Junk food linked to asthma and eczema in children

Asthma is a complex chronic medical condition with many genetic and environmental contributors.  Although food exposure does not suggest cause, research like this is certainly relevant and deserves attention.  Dr. Susarla

The high saturated fat levels in food such as burgers lower children's immune systems, it is believed.

A research project involving more than 50 countries found that teenagers who ate junk food three times a week or more were 39 per cent more likely to get severe asthma. Younger children were 27 per cent more at risk.

Both were also more prone to the eye condition rhinoconjunctivitis, according to The Sun newspaper

But just three weekly portions of fruit and vegetables could cut that risk by 14 per cent in the younger group and 11 per cent among the teens, it is believed.

Researchers from New Zealand's Auckland University looked at the diets of 181,000 youngsters aged six to seven and 319,000 aged 13-14.

The scientists then asked if the children had allergy symptoms.

They wrote in the journal Thorax, where the study is published: "Fast food may be contributing to increasing asthma, rhinoconjunctivitis and eczema.

"Regular consumption of fruit and vegetables is likely to protect against these diseases."

In the UK alone 1.1 million children already suffer with asthma and one in five get eczema.

The team of researchers warn that their results do not prove cause and effect.

Read article here.

Yes this does seem... fishy.  There could be other reasons to explain this association.  We will have to wait and see.  Dr Susarla.

Does Eating Fish During Infancy Cut Asthma Risk?

FRIDAY, Nov. 16 (HealthDay News) -- Adding fish to babies' diets during the first year of life might reduce their risk of asthma later on, a study by Dutch researchers suggests.

This window of protection appears to occur between 6 months and 12 months of age. Adding fish to the diet before that or not at all in the first year seems to carry an increased risk of wheezing and shortness of breath, the researchers said.

"This study provides insight into what the optimal timing of introduction can be for fish," said lead study author Jessica Kiefte-de Jong, from the pediatrics and epidemiology departments at Erasmus Medical Center in Rotterdam.

[See: Top Recommended Infant Formulas]

"The results may assist health care workers about the recommendations regarding the introduction of complementary feeding in infants," she added.

Pediatricians may not agree with the findings, however. One expert objects to feeding children fish at such a young age because of potential harms.

"I have never heard that fish is a preventive against asthma," said Dr. Antonio Rodriguez, director of pediatric pulmonology at Miami Children's Hospital.

"There is a danger of an allergic reaction feeding fish to children under 1 year of age," he said. "In addition, there is always concern about the toxicity of mercury in fish."

This is why fish is not fed to infants, he said.

Kiefte-de Jong agreed that before parents start introducing fish to their infants these findings need confirmation in a real clinical trial. She also said the researchers aren't quite sure why eating fish at this age might benefit children's lung health.

[See: Top Recommended Children's Multivitamins]

For the study, published online Nov. 12 in the journal Pediatrics, the research team collected data from a population-based study of more than 7,200 children born between April 2002 and January 2006 in Rotterdam.

Reviewing questionnaires on overall diet, the researchers looked at when parents introduced fish to their infants' diets. They also looked at symptoms of asthma that developed at ages 3 and 4 years.

Children who started eating fish at 6 to 12 months had a significantly lower risk of wheezing when they were 4 years old compared with children who began eating fish later, Kiefte-de Jong's group found.

For children who started eating fish earlier -- or not at all -- within the first year, the risk for wheezing increased at 4 years, they noted. The risk of shortness of breath increased slightly as well.

The researchers acknowledged that other factors besides when the children started eating fish might have influenced the children's breathing ability at preschool age. And the study did not prove that the introduction of fish during the first year of life prevented asthma later on.

Read article here.

Smokers' Kids Don't Get a Break in Cars

The conventional wisdom is probably not enough.  A home smoke-free policy is important, but it is not enough if cigarette smoke exposure occurs in other places, like the car.  Children with asthma and recurrent respiratory infections are especially susceptible.  Dr. Susarla

Smokers' Kids Don't Get a Break in Cars

Most parents who smoke don't make strong efforts to protect their kids from it in the car, a trial-based survey showed.

