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This Month in Archives of Pediatrics and Adolescent Medicine |

This Month in Archives of pediatrics & Adolescent Medicine FREE

Arch Pediatr Adolesc Med. 2008;162(1):7. doi:10.1001/archpediatrics.2008.7.
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DO FAMILY MEALS PROTECT ADOLESCENTS FROM DISORDERED EATING BEHAVIORS?

Disordered eating behaviors, such as unhealthy weight control practices and binge eating, are a concern for adolescent health, given their high prevalence and harmful consequences. In this 5-year longitudinal study of more than 2500 adolescents, Neumark-Sztainer and colleagues found that extreme weight control behaviors, such as using diet pills or laxatives or vomiting, were 3-fold more common among females than males. Having at least 5 family meals together per week lowered this risk by 30% among females. However, among males, regular family meals were associated with skipping meals and eating little. The reasons for these sex differences are unknown and need further investigation.

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ADOLESCENT PHYSICAL ACTIVITIES AS PREDICTORS OF YOUNG ADULT WEIGHT

Little is known about the effect of physical activity during adolescence on adult weight status. Using data from the National Longitudinal Study of Adolescent Health, Menschik and colleagues observed 3345 adolescents in grades 8 through 12 for more than 5 years. During the 5-year follow-up period, the prevalence of overweight doubled to 51%. Participation in some (but not all) physical activities, such as rollerblading, bicycling, and skateboarding, more than 4 times per week reduced the risk of being overweight as an adult. For each weekday that an adolescent participated in physical education, the odds of being overweight as an adult decreased by 5%. This study provides good evidence that promotion of physical activity in and out of school can have beneficial effects on adult health.

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FAMILY DIETARY COACHING TO IMPROVE NUTRITIONAL INTAKE AND BODY WEIGHT CONTROL

A family approach has been suggested as a way to achieve sustained dietary changes in school-aged children. In this trial of more than 1000 children and their families from 54 elementary schools, families were randomized to receive advice to reduce fat and increase complex carbohydrate intakes, advice to reduce both fats and sugars as well as increase intake of complex carbohydrates, or no dietary advice. The intervention took place in school, online, and by phone. At the end of the intervention, children assigned to either intervention group decreased their total energy intake. There were no significant differences in body mass index or physical activity levels at follow-up.

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Figure.

Changes in nutritional intake throughout the intervention. Group A was assigned to a low-fat, high–complex carbohydrate diet. Group B was assigned to a low-fat, low-sugar, high–complex carbohydrate diet. The control group was assigned to a usual diet. CC indicates complex carbohydrates; F, fats; and SS, simple sugars.

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FACING RESEARCH RISKS FOR THE BENEFIT OF OTHERS

This study sought to assess children's and parents' attitudes regarding pediatric research that poses minimal risk or a minor increase over minimal risk and does not offer the potential to benefit the child clinically. Children participating in research were significantly more likely to prefer to help other children by participating in research that would not benefit themselves than they were to participate in a charitable activity. More than 80% of children reported that they would be willing to participate in research that was not beneficial to them and posed a risk of a headache. Nearly half of the children were willing to consider participating in research that would not be beneficial to them but would pose a very small chance of a broken leg. These data give empirical support that it can be acceptable to expose children to research risks for the benefit of others, provided the research has the potential to gather data important for improving health and well-being and includes strict limits on risk.

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Figures

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Figure.

Changes in nutritional intake throughout the intervention. Group A was assigned to a low-fat, high–complex carbohydrate diet. Group B was assigned to a low-fat, low-sugar, high–complex carbohydrate diet. The control group was assigned to a usual diet. CC indicates complex carbohydrates; F, fats; and SS, simple sugars.

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