April 5, 2010
By Miriam Falco
If most new moms would breastfeed their babies for the first six months of life, it would save nearly 1,000 lives and billions of dollars each year, according to a new study published Monday in the journal Pediatrics.
“The United States incurs $13 billion in excess costs annually and suffers 911 preventable deaths per year because our breastfeeding rates fall far below medical recommendations,” the report said.
The World Health Organization says infants should be exclusively breastfed for the first six months of life “to achieve optimal growth, development and health.” The WHO is not alone in its recommendations.
The American College of Obstetricians and Gynecologists, the American Academy of Pediatrics, the American Academy of Family Physicians and the Centers for Disease Control and Prevention all agree that breast milk alone is sufficient for newborns and infants until they are 6 months old.
However, a 2009 breastfeeding report card from the CDC found that only 74 percent of women start breastfeeding, only 33 percent were still exclusively breastfeeding at three months and only 14 percent were still exclusively breastfeeding at six months.
Dr. Melissa Bartick, one of the new study’s co-authors, says the vast majority of extra costs incurred each year could be saved “if 80 to 90 percent of women exclusively breastfed for as little as four months and if 90 percent of women would breastfeed some times until six months.” Bartick is a hospitalist — a doctor who specializes in the care of hospitalized patients — at Cambridge Health Alliance, an instructor in medicine at Harvard Medical School and a mother of two.
Bartick and her co-author Arnold Reinhold found that most of the excess costs are due to premature deaths. Nearly all, 95 percent of these deaths, are attributed to three causes: sudden infant death syndrome (SIDS); necrotizing enterocolitis, seen primarily in preterm babies and in which the lining of the intestinal wall dies; and lower respiratory infections such as pneumonia.
Breastfeeding has been shown to reduce the risk of all of these and seven other illnesses studied by the study authors.
Bartick calculates $10.56 million for each of the estimated 911 children’s deaths. Researchers also included the direct costs of health care and parent’s time missed from work. They did not include the cost of formula, which is another added cost for moms who don’t breastfeed.
There are a lot of factors contributing to low breastfeeding rates in the United States, and Bartick says moms shouldn’t be blamed, because they receive mixed messages and often lack support from the moment their babies are born.
She says the biggest priority should be to improve maternity care practices. Bartick refers to a 2007 CDC survey of hospitals and birthing centers, which scored each facility to determine how well it complied with recommendations meant to encourage women to breastfeed.
According to that survey, Bartick says, “U.S. hospitals scored a 63 – that’s a D.”
Bartick says many hospitals delay immediate urgent skin-to-skin contact between mom and baby, which can make things harder for the newborn to act on its natural instincts to suckle.
Moms also need to be better educated about the importance of breastfeeding and they need adequate support after they leave the hospital in case they run into problems because the newborn isn’t properly latching on and therefore not getting enough food.
Dr. Alan Fleischman, medical director for the March of Dimes, was not surprised by the findings of the report. Fleischman, who did not work on this study, says if a new mom is struggling with breastfeeding, she may end up in a situation where “grandmother suggests to stop the silliness and give formula instead.”
He believes the mothers and grandmothers of new moms also need to be educated about the benefits of breastfeeding because for their generations, feeding their babies formula was the norm.
March 1, 2010
Wall Street Journal
By Shirley S. Wang
Obese children as young as age 3 show signs of an inflammatory response that has been linked to heart disease later in life, researchers said, in a finding that is likely to further stoke concerns about childhood obesity.
The results suggest that obesity-related disease processes may start earlier than previously believed. Nearly 30% of obese 3-to-5-year-olds had elevated blood levels of C-reactive protein—a widely studied marker for inflammation—compared with 17% of healthy-weight kids of the same age. The disparities widened as children aged, according to the study, which is being published Monday in the journal Pediatrics.
“It’s really important to be concerned about childhood obesity and to even be concerned when they are quite young,” said Asheley Skinner, a professor of pediatrics at the University of North Carolina School of Medicine, who was the first author of the study. “We can’t wait until they’re adolescents or adults.”
