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July 2006
CANADA
A little compulsion pays off in the gym
Because healthy bodies and minds go hand in hand, Ontario teenagers should be worried about how little physical activity many of them are getting. A new study indicates more than half of high-school students in Ontario drop physical education after Grade 9, the only year of secondary school in which it is mandatory. Even fewer participate in competitive and recreational high-school sports programs.
That should raise alarm bells for both parents and teachers. As obesity rises among young people and puts more kids at risk of lifelong health problems, it is critical that schools do a better job of encouraging exercise. To that end, a good first step would be to make physical education compulsory for at least one more year.
The study, published recently in the Journal of Adolescent Health, shows 98 per cent of Grade 9 students in Ontario take physical education. But that proportion drops to 50 per cent in Grade 10, when gym classes become optional. It falls even further in later years to 43 per cent in Grade 11 and 36 per cent in Grade 12. The study also shows only one-quarter of high-school students play inter-school sports and 15 per cent join less competitive intramural programs, although most schools offer them. Even more troubling is the fact that participation in physical education and school sports has dropped sharply since 1998, when a similar survey was done.
The risks of inactivity among young people are clear. Research shows kids are getting fatter. Over the past 25 years, the proportion of Canadian adolescents who are overweight has doubled. More disturbing, the obesity rate among teens has tripled. That means more and more young people are at risk of heart disease, diabetes and other ailments later in life. At the same time, teens are spending more time in front of computers and televisions and less time being active, despite clear evidence that exercise, combined with a balanced diet, is the best way to stay healthy. That is why parents should set a good example and make exercise a regular family activity.
But too few have the time or inclination to motivate their teens to get off the couch. Others lack the money to pay for sports outside school. Teens need more exercise than many parents think. Experts say they should get at least an hour of physical activity each day. Yet there are understandable reasons why many Ontario teens are dropping gym class after Grade 9. A shorter and tougher high-school curriculum means many students are scrambling to complete the academic credits they need to gain admission to college and university. Physical education simply is not a priority.
Many teens are also overly conscious of how they look, and consider gym class something to be endured rather than enjoyed. And parents who have bad memories of running laps under the supervision of drill-sergeant-like gym teachers may not encourage reluctant teens to stick with physical education after it becomes optional. That is unfortunate because behaviours shaped in childhood tend to carry over into adulthood. Inactive teens often become inactive adults.
Schools can do many things to promote physical activity. Expanding intramural programs beyond traditional sports such as basketball and soccer to appeal to less athletic students would be a good start. And introducing a more diverse curriculum could also make gym class more enticing to some students. But the best way to ensure teens are active is to put physical education on a more equal footing with math and English and make it compulsory for at least one more year.
30 July 2006
Special ed students may have high asthma rates
One in three special education students in New York City public schools has asthma, compared to just one in five in the general school population, a new study shows. "That's a huge number" -- it may be that many children in special education are there because they have asthma, co-author Dr. Luz Claudio of the Mount Sinai School of Medicine in New York City told Reuters Health. "Managing that disease successfully may remove them from special education."
The percentage of kids with asthma in special education was as high as 60 percent in some schools, she added. Low-income urban children are known to be at greater risk of having their asthma under poor control, Claudio noted. "It's a manageable chronic disease," she added, but "our findings show that a lot of kids from this group are not well managed."
To investigate whether there might be a relationship between having asthma and being in special education classes, Claudio and her colleague Jeanette A. Stingone surveyed 24 randomly chosen New York City public elementary schools via parent questionnaires. On average, 34 percent of students in special education classes had asthma, compared with 19 percent of children in the general school population. The researchers estimated that children with asthma had a 60 percent increased risk of being in special education compared with children without the disease.
Claudio and Stingone also found that children with asthma who were in special education classes were more likely to be low-income and were three times more likely to have been hospitalized for asthma in the past year, compared to children with asthma in regular classes. Asthmatic in special education were also half as likely to use a peak flow meter (a device that helps patients control asthma by monitoring their lung function) and 15 percent less likely to use a spacer, a device that delivers asthma medication to the lungs.
However, it was not exactly clear why the asthma rates were higher among special education students. While absenteeism due to illness could be one explanation, Claudio noted, the children in the current study with asthma who were in special education classes did not have significantly more school absences than the asthmatic children in regular classes.
"Because children spend so much of their time in school, there is an opportunity for public health interventions during the school day aimed at improving asthma control among children who are at risk or already experience learning difficulties," the researchers write in the September issue of the American Journal of Public Health. They are currently evaluating the effectiveness of an asthma management program based at a school in East Harlem, a neighborhood with one of the nation's highest rates of childhood asthma.
SOURCE: American Journal of Public Health,
September 2006.
Anne Harding
28 July 2006
Early social stimulation helps stunted children
Social stimulation and organised play sessions in early childhood can have long-term benefits for the emotional development of children with stunted growth, researchers said. About 30 percent of all children under 5 years old suffer from stunted growth due to malnutrition. It is also associated with behavioural problems in adolescence.
But scientists from the University of the West Indies in Kingston, Jamaica found that teenagers who had organised weekly play sessions with their mothers when they were babies were less likely to suffer from depression and anxiety or behave antisocially and had higher self esteem. "Stimulation in early childhood has sustained benefits to stunted children's emotional outcomes and development," Professor Susan Walker said in a report in the British Medical Journal. She and her team compared the impact of early social stimulation on 129 children between 9 months and 2 years old living in poor neighbourhoods in Kingston, all of whom were identified as stunted at that age.
The children were divided into four groups. One received milk supplements each week. Another had organised weekly play sessions with their mothers. The third group had both the dietary and social stimulation and the fourth group had no interventions. When the researchers re-examined 103 of the children 16 years later they found that the teenagers who had the social simulation as babies had fewer psychological and social problems than the other adolescents. The milk supplements had no significant impact on the children. "The next challenge is to develop interventions that can meet the needs of the enormous number of stunted children," Walker added.
http://news.scotsman.com/latest_uk.cfm?id=1095302006
CANADA
Less than half of high school students take physical education after grade 9
Ontario should consider changes to its high school physical education program, researchers said Tuesday after finding that most students are dropping gym classes, raising fears of obesity in teens. Researchers from the University of Toronto and the University of Guelph have found that less than half of Ontario high school students are fitting basketball and floor hockey into their timetables after Grade 9.
Participation in physical education dropped to 50 per cent in Grade 10 from 98 per cent in Grade 9, when it is mandatory. In Grades 11 and 12, the numbers fell even further to 43 and 36 per cent respectively. "It should be a wake up call to the government and also to school boards and parents," said Kenneth Allison, director of physical activity research at the U of T. "The opportunities and especially the participation by secondary schools in physical activity ... is lower than it should be."
