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Dads influence teen sexual behavior

October 30, 2012 By 1 Comment

Here at EBL, we’ve written before about why teenagers are more likely to make risky decisions compared to adults – including engaging in risky sexual activity. But we also know that parents can influence their teens’ decisions about sex—and we’re not just talking about a mom sitting down with a teen for “the talk.”

A new systematic review in the journal Pediatrics found evidence that dads have a unique influence on the sexual behavior of their adolescent children, independent of the mother’s impact.

For their analysis, researchers found 13 studies published between 1980 and 2011 that investigated fathers’ influence on sexual risk-taking for youth ages 11 to 18.  They used a sweeping definition of fathers that included stepfathers, adoptive fathers and other men who acted as the primary male caregiver to teens.

What did they find? Fathers (and father figures) matter. The emotional quality of the father-child relationship makes a difference: teens who considered themselves close to their fathers tended to begin having sex later. When fathers are communicative about sex, their children are more likely to make healthy decisions. Fathers’ attitudes matter too: when dads approved of adolescent sexual activity, teens tended to start having sex earlier compared with teens whose dads did not approve.

Maybe the most interesting findings dealt with parenting style: teens with either overly restrictive or overly lenient fathers tended to have sex earlier than teens with dads who found a more balanced approach.

The take home message? Dads and male adults who act as father figures should communicate with teens about their expectations and rules surrounding sexual behavior. And though it may be hard as teens become more independent, keeping a close, positive relationship helps keep adolescent children healthy.

Filed Under: Evidence-Based Living, Youth Development Tagged With: , ,

The evidence on super-sized soft drinks

October 26, 2012 By 1 Comment

Next year, New York City residents must say good-bye to their super-sized sodas and Double Big Gulps.  Beginning in March, the city will limit to 16 ounces the size of soft drinks sold at restaurants, street carts, movie theaters and sporting venues. The New York City Board of Health passed the proposal last month in an effort to reduce the consumption of sugary drinks thought to contribute to the nation’s obesity epidemic.

But what evidence do we have about sugary soft drinks and weight gain and harm our health?  We know that sugar-sweetened drinks account for nearly half of the total added sugars Americans consume and 7 percent of our total calories. But what impact does that have on our health?

New York Times writer Jane Brody also provides an overview of some of the evidence on this topic in her column this week. There are also several systematic reviews that tell the story:

  • A 2007 meta analysis in the American Journal of Public Health reviewed 88 studies that examined the association between soft drink consumption and nutrition and health outcomes. The analysis found consuming soft drinks led to increased energy intake and body weight, and was associated with lower intakes of milk, calcium, and other nutrients.  It also found an association between soda intake and diabetes.
  • Another systematic review, published in the American Journal of Clinical Nutrition in 2006 – which included 30 cross-sectional, prospective and experimental studies looking at the relationship between sugary soft drink consumption and weight gain – concluded that sugary soft drinks are associated with weight gain and obesity.
  • A third review published in Cambridge University’s Nutrition Research Reviews in 2008 came up with inconclusive results. The review examined 44 epidemiological studies and interventions and six meta-analyses – all looking at the relationship between sugary soda consumption and obesity. The author concluded that while sugary soft drinks are a source of calories, there is little evidence that they cause more weight gain than other sources of calories.  He said the impact of sugary sodas on weight gains depends on variables including how much soda is consumed each day and the formulation of the specific drink. His review also concluded that consuming large amounts of sugary soft drinks on a daily basis is most directly associated with weight gain.

So, did the New York City Board of Health make an evidence-based decision in limiting sugary soft drink sizes?  I think the answer is yes. While there is some mixed data on the association of soft drink consumption and weight gain, the evidence makes it abundantly clear that consuming large amounts of soda is the major problem. By limiting soft drinks sizes, the City is essential legislating the old adage, “Moderation in all things.”

Filed Under: Evidence-Based Living, Health and Wellness, In The Media Tagged With: , , , , ,

Do alternative medicine treatments help us save money?

October 24, 2012 By 2 Comments

As our society continues to debate how to improve the U.S. health care system, some researchers and policy makers are asking whether alternative therapies such as massage, acupuncture and aromatherapy are effective, and whether they help save money by resolving medical problems.

On a personal note, I’ve always been intrigued by medical treatments that fall outside of western medicine. I received acupuncture when I was pregnant with my son. He was breech, and there is some evidence that acupuncture can help babies to turn into the right position. (After trying several other treatment options including chiropractic adjustments and yoga, he did turn around, although it’s difficult to determine exactly what helped.)

