Personal Health: For Kids, Increased Screen Time Can Equal Increased Blood Pressure

Published on August 10th, 2009 in THE PHILADELPHIA INQUIRER.

Kids' screen time is linked to development of hypertension
More time plopped in front of a screen - computer, video, video game, and, particularly, television - may raise the risk of elevated blood pressure in children, according to a new study.

The researchers tracked activity levels of 111 children ages 3 to 8 - 57 boys and 54 girls - round-the-clock for a week via measurements from an accelerometer worn over the right hip as well as parents' reports of the average time their child spent sitting or engaging in activities that ranged from painting to watching TV. They also considered age, sex, height, percentage of body fat, and other differences.

Excessive TV time and total screen time were linked to elevated blood pressure - a risk factor for cardiovascular disease and other health problems - even when possibly related measures, such as body fat, were separated from the analysis. Children who spent less than 30 minutes a day in front of a screen tended to have the lowest blood pressures, the researchers report in the August issue of Archives of Pediatrics and Adolescent Medicine. (The average was 90 minutes.)

Interestingly, the researchers did not find an association between blood pressure and sedentary behavior in general, leading them to suggest that factors specific to watching a screen - eating foods high in sugar, fat and salt, for example, or disruptive sleep patterns that have been associated with TV time - might play a role. - Heather J. Chin

Read the full article here.

Pennsylvania: Pediatricians and Paperwork

Published on July 27, 2009 in THE PHILADELPHIA INQUIRER.

Summer's no vacation for pediatricians

Pediatricians know it's summer when the health forms start piling up.

For everything from day care and camps to college and driver's license applications, each form asks different questions and often requires handwritten answers.

"It's overwhelming, particularly in the summer" when camps, school, and sports seasons converge, says Jeffrey Bomze, a pediatrician whose Bryn Mawr practice sees around 3,000 patients a year. "It's not just a signature and out the door."

Every year, pediatricians typically see about 95 patients per week, according to the American Academy of Pediatrics. At nearly 5,000 patients per year, four health forms per child, and about eight minutes per form, that means one person could spend 333 workdays a year on health forms alone.

And it's getting worse.

Read the full story here.

HEALTH NEWS: Baby-Targeted TV Banned In France

(previously published here at www.thebulletin.us)

By: Heather J. Chin, The Bulletin

08/28/2008

From the colorful costumes of "Barney and Friends" to Saturday morning cartoons like "Dora the Explorer," television programming has long targeted the pre-preschool set in America. If we take a cue from France, however, that could change.

Last week, the High Audiovisual Council, France's broadcast authority, banned French channels from airing any TV shows with a target audience of children under three years old. The goal, as stated in the published ruling, is to "protect children under three from the [negative] effects of television."

"Television viewing hurts the development of children under three years old and poses a certain number of risks, encouraging passivity, slow language acquisition, over-excitedness, troubles with sleep and concentration as well as dependence on screens," wrote the council.

The ruling affects both French channels and cable operators that air foreign channels, specifically BabyFirstTV and BabyTV. BabyTV is owned by Rupert Murdoch's News Corp. and BabyFirstTV is owned by a Fox Entertainment affiliate, as well as Netherlands-based and LA-based investment groups.

Program development will be affected and French cable operators that air foreign channels with baby-targeted programs will now be required to air warning messages to parents, such as: "Watching television can slow the development of children under three, even when it involves channels aimed specifically at them."

While such baby-marketed products are touted as specially designed for parent-baby interactive viewing, critics argue that such specific channels are more often used as a babysitting tool.

In a June newspaper interview, France's minister for culture and communication, Christine Albanel, also urged parents not to use 24-hour channels as a sleep aid, deeming it actually counterproductive to a good night's sleep. Research shows that background noise and artificial light such as those from TVs impede the body's ability to wind down and rest.

Area medical professionals agree. Dr. Gary Emmett, director of hospital pediatrics at Thomas Jefferson University Hospital, said, "While watching TV is not always harmful, it is not always helpful." It also often has long-term effects on learning and physical health, since the time spent in front of the TV takes away from other activities.

