Flame retardants may be toxic to children

Contact: Debbie Jacobson djacobson@aap.org 847-434-7084 American Academy of Pediatrics

Lower intelligence, hyperactivity seen in children whose mothers were exposed to the chemicals during pregnancy

WASHINGTON, DC – Chemicals called polybrominated diphenyl ethers (PBDEs) have been used for decades to reduce fires in everyday products such as baby strollers, carpeting and electronics. A new study to be presented on Monday, May 6, at the Pediatric Academic Societies (PAS) annual meeting shows that prenatal exposure to the flame retardants is associated with lower intelligence and hyperactivity in early childhood.

“In animal studies, PBDEs can disrupt thyroid hormone and cause hyperactivity and learning problems,” said lead author Aimin Chen, MD, PhD, assistant professor in the Department of Environmental Health at University of Cincinnati College of Medicine. “Our study adds to several other human studies to highlight the need to reduce exposure to PBDEs in pregnant women.”

Dr. Chen and his colleagues collected blood samples from 309 pregnant women enrolled in a study at Cincinnati Children’s Hospital Medical Center to measure PBDE levels. They also performed intelligence and behavior tests on the women’s children annually until they were 5 years old.

“We found maternal exposure to PBDEs, a group of brominated flame retardants mostly withdrawn from the U.S. market in 2004, was associated with deficits in child cognition at age 5 years and hyperactivity at ages 2-5 years,” Dr. Chen said. A 10-fold increase in maternal PBDEs was associated with about a 4 point IQ deficit in 5-year-old children.

Even though PBDEs, except Deca-BDEs, are not used as a flame retardant in the United States anymore, they are found on many consumer products bought several years ago. In addition, the chemicals are not easily biodegradable, so they remain in human tissues and are transferred to the developing fetus.

“Because PBDEs exist in the home and office environment as they are contained in old furniture, carpet pads, foams and electronics, the study raises further concern about their toxicity in developing children,” Dr. Chen concluded.

###

To view the abstract, “Cognitive Deficits and Behavior Problems in Children with Prenatal PBDE Exposure,” go to http://www.abstracts2view.com/pas/view.php?nu=PAS13L1_3550.8.

The Pediatric Academic Societies (PAS) are four individual pediatric organizations that co-sponsor the PAS Annual Meeting – the American Pediatric Society, the Society for Pediatric Research, the Academic Pediatric Association, and the American Academy of Pediatrics. Members of these organizations are pediatricians and other health care providers who are practicing in the research, academic and clinical arenas. The four sponsoring organizations are leaders in the advancement of pediatric research and child advocacy within pediatrics, and all share a common mission of fostering the health and well-being of children worldwide. For more information, visit http://www.pas-meeting.org. Follow news of the PAS meeting on Twitter at http://twitter.com/PedAcadSoc.

90 percent of pediatric specialists not following clinical guidelines when treating preschoolers with ADHD

Contact: Terry Lynam tlynam@nshs.edu 516-465-2600 North Shore-Long Island Jewish (LIJ) Health System

Some prescribe medication too soon; others not even as a second-line treatment

NEW HYDE PARK, NY – A recent study by pediatricians from the Cohen Children’s Medical Center of New York examined to what extent pediatric physicians adhere to American Academy of Pediatrics (AAP) clinical guidelines regarding pharmacotherapy in treating young patients with Attention Deficit Hyperactivity Disorder (ADHD). The results showed that more than 90 percent of medical specialists who diagnose and manage ADHD in preschoolers do not follow treatment guidelines recently published by the AAP.

“It is unclear why so many physicians who specialize in the management of ADHD — child neurologists, psychiatrists and developmental pediatricians —  fail to comply with recently published treatment guidelines,” said Andrew Adesman, MD, senior investigator and chief of developmental and behavioral pediatrics at Cohen Children’s Medical Center in New Hyde Park.  “With the AAP now extending its diagnosis and treatment guidelines down to preschoolers, it is likely that more young children will be diagnosed with ADHD even before entering kindergarten.  Primary care physicians and pediatric specialists should recommend behavior therapy as the first line treatment.”

Current clinical guidelines for pediatricians and child psychiatrists associated with the American Academy of Child & Adolescent Psychiatry (AACAP) recommend that behavior therapy be the initial treatment approach for preschoolers with ADHD, and that treatment with medication should only be pursued when counseling in behavior management is not successful.

The study also found that more than one-in-five specialists who diagnose and manage ADHD in preschoolers recommend pharmacotherapy as a first-line treatment alone or in conjunction with behavior therapy.  Although the AAP recommends that pediatricians prescribe methylphenidate when medication is indicated, more than one-third of specialists who prescribe medication for preschool ADHD said they ‘often’ or ‘very often’ choose a medication other than methylphenidate initially (19.4 percent amphetamines; 18.9 percent non-stimulants).

“Although the AAP’s new ADHD guidelines were developed for primary care pediatricians, it is clear that many medical subspecialists who care for young children with ADHD fail to follow recently published guidelines,” said Jaeah Chung, MD, the study’s principal investigator who also practices at Cohen Children’s.  “At a time when there are public and professional concerns about over-medication of young children with ADHD, it seems that many medical specialists are recommending medication as part of their initial treatment plan for these children.”

###

To schedule an interview with Dr. Adesman, call 516-232-5229 or email Adesman@lij.edu.

To view the abstract, “Medication Management of Preschool ADHD by Pediatric Sub-Specialists: Non-Compliance with AAP Clinical Guideline, go to http://www.abstracts2view.com/pas/view.php?nu=PAS13L1_1365.5

This study is being presented at the Pediatric Academic Societies in Washington, D.C. on Saturday May 4, 2013 11:30-11:45 a.m. at the Walter E. Washington Convention Center (Rm. 102B).

93rd Health Research Report 14 NOV 2010 – Reconstruction

 

Editors Top Five:

 

Black raspberries may prevent colon cancer

Study finds Plantar Fasciitis? Stretching seems to do the trick

Obesity rate will reach at least 42 percent, say models of social contagion

Dangerous chemicals in food wrappers likely migrating to humans

U of T study Myth of a germ-free world:

A closer look at antimicrobial products

 

In This Issue:

1. Pregnant women who eat peanuts may put infants at increased risk for peanut allergy

2. Antibiotics have long-term impacts on gut flora

3. Common stomach bacteria may fight off inflammatory bowel disease caused by Salmonella

4. Black raspberries may prevent colon cancer, study finds

5. Daily dose of beet juice promotes brain health in older adults

6. Exposure of humans to cosmetic UV filters is widespread

7. Levels of coumarin in cassia cinnamon vary greatly even in bark from the same tree

8. Insufficient vitamin D levels in CLL patients linked to cancer progression and death

9. Obesity rate will reach at least 42 percent, say models of social contagion

10. Study shows a single shot of morphine has long lasting effects on testosterone levels

11. Plantar Fasciitis? Stretching seems to do the trick

12. Plant-based, olive oil diet also has health benefits for prostate cancer survivors

13. Canola-type rapeseed oil reduces the level of fibrinogen, a cause of thrombosis and inflammation

14. Mild painkillers in pregnancy are associated with an increased risk of male reproductive problems

15. Louisiana State University Health Sciences Center research shows fish oil component given up to 5 hours after stroke limits brain damage

16. Dangerous chemicals in food wrappers likely migrating to humans: U of T study

17. Soy May Stop Prostate Cancer Spread

18. DHA improves memory and cognitive function in older adults

19. Low blood levels of vitamin D linked to chubbier kids, faster weight gain

20. Exercise may reduce risk of endometrial cancer

21. Probiotics shorten diarrhea episodes

22. Myth of a germ-free world: a closer look at antimicrobial products

23. Fructose-rich beverages associated with increased risk of gout in women

Public release date: 1-Nov-2010

Pregnant women who eat peanuts may put infants at increased risk for peanut allergy

Researchers have found that allergic infants may be at increased risk of peanut allergy if their mothers ingested peanuts during pregnancy. The data are reported in the November 1 issue of the Journal of Allergy and Clinical Immunology.

Led by Scott H. Sicherer, MD, Professor of Pediatrics, Jaffe Food Allergy Institute at Mount Sinai School of Medicine, researchers at five U.S. study sites evaluated 503 infants aged three to 15 months with likely milk or egg allergies or with significant eczema and positive allergy tests to milk or egg, which are factors associated with an increased risk of peanut allergy. The study infants had no previous diagnosis of peanut allergy. A total of 140 infants had strong sensitivity to peanut based on blood tests, and consumption of peanut during pregnancy was a significant predictor of this test result.

“Researchers in recent years have been uncertain about the role of peanut consumption during pregnancy on the risk of peanut allergy in infants,” said Dr. Sicherer. “While our study does not definitively indicate that pregnant women should not eat peanut products during pregnancy, it highlights the need for further research in order make recommendations about dietary restrictions.”

In 2000, the American Academy of Pediatrics recommended that women whose infants were at increased risk of allergies based upon family history consider avoiding peanut products while pregnant and breast feeding. However, the recommendation was withdrawn in 2008 due to limited scientific evidence to support it. The Consortium of Food Allergy Research (CoFAR), which was just awarded a renewed $29.9 million grant from the National Institutes of Health, is conducting this ongoing, observational study to help better understand the risk factors behind a child’s developing peanut allergy, as well as allergies to milk and egg. The Consortium is also studying novel treatments for food allergies.

The authors caution that the study has limitations, including the reliance on the self-reporting of dietary habits among pregnant women. Importantly, the study has thus far only shown an increased risk for positive allergy test results to peanut.

Despite its limitations, the study has identified a potential risk factor that, if verified, could present an opportunity for risk reduction. The authors conclude that controlled, interventional studies should be conducted to explore these findings further.

“Peanut allergy is serious, usually persistent, potentially fatal, and appears to be increasing in prevalence,” said Dr. Sicherer. “Our study is an important step toward identifying preventive measures that, if verified, may help reduce the impact of peanut allergy.”

Public release date: 1-Nov-2010

Antibiotics have long-term impacts on gut flora

Also archived at http://www.vit.bz

93rd Health Research Technology Report 3

Short courses of antibiotics can leave normal gut bacteria harbouring antibiotic resistance genes for up to two years after treatment, say scientists writing in the latest issue of Microbiology, published on 3 November.

The researchers believe that this reservoir increases the chances of resistance genes being surrendered to pathogenic bacteria, aiding their survival and suggesting that the long-term effects of antibiotic therapy are more significant than previously thought.

Antibiotics that are prescribed to treat pathogenic bacteria also have an impact on the normal microbial flora of the human gut. Antibiotics can alter the composition of microbial populations (potentially leading to other illnesses) and allow micro-organisms that are naturally resistant to the antibiotic to flourish.

The impact of antibiotics on the normal gut flora has previously been thought to be short-term, with any disturbances being restored several weeks after treatment. However, the review into the long-term impacts of antibiotic therapy reveals that this is not always the case. Studies have shown that high levels of resistance genes can be detected in gut microbes after just 7 days of antibiotic treatment and that these genes remain present for up to two years even if the individual has taken no further antibiotics.

The consequences of this could be potentially life-threatening explained Dr Cecilia Jernberg from the Swedish Institute for Infectious Disease Control who conducted the review. “The long-term presence of resistance genes in human gut bacteria dramatically increases the probability of them being transferred to and exploited by harmful bacteria that pass through the gut. This could reduce the success of future antibiotic treatments and potentially lead to new strains of antibiotic-resistant bacteria.”

