Apathy and Global warming

Increased knowledge about global warming leads to apathy, study shows

The more you know the less you care - at least that seems to be the case with global warming. A telephone survey of 1,093 Americans by two Texas A&M University political scientists and a former colleague indicates that trend, as explained in their recent article in the peer-reviewed journal Risk Analysis.

"More informed respondents both feel less personally responsible for global warming, and also show less concern for global warming," states the article, titled "Personal Efficacy, the Information Environment, and Attitudes toward Global Warming and Climate Change in the USA."

The study showed high levels of confidence in scientists among Americans led to a decreased sense of responsibility for global warming.

The diminished concern and sense of responsibility flies in the face of awareness campaigns about climate change, such as in the movies An Inconvenient Truth and Ice Age: The Meltdown and in the mainstream media's escalating emphasis on the trend.

The research was conducted by Paul M. Kellstedt, a political science associate professor at Texas A&M; Arnold Vedlitz, Bob Bullock Chair in Government and Public Policy at Texas A&M's George Bush School of Government and Public Service; and Sammy Zahran, formerly of Texas A&M and now an assistant professor of sociology at Colorado State University.

Kellstedt says the findings were a bit unexpected. The focus of the study, he says, was not to measure how informed or how uninformed Americans are about global warming, but to understand why some individuals who are more or less informed about it showed more or less concern.

"In that sense, we didn't really have expectations about how aware or unaware people were of global warming," he says.

But, he adds, "The findings that the more informed respondents were less concerned about global warming, and that they felt less personally responsible for it, did surprise us. We expected just the opposite.

"The findings, while rather modest in magnitude - there are other variables we measured which had much larger effects on concern for global warming - were statistically quite robust, which is to say that they continued to appear regardless of how we modeled the data."

Measuring knowledge about global warming is a tricky business, Kellstedt adds.

"That's true of many other things we would like to measure in surveys, of course, especially things that might embarrass people (like ignorance) or that they might feel social pressure to avoid revealing (like prejudice)," he says.

"There are no industry standards, so to speak, for measuring knowledge about global warming. We opted for this straightforward measure and realize that other measures might produce different results."

Now, for better or worse, scientists have to deal with the public's abundant confidence in them. "But it cannot be comforting to the researchers in the scientific community that the more trust people have in them as scientists, the less concerned they are about their findings," the researchers conclude in their study.

Texas A&M University, March 28, 2008

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Smoking habits of 912 college students

Smoking Habits of College Freshmen

Studies show that smoking initiation typically occurs at age 15 or 16 and over a two- or three-year period gradually increases to daily smoking. Daily smokers continue to escalate their use of cigarettes over the next several years as they develop into chronic, heavily dependent smokers.

This study looked at the daily smoking habits of 912 college students at Purdue University during their freshman year to understand some of the factors that influence trajectories of smoking behavior and tobacco dependence. Students were assessed weekly over the course of the academic year using a web-based survey and provided monthly saliva samples for cotinine analysis. Rates of alcohol and marijuana use were also examined.

Results revealed several patterns of substance use. Heightened use of cigarettes, alcohol, and marijuana were observed during the earliest weeks of school, followed by steady rates of decline over the next several weeks, suggesting that many college freshmen initially experiment with substance use upon arriving on campus, but do not continue to use. Results also found a weekly pattern of smoking, with most cigarettes smoked on Fridays and Saturdays. This pattern was relative consistent across the academic year, with the exception of specific holidays when rates of use increased (i.e., Halloween and New Years Eve), and specific weeks when rates of use decreased (i.e., finals week, winter and spring break). Patterns of smoking and alcohol use were similar, especially for students with higher levels of use.

Among freshmen who had smoked very little prior to beginning college, findings revealed that their initial early-use episodes of smoking during college occurred within a social/party setting and that over 90% occurred when the person was with other people who were smoking. In addition, the majority (65%) of the first recorded early use of cigarettes occurred while the participant was drinking alcohol.

Title of Paper: "Smoking in College Freshmen: University Project of the Tobacco Etiology Research Network (UpTERN)." Lead author: Stephen T. Tiffany, University of Utah.

Health Matrix, Inc., December 04, 2007
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Potentially help for clinicians treat marijuana addiction

Marijuana withdrawal as bad as withdrawal from cigarettes

 
Study could potentially help clinicians treat marijuana addiction

Research by a group of scientists studying the effects of heavy marijuana use suggests that withdrawal from the use of marijuana is similar to what is experienced by people when they quit smoking cigarettes. Abstinence from each of these drugs appears to cause several common symptoms, such as irritability, anger and trouble sleeping - based on self reporting in a recent study of 12 heavy users of both marijuana and cigarettes.

"These results indicate that some marijuana users experience withdrawal effects when they try to quit, and that these effects should be considered by clinicians treating people with problems related to heavy marijuana use," says lead investigator in the study, Ryan Vandrey, Ph.D., of the Department of Psychiatry at the Johns Hopkins University School of Medicine.

Marijuana is the most widely used illicit drug in the United States. Admissions in substance abuse treatment facilities in which marijuana was the primary problem substance have more than doubled since the early 1990s and now rank similar to cocaine and heroin with respect to total number of yearly treatment episodes in the United States, says Vandrey.

He points out that a lack of data, until recently, has led to cannabis withdrawal symptoms not being characterized or included in medical reference literature such as the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, (DSM-IV) or the International Classification of Diseases, 10th edition (ICD-10).

Since the drafting of the DSM-IV in 1994, an increasing number of studies have surfaced suggesting that cannabis has significant withdrawal symptoms. What makes Vandrey's recent study unique is that it is the first study that compares marijuana withdrawal symptoms to withdrawal symptoms that are clinically recognized by the medical community - specifically the tobacco withdrawal syndrome.

"Since tobacco withdrawal symptoms are well documented and included in the DSM-IV and the IDC-10, we can infer from the results of this comparison that marijuana withdrawal is also clinically significant and should be included in these reference materials and considered as a target for improving treatment outcomes," says Vandrey.

