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Dr. Scott

Soft Drinks Consumption is Associated with Behavior Problems in 5 Year Olds

Drinking soda can have a number of adverse health effects. The high doses of sugar in liquid form are known to contribute to obesity. Other studies have shown that adolescents who drink more soda have higher tendencies towards aggression, suicidal thoughts, self harm, and withdrawal behavior. However no study has looked at how soda effects aggression levels in young children even though surveys have shown more than 40% of children aged 2-11 drink soda.

Many different things in a child’s environment can increase their odds of developing aggressive tendencies. Social factors such as a stressful or violent home environment are known to make children more aggressive. Other dietary influences such as sugar consumption or food coloring have been linked to attention and aggression issues in children. Also daily activities, such as watching TV, affect attention negatively.  This study attempted to isolate soda consumption from all of these other factors to look specifically at how soda consumption affected the children in the study.

The study involved nearly 3,000 children from 20 different hospitals in large cities throughout the United States. Daily soda consumption was documented and ranged from none to 4 or more. There were also detailed, validated questionnaires to include all of the risk factors mentioned that may also affect aggression and attention levels. What the study found was that drinking soda led to children being more likely to break things belonging to themselves or others, get into more fights, and to physically attack people. They also had a more difficult time paying attention and staying focused. The aggression and attention issues increased as the number of daily sodas increased. The children drinking 4 or more sodas per day, which was about 4%, had significantly higher rates of aggression and attention issues even when controlling for the other potential risk factors like home life, TV viewing and diet.

What is specifically in soda to cause the behavioral changes is still up for debate. Is it the high fructose corn syrup, the artificial colorings, or preservatives? Even without a key cause identified there is just no good reason to drink soda on a regular basis. I could write up papers every day on the damaging effects of soda and never find one paper suggesting soda is beneficial to any measure of health. Water is all our bodies need. To boring for you? Then mix it up with some fruit juice, made with real fruit by the way. Read the label; if its water, high fructose corn syrup and a splash of fruit juice for coloring run away!  Naturally brewed tea sweetened with honey is another good choice. Reinforce good choices in your children now and it will stay with them for a lifetime.

Journal of Pediatrics August 2013

Association of Autism with Induced or Augmented Birth procedures

Rates of autism spectrum disorder continue to rise. Currently 1 in 88 children will be diagnosed as falling somewhere on the autism spectrum scale. Despite the increased interest in the causes there has been no single factor alone that seems to be the cause nor will we ever likely find a single answer. The ultimate causes will likely be a combination of factors working together and this study helps to shed some light on a factor which has not previously been studied closely.

Other research has already shown the risk of a child developing autism spectrum disorder is influenced by certain factors such as the mother’s age and educational status so this study was able to separate those risk factors and look solely at how inducing or augmenting the birth of a baby affects the risk of developing autism. Induction or augmentation both involve giving Pitocin (artificial Oxytocin, the natural hormone women’s bodies produce during childbirth) to start childbirth in induction or to speed it up after natural labor contractions have started in augmentation.

This paper reviewed the records of every baby born in the state of North Carolina from 1990-1998, a total of over 900,000 individuals. In these records they were able to identify the age of the mother, education status, race, and some of the complications that may have occurred during the birth process such as levels of fetal distress. The researchers then matched the data from the births to educational records from 1997-2007. They were able to track and match over 625,000 children to include in this study.

This study confirmed the findings of previous studies linking the known risk factors such as mothers age with increased risk of developing autism spectrum disorder but it also found that independent of those risk factors, induced or augmented birth procedures increased the chance of an autism diagnosis, especially in boys. Despite this link there are still many questions left unanswered. Is the increased chance of developing autism in an induced or augmented birth due to the exposure of the baby to Pitocin or due to other factors that put the baby in distress causing the need to induce or augment the birth process?

There is evidence to support the idea that the exposure to Pitocin affects the developing brain as children diagnosed with autism have also been found to have a change in the brain receptors for Oxytocin. Oxytocin is a hormone which has many effects during the birth process such as causing contractions and initiating milk production after giving birth. However it is a hormone with many other functions throughout life in both sexes. It is one of the hormones which strongly affects bonding and empathy between people. Traits that are typically lacking in kids diagnosed with autism.