Less than a third reported having a policy of keeping the car smoke-free, said Jonathan Winickoff, MD, MPH, of Massachusetts General Hospital for Children in Boston, and colleagues.

Nearly half of those who had no such policy said they smoked with their child in the car, the group reported in the December issue ofPediatrics.

While there is "no safe level of exposure" to tobacco smoke, secondhand smoke inside a vehicle is especially problematic.

"Studies have shown that smoking one cigarette in a confined space such as inside a car creates unsafe levels of respiratory suspended particles," Winickoff's group pointed out.

Rolling the window down doesn't help much. One experiment showed that air quality was still as bad as in a smoky bar, and that residual toxins remain on surfaces in the car even when a cigarette isn't actively lit.

Aside from raising their risk of cancer, exposure contributes to children's risk of lower respiratory infections, sudden infant death syndrome, and ear infections as well as worsening asthma.

The researchers examined exit interviews with smokers who served as controls as part of the larger Clinical Effort Against Secondhand Smoke Exposure, a pediatric office-based intervention trial.

Among the 795 parents with a car who were interviewed, 73% said they or someone else had smoked in the car in the prior 3 months. The researchers reported that of the 562 parents who did not have a smoke-free car policy, 48% smoked in the car when their children were present.

Fewer than one in three parents (29%) reported having a smoke-free car policy. Only 24% reported having a strictly enforced (no tobacco in the prior 3 months) smoke-free car policy.

By comparison, 57% of the parents reported having a strictly enforced policy of no smoking in the home.

Smoke-free cars tended to go along with smoke-free homes, as 82% of smokers with a strictly-enforced car policy stuck to such a strategy at home too.

However, the association didn't go the other direction. Most parents (66%) who kept their kids from being exposed in the home didn't do so for the car, "suggesting that parents may not recognize tobacco smoke exposure in cars as an important exposure source for their children."

Conversations with pediatricians on the topic appeared to be uncommon.

Although about one in five parents reported having been asked about their smoking status, just 14% had been asked about whether smoking was allowed in their vehicle, and 12% were advised to have a policy of no smoking in the car.

After adjustment for other factors, smokers with an infant under 1 year of age were 64% more likely to have a strict no smoking in the car policy.

Lighter smokers (≤10 cigarettes per day) were substantially more likely to forgo smoking in the car, with an adjusted odds ratio of 3.59. However, having more than one smoker in the home lowered the chances of a strictly enforced smoke-free car policy by 44%, with an aOR of 0.56.

"Childhood tobacco smoke exposure in confined spaces should be considered an intervention priority in the pediatric setting because children's exposure to tobacco smoke is involuntary, and no one other than the child's healthcare provider may have the opportunity to advocate for smoke-free cars," the researchers concluded.

They cautioned that the study results were based on self-reporting that may have been subject to recall and response bias and without implying causality.

Read article here.

UK Child Dies From Fatal Asthma Attack

We don't think of asthma as a cause of death in the modern world.  Unfortunately, it still happens even though it is almost always preventable.  Dr. Susarla

MILLOM BOY, 9, DIED FROM BAD ASTHMA ATTACK

A NINE-YEAR-OLD boy died as a result of a serious asthma attack at his Millom home, an inquest heard.

Rylan Cosgrove, who was a Year Five pupil at Black Combe Junior School, died on February 21 this year.

The keen rugby player was taken by ambulance to Furness General Hospital but was already dead upon arrival.

The inquest into his death was told yesterday that he was only diagnosed with asthma in December.

Doctor Mohamed Anass Olabi told the hearing in Barrow Town Hall it was not unusual for children to be diagnosed with the condition a little later, but it was more common to have symptoms such as wheezing in their early years.

The pathologist’s post-mortem report confirmed acute asthma attack as the cause of death.

Dr Olabi said the report revealed no infection was found, but one of Rylan’s lungs was very full of mucus.