Vandrey added that this is the first "controlled" comparison of the two withdrawal syndromes in that data was obtained using rigorous scientific methods - abstinence from drugs was confirmed objectively, procedures were identical during each abstinence period, and abstinence periods occurred in a random order. That tobacco and marijuana withdrawal symptoms were reported by the same participants, thus eliminating the likelihood that results reflect physiological differences between subjects, is also a strength of the study.

Interestingly, the study also revealed that half of the participants found it easier to abstain from both substances than it was to stop marijuana or tobacco individually, whereas the remaining half had the opposite response.

"Given the general consensus among clinicians that it is harder to quit more than one substance at the same time, these results suggest the need for more research on treatment planning for people who concurrently use more than one drug on a regular basis," says Vandrey.

Vandrey's study, which appears in the January issue of the journal Drug and Alcohol Dependence, followed six men and six women at the University of Vermont in Burlington and Wake Forest University School of Medicine in Winston-Salem, N.C., for a total of six weeks. All were over 18 (median age 28.2 years), used marijuana at least 25 days a month and smoked at least 10 cigarettes a day. None of the subjects intended to quit using either substance, did not use any other illicit drugs in the prior month, were not on any psychotropic medication, did not have a psychiatric disorder, and if female, were not pregnant.

For the first week, participants maintained their normal use of cigarettes and marijuana. For the remaining five weeks, they were randomly chosen to refrain from using either cigarettes, marijuana or both substances for five-day periods separated by nine-day periods of normal use. In order to confirm abstinence, patients were given daily quantitative urine toxicology tests of tobacco and marijuana metabolites.

Withdrawal symptoms were self reported on a daily basis Monday through Friday using a withdrawal symptom checklist that listed scores for aggression, anger, appetite change, depressed mood, irritability, anxiety/nervousness, restlessness, sleep difficulty, strange dreams and other, less common withdrawal symptoms. Patients also provided an overall score for discomfort they experienced during each abstinence period.

Results showed that overall withdrawal severity associated with marijuana alone and tobacco alone was of similar frequency and intensity. Sleep disturbance seemed to be more pronounced during marijuana abstinence, while some of the general mood effects (anxiety, anger) seemed to be greater during tobacco abstinence. In addition, six of the participants reported that quitting both marijuana and tobacco at the same time was more difficult than quitting either drug alone, whereas the remaining six found that it was easier to quit marijuana or cigarettes individually than it was to abstain from the two substances simultaneously.

Vandrey recognizes that the small sample size is a limitation in this study, but the results are consistent with other studies indicating that marijuana withdrawal effects are clinically important.

Johns Hopkins Medical Institutions, January 25, 2008
http://www.brightsurf.com/news/headlines/35548/Marijuana_withdrawal_as_bad_as_withdrawal_from_cigarettes.html

Diet in the origin of metabolic syndrome

Dietary Intake and the Development of the Metabolic Syndrome

The Atherosclerosis Risk in Communities Study

Pamela L. Lutsey, MPH; Lyn M. Steffen, PhD, MPH, RD; June Stevens, PhD, MS, RD
From the Division of Epidemiology and Community Health, University of Minnesota, School of Public Health, Minneapolis (P.L.L., L.M.S.), and Department of Nutrition, University of North Carolina, Chapel Hill (J.S.).

Background— The role of diet in the origin of metabolic syndrome (MetSyn) is not well understood; thus, we sought to evaluate the relationship between incident MetSyn and dietary intake using prospective data from 9514 participants (age, 45 to 64 years) enrolled in the Atherosclerosis Risk in Communities (ARIC) study.

Methods and Results— Dietary intake was assessed at baseline via a 66-item food frequency questionnaire. We used principal-components analysis to derive "Western" and "prudent" dietary patterns from 32 food groups and evaluated 10 food groups used in previous studies of the ARIC cohort. MetSyn was defined by American Heart Association guidelines. Proportional-hazards regression was used. Over 9 years of follow-up, 3782 incident cases of MetSyn were identified. After adjustment for demographic factors, smoking, physical activity, and energy intake, consumption of a Western dietary pattern (Ptrend=0.03) was adversely associated with incident MetSyn. After further adjustment for intake of meat, dairy, fruits and vegetables, refined grains, and whole grains, analysis of individual food groups revealed that meat (Ptrend<0.001), fried foods (Ptrend=0.02), and diet soda (Ptrend=< 0.001) also were adversely associated with incident MetSyn, whereas dairy consumption (Ptrend=0.006) was beneficial. No associations were observed between incident MetSyn and a prudent dietary pattern or intakes of whole grains, refined grains, fruits and vegetables, nuts, coffee, or sweetened beverages.

Conclusions— These prospective findings suggest that consumption of a Western dietary pattern, meat, and fried foods promotes the incidence of MetSyn, whereas dairy consumption provides some protection. The diet soda association was not hypothesized and deserves further study.

Circulation. 2008;117:754-761.
© 2008 American Heart Association, Inc.

New dietary guidelines based on fructose

Too much fructose could leave dieters sugar shocked

In fact, many dieters may actually be cutting out the wrong foods altogether, according to findings from a UF paper published recently in the European Journal of Nutrition. Dieters should focus on limiting the amount of fructose they eat instead of cutting out starchy foods such as bread, rice and potatoes, report the researchers, who propose using new dietary guidelines based on fructose to gauge how healthy foods are.

"There's a fair amount of evidence that starch-based foods don't cause weight gain like sugar-based foods and don't cause the metabolic syndrome like sugar-based foods," said Dr. Richard Johnson, the senior author of the report, which reviewed several recent studies on fructose and obesity. "Potatoes, pasta, rice may be relatively safe compared to table sugar. A fructose index may be a better way to assess the risk of carbohydrates related to obesity."

Many diets -- including the low-carb variety -- are based on the glycemic index, which measures how foods affect blood glucose levels. Because starches convert to glucose in the body, these diets tend to limit foods such as rice and potatoes.

While table sugar is composed of both glucose and fructose, fructose seems to be the more dangerous part of the equation, UF researchers say. Eating too much fructose causes uric acid levels to spike, which can block the ability of insulin to regulate how body cells use and store sugar and other nutrients for energy, leading to obesity, metabolic syndrome and type 2 diabetes, said Johnson, the division chief of nephrology and the J. Robert Cade professor of nephrology in the UF College of Medicine. UF researchers first detailed the role of uric acid on insulin resistance and obesity in a 2005 study in rats.

