Primary school children who don't like eating fruit and vegetables are 13 times more likely to develop functional constipation than children who do, according to a study in the December issue of the Journal of Clinical Nursing. Drinking less than 400ml of fluid a day also significantly increases the risk. Dr Moon Fai Chan, assistant professor at the National University of Singapore, teamed up with Yuk Ling Chan, from the Hong Kong Polytechnic University, to study the diet and toileting habits of 383 children aged from eight to ten from a school in Hong Kong. Fifty-one per cent were boys and children who were on regular medication or who paid regular hospital or clinic visits were excluded. Seventy per cent of the children who took part in the study were ten-years-old, 22 per cent were nine and eight per cent were eight.
“A number of studies have suggested that functional constipation – which is due to dietary habits, environmental habits and psychosocial factors rather than a particular health problem – is getting worse among school-age children” says Dr Moon Fai Chan from the Alice Lee Centre for Nursing Study at the University. “It is estimated that functional constipation accounts for 95 per cent of cases of constipation affecting children once they pass infancy. The condition has serious consequences, as it can cause a wide range of distressing emotional and physical problems such as stress, soiling, problems at school, damaged self-confidence and reduced social interaction.”
Key findings of the study included:
- Seven per cent of the children who took part suffered from functional constipation and there were clear dietary differences between the children who did and did not have problems.
- Girls were more likely to have functional constipation than boys (8.2 per cent versus 6.6 per cent) and nine-year-olds were more likely to report problems (13.3 per cent) than eight-year-olds (10 per cent) and ten-year-olds (5.2 per cent).
- Children who only drank 200ml to 400ml of fluid a day were eight times more likely to experience problems than children who drank 600ml to 800ml and 14 times more likely than children who drank a litre or more.
- Children who said they did not like fruit or vegetables were 13 times more likely to suffer from functional constipation than children who did.
- Nine out of ten children refused to use the school toilets for bowel movements and the figure was the same for children with and without constipation.
The biggest problems with school toilets were that children preferred to go at home. They also cited lack of toilet paper and dirty toilets. “When we compared our findings with previous studies we found that the levels of functional constipation among Hong Kong school children was higher than those in the USA and UK, but similar to Italy” says Dr Chan. The authors have made a number of recommendations that they feel would help to tackle the problem. They suggest that:
- Primary schools should work with healthcare professionals to make children more aware of the problem, with regular healthcare education sessions in classrooms and at assemblies.
- Parents need to be educated about functional constipation so that they can spot problems in their children and make sure that their diet provides sufficient fluid, vegetables and fruit. They should also remind their children to pay regular toilet visits at school.
- School tuck-shops should stock high-fibre snacks such as popcorn, fresh food and dried fruit, instead of crisps and sweets.
- Children should be encouraged to drink plain water during lessons and drinking fountains should be installed.
- School toilets should be more user-friendly, private and well stocked with paper so that children feel more comfortable using them.
“We hope that this study will help to raise awareness of functional constipation, which can cause children real physical and emotional distress and seriously affect their quality of life” says Dr Chan.
Source: Investigating factors associated with functional constipation of primary school children in Hong Kong. Chan MF and Chan YL. Journal of Clinical Nursing. 19, pp3390-3400. (December 2010). DOI: 10.1111/j.1365-2702.2010.03366.x
Researchers have long speculated that the diet may help explain why nations in the Mediterranean region have historically had lower rates of heart disease and some cancers, including breast cancer, compared with other European countries and the U.S.
Until now, only two other studies have looked at the relationship between Mediterranean-style eating and the risk of breast cancer, both done in the U.S. Each found a connection between the diet and lower breast cancer risk, although in one the link was limited to breast cancers that lack receptors for the hormone estrogen — which account for about one-quarter of breast tumors.
The current study focused on women in Greece, as it is the “cradle” of the Mediterranean diet, and a large segment of the population still adheres to it, Dr. Dimitrios Trichopoulos, the senior researcher on the work, told Reuters Health by email.
