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Daily Dose

Infant Weight Gain & Obesity

1:15 to read

A new study out of Harvard that was published in Pediatrics, looks at infant weight gain and links to childhood obesity. This is an interesting study, as previous studies had typically looked at weight alone as a predicator for future problems with obesity. In this study the authors looked at both weight and length as a measure of fatness.

They also looked at weight as a dynamic process, in other words, it was not how much you weighed, but how quickly you gained the weight in infancy. The authors found that the correlation between rapid infant weight gain and later obesity was striking. Other studies have also looked at the relationship between infant and childhood weight but this study makes a compelling argument that early rapid weight gain, even in the first months of infancy, could have long term health consequences.

So, armed with this knowledge, what can a parent do? Follow the AAP guidelines to exclusively breast or formula feed your baby for the first six months of life. If a your-baby is formula fed, limit their daily intake to an appropriate amount for age. Many parents, for a multitude of reasons, decide to add cereal to their baby's bottle in hopes that this will "make their infant sleep through the night". To my knowledge there has never been any data to confirm this, (maybe the Mommy network) and additional calories in infancy may lead to long-term consequences. Juices and early introduction of your-baby foods may also add unnecessary calories. This study points out the need to modify weight gain in infancy in a manner that will balance the needs of an infant's brain as well as their body, during this time of rapid development.

That's your daily dose, we'll chat again soon.

Your Baby

Starting Baby on Solid Foods

Your goal over the next few months is to introduce a wide variety of foods. If your baby doesn't seem to like a particular food, reintroduce it at later meals. It can take quite a few tries before kids warm up to certain foods.Starting baby on solid foods can be an exciting and perplexing time for parents. What foods should I start with? How much? How often?

The American Academy of Pediatrics currently recommends gradually introducing solid foods when a baby is about 6 months old. Your pediatrician, however, may recommend starting as early as 4 months depending on your baby's readiness and nutritional needs. Be sure to check with your pediatrician before starting any solid foods. Is your baby ready? Breast milk or formula is the only food your newborn needs. Within four to six months, however, your baby will begin to develop the coordination to move solid food from the front of the mouth to the back for swallowing. At the same time, your baby's head control will improve and he or she will learn to sit with support — essential skills for eating solid foods. If you're not sure whether your baby is ready, ask yourself these questions: •       Can your baby hold his or her head in a steady, upright position? •       Can your baby sit with support? •       Is your baby interested in what you're eating? If you answer yes to these questions and you have the OK from your baby's doctor or dietitian, you can begin supplementing your baby's liquid diet. What Foods to Start With. Continue feeding your baby breast milk or formula as usual. Then: •       Start with baby cereal. Mix 1 tablespoon (15 milliliters) of a single-grain, iron-fortified baby cereal with 4 to 5 tablespoons (60 to 75 milliliters) of breast milk or formula. Many parents start with rice cereal. Even if the cereal barely thickens the liquid, resist the temptation to serve it from a bottle. Instead, help your baby sit upright and offer the cereal with a small spoon once or twice a day. Once your baby gets the hang of swallowing runny cereal, mix it with less liquid. For variety, you might offer single-grain oatmeal or barley cereals. Your baby may take a little while to "learn" how to eat solids. During these months you'll still be providing the usual feedings of breast milk or formula, so don't be concerned if your baby refuses certain foods at first or doesn't seem interested. It may just take some time. Do not add cereal to your baby's bottle unless your doctor instructs you to do so, as this can cause babies to become overweight and doesn't help the baby learn how to eat solid foods •       Add pureed meat, vegetables and fruits. Once your baby masters cereal, gradually introduce pureed meat, vegetables and fruits. Offer single-ingredient foods at first, and wait three to five days between each new food. If your baby has a reaction to a particular food — such as diarrhea, a rash or vomiting — you'll know the culprit. •       Offer finely chopped finger foods. By ages 8 months to 10 months, most babies can handle small portions of finely chopped finger foods, such as soft fruits, well-cooked pasta, cheese, graham crackers and ground meat. As your baby approaches his or her first birthday, mashed or chopped versions of whatever the rest of the family is eating will become your baby's main fare. Continue to offer breast milk or formula with and between meals. Foods to Avoid for Now. Some foods are generally withheld until later. Do not give eggs, cow's milk, citrus fruits and juices, and honey until after a baby's first birthday. Eggs (especially the whites) may cause an allergic reaction, especially if given too early. Citrus is highly acidic and can cause painful diaper rashes for a baby. Honey may contain certain spores that, while harmless to adults, can cause botulism in babies. Regular cow's milk does not have the nutrition that infants need. Fish and seafood, peanuts and peanut butter, and tree nuts are also considered allergenic for infants, and shouldn't be given until after the child is 2 or 3 years old, depending on whether the child is at higher risk for developing food allergies. A child is at higher risk for food allergies if one or more close family members have allergies or allergy-related conditions, like food allergies, eczema, or asthma. Introducing Juice. Juice can be given after 6 months of age, which is also a good age to introduce your baby to a cup. Buy one with large handles and a lid (a "sippy cup"), and teach your baby how to maneuver and drink from it. You might need to try a few different cups to find one that works for your child. Use water at first to avoid messy clean-ups. Serve only 100% fruit juice, not juice drinks or powdered drink mixes. Do not give juice in a bottle and remember to limit the amount of juice your baby drinks to less than 4 total ounces (120 ml) a day. Too much juice adds extra calories without the nutrition of breast milk or formula. Drinking too much juice can contribute to obesity can cause diarrhea. Infants usually like fruits and sweeter vegetables, such as carrots and sweet potatoes, but don't neglect other vegetables. Your goal over the next few months is to introduce a wide variety of foods. If your baby doesn't seem to like a particular food, reintroduce it at later meals. It can take quite a few tries before kids warm up to certain foods.

