Study: Possible Fast-food Link to Child Asthma and Eczema

“Fast food and takeaways linked to surge in child asthma and allergies,” reports The Guardian.

fast-food-link-child-asthmaAlong with many other papers, it reports on a study attempting to shed light on one of the enduring medical mysteries of recent times – what explains the sharp rise in allergic conditions that has occurred during the past few decades?

Researchers wanted to investigate the theory that changes to traditional diets in the developed world since World War Two may be partially responsible.

This was an international survey looking at the links between diet and three allergy-related conditions in adolescents and children:

  • Asthma
  • Eczema
  • Rhinoconjunctivitis (stuffy or runny nose and watery eyes)

The researchers found frequent fast-food consumption (three or more times a week) was significantly linked with an increased risk of what the researchers defined as severe asthma, severe rhinoconjunctivitis or severe eczema. In contrast, consumption of fruit at least three times per week was significantly associated with a decreased risk of severe asthma. However, these associations are not proof of direct cause and effect.

It is possible that there are other underlying factors associated with both diet and risk of these allergic conditions, which could explain the associations seen, such as socioeconomic status.

Whatever the evidence, encouraging your child to eat fresh fruit and vegetables regularly (at least five portions a day) is a good idea.

Where did the story come from?

The study was carried out by an international team of researchers. It was funded by a number of organisations, including the BUPA Foundation and Glaxo Wellcome International Medical Affairs, as well as by a number of New Zealand-based funding bodies.

The study was published in the peer-reviewed journal Thorax.

The results of this study were widely and accurately reported in the media, although reports didn’t make it clear that cause and effect cannot be implied from this study.

What kind of research was this?

The International Study of Asthma and Allergies in Childhood (ISAAC) study is a multicentre, international, cross-sectional study.

In this part of the study, the authors aimed to determine whether there was an association between food intake over the past year and current and severe symptoms of the following allergic conditions:

  • Asthma
  • Eczema
  • Rhinoconjunctivitis

The study involved a group of children aged six and seven years old, and a separate group of adolescents aged 13 and 14 years old.

Cross-sectional studies are good for determining prevalence: in this case, the results of the study can provide us with information on the number of children with symptoms of asthma, rhinoconjunctivitis and eczema, and on the diet of the children.

However, this study design has some limitations (see conclusions) and to determine a link, a cohort study would be needed. However, even a cohort study could not show whether fast food was actually causing the development of asthma, as fast-food intake could be a marker of many other factors, such as socioeconomic status, which could be the real cause of any association seen.

A randomised controlled trial would be required to prove causation, though such a trial would have both practical and ethical issues (obviously few parents would be happy to find their child had been placed in the ‘kebab and cheeseburger’ group).

What did the research involve?

This international study included 319,196 adolescents aged 13 to 14 years, and 181,631 children aged four to seven years. Information on the diet and clinical symptoms of asthma, rhinoconjunctivitis and eczema were collected using questionnaires. Questionnaires were self-completed by the adolescents and were completed by the parents of the children.

Clinical symptoms included:

  • Asthma: Wheezing or whistling in the chest in the past 12 months. If wheezing affected speech, occurred more than four times in the past 12 months, or caused sleep disturbance more than one night per week, then it was defined as severe symptoms.
  • Rhinoconjunctivitis: Sneezing or runny or blocked nose when not suffering from a cold/flu, and itchy watery eyes in the past 12 months. Symptoms were defined as severe if the nose problems were accompanied by itchy watery eyes and were reported as interfering with daily activities ‘a lot’.
  • Eczema: An itchy rash in the past 12 months. Symptoms were defined as severe if sleep disturbance was reported at least once per week.

The diet questionnaire asked questions on the average weekly consumption over the previous year (never/occasionally, once or twice per week, at least three times per week) of the following foods:

  • Meat (presumably home-cooked meat dishes as opposed to fast food)
  • Seafood
  • Fruit
  • Vegetables (green and root)
  • Pulses (peas, beans, lentils)
  • Cereal
  • Pasta (including bread)
  • Rice
  • Butter
  • Margarine
  • Nuts
  • Potatoes
  • Milk
  • Eggs
  • Fast food, such as burgers

The researchers then looked to see if there was an association between the food consumed and the clinical symptoms reported.

The researchers adjusted for a number of factors that they had also collected information on, as it was thought they could partially explain any association seen (confounders).

These included exercise, television watching, maternal education, maternal smoking in the first year of life and current maternal smoking. Gender, region of the world, language and per capita gross national income were also adjusted for.

What were the basic results?

