Child health news round-up (15-17 February 2010)
Contents:
* Many U.S. kids have chronic health problems: study
* Very premature twins do just as well as singletons
* Exercise may not boost obese teens’ metabolism
* Study: Lack of early light upsets teen sleep clock
* Sweet tooth ‘hints at depression’
* Key cancer gene ‘link to poverty’
* Grandparents ‘boost obesity risk’
* Class divide ‘in child obesity’
* How a baby can help save a life
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Many U.S. kids have chronic health problems: study Julie Steenhuysen (Editing by Andrew Stern and Philip Barbara) Tue Feb 16, 2010
http://www.reuters.com/article/idUKTRE61F58520100216
CHICAGO (Reuters) – More than a quarter of American children have a chronic health condition such as obesity or asthma, but many children overcome these problems with time, U.S. researchers said on Tuesday.
They said the findings make clear that chronic health conditions are rising among children, and access to healthcare is essential to diagnose and treat them.
“A lot of kids will have chronic conditions over the course of their childhood,” said Dr. Jeanne Van Cleave of Massachusetts General Hospital for Children in Boston, who worked on the study published in the Journal of the American Medical Association.
“It is very important for children to have continuous access to high-quality healthcare, especially primary care, where a lot of these conditions are picked up and treated,” she said in a telephone interview.
Van Cleave and colleagues used data from a government survey of three groups of children — each group with about 1,000 or more children — aged 2 through 8 between 1988 and 2006.
They found the rate of chronic health conditions — obesity, asthma and learning problems such as attention deficit hyperactivity disorder or ADHD — doubled to 26.6 percent in 2006 from 12.8 percent in 1994.
“The good news is, for about half of these kids, their conditions will go away over time,” Van Cleave said.
They found that 16.6 percent of all the children surveyed had a chronic condition at the beginning of the study period, and 20.8 percent reported having a chronic condition at the end.
But only 7.4 percent of the children had a chronic condition both at the beginning and at the end of the study period, and 9.3 percent of children reported having a chronic condition at the beginning of the study that was not present at the end.
“It’s a very hopeful finding. It offers a lot of opportunity for prevention and for finding out more about why certain chronic conditions resolve, and why others don’t, and why the same chronic condition in one child will resolve and why it doesn’t in another child,” Van Cleave said.
The trick, she said, is finding out why conditions go away so that more children may be helped.
She said future studies need to look at what factors surround the kids who see improvements compared with the ones who do not.
“Our study didn’t specifically look at for which children the chronic condition of obesity was less likely to resolve. That would be a very important piece of information we could use in actual medical care,” Van Cleave said.
Dr. Geetha Raghuveer of Children’s Mercy Hospital in Kansas City, Missouri, who was not involved with the study, said that while it was heartening that chronic conditions went away in several children, it was worrying that such a large percentage of children had a chronic health problem at some point.
She said these problems “will need prevention strategies geared toward larger environments such as families, schools, communities,” and laws that make nutritious foods more accessible and affordable.
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Very premature twins do just as well as singletons Tue Feb 16, 2010
SOURCE: Human Reproduction, online January 29, 2010
http://www.reuters.com/article/idUKTRE61F58K20100216
NEW YORK (Reuters Health) – Overall, very premature twins fare just as well as single babies born very early, and they may even face a lower risk of certain complications, new research shows.
But for twin pairs of the same sex but sharply different sizes who are born before 28 weeks, the risks of death and bleeding on the brain are higher than they are for single babies born at the same time, Dr. Jennifer Zeitlin of the Hopital Saint-Vincent de Paul in Paris and her colleagues found.
Premature birth is much more common among twins than singletons, Zeitlin and her team note; while one in every 10 twin pairs is born before 32 weeks’ gestation, just one in 100 singletons is born this early. There is evidence that preemie twins do better than singles of the same gestational age, they add.
A full-term pregnancy lasts for 39 weeks, while babies born between 28 and 31 weeks are considered “very preterm.” Babies born between 24 and 27 weeks’ gestation are “extremely preterm.”
To investigate outcomes for very premature and extremely premature twins compared to those of singletons born equally early, Zeitlin and her colleagues looked at births and stillbirths in nine European countries in 2003. Their analysis included 1,254 twins and 3,586 singletons born between 24 and 31 weeks’ gestation.