"Certainly we don't think fructose is the only cause of the obesity epidemic," Johnson said. "Too many calories, too much junk food and too much high-fat food are also part of the problem. But we think that fructose may have the unique ability to induce insulin resistance and features of the metabolic syndrome that other foods don't do so easily."

About 33 percent of adults in the United States are overweight or obese, according to the Centers for Disease Control and Prevention.

Studies at other institutions have shown that following a low-glycemic diet can reduce the risk for diabetes and heart disease, but the effect could occur because these dieters often are unintentionally limiting fructose as well by cutting out table sugar, Johnson said.

"Processed foods have a lot of sugar," Johnson said. "Probably the biggest source (of fructose) is soft drinks."

Johnson also noted that, in relation to obesity, the type of fructose found in foods doesn't seem to matter. For example, the fructose in an apple is as problematic as the high-fructose corn syrup in soda. The apple is much more nutritious and contains far less sugar, but eating multiple apples in one sitting could send the body over the fructose edge.

In another UF paper, published in October in the American Journal of Clinical Nutrition, Johnson and his collaborators tracked the rise of obesity and diseases such as diabetes with the rise in sugar consumption. The rates of hypertension, diabetes and childhood obesity have risen steadily over the years.

"One of the things we have learned is this whole epidemic brought on by Western diet and culture tracks back to the 1800s," he said. "Nowadays, fructose and high-fructose corn syrup are in everything."

Aside from soft drinks, fructose can be found in pastries, ketchup, fruits, table sugar and jellies and in many processed foods, including the sugar substitute high fructose corn syrup.

UF researchers plan to test a low-fructose diet in patients soon, Johnson said.

Kathleen Melanson, an associate professor of nutrition and food sciences at the University of Rhode Island, said establishing a fructose index for foods could "be an appropriate approach," depending on how foods are classified. It makes sense to limit foods prepared with high fructose corn syrup and table sugar, which often contain empty calories, but fruits are an important part of a person's diet, she added.

"One concern I have always had with the glycemic index is the potential to pigeonhole foods as good or bad," she said. (December 13, 2007)

University of Florida
http://www.brightsurf.com/news/

Risk of mortality in short and long sleep

Both short and long sleep is associated with increased mortality

The first study to assess the stability of three aspects of sleep behavior in relation to long-term mortality finds an increased risk of mortality in short sleep, long sleep and frequent use of medications, according to a study published in the October 1 issue of the journal SLEEP. (October 01, 2007)

The study, authored by Christer Hublin, MD, PhD, of the Finnish Institute of Occupational Health in Helsinki, Finland, focused on the responses of 21,268 twins to questionnaires administered in 1975 and 1981. The subjects were categorized as follows:

* Short sleepers (less than seven hours)
* Average sleepers
* Long sleepers (more than eight hours)
* Sleeping well
* Sleeping fairly well
* Sleeping fairly poorly/poorly
* Not users of hypnotics and/or tranquilizers
* Infrequent users of hypnotics and/or tranquilizers
* Frequent users of hypnotics and/or tranquilizers

According to the results, significantly increased risk of mortality was observed both for short sleep in men (+26 percent) and in women (+ 21 percent), and for long sleep (+24 percent and +17 percent respectively), and also frequent use of hypnotics/tranquilizers (+31 percent in men and +39 percent in women). The effect of sleep on mortality varied between age groups, with strongest effects in young men.

Between 1975 and 1981, sleep length and sleep quality changed in about one-third of the population. In men, there was a significant increase for stable short (1.34) and stable long (1.29) sleep for natural deaths, and for external causes in stable short sleepers (1.62).

"This study found an association between sleep behavior (most notably in sleep length) and mortality. The exact mechanisms remain unclear, and they should be assessed in experimental settings and other longitudinal studies. Morbidity and functional limitations as less severe outcomes should also be considered. Although the effect of sleep on mortality is fairly modest compared to, for example, smoking or components of the metabolic syndrome, it is still of considerable significance as it is associated with several common disorders such as cardiovascular diseases and diabetes. Optimizing sleep - in addition to disorder-specific treatment - could improve prognosis in these disorders. Our results add evidence to the association between sleep and health outcomes," said Dr. Hublin.

Those who think they might have a sleep disorder are urged to discuss their problem with their primary care physician, who will issue a referral to a sleep specialist.

American Academy of Sleep Medicine
http://www.brightsurf.com/news/headlines/33274/Both_short_and_long_sleep_is_associated_with_increased_mortality.html

Christmas Blessings for all!

Christmas Blessings for all!

Obesity and IQ

Study shows link between morbid obesity, low IQ in toddlers

September 01, 2006 - GAINESVILLE, Fla.-University of Florida researchers have discovered a link between morbid obesity in toddlers and lower IQ scores, cognitive delays and brain lesions similar to those seen in Alzheimer's disease patients, a new study shows.

Although the cause of these cognitive impairments is still unknown, UF researchers suspect the metabolic disturbances obesity causes could be taking a toll on young brains, which are still developing and not fully protected, they write in an article published in the Journal of Pediatrics this month.

"It's well-known that obesity is associated with a number of other medical problems, such as diabetes, hypertension and elevated cholesterol," said Daniel J. Driscoll, M.D., Ph.D., a UF professor of pediatrics and molecular genetics and microbiology in the College of Medicine and the lead author of the study. "Now, we're postulating that early-onset morbid obesity and these metabolic, biochemical problems can also lead to cognitive impairment."

Researchers compared 18 children and adults with early-onset morbid obesity, which means they weighed at least 150 percent of their ideal body weight before they were 4, with 19 children and adults with Prader-Willi syndrome, and with 24 of their normal-weight siblings. Researchers chose lean siblings as a control group "because they share a socioeconomic group and genetic background," Driscoll said.

The links between cognitive impairments and Prader-Willi syndrome, a genetic disorder that causes people to eat nonstop and become morbidly obese at a very young age if not supervised, are well-established. But researchers were surprised to find that children and adults who had become obese as toddlers for no known genetic reason fared almost as poorly on IQ and achievement tests as Prader-Willi patients. Prader-Willi patients had an average IQ of 63 and patients with early-onset morbid obesity had an average of 78. The control group of siblings had an average IQ of 106, which falls within the range of what is considered normal intelligence.

