Daily Archives: January 28, 2011

Kids Not So Stuck on Sugary Breakfast Cereals, Study Finds

It turns out that when kids are given a choice of cereals, and there is fruit on hand, most will be happy with low-sugar fare. In other words, getting your kids to happily eat nutritious, low-sugar breakfast cereals may be child’s play, researchers report. This was exactly what I predicted in my book, SuperSized Kids: How to protect your child from the obesity threat, currently on sale here.

SSK cover

The recent study finds that children will gladly chow down on low-sugar cereals if they’re given a selection of choices at breakfast, and many compensate for any missing sweetness by opting for fruit instead. Here are the details from HealthDay News:

The 5-to-12-year-olds in the study still ate about the same amount of calories regardless of whether they were allowed to choose from cereals high in sugar or a low-sugar selection. However, the kids weren’t inherently opposed to healthier cereals, the researchers found.

“Don’t be scared that your child is going to refuse to eat breakfast. The kids will eat it,” said study co-author Marlene B. Schwartz, deputy director of Yale University’s Rudd Center for Food Policy and Obesity.

Nutritionists have long frowned on sugary breakfast cereals that are heavily marketed by cereal makers and gobbled up by kids.

In 2008, Consumer Reports analyzed cereals marketed to kids and found that each serving of 11 leading brands had about as much sugar as a glazed donut. The magazine also reported that two cereals were more than half sugar by weight and nine others were at least 40 percent sugar.

This week, food giant General Mills announced that it is reducing the sugar levels in its cereals geared toward children, although they’ll still have much more sugar than many adult cereals.

In the meantime, many parents believe that if cereals aren’t loaded with sweetness, kids won’t eat them.

But is that true? In the new study, researchers offered different breakfast cereal choices to 91 urban children who took part in a summer day camp program in New England. Most were from minorities families and about 60 percent were Spanish-speaking.

Of the kids, 46 were allowed to choose from one of three high-sugar cereals: Froot Loops, Frosted Flakes and Cocoa Pebbles, which all have 11-12 grams of sugar per serving. The other 45 chose from three cereals that were lower in sugar: Cheerios, Rice Krispies and Kellogg’s Corn Flakes. They all have 1-4 grams of sugar per serving.

All the kids were also able to choose from low-fat milk, orange juice, bananas, strawberries and extra sugar.

Taste did matter to kids, but when given a choice between the three low-sugar cereals, 90 percent “found a cereal that they liked or loved,” the authors report.

In fact, “the children were perfectly happy in both groups,” Schwartz said. “It wasn’t like those in the low-sugar group said they liked the cereal less than the other ones.”

The kids in both groups also took in about the same amount of calories at breakfast. But the children in the high-sugar group filled up on more cereal and consumed almost twice as much refined sugar as did the others. They also drank less orange juice and ate less fruit.

Len Marquart, an associate professor of food science and nutrition at University of Minnesota-Twin Cities, said the study findings “confirm for people that their choices in the cereal aisle do make a difference.”

“The biggest challenges are taste and marketing. In the morning, kids are sleepy and cranky, and it’s hard to get them to sit down and eat breakfast,” he said. “The sugar cereals marketed with flash and color and cartoon characters help get kids to the kitchen table when nothing else seems to work. And, we have to be realistic, they do like the taste of presweetened cereals.”

But one solution is to be creative, he said. “Take Cheerios and put some strawberries and vanilla yogurt on top, and that’s going to taste better than any presweetened cereal anyway,” Marquart said.

Obama Admin Working to Rescind Conscience Rights on Abortion

The Obama administration is still working to overturn conscience rights for medical professionals on abortion that were put in place at the tail end of the Bush administration. Here are the chilling details in a report from LifeNews:

In 2008, the Bush administration issued a rule that prohibited recipients of federal money from discriminating against doctors, nurses and health care aides who refuse to take part in medical procedures to which they have religious or moral objections, such as abortion.

The rule implemented existing conscience protection laws that ensure medical professionals cannot be denied employment because they do not want to assist in abortions.

New information about the state of those protections and efforts to repeal them comes from legal papers the administration filed in a case the state of Connecticut launched against the conscience protections.

In a document filed in federal court in November, Obama administration attorneys admitted that the administration wants to finalize a rescission of the conscience rules but has been delayed because of other business — likely due to the HHS working on implementing the provisions of the ObamaCare law.

HHS “hope[d] to have an internal draft final rule prepared in the near future, but that the schedule is necessarily tentative given the possibility of unforeseen delays and the need to devote time and resources to other agency priorities,” the November legal paper said.

Responding to the paper, the federal court asked for more information about the delay.

