Healthy Kids

Are You Going to Have a Heart Attack in 35 Years?

February 28, 2013 by James Bogash

Seems like an awful long time to worry about. 35 years. Heck–I don’t even know what I’m doing this weekend, let alone in 3 1/2 decades. So why should anyone worry if they might have a heart attack in 35 years?

Because you will care in 35 years from now. Try to sound as tough as you’d like now, but once that crushing pain hits your chest and you get rushed to the ER to have your sternum cracked open with a spreader and have one of your more precious organs replumbed, you would be willing to go back and change it all.

On the other hand, maybe this is why you’ve made the right choices. You’re exercising with short burst methods, avoiding refined carbs and eating omega 3’s instead of omega 6’s. In general, you’re following the recommendations that can be found by by clicking here.

But it’s not you I’m addressing this post to. It’s your young child.

We are seeing growing evidence that heart disease begins in childhood. Or rather, we should NOT see heart disease beginning in childhood, but we are. Rest assured it is because of the preprogramming that begins in the womb and continues through childhood and adolescent. The poor lifestyle choices aquired early are very likely to perpetuate for the rest of his or her life.

This particular study took the research we have seen on risk factors for heart disease and put a practical spin on it. Basically, how likely are these risk factors going to turn into a heart attack 35 years later?

If you’re doing the math, we are talking about an adult in his or her 40’s or 50’s having a heart attack, the beginnings of which stretched back to childhood.

Researchers looked at the ESR levels of 433,577 young adult men in Sweden. ESR is a general marker of inflammation (erythrocyte sedimentation rate). And inflammation is a strong player in heart disease. So what did they find in those kids with higher levels of ESR?

Those kids who had an ESR of ≥15 mm/h had 70% increased risk of having had a heart attack 35 years later (Tweet this). And this was after accounting for traditional risk factors associated with heart disease.

70% increased risk. From behaviors your child is adopting NOW. It is becoming far too common to hear about parents in their 60’s or 70’s losing a child to heart disease. Unless we wake up and change our kids’ behaviors (which always starts with changing YOUR behaviors…), the number of parents burying their adult children will only go up.

What are YOU going to change today?

2 More Reasons Breast Feeding Beats Even the Best Baby Formula

February 9, 2013 by James Bogash

I hear it time and time again. “Baby Johnny didn’t have problems until I stopped breast feeding and switched to baby formula.” In the past, I have focused on the new food or formula being introduced. That has just been the path that made the most sense. After all, everything was going well until new foods were introduced into the baby’s system.

If the problem seems to be with the introduction of the baby formula, I will recommend switching to a hydrolyzed formula like Nutramigen or Alimentum. It’s not a matter of switching from soy to cow’s milk or vice versa–it’s just that your infant’s gut is not ready to handle anything other than mom’s milk until well after 6 months. This is why the hydrolyzed formulas are a better option–the proteins are already enzymatically pre-digested so his or her little digestive system has less to react to.

Of course, all of this was before I read this particular article.

I have addressed all the benefits of breast feeding over baby formula in a previous blog article that can be read by clicking here, so I won’t belabor the issue again.

Researchers identified two key abilities of breast milk that were not present in formula:

Breast milk had a natural ability to quiet smooth muscle cells, like those of the GI tract. This could help nursing infants from having abdominal cramping and pain.
Breast milk had higher antioxidant abilities over baby formula. Greater antioxidant protection can obviously lead to all kinds of protective benefits over the formula.

I won’t belabor the point again, but I will highlight that we really have NO idea the full breadth and diversity of compounds that are present in breast milk. As a result, even the best baby formula will be just a shadow of what breast feeding is to a developing newborn and infant.

Childhood Obesity Statistics: Is Your Child 7-11 Years Old?

January 23, 2013 by James Bogash

Childhood obesity statistics remain a concern even at the Presidential level. We know the answers, but we have to be willing to make the needed changes to our lives.