At the outset, the study participants completed detailed dietary questionnaires and gave information on their lifestyle habits and demographics. Each woman was given a Mediterranean diet score, ranging from 0 to 9, based on how often they consumed vegetables, legumes, fruit and nuts, whole grains, fish and olive oil or other sources of monounsaturated fats; they also won points by limiting meat and dairy.
Of the 14,800 women included, 240 were diagnosed with breast cancer over an average follow-up of 10 years.
Overall, postmenopausal women whose Mediterranean diet scores were in the 6-to-9 range were 22 percent less likely to develop breast cancer than their counterparts with scores between 0 and 3. That was with factors such as age, education, smoking history, weight and exercise habits taken into account.
The findings show an association between Mediterranean eating and lower breast cancer risk, but do not prove cause-and-effect, according to Trichopoulos, who is with the Harvard School of Public Health in Boston and the Bureau of Epidemiologic Research at the Academy of Athens in Greece.
Further studies are needed to confirm the results, he said.
However, other evidence suggests ways the Mediterranean diet might curb cancer risk.
Research has found, for instance, that women who closely follow the diet tend to have lower levels of estrogen, which fuels the growth of the majority of breast cancers, than other women do. Other studies in the lab suggest that the fats found in the Mediterranean diet — both olive oil and the omega-3 fats in oily fish — may slow the growth of cancer cells.
The diet is also typically rich in antioxidants, which protect body cells from damage that can eventually lead to disease, including cancer. Trichopoulos said that if the Mediterranean diet does have a protective effect against cancer, it is “likely” to involve that antioxidant component.
It also makes sense, said the researcher, that the diet could affect the risk of postmenopausal, but not premenopausal, breast cancer.
Younger women who develop breast cancer, he explained, often have a genetic vulnerability to the disease, whereas in older women, lifestyle and environmental exposures may be relatively more important contributors to risk.
Based on their findings, Trichopoulos and his colleagues write, the association between the Mediterranean diet and breast cancer is of “modest, but not negligible, strength.”
In the U.S., a woman's chance of being diagnosed with breast cancer rises from about a half a percent, or one in 233, during her 30s, to about four percent, or one in 27, during her 60s.
Established risk factors for breast cancer include older age and having had a first-degree relative diagnosed with the disease. Research has also linked obesity, sedentary lifestyle, use of hormone replacement therapy and high alcohol intake to an increased risk.
SOURCE: Journal of Clinical Nutrition
Dr. Gu and her colleagues studied a cohort of 2148 elderly subjects 65 years and older living in New York City. All subjects were healthy and free of dementia at study entry. Their dietary habits were obtained via questionnaire, and they were prospectively evaluated with the same standardized neurologic and neuropsychological measures approximately every 1.5 years for an average of 4 years.
The researchers used reduced rank regression to calculate dietary patterns according to their effect on 7 nutrients previously shown in the literature to be related to Alzheimer's disease: saturated fatty acids, monounsaturated fatty acids, ω-3 polyunsaturated fatty acids, ω-6 polyunsaturated fatty acids, vitamin E, vitamin B12, and folate.
During the follow-up, 253 individuals developed Alzheimer's disease. The study found that one dietary pattern — characterized by higher intakes of salad dressing, nuts, fish, tomatoes, poultry, cruciferous vegetables, fruits, and dark and green leafy vegetables and a lower intake of high-fat dairy products, red meat, organ meat, and butter — was significantly associated with a reduced risk for Alzheimer's disease.
Compared with subjects in the lowest tertile of adherence to this pattern, the Alzheimer's disease hazard ratio (95% confidence interval) for subjects in the highest tertile was 0.62 (0.43 – 0.89) after multivariable adjustment (P for trend = .01).
The study also found that subjects who were older, less educated, and current smokers tended to be less adherent to the protective diet. Hispanic individuals adhered less than white and black individuals (P = .02), and women tended to adhere more than men (P = .05).