The women carrying twins were less likely to develop high blood pressure during pregnancy than those with singletons, the researchers found: about 8 percent of those carrying twins, compared to about 22 percent of those carrying single babies.
They also found that severe bleeding and restrictions on the growth of the fetus were also less common in twin pregnancies.
Twins’ mothers were also more likely to have been given corticosteroids before delivery; these drugs are administered to speed up premature newborns’ lung development.
Among the very premature babies, the likelihood of dying in the first few weeks of life was lower for twins, who were also less likely to need oxygen. But once the researchers took factors such as mother’s age, pregnancy complications, and infant health problems into account, the difference disappeared.
For the extremely premature infants, however, the researchers calculated that the risk of death or serious bleeding in the brain was about 1.5 times higher for twins than it was for single babies. While about 17 percent of singletons suffered from such bleeding, roughly 24 percent of twins did.
The greater risks were only seen for same-sex twins in which one twin weighed at least 15 percent more than the other twin at birth.
“Why the effects of these twin-specific complications were so much more pronounced for extremely preterm births is an area for further study,” the researchers conclude.
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Exercise may not boost obese teens’ metabolism Amy Norton Tue Feb 16, 2010
SOURCE: American Journal of Clinical Nutrition, online January 27, 2010
http://www.reuters.com/article/idUKTRE61F57D20100216
NEW YORK (Reuters Health) – A few months of moderate aerobic exercise may not rev up obese teenagers’ ability to burn calories, even though it may increase thinner teens’ ability to burn dietary fat, new research suggests.
In a study of 28 obese and normal-weight teenagers, researchers found that after 12 weeks of treadmill and exercise-bike sessions, the heavier teens showed no changes in their bodies’ calorie- and fat-burning throughout the day.
Their thinner peers likewise showed no changes in daily calorie expenditure. However, their dietary-fat metabolism did increase, on average.
The findings, reported in the American Journal of Clinical Nutrition, do not mean obese kids should throw in the towel on exercise, given previous research. In an earlier study of the same workout regimen, the researchers found improvements in obese teenagers’ sensitivity to the blood-sugar-regulating hormone insulin; decreased insulin sensitivity often occurs before type 2 diabetes.
The teens also showed reductions in the deep layers of abdominal fat that surround the organs — the body fat that is considered especially important in the risk of diabetes and other health problems.
So together, the findings suggest that obese teenagers can get “important health benefits” from aerobic exercise even without changes in their calorie and fat metabolism, according to Dr. Agneta L. Sunehag, an associate professor of pediatrics at Baylor College of Medicine in Houston and the lead researcher on the new study.
In an email, she also pointed out that the study looked at one moderate-exercise regimen alone; the participants did not alter their eating habits or lose weight. It’s possible, Sunehag said, that exercise along with weight loss would affect obese teens’ metabolism.
It’s a common perception that exercise not only burns calories during the workout, but also leads to lasting changes in a person’s metabolism at rest. However, studies suggest that any effects may depend on the type and intensity of exercise, and on a person’s body composition.
Recent research has found, for example, that a few months of strength training may increase resting metabolism and daily calorie- and fat- burning in overweight women. Another study found that any exercise — strength training or aerobic — was related to a higher resting metabolism in women, but only for those who regularly worked out at a high intensity.
Until now, though, little has been known about the effects of exercise on obese teenagers’ calorie- and fat-burning, Sunehag said.
The study included 15 obese and 13 normal-weight Hispanic-American teenagers who completed a 12-week exercise program — walking on a treadmill or using an exercise bike for 30 minutes, four times per week.
At the beginning and end of the study, the researchers measured the teens’ total calorie expenditure over 24 hours. Each participant stayed in a room where a device measured their oxygen consumption and carbon dioxide production; that allows researchers to estimate a person’s calorie expenditure, as well as the proportions of fat, carbohydrates and protein they are burning.
In general, neither obese nor normal-weight teenagers showed changes in their overall calorie expenditure at the end of the study, but the thinner teens did show an increase in fat burning.
The reason for that discrepancy is not clear, according to Sunehag’s team, but studies of adults have had similar findings. One possibility, the researchers suggest, is that obese teenagers have an “impaired metabolic flexibility” that blunts their fat-burning response to exercise.
