Friday, December 15, 2017

Eating together as a family helps children feel better, physically and mentally



Children who routinely eat their meals together with their family are more likely to experience long-term physical and mental health benefits, a new Canadian study shows.

Université de Montréal doctoral student Marie-Josée Harbec and her supervisor, pyschoeducation professor Linda Pagani, made the finding after following a cohort of Quebec children born between 1997 and 1998.

The study is published today in the Journal of Developmental & Behavioral Pediatrics.

"There is a handful of research suggesting positive links between eating family meals together frequently and child and adolescent health," Pagani said. "In the past, researchers were unclear on whether families that ate together were simply healthier to begin with. And measuring how often families eat together and how children are doing at that very moment may not capture the complexity of the environmental experience."

The study looked at chilldren who had been followed by researchers since they were 5 months old as part of the Quebec Longitudinal Study of Child Development. At age 6, their parents started reporting on whether or not they had family meals together. At age 10, parents, teachers and the children themselves provided information on the children's lifestyle habits and their psycho-social well-being.

"We decided to look at the long-term influence of sharing meals as an early childhood family environment experience in a sample of children born the same year," Pagani said, "and we followed-up regularly as they grew up. Using a birth cohort, this study examines the prospective associations between the environmental quality of the family meal experience at age 6 and child well-being at age 10."

When the family meal environment quality was better at age 6, higher levels of general fitness and lower levels of soft-drink consumption were observed at age 10. These children also seemed to have more social skills, as they were less likely to self-report being physical aggressive, oppositional or delinquent at age 10.

"Because we had a lot of information about the children before age 6 - such as their temperament and cognitive abilities, their mother's education and psychological characteristics, and prior family configuration and functioning - we were able to eliminate any pre-existing conditions of the children or families that could throw a different light on our results," said Harbec. "It was really ideal as a situation."

Added Pagani: "The presence of parents during mealtimes likely provides young children with firsthand social interaction, discussions of social issues and day-to-day concerns, and vicarious learning of prosocial interactions in a familiar and emotionally secure setting. Experiencing positive forms of communication may likely help the child engage in better communication skills with people outside of the family unit. Our findings suggest that family meals are not solely markers of home environment quality, but are also easy targets for parent education about improving children's well-being."

"From a population-health perspective, our findings suggest that family meals have long-term influences on children's physical and mental well-being," said Harbec.

At a time when fewer families in Western countries are having meals together, it would be especially opportune now for psycho-social workers to encourage the practice at home - indeed, even make it a priority, the researchers believe. And family meals could be touted as advantageous in public-information campaigns that aim to optimize child development.

Drinking hot tea every day linked to lower glaucoma risk


Drinking a cup of hot tea at least once a day may be linked to a significantly lower risk of developing the serious eye condition, glaucoma, finds a small study published online in the British Journal of Ophthalmology.

But drinking decaffeinated and caffeinated coffee, decaffeinated tea, iced tea and soft drinks doesn't seem to make any difference to glaucoma risk, the findings show.

Glaucoma causes fluid pressure to build up inside the eye (intraocular pressure), damaging the optic nerve. It is one of the leading causes of blindness worldwide, and currently affects 57.5 million people, and is expected to increase to 65.5 million by 2020.

Previous research suggests that caffeine can alter intraocular pressure, but no study so far has compared the potential impact of decaffeinated and caffeinated drinks on glaucoma risk.

So the researchers looked at data from the 2005-2006 National Health and Nutrition Examination Survey (NHANES) in the US. This is a nationally representative annual survey of around 10, 000 people that includes interviews, physical examinations, and blood samples, designed to gauge the health and nutritional status of US adults and children.

In this particular year, it also included eye tests for glaucoma. Among the 1678 participants who had full eye test results, including photos, 84 (5%) adults had developed the condition.

They were asked how often and how much they had drunk of caffeinated and decaffeinated drinks, including soft drinks and iced tea, over the preceding 12 months, using a validated questionnaire (Food Frequency).

