JAMA news releases are made available to the public after 3 pm US Central time on the first 4 Tuesdays of each month. The Archives Journals news releases are made available to the public after 3 pm Central time on Mondays. We also provide a list of previous news releases.
THIS WEEK'S CONTENTS
ARCHIVES OF PEDIATRICS & ADOLESCENT MEDICINE NEWS RELEASES
Embargoed Until: 3 P.M. (CT), Monday, December 5, 2005
FOOD PRACTICES AND USING FOOD INCENTIVES IN MIDDLE SCHOOLS ASSOCIATED WITH OVERWEIGHT STUDENTS
TEEN WEIGHT CONTROL BEHAVIOR MAY REFLECT MOTHERS' ATTITUDES ON WEIGHT
PERSONAL FULFILLMENT MAY MOTIVATE ADOLESCENTS TO BE PHYSICALLY ACTIVE
ARCHIVES OF GENERAL PSYCHIATRY NEWS RELEASES
Embargoed Until: 3 P.M. (CT), Monday, December 5, 2005
BRAIN ENLARGEMENT MAY BE CHARACTERISTIC OF AUTISM
PSYCHOSOCIAL DISABILITY FLUCTUATES IN PARALLEL WITH BIPOLAR SYMPTOM CHANGES
MARITAL STRESS LINKED WITH SLOWER WOUND HEALING
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EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, December 5, 2005
Media Advisory: Martha Y. Kubik, Ph.D., R.N., call Mary Pattock at 612-624-0939.
FOOD PRACTICES AND USING FOOD INCENTIVES IN MIDDLE SCHOOLS ASSOCIATED WITH OVERWEIGHT STUDENTS
CHICAGO—Schoolwide food practices and policies that allow frequent snacking and consumption of foods and beverages high in calories and low in nutrients throughout the school day, and that permit use of food as incentives and rewards, were associated with higher body mass index in middle school students, according to an article in the December issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.
“Obesity has become one of the more complex and challenging public health issues of this decade, affecting two thirds of adults and almost one third (30 percent) of children…” according to background information in the article. School environmental factors have been implicated in the rising childhood obesity rates. A la carte and vending programs that sell foods and beverages high in calories and low in nutrients are pervasive in schools, and other school food practices that may contribute to childhood obesity, such as fundraising and student incentives, are also documented.
Martha Y. Kubik, Ph.D., R.N., and colleagues from the University of Minnesota, Minneapolis, examined data from sixteen middle schools and their eighth-grade students (n = 3,088) to investigate the association between body mass index (BMI; calculated as weight in kilograms divided by the square of height in meters) in young adolescents and schoolwide food practices. BMI was calculated from students’ self-reported height and weight. School administrators were interviewed about food-related school policies and practices, schoolwide food use guidelines and school-based health promotion activities. Based on interview answers, a food practice score was determined for each school, higher scores indicating more practices were allowed.
The researchers found that students’ BMI increased ten percent for every additional food practice permitted in their school. Average BMI of the students was 21. Eight percent of students were classified as overweight, while fifteen percent were categorized as being at risk for overweight. The average number of food practices allowed was three (range, 0 – 7). Of the seven food practice scale items, the most prevalent was the use of food as incentive and rewards (69 percent) and in classroom fundraising (56 percent). Thirty-one percent of schools allowed food in the classroom, while 38 percent allowed beverages in the classroom. Nineteen percent of schools allowed beverages in hallways, while 31 percent allowed snacks in the hallway.
“Food choice at school includes more than the foods and beverages offered as a part of school meal programs, a la carte, and in vending machines. Similarly, opportunities for eating during the school day extend well beyond the school lunchroom and breakfast and lunch,” the authors write. “Adolescence is a critical period for the development of obesity that persists into adulthood….School nutrition policies that consistently promote and support healthy dietary practices among young adolescents are urgently needed,” they conclude.
(Arch Pediatr Adolesc Med.
2005;159:1111 – 1114. Available pre-embargo to the media at www.jamamedia.org)
For more information, contact JAMA/Archives media relations at 312/464-JAMA (5262) or e-mail mediarelations{at}jama-archives.org.
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EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, December 5, 2005
Media Advisory: To contact Alison E. Field, Sc.D., call Aaron Patnode at 617-355-6420.
TEEN WEIGHT CONTROL BEHAVIOR MAY REFLECT MOTHERS' ATTITUDES ON WEIGHT
CHICAGO—Teenagers are more likely to think about wanting to be thin, and to be frequent dieters, if they accurately perceive that being thin is important to their mothers, according to a study in the December issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.
