Tag Archives: Journal of the American Medical Association

Imperial College London study: Feeding babies egg and peanut may prevent food allergy, study suggests

25 Sep

More children seem to have peanut allergies. Ross Brenneman wrote in the Education Week article, How Peanuts Became Public Health Enemy #1:

Researchers aren’t sure why, but over the past several years, the number of children reported to have allergies has doubled, to 5 percent of children in the United States. Yet at the same time, in schools and elsewhere, allergies have drawn what some see as an oversized amount of attention. A new paper out of Princeton University explores why that may have happened.

Allergy attacks are awful. I’ve been there plenty of times. Eyes swollen shut, coughing, hacking, sneezing—and that’s just garden-variety pollen. But severe allergic reactions, also known as anaphylaxia, can cause death, even for the constantly vigilant. That’s why the U.S. House of Representatives voted unanimously last week in favor of a bill that would incentivize states, through a pre-existing grant program, to make sure their schools have a supply of epinephrine (usually an EpiPen) on hand, as well as staff members trained in using it…

One percent. That’s it. One estimate pegs it closer to 1.4 percent for children, but only .6 percent for adults. Either way, it’s small. Not all of those affected are seriously allergic, either. One percent isn’t nothing, but it’s not the kind of number that would suggest a strong cultural reaction, either.
Why, then, have peanut allergies become such a well-known public health menace? Maybe it’s partly from the mystery surrounding all allergies; scientists don’t know why allergies exist and why some people grow out of them. It’s also not clear how much an allergy attack may be exacerbated by asthma; the two often go hand in hand….
http://blogs.edweek.org/edweek/rulesforengagement/2013/08/how_peanuts_became_public_health_enemy_number_one.html?intc=es

Kids With Food Allergies has some excellent resources.
http://www.kidswithfoodallergies.org/resourcespre.php?id=62&title=Peanut_allergy_avoidance_list&gclid=CJTC7sfLuLICFWdxQgodxHcAJQ

Kate Wighton wrote in Feeding babies egg and peanut may prevent food allergy:

Feeding babies egg and peanut may reduce their risk of developing an allergy to the foods, finds a new study.

In the research, which is the largest analysis of evidence on the effect of feeding allergenic foods to babies, scientists from Imperial College London analysed data from 146 studies. In total the studies involved more than 200,000 children.

The study, which was commissioned by the UK Food Standards Agency, also found feeding children peanut, between the ages of four and eleven months, may reduce risk of developing peanut allergy. In addition, the team analysed milk, fish (including shellfish), tree nuts (such as almonds) and wheat, but didn’t find enough evidence to show introducing these foods at a young age reduces allergy risk.

The research is published today in the Journal of the American Medical Association.

Although previous studies have found feeding children peanut and egg may reduce allergy risk, other studies have found no effect.

Dr Robert Boyle, lead author of the research from the Department of Medicine at Imperial, said: “This new analysis pools all existing data, and suggests introducing egg and peanut at an early age may prevent the development of egg and peanut allergy, the two most common childhood food allergies.

“Until now we have not been advising parents to give these foods to young babies, and have even advised parents to delay giving allergenic foods such as egg, peanut, fish and wheat to their infant.”

Allergies to foods, such as nuts, egg, milk or wheat, affect around one in 20 children in the UK. They are caused by the immune system malfunctioning and over-reacting to these harmless foods. This triggers symptoms such as rashes, swelling, vomiting and wheezing.

“The number of children diagnosed with food allergies is thought to be on the rise”, added Dr Vanessa Garcia-Larsen, a co-author on the study from the National Heart and Lung Institute at Imperial. “There are indications that food allergies in children have become much more common over the last 30 years.

The number of patients coming into our clinics has increased year-on-year, and allergy clinics across the country have seen the same pattern.”

She added that the reasons behind this rise are still unclear – doctors may be better at recognising food allergy, or there may be environmental factors involved.

In the new study, called a meta-analysis, the team initially analysed 16,289 research papers on allergies and other immune system problems. Out of these, 146 were used for data analysis of when to feed babies allergenic foods such as egg, peanut, wheat and fish.

The results showed that children who started eating egg between the ages of four and six months had a 40 per cent reduced risk of egg allergy compared to children who tried egg later in life.

