Mike Bock

Mortality among patients with nonfunctioning pituitary adenomas (NFPA) was higher in women than in man as well as in patients with a young age at diagnosis and those diagnosed with diabetes insipidus, according to a nationwide population-based study in Sweden.

Dr. Daniel S. Olsson of the University of Gothenburg and Sahlgrenska University Hospital in Gothenburg, Sweden, and his associates identified 2,795 unique patients with NFPA from the the Swedish National Patient Registry who had been diagnosed between 1987 and 2011. The mean age at diagnosis was 58 years, and the mean follow-up time was 7 years.

Standardized mortality ratio was increased in women with NFPA (1.29; 95% confidence interval, 1.11-1.48) but not in men (1.00; 95% CI, 0.88-1.12). Women with a diagnosis of hypopituitarism and/or diabetes insipidus had increased mortality ratio, but men did not (J. Clin. Endocrinol. Metab. 2015 May 7 [doi: 10.1210/jc.2015-1475]).

“We found an association between increased mortality and the presence of hypopituitarism in women with NFPA, which has been indicated in previous studies, but not clearly demonstrated. In contrast, men with hypopituitarism had no excess mortality,” the authors wrote.

Other predictors of excess mortality included being diagnosed under 40 years of age, as those patients had an increased SMR of 2.68 (95% CI, 1.23-5.09). Patients with hypopituitarism in combination with NFPA had an SMR of 1.06 (95% CI, 0.94-1.19) and for patients with diabetes insipidus the SMR was 1.71 (95% CI, 1.07-2.58).

Though the exact mechanisms behind the increased mortality ratios are unclear, the investigators noted that “adrenal insufficiency and its treatment in hypopituitary patients contributed to the excess mortality seen in these patients, although other pituitary hormone deficiencies, such as growth hormone deficiency may also play an important role.”

The authors noted that their study is the first to report the frequency of hypopituitarism (54%) in a large cohort of unselected patients with NFPA.

Dr. Olsen has received lecture fees from Pfizer and has been a consultant for Ipsen.

[email protected]

Mortality among patients with nonfunctioning pituitary adenomas (NFPA) was higher in women than in man as well as in patients with a young age at diagnosis and those diagnosed with diabetes insipidus, according to a nationwide population-based study in Sweden.

Dr. Daniel S. Olsson of the University of Gothenburg and Sahlgrenska University Hospital in Gothenburg, Sweden, and his associates identified 2,795 unique patients with NFPA from the the Swedish National Patient Registry who had been diagnosed between 1987 and 2011. The mean age at diagnosis was 58 years, and the mean follow-up time was 7 years.

Standardized mortality ratio was increased in women with NFPA (1.29; 95% confidence interval, 1.11-1.48) but not in men (1.00; 95% CI, 0.88-1.12). Women with a diagnosis of hypopituitarism and/or diabetes insipidus had increased mortality ratio, but men did not (J. Clin. Endocrinol. Metab. 2015 May 7 [doi: 10.1210/jc.2015-1475]).

“We found an association between increased mortality and the presence of hypopituitarism in women with NFPA, which has been indicated in previous studies, but not clearly demonstrated. In contrast, men with hypopituitarism had no excess mortality,” the authors wrote.

Other predictors of excess mortality included being diagnosed under 40 years of age, as those patients had an increased SMR of 2.68 (95% CI, 1.23-5.09). Patients with hypopituitarism in combination with NFPA had an SMR of 1.06 (95% CI, 0.94-1.19) and for patients with diabetes insipidus the SMR was 1.71 (95% CI, 1.07-2.58).

Though the exact mechanisms behind the increased mortality ratios are unclear, the investigators noted that “adrenal insufficiency and its treatment in hypopituitary patients contributed to the excess mortality seen in these patients, although other pituitary hormone deficiencies, such as growth hormone deficiency may also play an important role.”

The authors noted that their study is the first to report the frequency of hypopituitarism (54%) in a large cohort of unselected patients with NFPA.

Dr. Olsen has received lecture fees from Pfizer and has been a consultant for Ipsen.

[email protected]

Mortality among patients with nonfunctioning pituitary adenomas (NFPA) was higher in women than in man as well as in patients with a young age at diagnosis and those diagnosed with diabetes insipidus, according to a nationwide population-based study in Sweden.

Dr. Daniel S. Olsson of the University of Gothenburg and Sahlgrenska University Hospital in Gothenburg, Sweden, and his associates identified 2,795 unique patients with NFPA from the the Swedish National Patient Registry who had been diagnosed between 1987 and 2011. The mean age at diagnosis was 58 years, and the mean follow-up time was 7 years.

Standardized mortality ratio was increased in women with NFPA (1.29; 95% confidence interval, 1.11-1.48) but not in men (1.00; 95% CI, 0.88-1.12). Women with a diagnosis of hypopituitarism and/or diabetes insipidus had increased mortality ratio, but men did not (J. Clin. Endocrinol. Metab. 2015 May 7 [doi: 10.1210/jc.2015-1475]).

