Power Up Your Brain
Power Up Your Brain
by David Perlmutter, MD, FACN, ABIHM &
Albert Villoldo, Ph.D
Raise a Smarter Child by Kindergarten
Raise a Smarter Child by Kindergarten
by David Perlmutter, MD, FACN, ABIHM
The Better Brain Book


by David Perlmutter, MD, FACN, ABIHM
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Texting May Be Taking a Toll

May 26th, 2009

From NYTimes.com:

They do it late at night when their parents are asleep. They do it in restaurants and while crossing busy streets. They do it in the classroom with their hands behind their back. They do it so much their thumbs hurt.

Spurred by the unlimited texting plans offered by carriers like AT&T Mobility and Verizon Wireless, American teenagers sent and received an average of 2,272 text messages per month in the fourth quarter of 2008, according to the Nielsen Company — almost 80 messages a day, more than double the average of a year earlier.

The phenomenon is beginning to worry physicians and psychologists, who say it is leading to anxiety, distraction in school, falling grades, repetitive stress injury and sleep deprivation.

Dr. Martin Joffe, a pediatrician in Greenbrae, Calif., recently surveyed students at two local high schools and said he found that many were routinely sending hundreds of texts every day.

“That’s one every few minutes,” he said. “Then you hear that these kids are responding to texts late at night. That’s going to cause sleep issues in an age group that’s already plagued with sleep issues.”

The rise in texting is too recent to have produced any conclusive data on health effects. But Sherry Turkle, a psychologist who is director of the Initiative on Technology and Self at the Massachusetts Institute of Technology and who has studied texting among teenagers in the Boston area for three years, said it might be causing a shift in the way adolescents develop.

“Among the jobs of adolescence are to separate from your parents, and to find the peace and quiet to become the person you decide you want to be,” she said. “Texting hits directly at both those jobs.”

Psychologists expect to see teenagers break free from their parents as they grow into autonomous adults, Professor Turkle went on, “but if technology makes something like staying in touch very, very easy, that’s harder to do; now you have adolescents who are texting their mothers 15 times a day, asking things like, ‘Should I get the red shoes or the blue shoes?’ ”

As for peace and quiet, she said, “if something next to you is vibrating every couple of minutes, it makes it very difficult to be in that state of mind.

“If you’re being deluged by constant communication, the pressure to answer immediately is quite high,” she added. “So if you’re in the middle of a thought, forget it.”

Michael Hausauer, a psychotherapist in Oakland, Calif., said teenagers had a “terrific interest in knowing what’s going on in the lives of their peers, coupled with a terrific anxiety about being out of the loop.” For that reason, he said, the rapid rise in texting has potential for great benefit and great harm.

“Texting can be an enormous tool,” he said. “It offers companionship and the promise of connectedness. At the same time, texting can make a youngster feel frightened and overly exposed.”

Texting may also be taking a toll on teenagers’ thumbs. Annie Wagner, 15, a ninth-grade honor student in Bethesda, Md., used to text on her tiny LG phone as fast as she typed on a regular keyboard. A few months ago, she noticed a painful cramping in her thumbs. (Lately, she has been using the iPhone she got for her 15th birthday, and she says texting is slower and less painful.)

Peter W. Johnson, an associate professor of environmental and occupational health sciences at the University of Washington, said it was too early to tell whether this kind of stress is damaging. But he added,

“Based on our experiences with computer users, we know intensive repetitive use of the upper extremities can lead to musculoskeletal disorders, so we have some reason to be concerned that too much texting could lead to temporary or permanent damage to the thumbs.”

Annie said that although her school, like most, forbids cellphone use in class, with the LG phone she could text by putting it under her coat or desk.

Her classmate Ari Kapner said, “You pretend you’re getting something out of your backpack.”

Teachers are often oblivious. “It’s a huge issue, and it’s rampant,” said Deborah Yager, a high school chemistry teacher in Castro Valley, Calif. Ms. Yager recently gave an anonymous survey to 50 of her students; most said they texted during class.

“I can’t tell when it’s happening, and there’s nothing we can do about it,” she said. “And I’m not going to take the time every day to try to police it.”

Dr. Joffe says parents tend to be far less aware of texting than of, say, video game playing or general computer use, and the unlimited plans often mean that parents stop paying attention to billing details. “I talk to parents in the office now,” he said. “I’m quizzing them, and no one is thinking about this.”