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Study: Lack of early light upsets teen sleep clock LAURAN NEERGAARD http://m.apnews.com/ap/db_15901/contentdetail.htm?contentguid=YhMCdwxc
WASHINGTON (AP) – Sit by the window in school? Lack of the right light each morning to reset the body’s natural sleep clock might play a role in teenagers’ out-of-whack sleep, a small but provocative school experiment suggests.
Specialists say too few teens get the recommended nine hours of shut-eye a night. They’re often unable to fall asleep until late and struggle to awaken for early classes. Sleep patterns start changing in adolescence for numerous reasons, including hormonal changes and more school, work and social demands.
Researchers turned to a North Carolina school built for energy efficiency, with lots of skylights so classrooms could reduce use of electric lights yet still be brighter than usual indoors. That allowed testing of the effects when some eighth-graders at Smith Middle School in Chapel Hill suddenly lost exposure to a specific wavelength of light.
From waking until school ended, 11 students donned special orange goggles that block short-wavelength “blue light,” but not other wavelengths necessary for proper vision. Blocking that light for five days upset the students’ internal body clocks – delaying by half an hour their evening surge of a hormone called melatonin that helps induce sleep, Rensselaer Polytechnic Institute researchers reported Tuesday.
Teens who trudge to the bus stop before dawn or spend their days in mostly windowless schools probably suffer the same effect, as daylight is the best source of those short-wavelength rays, said lead researcher Mariana Figueiro of Rensselaer’s Lighting Research Center in Troy, N.Y.
“If you have this morning light, that is a benefit to the teenagers,” Figueiro said.
Figueiro’s study was a first step to test in real-world conditions findings from sleep laboratories showing that light effects on the 24-hour body clock may play a role in teen sleep problems too.
The study, published in the journal Neuroendocrinology Letters, is small and didn’t track student sleep, just an early sign of change, the evening melatonin surge that typically precedes sleep by about two hours.
But while preliminary, the study is well done and should spur additional research on everyday light exposure, said Dr. Judith Owens, an associate pediatrics professor at Brown University and sleep medicine specialist.
“There’s a biologically based shift in the natural sleep onset and wake-up time. I think what this study shows is that you can impact that shift with light manipulation,” Owens said. “The major take-home message is to get natural light exposure early in the day.”
Morning light isn’t the only factor, added Figueiro. Tuesday’s report is part of a larger study involving a second school in New York to examine evening light exposure – computer and TV light plus regular indoor lighting. Too much evening light can add to the problem, she said.
The research was funded by the National Institutes of Health and U.S. Green Building Council.
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Sweet tooth ‘hints at depression’
Story from BBC NEWS:
http://news.bbc.co.uk/go/pr/fr/-/2/hi/health/8506758.stm
Published: 2010/02/10
While most children like sweets, those with an extra-sweet tooth may be depressed or at higher risk of future alcohol problems, researchers say.
The US team report in the journal Addiction that certain children are especially drawn to very sweet tastes.
These were children who had a close relative with an alcohol problem or who themselves had symptoms of depression.
But it is unclear if the preference for the very sweet is down to genuine chemical differences or upbringing.
The researchers say sweet taste and alcohol trigger many of the same reward circuits in the brain.
“ It may be that even higher levels of sweetness are needed to make depressed children feel better ”
Lead researcher Julie Mennella
Lead author Julie Mennella said: “We know that sweet taste is rewarding to all kids and makes them feel good.
“In addition, certain groups of children may be especially attracted to the intense sweetness due to their underlying biology.”
Experts say alcoholics tend to have a sweet tooth.
But the link is less clear in children. Other US researchers have shown that a preference for the sweetest drinks was found in the ones undergoing growth spurts.
In the latest study, the scientists at the Monell Chemical Senses Center asked 300 children aged five to 12, of whom half had a family member with alcohol dependency, to taste five sweet water drinks containing different amounts of sugar.
The children were asked to say which tasted the best and were also asked questions to check for depressive symptoms.
A quarter had symptoms that the researchers believed suggested they might be depressed.
Sweet tooth
Liking for intense sweetness was greatest in the 37 children who had both a family history of alcoholism and reported depressive symptoms.
“ The taste difference may be explained by differences like parental control over sweet consumption ”
Taste expert Professor Tim Jacob
These children preferred the drink containing the most sugar – 24% sucrose, which is equivalent to about 14 teaspoons of sugar in a cup of water and more than twice the level of sweetness in a typical cola.
