By Anne Harding
NEW YORK (Reuters Health) Feb 04 - Parents often make mistakes when using a dosing cup to measure out liquid medicine for their children, a new study shows.
Just half got the dose right when using a cup with etched markings, while only 30% measured accurately using a cup with printed markings, Dr. H. Shonna Yin of New York University School of Medicine in New York City and her colleagues found. But when parents used a dropper, dosing spoon, or oral syringe, they got the dose right 85% of the time.
"The cups can be very confusing for a lot of different reasons," Yin told Reuters Health. "For example, cups might have both teaspoon and tablespoon markings, and this can lead to confusion because the abbreviations are so similar."
Dosing mistakes are the most common reason for preventable adverse drug events in children, Dr. Yin's team notes in the Archives of Pediatrics and Adolescent Medicine. And while such errors are known to occur frequently, there has been little study of factors that could help improve dosing accuracy.
To investigate, the researchers asked 302 parents visiting a public hospital pediatric clinic to measure out a 5 milliliter (one teaspoon) dose of liquid medicine using one of six different dosing instruments. They also assessed the parents' health literacy by showing them a nutrition label and asking them some questions about it.
Study participants using the printed cup were 27 times as likely to make a dosing error as those who used an oral syringe; etched markings were associated with an 11-fold increased risk of error. Large errors were six or seven times more common when using the cups compared to the syringe.
Having low health literacy also increased the likelihood of making a dosing mistake.
Most of the dosing mistakes made were overdoses, Dr. Yin noted, but it's not likely that giving these wrong doses to a child would cause serious harm. "You can have minor side effects like nausea, stomachaches, dizziness, and drowsiness," she said.
But even though such mistakes are rarely life-threatening, she added, "I don't think we should accept that it's inevitable for parents to misdose the medicines that they're giving their young children."
About one in four US parents has low health literacy, Dr. Yin said. While one approach to the problem of dosing mistakes would be to improve health literacy for all, she added, "a better approach is to try to make the tasks that we're giving people easier to navigate."
The US Food and Drug Administration is currently working on industry guidelines to improve the accuracy of dosage delivery devices.
Arch Pediatr Adolesc Med 2010.
Monday, February 8, 2010
Sunday, February 7, 2010
One Bowl = 2 Servings. F.D.A. May Fix That.
By WILLIAM NEUMAN
Published: February 5, 2010
Seeking a new weapon in the fight against obesity, the Food and Drug Administration wants to encourage manufacturers to post vital nutritional information, including calorie counts, on the front of food packages.
The calorie and nutritional information on many foods may be revised if portion sizes are increased to reflect a heavier population.
The goal is to give people a jolt of reality before they reach for another handful of chips. But the urgency of the message could be muted by a longstanding problem: official serving sizes for many packaged foods are just too small. And that means the calorie counts that go with them are often misleading.
So to get ready for front-of-package nutrition labeling, the F.D.A. is now looking at bringing serving sizes for foods like chips, cookies, breakfast cereals and ice cream into line with how Americans really eat. Combined with more prominent labeling, the result could be a greater sense of public caution about unhealthy foods.
“If you put on a meaningful portion size, it would scare a lot of people,” said Barry Popkin, a nutrition professor at the University of North Carolina. “They would see, ‘I’m going to get 300 calories from that, or 500 calories.’ ”
The problem is important because the standard serving size shown on a package determines all the other nutritional values on the label, including calorie counts. If the serving size is smaller than what people really eat, unless they study the label carefully they may think they are getting fewer calories or other nutrients than they are.
And if manufacturers increasingly push key nutrition facts to the front of packages — as many have begun doing — the confusion could be magnified. Rather than helping fight obesity, it may simply add to the perplexity over what makes a healthful diet.
“If people don’t understand the serving, whatever number they get for fat or calories is misleading,” said William K. Hubbard, a former F.D.A. official who consulted with the agency last year.
Consider the humble chip: most potato or corn chip bags today show a one-ounce serving size, containing a tolerable 150 calories, or thereabouts. But only the most disciplined snacker will stop at an ounce. For some brands, like Tostitos Hint of Lime, that can be just six chips.