Dr Olabi said: “It’s prevented the lungs from functioning and this has caused him to have shortness of breath and not much oxygen going through the system and then he collapsed.

“I think the likelihood of what caused his sad death is lack of oxygen, which affected his heart and eventually he was not able to cope – this is the most likely.”

Dr Olabi had researched similar cases in children and studied a report, published in March this year, titled Risk Factors for Childhood Asthma Death.

The report looked at children who died of asthma in the UK between 2001 and 2006.

Half of the children who died were labelled as having mild to moderate asthma, and one was not even known to have asthma.

Most were aged 11 to 13.

Dr Olabi said: “There are some factors here that have similarities – had it late, not very unwell, admitted once to hospital, and then sadly have a very bad asthma attack.

“What I’m trying to say is, it is not unheard of.”

In 2009, 12 children aged 14 or under died in the UK from the disease.

Dr Olabi said he did not believe there was anything that could have been done differently to prevent Rylan’s death.

But he added: “It’s a sad case, but it does exist.

“And until we get full education for families and the health care people, we won’t be able to prevent this completely.

“There are 12 cases of asthma deaths in children every year and we still think, of these 12 cases, possibly half of them could be prevented, so lots of hard work needs to be done in that area.”

Mr Ian Smith, South and East Cumbria coroner, recorded a verdict of death by natural causes.

He confirmed a police investigation was carried out, but there was nothing officers were concerned about.

Read article here

Animal Lovers Do Not Despair If You Have Asthma or Allergies

It's overly simplistic if not wrong to say that animals cause or are responsible for poor asthma control in children.  While pet dander may truly exacerbate symptoms in some children, having pets alone does not necessarily increase asthma risk or risk of poor control.  In fact, pets may be helpful.  Dr S

Why Having a Dog Helps Keep Kids Asthma-Free
If you’re a dog person, your kids might be in luck. Research suggests that children who grow up in homes with pets are less likely to develop allergies, and now a recent study by researchers from the University of California, San Francisco, sheds some light on why.

Working with mice, the scientists found that exposure to house dust from homes with a pet appeared to protect the mice against a common virus called respiratory syncytial virus (RSV), which infects the lungs and breathing passages and is a major cause of respiratory illness in young children. (In adults, it usually causes run-of-the-mill cold symptoms.) Severe infections in infancy are linked with an increased risk of developing respiratory problems like asthma later on.

Lead researcher Kei Fujimura and her team looked at three groups of mice. One group was fed house dust from homes with dogs, and then exposed to RSV; a second group was infected with RSV without exposure to dust; and a control group of mice was not exposed to RSV or dust.

The study found that the mice that ingested house dust and were exposed to RSV didn’t develop the telltale symptoms of infection, such as lung inflammation and mucus production — these animals looked just like the controls. The researchers then examined the microbes living in the protected animals’ guts, and found that the types of bacteria they harbored were different and more diverse than the bugs in the RSV-infected animals guts.

What do gut bugs have to do with asthma? Potentially a lot. Researchers are discovering that the microbiome, as it’s known — the vast community of good bacteria and viruses that live in and on the human body, including in the intestines — not only play a vital role in basic bodily functions like digesting food, producing vitamins and fending off infection, but may also contribute to the development of chronic conditions and diseases like obesity, cancer and asthma.

Our bodies begin to acquire these crucial microbes at birth, during our journey through the birth canal. From that point, exposure to everything — from grandparents to pets — influences the makeup of the microbiome. It’s theorized that microbial exposure in infancy, when the immune system is maturing, may help protect children against later allergies and asthma.

In earlier work, Fujimura found that house dust from homes with cats and dogs had significantly different types of bacteria than dust from homes without pets. And previous studies have suggested that early life pet exposure and ownership is associated with reduced risk of asthma. “This led us to speculate that microbes within dog-associated house dust may colonize the GI tract, modulate immune responses and protect the host against an asthmagenic pathogen, RSV,” she said in statement about the study, which was presented at the annual meeting of the American Society for Microbiology in San Francisco.

