KIDDOC.ORG

School starts too early, and we should make some noise about it.

noreply@blogger.com (Anonymous) — Tue, 18 Aug 2015 03:53:00 +0000

Jason Reed / Reuters

For the first time, the federal Centers for Disease Control and Prevention is urging education policymakers to start middle- and high-school classes later in the morning. The idea is to improve the odds of adolescents getting sufficient sleep so they can thrive both physically and academically.
The CDC’s recommendations come a year after the American Academy of Pediatrics urged schools to adjust start times so more kids would get the recommended 8.5 to 9.5 hours of nightly rest. Both the CDC and the pediatricians’ group cited significant risks that come with lack of sleep, including higher rates of obesity and depression and motor-vehicle accidents among teens as well as an overall lower quality of life.

john with child workout

noreply@blogger.com (Anonymous) — Sun, 09 Aug 2015 01:16:00 +0000

We changed our minds : Oops. Food Allergy Advice for Parents: Start Peanuts, Eggs and More Sooner - WSJ.com

noreply@blogger.com (Anonymous) — Sat, 06 Apr 2013 23:45:00 +0000

When will we ever make up our minds as docs? I suppose this is the inherent virtue of science, if we learn something new, we change our minds.
Interesting notes re association with vit d deficiency and food allergy.

increasing evidence for early food introduction, and hygiene hypothesis.

We'll reverse it all in another 10 years?

From Evernote:

Food Allergy Advice for Parents: Start Peanuts, Eggs and More Sooner - WSJ.com

Clipped from: http://online.wsj.com/article/SB10001424127887324662404578334423524696016.html

Food Allergy Advice for Kids: Don't Delay Peanuts, Eggs

Infants at risk for food allergies should be gradually introduced to suspect foods to build up tolerance, according to new recommendations from a leading allergy doctor group. WSJ's Sumathi Reddy joins Lunch Break with a look at the evidence. Photo: AP.

Parents trying to navigate the confusing world of children's food allergies now have more specific advice to consider. Highly allergenic foods such as peanut butter, fish and eggs can be introduced to babies between 4 and 6 months and may even play a role in preventing food allergies from developing.
These recommendations regarding children and food allergies—a rising phenomenon that researchers don't fully understand—come from the American Academy of Allergy, Asthma & Immunology in a January article in the Journal of Allergy & Clinical Immunology: In Practice. The AAAAI's Adverse Reactions to Foods Committee outlined how and when to introduce highly allergenic foods, which include wheat, soy, milk, tree nuts, and shellfish.

Enlarge Image

Getty Images
A new report recommends introducing highly allergenic foods to children earlier. The foods include eggs, fish, soy, milk and tree nuts. Above, edamame.

Enlarge Image

Getty Images
Highly allergenic foods such as peanut butter, fish and eggs can be introduced to babies between 4 and 6 months.

Getty Images

The recommendations are a U-turn from 2000, when the American Academy of Pediatrics issued guidelines that children should put off having milk until age 1, eggs until 2 and peanuts, shellfish, tree nuts and fish until 3. In 2008, the AAP revised its guidelines, citing little evidence that such delays prevent the development of food allergies, but it didn't say when and how to introduce such foods.
Food allergies affect an estimated 5% of children under the age of 5 in the U.S., according to the National Institute of Allergy and Infectious Diseases, part of the National Institutes of Health. The prevalence of a food allergy for children under 18 increased by 18% from 1997 to 2007.
"There's been more studies that find that if you introduce them early it may actually prevent food allergy," said David Fleischer, co-author of the article and a pediatric allergist at National Jewish Health in Denver. "We need to get the message out now to pediatricians, primary-care physicians and specialists that these allergenic foods can be introduced early."
Dr. Fleischer said more study results are needed to conclusively determine whether early introduction will in fact lead to lower food-allergy rates and whether they should be recommended as a practice.
The first trials to split children into groups, with some eating highly allergenic foods early on and others delaying, are continuing in the United Kingdom and Australia with some preliminary results expected to be out next year. This type of trial with children is rare and the results are highly anticipated.
One theory to explain why early introduction is important holds that if babies aren't exposed early enough to certain foods, their immune systems will treat them as foreign substances and attack them, resulting in an allergy.
"The body has to be trained in the first year of life," says Katie Allen, a professor and allergist at the Murdoch Childrens Research Institute at Royal Children's Hospital in Australia. (The institute was founded in part by the late Dame Elisabeth Murdoch, mother of Rupert Murdoch , who is chairman of News Corp., which owns The Wall Street Journal.) "We think there's a critical window, probably around 4 to 6 months, when the child first starts to eat solids," she says.
Another possible explanation from some experts for the increase in allergies: As westernized countries have become more hygienic, children don't have the same exposure to germs, which affects the development of the immune system.
Dr. Allen believes there may be a link between food allergies and vitamin D. In a study out this week in the Journal of Allergy and Clinical Immunology, researchers took blood samples from more than 5,000 babies and found that those with low vitamin D levels were three times more likely to have a food allergy.
Food-allergy reactions range from hives and eczema to asthma, vomiting and anaphylaxis, a life-threatening reaction in which the body's major systems quickly shut down. A 2011 prevalence study in the journal Pediatrics found that 39% of children with food allergies have a history of severe reactions.
The new recommendations include introducing highly allergenic foods after typical first foods have been eaten and tolerated, such as rice cereal, fruits and vegetables. They suggest children be fed the foods at home and in gradually increasing amounts. The AAAAI recommendations cited about half-a-dozen studies in making its new guidelines.
One observational study compared Jewish children in the United Kingdom with those in Israel, where the peanut-allergy rate is low. The 2008 study of more than 5,000 children in each country in the Journal of Allergy Clinical Immunology found the rate of peanut allergies among the U.K. children was 10 times that of those in Israel. Gideon Lack, a professor of paediatric allergy at King's College London, said the researchers followed up with surveys given to the parents of about 100 infants hundred in each country. They found that popular snacks with peanuts were given to Israeli babies often before they were 6 months of age, whereas the majority of babies in the United Kingdom didn't taste peanut products until after the age of 1.
Dr. Lack is in the midst of the much-anticipated, randomized controlled trial in the U.K., which is following 640 children with a high risk of allergy—determined by eczema—from infancy to the age of 5. Half of the children are consuming at least 24 grams of peanuts three times a week, while the others have none. About two-thirds of the children are now 5 and receiving peanut-allergy testing. Preliminary results are expected next year.
Some experts are critical of the observational studies cited in the recommendations. "The evidence that has come up is of great interest but it's all either anecdotal or epidemiological and not the intervention studies that are going on right now that will lead to answers in the next three years," said Robert Wood, director of Pediatric Allergy and Immunology at Johns Hopkins University School of Medicine.
Dr. Wood said he tells parent they don't need to feel pressured to do an early introduction. "You can do whatever you want because we're not sure what makes a difference," he said.

Enlarge Image

Read rest of the article here
http://online.wsj.com/article/SB10001424127887324662404578334423524696016.html

Not enough sleep makes you fat

noreply@blogger.com (Anonymous) — Tue, 19 Mar 2013 02:06:00 +0000

Adding substantially( pardon the pun ) to the large data set of evidence that points to inadequate sleep contributing massively to weight gain.

Lost Sleep Can Lead to Weight Gain

By TARA PARKER-POPE

Stuart Bradford

FACEBOOK
TWITTER
GOOGLE+
SAVE
E-MAIL
SHARE
PRINT

The best path to a healthy weight may be a good night’s sleep.

For years researchers have known that adults who sleep less than five or six hours a night are at higher risk of being overweight. Among children, sleeping less than 10 hours a night is associated with weight gain.

Now a fascinating new study suggests that the link may be even more insidious than previously thought. Losing just a few hours of sleep a few nights in a row can lead to almost immediate weight gain.

Sleep researchers from the University of Colorado recruited 16 healthy men and women for a two-week experiment tracking sleep, metabolism and eating habits. Nothing was left to chance: the subjects stayed in a special room that allowed researchers to track their metabolism by measuring the amount of oxygen they used and carbon dioxide they produced. Every bite of food was recorded, and strict sleep schedules were imposed.

The goal was to determine how inadequate sleep over just one week — similar to what might occur when students cram for exams or when office workers stay up late to meet a looming deadline — affects a person’s weight, behavior and physiology.

During the first week of the study, half the people were allowed to sleep nine hours a night while the other half stayed up until about midnight and then could sleep up to five hours. Everyone was given unlimited access to food. In the second week, the nine-hour sleepers were then restricted to five hours of sleep a night, while the sleep-deprived participants were allowed an extra four hours.

Notably, the researchers found that staying up late and getting just five hours of sleep increased a person’s metabolism. Sleep-deprived participants actually burned an extra 111 calories a day, according to the findings published last week in The Proceedings of the National Academy of Sciences.

But even though we burn more calories when we stay awake, losing sleep is not a good way to lose weight. The light sleepers ended up eating far more than those who got nine hours of sleep, and by the end of the first week the sleep-deprived subjects had gained an average of about two pounds.

During the second week, members of the group that had originally slept nine hours also gained weight when they were restricted to just five hours. And the other group began to lose some (but not all) of the weight gained in that first sleep-deprived week.

Kenneth Wrightdirector of the university’s sleep and chronobiology laboratory, said part of the change was behavioral. Staying up late and skimping on sleep led to not only more eating, but a shift in the type of foods a person consumed.

“We found that when people weren’t getting enough sleep they overate carbohydrates,” he said. “They ate more food, and when they ate food also changed. They ate a smaller breakfast and they ate a lot more after dinner.”

In fact, sleep-deprived eaters ended up eating more calories during after-dinner snacking than in any other meal during the day. Over all, people consumed 6 percent more calories when they got too little sleep. Once they started sleeping more, they began eating more healthfully, consuming fewer carbohydrates and fats. Dr. Wright noted that the effect of sleep deprivation on weight would likely be similar in the real world although it might not be as pronounced as in the controlled environment. The researchers found that insufficient sleep changed the timing of a person’s internal clock, and that in turn appeared to influence the changes in eating habits. “They were awake three hours before their internal nighttime had ended,” Dr. Wright said. “Being awakened during their biological night is probably why they ate smaller breakfasts.”

The effect was similar to the jet lag that occurs when a person travels from California to New York.