In the real world, many people might eat two or three times that, or more. Munch half a bag of Tostitos while watching the Super Bowl and you could take in about half the 2,000 calories an average person needs in a day.
“We are actively looking at serving size and evaluating what steps we need to take,” said Barbara O. Schneeman, director of the F.D.A. office that oversees nutrition labels. “Ultimately, the purpose of nutrition labeling is to help consumers make healthier choices, make improvements in their diet, and we want to make sure we achieve that goal.”
The push to re-evaluate serving size comes as the F.D.A. is considering ways to better convey nutrition facts to hurried consumers, in particular by posting key information on the front of packages. Officials say such labeling will be voluntary, but the agency may set rules to prevent companies from highlighting the good things about their products, like a lack of trans fats, while ignoring the bad, like a surfeit of unhealthy saturated fats.
On today’s food packages, many of the serving sizes puzzle even the experts.
For ice cream, the serving size is half a cup. For packaged muffins, it is often half a muffin. For cookies it is generally one ounce, equal to two Double Stuf Oreos. For most children’s breakfast cereals, a serving is three-quarters of a cup.
It is difficult to say exactly how much people eat, said Lisa R. Young, an adjunct professor of nutrition at New York University, but she said that research showed that the portions Americans serve themselves had been growing in recent years.
When it comes to cereal, she said, many children probably eat two cups or more.
Parents who glance at a box of Frosted Flakes and see that it contains 110 calories per serving may not realize that their children may be getting several times that amount each morning at breakfast.
“To consumers, the serving size appears to be inconsistent and unintuitive,” said Wendy Reinhardt Kapsak, senior director of health and wellness at the International Food Information Council Foundation. “They have trouble trusting it.”
They may also have trouble seeing it, where it usually appears in small type in the Nutrition Facts panel on food packages. In surveys conducted by the foundation, many more people say they look at the calorie number than at the serving size on which it is based.
Standard serving sizes were created by the F.D.A. in the early 1990s, partly to make it easier to compare the nutritional values of different products. Congress required that the serving sizes match what people actually ate. To determine that, the F.D.A. evaluated data from surveys of Americans’ eating habits taken in the 1970s and 1980s.
Some nutritionists say those surveys may be suspect, since people typically underestimate how much they eat. And there is general agreement that they are out of date.
The F.D.A. has vowed to re-evaluate serving sizes before. Amid concern over obesity, it said in 2005 that it was considering changes. That effort languished, but has now been revived by the Obama administration.
Still, the solution is not as simple as merely bumping up the standard portions for some foods. Officials worry that could send the wrong message. If the serving size for cookies rose to two ounces, from one ounce, for instance, some consumers might think the government was telling them it was fine to eat more.
A trip to the store shows how a smaller serving size can affect health or nutrient claims in ways that may confuse consumers.
Duane Reade, the pharmacy chain, sells 1.3-ounce bags of its Delish potato chips with the words “100 calories” in bold type across the front. But the calorie count refers to a one-ounce serving, and the label says the bag holds one-and-one-third servings. That appears to conflict with F.D.A. rules that require packages of that type to be labeled as a single serving. Doing the math, the full bag would appear to contain around 130 calories.
After being questioned about the bags by The New York Times, Duane Reade said it would correct the chip labels.
While in some cases companies have leeway in how they label smaller packages, in 2004 the F.D.A. urged manufacturers to label them as single-serving containers. The agency was interested primarily in making calorie counts clearer, but other food ingredients, like salt, also raise concerns.
Healthy Choice soups, made by ConAgra Foods, are sold in 14-ounce microwaveable bowls. Although they appear to be meant for one person, the label says they contain “about two servings.”
Many of the soups are billed as “Heart Healthy” and claim to have a reasonable amount of salt per serving. But a shopper has to examine the label closely to understand that the salt claim refers to half a bowl. A full bowl may contain close to half the daily salt allowance recommended for people with high blood pressure.