The Obama administration filed another legal paper December 1 stating “HHS still cannot be certain of a date for completing the rulemaking” but added “HHS expects to have a final rule published in the Federal Register within sixty to ninety days – i.e., as early as January 31, 2011, and no later than March 1, 2011.”

Obama officials asked the court to not mandate a time by which the rescission is made and said they hope to complete the rescission of the conscience rights prior to the court issuing a decision related to the Bush rules in the Connecticut challenge.

The Alliance Defense Fund, a pro-life legal group, points out that the papers make it clear the Obama administration intends to repeal the conscience protections on abortion, citing language saying the administration would notify the court “when the final rule regarding the proposed rescission is published.”

ADF Legal Counsel Matt Bowman said the Obama administration “wants to dismantle” the conscience protections “leaving little defense for the regulation and for health care workers.”

“Medical professionals should not be punished for holding to their beliefs, and they should not be forced to perform abortions against their conscience,” he told LifeNews.com. “Those pursuing this lawsuit, including organizations such as Planned Parenthood, would like nothing more than to deny health care workers the only means that exists to defend their federally protected right to opt out of abortions.”

ADF has been defending the rights of a nurse who was forced to assist in an abortion and is she is now seeking to join the lawsuit to oppose Connecticut’s efforts to overturn the Bush rules.

As LifeNews.com reported in November, Cathy Cenzon-DeCarlo lost a federal court ruling saying she doesn’t have the right to sue the hospital that forced her to participate in an abortion.

Now, the Alliance Defense Fund has filed a motion to intervene in State of Connecticut v. United States of America.

ADF is currently involved in a lawsuit in New York state court to defend Cenzon-DeCarlo’s conscience rights under state law, but the U.S. Court of Appeals for the 2nd Circuit upheld the dismissal of her federal lawsuit, leaving only an ongoing investigation by the U.S. Department of Health and Human Services as the means to defend her rights protected under federal law.

That investigation relies upon the conscience regulations implemented by former President George W. Bush that direct the department to conduct such investigations.

If Connecticut is successful or the Obama administration overturns the rules, “this case may cause Mrs. DeCarlo to again be illegally compelled to assist in abortions by her federally funded employer due to the removal of all her protective measures,” ADF legal papers say.

“Moreover, that Regulation has helped empower Defendant HHS’ Office of Civil Rights to actually and presently be investigating that violation on her behalf, explicitly telling Mrs. DeCarlo that the investigation is being pursued at least in part under the Implementing Regulation.

Yet in this case, Plaintiffs seek to invalidate that Regulation and Defendants have worked with Plaintiffs to stay the case based on their intent to rescind the Regulation,” the papers add.

ADF attorneys, working together with the Christian Legal Society’s Center for Law and Religious Freedom, are simultaneously attempting to intervene in the Connecticut case on behalf of several pro-life medical associations.

The judge cleared the motions from his calendar for now but determined that they can be considered once the case, which is currently on hold, moves forward.

Although federal law has long forbidden discrimination against health care professionals who refuse to perform abortions or provide referrals for them, the regulation required institutions that get federal funding to certify their compliance with laws protecting conscience rights.

It also promoted education within the medical community regarding their rights and provided an avenue of recourse in the event of discrimination through the Office of Civil Rights within HHS.

At the end of February, the Obama administration announced it began “reviewing” the regulations implementing conscience laws, the first step toward rescinding the rule altogether.

In 2009, Obama told students at Notre Dame he wanted to find common ground on abortion and used the conscience clause as an example. but he came under criticism from pro-life lawmakers who said he was working to remove the protections.

Now, it’s clear that the President was either being less than truthful or has changed his mind. I doubt the latter.

Surgeon general issues new tobacco warnings

Congrats to the new Surgeon General, for taking an even stronger stand on tobacco in her recent report, “How Tobacco Smoke Causes Disease.: The Los Angeles Times and Orlando Sentinel write that the report has found that “ANY exposure” to tobacco smoke can cause immediate damage to the human body.

“There is NO safe level of exposure to cigarette smoke,” Surgeon General Regina Benjamin said.

“Inhaling even the SMALLEST amount of tobacco smoke can also damage your DNA, which can lead to cancer.”

The report also finds almost NO difference between being a light smoker and a heavy smoker.

“That’s because of the inflammatory processes occur at very, very low doses,” said cardiologist Dr. Stanton Glantz.

The AP notes that the report “is the 30th issued by the nation’s surgeons general to warn the public about tobacco’s risks,” but “is unusual because it devotes more than 700 pages to detail the biology of how cigarette smoke accomplishes its dirty deeds — including the latest genetic findings to help explain why some people become more addicted than others, and why some smokers develop tobacco-caused disease faster than others.”

