CDC report finds sodium consumption high among U.S. children

More than 90 percent of U.S. children, aged 6-18 years, eat more sodium than recommended, putting them at risk for developing high blood pressure and heart disease later in life, according to a new CDC Vital Signs report.

This report provides the most recent data detailing how much sodium school-age children eat and where it comes from. Using data from CDC’s 2009-2010 National Health and Nutrition Examination Survey, CDC researchers determined that about 43 percent of sodium eaten by children comes from the 10 foods they eat most often: pizza, bread and rolls, cold cuts/cured meats, savory snacks, sandwiches, cheese, chicken patties/nuggets/tenders, pasta mixed dishes, Mexican mixed dishes, and soups.

“Too many children are consuming way too much sodium, and the result will be risks of high blood pressure and heart disease in the future,” said CDC Director Tom Frieden, M.D., M.P.H. “Most sodium is from processed and restaurant food, not the salt shaker. Reducing sodium intake will help our children avoid tragic and expensive health problems.”

Key findings in the Vital Signs report include:

• U.S. children aged 6 to 18 years eat an average of about 3,300 mg of sodium a day before salt is added at the table. The 2010 Dietary Guidelines for Americans recommend that children eat less than 2,300 mg per day total.
• Most sodium is already in food before it is purchased or ordered. Approximately 65 percent comes from store foods, 13 percent from fast food and pizza restaurant foods, and 9 percent from school cafeteria foods.

To help reduce the amount of sodium children are consuming daily, parents and caregivers, as well as schools, communities, and places that sell, make or serve food, are all encouraged to take steps to ensure more low-sodium options. For example, parents can establish healthy eating habits in their children by providing a diet high in fruits and vegetables without added sodium.

Schools and school districts can implement food purchasing policies and standards that reduce sodium in foods and put lower-sodium alternatives in vending machines, school stores and cafeterias. They can also strive to meet or exceed the United States Department of Agriculture’s (USDA) Nutrition Standards for foods served during the school day.

“Thanks to the Healthy, Hunger-free Kids Act and the work of schools across the country, students are now receiving healthier meals and snacks featuring less sodium, sugar and fat and more whole grains, fruits and vegetables, lean protein and low-fat dairy,” said Under Secretary for USDA’s Food, Nutrition, and Consumer Services, Kevin Concannon, “This report demonstrates the importance of continuing to move forward in our efforts to improvenutrition in schools, and to ensure that children and teens nationwide have access to safe, nutritious meals and snacks during the school day.”

http://www.medicalnewstoday.com/releases/282258.php

 

 

Passive smoking impairs children’s responses to asthma treatment

Children exposed to cigarette smoke at home have lower levels of an enzyme that helps them respond to asthma treatment, a study has found.

Passive smoking is known to worsen asthma symptoms in children and impair their response to inhaled steroid treatment, but how this effect occurs was not known.

Researchers at Imperial College London found that children with severe asthma with a parent who smokes at home have lower levels of the enzyme HDAC2 compared with those whose parents don’t smoke. HDAC2 is required for steroids to exert their beneficial anti-inflammatory effects in asthma.

The findings are reported in the journal Chest.

Professor Peter Barnes FRS, from the National Heart and Lung Institute at Imperial College London, said: “The mechanism we’ve identified makes children less sensitive to inhaled steroid treatment, so they suffer more symptoms and might have to take higher doses of steroids, which may lead to side effects.

“These findings underline the importance of legislation aimed at protecting children from being exposed to cigarette smoke. Restricting smoking in cars is a positive step, but the same should be applied in homes.”

Over a million children in the UK have asthma. Steroid treatments, usually taken using inhalers, are given to prevent asthma attacks, but for many patients, they aren’t completely effective.

The Imperial researchers studied 19 children with severe asthma receiving treatment at Royal Brompton Hospital in London. Nine had parents who smoked at home and 10 were from non-smoking households.

Cells from the lungs of children exposed to second-hand smoke had about half the levels of HDAC2 enzymes as those from children from non-smoking families.

“Children with asthma who are passively exposed to cigarette smoke have the same molecular abnormalities that lead to steroid resistance as adults who actively smoke,” said Professor Barnes. “The mechanism we’ve identified will be a target for new treatments to help children with severe asthma.”

http://www.medicalnewstoday.com/releases/272706.php

Picture courtesy of www.nlm.nih.gov

 

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Toddlers suffer 10 times as many burns and scalds as older children

According to new research in the UK, 1-year-old children receive 10 times the amount of burns and scalds as their older siblings.

The authors of the new study, which is published in Archives of Diseases in Childhood, say that half of all burns and scalds cases seen in European hospitals are made up of injuries to children.

