Posts Tagged ‘ JAMA ’

Decline in Preschool Obesity? Maybe Not, Experts Say

Tuesday, March 18th, 2014

A study published last month in the Journal of the American Medical Association, which claimed a 43 percent drop in the number of preschool-aged American kids who have a weight problem, is being questioned as a possible statistical anomaly, and not an indication that the childhood obesity epidemic is on its way out.  Reuters reports on the challenge, which is coming from obesity experts from Massachusetts General Hospital and other places:

In fact, based on the researchers’ own data, the obesity rate may have even risen rather than declined.

“You need to have a healthy degree of skepticism about the validity of this finding,” said Dr. Lee Kaplan, director of the weight center at Massachusetts General Hospital in Boston.

No evidence of the kinds of major shifts in the behavior among preschoolers aged 2 to 5 exists which would explain a 43 percent drop in their obesity rates, he said.

The latest study is based a well-respected data set taken from the National Health and Nutrition Examination Survey, or NHANES, which has been conducted annually since the 1960s and involves in-person interviews and physical exams.

The CDC defines obesity in adults as having a body mass index – a ratio of weight to height – above 30, but in children it is defined by where the individual falls on age- and sex-specific growth charts.

The 2011-2012 version of the survey included 9,120 people; 871 of them were 2 to 5 years old.

In some research 871 would be considered a large number. But when the obesity rate is fairly low, having a sample of a few hundred makes it easier for errors to creep in through random chance.

“In small samples like this, you are going to have chance fluctuations,” said epidemiologist Geoffrey Kabat of the Albert Einstein College of Medicine in New York City.

To be sure, the CDC scientists were aware of the statistical limitations of their data, and their paper clearly stated that the findings were imprecise.

The 43 percent headline figure refers to the drop from the 13.9 percent rate in 2003-04 to the 8.4 percent rate in 2011-2012. The change of 5.5 points represents a decline of 40 percent from the original 13.9 percent. (The 43 percent trumpeted by a CDC press release comes from rounding those numbers to 14 and 8, respectively.)

In addition to the small sample size and a lack of supporting evidence from other recent surveys of childhood weight, experts cite a dearth of signs of behavioral changes that would contribute to improving obesity numbers.  More from Reuters:

For obesity rates to drop, researchers reckon, young children have to eat differently and become more active. But research shows little sign of such changes among 2-to-5-year olds, casting more doubt on the 43 percent claim.

Such a decline would require changes in exercise, food consumption and sleep patterns, said Mass General’s Kaplan “There is no evidence of that,” he said.

In 2010 [WIC (Women, Infants and Children) program researcher Shannon] Whaley and her colleagues examined the effectiveness of WIC classes and counseling to encourage healthy eating and activities for women and children in the program.

Their findings were discouraging: Television watching and consumption of sweet or salty snacks actually rose, while fruit and vegetable consumption fell – changes that could lead to weight gain. One positive was a rise in physical activity.

Apart from the WIC program, few anti-obesity efforts target preschoolers, Kaplan pointed out. That makes a precipitous decline in obesity in that group highly unlikely.

Image: Brown bag lunch, via Shutterstock

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Parents Need to Pay Closer Attention to Loud Music and Hearing Loss

Wednesday, November 27th, 2013

Parents, particularly the parents of teenagers, are not as aware and vocal about the dangerous effects of prolonged exposure to loud music, according to a new study conducted by researchers at Penn State University.  As a result, teens are at elevated risk of long-term hearing problems.  More from Reuters:

One in eight American kids and teenagers – or more than 5 million – has a type of hearing loss that usually stems from overexposure to loud noises, according to the Centers for Disease Control and Prevention.

Parents can help prevent much of that hearing loss, the researchers said.

For the new study, they collected Internet survey responses from more than 700 parents of teenage children.

Almost 70 percent of the parents had not spoken with their child about noise exposure, mainly because they thought the actual risk of hearing damage was low.

But almost an equal number reported being willing to limit time listening to music and access to other excessively noisy situations to protect their teenager’s hearing, according to results published in JAMA Otolaryngology-Head and Neck Surgery.

On the whole, parents seemed willing to take steps to protect their kids, but often underestimated the risks of too much loud music.

“I think it just means that we have work to do in terms of raising awareness,” Sekhar said.

More educated parents and those with younger teens were most likely to be willing to take precautions with their kids, like limiting music time, limiting access to noisy situations or insisting on protective measures like earplugs.

Image: Teenager listening to loud music, via Shutterstock

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ADHD Diagnoses Jump 24 Percent in a Decade

Tuesday, January 22nd, 2013

The number of children diagnosed with attention deficit hyperactivity disorder (ADHD) has increased by 24 percent between 2001 and 2010, a new study published in the journal JAMA Pediatrics is reporting.  That brings the number of American children affected by the disorder in 2010 to 3.1 percent, up from 2.5 percent in 2001.  More from MSNBC.com:

Rates rose most among minority kids during the study period, climbing nearly 70 percent overall in black children, and 60 percent among Hispanic youngsters, according the study published in JAMA Pediatrics. Among black girls, ADHD rates jumped 90 percent.

Rates remained highest in white children, climbing from 4.7 percent to 5.6 percent during the study period.

The biggest factor driving this increase may be the heightened awareness of ADHD among parents, teachers, and pediatricians, says the study’s lead author Dr. Darios Getahun, a scientist with Kaiser Permanente. For kids who need help, that’s a good thing, Getahun says.

“The earlier a diagnosis is made, the earlier we can initiate treatment which leads to a better outcome for the child,” he says.

Image: Distracted child, via Shutterstock

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