All Posts tagged behavioral

Caffeine consumption common in kids

Even young children appear to be consuming more caffeine, so much so that caffeine could be contributing to sleep problems in primary school children, researchers found. Three-quarters of children ages 5 to 12 consumed caffeine on an average day in a survey of parents at routine clinic visits by William J. Warzak, PhD, of the University of Nebraska Medical Center in Omaha, and colleagues. The more caffeine children consumed, the fewer hours they slept on average (P=0.02), the researchers reported online in the Journal of Pediatrics, although not drawing a causal link. The average intake was two or three times higher than the 22- to 23-mg daily average reported nearly a decade ago, they noted.

Eight- to 12-year-olds in Warzak's study averaged 109 mg of caffeine — the equivalent of nearly three 12-oz cans of soda each day. But even the 52 mg of caffeine consumed by 5- to 7-year-olds on an typical day was well above the level known to have a physiologic effect on adults, the researchers noted. “There's really no role for caffeine in kids,” Marcie Schneider, MD, of the Albert Einstein College of Medicine in New York City, emphasized in commenting on the study. “We know that caffeine raises your blood pressure, raises your heart rate, and can be addictive.” Unlike older teens who are likely drinking coffee to wake up in the mornings for school, the assumption is that younger kids are getting most of their caffeine from soda, noted Schneider, who serves as a member of the American Academy of Pediatrics Committee on Nutrition.

She urged pediatricians to raise parents' awareness of the issue, perhaps as part of the yearly checkup. “We routinely ask kids what they're eating and drinking,” “It may be something that is worth pediatricians pointing out to parents that this kid does not need caffeine in their life partially because it does some things that are negative.”

Warzak's group surveyed parents of 228 children seen at an urban outpatient pediatric clinic during routine visits about the children's average daily consumption of drinks and snacks with an emphasis on caffeine-containing items. None of the children had a known sleep disorder or medical condition that might cause bedwetting. Illustrated depictions were provided to help parents accurately estimate serving sizes.

Nearly all of the caffeine intake was consumed through beverages. Few children got a meaningful amount of caffeine from food. “Caffeine's diuretic properties have encouraged behavioral health practitioners to eliminate caffeine from the diet of children with enuresis,” the researchers noted. However, they found that intake didn't correlate with the number of nights a child wet the bed (P=0.49). Overall, enuresis was actually less likely in children who consumed caffeine.

The researchers cautioned that interpretation of these results may be complicated by cultural differences in reporting children's behavioral health concerns and that their study could not draw any causal conclusions. Schneider also noted the use of parental reports and the relatively small sample as limitations. Although the findings offered no support for removing caffeine from children's diets on the basis of bedwetting, Warzak's group concluded in the paper that “given the potential effects of caffeine on childhood behavior, a screen of caffeine consumption might be beneficial when evaluating childhood behavioral health concerns.”

Source: Warzak WJ, et al “Caffeine consumption in young children” J Pediatr 2011; DOI: 10.1016/j.jpeds.2010.11.022.

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The Best Way To Reduce Heart Disease Risk

Artinian and her co-authors analyzed 74 studies conducted among U.S. adults between January 1997 and May 2007. The studies measured the effects of behavioral change on blood pressure and cholesterol levels; physical activity and aerobic fitness; and diet, including reduced calorie, fat, cholesterol and salt intake, and increased fruit, vegetable and fiber consumption.

Cardiovascular disease (CVD) is the leading cause of death in the United States. According to American Heart Association statistics, about 81.1 million adults, or one out of every three people in America, have at least one type of CVD, such as heart attack, stroke or heart failure. If cardiovascular diseases were completely eradicated, life expectancy could increase by nearly seven years.

“Lifestyle change is never easy and often under-emphasized in clinical encounters with our patients. This statement shows what types of programs work and supports the increased need for counseling and goal setting to improve healthy cardiovascular habits,” said Ralph Sacco, M.D., president of the American Heart Association. “We need to find more effective ways to make lifestyle change programs available, especially to the groups at highest risk for cardiovascular diseases – older Americans, African-Americans and people of Hispanic origin.”

Sacco added that the first step in making a change is to know your health status, “because a lot of people don't realize they're at risk for heart disease and stroke. The American Heart Association's My Life Check can help identify your risk level and offers simple steps to get started on the path to ideal cardiovascular health.”

Although obesity, physical inactivity and poor diet are well recognized as major risk factors for cardiovascular disease, it's often difficult for doctors and nurses to help patients reduce their risk for an extended period. They are faced with numerous obstacles, including time constraints, reimbursement problems and insufficient training in behavioral-change techniques, the statement authors write.

Despite these difficulties, Artinian said policy changes will eventually make critical interventions more readily available.

Federal health reform legislation includes provisions that would improve access to preventive services and help Americans make healthier food choices to control risk factors for heart disease and stroke. For example, the new law requires calorie information on restaurant menus and vending machine products and eliminates co-pays for certain preventive services under Medicare and new private health plans. The legislation also includes funding to support public health interventions at the state and local levels aimed at lowering risk factors for chronic disease.

“I'm looking forward to the future when we will have a healthcare system that gives more weight to the importance of prevention and changing lifestyle behaviors to help people stay healthy and reduce cardiovascular risk,” Artinian said.

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Behaviour therapy can calm irritable bowels

Lead researcher Dr. Jeffrey M. Lackner from the State University of New York, Buffalo said cognitive behavioral therapy was known to be a very promising treatment for IBS, with the current findings helping to identify which patients would likely maintain a positive response.

Lackner and his colleagues are conducting a larger, longer-term study, as the current study being a small one, it remains unclear how long the benefits of cognitive behavioral therapy may last i. e. do they carry over to 9 months, a year or more.

IBS symptoms include bouts of abdominal cramps, bloating and changes in bowel habits i. e. diarrhoea or constipation, or alternating episodes of both. While, no one knows the exact cause of the disorder, there are certain symptom triggers like particular foods, large meals and emotional stress.

Cognitive behavioral therapy helps IBS patients to recognize their symptom triggers and manage them. Other treatment options include general diet changes, like reducing gas-producing foods; fibre supplements, if constipation is a primary symptom; and anti-diarrhoeal medications, when diarrhoea is a primary symptom.

There are two prescription medications for specific IBS cases: Lotronex, for women with diarrhoea dominant IBS not responding to other treatments; and Amitiza, for constipation dominant IBS.

Around 20% of people have IBS symptoms, with women affected at about twice the rate of men

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