Body Image, Obesity Prevention, Pediatric Labeling – PediaCast 070

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Announcer: This is PediaCast.

Dr. Mike Patrick: Bandwidth for PediaCast is provided by Nationwide Children's Hospital, for every child, for every reason.

[Music]

Announcer: Welcome to PediaCast, a pediatric podcast for parents, the news edition. And now direct from Bird House Studios, here's your host, Dr. Mike.

0:00:32

Dr. Mike Patrick: Hi everyone, and welcome to PediaCast. It is episode 70 for Friday October 26th 2007, body image, obesity, and junk food. Now, you notice we had a little addition to our introduction today, and that is because we would like to welcome on board our new Bandwidth sponsor, Nationwide Children's Hospital. It's the, they used to be Columbus Children's Hospital and they renamed themselves recently to Nationwide Children's Hospital. So if you're wondering where Nationwide Children's Hospital is, it's in beautiful downtown Columbus, Ohio and it just happens to be the children's hospital where I learned to be a pediatrician.

0:01:16

So there's a special place in my heart [laughing] for Nationwide Children's Hospital. So we're very happy and pleased to have them on board for the next several months as our Bandwidth sponsor, so welcome to them. Also welcome to all of you who are joining us at Stickam, that's S-T-I-C-K-A-M dot com. And again we usually record PediaCast somewhere between 7 and 8pm Eastern Time. For those of you who would like to see and listen to it live, I should say.

0:01:50

I do want to mention a couple of things before we get started today. One of those, you know Pediascribe is the blog of course that my wife does. Well, she had a guest blogger yesterday on Thursday, which the guest blogger happened to be my daughter. Now what is my 13-year old daughter writing about? Well, I'm little embarrassed to say it [laughing] as a dad. She wrote about periods. Yes, okay, periods. And she reviews a product called Luna pads. Now, I don't know if you've heard of this before or not. I had not have heard of this particular product before my wife came across at, maybe a couple of months ago now.

0:02:36

But basically what this is, is instead of disposable panty liners, or it's not tampons, it would be. See I'm talking about feminine products and I'm a pediatrician. I should be able to do this. And usually I can, but when it's my daughter writing about it for crying out loud. So I'm kidding a little flustered. It's basically, where was I? Pads, you know menstrual pads, except they're not disposable. They're cloth and you wash them. Now before you go eww because honestly, that was my first [laughing] impression too.

0:03:14

But apparently, there is a group of people who really, actually, a large group of people who really like these for a whole bunch of different reasons which I really, for some reason I don't understand exactly. There you have it. And if you understand exactly what I'm talking about, if you go to Pediascribe.com and just read her post. I think there were some people who had some notions about this product beforehand, at least reading some of the comments, and you know so that it was like well, I don't know if I want anything to do with that. That's pretty icky.

0:03:49

And then once they had read her review, it's like "you know what; I might just try those, that's a pretty good idea…. So I'm going to let the review speak for itself and I'll not say much more about it. And then today, on the blog, they're going to have a contest. The folks who do Luna pads have agreed to give away an introductory kit. So if you're interested in seeing what they look like, there are pictures on the blog, and then you could enter to win an introductory packet of this product.

0:04:22

Okay, see, I'm getting really flustered. I really need to move on now. Just go to the show notes if you have any trouble finding those things, we'll have links. Okay, so what do we have coming up today in PediaCast? Well, dissatisfaction with the body image provades all cultures. IBM is going to pay for obesity prevention efforts for children of employees. Energy Now announces grants to combat childhood obesity. Schools gained ground in a battle against junk food, and just when you thought the entire episode was going to be about weight issues. We're going to end with pharmacists asked the FDA to improve pediatric labelings.

0:05:00

So that's all coming up. Don't forget if there's a topic that you would like us to discuss or you have an idea for the show, just let us know at PediaCast.org. Go to the contact link. You can also email PediaCast@gmail.com or call the voice line at 3474045437. That spells kids. The information presented in PediaCast is for general educational purposes only. We do not diagnose medical conditions or formulate treatment plans for specific individuals. If you have a concern about your child's health, call your doctor and arrange a face to face interview and hands on physical examination.