I have made it very clear where I stand on the childhood obesity epidemic. The vast majority of the fault lies not with the schools, not with the TV advertisers and not even with McDonald’s. Rather, it lies squarely in the laps of the parents. Let me relay a very sad story to illustrate the point.

My son, Keegan, is a 7 year old first grader. A few weeks ago, before I packed his lunch for the next day, we had an updated discussion about what I was putting into his lunch. We do this from time to time to make sure he’s eating enough and that he likes what I’m giving him. I asked him if he would eat some purple cauliflower if I put a few small pieces in his lunch. He noted concern that the other kids would make fun of him because he would be the only kid at the table eating cauliflower. With some negotiations he agreed to eat the cauliflower I put in his lunch (I pointed out that none of the other kids would have a square of dark chocolate in his or her lunch either, so he conceded my win).

A few days later I asked him if he ate the cauliflower. He said that he did, but he held it under the table so the other kids wouldn’t see him eating it. My heart broke. The idea that he should be ashamed to eat cauliflower in front of his friends both hurt me and angered me. What does this say about our collective child health rearing skills that a solitary child eating cauliflower should feel the need to eat this food out of sight? Shouldn’t the kids eating Doritos for lunch be the ones hiding in the corner in shame because, at some level, that child’s parents are completely oblivious about how much these foods destroy the future health of that child?

Do you think I’m being overly dramatic? If so, it’s because you haven’t yet read this particular article.

There has always been concern with rapid weight gain in a child leading to the rise in childhood obesity statistics. This concern extends to the weight gain in the womb due to gestational diabetes, as an infant when the child is on formula instead of breastmilk, as a toddler as they explore new foods or beyond. In this study, researchers looked broke weight gain into age categories to determine at what ages the rapid growth was the most associated with future health challenges (in this case, high blood pressure).

The age groups were broken down as follows: 3 to 9 months, 9 to 36 months, 3 to 7 years, and 7 to 11 years. The children’s blood pressure at age 11 was then determined. Here’s what they found:

Faster childhood linear growth between 7 and 11 years of age (getting taller) in girls led to a 27% higher risk of higher blood pressures.
In boys, this risk was over double the risk – 211%.
At age 11, both boys and girls with the highest BMI had 272% higher risk of having higher blood pressure (Tweet this).

Based on this study, the time bomb of health is ticking at my son’s school. The fact that Keegan’s friends would make fun of him for eating cauliflower (I have heard him say the same of hummus) speaks volumes as to the foods these kids are exposed to at home.

In your child’s lunchroom, would your child be in Keegan’s shoes, or would your child sneer at the idea of eating foods like cauliflower or hummus?

Breast Feeding vs the Best Baby Formula: More New Findings

January 14, 2013 by James Bogash

The eternal debate of Mother Nature vs Technology. Does breast feeding still beat the newest, best baby formula on the market? Your baby’s health is on the line.

It’s already pretty clear that breastfeeding is far superior to formula feeding. The reasons are many and have been reviewed in a prior blog post that can be read here. But, just in case these reasons are not enough to steer a new mother to breastfeeding, here’s an even bigger reason:

It’s because of what we do NOT know about breastfeeding.

What does this mean? It means that there is an awful lot that we probably don’t know about what compounds are present in breastmilk that are not present in formula. Just within the past decade or so we have added DHA to formula. Then probiotics. Then the fact that the bacterial composition in breast milk changes over time. Then prebiotics to support the growth of the good bacteria. Then the hormone visfatin that fights off obesity and diabetes was found in breastmilk.

It seems like we continue to find out new aspects to breast feeding. It then takes some time for these new findings to catch up to what companies are putting in the best baby formula money can buy. This can only mean one thing. Formula has always been, and always will be, inferior to breast feeding. Breast milk is just far too complicated for us to understand and thus, far too complicated to reproduce in its entirety.

