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Healthnotes Newswire (July 31, 2008)—Premature babies are at risk for complications in their mental development, but new evidence shows that their brains may get a boost from fatty acids: A study in Pediatrics reports that breast milk supplemented with omega-3 DHA (docosahexaenoic acid) and omega-6 AA (arachidonic acid) may improve brain development in premature infants.DHA and AA are two types of fatty acids essential for many bodily functions including brain, eye, and nervous system development. The optimal amounts of these fatty acids for premature infants has not been determined, but researchers suggest that increasing the amounts in early infancy may reduce the risk of developmental problems later in life.

Learning disabilities and school-related problems are more common among premature infants than full-term infants. Prior studies, however, have shown that premature infants who are breast-fed have higher IQs than babies receiving formula milk. This finding was attributed to higher concentrations of DHA found in human milk compared with formula milk. The authors of the new study considered the possibility that increasing the DHA content of human milk and adding AA could further improve preemies’ brain development.

Study results encouraging

In the study, 141 premature infants weighing less than 1,500 grams (about 3 pounds) were randomly assigned to receive human breast milk supplemented with either 32 mg of DHA and 31 mg of AA per 100 ml of milk, or breast milk supplemented with soy oil and medium-chain triglyceride oil. Infants received more than 100 ml of human milk per kilogram of body weight per day beginning on the first or second day of birth and continuing until discharge from the hospital (an average of nine weeks).

At six months of age, infants who received the human milk supplemented with DHA and AA were better at problem-solving and were better able to discriminate between familiar and unfamiliar objects compared with infants in the control group.

“There is growing evidence that DHA and AA have specific functions related to memory and problem-solving,” said Christine Henriksen, PhD, lead author of the study from the Department of Nutrition at the University of Oslo, Norway. Dr. Henriksen and her colleagues point out that these functions are critical for being able to focus, be attentive, learn, and process information. Further research is needed to understand the long-term impact of supplementing with fatty acids on school performance and attention capacity later in life.

Ensure you eat your EFAs

Babies are dependent on breast milk and/or fortified formula milk for DHA and AA, but there are other important sources of essential fatty acids (EFAs) to consider as the child grows older. In addition, recent research has shown that it is important for pregnant women to eat plenty of fatty acids in order to help optimize their baby’s brain function. You can find them in these sources:

• Fatty fish such as salmon, halibut, and tuna are good sources of DHA, which is also found in smaller amounts in eggs. Pregnant women should balance the need for fatty acids from fish with reducing exposure to mercury by limiting the amount of fish they eat and avoiding fish high in mercury content.

• AA is found in meat, chicken, and eggs.

• Some people may benefit from supplements that contain fatty acids. Check with your doctor about the appropriateness of using supplements to further enrich your diet.

(Pediatrics 2008;121:1137–45)

Healthnotes Newswire (July 10, 2008)—Good news for your little juice lovers: Although several studies have suggested that drinking fruit juice might contribute to overweight in children, a review of 21 studies found that the link was not strong. “There is no systematic association between consumption of 100% fruit juice and overweight in children and adolescents,” said the study’s authors in the American Journal of Lifestyle Medicine.

The origins of overweight

While genetics play a role, diet and exercise patterns are also intimately involved in maintaining healthy weight. In a previous study, one researcher found that children who drank more than 12 ounces of fruit juice per day were more likely to be overweight than children who drank less juice. Since juice is the drink of choice for many youngsters, the new study compiled evidence from studies concerning juice consumption and overweight in children to try to answer the question: Does drinking juice make kids fatter?

Only 6 of the 21 studies reviewed found a relationship between drinking 100% fruit juice and overweight in children, none of which were based on a nationally representative sample. Those that found a relationship did so only in adolescent girls and children who were overweight to begin with. The other 15 studies—5 of which were based on nationally representative samples—found no relationship between drinking juice and becoming overweight.

The authors concluded, “The data do support consumption of 100% fruit juice in moderate amounts and suggest that consumption of fruit juice may be an important strategy to help children meet the current recommendations for fruit.”

“As the mother of one child who wants nothing to do with juice, and another who would drink it all day long, it is a relief to read this new study. I feel like it’s one less thing for me to stress about as a mom,” said Erin Goodman, founder of the Rhode Island Birth Network.