0:05:36

Also your use of this audio program is subject to the PediaCast Terms of Use Agreement, which you can find at PediaCast.org. And with that in mind, we'll be back with News Parents Can Use right after this short break.

[Music]

0:06:17

Our News Parents Can Use edition is brought to you in conjunction with news partner Medical News Today, the largest independent health and medical news website. You can visit them online at MedicalNewsToday.com. Different cultures have different standards and norms for appropriate body size and shape which can affect health children perceive their body image. Some cultures celebrate a fuller body shape more than others. But researchers at the Center for Obesity Research and Education also known as CORE at Temple University have found that in overweight or obese child can still be unhappy with his or her body despite acceptance from within their ethnic group.

0:06:56

"This unhappiness is yet another consequence of childhood obesity,… said Dr. Gary Foster, director of CORE and president-elect of the North American Association for the study of obesity. "This data illustrate when treating overweight children. It's important to attend the psychological consequences that excess weight confers no matter what the ethnic group….

0:07:17

Researchers looked at data collection from 1,204 in 6th graders and 10 Philadelphia schools to determine the level of satisfaction each student had with his or her body image. After students answered the questionnaire to determine how satisfied they were with their bodies, the data were analyzed taking into account race, ethnicity, gender, and weight. The findings were presented at the North American Association for the Study of Obesities 2007 annual scientific meeting in New Orleans on October 23rd.

0:07:50

Among the findings well obese and overweight children of all ethnicities were unsatisfied with their body image. Asian children have the highest levels of dissatisfaction among all ethnic groups tested. "Culturally speaking, the ideal body shape is a lean one among Asian's children,… said Dr. Foster. However, in African American and Latino cultures, being lean is not always the ideal. Most current studies on body image look at perceptions across one or two groups mainly among Caucasians and African Americans.

0:08:21

But Foster noted that this study provides a rich sampling for a better understanding of how body image is perceived across different ethnic backgrounds. And speaking of concerns about body image, IBM plans to launch a program that will offer employees monetary incentive to have their children participate in obesity education, the Wall Street Journal reports. The programs, scheduled to begin next year will pay $150 to workers who sign up a child who completes a 12-week online program of diet and exercise training.

0:08:53

The program is open to all children, and IBM says it does not look at the health information submitted by employees. According to Jay Rendell McDonald, IBM senior vice president of human resources, the companies giving employees cash to get their attention because the incentives theoretically will save the company money.

0:09:12

In the future, McDonald said the effort to prevent health problems in these children who often are insured by the company's health care plan is a logical approach because if someone in a family has health problems, employees aren't always engaged to work because that's on your mind. IBM Institute of Wellness Programs five years ago that pay workers to improve their health. The company said the programs have had significant success, according to the journal, with 62% of employees currently participating in an annual fitness program, and that includes keeping an online diary of work-outs.

0:09:46

IBM estimates that the programs have saved the company between 100 million and a 130 million annually and avoided health care costs. In Energy Now, an alliance comprised of leading authorities in the physical education, nutrition and fitness technology fields today announced the availability of physical education grants to help schools in the Tri-state New York area combat child with obesity through a result based program.

0:10:13

In an effort to energize and motivate children to participate in regular physical activity and healthy eating habits, Energy Now will build physical education and nutrition programs that are doable, sustainable, and effective. The results-based program will allow physical education educators to collect valid and reliable data to monitor student progress and their program's effectiveness throughout the year. The program's resources will also serve as the foundation for students to lead active and healthier lifestyles by providing physical activity and nutrition education lessons that can be applied to their everyday lives.

0:10:51

"The Energy Now alliance recognizes that increasing the students' physical activity level is critical to effectively address childhood obesity,… said Charlene Bergeson, alliance chair of Energy Now. The grants would provide physical education in teachers with training along with the needed resources to monitor student progress and track results throughout the year. The grants will provide critical funding for schools to purchase physical education equipment based on their specific needs and schools will receive heart rate monitors, assessment technology, and training provided by Polar, a manufacturer of fitness products.

0:11:27

Additionally, the school nutrition foundation will provide a set of nutritional education lessons that include a lifestyle approach to eating habits based on actual cafeteria choices. And the National Association for Sport and Physical Education will give training on the National Standards for Physical Education.