Last fall, The Annals of Internal Medicine reported on a study by University of Chicago researchers, who found thatlack of sleep alters the biology of fat cells. In the small study — just seven healthy volunteers — the researchers tracked the changes that occurred when subjects moved from 8.5 hours of sleep to just 4.5 hours. After four nights of less sleep, their fat cells were less sensitive to insulin, a metabolic change associated with both diabetes and obesity.

“Metabolically, lack of sleep aged fat cells about 20 years,” said Matthew Brady, an associate professor of medicine at the University of Chicago and the senior author on the study.

“These subjects were in their low 20s but it’s as if they were now middle-aged in terms of their response. We were surprised how profound the effects were.”

Read rest of the article here
http://well.blogs.nytimes.com/2013/03/18/lost-sleep-can-lead-to-weight-gain/?hp

On building resilience by hearing and knowing the family story

noreply@blogger.com (Anonymous) — Mon, 18 Mar 2013 17:30:00 +0000

Building resilience in children and families is a kind of Holy Grail for healthy families. A simple but powerful tool, may be to hear and internalize the family stories. How a child fits into the larger intergenerational narrative. Feiler quotes Marshall Duke out of Emory who has formally studied the power of resilience and the family narrative. What a fun way to build resilience!

THIS LIFE

The Stories That Bind Us

Sarah Williamson

Families may want to create a mission statement similar to the ones many companies use to identify their core values.

By BRUCE FEILER

Published: March 17, 2013

I hit the breaking point as a parent a few years ago. It was the week of my extended family's annual gathering in August, and we were struggling with assorted crises. My parents were aging; my wife and I were straining under the chaos of young children; my sister was bracing to prepare her preteens for bullying, sex and cyberstalking.

Sure enough, one night all the tensions boiled over. At dinner, I noticed my nephew texting under the table. I knew I shouldn't say anything, but I couldn't help myself and asked him to stop.

Ka-boom! My sister snapped at me to not discipline her child. My dad pointed out that my girls were the ones balancing spoons on their noses. My mom said none of the grandchildren had manners. Within minutes, everyone had fled to separate corners.

Later, my dad called me to his bedside. There was a palpable sense of fear I couldn't remember hearing before.

"Our family's falling apart," he said.

"No it's not," I said instinctively. "It's stronger than ever."

But lying in bed afterward, I began to wonder: Was he right? What is the secret sauce that holds a family together? What are the ingredients that make some families effective, resilient, happy?

It turns out to be an astonishingly good time to ask that question. The last few years have seen stunning breakthroughs in knowledge about how to make families, along with other groups, work more effectively.

Myth-shattering research has reshaped our understanding of dinnertime, discipline and difficult conversations. Trendsetting programs from Silicon Valley and the military have introduced techniques for making teams function better.

The only problem: most of that knowledge remains ghettoized in these subcultures, hidden from the parents who need it most. I spent the last few years trying to uncover that information, meeting families, scholars and experts ranging from peace negotiators to online game designers to Warren Buffett's bankers.

After a while, a surprising theme emerged. The single most important thing you can do for your family may be the simplest of all: develop a strong family narrative.

I first heard this idea from Marshall Duke, a colorful psychologist at Emory University. In the mid-1990s, Dr. Duke was asked to help explore myth and ritual in American families.

"There was a lot of research at the time into the dissipation of the family," he told me at his home in suburban Atlanta. "But we were more interested in what families could do to counteract those forces."

Around that time, Dr. Duke's wife, Sara, a psychologist who works with children with learning disabilities, noticed something about her students.

"The ones who know a lot about their families tend to do better when they face challenges," she said.

Her husband was intrigued, and along with a colleague, Robyn Fivush, set out to test her hypothesis. They developed a measure called the "Do You Know?" scale that asked children to answer 20 questions.

Examples included: Do you know where your grandparents grew up? Do you know where your mom and dad went to high school? Do you know where your parents met? Do you know an illness or something really terrible that happened in your family? Do you know the story of your birth?

Dr. Duke and Dr. Fivush asked those questions of four dozen families in the summer of 2001, and taped several of their dinner table conversations. They then compared the children's results to a battery of psychological tests the children had taken, and reached an overwhelming conclusion. The more children knew about their family's history, the stronger their sense of control over their lives, the higher their self-esteem and the more successfully they believed their families functioned. The "Do You Know?" scale turned out to be the best single predictor of children's emotional health and happiness.

"We were blown away," Dr. Duke said.

And then something unexpected happened. Two months later was Sept. 11. As citizens, Dr. Duke and Dr. Fivush were horrified like everyone else, but as psychologists, they knew they had been given a rare opportunity: though the families they studied had not been directly affected by the events, all the children had experienced the same national trauma at the same time. The researchers went back and reassessed the children.

"Once again," Dr. Duke said, "the ones who knew more about their families proved to be more resilient, meaning they could moderate the effects of stress."

Why does knowing where your grandmother went to school help a child overcome something as minor as a skinned knee or as major as a terrorist attack?

"The answers have to do with a child's sense of being part of a larger family," Dr. Duke said.

Psychologists have found that every family has a unifying narrative, he explained, and those narratives take one of three shapes.

First, the ascending family narrative: "Son, when we came to this country, we had nothing. Our family worked. We opened a store. Your grandfather went to high school. Your father went to college. And now you. ..."

Second is the descending narrative: "Sweetheart, we used to have it all. Then we lost everything."

"The most healthful narrative," Dr. Duke continued, "is the third one. It's called the oscillating family narrative: 'Dear, let me tell you, we've had ups and downs in our family. We built a family business. Your grandfather was a pillar of the community. Your mother was on the board of the hospital. But we also had setbacks. You had an uncle who was once arrested. We had a house burn down. Your father lost a job. But no matter what happened, we always stuck together as a family.' "

Dr. Duke said that children who have the most self-confidence have what he and Dr. Fivush call a strong "intergenerational self." They know they belong to something bigger than themselves.

Leaders in other fields have found similar results. Many groups use what sociologists call sense-making, the building of a narrative that explains what the group is about.

Jim Collins, a management expert and author of "Good to Great," told me that successful human enterprises of any kind, from companies to countries, go out of their way to capture their core identity. In Mr. Collins's terms, they "preserve core, while stimulating progress." The same applies to families, he said.

Mr. Collins recommended that families create a mission statement similar to the ones companies and other organizations use to identify their core values.

The military has also found that teaching recruits about the history of their service increases their camaraderie and ability to bond more closely with their unit.

Cmdr. David G. Smith is the chairman of the department of leadership, ethics and law at the Naval Academy and an expert in unit cohesion, the Pentagon's term for group morale. Until recently, the military taught unit cohesion by "dehumanizing" individuals, Commander Smith said. Think of the bullying drill sergeants in "Full Metal Jacket" or "An Officer and a Gentleman."

But these days the military spends more time building up identity through communal activities. At the Naval Academy, Commander Smith advises graduating seniors to take incoming freshmen (or plebes) on history-building exercises, like going to the cemetery to pay tribute to the first naval aviator or visiting the original B-1 aircraft on display on campus.

Dr. Duke recommended that parents pursue similar activities with their children. Any number of occasions work to convey this sense of history: holidays, vacations, big family get-togethers, even a ride to the mall. The hokier the family's tradition, he said, the more likely it is to be passed down. He mentioned his family's custom of hiding frozen turkeys and canned pumpkin in the bushes during Thanksgiving so grandchildren would have to "hunt for their supper," like the Pilgrims.

"These traditions become part of your family," Dr. Duke said.

Decades of research have shown that most happy families communicate effectively. But talking doesn't mean simply "talking through problems," as important as that is. Talking also means telling a positive story about yourselves. When faced with a challenge, happy families, like happy people, just add a new chapter to their life story that shows them overcoming the hardship. This skill is particularly important for children, whose identity tends to get locked in during adolescence.

The bottom line: if you want a happier family, create, refine and retell the story of your family's positive moments and your ability to bounce back from the difficult ones. That act alone may increase the odds that your family will thrive for many generations to come.

"This Life" appears monthly in Sunday Styles. This article is adapted from Bruce Feiler's recently published book, "The Secrets of Happy Families: How to Improve Your Morning, Rethink Family Dinner, Fight Smart, Go Out and Play, and Much More."

noreply@blogger.com (Anonymous) — Wed, 18 Apr 2012 00:18:00 +0000

I try to always look for sleep related disorders, restless legs syndrome, snoring, straight forward sleep deprivation as concomitant as well as mimics of adhd. Sleep is a core task of childhood, and impacts mood , irritability, learning so profoundly.

Attention Problems May Be Sleep-Related
http://well.blogs.nytimes.com/2012/04/16/attention-problems-may-be-sleep-related/

by KATE MURPHY, well.blogs.nytimes.com
April 16th 2012

Diagnoses of attention hyperactivity disorder among children have increased dramatically in recent years, rising 22 percent from 2003 to 2007, according to the Centers for Disease Control and Prevention. But many experts believe that this may not be the epidemic it appears to be.

Many children are given a diagnosis of A.D.H.D., researchers say, when in fact they have another problem: a sleep disorder, like sleep apnea. The confusion may account for a significant number of A.D.H.D. cases in children, and the drugs used to treat them may only be exacerbating the problem.

“No one is saying A.D.H.D. does not exist, but there’s a strong feeling now that we need to rule out sleep issues first,” said Dr. Merrill Wise, a pediatric neurologist and sleep medicine specialist at the Methodist Healthcare Sleep Disorders Center in Memphis.

The symptoms of sleep deprivation in children resemble those of A.D.H.D. While adults experience sleep deprivation as drowsiness and sluggishness, sleepless children often become wired, moody and obstinate; they may have trouble focusing, sitting still and getting along with peers.

The latest study suggesting a link between inadequate sleep and A.D.H.D. symptoms appeared last month in the journal Pediatrics. Researchers followed 11,000 British children for six years, starting when they were 6 months old. The children whose sleep was affected by breathing problems like snoring, mouth breathing or apnea were 40 percent to 100 percent more likely than normal breathers to develop behavioral problems resembling A.D.H.D.

Children at highest risk of developing A.D.H.D.-like behaviors had sleep-disordered breathing that persisted throughout the study but was most severe at age 2 1/2.

“Lack of sleep is an insult to a child’s developing body and mind that can have a huge impact,” said Karen Bonuck, the study’s lead author and a professor of family and social medicine at Albert Einstein College of Medicine in New York. “It’s incredible that we don’t screen for sleep problems the way we screen for vision and hearing problems.”

