Healthy isn?t something you are or aren?t. It?s a hundred little things: eating a banana, walking in the park, putting a bandage on a boo-boo, playing tag, reading up on ways to keep you and your family well and safe. It?s a balance between living well and taking care, and you can start right where you are.
A blog by Christina Elston
Healthy isn't something you are or aren't. It's a hundred little things: eating a banana, walking in the park, putting a bandage on a boo-boo, playing tag, reading up on ways to keep you and your family well and safe. It's a balance between living well and taking care, and you can start right where you are.


Archive for May, 2012

FDA Warns About Fake Adderall

Thursday, May 31st, 2012

Pictured here, counterfeit versions of Adderall and packaging.

Adderall, a prescription medication given to treat attention deficit hyperactivity disorders (ADHD) and narcolepsy, has been in short supply lately because the manufacturer has had trouble procuring ingredients. Meanwhile, the U.S. Food and Drug Administration (FDA) is warning that a counterfeit version is being sold online.

The counterfeit version of 30 mg tablets of the Teva Pharmaceutical Industries product contains the wrong active ingredients, according to FDA. Rather than Adderall’s four active ingredients – dextroamphetamine saccharate, amphetamine aspartate, dextroamphetamine sulfate and amphetamine sulfate – the counterfeit product contains just tramadol (a long-acting prescription pain reliever) and acetaminophen (the active ingredient in Tylenol).

Actual Adderall tablets are marked with "dp" on one side and "30" on the other.

The two products are also different in appearance. Authentic Adderall tablets are orange/peach in color and scored with “dp” embossed on one side and “30” on the other. The counterfeit tablets are white and have no markings. And while Adderall is packaged only in 100-count bottles, the fake tablets are sold in blister packages.

FDA considers the counterfeit product ineffective and potentially harmful, and warns consumers not to use it. Instead, anyone who believes they have purchased counterfeit Adderall should contact FDA’s Office of Criminal Investigations at 800-551-3989 or www.fda.gov/OCI.

Untreated Fever During Pregnancy More Than Doubles Autism Risk

Thursday, May 24th, 2012

Researchers from the UC Davis MIND Institute have linked untreated fever during a mother’s pregnancy with increased risk of autism or developmental delays in her child. In a large study including detailed information on participants, they found that women who reported fever had 2.12 times higher odds of having a child with autism and 2.5 times higher odds of having a child with developmental delay than women who reported no fever during pregnancy, or those who took anti-fever medication.

The study involved more than 1,100 women and their babies.

“If someone has fever during pregnancy they should take it seriously,” says lead study author Ousseny Zerbo, now a postdoctoral researcher with Kaiser Permanente, adding that this means taking over-the-counter anti-fever medication, and seeking medical attention if the fever persists. “Particularly during pregnancy, a lot of people don’t want to take any medication,” Zerbo says.

But treating fever also treats the acute inflammation that accompanies it, and this could be the connection between fever and autism risk. Another recent study based on the same data found that mothers who were obese or had diabetes – conditions associated with chronic inflammation in the body – were also more likely to have children with autism.

Both studies were based on data from the Childhood Autism Risk from Genetics and the Environment (CHARGE) study, which collected information on a large group of California children ages 2 to 5.

Infection with bacteria or viruses triggers a healing response that releases inflammatory elements from white blood cells into the bloodstream. Called cytokines, these elements are able to cross the placenta, and could impact a developing baby’s brain. “I think we need to do a lot more study regarding inflammation during pregnancy,” says Zerbo.

The study was published online May 23 in the Journal of Autism and Developmental Disorders.

 

Babies Born By C-Section Twice As Likely To Be Obese

Wednesday, May 23rd, 2012

Rates of both Cesarean section birth and child obesity have soared in recent decades, and it turns out that the way children are brought into the world could have a big impact on their weight. Kids born by c-section have a different composition of bacteria in their guts than children born vaginally do, and scientists theorize this might make c-section babies more likely to be obese.

The weight difference between c-section and vaginally delivered babies showed up when researchers from Children’s Hospital Boston looked at 1,255 deliveries in eastern Massachusetts between 1999 and 2002. They measured and weighed the babies at birth, at 6 months, and at age 3.

