The New York Times The prevalence of dangerous strains of the human papillomavirus — the most common sexually transmitted infection in the United States and a principal cause of cervical cancer — has dropped by half among teenage girls in … Continue reading
by MARIA GODOY
Hannah Robertson, 9, and her mom, blogger Kia Robertson — with the makings for kale chips, of course.
Jamie Robertson/Courtesy Jamie Robertson
It’s not everyday that a 9-year-old girl chastises the CEO of one of the world’s biggest fast-food chains.
Yet that’s exactly what young Hannah Robertson did Thursday morning at McDonald’s annual shareholders meeting in Chicago. When the meeting opened up to questions, Hannah was first up at the mic with a pointed criticism.
“It would be nice if you stopped trying to trick kids into wanting to eat your food all the time,” she told McDonald’s CEO Don Thompson.
Hannah, a native of Kelowna, British Columbia, didn’t get to Chicago on her own, of course. She and her mother, Kia Robertson, who blogs about how parents can help kids make healthful food choices, showed up as part of a contingent from the watchdog group Corporate Accountability International.
“We want them to stop their predatory marketing to kids,” says Sriram Madhusoodanan, a national campaign organizer with the group.
Corporate Accountability has been pushing McDonald’s to change its ways for years. Two years ago, it launched a so-far-unsuccessful bid urging McDonald’s to retire Ronald, its famous clown mascot. Its latest social media campaign involves harnessing the power of mpm bloggers like Robertson to tell McDonald’s that they’re “not lovin’” the company’s efforts targeting kids, such as including toys in Happy Meals.
Ironically, as we previously reported on The Salt, mom bloggers are a demographic that McDonald’s actively courted as it revamped its Happy Meals — downsizing french fries and adding apples to every meal — in response to pressure from parents and public health officials.
CEO Thompson pointed to those efforts in defending his company’s marketing practices. “We sell a lot of fruits and veggies and are trying to sell even more,” he said in his reply to Hannah.
But Madhusoodanan wants to see the company do far more. His group put forth a shareholders’ proposal to get McDonald’s to assess its nutritional initiatives and their impact on childhood obesity to prevent eroding sales, in the face of growing public concern about the health impacts of fast food. It failed, attracting just 6.3 percent of shareholders’ votes.
Thompson — who Hannah says called her “brave” in a brief exchange after the meeting — challenged her mother Kia’s assertion that McDonald’s does an end run around parents. “We’re not marketing to schools,” he said point blank. “We don’t do that.”
“We are not the cause of obesity,” Thompson said. “We are not marketing unjustly to kids. Ronald is not a bad guy. … He’s about fun.” (Unless, of course, you’ve got afear of clowns.)
And just as the question period began with a young opponent for Thompson, it wrapped up with another child rushing to the mic in the CEO’s defense.
The young boy listed the many ways he thinks McDonald’s helps kids. He cited theRonald McDonald House Charities and events like McCare Nights, in which McDonald’s donates a portion of sales at a particular franchise to a school it has partnered with. Schools often urge parents and students to eat at McDonald’s on these nights to raise money for school activities. But that sort of soft marketing, says Madhusoodanan, is part of the problem.
“That’s exactly,” he says, “how they build brand loyalty.”
Kids’ Smoking Influences May Change Over Time
Last Updated: April 28, 2013, Doctor’s Lounge
SUNDAY, April 28 (HealthDay News) — Peer pressure to smoke may be more influential for kids in middle school than for older students, a new study reports.
Although their friends’ smoking behavior may hold less sway for teens over time, researchers said parents seem to remain influential over their children’s smoking behavior throughout high school. They suggested that smoking intervention programs focused on peer pressure to smoke would be more effective for students in middle (or junior high) school than high school, and parents could provide another possible anti-smoking strategy.
Based on previous research that looked at social development, “we thought friends would have more influence on cigarette use during high school than junior high school,” study author Yue Liao, a student with the Institute for Health Promotion and Disease Prevention Research at the Keck School of Medicine of the University of Southern California, said in a university news release.
“But what we found was friends have greater influence during junior high school than high school. We think the reason may be that friends’ cigarette use behavior may have a stronger influence on youth who start smoking at a younger age,” Liao continued. “During high school, cigarette use might represent the maintenance of behavior rather than a result of peer influence.”
For the study, the researchers examined information on about 1,000 teens involved in the Midwestern Prevention Project, the longest-running substance use prevention, randomized controlled trial in the United States. Randomized controlled studies are considered the gold-standard for research.
