OTC drugs are not always safe: the safety updates

Over-the-counter drugs, known as OTC drugs for short, are drugs available at your pharmacists without a doctor’s prescription. Normally, the status of OTC is only granted by drug authorities to drugs whose safety has been well-established over years and years of use. Many of the medications you have in your medicine cabinet at home are OTC, from the pills you take for fever and toothache (acetaminophen, ibuprofen, or aspirin) to your common cough and cold drugs (cough syrup, cold rubs, etc.) to your nutritional supplements. Many of these medicines are even used in children. However, recent studies have reported that some OTC drugs may present some health risks and side effects which are more serious than previously thought. That is why the US Food and Drug Administration (US FDA) has stepped on the safety of OTC drugs. This resource post brings you an update of these safety issues.

OTC drugs for adults

FDA toughens warnings on over-the-counter painkillers
In April this year, the US FDA announced new requirements for labelling OTC anti-fever and pain killer drugs such acetaminophen (also known as paracetamol, marketed as Tylenol) and non-steroidal anti-inflammatory drugs, or NSAIDs (e.g. ibuprofen, aspirin, marketed under Advil, Motrin and Aleve). The drugmakers are required to “more prominently display safety warnings” on the package inserts and labels of the said drugs. Specifically, the FDA are concerned about liver damage that can be caused by these drugs in case of overdose, those with chronic liver problems, and the danger of combining acetaminophen and NSAIDs with alcoholic drinks. There is also the risk of stomach bleeding when taking NSAIDs and the blood thinning drugs aspirin and warfarin.

OTC drugs for teens

What teens don’t know about OTC medications can hurt them
OTC drugs present risks to teens who are usually start to take their own health care in their hands but still lack the knowledge of proper use of medications. This can lead to complications, inadvertent as well as intentional abuse. A study by researchers at the University of Rochester Medical Center interviewed 100 youths age 14 to 20 years old, with the following results:

• 44% had ample knowledge about appropriate use of OTC drug.
• 75% had taken OTC drugs without adult supervision during the previous month.

“This tells health professionals that we need to teach our young people about safe use of over-the-counter pain medications,” says Dr. Karen Wilson, one of the study authors.

OTC drugs for children

In 2007, people were shocked about the news that several little children suffered from serious adverse events, some of them fatal, after taking OTC cough and cold medicines, as reported by the Philadelphia Medical Examiners Office.

In response, the US FDA had a second look at the safety of these OTC drugs. In January 2008, the regulatory body issued new OTC products recommendations which were later updated in October 2008. The new advisory strong advises against the use of OTC cough and drugs in children under the age of 2.

Study finds parents use cough medicines on under-2s despite the warnings
Despite the warnings, an Australian study revealed that 40% parents surveyed still use OTC drugs in under-two’s. Here are some of the figures from the study:

• 98% had purchased an OTC medication in the past year;
• Paracetamol was the most commonly used drug (95.9%);
• 47.3% had given their children topical teething gels;
• Almost half (42.8%) had given their children cough and cold medicines containing anti-histamines;
• Nearly all parents had used OTC medications to combat pain and fever;
• About 7% of parents had given their child over-the-counter medication to induce sleep or settle their child;
• Two parents had given their children paracetamol because they were “cranky”.

Treat with Care
This year, the OTC drug manufacturers in the US acted responsibly enough by taking the following steps:

• changing OTC drug labels.
• launching a large-scale public service campaign called “Treat with Care“.

“Treat with Care” is run by the Consumer Healthcare Products Association (CHPA), a not-for-profit association representing the makers of over-the-counter (OTC) products and the consumers who use these healthcare products

For the “Treat with Care” campaign, CHPA had no other than actress Chandra Wilson as their spokesperson. Wilson is best known for her role as the surgeon Dr. Miranda Bailey in the popular medical soap Grey’s Anatomy. In real life, Wilson is a mom of two whose youngest is in the age group affected by the OTC safety issues.

