Children's Health: Low-income communities more likely to face childhood obesity ♦ Study examines the downside of larger families ♦ Preschoolers who eat their veggies just as likely to eat junk food

Low-income communities more likely to face childhood obesity Race matters less than expected in study showing relationship between poverty and obesity. Although obesity rates were higher among African-American and Hispanic kids, the relationship disappeared when factoring in family income,

Even children with higher IQs behave better when their sleep apnea is fixed Many doctors will ask about quality of sleep when children have problems at school, but new research shows it's just as important to pay attention to how high achievers are sleeping.

Study examines the downside of larger families Large families often capture the public's attention, from 'The Brady Bunch' to '19 Kids and Counting.' But new research by economists offers strong evidence that children in larger families are more likely to fall behind in cognitive achievement and have behavioral and other problems.

Preschoolers who eat their veggies just as likely to eat junk food Public-health experts have long expected that kids who eat more carrots and apples are less likely to eat a lot of candy and fries, but new research is calling that into question.

Children's Health: Maternal chronic stress linked to more dental cavities in children ♦ Childhood kidney stones associated with atherosclerosis. ♦ Benefits of word repetition to infants

Teens with bulimia recover faster when parents are included in treatment Involving parents in the treatment of adolescents with bulimia nervosa is more effective than treating the patient individually.

Maternal chronic stress linked to more dental cavities in children Chronic maternal stress, when measured by biological markers, has been found for the first time to be associated with a higher prevalence of cavities among children Chronic stress was also found to be linked to lower probabilities of breastfeeding and dental visits by children.

Physical activity, sadness, and suicidality in bullied U.S. adolescents Across the U.S., nearly 20% of students report being bullied on school property. Bullying is associated with academic struggle, low self-esteem, anxiety, depression, substance abuse, and self-harm. Exercise has been widely reported to have robust positive effects on mental health including reduction in depression, anxiety, and substance abuse, and now research suggests that exercise for 4 or more days per week is associated with an approximate 23% reduction in both suicidal ideation and attempt in bullied adolescents in the United States.

Childhood kidney stones associated with atherosclerosis. A recent study is the first to examine and identify a link between kidney stones in children and thickened or hardened arteries -- precursors to a wide variety of cardiovascular diseases. Understanding the connection between kidney stones and cardiovascular risk factors in children may help physicians and parents implement prevention measures to reduce future risk of stroke, heart attack or other forms of vascular disease for affected children.

Benefits of word repetition to infants  New research suggests that young infants benefit from hearing words repeated by their parents. With this knowledge, parents may make conscious communication choices that could pay off in their babies' toddler years and beyond

Children's Health: New insights into the male bias of autism ♦ Where do the happiest children live? ♦ Differences in the brains and behavior of girls and boys with autism

Childhood obesity influenced by how kids are fed, not just what they eat As the childhood obesity epidemic increases, researchers are discovering that the way caregivers feed their kids may be just as important as what they give them to eat. A new study reviews how a mother's body mass index (BMI), ethnicity and personal eating habits may influence how she feeds her child.

New insights into the male bias of autism Male toddlers with autism have significant structural differences in their brains compared to females with the condition, according to research. The new work is looking at the links between sex/gender and autism, which reveal additional insights into the role of prenatal sex hormones and the 'female protective effect'

Research finds differences in the brains and behavior of girls and boys with autism Differences in the underlying biology of children's brains and behavior has been identified through a study on a large cohort of preschoolers with autism spectrum disorder. The findings may help explain how the condition affects a little-studied and poorly understood population of children: girls

Where do the happiest children live? Children in European countries tend to report higher levels of satisfaction with their friendships while children in African countries tend to be happier with their school lives. Children in northern European countries are particularly dissatisfied with their appearance and self-confidence. Most of the 50,000 children in the 15 countries rated their satisfaction with life as a whole (on a scale from zero to ten) positively, but the percentage of children with very high well-being (10 out of 10) varied from around 78% in Turkey and 77% in Romania and Colombia to around 40% in South Korea. The percentage with low well-being (less than 5 out of 10) varied from less than 2% in Romania and Colombia to over 7% in South Korea and South Africa

