Certain types of antipsychotic medication can cause children to put on weight—as much as 18 pounds—according to research appearing in the Journal of the American Medical Association.

Dr. Chrostoph Correll, MD, and associates observed 272 children aged 4 to 19 taking atypical antipsychotic medication for the first time. Drugs/Medications included olanzapine (Zyprexa), quetiapine (Seroquel), risperidone (Risperadol) and aripiprazole (Abilify)—drugs sometimes used to treat children with autism, schizophrenia or bipolar disorder.

Children’s weights were monitored over a 12-week period. During the last two weeks of the study, nearly all experienced significant weight gain. Average gain was as follows: 18.7 pounds with onanzapine, 13.7 pounds with quetiapine, 11.7 pounds with risperidone, and 9.7 pounds with aripiprazole. Children in the control group gained less than half a pound (.44 pounds) on average.

“(E)ffects such as age-inappropriate weight gain, obesity, hypertension, and lipid and glucose abnormalities are particularly problematic during development because they predict adult obesity, metabolic syndrome, cardiovascular morbidity, and malignancy,” authors of the study write.

Doctors were so concerned over weight gain in children taking onanzapine that they stopped treatment before the study was completed. “Each antipsychotic was associated with significantly increased fat mass and waist circumference,” authors write. “Altogether, 10 percent to 36 percent of patients transitioned to overweight or obese status within 11 weeks.”

As more children—some younger than 5-years-old—are diagnosed with bipolar and “disruptive behavior” disorders (such as ADHD), there is also a rise in atypical antipsychotic prescriptions. These medications are generally effective for children with autism and schizophrenia, but they may not be the best treatment for other conditions.

The authors suggest seeking alternative treatments. They write that, in view of the negative health outcomes, the benefits of using these medications “must be balanced against their cardiometabolic risks”, and say the results suggest including in prescription guidelines closer monitoring during the early months of treatment.

They also plan on researching whether or not diet restrictions and additional medications for weight and glucose control will help balance the potential negative effects of the drugs.

There are likely to be plenty of ghosts and ghouls about this Halloween, but one thing that may have parents spooked this time of year is candy and dental health. Roughly 30 percent of 5-year-olds in Plymouth, England, were found to have some form of tooth decay, according to a newly released review.

The review examined the 2007-2008 dental records of U.K. children, 211 of whom were Plymouth five-year-olds. This number was just under the national average of 30.9 percent, but other regions were significantly worse.

The United States had similar rates. Almost half of children ages 12 to 15 and about one in four American children aged 2 to 5 is affected by tooth decay. Overall, it affects 4 million children in the U.S. alone. Americans consumed an average of 23.8 pounds of candy each in 2008, and with the holiday season approaching, parents should be on the watch for cavities.

As Halloween approaches, candy consumption is likely to skyrocket, but there are plenty of ways to protect trick-or-treaters from tooth decay. Try these five tips to help reduce the amount of sugar:

1. Choose reduced-sugar or sugar-free candies. Most stores carry equally tasty sugar-free or reduced-sugar versions of Halloween favorites, including chocolate, peanut butter cups and various filled or hard candies. These options won’t completely eliminate the risk of tooth decay, but they can significantly cut sugar intake.

2. Give out unconventional goodies. When it comes to candy, sugar-free gum is your safest bet. Candies that can melt and/or stick to teeth are the worst. Other ideas might include stickers, press-on tattoos, plastic rings, or other small toys.

3. Go to a Halloween program or event. Choosing alternatives to trick-or-treating significantly cuts the candy haul. These events are a great place for adults and children to socialize while enjoying snacks and fun activities.

4. Set a limit. Put a limit on the amount of candy a child is allowed daily. This helps prevent candy binges while reducing sugar consumption. Candy can also be used as a reward for good behavior.

5. Donate excess candy. Many communities have programs that will send it to troops or donate $1 for every pound of candy donated. Candy can also be donated to fire stations, schools (for rewards), or other offices in the community.