"It was surprising to find that they had an average IQ score of 78, whereas their control siblings were 106," Driscoll said. "We feel this may be another complication of obesity that may not be reversible, so it's very important to watch what children eat even from a very young age. It's not just setting them up for problems later on, it could affect their learning potential now."

While performing head MRI scans of subjects, researchers also discovered white-matter lesions on the brains of many of the Prader-Willi and early-onset morbidly obese patients. White-matter lesions are typically found on the brains of adults who have developed Alzheimer's disease or in children with untreated phenylketonuria, the researchers wrote.

These lesions could be affecting food-seeking centers of the brain, causing the children to feel hungrier. But they are most likely a result of metabolic changes that damage the young, developing brain, Driscoll said.

More studies are needed to understand what is causing these cognitive impairments, said Merlin Butler, M.D., Ph.D., a professor of pediatrics at the University of Missouri and chief of genetics and molecular medicine at Children's Mercy Hospital and Clinics.

"This could be a really significant observation," Butler said. "It's an interesting concept. It's a whole new area of investigation."

The findings are preliminary and additional studies are planned, Driscoll said. Jennifer Miller, M.D., a UF assistant professor of pediatric endocrinology and the first author of the study, and other researchers from UF, All Children's Hospital in St. Petersburg, Fla., and Baylor College of Medicine also took part in the research.

Although there was no known genetic cause for early-onset morbid obesity in the subjects studied, Driscoll said there are likely genetic and hormonal factors at play that researchers have yet to discover, particularly since these children are becoming obese at a time when their parents still control what they eat. The researchers studied several sets of fraternal twins where one twin was lean and the other morbidly obese, yet their parents reported that each ate the same amount of food. In one case, the obese child actually ate less, Driscoll said.

Driscoll is also careful to point out that adults or children who become obese later in childhood are not at-risk for these cognitive impairments because their brains are sufficiently developed to fend off damage from obesity.

"We're all mindful that this is an obese society," he said. "We all need to be more careful with respect to what we eat, but in particular, that's very important for children under 4."

University of Florida
http://www.brightsurf.com/news/

Children of HIV-Infected Parents

Children of HIV-Infected Parents: Custody Status in a Nationally Representative Sample

Burton O. Cowgill, MPH (a,b), Megan K. Beckett, PhD ( c), Rosalie Corona, PhD (a,d), Marc N. Elliott, PhD (c), Annie J. Zhou, MS (c) and Mark A. Schuster, MD, PhD (a,b,c)
a) Department of Pediatrics, Mattel Children's Hospital, David Geffen School of Medicine; b) Department of Health Services, School of Public Health, University of California, Los Angeles, California; d) Department of Psychology, Virginia Commonwealth University, Richmond, Virginia; c) Rand, Santa Monica, California

OBJECTIVE. The purpose of this work was to determine the rates and predictors of custody status for children of HIV-infected parents.

PARTICIPANTS AND METHODS. Data came from interviews of 538 parents with 1017 children (0–17 years old) from a nationally representative sample of HIV-infected adults receiving health care in the United States. Outcomes were collected at 2 survey waves and included child custody status and who, other than the HIV-infected parent, had custody of the child. Child custody status was categorized as (1) in custody of HIV-infected parent at both survey waves, (2) infected parent had custody at first survey wave but not second survey wave, (3) not in custody of infected parent at either survey wave, and (4) infected parent gained custody between survey waves. Potential custodians included (1) other biological parent, (2) state, foster, or adoptive parent, (3) grandparent, and (4) relative, friend, nonbiological parent, or other. Multinomial logistic regression modeled both outcomes.

RESULTS. Forty-seven percent of the children were in the custody of their HIV-infected parent at both survey waves, 4% were in the parent's custody at the first but not second survey wave, 42% were not in custody at either survey wave, and the parent of 7% gained custody between survey waves. Parents cited drug use (62%) and financial hardship (27%) as reasons for losing custody. Children of HIV-infected fathers, older parents, parents living without other adults, parents with low CD4 counts, drug-using parents, and parents with 1 hospital stay were less likely to be in their parent's custody at either survey wave.

CONCLUSIONS. More than half of the children were not in custody of their HIV-infected parent at some time during the study period. Pediatricians and others taking care of children with HIV-infected parents may be able to offer counseling or referrals to assist parents with child custody issues.

PEDIATRICS Vol. 120 No. 3 September 2007, pp. e494-e503
© 2007 American Academy of Pediatrics.

Black and White Patients With Stroke

Differences in Stroke Subtypes Between Black and White Patients With Stroke

Hugh S. Markus, FRCP; Usman Khan, MRCP; Jonathan Birns, MRCP; Andrew Evans, MRCP; Lalit Kalra, FRCP; Anthony G. Rudd, FRCP; Charles D.A. Wolfe, FRCP; Paula Jerrard-Dunne, MRCP
From the Centre for Clinical Neuroscience, St George’s University of London (H.S.M., U.K., P.J.-D.); Departments of Stroke Medicine and Health and Social Care Research, Kings College London (J.B., A.E., L.K.); and Guy’s and St Thomas’ NHS Foundation Trust (A.G.R., C.D.A.W.), London, UK

Determining whether the distribution of stroke subtypes differs between ethnic groups is important in understanding the mechanisms of the increased stroke incidence in black patients.

In this study, 600 black and 600 white patients with stroke were prospectively and consecutively recruited to determine differences in stroke subtypes. The pathophysiological Trial of Org 10172 (TOAST) classification was used and compared with a clinical (Oxfordshire Community Stroke Project) subtype classification. Stroke subtypes were determined by one investigator by review of original imaging.

Black patients with stroke were significantly younger and had higher prevalences of hypertension, diabetes, and obesity. They were less likely to be smokers and had lower prevalences of myocardial infarction and atrial fibrillation. In the black patients, 33% of stroke was due to cerebral small vessel disease compared with 14% in the white stroke cohort.