The association between body weight of children and their parents is known to be affected by genetic and cultural factors. However, less is known about the relationship between the weight concerns and weight control practices of parents and their children. Mothers are thought to play a role in the transmission of cultural values about body weight and shape. Studies show that girls whose mothers diet and are concerned with their weight and shape are more likely than their peers to develop unhealthy weight control practices, according to background information in the article.
Alison E. Field, Sc.D., of Harvard-affiliated Brigham and Women’s Hospital and Children’s Hospital, Boston, and colleagues assessed the association between weight concerns and weight control practices of adolescents and their mothers. The authors conducted a cross-sectional study of 5,331 girls and 3,881 boys, with a mean [average] age of 14.9 years (range, 11.8 to 18.4 years), and their mothers. Participants were included in the analysis if both the adolescent and his or her mother returned a questionnaire mailed in 1999 and provided information on weight, height, and weight concerns.
Weight concerns were more common among girls, with 33 percent of girls and 8 percent of boys thinking frequently about wanting to be thinner. Approximately 54 percent of mothers reported that they thought about wanting to be thinner a lot or always, and 22 percent reported frequently attempting to lose weight during the past year. Also, 0.4 percent of girls and 3.7 percent of boys accurately perceived that their weight was important to their mother. Eight percent of girls had frequently dieted during the past year.
“Although few adolescents accurately perceived that their weight was important to their mother, adolescent boys and adolescent girls who accurately perceived that their weight was important to their mother were more likely to think frequently about wanting to be thinner and to frequently diet than their peers who accurately perceived that their weight was not important to their mother,” the authors report.
“Being overweight is associated with many adverse health consequences, so parents are justified in not wanting their adolescents to be overweight,” the authors write. “However, it is essential to strike a balance between promoting a healthy weight and not placing too much emphasis on the importance of weight.”
“Parents should be encouraged to be role models in incorporating physical activity and healthy nutrition into everyday lifestyle patterns, rather than implementing them as weight control strategies,” they conclude. “In addition, it would be advisable for clinicians who treat overweight and weight-concerned adolescents and young adults to promote physical activity for benefits other than weight control, such as helping to improve self-esteem.”
(Arch Pediatr Adolesc Med.
2005;159:1121-1126. Available pre-embargo to the media at www.jamamedia.org)
Editor's Note: This study was supported by a grant from the Boston Obesity Nutrition Research Center, Boston; by grants from the National Institutes of Health, Bethesda, Md.; by the Kellogg Company, Battle Creek, Mich.; and by a grant from the Maternal and Child Health Bureau, Rockville, Md.
For more information, contact JAMA/Archives media relations at 312/464-JAMA (5262) or e-mail mediarelations{at}jama-archives.org.
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EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, December 5, 2005
Media Advisory: To contact Katie Haverly, M.S., call David Williamson at 919-962-8596.
PERSONAL FULFILLMENT MAY MOTIVATE ADOLESCENTS TO BE PHYSICALLY ACTIVE
CHICAGO—Adolescents are most likely to report personal fulfillment as the strongest motivation to be physically active. Personal fulfillment motivation should be considered when designing physical activity promotion programs for youth, according to a study in the December issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.
Ensuring that youth are physically active is essential for their physical and emotional health. But rates of physical activity are low among youth and decline during adolescence, according to background information in the article. To increase physical activity among youth, motivations to be physically active must be understood more clearly.
Katie Haverly, M.S., and Kirsten Krahnstoever Davison, Ph.D., of the State University of New York at Albany, conducted a cross-sectional study to identify factors that motivate adolescents to be physically active, and to assess the links between activity motivation and physical activity. (Ms. Haverly is now with the Department of Health Education and Health Behavior, University of North Carolina, Chapel Hill.) A total of 202 students (92 girls, mean age 12.5 years; and 110 boys, mean age 12.7 years) at a middle school in rural central Pennsylvania took part in the study. The researchers assessed differences in motivators for groups at risk for physical inactivity – including girls vs. boys, overweight vs. non-overweight youth, and youth with low vs. high perceived sport competence.
“In this study, four sources of motivation were identified: personal fulfillment motivation (e.g., enjoyment, wanting to be fit), weight-based motivation (e.g., wanting to lose weight), parent-influenced motivation (e.g., parents want them to), and peer-influenced motivation (e.g., social activity with friends, to be like the popular kids at school),” the authors write.
“Adolescents were most likely to report personal fulfillment as the strongest motivating factor for physical activity, followed by weight-based motivation, peer motivation, and parent motivation,” they report.
Overweight adolescents reported significantly higher weight-based motivation, compared with those who were not overweight. Adolescents with low perceived sport competence reported significantly lower personal fulfillment motivation, compared with those with higher perceived sport competence.
