News in brief - Oct. 2, 2006

Childhood obesity initiatives studied - Many pregnant ex-smokers resume after delivery due to weight worries - Weakened nasal immune system linked to chronic sinusitis - Less disparity in childhood vaccination rates - E. coli outbreak triggers FDA warning

Childhood obesity initiatives studied

Schools, communities, industry and government have tackled the problem of childhood obesity with a host of new initiatives, but they are fragmented, and it's too soon to tell if they will be successful, according to a Sept. 13 Institute of Medicine report, "Progress in Preventing Childhood Obesity: How Do We Measure Up?"

Currently, one-third of American children and teens are obese or at risk of becoming obese, and that rate is projected to rise to 20% by 2010 if the current trajectory continues, noted the panel that drafted the report.

The problem has been recognized, and schools are responding with more nutritious offerings in cafeterias and vending machines, and communities are building sidewalks and bike paths. But it will take years of systematic evaluation of health outcomes as measured by body mass index to judge the success of these efforts, the panel concluded.

Panel members called on federal, state and local governments to provide the leadership for a sustained effort. They said Congress should periodically evaluate the food industry's actions and that the Food and Drug Administration should be given the authority to evaluate restaurants to ensure that nutrition information is accessible to young consumers.

Many pregnant ex-smokers resume after delivery due to weight worries

Smokers who gave up the habit during pregnancy were less motivated to continue refraining from tobacco use if they were concerned about weight gain, according to a study published in the October Annals of Behavioral Medicine.

Researchers interviewed 119 women in the third trimester who had smoked at least eight cigarettes a day but quit when they learned they were pregnant. Most did not want to resume smoking, but those who were less motivated were also more likely to use smoking for weight control. They were also less capable of managing their weight by other methods.

The authors suggest that interventions targeting women after delivery will need to address weight issues; they also intend to study the link between weight concerns, motivation and actual smoking behavior.

"The next step is to see if weight concerns play a role in women's actual behavior, beyond motivation, and to understand the best way to target this vulnerability with treatment," said Michele Levine, PhD, lead author and assistant professor of psychiatry at the University of Pittsburgh School of Medicine.

Weakened nasal immune system linked to chronic sinusitis

Two proteins vital to the immune response of the nose are low in patients with chronic sinusitis and nasal polyps who do not respond to usual treatment, according to a study presented at the annual meeting of the American Academy of Otolaryngology -- Head and Neck Surgery last month in Toronto.

Researchers analyzed the epithelial cells from 16 patients undergoing endoscopic sinus surgery and compared them to those from five healthy controls. Those with the condition had low levels of human beta-defensin 2 and mannose-binding lectin, two proteins crucial to mounting an effective immune system response. The authors suggest that manipulating these proteins may lead to more effective treatment.

"Colonization with microorganisms is a common problem in patients with chronic sinusitis and polyps, but the reasons for this are incompletely understood," said Andrew Lane, MD, senior author and associate professor at Johns Hopkins University School of Medicine in Baltimore. "Now we are uncovering new clues as to what might be wrong and perhaps ultimately how it might be treated."

Less disparity in childhood vaccination rates

The racial and ethnic gaps for childhood vaccine coverage have disappeared, according to the Centers for Disease Control and Prevention.

"That is very exciting news, because in the past these gaps have been major," said Anne Schuchat, MD, director of the CDC's National Center for Immunization and Respiratory Diseases.

The big picture also looks good as immunization rates for all children are at or near record highs, she said at a Sept. 14 briefing on the National Immunization Survey, an annual telephone interview sample of more than 17,000 children.

The survey focused on the use of six vaccines: diphtheria, tetanus and pertussis; measles, mumps and rubella; Haemophilus influenzae type b; hepatitis B and varicella. But it also revealed that there had been a significant increase in the administration of the pneumococcal conjugate vaccine, first licensed in 2000.

Immunization rates continue to vary from state to state, said Dr. Schuchat. Massachusetts had the highest coverage at 90.7% for 2005; Vermont had the lowest at 62.9%.

E. coli outbreak triggers FDA warning

The Food and Drug Administration on Sept. 14 issued a consumer alert about a multistate outbreak of E. coli O157:H7.

At press time, the illness, which preliminary epidemiological evidence has tied to consumption of fresh bagged spinach, was associated with one death and multiple hospitalizations. As of Sept. 18, cases had been reported in 19 states.

The FDA is advising consumers not to eat bagged spinach and is encouraging anyone with symptoms after eating this product to contact his or her physician.

Although most healthy adults recover from E. coli O157:H7 within a week, some people -- most often young children and the elderly -- develop hemolytic uremic syndrome.