appears to be stronger in adolescents with fewer conduct problems (Hussong et al., 2008)

Adolescents are able to tolerate higher levels of alcohol than adults and they are also more likely to experience the positive effects of alcohol. This may contribute to the development of binge drinking.


A meta-analysis of treatments for adolescent substance abuse found that treatment was effective in reducing alcohol use and that individual interventions performed better overall than family interventions (Tripodi et al., 2010). The number of studies included was relatively small (n = 16 and 26 outcomes), so the results should be interpreted with caution. However both individual and family-based behavioural treatments were effective in promoting long-term reduction in alcohol consumption (i.e. at 12-month follow-up). Behavioural interventions, either of an individual or of a familial nature, appear to be associated with long-term change. Further work is needed to identify the most effective interventions (Tripodi et al., 2010). Caselanos-Ryan et al. (2013) argue for the development and testing of preventative interventions to target early key risk factors for substance use disorders. Such interventions should be embedded in a public health policy that seeks to minimize or delay early onset of alcohol use in adolescents.


What Is Psychiatry?

What Is Psychiatry?

Psychiatry is the branch of medicine focused on the diagnosis, treatment and prevention of mental, emotional and behavioral disorders.

A psychiatrist is a medical doctor (an M.D. or D.O.) who specializes in mental health, including substance use disorders. Psychiatrists are qualified to assess both the mental and physical aspects of psychological problems.

People seek psychiatric help for many reasons. The problems can be sudden, such as a panic attack, frightening hallucinations, thoughts of suicide, or hearing “voices.” Or they may be more long-term, such as feelings of sadness, hopelessness, or anxiousness that never seem to lift or problems functioning, causing everyday life to feel distorted or out of control.

Diagnosing Patients

Because they are physicians, psychiatrists can order or perform a full range of medical laboratory and psychological tests which, combined with discussions with patients, help provide a picture of a patient’s physical and mental state. Their education and clinical training equip them to understand the complex relationship between emotional and other medical illnesses and the relationships with genetics and family history, to evaluate medical and psychological data, to make a diagnosis, and to work with patients to develop treatment plans.

Specific diagnoses are based on criteria established in APA’s Diagnostic and Statistical Manual of Mental Disorders(DSM-5), which contains descriptions, symptoms and other criteria for diagnosing mental disorders.

What Treatments Do Psychiatrists Use?

Psychiatrists use a variety of treatments – including various forms of psychotherapy, medications, psychosocial interventions and other treatments (such as electroconvulsive therapy or ECT), depending on the needs of each patient.

Psychotherapy, sometimes called talk therapy, is a treatment that involves a talking relationship between a therapist and patient. It can be used to treat a broad variety of mental disorders and emotional difficulties. The goal of psychotherapy is to eliminate or control disabling or troubling symptoms so the patient can function better. Depending on the extent of the problem, treatment may take just a few sessions over a week or two or may take many sessions over a period of years. Psychotherapy can be done individually, as a couple, with a family, or in a group.

There are many forms of psychotherapy. There are psychotherapies that help patients change behaviors or thought patterns, psychotherapies that help patients explore the effect of past relationships and experiences on present behaviors, and psychotherapies that are tailored to help solve other problems in specific ways. Cognitive behavior therapy is a goal-oriented therapy focusing on problem solving. Psychoanalysis is an intensive form of individual psychotherapy which requires frequent sessions over several years.

Most medications are used by psychiatrists in much the same way that medications are used to treat high blood pressure or diabetes. After completing thorough evaluations, psychiatrists can prescribe medications to help treat mental disorders. Psychiatric medications can help correct imbalances in brain chemistry that are thought to be involved in some mental disorders. Patients on long-term medication treatment will need to meet with their psychiatrist periodically to monitor the effectiveness of the medication and any potential side effects.

Class of Medications

  • Antidepressants – used to treat depression, panic disorder, PTSD, anxiety, obsessive-compulsive disorder, borderline personality disorder and eating disorders.
  • Antipsychotic medications – used to treat psychotic symptoms (delusions and hallucinations), schizophrenia, bipolar disorder.
  • Sedatives and anxiolytics – used to treat anxiety and insomnia.
  • Hypnotics – used to induce and maintain sleep.
  • Mood stabilizers – used to treat bipolar disorder.
  • Stimulants – used to treat ADHD.

Psychiatrists often prescribe medications in combination with psychotherapy.

Other treatments are also sometimes used. Electroconvulsive therapy (ECT), a medical treatment that involves applying electrical currents to the brain, is used most often to treat severe depression that has not responded to other treatments. Deep brain stimulation (DBS), vagus nerve stimulation (VNS), and transcranial magnetic stimulation (TMS) are a few of the newer therapies being used to treat some mental disorders. Light therapy is used to treat seasonal depression.