The students were first questioned in the seventh grade when they were 11 years old. They were reassessed after six months, and then once every year until they were in the 12th grade.
The participants were asked how many of their close friends and parents (or two important adults in their lives) smoked cigarettes. The students were also asked how many cigarettes they had smoked in the past month. Over the course of the study, the influence of the students’ friends and parents was analyzed to determine if it changed as the students got older.
The investigators found that kids’ smoking behavior is significantly affected by the habits of their peers and their parents in both middle school and high school. The influence of friends, however, is stronger in middle school. Although parents’ influence started to decrease in the final two years of high school, it did not change between middle school and high school.
Among students in grades 9 and 10, girls were more affected by their friends’ smoking behavior than boys, the researchers noted. As they advanced to 10th and 12th grades, however, friends and parents had less influence on girls. Meanwhile, boys at this age were increasingly swayed by their friends’ smoking habits.
“Boys tend to foster friendship by engaging in shared behaviors, whereas girls are more focused on emotional sharing,” Liao explained. “So, it is possible that boys are adopting their friends’ risky behaviors, like smoking, as the groups grow together over time.”
The study authors concluded their findings could aid in the development of teen anti-smoking programs.
“We observed a big dip in friends’ effect on smoking behavior from eighth to ninth grade. Thus, the first year of high school represents an opportunity for interventions to counteract peer influence and to continue to target parents as their behavior remains influential through the end of high school,” Liao said in the news release. “In addition, teaching students refusal skills during junior high school could be effective in decreasing cigarette use at the beginning of high school. Programs could also promote positive parenting skills to protect children from deviant peer influence.”
The researchers noted that more research is needed to explore the influence of siblings on teen smoking.
The study was published in the April 12 issue of the Journal of Adolescent Health.
The U.S. Centers for Disease Control and Prevention has more about teen smoking.
SOURCE: University of Southern California, news release, April 12, 2013
By Diana Simeon
It’s that time of year again: daylight savings, when we turn the clocks forward and, ugh, lose an hour of sleep.
Already wondering how it’s going to go on Monday morning when your teenager’s alarm goes off? Probably not so great, says Sasha Carr, Ph.D., a certified sleep consultant with the Family Sleep Institute and founder of Off to Dreamland.
“If you have a teenager, you should be concerned,” explains Carr. “It’s going to be rough on them on Monday morning to get up for school.”
Carr has some suggestions for making the transition easier. These include:
- Turn your clocks forward early on Friday evening, not late Saturday when you’re headed to bed. Yep, you read that correctly. By changing your household routine two days early, your teenager will have time to adjust to daylight savings over the weekend, making Monday morning all the easier. “Start daylight savings as of dinner on Friday. That gives that cushion of the weekend. It also helps that on Saturday and Sunday morning, your teenager doesn’t have to get up for school.”
Or, if you’d rather ease into it, you can move your clocks forward a half hour on Friday and then another half hour on Saturday, adds Carr.
- Don’t let your teenager sleep in. Teenagers are biologically designed to want to go to bed later at night and sleep later in the morning than children and adults. But this weekend in particular, says Carr, parents should get their teenagers up at a reasonable hour. “When a teenager sleeps super late on Saturday or Sunday morning and then has trouble getting up on Monday morning, that’s called weekend jetlag,” explains Carr. “I would suggest, especially this weekend, trying to get them up around 8 a.m.”
- Turn off computers, phones and any other devices, even the television, for 30 minutes before bedtime. “Staring at a screen does a number on melatonin, which is the most important sleep hormone we have,” explains Carr. “It’s been shown that just looking at a screen for even 10 seconds in the half hour before you’re trying to go to sleep will affect the secretion of melatonin in the brain … it’s like turning all the lights on in your house.”
The good news, says Carr, is that within a few days, your teenager should have made up for whatever sleep deficit daylight savings causes.
But in the meantime, anticipate some grumpiness.
“Unfortunately, I would put teenagers in the group that has the hardest time with daylight savings,” says Carr. “But they eventually make up for it because they’ll start to go to bed earlier once they make the adjustment.”
Daylight savings starts at 2 a.m. on Sunday, March 10.
Physically active children generally report happier moods and fewer symptoms of depression than children who are less active. Now researchers may have found a reason: by one measure, exercise seems to help children cope with stress.
Finnish researchers had 258 children wear accelerometers on their wrists for at least four days that registered the quality and quantity of their physical activity. Their parents used cotton swabs to take saliva samples at various times throughout a single day, which the researchers used to assess levels of cortisol, a hormone typically induced by physical or mental stress.