Children who ate peanut between the ages of four and eleven months had a 70 per cent reduced peanut allergy risk compared to children who ate the food at a later stage. However, the authors cautioned that these percentages are estimates based on a small number of studies……                                                                   http://www3.imperial.ac.uk/newsandeventspggrp/imperialcollege/newssummary/news_20-9-2016-14-46-0

Citation:

Feeding babies egg and peanut may prevent food allergy, study suggests

Date:        September 20, 2016

Source:    Imperial College London

Summary:

Feeding babies egg and peanut may reduce their risk of developing an allergy to the foods, finds a new study.

Journal Reference:

  1. Despo Ierodiakonou et al. Timing of Allergenic Food Introduction to the Infant Diet and Risk of Allergic or Autoimmune DiseaseA Systematic Review and Meta-analysis. JAMA, 2016 DOI: 10.1001/jama.2016.12623

Here is the citation from the Journal of the American Medical Association:

September 20, 2016, Vol 316, No. 11 >

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Original Investigation|September 20, 2016

Timing of Allergenic Food Introduction to the Infant Diet and Risk of Allergic or Autoimmune Disease A Systematic Review and Meta-analysis

Despo Ierodiakonou, MD, PhD1,2; Vanessa Garcia-Larsen, PhD2; Andrew Logan, PhD1; Annabel Groome, BSc1; Sergio Cunha, MD2; Jennifer Chivinge, BSc1; Zoe Robinson, BSc1; Natalie Geoghegan, BSc1; Katharine Jarrold, BSc1; Tim Reeves, BSc2; Nara Tagiyeva-Milne, PhD3; Ulugbek Nurmatov, MD, PhD4; Marialena Trivella, DPhil5; Jo Leonardi-Bee, PhD6; Robert J. Boyle, MD, PhD1

[+] Author Affiliations

JAMA. 2016;316(11):1181-1192. doi:10.1001/jama.2016.12623.

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ABSTRACT

ABSTRACT | INTRODUCTION | METHODS AND LITERATURE SEARCH | RESULTS | DISCUSSION | CONCLUSIONS | ARTICLE INFORMATION | REFERENCES

Importance  Timing of introduction of allergenic foods to the infant diet may influence the risk of allergic or autoimmune disease, but the evidence for this has not been comprehensively synthesized.

Objective  To systematically review and meta-analyze evidence that timing of allergenic food introduction during infancy influences risk of allergic or autoimmune disease.

Data Sources  MEDLINE, EMBASE, Web of Science, CENTRAL, and LILACS databases were searched between January 1946 and March 2016.

Study Selection  Intervention trials and observational studies that evaluated timing of allergenic food introduction during the first year of life and reported allergic or autoimmune disease or allergic sensitization were included.

Data Extraction and Synthesis  Data were extracted in duplicate and synthesized for meta-analysis using generic inverse variance or Mantel-Haenszel methods with a random-effects model. GRADE was used to assess the certainty of evidence.

Main Outcomes and Measures  Wheeze, eczema, allergic rhinitis, food allergy, allergic sensitization, type 1 diabetes mellitus, celiac disease, inflammatory bowel disease, autoimmune thyroid disease, and juvenile rheumatoid arthritis.

Results  Of 16 289 original titles screened, data were extracted from 204 titles reporting 146 studies. There was moderate-certainty evidence from 5 trials (1915 participants) that early egg introduction at 4 to 6 months was associated with reduced egg allergy (risk ratio [RR], 0.56; 95% CI, 0.36-0.87; I2 = 36%; P = .009). Absolute risk reduction for a population with 5.4% incidence of egg allergy was 24 cases (95% CI, 7-35 cases) per 1000 population. There was moderate-certainty evidence from 2 trials (1550 participants) that early peanut introduction at 4 to 11 months was associated with reduced peanut allergy (RR, 0.29; 95% CI, 0.11-0.74; I2 = 66%; P = .009). Absolute risk reduction for a population with 2.5% incidence of peanut allergy was 18 cases (95% CI, 6-22 cases) per 1000 population. Certainty of evidence was downgraded because of imprecision of effect estimates and indirectness of the populations and interventions studied. Timing of egg or peanut introduction was not associated with risk of allergy to other foods. There was low- to very low-certainty evidence that early fish introduction was associated with reduced allergic sensitization and rhinitis. There was high-certainty evidence that timing of gluten introduction was not associated with celiac disease risk, and timing of allergenic food introduction was not associated with other outcomes.

