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, January 2, 2006
ALCOHOL ADVERTISING MAY CONTRIBUTE TO INCREASED DRINKING AMONG YOUNG PEOPLE
PARENTS' IMPRESSIONS OF NEIGHBORHOOD SAFETY LINKED TO CHILDREN'S WEIGHT
ARCHIVES OF GENERAL PSYCHIATRY NEWS RELEASES
Embargoed Until: 3 P.M. (CT), Monday, January 2, 2006
REDUCED BRAIN VOLUME MAY PREDICT DEMENTIA IN HEALTHY ELDERLY PEOPLE
INCOME LEVEL MAY PREDICT RESPONSE TO DEPRESSION TREATMENT
PERINATAL COMPLICATIONS LINKED TO EATING DISORDERS
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EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, January 2, 2006
Media Advisory: To contact Leslie B. Snyder, Ph.D., call Beth Krane at 860-486-4656.
To contact editorialist David H. Jernigan, Ph.D., call Anna Haas at 202-687-0884.
ALCOHOL ADVERTISING MAY CONTRIBUTE TO INCREASED DRINKING AMONG YOUNG PEOPLE
CHICAGO—Young people who view more alcohol advertisements tend to drink more alcohol, according to a new study in the January issue of the Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.
Young people are beginning to drink at an earlier age than ever before and their actions can have consequences ranging from poor grades to alcoholism and car accidents, according to background information in the article. Several studies have found an association between exposure to alcohol advertisements and youth drinking, but have not been able to establish causality, the authors write. The alcohol industry has no federal restrictions on its advertising but is subject to voluntary codes dictating that 70 percent of the audience for their advertisements be adults older than age 21. The authors report that these ads still appear frequently in media aimed at young people.
Leslie B. Snyder, Ph.D., of the University of Connecticut, Storrs, and colleagues interviewed a random sample of young people aged 15 to 26 years in 24 U.S. media markets four times between 1999 and 2001. The researchers interviewed 1,872 young people in the first wave, 1,173 of the same respondents in the second, 787 in the third and 588 in the fourth.
Young adults who reported viewing more alcohol advertisements on average also reported drinking more alcohol on average-each additional advertisement viewed per month increased the number of drinks consumed by 1 percent. The same percentage increase, 1 percent per advertisement per month, applied to underage drinkers (those younger than age 21) as well.
The authors also analyzed youth drinking in relation to advertising dollars spent in respondents' media markets, based on information purchased from an industry source. They also purchased information about total alcohol sales in each state. "It is important to control for total alcohol consumption levels because markets with greater sales may attract more alcohol advertising from brands competing to sell in markets with more heavy drinkers," they write. Even with this control, young people drank 3 percent more per month for each additional dollar spent per capita in their market. Youth in markets with high advertising expenditures ($10 or more per person per month) also increased their drinking more over time, reaching a peak of 50 drinks per month by age 25.
"Given that there was an impact on drinking using an objective measure of advertising expenditures, the results are inconsistent with the hypothesis that a correlation between advertising exposure and drinking could be caused entirely by selective attention on the part of drinkers," the authors report. "The results also contradict claims that advertising is unrelated to youth drinking amounts: that advertising at best causes brand switching, only affects those older than the legal drinking age or is effectively countered by current educational efforts. Alcohol advertising was a contributing factor to youth drinking quantities over time."
(Arch Pediatr Adolesc Med.
2006;160:18-24. Available pre-embargo to the media at www.jamamedia.org)
Editor's Note: This study was funded by a grant from the National Institute of Alcohol Abuse and Alcoholism, Bethesda, Md., to Dr. Snyder.
EDITORIAL: REDUCE EXPOSURE TO ALCOHOL ADVERTISING TO REDUCE UNDERAGE DRINKING
In an accompanying editorial, David H. Jernigan, Ph.D., of the Center on Alcohol Marketing and Youth at Georgetown University, Washington, D.C., comments on the study on youth drinking and exposure to alcohol advertising.
"The work of Snyder et al marks the first time that a national longitudinal sample of young people in the United States has been studied and the first time that self-reported exposure has been complemented by an objective measure of how much alcohol advertising is available in the media environment in which young people live," Dr. Jernigan writes.