The Treat with Care campaign says:

• Always read and follow medicine labels exactly and use the measuring device that comes with the medicine.
• Do not give a medicine only intended for adults to your child.
• Only give the medicine that treats your child’s specific symptoms.
• Never give two medicines at the same time that contain the same active ingredient.
• Do not use oral cough and cold medicines for children under age 4.
• Never use an OTC medicine to sedate or make your child sleepy.
• Never give aspirin-containing products to your child for cold or flu symptoms unless told to do so by a doctor.
• If your child develops any side effects or reactions that concern you, stop giving the OTC medicine and contact a doctor immediately. 
• Keep all medicines out of your child’s reach and sight.
• Talk to a doctor, pharmacist, or other healthcare provider if you have any questions.

Photo credit: stock.xchng

http://www.youtube.com/watch?v=2wf2xKPJ2fs

               

The link between obesity and food allergies

Overweight children and adolescents are more likely to suffer from food allergies. This is according to a study by American researchers. Here are some of the figures to think about (Source: NY Times):

• Overweight children are 50% more likely to be allergic to milk.
• They are also 26% more likely to be allergic to at least one type of food.

For children as well as for parents, food allergies are a problem that can range from being a mild annoyance (e.g. skin rash) to life-threatening (food related anaphylaxis). According to the Food Allergy and Anaphylaxis Network, 4% of the American population (more than 12 million people) has some form of food allergy. Of these, 3 million are children.

90% of food allergies are due to the following food stuffs:

• milk
• eggs
• peanuts
• tree nuts (e.g., walnuts, almonds, cashews, pistachios, pecans)
• wheat
• soy
• fish
• shellfish.

The current study followed up 4,111 children and teenagers aged 2 to 19 years old and monitored the levels of total and allergen-specific immunoglobulin E (IgE) or antibodies to a wide spectrum of airborne (indoor and outdoor) and food allergens as well as the body weight of the participants. The researchers found that obese or overweight children have higher IgE levels compared to children with normal weight.

According to researcher Dr. Stephanie London, “The signal for allergies seemed to be coming mostly from food allergies. The rate of having a food allergy was 59 percent higher for obese children.”

The study results do not necessarily prove that excess weight can cause food allergies in children. However, the fact remains that there is a strong association between obesity and allergies. This is an association that cannot be simply ignored but should be investigated further.

In recent years, the problem of obesity, especially among children has been on the rise. The same is true with the problem of food allergies.

According to lead author Dr. Cynthia Visness

“Given that the prevalence of both obesity and allergic disease has increased among children over the last several decades, it is important to understand and, if possible, prevent these epidemics.”

The current study was funded by the National Institute of Environmental Health Sciences (NIEHS) and the National Institute of Allergy and Infectious Diseases (NIAID). The results have been published in the May issue of the Journal of Allergy and Clinical Immunology.

Photo credit: Stock.xchng

               

Fighting depression with exercise

Many children and adolescents suffer from clinical depression. That is why experts have recently come up with guidelines that recommended routine screening for depression in the younger segment of the population. The guidelines also recommended psychotherapy or psychotropic drugs or both in the management of clinical depression in adolescents. But aren’t there other ways - especially non-pharmacological approaches to manage depression?

Researchers at the Medical College of Georgia looked at the effect of exercise on depressive kids. The participants were 207 weight children aged 7 to 11 years old. The participants were tested for depressive symptoms using the Reynolds Child Depression scale as well as the Self-Perception Profile for Children, a test which measures childrens’ perception of themselves before (at baseline) and after the study. The children were randomly assigned to three different physical exercise regime which lasted for 13 weeks

• Group one: a “low-dose” exercise group which was physically active20 minutes each day
• Group two: a “high-dose” exercise group which was physically active for 40 minutes each day
• Group three: a control group which consisted of sedentary children.

Exercises consisted of activities which were fun but maximized for intensity and designed so that the participants’ heart rates exceeded more than 150 beats per minute.

The study results showed that depressive symptoms improved significantly with increasing exercise time even though no noticeable weight increase was observed. It seems that exercise has a positive impact on the children’s self-esteem. However, this positive effect was only observable in white but black participants.