The review highlights the necessity of using antibiotics prudently. “Antibiotic resistance is not a new problem and there is a growing battle with multi-drug resistant strains of pathogenic bacteria. The development of new antibiotics is slow and so we must use the effective drugs we have left with care,” said Dr Jernberg. “This new information about the long-term impacts of antibiotics is of great importance to allow rational antibiotic administration guidelines to be put in place,” she said.

Public release date: 1-Nov-2010

Common stomach bacteria may fight off inflammatory bowel disease caused by Salmonella

Helicobacter pylori in the mouse stomach put the brakes on colitis by reducing the immune response in the lower GI tract, U-M study shows

Ann Arbor, Mich. — Helicobacter pylori, a common stomach bacterium, reduced the severity of inflammation of the colon caused by Salmonella in mice, according to research from U-M Medical School scientists.

More than half the people in the world are infected with H. pylori, although it is very unusual to find it in the United States. But this research shows there may be an inflammation control benefit to hosting the H. pylori infection, says Peter Higgins, M.D., Ph.D., M.Sc., lead author of the study published last week in the journal Inflammatory Bowel Diseases.

“If we have evolved to live with certain bugs, maybe there is a reason,” said Higgins, assistant professor of gastroenterology in U-M’s Department of Internal Medicine. “This research demonstrates that having H. pylori in your stomach could have beneficial immune effects in other parts of the

Also archived at http://www.vit.bz

93rd Health Research Technology Report 4

body.”

In the study, mice were infected with H. pylori, allowed to develop immune tolerance for a month, and then infected with Salmonella, which induces the inflammatory bowel disease colitis. The data provided the first evidence that H. pylori infection in the stomach alters the immunological environment of the lower gastrointestinal tract and reduced the severity of Salmonella-induced colitis.

“This was surprising because H. pylori infects the stomach, not the colon. It appears to have a more global effect on the gut immune system,” says John Kao, M.D., senior author of this study and assistant professor in U-M’s Department of Internal Medicine.

“But it may explain why people in regions with lots of H. pylori infection — such as Asia and Africa — get fewer inflammatory bowel diseases, like ulcerative colitis and Crohn’s disease.”

It also may explain why H. pylori infection is so common, Higgins says. Salmonella was historically a rampant fatal infection that caused the plague of Athens, which led to rise of Sparta. It also likely led to the early death of Alexander the Great. So it would make sense that many humans carry the H. pylori bacteria, if it truly reduces the severity of inflammation caused by Salmonella, Higgins says.

The H. pylori infection is now more commonly found in developing countries or those with poor sanitation, where Salmonella and inflammatory bowel diseases are more common. Most people contract H. pylori in their first seven years of life, most commonly through exposure to feces.

Higgins does not recommend that inflammatory bowel patients should be infected with H. pylori, however. In the U.S., H. pylori infection is treated with antibiotics because it can lead to stomach ulcers or cancer, even though most people don’t notice they have it.

“There may be a reason we co-exist with H. pylori. Maybe we should not be so quick to get rid of it in patients who do not have stomach ulcers,” Higgins says, adding that this may be especially true in places where Salmonella remains a common threat.

“It would be reasonable for researchers to look at whether H. pylori infection is associated with reduced severity of other gut infections like cholera or Clostridium difficile. Many more studies are needed, however, to see if H. pylori could actually prevent inflammatory bowel disease.”

About U-M’s Division of Gastroenterology: U-M is one of the largest gastroenterology practices in the country and is a leader in the prevention, diagnosis, and treatment of diseases of the gastrointestinal tract and liver. Our 50-plus physicians are experts in the diagnosis and treatment of all diseases of the gastrointestinal system, from simple to complex, including those of the esophagus, stomach, small intestine, colon, rectum, liver, gallbladder, pancreas and biliary tract.

In addition to being leaders in the clinic, our faculty are also leaders in their respective areas of research, which span such varied interests as the role of peptides in the brain-gut interactions in functional bowel diseases to innovative treatments of viral hepatitis and liver cancer.

Public release date: 2-Nov-2010

Black raspberries may prevent colon cancer, study finds

Black raspberries are highly effective in preventing colorectal tumors in two mouse models of the disease, according to a University of Illinois at Chicago study.

The findings are published in the November issue of Cancer Prevention Research.

Also archived at http://www.vit.bz

93rd Health Research Technology Report 5

Colorectal cancer is the third most common cancer and the second leading cause of cancer-related death in both men and women in the U.S., according to the National Cancer Institute.

Building on previous research that found black raspberries have antioxidant, anti-cancer, anti-neurodegenerative and anti-inflammatory properties, the researchers looked at the fruit’s ability to prevent colon cancer.

“We saw the black raspberry as a natural product, very powerful, and easy to access,” said Dr. Wancai Yang, assistant professor of pathology at the UIC College of Medicine and senior author of the study, whose research focuses on the interactions of genetic and nutritional factors in the development of intestinal cancer and tumor prevention.

The researchers used two strains of mice, Apc1638 and Muc2, which each have a specific gene knocked out, causing the mice to develop either intestinal tumors (in the case of Apc1638) or colitis in the case of Muc2. Colitis is an inflammation of the large intestine that can contribute to the development of colorectal cancer.

Both mouse strains were randomized to be fed either a Western-style, high-risk diet (high in fat and low in calcium and vitamin D) or the same diet supplemented with 10 percent freeze-dried black raspberry powder for 12 weeks.

The researchers found that in both mouse strains the black raspberry-supplemented diet produced a broad range of protective effects in the intestine, colon and rectum and inhibited tumor formation.

In the Apc1638 mice, tumor incidence was reduced by 45 percent and the number of tumors by 60 percent. The researchers found that black raspberries inhibited tumor development by suppressing a protein, known as beta-catenin, which binds to the APC gene.

In the Muc2 mice, tumor incidence and the number of tumors were both reduced by 50 percent, and black raspberries inhibited tumor development by reducing chronic inflammation associated with colitis.

The researchers now hope to obtain funding to begin clinical trials in humans, said Yang. Because black raspberries not only prevent cancer but also inflammation, they may also protect against other diseases, such as heart disease.

Public release date: 2-Nov-2010

Daily dose of beet juice promotes brain health in older adults

Winston-Salem, N.C. – Researchers for the first time have shown that drinking beet juice can increase blood flow to the brain in older adults – a finding that could hold great potential for combating the progression of dementia.

The research findings are available online in Nitric Oxide: Biology and Chemistry, the peer-reviewed journal of the Nitric Oxide Society and will be available in print soon. (Read the abstract.)

“There have been several very high-profile studies showing that drinking beet juice can lower blood pressure, but we wanted to show that drinking beet juice also increases perfusion, or blood flow, to the brain,” said Daniel Kim-Shapiro, director of Wake Forest University’s Translational Science Center; Fostering Independence in Aging. “There are areas in the brain that become poorly perfused as you age, and that’s believed to be associated with dementia and poor cognition.”

Also archived at http://www.vit.bz

93rd Health Research Technology Report 6

High concentrations of nitrates are found in beets, as well as in celery, cabbage and other leafy green vegetables like spinach and some lettuce. When you eat high-nitrate foods, good bacteria in the mouth turn nitrate into nitrite. Research has found that nitrites can help open up the blood vessels in the body, increasing blood flow and oxygen specifically to places that are lacking oxygen.

In this study, the first to find a link between consumption of nitrate-rich beet juice and increased blood flow to the brain, Translational Science Center researchers looked at how dietary nitrates affected 14 adults age 70 and older over a period of four days.

On the first day, the study subjects reported to the lab after a 10-hour fast, completed a health status report, and consumed either a high- or low-nitrate breakfast. The high-nitrate breakfast included 16 ounces of beet juice. They were sent home with lunch, dinner and snacks conforming to their assigned diets.

The next day, following another 10-hour fast, the subjects returned to the lab, where they ate their assigned breakfasts. One hour after breakfast, an MRI recorded the blood flow in each subject’s brain. Blood tests before and after breakfast confirmed nitrite levels in the body.

For the third and fourth days of the study, the researchers switched the diets and repeated the process for each subject.

The MRIs showed that after eating a high-nitrate diet, the older adults had increased blood flow to the white matter of the frontal lobes – the areas of the brain commonly associated with degeneration that leads to dementia and other cognitive conditions.

“I think these results are consistent and encouraging – that good diet consisting of a lot of fruits and vegetables can contribute to overall good health,” said Gary Miller, associate professor in the Department of Health and Exercise Science and one of the senior investigators on the project.

To make the sometimes-bitter beet juice tastier – so a greater number of people will drink it and reap its health benefits – the university has worked with a company to create a new beet juice-based beverage. The university is currently looking into ways of marketing the beverage.

Public release date: 2-Nov-2010

Exposure of humans to cosmetic UV filters is widespread

UV filters were present in 85 percent of human milk samples of a research published in Chemosphere

Amsterdam, 2 November, 2010 – An investigation conducted in the context of the Swiss National Research Programme (NRP50), Endocrine Disrupters: Relevance to Humans, Animals and Ecosystems, demonstrates for the first time that internal exposure of humans to cosmetic UV filters is widespread.

In the course of the Summer and Fall 2004, 2005 and 2006 (3 cohorts), human milk was sampled by mothers who had given birth at the University Women’s Hospital in Basel. The participants filled out a detailed questionnaire with general questions and, as special feature, in depth questions on use of different types of cosmetic products.

Chemicals out of a large range of products including “modern” chemicals and classical persistent organic pollutants (POPs) were analyzed in the same human milk sample by analytical laboratories in Freiburg, Erlangen and Baden. The list comprised cosmetic UV filters, synthetic musk fragrances, pesticides, phthalates, parabens, flame retardants (polybrominated diphenylethers), and polychlorinated biphenyls

Also archived at http://www.vit.bz

93rd Health Research Technology Report 7

(PCBs); in total 89 analyses per milk sample. The chemical analytical data of milk samples of individual mothers were then compared with the information obtained through the questionnaire.

The investigation revealed that one and the same human milk sample contained a large range of chemical contaminants, most of which are known to interact with endocrine systems. Individual exposure patterns differed between different types of chemicals. The study demonstrates for the first time that internal exposure of humans to cosmetic UV filters is widespread. Cosmetic UV filters were present in 85% of human milk samples, at concentrations comparable to PCBs. Synthetic musk fragrances were also present in the milk samples. The presence of UV filters in human milk was significantly correlated with the use of cosmetic products containing these UV filters. As a result, exposure patterns differed between individuals.

It seems plausible that exposure to other cosmetic constituents such as synthetic fragrances is also linked to the use of the corresponding products. However, this could not be investigated because musk fragrances are not declared. In contrast, classical contaminants such as PCBs, DDT and metabolites of DDT as well as some other persistent organochlor pesticides represented a rather uniform background exposure. Their levels were in part correlated with each other and also with fat-rich nutrition.

A total daily intake of each individual chemical was calculated for each individual infant from their individual levels in human milk. Calculation included fat content of individual milk samples, total daily milk intake per infant and body weight of the infant. Some infants exhibited values of daily intake of PCBs and several organochlor pesticides that were above US EPA reference dose values.