Michael F. Jacobson, executive director of the Center for Science in the Public Interest, a consumer advocacy group, called such labeling disingenuous.
A ConAgra spokeswoman, Teresa Paulsen, said the Healthy Choice bowls contained more than one and a half times the F.D.A.-established standard serving for soup, which is about eight fluid ounces, or one cup.
Because of that, Ms. Paulsen said, “we think it makes sense to label the package as two servings.”
Published: February 5, 2010
Seeking a new weapon in the fight against obesity, the Food and Drug Administration wants to encourage manufacturers to post vital nutritional information, including calorie counts, on the front of food packages.
The calorie and nutritional information on many foods may be revised if portion sizes are increased to reflect a heavier population.
The goal is to give people a jolt of reality before they reach for another handful of chips. But the urgency of the message could be muted by a longstanding problem: official serving sizes for many packaged foods are just too small. And that means the calorie counts that go with them are often misleading.
So to get ready for front-of-package nutrition labeling, the F.D.A. is now looking at bringing serving sizes for foods like chips, cookies, breakfast cereals and ice cream into line with how Americans really eat. Combined with more prominent labeling, the result could be a greater sense of public caution about unhealthy foods.
“If you put on a meaningful portion size, it would scare a lot of people,” said Barry Popkin, a nutrition professor at the University of North Carolina. “They would see, ‘I’m going to get 300 calories from that, or 500 calories.’ ”
The problem is important because the standard serving size shown on a package determines all the other nutritional values on the label, including calorie counts. If the serving size is smaller than what people really eat, unless they study the label carefully they may think they are getting fewer calories or other nutrients than they are.
And if manufacturers increasingly push key nutrition facts to the front of packages — as many have begun doing — the confusion could be magnified. Rather than helping fight obesity, it may simply add to the perplexity over what makes a healthful diet.
“If people don’t understand the serving, whatever number they get for fat or calories is misleading,” said William K. Hubbard, a former F.D.A. official who consulted with the agency last year.
Consider the humble chip: most potato or corn chip bags today show a one-ounce serving size, containing a tolerable 150 calories, or thereabouts. But only the most disciplined snacker will stop at an ounce. For some brands, like Tostitos Hint of Lime, that can be just six chips.
In the real world, many people might eat two or three times that, or more. Munch half a bag of Tostitos while watching the Super Bowl and you could take in about half the 2,000 calories an average person needs in a day.
“We are actively looking at serving size and evaluating what steps we need to take,” said Barbara O. Schneeman, director of the F.D.A. office that oversees nutrition labels. “Ultimately, the purpose of nutrition labeling is to help consumers make healthier choices, make improvements in their diet, and we want to make sure we achieve that goal.”
The push to re-evaluate serving size comes as the F.D.A. is considering ways to better convey nutrition facts to hurried consumers, in particular by posting key information on the front of packages. Officials say such labeling will be voluntary, but the agency may set rules to prevent companies from highlighting the good things about their products, like a lack of trans fats, while ignoring the bad, like a surfeit of unhealthy saturated fats.
On today’s food packages, many of the serving sizes puzzle even the experts.
For ice cream, the serving size is half a cup. For packaged muffins, it is often half a muffin. For cookies it is generally one ounce, equal to two Double Stuf Oreos. For most children’s breakfast cereals, a serving is three-quarters of a cup.
It is difficult to say exactly how much people eat, said Lisa R. Young, an adjunct professor of nutrition at New York University, but she said that research showed that the portions Americans serve themselves had been growing in recent years.
When it comes to cereal, she said, many children probably eat two cups or more.
Parents who glance at a box of Frosted Flakes and see that it contains 110 calories per serving may not realize that their children may be getting several times that amount each morning at breakfast.
“To consumers, the serving size appears to be inconsistent and unintuitive,” said Wendy Reinhardt Kapsak, senior director of health and wellness at the International Food Information Council Foundation. “They have trouble trusting it.”