Physical activity has been shown to greatly help in managing depression in adults. In patients who suffered from stroke or cardiac events, exercise helps in improving health outcomes. In patients with primarily clinical depression, exercise leads to release of the hormone endorphin which induces positive feeling. The study results here suggest that physical exercise can positively affect children’s self-worth should therefore be considered as intervention against depressive symptoms.

This is very relevant considering the results of another study last year which showed that American children take more psychotropic medications that their counterpart in Western Europe. Comparing the US with two European countries, the annual prevalence of use of psychotropic medications is:

• US  - 6.7%
• The Netherlands - 2.9%
• Germany - 2.0%

The most common of these psychotropic drugs were antidepressants and stimulants and there was a tendency for multiple drug therapy among US kids. There is some indication that Europeans tend to use alternative ways of managing depression - including exercise.

               

May is Better Hearing and Speech Month

Our sense of hearing is one of the most important of our senses and hearing impairment can have a detrimental effect on our way of life. Here some figures to ponder upon:

• The World Health Organization (WHO) estimates that in 2005, 278 million people worldwide have moderate to severe hearing impairment in both ears.
• 80% of hearing-impaired people live in low- and middle-income countries (LMIC).
• 50% of cases of hearing impairment is avoidable through prevention, early diagnosis, and management.
• In the US alone, more than 5 million children have a language, speech or hearing disorder.
• In LMIC, less than 1 in 40 people who need a hearing aid can afford one.

Hearing and speech problems most often go together. These disorders may be due to birth and genetic defects, illnesses or injuries. The earlier hearing disorders occur in a child’s life, the higher are their impact in the child’s development, especially language and speech development as well as gross motoric skills and balance. Later on, it can affect the child’s social and learning skills. Like in most disorders, the key to successful resolution is early detection and intervention. Since 1927, the American Speech-Language-Hearing Association (ASHA) has observed the Better Hearing and Speech Month (BHSM) every May. The month is focused on raising awareness of speech and hearing disorders, especially among parents. Many parents are not adept in identifying such kind of disorders in their children, much more knowing what to do once they observe a problem. BHSM “provide parents with information about communication disorders to help ensure that they do not seriously affect their children’s ability to learn, socialize with others, and be successful in school.”

According to ASHA, some signs of speech and language disorders in children are:

• Stuttering 
• Articulation problems (”wabbit” instead of “rabbit”) 
• Language disorders such as the slow development of vocabulary, concepts, and grammar. 
• Voice disorders (nasal, breathy, or horse voice and speech that is too high or low)

As mother of twin boys who were born premature and brought up bilingually, I am always on alert whether my children’s language skills are developing normally on not.

The most common signs of hearing disorders in children are (source ASHA):

• Inconsistently responding to sound 
• Delayed language and speech development 
• Unclear speech 
• Sound is turned up on electronic equipment (radio, TV, cd player, etc.) 
• Does not follow directions 
• Often says “Huh?” 
• Does not respond when called 
• Frequently misunderstands what is said and wants things repeated

Normally, the pediatrician or the family doctor should check children right from infancy for hearing problems. It is also recommended that starting the age of 5 or at the latest, right before school entry, children should undergo a general physical exam which should include eye tests but also hearing and speech screenings.

The professionals who can help:

• An Ears, Nose & Throat (ENT) specialist (also called otolaryngologist) is specialized in disorders of these organs. However, only a small fraction of his or her work has something to do with the ears of hearing.
• An otologists (sometimes called neurotologists) is usually an ENT who has taken additional training or studies to specialized mainly with the ear and hearing disorders.
• An audiologist is non-medical professional who is specialized in the non-medical management of hearing and balance disorders. He or she is not a doctor but can conduct hearing screenings and perform rehabilitation therapies and refer patients to a medical specialist
• A speech-language pathologist can conduct evaluations and diagnosis of speech and language disorders as well as conduct therapies and rehabilitation problems.

               

Socioeconomic status and heart transplant outcomes

Here is another sad case of disparity among heart transplant recipients. It seems that children of low socioeconomic status tend to have worse health outcomes even after a heart transplant, according to Boston researchers.