This was a third more intense than the sweetness level preferred by the other children.
The researchers then decided to test whether the children’s taste difference had any impact on their reaction to pain or discomfort – past studies have suggested sweets may help act as analgesics as well as mood lifters.
They found non-depressed children were able to tolerate keeping their hands in very cold water for longer if they had a sugar hit.
However, the extra sugar did nothing to the depressed children’s pain threshold.
Cardiff University’s Professor Tim Jacob, an expert in smell and taste, said the findings were interesting, but that it was hard to make firm conclusions or generalisations from one study alone.
He said the findings could be down to brain chemistry, but might also be explained by behaviour and upbringing.
“While it is true that sweet things activate reward circuits in the brain, the problem is that sweets and sugar are addictive, because the activation of these reward circuits causes opioid release, and with time more is needed to achieve the same effect.
“But the taste difference may be explained by differences like parental control over sweet consumption.”
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Key cancer gene ‘link to poverty’
Story from BBC NEWS:
http://news.bbc.co.uk/go/pr/fr/-/2/hi/health/8517027.stm
Published: 2010/02/16
There is a genetic explanation for why women from poor backgrounds are less likely to beat breast cancer, Dundee University researchers have said.
Poor lifestyles may trigger a key gene mutation linked to worse prognosis, the British Journal of Cancer reports.
The researchers tested samples from 246 women and found that a woman’s postcode could be connected to the “health” of the p53 gene in her tumour cells.
Cancer charities said adopting a healthy lifestyle was advantageous.
The link between socio-economic status and a poorer outcome from various cancers has been detected before, with both unhealthier lifestyles and a tendency to be diagnosed later blamed for the differences.
The Dundee research offers more clues as to how those lifestyles may interfere with the body’s ability to protect itself from cancer.
“ Deprivation alone doesn’t cause breast cancer, but can affect prognosis when p53 is damaged as a result of lifestyle choices commonly associated with deprivation ”
Dr Lee Baker, Dundee University
Normally, the p53 gene is a “tumour suppressor”, telling cells with cancerous or pre-cancerous changes to self-destruct before they can thrive.
However, when it mutates, that ability is reduced or removed, making the appearance of cancer far more likely.
The researchers looked at frozen tumour tissue samples from a total of 246 women who underwent cancer treatment between 1997 and 2001.
Tests were carried out to determine the level of mutation in the p53 gene, and these were cross-referenced against the postcode where the woman lived, offering a rough snapshot of her background.
Women from deprived postcodes were more likely to have a p53 mutation, and were less likely to have survived cancer-free.
Poverty fight
Dr Lee Baker, who led the study, said: “This research makes a strong link between p53 and deprivation, and then between p53 mutation and recurrence and death.
“As a social issue, it shows that if we lift people up the deprivation scale they will be less likely to have problems with their p53 gene, and go on to develop breast cancer.”
He said that the way women lived could have a direct bearing on their p53 gene.
“Deprivation alone doesn’t cause breast cancer, but can affect prognosis when p53 is damaged as a result of lifestyle choices commonly associated with deprivation.”
Dr Caitlin Palframan, from Breakthrough Breast Cancer, said: “We know there is a connection between deprivation and breast cancer survival but we don’t yet know all the reasons for this.
“The researchers suggest a genetic link between deprivation and survival, but a range of lifestyle, environmental and genetic factors are all likely to play a part.”
She added: “Early detection of breast cancer is vital to increase the chance of successful treatment. That is why we encourage all women to be breast aware and attend screening when invited.”
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Grandparents ‘boost obesity risk’
By Emma Wilkinson
Health reporter, BBC News
Story from BBC NEWS:
http://news.bbc.co.uk/go/pr/fr/-/2/hi/health/8513112.stm
Published: 2010/02/15
Young children who are regularly looked after by their grandparents have an increased risk of being overweight, an extensive British study has suggested.
Analysis of 12,000 three-year olds suggested the risk was 34% higher if grandparents cared for them full time.
Children who went to nursery or had a childminder had no increased risk of weight problems, the International Journal of Obesity reported.
Nearly a quarter of preschool children in the UK are overweight or obese.
The researchers said very little research had been done on the influence of childcare on weight.