"Reading is directly correlated to success in school, while watching TV, and other things that [doctors] regard as passive, is not ... and is counter-related," he said.

Research published this July in the journal Childhood Development has also highlighted the negative effects of background noise on a toddler's ability to concentrate and learn, instead fostering restlessness and distraction.

BabyFirstTV first aired in the United States in 2006 to much debate over the value of such programming towards the youngest and most undeveloped, impressionable segments of society. The American Academy of Pediatrics recommends that children below age three should have zero hours of TV watching. However, a 2003 Kaiser Family Foundation study found that two-thirds of children under age six live in a home where the TV is on half the time, while one-third of children live in a home where it is on "most of the time" or "always."

According to Dr. Emmett, parents can help by fostering active playtime with other children and by reading storybooks with them. There is also a Philadelphia-area branch of the national charity NEMOURS that calls for a "two-one-five-zero" program: two hours or less of screen time a day, one hour of running or swift walking, five portions of fruit and vegetables a day and no sweets or sugary drinks.


Heather J. Chin can be reached at hchin@thebulletin.us

©The Evening Bulletin 2008

LOCAL: CHOP Given $15M For New Care Center

(previously published here at www.thebulletin.us)

By: Heather J. Chin, The Bulletin
07/25/2008

The Children's Hospital of Philadelphia will be opening a new pediatric care center in Norristown thanks to a $15 million gift from Athena and Nicholas Karabots of Fort Washington.

The new Karabots Pediatric Care Center will give families in-and-around the Norristown and Montgomery County communities convenient access to primary pediatric care, state-of-the-art clinical facilities and CHOP community and education programs.

"We are delighted and most grateful to the Karabots family for this generous donation," said Dr. Steven M. Altschuler, president and CEO of CHOP.

Community programs offered through Children's Hospital include Reach Out And Read, the Homeless Health Initiative, drug and substance abuse education, school readiness programs, and child abuse and neglect prevention.

"I have always felt strongly that all children, especially those living under difficult circumstances, deserve the opportunity to live a healthy and productive life," Nicholas Karabots said Wednesday. "To do this, they need to have access to good healthcare services. My wife and I are delighted to be able to support the creation of this facility that will help so many in need."

Children's Hospital of Philadelphia was the nation's first pediatric hospital and remains a leader in research, primary pediatric care and community outreach. It ranked number one in general pediatric care and specialized care (neonatal, cancer and respiratory care, among others) according to U.S. News & World Report.

The Karabots Foundation has also made contributions to the Philadelphia Museum of Art in its efforts to retain the Gross Clinic painting in Philadelphia, and helped fund and create the Karabots Center for MRI Diagnostics at Montgomery Hospital.

Mr. Karabots grew up in the South Bronx in New York City and rose to prominence in the printing and publishing business, including with Kappa Publishing Group, Inc., the largest publisher of puzzle magazines.



Heather J. Chin can be reached at hchin@thebulletin.us


©The Evening Bulletin 2008

HEALTH FEATURE: Summer Allergy Miseries

(previously published here at www.thebulletin.us)

By: Heather Chin, The Bulletin
07/18/2008

Don't think it's just you. It is not your imagination. Age has nothing to do with it. Things really are worse this year. Everyone is feeling the pressure.

Yes, this is a vintage year, maybe a historic year, for allergy miseries. Many of us are having just a little more trouble breathing. Our sinuses feel as though they are under attack. Coughing and sneezing and scratching incessantly at dry eyes seems to have become a more or less permanent condition.

Although observers described last year as an especially bad allergy season on the East Coast, with a mild winter and late growing season exacerbating already warm weather, 2008 is already providing even more frustrating conditions for allergy sufferers.

Tree pollen, mold and grass pollen were the most common, active pollen types in the Philadelphia area during June, with "very high" levels according to Weather.com's Pollen Almanac, and mold allergens have dominated the scene through the first half of July.

Seasonal allergies are caused by airborne pollens, which are released from trees and grasses during pollination and reproduction. Beginning with the spring pollination of trees and the early summer introduction of grass particles, allergens trigger the strongest reactions in summer and early fall.