The black stroke cohort had less large vessel atherosclerosis (odds ratio, 0.49; 95% confidence interval, 0.29 to 0.82; P=0.007) and cardioembolic disease (odds ratio, 0.54; 95% confidence interval, 0.37 to 0.80; P=0.002). Using a classification based on clinical syndrome alone gave a higher estimate of the frequency of small vessel disease stroke, particularly in white patients.

A relative excess of small vessel disease was observed in black patients with stroke compared with an excess of extracranial atherosclerosis and cardioembolic stroke in white patients with stroke that was independent of conventional risk factors and social class. Whether these excesses are due to differences in genetic susceptibility or as-yet undetermined differences in environmental risk remains to be determined.

Circulation. 2007;116:2157-2164

http://circ.ahajournals.org/cgi/content/abstract/116/19/2157

World Vegan Day

                                                         Vegan Children

Reed Mangels, PhD, RD and Sandra Hood, BSc (Hons), SRD

The number of vegans in the UK today is estimated at 0.5% but we do not know how many of these are children. In the US, a poll commissioned by the Vegetarian Resource Group in the year 2000 found that about 0.5% of 6 to 17-year-olds were vegan and did not eat meat, fish, poultry, dairy products or eggs.

Growth of Vegan Children
If a child's diet contains enough calories, normal growth and development can be expected and studies of vegan children have shown that their caloric intake is close to recommended levels and similar to intakes of non-vegan children of the same age.

Vegan children in the UK and the US have been found to be slightly shorter and lighter in weight than average but appeared to be growing at a normal rate. Children need a lot of energy in relation to their size and although healthy eating should be encouraged it is important that the diet be energy dense. Including foods such as vegetable oils, avocados, seeds, nut butters and pulses can provide both calories and nutrients. Dried fruits are also a concentrated source of energy and are an attractive food for many children. Children from an early age should be encouraged to brush teeth after eating dried fruits and other sweet foods to prevent tooth decay.

What Foods are Popular with Vegan Children?

Many vegan children like:

• Bagels with nut butter or hummous
• Bean burritos or tacos
• Fresh or dried fruit
• Mashed potatoes
• Oven-cooked chips
• Pancakes and waffles
• Pasta with tomato sauce
• Peanut butter and yeast extract sandwiches
• Pizza without cheese, topped with vegetables and pulses, tofu, or fake meat
• Raw vegetables with dips
• Shakes made with soya milk and fruit
• Spaghetti with tomato sauce
• Tofu/vegetarian dogs
• Veggie burgers
  

http://www.vegansociety.com/

"Rabbit food" is nutritious for people

Study details nutritional value of salad

Go ahead and indulge at the salad bar. "Rabbit food" is nutritious for people, too.

A new UCLA/Louisiana State University study of dietary data on more than 17,500 men and women finds consumption of salad and raw vegetables correlates with higher concentrations of folic acid, vitamins C and E, lycopene and alpha and beta carotene in the bloodstream.
Published in the September edition of the peer-reviewed Journal of the American Dietetic Association, the study also suggests that each serving of salad consumed correlates with a 165 percent higher likelihood of meeting recommended dietary allowances (RDA) for vitamin C in women and 119 percent greater likelihood in men.

The study is the first to examine the relationship between normal salad consumption and nutrient levels in the bloodstream, and also the first to examine the dietary adequacy of salad consumption using the latest nutritional guidelines of the Food and Nutrition Board of the National Academy of Sciences.
The findings blunt concerns about the human body's ability to absorb nutrients from raw vegetables, as well as concern that the structure and characteristics of some plants undercut nutritional value.

"The consistently higher levels of certain nutrients in the bloodstream of salad-eaters suggest these important components of a healthy diet are being well-absorbed from salad," said Lenore Arab, visiting professor of epidemiology at the UCLA School of Public Health and co-author of the study with L. Joseph Su, assistant professor at the LSU School of Public Health.

"The findings endorse consumption of salad and raw vegetables as an effective strategy for increasing intake of important nutrients. Unfortunately, we also found daily salad consumption is not the norm in any group, and is even less prevalent among African Americans," Arab said.

"We have so many food choices in this county. Increasing vegetable consumption is a wise strategy for composing a nutrient rich diet," she added. "In fact, our findings suggest that eating just one serving of salad or raw vegetables per day significantly boosts the likelihood of meeting the recommended daily intake of certain nutrients."

The study examined the relationship between reported salad consumption and blood serum nutrient levels, as well as dietary adequacy in pre- and post-menopausal women and men of comparable ages. The research team analyzed dietary data from 9,406 women and 8,282 men ages 18 to 45 and 55-plus contained in the National Health and Nutrition Examination Survey III conducted in 1988-94.

Salad consumption was based on reported intake of salad, raw vegetables and salad dressing. Laboratory measurements determined levels of nutrients in blood serum. Associations between salad consumption and serum nutrient levels were determined using statistical regression models. Measurements were adjusted to account for age, exercise, anti-cholesterol medication, smoking and other variables.

University of California-Los Angeles
http://www.brightsurf.com/news/

Sex hormone concentrations in postmenopausa

Dietary patterns, the Alternate Healthy Eating Index and plasma sex hormone concentrations in postmenopausal women

Teresa T. Fung (1, 2), Frank B. Hu (2, 3, 4), Robert L. Barbieri (5), Walter C. Willett (2, 3, 4), Susan E. Hankinson (3, 4)
1) Department of Nutrition, Simmons College, Boston, MA; 2) Department of Nutrition, Harvard School of Public Health, Boston, MA; 3) Department of Epidemiology, Harvard School of Public Health, Boston, MA; 4) Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; 5) Obstetrics Gynecology and Reproductive Biology, Brigham and Women's Hospital, Boston, MA