The study followed up 135 pediatric patients who received their first heart transplant at Children’s Hospital Boston from 1991-2005. The demographic profile of the study group are:

• 82% were white (110)
• 18 % were non whites (10 black; eight Hispanic; and seven from other racial groups).
• 58% were boys; 42% were girls
• median age is 8.4 years

The researchers grouped the patients based on their socioeconomic status and followed up their outcomes after heart transplantation. One-third (45) of the patients were classified as “low socioeconomic group” and compared to the remaining two-thirds.  The two groups were similar demographically.

The findings show that

• Children from low socioeconomic neighborhoods were 2.4 times more likely to have graft failure after transplant when compared to the controls.
• Minority children were 2.7 times more likely to suffer graft failure when compared to whites.
• Among 9 early deaths during transplant hospitalization, 6 deaths, or 13.3 percent, occurred in the lower socioeconomic group compared to three deaths, or 3.3 percent, in the higher socioeconomic group.
• Survival of the transplanted heart was significantly shorter in the low socioeconomic group at one year, three years, and five years post-transplantation.

The low socioeconomic group also had a higher likelihood of rejection and had a shorter time to death or retransplantation. The study indicates that “low socioeconomic status and non-white race appear to be independent risk factors for worse outcomes.”

Looking closely as to what “lower socioenconomic status” means based on six socioeconomic factors, the following can be used as indicators:

• lower median income;
• lower median value of housing;
• fewer adults with high-school and college education;
• fewer adults in managerial, professional or executive positions; and
• fewer households with rental, interest or dividends as the source of their income.

The reasons for this disparity in health outcomes due to socioeconomic status are not clear but it may be due to difficulty in using medical resources. Because all patients had health insurance coverage and equal access to medical resources, the causes of the difficulty could be at the family and personal level.

Last year, there was another post highlighting the disparity in organ transplantation in relation to ethnicity. That study showed that non-white children are more likely to die while waiting for a heart donor. Clearly, there is a need to delve deeper into the causes of these disparities.  Because I believe that each child deserves a fair chance regardless of skin color or bank account balance.

Photo credit: stock.xchng

               

7 steps to successful weight loss in children: The CORE Tool

In 2007, American researchers came up with recommendations to fight childhood obesity and they consisted of 4 steps based on “the principle of least intervention.” This year, a group of scientists from the Center of Obesity Research and Education (CORE) proposed that the previous recommendations be expanded to 7 steps in order to achieve more significant improvement.

The new model also proceeds stepwise, each step is more intensive and drastic than the previous one.

The so-called Seven Steps to Success are

1. Medical Management. Seeing your child’s pediatrician regularly will help provide you with feedback about progress and regular evaluations for potential health problems caused by excess weight (e.g., high blood pressure, liver problems, diabetes).
2. Education. Knowledge of the best ways to eat, stay active, and solve problems relating to weight is necessary for successful weight control.
3. Environmental Changes. Making changes in the environment in which your family lives can help (e.g., taking televisions and computers out of bedrooms, eliminating all high-fat food in the house).
4. Support Groups.
5. Cognitive–Behavior Therapy (CBT) I: Clinics or Short-Term Immersion. CBT is a scientifically based approach to helping people improve their motivation, goal-setting, and focusing skills. Professionally conducted CBT programs for overweight children are available (check local hospitals, clinics). Immersion programs focus on CBT full time, for example for 4 weeks in the summer.
6. CBT II: Long-term Immersion. Longer, more intensive, immersion programs are available in therapeutic boarding schools and clinics.
7. Bariatric Surgery +. For some seriously overweight teenagers who have tried the first six steps, specialized surgeries (bariatric surgeries like the gastric bypass) performed in surgical centers that have experience and understanding of this problem are important options.

It is important to know that the model is based on one important assumption – that obesity among children is a family affair. For it to work, the participation and commitment of all family members is essential.

Another review study published earlier this year suggests that family-based lifestyle interventions that include diet modifications, physical exercise and behavior therapy programs were effective in helping overweight children to lose weight. Furthermore, this loss weight was could be sustained for 6 months in young children and up to one year in adolescents.