Your Baby

Can More Fruit Consumed During Pregnancy Raise Baby’s IQ?

1:30

The USDA recommends that women consume 2 cups of fruit daily. This can include fruits that are fresh, canned, dried or frozen, as well as 100-percent fruit juice.

Fruit not only contains important vitamins, minerals and fiber but may also provide benefits for the children of moms-to-be who consume more fruit during pregnancy.

According to a new study from Alberta, Canada, the children of mothers that consumed higher levels of fruit during pregnancy, had better cognitive development by the time they were one-year-old.

Researchers said the effects of eating more fruit on test scores were significant.

"It's quite a substantial difference," Dr. Piush Mandhane, an associate professor of pediatrics at the University of Alberta, said in a press release.  "We know that the longer a child is in the womb, the further they develop -- and having one more serving of fruit per day in a mother's diet provides her baby with the same benefit as being born a whole week later."

For the study, researchers analyzed data on 688 one-year-old children collected as part of the Canadian Healthy Infant Longitudinal Development study, and considered the amount of fruit their mothers consumed during pregnancy, gestational age at birth, parental lifestyle factors, including income and education, and cognitive tests given to the children.

Two-thirds of the population falls between 85 and 115 on the traditional IQ scale, with the average at about 100. The researchers found if pregnant mothers ate six or seven servings of fruit or fruit juice per day, their children scored six or seven points higher on IQ tests at one year old. There was no improvement in learning when only the babies were fed fruit.

The researchers noted that future studies will explore longer-term benefits of increased fruit consumption during pregnancy beyond one year of life, as well as whether higher intake of fruit affects development of other parts of the brain.

"We found that one of the biggest predictors of cognitive development was how much fruit moms consumed during pregnancy. The more fruit moms had, the higher their child's cognitive development," Mandhane said.

Experts recommend that pregnant women eat a variety of foods throughout the day to make sure they and their baby get the nutrients they need. A balanced diet contains fruits and vegetables, breads and grains, protein and dairy. Doctors often prescribe prenatal vitamins just in case a mom-to-be isn’t able to get all the nutrients she needs by diet alone.

While fruit is important to one’s overall diet, pregnant women should consult with their OB/GYN about their intake if they are diabetic or susceptible to gestational diabetes.