The findings support the hygiene hypothesis of allergy and asthma development, which posits that exposure to germs in childhood helps strengthen the immune system, reducing the risk of childhood respiratory and allergic diseases. Studies have shown, for instance, that kids who grow up on farms and around livestock are less likely to develop asthma and allergies than those who live in more sterile urban environments.

“Everybody appreciates the fact that we’re all missing something big in asthma,” Dr. Robert Mellins, a pediatric pulmonologist at Columbia University, told ABC News. “People have appreciated that viral infections clearly have an association, and this kind of experiment is interesting because it suggests a mechanism of how that could come about.”

Fujimura concludes that identifying the specific species of microbes and the precise mechanisms that underlie the protective effect of dog-associated house dust could help researchers better understand and treat allergies and asthma.

Read full article here

The Facts About Asthma (in kids)

Parents, please check out my article in this month's issue of Houston Family Magazine in the "Talk to the Doc" section.  It features some fundamentals of childhood asthma I feel every parent should know. Dr S

The Facts About Asthma

by Sarat Susarla, MD

Board Certified in Pediatric Pulmonology, Sleep Medicine, and Pediatrics

Why worry if your child has a cough? Many self-limiting infections can trigger a cough, which will usually resolve within 7-10 days.

But when respiratory symptoms like cough are chronic or become associated with other problems like wheezing and shortness of breath, it’s time to consider asthma.

Asthma is a chronic lung condition associated with inflammation of the airways, making it hard to breathe. It often starts in childhood, although it affects people of all ages.

According to the American Academy of Pediatrics, between 80 and 90 percent of children develop symptoms by age 4 or 5.

And according to a 2010 National Health Interview Survey by the Centers for Disease Control, 7 million U.S. children (10%) aged 17 years and under have asthma.

Asthma seems to be on the rise, although the medical community isn’t sure if this is simply because we’re better at diagnosing the disease or whether it’s due to changes in our environment. Asthma is often confused with infections like bronchitis, which often present in a similar way.

Remarkably, rates of hospitalization and emergency room visits in children have not decreased in the past 10 years, despite the availability of highly effective preventative medication.

Asthma can be difficult to diagnose, especially in children. A combination of symptoms; family history (due to genetic factors); and lung function testing are helpful in reaching a diagnosis.

There is no cure for asthma, but it can be managed with medication.

Read more here

Severe Asthma in Children Linked to Fungus

Many children with poorly controlled asthma are sensitized to commonly occurring fungi.  SS

High Prevalence of Severe Asthma With Fungal Sensitization

ScienceDaily (May 22, 2012) — New research presented at the ATS 2012 International Conference in San Francisco suggests that a significant proportion of children with asthma failing Step 4 or greater therapy may have severe asthma with fungal sensitization (SAFS).

"Accordingly, we prospectively analyzed serum immunoglobulin E (IgE) levels and fungal sensitization patterns in 41 children failing combination asthma therapy. Of these 41 patients, 17 (41.5%) were diagnosed with SAFS.""SAFS is a newly described sub-phenotype of asthma, and its prevalence and clinical characteristics in children are unknown," said Alfin Vicencio, MD, chief of pediatric pulmonology and cystic fibrosis at the Cohen Children's Medical Center in Great Neck, NY, and David Goldman, associate professor of pediatric infectious diseases at the Children's Hospital at Montefiore, Bronx, NY.

Compared with those without SAFS, children with SAFS were older, had higher serum IgE levels, and performed worse on pulmonary function tests. These differences remained significant when children with SAFS were compared to a subset of children without SAFS who were sensitized to non-fungal environmental allergens.

The most commonly implicated organisms were Aspergillus spp (81.2%) and Alternaria spp (68.8%), but numerous other species were represented. More than 65% of children with SAFS exhibited sensitization to more than one fungal species. Airway remodeling and persistent eosinophilia may also be associated with SAFS, although the researchers note that additional studies are required to more clearly characterize these features of the disease.

