That Extra Slice: Study Finds When Kids Eat Pizza, They Eat More Calories

Pizza birthday party (Flickr Creative Commons)

Pizza birthday party (Flickr Creative Commons)

By Alvin Tran
Guest contributor

Parents, if you want to prevent your kids from eating too many extra calories, you might want to think twice about letting them have that “just one more” slice of chewy dough, tangy tomato sauce and glistening melted cheese.

In a new study, published Monday in the journal Pediatrics, researchers found that pizza contributed to children and adolescents consuming more calories, saturated fat, and sodium in their usual diet.

“They’re taking in substantially more nutrients we really want to be thinking about limiting,” said Lisa Powell, PhD, a University of Illinois at Chicago professor of health policy and administration and the study’s lead author.

Powell’s study, which analyzed 24-hour dietary recalls of more than 12,000 kids over a 7-year period, found that children between the ages of 2 and 11 consumed an extra 84 calories on the days they ate pizza, while adolescents consumed an extra 230 calories.

It’s not a good idea to eat pizza as a snack.
– Lisa Powell, PhD

They also consumed significantly more sodium and saturated fat, which nutrition and health experts often dub the “bad fat.”

There is a silver lining, however. Children’s overall caloric intake from pizza declined by 25 percent over the course of the study. The study’s adolescent population, which ranged from ages 12 and 19, also demonstrated similar trends: its caloric intake from pizza fell by 22 percent.

But while the number of calories that adolescents consumed dropped, their overall consumption, on average, did not significantly change over the course of the study. According to Powell and her co-authors, this may be due to a slight increase in pizza consumption.

“The average adolescent takes in 620 calories of pizza. By showing that they consume this extra 230 calories, that means that on days they consume pizza, they’re not adequately adjusting the caloric intake and other things they take in that day,” Powell said. “They may be eating pizza but they’re having this additional 230 calories that they’re taking in.”


Overall, pizza consumption remained highly prevalent across both groups. In 2009 to 2010, 20 percent of children and 23 percent of adolescents consumed pizza on a given day.

Powell and her colleagues also found that consuming pizza as a snack or from fast-food restaurants were the two greatest culprits influencing both children and adolescents’ overall daily calorie intake.

“It’s not a good idea to eat pizza as a snack. That’s one thing that teens and parents should keep in mind,” Powell said. Continue reading

White Coats For Black Lives: Toward Racial Equality In Health Care

Kaitlyn Veto/flickr

Kaitlyn Veto/flickr

Acknowledging the public health impact of racism and deep disparities in the quality and accessibility of medical care for patients of color, a national organization, White Coats for Black Lives, says it’s launching a new effort today, in celebration of Martin Luther King, Jr.

Dorothy Charles, one of the group’s organizers and a first year medical student at the University of Pennsylvania’s Perelman School of Medicine, offers some context in an email:

Racism profoundly impacts people of color: the black-white mortality gap in 2002, for example, accounted for 83,570 excess deaths. As future physicians, we are responsible for addressing the perpetuation of racism by medical institutions and seek policy change to eliminate disparities in outcomes.

Here’s a statement from the White Coats for Black Lives National Steering Committee:

Upon matriculating in medical school, students recite the Hippocratic Oath, declaring their commitment to promoting the health and well-being of their communities. On December 10, 2014, students from over 80 medical schools across the United States acted in the spirit of that oath as we participated in a “die in” to protest racism and police brutality. In our action, we called attention to grim facts about the public health consequences of racism, acknowledged the complicity of the medical profession in sustaining racial inequality, and challenged a system of medical care that denies necessary treatment to patients unable to pay for it, disproportionately patients of color.

Today, in celebration of the legacy of Dr. Martin Luther King Jr., we announce the founding of a national medical student organization, White Coats for Black Lives. This organization brings together medical students from across the country to pursue three primary goals:


1. To eliminate racism as a public health hazard

Racism has a devastating impact on the health and well-being of people of color. Tremendous disparities in housing, education, and job opportunities cut short the average Black life by four years. Physicians, physician organizations, and medical institutions must therefore publicly recognize and fight against the significant adverse effects of racism on public health. We additionally advocate for increased funding and promotion of research on the health effects of racism.