The importance of addressing obesity

According to the 2003-2004 National Health and Nutrition Examination Survey (NHANES), 17% of all children and adolescents are overweight. Among 2 to 5 year olds, the prevalence increased from 7 to 14% between 1988 and 2004; similar increases were seen among 6- to 19-year-olds in this time span, with an increase in the percentage of overweight children from 11 to 19%.

Says Dr. Matthew Baral, medical director of Hamilton Elementary School Clinic in Phoenix, “Eating the whole fruit is preferable to the juice, since the release of sugar in the bloodstream is somewhat blunted by the fiber in whole fruit. When consuming juice, dilute it with water to lessen the amount of sugar the child is getting.”

Help your child maintain a healthy weight

Here are some simple things that parents can do to help keep kids’ weight in a healthy range:

• Snack on fruits and veggies—Make a big fruit salad on the weekend; store in the fridge and eat all week. Keep ready-to-eat cut-up vegetables on hand for quick snacks. Baby carrots, snap peas, broccoli, and cauliflower are easy to eat on the go.

• Get moving in your free time—Set a positive example by making exercise a priority for the whole family.

• Limit TV time—Kids who watch more TV or eat while watching TV are more likely to become overweight.

• Avoid processed foods—Packaged snacks can contain hidden fats and sugar. Opt for home-baked goods to satisfy the urge to snack.

(AJLM 2008;doi:10.1177/1559827608317277)

Healthnotes Newswire (July 10, 2008)—When applied to the skin, honey may help prevent and treat skin diseases caused by bacteria, according to a new study published in Clinical Infectious Diseases. As the number of antibiotic-resistant infections increases, alternative solutions are needed for infections.

Some research has already demonstrated that honey may help with wound healing. In the new study, Revamil, a medical-grade honey, was effective in killing or reducing many types of bacteria on the skin of healthy volunteers, including bacteria that are susceptible to or resistant to antibiotics.

Compared with the control group, bacteria on the forearm were reduced 100-fold after honey was applied for two days, and more than 80% of the honey-treated skin patches showed no evidence of bacteria compared with only 21% of the control patches. Test tube studies also showed that within 24 hours honey killed all antibiotic-resistant and -susceptible strains of Staphylococcus aureus, Staphylococcus epidermis, Enterococcus faecium, Escherichia coli, Pseudomonas aeruginosa, Enterobacter cloacae, and Klebsiella oxytoca.

The study’s authors commented that since very few new antibiotics are being developed, alternative solutions are needed. Honey, they said, could be helpful in treating wound infections and in preventing infection at skin sites where bacteria are likely to thrive, such as catheter sites in ill patients. Further research is needed to understand the potential role of medical-grade honey in preventing and treating skin infections.

Honey may kill or suppress bacteria growth because of its high sugar content, high acid content, natural production of hydrogen peroxide, or because of other actions related to flower or bee components. Though the authors warn that pulling a jar of honey off of the shelf to treat skin infections may not get the job done (Revamil is produced in a greenhouse under standardized conditions), evidence from other studies suggests that raw, unprocessed honey may be effective.

(Clin Infect Dis 2008;46:1677–82)

Healthnotes Newswire (June 26, 2008)—Yet more proof points to the importance of exercise and healthy eating to reduce the chance of developing diabetes in people at risk for the disease. With the onset of type 2 diabetes, the body’s ability to keep blood sugar (glucose) levels in check begins to diminish. Losing weight, exercising regularly, and eating well can help improve insulin sensitivity, protecting against diabetes or possibly halting its progression.

“In people with impaired glucose tolerance, group-based interventions targeting lifestyle changes such as diet and exercise produce a durable and long-lasting reduction in incidence of type 2 diabetes,” said the authors of a new study in the Lancet.

As part of the 20-year study, 577 people with impaired glucose tolerance (a prediabetic condition) were assigned to a control group (no intervention), or to one of three lifestyle intervention groups (diet, exercise, or diet plus exercise). The dietary intervention focused on eating more vegetables and consuming less sugar and alcohol. The exercise intervention concentrated on increasing leisure time physical activity.

The interventions lasted for 6 years; then the people were followed for 14 more to determine the long-term effects of the lifestyle changes on the risk of developing diabetes and related complications, including heart disease.