Conclusions and Relevance  In this systematic review, early egg or peanut introduction to the infant diet was associated with lower risk of developing egg or peanut allergy. These findings must be considered in the context of limitations in the primary studies.                                                                                                     http://jama.jamanetwork.com/article.aspx?articleid=2553447

A physical examination is important for children to make sure that there are no health problems. The University of Arizona Department of Pediatrics has an excellent article which describes Pediatric History and Physical Examination http://www.peds.arizona.edu/medstudents/Physicalexamination.asp The article goes on to describe how the physical examination is conducted and what observations and tests are part of the examination. The Cincinnati Children’s Hospital describes the Process of the Physical Examination http://www.cincinnatichildrens.org/health/p/exam/
If children have allergies, parents must work with their schools to prepare a allergy health plan. See, Journal of American Medical Association study: Consumption of nuts by pregnant woman may reduce nut allergies in their children https://drwilda.com/tag/peanut-allergy/

Resources:

Micheal Borella’s Chicago-Kent Law Review article, Food Allergies In Public Schools: Toward A Model Code
http://www.cklawreview.com/wp-content/uploads/vol85no2/Borella.pdf

USDA’s Accomodating Children With Special Dietary Needs
http://www.k12.wa.us/ChildNutrition/pubdocs/SpecialDietaryNeeds.PDF

Child and Teen Checkup Fact Sheet
http://www.health.state.mn.us/divs/fh/mch/ctc/factsheets.html

Video: What to Expect From A Child’s Physical Exam

Where information leads to Hope. © Dr. Wilda.com

Dr. Wilda says this about that ©

Blogs by Dr. Wilda:

COMMENTS FROM AN OLD FART©
http://drwildaoldfart.wordpress.com/

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http://drwildareviews.wordpress.com/

Dr. Wilda©                                                                                                                                     https://drwilda.com/

 

 

Drexel University School of Public Health study: Parental depression associated with worse school performance by children

7 Feb

Moi said in Schools have to deal with depressed and troubled children:
Both the culture and the economy are experiencing turmoil. For some communities, the unsettled environment is a new phenomenon, for other communities, children have been stressed for generations. According to the article, Understanding Depression which was posted at the Kids Health site:

Depression is the most common mental health problem in the United States. Each year it affects 17 million people of all age groups, races, and economic backgrounds.
As many as 1 in every 33 children may have depression; in teens, that number may be as high as 1 in 8. http://kidshealth.org/parent/emotions/feelings/understanding_depression.html

Schools are developing strategies to deal with troubled kids.

Andrew M. Seaman of Reuters reported in Parents’ depression may affect kids’ school performance:

Children perform worse in school when their parents are diagnosed with depression, suggests a study from Sweden.

The study found a significant negative link between parents’ depression and kids’ school performance, said senior author Brian Lee, of the Drexel University School of Public Health in Philadelphia.

“We obviously know that depression is a bad thing like any other mental health outcome,” Lee said. “It’s less recognized that mental health outcomes affect other people than the people themselves. So for parents or guardians, a vulnerable population would be their children.”

Previous studies found children with depressed parents are more likely to have problems with brain development, behavior and emotions, along with other psychiatric problems, Lee and his colleagues write in JAMA Psychiatry. Few studies have looked at school performance, however.

For the new study, they used data from more than 1.1 million children born in Sweden between 1984 and 1994.

Three percent of the mothers and about 2 percent of fathers were diagnosed with depression before their children finished their last required year of school, which occurs around age 16 in Sweden.

Overall, when parents were diagnosed with depression during their children’s lifetime, the kids’ grades suffered. A mother’s depression appeared to affect daughters more than sons, they note.

Lee characterized the link between parental depression and children’s school performance as “moderate.”

On the range of factors that influence a child’s school performance, Lee said parental depression falls between a family’s economic status and parental education, which is one of the biggest factors in determining a child’s success in school.