The CORE tool also recommended several organizations active in the fight against obesity.

Organizations active in education on obesity and proper nutrition:

·        www.healthykids.ca

·        www.cspinet.org

·        www.calorieking.com

Support groups:

·        Take Off Pounds Sensibly (TOPS)

·        Weight Watchers

Clinics for CBT:

·        www.wellspringcamps.com

·        www.camplajolla.com

·        www.zeepreventorium.be

Clinics experienced in bariatric surgery:

·        www.fitprogram.ucla.edu

·        www.cincinnatichildrens.org

You can also download the full CORE tool at

Seven Steps to Success: A Handout for Parents of Overweight Children and Adolescents

               

Take the stress away from the dinner table

Resource post for March

Is meal time stress time at your home? With two preschoolers to take care of, it can sometimes be for me. But I and my husband do our best to make meal times stress-free especially in the evenings because we know that the more relaxed our evening is, the better the kids - and us - could sleep. Besides, stress, as we know, is bad for our health, affects our appetite (either way is possible), and can interfere with our digestion. There is therefore a need to remove stress from our evening meals.

A recent WebMD article gave the following recommendations - 6 Ways to De-Stress at the Dinner Table:

1. Turn down the volume.
2. Set the Table to Set the Mood.
3. Let There Be (Soft) Light.
4. Control the Conversation.
5. Keep Your Cool in the Kitchen.
6. Keep It Real.

I agree with some of the tips given in the above list, especially the first one. However, each family is different. Add to the cultural differences in eating habits and you will agree there is no magic formula to a stress-free evening. I’d like to share with you our family’s strategies to have relaxing mealtimes in the evening.

No TV, no toys. No TV is allowed at meal times and no toys are allowed on the table either. It only takes one match box car to tip a glass over.

Keep it simple. Stress doesn’t just occur at the dinner table but in the kitchen as well. That is why we try to keep evening meals as simple as possible. On weekdays, everybody in the family gets a substantial warm meal either at the office canteen or at school cafeteria. Suppers at home would consist of whole grain bread, cheese, cold cuts, and sliced fresh vegetables. Low-fat fruit yoghurt or fruit mousse serves as dessert. If necessary, I can quickly make a vegetable soup in winter time. However, having this simple, easy but still healthy meal in the evenings saves me the stress of kitchen work.

Now, you may ask. How can preschoolers survive without chicken nuggets, fries, or macaroni with cheese in the evening? Ours can because they’re used not used to having them in the first place. A study by Australian researchers called Parental Attitudes and Nutrition Knowledge. showed that children learn the taste for healthy food from their parents. And their preferences are already evident as early as age 5. Our kids would remind me if I forget the veggie cuts in the evening. They just love them.

Eat together. No matter how simple the fare is, it is important that the family sits together during the meal. According to the WebMD article “recent research at Columbia University found that children who regularly had dinner with their families are less likely to abuse drugs or alcohol, and more likely to do better in school. In fact, studies show the best-adjusted children are those who eat with an adult at least five times a week, says Ann Von Berber, PhD, chair of the department of nutrition sciences at Texas Christian University in Fort Worth.”

Keep it early. An early evening meal is recommended especially if you have little kids. Remember that going to bed with a full stomach is not really the best strategy for a good night sleep. We usually have supper at 6 pm, at the latest at 6:30 pm. That way, the kids can be in bed by 8 pm. However, an early supper is only possible if you keep it simple. Mind you, in some cultures (e.g. southern Europe, for example), dinner cannot start earlier than 8 pm.

Avoid take outs. We are not big fans of take outs, be it pizza or Chinese noodles or burgers. While some people think take outs are convenient, I think otherwise. I think take outs are unhealthy and wasteful (think of all those packaging) and should only be opted for under special circumstances.

Work as a team. Involve the kids in setting the table. Get them to help with peeling and slicing the vegetables, as well as with the cleaning up afterwards. This way, things go much faster.