"Our results suggest that SAFS may account for a significant proportion of severe asthma in our pediatric population," said Dr. Vicencio. "At this point, however, there are still many unanswered questions, including the role of anti-fungal therapy."

"We are actively pursuing new methods to identify fungal organisms in the lower airway, which would enable us to better define treatment protocols," Dr. Vicencio concluded. "In addition, we are hoping to identify genetic risk factors for disease, which could potentially lead to targeted preventive strategies early in life."

Read more here

May is National Asthma Awareness Month

Asthma rates in the United States increased over the past decade to their highest level ever, according to a new government report.

The portion of people in the U.S. with asthma rose from 7.3 percent in 2001 to 8.4 percent in 2010, according to the report from the Centers for Disease Control and Prevention.

That means 25.7 million people had asthma in 2010, including 7 million who were younger than 18.

Over the same period, death rates from the condition dropped 33 percent. For every 10,000 people with asthma, there were 1.4 deaths in 2010, compared with 2.1 deaths in 2001.

The disorder has been linked with poverty, and the new findings showed that 11.2 percent of people living below the poverty level had asthma. However, asthma was also reported by 7.3 percent of those who earn at least twice the poverty level.

The findings also showed 9.2 percent of females had asthma in 2010, whereas the rate among males was 7 percent.

Asthma is a chronic airway disorder that can be triggered by exercise, infections, certain chemicals, airborne irritants such as tobacco smoke, or allergens such as pollen. During an asthma attack, the airway becomes obstructed because of inflammation and constriction of the surrounding muscles. It is not clear how to prevent asthma from developing, and there is no known cure, the CDC says.

The new findings are based on data gathered during the National Health Interview Survey, in which CDC researchers conducted household interviews with a nationally representative sample of participants.

http://www.foxnews.com/health/2012/05/02/asthma-rates-at-highest-level-ever-cdc-says/

Early Detection of Asthma Flare-Ups Reduces Hospitalizations

Early detection leads to prompt treatment of symptoms... which reduces emergency room visits and hospitalizations.  A good line of communication with a pediatric asthma specialist is the key.  S Susarla

Reducing Hospital Admissions for Asthmatics

ScienceDaily (Apr. 4, 2012) — Children with moderate or severe asthma attacks who are treated with systemic corticosteroids during the first 75 minutes of triage in the Emergency Department (ED) were 16% less likely to be admitted to hospital. This highlights the importance of adopting a strategy to rapidly identify and begin treating children with moderate or severe asthma attacks directly after triage, according to a team of investigators working at the Sainte-Justine University Hospital Center (UHC), the University of Montreal, McGill University and the Research Institute of the McGill University Health Centre (RI MUHC).

"We knew that corticosteroids could help avoid hospital admissions and relapses. However, just how delays between ED admission and administration of the treatment impacted outcomes remained unclear," says Dr. Sanjit K. Bhogal, the lead author of a new study published in Annals of Emergency Medicine and graduate of the Department of Epidemiology, Biostatistics and Occupational Health at McGill.

"Our study demonstrates that, to be effective in preventing hospital admission, treatment with corticosteroids should be administered within 75 minutes of triage, regardless of patient age," says the senior author Dr. Francine Ducharme, who supervised the study while she was a McGill and RI MUHC researcher based at the Montreal Children's Hospital.

According to Dr. Ducharme, now pediatrician and researcher at Sainte-Justine UHC, "in fact, the earlier the treatment is given within this time frame, the more effective it is, hence the advantage of starting treatment right after triage. Furthermore, beginning early treatment reduces ED stay by almost 45 minutes for patients who will be discharged from the ED."

The challenge now is to ensure that the severity of the asthma attack is flagged at the triage stage in order to initiate treatment immediately. In fact, it seems that patients who are treated "too late" were due, for the most part, to not been given high triage priorities or to physicians not being able to assess them early enough. ED congestion did not significantly impact on the time frame for administering corticosteroids.