CNN says that the report “links smoking directly to 13 different cancers including esophagus, trachea, stomach, pancreas, kidney, bladder, cervix and acute myeloid leukemia.”

It also “ties smoking to more than a dozen chronic diseases like stroke, blindness, periodontitis, heart disease, pneumonia; reproductive problems like diminishing fertility; chronic obstructive pulmonary disease (COPD), asthma and other respiratory illnesses.”

The Washington Post “Checkup” blog reports that Matthew L. Myers, president of the Campaign for Tobacco-Free Kids, called the report “a stark reminder of how lethal and addictive smoking truly is.”

As Healthcare Reform Takes Hold, 74% of Physicians Will Retire or Seek Other Alternatives

Healthcare reform, should it survive legal challenge, repeal, and/or non-funding, will usher in a new era of medicine in which physicians will, according to a report in Modern Medicine, “largely cease to operate as full-time, independent, private practitioners accepting third party payments. Instead, they will work as employees, as part-timers, as administrators, in cash-only ‘concierge’ practices, or they will walk away from medicine altogether.” Here are the details from Modern Medicine:

These are some of the findings of a new report commissioned by The Physicians Foundation entitled “Health Reform and the Decline of Physician Private Practice”.

The report outlines provisions in the Patient Protection and Affordable Care Act (aka “Obamacare”) and examines economic, demographic, and other forces impacting the way doctors structure their practices and deliver care.

The report offers a road map for where medical practice is headed in the post-reform era, says Lou Goodman, PhD, president of The Physicians Foundation and chief executive officer of the Texas Medical Association.

Concern about patient care

“The private practice physician is rapidly disappearing,” Goodman notes. “Both market forces and the health care reform law are forcing physicians to find new ways of running a practice. We are extremely concerned about how this will affect patient care.”

Drawing on the perspective of a panel of healthcare experts and executives, the report projects physicians will follow one of four courses:

  • Work as employees of increasingly larger medical groups or hospital systems
  • Establish cash-only practices that eliminate third party payers
  • Reduce their clinical roles by working part-time
  • Opt out of medicine altogether by accepting non-clinical positions or by retiring.

Survey results in agreement

The projections are backed by results of a national physician survey included in the report.

Of some 2,400 physicians responding, only 26 percent said they would continue practicing the way they are in the next one to three years. The remaining 74 percent said they would:

  • retire,
  • work part-time,
  • close their practices to new patients,
  • become employed and/or
  • seek non-clinical jobs.

Based on the survey and other data, the white paper projects health reform will worsen the ongoing physician shortage and make it harder for many patients to access a physician.

In order to illustrate medical practice trends, the report includes case studies of medical practice models likely to proliferate post-reform, including studies of a medical home, an accountable care organization, a concierge practice, a community health center, and a small, hospital-aligned practice.

All-in-all, if this survey is accurate, the evolution of healthcare reform should be very interesting.

My Take on the new Vitamin D and Calcium Recommendations

You’re likely hearing a fair bit of controversy over the Institute of Medicine’s (IOM’s) new recommendations (RDA) for vitamin D and calcium. I first reported on this in my blog, “Institute of Medicine says megadoses of vitamin D, calcium unnecessary.”

The IOM calls for MORE vitamin D and LESS calcium … but many experts say the vitamin D doses are still not high enough.

Vitamin D

The new RDA is:

  • 400 IU for infants,
  • 600 IU for ages 1 to 70, and
  • 800 IU for over 70.

But these RDAs are based ONLY on the amount needed to prevent bone problems, such as rickets, osteomalacia, osteopenia, osteoporosis, and fractures.

Higher amounts of vitamin D are associated with a lower risk of falls, cancer, heart disease, autoimmune disorders, etc. But the RDA is not set higher because the IOM feels there’s not sufficient proof of these benefits.

The experts at Prescriber’s Letter (PL)are telling healthcare professionals, “Recommend 400 IU for infants, 600 IU for kids, and 800 to 2000 IU for adults. The higher adult dose is safe and may provide extra benefits.” I’m with Prescriber’s Letter on this one. I concur with the new guidelines from Osteoporosis Canada recommending 1000 IU/day for adults under age of 50 and 2000 IU/day for adults over 50.

PL goes on to say, “Discourage adults from taking over 4000 IU/day without monitoring. Consider vitamin D testing for people likely to be deficient due to advanced age … dark skin … limited sun … malabsorption … etc.”

As I’ve told you before (Vitamin D Supplementation and Cancer Prevention):  I check a vitamin D level as part of my annual exam. I do this on all adolescents and adults. If the vitamin D level is below 30, I suggest supplementing with vitamin D and rechecking.”