A new systematic review published in British Medical Journal Open analyzes cost studies on complementary and integrative medicine from 2001-2010. For the analysis, the researchers found 204 cost analysis studies of alternative medicine treatments. But only 22 of the studies met quality standards to be included in the review.

In an analysis that reviews broad array of medical conditions, it’s difficult to come up with a single conclusion. But the review did find that some alternative treatments yielded the same or better results as traditional medical treatments. In total, ten treatments showed cost savings. Among them are acupuncture for breech delivery, acupuncture for low back pain, tai chi for avoiding hip fractures and nutritional supplements to prevent cataracts.

The review concludes that there is some real potential in saving money in our health care system and helping people heal faster through alternative medicine treatments. But more high-quality studies are needed that measure economic as well as health outcomes, and combine alternative treatments with typical care methods to measure how they work together.

Filed Under: Evidence-Based Living Tagged With: , , ,

Do exercise programs for kids really work?

October 17, 2012 By 1 Comment

Nearly 12.5 million children – or 17 percent of the U.S. population ages 2-19 – are obese.  As a response to this growing problem, schools and community groups have launched intervention programs designed to get kids moving.  But do they work?

A new meta analysis published last month in the British Medical Journal was designed to answer just that question. It included 30 studies on exercise programs for children published worldwide between January 1990 and March 2012.

Studies in the review measured the effects of intervention programs that targeted children under 16 years old and lasted for at least four weeks. To be included, studies had to definitively measure levels of physical activity in children throughout the day – not just during the intervention class period – with devices like motion sensors.

In each case, the investigators expected that the programs would increase the children’s overall daily physical activity.

The review uncovered some surprising evidence: programs designed to encourage increased physical activity among kids didn’t work. On the whole, the programs increased  children’s overall physical activity levels by about 4 minutes a day – even though the programs themselves ranged from 30 to 90 minutes in length.

One explanation is that children unconsciously compensate for the energy they use during structured activity programs by being doing sedentary activities aftewards, Brad Metcalf, a research fellow and medical statistician at Peninsula College who led the review, told the New York Times. Another explanation is that many of the programs took place after school, replacing a time period when children are typically most active anyway.

This analysis did yield some clear results: that we need to come up with additional strategies for encouraging physical activity among children.

Filed Under: Evidence-Based Living, Health and Wellness, Youth Development Tagged With: , , ,

Gender bias in the field of medicine?

October 11, 2012 By Leave a Comment

In the early- and mid-1900s, women were forbidden to attend medical school or practice medicine across the United States.   While our society has made great strides in encouraging women to join and even become leaders in professions like medicine, it is important to understand how these efforts are playing out in real life.

For a new review published in the Journal of General Internal Medicine, researchers conducted a survey of 4,578 full-time faculty at 26 U.S. medical colleges. They found that women made up only 19 percent of full professors and only 12 percent of department chiefs. Their survey also found that while men and women were engaged in their work to a similar degree and both groups had similar aspirations for leadership roles, women did not feel the same sense on inclusion in their profession and were not as confident about their ability to be promoted.

The study confirms research by Cornell Professors Wendy Williams and Steve Ceci, who have dedicated their careers to understanding why women are more likely to pursue advancement in science and technology fields like  physics, chemistry, mathematics and engineering.

The husband-and-wife team has published a major systematic review that concludes women tend to drop out of math and science related fields because they shoulder more responsibility of caring for young children – and this duty often coincides with the most demanding years of their careers.

What’s the answer?  It’s clear that more research is needed to find out the support systems and environments needed to help women fulfill their career goals. From my perspective, more flexible schedules, accessible and quality childcare and longer maternity leaves would go a long way in helping women to achieve career advancement and raise their families at the same time.

Filed Under: Evidence-Based Living, Health and Wellness Tagged With: , ,

The evidence on arsenic and rice

October 9, 2012 By 2 Comments

The magazine Consumer Reports released a study last month that revealed low levels of arsenic – a chemical element that is toxic when consumed in higher doses – in rice and rice products grown across the world.

The study tested 223 types of rice and rice products – such as rice-based cereals and rice milk – purchased in the United States in April, May and August of this year. It found arsenic in every product it tested, and dangerous levels of inorganic arsenic in dozens of products. Consumer Reports the story points out that their study is “a spot check of the market and “too limited to offer general conclusions about arsenic levels in specific brands within/across rice product categories.”  Nevertheless, their article raises some surprising questions about toxins in our food supply.

Following the Consumer Reports study, the U.S. Food and Drug Administration released some preliminary results of a long-term study on arsenic levels in our food supply. Their study found levels of arsenic in rice similar to the Consumer Reports study.

So, what’s a rice-lover to do?  Consumer Reports recommends limiting consumption of rice and rice products, while the FDA is not recommending any limits on rice consumption.