Her research builds on earlier, smaller studies showing that children with nighttime breathing problems did better with cognitive and attention-directed tasks and had fewer behavioral issues after their adenoids and tonsils were removed. The children were significantly less likely than untreated children with sleep-disordered breathing to be given an A.D.H.D. diagnosis in the ensuing months and years.

Most important, perhaps, those already found to have A.D.H.D. before surgery subsequently behaved so much better in many cases that they no longer fit the criteria. The National Institutes of Health has begun a study, called the Childhood Adenotonsillectomy Study, to understand the effect of surgically removing adenoids and tonsils on the health and behavior of 400 children. Results are expected this year. .....

Why we are screening kids for cholesterol.

noreply@blogger.com (Anonymous) — Mon, 20 Feb 2012 23:58:00 +0000

Interestingly stress and sleep are identified as major risk factor(s).
NEWS AND FEATURES

NHLBI guidelines on cholesterol in kids: What’s new and how does this change practice?

Sarah de Ferranti, M.D., M.P.H., FAAP and
Reginald L. Washington, M.D., FAAP

New guidelines from the National Heart, Lung and Blood Institute (NHLBI) on reducing cardiovascular disease (CVD) in children and adolescents provide many recommendations that are consistent with previous AAP and American Heart Association (AHA) statements. A few provisions, however, are new and/or controversial, including the following:

All children should undergo cholesterol screening once between ages 9-11 years and once between ages 17-21 years.
Non-fasting total cholesterol and high-density lipoprotein (HDL) can be used for the initial lipid screening test.
Clinicians may recommend low-fat or no-fat dairy at age 1 year for high-risk patients.
For patients who fail lifestyle changes and require lipid-lowering medications, pharmacologic treatment should be considered at age 10 years.
Once low-density lipoprotein (LDL) is optimized, high non-HDL cholesterol may be targeted for residual CVD risk reduction.

GUIDELINES BASED ON EXTENSIVE REVIEW

The NHLBI released Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents (www.nhlbi.nih.gov/guidelines/cvd_ped/) in November 2011. The report was endorsed by the Academy, and a summary was published in a supplement to Pediatrics,http://pediatrics.aappublications.org/content/early/2011/11/09/peds.2009-2107C.citation.

The guidelines present the results of an expert committee review of more than 1,000 published documents on CVD as it relates to children and adolescents. The guidelines cover a range of CVD risk domains; they grade the quality of evidence in pediatrics for the first time; and they can be integrated into the Bright Futures guidelines on pediatric health maintenance.

Dr. de Ferranti

Data are presented that clearly support a relationship between early exposure to CVD risk factors and atherosclerosis, including pathology studies and studies of vasculature dysfunction. In a single document, these guidelines raise consciousness about both genetic and obesity-related CVD risk.

Although the guidelines are comprehensive (400-plus pages in the full document), much of what is recommended already is part of general practice, e.g. measure body mass index, encourage breastfeeding, assess family history and counsel about healthy lifestyle.

GOALS OF UNIVERSAL SCREENING

The new recommendation with the most impact is to perform universal lipid testing (fasting or non-fasting) once between ages 9 and 11 years and again between 17 and 21 years. This is in addition to selective screening previously recommended by the Academy and AHA. The goal is to identify familial hyperlipidemias (FH), found in one in 300-500 children but asymptomatic until there is myocardial ischemia. Untreated individuals with FH have a risk of premature coronary heart disease up to 20 times greater than those without FH. One study suggests that statin therapy can reduce the risk of cardiac events in FH to that of the general adult population but only if identified early.

In addition to the genetic LDL lipid disorders, universal lipid screening is likely to identify many more children with lipid abnormalities that require lifestyle modification. Data from the National Health and Nutrition Examination Survey suggest one in five U.S. adolescents has some type of lipid disorder (Centers for Disease Control and Prevention. MMWR2010;59(2):29-33).

Dr. Washington

The guidelines focus on lifestyle modification for the first six months in nearly all patients. Much of the initial management of identified CVD risk factors can be done in a primary care setting if nutrition support and lifestyle counseling are available. When lifestyle modifications fail to reduce the lipids to the desired level in patients with extreme lipid disorders, pharmacotherapy is recommended. Some fear this recommendation will lead to an avalanche of statin prescriptions for children. This fear probably is unfounded, based on the low prevalence of extremely elevated LDL, which is about 1% of the population.

In addition, the guidelines recommend initiating lipid-lowering medications in patients meeting criteria starting at age 10 years, whereas the 2008 AAP clinical report Lipid Screening and Cardiovascular Health in Childhood (http://aappolicy.aappublications.org/cgi/content/full/pediatrics;122/1/198) put more emphasis on age 8 years. Published data support clinical experience that in the short and medium term, lipid-lowering medications are well-tolerated and safe for the few patients who need them.

LIMITATIONS

These guidelines have some limitations. Emerging data suggest additional CVD risk factors such as early excess adiposity detected using weight for length in infants, inadequate sleep and high stress.

In addition, long-term safety and efficacy data on statins in childhood are not available, although adult studies support low side effects and reduced overall mortality.

Importantly, the burden of the guidelines on patients, families, providers and the health care system has yet to be explored.

Dr. de Ferranti is a member of the AAP Committee on Nutrition. Dr. Washington is a member of the AAP Section on Cardiology and Cardiac Surgery.

John 3:16 played during Broncos playoff game riff off of Tim Rebow

noreply@blogger.com (Anonymous) — Sun, 15 Jan 2012 05:58:00 +0000

BBC News - Clock change 'stops outdoor play' Point is : free play is really healthy.

noreply@blogger.com (Anonymous) — Sun, 13 Nov 2011 02:04:00 +0000

Amount of 'play light' may have a huge public health role against childhood obesity. Point is : free play is really healthy.

Clock change 'stops outdoor play'

by Helen Briggs, bbc.co.uk
November 9th 2011

Not putting the clocks back would help in the fight against child obesity, a study suggests.

According to research, children are more influenced by daylight than the weather when deciding whether or not to play outside.

UK researchers report that not changing the clocks would give more opportunities for active play.

It strengthens the public health arguments for proposed changes to daylight saving, they say.

The research, published in the Journal of Physical Activity and Health, studied the activity levels of 325 children in south-east England aged between eight and 11.

The children wore accelerometers to record the amount of exercise they did, and kept a record of their activities in a diary.

A team from the London School of Hygiene and Tropical Medicine and University College London found the children did more exercise outside on longer days, particularly at the end of the day during summer.

“Start Quote

This provides the most direct evidence yet that changing the clocks so that there is more daylight in the afternoon could increase children's physical activity”

End Quote

This happened regardless of the likes of rain, cloud or wind.

Outdoor play was a bigger factor in overall physical activity than other factors such as structured sport sessions and cycling or walking to school, the team says.

Co-researcher Dr Anna Goodman, of the London School of Hygiene and Tropical Medicine, told the BBC: "This provides the most direct evidence yet that changing the clocks so that there is more daylight in the afternoon could increase children's physical activity."

She added: "The fact that kids spend more time playing outdoors and are more physically active overall on these longer days could be important at a population level for promoting their fitness and in preventing child obesity.

"This strengthens the public health argument for the Daylight Saving Bill currently under consideration by the House of Commons, which proposes putting the clocks forward by an extra hour all year round."

The clocks were moved forward by an hour during World War II to increase productivity at munitions factories and help people get home safely before the blackout.

But some health experts argue that a change to this tradition would give children more opportunities for outdoor play, as well as making it safer for them to travel home from school.

'Safe space'

Tam Fry, a spokesperson for the National Obesity Forum, said: "The longer the daylight hours, the longer kids will play. They really don't seem to care much about the weather but they do care about the dark.

"They need clearly to see the environment in which they can roam unfettered, and it should be no surprise that longer summer evenings provide that environment.

"They will be healthier and fitter from their outdoor play. Pack them all off to a safe space until bedtime."

Ministers are writing to counterparts in Scotland, Wales and Northern Ireland to seek a UK-wide consensus on a trial.

It would see the UK adopt Central European Time, with BST plus one hour in summer and GMT plus one in winter.

Original Page: http://www.bbc.co.uk/news/health-15646812

Shared from Read It Later

RISk of obesity starts young. Infant growth charts can predict later obesity - latimes.com

noreply@blogger.com (Anonymous) — Sun, 13 Nov 2011 02:00:00 +0000

CAVEAT! It's only a risk, not a determination. If both parents are fit, and have healthy lifestyles, I don't this data applies, or at least not as robustly.
Infant growth can predict later obesity, a study indicates
by Shari Ro, latimes.com
November 7th 2011 Infant weight and height are faithfully charted at each pediatrician's visit to make sure the child is growing properly. But nowadays doctors are more likely to see babies who are growing too fast rather than ones lagging behind. A new study shows that rapid growth on these charts foretells obesity in childhood.
Researchers looked at the weight-for-length charts that show how a baby's weight compares to that of other babies of the same length. For example, babies on the 5th percentile growth line have a weight that puts them among the smallest 5% of all babies their length. Doctors mostly want to see that a child is following his or her growth curve over time and not falling off or jumping up. The major percentile lines are the 5th, 10th, 25th, 50th, 75th, 90th and 95th.
The study, which tracked more than 44,000 babies, found that those who rose two or more major percentiles -- for example, going from 50% to 90% at some point -- before age 2 were twice as likely to be obese at age 5 and 75% more likely to be obese at age 10.
Babies who jumped two or more percentiles before six months of age had the highest risk of obesity at age 10 as well as babies who were already in a high percentile at their first visit. For example a 6-month-old baby who started at the 75th percentile who jumped two or more percentiles in the next six months had an obesity prevalence of almost 30% at age 5. Babies who started at less than the 25th percentile and jumped two or more percentiles had an obesity prevalence at age 5 of about 7%.
"We shouldn't neglect these early gains and think that it's just baby fat, and that these children are going to grow out of it," said Dr. Elsie Taveras, the lead author of the study at Children's Hospital Boston.
Of all the babies in the study, 11.6% were obese at age 5 and 16% at age 10. Jumping two or more percentiles was common, the researchers found, with 43% rising two or more percentiles in their first six months of life and 64% at some point in their first two years.
The study was published Monday in the Archives of Pediatrics and Adolescent Medicine. The journal also carries an interesting commentary on child obesity by Dr. Robert C. Whitaker of the Center for Obesity Research and Education at Temple University.
Whitaker discusses the widespread social change that will be required to reverse the obesity epidemic. "The childhood obesity epidemic was an unexpected consequence of numerous well-intentioned decisions made by adults about how to improve our way of living. These decisions were often made without considering children or all aspects of their well-being," he writes.
Return to Booster Shots blog. Follow me: twitter.com/LATShariRoan

Original Page: http://www.latimes.com/health/boostershots/la-heb-infant-growth-20111107,0,2456006.story
Shared from Read It Later

Fat babies may mean something more than cuteness JK

noreply@blogger.com (Anonymous) — Wed, 09 Nov 2011 03:36:00 +0000

Fat babies may mean something more than cuteness JK

Infant growth can predict later obesity, a study indicates

Babies who grow too fast have a much higher risk of becoming obese, a study indicates. (Los Angeles Times)

By Shari Roan, Los Angeles Times / For the Booster Shots blog

November 7, 2011, 12:21 p.m.

