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.

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.

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.

 The air quality in and around your home may have negative effects on your child’s intelligence, according to a study by Columbia University Center for Children’s Environmental Health (CCCEH).

The study, released a week ago by the National Institute of Environmental Health Sciences (NIEHS), found that children exposed to chemical pollutants called polycyclic aromatic hydrocarbons found in the air, water, and soil scored lower on IQ tests than children with lower exposure.

Polycyclic aromatic hydrocarbons, or PAHs, are chemical pollutants that can be found in the air, water, and soil. PAHs are typically released from the burning of fossil fuels (coal, diesel, oil, gas, etc.), tobacco and other natural substances. Auto emissions are a major source of PAHs in the United States, especially in heavily trafficked urban areas.

Doctor Frederica Perera, lead author and professor of Environmental Health Sciences at Columbia University Mailman School of Public Health, compares the exposure to such pollutants to low-level lead exposure. “These findings are of concern because these decreases in IQ could be educationally meaningful in terms of school performance,” she says. “IQ is an important predictor of future academic performance.”

A child’s developing fetal and nervous system is more vulnerable than an adult’s, and PAHs have been associated with higher cancer risk, asthma, allergies, low birth weight, and a reduced head circumference. Reduced head circumference, according to CCCEH, is connected with lower cognitive functioning and academic performance. In this study, the first of its kind, researchers hoped to study the relationship of in utero PAH exposure on a child’s intelligence.
 
Participants were non-smoking black and Dominican-American women, aged 18-35, residing in Washington Heights, Harlem and South Bronx, N.Y.—areas with higher pollutant exposure. During pregnancy participants regularly completed questionnaires and were asked to wear monitors that measured PAH levels.

Researchers followed the children, measuring IQ levels at age three and again at age five using the Wechsler Preschool and Primary Scale of the Intelligence. Of the 249 children, 140 had higher than the average 2.26 n/m3 level of exposure. The mean score for all children was 98.72, with a mean score of 96.6 for children whose exposure was classified as “high” and 101.6 for children with lower exposure. Scores differed by 4.67 on the verbal and 4.31 points on the full-scale test.

Researchers will continue to follow children to age 11 to learn more about the effects of PAHs on intelligence and child development. “It should serve as a warning bell to us all,” says Linda Birnbaum, Ph.D., director of NIEHS. “We need to do more to prevent environmental exposures from harming our children.”

Want more information about health during pregnancy? Visit Healia's Pregnancy Community or take the Healia Pregnancy Quiz!

New laws in Louisiana, Connecticut, Georgia and Pennsylvania give students the right to carry and self-administer their own medications, including an asthma inhaler.
At this back-to-school time, find out how to tell if your child with asthma is ready to carry and use an inhaler on his or her own. Age and grade-level matter less than individual readiness, according to the Allergy&Asthma Network Mothers of Asthmatics (AANMA).

Parent/Child Asthma Inhaler Quiz
See how your answers to the following questions match up with your child’s answers. These are the best clues to determining your child’s readiness to self-manage asthma symptoms at school:

1. Does your child use an inhaler (preferably with a holding chamber) correctly at home? 

2. Does she know the name of her medication and when to use it? 

3. Does he stay calm when having asthma symptoms? 

4. Does she tell you when she is having symptoms or when she has used the inhaler? 

5. Does he use a peak flow meter? 

6. Does your child carry the inhaler at all times? 

7. Does he understand that the inhaler is not a toy and should not be shared with friends? 


If you and your child answer “Yes” to most of these questions, you have a child ready to learn about and take responsibility for his or her inhaler.
 
Asthma self-management begins at home. Parental instruction should be backed up by plenty of low-pressure practice. At school, teachers should be aware of the condition and supportive of the process.
Students who self-manage symptoms must be willing to notify teachers, the school nurse or designated administrator when they need to use their inhalers to treat symptom. They must be willing to tell their parents about all medication use or symptoms experienced while away from home.