Since the FDA and Consumers Reports found the same level of arsenic in food, the question in my mind is: Exactly how dangerous is low-level exposure to arsenic? A search of systematic reviews yielded some interesting results.

  • One meta-analysis found consuming arsenic in drinking water is associated with a higher risk of lung cancer.
  • Another analysis found chronic arsenic exposure can lead to mental retardation and developmental disabilities such as physical, cognitive, psychological, sensory and speech impairments – although in higher levels that measured in the rice products tested by Consumer Reports and the FDA.
  • Other analyses found inconclusive results on the relationship between arsenic exposure and diabetes and arsenic exposure and cardiovascular disease – although both of these reviews identified limitations in the study methodology and called for additional research.

My plan is to think more carefully about the rice products my family consumes.  I’m not going to throw out the brown rice in my pantry, and we will still enjoy stir fry and sushi on a regular basis. But I certainly plan to steer way from rice cereals and other rice products at the grocery store.

Filed Under: Evidence-Based Living, Health and Wellness, policy Tagged With: , , , , , , ,

What we know – and what we don’t – about Omega-3 fatty acids

October 4, 2012 By 2 Comments

Over the past four decades, there have been thousands of studies examining the health benefits of Omega-3 fatty acids – building blocks our bodies use to create cell membranes and maintain the connections between brain cells.

The medical community’s excitement over this nutrient began when observational studies of non-western diets – in Japan and among Eskimos in Greenland, for example – found significantly lower rates of heart disease and other chronic medical conditions.  (Humans can’t produce omega-3 fatty acids, so we must get them by eating fish, walnuts, flaxseed and green vegetables.)

Dozens have studies have identified these types of correlations. But earlier this year, a meta-analysis published in the Journal of the American Medical Association, which included 20 clinical trials involving nearly 70,000 people, concluded omega-3 fatty acids did not prevent heart attacks, strokes or deaths from heart disease.

Proponents of omega-3s point out that the authors of the JAMA analysis used the an especially strict standard to determine statistical significance. (Using the typical standard would have found a 9 percent reduction in cardiac deaths.)

But other systematic reviews – like this one by the Cochrane Collaboration – found it unclear whether omega-3 supplements reduce the risk of cardiac deaths.

So, what’s the bottom line?  This is one case where the evidence is truly unclear. One challenge is that longitudinal diet studies are difficult to perform because there are so many variables in what people eat over long periods of time. The it can be tough to differentiate between omega-3s consumed as part of a diet versus those taken in a supplement.  It is clear that foods like salmon, tuna and green vegetables are good for us – and including them in our diets is a step in the right direction. But we need more evidence to determine their exact effects, and to establish whether it’s worthwhile to take omega-3 supplements.

Filed Under: Cornell Cooperative Extension, Evidence-Based Living, Health and Wellness Tagged With: , , , ,

The facts on Social Security

October 1, 2012 By Leave a Comment

More than 75 years ago, the U.S. government created Social Security, the federal insurance program that provides benefits to individuals and their families who can no longer work because of disability, retirement or death. The program is complex, and its details are often debated among politicians.

Earlier this year, the Economic Policy Institute and the National Academy of Social Insurance published a guide that explains the facts about the Social Security program to young people. The document includes detailed, evidence-based explanations of Social Security’s history, beneficiaries, financing, and shortfalls. It pulls data from the Office of the Chief Actuary of the Social Security Administration, Congressional Budget Office, the Employee Benefits Research Institute, and the Center for Retirement Research.

Here’s a sampling of interesting facts from the document:

  • In 2012, about 159 million individuals or 94% of the American workforce, worked in Social Security-covered employment. (Those not covered include government employees covered by other insurance programs, farm workers who do not meet minimum work requirements and students.)
  • Approximately 55 million Americans received Social Security benefits in 2011. Seventy percent were retirees; 19 percent were disability beneficiaries and 11 percent were survivors of deceased workers.
  • Without Social Security income, it is estimated that nearly half senior citizens would be living in poverty. Instead, fewer than 10 percent of seniors live in poverty.
  • Because the U.S. population is aging and people are living longer, the Social Security program is projected to run up a deficit. The projected shortfall is 2.67% of taxable earnings over the next 75 years.
  • There are a variety of ways to compensate for the deficit including raising taxes, expanding coverage, investing in equities, increasing the retirement age and reducing cost-of-living increases.

The guide concludes that Social Security fulfills an important need in our society as an insurance program for American workers.  To learn more about Social Security benefits and about how your payroll taxes are used, it’s worth checking out this evidence-based document.

Filed Under: Evidence-Based Living, policy, The Learning Center Tagged With: , , ,
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