Psychiatric Training

To become a psychiatrist, a person must complete medical school and take a written examination for a state license to practice medicine, and then complete four years of psychiatry residency. The first year of residency training is typically in a hospital working with patients with a wide range of medical illnesses. The psychiatrist-in-training then spends at least three additional years learning the diagnosis and treatment of mental health, including various forms of psychotherapy and the use of psychiatric medications and other treatments. Training takes place in in-patient, out-patient, and emergency room settings.

After completing residency training, most psychiatrists take a voluntary written and oral examination given by the American Board of Psychiatry and Neurology to become a “board certified” psychiatrist. They must be re-certified every 10 years.

Some psychiatrists also complete additional specialized training after their four years of general psychiatry training. They may become certified in:

  • Child and adolescent psychiatry
  • Geriatric psychiatry
  • Forensic (legal) psychiatry
  • Addiction psychiatry
  • Pain medicine
  • Psychosomatic (mind and body) medicine
  • Sleep medicine

Some psychiatrists choose additional training in psychoanalysis or in psychiatric research.

Where Do Psychiatrists Work?

Psychiatrists work in a variety of settings, including private practices, clinics, general and psychiatric hospitals, university medical centers, community agencies, courts and prisons, nursing homes, industry, government, military settings, rehabilitation programs, emergency rooms, hospice programs, and many other places. About half of the psychiatrists in the U.S. maintain private practices and many psychiatrists work in multiple settings. There are about 45,000 psychiatrists in the U.S.

What Is the Difference Between a Psychiatrist and Psychologist?

A psychiatrist is a medical doctor (completed medical school and residency) with special training in psychiatry. A psychiatrist is able to conduct psychotherapy and prescribe medications and other medical treatments.

A psychologist usually has an advanced degree, most commonly in clinical psychology, and often has extensive training in research or clinical practice. Psychologists treat mental disorders with psychotherapy and some specialize in psychological testing and evaluation.


We Need to Talk About Kids and Smartphones

Markham Heid

Updated: Oct 10, 2017 8:24 AM ET
TIME Health
For more, visit TIME Health.

Nina Langton had no right to be depressed. At least, that’s how she saw it.

She had a great group of friends, lived in a prosperous neighborhood, and was close with her parents. Like most 16-year-olds at her Connecticut high school, Nina spent much of her free time on her smartphone. But unlike many of her classmates, she was never “targeted” on social media—her word for the bullying and criticism that took place daily on sites like Snapchat. “Part of what made my depression so difficult was that I didn’t understand why I was feeling so sad,” she says.

Later, after her attempted suicide and during her stay at a rehabilitation facility, Nina and her therapist identified body image insecurity as the foundation of her woe. “I was spending a lot of time stalking models on Instagram, and I worried a lot about how I looked,” says Nina, who is now 17. She’d stay up late in her bedroom, looking at social media on her phone, and poor sleep—coupled with an eating disorder—gradually snowballed until suicide felt like her only option. “I didn’t totally want to be gone,” she says. “I just wanted help and didn’t know how else to get it.”

Nina’s mom, Christine Langton, has a degree in public health and works at a children’s hospital. Despite her professional background, she says she was “completely caught off guard” by her daughter’s suicide attempt. “Nina was funny, athletic, smart, personable . . . depression was just not on my radar,” she says.

Nina, TIME Magazine

In hindsight, Langton says she wishes she had done more to moderate her daughter’s smartphone use. “It didn’t occur to me not to let her have the phone in her room at night,” she says. “I just wasn’t thinking about the impact of the phone on her self-esteem or self-image until after everything happened.”

It seems like every generation of parents has a collective freak-out when it comes to kids and new technologies; television and video games each inspired widespread hand-wringing among grown-ups. But the inescapability of today’s mobile devices—coupled with the personal allure of social media—seems to separate smartphones from older screen-based media. Parents, teens and researchers agree smartphones are having a profound impact on the way adolescents today communicate with one another and spend their free time. And while some experts say it’s too soon to ring alarm bells about smartphones, others argue we understand enough about young people’s emotional and developmental vulnerabilities to recommend restricting kids’ escalating phone habit.

The latest statistics on teen mental health underscore the urgency of this debate.

Between 2010 and 2016, the number of adolescents who experienced at least one major depressive episode leapt by 60%, according to a nationwide survey conducted by the U.S. Department of Health and Human Services. The 2016 survey of 17,000 kids found that about 13% of them had a major depressive episode, compared to 8% of the kids surveyed in 2010. Suicide deaths among people age 10 to 19 have also risen sharply, according to the latest data from the Centers for Disease Control and Prevention. Young women are suffering most; a CDC report released earlier this year showed suicide among teen girls has reached 40-year highs. All this followed a period during the late-1990s and early 2000s when rates of adolescent depression and suicide mostly held steady or declined.

“These increases are huge—possibly unprecedented,” says Jean Twenge, a professor of psychology at San Diego State University and author of iGen, which examines how today’s super-connected teens may be less happy and less prepared for adulthood than past generations. In a peer-reviewed study that will appear later this year in the journal Clinical Psychological Science, Twenge shows that, after 2010, teens who spent more time on new media were more likely to report mental health issues than those who spent time on non-screen activities.

