NBC-2 Interview of Dr. J. Brian Thornburg on the Appropriateness of BMI Screenings at School

BMI ChartWatch the NBC news video by clicking here.

By NBC-2

An 11-year-old’s weight is now the talk of the country after her story aired on the “Today” show and “Good Morning America.”

Lily Grasso is a star volleyball player, and by looking at her picture you can tell she’s far from obese.

But when school started last month, Lily brought home a letter from the Collier County Health Department that included results from her health screening.

Those results labeled her body weight “at risk.”

“I was crying when my parents told me the news was going to come, and I just didn’t know what people were going to say at school,” said Lily.

Her parents labeled it a “fat letter” that destroys a child’s self-esteem.

“I don’t think anyone will look at a letter and feel better about themselves,” said Lily’s mom, Kristen Grasso.

Doctor James Thornburg is a local Naples pediatrician. He says the body mass index can easily be off for athletes like Lily, adding that parents should follow up with their primary physician.

“It’s like any other static mark, you have to go find out what it really means because just a number on a piece of paper doesn’t really explain you as a person,” said Dr. Thornburg.

The Collier County Health Department says it has conducted the screenings for years, and has never received any complaints other than this incident.

“I was surprised because we don’t really get any complaints about this program” said Dr. Joan Colfer, with the Florida Department of Health and Collier County.

The department says whether the letters are sent home with children or mailed home is up to the school itself.

Department officials add the tests do more good than bad.

“These are important things that you need to find out about children early in life so you can make those corrections if needed,” said Colfer.

When asked if the department was considering a change in light of the incident, officials firmly said no.

“Absolutely not! This is a mandated by state law,” said Colfer.

Massachusetts is one state where representatives are trying to ban those screenings. Grasso’s mother wants the same push here in Florida.

“If we can change the law and get the tests out of schools even better,” said Lily’s mom.

Vitamin D supplementation prevents seasonal influenza A in schoolchildren

Vitamin D and fluSeasonal oscillation of influenza is prominent, its epidemic is explosive, and it ends abruptly. To explain this peculiar pattern, Cannell et al (1) hypothesized that the seasonal oscillation of serum vitamin D concentrations, which was recently discovered to up-regulate innate immunity, may affect the epidemic pattern of influenza. Vitamin D is mostly obtained from sun exposure; thus, serum vitamin D concentrations can be affected by season. In fact, serum concentrations of vitamin D have been shown to decrease in winter, the season when influenza occurs, to concentrations half those during the summer (1). In a post hoc analysis of side effect questions asked during a randomized controlled trial performed to determine whether vitamin D could prevent osteoporosis (2), cold and flu symptoms were reported 3 times less often in the vitamin D group than in the placebo group (3). However, although the authors conducted an additional randomized trial in 162 healthy adults, they could not reconfirm the benefit of vitamin D supplementation for the prevention of symptomatic upper respiratory tract infections (4). On the other hand, a significant inverse association between serum vitamin D intake and recent upper respiratory tract infections was seen in the third National Health and Nutrition Examination Survey (5). However, no rigorously designed clinical trials have evaluated the relation between vitamin D and physician-diagnosed influenza or delineated the necessary changes to prepare for an influenza pandemic (6). We conducted a randomized, double-blind, placebo-controlled trial comparing vitamin D3 supplements with placebo in schoolchildren to elucidate whether preventive intake of vitamin D supplements during winter and early spring seasons can reduce the incidence of seasonal influenza A.

In this randomized clinical trial, daily supplementation with 1200 IU vitamin D3 in school children between December and March showed a significant preventive effect against influenza A, although no significant difference was observed for influenza B. A 10-d course of postexposure prophylaxis with zanamivir or oseltamivir resulted in only an 8% decrease in the incidence of symptomatic influenza in children (7). In contrast, daily dietary probiotic supplementation was a safe effective way to reduce fever and other symptoms in small children (8). Moreover, a significant preventive effect of a product containing echinacea, propolis, and vitamin C on the incidence of respiratory tract infections was observed in children (9).

In conclusion, our study suggests that vitamin D3 supplementation during the winter season may reduce the incidence of influenza A. This effect was prominent in specific subgroups of schoolchildren. Moreover, asthma attacks were also prevented by vitamin D3 supplementation.

© 2010 American Society for Nutrition

Randomized trial of vitamin D supplementation to prevent seasonal influenza A in schoolchildren1,2,3

Early ADHD diagnosis a risk factor for depression

ADHD and Mood disordersBy Julie Steenhuysen

Children who are diagnosed with attention deficit hyperactivity disorder at an early age are at greater risk of depression and suicide than other teens and parents need to take the condition seriously, U.S. researchers said on Monday.