“The dietary pattern that was most protective against Alzheimer's reflected a diet rich in ω-3 and ω-6 polyunsaturated fatty acids, vitamin E, and folate but poor in saturated fatty acids and vitamin B12,” commented Dr. Gu. “The combination of nutrients in this dietary pattern reflects multiple pathways in the development of Alzheimer's disease.
“For example, vitamin B12 and folate are homocysteine-related vitamins that may have an impact on the disease through their ability to lower circulating homocysteine levels,” she said. “Vitamin E is a strong antioxidant, and the fatty acids may be linked to dementia and cognitive function through atherosclerosis, thrombosis, or inflammation. Fatty acids may also affect brain development and membrane functioning.”
She added that the study has several limitations. “We used a single measurement of the diet, and this might not have captured the long-term dietary habits of the subjects. We also excluded subjects from the final analysis because they were lost to follow-up, and this might have introduced selection bias. We also can't completely rule out the possibility that the reduced risk associated with this protective diet was due to residual confounding.”
Further studies are planned, Dr. Gu said. “We cannot say based on this study alone that this type of dietary pattern prevents Alzheimer's disease, but many studies have consistently shown that fruits and vegetables and unsaturated fatty acids are associated with a lower risk. We want to repeat these findings in different populations and see if they can be confirmed in other studies.”
Commenting on this study for Medscape Neurology, David Knopman, MD, professor of neurology at the Mayo Clinic and a member of the Mayo Clinic Alzheimer's Disease Research Center in Rochester, Minnesota, said that, despite the study authors' best efforts, it is still not clear whether diet alone makes a difference.
“Dietary habits, which often are lifelong, are certainly part of the array of health behaviors that contribute to better cognitive health in late life. However, diet and other health behaviors are intertwined. Because a healthy diet contributes to better cardiac health, lower weight, lower blood pressure and a lower risk for diabetes, there are many reasons to view the dietary habits described by Dr. Gu and colleagues as beneficial.”
The study was supported by federal National Institute on Aging grants. Dr. Gu and Dr. Knopman have disclosed no relevant financial relationships.
Arch Neurol. Published online April 12, 2010.
Lonely fruit and vegetables seems to be a national phenomenon. According to the USDA, fewer than 15 percent of elementary students eat the recommended 5 or more servings of fruits and vegetables every day. Furthermore, average fruit and vegetable intake among 6-11 year olds is only 3.5 servings a day.
Does low fruit and vegetable intake really matter when children are young? Chronic illness such as heart disease, stroke, and cancer are usually concerns for adults. However, life-long positive eating habits (such as eating low fat foods, consuming foods with high fiber, eating less processed foods) are habit-forming when started young. Furthermore, certain diseases such as diabetes and high cholesterol are starting to appear in children who are overweight. Finally, fruits and vegetables have so many naturally occurring vitamins, minerals, phytochemicals, and fiber that are good for your health.
Are our busy lifestyles to blame? Certainly, if you have kids you are getting in the car to go somewhere (to a restaurant, to soccer practice, etc.). Packaged food such as chips or power bars are very convenient and there is something about opening up a package that seems so easy compared to slicing up that lonely piece of fruit. It really is just a mindset though. Once you start packing up the fruits and veggies in Tupperware containers you will get in the habit. Plus, fruits and veggies are low in calories and fill you up.
We are constantly bombarded with food advertisements and not necessarily for healthy food such as fruits and vegetables. In fact, children 2 to 11 years old are exposed to an average of 150 to 200 hours of commercial messages, or 20,000 commercials a year and the majority of these advertisement are for cereals, candies, or other sweets.
So, what is a parent to do? Role modeling is my motto. If you are eating your fruits and vegetables, your children will too. In 2002, researchers at Pennsylvania State University examined parental pressure (“finish your vegetables” or “do as I say”) vs. role modeling (“do as I do”) among 191 five year old girls. The results showed that a daughter's fruit and vegetable intake was positively related to their parent's reported fruit and vegetable intake.
This family wellness article is provided by Nourish Interactive, visitwww.nourishinteractive.com for nutrition articles, family wellness tips, free children's healthy games, and tools. Available in English and Spanish.