  • For adolescents; milk, fruit, and vegetables were found to be ‘protective’ foods.
  • Fruit intake at least once or twice per week or at least three times per week was associated with a reduced the risk of current wheeze, severe asthma, rhinoconjunctivitis and severe rhinoconjunctivitis.
  • Milk was associated with a reduced risk of current wheeze when consumed once or twice per week, and severe asthma when consumed at least three times per week. Milk consumption once or twice per week was associated with a reduced risk of rhinoconjunctivitis and severe rhinoconjunctivitis. Drinking milk once or twice per week or at least three times per week was associated with a reduced risk of eczema, and when consumed once or twice a week, with severe eczema.
  • Eating vegetables was associated with a reduced the risk of current wheeze when eaten at least three times per week, and of severe rhinoconjunctivitis and severe eczema when eaten once or twice per week.
  • Butter, fast food, margarine, pasta, potato, pulses, rice, seafood and nuts were associated with an increased risk of one or more conditions when eaten once or twice per week or at least three times per week, without being associated with a reduced risk of any conditions.
  • An increased risk of all three conditions (current and severe) was associated with eating butter, fast food, margarine and pasta at least three times per week. In some cases, an association was seen if the foods were eaten once or twice per week.
  • The greatest increase in risk was associated with eating fast food at least three times per week. Eating fast food at least three times per week was associated with an increased risk of current wheeze, severe asthma, current rhinoconjunctivitis, severe rhinoconjunctivitis, current eczema and severe eczema.
  • For children; eggs, fruit, cereals, meat, milk, nuts, pasta, potato, pulses, rice, seafood, and vegetables were found to be ‘protective’ foods, and were associated with a reduced risk of at least one condition without being associated with an increased risk of any condition.
  • Eating eggs, fruit, meat and milk at least three times per week was associated with reduced risk of all three conditions (current and severe).
  • Fast food was found to be a ‘risk factor’ food. Eating fast foods once or twice per week or at least three times per week was associated with an increased risk of current wheeze and severe asthma. Eating fast foods at least three times per week was associated with an increased risk of current rhinoconjunctivitis, severe rhinoconjunctivitis, and severe eczema.

How did the researchers interpret the results?

The researchers conclude that their results “suggest that fast-food consumption may be contributing to the increased prevalence of asthma, rhinoconjunctivitis and eczema in adolescents and children. For other foods, the picture for adolescents and children is less clear. However, in concordance with international dietary recommendations, diets that have a regular consumption of fruit and vegetables are likely to protect against asthma, allergic disease and other non-communicable disease”. The researchers also suggest that further exploration of this association is needed.

Conclusion

This cross-sectional study found that for both adolescents and children, fast-food consumption was associated with an increased risk of what the researchers defined as severe asthma, rhinoconjunctivitis and eczema. Consumption of fruit at least three times per week, by contrast, was associated with a decreased risk of severe asthma.

Although eating a balanced diet including the recommended daily intake of fruit and vegetables has many health benefits, there are limitations to this study, some of which were noted by the authors.

These limitations include:

  • The cross-sectional study design meant that the children were not followed over time, so we don’t know the order of events. For example, we can’t say whether consumption of fast food occurred before the development of asthma or whether children/adolescents with asthma ate more fast food.
  • Diet and symptoms over the whole year were either self-reported or reported by the parents of the children. This means that they may be subject to recall bias.
  • Not all confounders could be adjusted for and it is possible that there are other underlying factors associated with both dietary habits and risk of these allergic conditions. For example, the researchers only adjusted for socioeconomic status at the country level, rather than at the individual level.
  • Diagnoses of asthma, rhinoconjunctivitis and eczema – in particular what the researchers defined as ‘severe’ cases of these conditions – were not confirmed by medical records, so we don’t know whether they were entirely accurate.

Despite these limitations, this was an impressive and wide-ranging study (involving more than half a million children from across the world) whose results suggest that the possible association between diet and allergy deserves further investigation.

Analysis by Bazian. Edited by NHS Choices. Follow Behind the Headlines on Twitter.

Summary

‘Teenagers more likely to have severe asthma and eczema if they eat fast food more than three times a week,’ The Guardian reports. The claim is based on wide-ranging research looking at the dietary patterns of children across the world.

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Child Health & Safety News Roundup: 08-22-2016 to 08-28-2016

twitter thumbIn this week’s Children’s Safety News: EpiPen Price Hike Sparks Concern for Allergy Sufferers https://t.co/hO98KFMPxT

Welcome to Pediatric Safety’s weekly “Child Health & Safety News Roundup”- a recap of the past week’s child health and safety news headlines from around the world. Each day we use Twitter and Facebook to communicate relevant and timely health and safety information to the parents, medical professionals and other caregivers who follow us. Occasionally we may miss something, but we think overall we’re doing a pretty good job of keeping you informed. But for our friends and colleagues not on Twitter or FB (or who are but may have missed something), we offer you a recap of the past week’s top 20 events & stories.

PedSafe Child Health & Safety Headline of the Week:
Doctors Are Urging Parents Everywhere To Keep Their Kids’ Baby Teeth
https://t.co/wLZYEirNeC

Pediatric vs. General Dentistry: Is There a Difference?