During the first 6 years, the people in the intervention groups had a 51% lower incidence of diabetes than did people in the control group. After 20 years, the intervention groups sustained a 43% lower diabetes incidence, and people in the intervention groups were diabetes-free for almost 4 years longer than people in the control group. The interventions did not seem to affect the risk of cardiovascular disease and other diabetic complications.

The World Health Organization estimates that at least 180 million people worldwide are living with diabetes. The risk of type 2 diabetes is higher in people with a family history of the disease; being overweight, having high triglycerides (a fat in the blood), and high blood pressure also raise risk.

Simple steps to protect your blood sugar

Dr. Leon Hecht, a New Hampshire naturopathic doctor specializing in diabetes, offers these tips for stabilizing blood sugar and avoiding diabetes and related problems.

• Focus your diet on whole foods, including vegetables, fruits, whole grains, lean animal proteins, legumes, nuts, and seeds.

• Eat a larger breakfast and a smaller dinner.

• Each day, make one meal a large salad with all the fixings.

• Decrease foods with flour in them—this means all cakes, cookies, and breads—as these foods will raise your need for insulin, causing you to store fat.

• Aim to lose abdominal fat, as weight in this area is a principal risk factor for type 2 diabetes.

(Lancet 2008;371:1783–9)

Healthnotes Newswire (June 19, 2008)—Childhood and teen obesity has leveled out, according to statistics from 2006. But it’s not time to celebrate yet—there is work to be done to reverse the trend and help kids become healthier. A new study reports that overweight and obesity rates in kids have not changed since 1999, giving us reason for both optimism and concern.

The study, published in the Journal of the American Medical Association, included data from the National Health and Nutrition Examination Survey, which has been conducted in multiple stages by the National Center for Health Statistics and the Centers for Disease Control and Prevention (CDC) since the 1960s. The researchers used health information collected from 2003 to 2006 for 8,165 children and adolescents ages 2 to 19. Body mass index (BMI) was calculated for each child and placed on the percentile graphs for boys and girls established in 2000 by the CDC.

What researchers found when the children weighed in

The surveys found:

• 11.3% of children and adolescents had an extremely high BMI, falling at or above the 97th percentile for their age

• 16.3% were obese, with BMI at or above the 95th percentile

• 31.9% were overweight, having BMI at or above the 85th percentile

• Children between 12 and 19 years old were more likely to have high BMI than younger children

• Mexican–American boys and girls and non-Hispanic black girls had higher BMI than non-Hispanic white boys and girls

When the researchers compared these percentages to those from previous surveys, no real change was seen since nearly a decade ago.

Based on data from older surveys, the trend in childhood overweight and obesity was clearly upward from 1980, when only 6.5% of children ages 6 to 11 were obese. By 1994 that number had risen to more than 11%, and by 2002, it had climbed to more than 16%, where it seems to have reached a plateau.

An opportunity to outpace obesity

Although the reasons for the change in trend is not yet known, we do know that some behaviors can help children avoid becoming overweight and obese. Taking steps when your children are young will help them develop positive habits that will keep them healthy into adulthood.

• Avoid fast foods, which are high in calories and fat. Home-cooked meals made with whole grains and lots of vegetables will help your family stay healthy.

• Watch the portions. Portion sizes of prepared foods are large and growing. Eat at home and try letting your children serve themselves. We tend to eat what’s put in front of us, but left to dish out their own food, children tend to take and eat smaller portions.

• Skip sugary soft drinks. These add empty calories in the form of high-fructose corn syrup, implicated in the rising trends in overweight, obesity, and type 2 diabetes.

• Keep kids active and limit screen time—including television, movies, and computers.

Healthcare professionals who work with children agree that these rates need to come down before we can breathe a sigh of relief. Said Cynthia Ogden, PhD, the study’s lead author and an epidemiologist at the National Center for Health Statistics, “It doesn’t mean we’ve solved it, but maybe there is some opportunity for some optimism here.”

(JAMA 2008;299:2401–5)

Healthnotes Newswire (June 12, 2008)—As the summer solstice approaches, many of us notice how much long, sunny days can lift the mood. New research suggests there may be a physiological basis for this phenomenon. A recent study found that people with minor or major depression had lower vitamin D levels than people without depression.