Infant weight and height are faithfully charted at each pediatrician's visit to make sure the child is growing properly. But nowadays doctors are more likely to see babies who are growing too fast rather than ones lagging behind. A new study shows that rapid growth on these charts foretells obesity in childhood.

Researchers looked at the weight-for-length charts that show how a baby's weight compares to that of other babies of the same length. For example, babies on the 5th percentile growth line have a weight that puts them among the smallest 5% of all babies their length. Doctors mostly want to see that a child is following his or her growth curve over time and not falling off or jumping up. The major percentile lines are the 5th, 10th, 25th, 50th, 75th, 90th and 95th.

The study, which tracked more than 44,000 babies, found that those who rose two or more major percentiles -- for example, going from 50% to 90% at some point -- before age 2 were twice as likely to be obese at age 5 and 75% more likely to be obese at age 10.

Babies who jumped two or more percentiles before six months of age had the highest risk of obesity at age 10 as well as babies who were already in a high percentile at their first visit. For example a 6-month-old baby who started at the 75th percentile who jumped two or more percentiles in the next six months had an obesity prevalence of almost 30% at age 5. Babies who started at less than the 25th percentile and jumped two or more percentiles had an obesity prevalence at age 5 of about 7%.

"We shouldn't neglect these early gains and think that it's just baby fat, and that these children are going to grow out of it," said Dr. Elsie Taveras, the lead author of the study at Children's Hospital Boston.

Of all the babies in the study, 11.6% were obese at age 5 and 16% at age 10. Jumping two or more percentiles was common, the researchers found, with 43% rising two or more percentiles in their first six months of life and 64% at some point in their first two years.

The study was published Monday in the Archives of Pediatrics and Adolescent Medicine. The journal also carries an interesting commentary on child obesity by Dr. Robert C. Whitaker of the Center for Obesity Research and Education at Temple University.

Whitaker discusses the widespread social change that will be required to reverse the obesity epidemic. "The childhood obesity epidemic was an unexpected consequence of numerous well-intentioned decisions made by adults about how to improve our way of living. These decisions were often made without considering children or all aspects of their well-being," he writes.

Return to Booster Shots blog.

Follow me: twitter.com/LATShariRoan

Didn't even realize she just received a flu shot

noreply@blogger.com (Anonymous) — Mon, 31 Oct 2011 21:34:00 +0000

Reminder to get a flu vaccine.

noreply@blogger.com (Anonymous) — Mon, 31 Oct 2011 05:42:00 +0000

The danger of overuse of technology. Translates to over diagnosis, and a waste of worry? THe case of the MRI.

M.R.I.'s, Often Overused, Ofte

by GINA KOLATA, mobile.nytimes.com

October 29th 2011

Dr. James Andrews, a widely known sports medicine orthopedist in Gulf Breeze, Fla., wanted to test his suspicion that M.R.I.'s, the scans given to almost every injured athlete or casual exerciser, might be a bit misleading. So he scanned the shoulders of 31 perfectly healthy professional baseball pitchers.

The pitchers were not injured and had no pain. But the M.R.I.'s found abnormal shoulder cartilage in 90 percent of them and abnormal rotator cuff tendons in 87 percent. "If you want an excuse to operate on a pitcher's throwing shoulder, just get an M.R.I.," Dr. Andrews says.

He and other eminent sports medicine specialists are taking a stand against what they see as the vast overuse of magnetic resonance imaging in their specialty.

M.R.I.'s can be invaluable in certain situations - finding serious problems like tumors or helping distinguish between competing diagnoses that fit a patient's history and symptoms. They also can make money for doctors who own their own machines. And they can please sports medicine patients, who often expect a scan.

But scans are easily misinterpreted and can result in misdiagnoses leading to unnecessary or even harmful treatments.

For example, said Dr. Bruce Sangeorzan, professor and vice chairman of the department of orthopedics and sports medicine at the University of Washington, if a healthy, uninjured person goes out for a run, a scan afterward will show fluid in the knee bone. It is inconsequential. But in an injured person, fluid can be a sign of a bone that is stressed or even has a crack and is trying to heal.

"An M.R.I. is unlike any other imaging tool we use," Dr. Sangeorzan said. "It is a very sensitive tool, but it is not very specific. That's the problem." And scans almost always find something abnormal, although most abnormalities are of no consequence.

"It is very rare for an M.R.I. to come back with the words 'normal study,' " said Dr. Christopher DiGiovanni, a professor of orthopedics and a sports medicine specialist at Brown University. "I can't tell you the last time I've seen it."

In sports medicine, where injuries are typically torn muscles or tendons or narrow cracks in bones, specialists like Dr. Andrews and Dr. DiGiovanni say M.R.I.'s often are not needed - they usually can figure out what is wrong with just a careful medical history, a physical exam and, sometimes, a simple X-ray.

M.R.I.'s are not the only scans that are overused in medicine but, in sports medicine, where many injuries involve soft tissues like muscles and tendons, they rise to the fore.

In fact, one prominent orthopedist, Dr. Sigvard T. Hansen, Jr., a professor of orthopedics and sports medicine at the University of Washington, says he pretty much spurns such scans altogether because they so rarely provide useful information about the patients he sees - those with injuries to the foot and ankle.

"I see 300 or 400 new patients a year," Dr. Hansen says. "Out of them, there might be one that has something confusing and might need a scan."

The price, which medical facilities are reluctant to reveal, depends on where the scan is done and what is being scanned. One academic medical center charges $1,721 for an M.R.I. of the knee to look for a torn ligament. The doctor who interprets the scan gets $244. Doctors who own their own M.R.I. machines - and many do - can pocket both fees. Insurers pay less than the charges - an average of $150 to the doctor and $960 to the facility.

Steve Ganobcik is something of a poster child for what can go wrong with the scans. A salesman who turns 44 on Saturday, Mr. Ganobcik twisted his knee skiing in Colorado in February. He continued skiing anyway and skied again the next two days as well, not wanting to cut his vacation short.

When he got home to Cleveland, his knee still bothered him, so he saw a sports medicine orthopedist. The doctor immediately ordered an M.R.I. and said it showed a torn anterior cruciate ligament, or A.C.L. It is one of the most common - and most devastating - sports injuries. The standard treatment is surgery, with a difficult recuperation lasting six months to a year.

Mr. Ganobcik looked into surgical techniques and decided he wanted a different one than the one his doctor offered. So he saw another sports medicine orthopedist who, agreeing that Mr. Ganobcik's ligament was torn, scheduled the operation.

Meanwhile, Mr. Ganobcik heard that Dr. Freddie H. Fu, chairman of the division of sports medicine at the University of Pittsburgh, had what might be an even better technique, so he went to see him.

To Mr. Ganobcik's surprise, Dr. Fu told him his ligament was not torn after all. His pain was from a fracture in a long bone in the lower leg that the other doctors had also noticed was broken. An M.R.I. at the University of Pittsburgh confirmed it, showing a perfectly normal A.C.L. (Dr. Fu adds that Mr. Ganobcik's original scans had an image that was ambiguous. He wanted a better one, to see if Mr. Ganobcik's ligament had been partly torn and was healing or had never been torn at all. He would not need surgery with a partial tear, but he would need more careful recuperation.)

Dr. Fu's suspicions were raised by Mr. Ganobcik's story. He could never have continued skiing with a torn A.C.L. The diagnosis "made no sense," Dr. Fu said.

And that, Dr. Fu says, illustrates a common problem: relying on an M.R.I. instead of a history and an exam. Dr. Fu's diagnosis "was a shock," Mr. Ganobcik said. "I thought he was going to talk about options for surgery."

M.R.I.'s can be extremely useful in sports medicine, said Dr. Andrew Green, the chief of shoulder and elbow surgery at Brown University. But, he says, there is a fine line between appropriate use and overuse.

That, at least, is what he found in one of the few studies to address the issue. The ideal study would randomly assign patients to have scans or not and then assess their outcomes. Such a study has not been done. Instead, a few researchers asked if scans made a difference for people who happened to have them. They found they did not - at least in two common situations.

Dr. Green and his colleagues reviewed the records of 101 patients who had shoulder pain lasting at least six weeks and that had not resulted from trauma, like a fall. Forty-three arrived bearing M.R.I.'s from a doctor who had seen them previously. The others did not have scans. In all cases, Dr. Green made a diagnosis on the basis of a physical exam, a history, and regular X-rays.

A year later, Dr. Green re-assessed the patients. There was no difference in the outcome of the treatment of the two groups of patients despite his knowledge of the findings on the scans. M.R.I.'s, he said, are not needed for the initial evaluation and treatment of many whose shoulder pain does not result from an actual injury to the shoulder.

Dr. DiGiovanni did a similar study with foot and ankle patients, looking back at 221 consecutive patients over a three-month period, 201 of whom did not have fractures. More than 15 percent arrived with M.R.I.'s obtained by doctors they had seen before coming to Dr. DiGiovanni. Nearly 90 percent of those scans were unnecessary and half had interpretations that either made no difference to the patient's diagnosis or were at odds with the diagnosis.

"Patients often feel like they are getting better care if people are ordering fancy tests, and there are some patients who come in demanding an M.R.I. - that's part of the problem," he said.

Some doctors might also feel they are providing better care if they order the scans, Dr. DiGiovanni said, and doctors often feel that they risk malpractice charges if they fail to scan a patient and then miss a diagnosis.

Dr. Hansen teaches his fellows - doctors in training - to be careful with scans and explains the risks of making the wrong diagnosis if they order them unnecessarily. He also knows it is not easy to refrain from ordering an M.R.I.

It's different for him, Dr. Hansen says. He is so eminent that patients tend not to question him.