Using data collected between 2010 and 2015 from more than 500,000 adolescents nationwide, Twenge’s study found kids who spent three hours or more a day on smartphones or other electronic devices were 34% more likely to suffer at least one suicide-related outcome—including feeling hopeless or seriously considering suicide—than kids who used devices two hours a day or less. Among kids who used electronic devices five or more hours a day, 48% had at least one suicide-related outcome.

Twenge also found that kids who used social media daily were 13% more likely to report high levels of depressive symptoms than those who used social less frequently. Overall, kids in the study who spent low amounts of time engaged in in-person social interaction, but high amounts of time on social media, were the most likely to be depressed.

Twenge is quick to acknowledge that her research does not prove a cause-and-effect relationship exists between smartphones and depression. “It’s possible that depressed kids are just more likely to spend time on their devices,” she says. “But that doesn’t answer the question of what caused this sudden upswing in teen depression and suicide.”

Some experts have pointed to the aftermath of the Great Recession, or rising student workloads, as possible non-device explanations for young people’s recent struggles. “But when you look at the economic or homework data, it doesn’t line up with the rise in teen suicide or depression,” Twenge says. Youth smartphone ownership does. “I’m open to exploring other factors, but I think the more we learn about kids and smartphones, the more we’re going to see that limiting their exposure is a good idea.”

Others agree it’s time to approach adolescent device use with greater caution. “What this generation is going through right now with technology is a giant experiment, and we don’t know what’s going to happen,” says Frances Jensen, chair of neurology at the University of Pennsylvania’s Perelman School of Medicine. While the science on kids and technology is incomplete, Jensen says what we already know about the minds of tweens and teens suggests giving a young person all-the-time access to an Internet-connected device “may be playing with fire.”

The teenage brain

To understand how device use may be affecting a young person’s mental health, it’s important to recognize the complex changes occurring in an adolescent’s still-developing brain.

For one thing, that brain is incredibly plastic and able to adapt—that is, physically change—in response to novel activities or environmental cues, says UPenn’s Jensen, who is the author of The Teenage Brain.

Some research has already linked media multitasking—texting, using social media and rapidly switching among smartphone-based apps—with lower gray-matter volume in the brain’s anterior cingulate cortex (ACC), a region involved in emotion processing and decision making. More research has associated lower ACC volumes with depression and addiction disorders.

“We know for a fact teens have very underdeveloped impulse control and empathy and judgment compared to adults,” Jensen says. This may lead them to disturbing online content or encounters—stuff a more mature mind would know to avoid. Teens also have a hyperactive risk-reward system that allows them to learn—but also to become addicted—much more quickly than grown-ups, she says. Research has linked social media and other phone-based activities with an uptick in feel-good neurochemicals like dopamine, which could drive compulsive device use and promote feelings of distraction, fatigue, or irritability when kids are separated from their phones.

Even if smartphones aren’t the root cause of a teen’s anxiety or other issues, Jensen adds, they may turn out to be an accelerant—the gasoline that turns a flicker of adolescent angst into a blaze.

Another area of the brain—the prefrontal cortex—is critical for focus and interpreting human emotion, and doesn’t fully develop until a person’s mid-20s, says Paul Atchley, a professor of psychology at the University of Kansas. “During our teenage years, it’s important to train that prefrontal cortex not to be easily distracted,” he says. “What we’re seeing in our work is that young people are constantly distracted, and also less sensitive to the emotions of others.”

While the research on smartphones is preliminary, Atchley says he believes studies will eventually show a clearer connection between the negative trends in teen mental health and rising smartphone use. But some scientists contend there isn’t enough cause-and-effect evidence to condemn smartphones.

“I see the rise in depression, especially among girls, and I understand why people are making these connections with new technologies,” says Candice Odgers, a professor of psychology and neuroscience at Duke University who has published research on teens and tech. “But so far, we have very little data to suggest mobile technologies are causing anxiety or social impairments.” She points to evidence that some young people, particularly marginalized groups like LGBT youth, can derive benefits from online communication through supportive exchanges with friends and family.

Odgers adds that jumping to conclusions and vilifying smartphones may lead us away from factors that may turn out to be more significant—a worry raised by other experts. “This is such a serious and polarizing issue that I think we need to set aside our assumptions until we have stronger data,” she says. At the same time, she doesn’t condone unrestricted smartphone access at any age. “I’m certainly not advocating giving an 8-year-old a smartphone,” she says. “But if you ask me what age is appropriate, or how much use is safe, I don’t think the existing evidence provides those answers.”

As researchers debate appropriate public health messaging, kids are receiving their first smartphone at ever-younger ages—the average is 10, according to one recent estimate—and they’re spending more and more time on their devices.

“I am probably on my phone 10 hours a day,” says Santi Potočnik Senarighi, a 16-year-old eleventh grader in Denver. Even when he’s not actively using his phone, Santi says it’s always with him, and he never considers taking a break. “This is part of my life and part of my work, and [that] means I need to be in constant contact.”