The study, published in the Archives of General Psychiatry, was conducted in the high-latitude country of the Netherlands (where sun exposure is limited) and included people age 65 and older. Vitamin D levels in 169 people with minor depression and 26 people with major depression were compared with those from 1,087 people without depression.

Vitamin D levels were 14% lower in the people with major and minor depression compared with nondepressed people. Levels of parathyroid hormone, the hormone that helps regulate calcium levels in the body, was 5% higher in people with minor depression and 33% higher in people with major depression. When vitamin D levels are low, parathyroid hormone levels tend to rise, and high levels of this hormone have been linked to depression in the past.

D is for daylight

Vitamin D, produced through a chemical reaction that begins in sun-exposed skin cells, plays a critical role in calcium metabolism by increasing the absorption of dietary calcium and decreasing the amount of calcium lost through urine. Long known to be necessary for healthy teeth and bones, recent evidence has pointed toward its importance in preventing depression and some cancers.

Older people tend to spend less time outside than younger people, and many don’t get adequate sunshine, making them more susceptible to vitamin D insufficiency and deficiency. In the current study, almost 39% of men and 57% of women had levels of vitamin D that are considered insufficient, which means they were low but not low enough to be called deficient. The rate of depression in older people, estimated to be about 13%, is higher than in younger people.

Easy does it

“The dilemma is that sun exposure without sunscreen, which is necessary for vitamin D production, increases the risk of skin cancer,” commented Dr. Julianne Forbes, a naturopathic doctor who practices in Maine.((Same comment as on other.)) “Be sensible—cover up or use sunscreen if you plan to be in the sun for an extended period, but don’t be afraid to head out for a short walk or get short bursts of sun exposure over the course of an ordinary day.”

People can take several steps to prevent depression:

• Stay active—There is a wealth of research demonstrating a link between inactivity and depression.

• Avoid too much alcohol, which is a natural depressant.

• Eat foods rich in folic acid and vitamin B12, especially if you’re an older adult. Deficiencies in both of these vitamins are more common in seniors and are linked with depression.

• Get a little sunshine when possible, and consider supplementing with 1,000 IU of vitamin D per day, especially in the winter and if you live in a northern latitude.

(Arch Gen Psychiatry 2008;65:508–12)

Healthnotes Newswire (May 29, 2008)—The President’s Council on Physical Fitness and Sport recently released a fitness test for people over age 18. The test helps estimate aerobic fitness level, muscle strength and endurance, flexibility, and body composition.

Better overall physical fitness helps lower the risk of cardiovascular disease, diabetes, high blood pressure, stroke, and certain cancers. It can also improve mood and help avoid accidents and muscle strain due to underused and inflexible muscle groups.

The new President’s Challenge and Adult Fitness Test was created to help people understand their own fitness level and make positive gains in physical fitness. The test is available as a downloadable booklet at www.adultfitnesstest.org/resources/testbooklet.pdf; individual results can be entered and evaluated online.

Each test section is followed by a “FITT” box which stands for Frequency—how often the exercise is performed; I—the intensity at which the exercise is carried out; T—time, or how long the session lasts; and T—type of exercise being performed. These boxes help users customize their fitness goals.

Aerobic Fitness

To test aerobic, or cardiovascular, fitness, choose a 1-mile walk or a 1.5-mile run. For the walk, after a brief warm up, have a partner time you walking at a brisk pace for one mile, and take your pulse immediately after finishing. For the running option, warm up with a light jog. Then, having a partner time you, run as fast as possible for 1.5 miles. Only attempt the run if you currently run for at least 20 minutes three or more times per week.

FITT tips

Frequency: Depending on the level of intensity, exercise three to five days per week.

Intensity: Moderate-intensity exercise is a brisk walk; vigorous activity is running.

Time: For moderate activity, do at least 30 minutes per session; vigorous activity should last for 20 to 30 minutes.

Type: Examples are walking, running, dancing, cycling, and swimming.

Muscular Strength and Endurance

These tests assess basic muscle strength required to carry out household or work-related tasks. Do half sit-ups by lying face-up on a rug or mat with knees bent at a right angle and feet flat on the floor. With palms flat on the floor, sit up and slide hands forward 3.5 inches (mark distance with masking tape on the working surface before starting). Having a partner time you, do as many sit-ups as you can in one minute. Then do push-ups with legs extended (men) or with knees touching the floor (women). Do as many push-ups as you can and record the number.

