Recently in Children's Health Category

Despite a general belief among physicians that extreme obesity is too difficult to treat, except with bariatric surgery, researchers at the Pennington Biomedical Research Center have learned a substantial proportion of individuals with extreme obesity can lose 10-percent or more of their body weight through medical treatment that does not include surgery.

10% Loss Improves Risk Factors and Health

Furthermore, even though those individuals are still obese, they have improvements in risk factors and other health markers.

Weight Loss Surgery Not Often Affordable or Reimbursed by Insurance

"This is important, because surgery is not often affordable or reimbursed by insurance," said leading scientist Dr. Donna Ryan. "In fact, many medical treatments are frequently not reimbursed by insurance if they are for obesity. So this research is needed to show that primary care doctors are capable of helping obese patients lose weight to improve health, even those with extreme obesity. "

Ryan said losing only five-percent of body weight can reap healthy benefits for the extremely obese, and nearly 61-percent of those in her clinical trial achieved that. More than 40-percent lost 10-percent body weight or more.

Physicians Trained in Intensive Medical Intervention

Ryan and her team spread out across Louisiana to recruit and train practicing physicians and their office staffs in eight cities in what she called "intensive medical intervention," in which physicians used a combination of medication, low-calorie diets and behavior changes. All of the techniques were endorsed by national guidelines for obesity management. Training of physicians and their staffs took about a day and a half.

Funded by the Louisiana Office of Group Benefits, which provides health coverage for state employees, the research team contacted state employees, seeking participants to screen for and enroll in the trial. Nearly 400 participants enrolled in the two-year trial, called LOSS, using the nearest trained physicians.

About half of the participants received the intensive medical intervention, the other half received what Ryan called "usual care." 

Program Starts with Low-calorie Liquid Diet

Those in the intense intervention group were immediately placed on a low-calorie liquid diet. They gradually moved to a low calorie, highly controlled diet using meal replacements, and received weight loss medication and group behavioral therapy that included lessons in exercise, activity, self-monitoring and recommendations for walking, water exercise and weight training. The group sessions were supervised by office staff.

Recommended Activities

• exercise
• activity
• self-monitoring
  
• recommendations for walking
• water exercise
  
• weight training

Success in Daily Routine of Doctor's Practice

"We conducted this trial as close to the reality of a typical clinic setting as we could," Ryan said, "We didn't want to learn just if these strategies worked, but if they would work in the daily routine of a doctor's practice."

Challenge of Keeping Weight Off

Ryan noted that the continual challenge in weight loss is keeping weight off, and that means sticking with a routine.

More than 50% of the LOSS participants stuck with it for two years or more, keeping much of the weight off, but Ryan said that does leave room for improving weight loss maintenance.

The LOSS trial results were published in the current issue of the Archives of Internal Medicine.

The Pennington Biomedical Research Center is a campus of the Louisiana State University System and conducts basic, clinical and population research.

Chronic kidney disease affects 26 million people in the United States.

Challenging prevailing wisdom that only children with end-stage kidney disease suffer physical, social, emotional and educational setbacks from their disease, research led by Johns Hopkins Children's Center shows that even mild to moderate kidney disease may seriously diminish a child's quality of life.

The findings, reported in the February issue of Pediatrics, suggest that earlier attention to quality-of-life issues in children with chronic kidney disease is needed.

"Even mild and moderate declines in kidney function may lead to serious physical, emotional, intellectual and social challenges," says lead investigator Arlene Gerson, Ph.D., a pediatric psychologist at Hopkins Children's.

Kidney Disease Screening is Needed

"What this means is we should be thinking about screening children for these challenges and intervening earlier than we once thought."

Recently diagnosed children who report learning problems may benefit from help before grades drop, researchers say, noting that children with chronic diseases currently do not qualify for special education until their scores decline dramatically.

Links Between Kidney Function and Quality of Life

In their study of 402 children, ages 2 to 16, with mild-to-moderate kidney disease, researchers analyzed the link between kidney function, disease severity, age of onset and disease duration, on the one hand, and physical, emotional, psychological and school functioning on the other.

The researchers also compared quality-of-life outcomes between healthy children and children with early-stage kidney disease. Children with mild-to-moderate kidney disease and their parents reported worse overall outcomes on standard quality-of-life questionnaires and worse outcomes on all quality-of-life factors.

Specifically, children with early-stage kidney disease scored on average 75 out of 100 on quality-of-life measures, compared to 83 out of 100 for healthy children. The difference was especially pronounced in school functioning, where children with early-stage kidney disease scored 64 out 100, compared to 80 out of 100 for healthy children.