This year, "with the mild winter, the trees have been blooming earlier, and the first cases of allergy exacerbation started in early March," said Corinna Bowser, M.D., an allergist at Adult and Pediatric Asthma and Allergy, in Havertown, whose practice serves patients throughout the region. "The counts have been [especially] high because it hasn't been raining a lot and rain usually clears the air of allergens."

Dr. Bowser said she has observed an increase in reports of first-time allergy suffering by people in their 40s and 50s. Allergic reactions to outdoor allergens usually first present themselves in teenagers and those in their 20s.

The creation of a seemingly new group of allergy sufferers may be the result of more people reporting their allergies, rather than the development of new airborne issues, Dr. Bowser, who is also part of the teaching faculty at the Philadelphia College of Osteopathic Medicine, said. Either way, it can be excruciating for allergy sufferers.

"People who have had allergies for some time, but never bad enough to seek care [may be] finally pushed over the edge [to seek treatment] now that the counts have been higher and the effect has been worse."

There are other theories and possibilities being considered by asthma, allergy and immunology specialists, including the impact of climate change (warmer temperatures leading to higher pollen counts) and something called the hygiene hypothesis.

"Our super clean environment, perhaps, may actually put more people at added risk for developing allergies down the line," Dr. John Sundy, an allergy specialist at Duke University Medical Center, told a local television station. This risk would come not from too little hand-washing, but from a lack of early exposure to natural environments that include allergy triggers like pollen, dust and animal fur.

American Lung Association statistics indicate residents under age 18 and over age 65 living in the five-county Philadelphia area are at a high risk of developing everything from pediatric asthma to chronic bronchitis and CV disease to diabetes.

Common allergy triggers in Pennsylvania, as listed on Weather.com, include alfalfa, honeysuckle, horse chestnut, poison sumac [leaves], post oak and prairie ragweed.

In addition to the typical plant-related allergens such as pollen and ragweed, atmospheric conditions such as ozone levels and levels of particulate matter also cause concern.

A recent German study suggests that pollution levels, especially those from vehicular-derived particles and aerosols, can increase the possibility of sensitivity to allergens.

Many options exist to aid allergy sufferers, ranging from asking doctors about allergy medications and antihistamines to timing outdoor activities to avoid early morning pollen saturation.


Heather Chin can be reached at hchin@thebulletin.us


©The Evening Bulletin 2008

Television Noise Could Inhibit Toddler Learning

(previously published here at www.thebulletin.us)

By: Heather J. Chin, The Bulletin

07/17/2008

To adults, background sounds from an unwatched TV show can be disregarded or embraced as comforting white noise, but a recent study shows this is not the case for infants and toddlers.
To their developing minds, TV noises could have the opposite effect, interfering with their ability to concentrate and learn according to findings published this week in the journal Childhood Development.

Researchers observed 50 toddlers between ages 1 and 3 at play in a room for an hour, with a half-hour of TV-free play and the other half-hour with the TV show "Jeopardy" airing in the room. When the TV was on, they noticed the children were more restless and distracted.

During a no-TV time, "the child gets an intent look on their face, they lean into the toy, their extraneous body movements decrease," wrote Dr. Daniel Anderson, a co-author of the study and a professor of psychology at the University of Massachusetts. "When they're in that state, they're much more likely to be learning."

In contrast, the children played for half as long - around 15 minutes - when the TV was turned on, were noticeably less calm and glancing up occasionally.

"You actually can see sometimes more aimless behavior, walking around like they're not quite sure what they're going to do next, " Dr. Anderson said.

In describing how these behaviors could be observed, Dr. Anderson said, "it's not something that you would really notice from just watching the child. [When we started the study] I really didn't know if children could just focus on their activity and shut out the background noise."

The American Academy of Pediatrics recommends zero hours of TV-watching for infant and toddlers below age three, but a Kaiser Family Foundation study in 2003 found that two-thirds of children under six years of age live in a home where the TV is on half the time, while one-third of children live in a home where it is on "most of the time" or "always."