"Given the findings of the study, the need to implement a nursing strategy that involves identifying the severity of the child's condition and beginning treatment as soon as a patient arrives in the ED, seemed obvious," said Dr. Ducharme, who is also clinical epidemiologist at the Sainte-Justine UHC, where the study data were compiled and analyzed. Dr. Ducharme also holds the Academic Chair in Clinical Research and Knowledge Transfer in Childhood Asthma at the Sainte-Justine UHC Research Center and is a full professor in the Faculty of Medicine of the University of Montreal.

The pediatric respiratory assessment measure (PRAM) scale, developed by Dr. Ducharme's team, was used to identify the degree of severity of the asthma attack and to rapidly initiate the severity-specific treatment recommended by asthma guidelines. At the Sainte-Justine UHC, Dr. Ducharme' s team has now develop a teaching module that will allow training of the triage nurses, ED physicians, and respiratory therapists to implement severity-specific guidelines and, whenever possible, to avoid patients being admitted to hospital.

The educational module will be available online by the end of 2012 on the University of Montreal's website. It is eagerly awaited by health institutions in Ontario and Alberta, as well as in several institutions in the US, which have decided to adopt the proposed treatment protocol based on the PRAM scale and who wish to receive training. The tool is an offspring of the integration of research, education and health care. As such, it will make it possible to transfer the knowledge acquired through the study to the EDs around the world, for the direct benefit of patients and their families.

http://www.sciencedaily.com/releases/2012/04/120404101953.htm

Asthma Signs in Early Infancy

Recurrent wheezing in infants should not be ignored.  Here is more evidence that signs of asthma may be present in even very young children and infants.   SS

Lung Function Deficits in Babies May Lead to Future Asthma

Joanna Broder

March 30, 2012 — In the future, scientists may want to explore ways to prevent childhood asthma long before it fully evidences itself, by focusing on neonates and young babies.

New research suggests that lung function deficits related to future asthma may develop before birth, in infanthood, and in early childhood, suggesting that asthma research could target prevention at these times.

Hans Bisgaard, MD, head of the Danish Pediatric Asthma Centre in Copenhagen, Denmark, and colleagues presented the results of their study in an article published online March 29 in the American Journal of Respiratory and Critical Care Medicine. The authors found that children who develop asthma by age 7 years have respiratory problems as infants, including increased bronchial responsiveness and deficits in lung function.

"It seems that lung function changes associated with asthma occur very early in life and maybe even before birth," Dr. Bisgaard, who is also a professor of pediatrics at the University of Copenhagen, said in a news release. "This may explain the lack of effect from early intervention with inhaled corticosteroids and should direct research into the pathogenesis and prevention of asthma towards the earliest phases of life."

The authors of the study, which is the most comprehensive prospective study yet of the association between early childhood asthma and lung function from birth to school age, note that it is unclear which comes first: the development of asthma or the development of deficits in lung function.

"These questions are important for the direction of research into the origins and prevention of asthma," they write. "[S]hould we expect genetic or prenatal programming of the disease; or is there an early window of opportunity to prevent airway remodeling during early symptoms?"

In the study, the researchers analyzed the interaction between asthma and lung function growth from neonatal age to age 7 years in the Copenhagen Prospective Studies on Asthma in Childhood (COPSAC), a prospective clinical study of a birth cohort of 411 children.

"Previous research on the relationship between neonatal lung function and the development of asthma has been conflicting," Dr. Bisgaard said in the news release. "Our study shows that children with asthma by age seven already had significant airflow deficits and increased bronchial responsiveness as neonates. Lung function deficits also progressed throughout childhood in our study, suggesting a potential opportunity for early intervention."

The newborns were enrolled in the first month of life and were assessed at 6-month intervals. Additional visits were arranged when there was an onset of respiratory symptoms.

The diagnosis of asthma was based on daily diary cards and health visits every 6 months during the first 7 years of life.

