Susceptibility to disease develops during childhood
April 29, 2019
Science Daily/University of Zurich
Traumatized children and children who develop multiple allergies tend to suffer in adulthood from chronic inflammatory diseases and psychiatric disorders. Researchers at the Universities of Zurich and Lausanne have demonstrated this in a study in which they identified five classes of early immune-system programming.
The human immune system forms during childhood: The "hygiene hypothesis" provides a widely regarded perspective on this. It postulates that improved hygiene, changes in agriculture and urbanization have caused our immune systems to come in contact with certain microbes less often or later in life than before. It is presumed that these developments have adversely resulted in an increased incidence of chronic inflammatory diseases, allergies and mental disorders such as depression.
Taking the hygiene hypothesis as a starting point, an interdisciplinary group of researchers at the Universities of Zurich and Lausanne analyzed epidemiological data from a cohort of almost 5,000 people who were born in the mid-20th century. They concentrated on the co-incidence of allergies, viral and bacterial diseases, and psychosocial stress in childhood. On the basis of early morbidity patterns, the scientists identified five different groups of people that they characterized by biomarkers (white blood cell counts, inflammatory markers) and, in a further step, by their association patterns with chronic inflammatory diseases and psychiatric disorders during adulthood.
One in five people have a very resistant immune system
The main group, which comprised almost 60% of the total cohort analyzed, possessed an ordinary, "neutral" immune system. Their disease burden during childhood was comparatively low. Childhood disease burden was even lower for the second-largest group comprising more than 20% of the total cohort: that group exhibited an especially resistant, "resilient" immune system. Even symptoms of common childhood diseases like measles, mumps or rubella, which were not preventable in the mid-20th century, appeared far less frequently in this group than in the "neutral" group.
The "resilient" group is juxtaposed by three smaller groups. The "atopic" group (7% of total cohort) exhibited incidents of multiple allergic diseases. The roughly same-sized "mixed" group (approximately 9%) was characterized by single allergic disorders such as drug allergies, for example, and by bacterial and rash-inducing childhood diseases like scarlet fever, pertussis or rubella. The smallest of the five groups (approximately 5%) comprised people who were traumatized in childhood. They were more susceptible to allergic diseases, but responded comparatively resiliently to common childhood viral diseases.
Hygiene hypothesis taken a step further
Comparative analyses revealed that the "neutral" and "resilient" groups were larger among people with earlier birth years than they were among individuals with later birth years. The exact opposite was true for the "atopic" group, which increased the later the birth year. "Our study thus corroborates the hygiene hypothesis," lead author Vladeta Ajdacic-Gross from the University of Zurich says, "but at the same time goes beyond it."
Differences between the groups also manifested themselves in later health. People belonging to the "resilient" group were better protected in adulthood not just against chronic inflammatory diseases, but also against mental disorders. Members of the "atopic" and "mixed" groups, on the other hand, were susceptible to elevated somatic and psychiatric health risks in later age. The "traumatized" group likewise exhibited a greater predisposition to psychiatric illness in adulthood as well as a higher risk of suffering from chronic inflammatory diseases, the latter only among women, however. "The findings of the study indicate that the human immune system acts like a switchboard between somatic and psychic processes," Ajdacic-Gross explains. "They help us understand why many people who do not have a history of psychosocial trauma get afflicted by mental disorders and, conversely, why traumatized people show a predisposition to chronic inflammatory diseases."
https://www.sciencedaily.com/releases/2019/04/190429134130.htm
Debate on daylight saving time and school start time
April 22, 2019
Science Daily/University of Surrey
A switch to permanent daylight saving time will undo any positive effects on sleep of delaying school start times, according to researchers from the University of Surrey.
Writing in the journal Current Biology, Professor Anne Skeldon and Professor Derk-Jan Dijk discuss proposals by the California state legislature to introduce permanent daylight saving time (DST) and how this switch could undermine a 2018 vote in the state to delay school start time for teenagers. The vote last year in the California legislature, currently vetoed by the State Governor, prohibited the start of schools before 8:30am in a bid to improve student health and boost graduation rates.