To evaluate the association between overall diet and sex hormones concentrations, we collected blood from 578 postmenopausal women ages 43 and 69 years in 1989 or 1990. Food intake was measured in 1990 via a food frequency questionnaire. We calculated the Alternate Healthy Eating Index (AHEI), and dietary patterns were identified by factor analysis. The cross-sectional association between diet and estrogens, sex hormone binding globulin (SHBG) were evaluated with linear regression and adjusted for energy and other potential confounders. We found a higher AHEI score was associated with lower concentrations of estradiol, free estradiol, and higher concentrations of SHBG. The prudent pattern, with higher intakes of fruits, vegetables, and whole grains, was not associated with any sex hormones. The Western pattern, which represents higher intakes of red and processed meats, refined grains, sweets and desserts, was associated with a higher level of estradiol and lower concentrations of SHBG. Further adjustment for BMI attenuated these results except for free estradiol (5th vs. 1st quintile = 0.09 vs. 0.11 pg/mL, p for trend = 0.03). In addition, the AHEI was inversely associated with estradiol among those with BMI > 25, and Western pattern with SHBG among those with BMI < 25.
In conclusion, we observed inverse associations between the AHEI score and several estrogens, and it was positively associated with plasma levels of SHBG. In contrast, the Western pattern was positively associated with estrogen levels and inversely with SHBG. However, these associations appeared to be largely accounted for by BMI.
Keywords: diet • nutrition • hormones • estrogen • postmenopause

International Journal of Cancer
Volume 121, Issue 3, Pages 803 - 809 (15 August 2007)
© 2007 Wiley-Liss, Inc.

Donation after cardiac death

Trends in Pediatric Organ Donation After Cardiac Death

Robert Mazor, MD and Harris P. Baden, MD
Division of Critical Care Medicine, Children's Hospital and Regional Medical Center, Seattle, Washington

OBJECTIVE. Organ donation after cardiac death is viewed as one way of partially closing the current gap between organ supply and demand. There are no published guidelines for organ donation after cardiac death specific to the pediatric population. The objective of this study was to examine the cumulative pediatric donation-after-cardiac-death experience to set the context for the development and sharing of best-practice guidelines.

PATIENTS AND METHODS. This was a retrospective, descriptive study that used data from the Organ Procurement and Transplantation Network/United Network for Organ Sharing database from 1993 to 2005. Organ data from all donors after cardiac death who were <18 years of age were analyzed. The list of donor medical centers was then cross-referenced with the member list from the National Association of Children's Hospitals and Related Institutions.

RESULTS. There were 683 organs from donation-after-cardiac-death donors <18 years of age. Of those, <5% were used for pediatric recipients. In comparison, 20% of non–donation-after-cardiac-death organs from pediatric donors were used for pediatric recipients. The vast majority of donation-after-cardiac-death organs donated were kidneys and livers. More than 50% of medical centers that had a pediatric organ-donation-after-cardiac-death donor had just 1. The medical center with the largest pediatric organ-donation-after-cardiac-death donation experience had 14 donors. Forty-three percent of medical centers that had 1 pediatric donation-after-cardiac-death donor were members of the National Association of Children's Hospitals and Related Institutions. Fifty-six percent of all of the pediatric donation-after-cardiac-death organs were donated from the National Association of Children's Hospitals and Related Institution member centers.

CONCLUSIONS. Data regarding the use of pediatric donation-after-cardiac-death organs for pediatric recipients remain sparse. Few medical centers have had enough donation-after-cardiac-death donor experience to report a tried-and-true approach. We advocate for comprehensive collection and reporting of outcome data for all-aged recipients of pediatric donation-after-cardiac-death organs to help facilitate the generation of evidence-based best-practice guidelines for pediatric donation after cardiac death.

Key Words: end of life • transplant

http://pediatrics.aappublications.org/cgi/content/abstract/120/4/e960
PEDIATRICS Vol. 120 No. 4 October 2007, pp. e960-e966
© 2007 American Academy of Pediatrics.

Cholesterol and Congenital defects

Adverse Birth Outcome Among Mothers With Low Serum Cholesterol

Robin J. Edison, MD, MPH (a), Kate Berg, PhD (a), Alan Remaley, MD (b), Richard Kelley, MD, PhD (c), Charles Rotimi, PhD (d), Roger E. Stevenson, MD (e) and Maximilian Muenke, MD (a)
a) Medical Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland; b) National Institutes of Health Clinical Center, Bethesda, Maryland; c) Kennedy Krieger Institute, Baltimore, Maryland; d) National Human Genome Research Center, Howard University, Washington, DC; e) Greenwood Genetic Center, Greenwood, South Carolina

OBJECTIVE. The objective of this study was to assess whether low maternal serum cholesterol during pregnancy is associated with preterm delivery, impaired fetal growth, or congenital anomalies in women without identified major risk factors for adverse pregnancy outcome.

METHODS. Mother-infant pairs were retrospectively ascertained from among a cohort of 9938 women who were referred to South Carolina prenatal clinics for routine second-trimester serum screening. Banked sera were assayed for total cholesterol; <10th>10th percentile but <90th percentile.

RESULTS. Prevalence of preterm delivery among mothers with low total cholesterol was 12.7%, compared with 5.0% among control subjects with mid–total cholesterol. The association of low maternal serum cholesterol with preterm birth was observed only among white mothers. Term infants of mothers with low total cholesterol weighed on average 150 g less than those who were born to control mothers. A trend of increased microcephaly risk among neonates of mothers with low total cholesterol was found. Low maternal serum cholesterol was unassociated with risk for congenital anomalies.

CONCLUSIONS. Total serum cholesterol <10th>

PEDIATRICS Vol. 120 No. 4 October 2007, pp. 723-733
© 2007 American Academy of Pediatrics.
http://pediatrics.aappublications.org/cgi/content/abstract/120/4/723

Prenatal cocaine exposure

Effects of Prenatal Cocaine Exposure on Growth

Gale A. Richardson, PhD (a), Lidush Goldschmidt, PhD (b) and Cynthia Larkby, PhD (a)
a) Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; b) University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania

OBJECTIVE. There has been a limited amount of research on the long-term effects of prenatal cocaine exposure on growth of the infant, and there has been no use of longitudinal growth models. We investigated the effects of prenatal cocaine exposure on offspring growth from 1 through 10 years of age by using a repeated-measures growth-curve model.

METHODS. Women were enrolled from a prenatal clinic and interviewed at the end of each trimester of pregnancy about their cocaine, crack, alcohol, marijuana, tobacco, and other drug use. Fifty percent of the women were white, and 50% were black. Follow-up assessments occurred at 1, 3, 7, and 10 years of age.