FITT tips

Frequency: Do muscular strength and endurance exercises on at least three days per week.

Intensity: Vary the intensity during the workout.

Time: Gradually increase the number of half sit-ups and push-ups until you can do three sets of 25 half sit-ups and three sets of 10 to20 push-ups.

Type: Master the test movements and then add other equipment (balance balls, weights, or elastic tubing).

Flexibility

These tests assess the range of motion of muscles needed to walk, lift, and step normally. Sitting on the floor, place a yardstick between the legs with feet about a foot apart. Place a piece of tape across the yardstick at the 15-inch mark. With fingers on the yardstick, slowly reach forward as far as possible. Record to the nearest inch that your fingertips can reach.

FITT tips

Frequency: Do flexibility exercises at least three days per week.

Intensity: Stretch to the point of tension, never to pain.

Time: Hold each stretch for 20 to 30 seconds, repeating three times.

Type: Begin with static stretches, gradually adding dynamic (moving) stretches. Try learning a practice that includes flexibility exercises, such as yoga and Pilates.

Body Composition

Body mass index (BMI) and waist circumference can be measured to estimate disease risk. To calculate BMI, weigh yourself and have a partner measure your height with shoes off. Wrap a flexible tape measure around your abdomen just above the hip bones; measure and record. Determine your BMI using the booklet’s chart.

A normal BMI is between 18.5 and 24.9; overweight is between 25 and 29.9; obese is greater than 30.

If you are overweight or obese, you can improve your BMI and waist circumference by making sure that you burn more calories than you eat. In order to lose weight, emphasize whole grains, fiber, fruits and vegetables; limit processed and high-carb, high-fat foods, and work in 60 to 90 minutes of daily moderate intensity exercise.

(www.adultfitnesstest.org/adultFitnesstestLanding.aspx; accessed 26 May 2008.)

Healthnotes Newswire (May 29, 2008)—If you want to help your kids do better in school, you can start by providing them with healthy food. A new study has found that a high-quality diet is linked to a higher level of academic performance in schoolchildren.

The researchers surveyed 5,200 fifth-graders and their parents for the study, published in the Journal of School Health, and used the information to calculate a score for each child’s diet that represented nutrient content; food variety; balance of protein, fat, and carbohydrate; and the amount of saturated fat, salt, and junk food eaten. Academic performance was measured using a standardized reading and writing test.

Children who had the highest diet quality scores—and therefore the healthy diets—were 41% less likely to fail the literacy test than children with the lowest diet quality scores, which indicated poor diets. Variety and adequate nutrition were linked with academic performance, and children who ate more fruits and vegetables and fewer calories from fat did better on the test.

“Dietary adequacy and variety were the specific factors found to positively influence academic performance, highlighting the value of eating a diverse array of foods in order to reach recommended levels of intake for nutrients and foods,” said study coauthor, Dr. Paul Veugelers, at the School of Public Health, University of Alberta, Canada.

Previous research showing that eating a healthy breakfast can help children do better in school influenced the widespread implementation of school breakfast programs. Other studies have found that being overweight or obese has a negative influence on academic performance, suggesting that school programs emphasizing both healthy eating and physical exercise might have the best effect on raising achievement in school.

Tips to build your kids’ brainpower

Parents can take the following steps to improve their children’s likelihood of doing well in school:

• Make sure your children get to bed on time and get plenty of sleep.

• Start them out with a healthy breakfast, including whole grains and fruits.

• Pack healthy foods to take to school, including whole grain bread for sandwiches, vegetables, fruits, and nuts and seeds.

• Make dinner a family affair and keep it wholesome and varied, introducing new foods to kids on a regular basis.

• Turn off the television, computer, and video games and encourage your kids to be active.

Establishing good habits early in life will help your children to be successful now and in the future.

(J Sch Health 2008;78:209–15)

Healthnotes Newswire (May 8, 2008)—Omega-3 fatty acids from fish offer many benefits to developing babies during pregnancy. But do contaminants such as mercury make eating fish unsafe? According to a new study in the American Journal of Epidemiology, pregnant women who eat two or more servings of fish each week may be providing their children with important nutrients that aid in cognitive development. Choosing fish with low mercury content appears to be even more beneficial.