The paper "calls into question the industry's argument that its roughly $1.8 billion in measured media expenditures per year have no impact on underage drinking. The fact that young people, regardless of drinking behavior at baseline, were more likely to drink more over time in environments with more alcohol advertising, even when controlling for alcohol sales in those environments, suggests that it is exposure to alcohol advertising that contributes to the drinking, rather than the reverse."
These and other recent findings, Dr. Jernigan writes, "point to alcohol advertising as an important arena for interventions seeking to reduce underage drinking and its tragic consequences."
(Arch Pediatr Adolesc Med.
2006;160:100-101. Available pre-embargo to the media at www.jamamedia.org)
Editor's Note: The Center on Alcohol Marketing and Youth is supported by grants from the Pew Charitable Trusts, Philadelphia, and the Robert Wood Johnson Foundation, Princeton, N.J.
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, January 2, 2006
Media Advisory: To contact Julie C. Lumeng, M.D., call the University of Michigan Health System Department of Public Relations at 734-764-2220.
PARENTS' IMPRESSIONS OF NEIGHBORHOOD SAFETY LINKED TO CHILDREN'S WEIGHT
CHICAGO—Children who live in neighborhoods that their parents believe are unsafe are more likely to be overweight than those in neighborhoods perceived as safe, according to a study in the January issue of the Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.
Almost 16 percent of 6- to 11-year-old children in the United States are overweight, defined as having a body mass index (BMI) of greater than or equal to the 95th percentile of national norms for age and sex, according to background information in the article. Children who are African-American or Hispanic, who watch large amounts of television or who have parents with high BMIs are more likely to be overweight, but little is known about how a child's neighborhood affects his or her risks. Few previous studies have looked specifically at the relationship between neighborhood safety and children's risk of being overweight.
Julie C. Lumeng, M.D., of the University of Michigan, Ann Arbor, and colleagues collected data from 768 children and families participating in the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development, a study of families in 10 diverse regions of the United States. The parents completed questionnaires that assessed how safe they thought their neighborhoods were at the time their children were in first grade. The ratings were divided into quartiles, with the first quartile perceived as the least safe and the fourth as safest. Their children's height and weight were measured in the laboratory when they were 4 ½ years old and again the spring of their first-grade year in school, when their mean (average) age was 7. BMI was calculated by dividing their weight in kilograms by the square of their height in meters.
The researchers found that 17 percent of children living in the first quartile of neighborhoods perceived as least safe by their parents were overweight, compared with 10 percent in the second quartile, 13 percent in the third quartile and only 4 percent of children living in the fourth, safest quartile. This relationship was not affected by any other variables that the researchers measured, including the education levels or marital status of the children's mothers, racial or ethnic backgrounds or participation in after-school activities.
"In effect, there may well be a relatively simple and straightforward relationship between living in a dangerous neighborhood and overweight; namely, in attempting to protect their children from harm, parents not only decrease the kind of physical activity that comes from playing outdoors in the neighborhood but inadvertently increase the likelihood of sedentary activity that comes from staying indoors," the authors report.
"Many areas of policy development related to the built environment and neighborhood safety have not traditionally been considered relevant to child health," they write. "However, such policies may have important implications for childhood overweight. For the individual physician, these results suggest the need to understand the character of a child's neighborhood when making recommendations for lifestyle and activity changes aimed at obesity prevention and treatment."
(Arch Pediatr Adolesc Med. 2006;160:25-31. Available pre-embargo to the media at www.jamamedia.org)
Editor's Note: This study was supported by a grant from the Health Resources and Services Administration, Maternal and Child Health Bureau, Rockville, Md., and a Fellow-to-Faculty Transition Award to Dr. Lumeng from the American Heart Association, Dallas.
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, January 2, 2006
Media Advisory: To contact corresponding author Monique M. B. Breteler, M.D., Ph.D., e-mail m.breteler{at}erasmusmc.nl.
REDUCED BRAIN VOLUME MAY PREDICT DEMENTIA IN HEALTHY ELDERLY PEOPLE
CHICAGO—Reduced volume, or atrophy, in parts of the brain known as the amygdala and hippocampus may predict which cognitively healthy elderly people will develop dementia over a six-year period, according to a study in the January issue of the Archives of General Psychiatry, one of the JAMA/Archives journals.