Just in case you think I’m off base and that the best baby formula now contains everything there is to be found in breast milk, let me direct you to this particular study.

Researchers looked at the antioxidant compounds present in breast feeding mothers during different stages of lactation–1, 4 and 13 weeks post partum. First of all, the list of antioxidant compounds found in the breast milk was quite extensive (Tweet this). The list included these classes of compounds:

The flavonoids (think compounds in tea, spices and vegetables):

Epicatechin
Epicatechin gallate
Epigallocatechin gallate
Naringenin
Kaempferol
Hesperetin
Quercetin

The carotenoids (those colored pigments found in nature–think beta-carotene):

Alpha-carotene
Beta-carotene
Alpha-cryptoxanthin
Beta-cryptoxanthin
Zeaxanthin
Lutein
Lycopene

The researchers found that the flavonoids remained relatively stable throughout the lactation period studied, but the carotenoids decreased over the time period studied. Why this change occurred, researchers were not able to ascertain. But clearly these are protective compounds available to breast feeding newborns that are not found in even the best baby formula. And I’m sure we have not even begun to discover the other gems that Mother Nature has infused into breastmilk.

If you have had a baby recently, did you feel that the hospital staff was undeniably dedicated to promoting breast feeding, or did you feel some pressure to use baby formula?

Diet during pregnancy have long term consequences on the health of the infant – (04-08-04)

December 23, 2012 by James Bogash

Modulation of neonatal immunological tolerance to ovalbumin by maternal essential fatty acid intake

The basic question is, does the diet of a pregnant and nursing mother have long term consequences on the health of the infant? Of course the answer is yes. This study was done in rats but should transfer to humans as well; it confirms that poorer quality fats lead to a increase in allergy to ovalbumin (egg whites). Once again, however, we venture into the tricky world of liability. As much as we try to avoid it, the big pink elephant in the room is the fact that parents are almost wholly to blame for the health of their children. Sure, there are genetic conditions that are not due to environment, but these are rare. As soon as we break down and start blaming the parents, then we can move on to educating them and hopefully changing behaviors.

Modulation of neonatal immunological tolerance to ovalbumin by maternal essential fatty acid intake – Pediatric Allergy Immunol..

Read entire article here

Can Chronic Pain Be Passed On to Your Children?

December 20, 2012 by James Bogash

My brain’s first response is of course not” This is chronic pain here, usually as a result of some type of injury or illness such as RA, lupus or arthritis.

But chronic pain is not something that is passed down in the genes like height or weight or eye color. Before any of us jump to the conclusion that chronic pain is not passed on, we need to step back and do a better evaluation of what “passed on by the parents” really means.

At first thought, most would consider this little phrase to refer to genetics. The magic of DNA encoding certain aspects of our being much like hair color (or lack thereof…), height, forked tongue, skin color. Then there are genetic single gene mutations like osteogenesis imperfecta, Marfan’s syndrome, Duchenne’s muscular dystrophy and sickle cell anemia just to name a few. These are conditions and characteristics that are clearly linked to the genes we got from out parents.

Then come the conditions that we THINK are related to genetics like heart disease, diabetes, osteoporosis and cancer. In reality, these diseases are NOT genetic in origin, despite what society thinks. Or rather I should say that they are not related to a single gene or two or three. Rather, these conditions are the end result of lifestyle’s interaction with tens or even hundreds of different genes, termed multigenetic inheritance. These situation is almost impossible to pin down as “genetic” because it is not like you got a single gene from your mom that caused you to get heart disease. Rather, it is the result of your lifestyle differently affecting ten or twenty or more genes that you got as a mix from both your mother and father. Because so many genes are involved, these conditions are so heavily influenced by lifestyle as to not be considered “genetic.”

THEN, we have those conditions that are passed on, not necessarily by lifestyle habits or genetics, but rather by a sort of programming. In a previous blog post, I have covered how stress in the parent plays a role in the health risks of the child. So if parental stress can alter a child’s health, what about chronic pain in a parent?

