Category Archives: The Saving America Series

New Guidelines for Fighting Obesity and Heart Disease in Children

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There are new recommendations on cholesterol screening, and much more, just issued by the National Heart, Lung and Blood Institute (NHLBI). TheirBob Tozzi at the November 2011 AHA Conference mission is clear from the document’s title: “Cardiovascular Risk Reduction in Children and Adolescents: The New NHLBI Guideline.”

The document is in direct response to the alarming proportion of children who have markedly abnormal cholesterol levels and evidence of atherosclerosis – a disease normally thought of as an adult medical problem. These recommendations are designed to help reverse the epidemic of obesity and the related diseases that are growing at an alarming rate in our children.

At the November 2011 American Heart Association Convention in Orlando, as I observed the NHLBI presentation about these new and much-anticipated recommendations for preventing heart disease in children, I looked around at the sparsely-filled room. It was set up with seats to accommodate 600 professionals. There were fewer than 200 in attendance. Perhaps this was because it was an evening presentation, or maybe it reflects physician frustration at the enormity of the public-health issue of obesity, with its secondary problems of hypertension, hypercholesterolemia and resultant heart disease.

In any case, the guideline document needs to be widely disseminated within the medical community.

The comprehensive NHLBI review began with a computer-generated initial list of 1 million articles. The final document incorporated the best-of-the-best research on the topic, representing a derived-consensus document.

These are the significant take-away points:

  • High cholesterol in children is related to the development of heart disease in the adult.
  • With the obesity epidemic, cholesterol levels are rising even higher. Reduction in obesity will lower cholesterol levels.
  • Early intervention is needed for hypercholesterolemia and poor health habits in children (the behaviors as well as the diseases continue into adulthood).
    Initial management for abnormal serum cholesterol is education about healthy diet and exercise.
  • Healthy diet-education is best handled with the entire family involved and a dietitian.
  • Examples of healthy diet include the DASH diet and the Mediterranean diet.
  • There should be universal screening for elevated cholesterol for ages 9-11 years.
  • There should be earlier screening for high-risk individuals.
  • Medications may be needed in about 1percent of children (upwards of 200,000 children).
  • Parents must increase the activity level of children and reduce TV and computer time. The recommended activity level for 5 years and older is one hour of moderate to vigorous exercise per day.

Quite simply, this list should be posted in every pediatric physician’s office across the United States.

Video: The Watanabe Rabbits

The Top 10 Reasons Why School Sports are Unhealthy

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I believe that high school sports, and behaviors related to school athletics, are fostering obesity, eating disorders and illness in America. Here is my Top 10 List of reasons why school sports are – counter-intuitively – leading to bad habits and worse health for America’s young people.

1)    Rapid weight-gain in childhood is associated with life-long obesity and heart disease. Bad behaviors that are associated with school athletics include bulking up for football, dropping and gaining weight for wrestling, and ultra-thin eating habits, leading to anorexia in young gymnasts.

2)    The concept that, “You’re an athlete – you’re working out, so you can eat whatever you want to eat,” promotes consumption of junk foods, which also extends to the spectators who consume junk foods sold at sporting events.

3)    Teaching the concept that endurance and intense aggressive training is a healthy lifestyle – “no pain, no gain” – reduces the likelihood that voluntary athletic behavior will continue into adulthood.

4)    If “winning isn’t everything, it’s the only thing” as the goal in sports participation, then inevitably there will be many losers. Ultimately this concept becomes a psychological negative when one thinks of health and its relationship to exercise.

5)    Lengthy afterschool practice sessions, combined with late-evening competition in Junior Varsity team sports, leads to missed hours of sleep, a drop in metabolism and a propensity toward obesity.

6)    Head injuries in soccer and hockey, as well as football concussions, are becoming a common cause of extended illness in young people.

7)    Repetitive damage to joints results in long-term disability, including back, knee and hip disease.

8)    This results not only in limiting one’s ability to ambulate as an adult, but subsequently results in weakened cardio-pulmonary function due to a lack of mobility, thereby increasing the likelihood of obesity, hypertension, diabetes, heart disease and stroke.

9)    Sadly, school athletics encourage the culture of drugs:  Taking stimulants for added stamina, including energy drinks such as Red Bull, often leads to the accepted use of steroids and other harmful and/or prohibited substances.

10) The overriding concept that winning is the most important part of the game is perhaps the umbrella theme promoting all the other unhealthy behaviors that affect today’s young athletes.

A Vicious Cycle of Subsidized Diet and Disability

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Where do your tax dollars go?