As this paper notes several times it is not a call to arms to abandon induction or augmented birth procedures as they can be live saving for the mother and child in certain cases. What is does bring to light are new areas which need to be researched and when appropriate going with a natural birth process is best.

JAMA Pediatrics doi10.1001/jamapediatrics.2013.2904

Frequency of Nut Consumption and its effects on fatal heart disease

On the heels of the last article I reviewed detailing the importance of starting your kids and family off on the right nutritional foot here is a study you can use to add a simple super food to you diets. It requires no preparation, special packaging or storage. It’s natures ready to eat snack, nuts!

Several studies have looked at the health benefits of adding nuts to your diet and have shown a decrease in death from heart disease in particular in people who eat nuts more frequently. The Adventist Health Study showed that people who consumed nuts more than 5 times per week had a 48% reduced chance of fatal cardiovascular disease. The Iowa Women’s Health Study showed similar results with a 57% decreased risk of fatal heart disease in women who consumed nuts 2-4 times per week. The Nurses’ Health Study and the Physician’s Health Study showed a 30% and 47% decrease in death from cardiovascular disease respectively in people who ate more nuts.  

One limitation of those studies, which this study does not have, is those studies were done on populations of people who typically eat less nuts so the correlation of increased nut consumption with decreased heart disease would be weaker. This study was done in Spain, a Mediterranean population which has a higher frequency of nut consumption and it was with an elderly population that were at increased risk for heart disease as they had already been diagnosed with high blood pressure, diabetes, high cholesterol or obesity.

The participants in this study were given detailed questionnaires about their previous dietary habits which included how frequently they ate nuts of all kinds, and then they were randomly put into one of three groups. The first was put on a Mediterranean diet supplemented with mixed nuts, the second a Mediterranean diet supplemented with extra virgin olive oil and the third was put on a low fat diet.

When breaking down the data from this study it supports what the other studies have shown. People who ate more than 3 servings of nuts per week, either before the study started or from being placed in the group told to increase nut consumption, had a 39% reduced risk of death from heart disease. What makes this study interesting and unique is that they also looked at death from cancer, which the other studies did not, and found a 40% lower risk of cancer death in the groups that ate nuts. Also since this was a Mediterranean population with greater frequency to eat nuts the researchers found that those who had the highest amounts of nut consumption before being put in the study and were then put in the group told to eat more nuts had a 63% reduced risk of death from all causes!  The participants put in the low fat diet group were found to have no change in rates of heart disease or cancer even if they were in the group who ate a lot of nuts before the study. This is presumed because they lost the protective effect of the nut consumption once they were put on the low fat diet and told to decrease all fat intake even the good fats found in nuts.

There are several reasons nuts are so beneficial to our health. They are high in fat however it is monounsaturated fatty acid which is good for us. They are also high in fiber, minerals, vitamins, and many bioactive compounds. They really are one of nature’s super foods. This study also went a step further by separating out some types of nuts, notably walnuts and showed an increased benefit in people who at more of them. This could be because walnuts are usually eaten raw and with the skin on. Dry roasting or cooking nuts at all breaks down the fats and can destroy some of the protective antioxidants in them.

So now the next time you are looking for a healthy, ready to eat snack that travels easily grab a bag of mixed nuts. The results of these studies show at least 3 servings (about 1 oz.) a week has significant benefits to your health. Go nuts!

BMC Medicine 2013,11:164

Food Advertising and Marketing Directed at Children and Adolescents in the US

There can be no more important time to have good nutrition in a person’s life then when they are young, still growing and developing. The food habits developed early on last a lifetime and influence food choices well into adulthood. Children will primarily follow what their parents do, after all the average toddler can’t run to the store to pick out what they want on their own, but the food companies spend billions directing marketing and advertising at young children and adolescents to influence their purchasing choices. They know that influencing a child by building brand familiarity and loyalty will pay off with years of dedicated buying even into adulthood. Though a toddler can’t purchase food on their own, marketing companies know how children can influence the parent’s decisions and refer to this as “nag factor” and “pestering power”. Requests from children start around 2 years of age and are most commonly for breakfast cereal followed by snacks then toys. The food industry knows all this and that is why spending on food advertising is second only to the automotive industry.