Delaying school times has been a contentious issue in North America and Europe with proponents arguing that such a postponement would enable teenagers, who typically go to bed later, to get the recommended amount of sleep, whilst opponents point to the logistical problems that would arise from such a change. DST, the practice of setting the clocks forward one hour from standard time (ST) during the summer months in order to make better use of natural daylight, is also a divisive issue. In March, the European parliament voted to stop changing the clocks, with European Union member states required to decide whether to stay on permanent DST or permanent ST by 2021. California, Florida and Washington are all due to vote on whether to stay on permanent DST. Skeldon and Dijk point out that a switch to permanent DST is incompatible with the aims of delaying school times.
They note that a later biological wake time under permanent DST undermines the benefits of delaying school start times on the sleep of teenagers. For example, from a biological perspective, teenagers would find it as hard to get up at 7am under DST as getting up at 6am during. Skeldon and Dijk conclude that the introduction of permanent DST and delaying school start times are contradictory, as teenagers would, on average, lose any sleep benefit gained from a later school start time as a result of the shift to permanent DST, meaning they'd still be getting inadequate levels of sleep.
Professor Skeldon, from the Department of Mathematics, said: "Each spring, altering the clocks prompts debate. We enjoy the sudden change to lighter evenings, but we do not find the shift to our schedules easy. However, for our sleep, permanent DST is not the solution. Setting our clocks to DST during the winter month's means that the sun will appear to rise one hour later, leaving even more of us to get up in the hours of darkness. Of course, for those who live predominantly inside, rarely experiencing natural light, a switch to permanent DST will have less of an impact. But these people will also only see limited benefits from delaying school/work start times.
"It is complicated, but the impact of switching to permanent daylight saving time on adolescent sleep appears to have been neglected in these considerations."
Professor Dijk, Director of the Surrey Sleep Research Centre, commented: "Many of us are confused about clock and circadian time, but for the sake of our health and well-being it is about time we get our heads around it."
https://www.sciencedaily.com/releases/2019/04/190422112809.htm
Major study finds one in five children have mental health problems
Results from the Ontario Child Health Study (OCHS)
April 17, 2019
Science Daily/McMaster University
One in five Ontario children and youth suffer from a mental disorder, but less than one-third have had contact with a mental health care provider, says the Ontario Child Health Study (OCHS).
Although those overall results echo a similar study from 1983, the new study found a much larger proportion of children and youth with a disorder had contact with other health providers and in other settings, most often through schools.
The new study, called the 2014 OCHS for when data collection started, found that the patterns of prevalence among different sexes and age groups have changed.
Hyperactivity disorder in boys four to 11 years old jumped dramatically from nine to 16 percent, but there has been a substantial drop in disruptive behaviour among males 12 to 16 years old from 10 to 3 per cent. There has been a steep increase in anxiety and depression among both male and female youth from 9 to 13 per cent.
At the same time, there was a significant rise in perceptions of need for professional help with mental health disorders, rising from seven per cent in the original OCHS in 1983 to 19 per cent in the 2014 OCHS. However, the study authors say it is difficult to estimate whether it is tied to the growing prominence of anti-stigma and mental health awareness campaigns over the past three decades.
In 30 years, the prevalence of any disorder increased in communities with a population of 1,000 to 100,000, rather than large urban areas, and there is strong evidence that poor children are more likely to have a disorder if their neighbourhood is one where violence is more common.
The study also found that in the past year more than eight per cent of youth thought about suicide, and 4 per cent reported a suicide attempt.
The 2014 OCHS study included 10,802 children and youth aged four to 17 in 6,537 families. It replicated and expanded on the landmark 1983 Ontario Child Health Study of 3,290 children in 1,869 families.
The Canadian Journal of Psychiatry has simultaneously published eight papers on different aspects of the 2014 OCHS results.
"This is a very robust study we feel represents the situation in Canada," said Michael Boyle, co-principal investigator of the study. "That means there are more than a million Canadian children and youth with a mental health problem. This needs to be addressed."
Co-principal investigator Kathy Georgiades added: "This study underscores the continued need for effective prevention and intervention programs."
https://www.sciencedaily.com/releases/2019/04/190417153803.htm
School bullying increases chances of mental health issues and unemployment in later life
April 17, 2019
Science Daily/Lancaster University
Victims of bullying in secondary school have dramatically increased chances of mental health problems and unemployment in later life.