New strategies may be able to prevent or delay the onset of Alzheimer's disease (AD), the most common cause of dementia among older adults, according to background information in the article. Accurate methods of identifying which people are at high risk for dementia in old age would help physicians determine who could benefit from these interventions. There is evidence that adults with AD and mild cognitive impairment, a less severe condition that is considered a risk factor for AD, have reduced hippocampal and amygdalar volumes. However, previous research has not addressed whether measuring atrophy using magnetic resonance imaging (MRI) can predict the onset of AD at an earlier stage, before cognitive symptoms appear.
Tom den Heijer, M.D., Ph.D., of the Erasmus Medical Center, Rotterdam, the Netherlands, and colleagues used MRI to assess the brain volumes of 511 dementia-free elderly people who were part of the Rotterdam Study, a large population-based cohort study that began in 1990. They screened the participants for dementia at initial visits in 1995 and 1996 and then in follow-up visits between 1997 and 2003, during which they asked about memory problems and performed extensive neuropsychological testing. The authors also monitored the medical records of all participants. During the follow-up, 35 participants developed dementia and 26 were diagnosed with AD.
People with severe amygdalar or hippocampal atrophy had the highest risk of developing dementia or AD over the course of the study, which followed participants for an average period of six years. "Concerning the extent of atrophy, we found in those destined to develop dementia volume reductions between 17 percent and 5 percent, depending on how long before the diagnosis of dementia the MRI was conducted," the authors report. "In persons with mild to moderate Alzheimer disease, volume reductions compared with healthy elderly persons are between 25 percent and 40 percent, suggesting that atrophy rates accelerate in patients with Alzheimer disease."
"Our study suggests that structural brain imaging can help identify people at high risk for developing dementia, even before they have any memory complaints or measurable cognitive impairment," they write. "However, we must bear in mind that most people with atrophy did not develop dementia, even after six years. Further prospective population studies are therefore required to find additional biomarkers, including other brain imaging parameters, that alone or in combination with clinical and genetic characteristics can help separate those who are at risk for developing dementia from those who are not."
(Arch Gen Psychiatry.
2006;63:57-62. Available pre-embargo to the media at www.jamamedia.org)
Editor's Note: This research was financially supported by the Netherlands Organisation for Scientific Research and the Health Research and Development Council, The Hague, the Netherlands.
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, January 2, 2006
Media Advisory: To contact Alex Cohen, Ph.D., call John Lacey at 617-432-0442.
INCOME LEVEL MAY PREDICT RESPONSE TO DEPRESSION TREATMENT
CHICAGO—Low-income people with depression are less likely to respond to treatment and more likely to be suicidal than those who have higher incomes, according to a study in the January issue of the Archives of General Psychiatry, one of the JAMA/Archives journals.
Socioeconomic factors, including income, education and occupation, have long been linked to health status, illness and death. Research has shown that people with lower socioeconomic status (SES) are more likely to develop a depressive illness and that their depression is more severe than that of people higher on the SES scale. Several studies have hypothesized that socioeconomic factors, including income and education, would also affect how people respond to medications and other therapies for depression, but have ultimately proved inconclusive, according to background information in the article.
Alex Cohen, Ph.D., of Harvard Medical School, Boston, and colleagues reanalyzed two previous clinical trials funded by the National Institute of Mental Health and conducted at the University of Pittsburgh. The 248 participants were all 59 years or older and receiving antidepressant medications combined with psychotherapy. Their education levels were assessed at the beginning of the original studies. Median annual household income for their areas was obtained from the U.S. Census Bureau. Low-income was defined as less than $25,000, middle-income between $25,000 and $50,000 and high-income more than $50,000. The subjects' depressive symptoms and response to treatment were measured weekly.
When the authors controlled for demographic factors, such as age and gender, and baseline clinical characteristics, including recurrence of depression and age at onset, they found that people in areas defined as middle-income were significantly more likely to respond to treatment than those in the low-income group. High-income people were only marginally more likely to respond to treatment than middle-income residents, but as a group, high- and middle-income study participants were significantly more likely to respond than those in low-income areas.
In addition, people in low-income areas were about twice as likely as those in middle-income areas and two and a half times as likely as those in high-income tracts to be suicidal, "suggesting an inverse relationship between the median household income of the neighborhoods in which subjects resided and suicidality," the authors write.