“Personal fulfillment was the most readily endorsed motivation to be active among all participants regardless of risk status, and was the only motivation that was consistently associated with significantly higher levels of self-reported physical activity,” the authors write. “Results from this study suggest that personal fulfillment motivation could be used as a basis for physical activity promotion programs for youth and that this strategy may be effective for all youth regardless of their risk status.”
(Arch Pediatr Adolesc Med. 2005;159:1115-1120. Available pre-embargo to the media at www.jamamedia.org)
Editor's Note: This study was supported by a grant from the Children, Youth, and Families Consortium at Pennsylvania State University, University Park.
For more information, contact JAMA/Archives media relations at 312/464-JAMA (5262) or e-mail mediarelations{at}jama-archives.org.
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EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, December 5, 2005
Media Advisory: To contact Heather Cody Hazlett, Ph.D., call David Williamson at 919-962-8596.
BRAIN ENLARGEMENT MAY BE CHARACTERISTIC OF AUTISM
CHICAGO—Magnetic resonance imaging (MRI) has found evidence of brain enlargement in a relatively large sample of children with autism, compared with children who do not have the disorder, according to a study in the December issue of Archives of General Psychiatry, one of the JAMA/Archives journals.
Autism is a complex neurodevelopmental disorder defined by social deficits, abnormalities in communication, and stereotyped, repetitive behaviors. While the neuroanatomical basis of this condition is not yet known, numerous lines of evidence suggest that abnormalities in brain volume may be characteristic of autism, according to background information in the article.
Heather Cody Hazlett, Ph.D., of the University of North Carolina, Chapel Hill, and colleagues examined brain volume and head circumference (HC) in children with and without autism. They analyzed data from an ongoing MRI study on 51 children with autism – aged 18 to 35 months – and a comparison group made up of 25 children without autism (14 with typical development, and 11 with developmental delay without evidence of a pervasive developmental disorder). Retrospective longitudinal HC measurements were also gathered from medical records on a larger sample of 113 children with autism and 189 control children, from birth to age three years.
“Significant enlargement was detected in cerebral cortical volumes but not cerebellar volumes in individuals with autism,” the authors report. “Enlargement was present in both white and gray matter, and it was generalized throughout the cerebral cortex.”
The cerebral cortex of the brain is responsible for the processes of thought, perception, and memory, among other functions. The cerebellum is a structure that controls complex motor functions. Gray matter (GM) represents information processing centers in the brain, while white matter (WM) represents connections between those processing centers.
“[In children with autism] head circumference appears normal at birth, with a significantly increased rate of HC growth appearing to begin around 12 months of age,” the authors write.
“The findings from this study confirm the presence of generalized cerebral cortical GM and WM brain volume enlargement at age two in individuals with autism,” they conclude. “Given the strong relationship between HC and brain volume, the onset of this enlargement appears likely to be during the postnatal [after birth] period and may begin as late as the latter part of the first year of life.”
(Arch Gen Psychiatry.
2005;62:1366-1376. Available pre-embargo to the media at www.jamamedia.org)
Editor's Note: This work was supported by grants to co-authors Guido Gerig, Ph.D., and Joseph Piven, M.D., from the National Institutes of Health, Bethesda, Md.
For more information, contact JAMA/Archives media relations at 312/464-JAMA (5262) or e-mail mediarelations{at}jama-archives.org.
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EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, December 5, 2005
Media Advisory: To contact Lewis L. Judd, M.D., call Debra Kain at 619-543-6163.
PSYCHOSOCIAL DISABILITY FLUCTUATES IN PARALLEL WITH BIPOLAR SYMPTOM CHANGES
CHICAGO—With every increase or decrease in depressive symptom severity, there is a corresponding significant and stepwise increase or decrease in psychosocial disability among patients with bipolar disorder, according to a study in the December issue of Archives of General Psychiatry, one of the JAMA/Archives journals.
Bipolar disorder is characterized by cycles of depression and abnormal elation, or mania. It has been found to be associated with increased suicidal behavior, increased health care use and costs, higher unemployment, higher dependence on public assistance, lower annual income, increased work absenteeism owing to illness, decreased work productivity, poorer overall functioning, lower quality of life, and decreased life span, according to background information in the article. Bipolar I disorder (BP-I), which includes episodes of mania, and bipolar II disorder (BP-II), which includes less severe episodes of abnormal mood elevation called hypomania, are dimensional illnesses in which patients experience fluctuating levels of severity of manic and depressive symptoms, interspersed with symptom-free periods.