Margret Schlumpf and Walter Lichtensteiger, who lead the research said, “Research on the effects of endocrine disrupters (chemicals interfering with hormone actions) has shown that it is of utmost importance to obtain information on simultaneous exposure of humans to different types of chemicals because endocrine active chemicals can act in concert. Information on exposure is particularly important for the developing organism at its most sensitive early life stages. Human milk was chosen because it provides direct information on exposure of the suckling infant and indirect information on exposure of the mother during pregnancy.”

An important question during the research was: To what extent lifestyle can influence the presence of chemicals in breast milk? This question was the foundation for the preparation of the questionnaire. The questions were focused particularly on the use of cosmetic products; information on the relationship between the exposure of human populations to constituents of cosmetics and the presence of these constituents in the human body was limited and, in the case of UV filters, absent.

Gert-Jan Geraeds, Executive Publisher of Chemosphere commented, “This study once again emphasizes the importance of global research on the impact of contaminants in the human environment and the need for continuous critical assessment of our priorities in environmental health and consumer habits. I am sure that this investigation will also spark debate at the upcoming first Environmental Health conference in Brazil, February 2011”.

Public release date: 3-Nov-2010

Levels of coumarin in cassia cinnamon vary greatly even in bark from the same tree

A “huge” variation exists in the amounts of coumarin in bark samples of cassia cinnamon from trees growing in Indonesia, scientists are reporting in a new study. That natural ingredient in the spice may carry a theoretical risk of causing liver damage in a small number of sensitive people who consume large amounts of cinnamon. The report appears in ACS’ bi-weekly Journal of Agricultural and Food Chemistry.

Also archived at http://www.vit.bz

93rd Health Research Technology Report 8

Friederike Woehrlin and colleagues note that cinnamon is the second most popular spice, next to black pepper, in the United States and Europe. Cinnamon, which comes from the bark of trees, is sold as solid sticks and powder with the country of origin rarely declared on the package label. There are two main types: Ceylon cinnamon (also known as “true” cinnamon) and cassia cinnamon. Ceylon grows in Sri Lanka (formerly Ceylon), the Seychelles, and Madagascar. Cassia generally comes from China and Indonesia. Both types can contain coumarin, a natural flavoring found in plants. Studies have linked high coumarin intake to liver damage in a small number of sensitive people.

The scientists analyzed 91 cinnamon samples purchased from stores in Germany. They found that coumarin levels varied widely among different bark samples of Cassia cinnamon. Therefore they analyzed cassia bark samples of five trees received directly from Indonesia and found a huge variation even among samples collected from a single tree. The study confirmed that cassia cinnamon has the highest levels of coumarin, while Ceylon had the lowest levels. On average, cassia cinnamon powder contained up to 63 times more coumarin than Ceylon cinnamon powder and cassia cinnamon sticks contained 18 times more coumarin than Ceylon sticks. “Further research is necessary to identify factors influencing the coumarin levels in cassia cinnamon and to possibly allow the harvesting of cassia cinnamon with low coumarin levels in the future,” the report notes.

Health officials say it is almost impossible for consumers to distinguish between Ceylon and cassia in cinnamon powder. Cinnamon sticks, however, do look different. Cassia cinnamon sticks consist of a thick layer of rolled bark, while Ceylon cinnamon sticks have thin layers of bark rolled up into a stick.

Public release date: 3-Nov-2010

Insufficient vitamin D levels in CLL patients linked to cancer progression and death

ROCHESTER, Minn. — Researchers at Mayo Clinic (http://www.mayoclinic.org/) have found a significant difference in cancer progression and death in chronic lymphocytic leukemia (CLL) patients who had sufficient vitamin D (http://www.mayoclinic.com/health/vitamin-d/NS_patient-vitamind) levels in their blood compared to those who didn’t.

In the Mayo Clinic study, published online in the journal Blood (http://bloodjournal.hematologylibrary.org/), the researchers found that patients with insufficient levels of vitamin D when their leukemia was diagnosed progressed much faster and were about twice as likely to die as were patients with adequate levels of vitamin D.

They also found solid trends: increasing vitamin D levels across patients matched longer survival times and decreasing levels matched shortening intervals between diagnosis and cancer progression. The association also remained after controlling for other prognostic factors associated with leukemia progression.

The finding is significant in a number of ways. For the first time, it potentially offers patients with this typically slower growing form of leukemia a way to slow progression, says the study’s lead author, Tait Shanafelt, M.D., (http://mayoresearch.mayo.edu/staff/shanafelt_td.cfm) a hematologist at Mayo Clinic in Rochester, Minn.

“This finding may be particularly relevant for this kind of leukemia because although we often identify it at an early stage, the standard approach is to wait until symptoms develop before treating patients with chemotherapy,” Dr. Shanafelt says. “This watch and wait approach is difficult for patients because they

Also archived at http://www.vit.bz

93rd Health Research Technology Report 9

feel there is nothing they can do to help themselves.”

“It appears vitamin D levels may be a modifiable risk factor for leukemia progression. It is simple for patients to have their vitamin D levels checked by their physicians with a blood test,” he says. “And if they are deficient, vitamin D supplements are widely available and have minimal side effects.”

While the researchers have not yet determined if vitamin D replacement in patients with initially low levels will reverse the more rapid progression associated with insufficiency, they are planning a study to explore that hypothesis.

This research adds to the growing body of evidence that vitamin D deficiency is a risk factor for development and/or progression of a number of cancers, the researchers say. Studies have suggested that low blood vitamin D levels may be associated with increased incidence of colorectal, breast and other solid cancers. Other studies have suggested that low vitamin D levels at diagnosis may be associated with poorer outcomes in colorectal, breast, melanoma and lung cancers, as well as lymphoma.

Replacing vitamin D in some patients has proven to be beneficial, the researchers say. For example, they cite a placebo-controlled clinical trial that found women who increased their vitamin D intake reduced their risk of cancer development.

Vitamin D insufficiency, in general, is widespread, Dr. Shanafelt says. “Between one-fourth and one-half of patients seen in routine clinical practice have vitamin D levels below the optimal range, and it is estimated that up to 1 billion people worldwide have vitamin D insufficiency,” he says.

Vitamin D is obtained from skin exposure to sunlight, from certain foods (fatty fish and eggs) and from supplements.

In this study, the research team, including physicians at the University of Iowa (http://www.uihealthcare.com/), enrolled 390 CLL patients into a prospective, observational study. They tested the blood of these newly diagnosed patients for plasma concentration of 25-hydroxyl-vitamin D and found that 30 percent of these CLL patients were considered to have insufficient vitamin D levels, which is classified as a level less than 25 nanograms per milliliter.

After a median follow-up of three years, CLL patients deficient in vitamin D were 66 percent more likely to progress and require chemotherapy; deficient patients also had a two-fold increased risk of death.

To confirm these findings, they then studied a different group of 153 untreated CLL patients who had been followed for an average of 10 years. The researchers found that about 40 percent of these 153 CLL patients were vitamin D deficient at the time of their diagnosis. Patients with vitamin D deficiency were again significantly more likely to have had their leukemia progress and to have died, Dr. Shanafelt says.

“This tells us that vitamin D insufficiency may be the first potentially modifiable risk factor associated with prognosis in newly diagnosed CLL,” he says.

Public release date: 4-Nov-2010

Obesity rate will reach at least 42 percent, say models of social contagion

Projections suggest obesity among American adults may not plateau until 2050

CAMBRIDGE, Mass. — Researchers at Harvard University say America’s obesity epidemic won’t plateau until at least 42 percent of adults are obese, an estimate derived by applying mathematical modeling to 40

Also archived at http://www.vit.bz

93rd Health Research Technology Report 10

years of Framingham Heart Study data.

Their work, published this week in the journal PLoS Computational Biology, runs counter to recent assertions by some experts that the obesity rate, which has been at 34 percent for the past five years, may have peaked. An additional 34 percent of American adults are overweight but not obese, according to the federal government’s Centers for Disease Control and Prevention.

The Harvard scientists say that their modeling shows that the proliferation of obesity among American adults in recent decades owes in large part to its accelerating spread via social networks.

“Our analysis suggests that while people have gotten better at gaining weight since 1971, they haven’t gotten any better at losing weight,” says lead author Alison L. Hill, a graduate student in Harvard’s Program for Evolutionary Dynamics, Biophysics Program, and at the Harvard-MIT Division of Health Sciences and Technology. “Specifically, the rate of weight gain due to social transmission has grown quite rapidly.”

The projections by Hill and colleagues are a best-case scenario, meaning that America’s obesity rate could rise above 42 percent of adults. One silver lining is that their model suggests the U.S. population may not reach this level for another 40 years, making the future rate of increase much more gradual than over the past 40 years. Only 14 percent of Framingham Heart Study participants were obese in 1971.

Along with co-authors David G. Rand, Martin A. Nowak, and Nicholas A. Christakis, Hill broke down the spread of obesity into three components:

•the rate at which obesity has spread through social networks, via transfer from person to person; •the rate of non-social transmission of obesity, such as through easier access to unhealthy foods or increasingly sedentary lifestyles;

•the rate of “recovery” from obesity, defined as weight loss sufficient to push body mass index (BMI) back below 30.

“We find that while non-social transmission of obesity remains the most important component in its spread, social transmission of obesity has grown much faster in the last four decades,” says Rand, a research scientist in the Program for Evolutionary Dynamics and a fellow in Harvard’s Department of Psychology and Berkman Center for Internet & Society.

Hill, Rand, and colleagues found that a non-obese American adult has a 2 percent chance of becoming obese in any given year — a figure that has risen in recent decades — and that this number rises by 0.4 percentage points with each obese social contact, meaning that five obese contacts doubles the risk of becoming obese.

By comparison, an obese adult has a 4 percent chance of losing enough weight to fall back to merely “overweight” in any given year. This figure has remained essentially constant since 1971.

“These results suggest that social norms are changing the propensity for becoming obese by non-social mechanisms, and also magnifying the effect that obese individuals have on their non-obese contacts,” the scientists write in PLoS Computational Biology

Public release date: 4-Nov-2010

Study shows a single shot of morphine has long lasting effects on testosterone levels

Also archived at http://www.vit.bz

93rd Health Research Technology Report 11

A single injection of morphine to fight persistent pain in male rats is able to strongly reduce the hormone testosterone in the brain and plasma, according to a new paper published in Molecular Pain. The study, led by Anna Maria Aloisi, M.D., of the Department of Physiology – Section of Neuroscience and Applied Physiology at the University of Siena, Italy, Sbarro Institute for Cancer Research and Molecular Medicine at Temple University in Philadelphia, University of Siena, and the Human Health Foundation in Spoleto, Italy, showed that opioids had “long lasting genomic effects in body areas which contribute to strong central and peripheral testosterone levels” including the brain, the liver and the testis.

The study showed increases in aromatase, an enzyme that is responsible for a key step in the biosynthesis of estrogen. The findings are particularly important since testosterone is the main substrate of aromatase, which is involved in the formation of estradiol. Both testosterone and estradiol are important hormones, engaged in cognitive functions as well as in mood, motor control and in many other functions, such as bone structure remodeling.

“Our lab became interested in gonadal hormones several years ago when it became clear that there were many differences in pain syndromes between the sexes,” says Dr. Aloisi. “In looking at differences, it was immediately apparent that these changes were introduced by different treatments, opioids in particular.”