There was no difference in the cortisol levels at home between children who were active and those who were less active. But when the researchers gave the children a standard psychosocial stress test at a clinic involving arithmetic and storytelling challenges, they found that those who had not engaged in physical activity had raised cortisol levels. The children who had moderate or vigorous physical activity showed relatively no rise in cortisol levels.
Those results indicate a more positive physiological response to stress by children who were more active, the researchers said in a study that was published this week in The Journal of Clinical Endocrinology and Metabolism. The children who were least active had the highest levels.
“This study shows that children who are more active throughout their day have a better hormonal response to an acute stressful situation,” said Disa Hatfield, an assistant professor of kinesiology at the University of Rhode Island, who was not involved in the study.
Dr. Hatfield noted that the study did not control for sugar intake, which has also been associated with higher levels of cortisol. And as the researchers themselves noted, the wrist-born accelerometers could not accurately measure certain activities like bicycling or swimming.
Michael F. Bergeron, a professor of pediatrics at the University of South Dakota and executive director of the National Youth Sports Health and Safety Institute, cautioned that chronic levels of cortisol might be a better measurement of a child’s propensity toward stress, rather than the single-day measurements taken in the new study.
“A single response to a single stressor may be what the body needs to do, and that’s not necessarily a bad thing,” he said.
Although elementary schools in the last decade have generally been supportive of physical education, only 29 percent of high school students meet the national guideline of 60 minutes a day, said Russell R. Pate, a professor of exercise science at the University of South Carolina, who has worked on national studies of fitness levels in students.
“It’s not a huge surprise that kids who are encouraged to be more active would be more relaxed,” he said.
In a school, a child who gets more activity on a daily basis, Dr. Hatfield said, will respond better to everyday stressors like tests and social challenges. “The study suggests the physiological reason: it may be because their hormonal response is different,” she said.
Safety Becomes a Concern With High-Caffeine Drinks
Red Bull is among the popular brands of high-caffeine energy drinks.
By BARRY MEIER
Published: October 23, 2012 79 Comments
Among the latest entrants in the energy industry’s caffeine race is a pocket-size squeeze bottle called Mio Energy.
MIO ENERGY, via PR Newswire
Each serving of MioEnergy, an additive sold by Kraft Foods, contains 60 milligrams of caffeine, as much as is in a six-ounce cup of coffee.
Tony Cenicola/The New York Times
By year’s end, Canada will cap caffeine levels in products like Rockstar.
Each half-teaspoon serving of Mio, which is sold by Kraft Foods, releases 60 milligrams of caffeine in a beverage, the amount in a six-ounce cup of coffee, the company says. But one size of the bottle, which users can repeatedly squeeze, contains 18 servings, or 1,060 milligrams, of caffeine — more than enough, health specialists say, to sicken children and some adults, and even send some of them to the hospital.
Several countries are reining in sales of energy drinks, pointing to the risks of excessive caffeine consumption by teenagers and even some adults. By year’s end, Canada will cap caffeine levels in products like Monster Energy, Red Bull and Rockstar. Also countries like Mexico, France and India have or are considering steps including taxing the drinks more heavily to discourage their use.
As consumption of energy drinks soars in the United States, some members of Congress have called for a review of the industry, and the New York State attorney general is investigating the practices of several producers. However, critics say the Food and Drug Administration has allowed the drinks to languish in a regulatory gray area and does not require companies to disclose how much caffeine their products contain.
“Their approach has been laissez-faire,” said Dr. Bruce A. Goldberger, a toxicologist at the University of Florida in Gainesville, who has been an industry critic. “The question is, what is it going to take to cause them to take action?”
F.D.A. officials say they lack sufficient evidence to act on caffeine levels in energy drinks, but continue to study the issue. Also, producers can market an energy drink as either a beverage or a dietary supplement, differing regulatory categories with different labeling and ingredient rules.
“We don’t have energy drinks defined by any regulation,” said Daniel Fabricant, the director of the F.D.A.’s dietary supplement division. “It is a marketing term.”
Agency officials, however, may soon face more pressure to regulate the products after the disclosure Monday that the agency had received reports of five deaths since 2009 that could be linked to Monster Energy, a top-seller. The drink’s manufacturer, Monster Beverage, disputed any suggestion that its products are unsafe.
The fatalities are also raising broader questions about whether companies monitor reports of deaths and serious injuries that may be tied to their products. A spokeswoman for Monster Beverage said Monday that the company was unaware of four of the five deaths reported to the F.D.A., even though such incident reports were part of an agency database.