“We found an association between increased mortality and the presence of hypopituitarism in women with NFPA, which has been indicated in previous studies, but not clearly demonstrated. In contrast, men with hypopituitarism had no excess mortality,” the authors wrote.

Other predictors of excess mortality included being diagnosed under 40 years of age, as those patients had an increased SMR of 2.68 (95% CI, 1.23-5.09). Patients with hypopituitarism in combination with NFPA had an SMR of 1.06 (95% CI, 0.94-1.19) and for patients with diabetes insipidus the SMR was 1.71 (95% CI, 1.07-2.58).

Though the exact mechanisms behind the increased mortality ratios are unclear, the investigators noted that “adrenal insufficiency and its treatment in hypopituitary patients contributed to the excess mortality seen in these patients, although other pituitary hormone deficiencies, such as growth hormone deficiency may also play an important role.”

The authors noted that their study is the first to report the frequency of hypopituitarism (54%) in a large cohort of unselected patients with NFPA.

Dr. Olsen has received lecture fees from Pfizer and has been a consultant for Ipsen.

[email protected]

For extremely preterm infants in the United States, there is considerable variation among hospitals in terms of the gestational age at which they begin active treatment as well as the survival outcomes, according to a study of nearly 5,000 infants born before 27 weeks’ gestation.

The overall rates of active treatment ranged from 22.1% (interquartile range, 7.7-100) among infants born at 22 weeks’ gestation to 99.8% (interquartile range, 100-100) among those born at 26 weeks’ gestation.

Currently, both the American Academy of Pediatrics and the American Congress of Obstetricians and Gynecologists recommend that clinicians and families make individualized decisions about the treatment of extremely preterm infants based on parental preference and the latest available data on survival and morbidity.

Courtesy Matthew Rysavy

Matthew A. Rysavy of the University of Iowa College Of Public Health, Iowa City, and his colleagues identified 4,987 infants born between April 1, 2006, and March 31, 2011, at 24 hospitals included in the National Institute of Child Health and Human Development’s Neonatal Research Network.

Overall, 4,329 (86.8%) received active treatment, including surfactant therapy, tracheal intubation, ventilatory support, parenteral nutrition, epinephrine, or chest compressions.

Treatment was administered to 22.1% of infants born at 22 weeks and 71.8% born at 23 weeks. For those born at 24 weeks’ gestation, the overall percentage receiving active treatment was 97.1%, while 99.6% born at 25 weeks received active treatment, and 99.8% born at 26 weeks received active treatment.

“We found that rates of active treatment among infants born at the end of 22 or 23 weeks of gestation were significantly higher than the rates among infants born earlier during the same weeks,” the researchers wrote. “Our findings suggest that physicians and families may ‘round up’ when considering gestational age in the decision to initiate potentially lifesaving treatment.”

The decision to provide active treatment varied widely between hospitals. The interquartile ranges for hospital rates of active treatment stretched from 7.7% to 100% among infants born at 22 weeks’ gestation, from 52.5% to 96.5% among infants born at 23 weeks’ gestation, and from 95.2% to 100% among infants born at 24 weeks’ gestation.

At 25 and 26 weeks’ gestation, most hospitals provided active treatment, but only 5 of the 24 hospitals in the study provided active treatment to all infants born at 22 through 26 weeks’ gestation, Mr. Rysavy and his associates reported.

Overall survival and survival without severe impairment ranged from 5.1% and 3.4%, respectively, among infants born at 22 weeks’ gestation, to 81.4% and 75.6%, respectively, among those born at 26 weeks’ gestation (N. Engl. J. Med. 2015;372:1801-11 [doi:10.1056/NEJMoa1410689]).

The researchers found that hospital rates of active treatment accounted for 78% and 75% of the between-hospital variation in survival and survival without severe impairment, respectively, for infants born at 22 or 23 weeks’ gestation. For infants born at 24 weeks’ gestation, rates of active treatment accounted for 22% of between-hospital variation in survival and 16% of variation in survival without severe impairment.

The rates, however, did not account for the variation in outcomes for infants born at 25 and 26 weeks’ gestation, Mr. Rysavy and his associates noted.

The study was supported by the National Institutes of Health. One of the researchers reported receiving personal fees from MedNax that were unrelated to the submitted work. Another researcher reported receiving a grant from the Bill and Melinda Gates Foundation that was not associated with the study.

[email protected]

For extremely preterm infants in the United States, there is considerable variation among hospitals in terms of the gestational age at which they begin active treatment as well as the survival outcomes, according to a study of nearly 5,000 infants born before 27 weeks’ gestation.

The overall rates of active treatment ranged from 22.1% (interquartile range, 7.7-100) among infants born at 22 weeks’ gestation to 99.8% (interquartile range, 100-100) among those born at 26 weeks’ gestation.

Currently, both the American Academy of Pediatrics and the American Congress of Obstetricians and Gynecologists recommend that clinicians and families make individualized decisions about the treatment of extremely preterm infants based on parental preference and the latest available data on survival and morbidity.