Santi’s dad, Billy Potočnik, says he worries about his son’s phone habit, as Santi is struggling in school. But every one of Santi’s friends has a smartphone and uses it constantly, and so Potočnik says confiscating his son’s phone feels oppressive. “If I try to take it away from him, he tells me he’s not doing anything bad on it,” which Potočnik says is usually true, “and it turns into a struggle.”

He and other parents say enduring that struggle day after day feels overwhelming. And to complicate matters, many schools and after-school groups now use social media or online platforms to coordinate events, or to post grades and homework. “It’s not as simple as saying, okay, time to take a break from your phone,” Potočnik says.

How teens ‘talk’

Colleen Nisbet has been a high school guidance counselor for more than two decades. One of her duties at Connecticut’s Granby Memorial High School is to monitor students during their lunch periods. “Lunch was always a very social time when students were interacting and letting out some energy,” she says. “Now they sit with their phones out and barely talk to each other.”

This scene—of kids collecting in parks or at one another’s houses only to sit silently and stare at screens—comes up over and over again when talking with parents and kids. “When you’re with people you don’t know well or there’s nothing to talk about, phones are out more because it’s awkward,” says Shannon Ohannessian, a 17-year-old senior at Farmington High School in Connecticut.

That avoidance of face-to-face interaction worries Brian Primack, director of the University of Pittsburgh’s Center for Research on Media, Technology, and Health. “Human beings are social animals,” he says. “We evolved over millions of years to respond to eye contact and touch and shared laughter and real things right in front of us.” There’s strong research linking isolation to depression, and time spent socializing with improved mood and well-being. If smartphones are getting between an adolescent and her ability to engage in and enjoy face-to-face interaction—and some studies suggest that’s happening—that’s a big deal, Primack says.

But while they’re not always speaking out loud, kids today are talking to each other—and about each other. They’re just doing it on their phones. Not all that talk is friendly. “They tell me they’re making comments or criticizing each other to friends while they’re all sitting together,” says Nisbet, the guidance counselor. Something about the phone just seems to “take the filter off,” she adds.

Backbiting and mean-girl gossip are nothing new, of course. But research suggests that, even among adults, the Internet has a disinhibition effect that leads people to speak in coarser, crueler ways then they would offline.

Maryellen Pachler, a Yale-trained nurse practitioner who specializes in the treatment of adolescent anxiety disorders, says her job used to involve convincing her patients that their fears were largely irrational. “Now I don’t think they’re irrational at all,” she says. “If you raise your hand in class or say something silly, I think it’s likely your classmates will be texting or posting something about it.”

She says the glamor and gleam of social media is also fueling a rise in teen anxiety. “My patients see their friends’ Snapchat or Instagram photos where they look so happy, and they feel like they’re the only ones who are faking it,” she says, referencing what researchers call the highlight reel effect of social media. “I want to tell them, listen, this girl you’re jealous of—she was in here with me yesterday!”

Teens agree social-media whitewashing is the rule, not the exception. “No one’s going to post something that makes them look bad,” Ohannessian says. “I know that, but it’s still hard to separate what you see on social media from real life.”

What’s next for teens and phones

There are doubtless many factors contributing to teen depression. Parents say kids today are busier than ever before—their lives increasingly crammed with the extracurriculars required to gain admission to a good college. But even those researchers who aren’t ready to slam smartphones say it’s important to restrict an adolescent’s device habit, and that too much social media or media multitasking is likely harmful.

“I don’t think these devices are the main cause, but I think they contribute to a lot of the things we worry about,” says David Hill, director of the American Academy of Pediatrics (AAP) Council on Communications and Media. “I speak to parents who are very concerned, and my take is to be much more rigid about setting limits—especially when it comes to phones in the bedroom at night.”

But the AAP’s current guidelines do not offer specifics when it comes to appropriate smartphone limits for children older than 6, and public health officials generally say parents should decide what is right for their kids, without offering specifics.

Educators are also grappling with smartphone-related dilemmas. Most schools allow smartphone use between classes and during free periods, but teachers say keeping students off their phones during class has become a tremendous burden.

Gina Spiers, an English teacher at San Lorenzo High School near Oakland, Calif., says she used to confiscate phones, but students would panic and cause a disruption in class. She and her school are fighting back—with encouraging results.

Starting this fall, San Lorenzo High joined several schools nationwide in working with a company called Yondr to restrict smartphone access during school hours. Yondr makes small, lockable phone pouches that students keep with them, but that can’t be opened until the end of the day.

“The changes have already been profound,” says Allison Silvestri, San Lorenzo’s principal. Kids are more focused and engaged during class, and student journals suggest the high schoolers are feeling less anxious and more relaxed. Silvestri says fewer fights have broken out this semester—a benefit she attributes to the absence of social media. “They have to look each other in the eye to make conflict happen,” she says. “There’s so much more joy and interaction, and I can’t count the number of parents who have asked me, ‘How do I buy this for my home?’”

