By Corinne Purtill, Los Angeles Times (TNS)

The ads on podcasts and social media were enticing: over-the-counter probiotic supplements that might ward off the worst effects of a hangover if taken before drinking.

As a bourbon reviewer who enjoys the taste of spirits but has all the time been vulnerable to hangovers, Eric Burke was intrigued. To test it, he ordered a couple of bottles of Pre-Alcohol, a probiotic drink from ZBiotics.

He drank the mixture of water, salt, flavoring and genetically modified bacteria. He then had a cocktail, a meal, and two bourbons and woke up the following morning feeling much brighter than he expected.

The next evening, encouraged by the success, he drank one other half-ounce bottle of pre-alcohol. He drank a bit of greater than he had the night before—a beer with dinner after which 4 glasses of bourbon.

This amount normally leaves him feeling sore and sluggish the following day.

That's exactly how he felt when he opened his eyes hours later.

“That was awkward,” said Burke, 48. “I woke up that morning and was like, 'Well, I'm not 21 anymore.' “

A hangover is a collection of physical and mental symptoms This is due to the inflammation and oxidative stress that alcohol causes in the human body.

One of the many factors contributing to next-day misery is the buildup of acetaldehyde, a chemical byproduct of the drinks' ethanol breakdown in the body. Acetaldehyde is a carcinogen that occurs primarily in nausea, stomach upset, sweating, and other physical symptoms associated with excessive consumption.

ZBiotics Pre-Alcohol and rival drug Myrkl from Swedish biotech company De Faire Medical AB both rely on live bacteria to process excess acetaldehyde. Other Researcher And Recreational drinker have also experimented with probiotics for similar purposes.

The hypothesis is that reducing the amount of acetaldehyde should also reduce the physical symptoms caused by the buildup.

“The more you drink, the more you have to deal with the effects of things other than acetaldehyde,” ZBiotics CEO Zack Abbott said by email when asked about Burke’s findings. “Still, acetaldehyde is a significant factor for the overwhelming majority of individuals, and pre-alcohol subsequently makes them feel higher (if not perfect) the following day.”

The U.S. Food and Drug Administration considers ZBiotics and Myrkl to be dietary supplements or functional foods rather than drugs and therefore does not evaluate their health claims. Microbiome experts warn that a probiotic supplement alone won't protect you from the worst effects of overindulgence.

Adding probiotics to your pre-party diet won't do you any harm, said Karsten Zengler, a microbiologist and professor of pediatrics and bioengineering at UC San Diego.

But it's also unlikely to have a significant impact on your well-being the next day because your gut is equipped with an army of bacteria capable of breaking down alcohol's byproducts, she said.

“There isn't a lot of ethanol and acetaldehyde in your colon to begin with,” Zengler said, and “the vast majority of bacteria in your gut already metabolize acetaldehyde for you, so simply adding a little more may not be enough.”

ZBiotics has funded studies demonstrating both the safety of their product and evidence that their bacteria effectively break down a significant amount of acetaldehyde under simulated intestinal conditions in a laboratory. As for the real impact of this collapse, Abbott pointed to an outside effect Paper from 2006 It found that rats given ethanol had fewer hangover-like symptoms the next day when acetaldehyde was removed.

Myrkl financed a small one study This showed that his product reduced blood alcohol levels in some participants. The subjects were instructed to do this Take the dietary supplement for one week before drinking instead of the single dose indicated on the package before the party. Myrkl did not respond to further questions after the study was made available.

The hard truth said Joris C. VersterPharmacology professor at Utrecht University in the Netherlands and founder of the Alcohol Hangover Research Group The consortium is that there is currently a scientifically validated way to prevent a hangover: drink less alcohol.

“Although there are many hangover products on the market, there is no convincing scientific evidence that these treatments are effective. Independent, double-blind, placebo-controlled clinical trials with social drinkers are needed,” Verster said. “Currently, the only effective way to prevent a hangover is to consume alcohol in moderation.”

As unpleasant as a hangover is, it serves a valuable purpose, he said Dr. Daryl DaviesProfessor of Clinical Pharmacy and Director of the Alcohol and Brain Research Laboratory on the USC Mann School of Pharmacy and Pharmaceutical Sciences.

“What I tell people is that when you get a hangover, you drink too much,” Davies said. “It’s the body trying to tell you that something is wrong.”

Originally published: January 7, 2025 at 11:42 am PST

Most prenatal supplements lack the quantity of omega-3 fatty acids that would help prevent premature birth, i.e. delivery before 37 weeks of pregnancy. That is a Key finding of a brand new studypublished by my team, within the American Journal of Perinatology.

Omega-3 fatty acids are essential nutrients that are mainly present in fatty fish. They help prevent inflammation and thus reduce the danger of premature birth.

However, our study showed that roughly one in six pregnancy supplements containing omega-3 fatty acids available in the marketplace within the United States provide the quantity most pregnant women need.