Girl in dentists chair toothbrushing a modelThe choice between pediatric dentistry and general dentistry is a dilemma parents have been facing for years. So, what are the benefits of a pediatric dentist, rather than a general dentist?

The main difference between a pediatric dentist and general dentist is education. General dentists must complete at least three or more years of undergraduate education, plus four more years of dental school. On the other hand, pediatric dentists must complete the same schooling as a general dentist, plus an additional two to three years of specialty training following dental school. General dentists do not uniformly receive training regarding the oral care of kids, although some may pursue additional training after dental school individually.

During their training, pediatric dentists learn about kid-specific oral health issues, such as sedatives for children, dental developmental difficulties, and root canals on adult teeth that have not fully formed. Pediatric dentists are also more likely to have affiliations with hospitals and established relationships with pediatricians and other child specialists, which creates a network of health professionals dedicated to finding the best solution for your child’s oral health needs.

In a pediatric dental office, doctors and team members normally have a better understanding of how visual and emotional factors can influence a child’s behavior throughout a visit. Oftentimes, pediatric dentists are better equipped to foster a more soothing, kid-friendly atmosphere for your children. Environment is extremely important when it comes to the relationship kids have with their dentists. Pediatric dental offices usually have brightly-colored walls and interactive toys or videos. These details may just seem like unnecessary bells and whistles, but an environment completely dedicated to kids easily gains a child’s trust.

Pediatric dentists are also trained in the behavior and interactions with children. In other words, pediatric dentists typically have the right personality for treating children. They do not become discouraged or irritated with kids who may cry or have anxiety about visiting the dentist, as they are trained to operate in these kinds of scenarios.

Despite these advantages of having a pediatric dentist, most children are treated by general dentists. A general dentist often has an existing relationship with the entire family, and therefore has a great deal of family history knowledge, which may apply to the diagnosis or treatment of a dental issue with a child.

If your child has abnormal oral health issues or severe dental anxiety, seeing a pediatric dentist may be a great option for you and your family. On the other hand, if your family has a standing relationship with a general dentist, and your child needs a regular checkup, seeing a general dentist would suffice. There are some general dentists who have received advanced training in children’s dentistry, even though they are not pediatric dentists. In this situation, it is up to the family to decide what is best for their child.

Ways to Track and Boost Your Baby’s Developing Vision

Baby with GlassesOne of the many things new parents of an infant struggle with is an inability to communicate with their new little bundle of joy, especially on a verbal level. When they cry, are they hungry, need a diaper change or is there a realistic medical problem happening with their health and welfare that needs our immediate attention … sometimes it’s difficult to tell.

When it comes to their irreplaceable eyesight, monitoring these formidable years are vital when it comes to recognizing possible vision development problems that could affect them in the future. With a myriad of different types of diseases, conditions and terms to deal with when it comes to their valuable vision, it’s almost always difficult for parents to know where to start with this important process.

Early AOA Recommendations

The renowned American Optometric Association (AOA) is all too happy to guide parents on this important pathway. They offer valuable advice on developmental processes and better vision for growing eyes, from birth to the toddler stage. After they’re born, although their environment is full of visual stimulation, infants have not yet developed the ability to recognize two objects at once.

Their primary focus is on something 8 to 10 inches from their face, which is usually mirrored by their parent’s face in front of their own. After a couple of months, they should start tracking objects, but don’t be overly concerned if they have difficulty focusing, their eyes appear crossed or seem to wander since this is completely normal at this stage.

Five, Six, Seven, Eight – Is Everything Going Great?

After three or four months of age, babies should start to track objects and reach for them with their hands. The perception of color should start developing further now and although it’s not as advanced as their older parent’s eyes, there’s still a general consensus that these tots start to disseminate different shades, colors and start to develop better depth perception. To help boost their perception skills, at this age, parents should:

  • Give them plenty of toys, blocks and other objects for them to grasp
  • Play patty-cake and other games that use eye-hand coordination
  • Make sure they have time to explore by letting them crawl around frequently

Nine and Ten – Let’s Do It Again – Getting To Year One

Baby with remoteAt nine months, babies will start to pull themselves up and while they’re continuing to approach their first birthday, they should be grabbing and grasping objects firmly. Once they’ve reached twelve months of age, they should be walking, but also encouraged to continue to crawl to heighten their depth perception and advance coordination skills. More ways to improve their developing vision during this time is to:

  • Play hide-and-seek with their playthings
  • Encourage them to continue crawling and entice them to go further distances
  • Name toys and objects to begin developing word association with vision

One Or Two – Before We Buckle A Shoe

There are still a few years before we begin teaching advanced techniques like tying shoelaces, but this time is when toddlers should be developing much better eye-hand coordination techniques. Rolling a ball to them and expecting the same in return for example. They’ll probably start throwing things on their own at this point without our help. Look for better aim as they continue to develop and participate with this process. To continue enhancing their visual skills, parents should:

  • Roll a ball back and forth to them
  • Read to them and show them pictures in the book
  • Give them balls, blocks and puzzle games to play with

If you believe your child may have possible or potential vision problems, take them to see an eye care professional as soon as possible. Eye exams are recommended initially at birth, at six months and then not again until they’re three years of age. But these rules aren’t set in stone and the majority of eyesight issues can be corrected, especially when caught early.