The study's co-author John Dwyer, an associate professor at Guelph's Department of Family Relations and Applied Nutrition, called the lack of student participation in exercise at school an alarming trend of inactivity among Canadian youth. "Typically it's recommended that adolescents should be getting at least 60 minutes of moderate to vigorous physical activity daily," said Dwyer. "If kids aren't getting it at school, they are physically inactive."
Over the past 25 years, obesity rates have more than tripled for Canadian children between the ages of 12 and 17. Obesity increases the risk of heart disease, high blood pressure and Type 2 diabetes. Dwyer said youth who are inactive at school are unlikely to exercise elsewhere. Both researchers suggested that requiring students to take more than one year of gym in high school could help. "If there were policies that indicated that students would need to take more than one credit of physical education during highschool... participation would increase," said Allison.
The study also found that only about 25 per cent of students took part in inter-school sports, although almost all of the 474 schools surveyed offered those programs. Fifteen per cent of students joined intramural programs. The new findings show a dramatic drop compared to a previous study on participation in physical education conducted in 1998. At that time, about 63 per cent of Grade 10 students took gym classes and about 29 per cent took part in intramural sports.
Researchers said students have indicated there's no space for gym classes in a high school timetable geared towards meeting the requirements for entrance to post-secondary schools. "Youth are telling us that one of the reasons they don't take physical education is because they and their parents feel that physical education is not a priority," said Dwyer. "They need to get into university, and they are better off putting their time and effort into academics," Dwyer added.
The research, published in the July issue of the Journal of Adolescent Health, is based on mailed-in responses from health and physical education teachers. It comes about a month after Ontario unveiled a $10-million action plan to tackle obesity, with a focus on boosting awareness and participation in active lifestyles. Valerie Poulin, spokeswoman for Education Minister Sandra Pupatello, said the government is taking a "life-long learning" approach to physical activity for students.
In October 2005, the provincial government made physical activity mandatory for students from Grades 1 to 8. The expectation is that students will have developed a fitness routine and want to continue exercising when it becomes a choice in Grade 10. The government also set aside $20 million in both 2005 and 2006 for school boards to open up school gyms to not-for-profit groups after hours. "We're in the hopes that this is going to instill life-long learning that will spill over into the secondary level," Poulin said.
Matthew Chung
26 July 2006
Teenagers using mothballs to get high: study
The 18-year-old French woman was hospitalized with scaly skin on her legs and hands, appearing unsteady and mentally sluggish, doctors said. They found the condition puzzling, especially since the woman's twin sister displayed similar, but less severe, symptoms and there was no family history of the problem, the doctors reported in this week's New England Journal of Medicine that several days later, doctors discovered the cause: a bag of mothballs stashed in her hospital room. The teenagers had been using the mothballs to get high, inhaling air from the bag for about 10 minutes a day because classmates had recommended it. The sicker of the young women also had been chewing half a mothball a day for two months.
The doctors described the high as "dangerous" and most likely under-reported in medical literature. The teenager told the doctors that she continued to use the mothballs during her hospitalization "because she thought her symptoms were not related to her habit," said Lionel Feuillet at the Hospital of Timone in Marseille, France.
Mothballs, used to prevent moth larva from getting into clothing, contain paradichlorobenzene, a substance also found in air fresheners and insect repellents that can cause liver and kidney failure, and severe anemia. The discovery comes at a time when teenagers are increasingly experimenting with legal drugs like OxyContin, widely known as "hillbilly heroin," and Vicodin, often bought online or taken from medicine cabinets, even before trying marijuana or alcohol, health officials say.
The sicker of the women took six months to recover fully. Her twin, who had only been "bagging" for a few weeks, recovered after three months. Feuillet told Reuters that a cleaning lady discovered the mothballs in the drawer of the patient's night table. When the woman was asked what she was doing with the bag, "she showed us how she used to breathe directly into the mothballs bag," Feuillet said. Although only three cases of getting high with paradichlorobenzene have been reported in medical literature, "since young people usually deny practicing self-intoxication, the incidence of this type of recreational activity is probably underestimated," Feuillet and his colleagues said in the Journal.
Gene Emery
26 July 2006
Lifestyle of young males leads to higher death rate
Young men throughout the world have higher death rates than women because of their riskier lifestyles, researchers said on Tuesday. Accidents and suicide are the leading killers in men aged 15 to 34 while deaths from illnesses such as heart disease, cancer and chronic liver disease rise sharply in 35- to 44-year-olds. "In every country there is an excess of male deaths due to potentially avoidable reasons. The main causes of death are those that are more or less directly attributable to lifestyle and risk-taking," said Alan White of Leeds Metropolitan University in England.
In a study published in the journal Men's Health and Gender, White and his colleague Mike Holmes analyzed the causes of death in men and women aged 15 to 44 in 44 countries. In each country the researchers found an excess of male deaths. In Thailand, 35 percent of male deaths were within that age group while in Sweden it was only 3.5 percent. Along with Thailand, Brazil, Kazakhstan and the Philippines had the highest male death rates among 15- to 44-year-olds while Japan, the Netherlands and Italy ranked among the lowest.
In Brazil, homicide was the principal cause of death among young men while in Japan it was suicide. Suicide rates were higher among men in the richer northern European countries than in nations further south. "I want to see governments recognize that men's health is an issue," White said in an interview. "If you start to take young men's health seriously then that will have a profound effect not only on the young men but on their families and on society. "Throughout the world the developing countries or those in transition have the highest rates of death among the age group 15 to 44 years."
Nations in sub-Saharan Africa and the Indian sub-continent were not included because of the lack of data. The researchers said deaths due to cancer, heart disease and chronic liver disease showed the importance of lifestyle factors such as smoking and alcohol consumption which are known to raise the risk of developing the disorders. In women, cancer of the breast, ovaries and cervix were the leading killers but men seemed to be more susceptible to cancers across the board. "Men have a higher incidence of developing the majority of cancers that should effect men and women equally. They are developing it sooner and they are dying from it sooner," White said.
Patricia Reaney
25 July 2006
Sexual health: youth service key to lowering teen pregnancy
A well-resourced youth service with a clear remit to tackle big social issues is a key factor in preventing teenage pregnancy, according to government guidance issued to local councils. Teenage Pregnancy Next Steps: Guidance for Local Authorities and Primary Care Trusts on Effective Delivery of Local Strategies, a non-statutory guidance document issued by the Department for Education and Skills (DfES) last week, lays out the Government's latest approach to tackling teenage pregnancy in a bid to meet its 2010 target to halve the teenage conception rate.
It highlights a wide regional variation in teenage pregnancy figures, with "hot spots" in almost every local authority in England, and sets out an action plan for London, the region that has made the least progress in cutting teenage pregnancies. Work led by the Government Office for London will target disadvantaged young women in schools, train professionals and provide more culturally appropriate services.