New research led by Lancaster University Management School researchers reveals stark consequences a decade on for pupils subjected to bullying. Those who are the victims of persistent or violent bullying suffer the worst consequences.
Dr Emma Gorman and Professor Ian Walker, of the Lancaster University Department of Economics, along with research partners Silvia Mendolia, of the University of Wollongong, and Colm Harmon and Anita Staneva, of the University of Sydney, found being bullied in school increases the extent of mental health problems at age 25 by 40%.
It also increases the probability of being unemployed at age 25 by about 35%; and for those in work, it reduces their income by around 2%.
Co-author Emma Gorman said: "Bullying is widespread in schools, and many studies document a negative relationship between bullying and educational outcomes. Bullying is also an important policy issue because of concern that in addition to educational outcomes, being bullied may lead to negative impacts on young people's lives in the long-term, such as low self-esteem, mental health conditions and poorer job prospects.
"Our research shows that being bullied has negative impact on important long-term outcomes, especially unemployment, income and ill-health. Being bullied causes detrimental effects on children's lives not just in the short-term, but for many years after. These are more pronounced among pupils who experience persistent bullying, or violent types of bullying.
"Our findings suggest that a more targeted approach to reduce the most extreme forms of bullying may be warranted."
The research, presented at the Royal Economic Society's annual conference at the University of Warwick, analysed confidential data on more than 7,000 school pupils aged 14-16 from the Longitudinal Study of Young People in England.
About half of pupils involved, who were interviewed at regular intervals until they were 21, and once again at age 25, reported experiencing some type of bullying between the ages of 14 and 16. The information -- reported by both the child and parents -- recorded how frequently the children were bullied, and what type of bullying they experienced.
Examples of bullying within the study include being called names; being excluded from social groups; being threatened with violence; and experiencing violence. As well as the consequences later in life, the research shows bullying affects the academic achievement of the victims while they are in school, and beyond into further and higher education.
Bullying reduces the probability of gaining five or more GCSEs at grades A*-C by 10%, and decreases the probability of staying on to take A-levels by 10%.
https://www.sciencedaily.com/releases/2019/04/190417130013.htm
Later school start times significantly reduce teen driving accidents
April 9, 2019
Science Daily/American College of Chest Physicians
A new study to be presented at CHEST Congress 2019 Thailand in Bangkok shows a significant decrease in teen driving accidents when school start is delayed. Researchers from Farwaniya Hospital in Kuwait and Boston Children's Hospital studied the impact of a 50-minute delay in high school start times in one of the largest school districts in the U.S.
The study compared data from two different academic years: 2014-15, which served as a baseline, and 2015-16, after the delayed start was implemented. Students, who were between the ages of 16-18, self-reported school-night sleep duration. The Fairfax (Virginia) County Youth Survey was used to determine the average sleep duration and driving under the influence of alcohol. The Virginia Department of Motor Vehicles provided de-identified data on driving accidents in both academic years.
There was a 5.25% decrease in the crash rate among teen drivers between the two academic years. This significant reduction was also seen in distraction-related accidents (8.7%) and alcohol-related accidents (20%). During this same time period, there was an increase in teen accident rates by 3.5% in the rest of the state of Virginia.
"Interventions in reducing sleep loss in young drivers such as delaying school start times may significantly reduce needless injuries and deaths due to drowsy driving," says Dr. Saadoun Bin-Hasan, lead researcher.
https://www.sciencedaily.com/releases/2019/04/190409135836.htm
Kids living near major roads at higher risk of developmental delays
April 9, 2019
Science Daily/NIH/Eunice Kennedy Shriver National Institute of Child Health and Human Development
Young children who live close to a major roadway are twice as likely to score lower on tests of communications skills, compared to those who live farther away from a major roadway, according to an analysis by researchers at the National Institutes of Health and the University of California, Merced. Moreover, children born to women exposed during pregnancy to higher-than-normal levels of traffic-related pollutants -- ultra-fine airborne particles and ozone -- had a small but significantly higher likelihood of developmental delays during infancy and early childhood. The study appears in Environmental Research.
"Our results suggest that it may be prudent to minimize exposure to air pollution during pregnancy, infancy, and early childhood -- all key periods for brain development," said Pauline Mendola, Ph.D., an investigator in the Division of Intramural Population Health Research at NIH's Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) and the study's senior author.