My colleagues and I used information from the US Department of Agriculture Database of dietary complement labels to discover prenatal supplements that contained omega-3 fatty acids. We then compared the quantity of omega-3 fatty acids listed on the product labels with that recommended amounts in the brand new guidelines published within the American Journal of Obstetrics and Gynecology Maternal-Fetal Medicine by a team of experts representing international obstetric and child health organizations.

The guidelines recommend different dosages of omega-3 fatty acids depending on whether a lady's baseline intake before pregnancy was sufficient or inadequate.

We found that 70% of prenatal supplements containing omega-3 fatty acids provided the quantity advisable for ladies to devour adequately. However, previous research has shown that only 5% of pregnant women and ladies of childbearing age Consume enough omega-3 fatty acids. Therefore, prenatal supplementation with the next amount of omega-3 fatty acids can be helpful for ladies with inadequate intake.

Why it matters

Premature birth is the most important reason behind this Child mortality worldwide. It can be probably the most common reason behind childhood illnesses, resulting in costly hospital stays Neonatal intensive care units. And then there's the hard part emotional toll that it impacts parents and families.

Premature birth also increases a baby's risk of long-term health consequences reminiscent of: mental disabilitychronic illnesses reminiscent of hypertension, diabetes and psychiatric illnesses in maturity.

And yet there are some few treatment options for premature births.

This is where omega-3 fatty acids come into play. They reduce the danger of premature birth by reducing the production of those fatty acids Signaling molecules that trigger labor.

A Cochrane review of 26 randomized controlled trials showed that 1,000 milligrams of additional omega-3 fatty acids per day can reduce the danger of preterm birth by 11% and the danger of early preterm birth (delivery before 34 weeks of pregnancy) by 42%.

Considering that prenatal supplements often don’t contain the required amount of omega-3 fatty acids, one option is to easily take a further omega-3 complement along with a prenatal vitamin to make up the difference and get the profit.

However, omega-3 supplements will not be all the time mandatory. The recent guidelines recommend that every one women of childbearing age devour 250 milligrams of omega-3 fatty acids per day. This amount may be obtained from about two 3-ounce servings per week of fatty fish reminiscent of salmon, mackerel, herring, sardines and anchovies.

If women increase their intake of omega-3 fatty acids before pregnancy, the advisable intake levels while pregnant are lower. This is one option to eliminate the necessity for supplements in the primary place.

However, because of this, women of childbearing age also need to think about the mercury content in fish negative effects on the neurological development of the fetus. While most forms of salmon are low in mercury, certain fish wealthy in omega-3 fatty acids could also be moderately high mercury content. It is significant to seek the advice of local health guidelines regarding mercury levels in fish to make sure secure consumption levels.

What will not be yet known

Omega-3 fatty acids are chemically unstable molecules that are inherently fragile and subsequently prone to oxidation, a process during which oxygen breaks down the molecule and renders it ineffective. Studies have shown large variation within the oxidation states In commercial omega-3 supplements. Worse still, there are few predictors of the standard of omega-3 supplements.

However, despite their high risk of oxidation, commercially available omega-3 supplements have shown an increased risk of oxidation proven advantages in clinical trials.

What's next?

Considering the inconsistent amounts of omega-3 fatty acids in prenatal supplements, their instability, and the likelihood that pre-pregnancy dietary sources offset complement needs, further research is required to grasp how increased omega-3 intake helps Women of childbearing age may be motivated.

Given that many ladies proceed to require omega-3 fatty acids from supplements, longitudinal studies to watch omega-3 levels in prenatal supplements will probably be critical.

Furthermore, ongoing efforts are needed to advertise the implementation of this information in clinical settings to make sure that pregnant women and the health care professionals who look after them can make the most of the good potential of omega-3 fatty acids in pregnancy prevention of preterm birth.

If there may be one thing doctors agree on, it’s that each one of their pregnant patients should take prenatal supplements. As a result, about 3 out of 4 expectant moms Follow your doctor’s advice.

But although they’re equally vital for the health of mother and child, Prenatal supplements usually are not regulatedThere are not any regulations that require these supplements to contain any nutrients in any respect, let alone the suitable doses.

Not surprisingly, research shows that none of essentially the most widely available over-the-counter prenatal supplements – whether tablets, capsules, softgels or gummy bears – provide sufficient amounts of 5 vital nutrients: Folic acid, iron, vitamin D, calcium and Docosahexaenoic acida member of the omega-3 fatty acid family.

All these nutrients are really helpful by the American College of Obstetricians and Gynecologistsand sufficient intake of those substances is related to improved health outcomes for each pregnant patients and their babies.

As an assistant doctor for general medicine with a Ph.D. in NutritionI started researching these products after my patients asked questions on them. I discovered that most of the vital nutrients needed while pregnant is missing from these productsOther dietary supplements, nevertheless, contained too little or an excessive amount of.

Folic acid

Folic acid, which reduces the speed of birth defects by 50%is the important reason for the event of prenatal supplements.

But folic acid only prevents birth defects if taken before day 28 of pregnancy. In other words, certain birth defects can only be prevented if a lady takes a prenatal complement before she knows she is pregnant.