Courtesy Matthew Rysavy

Matthew A. Rysavy of the University of Iowa College Of Public Health, Iowa City, and his colleagues identified 4,987 infants born between April 1, 2006, and March 31, 2011, at 24 hospitals included in the National Institute of Child Health and Human Development’s Neonatal Research Network.

Overall, 4,329 (86.8%) received active treatment, including surfactant therapy, tracheal intubation, ventilatory support, parenteral nutrition, epinephrine, or chest compressions.

Treatment was administered to 22.1% of infants born at 22 weeks and 71.8% born at 23 weeks. For those born at 24 weeks’ gestation, the overall percentage receiving active treatment was 97.1%, while 99.6% born at 25 weeks received active treatment, and 99.8% born at 26 weeks received active treatment.

“We found that rates of active treatment among infants born at the end of 22 or 23 weeks of gestation were significantly higher than the rates among infants born earlier during the same weeks,” the researchers wrote. “Our findings suggest that physicians and families may ‘round up’ when considering gestational age in the decision to initiate potentially lifesaving treatment.”

The decision to provide active treatment varied widely between hospitals. The interquartile ranges for hospital rates of active treatment stretched from 7.7% to 100% among infants born at 22 weeks’ gestation, from 52.5% to 96.5% among infants born at 23 weeks’ gestation, and from 95.2% to 100% among infants born at 24 weeks’ gestation.

At 25 and 26 weeks’ gestation, most hospitals provided active treatment, but only 5 of the 24 hospitals in the study provided active treatment to all infants born at 22 through 26 weeks’ gestation, Mr. Rysavy and his associates reported.

Overall survival and survival without severe impairment ranged from 5.1% and 3.4%, respectively, among infants born at 22 weeks’ gestation, to 81.4% and 75.6%, respectively, among those born at 26 weeks’ gestation (N. Engl. J. Med. 2015;372:1801-11 [doi:10.1056/NEJMoa1410689]).

The researchers found that hospital rates of active treatment accounted for 78% and 75% of the between-hospital variation in survival and survival without severe impairment, respectively, for infants born at 22 or 23 weeks’ gestation. For infants born at 24 weeks’ gestation, rates of active treatment accounted for 22% of between-hospital variation in survival and 16% of variation in survival without severe impairment.

The rates, however, did not account for the variation in outcomes for infants born at 25 and 26 weeks’ gestation, Mr. Rysavy and his associates noted.

The study was supported by the National Institutes of Health. One of the researchers reported receiving personal fees from MedNax that were unrelated to the submitted work. Another researcher reported receiving a grant from the Bill and Melinda Gates Foundation that was not associated with the study.

[email protected]

For extremely preterm infants in the United States, there is considerable variation among hospitals in terms of the gestational age at which they begin active treatment as well as the survival outcomes, according to a study of nearly 5,000 infants born before 27 weeks’ gestation.

The overall rates of active treatment ranged from 22.1% (interquartile range, 7.7-100) among infants born at 22 weeks’ gestation to 99.8% (interquartile range, 100-100) among those born at 26 weeks’ gestation.

Currently, both the American Academy of Pediatrics and the American Congress of Obstetricians and Gynecologists recommend that clinicians and families make individualized decisions about the treatment of extremely preterm infants based on parental preference and the latest available data on survival and morbidity.

Courtesy Matthew Rysavy

Matthew A. Rysavy of the University of Iowa College Of Public Health, Iowa City, and his colleagues identified 4,987 infants born between April 1, 2006, and March 31, 2011, at 24 hospitals included in the National Institute of Child Health and Human Development’s Neonatal Research Network.

Overall, 4,329 (86.8%) received active treatment, including surfactant therapy, tracheal intubation, ventilatory support, parenteral nutrition, epinephrine, or chest compressions.

Treatment was administered to 22.1% of infants born at 22 weeks and 71.8% born at 23 weeks. For those born at 24 weeks’ gestation, the overall percentage receiving active treatment was 97.1%, while 99.6% born at 25 weeks received active treatment, and 99.8% born at 26 weeks received active treatment.

“We found that rates of active treatment among infants born at the end of 22 or 23 weeks of gestation were significantly higher than the rates among infants born earlier during the same weeks,” the researchers wrote. “Our findings suggest that physicians and families may ‘round up’ when considering gestational age in the decision to initiate potentially lifesaving treatment.”

The decision to provide active treatment varied widely between hospitals. The interquartile ranges for hospital rates of active treatment stretched from 7.7% to 100% among infants born at 22 weeks’ gestation, from 52.5% to 96.5% among infants born at 23 weeks’ gestation, and from 95.2% to 100% among infants born at 24 weeks’ gestation.

At 25 and 26 weeks’ gestation, most hospitals provided active treatment, but only 5 of the 24 hospitals in the study provided active treatment to all infants born at 22 through 26 weeks’ gestation, Mr. Rysavy and his associates reported.

Overall survival and survival without severe impairment ranged from 5.1% and 3.4%, respectively, among infants born at 22 weeks’ gestation, to 81.4% and 75.6%, respectively, among those born at 26 weeks’ gestation (N. Engl. J. Med. 2015;372:1801-11 [doi:10.1056/NEJMoa1410689]).

