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Published on Leave a comment on Appendicitis in Children Can Be Treated With Antibiotics
Drawing of colon seen from front (appendix is colored red). Credit: Wikipedia

This is the second time I've seen research finding that antibiotics  alone could be used (instead of surgery) for the treatment of uncomplicated appendicitis (June 17, 2015 post), but this time in children. Appendicitis is inflammation of the appendix.  At the one year follow-up the researchers found that 75.7% of patients with uncomplicated appendicitis had been successfully treated with antibiotics alone and had not had any recurrences of appendicitis.

This is a major finding because for years the gold standard for appendicitis treatment has been an appendectomy. The times are a changing.

From Science Daily: Antibiotics alone can be a safe, effective treatment for children with appendicitis

Using antibiotics alone to treat children with uncomplicated acute appendicitis is a reasonable alternative to surgery when chosen by the family. A study led by researchers at Nationwide Children's Hospital found that three out of four children with uncomplicated appendicitis have been successfully treated with antibiotics alone at one year follow-up. Compared to urgent appendectomy, non-operative management was associated with less recovery time, lower health costs and no difference in the rate of complications at one year.

"Surgery has long been the 'gold standard' of care for treating appendicitis because by removing the appendix we eliminate the chance that the appendicitis will ever come back," said Dr. Deans. "However, early in our careers we noticed that patients with appendicitis who were placed on antibiotics overnight until their surgery the following morning felt better the next day. So, Pete and I asked ourselves: do they really need to have surgery?"

In the first study conducted and published in the United States examining non-operative management for appendicitis, they enrolled 102 patients age 7 to 17 who were diagnosed with uncomplicated acute appendicitis at Nationwide Children's between October 2012 and October 2013. Participants had early/mild appendicitis, meaning that they experienced abdominal pain for no more than 48 hours; had a white blood cell count below 18,000; underwent an ultrasound or CT scan to rule out rupture and to verify that their appendix was 1.1 centimeter thick or smaller; and had no evidence of an abscess or fecalith, which is hard stone-like piece of stool.

Thirty-seven families chose antibiotics alone and 65 opted for surgery. Those patients in the non-operative group were admitted to the hospital and received IV antibiotics for at least 24 hours, followed by oral antibiotics after discharge for a total of 10 days. Among those patients, 95% showed improvement within 24 hours and were discharged without undergoing surgery. Rates of appendicitis-related medical care within 30 days were similar between the groups with two patients in the non-operative group readmitted within 30 days for an appendectomy. At one year after discharge, three out of four patients in the non-operative group did not have appendicitis again and have not undergone surgery.

Appendicitis, caused by a bacterial infection in the appendix, is the most common reason for emergency abdominal surgery in children, sending more than 70,000 young people to the operating room each year. Although many of these cases are severe and require surgery, there are a good number that would be candidates for treatment with antibiotics alone, Dr. Minneci said.

According to the study results, patients who were transferred to Nationwide Children's from other institutions expressed concerns about the distance and time necessary to come back if the appendicitis recurred. These families opted for surgery more often. Patients whose families spoke primary languages other than English were more likely to choose antibiotics as a course of treatment due to cultural values to avoid surgery if at all possible.

Published on Leave a comment on Taking Antidepressants During Pregnancy and Autism

A large study found that using antidepressants during the second or third trimester of pregnancy increases the risk that the child will have autism by 87%,  especially if the mother takes selective serotonin reuptake inhibitors (SSRIs). A drawback was that the study looked at associations rather than actual cause (which would have meant randomly assigning women to either treatment or no treatment - which is unethical). From Medical Xpress:

Taking antidepressants during pregnancy increases risk of autism by 87 percent

Using antidepressants during pregnancy greatly increases the risk of autism, Professor Anick Bérard of the University of Montreal and its affiliated CHU Sainte-Justine children's hospital revealed today. Prof. Bérard, an internationally renowned expert in the fields of pharmaceutical safety during pregnancy, came to her conclusions after reviewing data covering 145,456 pregnancies.

"The variety of causes of autism remain unclear, but studies have shown that both genetics and environment can play a role," she explained. "Our study has established that taking antidepressants during the second or third trimester of pregnancy almost doubles the risk that the child will be diagnosed with autism by age 7, especially if the mother takes selective serotonin reuptake inhibitors, often known by its acronym SSRIs." Her findings were published today in JAMA Pediatrics.