"When I say 'You don't need a scan,' then it's over," Dr. Hansen said. His fellows get a different response. Patients, he says, "look at them like, 'You don't know what you're doing.' "

Original Page: http://mobile.nytimes.com/article?a=860324&f=26

Shared from Read It Later

Re anti vaccine movement.

noreply@blogger.com (Anonymous) — Thu, 20 Jan 2011 04:13:00 +0000

PERSPECTIVE

The Age-Old Struggle against the Antivaccinationists

Gregory A. Poland, M.D., Robert M. Jacobson, M.D.

N Engl J Med 364:97-99 | January 13, 2011

Since the introduction of the first vaccine, there has been opposition to vaccination. In the 19th century, despite clear evidence of benefit, routine inoculation with cowpox to protect people against smallpox was hindered by a burgeoning antivaccination movement. The result was ongoing smallpox outbreaks and needless deaths. In 1910, Sir William Osler publicly expressed his frustration with the irrationality of the antivaccinationists by offering to take 10 vaccinated and 10 unvaccinated people with him into the next severe smallpox epidemic, to care for the latter when they inevitably succumbed to the disease, and ultimately to arrange for the funerals of those among them who would die (see the Medical Notes section of the Dec. 22, 1910, issue of the Journal). A century later, smallpox has been eradicated through vaccination, but we are still contending with antivaccinationists.

The Cow Pock — or — the Wonderful Effects of the New Inoculation.

Since the 18th century, fear and mistrust have arisen every time a new vaccine has been introduced. Antivaccine thinking receded in importance between the 1940s and the early 1980s because of three trends: a boom in vaccine science, discovery, and manufacture; public awareness of widespread outbreaks of infectious diseases (measles, mumps, rubella, pertussis, polio, and others) and the desire to protect children from these highly prevalent ills; and a baby boom, accompanied by increasing levels of education and wealth. These events led to public acceptance of vaccines and their use, which resulted in significant decreases in disease outbreaks, illnesses, and deaths. This golden age was relatively short-lived, however. With fewer highly visible outbreaks of infectious disease threatening the public, more vaccines being developed and added to the vaccine schedule, and the media permitting widespread dissemination of poor science and anecdotal claims of harm from vaccines, antivaccine thinking began flourishing once again in the 1970s.¹

Little has changed since that time, although now the antivaccinationists' media of choice are typically television and the Internet, including its social media outlets, which are used to sway public opinion and distract attention from scientific evidence. A 1982 television program on diphtheria–pertussis–tetanus (DPT) vaccination entitled "DPT: Vaccine Roulette" led to a national debate on the use of the vaccine, focused on a litany of unproven claims against it. Many countries dropped their programs of universal DPT vaccination in the face of public protests after a period in which pertussis had been well controlled through vaccination² — the public had become complacent about the risks of the disease and focused on adverse events purportedly associated with vaccination. Countries that dropped routine pertussis vaccination in the 1970s and 1980s then suffered 10 to 100 times the pertussis incidence of countries that maintained high immunization rates; ultimately, the countries that had eliminated their pertussis vaccination programs reinstated them.² In the United States, vaccine manufacturers faced an onslaught of lawsuits, which led the majority of them to cease vaccine production. These losses prompted the development of new programs, such as the Vaccine Injury Compensation Program (VICP), in an attempt to keep manufacturers in the U.S. market.

The 1998 publication of an article, recently retracted by the Lancet, by Wakefield et al.³ created a worldwide controversy over the measles–mumps–rubella (MMR) vaccine by claiming that it played a causative role in autism. This claim led to decreased use of MMR vaccine in Britain, Ireland, the United States, and other countries. Ireland, in particular, experienced measles outbreaks in which there were more than 300 cases, 100 hospitalizations, and 3 deaths.⁴

Today, the spectrum of antivaccinationists ranges from people who are simply ignorant about science (or "innumerate" — unable to understand and incorporate concepts of risk and probability into science-grounded decision making) to a radical fringe element who use deliberate mistruths, intimidation, falsified data, and threats of violence in efforts to prevent the use of vaccines and to silence critics. Antivaccinationists tend toward complete mistrust of government and manufacturers, conspiratorial thinking, denialism, low cognitive complexity in thinking patterns, reasoning flaws, and a habit of substituting emotional anecdotes for data.⁵ Their efforts have had disruptive and costly effects, including damage to individual and community well-being from outbreaks of previously controlled diseases, withdrawal of vaccine manufacturers from the market, compromising of national security (in the case of anthrax and smallpox vaccines), and lost productivity.²

The H1N1 influenza pandemic of 2009 and 2010 revealed a strong public fear of vaccination, stoked by antivaccinationists. In the United States, 70 million doses of vaccine were wasted, although there was no evidence of harm from vaccination. Meanwhile, even though more than a dozen studies have demonstrated an absence of harm from MMR vaccination, Wakefield and his supporters continue to steer the public away from the vaccine. As a result, a generation of parents and their children have grown up afraid of vaccines, and the resulting outbreaks of measles and mumps have damaged and destroyed young lives. The reemergence of other previously controlled diseases has led to hospitalizations, missed days of school and work, medical complications, societal disruptions, and deaths. The worst pertussis outbreaks in the past 50 years are now occurring in California, where 10 deaths have already been reported among infants and young children.

In the face of such a legacy, what can we do to hasten the funeral of antivaccination campaigns? First, we must continue to fund and publish high-quality studies to investigate concerns about vaccine safety. Second, we must maintain, if not improve, monitoring programs, such as the Vaccine Adverse Events Reporting System (VAERS) and the Clinical Immunization Safety Assessment Network, to ensure coverage of real but rare adverse events that may be related to vaccination, and we should expand the VAERS to make compensation available to anyone, regardless of age, who is legitimately injured by a vaccine. Third, we must teach health care professionals, parents, and patients how to counter antivaccinationists' false and injurious claims. The scientific method must inform evidence-based decision making and a numerate society if good public policy decisions are to be made and the public health held safe. Syncretism between the scientific method and unorthodox medicine can be dangerous.

Fourth, we must enhance public education and public persuasion. Patients and parents are seeking to balance risks and benefits. This process must start with increasing scientific literacy at all levels of education. In addition, public–private partnerships of scientists and physicians could be developed to make accurate vaccine information accessible to the public in multiple languages, on a range of reading levels, and through various media. We must counter misinformation where it is transmitted and consider using legal remedies when appropriate.

The diseases that we now seek to prevent with vaccination pose far less risk to antivaccinationists than smallpox did through the early 1900s. Unfortunately, this means that they can continue to disseminate false science without much personal risk, while putting children, the elderly, and the frail in harm's way. We can propose no Oslerian challenge to demonstrate our point but have instead a story of science and contrasting worldviews: on the one hand, a long history of stunning triumphs, such as the eradication of smallpox and control of many epidemic diseases that had previously maimed and killed millions of people; on the other hand, the reality that none of the antivaccinationists' claims of widespread injury from vaccines have withstood the tests of time and science. We believe that antivaccinationists have done significant harm to the public health. Ultimately, society must recognize that science is not a democracy in which the side with the most votes or the loudest voices gets to decide what is right.

Disclosure forms provided by the authors are available with the full text of this article at NEJM.org.

References

RM Wolfe, LK SharpAnti-vaccinationists past and present.BMJ2002;325:430-432

EJ Gangarosa, AM Galazka, CR Wolfe, Impact of anti-vaccine movements on pertussis control: the untold story.Lancet1998;351:356-361

Wakefield AJ, Murch SH, Anthony A, et al. Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children. Lancet 1998;351:637-41. [Retraction, Lancet 2010;375:445.]

J McBrien, J Murphy, D Gill, M Cronin, C O'Donovan, MT CafferkeyMeasles outbreak in Dublin, 2000.Pediatr Infect Dis J2003;22:580-584

RM Jacobson, PV Targonski, GA PolandA taxonomy of reasoning flaws in the anti-vaccine movement.Vaccine2007;25:3146-3152

Source Information

From the Mayo Clinic Vaccine Research Group (G.A.P., R.M.J.), the Department of Medicine (G.A.P.), and the Department of Pediatric and Adolescent Medicine (G.A.P., R.M.J.), Mayo Clinic, Rochester, MN.

Study Linking Childhood Vaccine And Autism Was Fraudulent

noreply@blogger.com (Anonymous) — Mon, 10 Jan 2011 19:29:00 +0000

Even so, it may take years of dissipation for the skepticism re vaccines to fade.

http://www.npr.org/blogs/health/2011/01/06/132703314/study-linking-childhood-vaccine-and-autism-was-fraudulent?sc=17&f=1001

Study Linking Childhood Vaccine And Autism Was Fraudulent
by Scott Hensley

- January 6, 2011

Just when you think there's nothing left to say about a 13-year-old paper that purported to link childhood vaccination and autism, it turns out you're wrong.

In the latest issue of BMJ, the British Medical Journal, investigative reporter Brian Deer makes the case that the infamous Lancet study, withdrawn last year, wasn't just wrong -- it was fraudulent because key facts were altered to support the autism link.

The original paper reported on a dozen kids, eight of whom supposedly developed gastrointestinal trouble and "regressive autism," a form of the disorder that strikes later in childhood, after getting a combination vaccine against measles mumps and rubella. The work was led by Andrew Wakefield, an English doctor whose license was revoked last May for "serious professional misconduct" related to the work.

Where did the paper go wrong? Deer counts the ways after scouring health records and interviewing the patients families and various doctors. A few of the lowlights:

Only 1 of 9 kids said to have regressive autism clearly had it. Three had no form of autism.

Contrary to the paper's assertion that all the kids were normal before vaccination, five had some sort of preexisting developmental problems.

Behavioral problems the paper said popped up days after vaccination didn't actually appear for months in some kids, a fact that undercuts the causality of vaccination.

Wakefield's hypothesized link between vaccination and autism was flimsy from the start, and has since been repeatedly repudiated. But the provocative Lancet paper fueled a vigorous backlash against vaccination.

An accompanying editorial in BMJ argues that "clear evidence of falsification of data should now close the door on this damaging vaccine scare" for good.

CNN's Anderson Cooper interviewed Wakefield, who called Deer, "a hitman" hired to "take me down." Wakefield defended the paper and his methods. See the video below for the full discussion.

UPDATE 4:30 p.m.