In the U.S., 14% of 2-to-5-year-olds are considered overweight, or at the 85th percentile or greater of weight for height in their age group.
C-reactive protein, or CRP, has been shown to help predict risk of heart disease, stroke and death under certain conditions, according to the American Heart Association. Previous studies have found that overweight and obese adults show elevated levels of CRP, but less has been known about CRP in children.
The study examined three markers that measure different aspects of inflammation, including CRP, in more than 16,000 children nationwide between the ages of 1 and 17. By ages 15 to 17, CRP was elevated in about 60% of obese teens, compared with 18% of teens of healthy weight. The increase was even more pronounced for very obese kids, with nearly 43% of young children and 83% of teens showing CRP elevation.
A similar pattern of elevation was observed for the other two inflammatory markers, though one of the markers wasn’t elevated in obese children until the age of 6.
It isn’t known whether elevated CRP in young children will predict heart disease in adulthood. Such a study, which would involve following overweight and obese children until adulthood, hasn’t been done, Dr. Skinner said. But, she said there wasn’t any evidence to suggest that CRP response would be different in children than in adults; its response in the body is the same regardless of age. Inflammation is the body’s immune response to infection or injury.
The concern of finding CRP elevation in such young children is that its effects could be cumulative. Future research is needed to investigate whether that is the case, and also whether losing weight could reduce CRP response in kids, according to Dr. Skinner. This study was funded by the National Institutes of Health.
November 16, 2009
According to a recent study, as many as 77 percent of all Americans may be deficient in the vitamin essential for bone health and which may prevent H1N1 (Swine Flu) and seasonal flu, wheezing, winter-related eczema, upper respiratory infections and may help prevent cancer, autoimmune diseases such as multiple sclerosis, Type 1 diabetes, certain infectious diseases, myocardial infarctions – heart attacks – and many other serious diseases.
When subgroups of the population are considered, depending on which of the many reasonable definitions of deficiency are accepted, the picture is even more ominous. For example, an important new study from Children’s Hospital in Boston found that as many as 80 percent of Hispanic children and 92 percent of black children, what the study calls non-Hispanic black children, may also be deficient in this vitamin.
We’re talking about vitamin D, also called the sunshine vitamin and often considered the nutrient of the year, if not the decade. Its power as a determinant of human health can be captured by what happens when someone is D deficient. They are at risk for what is called rickets in children and osteomalacia in adults.
In its most extreme form, the bones soften and almost melt, making them so fragile that the simple act of walking up steps may cause bones to fracture and slight movement may cause excruciating pain. In its most severe form, a blood test for vitamin D may show zero. Dr. Fred Kaplan, an eminent orthopedic surgeon at the Hospital of the University of Pennsylvania, whose patient had zero D, said this is rare even in Third World countries.
Why, in the land of plenty and, now, also in the land of over-consumption, overweight and obesity, can there be an epidemic of a vitamin D deficiency or any other nutrient? The reasons may not be fully understood, but the picture is still clear: Over time, we have obtained most of our vitamin D from the sun. When ultraviolet B rays hit the skin they cause the formation of vitamin D. But, in an age of sunscreens and well-placed fear of skin cancer, we tend to either stay out of the sun or use a sunscreen to shield us from its rays, including the ultraviolet B ray.
Even if you stayed in the sun all day in some locations, you would not get enough vitamin D. For example, north of Philadelphia, between November and March, the suns rays are not strong enough to precipitate the formation of vitamin D. And, during early morning and late afternoon, the sun’s rays are not strong enough to generate vitamin D. That’s a big part of the picture, as authorities find that exposure to the sun is the main determinant of vitamin D in humans. This leads us to the next source of vitamin D — our food. Some dairy products, such as milk, are fortified with vitamin D, but we tend to avoid dairy products due to their cholesterol and saturated fat content. Other sources are fatty fish such as salmon, tuna, mackerel, and herring. Still other sources are fortified cereal and other foods such as orange juice, now, often fortified both with vitamin D and calcium. But, most people don’t eat enough of these foods to get enough vitamin D. So, that leaves supplementation with multi-vitamins that include D, combination calcium and vitamin D pills, or vitamin D stand-alones.
