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Favorite Five for Children
My favorite 5 articles found in my medical
journals this past month (with a focus on children this month) are:
Preventing childhood obesity by reducing consumption of carbonated drinks: cluster randomised controlled trial by Janet James in the April 2004 issue of the British Medical Journal found an education program for 7- to 11-year olds in school aimed at reducing the consumption of carbonated beverages (soft drinks) resulted in a reduction in the number of soft drinks consumed and the number of overweight and obese children. Consumption of one or more beverages daily with high sugar content is associated with a 10% greater energy (calorie) intake compared to children who do not consume these beverages. The education program objective was to discourage consumption of sweetened and unsweetened carbonated drinks along with encouragement for a healthy diet. They tasted fruits, learned about the sweetness of natural foods, and the importance of water as a beverage. Over 12 months the percentage of overweight and obese children decreased by .2%, compared to a 7% increase in a control group who did not receive the education -- they seem to have stopped the tide of rising girth with the education.
If the interests of the food industries could be set aside and the sole focus could be placed on the welfare of our children, the reduction of soft drinks and other sugary foods would be one of many changes that would be made in our children’s education. When I become Surgeon General, the school lunch program will have a pure vegetarian alternative served everyday along with a big dish of education which explains to the children the impact of the foods they choose everyday on their appearance and health. They will learn how an unhealthy diet rots their teeth, scars their faces with acne, creates heavy menstrual periods and breast pain, causes them to mature precociously, and makes them constipated, fat, and smelly. They will learn how food choices impact their future and the environment – and how a wise person does not destroy his own home (planet Earth). Finally, the osteoporosis, arthritis, heart disease and cancer they face in later years will be mentioned briefly.
James J, Thomas P, Cavan D, Kerr D. Preventing childhood obesity by reducing consumption of carbonated drinks: cluster randomised controlled trial. BMJ. 2004 May 22;328(7450):1237.
Child Abuse from the Dinner Table
Associations between overweight and obesity with bullying behaviors in school-aged children by Ian Janssen in the May 2004 issue of the journal Pediatrics found overweight and obese school-aged children are more likely to be the victims and the perpetrators of physical and verbal bullying behaviors than are their normal-weight peers. Bullying can include name-calling, teasing, rejection, rumors, sexual harassment, and physical damage. The consequences of being overweight are far greater than just “looking fat” and being unhealthy. Overweight adolescents are less likely to marry as adults, obese girls have less schooling and lower household incomes than non-obese girls. Obese children experience more depression, loneliness, sadness and nervousness. Plus, as this study shows, they are more likely to be victims of bullying and also to commit acts of power and aggression.
The number of 7- to 13-year-old children who are overweight or obese has increased from 12% in 1981 to 30% in 1996 as a result of increases in calories (fat and sugar) eaten as well as by a decrease in physical activity. Yet, obesity and associated consequences are, by and large, accepted as part of normal life, especially by those without the problem.
How would society (and you) react if children suffered comparable damage from starvation – my guess is people would be outraged and take action. But, because this is malnutrition due to overnutrition, the suffering is largely ignored. Now, add to this the physical suffering from the Western diet – the constipation, rectal bleeding, stomach pains, arthritis, headaches, and indigestion. If these physical pains were inflicted on a child by a stick-wielding adult, the perpetrator would serve time in prison. Because the pain is caused by a fork and spoon no one acts – but the hurting is just as real and horrible.
It is long past time for all adults, and especially parents of suffering children, to take full account of what is happening to those they love, and make long overdue changes. Explaining to the children the dietary cause of their problems and how these problems can be simply and permanently solved by changing to foods they already enjoy (cereals, sandwiches, soups, burritos, pastas, etc.) will enlist them in improving their present conditions and future lives.
Janssen I, Craig WM, Boyce WF, Pickett W. Associations between overweight and obesity with bullying behaviors in school-aged children. Pediatrics. 2004 May;113(5):1187-94.