The researchers analyzed the interaction between asthma and lung function growth from neonatal age to age 7 years by measuring neonatal spirometry and bronchial responsiveness to methacholine through forced flow-volume measurements. They also measured lung function through spirometry when the child turned 7 years old, using a pneumotachograph, which records the rate of airflow to and from the lungs.

The results showed that children with asthma at age 7 years had experienced a significant airflow deficit as newborns (forced expiratory flow rate [FEF]₅₀ reduced by 0.34 Z score by 1 month; P < .03). This deficit worsened significantly through early childhood (FEF₅₀ reduced by 0.82 Z score by age 7 years; P < .0001).

"We found that approximately 40% of the airflow deficit that was associated with asthma in our study was present at birth, while 60% developed through early childhood along with the disease," Dr. Bisgaard said in the news release. "This indicates that both prenatal and early childhood mechanisms are potential intervention targets for the prevention of asthma."

Further results showed that bronchial responsiveness to methacholine, which leads to narrowing of the airways, was also significantly related to the development of asthma. Reactivity of the neonatal airway was a stronger predictor of asthma than neonatal lung function, the research showed.

"This airflow deficit progressed in the first 7 years of life suggesting that disease mechanisms are operating both before and after birth," the authors write.

One limitation is that the study used a homogenous study sample, which might limit the generalizability of results to other populations, according to written materials from the American Thoracic Society.

The Lundbeck Foundation, the Pharmacy Foundation of 1991, the Augustinus Foundation, the Danish Medical Research Council, and the Danish Pediatric Asthma Centre provided the core support for the study. The authors have disclosed no relevant financial relationships.

Am J Respir Crit Care Med. Published online March 29, 2012. Abstract

http://www.medscape.com/viewarticle/761273

Childhood Obesity Linked To Asthma

Obesity has been linked to a number of diseases associated with inflammation.  This large study provides strong evidence that obese children are more likely to have asthma.  SS 

Kaiser Permanente Study Finds Obesity-Asthma Link in Children Varies by Race/Ethnicity

Electronic Health Records Used to Study 681,000 Youth

By Kaiser Permanente

Published: Monday, Feb. 27, 2012 - 6:08 am

PASADENA, Calif., Feb. 27, 2012 -- PASADENA, Calif., Feb. 27, 2012 /PRNewswire/ -- Children and adolescents who are overweight or obese are more likely to have asthma than their healthy weight counterparts, according to a new Kaiser Permanente Southern California study published in the online edition of Obesity. The study, which included more than 681,000 children between ages 6 and 19, found that the association between asthma and body mass index varied by race and ethnicity.

The study found that the association between BMI and asthma was weaker for African Americans, a group that was previously known to have the highest prevalence of asthma, than for youth from other racial and ethnic groups. Researchers found the strongest association between BMI and asthma in Hispanic youth.

"This research contributes to the growing evidence that there is a relationship between childhood obesity and asthma, and suggests that factors related to race and ethnicity, particularly for Hispanic youth, may modify this relationship," said study lead author Mary Helen Black, PhD, of the Kaiser Permanente Southern California Department of Research & Evaluation. "The study's large and diverse population, which is broadly representative of the Southern California region,allowed us to examine a wide range of BMI categories in relation to asthma among youth from five racial/ethnic groups."

Researchers also found that, among youth with asthma, being overweight or obese was associated with more frequent visits to the doctor or emergency department for asthma. In addition, overweight or obese youth with asthma used more inhaled and oral corticosteroid asthma drugs, when compared to healthy weight youth. The need for these medical treatments could have broader health implications as other studies have suggested a link between these medications and type 2 diabetes. 

The cross-sectional, population-based study included youth from a racially and ethnically diverse population. Asthma was fairly common in this population, affecting about 18 percent of the youth in the study. Researchers used electronic health records to obtain height and weight measurements, asthma diagnoses, and dispensed prescriptions for asthma-specific medications for children and adolescents in the Kaiser Permanente Southern California integrated health planfrom 2007 to 2009. 

This study is part of the Kaiser Permanente Southern California Children's Health Study, and their ongoing work to better understand and prevent childhood obesity.