The authors found that years of education did not affect treatment response or suicidality in this particular study group. "When the older subjects in our study came of age, economic and social success in the industrial economy was not so dependent on education," they write. "Thus, we speculate that years of education is a less accurate measure of SES in this sample."
Based on their findings, the authors "suggest that future clinical trials routinely gather data on individual income, educational degrees earned, occupation and aspects of the broader social environment such as social capital. However, to transform evidence into knowledge that will inform the treatment of depression, it is essential that future research examines all of the factors (for example, neighborhoods, stress, social support, race/ethnicity or income inequalities) that may mediate the association between SES and clinical outcomes."
(Arch Gen Psychiatry.
2006;63:50-56. Available pre-embargo to the media at www.jamamedia.org)
Editor's Note: This study was supported in part by grants from the National Institute of Mental Health, 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, January 2, 2006
Media Advisory: To contact corresponding author Paolo Santonastaso, M.D., e-mail paolo.santonastaso{at}unipd.it.
PERINATAL COMPLICATIONS LINKED TO EATING DISORDERS
CHICAGO—Certain complications during and immediately after birth are associated with the development of the eating disorders anorexia nervosa and bulimia nervosa, according to a study in the January issue of the Archives of General Psychiatry, one of the JAMA/Archives journals.
Eating disorders are believed to be caused by a complex interaction of genetic and environmental factors, according to background information in the article. Observational reports suggest that problems during neurodevelopment in the fetus might lead to anorexia nervosa or bulimia nervosa later in life, and some studies have found a correlation between obstetric complications and anorexia nervosa. "Obstetric complications might have more than one role in the etiopathogenesis of eating disorders; first, they may cause hypoxic-induced damage to the brain that impairs the neurodevelopment of the fetus, and second, the adequacy of nutrition during pregnancy and in the immediate postnatal period seems to influence the nutritional status of the adult and appetite programming throughout life," the authors write.
Angela Favaro, M.D., Ph.D., and colleagues at the University of Padua, Italy, completed an analysis of 114 females with anorexia nervosa, 73 with bulimia nervosa and a control group of 554 without either condition, all born at Padua Hospital between Jan. 17, 1971, and Dec. 30, 1979. Fifteen of the people with anorexia, 22 with bulimia and all of the control subjects had participated in a previous study of the prevalence of eating disorders in Padua. The authors added in a sample of 99 people with anorexia and 51 with bulimia who had been referred to an outpatient clinic for their conditions. They then merged the samples and analyzed data about obstetric complications obtained from hospital archives.
Several specific complications in the mother-including maternal anemia (low levels of hemoglobin in the blood), diabetes mellitus and placental infarction (death of part of the tissue of the placenta)-increased a child's risk of developing anorexia nervosa. Neonatal heart problems, hypothermia (low body temperature), tremors and hyporeactivity (a less than normal response to stimuli) also were associated with later development of anorexia. Placental infarction, neonatal hyporeactivity, early difficulties with eating, shorter than average birth length and low birth weight were associated with bulimia nervosa.
In addition, the number of complications affected the age at which the children developed anorexia nervosa. Those with more than five complications developed the disorder at an average age of 16.3, compared with 17.5 years for those with one to five complications and 18.8 years for those with no complications. "This type of relationship is considered evidence of a causal link and would indicate that an impairment in neurodevelopment could be implicated in the pathogenesis of anorexia nervosa," the authors write.
"These findings seem to show some resemblance to what has been found in schizophrenia and, with less evidence, in other severe psychiatric disorders," they report-that some obstetric complications may contribute to the development of psychiatric illnesses by robbing a fetus of the oxygen and nutrients needed for proper neurodevelopment or by causing neonatal brain damage. "However, this observation should lead to a search for other more specific risk factors that interact with perinatal factors and are able to predict the development of one particular psychiatric disorder rather than another."
In addition, they write, future research "should try to assess the prognostic impact of the presence of obstetric complications and whether this factor might help in the choice of appropriate and effective treatment."
(Arch Gen Psychiatry.
2006;63:82-88. Available pre-embargo to the media at www.jamamedia.org)
Editor's Note: This study was supported by the University of Padua, Padua, Italy.
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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