The primary way food companies advertise is through TV ads. 75% of food companies budgets and 95% of fast food companies budgets are for TV advertising. The average 2-4 year old watches 2 hours per day of TV increasing to 3 ½ hours for the pre and grade school years. That means the average US child will see between 20,000 and 40,000 commercials per year over 50% of which will be for food! The next area company’s focus on to direct advertising is on the internet which you can expect to continue to grow as more and more kids use the internet at a younger age and because the advertising on the internet is much less regulated than on television. Even the advertising on television is very loosely regulated.

In the early 1970s the first concerns about advertising to children were brought up by the children’s advocacy group, Action for Children’s Television (ACT), and led the governmental agencies, the FCC and FTC, to impose regulations that limited the amount of time during a children’s program that could be advertising and also required a “bumper” before the commercials. This is where “We’ll be back right after these messages” comes from. They also barred “host selling” meaning a character in the show airing cannot be in a commercial during that show. In 1978 the FTC did its own comprehensive review of advertising to children and found that it was deceptive, unfair and proposed to severely limit or ban any advertising during children’s programming. This drew expected opposition from food, toy and advertising industries claiming first amendment rights to tell people about their products. Congress bowed to industry pressure by not approving the FTC operating budget and removing their authority to restrict television advertising. In its place to monitor television and internet advertising is the Children’s Advertising Revue Unit (CARU). It can only make recommendations and has no legal authority. Oh and its advisors are executives from Burger King, Frito Lays, McDonalds, General Mills, Nabisco and Hershey. I’m sure these companies are just fine at self regulating.

A central problem with advertising directly to toddlers and children is they cannot discern that the message is designed to be persuasive and is just trying to sell something. Children up to 7-8 years of age just view advertising as fun unbiased information. Preteens aged 8-10 have the ability to recognize that the message from the advertisers may not be true though they still follow it. It isn’t until 11-12 and up that they possess the ability to realize that it is just a sales pitch and even then they can be persuaded with emotional messages easier than adults.

The advertising of cigarettes was drawn under scrutiny when it was found they were using methods to target teens. The Marlboro Man and Joe Camel were very successful at developing brand familiarity and encouraging underage smoking. A study showed that 30% of 3 year olds and 80% of 6 year olds could make the association between Joe Camel and a pack of cigarettes. Studies showing that this advertising worked to increase underage smoking lead to much of the ad campaigns being removed or regulated. Since most of the food which is advertised to children is high in fat and added sugar and goes against any sensible recommendations for a healthy diet shouldn’t it too be restricted? Several European countries have already done this. In Sweden no advertising at all is allowed on television or radio that targets children under the age of 12. The Swedish government views advertising to children as morally and ethically unacceptable, since children do not have the ability to properly analyze an advertiser’s message. In Belgium it is forbidden to broadcast commercials during children’s programming and 5 minutes before and after them. Australia does not allow any ads during television shows for preschoolers.

The take home message is don’t let the TV dictate what your children eat. You have the opportunity to set them up for a lifetime of healthy eating habits. Turn the TV off and lead by example. As a parent you should be buying and eating healthy foods to set the trends your kids will follow for the rest of their lives.

International Journal of Behavioral Nutrition and Physical Activity 2004,1:3

Association between Vitamin D levels and skin cancer in elderly men

Skin cancer incidence is on the rise, close to 1 million Americans are diagnosed a year making it the 4th most costly cancer of the Medicare population. At the same time Vitamin D is emerging in the research as a powerful protector from certain types of cancer. The dichotomy is the primary source of Vitamin D is from sun exposure. We are taught to avoid the sun and increase sunscreen use however the incidence of skin cancer continues to rise. So which is it? Should we avoid sun exposure or seek it out to increase our Vitamin D levels. That is one question this study looked at.