How Children Cope with Kidney Disease

The study also found that the younger the child at the time of the diagnosis and the longer the child lived with kidney disease, the better the overall quality of life, a surprising finding, suggesting that as time passes children learn to cope better with their condition, the researchers say.

The researchers found that children with impaired growth and shorter stature, a common effect of their disease, had worse overall quality of life and poorer physical functioning, an indicator of the importance of early treatment.

Treatments for Children's Kidney Disease

"Timely and individually tailored treatment, be it with nutrition, salt supplements or growth hormones, if needed, can make a big difference. We cannot overemphasize the importance of early intervention in children with early stages of chronic kidney disease," says senior investigator Susan Furth, M.D. Ph.D., a pediatric nephrologist at Hopkins Children's.

The research is part of an ongoing 57-center study funded by the National Institutes of Health to study chronic kidney disease in children.

Heavy backpacks place a measurable strain on the spines of children, with heavier loads causing greater spinal strain and increased back pain, reports a study in Spine, January 2010 

My husband and I started getting concerned about heavy backpacks when our son was required to carry a very heavy backpack weighted down with a year's worth of books when he was in gradeschool.  It just didn't make sense.  It's taken a long time to get the research to prove the problems.  But it's here now, and solutions need to be found -- such as eBook readers.

The next step in convincing schools to "lighten the load" is to show how expensive back pain and back care is to our society.  Maybe business and government can prevent that long term impact on healthcare costs by providing children is an alternative to heavy books.

Test Results for Children's Back Health 

Magnetic resonance imaging (MRI) scans show compression of the spinal discs and spinal curvature caused by typical school backpack loads in children, according to Dr. Timothy Neuschwander of University of California, San Diego, and colleagues.

Backpacks' Effects on Disc Height and Spinal Curve Linked to Back Pain

The study included eight children, mean age 11 years. A special upright MRI scanner was used to image the children's spines in standing position--first with an empty backpack, then with increasing weights of 9, 18, and 26 lb. These weights represented about 10, 20, and 30 percent of the children's body weight.

Two key spinal measurements changed as the backpack load increased.

• Heavier weights caused compression of the intervertebral discs, which act as a cushion between the vertebrae (bones of the spine).
  
• Especially in the lower spine, the disc height became smaller (reflecting greater disc compression) at heavier backpack weights.
• Heavier loads were also associated with increased curvature of the lower spine, either to the right or the left.
  

Half of the children had a significant spinal curve even with the 18 lb weight. Most of the children had to adjust their posture to bear the 26 lb backpack load.

As backpack weight increased, so did the amount of pain reported by the children. At the heaviest load, the average pain score was nearly five (on a ten-point scale).

Parents are increasingly concerned about the heavy backpacks their children have to carry. The new study is the first to use imaging techniques to see how backpacks affect children's spines.

More than 90 percent of U.S. children carry backpacks, typically with weights equal to 10 to 22 percent of their body weight.

Carry Backpacks on One Shoulder or Two?

The results suggest that heavy backpacks cause compression of the spinal disks and increased spinal curvature, both of which are related to back pain reported by the children. Although the children were wearing the backpack straps over both shoulders when the MRI scans were performed, the researchers note that spinal curvature could be even greater if the backpack was carried over one shoulder--as many children do.

Lower Back Pain for Children -- Through Adulthood

"Low back pain in children may be worsened by discogenic [disc-related] or postural changes," Dr. Neuschwander and colleagues write. This could have long-term implications, as children with back pain are at increased risk of having back pain as adults. The researchers call for similar studies to examine the effects of heavy backpacks in children with existing back pain.

About Spine
Recognized internationally as the leading journal in its field, Spine is an international, peer-reviewed, bi-weekly periodical that considers for publication original articles in the field of spine. It is the leading subspecialty journal for the treatment of spinal disorders. Only original papers are considered for publication with the understanding that they are contributed solely to Spine. According to the latest ISI Science Citation Impact Factor, Spine ranks highest among subspecialty orthopedic titles. Visit the journal website at www.spinejournal.com

EnviroFacts is an online tool that maps your area of choice with specific details about water quality, hazardous waste, air and land toxics, compliance issues and more.

Pollution Map...Online

The free online tool is based on GIS (Geographic Information Systems) where data is input into a visual format like a map. You can customize the type of information to display on your map or even map by topic instead of location to learn more about that issue. Search by Zip Code, City or County.