“ We know that obesity is a very complex issue with a wide range of factors involved ”
Department of Health spokesman
Yet childcare may have an effect on weight through diet and physical activity.
The study used data from the Millennium Cohort Study, which looked at the health of children aged between nine months and three years old, who had been born in the UK between 2000 and 2001.
The results showed that those looked after by grandparents part-time had a 15% higher risk of being overweight for their age compared with those solely looked after by their parents.
Those who were cared for by their grandparents full-time had a 34% increased risk of being overweight, the University College London team found.
Further analysis taking into account the child’s socio-economic background, found the increased risk was only apparent in children from the most advantaged groups – whose mothers had a managerial or professional job, had a degree, or lived with their partner.
There was also an increased risk of being overweight associated with other informal care provided by relatives or friends but only if that was full-time.
‘Best alternative’
The researchers said it was well-recognised that parents value care provided by grandparents and consider it to be the best alternative to full-time parent care.
They said the issue was about providing informal carers, such as grandparents, with better information and support around diet and exercise.
A recent announcement to provide grandparents with National Insurance credits for caring for grandchildren under the age of 13 years for at least 20 hours a week from 2011, “provides a potential opportunity for such health promotion”, they advised.
Study leader Professor Catherine Law said this study, which was backed by other work done in the US, did not look at why grandparent care was associated with being overweight but that indulgence of children and lack of physical exercise were two possible explanations.
“One of the ways forward would be to talk to small groups of grandparents to see the challenges they face.
“Some of the things that might help would be educating the population in general about healthy lifestyles but also things like avoiding food as a reward and suggestions for building activities into daily life.”
A Department of Health spokesman said: “We know that obesity is a very complex issue with a wide range of factors involved.
“The latest figures show that child obesity levels are the lowest reported since 2001. However, there’s no doubt that levels of obesity in this country, as in the rest of the developed world, are far too high.
“That’s why we’re investing time, energy and money into preventing people from becoming obese in the first place.”
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Class divide ‘in child obesity’
Story from BBC NEWS:
http://news.bbc.co.uk/go/pr/fr/-/2/hi/health/8412796.stm
Published: 2009/12/15
A widening class gap is likely to be seen in the coming years in childhood obesity, a study suggests.
Previous research has suggested rates in England may be levelling off.
But the University College London team found this was happening most in children aged two to 10 from wealthier backgrounds.
Researchers said obesity rates among the lower classes were likely to be significantly higher by 2015 – for girls the levels may even be double.
They analysed data gathered by the government-funded Health Survey for England.
Currently 6.9% of boys and 7.4% of girls are obese – with the difference between the lower and higher classes 0.6% and 1.5% respectively for boys and girls.
“ The widening socio-economic gap may be partly due to difficulties to reach and communicate health messages to families from lower socio-economic groups ”
Dr Emmanuel Stamatakis, lead researcher
But using historical trends, they predicted that by 2015 obesity rates could be above 10% for boys and 8.9% for girls.
Depending on the extent of the “levelling off” reported last month, the overall rates could be even lower.
However, it is the findings for social class that have shed even more light on the obesity problem.
The obesity rates for girls are likely to diverge from now on, the team said.
Among those from lower classes it is expected to keep rising to 11.2%, while for those from professional backgrounds it is likely to fall to 5.4%.
Among boys, both groups are likely to see a rise, but it will be faster in the lower class group, meaning 10.7% of this class boys will be obese compared with 7.9% of those from wealthier backgrounds.
Similar trends will also be seen in older aged children, the report in the Journal if Epidemiology and Community Health found.
Action
Lead researcher Dr Emmanuel Stamatakis said: “This highlights the need for public health action to reverse recent trends and narrow social inequalities in health.”
“The widening socio-economic gap may be partly due to difficulties to reach and communicate health messages to families from lower socio-economic groups.”
Tam Fry, of the National Obesity Forum, agreed awareness was more likely to be greater among wealthier families.
But he added: “It is also often quite expensive and time-consuming to buy healthy food and that puts wealthier parents at an advantage.”
He said it was not clear why the differences were so marked in girls, although he said he suspected it was partly to do with the fact that boys tend to be more active generally.
The Department of Health said there was still more to do despite the levelling off which had been seen.
A spokesman said: “Obesity levels are still too high.