Such cases have the potential for lifelong scarring or even death, so the researchers wanted to see what could be done to prevent these severe burns from occurring.

The researchers reviewed the medical records of 1,215 children under the age of 16 who were treated in emergency care departments and specialist burns units in the UK. The majority (58%) of the children had been scalded, while 32% had sustained contact burns. The remaining children had burns from other causes.

All of the scald injuries in the study occurred at home. This most often happened when a child reached up and pulled down a cup of tea or other hot drink – 48% of these injuries happened this way.

In children aged between 5 and 16, scalds were more likely to occur as a result of spilling hot water during food preparation – this accounted for 76% of scalds in this age group.

Two thirds of all contact burns were to the hands In the under-5s, and 81% of these burns were caused by touching hot items – such as hair straighteners and clothes irons – in the home. In older children, however, half of the contact burns occurred outside of the home.

The majority of burns and scalds occur in 1 year olds

Overall, three quarters of the children suffering burns were under 5 years old. The majority of injuries occurred in 1 year olds, who were 10 times more likely to be injured than older children. Nearly 1 in 5 burns were serious enough for the child to be admitted to a specialist burns unit.

The researchers noticed that after the age of 3, children seem to be much less likely to suffer burns or scalds.

They think this might be because by this age, the children are more aware of the dangers of heat – because their parents become more vigilant or because at that age, the children are spending less time in the home.

Some of the children were also injured intentionally – about 8% of the children in the study were referred to social services as abuse victims, though as this study was investigating how to prevent accidental burns and scalds, data from these children was not included in the analysis.

What could be done to minimize risk?

The authors of the study make several recommendations that they hope will help reduce the number of these injuries.

A previous study taken into account by the authors suggests that hot drinks can cause disfiguring scalds for up to 11 minutes after being poured. Although the authors concede that it might not be practical to enforce a universal product modification for some items responsible for childhood burns, such as mugs, they think it could be effective in products such as clothes irons or hair straighteners.

Hair straighteners retain enough heat for up to 8 minutes after being switched off to cause severe burns, so manufacturers may be able to make their products more safe for being around toddlers.

“Successful prevention is most likely to involve product design or environmental modification,” the researchers say, “and should be considered for hair straightener, iron, and oven-related burns.”

“Public information messages, children’s centers, health visitor or family nurse practitioners should address safety education as a matter of routine,” they add.

A 2012 study found that the risk of burn injuries to children may be linked with housing quality.

Written by David McNamee

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Copyright: Medical News Today
Not to be reproduced without the permission of Medical News Today.

 

http://www.medicalnewstoday.com/articles/272137.php

 

 

Day-care children learn to respond to hunger cues when allowed to pass bowls family-style

When children and child-care providers sit around a table together at mealtime, passing bowls and serving themselves, children learn to recognize when they are full better than they do when food is pre-plated for them, reports a new University of Illinois study of feeding practices of two- to five-year-old children in 118 child-care centers.

“Family-style meals give kids a chance to learn about things like portion size and food preferences. When foods are pre-plated, children never develop the ability to read their body’s hunger cues. They don’t learn to say, okay, this is an appropriate portion size for me,” said Brent McBride, director of the U of I Child Development Laboratory and lead author of the study.

The study found that Head Start centers were in significantly greater compliance with this and other Academy of Nutrition and Dietetics benchmarks than other centers surveyed, including participants in the USDA’s supplemental nutritionassistance program CACFP, and non-CACFP state-licensed centers.

The academy’s benchmarks were issued in 2011 to combat the problem of child obesity. One in four preschool children is overweight or obese, and more than 12 million preschoolers consume up to five meals or snacks daily at the nation’s child-care centers, McBride said.

“The academy also recommends that providers eat with children so they can model healthy behaviors, which Head Start staff are required to do,” said Dipti A. Dev, a U of I graduate student in nutritional sciences.

Teachers are also asked not to pressure children to take one or two more bites or finish a serving before another food or activity is offered, she said.

The researchers said that providers need to help children recognize their feelings of hunger and fullness.

“Instead of asking Are you done? teachers should ask children, Are you full? Or they should say, If you’re hungry, you can have some more, explained Dev, who is developing a packet of best feeding practices to share with providers.

“Asking the right questions can help children listen to their hunger and satiety signals,” she said.

The Illinois research is the first study to evaluate whether child-care providers are adhering to the academy’s guidelines for feeding practices. Most providers did promote healthy feeding by serving nutritious foods and not pressuring children to eat or restricting them from eating. Head Start programs stood out though as having the best policies and feeding practices.

In fact, Head Start teachers who use family-style meals are strong advocates for them, the researchers said.