Bottle-feeding Kills Babies
Breastfeeding and the risk of postneonatal death in the United States by Aimin Chen in the May 2004 issue of the journal Pediatrics found children who were breast-fed had a 21% reduced risk of death in the first year after birth compared to bottle-fed children. Longer breast-feeding was associated with lower risk of death. Even the risk of crib death (SIDS) was reduced by 16% with breast-feeding.
In underdeveloped countries where sanitation is lacking, bottle-feeding a child is equated to a “death sentence.” In modern societies with more cleanliness and modern medical facilities the adverse consequences of bottle-feeding are less dramatic, but still too real. The US is ranked 16th in infant deaths in the first few months following birth and the prevalence of breast-feeding is 22% at 6 months. Finland is ranked first, worldwide, with the fewest deaths for infants, with 60% of babies breast-fed at six months, and Sweden is second with 50% of babies breast-fed at this time.
Remember from previous newsletters, my first act when I become Surgeon General will be to make formula available by prescription only. See my January 2004 newsletter Favorite Five article, “Formula (Bottle) Feeding Causes Infant Brain Damage.”
Chen A, Rogan WJ. Breastfeeding and the risk of postneonatal death in the United States. Pediatrics. 2004 May;113(5):e435-9.
Soon Children Will Be on Blood Pressure Pills
Trends in blood pressure among children and adolescents by Paul Muntner in the May 5, 2004 issue of the Journal of the American Medical Association examined the trends in systolic and diastolic blood pressure among children and adolescents (8- to 17-year olds) between 1988 and 2000 and found the systolic (top number) pressure was up 1.4 mm Hg and the diastolic (bottom number) was up 3.3 mm Hg. Girls (1.5/3.2 mm Hg) had a larger increase than boys (1.4/2.3 mm Hg). The change was worse for Mexican Americans (2.3/4.4 mm Hg) and Blacks (1.9/4.1 mm Hg) than for Whites. This change in blood pressure parallels the rise in body weight (fatness) and general poor health in the USA – all due to malnutrition. Elevated blood pressure, weight, cholesterol and general poor health in children carry over into adulthood for one simple reason: diet and lifestyle habits, learned young, continue. Of course, all this would change if the child is fortunate enough to change his or her diet and add some exercise.
Although mention has been made by health officials of the importance of making diet and lifestyle changes, the ultimate change will be in prescribing practices of doctors. There is already talk about the need to detect elevated blood pressure early and start the children on a lifetime of blood pressure lowering medications with all their associated side effects and costs.
Muntner P, He J, Cutler JA, Wildman RP, Whelton PK. Trends in blood pressure among children and adolescents. JAMA. 2004 May 5;291(17):2107-13.
Food Additives Do Affect Your Child’s Behavior
The effects of a double blind, placebo controlled, artificial food colorings and benzoate preservative challenge on hyperactivity in a general population sample of preschool children by B. Bateman in the June 2004 issue of the Archives of Internal Medicine found artificial food colorings and a preservative in the diet of 3-year old children caused hyperactive behavior that was easily detected by their parents. When the substances were removed for a week there was significant reduction in hyperactive behavior, which reappeared when the chemicals were reintroduced for three weeks. The degree of hyperactivity was doubled with the chemicals in the diet. The authors concluded: “We believe that this (the results of the study) suggests that benefit would accrue for all children if artificial food colors and benzoate preservatives were removed from their diet.”
Additives are extensively used in food manufacturing and can simply be avoided simply by feeding your family a diet of natural plant foods, as we recommend. There are over 2000 recipes by Mary McDougall in print – all you have to do is find one dish your family likes for breakfast, one for lunch and three or four meals you can serve them for dinners. Eating out is possible if you choose restaurants with a vegetarian orientation (with very little oil added and no dairy products) – like authentic Mexican, Japanese, Thai, or Chinese.
Bateman B, Warner JO, Hutchinson E, Dean T, Rowlandson P, Gant C, Grundy J, Fitzgerald C, Stevenson J. The effects of a double blind, placebo controlled, artificial food colourings and benzoate preservative challenge on hyperactivity in a general population sample of preschool children. Arch Dis Child. 2004 Jun;89(6):506-11.