The Human Odyssey

The "Age 50 Effect" - A Shrunken Heart?

If you're 50 and you plan to give your heart to your honey this Valentine's Day, maybe you should first check to see whether it's gotten any smaller in the last year.  Researchers at St. Francis Heart Center in Roslyn, New York have determined that the human heart undergoes a particularly significant shrinkage around the age of 50.  Their study examined 218 normal individuals aged 20 to 80, who were free of illness, including any cardiac problems.  They used magnetic resonance imaging (MRI) to measure the size of the heart.  Dr. Nathaniel Reichek, director of the study, noted: "It has been recognized for some time that the heart chambers get smaller with age, but what pops out in this work is that there is an inflection point," he said of the 50-year mark, "where rapidly occurring change occurs."  The study leaves many questions, including whether or not it is possible to ameliorate this shrinkage through diet, exercise, or other interventions.  Still, for Valentine's Day, you might throw in a box of chocolates to make up for that extra cardiac shrinkage!

Parents: Don't Give Your Babies and Toddlers Cold Medicine!

On Thursday (January 17, 2008) the Food and Drug Administration (FDA) issued a public health advisory telling parents NOT to use over-the-counter cold and cough medicines for children under the age of two.  Such medications, says the FDA, can cause rapid heart rates, convulsions, and even death. According to Charles Ganley, M.D., director of the FDA's Office of Nonprescription Products,  "These medicines, which treat symptoms and not the underlying condition, have not been shown to be safe or effective in children under 2."  Many manufacturers of pediatric cold and cough medicines have already responded to this threat by recalling their products from stores around the country. To read the FDA's press release on this warning, click here.  For information on using humidiers as an alternative to cold and cough medicines, click here.  For additional non-drug alternatives, such as nasal sprays and chicken soup, click here.

Brain Abnormalities May Cause SIDS

An article in the November 1, 2007 issue of the Journal of the American Medical Association (JAMA) suggests that abnormalities in the lower brainstem affecting serotonin production may be a major predisposing factor in the occurrence of Sudden Infant Death Syndrome (SIDS) in infants.  The neurotransmitter serotonin is best known for its mood-regulating characteristics (many current antidepressant drugs affect the regulation of serotonin in the brain), but it also plays a vital role in regulating blood pressure and breathing.  The research took place at the Children's Hospital in Boston, Harvard Medical School, and at a number of other institutions. SIDS is the sudden and unexpected death of an infant under the age of one which can't be explained after an autopsy, a review of the infant and family's medical history, or an investigation of the scene and circumstances of the death.  Typically, the infant is found dead after being put into bed to sleep. 

The lower brainstem controls basic vital processes such as  breathing, blood pressure, heart rate, body temperature, and arousal.  In comparing the brains of infants who had died from SIDS with those who had died from other conditions, researchers discovered that the brainstems of children with SIDS has more neurons that produced serotonin, yet the neurons themselves seemed to have fewer receptors for serotonin (places where the neurotransmitter is received by the next neuron in the transmission of nerve signals from neuron to neuron), than infants in the control group.  Researchers hypothesize that SIDS infants have difficulty producing serotonin in the lower brainstem, thus creating communication problems between brain cells responsible for breathing and other vital functions. They see the larger than normal number of serotonin-producing neurons as a means of compensating for this per-neuron serotonin insufficiency.   These discoveries promise that SIDS may no longer be the great mystery it has been to infant researchers, but may be studied scientifically, and eventually result in the development of a drug or other intervention to optimize a newborn's serotonin levels in the lower brainstem, and thus prevent SIDS.  SIDS kills an estimated 2500 infants in the United States every year.  For more information on SIDS, including recommendations for preventing SIDS (such as positioning the infant to sleep on his/her back) click here.  To read the abstract of the original research paper, click here.