“The research findings are very relevant to the management of patients with chronic pain,” said Marco Pappagallo, M.D., professor and director of pain research and development, Department of Anesthesiology, Mount Sinai School of Medicine, New York, NY. “Today, primary care physicians, pain specialists, and a variety of health care professionals are asked not only to treat pain but how to manage side effects of drugs and to strive for the best possible comprehensive care and wellness of patients who experience chronic pain. Opioid induced hypogonadism can cause health complications to which patients with pain can be overly susceptible, including chronic fatigue, loss of stamina, emotional and sexual disturbances, as well painful skeletal and muscular complications.”

It has been known that patients treated with opioids for short or long periods show low levels of gonadal hormones. Hypogonadism was already described in opioid users and applied to pain patients as OPIAD (opioid induced androgen deficiency). It is also known that patients treated with opioids, including newer drugs (fentalyl, tramadol) have a high probability to be hypogonadic, with menopausal symptoms occurring in women and andropausal symptoms in men.

“The use of opioids puts a ‘physiological’ block on the reproductive system and can induce a long lasting absence of these essential hormones from the blood and the brain,” says Dr. Aloisi. “The normal effect of opioids to restrict reproduction in stressed subjects is multiplied by the higher levels/ long duration of opioids in the body.”

“Until a few years ago this condition was completely unrecognized by physicians although some reports clearly showed it in many kinds of patients,” notes Dr. Aloisi. “Today there remains some ignorance on this condition but gonadal hormones are more commonly cited as responsible for many chronic degenerative pathologies.”

Despite the side effects of opioids, Antonio Giordano, M.D., Ph.D., Director of the Sbarro Institute for Cancer Research and Molecular Medicine, warns that the study’s message is not meant to limit the use of opioids for pain. Instead, he suggests that doctors should “take into consideration this side effect, since it is very easy to find hormone replacement therapies. Using HRTs, patients can get relief from their pain, and improve their quality of life.”

Public release date: 4-Nov-2010

Also archived at http://www.vit.bz

93rd Health Research Technology Report 12

Plantar Fasciitis? Stretching seems to do the trick

New study compares two treatment methods for acute plantar

Rosemont, IL

According to a new study from the Journal of Bone and Joint Surgery (JBJS), patients with acute plantar fasciitis who perform manual plantar fasciitis stretching exercises, as opposed to shockwave therapy, had superior results and higher patient satisfaction.

Study details and findings:

A total of 102 patients who had acute plantar fasciitis pain, were randomly assigned to two groups. Acute is defined as any patient that experiences pain for less than six weeks. 54 people performed an eight-week stretching program, while 48 people received repetitive low-energy radial shock-wave therapy once a week for three weeks. Each group was asked to refrain from any other forms of physical therapy.

Patients in the stretching group, were told to perform stretching exercises three times a day, for eight weeks. All patients were contacted by phone every two weeks to check on training compliance. After four weeks, the patients were told to slowly return to their previous sport and/or recreational activity. Patients in group two received three sessions of radial shock-wave therapy, three times a week.

Patients were given follow-up evaluations at two, four and fifteen months. At both the two and fourth month evaluation, 65 percent of patients who performed the plantar fascia-specific stretch reported total satisfaction with treatment or satisfaction with treatment with minor reservations. Only 29 percent did so after shockwave therapy.

John Furia, MD, an orthopaedic surgeon in Pennsylvania and one of the study authors added that those who develop plantar fascia pain should begin non-operative treatment promptly. “The earlier you understand how stretching fits in, and the earlier you learn how frequently to perform the simple plantar stretch, the less likely you will require a more invasive treatment method,” stated Dr. Furia. “Shockwave therapy has been shown to be a very effective treatment for patients with chronic plantar fasciitis (pain for more than six to eight weeks), however acute cases are probably best treated with more simple measures,” he added.

How to do the stretch: According to the American Academy of Orthopaedic Surgeons (AAOS), this stretch should be performed in the seated position. Cross your affected foot over the knee of your other leg. Grasp the toes of your painful foot and bring your ankle up and your toes up. Place your thumb along the plantar fascia and rub it to stretch it. The fascia should feel like a tight band along the bottom of your foot when stretched. Hold the stretch for 10 seconds. Repeat it 10-20 times for each foot. Dr. Furia and Dr. Judy Baumhauer, orthopaedic surgeon and president-elect of the American Orthopaedic Foot and Ankle Society (AOFAS) recommend that this exercise be performed initially in the morning, before getting out of bed and after any long periods of sitting. If there is a sharp pain in your heel when getting up, a stretch should have been done before standing or walking. Dr. Baumhauer gives her patients a visual as a reference for this exercise.

Dr. Baumhauer, who was not involved in this study, has been counseling patients on the plantar fascia stretch for 15 years. “I am a firm believer in this type of stretch and nearly 80 percent of my patients have shown improvement in just eight weeks of stretching therapy.”

Relevant statistics:

•Plantar fasciitis is the most common cause of pain on the bottom of the heel, and approximately two

Also archived at http://www.vit.bz

93rd Health Research Technology Report 13

million patients are treated for plantar fasciitis each year.

•More than 80 percent of patients with plantar fasciitis will improve within 10 months of starting simple treatment methods.

•Dr. Furia suggests that approximately 20 percent of patients with plantar fasciitis develop a chronic condition.

Public release date: 7-Nov-2010

Plant-based, olive oil diet also has health benefits for prostate cancer survivors

PROVIDENCE, RI – Researchers from The Miriam Hospital say a plant-based, olive oil diet similar to the Mediterranean diet can improve the health of men with recurrent prostate cancer.

The findings may be of significance to men who have been treated with androgen deprivation therapy (ADT), a common treatment that blocks the level of circulating androgens (male hormones), which can fuel the growth of prostate cancers. This therapy has been associated with increased body mass index, excess body fat around the waist and elevated insulin levels – all symptoms of metabolic syndrome. Metabolic syndrome increases the risk of heart disease, stroke and diabetes.

According to Miriam researchers, the men who followed the olive oil diet lost an average of 12.4 pounds in an eight-week period. As a result of the diet and weight loss, participants also experienced a significant improvement in some of the risk factors of metabolic syndrome, particularly triglyceride levels (a type of fat found in the blood that can cause plaque buildup in artery walls).

The findings were presented today at the American Dietetic Association’s 2010 Food & Nutrition Conference & Expo in Boston.

“My plant-based olive oil diet is based on foods that research suggests will improve health, such as vegetables, nuts and olive oil, so it is a healthy diet for weight loss,” says lead author Mary Flynn, PhD, RD, LDN, a research dietitian at The Miriam Hospital. “Our study shows that the diet was not only successful as a weight loss tool for these men, but our participants liked the diet and planned to stay on it.”

According to the American Heart Association, metabolic syndrome is characterized by a group of metabolic risk factors in one person. These include abdominal obesity, blood fat disorders (including high triglycerides, low HDL cholesterol and high LDL cholesterol), elevated blood pressure, and insulin resistance or glucose intolerance (excessive fat tissue in and around the abdomen). Metabolic syndrome has become increasingly common in the United States, and it’s estimated that more than 50 million Americans are affected by it.

Extra virgin olive oil has been shown to decrease blood pressure, fasting insulin, glucose, oxidation and inflammation – all risk factors for heart disease and some cancers. Not only does extra virgin olive oil improve the taste of the meal, but because it’s a healthy fat, it also keeps the stomach fuller longer, so individuals are less likely to snack between meals. According to Flynn, the health benefits of olive oil start at about two tablespoons per day.

The health benefits of a plant-based diet are due to the phytonutrients found in plant products. In particular, carotenoids, which are found in dark vegetables, have been shown to help decrease the risk of cancer. Studies also have shown that olive oil – the only oil that is from a fruit – has numerous

Also archived at http://www.vit.bz

93rd Health Research Technology Report 14

phytonutrients that can improve health; it has been associated with decreasing oxidation, inhibiting tumors from forming or growing and decreasing inflammation. Research also suggests that about two tablespoons a day will improve insulin function and lower blood pressure.

The Miriam study included 11 men treated with ADT who developed metabolic syndrome. For eight weeks, they followed a plant-based olive oil diet, which included a minimum of three tablespoons of extra virgin olive oil daily, as well as four servings of vegetables a day. Nuts were allowed and poultry and seafood were limited to eight ounces a day. Men also kept daily food records for key food items and were asked to keep three-day food diaries at weeks four and eight. Participants’ weight loss goal was five percent of their baseline weight.

In addition to shedding an average of 12.4 pounds, men in the study lost an average of just over two inches in their waistline. They also experienced significant improvements in their triglyceride levels. At the start of the study, the average triglyceride level was more than 100 mg/dl; after eight weeks, it dropped down to a healthy range of less than 100 mg/dl.

“It’s possible that someday we may be able to recommend a diet that will prevent the development of metabolic syndrome in men being treated for recurrent prostate cancer, which would greatly decrease their risk of heart disease,” said Flynn.

A separate study led by Flynn earlier this year also showed that a plant-based, olive oil diet produced greater weight loss in breast cancer survivors compared to a more traditional low-fat diet.

Public release date: 8-Nov-2010

Canola-type rapeseed oil reduces the level of fibrinogen, a cause of thrombosis and inflammation

According to research on fatty acids conducted at the universities of Helsinki and Tampere, the consumption of canola-type rapeseed oil decreases the level of fibrinogen detrimental to health in the body. The increased fibrinogen level, caused by an imbalance in essential fats in one’s diet, decreases when saturated fatty acids are replaced with rapeseed oil. The research results were published in the journal Prostaglandins, Leukotrienes and Essential Fatty Acids.

A complex state of balance, the haemostatic balance, prevails in the bloodstream. One player in this balancing act is fibrinogen, the single most important blood coagulation factor. A high level of fibrinogen promotes the creation of thrombosis and maintains inflammation within the body. An increase in the fibrinogen level is closely linked with, for example, cardiovascular disease, strokes, diabetes, Alzheimer’s disease and dementia.

The new research demonstrates for the first time that an increase in the fibrinogen level of the blood is largely caused by the lack of omega-3-alpha-linolenic acid in the diet. When there is too little of this beneficial fatty acid found in one’s diet, an imbalance between fatty acids in the body is created. When the omega-3-alpha-linolenic acid level is too low, the body starts to manufacture more harmful omega-6-arachidonic acid out of the omega-6-linoleic acid, creating hormone-like compounds that cause thrombosis and inflammation. According to the researchers, the fat composition of rapeseed oil is optimal with regard to fatty acids essential to the body and consequently is well-suited to reduce the fibrinogen levels in the blood.

Levels of fibrinogen and cholesterol reduced

Also archived at http://www.vit.bz

93rd Health Research Technology Report 15

In all 42 research subjects, many of whom with high levels of fibrinogen and cholesterol, participated in the research. The study subjects replaced one-fourth of the food fat (margarine, cheese, butter) they used to rapeseed oil. The oil used was canola-quality spring turnip rape oil. They took about a tablespoon of oil a day, for example, mixed with a salad. The rapeseed oil dose doubled the intake of omega-3-alpha-linolenic acid during the experiment period of six weeks. Due to the regime, all higher-than-average fibrinogen levels decreased by approximately 30 per cent.

The research shows that controlling fibrinogen and cholesterol by changing the fat consumed is a point of departure in the prevention of diseases as well as from the perspective of successful individual medical treatment. According to Into Laakso, Ph.D. from the Faculty of Pharmacy at the University of Helsinki, harmful effects of fats in, for example, elderly people could be easily rectified by switching one-fourth of fats to rapeseed oil. Laakso also recommends that, in addition to cholesterol, healthcare centres should measure patients’ fibrinogen levels.