Bérard and her colleagues worked with data from the Quebec Pregnancy Cohort and studied 145,456 children between the time of their conception up to age ten. In addition to information about the mother's use of antidepressants and the child's eventual diagnosis of autism, the data included a wealth of details that enabled the team to tease out the specific impact of the antidepressant drugs. 

"We defined exposure to antidepressants as the mother having had one or more prescription for antidepressants filled during the second or third trimester of the pregnancy. This period was chosen as the infant's critical brain development occurs during this time," Prof. Bérard said. "Amongst all the children in the study, we then identified which children had been diagnosed with a form of autism by looking at hospital records indicating diagnosed childhood autism, atypical autism, Asperger's syndrome, or a pervasive developmental disorder. Finally, we looked for a statistical association between the two groups, and found a very significant one: an 87% increased risk." 

The findings are hugely important as six to ten percent of pregnant women are currently being treated for depression with antidepressants. In the current study, 1,054 children were diagnosed with autism (0.72% of the children in the study), on average at 4.5 years of age. Moreover, the prevalence of autism amongst children has increased from 4 in 10,000 children in 1966 to 100 in 10,000 today. While that increase can be attributed to both better detection and widening criteria for diagnosis, researchers believe that environmental factors are also playing a part.

"It is biologically plausible that anti-depressants are causing autism if used at the time of brain development in the womb, as serotonin is involved in numerous pre- and postnatal developmental processes, including cell division, the migration of neuros, cell differentiation and synaptogenesis - the creation of links between brain cells," Prof. Bérard explained. "Some classes of anti-depressants work by inhibiting serotonin (SSRIs and some other antidepressant classes), which will have a negative impact on the ability of the brain to fully develop and adapt in-utero".

Published on Leave a comment on Early Pesticide Exposure Linked to Poorer Lung Function

 Just a few years ago the type of pesticide (organophosphate, for example chlorpyrifos) looked at in this study was commonly used everywhere - in schools, homes, agriculture. It was easy to buy in stores (e.g., Raid spray), and was considered "safer" than older pesticides. Over time problem after problem has been found with them - with the latest being decreased lung function in children exposed to organophosphates early in life.

Keep in mind that with all current pesticides we know very little about long-term effects, especially on developing fetuses and children, and so we should be very, very careful about using them and avoid unnecessary use. Yes, that means using them for harmless lawn weeds is an unnecessary use. Common lawn weeds can not give a person cancer, birth defects, health problems, or illnesses, but pesticides can. From Medical Xpress:

Weaker breaths in kids linked to early pesticide exposure

Taking a deep breath might be a bit harder for children exposed early in life to a widely used class of pesticides in agriculture, according to a new paper by researchers at the University of California, Berkeley. A new study has linked the levels of organophosphate pesticide metabolites in the urine of 279 children living in California's Salinas Valley with decreased lung function. Each tenfold increase in concentrations of organophosphate metabolites was associated with a 159-milliliter decrease in lung function, or about 8 percent less air, on average, when blowing out a candle. The magnitude of this decrease is similar to a child's secondhand smoke exposure from his or her mother.

"Researchers have described breathing problems in agricultural workers who are exposed to these pesticides, but these new findings are about children who live in an agricultural area where the organophosphates are being used," said study senior author Brenda Eskenazi, a professor of epidemiology and of maternal and child health. "This is the first evidence suggesting that children exposed to organophosphates have poorer lung function."

The children were part of the Center for the Health Assessment of Mothers and Children of Salinas (CHAMACOS), a longitudinal study in which the researchers follow children from the time they are in the womb up to adolescence. The researchers collected urine samples five times throughout the children's lives, from age 6 months to 5 years, and measured the levels of organophosphate pesticide metabolites each time. When the children were 7 years old, they were given a spirometry test to measure the amount of air they could exhale.

"The kids in our study with higher pesticide exposure had lower breathing capacity," said study lead author Rachel Raanan, who conducted the research while she was a postdoctoral scholar in Eskenazi's lab. "If the reduced lung function persists into adulthood, it could leave our participants at greater risk of developing respiratory problems like COPD (chronic obstructive pulmonary disease)."

The study did not examine the pathways for the children's exposure to pesticides, but the researchers did recommend that farmworkers remove their work clothes and shoes before entering their homes. They also suggested that when nearby fields are being sprayed with pesticides, children be kept away and, if indoors, windows should be closed. Pesticide exposure can also be reduced by washing fruits and vegetables thoroughly before eating.