They said 18 percent of children in a study who were diagnosed with ADHD between ages 4 to 6 were depressed as adolescents – about 10 times higher than adolescents without ADHD.

And about 5 percent of children with an early ADHD diagnosis thought about committing suicide at least once, and were twice as likely as other children to have tried it.

“This is another pretty powerful demonstration that parents should not disregard ADHD in early childhood,” said Benjamin Lahey of the University of Chicago, who worked on the study published in the Archives of General Psychiatry.

ADHD is one of the most common child mental disorders and is estimated to affect around 3 percent to 5 percent of children globally.

Children with ADHD are excessively restless, impulsive and easily distracted, and often have difficulties at home and in school. There is no cure, but the symptoms can be kept in check by a combination of medication and behavioral therapy.

For the study, researchers from the University of Chicago and the University of Pittsburgh in Pennsylvania, followed 123 children diagnosed with ADHD at age 4 to 6 for up to 14 years, until they reached 18 to 20.

They compared these children with 119 children from similar neighborhoods and schools. The children were checked every year for the first four years, then during years 6 through 9 and 12 through 14.

“This is a study that … shows that children diagnosed at 4 to 6 years of age are at increased risk for depression and to some extent suicide during late childhood and adolescence,” Lahey said in a telephone interview.

The researchers did not study children diagnosed at an older age.

Lahey said suicide attempts were relatively rare, noting that more than 80 percent of children with ADHD did not try to commit suicide and no one in this study committed suicide.

SOMETHING TO TAKE SERIOUSLY

Even so, the disease is something to take seriously.

“We’ve known for a long time that children with ADHD are at risk for all kinds of problems such as accidental injuries,” Lahey said. Children with ADHD are also more likely than others to smoke and abuse drugs.

“At least some segments of the public tend to regard ADHD as something too minor to take seriously. There is a sense to some that it is psychiatriaztion of normal exuberance,” he said.

Last week, British researchers discovered the first direct evidence that ADHD is a genetic disorder, a finding they said should help dispel the myths that ADHD is caused by bad parenting or high-sugar diets.

“I think the best advice we can give is that they take it seriously and seek help from a mental health professional early on so they can help the child have the best possible outcome.”

Millions of people take ADHD drugs including Ritalin, Concerta, Adderall, Vyvanse and Strattera. Global sales of ADHD drugs were estimated at around $4 billion dollars in 2009.

SOURCE: link.reuters.com/xyb96p Archives of General Psychiatry, October 2010.

Food allergies make kids a target of bullies

Food allergy bullyingBy Elizabeth Landau, CNN

It’s tough enough having to avoid products with peanuts and other ingredients as a kid with severe food allergies. It’s tougher when someone at school waves a granola bar in your face at the peanut-free lunch table.

That’s what happened last week to a Pennsylvania fifth-grader whose mother asked that he not be identified. The boy had experienced allergic reactions to merely touching peanuts or breathing peanut particles in the past, so the act of granola-waving was more serious than for other allergy sufferers.

“He said [he was] scared, and ‘sad that he would do that to me,’ and ‘mad that he would do that to me,’ and worried that it’s going to happen again,” the boy’s mother said.

As the prevalence of food allergies grows in America, doctors are becoming more conscious of a disturbing trend in children getting picked on for not being able to eat certain foods.

According to a new study published in the Annals of Allergy, Asthma & Immunology, about 35 percent of children over age 5 with food allergies have experienced bullying, teasing or harassment. The study, which mostly surveys the parents of these children, said those negative social experiences, which included physical and verbal incidents, happened because of food allergies.

“The school has to really address it. It’s not the child’s job to take care of this problem, because there’s already an imbalance of power,” said study author Dr. Scott Sicherer, pediatric allergist at Mount Sinai School of Medicine in New York.

Gina Clowes, director of allergymoms.com and a coach for parents on food allergies, hears stories about food-allergic kids targeted by others in school all the time.

“They’ll make fun of what they’re eating,” she said. “I don’t know if it’s innocent or malicious, but some kids will literally threaten them with the peanut, or ‘I’m going to throw peanuts at you.’ “

While bullying with regard to food allergies isn’t all that different from bullying about other attributes, children with food allergies have an additional burden because they have the responsibility of taking care of themselves medically already, Clowes and Sicherer stressed.

“Here you have a child who already has to deal with not eating the same things as the other children; they already have to worry about is this meal safe for them; about having an allergic reaction,” Sicherer said. “This is an additional problem of someone making it even harder on them.”

The warning signs are similar to other forms of bullying, Clowes said: A child may appear sad, upset, withdrawn, anxious or say that he or she doesn’t want to go to school. But parents should also look for changes in their kids’ eating habits: They may come home with an untouched lunchbox, for example.

