Briefly noted: A Muntaner-Mas et al. J Pediatr 2018; 198: 90-7. This cross-sectional study with 250 Spanish children (10-12 year olds) examined obesity measures, physical fitness measures and academic performance. Key finding: “Children considered fit had better academic performance than their unfit peers…the association between body mass index and GPA was mediated by cardiorespiratory fitness and speed-agility.” The design of this study precludes establishing this association as a causal relationship.
“Common sense is not so common.” Voltaire,, Dictionnaire Philosophique 1764
A website that I learned about recently from the Journal of Pediatrics article, “The Elephant in the Examination Room: Addressing Parent and Child Mobile Device Use as a Teachable Moment:” commonsensemedia.org
Related blog post:
While mass shootings are occurring frequently and garner a lot of press, everyday children and adults are dying from more ‘mundane’ tragedies. To reduce some these –a recent AAP message: Is There an Unlocked Gun Where Your Child Plays?
Parents need to ask this question to protect their children.
A recent study (F de Benedetti et al. NEJM 2018; 378: 1908-19) presents data on canakinumab, an anti-interleukin-1β monoclonal antibody, for three hereditary periodic fever syndromes in the so-called “CLUSTER” trial. Canakimumab is administered as a subcutaneous injection. The three periodic fevers were the following:
- Familial Mediterranean Fever (colchicine-resistant)
- Mevalonate kinase
- Tumor necrosis factor-receptor-associated periodic syndrome (TRAPS)
This post has a couple interesting items:
- Arsenic levels were not increased in individuals with celiac disease who were consuming a gluten-free diet
- Cellphones: There are good reasons for physicians to avoid giving out their cellphone numbers to patients
- Enuresis -most patients respond to bedwetting alarms
RD Watkins et al. Practical Gastroenterology; 2018; 42: 12-6. In this retrospective review of 39 patients (with available arsenic levels), patients with celiac disease (adult & pediatric) had normal and/or undetectable arsenic levels. The mean duration on a gluten-free diet was 2.35 years for pediatric patients and 3.31 years for adults.
33 Charts/Bryan Vartabedian: Should Physicians Give Their Cell Phone Numbers to Patients
E Apos et al. J Pediatr 2018; 193: 211-6. This study showed that enuresis treatment with a bedwetting alarm system was effective in 76% of patients (n=2861) and that mean treatment time to achieve dryness was 62 days. The most frequent age group was 6 years to 10 years of age.
A recent review (I Hojsak et al. JPGN 2018; 66: 3-9) examined published trials regarding the role of probiotics in the prevention of nosocomial diarrhea. The review was conducted by a working group on behalf of ESPGHAN.
- “Recommendation: If probiotics for preventing nosocomial diarrhea in children are considered, the WG [working group] recommends using L rhamnosus GG (at least 10 to the 9th CFU/day, for the duration of hospital stay).
- Quality of evidence: Moderate
- Strength of recommendation: Strong
- Number needed to treat (in order for beneficial effect in one): 12 patients
The authors do not recommend L reuteri DSM17938 due to lack of efficacy; other probiotics did not receive a recommendation either due to lack of data or lack of efficacy.
It is possible that there have been unpublished negative probiotic studies which would alter the calculation of a beneficial effect.
My take: While the working group recommends L rhamnosus GG if probiotics are used to prevent diarrhea, the absolute benefit is low.
Related blog posts:
- How Good is Your Probiotic for Antibiotic-Associated Diarrhea
- “Low quality of evidence; strong recommendation” for Probiotics in Gastroenteritis
Pont SJ, et al. Pediatrics. 2017. doi: 10.1542/peds.2017-3034. A policy statement from the American Academy of Pediatrics addresses the issue of stigma associated wtih pediatric obesity. This is summarized in the following links:
- From Healio: AAP Empathetic Counseling Needed To Address Pediatric Obesity Stigma
- From NY Times: How Not To Talk to A Child Who is Overweight
An excerpt form NY Times piece:
Dr. Pont is one of the lead authors of a new policy statement from the American Academy of Pediatrics titled “Stigma Experienced by Children and Adolescents With Obesity.” The statement, published online Monday in the journal Pediatrics, advises pediatricians to use neutral words like “weight” and “body mass index” rather than terms like “obese” and “fat.” …
In a study published earlier this year in the journal Preventive Medicine, Dr. Puhl and her colleagues looked at the longitudinal effects of teenagers being teased about their weight. The study involved over 1,800 people who had been followed for 15 years and are now in their mid 30s…
“These teasing experiences have long-lasting implications for health and for health behavior.” For women especially, these adolescent experiences of teasing by peers or family members were associated with binge eating, poor body image, obesity, and a higher B.M.I. 15 years later, she said; for men there were some of the same associations, including obesity as adults, if they had been teased by their peers as adolescents…
Weight stigma does exactly the opposite; criticizing and inducing shame only make people feel terrible about themselves, not motivated or capable of making changes…
“Recognize that a child is far more than what their weight is, praise them for all the positives, so when we get to some of the more challenging topics, they can still maintain their self-esteem,”…
The most effective way for parents to help a child is to make healthy changes for the whole family, regardless of shape or size, Dr. Pont said. Try making small changes slowly, like adding one new green vegetable into the family diet, not keeping sugary drinks in the home or walking to school instead of driving.
Related blog posts:
- Can parents not know if their child is overweight?
- Six years later-Mediterranean diet comes out on top | gutsandgrowth
- Eliminating sweetened beverages to help obesity
- Childhood Obesity and Consensus Recommendations | gutsandgrowth
- “Negative Externality,” Splitting Checks, and Feeding Psychology | gutsandgrowth
- Sweetened Beverages -A Big Problem for Little Kids | gutsandgrowth