Public release date: 8-Nov-2010

Mild painkillers in pregnancy are associated with an increased risk of male reproductive problems

New evidence has emerged that the use of mild painkillers such as paracetamol (Tylenol, acetaminophen) , aspirin and ibuprofen, may be part of the reason for the increase in male reproductive disorders in recent decades. Research published in Europe’s leading reproductive medicine journal Human Reproduction today (Monday 8 November) shows that women who took a combination of more than one mild analgesic during pregnancy, or who took the painkillers during the second trimester of pregnancy, had an increased risk of giving birth to sons with undescended testicles (cryptorchidism) – a condition that is known to be a risk factor for poor semen quality and testicular germ cell cancer in later life. [1]

The researchers from Denmark, Finland and France found that women who used more than one painkiller simultaneously (e.g. paracetamol and ibuprofen) had a seven-fold increased risk of giving birth to sons with some form of cryptorchidism compared to women who took nothing.

The second trimester appeared to a particularly sensitive time. Any analgesic use at this point in the pregnancy more than doubled the risk of cryptorchidism. Of the individual painkillers, ibuprofen and aspirin approximately quadrupled the risk of cryptorchidism, while a doubling of the risk (although non-statistically significant) was found for paracetamol. Simultaneous use of more than one painkiller during this time increased the risk 16-fold.

These findings were supported by work that the researchers Dr Ulla Hass at the Technical University of Denmark (Søborg, Denmark) and Dr Bernard Jégou from INSERM (Institut National de la Santé at de la Recherche Médicale) at the University of Rennes (Rennes, France) carried out in rats. They found that analgesics disrupted androgen production, leading to insufficient supplies of the male hormone testosterone during the crucial early period of gestation when the male organs were forming. The effects of the analgesics on the rats was comparable to that caused by similar doses of known endocrine (hormone) disrupters such as phthalates – a family of chemical compounds used in the manufacture of plastics such as PVC.

Dr Henrik Leffers, senior scientist at the Rigshospitalet in Copenhagen (Denmark), who led the research, said: “If exposure to endocrine disruptors is the mechanism behind the increasing reproductive problems among young men in the Western World, this research suggests that particular attention should be paid to the use of mild analgesics during pregnancy, as this could be a major reason for the problems.”

The study looked at two groups of women, 834 in Denmark and 1463 in Finland, who joined the study

Also archived at http://www.vit.bz

93rd Health Research Technology Report 16

while they were pregnant. In Finland the women answered written questionnaires about their use of medication during pregnancy and in Denmark the women did the same or took part in a telephone interview, or both. The telephone interview asked specifically about the use of painkillers during pregnancy, while the written questionnaires did not. The baby boys were examined at birth for any signs of cryptorchidism, ranging from a mild form of the condition, in which the testis is located high in the scrotum, to the more severe form, in which the testis is so high up in the abdomen that it is non-palpable.

The researchers found that women significantly under-reported the use of painkillers in the written questionnaire because they did not consider mild painkillers to be “medication”. Among the 298 Danish mothers who took part in both the self-administered questionnaire and the telephone interview, 30.9% reported using painkillers in the questionnaire, but 57.2% reported it in the telephone interview.

The researchers could find no statistically significant effect in the group of Finnish women, but found significant effects amongst the Danish women.

Dr Leffers said: “We do not quite understand why the Finnish cohort does not show the same associations as the Danish cohort. However, the use of mild analgesics in the Finnish cohort was only examined by questionnaires, not by telephone interviews, and the telephone interviews gave the most reliable information in the Danish cohort, which may explain some of the differences. Moreover, the prevalence of cryptorchidism is much lower in Finland (2.4%) compared to Denmark (9.3%) and, therefore, this would require a larger cohort to find the same number of cases.”

The work examining the effects of the analgesics in rats showed that intrauterine exposure to paracetamol reduced the anogenital distance (the distance between the anus and the genitals) in the offspring. AGD is a sensitive marker for reduced intrauterine androgen levels and effects on AGD predicts increased risk for impaired reproductive performance of the adult animal. The researchers also found that mild analgesics reduced levels of testosterone in the rat foetal testis by approximately 50%.

Dr Jégou said that the mechanism by which mild analgesics reduced testosterone was poorly understood. “It seems to be related to their mode of action which involves inhibiting the production of prostaglandins – locally acting messenger molecules. In another study by David Kristensen et al., we have shown that endocrine disruptors of the phthalate type are almost as potent inhibitors of prostaglandin synthesis as pharmaceutical inhibitors such as mild analgesics. However, currently we do not know how a reduction of prostaglandin synthesis can reduce testosterone production.”

The researchers say that there has been a marked increase in the incidence of congenital cryptorchidism in recent decades, notably in Denmark where it has increased from 1.8% in 1959-1961 to 8.5% in 1997-2001. “The magnitude of this difference is too large to be accounted for by random fluctuations and differences in ascertainment. Moreover, this finding is in accordance with the reported decline in reproductive health in the adult male population over the past five decades,” they write in their paper.

Dr Leffers said: “Although we should be cautious about any over-extrapolation or over-statement, the use of mild analgesics constitutes by far the largest exposure to endocrine disruptors among pregnant women, and use of these compounds is, at present, the best suggestion for an exposure that can affect a large proportion of the human population.”

The researchers say that the risk from the analgesics is markedly higher than that seen for known endocrine disrupters such as phthalates, and that, as most Western women are inevitably exposed to low levels of endocrine disrupters, these together with analgesic use, could be contributing to the increased incidence of cryptorchidism and later life reproductive problems.

Dr Leffers said: “A single paracetamol tablet (500 mg) contains more endocrine disruptor potency than the combined exposure to the ten most prevalent of the currently known environmental endocrine

Also archived at http://www.vit.bz

store logo

Health Research Report

93rd Issue 14 NOV 2010

Compiled By Ralph Turchiano

www.vit.bz www.youtube.com/vhfilm 

www.facebook.com/engineeringevil www.engineeringevil.com  

www.healthresearchreport.me 

120922_0002

 

PDF to Word

Breast milk transmits drugs and medicines to the baby

Contact: SINC

info@plataformasinc.es

34-914-251-820

 

FECYT – Spanish Foundation for Science and Technology

 

There is great confusion among the scientific community about whether women who are drug abusers should breast feed their babies. In order to shed some light on this issue, scientists from various Spanish hospitals and research centres are reviewing the methods used to detect substances in breast milk, their adverse effects, and the recommendations that mothers should follow in this month’s issue of the journal Analytical and Bioanalytical Chemistry.

 

“The general recommendation is to totally avoid drug abuse while breastfeeding, because these substances can pass directly through to the newborn”, Óscar García Algar, co-author of the study and a doctor in the Paediatrics Department at the Hospital del Mar in Barcelona, tells SINC.

 

The researcher adds: “This recommendation extends to the prenatal period, because these substances are passed on to the foetus via the placenta, and then in the postnatal period via the environment. If they have exposure through the milk, they will certainly also have had it during the pregnancy, and they can also be in the environment, as is the case with tobacco smoke”.

 

For this study, the team used the average daily intake of the breastfeeding baby, around 150 millilitres of milk per kilo of weight, as a benchmark. The recommendations are listed for each substance, taking the advice of the American Academy of Pediatrics (AAP) as a reference.

 

Nicotine, caffeine and alcohol

 

The breast milk of smoking mothers contains between 2 and 240 nanograms of nicotine per millilitre, which means their babies receive a dose equivalent to 0.3 to 36 micrograms/kg/day. These infants tend to suffer more from colic and are more prone to respiratory infections.

 

The advice is to give up smoking during pregnancy and breastfeeding, or at least to limit the habit as much as possible, extend the time between the last cigarette and the baby’s feed, use nicotine patches, smoke outside the house and avoid smoky environments.

 

Caffeine – found in coffee, tea, cola drinks and medicines – can cause irritability and insomnia. Although the level of caffeine absorption varies greatly from one person to another, this substance has a lengthy half-life in newborns. For this reason, it is recommended to reduce consumption during breastfeeding to a maximum of 300 mg/day, equivalent to around three cups of coffee per day.

 

For alcohol, the exact risk is still ill-defined, and no studies have been carried out to correlate the dose, although some research suggests it can harm the infant’s motor development, as well as causing changes to their sleep patterns, reduce the amount they eat, and increase the risk of hypoglycaemia.

 

The AAP feels that alcohol consumption is compatible with breastfeeding, but this study states that no amount can be considered safe until the levels in breast milk are established. Strategies for minimising risk include feeding the baby before consuming alcoholic drinks, or at least allowing two or three hours to pass after drinking. Alcoholic women are advised to feed their babies with a bottle.

 

The risks of alcohol to the foetus in pregnant women have already been shown. “But despite this, a recent study by our group showed that 45.7% of the women who came to give birth in our hospital had consumed considerable amounts of alcohol during pregnancy”, says the doctor.

 

Cannabis, cocaine and other drugs

 

Cannabis, which is transmitted both through the mother’s milk and smoke, can cause sedation, lethargy, weakness and poor feeding habits in breastfeeding babies. The long-term risks are also unknown. Women are advised not to use it, but if they use marijuana occasionally, the experts advise them to do so several hours before feeding, and not to expose their children to the smoke.

 

The advice on cocaine, meanwhile, is to “totally avoid it” during breastfeeding. The first case of toxicity caused by this drug through breast milk was a baby boy just two weeks old who suffered irritability, trembling, dilated pupils, tachycardia and high blood pressure after feeding.

 

Women are also advised against breastfeeding if they take amphetamines. These can cause agitation, crying and lack of sleep. Using them also reduces a mother’s ability to care for her children.

 

Breastfeeding is not recommended either for women who use heroin, which is excreted into the milk in sufficient amounts to cause addiction in the baby. In the case of “need”, the advice is to allow at least one or two days to pass after taking the drug before feeding the baby, and to start a substitute treatment as soon as possible, if possible with methadone.

 

Other opiates used as medicines – morphine, meperidine and codeine – are excreted into the milk in minimal amounts and are compatible with breastfeeding, as are benzodiazepines, as long as they are taken in controlled doses. These are the drugs most frequently prescribed to women during pregnancy and after birth.

 

In terms of anti-depressant and anti-psychotic drugs, the AAP says “these can be a cause for concern during breastfeeding”. For now, their effects on breastfeeding babies are unknown, and further studies are recommended.

 

 

###

 

References:

 

Fríguls B, Joya X, García-Algar O, Pallás CR, Vall O, Pichini S. “A comprehensive review of assay methods to determine 5 drugs in breast milk and the safety of breastfeeding 6 when taking drugs”. Analytical and Bioanalytical Chemistry 397(3):1157-79, junio de 2010. Doi 10.1007/s00216-010-3681-0.

 

Researchers recommend pregnant women take 4,000 IU vitamin D a day

2010 study posted for filing

Contact: Susan Martin ssmartin@aap.org 847-434-7877 American Academy of Pediatrics

VANCOUVER, BRITISH COLUMBIA – Taking vitamin D supplements during pregnancy is not only safe for mother and baby, but also can prevent preterm labor/births and infections, according to results of a randomized controlled study to be presented at the Pediatric Academic Societies (PAS) annual meeting in Vancouver, British Columbia, Canada.