Back-to-School Asthma To-Do List for Parents
Ensure that backup medication is available in the school clinic should the child become separated from his medication at any time.
Complete required forms and keep them updated during the school year if contact information or emergency treatment plans change.
 

Not yet time for self-use of an inhaler? School personnel will need to ensure that the student’s medication travels with him from one classroom to the next to prevent treatment delays in times of need. Your child’s allergy or asthma management plan should specify this.
• For answers to common asthma questions, check the Healia Health Guide to Asthma.
• Test your knowledge of asthma—take this informative asthma quiz.
• Student-athletes with asthma and allergies can thrive on the playing field as long as they’re careful and follow these tips.

It’s not always easy to find time to eat together, but a study published in the May issue of the Journal of Adolescent Health found that frequent family meals improve the eating habits and attitudes of middle school-aged children. Students who dined with their families six or seven times a week consumed fewer soft drinks, ate breakfast more often, ate more healthfully, and exhibited less concern about undue weight gain.

Researchers at the University of Waterloo in Ontario, Canada surveyed more than 3,000 Canadian sixth, seventh, and eighth graders during the 2004-2005 school year. The students completed the web-based Food Behaviour Questionnaire, which included questions about dining frequency, 24-hour food intake, and family meals.

The results showed that family meals became less common as children grew older, and families in rural areas were more likely to eat together than families in urban locales. Children who frequently dined with their families had significantly higher-quality diets than children who rarely ate with their parents and siblings. Diet quality declined when meals were purchased outside of the home or when meals were skipped.

The study also showed that most of the students surveyed had suboptimal diets. The researchers encourage dining as a family to promote healthful eating habits.

Share your healthy family dining tips on the Healia Diet and Nutrition Community and Support Group. Try testing your nutrition knowledge by taking the Healia Diet and Nutrition Quiz. Need more information on healthy eating? Visit the Diet and Nutrition Health Guide.

_{Photo: S Baker, Flickr, Creative Commons}

Researchers report that adding one half cup of bleach to children’s bathwater can help ease skin irritations associated with atopic eczema. A University of Colorado study published in the current issue of Pediatrics found that bleach dilute baths drastically decreased prevalence of bacterial infections associated with the skin disease in patients from 6 to 17 years of age. The study showed that suppressing the growth of the bacterium responsible for the skin irritations helped reduce problems associated with eczema.

Atopic eczema is an allergic skin disease characterized by red, swollen, itchy skin accompanied by flaking, cracking, crusting and blistering. Children often respond by scratching skin raw, until bleeding or oozing occurs. This causes significant discomfort and is often embarrassing to the affected parties.

Conventional eczema treatments include oral antibiotics, which work against bacteria, and topical anti-itch creams, which sooth the skin and combat itchiness. But bacteria often become resistant to these medications, making future treatment even more difficult. Bleach baths might offer more permanent relief.

If you have other tips for relieving eczema symptoms, share them on the Healia Dermatitis Online Health Community and Support Group.

While obesity prevention has long been the focus of figure-conscious adults, a new Harvard Medical School study suggests that parents should also monitor the weight of their infant children. The study, released Monday and published in the April issue of Pediatrics, found that rapid weight gain during the first six months of life may put children at risk for obesity by the age of three.

"At first it may seem implausible that weight gain over just a few months early in infancy could have long-term health consequences, but it makes sense because so much of human development takes place during that period - and even before birth," says Matthew Gillman, M.D., S.M., the study’s senior author, and director of the Harvard Medical School Department of Ambulatory Care and Prevention’s Obesity Prevention Program.

Researchers documented the weights of 559 infants at birth, at six months and at three years of age. They then studied the correlation between the children’s initial weight gains during the first six months of life and the children’s weights at age three. The study showed that the children heaviest at birth and those who gained the most weight by six months together were 40 percent more likely to be obese by their third year.

"There is increasing evidence that rapid changes in weight during infancy increase children's risk of later obesity," says the study’s lead author, Elsie Taveras, M.D., M.P.H., assistant professor in the Harvard Medical School Department of Ambulatory Care and Prevention and co-director of the One Step Ahead clinic, a pediatric overweight prevention program at Children's Hospital Boston. "The mounting evidence suggests that infancy may be a critical period during which to prevent childhood obesity and its related consequences.”