A DfES spokesman said: "In London, the picture is variable. We know in Hackney there has been a fall in teenage conceptions, but in places such as Barnet it has risen. The guidance is to provide best practice for heads of primary care trusts and children's services directors."
The report calls for local authorities to incorporate successful measures, such as the provision of youth-focused contraception services and sex and relationships education training for youth workers and Connexions personal advisers, in their children and young people plans and teenage pregnancy strategies. Anne Weyman, chief executive of fpa, welcomed the document. "Youth work is very important, especially for disadvantaged young people, and especially when workers are properly trained about sexual health."
The guidance also highlights factors driving the regional variation in figures, including ethnicity, with higher pregnancy rates among young women with Black Caribbean, Black or White British heritage and lower rates among Asian young women. Phil Martin, information officer at the Black Health Agency, said: "Young women need sustainable, long-term projects". Each year about 39,000 under-18s become pregnant in the UK. The cost to the NHS is an estimated £63m.
Dipika Ghose
26 July 2006
http://www.ypnmagazine.com/news/index.cfm?fuseaction=full_news&ID=11126
Children need even more exercise
Children should do at least 90 minutes exercise each day, experts say. The current UK guidelines recommend an hour of exercise - but a recent study found only one in 10 children of school age achieve that limit. Writing in The Lancet, they say children should up their activity levels in order to ward off heart disease and obesity. The Department of Health said it would consider whether its guidelines needed to be reviewed following the study. If current trends continue, half of all children in England could be obese by 2020.
Sedentary lifestyles
Among children, the rates of obesity have
tripled during the last 20 years. One in 10 six-year-olds is obese. The
authors of the latest study stress that getting enough exercise is
important not only to tackle the problem of childhood obesity, but also
to prevent future generations dying prematurely from illnesses
associated with sedentary lifestyles.
They looked at over 1,730 children, aged nine or 15 years, from schools in Denmark, Estonia, and Portugal. For each child they measured a combination of risk factors for cardiovascular disease, including blood pressure, weight and cholesterol, to calculate a combined risk factor score. Over one weekend and two week days the children were asked to wear a monitor that measured how physically active they were.
The researchers found that their risk score for cardiovascular disease decreased with increasing physical activity. The lowest risk scores were found in the nine year olds who did 116 minutes of moderate to vigorous intensity activity and the 15 year olds who did around 88 minutes daily. This would correspond to walking at a speed of around 4 km/h for 90 minutes.
Professor Lars Bo Anderson, from the Norwegian School of Sports Sciences in Oslo, and his team stress that the 90 minutes of daily exercise they are recommending for children would not have to be done in one chunk; it would be spaced over the day.
Little and often
For example, a child could walk or cycle to
and from school, run around at lunchtime and play sports in the evenings
and at weekends. Neville Rigby of the International Obesity Task Force
said children were being stifled from doing exercise. "When you drive
your child to the school gate in your Chelsea tractor you are not
helping your child. "Most kids in a previous generation had to walk to
school, cycle to school or catch a bus."
Professor Chris Riddoch, head of the London Sports Institute at Middlesex University and one of the researchers who conducted the latest study, agreed, saying: "We have engineered a society that does not exercise - kids as well as adults." He said children needed to be allowed and encouraged to be active at every opportunity. "Every little bit helps. If we are not successful then the next generation of adults will be less healthy than we are and we are no role model." He said much was being done to improve the situation but that unless things changed the NHS would crumble under the strain of treating escalating ill health.
Concerted effort
A spokeswoman from the Department of Health said policy makers would
consider the implications of the new findings "very carefully in the
context of our efforts to halt the rise in obesity among children under
11 by 2010." "It is important that we keep our recommendations under
review as evidence like this comes to light," she added.
She said there were a number of schemes working to increase physical activity among young people, including issuing schoolchildren with pedometers - devices that measure how many steps someone takes. The government also wants all school pupils to receive two hours of PE and sport a day by 2010. Steve Shaffelburg of the British Heart Foundation said: "For children to develop a lifelong healthy attitude to physical activity, it will take a concerted effort from many groups working together to find long-lasting solutions."
SOURCE: The Lancet
20 July 2006
http://news.bbc.co.uk/1/hi/health/5198154.stm
Impulsive preschoolers at risk for teen drinking
How preschoolers behave may help predict whether they will drink alcohol or use illegal drugs like marijuana in adolescence, research hints. In a long-term study, children who had less control over their behavior and impulses between 3 and 5 years of age and those who gained behavioral control more slowly were more likely to drink alcohol at age 14. They were also more likely to develop an alcohol problem and try illicit drugs. Moreover, adolescents with higher resiliency in early childhood -- meaning they were flexible and could readily adapt to a changing environment -- were less apt to start drinking alcohol in the early teenage years.
These findings, reported in the journal Child Development, are "very important because we know that early drinking (at age 14 or earlier) is associated with a greater likelihood for alcohol abuse or dependence in adulthood," Dr. Maria M. Wong from Idaho State University said in a statement from the Society for Research in Child Development. "If early childhood behaviors such as behavioral control and resiliency put individuals at risk for alcohol and drug use, then programs aimed at changing those behaviors at an early age may protect individuals from experimenting with drugs and alcohol later on," she added.
Wong and colleagues examined the "developmental trajectories" of behavioral control and resiliency from early childhood to adolescence and their effects on early substance use in 514 children of alcoholics and a similar group of children without an alcoholic parent. From the time the children were 3 to 5 years of age to the time they reached 12 to 14 years of age, trained interviewers periodically rated the children's ability to control their impulses and behavior, and their flexibility in adapting to environmental demands. Once the children were adolescents, they provided information on their drinking and drug use.
According to Wong's team, about one half of all the teens reported some form of substance use during adolescence. Specifically, a little more than 44 percent began to drink by age 14. Between 12 and 17 years of age, 41 percent reported having been drunk at least once, 40 percent experienced one or more alcohol-related problems, and 58 percent reported using drugs other than alcohol. Not surprisingly, having an alcoholic parent markedly increased the risk of early alcohol use and subsequent alcohol-related problems. Children of alcoholics were three times more likely to start drinking by age 14 and four times more likely to report having been drunk at least once by age 17 than those who were not from an alcoholic family.
However, children of alcoholics were not more likely than the other children to begin using other illicit drugs by age 17. After subtracting out the effect of parental alcoholism, children with lower initial levels of behavioral control and slower development of behavioral control were much more likely to use alcohol by age 14, to report having been drunk, to have more alcohol-related problems, and to have used drugs other than alcohol.