Check on the UV Index for your area... or who produces air emissions!
Identify Brownfields, or Hazardous Waste Sties... or Water Discharges... or Public Water Systems Violations...

It pays to know where invisible or hidden dangers lurk...

Research a neighborhood before you move there!
Reserach what's IN YOUR current neighborhood!
Find a community service project to clean up for your family and neighbors...

Learn about the natural systems in your community...and how they affect your health:

• Air
• Land
• Facilities
• Water
• Toxics
• Waste
• Radiation
• Compliance
• ...Other

Visit http://www.epa.gov/enviro/ to explore this newly updated program.

The possibilities are endless as you explore your world on a different level. This resource can be used for school or for your own personal interests. Maybe it could lead to community service projects based on the pollution issues in your area or a great visual for a class project. You can also take a look at the Community Service Projects page on EPA's High School Website or just see the resources out there for you to use.

Learning WHAT is in your community is the first, vital step to doing something about the problem -- and avoiding what can be harmful to you and your family.  Knowledge is power!

Learn more

Lead Disclosure Required for Rental & Sale Properties

Property owners are required to disclose whether reports about lead-based paint or lead hazards existed for apartments prior to tenants signing lease agreements. Violations are subject to hefty fines via the federally regulated Toxic Substances Control Act.

Childhood lead poisoning from exposure to lead-based paint chips or dust continues to be an environmental challenge. Without adequate information about lead hazards, tenants and home owners cannot protect themselves and their families from the significant risks that these hazards present.

Many homes built before 1978 have lead-based paint.

The federal government banned lead-based paint from housing in 1978.

When you are home hunting, be sure to ask:

• When was this property built?
• Has it been tested for lead?  For mold?
• Do you have the required EPA disclosure information? 

Hazardous substances affect children, in particular.

Children with high levels of lead in their bodies can suffer from damage to the brain and nervous system, behavior and learning problems, such as hyperactivity, slowed growth, or hearing problems.

Federal law requires that persons and entities who sell or rent housing built before 1978 must

• provide an EPA-approved lead hazard information pamphlet;
  
• include lead notification language in sales and rental forms;
• disclose any known lead-based paint hazards and provide reports to buyers or renters;
• allow a lead inspection or risk assessment by home buyers;
• and maintain records certifying compliance with applicable federal requirements for three years.

Lead hazards may be controlled through specific maintenance practices or eliminated through abatement. For additional information on lead in paint, dust and soil, see: http://www.epa.gov/lead/.

HHS Secretary Kathleen Sebelius released a new report, Preventing and Treating Diabetes: Health Insurance Reform and Diabetes in America.

"Americans with diabetes are suffering in our current health care system," Secretary Sebelius said. "Health insurance reform will help ensure these Americans can get the prescription drugs and supplies they need and bring down premiums so all Americans can have high-quality, affordable health insurance."

As affordable treatment remains inaccessible to many Americans suffering from chronic diseases, people with diabetes shoulder some of the nation's highest health care expenses.

Annual health care expenses for a diabetic topped $11,477 in 2007.

The report notes:

• One in six individuals with diabetes report avoiding or delaying needed medical care because of cost. A box of 100 test strips for blood sugar monitors can cost up to $60 while the price of a vial of insulin can range from $30 to $70, mainly because generic brands are not manufactured in the United States.
• A study showed that 80 percent of people with diabetes went uninsured after having lost coverage due to health insurance transitions triggered by job change or layoff, a move, divorce, graduation from college, or a change in income or health status.
• If all states improved diabetes control to the level of the top four best performing states, at least 39,000 fewer patients would have been admitted for uncontrolled diabetes in 2004, potentially saving $216.7 million.
• Fourteen percent of American Indians, 12 percent of African Americans, and 10 percent of Hispanics have type 2 diabetes. These rates of diabetes are greater than in the non-Hispanic White population, which has a rate of only 7 percent.

The report outlines the ways health insurance reform will lower costs and improve access to quality health care services for Americans with diabetes. Health insurance reform will lower health care costs for people with diabetes by capping annual out-of-pocket expenses, eliminate discrimination for pre-existing conditions and health status, create a health insurance exchange so families can shop for suitable plans, provide coverage for preventive screenings, and reduce health disparities so that all Americans can have access to quality, affordable health care.

To learn more about how health insurance reform will help Americans with diabetes and view the complete report, visit www.HealthReform.gov.

Surgeon General Declares Thanksgiving as "Family Health History Day"

Surgeon General Regina M. Benjamin, today declared Thanksgiving Day 2009 to be the nation's sixth annual "Family Health History Day," when families can make plans for gathering their health history, with the aid of the My Family Health Portrait Web site.