Fish contains important nutrients such as omega-3 fatty acids and is generally high in protein and low in saturated fat. Many studies have suggested that eating fish several times per week is good for heart health and for preventing diseases such as a cancer. But fish may also contain contaminants such as unhealthy mercury. As a result, the Environmental Protection Agency (EPA) recommends that pregnant women not eat more than two 6-ounce servings of fish per week.

The authors of this new study were concerned that if pregnant women limit fish intake, their babies may not receive enough omega-3 fatty acids, which could impair the brain’s cognitive development. To determine the risks and benefits of eating fish during pregnancy on child development, the authors looked at dietary habits of 341 pregnant women, their mercury levels during pregnancy, and the cognitive development of their children at age three.

Women who ate the most fish (more than two servings per week) had higher mercury levels. However, higher fish intake was associated with better cognitive test performance, regardless of mercury levels. Compared with the children of women who never ate fish, the children of women who ate more than two servings of fish per week but had the lowest mercury levels had better cognitive test performance.

“Recommendations for fish consumption during pregnancy should take into account the nutritional benefits of fish as well as the potential harms from mercury exposure,” said Emily Oken, MD, and her colleagues from Harvard Medical School and Harvard School of Public Health. The authors believe that if mercury contamination were not present, the cognitive benefits of eating fish would be greater. They point out that other contaminants such as polychlorinated biphenyls may also be present in fish and were not measured in this study but may have an adverse effect on child development.

Best bets for eating fish during pregnancy

For women who are or may become pregnant, choose fish that are likely to have lower mercury levels such as:

• Canned light tuna

• Shrimp

• Salmon

• Pollock

• Catfish

The EPA points out that fish that is used for fish sticks or fast food sandwiches tend to be fish that are lower in mercury content. Fish best avoided by pregnant women include shark, swordfish, king mackerel, and tilefish.

(Am J Epidemiol 2008 Mar 28)

(What You Need to Know About Mercury in Fish and Shellfish. Environmental Protection Agency. www.epa.gov/waterscience/fish/advice/)

Healthnotes Newswire (May 1, 2008)—Weight-loss diets can lead to a modest decrease in blood pressure among people with hypertension, confirms a recent review published in the Archives of Internal Medicine.

Modern weight-loss programs range from dietary changes, weight-loss pills, and surgical procedures. A recent review looked at seven studies that compared a weight-loss diet with usual care among 1,632 people who had high blood pressure. After 12 months, the people on the weight-loss diet saw a decrease in their systolic blood pressure (the top number of the blood pressure reading). A weight loss of 4 kg (about 9 pounds) was necessary to achieve a reduction of 6 mm Hg in systolic blood pressure.

High blood pressure and being overweight are both major risk factors for developing cardiovascular problems such as heart disease and stroke. Maintaining a healthy weight and lowering blood pressure can decrease cardiovascular disease risk.

“High blood pressure is estimated to lead to more than 7 million deaths each year, approximately 13% of the total deaths worldwide,” said lead author of the review, Karl Horvath, MD, and his colleagues from the Department of Internal Medicine, Medical University of Graz, in Austria. “Lowering blood pressure levels in hypertensive patients has been shown to be a very effective means of reducing patients’ cardiovascular risk, with a significant reduction in cardiovascular morbidity and mortality.”

How to lower your risk

Being overweight and having high blood pressure are two independent risk factors for cardiovascular disease. But when you have both conditions, the risk is even greater. The following lifestyle tips may help you lower your risk of cardiovascular disease by maintaining a healthy weight and keeping blood pressure down:

• If you’re overweight, lose weight to maintain your optimal weight, which can be determined based on your height, body composition, and level of physical activity.

• Regular exercise is important for keeping weight down and for lowering blood pressure. Adults should engage in moderate physical activity for one hour each day.

• Follow a healthy diet that is low in cholesterol, added salt, and total fat, and emphasizes fruits, vegetables, and whole grains.

• Don’t smoke. Smoking is a risk factor for cardiovascular disease and other serious diseases.

If you are overweight or have high blood pressure, see a doctor to determine your optimal weight and to discuss other lifestyle changes that can help lower your risk for cardiovascular disease.

(Arch Intern Med 2008;168:571–80)