The researchers found that hospital rates of active treatment accounted for 78% and 75% of the between-hospital variation in survival and survival without severe impairment, respectively, for infants born at 22 or 23 weeks’ gestation. For infants born at 24 weeks’ gestation, rates of active treatment accounted for 22% of between-hospital variation in survival and 16% of variation in survival without severe impairment.

The rates, however, did not account for the variation in outcomes for infants born at 25 and 26 weeks’ gestation, Mr. Rysavy and his associates noted.

The study was supported by the National Institutes of Health. One of the researchers reported receiving personal fees from MedNax that were unrelated to the submitted work. Another researcher reported receiving a grant from the Bill and Melinda Gates Foundation that was not associated with the study.

[email protected]

To what extent were Andreas Lubitz’s reported ‘suicidal tendencies’ and depression factors in the catastrophe?

For more, read our Storify page detailing the incident and the response from the mental health community:

To what extent were Andreas Lubitz’s reported ‘suicidal tendencies’ and depression factors in the catastrophe?

For more, read our Storify page detailing the incident and the response from the mental health community:

To what extent were Andreas Lubitz’s reported ‘suicidal tendencies’ and depression factors in the catastrophe?

For more, read our Storify page detailing the incident and the response from the mental health community:

The Centers for Disease Control and Prevention will conduct contact tracing of individuals in Sierra Leone, including several American citizens, who may have come into contact with an American health worker who has become infected with the Ebola virus.

The patient returned to the United States by medevac and has been admitted to the National Institutes of Health Clinical Center for treatment, the agency said in a written statement.

Although none of the individuals currently being monitored in Sierra Leone have tested positive for Ebola, they will voluntarily self-isolate and remain under direct active monitoring for the 21-day incubation period before returning to the United States.

In the event that another Ebola case is confirmed, the CDC and the State Department are developing contingency plans for returning the other American health care workers to the United States by noncommercial air transport.

[email protected]

The Centers for Disease Control and Prevention will conduct contact tracing of individuals in Sierra Leone, including several American citizens, who may have come into contact with an American health worker who has become infected with the Ebola virus.

The patient returned to the United States by medevac and has been admitted to the National Institutes of Health Clinical Center for treatment, the agency said in a written statement.

Although none of the individuals currently being monitored in Sierra Leone have tested positive for Ebola, they will voluntarily self-isolate and remain under direct active monitoring for the 21-day incubation period before returning to the United States.

In the event that another Ebola case is confirmed, the CDC and the State Department are developing contingency plans for returning the other American health care workers to the United States by noncommercial air transport.

[email protected]

The Centers for Disease Control and Prevention will conduct contact tracing of individuals in Sierra Leone, including several American citizens, who may have come into contact with an American health worker who has become infected with the Ebola virus.

The patient returned to the United States by medevac and has been admitted to the National Institutes of Health Clinical Center for treatment, the agency said in a written statement.

Although none of the individuals currently being monitored in Sierra Leone have tested positive for Ebola, they will voluntarily self-isolate and remain under direct active monitoring for the 21-day incubation period before returning to the United States.

In the event that another Ebola case is confirmed, the CDC and the State Department are developing contingency plans for returning the other American health care workers to the United States by noncommercial air transport.

[email protected]

Regular sauna bathing was associated with improved hemodynamic function, including significantly reduced risk of sudden cardiac death, fatal coronary heart disease, fatal cardiovascular disease, and all-cause mortality, according to a study published in JAMA Internal Medicine.

Lead investigator Tanjaniina Laukkanen of the University of Eastern Finland, Kuopio, and her associates examined data from a prospective cohort study with 2,315 middle-aged men from eastern Finland (JAMA Intern. Med. 2015 Feb. 23 [doi:10.1001/jamainternmed.2014.8187]). They found that the risk of fatal coronary heart disease events was 23% lower for two to three sauna bathing sessions per week and 48% lower for four to seven sauna bathing sessions per week, respectively, when compared with just one sauna bath per week. Both differences were significant.

©RossHelen/thinkstockphotos.com

Frequency of sauna bathing, but not duration, was also inversely and significantly associated with all-cause mortality, with a 40% reduction among those with four to seven sessions per week.

Though the physiological effects of sauna bathing on cardiovascular health can vary considerably, the researchers noted that the increased heart rate and higher cardiovascular output observed during sauna bathing is physiologically similar to the cardiovascular benefits achieved through low- and moderate-intensity physical exercise training.

[email protected]

Regular sauna bathing was associated with improved hemodynamic function, including significantly reduced risk of sudden cardiac death, fatal coronary heart disease, fatal cardiovascular disease, and all-cause mortality, according to a study published in JAMA Internal Medicine.

Lead investigator Tanjaniina Laukkanen of the University of Eastern Finland, Kuopio, and her associates examined data from a prospective cohort study with 2,315 middle-aged men from eastern Finland (JAMA Intern. Med. 2015 Feb. 23 [doi:10.1001/jamainternmed.2014.8187]). They found that the risk of fatal coronary heart disease events was 23% lower for two to three sauna bathing sessions per week and 48% lower for four to seven sauna bathing sessions per week, respectively, when compared with just one sauna bath per week. Both differences were significant.