2. To end racial discrimination in medical care

We recognize that insurance status serves in our healthcare system as a “colorblind” means of racial discrimination. While it is illegal to turn patients away from a hospital or practice because of their race, patients across the country are frequently denied care because they have public insurance or lack health insurance. We support the creation of a single payer national health insurance system that would give all Americans equal access to the healthcare they need. Such a system would create a payment structure that reflects the fact that “Black lives matter.” Moreover, ample evidence suggests that patients of color receive inferior care even when they are able to see a doctor or nurse; we therefore advocate for the allocation of funding for research on unconscious bias and racism in the delivery of medical care. Continue reading

Trying To Turn Up Heat On Health Cost Control In Mass.

Updated Jan. 17, 2015, 4:15 p.m.

BOSTON — In 2012, Massachusetts became the first state in the country to set a goal to cut health care spending.

In 2013, the state beat the goal. Spending grew 2.3 percent, well below the gross state product (GSP), 3.6 percent.

Now, at the start of 2015, the state’s largest employer group says good, time to set a more aggressive goal.

We should “congratulate ourselves for being successful in year one,” says Rick Lord, president and CEO at Associated Industries of Massachusetts (AIM), and “set a target that’s more aggressive.”

AIM is backing legislation filed by House Minority Leader Brad Jones that would lower the benchmark from straight GSP to GSP minus 2 points starting next year and continuing through 2022. After that, the cap would go back to even with GSP.

Continue reading

Miralax Dilemma: As Common Laxative Studied, Parents Ask, ‘Is It Safe?’

Miralax is seen on a store shelf. (Robin Lubbock/WBUR)

Miralax is seen on a store shelf. (Robin Lubbock/WBUR)

By Ricki Morell

If you, like millions of parents, routinely give your child Miralax for constipation, recent reports that the Food and Drug Administration is studying a possible link between the common laxative and neuropsychiatric problems probably sounded scary.

After years of complaints from activists, two Children’s Hospital of Philadelphia researchers are now leading an FDA study of the ingredient — polyethylene glycol 3350, or PEG 3350 — to see how it affects children.

“We’re pleased that they’re going to be looking at behavior changes because that’s never been done before,” said Carol Chittenden, co-director of The Empire State Consumer Project, a nonprofit consumer group in Rochester, New York, that pushed the FDA to embark on the study. “Parents are feeling anxious but also validated because they’ve been telling their doctors for years about these symptoms.”

Just because the FDA is doing a study, doesn’t make it dangerous.
– Dr. Samuel Nurko

Miralax is sold over the counter as an adult laxative, but pediatricians and gastroenterologists routinely prescribe it to infants, toddlers and older children. And they often prescribe it for long-term daily use for chronic constipation, even though the label says it should be used for no more than seven days “unless advised by your doctor.”

Dr. Samuel Nurko, director of the Center for Motility and Functional and Gastrointestinal Disorders at Boston Children’s Hospital, said parents have little reason to worry. Dr. Nurko, who was involved in previous studies of Miralax, some partially funded by the drug company that used to own Miralax, argues that the drug isn’t approved for children because of the technicalities surrounding the FDA study process. He believes Miralax is safe for children.

“Just because the FDA is doing a study, doesn’t make it dangerous,” Dr. Nurko said. “From my perspective, the risk of not treating constipation is worse. Do you think the FDA would leave it on the market if it were dangerous? I think it’s an overreaction but I’m glad that they are studying it.”

About 5 percent of children suffer from constipation, according to the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition, which has guidelines for long-term use of Miralax among other constipation treatments.

FDA spokesperson Andrea Fischer said in an email that the agency is funding the $325,000 study to explore pediatric safety concerns even though “the FDA has not determined that there is enough data to warrant additional warnings regarding these products, or to issue specific warnings about pediatric use of the drugs at this time.”

The FDA first tested Miralax in 2008 and found small amounts of ethylene glycol and diethylene glycol, toxic ingredients also found in antifreeze. In subsequent tests in 2013, it found no detectable levels of those ingredients.

Chittenden says any hint that PEG can lead to side effects known to be associated with ethylene glycol or diethylene glycol toxicity is disturbing. According to a 2009 FDA drug oversight report, neuropsychiatric side effects “may include seizures, tremors, tics, headache, anxiety, lethargy, sedation, aggression, rages, obsessive-compulsive behaviors including repetitive chewing and sucking, paranoia and mood swings.”