This study consisted of 1,108  elderly men, average age of 73, and compared the levels of Vitamin D in their blood and the incidence of developing skin cancer at the start of the study and then again 5 years later. Due to the common perception that exposure to the sun causes skin cancer the researchers expected to see higher levels of Vitamin D in the subjects that had been diagnosed with skin cancer. In order to determine if the Vitamin D levels measured in their blood were due to food supplementation or sun exposure all participants in the study were given questionnaires that covered what foods they ate, activity levels, and how much time they spent outdoors and the blood measurement of Vitamin D was done in such a way that they could differentiate the two.

What they found was that the men in the study that had been diagnosed with skin cancer had lower amounts of Vitamin D than those who had not been diagnosed. They also found a weak correlation of decreased skin cancer in the men who reported the highest levels of walking outside. It is worth noting that the men in this study were from centers in Oregon, Minnesota, and southern California so it was representative of several different geographic areas.

This study supports other research that shows responsible exposure to the sun can increase Vitamin D levels naturally which in turn is protective against certain types of cancers. This should be common sense. We used to spend predominantly all of our time working and playing outdoors. Only recently have we transitioned to a society that spends the majority of our time inside out of the sun. When we do go out we are told the sun is killing us and we need to cover ourselves in sunscreen. As people follow this misleading advice they decrease their sun exposure while skin and many other cancers continue to rise.

So get outside don’t be afraid of the sun. Just engage responsibly by limiting exposure in the beginning of the spring and summer and avoid burning your skin, which is damaging. If needed cover up or use a protective sunscreen like one recommended by www.ewg.org.

Cancer Causes Control 2010 March; 21(3): 387-391

Resurrecting Free Play in Young Children

The importance of children being allowed to engage in free unstructured play time is often overlooked in our busy and over-scheduled lives. In response to the obesity epidemic we are facing there is a push for exercise and increased activity in children but the authors of this research paper felt that changing the focus of the terminology to play would be more effective and beneficial.

Pushing structured exercise or team sports can put some parents off who do not engage in those activities themselves and just telling a parent to increase activity levels can be misleading. A child that interrupts a parent while they are trying to work on something or that runs from task to task may be labeled as over active, when they are just expressing normal behavior. Changing the terms and simply saying children need more time to play can help avoid these pitfalls. Unstructured play is also better for a developing child’s brain. Young children have different needs. Watch a child play without boundaries and rules and they typically run around in short bursts of activity followed by frequent rest breaks and move from game to game without focusing on one task for too long. The goals of increased physical activity should focus on three A’s: Attention (cognitive), Affiliation (social), and Affect (emotional) goals as opposed to the two F’s Fitness and Fatness that are the typical focus. Here is how free play enriches the three A’s.

Attention: A study of 500 Preschool teachers and 800 parents found that 90% of the teachers and 86% of the parents felt that kids who were physically active were able to pay attention and learn better. Playing outdoors encourages free play and gross motor movement as there are no rules or confinement which helps burn off excess energy better. The decrease in structure also promotes decision making, problem solving, and creative thinking. These tasks are often referred to as executive functioning, a higher level skill which integrates planning and organization. All activities that help children focus and work more productively in the classroom and build important life skills.

Affiliation: Free play forces kids to solve social problems and work together. Deciding what to play, who plays what roles, when to stop, and what are the rules are all decided by them. This is teaching more vital life skills about working together that they will use forever. Solving these social issues also fosters empathy, an understanding of one’s own feelings and the feelings of others.

Affect: Ask any parent what they want for their child and invariably for them to be happy will come up. It is well established in the literature that exercise helps adults suffering from depression and that those who are physically active are protected against developing depression. The same can apply to children. The stresses they experience in their daily lives should not be minimized. To them a hole in their favorite ball really is a stressful event. Gross motor activity and free play helps the body relive this daily stress and it’s even better if the activity is done outdoors as the sun exposure helps mood too. Ever heard of Seasonal Affective Disorder (S.A.D.) affecting mood of people in winter in colder climates where they don’t get enough outdoor sun exposure?