There may be another reason for the epidemic – the epidemic of the overweight and obese, who cannot process vitamin D efficiently and are, consequently, more likely to be vitamin D deficient. One final reason for identifying the epidemic is better testing methods for vitamin D. There is a simple blood test now used to determine vitamin D status.
Still another reason for the D epidemic is the aging of the population, as older people — even the middle-aged — are more likely to have D deficiency.
There are other risk factors for a D deficiency, but they probably don’t play a big role in the growing number of people with that deficiency. Consumer Reports catalogued the following risk factors: “Being dark-skinned, middle-aged, or overweight; having a history of gastric-bypass surgery or a condition that interferes with the ability to absorb nutrients from food, such as celiac disease; having a history of kidney or liver disease, multiple sclerosis, osteoporosis, or thyroid problems; taking medications that reduce blood levels of vitamin D, such as cholestyralmine (Questran and generic), colestripel (Colestid and generic), certain anticonvulsants; or orlistat (Alli, Xenical)” (Consumer Reports on Health, Nov. 2009).
This epidemic of vitamin D deficiency recently came into focus with the publication of an important study led by Dr. Jonathan Mansbach at Children’s Hospital In Boston. The study appears in the November issue of the journal Pediatrics. The study looked at vitamin D levels of 5,000 children and, extrapolating to the entire U.S. population of children, found that millions were receiving what the study called suboptimal levels of D. As noted above, depending on the definition of deficiency or suboptimal levels, the study found 80 percent of Hispanics and 92 percent of black children were at the suboptimal levels. Others have previously documented widespread vitamin D deficiency in children. For example, Dr. Babette Zemel, a vitamin D expert at Children’s Hospital of Philadelphia (CHOP), who is Director of the Nutrition and Growth Laboratory of that hospital and Associate Professor of Pediatrics at Penn’s medical school, found that 55 percent of children she studied were vitamin D deficient, in a study published in 2007.
The Mansbach study notes that we’re far from knowing everything we should about how to bring children and adults up to optimal levels, how to avoid any long-run adverse consequences and exactly what level of vitamin D is optimal.
October 26, 2009
By Associated Press
At least 1 in 5 U.S. children ages 1 to 11 doesn’t get enough vitamin D and could be at risk for a variety of health problems including weak bones, the most recent national analysis suggests.
By a looser measure, almost 90 percent of black children that age and 80 percent of Latino kids could be vitamin D deficient – “astounding numbers” that should serve as a call to action, said Dr. Jonathan Mansbach, lead author of the new analysis and a researcher at Harvard Medical School and Children’s Hospital in Boston.
The deficiency is a concern because recent studies suggest the vitamin might help prevent infections, diabetes and some cancers.
The new analysis, released online today by the journal Pediatrics, is the first assessment of varying vitamin D levels in children ages 1 through 11. The study used data from a 2001-06 government health survey of almost 3,000 children who had blood tests measuring vitamin D.
October 13, 2009
NBC Los Angeles
Convenience stores may be just that, an easy, fast place to shop. But now, a new study indicates that kids with easy access to convenience stores may be paying for it with a weight gain.
It may not surprise you to hear that teenagers like to buy fattening junk food in convenience stores. But, according to a new study in the journal Pediatrics, researchers at Temple University surveyed more than 800 kids outside urban convenience stores both before and after school. And they found, perhaps not surprisingly, that most of them buy lots of high calorie, low nutrition foods like chips and candy.
The researchers suggest that in future efforts to fight teenage obesity, more attention should be paid to how close convenience stores are to schools.
Click here for the full report.