Diethylene glycol toxicity can also cause “metabolic acidosis,” or too much acid in the blood, which, in severe cases, can lead to shock or death.

But Fischer emphasized that the link between these side effects and Miralax is so far unproven. Continue reading

How Art Can Re-Order A Harsh, ‘Deformed’ Childhood

Artist Evelyn Berde was born with congenital scoliosis in 1950 and spent many years in and out of Massachusetts General Hospital, confined to a bed for months at a time.

Her art, she says, is informed by her experience living with her “deformity,” as it was referred to back then, and her childhood growing up in the old West End of Boston, a low-income neighborhood near MGH and the Charles River, which was razed in the late 1950s, displacing many residents.

It wasn’t an easy childhood: Alcoholism ran in the family and Evelyn’s brother drowned in the Charles River when he was nine and she was just six. Evelyn was subjected to numerous surgeries and procedures for her scoliosis — some that now seem barbaric.

But art, she says, “has the ability to lift us out of one place and take us to another.”

Here, you can listen to Evelyn talk about five of her paintings and tell the stories that helped shape them.

Artist Evelyn Berde's "Shame" (Courtesy Berde)

Artist Evelyn Berde’s “Shame” (Courtesy Berde)

Artist Evelyn Berde's "July 12, 1956" (Courtesy Berde)

Artist Evelyn Berde’s “July 12, 1956″ (Courtesy Berde)

Continue reading

Diaper Power: Expanding Gel Could Help Scientists See Brain Workings

If this were a glam-genius movie along the lines of “The Imitation Game,” we’d see an exhausted, stymied scientist changing the over-wet diaper of his cranky baby, then suddenly straightening up and gasping in the throes of a revelation: “What if — what if — we don’t try to improve the microscope? What if we just make the thing we’re trying to see bigger? We could expand it just like the gel in this huge wet diaper!”

Sadly, it didn’t happen that way. So the moral of this story is not that scientists should change more diapers. But a report just out in the journal Science does point the way to a promising new scientific tool that could prove helpful in the monumental efforts under way to map the brain. And yes, it involves diapers — or rather, the polymer gel that makes disposable diapers expand so rapidly when wet.

Turns out, with some chemical tweaking, that gel can be used to expand brain tissue without distorting its structure, so it may allow scientists to map the nano-scale 3-D connections between neurons — even potentially to get a full picture of how information flows in small animal brains or parts of the human organ.

I spoke with neuro-engineer Ed Boyden of MIT’s Media Lab and McGovern Institute for Brain Research, senior author on the new study in Science, co-authored with MIT grad students Fei Chen and Paul Tillberg. Our conversation, lightly edited:

How would you sum up what you report in this “Science” paper?

Over the last several hundred years, microscopists have been imaging life. The way they do it is they use a glass lens to magnify the light coming out of the biological sample. This has been very, very powerful, and untold numbers of insights have emerged from it, but there’s a problem: How can you image a large, 3-D object with nano-scale precision? Light cannot go down to very, very fine precision because light is sort of finite in size, you could say. It has a wavelength that’s really large compared to single molecules.

What we’ve found is that, in contrast to lens-based magnification, you can physically magnify an object and make it bigger. So that was the first key finding: We can physically magnify an object.
The second key finding is that we have engineered a chemical system that lets you do this very, very precisely and with good resolution.

And a third take-home message from the paper is that we have now shown that the chemical process we developed is very isotropic — that is, it’s very smooth and even, and doesn’t introduce distortion, all the way down to the nanoscale.

Why does being able to analyze brain tissue at this nanoscale resolution matter?

If you want to understand the brain, well, brain circuits are quite large. The individual cells in the brain could be millimeters or centimeters in size in terms of their length. But the actual things that organize the brain — the connections called synapses — are nanoscale. So if you want to understand how a brain circuit funnels information or processes information, you need to be able to map a large, 3-D object with nanoscale precision, and that’s something our technology is enabling.

What could be done with it?

In neuroscience, we’re excited by the possibility that you could try to map an entire small brain, in organisms like flies or worms. We think it’s possible you could expand the entire nervous system or the entire brain and then see the whole thing.