So playing outside requires no equipment and no planning, benefits brain development, social and emotional well being and mood. Why are you still in here reading this? Go out and play!

Arch Pediatric Adolesc Med 2005;159:46-50

Improvement of a Child with ADHD Undergoing Chiropractic Care

Attention deficit hyperactivity disorder while becoming more prevalent still evades a clear cause. Studies have already compared PET scans, SPECT scans, MRI, CAT scans and blood or urine tests of kids diagnosed with ADHD to those without and found no differences. Even without a clear diagnosis or cause, addictive drugs altering brain chemistry are the first choice of treatment in most cases. This study reports on a family who did not choose that route for fear of dangerous side effects and instead sought out safer alternative methods.

This study is on a 4 year old boy who was diagnosed with ADHD at 2 years old. He was extremely hyperactive to the point he was discharged from daycare for being too difficult to manage. In addition to the hyperactivity he also had a history of ear infections, 12 infections before he was 15 months old, leading to having tubes surgically inserted to help drainage after multiple courses of antibiotics for the repeated infections. After the tubes were inserted he still had two cases of ear infections. This child was also diagnosed with asthma at 2 years of age and put on a nebulizer and had a persistent cough for which he was also taking regular medications. The parents commented that he did not have good sleep patterns never sleeping more than 6 hours per night and did not eat normal amounts of food, frequently eating very little. Since the parents choose to not go the medication route they brought their son to a Chiropractor to see if they could help.

The Chiropractor preformed a detailed examination of his spine to check for Subluxations or misalignments in his spine that could be affecting how his nervous system is functioning. The Chiropractor found Subluxations in his upper and lower neck. The x-ray examination revealed changes to his spinal structure. The normal structure of the spine when viewed from the side is for it to have 3 smooth curves. It curves forward in the neck, backwards in the mid back where the ribcage is, and forward again in the lower back. This child’s curve in his neck was bent the opposite direction and curved backwards! Due to the findings he was placed on a corrective treatment plan to improve his spine. He was seen 3 times per week for a total of 2 ½ months. After 12 days of care his parents noted he was regaining a normal appetite. After 28 days the parents reported that his appetite was normal, his sleep patterns had improved, coughing had stopped, and he was less hyperactive. At the time of his final re-exam he had been removed from his asthma and coughing medications, his school work had improved to the point his behavior became a non-issue. The follow up x-ray examination showed the curve in his neck had returned to its normal forward curve. At this time his visit frequency was decreased. Unfortunately for the family they moved to another town and were not able to be seen regularly by the Chiropractor. They returned over one year later and reported that their son had started to regress and his hyperactivity was returning.

The link to Chiropractic care helping a child with hyperactivity issues lies in the way the misalignments in his neck were affecting his nervous system. As the forward curve in the neck straightens, or in this case bends the wrong way, it puts tension on the spinal cord. This tension on the spinal cord is like a dam in a river restricting flow of nerve impulses from the brain to all other areas of the body. The change in neck curve also strains the muscles and joints in the neck. All of this information is constantly fed back to the brain letting our body know it is in trouble and needs to be fixed. This feedback can be overwhelming and cause nervous hyperactivity in some individuals. The stress on the spine and nervous system also affects the centers that control breathing which are located at the base of the brain were the spinal cord starts. The irritation of the breathing centers can be causing the asthma, and difficulty sleeping. If a child isn’t breathing or sleeping well it makes perfect sense that they would have trouble focusing. By restoring his spine to the normal structure it allowed his nervous system to function properly taking pressure off the breathing centers and normalizing the information flow of his muscles and joints to his brain. Take care of your spine so your nervous system can function properly it’s as simple as that!

J Vertebral Subluxation Res. April 20, 2009

The Effects of Music Therapy on Vital Signs, Feeding and Sleep in Premature Infants

Ok so this study told us what mom’s have always known. Singing lullabies to your baby will calm them down. What made this study interesting is that the researchers were looking specifically at babies that were born prematurely and had breathing problems due to underdevelopment of their lungs, an infection, or were small for their age. Then they measured if live singing of lullabies, not recorded music, had any effect on how the babies slept, their levels of distress, and suckling behavior. They also utilized two specialized instruments designed to mimic the type of sounds that would be heard in the womb.