“I’ve had parents say kids go the entire day without eating because they’re being made fun of for special foods,” Clowes said.

The latest data from the Centers from Disease Control and Prevention show that about 3.9 percent of children younger than 18 in the United States have food allergies, representing an 18 percent increase from 1997 to 2007.

None of the incidents reported in the study resulted in allergic reactions, but the danger of them resulting in a dangerous reaction is self-evident, the study authors wrote. The emotional toll is also great. Common consequences included feelings of sadness or depression and embarrassment or humiliation.

This is the first study to address the scope of bullying as it relates to food allergies, the authors said. The information about allergic individuals came from 353 surveys, most of which were completed by parents who were attending various Food Allergy & Anaphylaxis Network conferences.

More children with food allergies may experience acts of bullying and other targeted negative behaviors than their peers, Sicherer said. A 2001 National Institute of Child Health and Human Development study found that about 17 percent of children in grades six to 10 reported being bullied. By comparison, 50 percent of kids in that age group in the food allergy study were reported to have experienced bullying, teasing or harassment.

The study had the limitation of obtaining most data from parents, rather than children themselves. On the other hand, some children likely do not report these incidents to their parents, meaning Sicherer and colleagues could have underestimated behaviors targeted at food-allergic children.

Parents should inform teachers and administrators right away if an incident occurs, Clowes said.

Children should try to stay away from the person who has bullied them and stand by trusted friends, Sicherer said. Ultimately, it also takes intervention on someone else’s part to speak to whomever is doing the bullying, so children should tell trusted adults what’s going on, he said.

Dr. Stanley Fineman, a practicing allergist with the Atlanta Allergy & Asthma Clinic, said allergists don’t normally ask children if they’ve been bullied or harrassed, but that this study suggests they should. In his own practice, Fineman has heard of incidents such as a child eating peanut butter and then spitting on a peer. He will more regularly inquire about allergy-related incidents because of the new data, he said.

“We as physicians need to specifically ask our patients directly what sort of bullying or harassment type situations have they had in school, because this is something that has not been on our radar screen as it probably should be,” he said.

The Pennsylvania mother whose child got a granola bar waved in his face last week isn’t worried about her son managing his allergies — it’s the other kids she’s nervous about. The teachers at the school have been understanding, but she believes there needs to be more education that one person’s allergy is not the same as another’s — and her son is particularly sensitive. She also dislikes that the school puts her son into a category called “peanut kids,” who get a peanut-free table.

“It’s very open, it’s obvious who has a problem and what the problem is,” she said. “Sometimes I don’t think people understand the severity of it.”

National Farm to School Network

Farm to schoolFarm to school is the practice of sourcing local food for schools or preschools and providing agriculture, health and nutrition education opportunities, such as school gardens, farm field trips and cooking lessons. Farm to school improves the health of children and communities while supporting local and regional farmers. Since each Farm to School program is shaped by its unique community and region, the National Farm to School Network does not prescribe or impose a list of practices or products for the farm to school approach. The National Farm to School Network supports the work of local farm to school programs all over the country by providing free training and technical assistance, information services, networking, and support for policy, media and marketing activities. Our network includes national staff, eight regional lead agencies and leads in all 50 states. Click on the map above to contact the state lead in your area for more information, or contact someone on our national staff directly. We are here to help you get started and keep programs growing!

What is farm to school? 
Farm to school is broadly defined as any program that connects schools (K-12) and local farms with the objectives of serving healthy meals in school cafeterias, improving student nutrition, providing agriculture, health and nutrition education opportunities, and supporting local and regional farmers. Farm to school programs exist in all 50 states, but since farm to school is a grassroots movement, programs are as diverse as the communities that build them.

What are the benefits of farm to school?
Farm to school programs are based on the premise that students will choose healthier foods, including more fruits and vegetables, if products are fresh, locally grown, and picked at the peak of their flavor and if those choices are reinforced with educational activities. Farm to School programs provide benefits to the entire community: children, farmers, food service staff, parents, and teachers.

  • The choice of healthier options in the cafeteria through farm to school meals results in consumption of more fruits and vegetables with an average increase of 0.99 to 1.3 servings per day, including at home.
  • Schools report a 3 to 16 percent increase in school meal participation when farm-fresh food is served through farm to school programs.
  • Farm to school programs open new markets for farmers and help expand their customer base by raising awareness about local food systems.
  • Farm to school programs are also known to increase school meal participation rates.

How can I start a farm to school program in my community?
Farm to school programs exist in all 50 states, so support and resources are available no matter where you are. And you don’t have to be a cafeteria manager or school board member to get involved – parents, teachers and even students have the power to start programs and make change happen! For tips and resources to help you get started, visit the National Farm to School Network‘s website, and read the “How to Start a Program” page.