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January
2002
Young
Children Need Seat Restraints on Flights, too.
Although child safety seats are mandatory for all children less than
40 pounds riding in automobiles, there are no such laws for children
riding in airplanes. Children younger than 2 years of age are not required
to be strapped in for take off or landing on commercial aircrafts.
Indeed, they are most likely to be found being held by a parent on
their lap.
The American Academy of Pediatrics (AAP) has recently published recommendations
encouraging regulations requiring all passengers to be properly restrained
during flights. Similar to Child Safety Seat laws for automobile passengers,
the AAP recommends infants less than one year old or less than 20 pounds
ride in rear facing seats properly installed in an airline seat. A
forward-facing seat should be used for children at least one year old
and weighing 20 to 40 pounds. Safety seats should not exceed 16 inches
in width to fit into commercial aircraft seats. Children weighing more
than 40 pounds can be secured safely using a seat belt in a traditional
manner used by older children and adults.
While parents may be tempted to hold an infant on their lap rather
than to purchase a separate seat, these new regulations encourage safety
over expense. Passengers can always ask if discounted seats for infants
and children are available for their destination and flight.
January 2002 Update
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Advanced
Macular Degeneration and Nutritional Supplements
Nutritional
supplements may help slow the progression of advanced macular
degeneration (AMD), the most common cause of vision loss in people
over age 55, a new study suggests.
The Age-Related Eye Disease Study (AREDS), reported in the
October 2001 Archives of Ophthalmology, is the largest
clinical trial to have tested the impact of nutritional supplements
on AMD and cataracts. AREDS involved nearly 5,000 women and
men, ages 55-80, at 11 clinical centers nationwide. Participants
in the macular degeneration portion of the study were divided
into groups depending upon the severity of their condition.
They received one of the following daily regimens: 1) antioxidants
(500 mg vitamin C, 400 IU vitamin E, 15 mg beta-carotene),
2) zinc (80 mg, plus 2 mg copper to prevent anemia), 3) a combination
of the antioxidants and zinc, or 4) a placebo. Participants
were evaluated every six months for vision loss and annually
for retinal changes.
Over the seven-year study, combined antioxidants and zinc reduced
the risk for progression to advanced AMD by 25%, compared with
placebo, among those who already had extensive intermediate
or large drusen or advanced AMD in one eye. This treatment
also reduced the AMD-related loss of visual acuity by about
19%. Antioxidants or zinc alone reduced the risk, but to a
lesser extent. AREDS subjects with early or no AMD got no measurable
benefit from the supplements. In the companion study of cataract
development, antioxidants and zinc (separately or in combination)
had no beneficial effect.
Though participants reported no major side effects, the long-term
consequences of taking these nutrients at levels above the
Recommended Dietary Allowance (RDA), as AREDS participants
did, are unknown.
January 2002 Update
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White-Coat
Hypertension
Most people
feel a bit anxious during a doctor's visit. But for some people,
their anxiety causes temporary high blood pressure, detectable
during the time of the visit. Physicians have been debating whether
or not they should treat this phenomenon, referred to as "white-coat" hypertension.
Some believe the short-lived blood pressure elevation is harmless,
while others believe it should be treated like persistent high
blood pressure.
In a recent study, researchers compared changes in the heart's
function and size among people with persistent, untreated high
blood pressure,
"white coat" high blood pressure, and normal blood
pressure. Participants were carefully matched by age, sex,
and weight, as well as in-clinic and out-of- clinic blood pressures.
Results of the study show participants with "white coat" hypertension,
when compared to participants with normal blood pressure, had
thicker walls in portions of their hearts, increased heart
mass, and alterations in the diastolic (relaxing) portion of
the heartbeat. Those people with persistent high blood pressure
had even greater changes in the heart. These findings suggest
"white coat" hypertension, while a temporary condition,
may cause damage to the heart. This study reinforces the argument
for treating
"white coat" hypertension.
If you experience this condition, you should consult your doctor
about treatment options. Simple lifestyle changes may be all
you need or medication might be necessary. In any case, the
possible benefits will outweigh the risks.
January 2002 Update
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Sugar
and Tooth Decay
"If
you eat too much candy your teeth will rot!" We've known
about the link between sugar consumption and tooth decay for
centuries. The bacteria in dental plaque feeds on sugar, and
the acid produced by the bacteria attacks the protective enamel
surface of the teeth, allowing for tooth decay to proceed. But
since the advent of fluoride in water, toothpaste, dental treatments,
and even processed foods, do we still need to restrict how much
sugar we eat?
A recent review answers this question. Researchers examined
the results of 36 studies conducted in countries where fluoride
exposure is widespread. Only two of the studies showed people
who consumed high amounts of sugar had a high risk of tooth
decay. The remaining studies showed only a moderate to weak
association. Does this mean we can eat all the candy we want
and not have to worry about tooth decay? Not quite. Moderation
is still key, because while the risk is much less than it was
during the pre-fluoride era, consuming sugar was still found
to be a moderate to mild risk factor for tooth decay.
If sugar has a role in tooth decay, can sugar substitutes have
a role in the prevention of tooth decay? A review of fourteen
studies showed a 30 to 60 percent decrease in the rate of tooth
decay among study participants who used sugar substitutes compared
to participants using sugar. In the studies, participants chewed
gum or used toothpaste containing either sugar or the sugar
substitutes xylitol or sorbitol. Xylitol gave the largest decrease
in tooth decay. Sugar-free gums, particularly those containing
xylitol, may help prevent tooth decay by decreasing acid production
and promoting the flow of saliva to clear sugars from the mouth.
January 2002 Update
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