Tuesday, January 08, 2008
Sunday, December 02, 2007
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/
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/
Friday, November 16, 2007
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.
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.
Wednesday, November 07, 2007
Black and White Patients With Stroke
Differences in Stroke Subtypes Between Black and White Patients With StrokeHugh 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
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
Thursday, November 01, 2007
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.
What Foods are Popular with Vegan Children?
Many vegan children like:
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/
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