The smartphone experiment at San Lorenzo doesn’t meet the standards of the scientific method. But it’s one more piece of evidence linking mobile devices with the troubles today’s teen are facing. While there are no doubt helpful and healthy ways young people could use smartphones to enrich their lives, it’s becoming harder to argue that the status quo—near-ubiquitous teen smartphone ownership, coupled with more-or-less unfettered Internet access—is doing kids good.

A few months after her suicide attempt, Nina Langton addressed her high school classmates and spoke openly about her depression. She described the stigma of mental illness, and lamented the fact that, while many teens experience depression, very few are willing to talk about it or ask for help. “I was worried for so long about opening up about my struggles because I thought I would be judged,” she said.

After she gave the speech, “so many people my age reached out to me about their own experiences with technology and depression and therapy,” she says. “I think this is a big problem that needs to be talked about more.”


Resistance Exercise Linked to Reduced Anxiety

The Effects of Resistance Exercise Training on Anxiety_ A Meta-Analysis and Meta-Regression Analysis of Randomized Controlled Trials _ SpringerLink (1)

Resistance Exercise Linked to Reduced Anxiety

By Lisa Rapaport

People who do resistance exercises like weight lifting may experience less anxiety than people who don’t work out, a research review suggests.

Researchers analyzed data from 16 previously published studies with a total of 922 participants who were randomly assigned to do resistance training or be inactive. The study was published in Sports Medicine, online August 17.

Resistance workouts were associated with a reduction in anxiety symptoms whether or not participants had a mental health disorder, though the effect was more pronounced in healthy people who didn’t report any physical or psychological problems.

“The positive effects of exercise training on mental health are well established; however, the majority of this knowledge is based on studies involving aerobic-based training,” said lead study author Brett Gordon, a physical education and sports researcher at the University of Limerick in Ireland.

“RET (resistance exercise training) significantly reduced anxiety in both healthy participants and those with a physical or mental illness, and the effect size of these reductions is comparable to that of frontline treatments such as medication and psychotherapy,” Gordon said by email. “RET is a low-cost behavior with minimal risk, and can be an effective tool to reduce anxiety for healthy and ill alike.”

Because the analysis only focused on resistance training, the results can’t show whether this type of activity might be better or worse than aerobic or other types of exercise for easing anxiety symptoms.

While the effects of resistance exercise on the brain are not as well understood as the impact of aerobic workouts, emerging research has also linked resistance training to less shrinkage of white matter in the brain, said Dianna Purvis Jaffin of the Brain Performance Institute at the University of Texas at Dallas.

White matter is composed of nerve fibers that connect neurons in different parts of the brain. Changes in white matter can occur with age, and are thought to be involved in cognitive and behavioral problems.

It’s possible that exercise might help ease anxiety simply by distracting people from how they’re feeling and giving them something else to focus on, Jaffin, who wasn’t involved in the current study, said by email.

“Exercise generally requires some level of concentration on the activity and may serve as a distraction, and at least acutely (meaning – during that bout of exercise and a bit after) interrupt rumination and obsessive worrying,” Jaffin said.

“Finally, since people with anxiety tend to have uncertainty about their future, they may obsessively worry and lack confidence,” Jaffin added. “Exercise can improve self-efficacy, the belief that one can succeed in particular situations, which may make someone feel more empowered.”

While the amount of exercise may influence the impact of workouts on mental health, there isn’t enough evidence available yet to prescribe a specific amount of activity, said Steven Petruzzello, a body mechanics researcher at the University of Illinois Urbana-Champaign who wasn’t involved in the study.

Absent this sort of prescription, choosing an enjoyable workout makes sense, Petruzzello said by email.

In the current analysis, people did resistance exercises on two to five days per week for an average of 11 weeks.

“The best advice at the present time is to ‘just do it’ – it being whatever the person finds enjoyable or at least tolerable,” Petruzzello said. “For some that might mean going for a walk, for others it might entail more vigorous forms of activity.”


Sports Med 2017.

(c) Copyright Thomson Reuters 2017. Click For Restrictions –

Probiotic May Ease Depression

Probiotic May Ease Depression in IBS Patients

Alan R. Jacobs, MD


August 18, 2017
This is the Medscape Neurology Minute. I’m Dr Alan Jacobs.
Researchers from McMaster University in Canada have published a randomized, double-blind, placebo-controlled study investigating the effects of probiotics on anxiety and depression in patients with irritable bowel syndrome (IBS).[1] Forty-four adults with IBS or a mixed-stool pattern, and mild-to-moderate anxiety and/or depression, were randomly assigned to taking daily probiotic Bifidobacterium longum NCC3001 or placebo for 6 weeks.
At week 6, twice as many patients who received the probiotic had reductions in depression scores, while there was no effect on anxiety or IBS symptoms. Patients in the probiotic group also had mean increases in quality-of-life scores and decreases in fMRI-measured responses to negative emotional stimuli in multiple brain regions, including the amygdala and frontolimbic regions, compared with placebo. At 10 weeks, depression scores were reduced in patients given probiotic versus placebo.