One in four of the babies were delivered by c-section (a rate lower than the national average of one in three). Moms in the study who delivered by c-section tended to weigh more than those delivering vaginally, so the birthweight of their babies tended to be higher. They also breastfed their babies for a shorter period of time.

Even when these and other factors were taken into account, babies delivered by c-section were twice as likely to be obese by age 3 as those delivered vaginally. Just under 16% of the children delivered by c-section were obese, compared with only 7.5% of those born vaginally. Nationally, the obesity rate among kids ages 6-11 is nearly 20%, according to government figures.

Previous research has shown that children born by c-section have higher numbers of Firmicutes bacteria and lower numbers of Bacteroides bacteria in their guts than those born vaginally. This could increase the energy their bodies extract from food, and stimulate cells to boost insulin resistance, inflammation and fat deposits, say the study authors. They point out that the apparent link between cesarean delivery and obesity should prompt mothers to avoid c-sections unless they are medically necessary.

The research appears online in the Archives of Disease in Childhood, a BMJ publication.

Diabetes In Teens More Than Doubles In a Decade

Monday, May 21st, 2012

Twenty three percent of kids ages 12 to 19 in the U.S. now have diabetes or prediabetes, according to a study out today in the journal Pediatrics. A decade ago that figure was just nine percent.

Looking at risk factors for heart disease and stroke in adolescents, researchers from the U.S. Centers for Disease Control and Prevention (CDC) examined data on more than 3,300 adolescents participating in a national survey from 1999 to 2008. Along with the increase in diabetes, they found that:

• 61% of obese teens in the survey had one risk factor for cardiovascular disease – such as high LDL cholesterol, high blood pressure, physical inactivity or diabetes – besides their weight

• 49% of overweight teens had one additional cardiovascular risk factor

• 37% of normal-weight teens had at least one cardiovascular risk factor

“I think this is an eye opener,” says Steven Mittelman, M.D., Ph.D., of the Children’s Hospital Los Angeles Center for Endocrinology, Diabetes & Metabolism, who was not involved in the study. “Parents really need to think about what their kids are eating and what their activity level is. Parents have to step up and help prevent these devastating diseases that last a lifetime.”

One of every three children with diabetes now has type 2 (which used to be called “adult-onset diabetes,” but is now far too common in children to merit that name), and Mittelman points out that the disease is not easily managed in kids. Adults with type 2 diabetes can improve their health with lifestyle changes and medications, but 50 percent of kids diagnosed with type 2 will end up on insulin within five years – and need it for the rest of their lives. “Over time that number will get worse, so eventually most teenagers diagnosed with type 2 diabetes will need insulin,” he says.

The prevalence of obesity among teens did not increase during the study period. “The prevalence of obesity and overweight really plateaued in the last 10 years,” says Mittelman, who credits public education about the obesity epidemic with spurring some progress. There are still far too many overweight kids, “but at least it’s not going up like it was 10 years ago,” he says.

His suggestions for parents looking to improve their kids health:

Pay attention during checkups. Doctors should be checking children’s height, weight and blood pressure at every visit, and taking the time to calculate Body Mass Index (BMI, a measure of height related to weight) for patients. Under some circumstances, they should also test kids’ cholesterol levels, and test for diabetes.

Know your family history. Let your pediatrician know if your child’s parents or grandparents have high cholesterol, diabetes or heart disease. Find out what medications your child’s grandparents take, and share that information as well. “That helps us know what might run in the family,” Mittelman says.

Check out resources that get kids moving. Mittelman recommends the CDC childhood obesity page (cdc.gov/obesity/childhood), Michelle Obama’s Let’s Move! campaign (LetsMove.gov) and your local YMCA (YMCA.org) as great places to start. “I often send my parents who say they have a tough time getting their kids to exercise [to the YMCA],” he says. “They really are focused on healthy weight.”

Mittelman is quick to point out that heart disease and diabetes are just two of the many life-threatening conditions caused by obesity. He specializes in studying the connections between obesity and cancer (and says that 20% of cancers in the U.S. are now caused by obesity). Studies show that many kids carry their weight problems into adulthood, but Mittelman and other experts consider adolescence a key window for change. And much of that change is up to moms and dads.