The authors noted that although organophosphate pesticides are still widely used, most residential uses of organophosphate pesticides in the United States were phased out in the mid-2000s. In California, use of organophosphates in agriculture has also declined significantly from 6.4 million pounds in 2000, when the study began, to 3.5 million pounds in 2013, the year with the most recent pesticide use data. 

Published on Leave a comment on What is “Seeding” the Microbiomes of Babies Born By C-section?

The mother is an important source of the first microbiome for infants by "seeding" the baby's microbiome - from the vaginal birth and then breastfeeding. However, research finds that infants born by C-section acquire bacteria commonly found on skin (Staphylococcus, Corynebacterium, and Propionibacterium) rather than the bacteria acquired during a vaginal birth.

This study examined the source of the skin-type bacteria found on C-section babies. The researchers analyzed the dust from operating rooms (which they collected right after C-sections) and found that it contains deposits of human skin bacteria and human skin flakes. The researchers point out that "Humans shed up to 37 million bacterial genomes into the environment per hour." Operating rooms are occupied by humans, lack natural ventilation, and even though they are regularly cleaned, the humans using the operating rooms shed bacteria and skin flakes. From Microbiome:

The first microbial environment of infants born by C-section: the operating room microbes

Newborns delivered by C-section acquire human skin microbes just after birth, but the sources remain unknown. We hypothesized that the operating room (OR) environment contains human skin bacteria that could be seeding C-section born infants. To test this hypothesis, we sampled 11 sites in four operating rooms from three hospitals in two cities. Following a C-section procedure, we swabbed OR floors, walls, ventilation grids, armrests, and lamps....The bacterial content of OR (operating room) dust corresponded to human skin bacteria, with dominance of Staphylococcus and Corynebacterium. Diversity of bacteria was the highest in the ventilation grids and walls but was also present on top of the surgery lamps. 

We conclude that the dust from ORs, collected right after a C-section procedure, contains deposits of human skin bacteria. The OR microbiota is the first environment for C-section newborns, and OR microbes might be seeding the microbiome in these babies. 

In the present study, we used 16S rRNA gene sequencing to show that OR dust, collected right after a C-section procedure, contains bacteria similar to human skin microbiota. Previous studies using culture-dependent methods also showed that over 85 % of air samples from ORs had skin-like bacteria which were mostly coagulase-negative staphylococci and Corynebacterium. These airborne skin-bacteria could be from individuals present during C-section but could also be shed by cleaning personnel between operations.

In our study, 30 % of samples failed to yield sufficient DNA sequences to be analyzed. While there are no published data on the microbiota in operating rooms using 16S rRNA gene sequencing, very few bacteria (average 3.3–3.5 CFU/10 cm2) were detected in ORs after regular decontamination using standard culturing methods, consistent with the low sequence numbers in our study.

In addition, we found that the microbiota of OR samples was more similar to human skin microbiota than oral microbiota and that OR dust contains deposits of human skin flakes. These results reveal that while the use of surgical masks has limited effectiveness at curtailing oral microbial shedding, skin flakes from individuals present during C-section and/or from cleaning personnel between operations could be a more influential factor contributing to the structure of OR microbiota.

Our SourceTracker analysis results suggest that the OR microbes could play a role in seeding infants born by C-section. C-section born infants, in particular, may be solely receiving this inoculum, while vaginally born infants have exposure to vaginal bacteria. The results of these further studies could be relevant to the possible effects on the priming of the immune system by skin bacteria from environmental sources as the primordial inoculum seeding the infant microbiome. This might be relevant to the increased risk of immune diseases observed in C-section born infants.

Published on Leave a comment on When Do Football Players Recover From Concussions?

New research showed that eight days after a concussion, the concussed athletes (football players) looked and felt like they had recovered (clinical recovery), but MRIs showed that there were still neurophysiological abnormalities (significant blood flow decrease) in their brains. They did not look at if and when the blood flow returned to normal, but that research also needs to be done.

It is very disturbing to look at both this research and also the finding that the off-season is not enough for high school football players to recover from the repeated hits (not concussions, but sub-concussive hits) that they receive during the football season (Nov. 24, 2015 post). Do student football players really know and understand the dangers to their brains from the repeated hits and also concussions that occur in football? From Medical Xpress:

Reduced blood flow seen in brain after clinical recovery of acute concussion

Some athletes who experience sports-related concussions have reduced blood flow in parts of their brains even after clinical recovery, according to a study presented today at the annual meeting of the Radiological Society of North America (RSNA). The results suggest a role for MRI in determining when to allow concussed athletes to return to competition.