The authors concluded that the probiotic Bifidobacterium longum reduces depression and increases quality of life in patients with IBS, and that this reduction is associated with reduced limbic reactivity in the brain.Donald Rauh

Donald Rauh M.D., Ph.D., FAPA
Diplomate of the American Board of Psychiatry & Neurology
Board Certified in General Psychiatry and in  Child & Adolescent Psychiatry

Childhood Anxiety Disorder

Childhood Anxiety Disorders

Generalized Anxiety Disorder

If your child has generalized anxiety disorder, or GAD, he or she will worry excessively about a variety of things such as grades, family issues, relationships with peers, and performance in sports.  Learn more about GAD.

Children with GAD tend to be very hard on themselves and strive for perfection. They may also seek constant approval or reassurance from others.

Panic Disorder

Panic disorder is diagnosed if your child suffers at least two unexpected panic or anxiety attacks—which means they come on suddenly and for no reason—followed by at least one month of concern over having another attack, losing control, or “going crazy.”  Learn more about panic disorder and panic attacks.

Separation Anxiety Disorder

Many children experience separation anxiety between 18 months and three years old, when it is normal to feel some anxiety when a parent leaves the room or goes out of sight. Usually children can be distracted from these feelings.

It’s also common for your child to cry when first being left at daycare or pre-school, and crying usually subsides after becoming engaged in the new environment.

If your child is slightly older and unable to leave you or another family member, or takes longer to calm down after you leave than other children, then the problem could be separation anxiety disorder, which affects 4 percent of children. This disorder is most common in kids ages seven to nine.

When separation anxiety disorder occurs, a child experiences excessive anxiety away from home or when separated from parents or caregivers. Extreme homesickness and feelings of misery at not being with loved ones are common.

Other symptoms include refusing to go to school, camp, or a sleepover, and demanding that someone stay with them at bedtime. Children with separation anxiety commonly worry about bad things happening to their parents or caregivers or may have a vague sense of something terrible occurring while they are apart.

Social Anxiety Disorder

Social anxiety disorder, or social phobia, is characterized by an intense fear of social and performance situations and activities such as being called on in class or starting a conversation with a peer. Learn more about social anxiety disorder.

This can significantly impair your child’s school performance and attendance, as well as his or her ability to socialize with peers and develop and maintain relationships.

  • Watch this VIDEO: Rose, a teen, speaks about her social anxiety and how cognitive-behavioral therapy (CBT) helped her.

Selective Mutism

Children who refuse to speak in situations where talking is expected or necessary, to the extent that their refusal interferes with school and making friends, may suffer from selective mutism.

Children suffering from selective mutism may stand motionless and expressionless, turn their heads, chew or twirl hair, avoid eye contact, or withdraw into a corner to avoid talking.

These children can be very talkative and display normal behaviors at home or in another place where they feel comfortable. Parents are sometimes surprised to learn from a teacher that their child refuses to speak at school.

The average age of diagnosis is around 5 years old, or around the time a child enters school.

Specific Phobias

A specific phobia is the intense, irrational fear of a specific object, such as a dog, or a situation, such as flying. Common childhood phobias include animals, storms, heights, water, blood, the dark, and medical procedures.

Children will avoid situations or things that they fear, or endure them with anxious feelings, which can manifest as crying, tantrums, clinging, avoidance, headaches, and stomachaches. Unlike adults, they do not usually recognize that their fear is irrational. Learn more about phobias.


Obsessive-compulsive disorder (OCD) and posttraumatic stress disorder (PTSD) are closely related to anxiety disorders, which some may experience at the same time, along with depression.

Obsessive-Compulsive Disorder (OCD)

OCD is characterized by unwanted and intrusive thoughts (obsessions) and feeling compelled to repeatedly perform rituals and routines (compulsions) to try and ease anxiety.  Learn more about OCD.

Most children with OCD are diagnosed around age 10, although the disorder can strike children as young as two or three. Boys are more likely to develop OCD before puberty, while girls tend to develop it during adolescence.

Posttraumatic Stress Disorder (PTSD)

Children with posttraumatic stress disorder, or PTSD, may have intense fear and anxiety, become emotionally numb or easily irritable, or avoid places, people, or activities after experiencing or witnessing a traumatic or life-threatening event.  Learn more about PTSD.

Not every child who experiences or hears about a traumatic event will develop PTSD. It is normal to be fearful, sad, or apprehensive after such events, and many children will recover from these feelings in a short time.

Children most at risk for PTSD are those who directly witnessed a traumatic event, who suffered directly (such as injury or the death of a parent), had mental health problems before the event, and who lack a strong support network. Violence at home also increases a child’s risk of developing PTSD after a traumatic event.