Large Investment Groups Buy Nursing Homes and Care Declines

The New York Times examined more than 1200 nursing homes purchased by private investment groups in the past eight years, and discovered that, compared to national averages, these homes declined in care given, and scored lower in 12 of 14 indicators used to track ailments of long-term residents.  Homes owned by such investment firms as Warburg Pincus and the Carlyle Group (owners of Dunkin' Donuts), had greater than average incidences in residents of bedsores, easily preventable infections, and unecessary restraints in freedom and mobility.  Investment firms move in and take over unprofitable nursing homes, fire nursing staff and cut back on other resources, begin making money, and then may sell the homes at a big profit.  While this particular strategy benefits investors, it leaves many aged nursing home residents more vulnerable to a range of age-related risks including depression, loss of mobility, and loss of the ability to dress and feed themselves.  A big problem with investor-owned nursing homes is that they often legallly structure their ownership in such a way that it becomes difficult to sue them when residents become ill or die due to neglect.  Because they are privately owned, they are also immune to many of the local, state, and national regulations that apply to publicly owned nursing homes.  They are, therefore, able to function below the radar screens, and above the law.  According to the New York Times, nursing homes received $75 billion in 2006 from Medicare and Medicaid, making them a veritable cash cow for those investment groups that prey on them, cutting expenses, making huge profits, and leaving residents with sub-par living conditions.  To read the entire New York Times article, click here. 

Early Puberty Raises Risk of Later Breast Cancer

According to a new report commissioned by the Breast Cancer Fund, a California group that uses cigarette tax money to support research on the environmental causes of breast cancer, the average age of puberty has fallen steadily in the past several decades, bringing with it greater risks for later breast cancer, as well as a host of other social and emotional difficulties for girls who reach menarche (age of first menstruation) before age 12.  The average age of menarche in the United States is 12.6 years (for U.S. black girls 12.1).  Early maturation of the ovaries means that a girl will produce more estradiol (a form of estrogen) over her lifetime than average.  Research shows a clear relationship between estrogen and breast cancer development.  In addition, early puberty can bring with it other problems such as depression, eating disorders, attempted suicide, drug abuse, and conduct disorders.  The causes of early puberty in girls are still unclear but may involve several factors including low birth weight, formula feeding, low physical activity, childhood obesity, hormones in meat and milk, family emotional dysfunction, and second-hand tobacco smoke. The author of the report, biologist Sandra Steingraber, writes: "because it arises from a combination of many different stressors in different aspects of the environment--psychosocial, nutritional, behavioral, chemical--early puberty is not an event that will be reversed by single actions by single-purpose agencies. It is a multi-causal threat to the well-being of girls and women that ultimately requires a comprehensive, integrated, unified response."  To download the entire 73-page report, click here.

Hypertension in Children and Adolescents on the Rise

A study that appeared in the August 22/29, 2007 issue of the Journal of the American Medical Association (JAMA), reports that pediatric hypertension is increasing as a result of the obesity epidemic in the United States, and that in most cases, high blood pressure in children goes undiagnosed.  The study observed over time 14,000 children aged 3 to 18 at outpatient clinics in a large academic urban medical care system in Ohio.  Of these, over 500 had hypertension (3.6%). Almost three-quarters of these cases had been up to that point undiagnosed.  One of the problems is that doctors do not routinely take children's blood pressure, assuming that hypertension is an adult problem. If one extrapolates from these findings, then nationwide, roughly 2 million children have high blood pressure, and 1.5 million of those cases are undiagnosed. Left untreated, high blood pressure can lead to a variety of health problems including heart disease, stroke, artery damage, and kidney disease, which are problems that often take years to develop after the first onset of hypertension.  There is concern that this increase in undiagnosed hypertension in children and adolescents could be a warning sign that the nation's obesity epidemic is predisposing many youngster to developing serious health problems later on in life.  (see April 2, 2007 post in The Human Odyssey blog:  "TV Food Ads Contribute to Child Obesity." 