Keep the special touches for the weekend. Weekends are slow food time at home. Saturdays and Sundays are the days reserved for specially prepared meal. There is more time to plan and shop and cook on the weekends. No need to rush or panic. Whoever is in the kitchen doesn’t get stressed or harried. On the weekends, we start our day together with a late breakfast or brunch. Early afternoon, we have a light snack which could be soup, fruit salad, or cake. And then we end the day with a 3-course meal. With candlelight and all. In the summer time, a barbecue on the terrace is warranted.

I like cooking for my family. But I can’t do it 7 days a week under time pressure after having had a long working day. I will be stressed, my husband will be stressed, and the kids will be stressed. Meal times should be times when a family sit together and talk, not argue or bicker. After a day’s work or school, the evening meal is the time to wind down and talk about the day’s events. The less stress there is, the better for everybody.

 

Photo credit: stock.xchng

               

End-of-life care for pediatric cancer patients

Cancer is the leading disease that causes death to children ages 1 to 19. Over the last decades, the treatment of pain and the quality of end-of-life (EOL) care for children with cancer has improved. However, a lot of work still needs to be done to make it more effective. Children with terminal cancer normally receive pain medications but many parents have reported that their dying children suffering from pain in the last few days of their lives. Attending physicians and nurses also admitted that they have difficulties in pain management. A study which interviewed parents also revealed that pediatric oncologists may need to further improve their pain management skills.

 Opioids are a class of drugs commonly prescribed to young cancer patients in hospitals to relieve them from pain during their last week of life. This latest findings of a study, however, showed that treatments of opioids greatly vary among hospitals. The investigators examined the cases of 1,466 patients ages 24 or younger using the data from the Pediatric Health Information System. The patients were treated at 33 hospitals at the time of death from 2001 to 2005. The results showed that only 56% of the patients have received daily therapy of opioids during the hospital stay of their last week of life. The daily opioid therapy varied significantly among children’s hospital ranging from 0 to 90.5% of the eligible patients. Sixty-four percent of the patients with private insurance received opioids daily, while only 52% of those with Medicaid or other government coverage received the drug. Patients aged 10-19 also received more opioid treatments (61%) compared to the younger or older patients. Furthermore, patients with brain tumors received lesser opioid therapies compared to those with other types of cancer such as leukemia or lymphoma.

 The manner in which opioids are used in palliative care within a hospital may be due to several factors. Regardless of the reasons, the variation of pediatric EOL care practices among hospitals suggests that changes in EOL care practices would be most effective if they are adapted to the specific configuration of each hospital which would take into consideration the social, cultural, technical and institutional factors.

 According to Dr. Andrea D. Orsey co-author of the study:

“The findings demonstrate how useful it would be to have indicators to measure the quality of pediatric end-of-life care and enable comparisons across hospitals. Interventions to improve practices in pediatric end-of-life care may be most effective if adapted individually to each hospital”.

Dr. Sarah Friebert, another reseacher on the subject adds:

“Good pain management seems to be the least we can do for our pediatric patients with cancer. Importantly, for those for whom the journey of cancer will not end in cure, relief of distress from pain at the end of life carries long-lasting implications for bereaved parents, who cope much better when their dying children’s pain is well controlled”.

               

The carcinogens in third hand smoke

It is an undeniable fact based on irrevocable evidence. Cigarette smoke is bad for our health and can cause cancer. Cigarette smoke contains more than 4000 chemicals, and 250 of these are poisonous gases and other toxic chemicals, according to this New York Times article. According to Cancer Research UK, cigarette smoke contains at least 69 carcinogens. Some of these are listed below.

• Tar - a mixture of dangerous chemicals
• Arsenic - used in wood preservatives
• Benzene - an industrial solvent, refined from crude oil
• Cadmium - used in batteries
• Formaldehyde - used in mortuaries and paint manufacturing
• Polonium-210 - a highly radioactive element
• Chromium - used to manufacture dye, paints and alloys
• 1,3-Butadiene - used in rubber manufacturing
• Polycyclic aromatic hydrocarbons - a group of dangerous DNA-damaging chemicals
• Nitrosamines - another group of DNA-damaging chemicals
• Acrolein - formerly used as a chemical weapon

Remember Polonium 210? It was the radioactive material used in the well-publicized 2006 murder of the Russian ex-spy Alexander V. Litvinenko.