That would be very exciting because you could try to follow the pathways that lead in from the sensory organs — like the eyes — all the way to the motor outputs — to the muscles, and look at all the stuff in between: What makes decisions? What makes memories? And then map that.

One could imagine that at some time in the future you could try to load up these molecular maps of a neural circuit into a computer and then try to simulate a brain in a computer.

What about human brains? Continue reading

Sleepy Students: A Pediatrician’s Plea For Later School Start Times

(eltpics/Flickr via Compfight)

(eltpics/Flickr via Compfight)

By Dr. Marvin Wang, M.D.

Last August, the American Academy of Pediatrics (AAP) issued a statement regarding school start times, really a plea to all middle and high schools to start the school day no earlier than 8:30 a.m.

The statement emerged as a result of accumulating evidence showing that earlier school start times effectively restrict an adolescent’s ability to get regular healthful sleep.

The timing of the AAP’s statement came on the heels of another sentinel event in my family’s life. Just a month after its publication, my daughter started school. No big deal, except for the fact that she has never been to school before. Until this year, she was exclusively homeschooled here in Jamaica Plain, Massachusetts.

My wife and I didn’t have any major agenda driving this decision, other than the fact that we knew we could do it (we work part-time) and it seemed like it would be more family fun. The many details of our homeschooling adventures are really for another time, though.

The reason I even bring up the topic is that as a homeschooler, my daughter was able to wake up when she wanted to (usually within reason). On a regular day, she was used to getting up at 8:30ish (despite sometimes our having to pry her out later).

After a whole lifetime of this, imagine the draconian lifestyle shift of being asked to get up at 6 a.m. every weekday! This is the routine that is better known to most people as “going to school.” Now, let’s be clear about a few things: 1) our daughter wanted this. She asked to take the exam for the Boston Public Schools, in hopes of going to Boston Latin School, where she watched many of her friends attend; 2) she knew the early mornings were part of the routine; and 3) BLS actually has a relatively benign start time of 7:45 a.m., compared to many of its counterparts in the district and the state.

So what’s all the fuss? It cannot be a novel idea to most adults that the typical school teenager is a surly blob on most weekday mornings. Should we be surprised to learn that we have been breeding generations of sleep-deprived adolescents? Should we, as educators, parents and “concerned citizens” be worried about this?

First, let’s look at what’s new since the AAP statement came out.

Indeed, the movement is picking up steam in some parts of the country, as whole districts have approved later start times. In Massachusetts, districts like Sharon, Easton, Duxbury and Nauset have done so.

And there are some new studies corroborating the AAP’s stance:

In looking at the neurobehavioral issues in teens, it turns out that just one night of sleep deprivation in an adolescent has marked worsening of sustained attention, reaction speed, cognitive processing speed and subjective sleepiness. When the sleep was restored, the teens were able to significantly improve all their cognitive abilities.

One study showed that sleep restricted teens (average of five hours/night) were more likely to be lower academic quartiles than those who slept more (average 6 ½ hours/night…which is still two hours less than optimal!). But looking at the results, one also finds that the perceived sleepiness among the sleep restricted group was at least twice that the sleep appropriate group. Continue reading

Why To Exercise Today (Even A Short Walk): Avoiding A Premature Death

I’ve been having such a hard time dragging myself out in the frigid, icy cold to run or get to a gym lately: there are so many excellent reasons not to do it. But here’s the best I could come up with today for why I shouldn’t listen to that “stay-warm-and-slip-into-bed-with-a-laptop little voice in my head: exercise is truly the “best way to avoid an early death,” according to U.K researchers, who report that even small chunks of exercise — a brisk 20-minute walk, for instance — can provide benefits.

Steve Koukoulas/flickr

Steve Koukoulas/flickr

The U.K. Telegraph headline sums up the new study tidily: “Lack of exercise is twice as deadly as obesity, Cambridge University finds.”

Indeed, this cohort study of 334,161 European men and women over 12 years, published in the American Journal of Clinical Nutrition found that “physical inactivity may theoretically be responsible for twice as many total deaths as high BMI” and concludes: “The greatest reductions in all-cause mortality risk were observed between the inactive and the moderately inactive groups across levels of general and abdominal adiposity, which suggests that efforts to encourage even small increases in activity in inactive individuals may be of public health benefit.”