Conversely, children with higher initial levels of resiliency in early childhood were less likely to drink and experience drunkenness at an early age. They were also less apt to show signs of sadness, anxiety, aggressiveness or delinquent behavior. Wong and colleagues believe it's important to understand the antecedents of early alcohol use by teenagers. It is possible that lower initial levels of behavioral control and resiliency, as well as slower development of behavioral control over time, "may be important risk factors for problematic substance use in late adolescence or early adulthood."
SOURCE: Child Development, July/August 2006.
19 July 2006
Kids risk early deafness with MP3 players: charity
Teenagers and young adults who listen to MP3 players too loudly and too often risk going deaf 30 years earlier than their parents' generation, a charity warned on Thursday. Deafness Research UK said a national survey in Britain showed that 14 percent of 16-34 year-olds use their personal music players for 28 hours a week.
More than a third of the 1,000 people questioned in the poll said they had ringing in the ear, a sign of damage to hearing, after listening to loud music. "We are warning young people that they are putting themselves at risk of going deaf 30 years earlier than their parents' generation," said Vivienne Michael, chief executive of Deafness Research UK. Young people are exposed to loud noise from MP3 players, sophisticated sound systems in homes, clubs and cars but many are unaware of the damaging effect it can have on hearing.
Nearly 40 percent of the people questioned in the poll said they did not know that listening to loud music on a personal music player or in clubs or cars could damage their hearing. Twenty-eight percent said they went to noisy bars, pubs or nightclubs once a week. "Hearing loss can make life unbearable. It cuts people off from their family and friends and makes everyday communication extremely difficult," Michael said in a statement.
The charity advises people to follow the 60-60 rule. Do not listen to your MP3 player at more than 60 percent of maximum volume and do not listen to it for more than 60 minutes at a time. It also added that if the music from a headset is loud enough for the people around to hear, then it is loud enough to cause hearing damage. Noise levels exceeding 105 decibels can damage hearing if endured for more than 15 minutes, according to Britain's Health and Safety Executive. Normal conversation is about 60 decibels. Heavy traffic is about 85 decibels and loud personal music players are 112 decibels.
19 July 2006
Autistic boys lack certain brain cells: study
Men and boys with autism have fewer neurons in the amygdala, a part of the brain involved in emotion and memory, U.S. researchers reported on Tuesday. The team at the University of California, Davis, looked at the brains of nine autistic men and boys, aged 10 to 44, and compared them to 10 brains of males who did not have autism. They counted the number of neurons to see whether the brain cells were smaller or fewer in number.
Writing in the Journal of Neuroscience, David Amaral, research director of the UC Davis Medical Investigation of Neurodevelopmental Disorders Institute, and former graduate student Cynthia Mills Schumann said they found significantly fewer neurons in the brains of the people with autism. "One possibility is that there are always fewer neurons in the amygdala of people with autism. Another possibility is that a degenerative process occurs later in life and leads to neuron loss. More studies are needed to refine our findings," Schumann said in a statement.
In May, the U.S. Centers for Disease Control and Prevention found that up to one in every 175 U.S. children has autism, a disease that can cause symptoms ranging from social isolation to repetitive and damaging behaviors and sometimes mental retardation. "While we have known that autism is a developmental brain disorder, where, how and when the autistic brain develops abnormally has been a mystery," Dr. Thomas Insel, director of the National Institute of Mental Health, which funded the study, said in a statement.
"This new finding is important because it demonstrates that the structure of the amygdala is abnormal in autism. Along with other findings on the abnormal function of the amygdala, research is beginning to narrow the search for the brain basis of autism." Neurologists believe the amygdala is important in autism because it generates appropriate emotional responses and helps the brain process memories that are key to social learning. "We're in the very early stages of understanding autism and its neurological pathologies. It's clearly a process with many steps, and at least we are now one step further," Amaral said.
SOURCE: Journal of Neuroscience
18 July 2006
Conventional family violence programmes have targeted women and children and there is a missing line to the men.
Reaching out to males in abuse cases
To bridge the gap, the Ministry of Community Development, Youth and Sports (MCYS) will work closely with academics, psychologists and family service centres, among others, to analyse trends in Singapore's troubled families and find out more about the reasons behind divorce and family violence. Armed with more knowledge, the ministry hopes to organise more activities to reach out to the men, said MCYS Minister of State Mrs Yu-Foo Yee Shoon.
Last year, of the 2,692 personal protection orders (PPO) taken out, 10.5 per cent were from husbands against their wives. Said Mrs Yu-Foo: "The men also need some skills on how to say 'no' to unhealthy relationships and also how to communicate with their wives. "Hopefully, through collaborations with our partners, we can organise more events for men next year. I hope they won't be embarrassed about attending them. They should be brave and seek help, whether they are the aggressors or the victims." Mrs Yu-Foo was speaking at the launch of the first global domestic violence report by The United Nations Children's Fund (Unicef) and The Body Shop. The report shows that as many as 275 million children around the world are exposed to violence at home.
Among Asia-Pacific countries, about 75,000 to 82,000 children in Hong Kong are exposed to violence. In Malaysia, the number is 951,000. Singapore was not involved in the study. But figures released by the Subordinate Court last year show that children were witnesses to domestic violence in 600 of such cases, or 32 per cent, between January 2003 and March 2004. And of the 81 per cent who tried to intervene, 68 per cent were injured in the process.
On its part, The Body Shop, through sales of specially developed products starting tomorrow, aims to raise $60,000 for Singapore's Centre for Promoting Alternatives to Violence, which provides counselling to aggressors, victims and child witnesses of family violence.
Tan Hui Leng
19 July 2006
http://www.todayonline.com/articles/131439.asp
Marijuana tied to precancerous lung changes
Smoking marijuana can cause changes in lung tissue that may promote cancer growth, according to a review of decades of research on marijuana smoking and lung cancer. Still, it is not possible to directly link pot use to lung cancer based on existing evidence.
More than 40 percent of Americans 12 and older have tried marijuana at least once, Dr. Reena Mehra of Case Western Reserve University in Cleveland, Ohio and her colleagues point out. "Given the widespread use of marijuana, its use for what are believed to be medicinal purposes, and the increasing abuse and dependence on this substance, it is important to examine potential adverse clinical consequences," they write in the Archives of Internal Medicine.
To investigate whether marijuana smoking might lead to precancerous changes in the lungs or lung cancer, Mehra and her team reviewed 19 studies of the topic. Analyses of sputum and lung tissue performed in some of these studies found more cancer-promoting changes in pot smokers than in cigarette smokers or non-smokers, including oxidative stress, dysfunction of tumor-fighting cells, changes in tissue structure and DNA alterations, the researchers report.