Compared with those who didn't drink hot tea every day, those who did, had a lower glaucoma risk, the data showed.

After taking account of potentially influential factors, such as diabetes and smoking, hot tea-drinkers were 74 per cent less likely to have glaucoma.

But no such associations were found for coffee--caffeinated or decaffeinated--decaffeinated tea, iced tea or soft drinks.

This is an observational study so no firm conclusions can be drawn about cause and effect, and the absolute numbers of those with glaucoma were small. Information on when glaucoma had been diagnosed was also unavailable.

Nor did the survey ask about factors like cup size, tea type, or the length of brewing time, all of which might have been influential.

But tea contains antioxidants and anti-inflammatory and neuroprotective chemicals, which have been associated with a lowered risk of serious conditions, including heart disease, cancer, and diabetes, say the researchers.

And previous research has suggested that oxidation and neurodegeneration may be involved in the development of glaucoma, they add, concluding: "Further research is needed to establish the importance of these findings and whether hot tea consumption may play a role in the prevention of glaucoma."

Regular takeaways linked to kids' heart disease and diabetes risk factors


Kids who regularly eat take-away meals may be boosting their risk factors for heart disease and diabetes, suggests research published online in the Archives of Disease in Childhood.

And they are also more likely to be consuming too many calories and fewer vitamins and minerals than kids who eat home cooked food, the findings indicate.

In the UK, the consumption of 'take-aways' rose by more than a quarter between 1996 and 2006 alone, a pattern of behaviour that has been made even easier with the advent of online apps and dedicated meal delivery services, say the researchers.

The available evidence indicates that among adults, a high take-away count is associated with poorer quality diet, more body fat, and a higher risk of type 2 diabetes and heart disease. And the researchers wanted to find out if a similar diet in kids might be storing up similar problems.

They therefore quizzed 1948 ethnically diverse 9-10 year olds from 85 primary schools in London, Birmingham, and Leicester about their usual diets, including the source of their meals, and how often they ate take-aways.

The schools were part of the Child Heart And health Study in England (CHASE), which looked at the potential prompts for heart disease and diabetes risk factors in pre-teens from a wide range of ethnic backgrounds.

Photos of common foods were used to aid the children's recall and estimate portion size. Energy density and nutrient levels of the foods eaten were calculated from their responses.

The children's height, weight, waist circumference, skinfold thickness, and body fat composition (bioelectrical impedance) were all measured. Their blood pressure was taken, as well as a blood sample to discover levels of circulating blood fats (total and low:high density cholesterol).

Their parents also filled in questionnaires on their employment status and job roles. Around a quarter of them were in managerial/professional posts, with a similar proportion in clerical/admin roles (intermediate occupations). Some 29 per cent did routine/manual jobs, while 16 per cent were either unemployed or home makers.

One in four children (499; 26%) said they never or rarely ate take-away meals; nearly half (894; 46%) said they ate a take-away less than once a week; and 555 (28%) said they ate this type of meal at least once a week.

Boys were more frequent consumers of take-aways than girls as were children from less affluent backgrounds.

There were no differences in blood pressure or insulin resistance between those who regularly ate take-aways and those who didn't.

But skinfold thickness, body fat composition, and blood fats all tended to be higher in regular consumers of take-aways. The differences in blood fats were similar across all ethnic groups.

The foods eaten were more energy dense while protein and starch intakes were lower among regular consumers of take-aways, and intakes of vitamin C, iron, calcium and folate were also lower.
If this dietary pattern were to be sustained, it could store up subsequent health problems, warn the researchers.

A separate analysis, comparing the nutrient intake of the previous evening's meal in relation to its source, showed that take-aways were more energy dense, and contained more fat and saturated fat than meals prepared at home.