“We’ll only turn the tide on obesity for good if everyone – government, families and industry – play their part.”
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How a baby can help save a life
By Jane Elliott
Health reporter, BBC News
Story from BBC NEWS:
http://news.bbc.co.uk/go/pr/fr/-/2/hi/health/8485106.stm
Published: 2010/02/14
Philip Meehan’s life was saved by a baby he will never know.
When he was diagnosed with leukaemia doctors told him he desperately needed a bone marrow transplant.
As an only child, he had no family matches and despite a six-month search the NHS and the Anthony Nolan Trust failed to find a living donor.
“They were getting a bit twitchy because I had to have a bone marrow transplant, so they talked to me about a relatively new, but not experimental, treatment from cord blood,” he said.
‘Huge potential’
One single umbilical cord was found to be a partial match – not the best odds, but Philip’s only realistic hope.
But others might not be as lucky.
“ Taking cord blood does not impinge on the mother or baby – it is just recycling ”
Philip Meehan
The Anthony Nolan Trust says 50,000 cord bloods would meet the UK’s need for transplant and research purposes.
Cord blood is the blood that remains in the placenta and umbilical cord after a baby is born. It is a rich source of stem cells, which can be used to treat conditions such as leukaemia.
Cord blood offers an alternative to using bone marrow, with the advantage of being immediately available and easier to match to a potential recipient.
Henny Braund, chief executive of the trust, would like to see far more cord blood collection facilities.
“Umbilical cord blood offers us huge potential to save not just a few, but many more lives from leukaemia,” she said.
“There are the benefits these stem cells offer to regenerative medicine and research.
“But at the moment we’re quite simply throwing away this opportunity.
“We do not have sufficient cord blood collection facilities in the UK, so valuable cord blood is being wasted once a mother has given birth.
“The Anthony Nolan Trust has had to import 268 cord blood units from abroad for transplant over the past four years.
“This is an unnecessary cost when we have the opportunity to collect this cord blood at home.”
‘Fantastic resource’
Professor Ghulam Mufti, director of pathology at King’s College Hospital and a haemato-oncology consultant, said cord cells were a fantastic resource.
“These cells can go on to create a whole range of different cells in the blood or the immune system,” he said.
“If someone needs new bone marrow cells, the stem cells find their way into the bone marrow and start creating healthy cells to replace the damaged ones.
“This makes cord blood a viable alternative to bone marrow transplants for patients who either cannot find a marrow donor match or in whom a previous transplant has failed.
“It is much easier to match cord blood than bone marrow – for a bone marrow transplant, we have to find a donor who has a 95% perfect match to the patient, or their body will just reject it.
“But with the stem cells from umbilical cord blood, that match only has to be 70 to 80% perfect for the transplant to work.”
‘Just recycling’
Philip, aged 43, from West Sussex, says that he is certainly very grateful for the unknown mother and baby who saved him.
“Not a day goes by without my wondering about the baby who loaned me some of their stem cells.
“Due to the trust’s programme of anonymity I will never know who they are, but I will always be grateful and wish them the same hope for a long life and a healthy future as they gave me,” said the sound engineer.
“Taking cord blood does not impinge on the mother or baby – it is just recycling.”
Philip’s health problems started in 2007 after he went for a holiday to the Lake District.
“I was just tired every day and when I came back I was still tired and out of breath and feeling a bit rubbish so I went along to see my GP for a blood test.
“That day I signed for another six months on my flat and then that afternoon got a call to go to the Royal Sussex in Brighton saying ‘bring your pyjamas’. I was there for six weeks.”
Six months later he had the transplant at King’s College Hospital, which has a collection service.
“You can’t really say you are ever 100% cured, but they say the longer you go the higher the chances you won’t relapse,” he said.
“I still get very tired and have the memory of a goldfish, but my strength is coming back.
“In terms of getting back to normal, I am not back to normal, but I am pretty close.”
But Philip said he had nearly turned down any treatment fearing it would be too difficult.
“I just thought it was going to be very difficult doing this when I don’t have a reason to.
“I am not married, not in a relationship and do not have children.
“The thing that made a difference to me was meeting someone who had gone through it and proved it was not a death sentence and since then I have become a bit of an advocate.”
He now lobbies MPs for better collection and is helping the hospital and Anthony Nolan Trust raise the profile of cord collection provision.
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