The study was published in the online edition of EBioMedicine,

Story source: Stephen Feller, http://www.upi.com/Health_News/2016/05/26/Eating-fruit-while-pregnant-helps-babys-cognitive-development-study-says/3311464273928/?spt=sec&or=hn

Your Baby

BPA Consumed During Pregnancy Linked to Obesity in Kids

1:45

Bisphenol A (BPA) is a chemical produced in large quantities and used primarily in polycarbonate plastics and epoxy resins.

You’ll find polycarbonate plastics in some plastic water bottles, food storage containers and plastic tableware. Epoxy resins are used in lacquers to coat metal products such as food cans, bottle tops, and water supply pipes.

The primary source of exposure to BPA for many people is through food and beverages.

Why should you be concerned about Bisphenol A?

BPA is thought to act as an endocrine disruptor--a compound that mimics or disrupts hormones produced by the human body. Previous research has linked BPA to asthma, ADHD, depression, anxiety and early puberty in girls. It has also been linked to diabetes, obesity and heart disease in adults.

A new study has also found a possible link between BPA and child obesity.

Researchers at Columbia University found that children of women exposed to BPA during pregnancy were likely to have more body fat by age seven. Increased body fat has been linked to a higher risk of obesity.

"This study provides evidence that prenatal exposure to BPA may contribute to developmental origins of obesity as determined by measures of body fat in children as opposed to the traditional indicator of body mass index, which only considers height and weight,” lead author of the study. Lori Hoepner, DrPH, said in a press release.

Dr. Hoepner and her colleagues studied 369 maternal-child pairs from pregnancy through early childhood.

The researchers collected urine samples during the last three months of pregnancy.

Urine samples were also collected from the children at ages three and five. The children's heights and weights were measured at age five and age seven.

At age seven the researchers also measured waist circumference and fat mass.

The researchers found 94 percent of the women had BPA in their urine--an indication that they had been exposed to the chemical.

Dr. Hoepner and colleagues found that children who had been exposed to BPA in the womb had a higher body fat mass. Even though the children might have been within the normal ranges for height and weight, they had a greater percentage of fat than would be normal at that age.

The researchers found a strong association between BPA, fat mass and waist circumference in girls. They also found that childhood exposure to BPA was not associated with fat mass, indicating that the prenatal exposure was the problem.

Some studies indicate that infants and children may be the most vulnerable to the effects of BPA. This new study also suggests that pregnant women might want to avoid BPA products.

The National Institute of Environmental Health Sciences offers these tips for reducing BPA exposure:

•       Don’t microwave polycarbonate plastic food containers. Polycarbonate is strong and durable, but over time it may break down from over use at high temperatures. Use glass or ceramics for microwaving foods.

•       Plastic containers have recycle codes on the bottom. Some, but not all, plastics that are marked with recycle codes 3 or 7 may be made with BPA.

•       Reduce your use of canned foods. Choose glass or other safe packaging or fresh or frozen foods when possible.

•       Opt for glass, porcelain or stainless steel containers, particularly for hot food or liquids.

•       Use baby bottles that are BPA free. 

The study was published in the May issue of Environmental Health Perspectives.

Story sources: Beth Greenwood, http://www.dailyrxnews.com/prenatal-exposure-bpa-was-associated-increased-fat-mass-children-columbia-university-study-found

http://www.niehs.nih.gov/health/topics/agents/sya-bpa/

 

Your Child

Special Diet for Kids With Crohn Disease, Colitis

1:45

A special diet may help children with Chron disease and ulcerative colitis without the use of medications, according to a new study.

Chron disease is a chronic inflammatory bowel disease (IBD) that was once considered rare in children. It is now recognized as one of the most important chronic diseases that affect children and teens with approximately 20-30 percent of all patients with Chron presenting symptoms when they are younger than 20 years old.

The diet includes non-processed foods, such as fruits, vegetables, meats and nuts. Over 12 weeks, the diet appeared to ease all signs of these inflammatory bowel diseases in eight of the 10 affected children, researchers report.

