The Kidfixer Newsletter

A quarterly newsletter from Doctors Mesibov, Altman, Jacobs & Rubinos            Winter 2017


E-Cigarettes: A 1-Way Street to Traditional Smoking and Nicotine Addiction for Youth

From the journal Pediatrics

In a study in this month’s issue of Pediatrics, researchers examined cigarette and electronic cigarette (e-cigarette) use in high school students from 2013 to 2015 in Connecticut. They found that using e-cigarettes significantly and strongly predicted combustible (“real”) cigarette use. In other words, e-cigarette use leads to traditional cigarette smoking use.

In contrast, traditional combustible cigarette use did not predict future e-cigarette use. Teens rarely switch from traditional cigarettes to e-cigarettes, the way adults often do to limit the harmful effects of smoking. E-cigarette products were not part of young people’s efforts to quit. Also, a substantial proportion of both cigarette and e-cigarette users progressed to heavy use, reporting that they smoked 21 to 30 days in the past month at the 2-year follow-up. This is consistent with patterns of use seen with young people’s increasing addiction to nicotine in numerous studies. These findings add longitudinal data and evidence to the growing evidence base that reveals that the use of e-cigarettes by young people leads to smoking traditional cigarette products and, importantly, reveals that the reverse pattern is not true. E-cigarettes cause combustible smoking; they lead young people to cigarette use and nicotine addiction. And this pathway is a 1-way street.

Smartphones and Tablets and Adolescents: Small Size, Big Problems?

From the journal Pediatrics

Research has shown that when children watch too much television, their risk of obesity increases. However, more and more screen time is coming from other devices, like tablets and smartphones, and the impact of these devices has not been researched as much. In a new study scheduled for publication in The Journal of Pediatrics, researchers found that children who reported spending more time on screen devices and watching television engaged in behaviors that can lead to obesity.

Dr. Erica L. Kenney and Dr. Steven L. Gortmaker from the Harvard T.H. Chan School of Public Health studied data from the 2013 and 2015 waves of the Youth Risk Behavior Surveillance System, which included 24,800 adolescents in grades 9-12. The survey gathered data on the following: hours spent on screen devices (including smartphones, tablets, computers, and video games) and watching television, hours of sleep on an average school night, number of sugar-sweetened beverages consumed in the previous 7 days, and frequency of physical activity (at least 60 minutes per day) for the past 7 days.

The researchers found that almost 20% of U.S. adolescents spent more than 5 hours a day on smartphones, tablets, computers, and videogames compared with only 8% watching more than 5 hours a day of television. Watching too much television continued to be associated with obesity and poor diet among adolescents. However, the researchers also found that adolescents who spent more than 5 hours a day on screen devices were twice as likely to drink a sugary drink each day and not get enough sleep or physical activity, and were about 43% more likely to have obesity compared with adolescents who did not spend time on these devices.

Although this study cannot conclude definitively that using screen devices is causing higher rates of obesity, the findings are cause for concern. According to Dr. Kenney, “This study would suggest that limiting children’s and adolescents’ engagement with other screen devices may be as important for health as limiting television time.” Until more research is done, clinicians may want to encourage families to set limits for both television and other screen devices.

Put down that smartphone and read to me!

From the Journal of Pediatrics

Shared reading between a mother and child is known to benefit that toddler's cognition, social and emotional development, and brain growth. But just what happens inside the brain? To answer this, researchers provided a rather novel study: They examined the brains (by MRI) of 4 year-old girls while being read an age-appropriate book by their mothers. The result? The MRIs of these girls showed activation of several areas of the brain brought about by reading. Interestingly, when mothers stopped reading to answer their cell phones, this activation immediately stopped! Shared reading quality scores were significantly negatively correlated with maternal distraction by smartphones.

Better Brown-Bag Lunches

From the Tufts Nutrition Newsletter

Lunches you pack for yourself or your family can be healthier than meals purchased away from home, but only if you plan food choices wisely.

Depending on what you pack in lunches for yourself or family members, you may not do better nutritionally than the cafeterias or eateries you're passing up. Studies suggest it's common for kids' packed lunches to be low in vegetables, fruits, whole grains and dairy products.

"Think of the lunch you send with kids as a tool for teaching good nutrition," says Jennifer Sacheck, PhD, an associate professor at Tufts' Friedman School. "Although it may take a little extra thought and effort to pack a nutritious lunch, it's worth it over the longer term - not only for supporting daily energy and good health but also for teaching healthy eating habits that can carry over into adulthood." And keep in mind, what kids see you packing for yourself sets an example for them, too.

Makeover Needed:

A study from Tufts’ Friedman School published in the Journal of the Academy of Nutrition and Dietetics looked at packed lunches of elementary schoolchildren in eastern Massachusetts. They found that only 27% of packed lunches met at least three of five food group standards followed by the National School Lunch Program. Those standards require providing certain amounts and types of: 1) fruit (excluding juice), 2) vegetables, 3) grains, 4) meat/meat alternates and 5) fluid milk. Tufts’ researchers found that only 11% of the packed lunches contained vegetables, 17% contained dairy foods and 34% contained fruit.

This and other studies have shown kids' lunches often contain less healthful options, including prepackaged snack foods like potato chips and puffed snacks; sugar-sweetened beverages such as fruit punch and sports drinks; prepackaged lunch combinations like salty processed meat and crackers; and desserts like sugar-sweetened fruit snacks, cookies and candy. Such prepackaged foods and treats can leave kids (and adults) short on nutrients.

Little is known about what adults pack in their lunches. But, the Scientific Report of the 2015 Dietary Guidelines Advisory Committee notes that current eating patterns in the US are too low in vegetables, fruits, whole grains and healthful dairy products, on average. And they’re too high in refined grains, added sugars and sodium.

Nutritious Packing:

Whether packing lunch for yourself or a family member:

    • Use MyPlate (above) to help you plan a nutritious, well-balanced meal.

   • Choose healthy proteins. Try strips of baked, skinless chicken breast, canned salmon or tuna, cheese, nuts and nut/seed butters (check school policy on peanuts), hardboiled eggs, beans and tofu.

   • Opt for whole grains, such as for pasta, breads, tortillas and crackers.

  • Always include a vegetable. Almost any cut vegetable can be packed. Healthful dips may encourage trying new veggies.

  • Think of fruit as dessert. If you pre-cut fruit like pears and apples, add a few drops of lemon juice to deter browning.

  • Skip sugar-sweetened drinks like sodas, fruit drinks, sweetened teas and sports drinks. Pack an insulated water bottle.

Special Tips for Kids’ Lunches:

  • Keep it colorful, such as with assorted fruits and veggies. Kids like lots of color.

• Make it fun. Cut healthy foods into fun shapes (with mini cookie cutters) or slice a wrap crosswise into 1-inch pinwheels.

• Involve the kids. For example, ask them to portion foods into reusable containers.

• Give a choice. Ask what they prefer within categories, such as veggies and fruits.

• Keep portions kid-sized. Younger kids tend to prefer smaller amounts of a greater number of foods rather than larger portions of a few foods.