Apr 23, 2014

TV, Computer Time Tied to Heavier, Less Happy Kids

Kids who spend more time plunked in front of screens may become unhappier, new research suggests. Meanwhile, mothers who devote the most effort to monitoring their kids' exposure to computers and TVs could prevent them from putting on extra pounds.


The findings in a pair of new studies aren't definitive, and there's still intense debate about exactly how TV, video games and computer use affect children.


Still, "parents who read these studies should be heartened that they can make a difference in the health and well-being of their children," said Diane Gilbert-Diamond, an assistant professor of community and family medicine with the Geisel School of Medicine at Dartmouth.


"They can reduce the amount of TV and other media that they allow their children to view, and encourage their children to engage in more active play," said Gilbert-Diamond, who was not involved with the new research.


Both studies appeared online March 17 in JAMA Pediatrics.


Previous studies have suggested that TV watching, especially in high amounts, may not be good for kids, another expert noted. "The amount is most related to things like physical health and school performance, whereas content is most related to behaviors such as aggression," said Douglas Gentile, an associate professor of psychology at Iowa State University.


However, it's difficult for researchers to figure out the exact role, if any, that television and other types of technology -- such as video games -- play in encouraging obesity or violence.


For example, kids may turn to more television-watching because they don't like exercising. In that case, the TV might not be at fault if they put on extra pounds. Along those lines, kids prone to aggression may be drawn to violent programs, making the shows less responsible for their actions.


In one new study, an international team of researchers tracked about 3,600 European children aged 2 to 6 years who took part in a health research project over a three-year period. The investigators found evidence that kids who were exposed to more screen time -- especially television -- were more likely to suffer declines in what the study called "well-being." They were also more likely to have more emotional problems and family dysfunction.


While the study shows that screen time potentially makes a difference in children's lives, the precise extent of the effect would only be available through a complicated statistical analysis.


In the other study, researchers tracked 213 children and most of their parents in the U.S. Northwest from 1998 to 2012. The study authors focused on the kids at ages 5, 7 and 9.


The researchers found that kids were thinner if their mothers -- but not their fathers -- more closely monitored their screen time. Over the ages of 5, 7 and 9 years, 22 percent of the kids on average were overweight and 19 percent were obese.


When it came to avoiding overweight in children, monitoring of screen time appeared to be especially important when compared to other parental duties, such as monitoring kids to protect them from problems like drug use and crime. Keeping an eye on computer, video game and TV time "was what really mattered in understanding children's weight development," said study lead author Stacey Tiberio, a research associate with the Oregon Social Learning Center.


What's next for research? Tiberio said it's important to understand why monitoring by mothers may matter. And there are questions about issues such as food commercials (could they make kids want to eat more?) and being in front of a screen (could it disrupt when kids are hungry and what they do about it?).


Gilbert-Diamond, the Dartmouth professor, said researchers need to better understand the connection between media use, such as TV watching, and the well-being of children. It's possible that kids who are unhappier may be drawn to screens, an alternative to the theory that screen time causes unhappiness, she said.


Iowa State's Gentile called for careful monitoring of the technology that kids soak up. More involvement "can have long-lasting and profound effects on children's health and well-being," he said.


SOURCES: Diane Gilbert-Diamond, Sc.D., assistant professor, department of community and family medicine, Geisel School of Medicine at Dartmouth, Lebanon, N.H.; Stacey Tiberio, Ph.D., research associate, Oregon Social Learning Center, Eugene, OR; Douglas Gentile, Ph.D., associate professor, psychology, Iowa State University, Ames, IA; March 17, 2014, JAMA Pediatrics, online




Study finds that Underweight is even deadlier than Overweight

It's said you can never be too rich or too thin, but new research suggests otherwise. People who are clinically underweight face an even higher risk for dying than obese individuals, the study shows.

Compared to normal-weight folks, the excessively thin have nearly twice the risk of death, researchers concluded after reviewing more than 50 prior studies.

Obesity has occupied center stage under the public health spotlight, but "we have [an] obligation to ensure that we avoid creating an epidemic of underweight adults and fetuses who are otherwise at the correct weight," said study leader Dr. Joel Ray, a physician-researcher at St. Michael's Hospital in Toronto.

The findings appear in the March 28 issue of the Journal of Epidemiology and Public Health.