However, none of the studies they analyzed found evidence that marijuana smoking actually caused lung cancer, after factoring in the effects of tobacco use. "We must conclude that no convincing evidence exists for an association between marijuana smoking and lung cancer based on existing data," Mehra and her team write.
Nevertheless, they add, the precancerous changes seen in studies included in their analysis -- as well as the fact that marijuana smokers generally inhale more deeply and hold smoke in their lungs longer than cigarette smokers, and that marijuana is smoked without a filter -- do suggest that smoking pot could indeed boost lung cancer risk. It is known, they add, that marijuana smoking deposits more tar in the lungs than cigarette smoking does.
The failure to find a marijuana-lung cancer link may have been due to methodological flaws in existing research, rather than the absence of such a link, the researchers say. Doctors should advise their patients that marijuana does indeed have potential adverse effects, they conclude, including causing precancerous changes in the lungs.
SOURCE: Archives of Internal Medicine, July 10, 2006.
13 July 2006
Child autism rate is 25 times accepted figure, study
warns
Childhood autism is much more widespread in Britain than previously thought, according to a comprehensive survey of school-age children published today. Doctors at St Thomas' hospital in London screened children aged nine and 10 and diagnosed autism or related disorders in more than 1%. The figure suggests autism is 25 times more common than the four to five cases per 10,000 people widely accepted in the 1990s.
Writing in the Lancet, Professor Gillian Baird, who led the study, called for local authorities to acknowledge the additional support people with autism spectrum disorders (ASDs) require. "Services in health, education and social care will need to recognise the needs of children with some form of ASD, who constitute 1% of the child population," she said.
The study sheds no light on whether the number of children born with autism is rising. Instead, the higher levels are believed to reflect a large number of cases that would previously have gone unrecognised. Autism is diagnosed using behavioural and psychological tests, but the criteria have broadened in recent years as doctors have included related disorders such as Asperger's syndrome.
"The core feature is an impairment in social interaction, so there's a difficulty with social relationships, and that can range from being withdrawn and aloof to simply not fitting in very easily," said Prof Baird. "In previous years, most children who had a diagnosis of autism would perhaps have some learning difficulties, but we're now recognising autism in young people who don't have learning difficulties and indeed are very capable."
Ian Sample
14 July 2006
http://www.guardian.co.uk/uk_news/story/0,,1820066,00.html
Pot may indeed lead to heroin use, rat study shows
Teens who experiment with marijuana may be making themselves more vulnerable to heroin addiction later in life, if the findings from experiments with rats are any indication. "Cannabis has very long-term, enduring effects on the brain," Dr. Yasmin Hurd of the Mount Sinai School of Medicine in New York, the study's lead author, told Reuters Health in an interview. Whether or not trying marijuana is a 'gateway' to use of so-called harder drugs like heroin and cocaine has been hotly debated, she and her colleagues note in the journal Neuropsychopharmacology.
To investigate whether pot smoking could cause brain changes that might predispose an individual to later drug use, Hurd and her team looked at rats exposed to the active ingredient in marijuana, THC, during a developmental period similar to human adolescence. To mimic the relatively small amount used by most teens experimenting with pot, the rodents received periodic, small doses of THC.
As young adults, the animals were fitted with catheters that allowed them to self-administer heroin. The researchers compared the amount and frequency of their drug use with that of rats that had not been given THC previously. The THC-exposed rats were more sensitive to the effects of heroin, the researchers found, and also consistently used larger amounts of the drug.
The researchers also found that the THC-exposed rats showed disturbances in the brain's endogenous opioid system, which is often popularly referred to as the "reward system" of the brain and, in humans, is involved in experiencing pleasure. "I was really surprised at how specific and enduring the effects of cannabis were," Hurd said. She and her colleagues conclude: "The current findings provide direct evidence in support of the gateway hypothesis that adolescent cannabis exposure contributes to greater heroin intake in adulthood."
SOURCE: Neuropsychopharmacology
Anne Harding
12 Julky 2006
In-home eating rules may improve teens' diet
A team of dietitians and nutritionists in California say they've identified a number of promising ways to help adolescents make healthier food choices -- like reaching for fruits and vegetables instead of cookies and sweets. Dr. Marion F. Zabinski from the University of California, San Diego, and colleagues used an online questionnaire to determine psychological and social factors that correlated with fruit, vegetable, and dietary fat intake among 878 girls and boys ages 11 to 15 years.
The researchers also interviewed the adolescents on multiple occasions to ask about what they had eaten the day before. Among the team's findings, healthy "household eating rules" emerged as one of "the most consistently supported correlates" of fruit and vegetable and fat intake among the adolescents. These rules included having healthful snacks available at home, eating vegetables with dinner and fruit with breakfast, and limiting certain foods like sweet snacks, desserts, and soda.
Parents can provide a healthful food environment, at least at home, by making sure healthy food choices are consistently available and promoted, the researchers note in the Journal of the American Dietetic Association. "Teaching parents about the value of household rules for healthful foods may be an important component of interventions for adolescents of all ages," they write.
Child "behavior change" strategies, such as setting goals to eat at least five servings of fruits and vegetables a day, were also strongly related to fruit, vegetable and fat intake. Teaching behavior-change techniques may be particularly effective for adolescents age 13 and older, given that these older adolescents are beginning to make more decisions for themselves about what they eat and don't eat. Although "increasing reliance on peer influence is often discussed as a hallmark of adolescent development," peer influences did not seem to have much effect on dietary choices, the team found.
SOURCE: Journal of the American Dietetic Association,
June 2006.
11 June 2006
Asthmatic children receiving wrong treatment, expert warns
Asthmatic children are not simply mini-adults with breathing disorders, a leading pediatric pneumologist told an international conference in Montreal on Monday. Treating children with adult medication can be a grave mistake because steroid therapy doesn't work and can lead to more hospitalization, said Hans Bisgaard, professor of pediatrics at Copenhagen University Hospital and head of the Danish Pediatric Asthma Centre. ''Asthma is the No. 1 cause of hospitalization of our children in the western world,'' Bisgaard said.
Inhaled corticosteroids that adults use are not efficient with children and infants, he added. ''It's just not the same disease as you see in the adult,'' Bisgaard said. ''This is very much a big problem.'' In particular, Bisgaard referred to steroid treatments of viral infections that can produce asthma-like symptoms, including wheezing and feelings of tightness in the chest plus shortness of breath. ''Doctors have been arguing for decades about what to call this asthma,'' he said.
Infants and children with severe asthma should, and do, get a short course of steroids to control the condition, but mild, intermittent attacks need something else because that's where steroids fail, he said. ''It's a major mistake thinking that one-size-fits-all,'' he said. Diagnosing asthma in early childhood has always been difficult, said medical professor Malcolm Sears of McMaster University in Hamilton. Most childhood asthma starts out as occasional wheezing. ''Is the wheezing viral or the first indication of persistent asthma? Only follow-up will show the evolution of the disease,'' said Sears, who is also research director of the Firestone Institute for Respiratory Health at St. Joseph's Healthcare in Hamilton.