Eating Disorders Among Boys On the Rise

I was alarmed to read that a recent study published in the International Journal of Eating Disorders suggested that eating disorders and other weight control methods such as dieting, diet product use, and vigorous exercise, have risen among male adolescents between 1995 and 2005.   In a November 26, 2007 press release, the Academy for Eating Disorders (which publishes the International Journal of Eating Disorders), writing about the study, noted: "The increase in weight control behaviors among males indicates that the social pressure for men to achieve unrealistic body ideals is growing, putting young males at an increased risk of body dissatisfaction and developing an eating disorder, according to the authors." It seems, then, that the ultra-thin super-models that drive adolescent girls toward anorexia and bulemia, have their counterpart for males in ultra-fit/ultra-muscular boxers, soccer stars, basketball players, martial arts movie stars, and infomercial fitness gurus.  While eating disorder prevalence among females still outstrips that of males (the study, for example, revealed that 53.8% of adolescent females dieted, compared to 23.8% males), the rise of eating disorders among males is particularly problematic, according to the authors of the study, since males are less likely to seek treatment, and since preventative measures have up until now largely ignored males.  Yet males go through puberty, experience rapid shifts in body image, become acutely self-conscious, and look to their peer groups (who look to mass media) for cues as to how they need to physically appear in order to be cool.  The rise in nutritional supplements, weight training programs, fitness centers, and even well-publicized steroid use among sports heroes, all represent social influences that combine with these biological and psychological developments in young male teens to create the kinds of eating and weight problems we're seeing on the rise.  For information about teen body image and self-esteem, go to the Nemours Foundation website. For information about steroid use among boys, see an article in the March 11, 2007 issue of Science Daily, and a journal article in the March 3, 2007 issue of Pediatrics

ADHD as a Developmental Issue (Not a Medical One)

I was very glad to see the research report this week (November 16, 2007) in the Proceedings of the National Academy of Sciences (PNAS), concluding that children labeled ADHD have normal brains that simply develop later than their peers.  This study compared brain scans over a period of years between a group of  223 children diagnosed as having ADHD and a group of 223 children in a control group. Typically, brain growth in the cerebral cortex goes through a developmental process of thickening for the first few years of life, then a peak, after which there is a "thinning down" or "pruning" of cortical tissue as the brain becomes more efficient in its adaptation to the surrounding environment (e.g. connections that are not required for adaptation are eliminated).  The study revealed that the average age for this peaking of cortical development was 7.5 years old in "normal kids", but that in children labeled ADHD it was 10.5 years old, three years later. This research strongly suggests that kids identified as having ADHD are really latebloomers after all.

I've argued this case in my books The Myth of the A.D.D. Child, and  ADD/ADHD Alternatives in the Classroom.  In my own work with kids with this label, I noticed that they acted younger than their peers.  I remember one seventh grade student in my special education class who would see something that interested him on the other side of the classroom, and simply get up and walk toward it, like a toddler would do.  Some people might call this "immaturity," but there is a much better word to use that captures the vitality and freshness of these kids:  neoteny.  Neoteny is a Latin word meaning "holding youth."  In an April 8, 2007 post in this blog, I wrote a piece called "Neoteny: The Lost Fountain of Youth Rediscovered," where I explained that neoteny is essentially the retaining of childlike characteristics into adulthood.  There appears to be a tendency, as species evolve, for more of "the child" to be retained into adulthood.  This has obvious survival value, inasmuch as retaining the "plasticity" of the child's brain later on in development, gives the human species more flexibility in adapting to changing circumstances.  It's curious in this regard to note that many of the most advanced creators and thinkers in civilization have had more than a little of the child in them.  Einstein said "I never grew up."  Newton compared what he did to child's play on the beach.  Picasso said it took him his whole life to learn how to paint like a child. In my book Awakening Genius in the Classroom, I've argued that it's these neotenous characteristics of childhood--playfulness, creativity, imagination, vitality, curiosity, flexibility--that need to be retained into adulthood if our society is going to continue to transform and evolve.  It appears from this week's study in PNAS, that kids labeled ADHD are slower to grow up, and as a result, they have more of their childhood available to them than the average person as they move into adulthood.  This is why they're constantly moving, imagining, making associations, and playing around when they're supposed to be "serious."  We should admire these qualities in them.  We need to stop using negative terms to describe these kids.  Attention Deficit Hyperactivity Disorder, after all, has three negative words in it:  deficit, hyperactive, and disorder.  If by retaining more of their youth into later development these kids are the vanguard, so to speak, in the evolution of our species, then I think it would be more appropriate to give them positive labels:  "evolutionarily gifted," comes to mind.  And yet the scientific community continues to use the disease-based "medical model" term that doesn't at all speak to the true nature of these kids. 