Studies included in the analysis followed people for five years or more and focused on associations between BMI (body-mass index, a key indicator of healthy weight) and fatalities related to any cause.

Ray's team also looked at how death rates related to weight patterns among newborns and stillborns.

Underweight patients of all ages (those with a BMI of 18.5 or under) were found to face a 1.8 times greater risk for dying than patients with a normal BMI (between 18.5 and 25.9), the study found.

By contrast, obese patients (those with a BMI between 30 and 34.9) face a 1.2 greater risk for dying than normal-size patients. Severely obese patients -- those with a BMI of 35 or more -- faced a 1.3 times greater risk.

Ray said it's important to keep a healthy body size in mind when attempting to tackle the obesity epidemic.

"BMI reflects not only body fat, but also muscle mass. If we want to continue to use BMI in health care and public health initiatives, we must realize that a robust and healthy individual is someone who has a reasonable amount of body fat and also sufficient bone and muscle," Ray said in a hospital news release. "If our focus is more on the ills of excess body fat, then we need to replace BMI with a proper measure, like waist circumference."

Typical factors linked to a higher risk for being underweight included malnourishment, drug or alcohol use, smoking, poverty and mental health issues.



Apr 22, 2014

Vegetables in Childhood May Benefit Breast Health

Girls who ate the most fruits and vegetables rich in carotenoids were less likely to get benign breast disease, a new study suggests.


Carotenoids are a group of pigments that typically produce an orange, red or dark green color. They are believed to have antioxidant properties that may guard against disease.


Benign breast disease describes a variety of noncancerous conditions of the breast; some forms raise the risk of breast cancer.


"There have been a number of studies about carotenoids and breast cancer," said lead researcher Caroline Boeke, a postdoctoral fellow at Channing Division of Network Medicine at Brigham and Women's Hospital and Harvard School of Public Health, in Boston.


While the studies have produced mixed results, she said, overall they suggest a protective effect of the carotenoids. So her team decided to analyze the intake of these vegetables by girls enrolled in an ongoing study that began in 1996.


For her study, Boeke and her colleagues looked at food reports from 1996 through 1998 and then evaluated reports in 2005, 2007 and 2010 from girls who got a diagnosis of benign breast disease from a doctor after having a biopsy.


In all, Boeke studied nearly 6,600 girls, and 122 reported a diagnosis of benign breast disease.


When she looked at carotenoid intake, she found high intakes were protective. "The odds of benign breast disease in those who consumed the most beta carotene were about half that of those who consumed the least," she said.


Girls in the highest intake group ate two to three servings of carotenoid-rich foods weekly, she said.


The study is published in the May issue of Pediatrics.


"It's an observational study, so we can't say for sure the carotenoids cause the lower risk," Boeke noted. "We can only say there's an association."


She did take into account other factors that might affect the risk of benign breast disease, such as alcohol intake, physical activity, family history and body mass index (a measure of body fat using height and weight).


Why might the fruits and vegetables help? It's not known for sure, but Boeke said it may be due partly to their antioxidant properties. Carotenoids absorb harmful substances known as free radicals which can harm cells.


The study looked only at food intake, not supplements, and Boeke said she would not recommend supplements since other research has found some harmful effects with supplement use.


Other foods that are rich in carotenoids include yams, melons, spinach and kale.


The most common kind of benign breast disease in teens and young women is a noncancerous tumor known as a fibroadenoma, according to Boeke.


The period of time between the start of a girl's period and the first birth is a sensitive one for the breasts, as they are very vulnerable to environmental exposures, according to background information in the study.


Not many lifestyle habits have been shown to protect against benign breast disease, said Dr. Joanne Mortimer, director of women's cancer programs and co-director of the breast cancer program at the City of Hope Comprehensive Cancer Center, in Duarte, Calif.


The study has limitations, she said, including the self-report by the girls of a benign breast disease diagnosis by a doctor and the food questionnaires, which are always subject to error since it's difficult to remember exactly what was eaten.


SOURCES: Caroline Boeke, Sc.D., postdoctoral fellow, Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard School of Public Health, Boston; Joanne Mortimer, M.D., director, women's cancer programs, and co-director, breast cancer program, City of Hope Comprehensive Cancer Center, Duarte, Calif.; May 2014 Pediatrics




Apr 21, 2014

Genes May Influence Weight Gain from Fried Foods

Genetics help determine whether a frequent diet of fried food will make you fat, according to a new Harvard study.