This is an observational study so no firm conclusions can be drawn about cause and effect, and further research would be needed to explore causal links, caution the researchers.
But they point out: "The higher total cholesterol and LDL [low density or 'bad'] cholesterol concentrations observed in the frequent take away meal group, if sustained, are sufficiently large to increase long term [coronary heart disease] risk by around 10%."

And they go on to say: "These results suggest that further increases in take away meal consumption (and marketing directed at encouraging such increases) are likely to have adverse public health consequences and should be actively discouraged.

"The government should be considering health protection initiatives to reverse the current trends in take away meal consumption, in the context of broader efforts to improve childhood diet and nutrition in home and school settings."

Allergens are widespread in US homes



Allergens are widespread, but highly variable in U.S. homes, according to the nation's largest indoor allergen study to date. Researchers from the National Institutes of Health report that over 90 percent of homes had three or more detectable allergens, and 73 percent of homes had at least one allergen at elevated levels. The findings were published November 30 in the Journal of Allergy and Clinical Immunology.

"Elevated allergen levels can exacerbate symptoms in people who suffer from asthma and allergies, so it is crucial to understand the factors that contribute," said Darryl Zeldin, M.D., senior author and scientific director at the National Institute of Environmental Health Sciences (NIEHS), which is part of NIH.

Using data from the 2005-2006 National Health and Nutrition Examination Survey (NHANES), the researchers studied levels of eight common allergens - cat, dog, cockroach, mouse, rat, mold, and two types of dust mite allergens - in the bedrooms of nearly 7,000 U.S. homes.

They found that the presence of pets and pests had a major influence on high levels of indoor allergens. Housing characteristics also mattered - elevated exposure to multiple allergens was more likely in mobile homes, older homes, rental homes, and homes in rural areas.

For individual allergens, exposure levels varied greatly with age, sex, race, ethnicity, and socioeconomic status. Differences were also found between geographic locations and climatic conditions. For example, elevated dust mite allergen levels were more common in the South and Northeast, and in regions with a humid climate. Levels of cat and dust mite allergens were also found to be higher in rural areas than in urban settings.

To provide a more complete picture, the research team also compared allergen exposure and previously reported sensitization patterns from this survey. Sensitization, which makes a person's immune system overreactive to allergens, may increase the risk of developing allergies and asthma. NHANES 2005-2006 allowed national level comparisons of exposure and sensitization for the first time.

The team uncovered several differences. Although males and non-Hispanic blacks were less likely to be exposed to multiple allergens, sensitization was more common in these groups, compared to females and other racial groups, respectively. Patterns also differed for urban and rural settings. Exposure to several elevated allergens was most prevalent in rural areas, whereas sensitization rates were shown to be higher in urbanized areas.

Overlaps were also found. For dust mite allergens, exposure and sensitization was most prevalent in the Southern and Northeastern regions, and for cockroach allergen in the South. Patterns also reflected socioeconomic variations, especially for pet and cockroach allergens, according to lead author Paivi Salo, Ph.D., of NIEHS.

The researchers emphasized that the relationships between allergen exposures, allergic sensitization, and disease are complex. Studies are still investigating how allergen exposures interact with other environmental and genetic factors that contribute to asthma and allergies.

In the meantime, the following preventive actions may help reduce exposure to indoor allergens and irritants.
  • Vacuuming carpets and upholstered furniture every week.
  • Washing sheets and blankets in hot water every week.
  • Encasing mattresses, pillows, and box springs in allergen-impermeable covers.
  • Lowering indoor humidity levels below 50 percent.
  • Removing pets from homes or at least limiting their access to bedrooms.
  • Sealing entry points and eliminating nesting places for pests, as well as removing their food and water sources.
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"Asthma and allergies affect millions of Americans," said Salo. "We hope this comprehensive study provides beneficial information to a wide audience, from patients to clinicians."

Coloring books make you feel better, but real art therapy much more potent


A new study shows that while those adult coloring books can reduce stress, they're still not art therapy.