As NPR's Jon Hamilton reports on today's All Things Considered, more revelations about Wakefield aren't likely to make the fear of vaccines go away. But David Ropeik, is an instructor at Harvard, says something else eventually will. "As more and more people get measles and kids die, which is happening around the world. Eventually the threat of the disease will come back and surmount our fear of the vaccine." [Copyright 2011 National Public Radio]

To learn more about the NPR iPhone app, go to http://iphone.npr.org/recommendnprnews

Article: Parents Embrace ‘Race to Nowhere,’ on Pressures of School - NYTimes.com

noreply@blogger.com (Anonymous) — Fri, 10 Dec 2010 05:01:00 +0000

On the debate of defining childhood.

Parents Embrace 'Race to Nowhere,' on Pressures of School - NYTimes.com
http://www.nytimes.com/2010/12/09/education/09nowhere.html?ref=homepage&src=me&pagewanted=all

Advertise on NYTimes.com

Parents Embrace Documentary on Pressures of School

By TRIP GABRIEL

Published: December 8, 2010

It isn't often that a third of a movie audience sticks around to discuss its message, but that is the effect of "Race to Nowhere," a look at the downside of childhoods spent on résumé-building.

"How do you help your children balance when the whole education system is pushing, pushing, pushing, and you want your kids to be successful?" Alethea Lewis, a mother of two, asked a roomful of concerned parents who had just seen the film, a documentary, last week in Bronxville, N.Y., at a screening co-sponsored by the private Chapel School.

With no advertising and little news media attention, "Race to Nowhere" has become a must-see movie in communities where the kindergarten-to-Harvard steeplechase is most competitive.

More than 1,100 attended a screening last week at New Trier High School in Winnetka, Ill. About 500 saw it at the 92nd Street Y in Manhattan in November. It has been shown to a roomful of fathers at Pixar during lunch hour and twice to employees at the Silicon Valley headquarters of Google.

All 325 seats in the auditorium of New Canaan Country School in Connecticut were filled during a screening for parents last Thursday night. Francie Irvine, the assistant head of school, said, "Our parents' association president called me and said, 'My sister just saw this in California and we have to, have to, have to have it here.' "

The film portrays the pressures when schools pile on hours of homework and coaches turn sports into year-round obligations. Left somewhat unexamined is the role of parents whose high expectations contribute the most pressure of all.

"Everyone expects us to be superheroes," one high school senior in the film says.

Another tells of borrowing her friends' prescription for Adderall to juggle her many commitments. "It's hard to be the vice president of your class, play on the soccer team and do homework," she says.

The movie introduces boys who drop out of high school from the pressure, girls who suffer stress-induced insomnia and worse, and students for whom "cheating has become another course," as one puts it.

"When success is defined by high grades, test scores, trophies,"' a child psychologist says in the film, "we know that we end up with unprepared, disengaged, exhausted and ultimately unhealthy kids."

Vicki Abeles, the middle-aged mother and first-time filmmaker who made "Race to Nowhere," picked up a camera when a doctor said that her then-12-year-old daughter's stomachaches were being caused by stress from school.

"I was determined to find out how we had gotten to a place where our family had so little time together," she explains in the film, which has an unslick, home-video quality, "where our kids were physically sick because of the pressures they were under."

In many ways, the movie is the alter ego to the better-known "Waiting for Superman," another education documentary playing around the country this fall.

That film has earned $6.3 million at the box office since its release and ranks 20th among the most successful documentaries ever, according to Box Office Mojo, in no small part because of a blast of publicity. The director appeared on "The Oprah Winfrey Show," and President Obama greeted its stars at the White House.

"Race to Nowhere" had a one-week run in two theaters, in New York and Los Angeles, but it has primarily been screened by community groups in school auditoriums, churches and temples. Local sponsors like parent-teacher associations sell tickets and split the take with the filmmakers.

Ms. Abeles, a corporate lawyer who briefly traded on the gold desk at Goldman Sachs before moving to Northern California with her family, said the film cost her and other backers in the "mid-six figures." It will have been shown at some 700 locations through February.

With her movie's grass-roots success, Ms. Abeles has been approached by major distributors offering to place it in commercial theaters. But she is not convinced that the movie would reach as wide an audience or inspire viewers to stay for the discussions, which are moderated by principals, child psychologists and sometimes Ms. Abeles herself. The film's Web site encourages viewers to follow up with local activism (and also links to research and studies supporting the film, which pretty much avoids citing any data).

"My passion is around the change this film has the potential to create," Ms. Abeles said.

While "Waiting for Superman" lionizes urban reformers who embrace standardized testing as a necessary yardstick to hold schools and teachers accountable, Ms. Abeles believes that the testing movement is what has caused education to go off the tracks.

She talks to students, teachers and experts who say that teaching to tests, including the Advanced Placement tests, narrows education and diminishes creativity and independent thinking. Employers complain that college graduates these days lack initiative. An educator, Denise Pope, a lecturer at Stanford, says that the University of California requires remedial courses of half its students, even though their high school grades were stellar.

"They're spitting back but not retaining the information," Dr. Pope said.

Most of the families in "Race to Nowhere" are suburban and privileged, and the film has found its audience in those communities where parents often move for excellent schools. In addition to New Canaan and Winnetka, there were screenings last week in Los Altos, Calif., Bethesda, Md., and Chappaqua, N.Y. — towns where an Ivy League sticker on the back of a Range Rover is a given.

"You would not believe what reactions you get from other parents when you mention what colleges your children are looking at — you're so judged," Tara Vessels, a mother at New Canaan Country School, told about 40 other parents and staff members who discussed the movie last Friday in the school cafeteria.

The school espouses a "whole child" philosophy, and its mission statement, inscribed on the cafeteria walls, includes the sentence: "We value the imagination and curiosity of children and respect childhood as an integral part of life."

But parents said the larger community imposed its own values, and their children clamored to join an ice hockey league that practices until 10 p.m.

"Imagine if a sign out front of school says 'Mistakes Are Made Here Often,' " mused one teacher, echoing a theme in the movie that schools should accept failure as part of learning. "No one would come here! But why not?"

A mother complained that her 13-year-old "had a chapter test, and that night had to study for a quiz" in the same class. "What is the point of all the testing?" she said. "It's so stressful."

Tim Bazemore, the head of school, acknowledged ruefully that "the whole child in high school is a full résumé," telling the parents that this reflected "a failure of education leadership."

Nonetheless, he wondered how parents would feel if teachers assigned less homework and did not penalize students who did not do it. Would families think the school was failing to prepare their children for high school and beyond?

The school "needs an honest dialogue with you," Mr. Bazemore said.

The finest journalism in Texas? The New York Times, as low as $3.70 a week.

Find your dream home with
The New York Times Real Estate

Fan The New York Times on Facebook

The new issue of T is here

See the news in the making. Watch TimesCast, a daily news video.

Advertise on NYTimes.com

(via Instapaper)

Triple That Vitamin D Intake, Panel Prescribes - WSJ.com

noreply@blogger.com (Anonymous) — Wed, 01 Dec 2010 04:54:00 +0000

Lot of different angles on Vitamin D and The IOM report.

Another take on the IOM report

From Evernote:

Triple That Vitamin D Intake, Panel Prescribes - WSJ.com

Clipped from: http://online.wsj.com/article/SB10001424052748704584804575645023841631864.html

Triple That Vitamin D Intake, Panel Prescribes

By MELINDA BECK

A long-awaited report from the Institute of Medicine to be released Tuesday triples the recommended amount of vitamin D most Americans should take every day to 600 international units from 200 IUs set in 1997.

That's far lower than many doctors and major medical groups have been advocating—and it could dampen some of the enthusiasm that's been building for the sunshine vitamin in recent years.

Many doctors have added blood tests of vitamin D levels to annual physicals, and sales of vitamin D supplements have soared to $425 million last year from $40 million in 2001, according to the Nutrition Business Journal.

View Full Image

Getty Images

The IOM panel also issued new recommendations for daily calcium intake, up to 1,200 milligrams for women 51 and older.

Who Needs Extra D

Some people are at high risk for vitamin D deficiency, and experts believe they may benefit from more vitamin D than the new recommendations:

People age 50 and older: This group is at increased risk for Vitamin D insufficiency. As people age, their skin is less efficient in synthesizing the vitamin and the kidney is less able to convert it to its active hormone form.
People with osteoporosis: Vitamin D is crucial for building and maintaining strong bones.
People with limited sun exposure: This population includes the homebound, those living in northern latitudes and individuals who wear long robes and head coverings.
People with dark skin: Greater amounts of the pigment melanin result in darker skin and reduce the skin's ability to produce vitamin D from sunlight. People who have immigrated from sunnier climates may find their levels dropping sharply in latitudes where the sun's rays aren't as strong much of the year.
People with fat malabsorption: Vitamin D requires some dietary fat in the gut for absorption. Individuals who have a reduced ability to absorb dietary fat might require supplements. Fat malabsorption is associated with conditions including pancreatic enzyme deficiency, Crohn's disease, cystic fibrosis, celiac disease, surgical removal of part of the stomach or intestines and some forms of liver disease.
People taking certain medications:Prednisone and anti-seizure drugs can cause vitamin D to be absorbed and metabolized more quickly, reducing available blood levels.
People who are obese: Individuals with a body mass index equal to or greater than 30 typically have a low concentration of the vitamin in the blood.

Source: National Institutes of Health Office of Dietary Supplements

The power of love over bureaucracy

noreply@blogger.com (Anonymous) — Tue, 30 Nov 2010 00:09:00 +0000

TARAZ JOURNAL

Unwrapping Red Tape to Find the Gift of Family

Maxim Marmur for The New York Times

For months, Rebecca Compton went daily to an orphanage in Taraz, Kazakhstan, to visit Noah.

By CLIFFORD J. LEVY

Published: November 23, 2010

REPRINTS
SHARE

TARAZ, Kazakhstan — He was first placed into their arms nearly a year ago, an underweight 9-month-old baby in a gray sweatshirt. They were at an orphanage behind a crumbling housing project here in Central Asia, unimaginably far from their home in suburban Philadelphia, but immediately, they knew that they did not want to let him go.

The New York Times

Taraz officials have grown more cautious on adoptions.

They decided to call him Noah.

"He seems like the right little guy for us," Rebecca Compton, a college professor, wrote as she and her husband, Jeremy Meyer, a labor lawyer, began what they thought would be a standard adoption process.

But these days in Kazakhstan, Russia and other former Soviet republics, adoptions are often far from standard, especially in light of the highly publicized — and deeply embarrassing — return of a 7-year-old Russian boy to Moscow in April by his adoptive American mother.

Ms. Compton and Mr. Meyer assumed they would soon be flying back to the United States with Noah. Then the delays mounted. Kazakh officials refused to sign off on the adoption.