For this reason, the American College of Obstetrics and Gynecology recommends that ladies should begin taking prenatal supplements no less than three months before pregnancy.

However, only about one third of ladies – and only 10% of African-American women. For them, folic acid, which is presupposed to prevent birth defects, comes too late.

Even women who take supplements early in pregnancy will not be getting the nutrients they need, including 400 micrograms of folic acid — an artificial version of folate — from their every day prenatal complement. 27% of prenatal supplements contain less than this amount.

On the opposite hand, while rare, it isn’t not possible to seek out products containing greater than 1 milligram of folic acid – a potentially dangerous amount that has been linked to impaired cognitive development, especially reduced verbal skills.

Omega-3 fatty acids

After their Introduction within the Eighties as a straightforward multivitamin with some extra folic acid, prenatal supplements have evolved to offer an additional dietary boost. One of those supplements, omega-3 fatty acids, function constructing blocks for the development of the fetal brain. In fact, 40% of the human brain consists of omega-3 fatty acids.

A study on rats showed that insufficient intake of omega-3 fatty acids while pregnant results in significant decrease in omega-3 levels within the mother's brain. Although such a study could never be conducted in humans, it suggests that moms may forgo omega-3 fatty acids from their very own brains to support their baby's brain development.

But other studies linking low values of omega-3 fatty acids in postpartum depressionthe intellect of a toddler or other significant results have produced mixed results.

However, there appears to be a connection between Omega-3 fatty acids and premature birthswith increased intake resulting in reduced risk. Premature birth – Delivery before the thirty seventh week of pregnancy – is coming within the US and worldwide, with greater than 1 in 10 babies born prematurely.

New guidelines recommend that pregnant women who don’t frequently devour enough omega-3 fatty acids should devour 600 to 1,000 milligrams of omega-3 fatty acids every day. Studies have shown that that is sort of not possible to be present in a prenatal complement.

However, patients who eat fatty fish twice every week – this will be salmon, mackerel, herring, sardines or anchovies – may only need a further 100-200 milligrams every day Omega-3 fatty acids while pregnantAnd about 40% of business prenatal supplements provide this amount.

But most Americans don’t eat two servings of fatty fish per week. 95% of pregnant and breastfeeding women within the US You usually are not getting enough omega-3 fatty acidsWhile many ladies avoid fish while pregnant because of Concerns about mercuryFatty fish that contain omega-3 fatty acids are low in mercury and usually are not among the many fish that needs to be avoided while pregnant.

Choline

Choline can also be crucial for fetal brain development. Its requirement increases to 450 milligrams per day while pregnant and much more during breastfeeding – 550 milligrams per day.

With the exception of organ meats resembling beef liver, few foods contain enough choline to satisfy this need. One egg accommodates about 150 milligrams of choline, a 3-ounce steak accommodates 117, and a half-cup of soybeans accommodates 107. Salmon, broccoli, Brussels sprouts, cauliflower, green peas, and kidney beans also contain some choline.

Because these usually are not large amounts, pregnant women have to devour several choline-rich foods every day and may have a complement to achieve the really helpful amount.

But apparently this isn’t the case for nearly anyone: 95% of pregnant women ingest insufficient amounts of cholineand greater than half of prenatal supplements haven’t any cholineThose that do typically provide far too little of it – lower than 100 milligrams.

In addition, some research suggests that taking even higher amounts of choline than really helpful in guidelines may provide additional advantages.

A study showed that doubling the really helpful amount within the third trimester of pregnancy improve a toddler’s attention spanAnother study found that a few of the effects of fetal alcohol syndrome will be alleviated with 4 times the really helpful amount of choline.

solutions

These three examples clearly show that taking prenatal supplements is not any guarantee of a nutritionally adequate pregnancy.

Part of the issue is an absence of coaching: doctors are learned little or no about nutrition during my medical studiesand I've observed that the majority patients simply assume that they're getting every thing they need from their prenatal supplements.

Since there are not any regulatory standards for these products, there isn’t any incentive to enhance them. Nobody is forcing these corporations to alter their recipes, so it isn’t a priority for them.

My intention here isn’t to discredit these products, but quite to point out that they alone usually are not enough.

Finding one of the best complement with just the best amount of every nutrient – ​​not an excessive amount of and never too little – is difficult, if not not possible. Even the worth is no quality feature.

To ensure an adequate supply of those nutrients, pregnant women or those planning to grow to be pregnant should consider the next three things:

1) Choose a prenatal complement containing no more and at least the really helpful 400 micrograms of folic acid every day and take it three months before conception.

2) Eat two servings of fatty fish weekly and take a 100-200 mg omega-3 fatty acid complement every day. If you don't eat fatty fish frequently, take a 600-1,000 mg complement.

3) Assess current intake of choline-rich foods and consider taking a choline complement if needed.

Getting adequate nutrition while pregnant requires an incredible amount of effort and chances are you’ll feel like you might be on your personal to do it.

I give my patients a guide to assist them manage their dietary needs while pregnant. This may help provide the knowledge needed to beat the inadequacies of prenatal supplements.

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