Some will argue, "but these kids are troubled and troublesome to themselves and to others.  Research shows it."  Yes, this is true.  If you're evolutionarily advanced, and you have to function in an environment of Neanderthals, then, yes, this is a problem.  And that's what it is like for so many of these kids, who come into school in kindergarten brimming with enthusiasm, vitality, creativity, and spark, and have to sit for hours every day doing meaningless tasks in boring workbooks overseen by teachers who care far more about following rules than exploring exciting ideas.  Now we're even seeing a new development that can only make things worse:  the societal tendency to push developmental timetables backwards (again, toward the prehistoric).  We're increasingly expecting kindergarteners to do the work that second graders used to do and creating even less opportunity for the "child" in these kids to express itself (see my January 4, 2007 post "Preschoolers Need Play, Not Academics!"). 

So, here you have the situation:  evolutionarily advanced human beings bringing more of the child into later development, on the one hand, and evolutionarily regressive societal forces pushing more of the adult back into early development, on the other.  Is it any wonder that kids labeled ADHD have problems?  Their so-called "symptoms" (again, to use the medical model), are really the mismatch, the incredible disjunction, between the way in which evolution has fashioned them (as the cutting edge of the species), and the way in which an ignorant society has tried to push them back into the Stone Age.  It's this incapacity (this "deficit deficiency") of the ADHD community of researchers, psychiatrists, psychologists, special education teachers, parents, and others to understand these gifts (and to create environments where these gifts are allowed to flourish), that gives rise to most of the "problems" and "symptoms" you see among kids labeled ADHD:  poor self-esteem, negative social relationships, distractibility (which is just a "divergent mind" operating in a boring environment), and impulsivity (which is called "spontaneity" when that environment is open to new discoveries).  I hope that this new study in the prestigeous Proceedings of the National Academy of Sciences, will prompt people who work with children labeled ADHD, to be open to a few new discoveries of their own, and to start thinking of this matter as a developmental (and evolutionary) issue, and not a medical one.

World Congress in Monterrey, Mexico Highlights the Importance of Early Childhood Development