"An important first step in preventing illness is learning about health conditions in our families that may put us at risk for inheriting diseases such as diabetes, heart disease, cancer, Alzheimer's, mental illness, and many others," said Dr. Benjamin.  "Discussing family health information with each other can often uncover things you never knew, simply because no one ever asked."

Your family health history can help direct your doctor, physician assistant, or nurse practitioner to specific tests or treatment plans you may need to take to prevent or delay disease.  For example, you can be tested for a heart condition or cancer because it's in your family history.

You can find the Office of the Surgeon General's
My Family Health Portrait Web site at
https://familyhistory.hhs.gov.

Once you have entered family health information, the on-line portal assembles the information into a medical "family tree" format that is useful for health care clinicians. This tool is free for anyone to use.

Filling out the "My Family Health Portrait" usually takes about 20 minutes.  You can share the Web portal with your family members to help fill in missing information. The portal also allows relatives to create their own family health history by adding to information already entered by another family member.

After filling in the information, you can save the information to your computer and -- if you want to -- share it with your doctor.  The Surgeon General's Web site does not retain the information once the tool has been used to assemble it.

"On this Thanksgiving holiday, I hope you and your family will take a few minutes to create a family health portrait," Dr. Benjamin said.   "Learning your family's health history is a valuable investment to make in your health and your family's health."

Bisphenol A (BPA) Is Found in Canned Food Lining, Water Pipes, Plastic Items

Daughters of women exposed to a common chemical found in some plastics while they were pregnant are more likely to have unusually aggressive and hyperactive behaviors as 2-year-olds, according to a new study by researchers at Simon Fraser University, the University of North Carolina at Chapel Hill and Cincinnati Children's Hospital.

UNC-Chapel Hill measured the BPA levels in the urine of 249 Ohio women at three stages--during pregnancy at 16 weeks and 26 weeks and following birth. When the children turned two, their behavior was evaluated using the Behavioral Assessment System for Children-2 (BASC-2).

BPA is commonly used in the production of polycarbonate plastics and epoxy resins that can be found in some types of plastic bottles, canned food linings, water supply pipes and medical tubing. According to the Centers for Disease Control and Prevention, some 93% of U.S. residents have detectable levels of BPA in their urine.

This study--published October 6, 2009, in Environmental Health Perspectives, was the first to look at the link between prenatal BPA exposure and childhood behavior.

Early exposure to BPA during pregnancy looks like it may negatively impact the baby's developing nervous system--and have a particularly behavior-altering impact on growing girls.

BPA has been used in products for decades, and concerns about its safety have been growing in recent years, Braun said. Previous studies in mice have shown that the offspring of mothers with high BPA exposure during pregnancy were more aggressive than offspring not exposed to high prenatal levels of BPA.

"We wanted to know if there was a risk in humans for neurodevelopment problems," he said. "Study results indicate that exposure to BPA early in the pregnancy seems to be the most critical issue. The most damaging exposure might happen before a woman even knows she's pregnant."

The researchers do not know why boys seem so much less affected by exposure to the chemical.

SOURCES:

The study was funded in part by the National Institute of Environmental Health Sciences and the U.S. Environmental Protection Agency.

For more information on the study, visit: www.ehponline.org.

Nearly 2 out of 3 Americans are overweight or obese and obesity is now the fastest growing cause of disease and death in the country.

In 2000, the total annual cost of obesity in America was $117 billion.

The most alarming aspect of this trend is the rapid rise in rates of childhood obesity, which has been linked to early-onset type II diabetes, and has substantial impacts on life expectancy and quality of life. Integrated strategies are needed to improve outcomes across the country.

The first phase of the study determined that no single effort to curb childhood obesity will be sustainable or effective on a broad scale if the larger food system is not addressed.

Researchers from the Urban Design Lab at Columbia University's Earth Institute and the Collaborative Initiatives at Massachusetts Institute of Technology (MIT) have joined to address the complex issues related to this epidemic.

The second phase developed and refined the concept of a comprehensive food system infrastructure that promotes access and affordability to healthy food by integrating local, regional, and national efforts. Using data, analysis and recommendations from the first phase, industry leaders were engaged in a conversation on the future of our food system. Several models were explored as building blocks for a new national food infrastructure.

Among these models, the most promising is the Integrated Regional Foodshed. This overarching concept is similar to a watershed, where most of the necessary food for a region is provided within a defined geographic area thereby decreasing the cost of healthy foods by decreasing production, processing, and transportation costs and increasing access.