Just in case you suffer from chronic pain, before you go and get defensive you need to keep an open mind as you read this particular study. Researchers looked at the children (aged 13-18) of parents who suffered from some type of chronic pain. Here is what they found:

Chronic pain in the mom led to a 50% increased risk of the child complaining of chronic nonspecific pain and chronic multisite pain, (Tweet this)
Paternal chronic pain was also associated with increased odds of pain in adolescents and young adults.
The odds of chronic pain in these children was even higher when both parents reported pain.
In children living primarily with their mothers, there were clear associations between maternal pain and pain in the kids.
In children living primarily with their fathers, there was no increased risk of chronic pain in the child.

So what does this mean? Could it mean that there is a potential for children to pick up on complaints of chronic pain from his or her parent(s) and begin to adopt some of these same attitudes, thus creating the scenario for chronic pain? Unfortunately, the hard answer here is probably yes. Parental attitudes and vocalization of chronic pain does appear to influence the risk of their child complaining of some type of chronic pain as well.

However, this could also have other explanations. Maybe the family is overall more sedentary. It is likely that a family to sits around watching TV together is getting less exercise. Less exercise increases the risk of chronic pain. It is also entirely possible that attitudes towards seeking care for acute pain may strongly influence this relationship.

If mom or dad brushes off getting care for an acute situation or after an injury (which can increase the chance that those symptoms will become chronic), it seems very likely that they will brush off getting treatment for that child if he or she complains of some type of acute pain. It’s not that the parent is ignoring little Johnny’s complaint of back pain, but maybe the family attitude is one of stoichism and shunning any type of help. This could lead the child experiencing neck pain and headache from carrying a too-heavy backpack to not get the care he or she needs.

Whichever is the case (and it is likely to be some blending of these scenarios), if you experience chronic pain, you need to be aware that this will increase the risk of your child experiencing chronic pain. Be an advocate for their symptoms and make sure you don’t delay seeking treatment (from a chiropractor, preferably) as soon as it is noticed. Maybe this can help break a cycle.

Childhood ADHD / Behavioral Problems? This Might Be a Cause

December 12, 2012 by James Bogash

Some days your child seems fine. Other days a truckload of Valium couldn’t calm him or her down. You hate the label of ADHD. Could something else be wrong?

I was recently in a situation around a bunch a 1st graders. One of the children seemed particularly zoned out and someone mentioned that he must be medicated today. I don’t think it gets much sadder than that. I’m sure that there are children who may truly be classified as uncontrollable and disruptive, but this number cannot possibly be as high as the number of children we are medicating.

I personally believe that there are two aspects to childhood behaviors as they relate to ADHD and anxiety. The first aspect is exposures in the womb. There is mounting evidence on how much exposures in the womb play a role in the risk of a child being diagnosed with anxiety disorder or ADHD later on in childhood. Some of these exposures include:

The second aspect has to do with the child’s lifestyle and family environment once he or she is born. The first aspect, exposures in the womb, no one can go back and change. This aspect, however, is readily under a parent’s control.

While I’m sure there are many other aspects to helping your child’s brain, these are a few I have covered in past blog posts:

This is a brain we are talking about. And a developing one at that. This developing brain needs EVERY ounce of nutrition we can give it, while at the same time not abusing the brain with unneeded chemicals, pesticides and stress (including parental stress).

Stress, of course, can relate to sleep.

This particular study demonstrates just how massively important sleep is to your child’s delicate brain. Researchers looked at a group of 7-11 year old children and set up two scenarios. One hour of sleep restriction (using normal weekday sleep duration as a baseline) and one hour of sleep extension. The teachers then rated the children on their behavior the next day. Here’s what they found:

A mere 27 minutes of extra sleep was associated with improvement emotional ability and restless-impulsive behavior scores as well as a reduction in daytime sleepiness. (Tweet this)
On the flip side, 54 minutes of sleep restriction showed deterioration on these same measures.

