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
There are some tricks that can help make any fast food meal better for you and your family. Follow these tips to cut down on fat, sodium, sugar, overall calories and make your meal healthier:
- If you are ordering á la Carte items on the menu, find out if there is a child’s size available. Another option is to order the regular size and split the order and share it. Avoid ordering extra large portions just because they are a deal! These deals usually have the words jumbo, giant, super sized or deluxe in the name.
- Don’t be shy about making substitutions! Children love kid’s meals because it comes with a toy and it is usually in a cool looking box. Let them order it but ask to make substitutions for the fries and soda if possible. Many restaurants will offer milk or water as a beverage and apple slices instead of fries.
- Talk to your child before ordering a meal and give them a choice of milk, juice or water (make sure it is low fat milk or 100% fruit juice.) Explain to them that soda is high in empty calories that will just fill up their tummies.
- Let your child know that they can ask for items prepared a specific way. For example, salad dressing on the side, baked or grilled instead of fried, brown rice instead of white rice.
- Finally, set a good example by ordering a healthy meal for yourself.
What Can Parents Do?
By learning how the food is prepared, you will be able to make healthier choices ordering from a menu:
- Order foods that are not breaded or fried because they are higher in fat and calories. Foods that are breaded and deep fried include: chicken nuggets, fried chicken, fried fish sandwiches, onion rings and french fries.
- Order foods that are prepared by being steamed, broiled, grilled, poached, or roasted.
- Have gravy, sauces and dressings served on the side so you can control the amount you eat.
- Use salsa and mustard instead of mayonnaise.
- Use non-fat milk or low fat milk instead of whole milk or heavy cream.
- Order a salad with ‘lite’ or non-fat dressing instead of regular dressing.
- Choose a regular, single patty hamburger without mayonnaise and cheese.
Over the last few years, many chain restaurants have been adding healthier menu options. They also started providing nutrition information for all the foods on the menu, but you usually need to ask for it. Try checking their website as well for additional information.
Hamburger fast food restaurants are the most popular with children. However, other options are available such as Asian food, sandwiches, or Mexican grills. Keep in mind that every fast food restaurant has both healthy and less-healthy choices. Here are some pointers to remember that can help you make better choices when eating out at various fast food places:
- Choose grilled soft tacos or burritos instead of a crispy shell or gordita-type burritos.
- Black beans are a better choice because they have less fat than refried beans.
- Ahhh, the Mexican condiments! Salsa is low in calories and fat and it makes a great substitute for sour cream, guacamole and cheese.
- Choose lean meats such as chicken breast, lean ham or roast beef, instead of salami or bacon.
- Ask for 100% whole wheat bread for sandwiches. Skip the croissants and biscuits because they are high in fat.
- Add low fat salad dressings instead of special sauces or mayonnaise.
- Choose baked chips or pretzels instead of regular potato chips.
- Steamed brown rice has more nutrients and less calories than fried rice.
- Stir fried, steamed, roasted or broiled dishes are healthier choices than battered or deep fried.
- Sauces such as low sodium soy sauce, rice wine vinegar, wasabi, or ginger are better choices than sweet and sour sauce or coconut milk.
It’s OK to enjoy fast food once in a while, but try to limit the visits to no more than twice a month. An average meal at a fast food restaurant has around 1000 calories and does not have the vitamins, minerals and other important nutrients that your child needs to grow healthy and strong. While fast food consumption has greatly increased over the years there are several contributing factors why childhood obesity is becoming more and more prevalent. While all the above information is important, we need to keep things in perspective by understanding that the weight epidemic in this country is because of how much food children eat, rather than what food children eat.
If your family is going to have fast food for one meal, just make sure the other meals that day contain healthier foods like fruits and vegetables. Perhaps you could take an afternoon with your child and prepare a few homemade meals in advance that can be served quickly to avoid the temptation of getting fast food too often while at the same time teaching them some simple food preparation steps. Either way, just remember, it is not that difficult to eat healthy even when you don’t have much time.
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.
People who take aspirin regularly for a year or more may be at an increased risk of developing Crohn's disease, according to a new study by the University of East Anglia (UEA). Led by Dr Andrew Hart of UEA's School of Medicine, the research was presented for the first time at the Digestive Disease Week conference in New Orleans.
Crohn's disease is a serious condition affecting 60,000 people in the UK and 500,000 people in the US. It is characterized by inflammation and swelling of any part of the digestive system. This can lead to debilitating symptoms and requires patients to take life-long medication. Some patients need surgery and some sufferers have an increased risk of bowel cancer.
Though there are likely to be many causes of the disease, previous work on tissue samples has shown that aspirin can have a harmful effect on the bowel. To investigate this potential link further, the UEA team followed 200,000 volunteers aged 30-74 in the UK, Sweden, Denmark, Germany and Italy. The volunteers had been recruited for the EPIC study (European Prospective Investigation into Cancer and Nutrition) between 1993 and 1997.
The volunteers were all initially well, but by 2004 a small number had developed Crohn's disease. When looking for differences in aspirin use between those who did and did not develop the disease, the researchers discovered that those taking aspirin regularly for a year or more were around five times more likely to develop Crohn's disease.
The study also showed that aspirin use had no effect on the risk of developing ulcerative colitis — a condition similar to Crohn's disease.
“This is early work but our findings do suggest that the regular use of aspirin could be one of many factors which influences the development of this distressing disease in some patients,” said Dr Hart.
“Aspirin does have many beneficial effects, however, including helping to prevent heart attacks and strokes. I would urge aspirin users to continue taking this medication since the risk of aspirin users possibly developing Crohn's disease remains very low — only one in every 2000 users, and the link is not yet finally proved.”
Further work must now be done in other populations to establish whether there is a definite link and to check that aspirin use is not just a marker of another risk factor which is the real cause of Crohn's disease. The UEA team will also continue its wider research into other potential factors in the development of Crohn's disease, including diet.
Patients who use vitamin supplements also showed lower levels of plasma homocysteine than in patients who did not (P = 0.001) or healthy controls (P = 0.003). Vitamin B6 and folate were both associated with homocysteine levels, whereas vitamin B12 was not. Twenty-four (48%) of 50 controls and 23 (50%) of 46 of the celiac disease patients carried the MTHFR thermolabile variant T-allele (P = 0.89).
The research team concludes that Homocysteine levels are dependent on Marsh classification and the regular use of B-vitamin supplements reduces of homocysteine levels in patients with celiac disease.The study confirms earlier studies suggesting that both the presence and severity of celiac disease determined homocysteine levels.
The regular use of supplemental B vitamins resulted in higher levels of serum vitamin B6, folate, vitamin B12 and lower levels of plasma homocysteine in patients with celiac disease. Moreover, supplemental B vitamins seem to offer protection against the effects of villous atrophy on homocysteine levels, independent of the genetic susceptibility status as determined by carriage of the C677T polymorphism of 5,10 methylenetetrahydrofolate reductase.
World J Gastroenterol. 2009;15:955–960
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.