“Parents do have the power,” he says.

Rats Fed Processed Sugar Get Stuck In the Maze

Wednesday, May 16th, 2012

Everyone knows sugar is bad for the body, but new research from UCLA shows it’s bad for the brain as well. Scientists also believe that omega-3 fatty acids can help counteract the learning and memory disruptions created by processed sweetener.

Researchers fed rats a solution of water spiked with high-fructose corn syrup. The animals drank the sweetened substance for just six weeks, but Americans consume it all year around – more than 40 pounds on average – as an additive to everything from ketchup to baby food. Half the rats were also given omega-3 supplements.

Before starting their experimental diet, the rats practiced navigating a maze with visual landmarks to help them find their way to the only exit.

After six weeks of fructose, the rats who didn’t receive omega-3s were slower in the maze, and had trouble remembering the route they had learned. They also showed signs of resistance to insulin, which controls blood sugar and regulates brain signals. Omega-3s are necessary to help brain cells transmit signals to each other, making learning and memory possible, and supplements seemed to protect those chemical connections in the brains of some of the rats.

Though this study was in rats, rather than humans, lead author Fernando Gomez-Pinilla, a UCLA neurosurgeon, suggests people should minimize their processed fructose intake as much as possible (fructose found naturally in fruits, which also contain antioxidants, fiber, and other important nutrients, is fine) and choose snacks like fresh berries and Greek yogurt. And as a nutritional insurance policy (and to counteract those moments of weakness in the ice cream aisle), boost intake of omega-3-rich foods like salmon and walnuts or take a daily supplement containing 1 gram of DHA.

 

Beware Batteries, Bottles, Binkies – and Sippy Cups!

Monday, May 14th, 2012

Coin- and button-sized batteries from common electronic gadgets can be harmful if swallowed.

If the list of hazards awaiting your vulnerable young child seems never-ending, brace yourself for the results of two studies published online today in the journal Pediatrics. Button-size batteries like the one in your TV remote or calculator send a child to the Emergency Room every three hours in the U.S. And bottles, pacifiers and sippy cups aren’t much safer, injuring a child severely enough for an ER visit every four hours.

Both studies used 20 years worth of reports (1990-91 to 2009-10) from the National Electronic Injury Surveillance Data System (NEIS), a government database that collects information on product-related injuries across the country, and were conducted by Nationwide Children’s Hospital.

New coin- and button-size batteries now common in games, remote controls and other electronics doubled the number of battery-related injuries during the past eight years, researchers noted. Most of these (more than 80%) were to children younger than 5.

Overall around 66,000 children went to the ER with battery-related injuries during the study period. The majority fished button-size batteries out of products and swallowed them. If a battery makes it through to the digestive tract, most will pass through without causing harm. However, if a battery lodges in the throat it can take as little as two hours for current from the battery conducted by saliva, or leakage from the battery, to permanently damage the esophagus, vocal cords or surrounding nerves. This can paralyze tissues or cause a child to bleed to death. No deaths were reported in the study, but the authors note that the NEISS database does not do a good job of tracking deaths.

Smaller numbers of children were taken to the ER with batteries lodged in their noses or ears.

To keep batteries out of children’s hands, etc., experts recommend that parents tape shut the battery compartments of all electronic devices in their homes, and store extra batteries well out of children’s reach. Ultimately, they say manufacturers should design battery compartments that can’t be opened without a screwdriver.

Toddlers walking around (unsteadily) while drinking from a bottle can get hurt if they fall.

The data on bottles, pacifiers and sippy cups are new not because of the products, but because of the focus. Previous research centered around choking from broken pacifier parts and burns from overheated formula in bottles. This study looks at a range of injuries caused by these products – most to children around age 1, who were walking around sucking pacifiers or drinking from bottles or sippy cups, and fell. Only around 4% of more than 45,000 injuries recorded over 20 years were caused by any sort of product malfunction. Cuts and bruises to the mouth, lips, teeth and face were the most common injuries noted.