Previous studies have linked exposure to common air pollutants in pregnancy to low birthweight, preterm birth and stillbirth. A few studies have found a higher risk of autism and of lower cognitive functioning in children living near freeways, but results of studies about how prenatal and early childhood exposure to air pollution might affect development have been inconsistent.
Given that a large proportion of the U.S. population lives close to major roadways, which are major sources of air pollution, the researchers sought to determine if living near heavily traveled roads was linked to lower scores on developmental screens -- questionnaires or checklists that indicate whether a child is developing normally or needs to be referred to a specialist for further testing.
The researchers analyzed data from the Upstate KIDS Study. They matched the addresses of 5,825 study participants to a roadway data set, calculating the distance of each address to the nearest major roadway. For each participant, they matched home address, mother's work address during pregnancy, and address of the child's day care location to an Environmental Protection Agency data set for estimating air pollution levels. From 8 months to 36 months of age, the children were screened every 4 to 6 months with the Ages and Stages Questionnaire, a validated screening measure evaluating five domains of child development: fine motor skills, large motor skills, communication, personal social functioning and problem-solving ability.
Compared to children living more than half a mile from a major roadway, children living from roughly 164 feet to .3 miles from a major roadway were twice as likely to have failed at least one screen of the communications domain.
The researchers also estimated exposures to ozone and fine inhalable particles (PM2.5), two pollutants produced by car traffic. Fine inhalable particles are 30 times smaller than the width of a human hair, can pass through the lungs' defenses, and are absorbed directly into the bloodstream.
Prenatal exposure to elevated PM2.5 led to a 1.6 to 2.7 percent higher risk of failing any developmental domain, while higher ozone exposure led to a .7 to 1.7 percent higher risk of failing a developmental domain. In contrast, higher postnatal exposure to ozone was linked to a 3.3 percent higher risk of failing most domains of the developmental screen at 8 months, a 17.7 percent higher risk of overall screening failure at 24 months, and a 7.6 percent higher risk of overall screening failure at 30 months.
These results led the researchers to conclude that early childhood exposure to air pollutants may convey a higher risk for developmental delays, compared to similar exposures in the womb. The study is associational and so cannot prove cause and effect. The authors noted that larger studies are necessary to confirm these links.
"It is not clear why exposure to pollutants after birth is linked to a higher risk of developmental delay," said Sandie Ha, Ph.D., of the Department of Public Health at the University of California, Merced, and lead author of the study. "However, unlike exposure during pregnancy, exposure during childhood is more direct and does not go through a pregnant woman's defenses."
https://www.sciencedaily.com/releases/2019/04/190409164002.htm
Childhood trauma has lasting effect on brain connectivity in patients with depression
April 8, 2019
Science Daily/University of Pennsylvania School of Medicine
A study lead by Penn Medicine researchers found that childhood trauma is linked to abnormal connectivity in the brain in adults with major depressive disorder (MDD). The paper, published this week in Proceedings of the National Academy of Sciences (PNAS), is the first data-driven study to show symptom-specific, system-level changes in brain network connectivity in MDD.
"With estimates of approximately 10 percent of all children in the United States having been subjected to child abuse, the significance of child maltreatment on brain development and function is an important consideration," said Yvette I. Sheline, MD, McLure professor of Psychiatry, Radiology, and Neurology, and director of the Center for Neuromodulation in Depression and Stress (CNDS) in the Perelman School of Medicine at the University of Pennsylvania. "This study not only confirms the important relationship between childhood trauma and major depression, but also links patients' experiences of childhood trauma with specific functional brain network abnormalities. This suggests a possible environmental contributor to neurobiological symptoms."
MDD is a common mental disorder characterized by a variety of symptoms -- including persistently depressed mood, loss of interest, low energy, insomnia or hypersomnia, and more. These symptoms impair daily life and increase the risk of suicide. In addition, experiences of childhood trauma, including physical, sexual, or emotional abuse, as well as physical or emotional neglect, have been associated with the emergence and persistence of depressive and anxiety disorders. However, the neurobiological mechanisms underlying MDD are still largely unknown.