Yet, Ms. Compton and Mr. Meyer would not give up.

They took leaves from their jobs, remaining in Kazakhstan for months on end while engaging in a bewildering fight with the Kazakh bureaucracy. It was not until last week, after setting aside their lives to pursue a child whom they now deeply loved, that they finally learned whether they could adopt him — whether this Thanksgiving would be a day of joy or despair.

"This is one of the only times when I have ever had this experience of feeling so helpless about something that I care so much about," Ms. Compton said. The obstacles that Ms. Compton and Mr. Meyer have faced reflect the rising complexity of foreign adoptions in the former Soviet Union, which since Communism's fall two decades ago has been a popular destination for prospective parents. As these countries become more stable, they are growing increasingly resistant to the idea of sending future generations abroad.

But they still maintain large orphanage systems, so a debate periodically flares over what is in the best interests of the children. The authorities would like local parents to adopt, but there are not enough in countries like Kazakhstan and Russia.

The issue is not necessarily poor conditions in orphanages. The one in Taraz is clean and well run, and the children seem happy. But experts say children are more likely to thrive in a good family.

Ms. Compton has spent much of the last year in Taraz, a city on the old Silk Road where English is rarely heard and boiled horse meat is typical fare. For months, she went daily to the orphanage to see Noah.

Born premature, he had lagged developmentally, but with the constant attention he has started to catch up, turning into a spirited toddler before the Americans' eyes. On a recent visit to the orphanage, he giggled and squirmed while Ms. Compton read him a book with purple dinosaurs and blue whales, as if they were any mother and child.

"When I am here, I have no doubt about what I am doing," she said. "As soon I see him, I don't think about the legal situation, or how long I have been in Taraz. I just want to hold him."

But visiting hours soon ended. She had to leave the orphanage, and he stayed behind.

On many nights in recent months, she has retreated to her hotel room and not known whether to scream or cry or bang her head against the wall in frustration. She said she once dreamed that she was hugging Noah, but then he disappeared, though she could still feel his touch. Then she located him nearby, "looking up at me with his dark searching eyes," she recalled, but he vanished again.

Foreign adoptions in Kazakhstan can go relatively smoothly, but Ms. Compton and Mr. Meyer had unfortunate timing.

In January, soon after they began the adoption process, Casey Johnson, the daughter of Woody Johnson, the owner of the New York Jets, died. Ms. Johnson, who had adopted a baby from Taraz in 2007, had led a troubled life, and her death raised questions in Kazakhstan about whether the adoption should have been allowed. Local officials became exceedingly cautious, and slowed down several adoptions.

Then in April, the 7-year-old boy was returned to Moscow on his own by his American mother, and the Kremlin demanded new adoption safeguards from the United States. That had a ripple effect across the countries of the former Soviet Union.

In May, a court rejected Ms. Compton's and Mr. Meyer's petition to adopt Noah, contending that the orphanage had not done enough to determine whether Kazakhs might want him. They appealed.

Ms. Compton, 40, who is the chairwoman of the psychology department at Haverford College in Pennsylvania, and Mr. Meyer, 40, had little ability to deal with the Kazakh legal system, which often seemed highly dysfunctional. They do not know Kazakh or Russian, the languages here, and were dependent on interpreters, consultants and lawyers.

"We are never quite sure what is going on," Mr. Meyer, who had to return to Pennsylvania over the summer for work, said last month. "We are in the dark about the most important thing in our life."

Raisa Sher, the federal children's ombudsman in Kazakhstan, said in an interview that Taraz officials were applying the law correctly. She said Kazakhstan was supporting efforts to keep babies in the country, so officials had to ensure that foreign adoptions were a last resort.

"It is very sad when a country cannot provide for its own children," she said. "We consider these foreign adoptions only a temporary measure."

Kazakh officials even suggested that Ms. Compton and Mr. Meyer seek another baby, as if Noah could be exchanged for someone else. They cringed at the thought that a child who had been given up by one set of parents would be abandoned by another.

But by September, there seemed to be an opening. With the government under intense lobbying by Ms. Compton and Mr. Meyer and their supporters, a local court indicated that it would reconsider their case if it could be shown that no Kazakhs wanted to adopt Noah.

The orphanage presented evidence. Then there were more sleepless nights while they waited in Taraz for the decision. This month, the court preliminarily endorsed the adoption. "We won. We won!!" they wrote on their private blog.

Last week, they received final approval, and on Friday they walked out of the orphanage with a new, by now 20-month-old member of their family. They are hopeful that other foreigners who have also had Taraz adoptions blocked will obtain similar relief.

Ms. Compton and Mr. Meyer have to remain in Kazakhstan for a few more weeks, but they said they were fine celebrating Thanksgiving in a foreign land, given how much they had to be thankful for.

They noted that the holiday reminded them of Noah's Kazakh name, Aldanysh. Loosely translated, it means "survivor."

Fwd: Switching Gears: More Commuters Bike To Work

noreply@blogger.com (Anonymous) — Mon, 29 Nov 2010 20:16:00 +0000

All the cool people are doing it. You have to build it in.

I found the following story on the NPR iPhone App:
http://www.npr.org/2010/11/23/131539669/switching-gears-more-commuters-bike-to-work?sc=17&f=1001

Switching Gears: More Commuters Bike To Work
by Allison Aubrey

- November 29, 2010

One way National Geographic staffers in Washington, D.C., can get to know their company's CEO is to take him up on his long-standing offer: to go for a lunchtime bike ride.

"Anyone still downstairs? OK, so we ready to go, guys?" National Geographic Society CEO John Fahey asks a group of about 20 employees

Fahey, an avid biker, says he's just trying to encourage a little exercise -- and he wants the opportunity to get to know folks informally. As the group makes the 15-mile trek to Hains Point along the Potomac River and back, Fahey makes a point of chatting with everyone, staffers say.

At National Geographic -- which is a hub of outdoorsy, adventure-seeking types who think nothing of biking busy city streets -- lots of the staffers who join Fahey for the lunchtime rides also use their bikes to get to and from work every day.

"I've been riding in for 19 years," says senior photo editor Dan Westergren, adding that he has definitely noticed the boom -- especially as bike paths and bike lanes along city streets have improved.

Westergren's commute is a combined 12 miles to and from home. And he says, given all the biking he does, he doesn't need a gym membership to stay fit.

"Really, to build it into your daily routine by commuting for me has just been the best thing," he says.

Cycling Culture

If you bike to work in Washington, D.C., Minneapolis, Chicago or San Francisco, you're part of a boom. Cycling has at least tripled over the past two decades in these -- and other -- big cities across the U.S.

"It's almost like a snowball effect," says researcher John Pucher of Rutgers University. "People see other people cycling and they say, 'Wow!' " As part of a three-year research project for the U.S. Department of Transportation, Pucher has completed a preliminary report that documents the increase in biking in nine major North American cities.

"It's almost become a cultural phenomenon," Pucher says. "It's become the 'in' thing to do." For many city dwellers, it's a money saver, a time saver and a way to sneak in daily exercise.

Research shows that the extra physical activity that people get from walking and biking to work or school is not offset by less recreational activity.

"[Active commuters] actually double the amount of their total physical activity," says Pucher. And as a result, Pucher says cities with lots of "active" commuters tend to be healthier. The most recent evidence comes from a study Pucher and his colleagues published in the American Journal of Public Health.

They found that the U.S. cities with the highest rates of walking and cycling to work have obesity rates that are 20 percent lower and diabetes rates that are 23 percent lower -- compared with U.S. cities with the lowest rates of walking and cycling.

Just 'Hide The Bike Grease'

There are, of course, a few daily obstacles. Take the weather. "In the winter it's just gross sometimes with the ice," staffer Julia Yordanova says. And there are also the dangers of traffic. "It's the cab drivers," says Jonathan Irish.

Not to mention the need to try to fit in a shower at the office. "You just try to hide the bike grease on your calf as you're sitting in a meeting," says Barbara Noe, an editor at Travel Books.

But hey, if the office culture tolerates a little sweat on the brow -- or grease on the calf -- take it a sign of good health. That's the way Pucher sees it.

To learn more about the NPR iPhone app, go to http://iphone.npr.org/recommendnprnews

Vitamin D Lowers Diabetes Risk - TIME

noreply@blogger.com (Anonymous) — Thu, 25 Nov 2010 17:35:00 +0000

The causality of vitamin D and diabetes is still uncertain, but there are numerous studies to make connection between Vitamin D deficiency and other autoimmune issues so this biologically plausible. Bottom line, probable benefit, unclear risk on a WHOLE population level, but on an individual level, may make a lot of sense to Supplement.

From Evernote:

Vitamin D Lowers Diabetes Risk - TIME

Clipped from: http://www.time.com/time/health/article/0,8599,1722399,00.html

Vitamin D Lowers Diabetes Risk

By Sora Song Thursday, Mar. 13, 2008

Steve Nagy / Design Pics / Corbis

0digg

Giving children vitamin D supplements in infancy may shear their risk of developing type 1 diabetes later in life. In an analysis of previously published studies, British researchers found significant evidence that supplements of the vitamin were associated with a 29% reduced risk of the disease.

Participants in the studies were given vitamin D supplements from birth onward, for a variable time period, and were tracked for some 15 to 30 years, according to Dr. Christos Zipitis, a pediatrician with the Stockport NHS Foundation Trust and lead author of the new paper, which appears online this week in the Archives of Disease in Childhood. Types and doses of vitamin D supplements varied, and were not always reported, but Zipitis says supplementation was roughly 10 mcg, or 400 I.U., of vitamin D daily — the amount typically found in infant multivitamins. Based on data from three case-control studies involving 6,455 participants, the new paper found that infants who were given supplements were 29% less likely to develop type 1 diabetes compared with infants who never got extra vitamin D. Zipitis, who reviewed a total of five studies, also found evidence that the vitamin's protective effect increased with larger doses and more regular supplementation. "[Our study] provides the strongest evidence to date that vitamin D might be protective against type 1 diabetes in later life," says Zipitis. "Obviously we're based on other studies, so this has come up before. The new thing with our study is the strength of the association and the confidence with which we can talk about it."

Given the limits of the available data, however, the paper was unable to say how much vitamin D the children were getting from sources other than supplementation, or whether they were deficient to begin with. But Zipitis says children who had rickets, a bone disorder caused by extreme vitamin D deficiency, "were at a much higher risk of developing type 1 diabetes — I think about three times higher than the rest of the population, which would suggest that the higher the level of vitamin D in your body, the less likely you are to develop type 1 diabetes."