A large proportion don't go on to develop asthma, he added. ''The question of how to treat them, if at all, are the kinds of questions being answered by Dr. Bisgaard studies and others,'' he said. The right treatment is crucial because asthma goes on to alter lung function. ''Chronic inflammation can lead to permanent changes in the airway wall, which makes the asthma irreversible,'' Sears said.
High doses of inhaled steroids are extremely effective in controlling the condition, but it's controversial and it's not a cure, said McGill University Health Centre pediatrics professor Francine Ducharme, who is also head of asthma research at the Montreal Children's Hospital.
''It works beautifully to control symptoms,'' Ducharme said of major study on children with a family history of asthma that took steroids daily for three years. ''It had a preventative effect. But once you stop, it doesn't alter the progression of the disease. Everyone came back to the same number of episodes and severity.''
Asthma is now the most common chronic disease of childhood. Ten to 20 per cent of children in Canada have been diagnosed with the disease, and about 20 children and 500 adults die each year from asthma, according to the Canadian Lung Association.
The seventh International Congress on Pediatric Pneumology held in Montreal ended yesterday.
http://www.canada.com/theprovince/news/story.html?id=11de4b3e-13e7-4c5a-93ff-e6eef3ea3d28&k=25537
Depression linked with risky teen sex
Research by scientists at University of California, San Francisco, has shown that teenagers with higher depression symptoms are more likely to engage in risky sexual behavior. The study published in July's edition of the Journal Pediatrics urges parents to help their adolescent children seek mental health care if they are depressed.
In their study, Dr. Jocelyn A. Lehrer and her colleagues analyzed results of a large national study of adolescent health that included 4,152 boys and girls who were interviewed at home in 1995 and followed up a year later. The participants were assessed for the levels of depressive symptoms using a 19-item questionnaire.
Researchers found that the boys who scored higher on the depression symptom test were more likely to report not using the condoms or any other type of birth control when having sex. They were also more likely to have used drugs or alcohol before their last sexual encounter. And the girls who scored high on the test were also less likely to have used birth control or condoms the last time they had sex, and were more likely to have had three or more sexual partners over the previous year.
Though many previous studies have suggested a link between depression and risky sex, Lehrer and her team note, their analysis is unique because it looked at a large, nationally representative sample over a one-year period. Explaining the cause behind the sexual risks by depressed teens Lehrer said, "Youth who are both emotionally distressed and socially isolated may be more likely to seek or be successfully pressured into sexual activity, in the name of some kind of shared intimacy, or to maintain relationships that they value.
Teens may also use sex as a way to cope with their symptoms of depression, she told Reuters Health. Lehrer said the findings of the study suggest that parents must become "familiar with signs of depression among adolescent boys and girls" and that along with "providing strong and consistent emotional support to their teens, it is important for parents to encourage and actively support their teens in seeking mental health care when needed."
The researchers noted that as many as 20 percent of adolescents may experience major depression and that half of new cases of sexually transmitted infections occur in adolescents, while teens also face a disproportionate risk of contracting HIV.
Shaveta Bansal
10 July 2006
http://www.allheadlinenews.com/articles/7004173317
Middle-class girls 'most at risk of becoming binge drinkers'
Teenage girls from middle-class homes are more likely to binge drink than those from poorer communities, according to new research. Although boys start drinking at a younger age, girls consume alcohol more regularly and by the time they are 14 their consumption outstrips that of the opposite sex. Experts claim those children with both parents out at work were most likely to start drinking because they have more money and spare time without parental supervision to experiment. Their findings will alarm parents, especially as almost all the girls surveyed admitted they had behaved in a way they regretted or put themselves in dangerous situations while drunk.
Steve Barrett, editor of the magazine Young People Now, who along with the Office of the Children's Commissioner ordered the research, said three quarters of under 16's living in affluent areas admitted drinking alcohol, compared to fewer than 60 per cent of those from poorer communities. 'Middle-class children who have two working parents and are living in affluent areas or rural communities are significantly more likely to have tried alcohol than any other group,' Mr Barrett said. 'This might be because these young people have access to their parents' alcohol and money to buy it themselves.Those with two working parents have more time without parental supervision to drink without their parents knowledge.'
Experts surveyed 2,500 11 to 16-year-olds from 300 state schools across England and Wales for the study. They discovered that children today were twice as likely to drink as those of a similar age four years ago. Three quarters of under 16's admitted trying alcohol, while a fifth claimed they were regular drinkers. As many as 30 per cent of 14-year-olds and 50 per cent of children aged 15 said they drank every week.
Young white people were twice as likely to be regular drinkers than those from black or Asian backgrounds. More than a third of girls aged 15 told the poll, conducted by MORI, that they drank regularly, compared to less than 30 per cent of boys. As a consequence they were more likely to do things they regretted, the study said.
A quarter of girls said they had kissed someone they wished they hadn't while drunk and 60 per cent of 14-year-old girls admitted losing their virginity while inebriated. Around 25 per cent said they had walked through dark places they usually avoided when intoxicated and a fifth also admitted to injuring themselves while drunk, compared to just over 10 per cent of boys.
One 13-year-old schoolgirl, from North London, who did not wish to be named, said she started drinking aged 10. 'I live in a really nice house and both my parents work but that means I have lots of time to do things they never find out about,' she said. 'I had my first drink at Christmas. I like the taste and the way it makes me feel. I know alcohol can be bad for you, but I don't worry about that. I find getting drunk scary; I've done some things I regret when I've been drunk, like saying stupid things to my friends, so I don't do it very often.'
The report also found that children whose parents drank regularly were more likely consume alcohol, with 60 per cent of those whose fathers drink frequently using alcohol on a weekly basis. The findings are particularly worrying in light of research published earlier this week which claimed almost half of children who start drinking in their early teens are likely to become alcohol dependent by the age of 25. Drinking accounts for a third of truancy in some parts of the UK, while in 2004-2005 nearly 5,000 youngsters under 18 were admitted to hospital with alcohol-related illnesses.
Bullied children may have behaviour issues
Children who are bullied during their early school years may experience behaviour problems as a result, new study findings suggest. "Our results indicate that bullying victimisation in the early school years is an influential experience for a child's behavioural development and mental health problems," study author Dr Louise Arseneault, of King's College, London, and her colleagues write. "Prevention and intervention programmes aimed at reducing mental health problems during childhood should target bullying as an important risk factor," they add.