Often, the now-ubiquitous adult coloring books will advertise themselves as "art therapy." But actual art therapists contend that such a claim is misleading, that true art therapy is about growth and relationships and not simply about "feeling better."

In light of that, Girija Kaimal, EdD, assistant professor in Drexel University's College of Nursing and Health Professions led a study that shows that while coloring alone does have some positive effect, it is not nearly as potent as involving an art therapist.

"The main takeaway is that coloring has some limited benefits like reducing stress and negative mental states," Kaimal said. "But it does not shift anything else of substance, develop relationships, nor result in any personal development."

Kaimal and her Canadian Art Therapy Association Journal study co-authors -- Janell Mensinger, PhD, associate research professor in Drexel's Dornsife School of Public Health, and doctoral stduents Jessica Drass and Rebekka Dieterich-Hartwell -- ran two, separate 40-minute exercises, one consisting of pure coloring and the other involving direct input from an art therapist, to see if one of the other led to significant differences in mood and stress levels.

"The art therapists' open studio sessions resulted in more empowerment, creativity and improved mood, which are significant for individuals striving to improve their quality of life and make lasting change," Kaimal said.

Every participant -- of which there were 29, ranging in age from 19 to 67 -- took part in each exercise. In the pure coloring exercise, the participants colored in a pattern or design. Although an art therapist was in the room, they did not interact with the person coloring.

In the other exercise, participants were put in an "open studio" situation, where an art therapist was present and able to facilitate the session, as well as provide guidance and support to process the experience and artwork. The participants were able to make any type of art they wished, whether it involved coloring, sketching, doodling, or working with modeling clay. As the participants worked on their piece, the art therapists created art as well, and were available to assist the participants if they asked for it.

Each person took standardized surveys before and after their sessions that ranked their stress levels and feelings.

Perceived stress levels went down by at roughly the same levels for both exercises (10 percent for coloring; 14 percent for open studio). Negative mental states also showed similar decreases in levels (roughly a 7 percent decrease for coloring; 6 percent for open studio).

But while the coloring exercise didn't show significant changes for any other effects, the participants displayed an approximate 7 percent increase in self-efficacy, 4 percent increase in creative agency, and a 25 percent increase in positive feelings after their art therapist-aided open studio sessions.

"Many of the outcomes were enabled through the relational support from the art therapist," Kaimal explained. "The art therapist-facilitated session involves more interpersonal interaction, problem solving around creative choices and expression, empowerment and perhaps more learning about the self and others. That all contributes to the outcomes we saw."

So while coloring did help alleviate bad feelings, it didn't create good feelings in the way that actual art therapy might.

"Coloring might allow for some reduction in distress or negativity, but since it is a structured task, it might not allow for further creative expression, discovery and exploration which we think is associated with the positive mood improvements we saw in the open studio condition," Kaimal said.

Vitamin deficiency in later life


One in two persons aged 65 and above has suboptimal levels of vitamin D in the blood.. Moreover, as the authors of the study report in the peer-reviewed journal Nutrients, one in four older adults has suboptimal vitamin B12 levels.

Since more than 30 years, the KORA Cooperative Health Research platform has been examining the health of thousands of people living in the greater Augsburg area in Southern Germany. The aim of the study is to understand the impact of environmental factors, lifestyle factors and genes on health. "In this context, we were also interested in examining the micronutrient status of older adults, including vitamins" explains study leader Dr. Barbara Thorand of the Institute of Epidemiology (EPI), Helmholtz Zentrum München. 

Overall, the scientists examined blood samples of 1,079 older adults, aged 65 to 93 years from the KORA study*. Their analysis focused on levels of four micronutrients: vitamin D, folate, vitamin B12 and iron.

