Link between obesity and dental health in homeless children strengthened

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Children seem to gain extra weight after having their tonsils removed

THE QUESTION Tonsils often are removed to eliminate infections that cause sore throats and trouble swallowing and to help a child breathe better while sleeping. Might a tonsillectomy also affect the child's weight?

THIS STUDY analyzed data from nine studies, involving 795 children who had a tonsillectomy, with or without adenoid removal, before they turned 18. Their weights ranged from normal to extremely obese. In the first few years after their surgery, most of the children gained weight beyond what was expected as they grew taller. In more than half of the children, weight increased 46 to 100 percent. Most of the others gained as well, but in lesser amounts, although youths who were the most obese at the start neither gained nor lost weight after a tonsillectomy.

WHO MAY BE AFFECTED? Children with inflamed tonsils, and parents who must decide whether to have the tonsils removed. Although tonsillectomies are not done as often as they were a few decades ago, about a half-million children still have the operation each year in the United States.

CAVEATS The study suggested a link between tonsillectomy and subsequent weight gain, but it was not designed to prove cause and effect. It also did not determine the exact mechanism that may cause weight gain after a tonsillectomy. Citing the increasing number of obese children, the authors urged parents to add potential weight gain to the list of factors they consider when deciding whether to have a child's tonsils removed.

FIND THIS STUDY February issue of Otolaryngology - Head and Neck Surgery (oto.sagepub.com/content/144/2/154.abstract).

LEARN MORE ABOUT tonsils at www.entnet.org/healthinformation (click on "throat") and www.mayoclinic.com.

- Linda Searing

The research described in Quick Study comes from credible, peer-reviewed journals. Nonetheless, conclusive evidence about a treatment's effectiveness is rarely found in a single study. Anyone considering changing or beginning treatment of any kind should consult with a physician.

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AnyBody: Parents are ignoring their children for their BlackBerry

Okay, I admit it: Sometimes I ignore my children for my BlackBerry - mostly for work-related reasons, although, to be totally honest, there's the occasional personal e-mail or text in there, too. It's just so hard to disregard that bright red flash, signaling a new message. I mean, what if there's a problem with my next column? Maybe an editor is writing with a plum new freelance assignment. . . . What if my babysitter can't make it tomorrow, or there's some pressing missive from a friend?

Before you start throwing stones, dear readers, I've seen YOU out there ignoring your kids, too: Typing furiously on your smartphone at Starbucks or, while your offspring sit across the table, equally engrossed in handheld video games; checking Facebook or playing online Scrabble in the carpool line; texting away during soccer practice; and staring at your cell - instead of your charges - at the playground. And I won't even mention those of you who sneak peeks at red lights, with the kids in the back seat, since that's now illegal in many places and dangerous everywhere.

Forget stressing about young people's texting, Twitter and gaming habits. Increasingly, it is adults' constant, obsessive use of these technologies that's coming under fire.

"It's now children who are complaining about their parents' habits," says clinical psychologist and MIT professor Sherry Turkle, who interviewed more than 300 young people and 150 adults for her new book, "Alone Together: Why We Expect More From Technology and Less From Each Other."

What she found, over and over again, was children who feel that their parents often pay less attention to them than to their smartphones, particularly at mealtime, in the car at school pickup and during games or sport events - but even, on occasion, during bedtime stories.

"These are not people who are dysfunctional, who are out of control, who are addicted - they've just kind of let things get away from us," says Turkle. "It starts with the reality that people are expected to be online 24-7 - we're on all the time for our jobs - and it ends in the fantasy of 'there's something new just around the corner, waiting in your in box.' "

While there are many upsides to technology and constant connectivity, experts say there's also a cost for not paying as much attention to one another, especially within families. For one thing, parents who are easily distracted by their phones or iPads are modeling potentially harmful behavior for their impressionable children, says Patrick Kelly, a child and adolescent psychiatrist at the Johns Hopkins Children's Center.

He adds that putting these devices first can create discipline issues, too - as with my friend Hannah's 2-year-old son, who has taken to shouting "no, no, no!" and throwing Hannah's BlackBerry on the floor whenever she picks it up to check e-mail.

"If you're taking [parental attention] away from the child, for what looks like it is not a good reason, kids might think, 'What am I doing wrong that my parents don't like me?' and may start acting out to get their parents' attention because they have a hard time distinguishing positive from negative attention," says Kelly.

He has had couples bring a child in for a psychological evaluation and then start texting or e-mailing while their offspring is opening up, answering personal questions. "It's just like [putting a child in] a timeout: If you remove yourself from your child, that's punishment, and when that happens for no reason that a child can comprehend, it sends mixed messages and creates a lot of distress in the child's life, particularly younger children who just don't get that Mommy's working or Daddy has to take this call but will be back in five minutes."