Last year, the KPSC Children's Health Study found that 7 percent of boys and 6 percent of girls ages 2 to 19 in the population were extremely obese. This study also has used electronic health records to determine that children who were obese or overweight have a significantly higher prevalence of psoriasis, a chronic inflammatory disease of the skin.

Other study authors included Ning Smith,PhD, Steven Jacobsen, MD, PhD, and Corinna Koebnick, PhD, from the Department of Research & Evaluation, Kaiser Permanente Southern California; and Amy H Porter, MD, from the Department of Pediatrics, Kaiser Permanente Los Angeles Medical Center.

Read more here: http://www.sacbee.com/2012/02/27/4294206/kaiser-permanente-study-finds.html#storylink=cpy

http://www.sacbee.com/2012/02/27/4294206/kaiser-permanente-study-finds.html

Indoor Allergens: Is it your house or your vacuum cleaner?

An old vacuum cleaner could be part of the problem for people suffering from asthma and allergies.

Are Vacuum Cleaners Bad for Your Health?

Australian Study Shows Most Vacuum Cleaners Release Dust, Bacteria Back Into the Air

Jan 6, 2012 -- You vacuum your house religiously to get rid of all the dust, dirt, and bacteria and make sure your indoor air is up to snuff.

But new research suggests that some vacuum cleaners may actually be making things worse, not better.

Certain vacuum cleaners spit fine dust and bacteria back into the air, where they can spread infections and trigger allergies.

Australian researchers tested 21 vacuum cleaners from 11 manufacturers, including two commercial models. The vacuums were six months to 22 years old, and ranged from less than $100 to almost $800. Brands included Dyson, Electrolux, Hoover, iRobot, and Sanyo. The researchers measured 62 different air emissions.

All released some bacteria, dust, and allergens back into the air. Newer and more expensive vacuum cleaners generally caused less indoor air pollution than older, cheaper models, the study showed.

Vacuums with high-efficiency particulate air (HEPA) filters released only slightly lower levels of dust and bacteria than vacuums that did not use these special filters. HEPA filters are supposed to remove 99.9% of the pollen, animal dander, and even bacteria from the air.

The new findings appear in Environmental Science & Technology.

“Both vacuum cleaning and the act of vacuuming can release and re-suspend dust and allergens, leading to increased exposure,” write study researchers from Queensland University of Technology in Brisbane, Australia.

Indoor Air Cleaning Tips From the Pros

But don’t go throwing your trusty vacuum cleaner out so quickly, says Viviana Temino, MD. She is an assistant professor of allergy and immunology at the University of Miami School of Medicine.

“For a vacuum to do more harm than good, it has to be a really old vacuum cleaner that has never been cleaned,” she says. “In general, most vacuums do take up more dust, dirt, and allergens than they release."

HEPA filters are still the way to go, she says: “They remove more particles than they release back.”

There are other things you can do to keep your indoor air clean. “If you or someone in your home does have indoor allergies, get rid of your carpet,” she says. “If you have throw rugs, wash them once a week in really hot water. This will kill off dust mites and other allergens.”

Feather dusters just relocate dust around the room. Instead, try a microfiber or electrostatic cloth. These don't stir up dust, she says.

Jeffrey May says HEPA filters are still the best. He is the principal scientist at May Indoor Air Investigations in Tyngsborough, Mass., and author of several books, including My House Is Killing Me! The Home Guide for Families With Allergies and Asthma. “A junky old vacuum cleaner will definitely release more allergens than a newer one,” he says.

His advice? Get a vacuum cleaner that has a HEPA filter, and change the filter and clean your house regularly. “Make sure to vacuum under furniture and behind furniture,” May says. “You can't believe the stuff that accumulates there, and this can be an enormous source of allergens.”

By Denise Mann
WebMD Health News

Reviewed by Michael W. Smith, MD

http://www.webmd.com/allergies/news/20120106/are-vacuum-cleaners-bad-for-health