Decisions to clear concussed athletes to return to action are typically based on symptoms and cognitive and neurological test results. However, there is increasing evidence that brain abnormalities persist beyond the point of clinical recovery after injury. To find out more, researchers from the Medical College of Wisconsin in Milwaukee studied concussed football players with arterial spin labeling, an advanced MRI method that detects blood flow in the brain.

Dr. Wang and colleagues studied 18 concussed players and 19 non-concussed players. They obtained MRI of the concussed players within 24 hours of the injury and a follow-up MRI eight days after the injury and compared results with those of the non-concussed players. Clinical assessments were obtained for both groups at each time point, as well as at the baseline before the football season.

The concussed players demonstrated significant impairment on clinical assessment at 24 hours post-injury, but returned to baseline levels at eight days. In contrast to clinical manifestation, the concussed players demonstrated a significant blood flow decrease at eight days relative to 24 hours post-injury, while the non-concussed players had no change in cerebral blood flow between the two time points.

"In eight days, the concussed athletes showed clinical recovery," Dr. Wang said. "However, MRI showed that even those in clinical recovery still had neurophysiological abnormalities. Neurons under such a state of physiologic stress function abnormally and may become more susceptible to second injury." "For years, we've relied on what athletes are telling us," Dr. McCrea said. "We need something more objective, and this technology may provide a greater measurement of recovery."

Published on Leave a comment on Brains of Teen Football Players Don’t Fully Heal During the Off Season

This past week there was discussion of the number of high school football players that die annually while playing football (at least 5). But the bigger risk - because it involves so many players - is the damage to brains that occurs from concussions and from just being hit in football. The response from football enthusiasts is that there are safeguards now - that football players don't play after a concussion until they "heal" (show no obvious symptoms). But do they really heal? And much of the damage is from repeated hits, without having a concussion (sub-concussive blows or hits), what about the damage from that?

This study found that repeated head hits in football can cause changes in brain chemistry and metabolism, even in high school players not diagnosed with concussions. And even after the lengthy off-season (somewhere between two and five months after the season has ended)—the majority of players are still showing that they had not fully recovered. The researchers also made it clear that 2 weeks is not enough time to heal from a concussion. Scary long-term implications - what is happening to brains that never truly heal from past seasons as the players start playing in the next season? From Futurity:

High School Football: Teen Brains Don't Heal During Offseason

Brain scans of high school football players taken before, during, and after the season raise concerns they don’t fully recover from repeated head hits. The researchers used an imaging technique called proton magnetic resonance spectroscopy (1H MRS) to study the brains of 25 high school football players and compared them to the brains of teenagers involved in non-contact sports. The findings suggest repeated head hits in football can cause changes in brain chemistry and metabolism, even in players not diagnosed with concussions. 

“We are seeing damage not just to neurons, but also to the vasculature and glial cells in the brain,” says Eric Nauman, professor of mechanical engineering, basic medical sciences, and biomedical engineering at Purdue University. “I was particularly disturbed that when you get to the offseason—we are looking somewhere between two and five months after the season has ended—the majority of players are still showing that they had not fully recovered.”

The 1H MRS data provide details about the blood flow, metabolism, and chemistry of neurons and glial cells important for brain function. The data also revealed a “hypermetabolic response” during the preseason, as though the brain was trying to heal connections impaired from the previous season. “We found that in the preseason for the football players in our study, one part of the brain would be associating with about 100 other regions, which is much higher than the controls,” says Thomas Talavage,  professor of electrical and computer engineering and biomedical engineering and co-director of the Purdue MRI Facility.

“The brain is pretty amazing at covering up a lot of changes. Some of these kids have no outward symptoms, but we can see their brains have rewired themselves to skip around the parts that are affected.”

One of the research papers shows that knowing a player’s history of specific types of hits to the head makes it possible to accurately predict “deviant brain metabolism,” suggesting that sub-concussive blows can produce biochemical changes and potentially lead to neurological problems, which indicates a correlation between players taking the heaviest hits and brain chemistry changes.