“Teachers who don’t do family-style meals have all these reasons that they don’t: there’s too much waste, it’s messy, young kids don’t have the developmental skills – the fine motor control – to do that,” McBride said.

“But Head Start teachers were telling us ways you could help develop those fine motor skills: for instance, using scoops in the sandbox or pouring water in the water table,” he added.

“When you first do easel painting with a two-year-old, it’s really messy because they don’t have fine motor control, but you still do it even though it’s messy. The same thing is true for family-style meal service. It may be messy at first until they develop the appropriate skills and learn to pour the right way or hold the cup as they’re pouring. It’s a developmental progression,” he said.

If children don’t want to eat, teachers shouldn’t urge them to eat anyway out of concern that the kids may get hungry before the next meal or snack is served, he said.

“If a child doesn’t eat at one meal, he’ll compensate for it over a 24-hour period. Making kids eat when they’re not hungry is probably the worst thing you can do. It teaches them not to pay attention to their body’s signals,” Dev said.

http://www.medicalnewstoday.com/releases/271197.php

Picture courtesy of www.tonisday-care.com

Guidelines to improve early diagnosis & effective treatment of heart failure in children

Heart failure in children is an important cause of childhood health problems and death. The Children’s Heart Failure Study Group of the Canadian Cardiovascular Society, in collaboration with the Canadian Pediatric Cardiology Association, has developed new guidelines to assist practitioners in primary care and emergency departments to recognize and successfully manage heart failure in children with undiagnosed heart disease and symptoms of possible heart failure. The guidelines are published in the December issue of the Canadian Journal of Cardiology.

“Most practitioners in primary care or emergency departments have little practical experience with the presentation or management of heart failure in children. The symptoms are dissimilar to those of adults, and are quite variable,” explains Paul F. Kantor, MBBCh, of the Stollery Children’s Hospital, University of Alberta, who led the project. “Currently, our experience is that nearly all cases of new-onset heart failure are diagnosed only when the patient has reached a state of severe decompensation, and less than 50% of children who present with such symptoms of heart failure survive for five years without cardiac transplantation. Early diagnosis and effective treatment therefore are very important, since the preservation of the heart may actually improve with earlier detection.”

Heart failure is a clinical syndrome in which the heart fails to pump blood adequately to meet the requirements of the body’s organs. In children this may be present at birth or develop at any stage of childhood or adolescence. The main causes in developed countries are primary cardiomyopathies, or diseases of the heart muscle (which account for 60% of children requiring a cardiac transplant), and congenital heart diseases. The incidence of primary cardiomyopathy in developed countries is reported to be between 0.8 and 1.3 cases per 100,000 children up to the age of 18, but is ten times higher in infants up to one year old. Congenital heart disease occurs in nearly one percent of live births. Only a small percentage of these defects however are severe enough to result in heart failure during childhood.

Other causes of heart failure include systemic processes such as inflammatory diseases, metabolic disorders, endocrine derangements, and kidney disease, which result in an unknown number of cases. Ten to 14 thousand children are hospitalized every year in the United States with heart failure as one of their diagnoses. Of those, about 27% (approximately 3,000) have abnormalities of the heart muscle (including irregular heart rhythm) as an underlying cause.

On a global scale, parasitic infection, nutritional deficit, and rheumatic heart disease are the main causes of heart failure in childhood.

The symptoms of heart failure in children differ from those in adults. Two unique clinical features of heart failure in children, say the guidelines’ authors, are the possible coexistence of structural congenital heart lesions, with simultaneous over-circulation to the lungs, and under-perfusion to the body (when the two circulations are linked in parallel by an intracardiac shunt or a patent arterial duct); and a change in symptom complexes over time from infancy through adolescence. In infants and young children, these are mainly respiratory and feeding difficulties.

The guidelines group makes five recommendations to help physicians detect heart failure in children; 16 recommendations to assist in the diagnosis; and 10 recommendations for the early management of heart failure to bring it under control. The guidelines also include a table summarizing the typical features of heart failure in children, using the New York Heart Association (NYHA) and Ross classifications of functional class, and a helpful algorithm defining the treatment options for managing heart failure.

http://www.medicalnewstoday.com/releases/270078.php

Childhood exercise ‘may reduce effects of maternal obesity’

A new animal study suggests that children of obese mothers could reduce their risk of developing negative health effects linked to obesity by exercising during childhood. This is according to a study published in the American Journal of Physiology – Regulatory, Integrative and Comparative Physiology.

Obesity during pregnancy can lead to many health problems for a mother, including gestational diabetes, preeclampsia and thrombosis. It also increases the risk of the child developing obesity-related conditions as an adult, such as heart diseaseor diabetes.