They may also have trouble seeing it, where it usually appears in small type in the Nutrition Facts panel on food packages. In surveys conducted by the foundation, many more people say they look at the calorie number than at the serving size on which it is based.
Standard serving sizes were created by the F.D.A. in the early 1990s, partly to make it easier to compare the nutritional values of different products. Congress required that the serving sizes match what people actually ate. To determine that, the F.D.A. evaluated data from surveys of Americans’ eating habits taken in the 1970s and 1980s.
Some nutritionists say those surveys may be suspect, since people typically underestimate how much they eat. And there is general agreement that they are out of date.
The F.D.A. has vowed to re-evaluate serving sizes before. Amid concern over obesity, it said in 2005 that it was considering changes. That effort languished, but has now been revived by the Obama administration.
Still, the solution is not as simple as merely bumping up the standard portions for some foods. Officials worry that could send the wrong message. If the serving size for cookies rose to two ounces, from one ounce, for instance, some consumers might think the government was telling them it was fine to eat more.
A trip to the store shows how a smaller serving size can affect health or nutrient claims in ways that may confuse consumers.
Duane Reade, the pharmacy chain, sells 1.3-ounce bags of its Delish potato chips with the words “100 calories” in bold type across the front. But the calorie count refers to a one-ounce serving, and the label says the bag holds one-and-one-third servings. That appears to conflict with F.D.A. rules that require packages of that type to be labeled as a single serving. Doing the math, the full bag would appear to contain around 130 calories.
After being questioned about the bags by The New York Times, Duane Reade said it would correct the chip labels.
While in some cases companies have leeway in how they label smaller packages, in 2004 the F.D.A. urged manufacturers to label them as single-serving containers. The agency was interested primarily in making calorie counts clearer, but other food ingredients, like salt, also raise concerns.
Healthy Choice soups, made by ConAgra Foods, are sold in 14-ounce microwaveable bowls. Although they appear to be meant for one person, the label says they contain “about two servings.”
Many of the soups are billed as “Heart Healthy” and claim to have a reasonable amount of salt per serving. But a shopper has to examine the label closely to understand that the salt claim refers to half a bowl. A full bowl may contain close to half the daily salt allowance recommended for people with high blood pressure.
Michael F. Jacobson, executive director of the Center for Science in the Public Interest, a consumer advocacy group, called such labeling disingenuous.
A ConAgra spokeswoman, Teresa Paulsen, said the Healthy Choice bowls contained more than one and a half times the F.D.A.-established standard serving for soup, which is about eight fluid ounces, or one cup.
Because of that, Ms. Paulsen said, “we think it makes sense to label the package as two servings.”
Saturday, February 6, 2010
Airport Body Scanning Raises Radiation Exposure
Feb. 5 (Bloomberg) -- Air passengers should be made aware of the health risks of airport body screenings and governments must explain any decision to expose the public to higher levels of cancer-causing radiation, an inter-agency report said.
Pregnant women and children should not be subject to scanning, even though the radiation dose from body scanners is “extremely small,” said the Inter-Agency Committee on Radiation Safety report, which is restricted to the agencies concerned and not meant for public circulation. The group includes the European Commission, International Atomic Energy Agency, Nuclear Energy Agency and the World Health Organization.
A more accurate assessment about the health risks of the screening won’t be possible until governments decide whether all passengers will be systematically scanned or randomly selected, the report said. Governments must justify the additional risk posed to passengers, and should consider “other techniques to achieve the same end without the use of ionizing radiation.”
President Barack Obama has pledged $734 million to deploy airport scanners that use x-rays and other technology to detect explosives, guns and other contraband. The U.S. and European countries including the U.K. have been deploying more scanners at airports after the attempted bombing on Christmas Day of a Detroit-bound Northwest airline flight.
“There is little doubt that the doses from the backscatter x-ray systems being proposed for airport security purposes are very low,” Health Protection Agency doctor Michael Clark said by phone from Didcot, England. “The issue raised by the report is that even though doses from the systems are very low, they feel there is still a need for countries to justify exposures.”