In the 1950s and ’60s, people were concerned that vitamin D could cause birth defects, according to Carol L. Wagner, MD, lead author of the study and a pediatric researcher at Medical University of South Carolina. It now is known that vitamin D is important for maternal and infant health, including bone health and immune function.

Recent studies have shown that vitamin D deficiency during pregnancy is a serious public health issue.

“Diet doesn’t provide enough vitamin D, and we don’t go in the sun as much as we need,” Dr. Wagner said.

Therefore, she and her colleagues, including Bruce W. Hollis, PhD, who has worked in the field of vitamin D research for the last 30 years, set out to determine the optimal dose of vitamin D supplements for pregnant women without doing harm.

Researchers randomized 494 pregnant women at 12-16 weeks’ gestation into three treatment groups. Group one received 400 International Units (IU) of vitamin D a day until delivery; group two received 2,000 IU and group three received 4,000 IU. The women were evaluated monthly to ensure safety.

“No adverse events related to vitamin D dosing were found in any of the three arms of the study,” Dr. Wagner said.

Investigators also looked at the effects of vitamin D supplementation on complications during pregnancy, including preeclampsia, gestational diabetes, infections, and preterm labor and birth.

“The spectacular part of the study was it showed women replete in vitamin D had lower rates of preterm labor and preterm birth, and lower rates of infection,” Dr. Wagner said.

The greatest effects were seen among women taking 4,000 IU of vitamin D per day. Therefore, the researchers recommend this daily regimen for all pregnant women.

###

Dr. Wagner will discuss the two parts of the study in separate presentations. The outcomes of vitamin D supplementation during pregnancy will be presented on Saturday, May 1, and the safety of vitamin D supplementation will be presented on Sunday, May 2.

To view part 1 of the study on safety, go to http://www.abstracts2view.com/pas/view.php?nu=PAS10L1_2450&terms. To view part 2 of the study on outcomes, go to http://www.abstracts2view.com/pas/view.php?nu=PAS10L1_2481&terms.

The Pediatric Academic Societies (PAS) are four individual pediatric organizations who co-sponsor the PAS Annual Meeting – the American Pediatric Society, the Society for Pediatric Research, the Academic Pediatric Association, and the American Academy of Pediatrics. Members of these organizations are pediatricians and other health care providers who are practicing in the research, academic and clinical arenas. The four sponsoring organizations are leaders in the advancement of pediatric research and child advocacy within pediatrics, and all share a common mission of fostering the health and well being of children worldwide. For more information, visit www.pas-meeting.org. Follow news of the PAS meeting on Twitter at http://twitter.com/PedAcadSoc.

American Academy of Pediatrics Weighs In For the First Time on Organic Foods for Children ( Actual Press Release from AAP)

10/22/2012
AAP report cites lower pesticides in organic produce and potentially lower risk of exposure to drug-resistant bacteria, but says the most important thing for children is to eat a wide variety of produce, whether it’s conventional or organic

Article Body
NEW ORLEANS – Parents know it’s important for children to eat a wide variety of fruits and vegetables, low-fat dairy products, and whole grains. But it’s less clear whether spending the extra money on organic foods will bring a significant benefit to their children’s health.
To offer guidance to parents – and the pediatricians caring for their children’s health – the American Academy of Pediatrics (AAP) has conducted an extensive analysis of scientific evidence surrounding organic produce, dairy products and meat. The conclusion is mixed: While organic foods have the same vitamins, minerals, antioxidants, proteins, lipids and other nutrients as conventional foods, they also have lower pesticide levels, which may be significant for children. Organically raised animals are also less likely to be contaminated with drug-resistant bacteria because organic farming rules prohibit the non-therapeutic use of antibiotics.
However, in the long term, there is currently no direct evidence that consuming an organic diet leads to improved health or lower risk of disease. However, no large studies in humans have been performed that specifically address this issue.
“What’s most important is that children eat a healthy diet rich in fruits, vegetables, whole grains, and low-fat or fat-free dairy products, whether those are conventional or organic foods. This type of diet has proven health benefits,” said Janet Silverstein, MD, FAAP, a member of the AAP Committee on Nutrition and one of the lead authors of the report. “Many families have a limited food budget, and we do not want families to choose to consume smaller amounts of more expensive organic foods and thus reduce their overall intake of healthy foods like produce.”
The AAP report, “Organic Foods: Health and Environmental Advantages and Disadvantages,” will be released at a news conference at 1 p.m. CT Monday, Oct. 22 at the AAP National Conference & Exhibition in New Orleans. It will be published in the November 2012 issue of Pediatrics (published online Oct. 22).
The report outlines the research that has been conducted on organic foods, including convincing evidence of lower exposure to pesticides and less contamination of livestock with drug-resistant bacteria.
“At this point, we simply do not have the scientific evidence to know whether the difference in pesticide levels will impact a person’s health over a lifetime, though we do know that children – especially young children whose brains are developing – are uniquely vulnerable to chemical exposures,” said Joel Forman, MD, FAAP, a member of the AAP Council on Environmental Health and one of the lead authors of the AAP clinical report.
If cost is a factor, families can be selective in choosing organic foods, Dr. Forman said. Some conventionally grown fruits and vegetables tend to have lower pesticide residues. The AAP cites organic shopper’s guides like those provided by Consumer Reports and the Environmental Working Group as references for consumers.
The AAP found no individual health benefit from purchasing organic milk, but emphasizes that all milk should be pasteurized to reduce the risk of bacterial infections. Raw milk increases the risk of serious infection with bacteria including Salmonella, E. coli, Listeria, Campylobacter and Brucella.
Purchasing meat from organic farms that do not use antibiotics for nontherapeutic uses has the potential to reduce antibiotic resistance in bacteria that infect people. The AAP calls for large, well-designed, prospective cohort studies that directly measure environmental exposures such as estrogen at low levels to understand the impact of hormonal exposure of children through milk and meat.
The AAP report also notes that the motivation to choose organic produce, meat and dairy products may be reasonably based on larger environmental issues, as well as human health impacts like pollution and global climate change.
“Pediatricians want families to have the information they need to make wise food choices,” said Dr. Forman. “We hope that additional research will improve our understanding of these issues, including large studies that measure environmental exposures and neurodevelopment.”
###
The American Academy of Pediatrics is an organization of 60,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. For more information, visit www.aap.org.

Same Report 2 Titles ( Organic fruit and vegetables are no better for children, pediatricians claim ) – ( American Academy of Pediatrics Reviews The Benefits of Organic Foods )

Article # 1

.

2nd article  at Bottom
.
3rd and 4th  article link to the Actual PR release…From the OTA the Other the Original Release from the AAP
.
.
.

Organic fruit and vegetables are no better for children, pediatricians  claim

By Associated Press

PUBLISHED:16:43 EST, 22  October 2012| UPDATED:16:44 EST, 22 October 2012

Organic fruits and vegetables are not necessarily safer or more nutritious than  conventional foods, a leading pediatricians group has claimed.

Parents who  want to reduce their kids’ exposure to pesticides may seek out organic produce,  but science has not proven that eating  pesticide-free food makes people healthier, the American Academy of Pediatrics  said.

‘Theoretically there could be negative  effects, especially in young children with growing brains,’  said Dr. Janet Silverstein, a co-author on the report.

Findings: Pediatricians have claimed pesticide-free foods, as those pictured, aren't necessarily safer or more nutritious for children than conventional foods
Findings: Pediatricians have claimed pesticide-free  foods, as those pictured, aren’t necessarily safer or more nutritious for  children than conventional foods

Yet Silverstein, a  pediatric endocrinologist at the University of Florida in Gainesville, added that rigorous scientific evidence  is lacking.

‘We just can’t say for certain that organics  is better without long-term controlled studies,’ she said.

The report was published online on Monday in  Pediatrics and echoes a Stanford University study released last  month.

That research concluded that while eating  organic fruits and vegetables can reduce pesticide exposure, the amount measured  in conventionally grown produce was within safety limits.

More digging: Doctors said there were limited studies showing its damage
More digging: Doctors said there were limited studies  showing its damage

Since organic foods tend to be costlier, a  good strategy for penny-pinching parents concerned about pesticides is to buy  only organic versions of foods with the most pesticide residue – including  apples, peaches, strawberries and celery, Silverstein said.

But the pediatricians group says higher  prices on organic foods might lead some parents to buy fewer fruits and  vegetables over all.

They fear this is not a good strategy since  both have health benefits including reducing risks for obesity, heart disease  and some cancers.

Parents should aim to provide their families  a diet rich in fruits and vegetables, whether organic or not, along with plenty  of whole grains and low-fat or fat-free dairy products, the report  says.

Read more: http://www.dailymail.co.uk/news/article-2221619/Organic-fruit-vegetables-better-children-doctors-claim.html#ixzz2A58JY8ov Follow us: @MailOnline on Twitter | DailyMail on Facebook

Article # 2

American Academy of Pediatrics Reviews The Benefits of Organic Foods

by in Parenting

In the last few years the benefits of organic foods has always been a big question for many families. In fact Stanford University doctors recentlyrevealed that because they were ‘inadequately prepared when it came to answering their patients’ questions regarding the nutritional value of organic foods, they combed through thousands of studies on 237 of the most commonly compared organic and conventionally grown foods. In the end it was found that organic foods did not prove themselves to be any more nutritious than conventionally grown foods.  The big issue, however, is pesticide exposure.

Looking to make things a little easier for parents ‘confused by conflicting marketing messages regarding healthy food choices for their children’, the American Academy of Pediatrics(AAP) did their own research, which is scheduled to appear in the November issue of the journal Pediatrics. Calling the report a major milestone for the organic sector, the Organic Trade Association (OTA) hails it as a confirmation of the significance of the benefits that organic provides.

“OTA commends the American Academy of Pediatrics—which is THE authority for pediatricians and parents—for examining the health and environmental benefits of organic foods. The science cited in this report points firmly towards positive aspects of organic farming, and confirms many reasons for purchasing organic foods,” said Christine Bushway, OTA’s CEO and Executive Director. She added, “This information will help empower parents as they make decisions about what to feed their children.”

Overall, the clinical report cited the following contributions of organic farming and food consumption:

  • Lower exposure to pesticides known to cause disease
  • Lower exposure to drug-resistant bacteria
  • Higher beneficial nutrient levels such as Vitamin C, total phenols and phosphorus
  • Lower levels of detrimental substances such as nitrates
  • Yields comparable to those of conventional farming techniques while avoiding environmental pollution and reducing fossil fuel consumption
  • Lower pesticide exposure for farm workers
  • Lower overall environmental impact than conventional farming.

Co-authors Dr. Joel Forman and Dr. Janet Silverstein added that there is a need for additional studies to improve our understanding of the long-term health effects of pesticide exposure from conventional foods and from the consumption of meat from hormone-treated animals, as well as to study nutritional aspects of food grown organically.