Studies have been done on the effect of TV-watching on young children, but the effect of background noise on their ability to learn is new. Time-strapped parents and older siblings often combine TV-watching and time spent on childcare, so with young children being exposed to TV more frequently, the effect could be great.

For Dr. Gary Emmett, director of general pediatrics at Thomas Jefferson University Hospital in Philadelphia, a complementary prudent question would be whether children would grow up with language and cognitive difficulties.

"Reading is directly correlated to success in school, while watching TV and other things that [doctors] regard as passive... is counter-related ... Watching TV, while not always harmful is not always helpful."

To combat this problem, Dr. Emmett notes that language-rich homes - where families read, talk and engage in regular verbal communication - the impact of background distractions such as TV don't have as much of an effect as in language-poor homes.

Dr. Dimitri Christakis, the George Adkins professor of pediatrics at the University of Washington and Seattle Children's Research Institute, agreed.

"There have been a lot of studies that explored this, and early television is associated with delayed language, delayed cognitive developments, shorter attention span," he said, "What we haven't found yet is the mechanism."

According to Dr. Emmett, behavior and physical activity work together for health. As another study published this week in the Journal of the American Medical Association found, by the time children turn 15, their daily levels of activity slow down to below the recommended one hour per day.

In Pennsylvania and the tri-state area, there are pediatric medicine self-promotion programs available to families to begin working towards placing a greater emphasis on both feeding the mind and feeding the body.

Used at NEMOURS charity at the DuPont Hospital for Children in Florida, as well as in Delaware, Pennsylvania and New Jersey and called the "5-2-1-almost none" program (in Philadelphia, it's the 2-1-5-0 program, after Philadelphia area code), it calls for: five portions of fruit and vegetables a day, two hours or less a day of screen time (TV, computers, video games), one hour of running rather than walking, and no sweets and drinks.

"We're trying to get in [to the family routine] in the simplest way we can," said Dr. Emmett, who applies it in his work with families. "People always want things to be simplified, but things are complex. [We have to address] both issues (body and mind), not one."

Heather J. Chin can be reached at hchin@thebulletin.us

©The Evening Bulletin 2008

New Clue Found In Cause Of SIDS

(previously published here at www.thebulletin.us)

By: Heather J. Chin, The Bulletin

07/10/2008

Sudden Infant Death Syndrome (SIDS), the leading cause of death among infants younger than 1 year old, could result from a deficit imbalance of serotonin levels in the brain, according to a new study published in the July issue of the journal Science.

SIDS describes the sudden, unexplained death of an infant between 1 month and 1 year of age. Also called "crib death" since it often occurs while the infant is asleep, SIDS strikes many seemingly healthy infants and can only be diagnosed after ruling out all other possible causes. African Americans and Native Americans are two to three times more likely than Caucasians to die from SIDS, and boys are more often affected than girls.

Serotonin is a neurotransmitter - a signaling chemical - that affects brain and organ function throughout the body, influencing an individual's mood balance and playing a role in everything from depression, anger and appetite, to the regulation of body temperature, heart rate and arousal from sleep.

Dr. Cornelius Gross, Ph.D., and colleagues from the European Molecular Biology Laboratory near Rome, Italy, made the "chance discovery" of SIDS-like symptoms while attempting to determine serotonin's role in aggression and society. They observed that genetically engineered mice with abnormally low levels of serotonin experienced erratic drops in heart rate and a drop in body temperature. But it was after over half of the mice used in the study died, all before three months of age, that the scientists made the association between serotonin levels and SIDS.

Dr. Gross emphasized that the SIDS-like symptoms exhibited by the lab mice were not indicative of symptoms experienced by human infants who suffered from SIDS, since the mice had been engineered to have an overactive gene that inhibits serotonin production.

SIDS incidence rates peak at three to four months in babies born at full-term, and at around three to four months after the due date of babies born prematurely. This period is notable as the time around when infants can turn over by themselves while asleep, thus increasing the likelihood of putting their faces against soft material.