11/25/14 Health News: Drink will reduce your cancer risk ♦ Untapped source of antibiotic drugs ♦ Personalized vaccines ♦ Longer work hours for moms means obesity for preschoolers

This drink will substantially reduce your cancer risk

Attention, ladies: Science says it’s time to put the kettle on. A new study in the American Journal of Clinical Nutrition found that women who consumed the most flavonoids, a type of antioxidant abundant in tea, were significantly less likely to develop endothelial ovarian cancer—the fifth leading cause of cancer death among women.  Continue Reading

Life's extremists may be an untapped source of antibacterial drugs

Life's extremists, a family of microbes called Archaea, may be an untapped source of new antibacterial drugs. That conclusion arises from the discovery of the first antibacterial gene in this ancient lineage  Continue Reading

Possibilities for personalized vaccines

Medical researchers are considering the possibilities for personalized vaccines in all types of cancer. The first vaccine will be prepared from a warehouse of 72 targets previously identified by the researchers as relevant for treatment in glioblastoma Continue Reading

Longer work hours for moms mean less sleep, higher BMIs for preschoolers

A link between moms' employment and overweight/obesity in preschoolers has been found by researchers. The study investigated links between mothers' employment status and their children's weight over time, exploring the impact of potential mediators, such as children's sleep and dietary habits, the amount of time they spent watching TV and family mealtime routines  Continue Reading

Don’t Leave Childhood Depression Untreated

Every psychological disorder, including depression, has some behavioral components.

Depressed children often lack energy and enthusiasm. They become withdrawn, irritable and sulky. They may feel sad, anxious and restless. They may have problems in school, and frequently lose interest in activities they once enjoyed.

Some parents might think that medication is the solution for depression-related problem behaviors. In fact, that’s not the case. The Food and Drug Administration hasn’t approved any drugs solely for the treatment of “behavior problems.” When FDA approves a drug for depression—whether for adults or children—it’s to treat the illness, not the behavior associated with it.

“There are multiple parts to mental illness, and the symptoms are usually what drug companies study and what parents worry about. But it’s rare for us at FDA to target just one part of the illness,” says Mitchell Mathis, M.D., a psychiatrist who is the Director of FDA’s Division of Psychiatry Products.

Depression Is Treatable

The first step to treating depression is to get a professional diagnosis; most children who are moody, grouchy or feel that they are misunderstood are not depressed and don’t need any drugs.

Only about 11 percent of adolescents have a depressive disorder by age 18, according to the National Institute of Mental Health (NIMH). Before puberty, girls and boys have the same incidence of depression. After adolescence, girls are twice as likely to have depression as boys. The trend continues until after menopause. “That’s a clue that depression might be hormonal, but so far, scientists haven’t found out exactly how hormones affect the brain,” says child and adolescent psychiatrist Tiffany R. Farchione, M.D., the Acting Deputy Director of FDA’s Division of Psychiatry Products.

It’s hard to tell if a child is depressed or going through a difficult time because the signs and symptoms of depression change as children grow and their brains develop. Also, it can take time to get a correct diagnosis because doctors might be getting just a snapshot of what’s going on with the young patient.

“In psychiatry, it’s easier to take care of adults because you have a lifetime of patient experience to draw from, and patterns are more obvious” says Mathis. “With kids, you don’t have that information. Because we don’t like to label kids with lifelong disorders, we first look for any other reason for those symptoms. And if we diagnose depression, we assess the severity before treating the patient with medications.”

Getting the Proper Care

The second step is to decide on a treatment course, which depends on the severity of the illness and its impact on the child’s life. Treatments for depression often include psychotherapy and medication. FDA has approved two drugs—fluoxetine (Prozac) and escitalopram (Lexapro)—to treat depression in children. Prozac is approved for ages 8 and older; Lexapro for kids 12 and older.

“We need more pediatric studies because many antidepressants approved for adults have not been proven to work in kids,” Farchione says. “When we find a treatment that has been shown to work in kids, we’re encouraged because that drug can have a big impact on a child who doesn’t have many medication treatment options.”

FDA requires that all antidepressants include a boxed warning about the increased risks of suicidal thinking and behavior in children, adolescents and young adults up to age 24. “All of these medicines work in the brain and the central nervous system, so there are risks. Patients and their doctors have to weigh those risks against the benefits,” Mathis says.