3-D Imaging
A backscatter x-ray is a machine that can render a three- dimensional image of people by scanning them for as long as 8 seconds, the report says. The technology has also raised privacy issues in countries including Germany because it yields images of the naked body.
The Committee cited the IAEA’s 1996 Basic Safety Standards agreement, drafted over three decades, that protects people from radiation. Frequent exposure to low doses of radiation can lead to cancer and birth defects, according to the U.S. Environmental Protection Agency.
Most of the scanners deliver less radiation than a passenger is likely to receive from cosmic rays while airborne, the report said. Scanned passengers may absorb from 0.1 to 5 microsieverts of radiation compared with 5 microsieverts on a flight from Dublin to Paris and 30 microsieverts between Frankfurt and Bangkok, the report said. A sievert is a unit of measure for radiation.
European Union regulators plan to finish a study in April on the effects of scanning technology on travelers’ privacy and health. Amsterdam, Heathrow and Manchester are among European airports that have installed the devices or plan to do so.
The U.S. Transportation Security Administration has said that it ordered 150 scanners from OSI Systems Inc.’s Rapiscan unit and will buy an additional 300 imaging devices this year. The agency currently uses 40 machines, which cost $130,000 to $170,000 each, produced by L-3 Communications Holdings Inc. at 19 airports including San Francisco, Atlanta and Washington D.C.
To contact the reporter on this story: Jonathan Tirone at jtirone@bloomberg.net
Pregnant women and children should not be subject to scanning, even though the radiation dose from body scanners is “extremely small,” said the Inter-Agency Committee on Radiation Safety report, which is restricted to the agencies concerned and not meant for public circulation. The group includes the European Commission, International Atomic Energy Agency, Nuclear Energy Agency and the World Health Organization.
A more accurate assessment about the health risks of the screening won’t be possible until governments decide whether all passengers will be systematically scanned or randomly selected, the report said. Governments must justify the additional risk posed to passengers, and should consider “other techniques to achieve the same end without the use of ionizing radiation.”
President Barack Obama has pledged $734 million to deploy airport scanners that use x-rays and other technology to detect explosives, guns and other contraband. The U.S. and European countries including the U.K. have been deploying more scanners at airports after the attempted bombing on Christmas Day of a Detroit-bound Northwest airline flight.
“There is little doubt that the doses from the backscatter x-ray systems being proposed for airport security purposes are very low,” Health Protection Agency doctor Michael Clark said by phone from Didcot, England. “The issue raised by the report is that even though doses from the systems are very low, they feel there is still a need for countries to justify exposures.”
3-D Imaging
A backscatter x-ray is a machine that can render a three- dimensional image of people by scanning them for as long as 8 seconds, the report says. The technology has also raised privacy issues in countries including Germany because it yields images of the naked body.
The Committee cited the IAEA’s 1996 Basic Safety Standards agreement, drafted over three decades, that protects people from radiation. Frequent exposure to low doses of radiation can lead to cancer and birth defects, according to the U.S. Environmental Protection Agency.
Most of the scanners deliver less radiation than a passenger is likely to receive from cosmic rays while airborne, the report said. Scanned passengers may absorb from 0.1 to 5 microsieverts of radiation compared with 5 microsieverts on a flight from Dublin to Paris and 30 microsieverts between Frankfurt and Bangkok, the report said. A sievert is a unit of measure for radiation.
European Union regulators plan to finish a study in April on the effects of scanning technology on travelers’ privacy and health. Amsterdam, Heathrow and Manchester are among European airports that have installed the devices or plan to do so.
The U.S. Transportation Security Administration has said that it ordered 150 scanners from OSI Systems Inc.’s Rapiscan unit and will buy an additional 300 imaging devices this year. The agency currently uses 40 machines, which cost $130,000 to $170,000 each, produced by L-3 Communications Holdings Inc. at 19 airports including San Francisco, Atlanta and Washington D.C.