RESULTS. Cross-sectional analyses showed that children exposed to cocaine during the first trimester (n = 99) were smaller on all growth parameters at 7 and 10 years, but not at 1 or 3 years, than the children who were not exposed to cocaine during the first trimester (n = 125). The longitudinal analyses indicated that the growth curves for the 2 groups diverged over time: children who were prenatally exposed to cocaine grew at a slower rate than children who were not exposed. These analyses controlled for other factors associated with child growth.

CONCLUSIONS. To our knowledge, this is the first study of the long-term effects of prenatal cocaine exposure to conduct longitudinal growth-curve analyses using 4 time points in childhood. Children who were exposed to cocaine during the first trimester grew at a slower rate than those who were not exposed. These findings indicate that prenatal cocaine exposure has a lasting effect on child development.

PEDIATRICS Vol. 120 No. 4 October 2007, pp. e1017-e1027
http://pediatrics.aappublications.org/cgi/content/abstract/120/4/e1017

Phytochemicals of Antioxidants

Researcher Focuses on Pros, Cons of Antioxidants from Fruits and Vegetables

Nutrition: It's not just the four basic food groups any more.

Researcher Dr. Susanne Mertens-Talcott of Texas A&M University is looking into how plant-based phytochemicals, including antioxidants and herbal supplements, can be useful in the promotion of health and prevention of chronic diseases.

This field is still growing. In the U.S. more than $20 billion was spent on dietary supplements in 2005, said Talcott, who is in a joint research and teaching position with the department of nutrition and food science and the department of veterinary physiology and pharmacology.

"Over $7 billion was spent on herbal dietary supplements in 2005." These supplements are plant-based, including grape seed extract, St. John's wort, ginseng and biloba extract, she added.

"In addition to that there is the segment of so-called 'functional foods,' including antioxidant foods - for example, fruit juices and beverages and grain-based products," Talcott said.

The amount spent on these foods each year "has increased drastically; however, we do not know yet how efficacious these different antioxidants really are in the prevention of chronic diseases such as cardiovascular disease and cancer," she said. "We also do not know very much about the mechanisms, which appear to include antioxidant and anti-inflammatory effects of these phytochemicals."

This can be important to health since these reactive oxygen species or 'free radicals' may play a role in some diseases, including Alzheimer's, cancer and atherosclerosis, she said.

"However, other mechanisms, including the prevention of chronic inflammation and interaction with intracellular mechanisms, may be as important in the prevention of chronic diseases," she said. But are they safe? Are they efficient? How much is required? And how much is too much? Talcott is looking for the answers to these questions through her research.

"My overall goal is to find out more about the safety and efficacy of phytochemical dietary supplements," she said. Because these items are already popular with consumers, "we need to follow up with research. We know very little about (dose) recommendations and how safe (they are)."

Phytochemicals, also called secondary plant compounds - including antioxidants - have been defined as chemicals found in plants that have protective or disease-fighting properties ( http://phytochemicals.info/ ).

Pomegranate juice and extract have been the focus of much of her studies. Because these are used in different food products, they are found as ingredients in many different items in supermarkets, Talcott said.

She has also done research on the properties of muscadine grapes and acai, a palm fruit from Brazil, as well as isolated compounds including quercetin and ellagic acid, which are also sold as dietary supplements.

The results of some of her studies were published in the Oct. 13, 2006, edition of the Journal of Agricultural and Food Chemistry. The article was titled "Absorption, Metabolism and Antioxidant Effects of Pomegranate (Punica granatum L.) Polyphenols after Ingestion of a Standardized Extract in Healthy Human Volunteers."

In addition to her research, Talcott teaches a class on "Special Topics in Phytochemicals of Fruits and Vegetables" for students who are majoring in nutrition and food science. Many of the students are planning to enter medical or pharmacy school, she added.

"It is my goal to give students as much relevant information, which they directly can apply in their desired profession," Talcott said. "Consumers and patients have many questions about herbal dietary supplements, and health care professionals and (members of the) food industry are and will be even more confronted with these questions."

For example, Dr. Joseph M. Betz was a recent guest lecturer in Talcott's class. Betz is the director of the Dietary Supplement Methods and Reference Materials Program Office of Dietary Supplements at the National Institutes of Health in Bethesda, Md. He discussed Food and Drug Administration rules as to the differences between foods and drugs and how each must be labeled. With regard to herbal supplements, this can sometimes be a little tricky, he said.

During the question and answer period at the end of his talk, one of the students asked about a recent study on antioxidants. According to news reports, the study seemed to find that antioxidants - especially vitamins A and E - don't have the beneficial properties they are thought to have and may even increase mortality.

Talcott offered this clarification in regard to the study: "This study statistically analyzed many different clinical studies with vitamins A, E (and) C, beta-carotene and selenium. The performed statistical analysis indicated that vitamin A and E and beta-caraotene may increase mortality in some of the selected studies. The meaning of this study currently is being discussed."

The study looked at synthetic antioxidants, she said, which are not the same compounds that she is researching.

"Even though we still have a lot to learn about the efficacy, safety and dosing recommendations for herbal supplements and antioxidant foods, we can be confident to recommend a healthy balanced diet according to the food-pyramid rich in fresh fruits and vegetables. I also would not see a problem with the intake of reasonable amounts of standardized high-quality antioxidant dietary supplements," she said.

"It is my long-term goal to see science-based intake recommendations developed for those herbal plant compounds which have a proven potential in the promotion of health and prevention of chronic disease."

Texas A&M University
http://www.brightsurf.com/news/

The negative effect of antioxidant supplements

Use of some antioxidant supplements may increase mortality risk

Contradicting claims of disease prevention, an analysis of previous studies indicates that the antioxidant supplements beta carotene, vitamin A, and vitamin E may increase the risk of death, according to a meta-analysis and review article in the February 28 issue of JAMA.

Many people take antioxidant supplements, believing they improve their health and prevent diseases. Whether these supplements are beneficial or harmful is uncertain, according to background information in the article.