"The results are very clear," explains first author Romy Conzade. "Fifty-two percent of the examined older adults had vitamin D levels below 50 nmol/L and thus had a suboptimal vitamin D status." The scientists also observed shortages with regard to some of the other micronutrients. Notably, twenty-seven percent of older adults had vitamin B12 levels below the cut-off. Moreover, in eleven percent of older adults, iron levels were too low, and almost nine percent did not have enough folate in their blood.

EPI director Professor Annette Peters puts the data into context: "By means of blood analyses, the current study has confirmed the critical results of the last German National Nutrition Survey (NVS II)**, which revealed an insufficient intake of micronutrients from foods. This is a highly relevant issue, particularly in light of our growing aging population." 

Are dietary supplements the way forward?

The majority of older adults with suboptimal vitamin levels had in common that they were very old, physically inactive or frail. Special attention should, therefore, be paid to these groups with a higher risk for micronutrient deficiencies, explain the researchers.

"Our study also shows that regular intake of vitamin-containing supplements goes along with improved levels of the respective vitamins," says Barbara Thorand. "However, vitamin-containing supplements are not a universal remedy, and particularly older people should watch out for maintaining a healthy and nutritious diet." 

In this context, the authors say their next objective is to continue investigating the metabolic pathways that link supplement intake, micronutrient status and disease states.

Erectile dysfunction is red flag for silent early cardiovascular disease SAGE


Despite decades long prevention and treatment efforts, cardiovascular (CV) disease continues to be the leading cause of death worldwide. Early detection of CV disease can allow for interventions to prevent heart attack and stroke, including smoking cessation, medications such as a statins, blood pressure control, weight management, exercise, and improved diet. A new study published online first today in the journal Vascular Medicine, focuses on a novel risk factor for cardiovascular disease that rarely receives attention - erectile dysfunction.

In addition to being an important health and quality of life issue for men, erectile dysfunction has long been associated with CV disease. Risk factors for erectile dysfunction and CV disease are similar - including older age, smoking, obesity, and diabetes, among others. In addition, multiple overlapping mechanisms lead to the development of both erectile dysfunction and CV disease.

In the article entitled "The relationship of erectile dysfunction and subclinical cardiovascular disease: A systematic review and meta-analysis," Drs. Chukwuemeka Osondu (Baptist Health South Florida), Bryan Vo (Florida International University), Ehimen Aneni (Mount Sinai Medical Center), and colleagues sought to establish erectile dysfunction as a simple and effective marker of underlying subclinical CV disease. They hypothesized that "measures of erectile dysfunction could be a simple effective CV disease risk stratification tool, particularly in young men who are less likely to undergo aggressive CVD risk assessment and management."

The authors conducted a systematic review and meta-analysis of 28 studies that examined the link between erectile dysfunction and measures of early CV disease. They report a significant association of erectile dysfunction with impaired endothelial function (measured by brachial flow-mediated dilation using ultrasound), a marker of the ability of blood vessels to relax that is an early event in vascular disease development.

n addition, the authors report that erectile dysfunction was associated with increased carotid intimal medial thickness (carotid IMT), an early manifestation of atherosclerosis. The results for the association of erectile dysfunction and coronary artery calcium scoring were inconclusive due to small number of studies with limited sample size. The authors identify this as an area in need of future study.

As explained by the authors, "Our study findings indicate that [young] men [with erectile dysfunction] are at greater risk of having identifiable subclinical CV disease and will benefit from an active CV disease work-up...Our study supports a more aggressive CV disease risk assessment and management for persons with erectile dysfunction, including young men who may otherwise be categorized as low risk due to their young ages."

In an accompanying editorial, Drs. Naomi Hamburg and Matt Kluge (Boston University) agree: "The presence of erectile dysfunction portends a higher risk of future cardiovascular events, particularly in intermediate risk men, and may serve as an opportunity for intensification of cardiovascular risk prevention strategies." They add "The findings add to the growing evidence supporting additional trials to determine the clinical impact of erectile dysfunction screening and the appropriate cardiovasculardirected evaluation and treatment of men with erectile dysfunction."