The mother of a 14-year-old Maryland girl who died last December from a heart arrhythmia after drinking two large cans of Monster Energy in 24 hours obtained the records by requesting them under the Freedom of Information Act. Last week, she filed a lawsuit against Monster Beverage, a publicly traded company based in Corona, Calif., seeking unspecified damages.
Under the new Canadian rules, the big, 24-ounce size of Monster Energy that the Maryland teenager, Anais Fournier, drank will be banned because it contains 240 milligrams of caffeine, 60 milligrams more than the limit set by the new standards. Companies there will also track the types of consumers using their products and compile data about any health problems linked to them.
In the United States, a report last year by the federal Substance Abuse and Mental Health Services Administration found that the annual number of emergency room visits in this country linked to energy drinks rose to over 12,000 in 2009, the latest year for which data is available. The figure represents a tenfold jump from the number of such visits reported in 2005.
The caffeine used in the beverages, which are also high in sugar, can come from a variety of sources, like synthetic caffeine, the guarana plant and tea extracts. Producers can mask the caffeine levels by including it among other ingredients as part of a drink’s “energy blend.”
The issue of how, or whether, to restrict levels of caffeine in energy drinks sold here is being raised as a seismic shift is occurring in beverage consumption. In some stores, sales of energy drinks now outpace those of sodas.
Overall, sales of energy drinks in the United States grew an estimated 16 percent last year to $8.9 billion, a record level, according to Beverage Digest, a trade publication.
Even industry critics acknowledge that the boom represents a triumph of sleek packaging and promotion that centers on advertising the drinks to young people with appealing images and claims. While many 16-ounce energy drinks sell for $2.99 a can, over-the-counter drugs like NoDoz that contain about the same amount of caffeine cost about 30 cents a tablet.
On a company Web site promoting Mio Energy, Kraft says that the black cherry flavor of the additive is “so wild it could get you arrested on a plane, but it’s worth the lawyer fees.” The bottle’s label notes on the side that it is “not for children,” a category that the beverage industry usually defines as those under 12.
Medical specialists say that healthy adults can safely consume 400 milligrams or more of caffeine daily. The drug, which acts as a stimulant, also provides benefits, like increased alertness.
Far less is known, however, about the impact of high caffeine use on teenagers, and specialists say the drug can pose dangers to those with undiagnosed health conditions like heart problems.
Roland Griffiths, a caffeine specialist at Johns Hopkins University and an industry critic, said that high caffeine use by young people can cause a cycle of rushes and crashes that can add “a degree of variance to their moods and psychological well-being that they don’t really need.”
Officials in Canada said they decided to take a uniform regulatory approach to energy drinks since they are sold alongside beverages. “If it looks like a duck and quacks like a duck, it ought to be regulated like a duck,” said Anatole Papadopoulos, an official of Health Canada, that country’s counterpart to the F.D.A.
The new Canadian rules do not affect small energy “shots” like 5-hour Energy, a top-selling brand. But the rules cap the level of caffeine in cans of energy drinks at 180 milligrams. Along with the 24-ounce can of Monster Energy, other products like the 20-ounce Red Bull, popular in the United States, would run afoul of the rules.
The Canadian action is a step back from the recommendations of a scientific panel there, which urged that, among other things, energy drinks be labeled “stimulant drug containing drinks.” Still, the move may also create a public relations conundrum for the industry.
While the Canadian Beverage Association, which represents energy drink makers like Coca-Cola and PepsiCo, has endorsed the new rules there, , a sister trade group here, the American Beverage Association, that represents many of the same companies, said through a spokeswoman it will fight caffeine caps in this country.
Wendy Crossland, the mother of the 14-year-old girl who died in Maryland, said that the F.D.A. needs to require energy drink producers to disclose how much caffeine the beverages contain.
In Canada, the death in 2008 of Brian Shepard, 15, of an irregular heartbeat after drinking a can of Red Bull, helped spur calls for regulations. His father, James Shepard, said he could not believe that nothing was being done in America.
“In the States, the amount of caffeine in some of those cans is huge, and you are drawing kids to it,” said Mr. Shepard, an automobile mechanic in Toronto. “It is disgusting.”
Preventing Sports Concussions Among Children
The New York Times
By ROBERT C. CANTU
Published: October 6, 2012
This fall, about three million children younger than 14 are playing organized tackle football in the United States. Is that a good thing?
For many parents and coaches, that means three million children are getting some pretty serious exercise, hanging out with old friends and making new ones, and unplugging from technology, for a few hours at least.