The concerns of the researchers in this study were that while the sterile environment of the NICU in the hospital provided life saving therapies for preemie babies the sounds of the NICU are difficult to control and can be over stimulating and disturbing to the sleep and rest patterns of the babies. Also it does nothing to help foster the bond between mother and baby.

For this study the researchers tested three different types of music and their effects on the preemie babies. The first an instrument called an ocean disc, is made of a disc with small metal balls in it which when played mimics the fluid sounds of the womb. A second instrument called a gato box, was used to provide a soft rhythmic sound to simulate the heartbeat sound heard in the womb. The last musical intervention was lullabies sung live either by the parent or a music therapist. If the parent had a song that they grew up hearing or singing they would use that song otherwise they sung “Twinkle Twinkle Little Star”.  After the babies had one of the musical interventions they would measure heart rate, activity level, feeding and sleeping patterns. The researchers also measured stress levels of the parents.

There were significant improvements in all measures with the musical interventions. Here is how they broke down. The ocean disc lowered heart rate during playing and for a time afterwards, and increased the good sleep patterns. The gato box was had the positive effect of lowering heart rate and increasing active suckling. Live singing of lullabies caused the most positive changes. During singing the babies were more alert with a lower heart rate. Showing that they were not stressed just more engaged in their surroundings while also improving sleep patterns. The singing also increased calorie intake, improved general feeding behavior, and lowered parental stress levels.

This study shows how important the close physical contact and human interaction is even for the smallest of us. One of the most significant risks for preemie babies is the underdevelopment of their lungs, as this is the last system to form before birth. The live singing instinctively trains the babies on how to control their breathing and enhanced their development. The live singing is why this study showed such strong benefits for the babies over other studies that used recorded music. Oh and this study showed that it didn’t matter how good the parent could sing, the benefits were the same, so you can’t use that as an excuse. Now go sing proud to your baby!

Pediatrics 2013; 131:902-918

Resolution of Breastfeeding Difficulty Following Subluxation Based Chiropractic Care

This study followed an 8 week old baby girl that had difficulty breastfeeding from the time she was born. As is well established breast feeding is the best source of nourishment for a developing infant and the inability to nurse easily can be very stressful on both the mother and child. The mother had been working with a lactation consultant but was not seeing improvement so was advised to seek the assistance of a Chiropractor.

The first obvious difference this study pointed out was that traditional medical views put a problem of nursing on the mother. They treat the problem with nipple shields, medicine droppers or spoon feeding to deliver the milk, even introducing early bottle feeding. The Chiropractic evaluation looked specifically for a dysfunction in the baby’s inherent ability to suckle.

The Chiropractic exam looked for subluxations (misalignments, fixations) in the baby’s spine and cranial (skull) bones, as the bones are not fused in infants as they are in adults. The Chiropractor found subluxations in the upper neck, pelvis and cranial bones. After the first adjustment there was no change in breastfeeding however the mother did comment that her baby was able to go to the bathroom easier. By the fourth adjustment by the Chiropractor the mother reported that her baby was nursing much better and was nursing normally by her sixth adjustment.

The reason focusing on the baby utilizing Chiropractic adjustments can be beneficial comes back to the basic Chiropractic principle that the better the nervous system is able to function the better the body is able to function. Nearly all of the muscles of the tongue are controlled by a nerve that comes off of the spinal cord between the skull and the first bone of the spine. Subluxations in this area could affect the function of this nerve thereby affecting function of the tongue. Inability to control the tongue properly would prevent the baby from being able to latch on and suckle properly. Subluxations in this area can also affect function of the jaw muscles preventing proper suckling.

Take care of the spine, allow the nervous system to function properly and normal function can be restored; it’s as simple as that!

J Pediatric, Maternal & Family Health- January 17, 2003