Regularly brushing teeth and reducing sugar intake can help prevent cavities. Consuming fewer sweets can also help decrease children’s risk for obesity and diabetes. Dentists and parents alike recommend that candy be consumed in moderation.

Early obesity in women may be linked with difficulty in becoming pregnant. Women who became obese by age 18 and participated in a weight-loss surgery study showed higher rates of infertility and polycystic ovarian syndrome (PCOS).

Forty-two percent of the women in the study trying to conceive experienced infertility, but pregnancy was more likely for women who became obese after age 18. The good news is, surgical weight loss may increase fertility.

The study, the Longitudinal Assessment of Bariatric Surgery (LABS), provided information on the fertility of obese women considering surgical weight loss procedures.

Obesity can interfere with a woman’s hormone levels, making it difficult to become pregnant. This also makes vitro procedures less likely to work. Even in the event of conception, there are major health risks to both mother and child. Not only are miscarriage rates higher, but there are also a higher rates of premature and still-births.

Weight loss surgery, also known as bariatric or metabolic surgery, which includes gastric bypass surgery and lap banding, may help obese women trying to conceive. Many women don't know that having such a procedure is an option.

Research shows that bariatric surgery can reduce pregnancy complications for obese women, and LABS participants were no exception. Roughly 62 percent of LABS participants who underwent surgery who hoped to conceive experienced at least one live birth after infertility.

After weight loss surgery, doctors advise women to wait at least 18 months after surgery (6 months after banding) before trying to become pregnant. They also suggest using contraceptives while waiting for the body to become more stable.

“As the incidence of obesity increases in the United States, women’s health care practitioners are likely to care for a substantial number of patients who will undergo bariatric surgery,” says Dr. William Gibbons of the American Society for Reproductive Medicine. “Studies like this one are extremely useful to help us determine how to advise these patients and best meet their needs.”

Find more information about pregnancy after bariatric surgery, or test your knowledge with Healia’s Pregnancy Quiz.

A certain type of unsaturated fatty acid, CLA, and safflower oil may be key ingredients in helping postmenopausal women with type 2 diabetes drop pounds and improve blood sugar, or blood glucose, levels, according to research from Ohio State University (OSU).

After menopause, many women experience weight gain, which increases the risk of developing metabolic conditions. For women with type 2 diabetes, weight loss and glucose management can become extremely difficult to manage. Researchers found that both CLA and safflower oil proved particularly beneficial to postmenopausal women with type 2 diabetes.

CLA, conjugated linoleic acid, is an unsaturated fatty acid found primarily in meat and dairy products of cows, goats and sheep. CLA has been known to help people wishing to build muscle, lose weight and prevent heart disease.

Safflower oil is a plant-based oil similar to sunflower oil that is used in cooking oils, salad dressings and some margarines. Safflower oil, SAF, is a colorless and flavorless source of omega-6 fatty acids, and has been known to promote healthier skin and hair, reduce cholesterol and boost the immune system.

Thirty-five women completed a 36-week study comparing the effects of CLA and safflower oil on weight and body mass. Each supplement was consumed for sixteen weeks. Participants took roughly two teaspoons of either oil daily.

CLA began to cut body fat and reduce BMI after just eight weeks. “This magnitude of reduction has not been reported in an intervention that used a linoleic acid-rich oil,” wrote lead authors Martha Belury and Leigh Norris, both from the Department of Human Nutrition at OSU.

Safflower oil, originally meant for baseline comparison, yielded exciting changes of its own. Safflower oil reduced trunk mass and increased lean muscle mass, resulting in an average loss of 6.3 percent of body fat. It also reduced insulin resistance and fasting blood glucose levels.

“I never would have imagined such a finding,” Belury says. “This study is the first to show that such a modest amount of linoleic acid-rich oil may have a profound effect on body composition in women."

Belury and associates are pleased with the results of their study, and hope to explore the effects further. They believe that CLA and safflower oil show great promise in weight and glucose management for women with type 2 diabetes.

“It is possible that further reductions in BMI are achievable with a longer length of supplementation,” the authors wrote. “The use of lower doses of CLA over longer durations of intervention may prove to be an effective weight-loss aid."