Lewis L. Judd, M.D., of the University of California, San Diego, and colleagues conducted a study to provide detailed data on psychosocial disability in relation to symptom status during the long-term course of BP-I and BP-II. They analyzed data on 158 patients with BP-I and 133 patients with BP-II who were followed up for an average of 15 years in the National Institute of Mental Health Collaborative Depression Study.
The authors found that symptom severity and psychosocial disability fluctuate together during the course of illness.
“Psychosocial impairment increases significantly with each increment in depressive symptom severity for BP-I and BP-II and with most increments in manic symptom severity for BP-I,” they write.
When patients with BP-I or BP-II are asymptomatic, their psychosocial functioning is good, but not as good as that of well controls.
“When patients with BP-I or BP-II have no mood disorder symptoms, their psychosocial functioning normalizes and is rated as good; when they are experiencing subsyndromal depression, psychosocial functioning is between good and fair; when minor depressive or dysthymic symptoms are present, functioning is fair; and when patients have symptoms at the threshold for major depression, functioning is poor,” the authors write.
“These findings indicate that the depressive phase of bipolar illness is equal in importance to the manic or hypomanic phase, and they confirm the advantage of studying BP-I and BP-II separately,” the authors conclude.
(Arch Gen Psychiatry.
2005;62:1322-1330. Available pre-embargo to the media at www.jamamedia.org)
For more information, contact JAMA/Archives media relations at 312/464-JAMA (5262) or e-mail mediarelations{at}jama-archives.org.
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EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, December 5, 2005
Media Advisory: To contact Janice K. Kiecolt-Glaser, Ph.D., call Earle Holland at 614-292-8384.
MARITAL STRESS LINKED WITH SLOWER WOUND HEALING
CHICAGO—Married couples who had higher levels of hostile behaviors had slower healing times of blister wounds, possibly because of the corresponding change in the level of proinflammatory proteins in the blood, according to a study in the December issue of Archives of General Psychiatry, one of the JAMA/Archives journals.
Marital discord has been associated as a risk factor for several illnesses, according to background information in the article. Possible mechanisms have included changes in blood pressure and endocrine levels. Stress has been linked with a change in the production of proinflammatory cytokines, proteins in cells that play a key role in wound healing.
Janice K. Kiecolt-Glaser, Ph.D., of Ohio State University, Columbus, and colleagues conducted a study to assess how hostile marital behavior affected a health outcome, wound healing, as well as the production of proinflammatory cytokine. The study included 42 healthy married couples, aged 22 to 77 years (average, 37 years old), married an average of 12.6 years. Couples were admitted twice to a hospital research unit for 24 hours. During the first admission, couples had a structured social support interaction, and during the second admission, they discussed a marital disagreement. Couples rated their behavior and responses. A vacuum pump was used to produce blisters on the arm. The blister wound was examined several times over a 12 day period to determine the degree of healing and blood was drawn to measure cytokine levels.
The researchers found that couples’ blister wounds healed more slowly following marital conflicts than after social support interactions. Couples who demonstrated consistently higher levels of hostile behaviors across both their interactions healed at 60 percent of the rate of low-hostile couples and had a median (midpoint) time to healing of one day longer.
Local cytokine production was lower at wound sites following marital conflicts than after social support interactions. High-hostile couples also produced relatively larger increases in cytokine values the morning after a conflict than after a social support interaction compared with low-hostile couples.
“These changes are important because both stressors and depression can sensitize the inflammatory response in such a way that they produce heightened responsiveness to stressful events as well as antigen challenge. Furthermore, more frequent or persistent stress-related changes in plasma levels of these key cytokines have broad implications for health; elevated levels of proinflammatory cytokines have been linked to a variety of age-related disease, including cardiovascular disease, osteoporosis, arthritis, type 2 diabetes mellitus, certain cancers, and frailty and functional decline. Moreover, inflammatory activation can enhance development of depressive symptoms. Thus, relationships characterized by hostility, repeated conflicts, and heightened [cytokine] levels could have negative consequences for both physical and mental health. Indeed, our data are consistent with the growing epidemiological evidence that marital stress is a risk factor for mental and physical health,” the authors write.
“If chronically hostile or abrasive relationships produce more frequent and more pronounced proinflammatory cytokine changes, then individuals in troubled relationships could be at greater risk over time,” the researchers conclude.
(Arch Gen Psychiatry.
2005;62:1377-1384. Available pre-embargo to the media at www.jamamedia.org)
Editor's Note: This research was supported in part by grants from the National Institutes of Health, Bethesda, Md., and Ohio State University.
For more information, contact JAMA/Archives media relations at 312/464-JAMA (5262) or e-mail mediarelations{at}jama-archives.org.
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