Copyright ©2009 Nourish Interactive – All Rights Reserved.
Diets that encourage and promise rapid weight loss often lead to weight being regained just as quickly. Australian women spend over $400 million per year in a fruitless quest to be slim, with 95% of people who go on weight loss diets regaining everything they have lost plus more within two years.
Not only are many popular diets ineffective, but they are also a health risk. Research into popular diet books has found that only one in four diets reviewed met current nutrition guidelines with many eliminating important, nutritious foods.
The Dietitians Association recommends weight loss diets that:
- Meet individual nutritional and health needs
- Fit with individual lifestylesInclude a wide variety of foods from all food groups
- Promote physical activity
- Focus on realistic life-long changes to eating and exercise habits.
The Dietitians Association does not recommend weight loss diets that:
- Cut out entire food groups or specific nutritious foods
- Promote and promise rapid weight loss without the supervision of a dietitian and doctor
- Focus on short-term changes to eating and exercise habits
- Recommend unusual foods or eating patterns
- Encourage miracle pills and potions.
There is no one magic or ‘ideal’ weight loss diet. It is possible to lose weight while meeting individual nutrition and lifestyle needs through a variety of approaches.
To lose weight and keep it off see an Accredited Practising Dietitian (APD) like Nastaran. Nastaran can help you get off the dieting merry go round by developing a lifestyle plan that’s right for you and can be followed for life.
For many parents, dealing with an overweight child is a delicate issue. These four steps can put you and your child on the right path to a healthier lifestyle.
An important first step is to let your overweight child know she's OK, whatever her weight. A child's feelings about herself often reflect her parents' feelings about her. For example, if your child gets the message that you are unhappy with the way she looks, that impacts how she feels about herself. If you accept your child at any weight, and emphasize her strengths (e.g., good grades, musical talent, leadership skills), she learns how to feel good about herself. Let your child know she can talk openly with you and share her concerns about her weight. This issue may come up when she is shopping for clothes, participating in an athletic event or donning a bathing suit when it's time to hit the beach or pool. Your child probably knows better than anyone else that her weight is an issue. For that reason, she needs your support, acceptance and encouragement.
Focus On the Family.
Don't set your overweight child apart because of his weight or make a special issue out of it. Instead, make gradual, healthful changes in the whole family's physical activity and eating habits. Family involvement helps to teach everyone healthful habits and does not single out the overweight child as “being on a diet.” Changing the family environment provides your overweight child with the support he needs.
Increase Your Family's Physical Activity.
Regular physical activity, combined with good eating habits, is a must for promoting a healthy weight–and good health–among the whole family. Below are some simple ways to get the whole family moving:
- Be a role model for your children. If your children see you enjoying regular physical activity, they're more likely to get active and stay active for life.
- Plan family activities that are fun for everyone such as walking, dancing, biking or swimming. For example, schedule a walk with your family after dinner instead of watching TV. Make sure the activities you plan are done in a safe environment.
- Be sensitive to your child's needs. Overweight children may feel uncomfortable about participating in certain activities. Help your child find physical activities he enjoys and that aren't embarrassing or too difficult.
- Reduce the amount of time you and your family spend in sedentary activities such as watching TV or playing video games.
- Find ways for you and your family to be more active throughout the day. For example, walk up the stairs instead of taking the elevator, do some stretching during a work or school break, or encourage your child to walk to and from school, if possible.
- If your child likes structured sports activities or classes, sign him up and support his regular participation.
Teach Your Family Healthy Eating Habits Right from the Start.
Teaching good eating habits early and by example will help children develop a healthy attitude about food–that it's enjoyable, and required for energy to keep the body running right and to grow properly. Parents should provide children with the structure of regular meals and snacks, and choose the foods offered. Parents should allow children to choose what to eat from among the foods offered and how much.
To learn more about nutrition for children, make an appointment with Nastaran. See your doctor if you think your child has a serious weight problem.