The study appears online in The Journal of Clinical Nutrition.

Legislators are considering the option of food taxes on sweetened beverages, including soda pop, and snack foods in an effort to battle obesity. Forty states are in support of a small tax on soda, while New York and Maine believe a higher tax may be necessary.

 
According to a report in The New England Journal of Medicine, sugar consumption has risen 30 percent over the last decade. For teens and children, soda accounts for 10-15 percent of total calories consumed. By removing just ¼ of the sugar in sweetened beverages, consumers can reduce annual caloric intake by 8,000 calories. This figure equates to roughly two pounds of weight in a year.

“Americans consume about 250 to 300 more calories daily today than they did several decades ago,” according to authors Kelly D. Brownell, Ph.D., and Thomas R. Frieden, M.D., M.P.H. “Though no single intervention will solve the obesity problem, that is hardly a reason to take no action.”

Such a high rate of sugar intake can do more than expand the waistline. It can also increase the risk of type 2 diabetes, heart disease, and other problems as a result of poor nutrition and weight gain. The objectives of those in support of a tax are twofold—to lower consumption, and to encourage soft drink producers to decrease the amount of caloric sweeteners in their products.

There are strong arguments on both sides. People arguing against the tax point out that food is necessary to survive. They believe raising prices will make it more difficult for low-income families to eat. Others argue that the poor would benefit the most. As the price of fresh produce and other healthier options goes up, soda and junk food prices are going down. People with tighter budgets consume more of the cheap but less nutritious foods and beverages.

“As Coca-Cola prices increased by 12 percent, sales dropped by 14.6 percent,” Frieden and Brownell wrote. Analysts believe that a 1 cent-per-ounce price increase could reduce consumption by as much as 10 percent. Justin Wilson, senior research analyst for the Center for Consumer Freedom, argues that such a tax is manipulation against the consumer. “The tax code should not be used as a method for social engineering, and that’s what this is,” he said.  Legislators see the issue a little differently.

Higher prices have been used effectively in the past to reduce tobacco sales, and any revenue from a tax on soda could raise up to $14.9 billion per year. This money could be used to support health reforms or other programs. New Yorkers’ support rose by 20 percent when lawmakers suggested using these funds for obesity prevention programs.

Ice cream and other foods with certain types of saturated fat may encourage overeating. The fat interferes with the brain, interrupting signals that tell the body it is full, according to a new study from the University of Texas Southwestern. If you’ve been enjoying a lovely weekend with Ben&Jerry’s, stop right there!

UT Southwestern conducted a study on the effects of different types of fats on the hypothalamus and other parts of the brain. “Normally, our body is primed to say when we’ve had enough, but that doesn’t always happen when we’re eating something good,” said study author Dr. Deborah Clegg, assistant professor of internal medicine at UT Southwestern. What they found was that certain fatty acids blocked hormone signals from insulin and leptin, hormones that regulate weight and appetite.

The study examined the effects in rats. The animals received equal amounts of different types of fats. The first group of rats was fed a diet high in palmitic fatty acids, the second monounsaturated fatty acids, and the third with oleic fatty acids. These groups were then divided further into two groups. In the first group, fats were directly injected into the bran via the carotid artery, while the second group of rats received fats via a tube.

“We found that the palmitic acid specifically reduced the ability of leptin and insulin to activate their intracellular signaling cascades,” Dr. Clegg said. “The oleic fat did not do this. The action was very specific to palmitic acid, which is very high in foods that are rich in saturated fat.”

Oleic acids are naturally-occuring “good” fats found in foods such as olives and some types of soybeans. Palmitic acid, in contrast, is a type of saturated fatty acid typically found in foods high in animal fats, such as beef, butter, and cheese. These types of fats are intended for long-term energy storage, but when a person consumes a diet high in palmitic acid it can accelerate obesity.

“What we’ve shown in this study is that someone’s entire brain chemistry can change in a very short period of time,” Dr. Clegg said. The study showed that the effects of these types of fats can last as long as three days.