The data shows that the neurons in the motor cortex region in the brains of football players produced about 50 percent less of the neurotransmitter glutamine compared to controls. “We are finding that the more hits you take, the more you change your brain chemistry, the more you change your brain’s ability to move blood to the right locations,” Nauman says.

“Recent proton magnetic resonance spectroscopy studies argue that the recommended two-week window of rest is insufficient for full metabolic recovery after concussion,” Nauman says. “Those returning to play prior to full recovery could incur a second concussion with symptoms and metabolic changes more lasting than the first.”

Published on Leave a comment on Breast Milk and Preserving Sight In Preemies

Another excellent reason to breastfeed premature infants - to increase the odds of preventing retinopathy of prematurity (ROP), which is the reason preemies can go blind. It occurs when blood vessels in the retinas of premature infants start to grow out of control. If the abnormal growth continues, the retinas detach, and this can cause blindness.

Sadly, an ROP epidemic occurred in the 1940s and early 1950s when hospital nurseries began using excessively high levels of oxygen in incubators to save the lives of premature infants. During this time, ROP was the leading cause of blindness in children in the US. In 1954, scientists funded by the National Institutes of Health determined that the relatively high levels of oxygen routinely given to premature infants at that time were an important risk factor, and that reducing the level of oxygen given to premature babies reduced the incidence of ROP.

Nowadays ROP is a leading cause of childhood blindness in developed countries. A large US study found that in extremely preterm infants with a gestational age of 22 to 28 weeks, the incidence of ROP was 59% (96% at 22 weeks and 32% at 28 weeks). ROP is considered a  multifactorial disease, and risk factors such as prematurity, low birth weight, oxygen therapy, and oxidative stress have been associated with its development.

This recent study was a meta-analysis of five studies (of 2208 pre-term infants), and it found that the overall incidence of ROP was reduced among infants fed human breast milk compared with those fed formula. The best results in preventing severe ROP was in babies fed exclusively breast milk (up to 90% reduction) or mainly human breast milk feeding. It is thought that breast milk may protect against the development of ROP because of its antioxidant and immune-protective properties.  Note that studies involving donor milk were not included because past studies did not find any advantage for donor milk over formula. This may be possibly related to loss of the breast milk microbes (breast milk normally contains up to 700 species of bacteria) during processing (pasteurizing/heat treatment of milk for 30 minutes) and storage of donor milk. From NPR:

Mother's Milk May Help Prevent Blindness In Preemies

If Stevie Wonder had been born three decades later, we might never have gotten "Superstition" and "Isn't She Lovely" — but the musician might never have gone blind, either. Born premature, Wonder developed retinopathy of prematurity, an eye disease that afflicts more than half of babies born before 30 weeks of gestation.Though treatments were developed in the 1980s, about 400 to 600 U.S. children and 50,000 children worldwide still go blind every year from the condition. Now a study suggests that number could be slashed by more than half if all those preemies received their mothers' milk.

The study, actually a combined analysis of five studies from 2001 through 2013, found that preemies receiving human milk from their mothers had 46 to 90 percent lower odds of retinopathy of prematurity (ROP), depending on how much milk they received and how severe the ROP was. The studies were observational, so they cannot show that breast milk directly caused the lower risk.

Of the infants who develop ROP, most recover and develop well without treatment, but about 10 percent develop severe ROP, increasing their risk of blindness, Chiang said. About half of those infants need treatment, which will prevent blindness in 80 to 90 percent of them.

The new research analyzed the outcomes of 2,208 preterm infants based on whether they received exclusive human milk, any human milk, mainly human milk (more than 50 percent), exclusive formula, any formula or mainly formula. The study did not include donor milk, so all the milk was the mother's pumped or hand-expressed breast milk.

Infants who exclusively received breast milk had 89 percent reduced odds of severe ROP compared to infants who received any formula. Infants who received a mixture of breast milk and formula had roughly half the odds of developing severe ROP compared to infants exclusively receiving formula. The analysis included a very large older study that had found no reduced risk for ROP from breast milk, but most infants in that study received less than 20 percent breast milk.

Until the 1940s and 1950s, ROP did not exist because infants born prematurely rarely survived, Chiang said. As doctors learned to how to keep these tiny babies, usually little more than 3 pounds at birth, alive, they discovered that the blood vessels in their retinas would often start to grow out of control. If the abnormal growth continued, their retinas detached, causing blindness.