To contact the reporter on this story: Jonathan Tirone at jtirone@bloomberg.net
Friday, February 5, 2010
The Hidden Danger of ‘an Aspirin a Day’
By THE NEW YORK TIMES
Dr. Neena S. Abraham, a gastroenterologist at the Michael E. DeBakey V.A. Medical Center and associate professor of medicine at the Baylor College of Medicine in Houston, recently took readers’ questions about ulcers, a potentially life-threatening condition increasingly tied to Nsaid pain relievers. Here, Dr. Abraham discusses the potential dangers of taking a daily baby aspirin, which doctors often recommend for those at high risk of heart disease.
An Underappreciated Risk of an Aspirin a Day
By Neena Abraham, M.D.
If your physician has suggested you take aspirin to reduce your risk of heart disease, it is important to remember that even small doses of daily aspirin — including “baby aspirin,” at a dose of 81 milligrams daily — can increase your risk of ulcers and bleeding. It is important to remember that all Nsaids, including over the counter aspirin, have the potential to damage the tissue of the gastrointestinal tract. Damage can occur anywhere, from mouth to anus.
Over-the-counter doses of aspirin, or buffered or enteric coated aspirin preparations, do not eliminate the risk of developing an Nsaid-related ulcer. Your risk for bleeding is still two- to four-fold greater than if you were not taking the aspirin product at all.
This risk increases in magnitude as the dose of the aspirin increases. Some studies have suggested that one-third of aspirin-induced ulcers are related to over-the-counter aspirin use. The excess ulcer bleeding risk associated with aspirin use is estimated at 5 extra cases per 1,000 patients per year.
However, it is important to remember that your risk of aspirin-induced ulcer will further increase if you have high-risk features such as:
* being older than 60,
* having a history of gastric or duodenal ulcer,
* having active Helicobacter pylori infection (the bacterium linked to ulcers),
* taking aspirin at the same time as you take full strength Nsaids (such as ibuprofen, Motrin and naproxen), anticoagulants (such as warfarin) or antiplatelet agents (such as clopidogrel or ticlopidine); or taking aspirin if you are a chronic steroid user.
Aspirin is not a nutritional supplement — it is a medication with real risks and side-effects, so it should not be taken without explicit cardiovascular risk assessment by your physician.
If you and your doctor determine that the benefit of taking aspirin to prevent heart disease exceeds the risk of gastrointestinal bleeding, ensure you are only taking the minimum dose of aspirin required for cardiovascular risk reduction (in the United States, that is a dose of 81 milligrams a day).
If you have high-risk features for aspirin and Nsaid-induced ulcers, as discussed above, discuss with your physician the appropriateness of taking a stomach protecting medication, such as a proton-pump inhibitor. It may also be important to be tested and treated for H. pylori infection to minimize your risk of ulcer formation.
Dr. Neena S. Abraham, a gastroenterologist at the Michael E. DeBakey V.A. Medical Center and associate professor of medicine at the Baylor College of Medicine in Houston, recently took readers’ questions about ulcers, a potentially life-threatening condition increasingly tied to Nsaid pain relievers. Here, Dr. Abraham discusses the potential dangers of taking a daily baby aspirin, which doctors often recommend for those at high risk of heart disease.
An Underappreciated Risk of an Aspirin a Day
By Neena Abraham, M.D.
If your physician has suggested you take aspirin to reduce your risk of heart disease, it is important to remember that even small doses of daily aspirin — including “baby aspirin,” at a dose of 81 milligrams daily — can increase your risk of ulcers and bleeding. It is important to remember that all Nsaids, including over the counter aspirin, have the potential to damage the tissue of the gastrointestinal tract. Damage can occur anywhere, from mouth to anus.
Over-the-counter doses of aspirin, or buffered or enteric coated aspirin preparations, do not eliminate the risk of developing an Nsaid-related ulcer. Your risk for bleeding is still two- to four-fold greater than if you were not taking the aspirin product at all.
This risk increases in magnitude as the dose of the aspirin increases. Some studies have suggested that one-third of aspirin-induced ulcers are related to over-the-counter aspirin use. The excess ulcer bleeding risk associated with aspirin use is estimated at 5 extra cases per 1,000 patients per year.