“Our findings suggest that when you eat something high in fat, your brain gets 'hit' with the fatty acids, and you become resistant to insulin and leptin,” she said. “Since you’re not being told by the brain to stop eating, you overeat.”

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Glucose intolerance during pregnancy may put women at greater risk for heart disease. According to Baiju Shah, MD, PhD, FRCP, of the Institute for Clinical and Evaluative Sciences in Toronto, co-author of a recent study on women with gestational diabetes, even mild glucose intolerance—below the threshold for gestational diabetes—increases the chances of later cardiovascular disease. 
Gestational diabetes had been connected to cardiovascular disease prior to this study, but little was known of the links between minor glucose intolerance and heart disease. Type 2 diabetes and cardiovascular disease share several characteristics including obesity, insulin resistance and cholesterol problems. Oftentimes, individuals with one condition will develop the other. Women with gestational diabetes may experience similar metabolic complications as soon as 3 months after giving birth.

Researchers analyzed the medical records of all Ontario women between the ages of 20 and 49 who had given birth between April 1994 and March 1998.  Participants were divided into three groups: those who were diagnosed with gestational diabetes, those who received an oral glucose tolerance test, and those who were not screened using oral glucose testing. One birth was selected at random for women with multiple deliveries; the median ages were between 29.2 and 31.1.

Women are tested for gestational diabetes (a type of diabetes that develops when women experience unusually high glucose levels during pregnancy) during the second trimester of pregnancy (13-27 weeks). The first step is a glucose challenge test, taken by measuring glucose levels one hour after ingesting a sugary substance such as glucola. If results are abnormal (≥7.8 mmol/L), a second oral glucose tolerance test (OGGT) is taken.

Participants in the study were followed up until March 31, 2008, providing information reflecting cardiovascular disease development for a median of 12.3 years after childbirth. “If you followed 10,000 people for one year, 4.2 of them would have an event,” Dr. Shah explains. “If you followed those 10,000 people for 10 years, 42 of them would have an event…In other words, these are extremely rare events.”

Although the differences were minor—absolute risk was 0.16% and 0.05% for women with gestational diabetes and women who received an OGGT, respectively—the results indicate a need for further research. "We shouldn't be ignoring these mild abnormalities during pregnancy,” Dr. Shah says. “(They) may benefit from extra surveillance and/or cardiovascular disease screening.”

More information is needed to establish the exact relationship between glucose intolerance and cardiovascular disease. In the meantime, proper nutrition and exercise may reduce your risk for both gestational diabetes and cardiovascular disease.

Read more about gestational diabetes and cardiovascular disease.

Seven in ten children in the United States are not getting enough vitamin D, according to the National Health and Nutrition Examination Survey (NHANES, 2001-2004).

Vitamin D, 25-Hydroxyvitamin D, is a fat-soluble vitamin that promotes calcium absorption, fortifying bones and teeth, and maintaining the level of calcium and phosphorus in the blood.

Vitamin D deficiency can result in conditions such as rickets in children (usually <11 ng/mL), and osteomalacia and osteoporosis in adults (typically levels <25 ng/mL). Low levels of vitamin D also increase the risk of bone and heart disease, and are also associated with higher blood pressure and lower calcium and HDL cholesterol levels in later life.

Based on the information obtained from the survey, researchers found that, of more than 6,000 of children followed, nine percent (equal about 7.6 million) were vitamin D deficient, and a greater number were found to be getting an insufficient amount—61%, representing 50.8 million U.S. children. Only 4% received the recommended daily amount of vitamin D.

Children classified as “insufficient” had 15-29 ng/mL, while those who were classified as “deficient” had levels of 15 ng/mLor less. Normal range, according to the National Institute of Health, is 30-74 ng/mL.

The study is the largest of its kind to date, gaining nationwide rather than just regional data. "We expected the prevalence of vitamin D deficiency would be high,” says lead author Juhi Kumar, M.D., M.P.H., of the Children's Hospital at Montefiore Medical Center, “but the magnitude of the problem nationwide was shocking."