Here’s more from The Telegraph report:

Using the most recent available public data, the researchers calculated that 337,000 of the 9.2 million deaths that occurred in Europe in 2008 could be attributed to obesity.

But physical inactivity was thought to be responsible for almost double this number – 676,000 deaths. Continue reading

When A Nasty Cold Swept Harvard Medical School: Lessons To Be Learned

(Wikimedia Commons)

(Wikimedia Commons)

Last August and September, a nasty cold swept through the Harvard Medical School campus.

As documented by J Bradley Segal in the Harvard Medical Student Review, a survey of 400 students at the med school and the Harvard School of Dental Medicine found that it hit roughly a quarter of first-year students and a third of second-year students.

Ugh. But surely a “teachable moment.” Segal explores what’s known about the common cold in his review and case study, titled “The Most Common Illness,” and analyzes which factors may have helped determine who fell victim to the virus and who did not:

…going to a bar or party with classmates in the last week and studying with classmates some or all of the time significantly increased the risk of contracting the illness. For both classes, living in the medical school dorm, spending more than 30 minutes a day in the medical education building, or regularly attending lecture did not significantly alter the risk of becoming ill.

Interesting. Reminds me of past findings in schoolchildren, that playdates can influence contagion. Bars and parties and study dates are the young-adult versions of viral playdates, it seems.

And as for prevention, it just can’t’ be repeated often enough: Wash your hands, wash your hands, wash your hands. Segal writes:

Hand Washing — The Punch Line

What do we have to prevent the cold, then? The answer can be gleaned from a classic experiment in 1980 in which one group of random volunteers dipped their fingers in dilute iodine solution—it was known to have virucidal properties (Hendley et al., 1978)—and were compared to volunteers who dipped their hands into water that was died to look and smell like iodine (Gwaltney et al., 1980). Immediately after drying their hands, volunteers made hand contact with rhinovirus-positive donors who had just picked their noses (“The donors contaminated their hands with nasal secretions by finger-to-nose contact”), and 15 min later, volunteers touched their own eyes and noses. This was repeated for 3 days. None of the eight iodine-exposed volunteers became infected, while all seven controls became ill (p < 0.001). Unfortunately, routine iodine use is impractical given that many patients do like having iodine-stained hands. Continue reading

Study: Vitamin D Boosts Survival For Some Colon Cancer Patients

Suzanne Schroeter/flickr

Suzanne Schroeter/flickr

When it comes to vitamins, much of the recent news has been grim.  “Enough is enough: Stop wasting money on vitamin and mineral supplements” was the headline of a medical journal  editorial not so long ago.

One exception may be Vitamin D, aka the sunshine nutrient.

Vitamin D is no silver bullet, according to the research. But studies have shown that when your levels are too low, it can be bad for your health.

Now, a new study by researchers at the Dana-Farber Cancer institute finds that high levels of vitamin D increase survival in certain patients with colon cancer.

From the Dana-Farber news release:

… clinical trial patients with metastatic colorectal cancer who had high levels of vitamin D in their bloodstream prior to treatment with chemotherapy and targeted drugs, survived longer, on average, than patients with lower levels of the vitamin. Those findings were reported today at the 2015 American Society of Cancer Oncology (ASCO) Gastrointestinal Cancers Symposium in San Francisco.

…The research, based on data from more than 1,000 patients with metastatic colorectal cancer who enrolled in a phase 3 clinical trial of chemotherapy plus biologic therapies, adds to vitamin D’s already impressive luster as a potential cancer-inhibiting agent. In the study, patients with the highest blood levels of vitamin D survived for a median period of 32.6 months, compared to 24.5 months for those with the lowest levels…

The study’s lead researcher Kimmie Ng, MD, MPH, a medical oncologist at Dana-Farber said in an email to me:

“There is a lot of debate about what can be concluded from observational studies of vitamin D and colorectal cancer survival, with many believing that higher vitamin D levels may just be a proxy for better health or less aggressive disease. But this is where our study truly stands out from the rest – we had very detailed and comprehensive data on patient and tumor characteristics, survival, response to chemotherapy, and diet and lifestyle factors. Even after controlling for all of these variables in our analysis, our results did not change – higher plasma vitamin D was still associated with significantly better survival. Continue reading