According to previous research, victimisation may be associated with mental health problems in adults. It is also known that some mental health problems in adults stem from poor mental health in childhood. In the current study, Arseneault and her team investigated bullying in childhood, looking at the extent to which bullying contributed to later adjustment problems. They analysed information for 2 232 subjects who participated in home-visit assessments at five years old and follow-up assessments at age seven.
Those assessments revealed that the majority of children had never bullied another child or experienced bullying between ages five and seven. However, 14.4 percent were "pure victims" and 6.2 percent were "bully/victims," children who had been bullied and who also victimised others. Another 1 387 children who were not involved in bullying served as a comparison, or "control", group. Both groups of children had significantly more behaviour problems and problems adjusting in school at seven years old, compared with the control children, the investigators report in the journal Pediatrics.
Pure victims had more internalising problems, such as being withdrawn, anxious or depressed, and were also more unhappy at school compared with children in the control group. Bully/victims also had internalising problems. In addition, they had fewer pro-social behaviours, such as being considerate of other people's feelings; and were less happy at school at age age compared with the pure victims and children in the control group.
In light of their findings, "bullying could be regarded as a stressful life event that might influence children's normal development", Arseneault and her co-authors conclude.
Source: Pediatrics
7 July 2006
http://www.iol.co.za/index.php?set_id=1&click_id=117&art_id=qw1152219606875B243
Psycho-therapy may benefit sex offenders: study
Psychological treatments do not cure sex criminals but they may help reduce the number of times they re-offend, researchers said. Types of psychological therapies, which are usually stipulated during sentencing, vary but criminals who complete treatment programs tend to re-offend less often and less seriously.
"Sexual offending, like many medical conditions, cannot be cured," said Belinda Brooks-Gordon, a psychologist at the University of London, in The British Medical Journal. She and criminologist Charlotte Bilby reviewed 34 studies of the effectiveness of various types of treatments including psychoanalysis, behavioral therapy, psychotherapy and drug therapy to rehabilitate sexual offenders. They found behavioral therapies seemed to have a positive effect at least in the short term but said more research is needed to see if they are effective over longer time periods. Offenders who did not complete the treatment were more likely to repeat their crimes.
"We definitely need more attention to good ... qualitative studies," said Brooks-Gordon. She added that a better understanding of which treatments are either controlling or moderating the offender's behavior could help to focus resources on the therapies that are most effective.
Source: British Medical Journal
30 June 2006
People with learning difficulties abused: report
Checks will be carried out on all services providing care to Britons with learning difficulties after two independent bodies said on Wednesday there were "serious concerns" about their treatment. The warning came after an investigation by the Healthcare Commission and the Commission for Social Care Inspection (CSCI) into Cornwall NHS Trust found what they called unacceptable standards of care including evidence of institutional abuse.
"Let us first be clear we are not saying that the abusive behavior we found in Cornwall is happening everywhere," said a joint statement from Anna Walker, the Healthcare Commission's chief executive, and David Behan, CSCI chief inspector. "But sadly Cornwall is not the only service where serious allegations have been made in recent months."
The Cornwall inquiry said there had been serious failings at Budock Hospital near Falmouth, which treated 18 inpatients, and at four children's units and 46 houses occupied by people with learning difficulties. Abuse ranged from physical to the misuse of people's money. The report said there was evidence some staff were hitting, dragging and pushing residents. Staff were also reported to have withheld food and given people cold showers.
A number of staff, although well-intentioned, were not properly trained or using best practices. There was an over-reliance on medication to control behavior, and an illegal and prolonged use of restraint. One person spent 16 hours a day tied to a bed or wheelchair by staff in the mistaken belief it was for the patient's own protection, the report found.
A number of staff have since been disciplined and a ward at Budock closed down.
No excuses
"The failings which have been brought to light are shocking and
shameful. There are no excuses," said Lezli Boswell, the trust's new
chief executive who took over in May. "I cannot and will not attempt to
justify what has happened as it is inexcusable. My job now, as the new
chief executive, is to turn the services around."
The Healthcare Commission has recommended that Health Secretary Patricia Hewitt place the Cornwall Trust under special measures. It also said it would work with the CSCI to examine all NHS and independent providers of care for those with learning difficulties. "Instances of abuse can be symptomatic of services that have been neglected for too long," the joint statement said. "They are the most serious sign of a problem, but our concerns are much broader. We detect a widespread lack of understanding about the rights and needs of people with learning disabilities."
More than a million people in England, about 2 percent of the population, are estimated to have learning disabilities. "It is not acceptable to overlook the needs of these vulnerable people because they rarely capture the headlines or in some cases are unable to champion their own rights," the statement added.
Drinking in early teens increases the risk of
alcoholism
CHILDREN who start drinking alcohol in their early teens are more likely to suffer alcoholism later in life, researchers warned yesterday. A study in the United States found that adults who had their first drink before 14 faced a greater risk of experiencing alcohol dependence and at an earlier age. The study raised concerns about the growing numbers of young people experimenting with alcohol.
Many parents believe that allowing teenagers to drink in their presence will encourage responsible drinking in the future. But the researchers from Boston University School of Public Health warned that drinking alcohol at an early age may have effects on the developing brain that may lead to dependence later on. Alcohol campaigners also urged parents not to allow their children aged under 18 to drink due to the problems it could lead to later in life.
Figures show that 20 per cent of 13-year-olds and 43 per cent of 15-year-olds in Scotland have had at least one alcoholic drink in the past week. It is also estimated that the amount of alcohol consumed by people under the age of 16 has more than doubled in a decade.
The latest research, published in the Archives of Paediatrics and Adolescent Medicine, questioned 43,000 adults about their use of alcohol and other lifestyle factors. It found that for those who starting drinking before age 14, 47 per cent had suffered alcohol dependence at some point during their lives. This compared with only 9 per cent who began drinking at age 21 or over - the legal drinking age in the US. For each extra year before 21 that someone started drinking, the greater their chance of developing alcohol dependence, regardless of other factors such as a family history of alcoholism, smoking and drug use.
Gillian Bell, of the campaign group Alcohol Focus Scotland, said it had had concerns for some time that people starting drinking earlier was fuelling later alcohol problems.
A spokeswoman for Alcoholics Anonymous in Scotland said that in the past four or five years it had seen a growing number of younger people seeking help.
Source: Archives of Paediatrics and Adolescent Medicine
Lyndsay Moss
4 July 2006
http://news.scotsman.com/health.cfm?id=973142006
UK government considers raising smoking age limit
The Department of Health (DoH) announced on Monday
it was considering whether to raise the age limit for buying cigarettes
or tobacco from 16 in a bid to cut the level of smoking among teenagers.
A consultation exercise has been launched to look at whether the age
limit should be increased to 17 or 18, which would bring it into line
with the sale of alcohol.