It is a medical fact that soda and sugary drinks contribute to our nation’s rampant obesity problem. According to a 2010 report in The American Journal of Public Health, the federal government’s Food Stamps program allows an estimated $4 billion per year to be used to help fuel the obesity epidemic by paying for these high-calorie, obesogenic drinks. So every year, our tax payments are used to fund this unhealthy dietary practice, fostering a national health crisis.

Not only are we paying for consumption of these drinks, but we must also subsidize the health care costs that are related to obesity, hypertension, diabetes, and joint-replacements, as well as for scooters that allow these overweight and disabled individuals to have some freedom of movement.

Our tax dollars that are used to pay for these unhealthy products make their way back to the companies that produce these products. Those tax dollars can then be recycled to pay for the advertising that helps fuel our children’s’ consumption of products that promote obesity, sickness and dependence on the subsidized healthcare.

It is a vicious cycle that requires vigorous action at the medical, educational and regulatory levels.

As a wise commentator said, when you subsidize a certain kind of behavior, you get more of it.

As with too many generic crises, unfortunately, we can thank the logic of subsidies and entitlements for the perpetuation of an entirely avoidable and worsening behavior-related health disaster.

 

 

Are Your Supplements Killing You?

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Certain benefits that have been widely publicized for many years regarding dietary supplements may be ill-advised at best, according to a recent study in the Archives of Internal Medicine.

Indeed, one might almost say that confusion abounds. This new study on women’s health reports that dietary supplements are resulting in a higher mortality rate for women. But before we start to panic, let’s look at a few facts.

1) This study was conducted on older women with a mean age of 61 years.

2) Those taking iron supplements showed the greatest risk of earlier mortality.

Excess iron in the bloodstream is associated with increased atherosclerosis and subsequent heart attacks and strokes. It acts as a catalyst that increases the risk of free radical damage to the vascular system and associated tissue, thereby accelerating the aging process.

But back to the study.

When attempting to analyze this study, the most important piece of information is that these women are in a post-menopausal group that would no longer need to take extra iron to maintain health. After loss of menses, the risk of iron-deficiency anemia is low, and the risk of over accumulation increases.

Of course, most women who are trying to stay healthy are probably getting enough iron from fortified foods and dark green vegetables, as well as the occasional intake of red meat.

So here’s the bottom line: Iron supplementation is needed for the iron-deficient person. This is much more common in younger women, especially those who experience a heavy menstrual flow each month.

So, my recommendation for older men and women is to be smart, have blood work to check your iron status. Unless you receive a doctor’s indication that you are iron deficient, it’s best to skip that vitamin that contains iron.

Hypertrophic Cardiomyopathy

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The Saving America Series

Physicians commonly make mistakes in EKG readings for children!

In a study published July 2011 in The Journal of Pediatrics, it is made clear that mistakes are occurring too often in the reading of EKG for children and young athletes. Unfortunately, some in the medical community seize upon the flaws in childhood screening to conclude that it is just not worth screening children.

I am flabbergasted that more professionals do not view these documented flaws in test reading as an urgent call to do better.

I have proposed a systematic approach to screening children that has both accountability and education built into the system. Designing screening programs that are specialized to accomplish a specific medical task can reduce mistakes and increase the accuracy of results. This approach also reduces the cost of screening and, most important, does a better job of protecting our children’s health.

We live in a culture where millions can be spent to perfect the perfect aluminum baseball bat to ensure a greater number of home runs, even though it increases the risk of injury and death to our children.

Let’s begin to get our priorities straight and put our efforts where it counts: our children’s health and future security.

Early Screening as a Priority

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The Saving America Series

Physicians commonly make mistakes in EKG readings for children!

In a study published July 2011 in The Journal of Pediatrics, it is made clear that mistakes are occurring too often in the reading of EKG for children and young athletes. Unfortunately, some in the medical community seize upon the flaws in childhood screening to conclude that it is just not worth screening children.

I am flabbergasted that more professionals do not view these documented flaws in test reading as an urgent call to do better.

I have proposed a systematic approach to screening children that has both accountability and education built into the system. Designing screening programs that are specialized to accomplish a specific medical task can reduce mistakes and increase the accuracy of results. This approach also reduces the cost of screening and, most important, does a better job of protecting our children’s health.

We live in a culture where millions can be spent to perfect the perfect aluminum baseball bat to ensure a greater number of home runs, even though it increases the risk of injury and death to our children.

Let’s begin to get our priorities straight and put our efforts where it counts: our children’s health and future security.