Depression can lead to suicide. Children who take antidepressants might have more suicidal thoughts, which is why the labeling includes a boxed warning on all antidepressants. But the boxed warning does not say not to treat children, just to be aware of, and to monitor them for, signs of suicidality.

“A lot of kids respond very well to drugs. Oftentimes, young people can stop taking the medication after a period of stability, because some of these illnesses are not a chronic disorder like a major depression,” Mathis adds. “There are many things that help young psychiatric patients get better, and drugs are just one of them.”

It’s important that patients and their doctors work together to taper off the medications. Abruptly stopping a treatment without gradually reducing the dose might lead to problems, such as mood disturbance, agitation and irritability.

Depression in children shouldn’t be left untreated. Untreated acute depression may get better on its own, but it relapses and the patient is not cured. Real improvement can take six months or more, and may not be complete without treatment. And the earlier the treatment starts, the better the outcome.

“Kids just don’t have time to leave their depression untreated,” Farchione says. “The social and educational consequences of a lengthy recovery are huge. They could fail a grade. They could lose all of their friends.”

Medications help patients recover sooner and more completely.

Zebrafish Help Finding Possible Cures for Childhood Epilepsy

Study finds zebrafish model may help identify treatments for a severe form of childhood epilepsy. Results of a study in “Nature Communications” suggest that zebrafish carrying a specific mutation may help researchers discover treatments for Dravet syndrome (DS), a severe form of pediatric epilepsy that results in drug-resistant seizures and developmental delays.

Scott C. Baraban, Ph.D., and his colleagues at the University of California, San Francisco (UCSF), carefully assessed whether the mutated zebrafish could serve as a model for DS, and then developed a new screening method to quickly identify potential treatments for DS using these fish. laboratory in 2005.

The researchers found that the zebrafish that were engineered to have a gene mutation that causes DS in humans exhibited some of the same characteristics, such as spontaneous seizures, commonly seen in children with DS. Unprovoked seizure activity in the mutant fish resulted in hyperactivity and whole-body convulsions associated with very fast swimming. These types of behaviors are not seen in normal healthy zebrafish.

“We were also surprised at how similar the mutant zebrafish drug profile was to that of Dravet patients,” said Dr. Baraban. “Antiepileptic drugs shown to have some benefits in patients also exhibited some antiepileptic activity in these mutants. Conversely, many of the antiepileptic drugs that do not reduce seizures in these patients showed no effect in the mutant zebrafish.”

In this study, the researchers developed a fast and automated drug screen to quickly test the effectiveness of various compounds in mutant zebrafish. The researchers tracked behavior and measured brain activity in the mutant zebrafish to determine if the compounds had an impact on seizures.

“The mutants seize often, so it is relatively easy to monitor their seizure behavior at baseline and then again after a drug application,” said Dr. Baraban. “Using zebrafish  we can accurately quantify this seizure behavior. In this way, we can test almost 100 fish at one time and quickly determine whether a drug candidate has any effect on these spontaneous seizures.”

In the first such application of this approach, UCSF researchers screened 320 compounds and found that clemizole was most effective in inhibiting seizure activity. Clemizole is approved by the U.S. Food and Drug Administration and has a safe toxicology profile. “This finding was completely unexpected. Based on what is currently known about clemizole, we did not predict that it would have antiepileptic effects,” said Dr. Baraban.

These findings suggest that mutant zebrafish may serve as a good model of DS and that the drug screen may be effective in quickly identifying novel therapies for epilepsy.

Dr. Baraban also noted that someday these experiments can be “personalized,” by looking at mutated zebrafish that use genetic information from individual patients.

Dr. Fureman noted that these findings not only describe a novel model of Dravet syndrome, but the positive results with an unexpected FDA-approved drug may lead to new therapeutic avenues. “There is more work to be done, but I am very pleased to see these initial results.For more information about Dravet syndrome and epilepsy, please visit:

http://www.ninds.nih.gov/disorders/dravet_syndrome/dravet_syndrome.htm

• http://www.ninds.nih.gov/disorders/epilepsy/epilepsy.htm