Now, we know the hazards of first and second hand smoking. But here’s something newly recognized - and just as dangerous - third hand smoke.

So what’ third hand smoke?

According to this study recently published in the journal Pediatrics, “third hand smoke is residual tobacco smoke contamination that remains after the cigarette is extinguished.”

It seems that long after smoking is finished, long after the cigarette butt has been thrown away, the toxic substances in the cigarette smoke persist and stay, sticking to your clothes, hair, the furniture, the curtains, the carpet, the car upholstery. This means that by simply taking away the smokers and opening the windows does not make a room “smoke-free.”

In these days where smoke-free legislations have become widespread in developed countries, there are concerns about the possible increase of smoking in the privacy of the home, thus creating an environment full of second and third hand smoke. Unfortunately, the people most highly susceptible to toxic substances in the cigarette smoke are children. A little baby in its smoker mother’s arms, the little one crawling on the carpet, the toddler hiding behind the curtain or the school-aged child in the back seat of the car. They are exposed to the abovelisted carcinogens even if Mom or Dad never smokes in their presence through third hand smoke. This is why there is now a discussion going on about banning smoking at home.

This survey polled people’s opinion on third hand smoke and home smoking bans. A large majority of people, non-smokers as well as smokers are well aware of the hazards of third hand smoke. However, as expected, it is easy for the non-smokers to say “yes” to home-smoking ban than the smokers.

Nicotine addiction is a very hard habit to kick and I’m sure many smoking parents are doing their best to protect their children from the hazards of cigarette smoke. Unfortunately, short of quitting, they can’t really get rid of the threat of cigarette smoke.

I am all for home-smoking ban but this should be coupled with educational drives and smoking cessation help and support. In marginalizing smoking parents, we are also marginalizing their children.

               

High BP trends among America’s children

The latest statistics from the US National Health and Nutrition Examination Surveys (NHANES) are out and the numbers do not look too good for American children and teenagers.

NHANES are surveys conducted by National Center for Health Statistics, Centers for Disease Control and Prevention (CDC) which provide “cross-sectional, nationally representative health examination data on the US civilian, noninstitutionalized population.”

CDC researchers, in collaboration with colleagues from Wake Forest University School of Medicine Department of Epidemiology and Prevention, North Carolina, conducted an analysis of NHANES data from the following years: 1988 to 1994, 1999 to 2002, and 2003 to 2006. These are data of children and adolescents in the age range of 8 to 17 years old. The researchers specifically looked at the elevated blood pressure (BP) and estimates of BP before reaching elevated levels.

BP was measured and classified based on the update guidelines in the Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents. The results of the data analysis showed that overweight and obese children and adolescents are more likely to suffer from elevated BP.

Hypertension or above normal BP is common among adults. However, there is increasing indication that elevated BP is also becoming a problem among children as well. This is troubling because other research studies have shown that high BP tracks through life, and that “BP levels measured in childhood and adolescence are also associated with elevated BP in adulthood.”

Hypertension is well-known risk factor for chronic health conditions such as cardiovascular disorders (e.g. heart attack, heart failure, stroke) and kidney disease. However, hypertension can be managed with lifestyle change strategies.

High BP in children has been also linked to other health conditions.

Sleep breathing disorder is a condition “characterized by short periods of upper airway obstructions that are complete (apnea) or partial (hypopnea), or a longer period of insufficient air movement (obstructive hypoventilation).” This sleep disturbance leads to restless sleep, snoring and daytime sleepiness. Sleep breathing disorder, which seems to cause hypertension, has been associated with obesity and enlarged nostrils.

Other studies have linked high BP to lack of physical activity among children and adolescents, as reported by British researchers. The study was part of the Avon Longitudinal Study of Parents and Children.

Photo credit: stock. xchng

               

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