©RossHelen/thinkstockphotos.com

Frequency of sauna bathing, but not duration, was also inversely and significantly associated with all-cause mortality, with a 40% reduction among those with four to seven sessions per week.

Though the physiological effects of sauna bathing on cardiovascular health can vary considerably, the researchers noted that the increased heart rate and higher cardiovascular output observed during sauna bathing is physiologically similar to the cardiovascular benefits achieved through low- and moderate-intensity physical exercise training.

[email protected]

Regular sauna bathing was associated with improved hemodynamic function, including significantly reduced risk of sudden cardiac death, fatal coronary heart disease, fatal cardiovascular disease, and all-cause mortality, according to a study published in JAMA Internal Medicine.

Lead investigator Tanjaniina Laukkanen of the University of Eastern Finland, Kuopio, and her associates examined data from a prospective cohort study with 2,315 middle-aged men from eastern Finland (JAMA Intern. Med. 2015 Feb. 23 [doi:10.1001/jamainternmed.2014.8187]). They found that the risk of fatal coronary heart disease events was 23% lower for two to three sauna bathing sessions per week and 48% lower for four to seven sauna bathing sessions per week, respectively, when compared with just one sauna bath per week. Both differences were significant.

©RossHelen/thinkstockphotos.com

Frequency of sauna bathing, but not duration, was also inversely and significantly associated with all-cause mortality, with a 40% reduction among those with four to seven sessions per week.

Though the physiological effects of sauna bathing on cardiovascular health can vary considerably, the researchers noted that the increased heart rate and higher cardiovascular output observed during sauna bathing is physiologically similar to the cardiovascular benefits achieved through low- and moderate-intensity physical exercise training.

[email protected]

Drastic steps may be needed to rein in unhealthy American dietary habits and create a national “culture of health” that discourages preventable diseases, the 2015 Dietary Guidelines Advisory Committee recommended in a report submitted for review to the Secretaries of the U.S. Department of Health & Human Services and the U.S. Department of Agriculture.

The average American diet does not meet recommendations for vegetables, fruit, dairy, or whole grains, and exceeds recommendations for sodium, saturated fat, refined grains, solid fats, and added sugars, according to the advisory committee. The report recommended that the general population consume less than 2,300 mg of dietary sodium per day, less than 10% of daily calories from saturated fat, and a maximum of 10% of daily calories from added sugars.

Courtesy of National Cancer Institute

The report placed special emphasis on “persistent, prevalent, preventable health problems,” such as obesity, cardiovascular disease, and type 2 diabetes. In order to reduce the burden of chronic disease morbidity and mortality (and also reduce health care costs), health programs will ultimately need to ensure that citizens are provided with the knowledge and tools required to improve the quality of their diet.

“These actions will require a paradigm shift to an environment in which population health is a national priority and where individuals and organizations, private business, and communities work together to achieve a population-wide ‘culture of health’ in which healthy lifestyle choices are easy, accessible, affordable, and normative,” the authors wrote.

The Dietary Guidelines Advisory Committee is a panel of 18 experts assembled to review and improve upon 2010’s Dietary Guidelines for Americans and develop recommendations for the 2015 edition. The HHS and USDA will review the report and begin the process of updating the guidelines in order to inform the 2015 edition of the Dietary Guidelines for Americans, due to be finalized later this year.

Although healthy dietary patterns like the Mediterranean diet can go a long way, health care professionals may want to directly counsel patients on eating well and avoiding chronic health problems. Medical professionals should “embrace a new leadership role in prevention,” the authors recommended.

The public is encouraged to view the independent advisory group’s report and provide written comments at www.dietaryguidelines.gov for a period of 45 days after publication in the Federal Register.

[email protected]

Drastic steps may be needed to rein in unhealthy American dietary habits and create a national “culture of health” that discourages preventable diseases, the 2015 Dietary Guidelines Advisory Committee recommended in a report submitted for review to the Secretaries of the U.S. Department of Health & Human Services and the U.S. Department of Agriculture.

The average American diet does not meet recommendations for vegetables, fruit, dairy, or whole grains, and exceeds recommendations for sodium, saturated fat, refined grains, solid fats, and added sugars, according to the advisory committee. The report recommended that the general population consume less than 2,300 mg of dietary sodium per day, less than 10% of daily calories from saturated fat, and a maximum of 10% of daily calories from added sugars.

Courtesy of National Cancer Institute

The report placed special emphasis on “persistent, prevalent, preventable health problems,” such as obesity, cardiovascular disease, and type 2 diabetes. In order to reduce the burden of chronic disease morbidity and mortality (and also reduce health care costs), health programs will ultimately need to ensure that citizens are provided with the knowledge and tools required to improve the quality of their diet.

“These actions will require a paradigm shift to an environment in which population health is a national priority and where individuals and organizations, private business, and communities work together to achieve a population-wide ‘culture of health’ in which healthy lifestyle choices are easy, accessible, affordable, and normative,” the authors wrote.