According to a study released in the April 2007 issue of Acta Paediactrica, roughly 20 percent of four year-olds were considered overweight or obese in 2002, compared to just 10 percent in 1982. With such a startling rise in childhood obesity, proper nutrition must be emphasized at an increasingly younger age.

“[The Harvard Medical School study] data clearly shows how the earliest interventions might actually have very long-term benefits," Taveras says.

To learn more about infant and toddler health, join Healia’s Infant and Toddler Health Community Support Group. For more information about obesity, visit the Healia Obesity/Overweight Health Guide.


Sources: HarvardScience Medicine&Health, “Infant weight gain linked to childhood obesity: Early interventions may have long-term benefits.” Web release, 3/30/2009. By: David Cameron, Harvard Medical School. (http://www.harvardscience.harvard.edu/medicine-health/articles/infant-weight-gain-linked-childhood-obesity)

    “Weight Status in the First 6 Months of Life and Obesity at 3 Years of Age.” Elsie M. Taveras, Sheryl L. Rifas-Shiman, Mandy B. Belfort, Ken P. Kleinman, Emily Oken, and Matthew W. Gillman. Pediatrics 2009; 123: 1177-1183.  (http://pediatrics.aappublications.org/current.shtml)



_{Photo: iwantBDphotography, Flickr, Creative Commons}

Researchers may have found a way to cure children of severe peanut allergies, the most dangerous food allergy. The small study is the first to show that food allergies, dangerous reactions to certain foods that can result in death by anaphylaxis, may be overcome by controlled daily doses of the offending food. However, as this is a preliminary study, parents and physicians should NOT attempt this treatment yet.

Scientists were able to induce long-term peanut tolerance by exposing a small group of children with severe peanut allergies to increasing amounts of peanut flour over a period of months. The technique, called oral immunotherapy, is similar in principle to the "allergy shots" available for airborne allergies: the body is exposed to small amounts of an allergen and over time, the body adapts to it.

In the study, 29 children with severe peanut allergies spent a day in the hospital swallowing very small but slowly increasing doses of a specially-prepared peanut flour, up to the point where they started to have a reaction. After that, the children and their parents were sent home with a supply of the peanut flour and instructions on how to take a daily dose just under the amount that caused a reaction. For the severely allergic, this is usually around the equivalent of 1/1,000^th of a peanut. Over a period of eight to ten months, the daily dose of peanut flour was gradually increased until the children could tolerate the equivalent of 15 peanuts worth of peanut flour. Thereafter, the children continue to take a constant daily maintenance dose.

Some of the children in the study have been on maintenance therapy for 2.5 years. After completing a series of challenge tests involving real peanuts, four of these children were able to stop the daily treatments and eat peanuts normally.

The children were also tested for their levels of peanut-specific IgE antibodies, the body molecules that cause them to react to the peanuts in the first place. At the study outset, most of the children had IgE levels greater than 25. At the end of the study, their peanut IgE levels were less than 2 and have remained low.

The researchers caution that the technique is still under study and warn parents and physicians NOT to attempt it on their own. Because only a small number of individuals participated in the study, more research is needed before scientists can be confident in the results. Also, it is possible that some patients may have allergy symptoms so severe that the treatment may not work.

Only time will tell if the effects of the treatment continue to last. For now, the four children who were able to stop the daily peanut flour doses have been instructed to eat the equivalent of a tablespoon of peanut butter each day to ensure that they remain allergy-free. A study currently underway is examining the effect of the peanut flour treatment compared to a control group not receiving the treatment.

Want to learn more about food allergies? Join the Healia Support Group Community for Food Allergy. You can also read the Healia Health Guide to Allergies. For information on seasonal allergies, consult the Healia Health Guide to Outdoor Allergies.

_{Photo: EuroMagic, Flickr, Creative Commons}