For those who counter that Facebook and text messaging are helping them stay more in touch with their kids than ever before, experts stress that while these technologies can be a positive communication tool, there is simply no substitute for face-to-face contact. "Being able to look your child in the eye, to reflect what they're thinking and to be excited about the big test or disappointed about that breakup, and to really be there with them in a way you can't be in a text, is incredibly valuable, because it teaches kids to reflect on their own mental state and shows they're not alone in the world," says Kelly. "Eye contact is the number-one sign that you're relating to your kid."

As it turns out, we're also hurting ourselves when we juggle work, children and various technology tools at the same time. "Multitasking has been heralded for quite a few years as a skill we needed to master in order to catch up with our children, but research is now showing that the more we multitask, the more we degrade our performance in every one of those tasks," says Turkle. Her book cites a 2009 study from Stanford University, published in Proceedings of the National Academy of Sciences. It found that heavy multitaskers performed much worse on a series of cognitive and memory tests that involved distraction than those who focused on just one thing at a time.

Obviously, there are many parents - and families - who do manage technology responsibly, setting limits and spending tech-free time with their children or partners every day. All of the experts I interviewed recommend this. Some sainted moms and dads even put down their smartphones entirely when the kiddies are around.

But as I sit here writing this article, checking my BlackBerry for e-mails on another looming deadline and paying bills online, while monitoring with one ear a sick child, I particularly appreciate Turkle's sane, practical approach to this problem. "I specifically do not use term 'addiction,' because if you're addicted [to technology use], you have one choice and one choice only - to throw it away - and we're not going to throw this away," she says. "These technologies are with us, but we have to learn to live with them in a healthy way, according to our human values. And our human values are not to put our kids fifth, after texts, e-mail, Twitter and everything else."

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New approaches for controlling pesticide exposure in children

Instead of relying too heavily on traditional pesticides, people should embrace “integrated pest management” measures, such as filling cracks in walls that let insects in and damp conditions that attract pests. Credit: Hemera/Thinkstock

New research on household pesticide contamination emphasizes the need for less reliance on pesticides and more emphasis on neatness, blocking cracks where insects can enter and other so-called "integrated pest management" (IPM) measures, scientists have concluded. Their study appears in the ACS' journal Environmental Science & Technology.

Chensheng Lu and colleagues cite previous studies showing that urban, low-income, multifamily, public housing dwellings are prone to severe pest infestation problems. Families in Boston public housing developments, for instance, rank pest infestation, pesticide use and pest allergies second only to crime as matters of concern. In an effort to encourage use of IPM, which reduces reliance on traditional pesticides, Lu's team studied exposure to 19 pesticides among children in 20 families in Boston's public housing.

They found pesticides in all of the homes, along with indications—such as sighting of live pests or pest debris—that traditional pesticides were not effective. "The results from the current study, as well as other recent studies, conducted in low-income public housing, child care centers and randomly selected homes in the U.S. should accentuate the need for alternative pest management programs," the report states. IPM focuses on eliminating the cause of pest infestations by minimizing access to food, water, hiding places, and sealing cracks and other openings in walls to prevent entry of pests.

More information: "Household Pesticide Contamination from Indoor Pest Control Applications in Urban Low-Income Public Housing Dwellings: A Community-Based Participatory Research" Environmental Science & Technology. DOI: 10.1021/es303912n

Abstract
We designed this community-based participatory research (CBPR) project aiming to generate evidence-based research results to encourage residents living in urban low-income public housing dwellings engaging in a community-wide integrated pest management (IPM) program with the intention to improve their health and quality of life, as well as household conditions. We enrolled 20 families and their children in this study in which we utilized environmental exposure assessment (surface wipe and indoor air) tools to quantitatively assessing residential pesticide exposure in young children before the implementation of an IPM program. We analyzed those samples for 19 organophosphate (OP) and pyrethroid pesticides.
The most commonly detected pesticides were pyrethroids, particularly permethrin and cypermethrin with average concentrations of 2.47 and 3.87 µg/m2, respectively. In many dwellings, we detected OPs, which are no longer available on the market; however, their levels are significantly lower than those of pyrethroids. None of the 20 families was free from pesticide contamination in their households, and pesticides were commonly detected in living room and children's bedroom.
The correlation among household hygienic conditions, the sighting of live pests/pest debris, and the degree of indoor pesticide contamination highlights the failure of conventional chemical-based applications for pest controls. The results from the current study, as well as other recent studies, conducted in low-income public housing, child care centers, and randomly selected homes in the U.S. should accentuate the need for alternative pest management programs that incorporate safer and more sustainable protocols for pest controls.

Journal reference: Environmental Science & Technology

Provided by American Chemical Society

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