The cause of ROP isn't entirely understood, but scientists believe oxidative stress can stimulate the abnormal growth of the blood vessels. Providing preemies with oxygen is often key to their survival, but that oxygen exposure might lead to ROP, according to Jianguo Zhou, a neonatologist in Shanghai, and lead author of the study.

Published on Leave a comment on American Academy of Pediatrics: End Routine Antibiotic Use in Animals

The American Academy of Pediatrics released a new report that the overuse of antibiotics in animals poses a real health risk to children. Giving routine antibiotics to animals leads to antibiotic resistant bacteria  - which means that antibiotics may not work when given to people. Most of the antibiotics sold in the U.S. each year - 80 percent- are used in animals that people than eat. The great majority of antibiotics given to animals are the same ones given to humans.The main way to ensure that the meat that you are purchasing is antibiotic-free is to buy meat labeled organic. And to buy organic dairy products (milk, butter, cheese, cream). Note that the reason routine use of antibiotics in animals has not been stopped so far in the USA is due to agriculture industry lobbying. From Medical Xpress:

Pediatricians' group urges cuts in antibiotic use in livestock

Overuse of antibiotics in farm animals poses a real health risk to children, the American Academy of Pediatrics warns in a new report.This common practice is already contributing to bacterial resistance to medicines and affecting doctors' ability to treat life-threatening infections in kids, according to the paper published online Nov. 16 in the journal Pediatrics.

"The connection between production uses of antibiotics in the agricultural sector to antibiotic resistance is alarming," said Victoria Richards, an associate professor of medical sciences at the Quinnipiac University School of Medicine in Hamden, Conn. She believes the danger is "not only for infants and children but other vulnerable populations, such as the pregnant and the older individuals."

As the academy explained in its warning, antibiotics are often added to the feed of healthy livestock to boost growth, increase feed efficiency or prevent disease. However, the practice can also make antibiotics ineffective when they are needed to treat infections in people. Some examples of emerging antibiotic germs include methicillin-resistant staphylococcus aureus (MRSA), C.difficile, and highly resistant strains of the tuberculosis bacterium. Each year, more than 2 million Americans develop antibiotic-resistant infections and more than 23,000 die from these infections, the academy said. And in 2013, the highest incidence of such infections was among children younger than 5, federal government statistics show. 

"Children can be exposed to multiple-drug resistant bacteria, which are extremely difficult to treat if they cause an infection, through contact with animals given antibiotics and through consuming the meat of those animals," report author Dr. Jerome Paulson, immediate past chair of the academy's executive committee of the Council on Environmental Health, said in an academy news release."Like humans, farm animals should receive appropriate antibiotics for bacterial infections," he said. "However, the indiscriminate use of antibiotics without a prescription or the input of a veterinarian puts the health of children at risk."

Spaeth noted that the U.S. Centers for Disease Control and Prevention, as well as the World Health Organization, have both called for a curbing of antibiotic use in animals. But the authors of the new report expressed concern over resistance from the agriculture and farming industry to such measures.

Published on Leave a comment on Exposure to Animals In First Year of Life and Lower Risk of Asthma

Labrador Retriever image Other studies have found this same association - that living with a dog or farm animal has health benefits such as lower risk of allergies and asthma. In a Swedish nationwide study looking at over a million children, the association between early exposure to dogs and farm animals and the risk of asthma was evaluated. All children born in Sweden from January 1, 2001, to December 31, 2010 were included. The researchers found that exposure to dogs and farm animals during the first year of life reduces the risk of asthma in children at age 6 years. From Science Daily:

Early contact with dogs linked to lower risk of asthma

A team of Swedish scientists have used national register information in more than one million Swedish children to study the association of early life contact with dogs and subsequent development of asthma. This question has been studied extensively previously, but conclusive findings have been lacking. The new study showed that children who grew up with dogs had about 15 percent less asthma than children without dogs.

A total of more than one million children were included in the researchers' study linking together nine different national data sources, including two dog ownership registers not previously used for medical research...."Earlier studies have shown that growing up on a farm reduces a child's risk of asthma to about half. We wanted to see if this relationship also was true also for children growing up with dogs in their homes. Our results confirmed the farming effect, and we also saw that children who grew up with dogs had about 15 percent less asthma than children without dogs.