I see those positives. Yet if it were my call, those millions would be playing touch football instead. Many would be learning the fundamentals of tackling and other football skills. But they would not be playing tackle football until they turned 14.
The reason is simple. Tackle football is too dangerous for youngsters. Exposure to head trauma is too risky. What we know about football and the vulnerabilities of children’s brains leads me to this conclusion. More worrisome is what we don’t know. How will the hits absorbed by a 9-year-old today be felt at 30, or 50?
I’ve been treating young athletes for concussions and other head trauma for four decades. In an average year, I’ll meet with patients to discuss their concussion symptoms 1,500 times or more. I’ve treated children for concussions in any sport you can name, and a few you wouldn’t think of. I’ve seen pole-vaulters, BMX riders and tennis players. Not that long ago, I treated a young man injured playing Ultimate Frisbee.
I’m not in favor of abolishing any sport for children, football included. Sports have too much to offer young people. There is nothing like being part of a Little League team or competing as a swimmer, tennis player or golfer to promote perseverance, sportsmanship, fair play, to keep fighting until the last point in the match or the last out. These are traits that carry us through life’s challenges.
In light of what we now know about concussions and the brains of children, though, many sports should be fine-tuned. But many parents and coaches are satisfied with the rules as they are. They like seeing youngsters in helmets and pads, and watching them slide headfirst into second base. The closer the peewee games resemble those of the professionals, the happier we are. It’s natural for a parent or a coach. Even a neurosurgeon.
But children are not adults. Their bodies are still maturing. Their vulnerabilities to head trauma are far greater.
A child’s brain and head are disproportionately large for the rest of the body, especially through the first five to eight years of life. And a child’s weak neck cannot brace for a hit the way an adult’s can. (Think of a bobblehead doll.) A child’s cranium at 4 is about 90 percent the size an adult’s. That’s important to a discussion of concussions and concussion risk.
We cannot eliminate head trauma from youth sports. What we can change is our mind-set so protecting the head and the brain is always a top consideration.
The guiding principle should be that no head trauma is good head trauma. Let’s re-examine youth sports and take steps to keep young athletes safe. I would like to see these changes written into the rules across the country.
SOCCER Many parents and coaches are surprised to learn that soccer is not among the safer sports for head trauma. It is actually one of the riskiest. In 2010, more high school soccer players sustained concussions than did athletes in basketball, baseball, wrestling and softball combined, according to the Center for Injury Research and Policy in Columbus, Ohio.
Most of that risk comes from one play: heading the ball. When two or more leap to direct the ball with their heads, a number of collisions can occur with heads, shoulders and elbows. From a neurological standpoint, nearly all are bad. About 90 percent of the patients I see with soccer head trauma and concussion are related to heading accidents.
It’s an easy call for me: take heading out of soccer until the players are 14.
ICE HOCKEY The progressive leadership of USA Hockey and Hockey Canada have done most of the heavy lifting in this sport. Hockey Canada outlawed checking to the head throughout amateur hockey. In 2011, USA Hockey approved a ban on body checking before the age of 13. I would extend the ban on body checking to 14. (The previous rule permitted body checking for players as young as 11.)
BASEBALL AND SOFTBALL Batting helmets are mandatory at every level of baseball, yet it’s surprising how little we do to ensure that they stay on. Some youth leagues around the country have mandated chin straps for years. All youth and high school leagues should require them.
In addition, headfirst slides should be eliminated. When a child’s head plows into an ankle or a shin, the leg always wins. Worse are home-plate collisions in which the head of the base runner can crash into the catcher’s hard shinguards.
FIELD HOCKEY AND GIRLS’ LACROSSE
I have heard that girls would be emboldened to play more aggressively if helmets were required in these sports, and that the net effect would be more injuries, not fewer. I say hold officials accountable for enforcing the rules, and that will not happen.
In lacrosse, some officials now favor something like a bike helmet to protect the top of the head. That is not good enough. When helmets that cover the entire head are required, fewer young women will sustain concussions.
Field hockey rules state that players should not raise their sticks above the knee. But that rule is broken in every game, often resulting in concussions, eye injuries, cuts, broken noses and more. Helmets are needed, although they do not have to be as robust as football helmets.
]I would expect resistance to these recommendations from parents of the 16,000 players in Pop Warner football’s tackle division for 5- to 7-year-olds, for example. But let’s begin the debate.
Robert C. Cantu, a clinical professor in the department of neurosurgery and a co-director of the Center for the Study of Traumatic Encephalopathy at the Boston University School of Medicine, is a co-author with Mark Hyman of the new book “Concussions and Our Kids.”