0:11:45

Information packets will also be distributed to grant recipients that include additional resources and details about various activities, contests, and promotions available through Energy Now. An estimated 17% of children or adolescents from age 2 to 19 are overweight, according to the Centers for Disease Control and Prevention, which has declared childhood obesity a national epidemic. The National Center for Health Statistics reports that almost 1 in 4 children do not participate in any free time physical activity.

0:12:18

"We know that when students are personally engaged, positive change can take place,… said Bergeson. This program focuses on results and aims to engage students by energizing and motivating them to get physically active and eat healthy. In the first year, public middle schools in New York, New Jersey and Connecticut will be eligible to apply for the grants, which are valued at more than $12,000 each. The pilot program will award 10 grants. Eligibility requirements include State certification for physical education teachers, a standard based curriculum, and an agreement to persist pay in various activities and professional development training throughout the grant period.

0:12:58

The program's evaluation committee will review and score each grant submission and the winning schools will be announced in December. The deadline to apply for the grant is November 12, 2007. For detailed list of eligibility requirements, or to apply for the Energy Now grant, visit EnergyNow.com. And of course, we'll have a link to their site in the show notes. Now, there may not be any other educators in New York, New Jersey or Connecticut. But I'll bet there are some parents who live in those 3 states, so if you're listening now make sure you let your school know about the availability of this grant.

0:13:33

A new study by the US Centers for Disease Control and Prevention is found at American schools are starting to make progress in the battle against junk food and promoting physical activity. However, the report concludes that considerable more progress is needed to improve the health and well being of American students.

0:13:49

The CDC study is entitled "The School Health Policies and Programs Study 2006… and is published as a collection of articles in the October 2007 issue of the Journal of School Health. "American schools have made significant improvements in policies and programs intended to promote student health and safeties,… said the report. Particularly praise worthy are improvements in policies surrounding nutrition, physical activity and the use of tobacco, but there's still a long way to go.

0:14:19

This is the largest and most comprehensive study of American school health policies and programs and is conducted every 6 years. The last 2 times were in 2000 and 1994. CDC Director Julie Gerberding says the goal of the study is to give education and health officials' information to help them develop an improved program that can significantly benefit our school aged children. The main findings of the study include the following improvements between 2000 and 2006.

0:14:49

States that ban schools from selling junk food and vending machines went up from 8 to 32%. The proportion of school districts that have implemented their own such ban went up from 4 to 30%. Schools selling water either in vending machines or in the cafeteria went up from 30 to 46%. States that have made regularly scheduled recess a requirement in elementary schools went up from 4 to 12%.

0:15:16

The proportion of school districts implementing their own requirements for elementary recess went up from 46 to 57%. And schools that ban all alcohol, I'm sorry, school of course they ban alcohol [laughing]. Schools that ban all tobacco including its use during off campus events went up from 46 to 64%. Schools selling cookies and other baked goods high in fat went down from 38% to 25%. They are selling magazines now instead.

0:15:46

Schools offering salads ala-cart went up from 53 to 73%. And schools offering French fries ala-cart went down from 40 to 19%. The report also highlighted areas for improvements, and these include 77% of high schools still sell soda or fruit drinks that are not 100% juice. Sixty-one percent of high school sells salty snacks that are not low in fat. Only 4% of elementary schools provide daily physical education or its equivalent for the entire school year for students in all grades.

0:16:19

The figure for middle school is slightly better at 8%, but worst for high schools at 2%. Overall, 22% of schools do not require students to take any physical education, and 36% of schools still have no policies that ban the use of tobacco at all times throughout the school. Director of the CDC's division of adolescent and school health Dr. Howell Wechsler said, "If we want to build on the improvements that schools have made over the past six years, we need to involve many people and programs…. He called on families, schools, administrators and board members to work together to promote health and safety among America's youth.

0:16:57

Director of the Montifi or Medical Centers and School Health Program in New York City Dr. David Apple told the Washington Post, he finds the report encouraging but still childhood obesity is still a major concern. Apple expressed disappointment in some of the reports key findings and said for example, its humbling only 46% of schools were offering water to drink. He told the newspaper that a lot of the areas where the CDC found progress should be at 100%.