The Dietary Guidelines Advisory Committee is a panel of 18 experts assembled to review and improve upon 2010’s Dietary Guidelines for Americans and develop recommendations for the 2015 edition. The HHS and USDA will review the report and begin the process of updating the guidelines in order to inform the 2015 edition of the Dietary Guidelines for Americans, due to be finalized later this year.

Although healthy dietary patterns like the Mediterranean diet can go a long way, health care professionals may want to directly counsel patients on eating well and avoiding chronic health problems. Medical professionals should “embrace a new leadership role in prevention,” the authors recommended.

The public is encouraged to view the independent advisory group’s report and provide written comments at www.dietaryguidelines.gov for a period of 45 days after publication in the Federal Register.

[email protected]

Drastic steps may be needed to rein in unhealthy American dietary habits and create a national “culture of health” that discourages preventable diseases, the 2015 Dietary Guidelines Advisory Committee recommended in a report submitted for review to the Secretaries of the U.S. Department of Health & Human Services and the U.S. Department of Agriculture.

The average American diet does not meet recommendations for vegetables, fruit, dairy, or whole grains, and exceeds recommendations for sodium, saturated fat, refined grains, solid fats, and added sugars, according to the advisory committee. The report recommended that the general population consume less than 2,300 mg of dietary sodium per day, less than 10% of daily calories from saturated fat, and a maximum of 10% of daily calories from added sugars.

Courtesy of National Cancer Institute

The report placed special emphasis on “persistent, prevalent, preventable health problems,” such as obesity, cardiovascular disease, and type 2 diabetes. In order to reduce the burden of chronic disease morbidity and mortality (and also reduce health care costs), health programs will ultimately need to ensure that citizens are provided with the knowledge and tools required to improve the quality of their diet.

“These actions will require a paradigm shift to an environment in which population health is a national priority and where individuals and organizations, private business, and communities work together to achieve a population-wide ‘culture of health’ in which healthy lifestyle choices are easy, accessible, affordable, and normative,” the authors wrote.

The Dietary Guidelines Advisory Committee is a panel of 18 experts assembled to review and improve upon 2010’s Dietary Guidelines for Americans and develop recommendations for the 2015 edition. The HHS and USDA will review the report and begin the process of updating the guidelines in order to inform the 2015 edition of the Dietary Guidelines for Americans, due to be finalized later this year.

Although healthy dietary patterns like the Mediterranean diet can go a long way, health care professionals may want to directly counsel patients on eating well and avoiding chronic health problems. Medical professionals should “embrace a new leadership role in prevention,” the authors recommended.

The public is encouraged to view the independent advisory group’s report and provide written comments at www.dietaryguidelines.gov for a period of 45 days after publication in the Federal Register.

[email protected]

Although many commercial foods made for infants tend to have little sugar and sodium added, a large number of dinners, snacks, and desserts sold in the United States that are designed for toddlers contain added sugar and salt, according to a study published in Pediatrics.

In fact, 72% of toddler dinners examined contained added sodium – with an average of 2,295 mg of sodium per 1,000 kcal – and 32% percent of toddler dinners contained added sugar, wrote Mary E. Cogswell, DrPH, of the Centers for Disease Control and Prevention, Atlanta, and her associates. The majority of dairy-based desserts (70%) and fruit juices (88%) intended for both infant and toddler consumption also contained added sugar.

For infant diets, nearly all of the vegetables, dinners, fruits, dry cereals, and ready-to-serve mixed grains and fruits examined by the researchers were low in sodium content and did not contain added sugars. But 52% of ready-to-serve mixed grains and fruits contained too much added sugar, and 44% of those took more than one-third of their total calories from sugar.

©Purestock/thinkstockphotos.com

Dr. Cogswell and her associates used a nutrition database to identify 1,074 food products sold in the United States and marketed to infants, toddlers, or both. They evaluated the products for sugar content and sodium content based on package information. Nutritional content was assessed based on amount per 100 g (concentration), amount per serving, and total amount in relation to calories.

Approximately 79% of U.S. children aged 1-3 years exceed the upper level of 1,500 mg/day of sodium recommended by the Institute of Medicine, the researchers noted (Pediatrics 2014 [doi:10.1542/peds.2014-3251]).

“Key advice for parents includes limiting juice and avoiding sugar-sweetened beverages and energy-dense, nutrient-poor snacks; if purchasing commercial toddler foods, the labels should be checked for sodium and added sugar,” the authors wrote.

The study was supported by the CDC. The authors reported no relevant financial disclosures.

[email protected]

Although many commercial foods made for infants tend to have little sugar and sodium added, a large number of dinners, snacks, and desserts sold in the United States that are designed for toddlers contain added sugar and salt, according to a study published in Pediatrics.

In fact, 72% of toddler dinners examined contained added sodium – with an average of 2,295 mg of sodium per 1,000 kcal – and 32% percent of toddler dinners contained added sugar, wrote Mary E. Cogswell, DrPH, of the Centers for Disease Control and Prevention, Atlanta, and her associates. The majority of dairy-based desserts (70%) and fruit juices (88%) intended for both infant and toddler consumption also contained added sugar.