Eating fried food more than four times a week had twice as big an effect on body size for people at high genetic risk of obesity compared with people at low risk, researchers found after analyzing data from three U.S. trials.


Moreover, the more pro-obesity genes you carry, the bigger you'll get chowing down on fried chicken and such, the researcher said.


Such findings help explain why Americans' overall bad health habits don't affect everyone equally, said Claude Bouchard, chairman of genetics and nutrition at the Human Genomics Laboratory of Pennington Biomedical Research Center, in Baton Rouge, La.


"Our dietary habits and our lack of physical activity is driving the obesity epidemic, but the force of the behavioral driver is not the same in everyone," Bouchard said.


"We also have a biology driver, and that driver for some people is very minor," he said. "For others, it's a powerful agent enhancing the risk of behavior."


Other studies have noted similar interactions between these genetic risks and other environmental risk factors for obesity, including physical activity and total calorie intake, Bouchard said. People who are more sedentary or eat more are more likely to gain weight if they carry these genetic risks.


In the future, genetic testing could help reveal who is at higher risk of obesity, so they can take preventive measures, Bouchard said.


"It's not a sentence for obesity, but rather an increased susceptibility to obesity," he said. "Your peers can afford to have an extra serving or be sedentary and they will be OK, but for you it won't happen. That's important to know."


The findings, published March 19 in the journal BMJ, are based on an analysis of more than 37,000 men and women who participated in three U.S. health trials.


For each person, the researchers looked at a panel of 32 known genetic variants associated with obesity. They tracked fried food consumption using questionnaires and looked at each person's body-mass index (BMI), a measurement of body fat based on height and weight.


People with genetic risk scores in the top third tended to have a BMI that was 1 unit higher in women and 0.7 units higher in men if they ate fried food four or more times a week, compared with people at the same risk who ate such food less than once a week.


But for participants with the lowest genetic risk, little differences was seen between those who ate the most fried food versus very little -- just half a unit in women and 0.4 units in men.


A BMI of 25 or more is considered overweight, while a BMI of 30 or more is considered obese.


The research team also found that a person's overall risk of obesity from fried foods increases exponentially with every 10 genetic variants, or alleles, that predispose them to obesity.


Those who eat less than one serving a week have a 61 percent increased risk of obesity for every 10 risk genes, but that person's risk rises to 112 percent with one to three servings of fried food a week.


"If you have people who have 30, 35, 40 risk alleles, their total risk on average would be much, much larger," Bouchard said.


The researchers don't have the biological evidence to say why these genes inflate the body's reaction to fried foods, said senior author Lu Qi, an assistant professor of nutrition at the Harvard School of Public Health. He said, however, that they believe it may stem from the way some genes are tied to the body's energy balance.


"It's likely through the interplay between the genetic factors and the dietary factors in managing energy balance," he said.


SOURCE: Lu Qi, assistant professor, nutrition, Harvard School of Public Health, Boston; Claude Bouchard, John W. Barton Sr. Chair in Genetics and Nutrition, Human Genomics Laboratory, Pennington Biomedical Research Center, Baton Rouge, La.; March 19, 2014, BMJ




Weight-Loss Surgery Might Help Mild Knee Pain

Small, early study of obese patients found improvement similar to knee replacement.

Weight-loss surgery reduces knee pain in obese people, and the results are similar to those seen in patients who have a knee replacement, according to a small new study.

The study included 20 obese patients who had weight-loss surgery and 40 patients who had total knee replacement due to arthritis.

One year after their procedure, the patients who had weight-loss surgery reported significant improvements in knee pain. Their results were comparable to the patients who had a knee replacement, according to the study, which was presented Friday at the annual meeting of the American Academy of Orthopaedic Surgeons, in New Orleans.

Compared to the knee-replacement patients, the weight-loss patients showed much greater improvement in knee function six months after surgery, according to an academy news release. After one year, however, the difference was much smaller.

Weight-loss patients who had knee arthritis reported less improvement in knee pain and function after surgery than those without arthritis.

Doctors should consider weight-loss surgery for obese patients who have knee problems but do not have advanced arthritis in the knee, the researchers concluded.

Because this study was presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

SOURCE: American Academy of Orthopaedic Surgeons, news release, March 14, 2014

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