The researchers caution that depression may have been undermeasured in the population. Also, they can’t say that a parent’s depression actually causes children to perform worse in school…. http://www.reuters.com/article/us-health-school-depression-parents-idUSKCN0VC2VS

Citation:

Parental depression associated with worse school performance by children

Date:      February 3, 2016

Source:   The JAMA Network Journals

Summary:

Having parents diagnosed with depression during a child’s life was associated with worse school performance at age 16 a new study of children born in Sweden reports.

Journal References:

  1. Hanyang Shen, Cecilia Magnusson, Dheeraj Rai, Michael Lundberg, Félice Lê-Scherban, Christina Dalman, Brian K. Lee. Associations of Parental Depression With Child School Performance at Age 16 Years in Sweden. JAMA Psychiatry, 2016; DOI: 10.1001/jamapsychiatry.2015.2917
  2. Myrna M. Weissman. Children of Depressed Parents—A Public Health Opportunity. JAMA Psychiatry, 2016; DOI: 10.1001/jamapsychiatry.2015.2967

Associations of Parental Depression With Child School Performance at Age 16 Years in Sweden ONLINE FIRST

Hanyang Shen, MPH, MSc1; Cecilia Magnusson, MD, PhD2,3; Dheeraj Rai, MRCPsych, PhD4,5; Michael Lundberg, MPH2,3; Félice Lê-Scherban, PhD1; Christina Dalman, MD, PhD2,3; Brian K. Lee, PhD, MHS1,6

[+] Author Affiliations

JAMA Psychiatry. Published online February 03, 2016. doi:10.1001/jamapsychiatry.2015.2917

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ABSTRACT

ABSTRACT | INTRODUCTION | METHODS | RESULTS | DISCUSSION | CONCLUSIONS | ARTICLE INFORMATION | REFERENCES

Importance  Depression is a common cause of morbidity and disability worldwide. Parental depression is associated with early-life child neurodevelopmental, behavioral, emotional, mental, and social problems. More studies are needed to explore the link between parental depression and long-term child outcomes.

Objective  To examine the associations of parental depression with child school performance at the end of compulsory education (approximately age 16 years).

Design, Setting, and Participants  Parental depression diagnoses (based on the International Classification of Diseases, Eighth Revision [ICD-8], International Classification of Diseases, Ninth Revision [ICD-9], and the International Statistical Classification of Diseases, 10th Revision [ICD-10]) in inpatient records from 1969 onward, outpatient records beginning in 2001, and school grades at the end of compulsory education were collected for all children born from 1984 to 1994 in Sweden. The final analytic sample size was 1 124 162 biological children. We examined the associations of parental depression during different periods (before birth, after birth, and during child ages 1-5, 6-10, and 11-16 years, as well as any time before the child’s final year of compulsory schooling) with the final school grades. Linear regression models adjusted for various child and parent characteristics. The dates of the analysis were January to November 2015.

Main Outcome and Measure  Decile of school grades at the end of compulsory education (range, 1-10, with 1 being the lowest and 10 being the highest).

Results  The study cohort comprised 1 124 162 children, of whom 48.9% were female. Maternal depression and paternal depression at any time before the final compulsory school year were associated with worse school performance. After covariate adjustment, these associations decreased to −0.45 (95% CI, −0.48 to −0.42) and −0.40 (−0.43 to −0.37) lower deciles, respectively. These effect sizes are similarly as large as the observed difference in school performance between the lowest and highest quintiles of family income but approximately one-third of the observed difference between maternal education of 9 or less vs more than 12 years. Both maternal depression and paternal depression at different periods (before birth, after birth, and during child ages 1-5, 6-10, and 11-16 years) generally were associated with worse school performance. Child sex modified the associations of maternal depression with school performance such that maternal depression had a larger negative influence on child school performance for girls compared with boys.

Conclusions and Relevance  Diagnoses of parental depression throughout a child’s life were associated with worse school performance at age 16 years. Our results suggest that diagnoses of parental depression may have a far-reaching effect on an important aspect of child development, with implications for future life course outcomes.                                                                                     http://archpsyc.jamanetwork.com/article.aspx?articleid=2488039

Here is the press release from Drexel University:

Parental Depression Negatively Affects Children’s School Performance

February 03 2016

A new study has found that when parents are diagnosed with depression, it can have a significant negative impact on their children’s performance at school.