The Facts about Iron Deficiency and Teen Girls

Only 60% of teenage girls have the recommended amount of iron in their diet. A lack of iron can make you feel tired, faint and breathless. It can also make it difficult to concentrate, which makes studying and taking exams more difficult. But it’s easy to get more iron into your diet.

Registered dietitian Azmina Govindji explains why iron is so important for girls and young women, and how to get more iron into your diet.

Why is it so important for teenage girls to get enough iron?
“Girls start their periods when they go through puberty, which is usually during the teenage years, and with blood loss comes iron loss. It’s important to ensure you have adequate iron from a variety of foods to avoid the unpleasant physical effects of iron deficiency, such as tiredness and breathlessness.”

How do you know if you’re short of iron?
“Symptoms of iron deficiency include tiredness, feeling faint, and breathlessness, but iron deficiency can only be diagnosed through a blood test. If you believe you may be low in iron because you’re feeling tired and lethargic, speak to your GP (*pediatrician or family doctor) or a registered dietitian. If your blood iron levels are found to be low, you may be prescribed a supplement.”

Should all teen girls take an iron supplement?
“No. You can usually get all the iron you need by eating a healthy balanced diet. Only take an iron supplement if you have been advised to by your GP (*pediatrician or family doctor) .”

iron-deficiency-and-teen-girlsCan you recommend some easy tips to get more iron into your diet?
“Iron-containing snacks include dried fruits such as apricots and raisins, and unsalted nuts. Keep these foods in your bag and you’ll have healthy iron-rich treats when you’re feeling peckish (*hungry). Red meat is a very rich source of iron, although you don’t need to eat it every day. Most breakfast cereals are fortified with iron, so they’re a great addition to your daily routine.”

Checklist of iron-rich foods

  • Red meat (beef, lamb, pork) is rich in iron that is easily absorbed. As a general rule, the darker the meat, the more iron it contains
  • Poultry contains some iron, and the leg meat is richer in iron than the breast meat
  • Fish contains some iron, especially oily fish (such as mackerel and sardines) and molluscs (such as mussels)
  • Green leafy vegetables, such as watercress and kale
  • Baked beans
  • Boiled or poached egg
  • Wholemeal bread
  • Fortified breakfast cereal
  • Dried figs and apricots
  • Raisins
  • Sesame seeds

Meal ideas

If you’re concerned that you’re not getting enough iron in your diet but don’t know where to start, try some of our meal plan ideas:

Breakfast

  • Fortified breakfast cereal with lower-fat milk
  • Poached/boiled egg on wholemeal toast with baked beans and a grilled tomato

Lunch

  • Sardines on wholemeal toast
  • Chicken salad with watercress, tomatoes, raw carrot and new potatoes
  • Bean salad with chickpeas, red kidney beans, onion, garlic, lemon juice, cucumber and tomato
  • Pitta bread with houmous, red pepper and celery

Dinner

  • Beef or vegetable stir fry with spring greens and cashew nuts and brown rice
  • Spaghetti bolognese with beef or lamb mince (*ground beef or lamb) and salad (or soya mince and lentils for a vegetarian option)

Snacks

  • Dried fruit, such as apricots or figs
  • Almonds
  • Small bar of dark chocolate
  • Small fruit flapjack

Editor’s Note: *clarification provided for our US readers.





Child Health & Safety News Roundup: 08-15-2016 to 08-21-2016

twitter thumbIn this week’s Children’s Safety News: McDonald’s Happy Meal toy yanked out of restaurants after parents complain it’s not safe https://t.co/1jyznl0AZN 

Welcome to Pediatric Safety’s weekly “Child Health & Safety News Roundup”- a recap of the past week’s child health and safety news headlines from around the world. Each day we use Twitter and Facebook to communicate relevant and timely health and safety information to the parents, medical professionals and other caregivers who follow us. Occasionally we may miss something, but we think overall we’re doing a pretty good job of keeping you informed. But for our friends and colleagues not on Twitter or FB (or who are but may have missed something), we offer you a recap of the past week’s top 15 events & stories.

PedSafe Child Health & Safety Headline of the Week:
Pregnant Women Advised to Avoid Travel to Active Zika Zone in Miami Beach
https://t.co/qOrZ2osS2Z

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