Goran Bjelakovic, M.D., Dr.Med.Sci., of the Center for Clinical Intervention Research, Copenhagen University Hospital, Copenhagen, Denmark, and colleagues conducted an analysis of previous studies to examine the effects of antioxidant supplements (beta carotene, vitamins A and E, vitamin C [ascorbic acid], and selenium) on all-cause death of adults included in primary and secondary prevention trials. Using electronic databases and bibliographies, the researchers identified and included 68 randomized trials with 232,606 participants in the review and meta-analysis. The authors also classified the trials according to the risk of bias based on the quality of the methods used in the study, and stratified trials as "low-bias risk" (high quality) or "high-bias risk" (low quality).

In an analysis that pooled all low-bias risk and high bias risk trials, there was no significant association between antioxidant use and mortality. In 47 low-bias trials involving 180,938 participants, the antioxidant supplements were associated with a 5 percent increased risk of mortality. Among low-bias trials, use of beta carotene, vitamin A, and vitamin E was associated with 7 percent, 16 percent and 4 percent, respectively, increased risk of mortality, whereas there was no increased mortality risk associated with vitamin C or selenium use.

"Our systematic review contains a number of findings. Beta carotene, vitamin A, and vitamin E given singly or combined with other antioxidant supplements significantly increase mortality. There is no evidence that vitamin C may increase longevity. We lack evidence to refute a potential negative effect of vitamin C on survival. Selenium tended to reduce mortality, but we need more research on this question," the authors write.

"Our findings contradict the findings of observational studies, claiming that antioxidants improve health. Considering that 10 percent to 20 percent of the adult population (80-160 million people) in North America and Europe may consume the assessed supplements, the public health consequences may be substantial. We are exposed to intense marketing with a contrary statement, which is also reflected by the high number of publications per included randomized trial found in the present review."

"There are several possible explanations for the negative effect of antioxidant supplements on mortality. Although oxidative stress has a hypothesized role in the pathogenesis of many chronic diseases, it may be the consequence of pathological conditions. By eliminating free radicals from our organism, we interfere with some essential defensive mechanisms . Antioxidant supplements are synthetic and not subjected to the same rigorous toxicity studies as other pharmaceutical agents. Better understanding of mechanisms and actions of antioxidants in relation to a potential disease is needed," the researchers conclude.

JAMA and Archives Journals
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Beneficial effect of apples and fish

Eating apples and fish during pregnancy may protect against childhood asthma and allergies

Women who eat apples and fish during pregnancy may reduce the risk of their children developing asthma or allergic disease, suggests a new study presented at the American Thoracic Society 2007 International Conference, on Sunday, May 20.

The SEATON study, conducted at the University of Aberdeen, UK, found that the children of mothers who ate the most apples were less likely to ever have wheezed or have doctor-confirmed asthma at the age of 5 years, compared to children of mothers who had the lowest apple consumption. Children of mothers who ate fish once or more a week were less likely to have had eczema than children of mothers who never ate fish.

The study did not find any protective effect against asthma or allergic diseases from many other foods, including vegetables, fruit juice, citrus or kiwi fruit, whole grain products, fat from dairy products or margarine or other low-fat spreads.

The researchers studied 1212 children born to women who had filled out food questionnaires during their pregnancy. When the children were 5 years old, the mothers filled out a questionnaire about the children's respiratory symptoms and allergies, as well as a questionnaire about their child's food consumption.

The children were also given lung function and allergy tests. Previous studies in the same children have found evidence for protective effects of vitamin E and D and zinc during pregnancy in reducing the risk of children's wheeze and asthma, notes researcher Saskia Willers, M.Sc. of Utrecht University in the Netherlands. If the new results are confirmed, she says, "recommendations on dietary modification during pregnancy may help to prevent childhood asthma and allergy."

Willers concludes that at least until age 5, a mother's diet during pregnancy might be more influential on a child's respiratory health than the child's own diet. She notes that further study of this group of children will be needed to see whether the association with the mothers' diet declines in older children, and if mothers' and their childrens' diets interact in older children.

Willers suggests that the beneficial effect of apples may come from powerful antioxidants called flavonoids, while fish's protective effect may come from omega-3 fatty acids, which other studies have suggested have a protective effect on the heart and may have a protective effect in asthma. "Other studies have looked at individual nutrients' effect on asthma in pregnancy, but our study looked at specific foods during pregnancy and the subsequent development of childhood asthma and allergies, which is quite new," Willers says. "Foods contain mixtures of nutrients that may contribute more than the sum of their parts."

American Thoracic Society
http://www.brightsurf.com/news/

Fruit - high antioxidant properties

Native fruits bear sweet antioxidants

Twelve native Australian fruits that are exceptional sources of antioxidants have been identified in research published in the journal Innovative Food Science & Emerging Technologies.

The fruits: Kakadu plum, Illawarra plum, Burdekin plum, Davidson's plum, riberry, red and yellow finger limes, Tasmanian pepper, brush cherry, Cedar Bay cherry, muntries and Molucca raspberry; were compared with blueberries (cultivar Biloxi) - a fruit renowned for its high antioxidant properties.

"Finding unique food ingredients and flavours with health-promoting properties is a key market requirement these days," says research team leader, Food Science Australia's Izabela Konczak. "And, by encouraging growers to cultivate native fruits, we are also contributing to the growing need to ensure agriculture becomes more sustainable."

Co-author Dr Michael Netzel - a post-doctoral researcher at Food Science Australia supported by Germany's Alexander von Humboldt Foundation - says the native fruits were shown to be rich sources of antioxidants, with stronger radical scavenging activities than blueberries.

"Compared to blueberries' TEAC value of 39.45 trolox equivalents per gram, Kakadu plum and Burdekin plum had TEAC values of 204.8 and 192.0 trolox equivalents per gram," Dr Netzel says.

"Using native Australian fruits as a source of phytochemicals for use in foods could offer enormous opportunities for the food and functional food industries.

"Studies to identify additional antioxidant compounds as well as clinical trials for testing the fruits' bioactivity in vivo, are in progress." he says.

While Australian native fruits have been eaten by indigenous people for thousands of years, this is the first scientific study of the fruits as a source of antioxidants and confirms preliminary results published in the Journal of Agricultural and Food Chemistry in 2006.

This research supports CSIRO efforts to realise the potential of Australia's fledgling native food industry which is currently estimated to be worth $A14 million annually.

Food Science Australia is a joint venture between CSIRO and the Victorian Government.

CSIRO Australia
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