Still, some parents are starting to take measures. Greg Hardesty, a reporter in Lake Forest, Calif., said that late last year his 13-year-old daughter, Reina, racked up 14,528 texts in one month. She would keep the phone on after going to bed, switching it to vibrate and waiting for it to light up and signal an incoming message.

Mr. Hardesty wrote a column about Reina’s texting in his newspaper, The Orange County Register, and in the flurry of attention that followed, her volume soared to about 24,000 messages. Finally, when her grades fell precipitously, her parents confiscated the phone.

Reina’s grades have since improved, and the phone is back in her hands, but her text messages are limited to 5,000 per month — and none between 9 p.m. and 6 a.m. on weekdays.

Yet she said there was an element of hypocrisy in all this: her mother, too, is hooked on the cellphone she carries in her purse.

“She should understand a little better, because she’s always on her iPhone,” Reina said. “But she’s all like, ‘Oh well, I don’t want you texting.’ ” (Her mother, Manako Ihaya, said she saw Reina’s point.) Professor Turkle can sympathize. “Teens feel they are being punished for behavior in which their parents indulge,” she said. And in what she calls a poignant twist, teenagers still need their parents’ undivided attention.

“Even though they text 3,500 messages a week, when they walk out of their ballet lesson, they’re upset to see their dad in the car on the BlackBerry,” she said. “The fantasy of every adolescent is that the parent is there, waiting, expectant, completely there for them.”

Study Finds Some Youths ‘Addicted’ to Video Games

April 28th, 2009

From WashingtonPost.com:
A new study concludes that children can become addicted to playing video games, with some skimping on homework, lying about how much they play and struggling, without success, when they try to cut back.

In what is described as the first nationally representative study in the United States on the subject, researcher Douglas Gentile of Iowa State University found that 8.5 percent of American youths ages 8 to 18 who play video games show multiple signs of behavioral addiction.

“For some kids, they play in such a way that it becomes out of balance. And they’re damaging other areas of their lives, and it isn’t just one area, it’s many areas,” said Gentile, a psychologist and assistant professor whose study was posted online today by the journal Psychological Science.

To get at gaming addiction, Gentile adapted diagnostic criteria for pathological gambling into a series of questions about video game use. The questions became part of a 2007 Harris Poll survey of 1,178 children and teens. Gamers were deemed “pathological” if they reported at least six of the 11 symptoms.

Symptoms included spending increasing amounts of time and money on video games to feel the same level of excitement; irritability or restlessness when play is scaled back; escaping problems through play; skipping chores or homework to spend more time at the controller; lying about the length of playing time; and stealing games or money to play more.

Four times as many boys as girls were considered “pathological gamers.”

Gentile said he started his research with doubts about the possibility of addiction. “I thought this was parental histrionics — that kids are playing a lot and parents don’t understand the motivation, so they label it an addiction,” he said. “It turns out that I was wrong.”

What he found, he said, was that children considered pathological gamers did worse in school, had trouble paying attention in class and reported feeling “addicted.” They were twice as likely to report attention-deficit disorder or attention-deficit hyperactivity disorder.

The study found that 88 percent of the nation’s children ages 8 to 18 play video games. With 45 million children of that age in the country, the study would suggest that more than 3 million are addicted “or at least have problems of the magnitude” that call for help, Gentile said.

“It’s not that the games are bad,” said Gentile, who is also director of research at the nonprofit National Institute on Media and the Family. “It’s not that the games are addictive. It’s that some kids use them in a way that is out of balance and harms various other areas of their lives.”

The study said that the findings leave many questions unresolved. The study could not say, for example, whether pathological game-playing caused poor school performance or whether “children who have trouble at school seek to play games to experience feelings of mastery.”

Gentile also said the research did not indicate what the warning signs of addiction might be or how to best treat such a problem.

Even when the study accounted for hours of play, the gamers deemed addicted performed worse in school.

Other experts said that although they agree that too much video-gaming can take a toll, they are not convinced by the study’s addiction findings.

“I think kids use this just the way kids watch television, the way kids now use their cellphones,” said Michael Brody, chairman of the media committee of the American Academy of Child and Adolescent Psychiatry. “They do it to relieve their anxiety and depression. It’s all a matter of balance.”

Mark Griffiths, director of the International Gaming Research Unit at Nottingham Trent University in the United Kingdom, contended that game addiction exists but in smaller numbers than the study suggests.

“In all honesty, if there really were 8.5 percent of children who were genuinely addicted, there would be treatment clinics all over America.”