To address this challenge, a team led by Sheline utilized functional magnetic resonance imaging (fMRI) to investigate the brain networks and patterns that underlie the disorder. Researchers compared brain activity in 189 participants with MDD to activity of 39 healthy controls. First author Meichen Yu, a post-doctoral fellow in the CNDS, conducted statistical analyses to determine the associations between temporal correlations in connectivity within and between 10 well-established, large-scale resting state networks (RSNs) and clinical measures, including both past history of trauma and current clinical symptoms, such as depression, anxiety, suicidality. These symptoms were measured by 213 item-level survey questions.
The authors found that in patients with MDD, while the strongest correlations were with childhood trauma, abnormal network connectivity was also associated with current symptoms of depression. Even though participants in this study were not selected as participants based on a history of trauma, and the brain imaging took place decades after trauma occurred, prior trauma was evident in abnormal functional connectivity.
"These results suggest that resting-state network connectivity may point to some of the brain mechanisms underlying the symptoms of major depressive disorder," Sheline explains. "It may have the potential to serve as an effective biomarker, aiding in the development of depression biotypes and opening up the possibility of targeted diagnosis."
https://www.sciencedaily.com/releases/2019/04/190408161610.htm
More sleep may help teens with ADHD focus and organize
Study is first to find executive functioning skills deteriorate with lack of sleep
April 8, 2019
Science Daily/American Physiological Society
Teenagers with attention deficit hyperactivity disorder (ADHD) may benefit from more sleep to help them focus, plan and control their emotions. The findings -- the first of their kind in young people with ADHD -- will be presented today at the American Physiological Society's (APS) annual meeting at Experimental Biology 2019 in Orlando, Fla.
ADHD is one of the most common neurobehavioral disorders among children and adolescents. People with ADHD often have trouble with executive function, which are skills that contribute to being able to focus, pay attention and manage time. Executive function challenges in young people may interfere with academic performance, social skills and emotional development. Previous research has found that a lack of sleep contributes to poorer executive functioning in typically developing adolescents, but teens with ADHD have not been studied.
Researchers from Cincinnati Children's Hospital Medical Center measured executive function in adolescent volunteers with ADHD after two separate sleep trials. The volunteers spent a week in which their sleep was restricted to six and a half hours per night, followed by a week in which they were allowed to sleep up to nine and a half hours each night. After each trial, the research team administered the Behavior Rating Inventory of Executive Function, Second Edition (BRIEF2), a widely used measure of executive function in children up to age 18. The BRIEF2 assesses executive function areas such as working memory, planning and organization, emotional control, initiation and inhibition.
The tests showed significant deficits in all of the assessed areas following the sleep-restriction week as compared to the sleep-extension week. "Increased sleep may significantly [and positively] impact academic, social and emotional functioning in adolescents with ADHD, and sleep may be an important future target for future intervention," the researchers wrote.
https://www.sciencedaily.com/releases/2019/04/190408081816.htm
Screen time -- even before bed -- has little impact on teen well-being
April 5, 2019
Science Daily/Association for Psychological Science
Data from more than 17,000 teenagers show little evidence of a relationship between screen time and well-being in adolescents. The study, published in Psychological Science, a journal of the Association for Psychological Science, casts doubt on the widely accepted notion that spending time online, gaming, or watching TV, especially before bedtime, can damage young people's mental health.
"Implementing best practice statistical and methodological techniques we found little evidence for substantial negative associations between digital-screen engagement and adolescent well-being," said Amy Orben, a Researcher at the Oxford Internet Institute (OII) and College Lecturer at the Queen's College, University of Oxford.
"While psychological science can be a powerful tool for understanding the link between screen use and adolescent well-being, it still routinely fails to supply stakeholders and the public with high-quality, transparent, and objective investigations into growing concerns about digital technologies. Analyzing three different datasets, which include improved measurements of screen time, we found little clear-cut evidence that screen time decreases adolescent well-being, even if the use of digital technology occurs directly before bedtime," said Professor Andrew Przybylski, Director of Research at the OII and coauthor on the study.
The research found that adolescents' total screen time per day had little impact on their mental health, both on weekends and weekdays. It also found that the use of digital screens 2 hours, 1 hour, or 30 minutes before bedtime didn't have clear associations with decreases in adolescent well-being, even though this is often taken as a fact by media reports and public debates.