Agreeing that additional scientific research is needed to improve understanding of long-term health effects from dietary choices, Bushway added,

“It is clear that organic presents a valuable option for consumers who want to lower their families’ exposure to pesticides and antibiotic-resistant bacteria, and reduces risk to farm workers and their families from exposure to toxic pesticides while maintaining agricultural productivity. With scientific research already demonstrating that pregnant women and children are uniquely vulnerable to exposure to pesticides, it is important to remember that organic food—particularly produce—is available at competitive prices at many venues, making this decision easier for parents.”

http://www.growingyourbaby.com/2012/10/22/american-academy-of-pediatrics-reviews-the-benefits-of-organic-foods/

Cyberbullying only rarely the sole factor identified in teen suicides

Contact: Debbie Jacobson djacobson@aap.org 847-434-7084 American Academy of Pediatrics

NEW ORLEANS – Cyberbullying – the use of the Internet, phones or other technologies to repeatedly harass or mistreat peers – is often linked with teen suicide in media reports. However, new research presented on Saturday, Oct. 20, at the American Academy of Pediatrics (AAP) National Conference and Exhibition in New Orleans, shows that the reality is more complex. Most teen suicide victims are bullied both online and in school, and many suicide victims also suffer from depression.

For the abstract, “Cyberbullying and Suicide: A Retrospective Analysis of 41 Cases,” researchers searched the Internet for reports of youth suicides where cyberbullying was a reported factor. Information about demographics and the event itself were then collected through searches of online news media and social networks. Finally, descriptive statistics were used to assess the rate of pre-existing mental illness, the co-occurrence of other forms of bullying, and the characteristics of the electronic media associated with each suicide case.

The study identified 41 suicide cases (24 female, 17 male, ages 13 to 18) from the U.S., Canada, the United Kingdom and Australia. In the study, 24 percent of teens were the victims of homophobic bullying, including the 12 percent of teens identified as homosexual and another 12 percent of teens who were identified as heterosexual or of unknown sexual preference.

Suicides most frequently occurred in September (15 percent) and January (12 percent) although these higher rates may have occurred by chance. The incidence of reported suicide cases increased over time, with 56 percent occurring from 2003 to 2010, compared to 44 percent from January 2011 through April 2012.

Seventy-eight percent of adolescents who committed suicide were bullied both at school and online, and only 17 percent were targeted online only. A mood disorder was reported in 32 percent of the teens, and depression symptoms in an additional 15 percent.

“Cyberbullying is a factor in some suicides, but almost always there are other factors such as mental illness or face-to-face bullying,” said study author John C. LeBlanc, MD, MSc, FRCPC, FAAP. “Cyberbullying usually occurs in the context of regular bullying.”

Cyberbullying occurred through various media, with Formspring and Facebook specifically mentioned in 21 cases. Text or video messaging was noted in 14 cases.

“Certain social media, by virtue of allowing anonymity, may encourage cyberbullying,” said Dr. LeBlanc. “It is difficult to prove a cause and effect relationship, but I believe there is little justification for anonymity.”

Now puberty starts at 9! Boys in U.S. reaching adolescence younger, study says

By Associated Press Reporter

PUBLISHED:18:57 EST, 20  October 2012| UPDATED:23:16 EST, 20 October 2012

 

When it comes to the birds and the bees, some  parents may want to have that talk with their boys a little sooner than they  expected.

Researchers have found signs of puberty in  American boys up to two years earlier than previously reported – age 9 on  average for blacks, 10 for whites and Hispanics. Other studies have suggested  that girls, too, are entering puberty younger.

Why is this happening? Theories range from  higher levels of obesity and inactivity to chemicals in food and water, all of  which might interfere with normal hormone production. But those are just  theories, and they remain unproven.

Puberty 

Early: Researchers have found signs of puberty in  American boys up to two years earlier than previously reported (stock photo)

Doctors say earlier puberty is not  necessarily cause for concern. And some experts question whether the trend is  even real.

Dr William Adelman, an adolescent medicine  specialist in the Baltimore area, says the new research is the first to find  early, strong physical evidence that boys are maturing earlier. But he added  that the study still isn’t proof and said it raises a lot of  questions.

Earlier research based on 20-year-old  national data also suggested a trend toward early puberty in boys, but it was  based on less rigorous information. The new study involved testes measurements  in more than 4,000 boys. Enlargement of testes is generally the earliest sign of  puberty in boys.

The study was published online Saturday in  Pediatrics to coincide with the American Academy of Pediatrics’ national  conference in New Orleans.

Dr Neerav Desai, an adolescent medicine  specialist at Vanderbilt University in Nashville, said he’s seen a subtle trend  toward slightly earlier puberty in boys. He said it’s important for parents and  doctors to be aware so they can help children emotionally prepare for the  changes that come with puberty.

Doctors generally consider puberty early if  it begins before age 8 in girls and before age 9 in boys.

Boys are more likely than girls to have an  underlying physical cause for early puberty. But it’s likely that most, if not  all, of the boys in the study were free of any conditions that might explain the  results, said lead author Marcia Herman-Giddens, a researcher at the University  of North Carolina in Chapel Hill.

Puberty 

Sooner: Other studies have suggested that girls, too,  are entering puberty younger (stock photo)

Problems such as thyroid abnormalities and  brain tumors have been linked to early puberty. But boys with chronic medical  conditions or who were using medicines that could affect puberty were excluded  from the research.

In girls, early puberty has been linked with  increased chances for developing breast cancer, but whether it poses health  risks for boys is uncertain. Some scientists think early testes development may  increase the risk for testicular cancer, but a recent research analysis found no  such link.

‘If it’s true that boys are starting puberty  younger, it’s not clear that means anything negative or has any implications for  long-term,’ said Adelman, a member of the American Academy of Pediatrics’  committee on adolescence.

For the new study, researchers recruited  pediatricians in 41 states who participate in the academy’s office-based  research network. Doctors asked parents and boys aged 6 to 16 to take part  during regular checkups. The visits took place between 2005 and  2010.

Half of the boys were white. The rest were  almost evenly divided among blacks and Hispanics.

On average, white boys started puberty at age  10, a year and a half earlier than what has long been considered the normal  average. For black boys, the average age of 9 was about two years earlier than  in previous research. Among Hispanics, age 10 was similar to previous research  that only involved Mexican-American boys. The new study included boys from other  Hispanic backgrounds.

Testes enlargement was seen at age 6 in 9  percent of white boys, almost 20 percent of blacks and 7 percent of  Hispanics.

Pubic hair growth, another early sign of  puberty, started about a year after testes enlargement in all groups but still  earlier than previously thought.

In girls, breast development is the first  sign, and recent research suggested that it starts at age 7 in about 10 per cent  of white girls, 23 per cent of blacks and 15 per cent of Hispanics. That’s  substantially higher than rates reported more than a decade ago.

But some experts have questioned methods used  in studies in girls, noting that the age when girls start menstruating has not  changed much and remains around age 12 on average.

Dr Dianne Deplewski, a pediatric  endocrinologist at the University of Chicago, has not seen any increase in boys  referred to her for signs of early puberty. She said it’s possible that the new  study results were skewed by families who brought their boys to the doctor  because they already had concerns about their health.

The study had other limitations. Testes were  measured just once, and doctors weren’t randomly recruited but volunteered to  participate. That means it’s possible that those with early maturing patients  were overly represented, but Herman-Giddens said it’s unlikely boys in the study  were different from those in the general U.S. population.

She said the research methods weren’t perfect  but that they’re the best to date. She also stressed that the results shouldn’t  be used to establish a ‘new normal’ for the start of puberty in  boys.

‘Just because this is happening doesn’t mean  this is normal or healthy,’ the researcher said.

Read more: http://www.dailymail.co.uk/news/article-2220832/Boys-U-S-entering-puberty-younger-new-study-shows.html#ixzz29x8sZQOe Follow us: @MailOnline on Twitter | DailyMail on Facebook

New infant formula safety advice could prevent infant suffering

2009 release posted for filing
Contact: Lucy Collister
lcollister@wiley.com
44-01-865-476-241
Wiley-Blackwell

Published in Letters in Applied Microbiology

Wheat-based infant follow-on formulas are better reconstituted with fruit juice and should be stored in the fridge at 4°C to prevent growth of meningitis bacteria, according to recent research.

The results of a study, published today in the Society for Applied Microbiology journal, Letters in Applied Microbiology, have shown that Cronobacter species do not grow in wheat-based infant formula stored at 4°C.

Cronobacter is a recently defined genus of bacteria and was previously known as Enterobacter sakazakii. Cronobacter species have been frequently isolated from the environment and various food products including infant formula. These bacteria have been associated with infant meningitis, enteritis and septicaemia, so prevention of infant’s consumption is vital in maintaining their safety.

These bugs will grow at 25°C or 37°C, but less so when the formula is made up using apple or grape juice than when made up using water or milk.

“This is valuable information for parents, infant formula producers and regulators and should be used when preparing and storing the reconstituted wheat based infant formula. It is also important that formula is prepared hygienically” said researcher Tareq Osaili.

Pacifiers may have emotional consequences for boys

Contact: Paula Niedenthal niedenthal@wisc.edu 608-890-4379 University of Wisconsin-Madison

MADISON — Pacifiers may stunt the emotional development of baby boys by robbing them of the opportunity to try on facial expressions during infancy.

Three experiments by a team of researchers led by psychologists from the University of Wisconsin–Madison tie heavy pacifier use as a young child to poor results on various measures of emotional maturity.

The study, published today by the journal Basic and Applied Social Psychology, is the first to associate pacifiers with psychological consequences. The World Health Organization and American Academy of Pediatrics already call for limiting pacifier use to promote breast-feeding and because of connections to ear infections or dental abnormalities.

Humans of all ages often mimic — unwittingly or otherwise — the expressions and body language of the people around them.

“By reflecting what another person is doing, you create some part of the feeling yourself,” says Paula Niedenthal, UW–Madison psychology professor and lead author of the study. “That’s one of the ways we understand what someone is feeling — especially if they seem angry, but they’re saying they’re not; or they’re smiling, but the context isn’t right for happiness.”

Mimicry can be an important learning tool for babies.

“We can talk to infants, but at least initially they aren’t going to understand what the words mean,” Niedenthal says. “So the way we communicate with infants at first is by using the tone of our voice and our facial expressions.”

With a pacifier in their mouth, a baby is less able to mirror those expressions and the emotions they represent.

The effect is similar to that seen in studies of patients receiving injections of Botox to paralyze facial muscles and reduce wrinkles. Botox users experience a narrower range of emotions and often have trouble identifying the emotions behind expressions on other faces.

“That work got us thinking about critical periods of emotional development, like infancy,” says Niedenthal, whose work is supported by the French Agence Nationale de la Recherche. “What if you always had something in your mouth that prevented you from mimicking and resonating with the facial expression of somebody?”

The researchers found six- and seven-year-old boys who spent more time with pacifiers in their mouths as young children were less likely to mimic the emotional expressions of faces peering out from a video.

College-aged men who reported (by their own recollections or their parents’) more pacifier use as kids scored lower than their peers on common tests of perspective-taking, a component of empathy.

A group of college students took a standard test of emotional intelligence measuring the way they make decisions based on assessing the moods of other people. Among the men in the group, heavier pacifier use went hand-in-hand with lower scores.

“What’s impressive about this is the incredible consistency across those three studies in the pattern of data,” Niedenthal says. “There’s no effect of pacifier use on these outcomes for girls, and there’s a detriment for boys with length of pacifier use even outside of any anxiety or attachment issues that may affect emotional development.”

Girls develop earlier in many ways, according to Niedenthal, and it is possible that they make sufficient progress in emotional development before or despite pacifier use. It may be that boys are simply more vulnerable than girls, and disrupting their use of facial mimicry is just more detrimental for them.