Vitamin D

Vitamin D Insufficiency and FL Outcomes

Blood Cancer J; ePub 2017 Aug 25; Tracy, et al

August 30, 2017

Indolent Lymphoma for July/August 2017

  1. Vitamin D Insufficiency and FL Outcomes
  2. Grade 3 Follicular Lymphoma Outcomes Evaluated

There appears to be a link between vitamin D insufficiency (VDI) and early clinical failure in patients with follicular lymphoma, according to an observational prospective cohort study involving 642 individuals. Participants had follicular lymphoma that was diagnosed at a median of 60 years of age between 2002 and 2012. Investigators looked at whether VDI was linked with adverse outcomes. Among the results:

  • At a median follow-up of ~5 years, 46% of patients experienced either an event or treatment failure.
  • 7% had a lymphoma-related death.
  • Overall, patients with VDI were more than twice as likely to experience inferior event-free survival at 1 year; the same was true for overall survival.
  • They were nearly 3 times more likely to experience inferior lymphoma-specific survival.
  • Among patients treated with immunochemotherapy, those with VDI were ~3 times more likely to experience inferior event-free survival; the same was true for overall survival.
  • They were nearly 6 times more likely to experience inferior lymphoma-specific survival.

Citation:Tracy S, Maurer M, Witzig T, et al. Vitamin D insufficiency is associated with an increased risk of early clinical failure in follicular lymphoma. [Published online ahead of print August 25, 2017]. Blood Cancer J. doi:10.1038/bcj.2017.70.


Study Rebuts Popular Claim Against Antidepressant Effectiveness

The antidepressants paroxetine and citalopram distinctly outperformed placebo among patients who experienced no adverse effects from the drugs in US Food and Drug Administration (FDA)-registered, placebo-controlled trials, according to a new mega-analysis published online in Molecular Psychiatry.

The findings reject a widely disseminated theory, reported on in media outlets including Newsweek and 60 Minutes, that such medications exert no actual antidepressant effect.

“It has been suggested that the superiority of antidepressants over placebo in controlled trials is merely a consequence of side effects enhancing the expectation of improvement by making the patient realize that he/she is not on placebo,” wrote researchers from the University of Gothenburg, Sweden. “We explored this hypothesis in a patient-level post hoc analysis.”

Donald Rauh M.D., Ph.D., FAPA
Diplomate of the American Board of Psychiatry & Neurology
Board Certified in General Psychiatry and in  Child & Adolescent Psychiatry


Association of Nut Consumption with Total and Cause-Specific Mortality

Ying Bao, M.D., Sc.D., Jiali Han, Ph.D., Frank B. Hu, M.D., Ph.D., Edward L. Giovannucci, M.D., Sc.D., Meir J. Stampfer, M.D., Dr.P.H., Walter C. Willett, M.D., Dr.P.H., and Charles S. Fuchs, M.D., M.P.H.

N Engl J Med 2013; 369:2001-2011November 21, 2013DOI: 10.1056/NEJMoa1307352


Increased nut consumption has been associated with a reduced risk of major chronic diseases, including cardiovascular disease and type 2 diabetes mellitus. However, the association between nut consumption and mortality remains unclear.


We examined the association between nut consumption and subsequent total and cause-specific mortality among 76,464 women in the Nurses’ Health Study (1980–2010) and 42,498 men in the Health Professionals Follow-up Study (1986–2010). Participants with a history of cancer, heart disease, or stroke were excluded. Nut consumption was assessed at baseline and updated every 2 to 4 years.


During 3,038,853 person-years of follow-up, 16,200 women and 11,229 men died. Nut consumption was inversely associated with total mortality among both women and men, after adjustment for other known or suspected risk factors. The pooled multivariate hazard ratios for death among participants who ate nuts, as compared with those who did not, were 0.93 (95% confidence interval [CI], 0.90 to 0.96) for the consumption of nuts less than once per week, 0.89 (95% CI, 0.86 to 0.93) for once per week, 0.87 (95% CI, 0.83 to 0.90) for two to four times per week, 0.85 (95% CI, 0.79 to 0.91) for five or six times per week, and 0.80 (95% CI, 0.73 to 0.86) for seven or more times per week (P<0.001 for trend). Significant inverse associations were also observed between nut consumption and deaths due to cancer, heart disease, and respiratory disease.

In two large, independent cohorts of nurses and other health professionals, the frequency of nut consumption was inversely associated with total and cause-specific mortality, independently of other predictors of death. (Funded by the National Institutes of Health and the International Tree Nut Council Nutrition Research and Education Foundation.)


Scientists Say This Food May Help Colon Cancer

It turns out that eating a handful of nuts daily could effectively keep colon cancer from recurring after surgery. In fact, research, from Dana-Farber Cancer Institute in Boston, suggests that eating certain nuts might prove to be as effective as chemotherapy, and may actually keep patients from dying.

Nuts and colon cancer

A daily handful or two of nuts may work as well as standard chemotherapy. That’s what an observational study tells us. Funded by the U.S. National Institutes of Health, the study looked at over 800 patients with stage III colon cancer. Stage III means the cancer may have spread to surrounding tissues, but hasn’t made its way to distant organs. They had also received surgery and chemotherapy for their colon cancer.