"The study shows that without other intervention, other changes, we can improve individuals' clinical as well as laboratory markers," said study author Dr. David Suskind. He's a professor of pediatrics and director of clinical gastroenterology at Seattle Children's Hospital.

"I'm not surprised," Suskind added, "primarily because preliminary studies ... opened our eyes to the idea that diet had an impact."

Standard treatment for Chron disease and ulcerative colitis usually includes steroids and other immune-suppressing drugs. With severe symptoms, surgery is sometimes required to remove portions of the intestine.

Suskind and his team put the 10 patients, between the ages of 10 and 17, on a special diet. The diet is known as the specific carbohydrate diet. No other measures were used to treat the study participants' active Crohn's or ulcerative colitis.

The diet removes grains, most dairy products, and processed foods and sugars, except for honey. Those on the specific carbohydrate diet can eat nutrient-rich foods such as fruits, vegetables, meats and nuts.

Suskind noted that scientists aren’t sure why the diet seems to work, but there are several theories.

First, it's known that diet affects the gut microbiome -- the array of bacteria in the digestive tract contributing to digestion and underlying the immune system .

"One of the likely reasons why dietary therapy works is it shifts the microbiome from being pro-inflammatory to non-inflammatory," he said.

"Another potential [reason] is there are a lot of additives in the foods we eat that can have an effect on the lining of the intestines. This diet takes out things deleterious to the mucus lining in the intestinal tract," Suskind said.

Other IBD researchers are praising the small study.

Dr. James Lewis is chief scientist for the Crohn's and Colitis Foundation of America's IBD Plexus Program. He's helping lead national research in progress comparing the effectiveness of the specific carbohydrate diet to the so-called Mediterranean diet in inducing remission in patients with Crohn's disease. The Mediterranean diet stresses eating mostly plant-based foods.

Lewis praised Suskind's new study, noting that despite its small size, it adds to growing research suggesting a potential therapeutic benefit from the specific carbohydrate diet to inflammatory bowel patients.

"Even our most effective [standard] therapies leave a proportion of patients with persistently active disease or the inability to completely heal the intestine," Lewis said. "Because of that alone, we need other therapeutic approaches."

The study was published in the recent edition of the Journal of Clinical Gastroenterology.

Story sources: Maureen Salamon, http://www.webmd.com/ibd-crohns-disease/crohns-disease/news/20170109/special-diet-may-be-boon-for-kids-with-crohns-colitis#1

http://emedicine.medscape.com/article/928288-overview

 

Your Child

Importance of Breakfast

When your child was an infant, you were diligent about feeding them on schedule. So, why do so many parents let their children skip breakfast before heading out to school? A new study shows that 12 to 35 percent of adolescents skip breakfast and that number increases with age.

“Breakfast is another time to spend with your child,” says pediatrician Dr. Sue Hubbard. She says a healthy breakfast should have protein, fiber and calcium. “Try and stay away from sugar coated cereals” she advises. Dr. Hubbard also emphasizes that parents need to read cereal box labels and stay from breakfast bars because many of them contain large amounts of sugar. “A good thing as you’re running to the door and getting in carpool is a piece of peanut butter toast on whole wheat grain bread with some milk on the side,” she says. “Breakfast gives your child fuel for the day.”

Daily Dose

The Importance of Vitamin D

New research is showing that vitamin D is equally important in preventing heart disease and diabetes.Doctors have known the importance of calcium and vitamin D for children's bone health and for preventing osteopenia and osteoporosis later in life. Now new research is showing that vitamin D is equally important in preventing heart disease and diabetes. Infants are breast-fed or formula fed until their first birthday and then begins drinking milk as their main source of calcium and vitamin D.