Recommendations about use of pacifiers, bottles and sippy cups focus on protecting the teeth from decay (in the case of bottles and sippy cups) and becoming crooked (in the case of pacifiers), rather than preventing injuries. Experts suggest that by age 1, children should be transitioned away from these products and drinking only from lidless cups.

Research has shown, however, that children commonly continue to use these products through age 2 and beyond. The authors of this study suggest that parents consider the risk of injury to children who are learning to walk, encourage their children to stay seated while drinking, and help them transition away from bottles, pacifiers and sippy cups by age 1. Just to be safe.

Broccoli and Eggs During Pregnancy Could Program Healthier Babies

Friday, May 11th, 2012

Boosting intake of a nutrient called choline during pregnancy could be the key to decreasing babies’ chances of hypertension and diabetes – for life. That’s the finding from a small study published last week out of Cornell University.

Choline, an essential nutrient similar to the B vitamins, is used in many chemical reactions in the body and is especially important to the central nervous system. It is present in breast milk and routinely added to infant formula, though not common in prenatal vitamins.

Researchers followed a group of 26 third-trimester pregnant women for 12 weeks, providing all of their meals and beverages and monitoring their choline intake. Half of the women consumed the recommended 450 milligrams daily, while the other half took more than double that amount, 930 mg.

Babies born to women taking the higher amount of choline had 33 percent lower concentrations of the hormone cortisol, which is produced in response to stress and raises the body’s blood sugar level, than those whose mothers took less choline. Marie Caudill, Ph.D., RD, associate professor of nutritional sciences at Cornell and lead author of the study, believes the choline impacted the genes involved in cortisol production in the babies, and that the effect should be permanent.

“We would expect that a 33 percent reduction in cortisol concentrations would be enough to [reduce] risk of stress-related diseases throughout life,” says Caudill. “However, we did not follow the babies to assess whether this reduced response to stress was maintained. Additional studies are needed to replicate our study findings and to assess whether this early nutritional manipulation results in changes that last throughout life.”

During pregnancy, Caudill says that choline is especially needed to remove fat from the liver and transport it to other areas of the body, such as the placenta. And animal studies have consistently shown that boosting choline levels in the mother improves lifelong brain function in her offspring.

“We know that there is a high demand for choline during pregnancy and that most women are not consuming the recommended intake levels of 450 mg per day,” says Caudill.

Dietary sources of choline include:

• Egg, 1 large:  125 mg

• Beef steak, 3 oz:  110 mg

• Salmon, 3 oz: 95 mg

• Pork, loin chop, 3 oz:  95 mg

• Chicken breast, 3 oz: 75 mg

• Beef ground, 85% lean, 3 oz: 70 mg

• Milk, 1% low fat, 1 cup: 45 mg

• Baked beans, canned, ½ cup: 40 mg

• Yogurt, low fat, 8 oz: 30 mg

• Broccoli, cooked, ½ cup: 30 mg

• Cauliflower, cooked, ½ cup: 24 mg

Caudill says the boosted choline levels reached by some women in her study were achieved with the help of supplements, and that reaching 930 mg per day would be difficult through diet alone. If further research bears out her findings, supplements could be especially helpful for women experiencing anxiety, depression or even preeclampsia during pregnancy. And while further study is needed to test its potential benefits to Baby, she says there is no harm in mothers taking choline supplements now, as long as they stay below the 3,500 mg per day upper safe level established by the Institute of Medicine.

The study was published online in The Journal of the Federation of American Societies for Experimental Biology.

Many Obese Children With Asthma Held Back By Weight, Not Breath

Wednesday, May 9th, 2012

Two current health crises in children – asthma and obesity – often strike together. And among kids dealing with both, lack of physical activity frequently comes in to create a “perfect storm” that hits health hard.

Looking at one of these kids, it is easy to imagine a sequence of events:

1. The child is diagnosed with asthma.

2. Asthma impairs the child’s ability to exercise.

3. The child gains weight.

But if a child’s asthma is well controlled, this doesn’t have to be the case. That is the message from new research out of The Children’s Hospital at Montefiore and Albert Einstein College of Medicine in New York.

Pediatric pulmonologist Deepa Rastogi, M.D., and colleagues found that when obese children with asthma were asked to walk for six minutes, it was their obesity – not their lung function – that held them back.