Consider these facts when deciding on your child’s bedtime and wake time. Do they wake up later on the weekends then they do during the week? It is possible they are not getting the extra sleep his or her brain really needs. So maybe your child does not need meds. Maybe just 27 minutes more of sleep could work miracles.

Do you use “catch up” sleep on the weekends for yourself or your children to make up for less sleep time during the week?

CT Scan Side Effects: Beware of Pediatric ER Visits

December 3, 2012 by James Bogash

We love technology in medicine like CT scans, however, it is replacing a well thought out diagnosis. But are CT scan side effects worth the information obtained?

Regardless of whether it is for a child or for yourself, going to the emergency is dangerous business. Not only is the ER a breeding ground for bacteria like MRSA and C. diff, but the risk of unnecessary procedures being done is ridiculously high. Some of these may be harmless like bloodwork (not considering the pain of the blood draw and the pain of the cost of labs being done in the hospital) or an ultrasound.

But some may be downright dangerous.

Several years ago someone raised a scary question. We know that the potential CT scan side effects from radiation (computerized tomography, also called a CAT scan) is very, very high. As an example, a single CT scan of the chest is equal to about 133 two-view xrays of the chest. I’ve had patients who had several CT scans done in a single ER visit. If you do the math, you’ll realize this becomes amazingly high.

And keep in mind that there is NO safe level of radiation. Radiation is cumulative. A single dose today can affect you decades down the road.

There are an overwhelmingly high number of CT scans done in the US every year. Approximately 70 million scans are done every year. Yup – 70 MILLION. I know that ERs use them because they are quick and very billable, as anyone who has looked at a hospital bill can affirm. MRIs have no radiation exposure but the turnover time is much, much longer.

A group of researchers back in 2009 estimated the number of cancers resulting from CT imaging in the United States. The number? A massive 29,000 cases that is produced as a result of the CT scans done in a single year. Half of these would be expected to be fatal, resulting in 14,500 cancer deaths per year as a result of an exceedingly high number of CT scans done per year.

So, the above study was done in 2009 and actually got quite a bit of press. So, hopefully, medical providers have learned from this and are ordering advanced imaging with care. The cynically part of me realizes how slow medicine is to adopt new research when money and dogma is involved. The hopeful part of me believes that studies like the CT radiation cancer study will cause drastic changes in the way we practice medicine.

It better. You see, prior to this study in 2009, CT rates were going anywhere but down. This particular study looked at abdominal CT scans (one of the higher radiation dose imaging scans) of children in the ER presenting for abdominal pain and how the number of CT scans changed from 1998 to 2008. The findings are a little scary:

Of all pediatric ED visits, 6.0% were for abdominal pain
The use of CT scans of the abdomen in these kids was 0.9% in 1998
This skyrocketed to 15.4% in 2008 (an increase of over 1700%)
There was no change in the use of ultrasounds or X-rays, which can be used to rule out many causes of abdominal pain in kids
There was no increase in the diagnosis of appendicitis or in hospital admissions
Older and male patients were more likely to have a CT scan
Black children were one-half as likely to undergo a CT scan

In a nutshell, the number of kids getting CT scans of the abdomen went up exponentially in a decade, without any use of alternative imaging like an ultrasound (which does not give off radiation). These kids were no more likely to be diagnosed with appendicitis or be admitted to the hospital. In other words, there really was no rationale for the increased use of abdominal CT scans in these kids.

I can’t exactly explain why this number was on the rise (even though hopefully, after the 2009 study was released, this trend has been strongly reversed). Maybe as defensive medicine? Maybe relying less on a physician’s diagnostic skills and more on technology?

Either way, if your child has to go to the ER for abdominal pain, make sure you ask questions and ensure that every test being ordered is absolutely necessary.