Additional components of the study have examined new models for food production, retail, and education.  Representative pilots include:

•  Food Terminals, which are transformed urban and suburban spaces designed to foster partnerships around food production, retail, and education, would occupy non-traditional sites in areas with low food access.

•   Networks of Mobile Markets in retrofitted buses or trucks could provide food retail for underserved rural areas. These mobile markets could operate from existing food distribution centers.

•   Lawn to Farm envisions an expansion of the existing trend of converting underused suburban spaces, such as lawns, into food-producing landscapes.

•   The 10 x 10 project, comprising modular food production units distributed to schools, community centers, and Boys and Girls Clubs, would provide children with a hands-on, direct food production experience, as well as appreciation of fresh foods. Educational projects will achieve the greatest success if dependent on an Integrated Regional Foodshed that enables people to act on what they learn. 

About the Research Members

The Urban Design Lab (UDL) integrates social processes, education initiatives, technological solutions, and political empowerment to create long-lasting sustainable changes in communities. UDL also provides technical and consultation services to community-based organizations, with the goal of incorporating sustainable alternatives for meeting development needs.

Collaborative Initiatives (CI) at MIT works to develop systemic solutions to complex "big-picture" issues that can be addressed effectively only through multidisciplinary efforts. CI brings together leaders and technical experts from a range of disciplines who who are not satisfied with traditional mechanisms for change, and want to accelerate the development and application of new ideas.

The United Health Foundation funded this research project.  The foundation was established by UnitedHealth Group in 1999 as a not-for-profit, private foundation dedicated to improving health and health care. Its mission is to support health and people in communities by working with others to improve the quality and cost effectiveness of medical outcomes; to expand access to health-care services for those in challenging circumstances; and to enhance the well-being of communities.

Children absorb lead at a much higher rate than adults and toddlers put EVERYTHING in their mouths... so lead in the soil and wall paint, and even their toys becomes a danger to their health that lasts up to 30 years.

SOLUTIONS: To reduce lead content in the environment, old pipes should be replaced, as should old, flaky paint. Any toys used in the yard, park or garden, such as buggies and bikes that come into contact with soil should be washed regularly. Have a child's lead level checked if you live (or lived during their toddler years) in an old house that used lead-based paint on walls or window sills... or even outdoor painted walls.

The campaign for car drivers to make the switch from leaded to unleaded gasoline has been hailed as a major environmental success story in recent years. But despite the dramatic change in our driving habits lead pollution in the environment remains a health hazard and, according to the latest research from Children of the 90s, one to which children are particularly vulnerable.

The research published this week in the online edition of the Archives of Diseases in Childhood, reveals that raised levels of lead in blood - at even quite modest levels - adversely affect behavior and educational attainment.

Children of the 90s measured the levels of lead in the blood samples of nearly 500 youngsters at age two years eight months and linked these levels to the SATS results of the children at age seven years. After adjusting for the many factors, which can affect educational attainment, the analysis showed a clear link between levels of lead in the blood and exam results.

Lead researcher, Professor Alan Emond, Head of the Centre for Child and Adolescent Health at the University of Bristol, said his results demonstrated that those children with lower levels of lead in their blood (between two - five microg/dl) were found to perform significantly better in their SATS that those with blood lead above five microg/dl.

Currently, the World Health Organisation has set the international acceptable level of lead in blood - known as the 'threshold of concern' - at ten microg/dl, but Professor Emond is now calling for this figure to be halved to just five microg/dl based on these results.

"Exposure to lead early in childhood has effects on subsequent educational attainment, even at low blood levels (five-ten microg/dl). Our results suggest that the threshold for clinical concern should be reduced to five microg/dl."

He adds, "We also talked to teachers as part of this research and found that children with lead levels above ten microg/dl were nearly three times as likely to show hyperactivity and anti-social behaviour."

Children are at the greatest risk because lead is more easily absorbed by their growing bodies and because their tissues are especially sensitive to damage. The main sources of environmental lead include water supplies (lead pipes), old lead paint and soil. Blood lead levels appear to peak between the ages of two and three years - the ages when toddlers tend to put most items (including toys) in their mouths.

"While adults absorb around 10-15 per cent of an ingested quantity of lead, this amount can increase to 50 per cent in infants and young children. This lead is then absorbed into the bone where it can remain for up to 30 years," he said.

"Lead gets incorporated into the bones and is gradually released into the blood and circulates throughout the body. It interferes with enzymes and affects many systems - including the central nervous system."