Medical News Today recently reported on a study suggesting that excessive weight gain during pregnancy increases the risk of having overweight or obese children.

With these risks in mind, researchers from Johns Hopkins University School of Medicine, led by Kellie L. K. Tamashiro, conducted a study on overweight rat mothers and their pups to determine the impact of exercise on the rats’ appetite, and whether it would have any effect on their health.

Exercise ‘may improve leptin sensitivity’

The investigators fed pregnant rats a high-fat diet throughout their pregnancy and while they were nursing their pups.

The rat pups were fed a healthy, standard low-fat diet. At 4 weeks of age – the equivalent to rodent early adolescence – some of the pups were able to use running wheels in their cages while the others were not. The running wheels were removed after 3 weeks.

At 14 weeks of age, the rat pups had their brains injected with leptin – an appetite-suppressing hormone.

Fat cells naturally secrete leptin, which helps many people maintain a healthy weight, the researchers explain. Although obese individuals have more leptin circulating in their bloodstream because they have more fat, the body appears to stop responding to the hormone.

But when it came to the study results, the researchers found that although the exercising rat pups weighed the same as the pups who did not exercise, they had fewer fat deposits and better brain responses to leptin weeks after exercise ceased.

“There was something about the exercise that improved their leptin sensitivity, even the equivalent in humans of years later,” says Tamashiro.

Results could apply to humans

The researchers say that since many mammals – including rats and humans – have similar biology, their findings suggest that exercise during early childhood could reduce some of the health risks associated with children of obese parents.

“Just 3 weeks of exercise early in life had a persistent effect on the satiety centers of the brains of these rat pups.

If we can find a way to take advantage of that phenomenon in humans that would be great, because preventing obesity is probably going to be much easier to do than reversing it.”

Tamashiro says that modern-day children do not have as many opportunities to carry out physical activity in school, and they are spending an increasing amount of time playing video games or engaging in other activities that require no exercise.

“Our research suggests that efforts to increase activity in kids could have positive long-term effects, regardless of whether they continue to exercise into adulthood,” she adds.

Earlier this year, Medical News Today reported on a study suggesting that current recommendations for children to exercise 1 hour are day are not enough.

 

http://www.medicalnewstoday.com/articles/269382.php

Ask young patients about social media use

ORLANDO – Half of the teens who made comments on social media about their feelings and caused concern among those who saw the comments were brought to the hospital for assessment, according to a small survey of adolescents admitted to the child and adolescent psychiatry unit of Ohio State University Harding Hospital, Columbus.

Tragic suicides or homicides after social media use have gained national attention in recent years, but studies like this highlight the flip side of social media platforms: They can make it easier to find out when teens are in distress and help them access timely treatment and support.

The fact that these teens turned to social media to express emotional stress, “shows that [they] are having trouble conveying emotions to parents, counselors, or friends, so they’re finding a different avenue,” said Dr. Sathyan Gurumurthy, who presented the unpublished study at the annual meeting of the American Academy of Child and Adolescent Psychiatry. “So, as professionals, we have to gain a better understanding of how they convey emotions.”

And given the generalized use of social media today, it is important for clinicians to ask children and adolescents about social media use during initial assessment, advised Dr. Gurumurthy, a resident physician at OSU’s Wexner Medical Center. “Talk to them about social media: how they use it and what sites they’re using,” he said in an interview.

The results of the yearlong study are based on the 6-month data from an eight-question survey. Researchers were able to collect 32% of the surveys that were handed out to teens and their families at the time of admission.

Of the 82 patients who completed the survey, 54 (66%) said they had made a comment on social media about their emotional disturbance. Of those patients, 32 (60%) said their comments caused a concern, and 16 of those patients (50%) were brought to the hospital for assessment because of their comments.

Seventy-three teens were hospitalized for suicidal ideation; and they had confided mostly in friends, parents, or counselors (around 25 each). Six of the patients said that they had confided in an “Internet friend.”

Half of these teens also said they preferred to communicate their suicidal thoughts in person, while 15% said they preferred social sites, and 9% preferred texts. Of the social sites, Facebook was the most popular (41%) among teens.

Of note was that only 25% circled “parent” as the person aware of their social media comments, said Dr. Gurumurthy.

“Many parents have minimal monitoring of their kids’ social media, and they have to be more involved in social media,” he advised.

Dr. Gurumurthy said the group is still gathering data and hopes to increase the number of survey respondents. He said future studies gathering social media use data from outpatient and emergency department visits could reveal other possible correlations.

http://www.pediatricnews.com/single-view/ask-young-patients-about-social-media-use/536bfa730dbac5b14e096c8444bae212.html