Researchers at Drexel University led a team including faculty from the Karolinska Institutet in Stockholm, Sweden, and the University of Bristol in England in a cohort study of more than a million children born from 1984 until 1994 in Sweden. Using computerized data registers, the scientists linked parents’ depression diagnoses with their children’s final grades at age 16, when compulsory schooling ends in Sweden.

The research indicated that children whose mothers had been diagnosed with depression are likely to achieve grades that are 4.5 percentage points lower than peers whose mothers had not been diagnosed with depression. For children whose fathers were diagnosed with depression, the difference is a negative four percentage points.

Put into other terms, when compared with a student who achieved a 90 percent, a student whose mother or father had been diagnosed with depression would be more likely to achieve a score in the 85–86 percent range.

The magnitude of this effect was similar to the difference in school performance between children in low versus high-income families, but was smaller than the difference for low versus high maternal education (low family income: -3.6 percentage points; low maternal education -16.2 percentage points).

How well a student does in school has a large bearing on future job and income opportunities, which has heavy public health implications, explained Félice Lê-Scherban, PhD, assistant professor in the Dornsife School of Public Health. On average in the United States, she said, an adult without a high school degree earns half as much as one of their peers with a college degree and also has a life expectancy that is about 10 years lower.

“Anything that creates an uneven playing field for children in terms of their education can potentially have strong implications for health inequities down the road,” Lê-Scherban said.

Some differences along gender lines were observed in the study. Although results were largely similar for maternal and paternal depression, analysis found that episodes of depression in mothers when their children were 11–16 years old appeared to have a larger effect on girls than boys. Girls scored 5.1 percentage points lower than their peers on final grades at 16 years old when that factor was taken into account. Boys, meanwhile, only scored 3.4 percentage points lower.

Brian Lee, PhD, associate professor in the Dornsife School of Public Health, said there were gender differences in the study’s numbers, but didn’t want to lose focus of the problem parental depression presents as a whole.

“Our study — as well as many others — supports that both maternal and paternal depression may independently and negatively influence child development,” Lee said. “There are many notable sex differences in depression, but, rather than comparing maternal versus paternal depression, we should recognize that parental depression can have adverse consequences not just for the parents but also for their children.”

Depression diagnoses in a parent at any time during the child’s first 16 years were determined to have some effect on the child’s school performance. Even diagnoses of depression that came before the child’s birth were linked to poorer school performance. The study posited that it could be attributed to parents and children sharing the same genes and the possibility of passing on a disposition for depression.

The study, “Associations of Parental Depression With Child School Performance at Age 16 Years in Sweden,” whose lead author was Drexel alumna Hanyang Shen, was published in JAMA Psychiatry.

Media Contact:
Frank Otto
fmo26@drexel.edu
215.571.4244

If you or your child needs help for depression or another illness, then go to a reputable medical provider. There is nothing wrong with taking the steps necessary to get well.

Related:

Schools have to deal with depressed and troubled children
https://drwilda.wordpress.com/2011/11/15/schools-have-to-deal-with-depressed-and-troubled-children/

School psychologists are needed to treat troubled children
https://drwilda.wordpress.com/2012/02/27/school-psychologists-are-needed-to-treat-troubled-children/

Battling teen addiction: ‘Recovery high schools’
https://drwilda.wordpress.com/2012/07/08/battling-teen-addiction-recovery-high-schools/

Resources:
1. About.Com’s Depression In Young Children http://depression.about.com/od/child/Young_Children.htm

  1. Psych Central’s Depression In Young Children http://depression.about.com/od/child/Young_Children.htm
  2. Psychiatric News’ Study Helps Pinpoint Children With Depression http://psychnews.psychiatryonline.org/newsarticle.aspx?articleid=106034
  3. Family Doctor’s What Is Depression? http://familydoctor.org/familydoctor/en/diseases-conditions/depression.html
  4. WebMD’s Depression In Children http://www.webmd.com/depression/guide/depression-children
  5. Healthline’s Is Your Child Depressed?

http://www.healthline.com/hlvideo-5min/how-to-help-your-child-through-depression-517095449

  1. Medicine.Net’s Depression In Children http://www.onhealth.com/depression_in_children/article.htm

Where information leads to Hope. © Dr. Wilda.com

Dr. Wilda says this about that ©

Blogs by Dr. Wilda:

COMMENTS FROM AN OLD FART©
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Dr. Wilda ©
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