Vitamin D deficiency is more common for female children, those that are older, obese, drink less than one glass of milk week, and those who spend four hours or greater on the computer or watching television per day. African-American and Mexican-American children also had a greater risk.“It’s very hard to get enough vitamin D from dietary sources alone,” says Dr. Michal Melamed of the Albert Einstein College of Medicine in Bronx, New York.

Melamed, co-leader of the study, attributes part of this problem to lifestyle, recommending parents send their children outdoors. One source of vitamin D is UV-B sunlight, which converts cholesterol in the skin into vitamin D. She also recommends ditching the sunscreen for a while: “Just 15 to 20 minutes a day should be enough…don't put sunscreen on them until they've been out in the sun for 10 minutes, so they get the good stuff but not sun damage.” Individuals with darker skin and those who live in northern regions with less sun exposure should spend more time outdoors.

The American Academy of Pediatrics recommends that children and teens get at least 400 IU per day, double the previous recommendation of 200IU per day. Good sources of vitamin D include fish, milk, eggs, cod liver oil, and fortified foods. Vitamin D levels can also be increased with the use of supplements.

The study's abstract is available online, and will be published in September's issue of Pediatrics.

Obese women should limit weight gain to between 11 and 20 pounds during gestation, according to an updated set of pregnancy weight gain guidelines released Thursday by the Institute of Medicine. Previously, the Institute did not recommend a specific gestational weight gain range for obese women, but the section was added in response to increasing obesity rates and high weight gain trends in pregnant women. This is the first time the Institute has issued new pregnancy weight gain guidelines in nearly 20 years.

The Institute of Medicine also reevaluated the weight gain recommendations for overweight, normal weight, and underweight women, though the alterations in these weight groups were minute. The Institute now suggests overweight women gain between 15 and 25 pounds, normal weight women gain 25 to 35 pounds, and underweight women gain 28 to 40 pounds during gestation.

These guidelines are based on multiple factors affecting the health of the mother and embryo. Most central to the Institute’s recommendations is the body mass index (BMI) of the expectant mother, a measurement based on acceptable weight to height ratios. Women with a BMI of 30 or greater are considered obese, while a BMI of 25 to 29.9 is considered overweight. Normal weight women have BMIs between 18.5 and 24.9 and a BMI below 18.5 falls in the underweight range.

To measure your BMI, visit the National Institute of Health’s body mass index calculator.

Test your pregnancy knowledge on the Healia Pregnancy Quiz and challenge yourself on the Weight Management Quiz. After taking the quizzes, visit the Healia Pregnancy Health Guide for more pregnancy information and check out the Healia Obesity and Overweight Health Guide to learn more about weight gain.

^{Photo: Crystal_1979, Flickr, Creative Commons}

Restless legs syndrome (RLS), a medical condition characterized by uncomfortable sensations that create an irresistible urge to move the legs during sleep, may be linked to obesity and belly flab according a study published this week in Neurology. The previously obscure neurological disorder has recently attracted attention after late-night commercials about RLS medications brought the condition into the medical limelight.

According to the Restless Legs Syndrome Foundation, 12 million Americans suffer from RLS. The Harvard Medical School study of 88,000 women and men found that those with large waist circumferences were 60 percent more likely to develop RLS than the general population. People with a body mass index (BMI) exceeding 30 were 40 percent more likely to have RLS. A BMI above 25 is considered overweight and a BMI above 30 is considered obese.

Though the Harvard study found an association between obesity, waist size and RLS, there is no current evidence to prove weight gain causes the disorder. Researchers speculate that higher risk for RLS correlates with lower levels of the brain chemical dopamine, which transmits neurological signals and controls muscle movement. Low dopamine levels are common in people with obesity and people with RLS.

Weight loss has not been identified as an effective treatment for RLS.

For more information about RLS, visit the Restless Legs Syndrome Foundation website. Share advice and tips about RLS at Healia’s Restless Legs Syndrome Online Health Community and Support Group.


Source: Neurology. Volume 72, Issue 14. http://www.neurology.org/cgi/content/abstract/72/14/1255


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