Researchers looked at 140 children, among them obese children with and without asthma, and normal-weight children with and without asthma. All children in the study with asthma had their disease under good control, meaning they had not needed prednisone, a medication used to treat an exacerbation, in at least three months. Researchers tested each child’s lung function and measured the distance they could walk in six minutes.

For children who were not obese, both asthmatic and non-asthmatic, their distance was linked to their lung function. The lower their lung function, the less ground they could cover.

But for obese children, their distance was linked to their BMI (a measure of weight compared to height). Whether or not they had asthma, the higher their BMI, the shorter the distance they could walk.

“If you have well-controlled asthma, then your exercise limitation may not be your asthma, it may be your body weight,” says Rastogi.

She explains that parents often discourage children with asthma from being active because they are afraid of bringing on attacks. “By the time they are in school they become programmed that they have asthma and they can’t exercise, and by then we have missed the opportunity to teach parents about keeping their children active with appropriate use of controller medications,” Rastogi says. Instead, the focus should be on keeping kids as active as they can be while maintaining good control of asthma.

Her message to parents is to partner with their healthcare provider to get their child’s asthma under control. “That’s the first step, always,” she says. “Then, with good control, encourage activity. If it appears that your child is limited in their exercise ability, talk to your health care provider to investigate further into the cause for the limited ability.”

Her study was published in March in the journal Pediatric Pulmonology.

Type 2 Diabetes Toughest To Treat In Children

Monday, May 7th, 2012

Treatment with medications and lifestyle interventions that have been successful in adults fails in as many as half of children with type 2 diabetes, underscoring the need to get the childhood obesity epidemic under control and prevent the disease in the first place.

Researchers from the University of Pennsylvania School of Nursing looked at 699 overweight children ages 10 to 17 recently diagnosed with type 2 diabetes. They found that treatment with medication commonly used to control diabetes in adults did not help almost half of patients maintain healthy blood sugar levels, forcing those children to begin insulin injections within a year. One in five of the children in the study had a serious complication such as very high blood sugar, and many were hospitalized.

Among various treatment programs, the study found that:

• Treatment with a medication called Metformin (also called Glucophage) alone failed 52 percent of children in the study.

• Treatment with Metformin plus a medication called rosiglitazone (brand name Avandia) failed 39 percent.

• Metformin plus an intensive diet, exercise and weight-loss program failed 47 percent of children. The intervention included a lifestyle coach and a family member designated for support.

Better treatment to manage type 2 diabetes in children is needed, but study author Terri H. Lipman, Ph.D., said prevention is key. “What we have learned is that the effect of the obesity-prone environment of these youths is even more difficult to overcome than we had predicted,” she said in a statement accompanying release of her study, which was published in May in The New England Journal of Medicine.

 

Jog Regularly, Live Longer

Thursday, May 3rd, 2012

An hour or two per week of jogging at a moderate pace can help you live five to six years longer, according to research shared at a major European cardiology conference this week.

The finding was based on an analysis of the Copenhagen City Heart Study, which enrolled 20,000 men and women ages 20-93 in the 1970s, 80s, 90s, and from 2001 to 2003. Researchers compared data on more than 1,800 joggers with non-joggers participating in the study, following subjects for up to 35 years.

Jogging was linked with a 44 percent lower risk of death for both men and women, and the data showed that jogging boosted life expectancy by 6.2 years for men and 5.6 years for women. But the health benefits of jogging – like those associated with drinking red wine – are greatest in moderation, with mortality lower in people reporting just one to two and a half hours of average-pace jogging per week than in non-joggers or those who took jogging to extremes.

To achieve the ideal jogging pace, aim to feel just “a little breathless,” the authors advise. They attribute a number of health benefits to the practice:

• Improved oxygen uptake

• Increased insulin sensitivity

• Higher HDL cholesterol and lower triglycerides

• Lower blood pressure

• Improved heart function

• Increased bone density

• Boosted immune function

• Obesity prevention

• Improved mood

The research was presented May 3 at the EuroPRevention2012 meeting organized by a branch of the European Society of Cardiology.