However, as noted by Dr. Gary Emmett, a general pediatrician with Jefferson University Hospital in Philadelphia, precautionary measures have cut the incidence rate in the U.S. by more than 50 percent in the past 20 years. According to the CDC and the National Center for Health Statistics, SIDS deaths are down from 1.43 deaths per live birth (1984) to 0.51 deaths per live birth (2005) - around 2,500 deaths annually.

The study's findings are far from being conclusive, it supports previous studies done by Dr. Hannah Kinney, from the Children's Hospital of Boston, where inadequate serotonin levels were linked to SIDS, but not in a way that could establish a method to measure risk or related symptoms.

Doctors and researchers hope that this connection might spur further awareness, interest and development into creating ways to screen infants for risk of SIDS.

"Now that [low serotonin levels has] come up as strongly related to two different species, we know we're on the right track [and] it'll encourage people to study this more in living human beings," said Dr. Emmett.

Referring to his study, Dr. Gross added that "Maybe there is some kind of signature we could find in these mice before they have a crisis, some way they respond when they wake up from sleep. That might help us identify those kids most at risk [for] SIDS and provide parents with some[thing] ... before a crisis occurs."


Heather Chin can be reached at hchin@thebulletin.us

©The Evening Bulletin 2008

Non-Parent Care May Spur Infant Weight Gain

(previously published here at www.thebulletin.us)

By: Heather Chin, The Bulletin

07/08/2008

Aspects of modern family life, from stay-at-home parenting to childhood obesity, are increasingly residents of the public awareness, spurring conversation, influencing decisions, and permeating how we manage time in the workplace.

It may come as little surprise, then, that a new report in the Archives of Pediatric Medicine, one of the JAMA/Archives journals, has found a connection between child care by someone other than a parent and higher infant weight gain.

Nine-month-old infants regularly cared for by either a parent or a non-parent figure were observed during the study, conducted by researchers Juhee Kim, Sc.D., of the University of Illinois at Urbana-Champaign, and Karen E. Peterson of the Harvard School of Public Health, Boston, over the course of one year, during 2001 and 2002.

During regular home visits, the infants were weighed and measured and each respective primary caregiver provided information regarding type and intensity of child care, which included feeding practices.

The increase in weight came from what the researchers noted were higher rates of unfavorable feeding practices with the infants by non-parent regular caregivers.

"Infants who initiated child care at younger than three months were less likely to have been breastfed and were more likely to have received early introduction of solid foods than those in parental care," wrote the authors. Early introduction to solid foods is considered in the study to be a risk factor for weight gain, and both the National Institute of Child Health and Human Development and the American Academy of Family Physicians support breastfeeding for the first six months of care by women who don't have health problems.

Compared to infants who were cared for by parents, those in part-time care gained 174 grams (around 0.4 pounds) more weight, while infants cared for by relatives gained 162 grams (or around 0.35 pounds) more weight, were less likely to begin breastfeeding and also had a higher rate of early introduction to solid foods.

Out of 8,150 nine-month-old infants evaluated during home visits over the study period, a total of 55.3 percent of the infants evaluated received regular child care from a non-parent figure. Of these, half received full-time child care, 40.3 percent began care before 3 months of age, 39.3 percent began care between 3 and 5.9 months of age, and 20.7 percent began care at 6 months of age or older.

"Our study results provide new evidence that child care influences both infant feeding practices and risk of [becoming] overweight at least during infancy," the authors wrote in their conclusion.

According to background info in the study, almost 75 percent of infants in their first year of life receive some form of child care by individuals not their parents. In addition, the authors describe how child care is often associated with positive cognitive and language development, as well as strength in the social, emotional and academic realms.

As the first available study into the relationship between child care, feeding practices and infants' weight, both Dr. Kim and Dr. Peterson consider their findings to be simply a first step in understanding at least some of the factors that may lead up to a child being overweight. "Child care factors were associated with unfavorable infant feeding practices and more weight gain during the first year of life," they said, "[and] the effects ... warrant longer follow-up to determine subsequent risk [of such increased weight]."

Heather Chin can be reached at hchin@thebulletin.us

©The Evening Bulletin 2008