However, it is important to remember that your risk of aspirin-induced ulcer will further increase if you have high-risk features such as:
* being older than 60,
* having a history of gastric or duodenal ulcer,
* having active Helicobacter pylori infection (the bacterium linked to ulcers),
* taking aspirin at the same time as you take full strength Nsaids (such as ibuprofen, Motrin and naproxen), anticoagulants (such as warfarin) or antiplatelet agents (such as clopidogrel or ticlopidine); or taking aspirin if you are a chronic steroid user.
Aspirin is not a nutritional supplement — it is a medication with real risks and side-effects, so it should not be taken without explicit cardiovascular risk assessment by your physician.
If you and your doctor determine that the benefit of taking aspirin to prevent heart disease exceeds the risk of gastrointestinal bleeding, ensure you are only taking the minimum dose of aspirin required for cardiovascular risk reduction (in the United States, that is a dose of 81 milligrams a day).
If you have high-risk features for aspirin and Nsaid-induced ulcers, as discussed above, discuss with your physician the appropriateness of taking a stomach protecting medication, such as a proton-pump inhibitor. It may also be important to be tested and treated for H. pylori infection to minimize your risk of ulcer formation.
Thursday, February 4, 2010
One in Five Kids With Abnormal Lipids
February 3, 2010 (Atlanta, Georgia) — New data from the Centers for Disease Control and Prevention (CDC) shows that one in five youths aged 12 to 19 years has abnormal lipid levels [1]. Also, nearly one-third of these youths are obese or overweight and based on their body-mass index (BMI) are candidates for lipid screening, according to investigators.
In an editorial accompanying the new report [2], the CDC urges clinicians to be aware of the lipid screening guidelines so that interventions for overweight or obese children and youths can be recommended. "Healthcare providers can refer eligible youths to nutritional counseling, community fitness programs, and school-based lifestyle programs," writes the CDC.
The new report, from a combined sample of four National Health and Nutrition Examination Survey (NHANES) surveys taken from 1999 to 2006, includes data on 9187 youths, of which 3733 provided fasting blood samples for lipid testing.
Among the sample, 20% had at least one abnormal lipid measurement, such as elevated LDL cholesterol (>130 mg/dL), reduced HDL cholesterol (35 mg/dL), or elevated triglyceride levels (>150 mg/dL). Researchers also showed that compared with normal-weight youths, those who were overweight or obese were significantly more likely to have at least one abnormal lipid measurement.
In addition to these findings, the CDC report also showed that boys were more likely than girls to have low HDL cholesterol, while older youths, those aged 18 to 19 years, were more likely to have low HDL and elevated triglyceride levels than kids aged 12 or 13 years.
The researchers point out that, based on the American Academy of Pediatrics (AAP) screening recommendations, 32% of youths would be eligible for lipid screening based solely on their BMI. The AAP recommends screening based on family history of high cholesterol or premature cardiovascular disease or an unknown family history of high cholesterol or premature disease, as well as the presence of at least one major cardiovascular disease risk factor, including overweight/obesity.
Wednesday, February 3, 2010
Fish oil pills show promise in preventing schizophrenia
CTV.ca News Staff
Date: Tuesday Feb. 2, 2010 2:09 PM ET
Taking fish oil may help prevent schizophrenia and other psychotic disorders in at-risk young adults, new research suggests.
The study, in the Archives of General Psychiatry, found that young people at very high risk of developing psychosis were much less likely to develop full psychotic disorders over the next year if they took fish oil capsules for just 12 weeks.
The study looked at 81 young patients who did not yet meet the criteria for a diagnosis of psychosis, but who had begun to show enough mental illness symptoms to prompt them to seek psychiatric care.
These patients had either had mild psychotic symptoms, transient psychosis, or a family history of psychotic disorders plus a decrease in functioning.
Schizophrenia and other severe psychotic illnesses are typically diagnosed in adolescence or early adulthood. It's been shown that young people with early symptoms have as high as a 40 per cent risk of becoming psychotic in the next year.
