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American Academy Of Pediatrics Endorses Guidelines For Checking LDL Cholesterol Levels In Kids

Why would a pediatrician draw blood from your 9-, 10-, or 11-year-old at his or her next annual wellness visit? Because the American Academy of Pediatrics (AAP) recently endorsed updated guidelines that call for checking LDL (bad) cholesterol levels in all kids between the ages of 9 and 11.

The cholesterol-test recommendation created quite a stir. But wait, there’s more. The guidelines also call for annual blood pressure checks beginning at age 3, and periodic blood sugar measurements starting between ages 9 to 11. There’s also a strong recommendation for kids and adolescents to limit sedentary screen time to two hours or less per day, and to get at least an hour a day of moderate physical activity.

The biological basis for these guidelines is that atherosclerosis (the fatty gunk in arteries that causes heart attacks, strokes, and other serious problems) starts during youth. In many cases, Read more »

*This blog post was originally published at Harvard Health Blog*

Study Provides Reassuring Evidence Regarding ADHD Drugs

If your child is being treated for attention deficit hyperactivity disorder (ADHD), you may have one less thing to worry about today. A study involving 1.2 million children and young adults provided reassuring evidence that the drugs used to treat ADHD do not increase the risk of death from heart disease.

Researchers, who published their results yesterday in the New England Journal of Medicine, analyzed medical records from a nationwide private insurance plan along with health plans based in Tennessee, California, and Washington State. They compared children taking stimulant drugs (like Ritalin and Adderall) that are commonly used to treat ADHD to children not taking these drugs.

Among all of the children, heart attack, stroke, or sudden death were rare, affecting a little more than 3 in every 100,000 children per year. Cardiac problems were no more common among children using a stimulant as among those not taking one.

The study Read more »

*This blog post was originally published at Harvard Health Blog*

Do Chronic Diseases Begin In Utero?

Heart disease. Stroke. Diabetes. Asthma. Osteoporosis. These common scourges are often pegged to genes, pollution, or the wear and tear caused by personal choices like a poor diet, smoking, or too little exercise. David Barker, a British physician and epidemiologist, has a different and compelling idea: these and other conditions stem from a developing baby’s environment, mainly the womb and the placenta.

Barker was the invited speaker at this year’s Stare-Hegsted Lecture, which is a big deal at the Harvard School of Public Health. In just over an hour, he covered the basics of what the British Medical Journal used to call the Barker hypothesis. It has since come to be known as the developmental origins of chronic disease. (You can watch the entire talk here.)

It goes like this: During the first thousand days of development, from conception to age 2, the body’s tissues, organs, and systems are exquisitely sensitive to conditions in their environment during various windows of time. A lack of nutrients or an overabundance of them during these windows programs a child’s development and sets the stage for health or disease. Barker and others use low body weight at term birth is a marker for poor fetal nutrition.

When a fetus is faced with a poor food supply, it Read more »

*This blog post was originally published at Harvard Health Blog*

Guidance For Parents: How To Raise Kids In The Internet Age


As many who were children before the era of cell phones will remember, contacting a friend by phone often involved mastering at least the following script: “Hi, Mrs. Doe. Is Johnny home?” Not so today, in the world of cell phones, texting, email, Facebook, and Twitter.

If you are a parent and don’t use or understand the new technologies, the American Academy of Pediatrics (AAP) has just issued a guideline saying that you probably should. More than half of teens connect to a social media site at least daily. Three-quarters have cell phones that they can use for social networking as well as texting. In a guideline published in March, the AAP makes the important (if obvious) point that today’s children are growing up on the Internet. Since children and adolescents now spend a great deal of time there, parents have good reasons to know what the place is like. Read more »

*This blog post was originally published at Harvard Health Blog*

Baseball Safety: Should We Ban Non-Wood Bats?


Opening Day, the first day of the 2011 major league baseball season, was March 31st. The first pitch was thrown a little after 1 p.m., and sometime after that baseball fans heard the first crack of the bat of a brand-new season.

Even nonfans can rejoice at this sign of spring, and a promise that summer days are ahead.

But you won’t hear the crack of the bat very much these days from other diamonds—Little League, high school, and college. It has been replaced by pings and thunks as most players at those levels now use metal bats or composite ones, which that are made with a mixture of materials, including graphite.

Players started using metal (usually aluminum) bats about 30 years ago. They last longer than wooden bats and send the ball farther. The composite models have come on strong more recently.

But there’s growing concern that nonwood bats may pose a safety hazard to fielders—especially pitchers— because they make a hit baseball go faster. The added speed gives fielders less time to react and, if they are hit, increases their risk of injury. Read more »

*This blog post was originally published at Harvard Health Blog*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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