“It could be that parents are inadvertently compensating for girls using the pacifier, because they want their girls to be emotionally sophisticated. Because that’s a girly thing,” Niedenthal says. “Since girls are not expected to be unemotional, they’re stimulated in other ways. But because boys are desired to be unemotional, when you plug them up with a pacifier, you don’t do anything to compensate and help them learn about emotions.”

Suggesting such a simple and common act has lasting and serious consequences is far from popular.

“Parents hate to have this discussion,” Niedenthal says. “They take the results very personally. Now, these are suggestive results, and they should be taken seriously. But more work needs to be done.”

Sussing out just why girls seem to be immune (or how they may compensate) is an important next step, as is an investigation of what Niedenthal calls “dose response.”

“Probably not all pacifier use is bad at all times, so how much is bad and when?” she asks. “We already know from this work that nighttime pacifier use doesn’t make a difference, presumably because that isn’t a time when babies are observing and mimicking our facial expressions anyway. It’s not learning time.”

But even with more research planned to further explain the new results, Niedenthal is comfortable telling parents to consider occasionally pocketing the pacifier.

“I’d just be aware of inhibiting any of the body’s emotional representational systems,” Niedenthal says. “Since a baby is not yet verbal — and so much is regulated by facial expression — at least you want parents to be aware of that using something like a pacifier limits their baby’s ability to understand and explore emotions. And boys appear to suffer from that limitation.”

###

 

— Chris Barncard, 608-890-0465, barncard@wisc.edu

Having a tonsillectomy can cause Obesity

Contact: David March
dmarch1@jhmi.edu
410-955-1534
Johns Hopkins Medicine

Age, not underlying diagnosis, key factor in weight gain in children after tonsillectomy

Potentially worrisome weight gains following tonsillectomy occur mostly in children under the age of 6, not in older children, a study by Johns Hopkins experts in otolaryngology- head and neck surgery shows.

Sudden increases in body mass index, or BMI, have been routinely observed for months after some of the more than half-million surgeries performed annually in the United States to remove the sore and swollen tissues at the back of the throat.

The Johns Hopkins study, in 115 children in the Baltimore region, is believed to be the first to dispel long-held beliefs that such weight gains occurred mostly in children whose tonsils were removed as primary treatment for diagnosed sleep apnea, when the swollen, paired tissues partially obstruct breathing and disrupt sleep. It is also believed to be the largest study to analyze weight gain specific to every child’s age group, from 1 through 17.

Although researchers have yet to pinpoint the underlying cause of the weight-gain phenomena, they did find that it happened at the same rate in the 85 children who had the surgery for obstructive sleep apnea as in the 30 who had it due to recurrent episodes of tonsil inflammation.

Senior study investigator, otolaryngologist and sleep medicine expert Stacey Ishman, M.D., M.P.H., says her team’s study findings, scheduled to be presented Sept. 12 at the annual meeting of the American Academy of Otolaryngology—Head and Neck Surgeons in Washington, D.C., should help alleviate rising concerns among many parents whose adolescent children are already overweight that tonsillectomy may aggravate the problem; or start one in normal weight kids. Recent surveys have shown that record numbers of American children, as many as one-third, are overweight or obese.

“Our study results show that parents’ current concerns about weight gain are serious, but only underweight or normal weight children between the ages of 2 and 6 are most likely to gain even more weight, not older children,” says Ishman, an assistant professor at the Johns Hopkins University School of Medicine.

“Parents with overweight adolescent children need not fear tonsillectomy, and those with younger, normal weight and overweight children just really need to closely watch their child’s diet following surgery, and make caloric adjustments,” says Ishman, who has performed hundreds of the roughly 30-minute procedures that typically require a general anesthetic.

In the study, researchers analyzed the medical records of children between the ages of 6 months and 18 years who had had their tonsils removed at the Johns Hopkins Outpatient Center between 2008 and 2011. Researchers looked only at those medical records for children who had been routinely examined for at least six months after their procedure, with detailed measurements of any possible weight gain, which were averaged and compared based on a formula involving age, gender and height. All also had a history of recurrent tonsillitis or obstructive sleep apnea, as strictly determined by an individual sleep study analysis.

Results showed an averaged post-surgical weight gain of 2 to 5 pounds – or a 1.0- to 1.2-point increase in averaged BMI scores—but the gains were not dependent on whether the underlying condition was inflammation or sleep apnea. Only age mattered, researchers say, after discounting gender and height.

Ishman says that while such weight gains might appear small, in these children’s small bodies, whose initial weight was between 22 and 60 pounds (or between 10 to 30 kilos), “a 10 percent weight gain can be quite worrisome.”

Results showed a normal weight, 5-year-old boy, weighing 40 pounds (or 18 kilos) and measuring 42 inches tall, who gained 3 pounds after tonsillectomy, would move from the 68th percentile to the 89th percentile in their age-weight group, and become overweight. For an underweight 5-year-old boy of similar height, originally weighing 34 pounds (15 kilos), the same 3-pound weight gain would shift them from the 24th percentile group to the 28th percentile, moving them closer to a normal weight.

However, she says, in an overweight 10-year-old boy, already weighing 90 pounds (41 kilos) and 55 inches tall, there was no weight gain post tonsillectomy, and he remained in the 92nd percentile group, meaning his poor condition did not worsen.

Ishman says her team’s next steps are to gain a better understanding of why and how children’s age affects weight gain post-tonsillectomy. She already has plans to monitor children immediately after surgery to find out what factors or interventions may help underweight children gain pounds, while helping those who are overweight to not get any bigger.

Since 2002 tonsillectomy has been recommended by the American Academy of Pediatrics as the primary treatment for obstructive sleep apnea, as sleeping aids and drug therapies are not as effective. Studies have shown that if left untreated, sleep apnea can lead to long-term health problems, including increased heart and lung diseases, even death.

 

###

 

Funding support for this study was provided by The Johns Hopkins Hospital.

In addition to Ishman, other Johns Hopkins researchers involved in this study were David Smith, M.D., Ph.D., and Emily Boss, M.D., M.P.H. Other study co-investigators included Ami Vikani, B.S., at the George Washington University School of Medicine, in Washington, D.C.; and Fernando Aguirre-Amezquita, M.D., at Escuela de Medicina Ignacio A. Santos de Monterrey, in Mexico.

For more information, go to:
http://www.hopkinsmedicine.org/otolaryngology/our_team/faculty/ishman.html
http://www.entannualmeeting.org/12/

Teething Baby? Avoid Benzocaine, FDA Says

SUNDAY, July 29 (HealthDay News) — Parents should not use benzocaine products to relieve teething pain in babies except under the  advice and supervision of a health care professional, the U.S. Food and  Drug Administration says.

Benzocaine is a local anesthetic found in over-the-counter products  such as Anbesol, Orajel, Baby Orajel, Orabase and Hurricane.

The use of benzocaine gels and liquids to relieve gum and mouth pain  can lead to a rare but potentially deadly condition called methemoglobinemia, in which the amount of oxygen carried through the  bloodstream is greatly reduced. Children under 2 years old are at  particular risk for the condition, the FDA said in a news release.

The agency first warned about the potential dangers of benzocaine in  2006 and has since received 29 reports of benzocaine gel-related cases of  methemoglobinemia. Nineteen of those cases occurred in children, 15 of  them under 2 years of age.

The FDA also noted that parents may have difficulty recognizing the  symptoms of methemoglobinemia, which include: pale, gray or blue-colored  skin, lips and nail beds; shortness of breath; fatigue; confusion;  headache; light-headedness and rapid heart rate.

Symptoms can occur within minutes to hours after benzocaine use, and  after using the drug for the first time or after several uses. Parents  should immediately call 911 (or the local emergency number outside the  United States) if a child has symptoms of methemoglobinemia after being  given benzocaine, the FDA said in the news release.

Instead of using benzocaine to ease teething pain, the American Academy  of Pediatrics suggests that parents give a child a teething ring chilled  in the refrigerator, or use a finger to gently rub or massage the child’s  gums

New lipid screening guidelines for children overly aggressive, UCSF researchers say

Recommendations fail to weigh benefits against potential harms

Recent guidelines recommending cholesterol tests for children fail to weigh health benefits against potential harms and costs, according to a new commentary authored by three physician-researchers at UCSF.

Moreover, the recommendations are based on expert opinion, rather than solid evidence, the researchers said, which is especially problematic since the guidelines’ authors disclosed extensive potential conflicts of interest.

The guidelines were written by a panel assembled by the National Heart, Lung and Blood Institute (NHLBI) and published in Pediatrics, in November 2011. They also were endorsed by the American Academy of Pediatrics.  The guidelines call for universal screening of all 9 to 11-year-old children with a non-fasting lipid panel, and targeted screening of 30 to 40 percent of 2 to 8-year-old and 12 to 16-year old children with two fasting lipid profiles. Previous recommendations called only for children considered at high risk of elevated levels to be screened with a simple non-fasting total cholesterol test.

IMAGE:This is Mark Pletcher, MD, MPH.Thomas Newman

The call for a dramatic increase in lipid screening has the potential to transform millions of healthy children into patients labeled with so-called dyslipidemia, or bad lipid levels in the blood, according to the commentary by Thomas Newman, MD, MPH, Mark Pletcher, MD, MPH and Stephen Hulley, MD, MPH, of the UCSF Department of Epidemiology and Biostatistics and e-published on July 23 in Pediatrics.

“The panel made no attempt to estimate the magnitude of the health benefits or harms of attaching this diagnosis at this young age,” said Newman. “They acknowledged that costs are important, but then went ahead and made their recommendations without estimating what the cost would be.  And it could be billions of dollars.”

Some of the push to do more screening comes from concern about the obesity epidemic in U.S. children.   But this concern should not lead to more laboratory testing, said Newman.

“You don’t need a blood test to tell who needs to lose weight. And recommending a healthier diet and exercise is something doctors can do for everybody, not just overweight kids,” he said

The requirement of two fasting lipid panels in 30 to 40 percent of all 2 to 8-year olds and 12 to 16 –year- olds represents a particular burden to families, he said.

“Because these blood tests must be done while fasting, they can’t be done at the time of regularly scheduled ‘well child’ visits like vaccinations can,” said Newman.  “This requires getting hungry young children to the doctor’s office to be poked with needles on two additional occasions, generally weekday mornings. Families are going to ask their doctors, ‘Is this really necessary?’   The guidelines provide no strong evidence that it is.”

IMAGE:This is Stephen Hulley, MD, MPH.Click here for more information.

The authors note that the panel chair and all members who drafted the lipid screening recommendations disclosed an “extensive assortment of financial relationships with companies making lipid lowering drugs and lipid testing instruments.” Some of those relevant relationships include paid consultancies or advisory board memberships with pharmaceuticals that produce cholesterol-lowering drugs such as Merck, Pfizer, Astra Zeneca, Bristol-Myers Squibb, Roche and Sankyo.

“The panel states that they reviewed and graded the evidence objectively,” said Newman. “But a recent Institute of Medicine report recommends that experts with conflicts of interest either be excluded from guideline panels, or, if their expertise is considered essential, should have non-voting, non-leadership, minority roles.”

Evidence is needed to estimate health benefits, risks and costs of these proposed interventions, and experts without conflicts of interest are needed to help synthesize it, according to Newman. He said that “these recommendations fall so far short of this ideal that we hope they will trigger a re-examination of the process by which they were produced.”