In a bid to lower that risk, the researchers, led by Dr. G. Paul Amminger, of Medical University of Vienna, Austria, had 41 of the patients take four daily fish oil capsules containing a total of 1.2 grams of omega-3 polyunsaturated fatty acids for 12 weeks; another 40 patients took placebo capsules.
Only six per cent of all the patients dropped out during the study, suggesting the fish oil was well-tolerated.
After one year, two patients in the fish oil group (4.9 per cent) had been diagnosed with a psychotic disorder, compared to 11 (27.5 per cent) in the placebo group.
The patients taking fish oil also showed significant reductions in their psychotic symptoms and improvements in function, while they were at no greater risk of side effects than those taking the placeboes.
The authors think that patients with schizophrenia may have an underlying dysfunction in fatty acid metabolism, so providing them with extra omega-3 polyunsaturated fatty acids may help to prevent the progression to psychotic disease. Fish oil is also thought to boost levels of glutathione, an antioxidant that protects the brain against oxidative stress.
The authors note that fish oil capsules are inexpensive, safe, and would probably be more palatable to young people than anti-psychotic medications, which are known to cause significant side effects, such as weight gain and sexual problems.
"The finding that treatment with a natural substance may prevent or at least delay the onset of psychotic disorder gives hope that there may be alternatives to antipsychotics for the prodromal [early symptomatic] phase," the authors write.
The researchers are now beginning a larger international study in eight cities with hopes of replicating these findings.
Tuesday, February 2, 2010
Scientists link serotonin deficit to SIDS
The number of babies who die of sudden infant death syndrome has dropped in half over the last 20 years, thanks to a campaign urging parents to put babies to sleep only on their backs. But SIDS is still the leading cause of death in babies between one month and one year old and the number of deaths hit a plateau in 2000, despite greater awareness of risk factors for the baffling disorder.
New research from a team led by a Children's Hospital Boston neuropathologist sheds light on a possible biological cause, pinpointing a defect in the brain that might account for babies who suddenly and unexpectedly die during their sleep. The findings, published in this week's Journal of the American Medical Association, build on previous work that scientists hope will one day lead to a test and treatment.
In the new study, Dr. Hannah Kinney and her colleagues compared the brainstems of 41 babies who had died of SIDS to the brainstems of seven babies who died of other causes and five babies who were hospitalized with low oxygen levels before their deaths. Researchers have suspected that SIDS involves problems with inadequate oxygen, so Kinney wanted to compare the SIDS babies to the two groups. The brainstem is the part of the brain that controls breathing, responds to rebreathing too much carbon dioxide, and regulates blood pressure and body temperature, which are all important in sleeping and waking.
"We found an abnormality in the wiring, in the circuits that control these vital functions," Kinney said in an interview.
In 35 of the 41 SIDS babies, serotonin levels were 26 percent lower than in all the babies who did not die of SIDS and levels of an enzyme that spurs serotonin production were 22 percent lower. Binding to serotonin receptors was 50 percent lower in SIDS babies.
Kinney had previously found differences related to serotonin receptors in SIDS babies' brainstems, but it was not clear whether there was too much or too little of the neurotransmitter that sends signals between nerve cells. An unanswered question was whether the serotonin was there and the babies' brains were unable to use it.
Marian Willinger, who is responsible for the SIDS research program at the National Institute of Child Health and Human Development, called Kinney's results on a serotonin deficit important.
"I think this is an important advance in our understanding of what's wrong with the brainstem of many babies who die from SIDS," she said in an interview. "It helps us ... to understand the pathophysiology, how the baby dies, because we don't really know."
Kinney said the goal is to identify the infants who have this problem.
"We are closer than we have been, but we still have quite a journey to go, to test and then identify it in the living infant and then to have a treatment for it," she said. "Those are long-term goals and we know we are years away from them."
Kinney and Willinger both emphasized avoiding known risk factors parents can control, such as bed sharing, soft bedding, and smoking while research on the biological causes of SIDS continue.
From boston.com
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