Unlike other studies, the Oxford research analyzed data from Ireland, the US, and the UK to support its conclusions. The researchers used a rigorous methodology to gather how much time an adolescent spends on screens per day, including both self-reported measures and time-use diaries. This is important as many studies are based solely on self-reported digital technology use, even though recent work found only one third of participants give accurate accounts of how much time they spend online when asked after the fact.
The researchers were also able to create a comprehensive picture of teens' well-being, examining measures of psychosocial functioning, depression symptoms, self-esteem, and mood, with data provided by both young people and their caregivers.
Additionally, the final of the three studies conducted was preregistered, meaning that the researchers publicly documented the analyses they would run before they analyzed the data. This prevents hypothesizing after the results are known, a challenge for controversial research topics.
"Because technologies are embedded in our social and professional lives, research concerning digital-screen use and its effects on adolescent well-being is under increasing scrutiny," said Orben. "To retain influence and trust, robust and transparent research practices will need to become the norm -- not the exception. We hope our approach will set a new baseline for new research on the psychological study of technology," added Przybylski.
The insights come days ahead of the anticipated release of the UK government's new White Paper on Online Harms, which is expected to set out plans for legislation governing social media companies. This new study builds on previous work by Orben and Przybylski that used novel and transparent statistical approaches to show that technology use has a minuscule influence on adolescent well-being.
The study used data from Ireland, the US, and the UK. In Ireland, it covered 5,363 young people tracked under the Growing Up in Ireland project. In the US, the data covered 709 subjects of a variety of ages compiled by the United States Panel Study of Income Dynamics. And in the UK, the dataset included responses from 11,884 adolescents and their caregivers surveyed as part of the Millennium Cohort Study.
https://www.sciencedaily.com/releases/2019/04/190405080922.htm
Stress in childhood and adulthood have combined impact on hormones and health
April 3, 2019
Science Daily/Association for Psychological Science
Adults who report high levels of stress and who also had stressful childhoods are most likely to show hormone patterns associated with negative health outcomes, according to findings published in Psychological Science, a journal of the Association for Psychological Science.
One of the ways that our brain responds to daily stressors is by releasing a hormone called cortisol -- typically, our cortisol levels peak in the morning and gradually decline throughout the day. But sometimes this system can become dysregulated, resulting in a flatter cortisol pattern that is associated with negative health outcomes.
"What we find is that the amount of a person's exposure to early life stress plays an important role in the development of unhealthy patterns of cortisol release. However, this is only true if individuals also are experiencing higher levels of current stress, indicating that the combination of higher early life stress and higher current life stress leads to the most unhealthy cortisol profiles," says psychological scientist Ethan Young, a researcher at the University of Minnesota.
For the study, Young and colleagues examined data from 90 individuals who were part of a high-risk birth cohort participating in the Minnesota Longitudinal Study of Risk and Adaptation.
The researchers specifically wanted to understand how stressful events affect the brain's stress-response system later in life. Is it the total amount of stress experienced across the lifespan that matters? Or does exposure to stress during sensitive periods of development, specifically in early childhood, have the biggest impact?
Young and colleagues wanted to investigate a third possibility: Early childhood stress makes our stress-response system more sensitive to stressors that emerge later in life.
The researchers assessed data from the Life Events Schedule (LES), which surveys individuals' stressful life events, including financial trouble, relationship problems, and physical danger and mortality. Trained coders rate the level of disruption of each event on a scale from 0 to 3 to create an overall score for that measurement period. The participants' mothers completed the interview when the participants were 12, 18, 30, 42, 48, 54, and 64 months old; when they were in Grades 1, 2, 3, and 6; and when they were 16 and 17 years old. The participants completed the LES themselves when they were 23, 26, 28, 32, 34, and 37 years old.
The researchers grouped participants' LES scores into specific periods: early childhood (1-5 years), middle childhood (Grades 1-6), adolescence (16 and 17 years), early adulthood (23-34 years), and current (37 years).
At age 37, the participants also provided daily cortisol data over a 2-day period. They collected a saliva sample immediately when they woke up and again 30 minutes and 1 hour later; they also took samples in the afternoon and before going to bed. They sent the saliva samples to a lab for cortisol-level testing.