The government is also looking at whether there should be tougher measures introduced at shops that sell cigarettes to under-age children. "Smoking is dangerous at any age, but the younger people start, the more likely they are to become life-long smokers and to die early," Health Minister Caroline Flint said. "Someone who starts smoking aged 15 is three times more likely to die of cancer due to smoking than someone who starts in their late twenties."
The government said about 9 percent of children aged between 11 and 15 smoke. Raising the age limit to the same required to buy alcohol would bring Britain into line with the likes of Canada, Australia and the United States. It is also pondering new sanctions including banning shops that regularly sell cigarettes to children from being allowed to sell tobacco at all.
The DoH said there was evidence that nearly 70 percent of underage smokers bought cigarettes from small local shops and newsagents. "Access to cigarettes by under-16s is not as difficult as it should be and this is partly due to retailers selling tobacco to those under the legal age," Flint said. "If a particular shop is known locally as the place for children and teenagers to easily buy tobacco, we want to stop that shop selling it."
Anti-smoking campaign groups welcomed the proposals but warned they might not have much effect. "I don't think it will affect the number of young smokers as children smoke because it is seen as an adult habit, so in a way you are giving children even more incentive to start," Ian Willmore, of Action on Smoking and Health (Ash) told the BBC.
The consultation comes after MPs voted in February to ban smoking in pubs, restaurants and work places from the middle of next year. The ban has already been introduced in Scotland and Ireland.
3 July 2006
Experts debate whether children should be called obese
Is it OK for doctors and parents to tell children and teens they're fat? That seems to be at the heart of a debate over whether to replace the fuzzy language favored by the U.S. government with the painful truth telling kids if they're obese or overweight.
Labeling a child obese might "run the risk of making them angry, making the family angry," but it addresses a serious issue head-on, said Dr. Reginald Washington, a Denver pediatrician and co-chair of an American Academy of Pediatrics obesity task force. "If that same person came into your office and had cancer, or was anemic, or had an ear infection, would we be having the same conversation? There are a thousand reasons why this obesity epidemic is so out of control, and one of them is no one wants to talk about it."
The diplomatic approach adopted by the federal Centers for Disease Control and Prevention and used by many doctors avoids the word "obese" because of the stigma. The CDC also calls overweight kids "at risk of overweight." Those favoring a change say the current terms encourage denial of a problem affecting increasing numbers of U.S. youngsters.
Under a proposal studied by a committee of the American Medical Association, the CDC and others, fat children would get the same labels as adults overweight or obese. The change "would certainly make sense. It would bring the U.S. in line with the rest of the world," said Tim Cole, a professor of medical statistics at the University College London's Institute of Child Health. The existing categories are convoluted and "rather ironic, since the U.S. leads the world in terms of obesity," Cole said. "There must be an element of political correctness."
The debate illustrates just how touchy the nation is about its weight problem.
Obese "sounds mean. It doesn't sound good," said Trisha Leu, 17, who thinks the proposed change is a bad idea. The Wheeling, Ill., teen has lost 60 pounds since March as part of an adolescent obesity surgery study at the University of Illinois at Chicago. "When you're young, you don't understand what obese means," Leu said. "I still don't understand it."
The CDC adopted the current terms in 1998, using weight-to-height ratios and growth charts from a generation of children much slimmer than today's. Children are said to be "at risk for overweight" if their body-mass index is between the 85th and 94th percentiles. They're "overweight" if their body-mass index is in the 95th percentile or higher or greater than at least 95% of youngsters the same age and gender. Many pediatricians understand the first category to mean "overweight" and the second one to mean "obese," said the CDC's Dr. William Dietz. He said the word "obese" was purposely avoided because of negative connotations but conceded that many pediatricians find the current language confusing.
Adding to the confusion is the fact that about 17% of U.S. children are in the highest category, and that almost 34% are in the second-highest category. That sounds like a mathematical impossibility, but it's because the percentiles are based on growth charts from the 1960s and 1970s, when far fewer kids were too fat.
In children, determining excess weight is tricky, partly because of rapid growth especially in adolescence that can sometimes temporarily result in a high body-mass index.
For children in at least the 95th percentile, high BMI "is almost invariably excess fat," Dietz said. But there's less certainty about those in the second-highest category. So to avoid mislabeling and "traumatizing" kids, the CDC chose to be diplomatic, Dietz said.
The committee, set up by the American Medical Association, involves obesity experts from 14 professional organizations including the American Academy of Pediatrics. Their mission is to update recommendations for prevention, diagnosis and management of obesity in children. Final recommendations are expected in September, and the participating groups will decide individually whether to adopt them.
Dr. Ronald Davis, the AMA's president-elect, said it's unclear whether the expert committee can develop a consensus on the obesity terms. "There are seemingly legitimate arguments on both sides," said Davis, a preventive medicine specialist with Henry Ford Health Systems in Detroit.
Maria Bailey of Pompano Beach, Fla., whose 12-year-old daughter, Madison, is self-consciously overweight, opposes the proposed change. She said their pediatrician has told her daughter to exercise more and see a nutritionist, but "hasn't told her that she's in a (weight) category." We're already raising a generation of teenagers who have eating disorders," Bailey said. "I think it would just perpetuate that."
Paola Fernandez Rana of Fort Lauderdale, has a 9-year old daughter who at 40 pounds overweight is considered obese. Rana said doctors "refer to it as the 'o-word' " in front of her daughter "in an effort not to upset her. They very clearly told me she was obese," Rana said. But she said she agreed with the term and thinks that at some point it should be used with her daughter, too. "Obviously I don't want my daughter to be overweight, but ... in order to change the situation, she is ultimately going to need to hear it," Rana said.
Dr. Michael Wasserman, a pediatrician with the Ochsner Clinic in Metairie, La., agreed. Using the term "at risk for overweight" is misleading, creating the perception "that I'm only at risk for it now, so I don't have to deal with it now," said Wasserman, who is not on the committee. "There's a tremendous amount of denial by parents and children," he said.
Chicago pediatrician Rebecca Unger, also not a committee member, said she likes using the term "at risk for overweight" because it gives patients hope that "we can do something about it."
| A LOOK AT TERMINOLOGY
A committee convened by the American Medical Association, the federal Centers for Disease Control and Prevention, and others is studying childhood obesity. Among the proposals is the use of clearer language to define the problem for doctors and the public.
The CDC defines children ''at risk of overweight'' as those with a body-mass index in the 85th to 94th%ile for their gender and age. That means they are heavier than 85% to 94% of children their same age and sex. The CDC defines ''overweight'' as those heavier than 95% of children their age and gender, a category most experts agree qualifies as ''obese.''
|
http://www.usatoday.com/news/health/2006-07-02-obese-or-not_x.htm
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