"These kind of epidemiological studies look for associations in large populations but do not provide answers on whether and how animals could protect children from developing asthma. We know that children with established allergy to cats or dogs should avoid them, but our results also indicate that children who grow up with dogs have reduced risks of asthma later in life. Thanks to the population-based design, our results are generalizable to the Swedish population, and probably also to other European populations with similar culture regarding pet ownership and farming" says Catarina Almqvist Malmros, senior author on the study, Paediatrician at Astrid Lindgren Children's Hospital and Professor in Clinical epidemiology at Dept of Medical Epidemiology and Biostatistics at Karolinska Institutet, Stockholm.

Published on Leave a comment on Reducing Sugar Improves Health

This study showed that children reducing sugar consumption (but not fruits), and without reducing calories, after 10 days improved all sorts of metabolic health markers: blood pressure, LDL cholesterol, triglycerides, liver function, fasting blood glucose, and insulin levels. As one of the researchers said: "I have never seen results as striking or significant in our human studies; after only nine days of fructose (sugar) restriction, the results are dramatic and consistent from subject to subject." Once again, not all calories are the same.

On average, the obese children in this study had been getting about 27 percent of their daily calories from sugar, and during the study period it was lowered to about 10 percent of daily calories. By comparison, the average American takes in about 15 percent, though children typically consume much more than this in part because they have the highest intake of sugar-sweetened beverages. In February of this year, the federal government’s Dietary Guidelines Advisory Committee recommended that Americans limit their intake of added sugars to no more than 10 percent of daily calories. From Medical Xpress:

Obese children's health rapidly improves with sugar reduction unrelated to calories

Reducing consumption of added sugar, even without reducing calories or losing weight, has the power to reverse a cluster of chronic metabolic diseases, including high cholesterol and blood pressure, in children in as little as 10 days, according to a study by researchers at UC San Francisco and Touro University California.

"This study definitively shows that sugar is metabolically harmful not because of its calories or its effects on weight; rather sugar is metabolically harmful because it's sugar," said lead author Robert Lustig, MD, MSL, pediatric endocrinologist at UCSF Benioff Children's Hospital San Francisco. "This internally controlled intervention study is a solid indication that sugar contributes to metabolic syndrome, and is the strongest evidence to date that the negative effects of sugar are not because of calories or obesity."

Metabolic syndrome is a cluster of conditions—increased blood pressure, high blood glucose level, excess body fat around the waist, and abnormal cholesterol levels—that occur together and increase risk of heart disease, stroke, and diabetes. Other diseases associated with metabolic syndrome, such as non-alcoholic fatty liver disease and type 2 diabetes, now occur in children—disorders previously unknown in the pediatric population.

In the study, 43 children between the ages of 9 and 18 who were obese and had at least one other chronic metabolic disorder, such as hypertension, high triglyceride levels or a marker of fatty liver, were given nine days of food, including all snacks and beverages, that restricted sugar but substituted starch to maintain the same fat, protein, carbohydrate, and calorie levels as their previously reported home diets.....The study menu restricted added sugar (while allowing fruit), but substituted it by adding other carbohydrates such as bagels, cereal and pasta so that the children still consumed the same number of calories from carbohydrate as before, but total dietary sugar was reduced from 28 to 10 percent, and fructose from 12 to 4 percent of total calories, respectively. The food choices were designed to be "kid food" - turkey hot dogs, potato chips, and pizza all purchased at local supermarkets, instead of high sugar cereals, pastries, and sweetened yogurt.

Children were given a scale and told to weigh themselves everyday, with the goal of weight stability, not weight loss. When weight loss did occur (a decrease of an average of 1 percent over the 10-day period but without change in body fat), they were given more of the low-sugar foods."When we took the sugar out, the kids started responding to their satiety cues," said Schwarz. "They told us it felt like so much more food, even though they were consuming the same number of calories as before, just with significantly less sugar. Some said we were overwhelming them with food."

After just 9 days on the sugar-restricted diet, virtually every aspect of the participants' metabolic health improved, without change in weight. Diastolic blood pressure decreased by 5mm, triglycerides by 33 points, LDL-cholesterol (known as the "bad" cholesterol) by 10 points, and liver function tests improved. Fasting blood glucose went down by 5 points, and insulin levels were cut by one-third. "All of the surrogate measures of metabolic health got better, just by substituting starch for sugar in their processed food—all without changing calories or weight or exercise," said Lustig. "This study demonstrates that 'a calorie is not a calorie.' Where those calories come from determines where in the body they go. Sugar calories are the worst, because they turn to fat in the liver, driving insulin resistance, and driving risk for diabetes, heart, and liver disease."