The researchers found that neither total life stress nor early childhood stress predicted cortisol level patterns at age 37. Rather, cortisol patterns depended on both early childhood stress and stress at age 37. Participants who experienced relatively low levels of stress in early childhood showed relatively similar cortisol patterns regardless of their stress level in adulthood. On the other hand, participants who had been exposed to relatively high levels of early childhood stress showed flatter daily cortisol patterns, but only if they also reported high levels of stress as adults.
The researchers also investigated whether life stress in middle childhood, adolescence, and early adulthood were associated with adult cortisol patterns, and found no meaningful relationships.
These findings suggest that early childhood may be a particularly sensitive time in which stressful life events -- such as those related to trauma or poverty -- can calibrate the brain's stress-response system, with health consequences that last into adulthood.
Young and colleagues note that cortisol is one part of the human stress-response system, and they hope to investigate how other components, such as the microbiome in our gut, also play a role in long-term health outcomes.
https://www.sciencedaily.com/releases/2019/04/190403080454.htm
Defining obesity in children should be based on health issues, not just BMI
Mental health issues are consistent across BMI groups
April 2, 2019
Science Daily/McMaster University
A new study aims to identify what influences the success participants achieve in weight management programs and help improve these programs. The study follows participants for three years.
Physicians are told to gauge the severity of a child's problem with obesity using the body mass index (BMI) that measures weight against height. But that doesn't work well to identify health issues, especially those of mental health, in children with obesity seeking care, says a study led by McMaster University.
Other medical issues, including high blood pressure, prediabetes and non-alcoholic fatty liver disease are also common, and are only slightly more frequent in those with the most severe obesity compared to those with less severe obesity, according to the study.
The details of the study called the Canadian Pediatric Weight Management Registry (CANPWR) were published today in The Lancet Child & Adolescent Health. This study found two thirds of children entering weight management programs across Canada have severe obesity based on their BMI.
"We found that social and mechanical health issues were more common in those with the highest body mass index. However, mental health issues, for example, are consistent across the BMI groups," said Katherine Morrison, principal investigator of the CANPWR study, and professor of the Department of Pediatrics at McMaster.
"If you are only using BMI to identify the youth who need the most care, you would be presuming the kids with the lowest BMI class would be the least likely to have mental health issues or metabolic issues, but our findings suggest this is not true. This study suggests that using a clinical staging system, one that evaluates the health of the child and not just the BMI, is likely the best approach."
Morrison is also co-director of the Centre for Metabolism, Obesity and Diabetes Research at McMaster, an investigator of the Population Health Research Institute, and a pediatric endocrinologist at McMaster Children's Hospital. She said the end goal is to improve care of these children.
"There is a lot said about preventing obesity, we also really need to focus on how best to treat children with obesity. This is especially true when we see the burden of health illness that is associated with obesity in children entering weight management programs."
The CANPWR study aims to identify what influences the success participants achieve in weight management programs and help improve these programs. The study follows participants for three years.
The 10 clinics taking part in the study are in Vancouver, Edmonton, Calgary, Toronto, Hamilton, Ottawa and Montreal.
The paper used information from 847 children with obesity and the health issues were determined at their initial visit to one of the multidisciplinary weight management clinics across Canada. Participants were aged five to 17 at the time of enrolment.
In this study, researchers showed that using a clinical staging system called the Edmonton Obesity Staging System for Pediatrics, or EOSS-P, was more useful for understanding the health issues of the children in these clinics than the BMI class system. They suggest that using a clinical staging system will better assist the design of health care interventions for children with obesity.
Obesity-related health issues were common. Mental health concerns were the most common (90 per cent), followed by metabolic (85 per cent), social (65 per cent) and mechanical (62 per cent) health issues. The most common mental health issue identified was anxiety.
The most commonly identified metabolic health complication was dyslipidemia, followed by non-alcoholic fatty liver disease.
Bullying was the most commonly identified social health factor, followed very closely by low household income. More than one-third of children in the highest obesity group came from low income homes, which was significantly higher than those with lower levels of obesity.
Those with the most severe obesity by BMI were more likely to have experienced bullying, and more likely to report difficulties with peer relationships, compared to the less severe obesity groups.
https://www.sciencedaily.com/releases/2019/04/190402215621.htm