I give my patients two options:

  • OTC vitamin D, 2000 IU per day, and recheck the level in 4-6 months, or
  • Prescription vitamin D, 50,000 IU per week for 12 weeks and then recheck the level.
I check a vitamin D level as part of my annual exam. I do this on all adolescents and adults.
If the vitamin D level is below 50, I suggest supplementing with vitamin D and rechecking.
I give my patients two options:
OTC vitamin D, 2000 IU per day, and recheck the level in 4-6 months, or
Prescription vitamin D, 50,000 IU per week for 12 weeks and then recheck the level.

PL recommends, “Aim for a serum 25-hydroxyvitamin D level above 20 ng/mL for bone health … but below 60 ng/mL until more is known about the long-term safety of higher levels.” In my practice, we’re aiming for levels of 30 to 50 ng/mL.

Calcium

The new RDA for elemental calcium is:

  • 1300 mg for adolescents,
  • 1000 mg for women up to 50 and men up to 70, and
  • 1200 mg for older adults.

PL says, “Advise people not to get carried away with calcium supplements. Recommend not going over 2000 mg/day from food AND supplements for adults over 50. Too much calcium FROM SUPPLEMENTS might increase the risk of kidney stones and POSSIBLY heart attacks.

You can read more in my blog, “Can Calcium Supplements Cause Heart Attacks?

Institute of Medicine says megadoses of vitamin D, calcium unnecessary

In a front-page article, the New York Times says, “The very high levels of vitamin D and calcium that are often recommended by doctors and testing laboratories – and can be achieved only by taking supplements – are unnecessary and could be harmful, an expert committee says” in a low-awaited report.

The “group said most people have adequate amounts of vitamin D in their blood supplied by their diets and natural sources like sunshine.” Dr. Clifford J. Rosen, “a member of the panel and an osteoporosis expert at the Maine Medical Center Research Institute,” said, “For most people, taking extra calcium and vitamin D supplements is not indicated.”

The AP reports, “Long-awaited new dietary guidelines say there’s no proof that megadoses prevent cancer or other ailments – sure to frustrate backers of the so-called sunshine vitamin.”

This “decision by the prestigious Institute of Medicine, the health arm of the National Academy of Sciences, could put some brakes on the nation’s vitamin D craze, warning that super-high levels could be risky.”

Notably, “a National Cancer Institute study last summer was the latest to report no cancer protection from vitamin D and the possibility of an increased risk of pancreatic cancer in people with the very highest D levels. Super-high doses – above 10,000 IUs a day – are known to cause kidney damage, and the report sets 4,000 IUs as an upper daily limit – but not the amount people should strive for.”

According to a report in the Wall Street Journal, the committee members disagreed with previous findings that Americans and Canadians do not consume sufficient vitamin D, and instead suggested that a blood level of 20 nanograms/ml was adequate.

This suggestion contradicts groups such as the Endocrine Society and the International Osteoporsis Foundation, which have recommended 30 ng/ml for good bone health — and is what I recommend for my patients.

Meanwhile, the NIH has begun to recruit participants for a large study that will compare the impact on health of vitamin D and omega-3 fatty acids derived from fish oil.

USA Today reports, “According to the report, children and adults younger than 71 need no more than 600 international units (IUs) of vitamin D a day and should consume 700 to 1,300 milligrams of calcium a day, depending on their age.”

Indeed, the “committee was surprised to see that most Americans are meeting their needs for both of the nutrients, except for adolescent girls who may not be getting enough calcium and some elderly people who don’t get enough of either, says Catharine Ross, professor of nutrition at Pennsylvania State University and chairwoman of the panel that prepared the report.”

Still, Time points out, “Those 71 years or older … may need more vitamin D, up to 800 IU a day, to combat deteriorating bone,” the group said.

Due to “the lack of sufficient data to date, advice on vitamin D up to this point was not considered as a recommended dietary allowance, which is based on stronger scientific evidence, but rather an adequate intake suggestion, and stood at anywhere from 200 IU to 400 IU for adults.”

Notably, the “new recommendations are based on data from more than 1,000 studies, most of which included trials in which volunteers were randomly assigned to receive either vitamin or calcium supplements or a placebo, after which their health outcomes were compared to one another.”

The Washington Post “The Checkup” blog says, “The United States and Canada asked the Institute of Medicine, which is part of the National Academy of Sciences, to update the official vitamin D recommendations for the first time since 1997.”

You read more about my application of this report in my blog, “My Take on the new Vitamin D and Calcium Recommendations.”