Past research has come to the same conclusion. Countries with lots of sunshine, which triggers vitamin D production in the body, for example, have a lower incidence of type 1 diabetes than relatively sunless places. Studies have also shown that new cases of type 1 diabetes crop up more often in winter, when there is less sunshine all around, than in summer. In addition, says Zipitis, when doctors check vitamin D blood levels of newly diagnosed type 1 diabetes patients, they are generally lower than average. "In the U.K. and other European countries, we haven't got the right UV radiation for most of the year," he says, adding that vitamin D deficiency is a re-emerging problem in the U.K., and that doctors are seeing a resurgence of rickets in children. "With all the scares about skin cancer, when people go outside, they're covered with sunblock, which doesn't allow the conversion of UV light into vitamin D. That's where the supplements come in."

Insufficient blood levels of vitamin D have been linked to several health problems aside from rickets and type 1 diabetes, including other autoimmune diseases such as rheumatoid arthritis and multiple sclerosis, along with some rare but serious heart problems like cardiomyopathy. Indeed a host of recent studies has shown myriad benefits of taking supplements. Beyond better bone health, stronger muscles and fewer fractures in adults, research also suggests vitamin D can reduce the risk of various cancers. A study of 1,179 postmenopausal women published in the American Journal of Clinical Nutrition last year found that women who took calcium and 1,100 I.U. of vitamin D daily had 80% fewer cancers than women who took a placebo or calcium alone.

For infants, the American Academy of Pediatrics (AAP) currently recommends a supplement of 200 I.U. of vitamin D per day, starting at two months of age for breastfed babies. Once infants are weaned to vitamin-D fortified formula, however, supplements are no longer necessary.

zsleep Childhood Sleep Time and Long-Term Risk for Obesity: A 32-Year Prospective Birth Cohort Study -- Landhuis et al. 122 (5): 955 Figure 1 -- Pediatrics good graph zpted

noreply@blogger.com (Anonymous) — Sun, 14 Nov 2010 15:57:00 +0000

From Evernote:

zsleep Childhood Sleep Time and Long-Term Risk for Obesity: A 32-Year Prospective Birth Cohort Study -- Landhuis et al. 122 (5): 955 Figure 1 -- Pediatrics good graph zpted

Clipped from: http://pediatrics.aappublications.org.proxy.uchicago.edu/cgi/content/full/122/5/955/F1

Click here to download a slide of this image in PowerPoint format. You do NOT need to request permission if you are reproducing or paraphrasing a table or figure to make slides or handouts for an educational lecture or discussion that is under the auspices of a not-for-profit educational organization. Otherwise, contact permissions@aap.org for additional information or to make a request. Click on image to view larger version.

FIGURE 1 BMIs for short, moderate, and long sleepers at every assessment between ages 3 and 32 years. Error bars represent ±1 SEM.

The surreptitious flu shot. Didn't even realize she just received a flu shot

noreply@blogger.com (Anonymous) — Sun, 07 Nov 2010 23:19:00 +0000

Really? - The Claim - Lack of Sleep Increases Weight - Question - NYTimes.com : Lots of Evidence that sleep and weight gain are linked.

noreply@blogger.com (Anonymous) — Sat, 06 Nov 2010 11:44:00 +0000

From Evernote:

Really? - The Claim - Lack of Sleep Increases Weight - Question - NYTimes.com

Clipped from: http://www.nytimes.com/2010/04/27/health/27real.html

Reload Original Page Print Page Email Page

Really? - The Claim - Lack of Sleep Increases Weight - Question

Looking to lose a little weight? Portion size and exercise are crucial. But don’t forget about a good night’s rest.

Scientists have known for years that skimping on sleep is associated with weight gain. A good example was a study published in 2005, which looked at 8,000 adults over several years as part of the National Health and Nutrition Examination Survey. Sleeping fewer than seven hours a night corresponded with a greater risk of weight gain and obesity, and the risk increased for every hour of lost sleep.

More recent studies have taken a much closer look.

One published this year in The American Journal of Clinical Nutrition took a small group of men and measured their food intake across two 48-hour periods, one in which they slept eight hours and another in which they slept only four. After the night of abbreviated sleep, the men consumed more than 500 extra calories (roughly 22 percent more) than they did after eight hours of sleep. A University of Chicago study last year had similar findings in both men and women: subjects took in significantly more calories from snacks and carbohydrates after five and a half hours of sleep than after eight and a half hours.

Some studies pin the blame on hormones, arguing that decreased sleep creates a spike in ghrelin, a hormone that stimulates appetite, and a reduction in leptin, which signals satiety. But more study is needed.

THE BOTTOM LINE

Losing sleep may increase appetite and, as a result, weight.

ANAHAD O’CONNOR scitimes@nytimes.com

Readability — An Arc90 Laboratory Experiment Follow us on Twitter »

Fonts by Typekit

On being annoyed

noreply@blogger.com (Anonymous) — Sat, 06 Nov 2010 11:44:00 +0000

If you are easily annoyed, it probably means that you are pretty annoying

The 10 Biggest Choking Hazards - NYTimes.com

noreply@blogger.com (Anonymous) — Sat, 06 Nov 2010 11:43:00 +0000

May 24, 2010

The 10 Biggest Choking Hazards

By LAURIE TARKAN

According to a 2008 study, the 10 foods that pose the highest choking hazards for young children are hot dogs, peanuts, carrots, boned chicken, candy, meat, popcorn, fish with bones, sunflower seeds and apples.

Dr. Gary Smith, the lead author of American Academy of Pediatrics’ policy statement on food hazards, says some foods should simply not be given to children under 4 or 5: he mentioned raw carrots, marshmallows, peanuts, popcorn, hard candies and gumballs.

If feeding a young child a hot dog, he said, cut it lengthwise before slicing it. (Simply slicing it into nickel-size chunks makes it more dangerous than not slicing it at all.) Cut grapes into quarters. Flat lollipops are safer than ball-shaped suckers.

If a child is choking, call 911 — time is of the essence. Health authorities also recommend acting quickly to remove the object. If a child is more than 1 year old, perform the Heimlich maneuver. If the child is younger than 1, rest the child face down on your knee and slap the back between the shoulder blades five times.

“It’s important that all caregivers are CPR-certified,” said Erika Bleiberg, an emergency medical technician in Glen Ridge, N.J., who is a certified CPR instructor. “Even if the E.M.T. is there within three minutes, that’s a lot of time for a little brain to not have oxygen.” LAURIE TARKAN

This article has been revised to reflect the following correction:
Correction: May 27, 2010
Because of an editing error, an article on Tuesday about the top 10 choking hazards for children omitted some steps to take if a child is choking and seems unable to cough out the obstruction. Besides having someone call 911, the health authorities recommend acting quickly to remove the object. If a child is more than 1 year old, perform the Heimlich maneuver. If the child is younger than 1, rest the child face down on your knee and slap the back between the shoulder blades five times. More information can be found at healthychildren.org.

via nytimes.com

KIDDOC.ORG

School starts too early, and we should make some noise about it.

john with child workout

We changed our minds : Oops. Food Allergy Advice for Parents: Start Peanuts, Eggs and More Sooner - WSJ.com

From Evernote:

Food Allergy Advice for Parents: Start Peanuts, Eggs and More Sooner - WSJ.com

Food Allergy Advice for Kids: Don't Delay Peanuts, Eggs

Not enough sleep makes you fat

Adding substantially( pardon the pun ) to the large data set of evidence that points to inadequate sleep contributing massively to weight gain.

Lost Sleep Can Lead to Weight Gain

On building resilience by hearing and knowing the family story

Why we are screening kids for cholesterol.

NHLBI guidelines on cholesterol in kids: What’s new and how does this change practice?

GUIDELINES BASED ON EXTENSIVE REVIEW

GOALS OF UNIVERSAL SCREENING

LIMITATIONS

Related article in AAP News:

John 3:16 played during Broncos playoff game riff off of Tim Rebow

BBC News - Clock change 'stops outdoor play' Point is : free play is really healthy.

RISk of obesity starts young. Infant growth charts can predict later obesity - latimes.com

Fat babies may mean something more than cuteness JK

Fat babies may mean something more than cuteness JK

Infant growth can predict later obesity, a study indicates

Didn't even realize she just received a flu shot

Re anti vaccine movement.

PERSPECTIVE

The Age-Old Struggle against the Antivaccinationists

References

Source Information

Study Linking Childhood Vaccine And Autism Was Fraudulent

Article: Parents Embrace ‘Race to Nowhere,’ on Pressures of School - NYTimes.com

Parents Embrace Documentary on Pressures of School

By TRIP GABRIEL

Published: December 8, 2010

Triple That Vitamin D Intake, Panel Prescribes - WSJ.com

From Evernote:

Triple That Vitamin D Intake, Panel Prescribes - WSJ.com

Triple That Vitamin D Intake, Panel Prescribes

By MELINDA BECK

Who Needs Extra D

Related Health Videos

The power of love over bureaucracy

TARAZ JOURNAL

Unwrapping Red Tape to Find the Gift of Family

By CLIFFORD J. LEVY

Published: November 23, 2010

The New York Times

Fwd: Switching Gears: More Commuters Bike To Work

Vitamin D Lowers Diabetes Risk - TIME

From Evernote:

Vitamin D Lowers Diabetes Risk - TIME

Vitamin D Lowers Diabetes Risk

MORE

zsleep Childhood Sleep Time and Long-Term Risk for Obesity: A 32-Year Prospective Birth Cohort Study -- Landhuis et al. 122 (5): 955 Figure 1 -- Pediatrics good graph zpted

From Evernote:

zsleep Childhood Sleep Time and Long-Term Risk for Obesity: A 32-Year Prospective Birth Cohort Study -- Landhuis et al. 122 (5): 955 Figure 1 -- Pediatrics good graph zpted

The surreptitious flu shot. Didn't even realize she just received a flu shot

Really? - The Claim - Lack of Sleep Increases Weight - Question - NYTimes.com : Lots of Evidence that sleep and weight gain are linked.

From Evernote:

Really? - The Claim - Lack of Sleep Increases Weight - Question - NYTimes.com

Really? - The Claim - Lack of Sleep Increases Weight - Question

On being annoyed

The 10 Biggest Choking Hazards - NYTimes.com

The 10 Biggest Choking Hazards

By LAURIE TARKAN