I just got back from the 1st World Congress/7th International Early and Preschool Education Conference in Monterrey, Mexico.  In addition to participating in a colloquium with educators and politicians (see photo above), I also gave a keynote talk on "Awakening the Natural Genius in Every Child" to 4000 early childhood educators.  The Congress was part of the Universal Forum of Cultures, a three-month extravaganza of cultural events involving 1.5 million people in Monterrey (the third largest city in Mexico). I was impressed with all the work being done, particularly in Latin America, to further the lives of young children.  I visited a site in Monterrey created by CENDI (Centros de Desarrollo Infantil - Center for Early Childhood Development) that provides low income parents in Monterrey with child care, medical care, parent training, pre-natal instruction, and many other services (see photo on left).  I couldn't help but think that while I was visiting this full-spectrum developmental center, our president, George Bush, was busy vetoing a bill to provide medical care to more children in the United States.  Accompanying us on our tour to the CENDI site was Dr. James Heckman, the 2000 Nobel Prize winner in Economics, who has been focusing his energies on research demonstrating the positive economic impact of providing for the health, emotional, and educational needs of young children, as opposed to neglecting those needs and having to pay billions of dollars in costs as a result of mental illness, violence, illiteracy, and other societal ills.  His book Inequality in America, sheds important light on the importance of nations' investing in their young children.  Another important individual I met during the conference was Dr. Franklin Martinez Mendoza (below left), who was a key architect in the development of the early childhood development program in Cuba, a country with a literacy rate of 99.8% (higher than the United States). Also impressive was a presentation given by Dr. Osmar Terra, the Secretary of Health for the state of Rio Grande do Sul in Brazil, who laid out in most brilliant fashion the latest work in neuroscience chronicling the negative impact of trauma on the brain in infancy and early childhood.  There were in all over 100 presenters at the conference, and I count myself lucky to have met so many wonderful people who are working to make the lives of young children around the world better.

Teen Suicide Rate Soars

A new report from the Centers for Disease Control and Prevention indicates a big increase in the percentage of teenage suicides from 2003 to 2004 (the most current years for which comprehensive statistics are available).  For all young people between the ages of 10 and 24, the suicide rate rose 8 percent.  This is the biggest single year increase in fifteen years.  The largest increase was in the suicide rate for girls aged 10-14, where it went up 78 percent in one year, from 56 suicides in 2003 to 94 suicides in 2004.  Suicide rates for girls 15-19 increased 32 percent, and for boys in that age bracket, the rate went up 9 percent.  Another dramatic development is in the method that older children and adolescents are now using to kill themselves;  the use of firearms has declined, while the use of hanging or suffocation has increased substantially, now accounting for 71 percent of all the suicides in girls aged 10-14. 

Experts are puzzled by the rise in the number of teen suicides.  Some have suggested that the increase may be related to a decline in the use of antidepressants with teenagers ever since public attention was focused on the suicide risk that antidepressants might hold for depressed adolescents just beginning antidepressant (SSRI) drug theapy.  Others point to the increasingly turbulent lives of teenagers in the 21st century.  Richard Lieberman, the coordinator of the suicide prevention program in the L.A. Public School System noted in an Associated Press release:    "There's a lot of pressure in and around middle school kids. They're kind of all transition kids. They're turbulent times to begin with . . . The hotline's been ringing off the hook with middle school kids experimenting with a wide variety of self-injurious behavior, exploring different ways to hurt themselves."

Risk factors associated with teen suicide or suicide attempts include:  a previous suicide attempt, depression, alcohol/drug abuse, a family history of mental disorders, substance abuse, stressful life experiences, and/or access to firearms, poisons, or other methods of committing suicide (including hanging and suffocation).

Warning signs of suicide in a young person may include, a sudden change in personality, relationship problems with peers, chronic boredom or difficulty concentrating, comments or writings about suicide, substance abuse problems, major traumas or life transitions, psychosomatic complaints, change in eating or sleeping patterns, deteriorating performance in school, giving away highly-prized personal possessions, negative self-statements, self-destructive behavior, and/or chronic sadness or anxiety.

If you know an adolescent who is considering suicide, or if you are a young person considering suicide, get help immediately by calling 1-800-SUICIDE or by looking up in your local phone book a suicide hotline or crisis center, or find a trusted friend, relative, or mental health professional that you can talk to about what's bothering you so that you can get help right away.