For infant diets, nearly all of the vegetables, dinners, fruits, dry cereals, and ready-to-serve mixed grains and fruits examined by the researchers were low in sodium content and did not contain added sugars. But 52% of ready-to-serve mixed grains and fruits contained too much added sugar, and 44% of those took more than one-third of their total calories from sugar.

©Purestock/thinkstockphotos.com

Dr. Cogswell and her associates used a nutrition database to identify 1,074 food products sold in the United States and marketed to infants, toddlers, or both. They evaluated the products for sugar content and sodium content based on package information. Nutritional content was assessed based on amount per 100 g (concentration), amount per serving, and total amount in relation to calories.

Approximately 79% of U.S. children aged 1-3 years exceed the upper level of 1,500 mg/day of sodium recommended by the Institute of Medicine, the researchers noted (Pediatrics 2014 [doi:10.1542/peds.2014-3251]).

“Key advice for parents includes limiting juice and avoiding sugar-sweetened beverages and energy-dense, nutrient-poor snacks; if purchasing commercial toddler foods, the labels should be checked for sodium and added sugar,” the authors wrote.

The study was supported by the CDC. The authors reported no relevant financial disclosures.

[email protected]

Although many commercial foods made for infants tend to have little sugar and sodium added, a large number of dinners, snacks, and desserts sold in the United States that are designed for toddlers contain added sugar and salt, according to a study published in Pediatrics.

In fact, 72% of toddler dinners examined contained added sodium – with an average of 2,295 mg of sodium per 1,000 kcal – and 32% percent of toddler dinners contained added sugar, wrote Mary E. Cogswell, DrPH, of the Centers for Disease Control and Prevention, Atlanta, and her associates. The majority of dairy-based desserts (70%) and fruit juices (88%) intended for both infant and toddler consumption also contained added sugar.

For infant diets, nearly all of the vegetables, dinners, fruits, dry cereals, and ready-to-serve mixed grains and fruits examined by the researchers were low in sodium content and did not contain added sugars. But 52% of ready-to-serve mixed grains and fruits contained too much added sugar, and 44% of those took more than one-third of their total calories from sugar.

©Purestock/thinkstockphotos.com

Dr. Cogswell and her associates used a nutrition database to identify 1,074 food products sold in the United States and marketed to infants, toddlers, or both. They evaluated the products for sugar content and sodium content based on package information. Nutritional content was assessed based on amount per 100 g (concentration), amount per serving, and total amount in relation to calories.

Approximately 79% of U.S. children aged 1-3 years exceed the upper level of 1,500 mg/day of sodium recommended by the Institute of Medicine, the researchers noted (Pediatrics 2014 [doi:10.1542/peds.2014-3251]).

“Key advice for parents includes limiting juice and avoiding sugar-sweetened beverages and energy-dense, nutrient-poor snacks; if purchasing commercial toddler foods, the labels should be checked for sodium and added sugar,” the authors wrote.

The study was supported by the CDC. The authors reported no relevant financial disclosures.

[email protected]

More than 86% of foster and adopted youth with fetal alcohol spectrum disorder were either not diagnosed or had been misdiagnosed, as the disorder is often mistaken for behavioral issues such as attention-deficit/hyperactivity disorder, a study showed.

According to Dr. Ira J. Chasnoff and his associates, 125 of 156 (80.1%) children and adolescents who met the criteria for a diagnosis within the fetal alcohol spectrum had never been diagnosed as affected by prenatal alcohol exposure. And of the 31 children who had been recognized before referral as affected by prenatal alcohol exposure, 10 had their fetal alcohol spectrum disorder (FASD) diagnoses changed within the spectrum, representing a misdiagnosis rate of 6.4% (Pediatrics 2014 [doi:10.1542/peds.2014-2171]).

Dr. Chasnoff and his colleagues at Children’s Research Triangle (CRT), Chicago, collected data from a sample of 547 children aged 4-18 years who were referred to a Chicago children’s mental health center for behavioral issues. All of the children in the sample were in foster or adoptive homes at the time of referral and evaluation, and the most common reason for referral of the 547 children to the CRT clinic was “behavioral problems.”

Neurodevelopmental deficits among children who have confirmed prenatal exposure to alcohol but who do not meet diagnostic criteria for FASD (growth retardation, central nervous system impairment, and facial dysmorphology) are common. The most common mental health diagnoses for the children at the time of referral were attention-deficit/hyperactivity disorder (ADHD), post-traumatic stress disorder, and conduct disorder.

The researchers cautioned that FASD can have far-reaching consequences for development and that properly diagnosing the disorder should happen as early as possible. Looking beyond the physical criteria (facial dysmorphology) and adhering to modern diagnostic criteria should help more doctors recognize the disorder, as well as increase public awareness of the signs and symptoms of FASD.