0:17:25

And finally, the American Pharmacist Association told the Food and Drug Administration that more complete, comprehensive and understandable labeling information is needed on over-the-counter products intended for pediatric patients. Testifying before the FDA joint meeting of the Non-prescription Drugs Advisory committee and the Pediatric Adviser committee on safety and efficacy of over-the-counter cough and cold products marketed for pediatric use.

0:17:51

Pharmacy Association President and Community Pharmacist Wendy Landis described the important role pharmacist play in helping consumers manage and improve their medication use including the selection, dosing, and administration of over-the-counter products. Pharmacists rely on the FDA to determine whether medications including over-the-counter products are safe and effective. However, the number of products from which consumers must choose combined with confusing labeling can lead to unintentional misuse of these products.

0:18:21

"We encourage consumers particularly parents trying to treat their children to take advantage of their pharmacist medication expertise,… stated Landis. Landis presented the following recommendations for addressing the issue of appropriate use of over-the-counter cough and cold products in pediatric patients.

0:18:39

He said drug manufacturer should provide complete, comprehensive, and understandable information on product labels, discontinue the use of same brand name or brand name line extensions when the product contains different active ingredients, and things that they should include the following statements on over the counter product label. Ask your doctor or pharmacist about the directions for using this product and do not use in children under 2 years of age.

0:19:06

He also thinks they should standardize over-the-counter dosing units. Improve over-the-counter drug monograph information and include pharmacist representation on FDA advisory committees that address over-the-counter products. I personally agree with many of these recommendations. It's hard to advise people on over-the-counter products when the same name line is used for medicines with different active ingredients. It's just so easy for parents to pick up the wrong one.

0:19:35

And here's an example of why dosing units need some standardization. Back a few years ago, Infant Motron and Infant Advil drops, both of those contain Ibuprofen as the active ingredient and both of them had 50 milligrams per 1.25 milliliters, which is a quarter of a teaspoon. The only thing was the Infant Advil came in a syringe to measure it, and the one syringe full was 1.875 milliliters, which translates into 75 milligrams. But the Infant Motron had a dropper and the top of the dropper was 1.25 milliliters or 50 milligrams.

0:20:15

It was very confusing to people because if a doctor said, you know, "do 1 dropper full of Motron,… you know, are you talking about 50 milligrams if it's the Motron dropper? But if they got the
Infant Advil, which is actually syringe. But hey, it's a cylinder and so you know people are not necessarily stopping to say, hey this is a syringe not a dropper. And the top with that one was 75 milligrams, so it was very confusing. Personally I thought the Motron, the way they did it made the most sense, because both children's Motron and children's Advil, the children's version of the Infant, come 100 milligrams per teaspoon so it sort of make sense to me that the Infant version would be 50 milligrams per dropper. They just sort of felt right. So to avoid confusion, I would just tell people to make sure they were getting the Motron one. Because again it just made more sense to me to divide it up that way. But in 2003, Motron actually caved and switched to their syringe system so we have standard measuring syringes now for both Motron and Advil.

0:21:15

But immediately after that, there was a product that was still in the market for a while called Pedia Care Fever, which was also a single ingredient Ibuprofen. And they kept theirs the 50 milligrams per quarter teaspoon, the 1.25 milliliter dropper. So theirs was 50 milligrams for one dropper full, while as Motron and Advil both went to 75 milligrams. So it was just very, very confusing for us to advice people. So personally, I still think Advil should have been the one to make the change but, and you know I still reward Motron for changing by still using their name when I recommend Ibuprofen. I know, there goes my shot-head Advil sponsorship [laughing].

0:21:59

Okay so that wraps up our News Parents Can Use this week. And we'll be back to wrap up the show right after this.

[Music]

0:22:39

Thanks goes out to Medical News Today for helping us out with the news segment. And also to Vlad over at VladStudio.com for providing the art work for the show, as he always does. Don't forget the PediaCast shop is available for you to get T-shirts to help us spread the word about the program. Also the poster page on the website will help with that, as well iTunes reviews, and of course word of mouth.

0:23:00

Don't forget to check out Pediascribe to see my 13-year old daughter's review on Luna pads and then also the contest to get your free introductory kit. So everybody have a great weekend. Go a Buck Ice beat Penn State. Okay and I'll see you all on Monday. And until then this is Dr. Mike saying stay safe, stay healthy, and stay involved with your kids. So on, everybody.

[Music]

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