According patients filled out diet questionnaires, which included questions regarding the amount of nuts they ate. During the observational study, the patients were followed for seven years after completing chemotherapy. Nearly one in five patients said they ate at least two ounces of nuts a week. Researchers found that those who ate two ounces or more of nuts per week had a 42 percent lower chance of cancer recurrence and 57 percent lower chance of death than those who did not eat nuts.

What kind of nuts help cancer?

Researchers found that tree nuts, like almonds and cashews, provided post-cancer benefits.

However, it seems that the benefits were only linked to tree nuts such as almonds, walnuts, hazelnuts, cashews, Brazil nuts, pistachios and pecans according to lead researcher Dr.Temidayo Fadelu, a clinical fellow at Dana-Farber. Further analysis revealed that peanuts and peanut butter did not provide any post colon-cancer benefits. Unlike tree nuts, peanuts fall within the legume family and are a cousin to well-known legumes such as peas, beans and lentils.

Cancer survival linked to nuts and healthy lifestyle

A second study found that to improve the odds for survival, colon cancer patients should eat nuts along with an overall healthy diet and regular exercise. In fact, that study found that colon cancer survivors with the highest healthy lifestyle scores — healthy eating, exercising and maintaining a healthy weight — had a lower risk of death than those with the lowest scores.

“Diet and lifestyle can influence both the risk of cancer coming back and can help you live longer,” said Dr. Bruce Johnson, chief clinical research officer at Dana-Farber Cancer Institute in Boston. “Once you get cancer, it’s not too late to adopt these,” said Johnson. “It makes a difference. A third of our cancer risk is related to things we can prevent.”

Eating nuts daily may help you live longer

Two other long-running Harvard studies published in the New England Journal of Medicine found that people who ate nuts every day lived longer, healthier lives than people who didn’t eat nuts. The conclusions were gathered from nearly 120,000 participants who answered questions about their diets at the beginning of the studies in the 1980s. Then during a 30-year follow-up, they answered questions every two to four years.  

Participants were categorized into six groups, ranging from never eating nuts to eating them seven or more times per week. The more often people ate nuts, the lower their risk was of premature death. Eating nuts lowers LDL (“bad”) cholesterol and raises HDL (“good”) cholesterol, reports an earlier study by Dr. Penny Kris-Etherton, professor of medicine at the University of Pennsylvania. They also lower blood pressure and blood pressure responses to stress, according to Dr. Kris-Etherton.

Etherton’s research also indicates that eating nuts regularly helps boost a process called reverse cholesterol transport. A process whereby HDL particles in the blood sweep out fatty plaque from clogged arteries. That’s because of the composition of nuts, which includes fiber, healthy fats, vitamins, minerals and phytochemicals. Together, these components in nuts provide cardioprotective, anticarcinogenic, anti-inflammatory and antioxidant properties.

But can eating nuts daily make you gain weight?

                                   Despite being high in fat, nuts don’t tend to cause weight gain.

If you’re worried that eating nuts might make you fat, since they’re high in fat, the fact is, frequent nut eaters are actually less likely to gain weight. In fact, those who eliminate fat from their diet tend to indulge more in carbohydrates. And the more carbs converting to sugar in the body, the fatter you get. A 2009 Harvard study found that higher nut consumption was not associated with weight gain.  

In fact, during an eight-year follow-up study of healthy, middle-aged women who reported eating nuts twice a week, researchers found that they had a slightly lower risk of weight gain and obesity. The result of this study suggests that adding nuts into your diet does not lead to greater weight gain and may actually help you control your weight. Instead, it was associated with a slightly lower risk of weight gain and obesity.

How to add nuts into your diet

Add nuts to your salad for a quick fix of healthy fat.

Sure, that pecan pie is loaded with nuts, but that may not be the best way to get your daily health fix. Here are other better ways to reap the many healthful benefits nuts provide.

  • Add nuts to your salad
  • Make killer tacos with walnut taco meat
  • Add nuts to your hot or cold cereal
  • Pre-bag an assortment of nuts (almonds, cashews, brazil nuts and walnuts) for a quick afternoon snack
  • Spread a little almond butter on your toast
  • Sprinkle chopped pistachios on your pasta with olive oil, garlic and parmesan cheese
  • Add almonds to your fresh, organic green beans
  • Add ground almonds to your smoothie
  • Bake them into a healthy, homemade granola and seed bar — sweetened with raw honey, of course
  • Add chopped nuts to your fruit and yogurt

The bottom line when it comes to nuts and cancer

Tree nuts contain high amounts of healthy fatty acids, fiber and flavonoids, but don’t assume these studies are saying that you should forgo chemo for cashews, healthy diet and exercise. That would be irresponsible.

However, these studies are very promising in that they encourage a healthy diet, including tree nuts and exercise, as a means to improve survival rate after colon cancer surgery. And even if you don’t have cancer, improve your average life expectancy by simply adding nuts to your diet. It certainly can’t hurt! 

Source: — Katherine Marko,