“The role of the pediatrician and other children’s health care providers is clear: early recognition of the child or adolescent with FASD, referral to a provider who can 1conduct a full evaluation, and participation in the development of a targeted treatment plan that incorporates mental health treatment, behavioral management strategies, and special education services,” the investigators wrote. “Learning disorders, communication disorders, and intellectual disability, objective signs of significant neurocognitive damage, had not been recognized in a large majority of the children with these disabilities.”

The study was supported in part by a grant from the Administration for Children and Families, Department of Health & Human Services. The investigators had no relevant financial disclosures.

More than 86% of foster and adopted youth with fetal alcohol spectrum disorder were either not diagnosed or had been misdiagnosed, as the disorder is often mistaken for behavioral issues such as attention-deficit/hyperactivity disorder, a study showed.

According to Dr. Ira J. Chasnoff and his associates, 125 of 156 (80.1%) children and adolescents who met the criteria for a diagnosis within the fetal alcohol spectrum had never been diagnosed as affected by prenatal alcohol exposure. And of the 31 children who had been recognized before referral as affected by prenatal alcohol exposure, 10 had their fetal alcohol spectrum disorder (FASD) diagnoses changed within the spectrum, representing a misdiagnosis rate of 6.4% (Pediatrics 2014 [doi:10.1542/peds.2014-2171]).

Dr. Chasnoff and his colleagues at Children’s Research Triangle (CRT), Chicago, collected data from a sample of 547 children aged 4-18 years who were referred to a Chicago children’s mental health center for behavioral issues. All of the children in the sample were in foster or adoptive homes at the time of referral and evaluation, and the most common reason for referral of the 547 children to the CRT clinic was “behavioral problems.”

Neurodevelopmental deficits among children who have confirmed prenatal exposure to alcohol but who do not meet diagnostic criteria for FASD (growth retardation, central nervous system impairment, and facial dysmorphology) are common. The most common mental health diagnoses for the children at the time of referral were attention-deficit/hyperactivity disorder (ADHD), post-traumatic stress disorder, and conduct disorder.

The researchers cautioned that FASD can have far-reaching consequences for development and that properly diagnosing the disorder should happen as early as possible. Looking beyond the physical criteria (facial dysmorphology) and adhering to modern diagnostic criteria should help more doctors recognize the disorder, as well as increase public awareness of the signs and symptoms of FASD.

“The role of the pediatrician and other children’s health care providers is clear: early recognition of the child or adolescent with FASD, referral to a provider who can 1conduct a full evaluation, and participation in the development of a targeted treatment plan that incorporates mental health treatment, behavioral management strategies, and special education services,” the investigators wrote. “Learning disorders, communication disorders, and intellectual disability, objective signs of significant neurocognitive damage, had not been recognized in a large majority of the children with these disabilities.”

The study was supported in part by a grant from the Administration for Children and Families, Department of Health & Human Services. The investigators had no relevant financial disclosures.

More than 86% of foster and adopted youth with fetal alcohol spectrum disorder were either not diagnosed or had been misdiagnosed, as the disorder is often mistaken for behavioral issues such as attention-deficit/hyperactivity disorder, a study showed.

According to Dr. Ira J. Chasnoff and his associates, 125 of 156 (80.1%) children and adolescents who met the criteria for a diagnosis within the fetal alcohol spectrum had never been diagnosed as affected by prenatal alcohol exposure. And of the 31 children who had been recognized before referral as affected by prenatal alcohol exposure, 10 had their fetal alcohol spectrum disorder (FASD) diagnoses changed within the spectrum, representing a misdiagnosis rate of 6.4% (Pediatrics 2014 [doi:10.1542/peds.2014-2171]).

Dr. Chasnoff and his colleagues at Children’s Research Triangle (CRT), Chicago, collected data from a sample of 547 children aged 4-18 years who were referred to a Chicago children’s mental health center for behavioral issues. All of the children in the sample were in foster or adoptive homes at the time of referral and evaluation, and the most common reason for referral of the 547 children to the CRT clinic was “behavioral problems.”

Neurodevelopmental deficits among children who have confirmed prenatal exposure to alcohol but who do not meet diagnostic criteria for FASD (growth retardation, central nervous system impairment, and facial dysmorphology) are common. The most common mental health diagnoses for the children at the time of referral were attention-deficit/hyperactivity disorder (ADHD), post-traumatic stress disorder, and conduct disorder.

The researchers cautioned that FASD can have far-reaching consequences for development and that properly diagnosing the disorder should happen as early as possible. Looking beyond the physical criteria (facial dysmorphology) and adhering to modern diagnostic criteria should help more doctors recognize the disorder, as well as increase public awareness of the signs and symptoms of FASD.

“The role of the pediatrician and other children’s health care providers is clear: early recognition of the child or adolescent with FASD, referral to a provider who can 1conduct a full evaluation, and participation in the development of a targeted treatment plan that incorporates mental health treatment, behavioral management strategies, and special education services,” the investigators wrote. “Learning disorders, communication disorders, and intellectual disability, objective signs of significant neurocognitive damage, had not been recognized in a large majority of the children with these disabilities.”

The study was supported in part by a grant from the Administration for Children and Families, Department of Health & Human Services. The investigators had no relevant financial disclosures.