For many children who "choose" (I don't get the choice thing) not to drink milk they may substitute soft drinks, juices or water. Unfortunately none of the other beverages contains the necessary calcium and vitamin D and this may lead to vitamin D deficiency. Recommendations in the last year have added that babies that are exclusively breast fed should be given a daily vitamin supplement, like poly vi sol or tri vi sol, to ensure that they are getting at least 400 IU of vitamin D per day. The recommendations also suggest that all children need at least 400 IU of vitamin D per day, and studies are being to conducted to see if the requirements are even higher. In addition children need to continue getting somewhere between 1,000 mg - 1,500 mg of calcium per day, depending on their age. The current research by the American Heart Association looked at teens and vitamin D levels. Their findings showed that teens with the lowest vitamin D levels had a four times greater chance of developing metabolic syndrome (putting them at risk for diabetes) and a 2.4 times greater risk of developing high blood pressure. How do you ensure adequate vitamin D and calcium for your family? A healthy diet should contain fortified milk and orange juice, as well as other dairy products with added vitamin D, egg yolks, tuna and salmon and some ready to eat breakfast cereals. Read the labels; look for vitamin D and calcium in foods. Sunshine is also a good source of vitamin D, but wear your sunscreen! That's your daily dose, we'll chat again tomorrow.

Daily Dose

The Obesity Epidemic Continues

The obesity epidemic continues with no end in sight. It is one of our major public health problems and the ongoing health care concerns of patients with obesity are well known. There have been many different studies looking for a biologic basis for obesity. There is a new study just released from the International Journal of Obesity that suggests that there is behavioral link for obesity.

In the study 226 families, both children and their parents were followed over three years with serial height and weight measurements. The results showed that obese mothers were 10 times more likely to have obese daughters, while obese fathers had a six-fold chance of having an obese son. In both cases, children of the opposite sex were not affected. Researchers therefore believe that the link for obesity may be behavioral rather than genetic. It would be very unusual to have genetics influence children only along gender lines. Rather, it seems that there may some form of “behavioral sympathy” related to becoming overweight. It seems that daughters copy lifestyles of their mothers, and sons their fathers. Looking further, researchers noted that eight in 10 obese adults were not severely overweight or obese when they themselves were children. In other words, the parents are passing their eating habits and behaviors on to their children, which brings us back to “modeling behavior”. I bring up the discussion of eating habits and nutrition when children are beginning their first table foods. Parents want to feed their children healthy foods, but they also worry if their child will not eat what the parent has prepared. Starting from the first foods the “notion” of eating healthy needs to be positively re-enforced. One way to do this is by preparing meals together which can teach cooking skills along with making healthy food choices. The idea that our children are going to like everything that we make, or clean their plates is obsolete. I think that our job as parents is to provide good food choices, a happy family mealtime and to be models of healthy eating. With this should come daily exercise. This study seems to confirm that it may be nurture, not nature that is contributing to the worldwide obesity problem. That’s your daily dose, we’ll chat again tomorrow.

Daily Dose

Cut Soda to Fight Childhood Obesity

Getting rid of sugar-laden drinks and replacing them with water has a dramatic impact on the amount of calories children consume and could help in the fight against childhood obesity. Researchers from Columbia Mailman School of Public Health in New York found that children get 10 to 15 percent of the daily caloric intake from empty calories.

"The key observation is that when kids substitute sugar-sweetened beverages with water, there is a significant decline in total energy intake without any compensatory increase in the consumption of other beverages or food," said Dr. Y. Claire Wang. Dr. Wang also noted that substituting calorie-free beverages "is a simple and effective way of eliminating the excess calories while improving the diet quality." Sugar-sweetened beverages "should be viewed as treats, not necessities, and water is a perfect substitute for the purpose of thirst-quenching," Wang said. Wang and her colleagues looked at diet data from the 2003-2004 National Health and Nutrition Survey of over 4,000 children aged two to 19 years. They found that substituting sugar-sweetened beverages with water was associated with significant reductions in total calories consumed. Wang and colleagues estimate that replacing all sugary drinks with water could cut out an average of 235 calories out of kids' diets each day. Since the late 1970s, consumption of sugary drinks by children and adolescents has increased "substantially," and is thought to be "an important contributing factor to obesity," the researchers point out in the Archives of Pediatrics and Adolescent Medicine. "Replacing these liquid calories with calorie-free beverage alternatives therefore represents a key strategy to eliminate excess calories and to prevent obesity in childhood," they conclude.

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