For more information (including screening programs, list of warning signs, and treatment options), go to these resources:

SafeYouth.org

SOS Signs of Suicide Prevention Programs

Teen Suicide.us

Yellow Ribbon International Suicide Prevention Program

SaferChild.org

This article is syndicated on Reuters via Basil & Spice

Parents: Don't Let Your Babies Watch TV

On a typical day in America, 68% of infants (aged 0-2) are watching television.  Up to 20% of American babies have a television in their bedrooms.  That's what a survey in the journal Pediatrics this month (May, 2007) reveals.  Pediatrics is published by the American Academy of Pediatrics (AAP), which recommends in its media guidelines to parents that children from ages 0-2 watch NO television at all. So who's not getting the message?  The survey revealed that only 6% of the parents of children from 0-2 were aware of these guidelines.  The study also indicated that ethnicity, family income, and parental education were not relevant to who did and didn't watch TV.  What's going on?  The authors of the study write: " It is clear that in many American families, television is an almost constant presence in daily life. Among young children, this means that they will watch more television."  Baby is just following its role model parents.

Here's the problem.  During the years from 0-2 the brain is going through an incredibly rich process of transformation.  The baby's brain is a veritable thicket of dendrites or brain connections that are strengthened or weakened depending in part upon what kinds of environmental stimuli she receives.  Now, baby has just come into the world, so the most important thing for her wellbeing and survival is that she spend a lot of time interacting with the real world, not watching a fake world.  Through multi-sensory contact with nature, toys, people, and virtually every concrete thing she comes into contact with, she builds a cognitive and emotional map of the universe she will inhabit for the next several decades.  Even a moment of time in front of the television for these little ones, is a moment when they are deprived of this multi-sensory richness.  Television, for all it is cracked up to be by media people and educators who should know better (e.g. "it can be very educational" they claim), does not have visual richness (it's made up of pixels, not real substances), nor does it have auditory richness (infants are particularly sensitive to the hum of electronics, and digital music is no replacement for live music), and of course, importantly, there are no opportunities for hands-on interaction (a joy stick for baby is no substitute for baby's tactile and kinesthetic curiosity about the world), and above all, there is no human contact in watching TV.  Baby is being hardwired for a lot of important social and emotional patterns that will help or hinder her for the rest of her life.  If her "substitute mother" is an electronic box, rather than a warm living and loving parent, then she's going to be wired to relate to people as machines instead of human beings.  This is not a good thing for baby, nor is it good for society (we have enough evidence of people disconnecting from real human contact as it is in our fragmented culture).  So, parents, don't let your babies watch TV.  Period.  You wouldn't leave them out on a busy highway.  You would leave them in a room with a rabid pit bull.  You wouldn't leave them in a room with medicine bottles and electric sockets laying around.  So, don't let them watch TV.  TV is the electronic equivalent of all of these other things, only instead of inflicting physical damage, the damage is subtle cognitive, emotional, social, neurological corrosion that may not even be apparent until years later.  If only 6% of parents know the American Academic of Pediatrics guidelines of no television for infants, then it's up to you to spread the word.  Download a copy of the AAP guidelines (click here) and share them with other parents.  Your baby will thank you. 

Worm Gene May Hold Promise for Human Longevity

Scientists at the Salk Institute in La Jolla, California reported in the journal Nature today that they have discovered the existence of a genetic pathway in roundworms (Caenorhabditis elegans) that appears to extend their lives when their caloric intake has been reduced.  This finding may have implications for human longevity.  It's been known for some time that reducing the intake of calories extends the lives of human beings and other living creatures.  However, this is the first time that a specific genetic mechanism has been discovered that appears to be set off by a reduced-calorie diet.  Now that this link has been revealed, it may be possible to regulate this genetic pathway through drugs rather than a reduced calorie diet (a regimen that is difficult for many humans to follow).  Such a discovery may result in a significant extension of life for human beings.  While the specific gene was discovered in roundworms, scientists have discovered exact counterparts for this gene in mammals: three genes that have been labeled FoxA 1, 2, and 3.  These genes belong to a large family of master regulator genes that control other genes. While today's finding is significant for the possibility of extending lifespan in human beings, much research remains to be done to further define these genetic pathways and to develop drugs that do not have harmful side effects for human beings.   To read a report on these findings in The New York Times, click here.