The American Academy of Pediatrics recommends that screen time, including television, computer and video games, not exceed one to two hours a day and that it be “quality programming.”

Donald Shifrin, past chairman of the academy committee that examines media impact, said that “maybe this is an ‘Aha!’ moment for parents to say, ‘We’re going to look and see whether these games are being used in a balanced way.’ ”

Low Vitamin D Hurts Teens’ Hearts

March 16th, 2009

From Web MD
Low vitamin D levels greatly increase a teenager’s risk of diabetes and heart disease, Johns Hopkins researchers find.

It is becoming clear that adults who get too little vitamin D are at higher risk for diabetes and heart disease. Now, it appears vitamin D levels also affect these risks earlier in life, say Johns Hopkins researchers Jared P. Reis, PhD, and colleagues.

The researchers analyzed data from 3,577 adolescents aged 12 to 19 enrolled in National Health and Nutrition Examination surveys from 2001 through 2004.

Compared to the 25% of teens with the highest levels of vitamin D in their blood (more than 26 nanograms per milliliter), the 25% of teens with the lowest vitamin D levels (less than 15 ng/mL) had:

Fourfold greater risk of metabolic syndrome, a combination of risk factors for diabetes
2.54 times greater risk of high blood sugar
2.36 times greater risk of high blood pressure
Black teens averaged about half the vitamin D levels seen in white teens (15.5 ng/mL vs. 28.0 ng/mL).

Although the findings suggest that vitamin D supplements would be helpful, Reis warns that it remains to be proven whether this would reduce diabetes and heart disease risk.

“We believe clinical trials designed to determine the effects of vitamin D supplementation on heart disease risk factors in adolescents should be conducted before recommendations can be made for vitamin D in the prevention of cardiovascular disease,” Reis says in a news release.

And supplements may not be the best way to get vitamin D, suggests American Heart Association past president Robert H. Eckel, MD.

“The AHA recommends an overall healthy diet and lifestyle, and that people get their nutrients primarily from food sources rather than supplements,” Eckel says in the news release.

How much vitamin D is enough? That’s still being debated. The American Academy of Pediatrics recently suggested a daily intake of 400 IU. But some experts say children and teens need more than 1,000 IU of vitamin D every day.

People who are obese are more likely to have vitamin D deficiency than normal-weight people. Reis suggests this may be because vitamin D is fat soluble and gets tucked away in fat tissue.

“We are just now starting to understand the role that vitamin D may play in cardiovascular health,” Reis says.

Reis reported the findings at this week’s American Heart Association meeting in Palm Harbor, Fla.

Kids Who Spend More Time Outdoors Have Better Vision

February 9th, 2009

From
Kids who spend more time outside — and away from the television set — are less likely to develop myopia, the inability to see things clearly at a distance.

The new report, from researchers in Boston, doesn’t determine whether too much indoor activity actually causes poor eyesight. And even if it does, researchers haven’t pinpointed what the exact mechanism might be.

Still, “it would seem prudent to encourage outdoor activities — not necessarily sports — for all growing children and young adults in order to reduce the progression of myopia,” said Howard C. Howland, a professor of neurobiology and behavior at Cornell University.

About a third of Americans suffer from myopia, said study author Jane Gwiazda, director of research at The New England College of Optometry. The rates are much higher in some parts of Asia.

The condition seems to be caused by both genetics and the environment, Gwiazda said. The condition is more common in people who engage in a lot of “near work” due to their jobs, she said.

The study authors gave questionnaires to the parents of 191 children who were at an average age of 13.3 years. Among other things, the researchers asked about the children’s time spent using the computer, reading for pleasure and watching TV.

The children’s eyesight was tested annually.

The findings were published in the January issue of Optometry and Vision Science.

The children who developed myopia — also known as nearsightedness — spent less time in outdoor activities, an average of 8.3 hours a week compared to 12.6 hours among the other children.

Those with myopia also watched more television (12.5 hours vs. 8.4 hours a week).

What’s going on? “One possibility is that all the hours spent viewing objects at a distance rather than up close, as happens outdoors, provides a ‘stop’ signal to block myopia progression,” Gwiazda said. “Outdoor exposure also may be beneficial, because sunlight causes the pupil to constrict, resulting in a larger depth of focus — the range in which objects appear clear — and less image blur that’s associated with myopia development.”

In other words, the eye may see more clearly outside in the sunlight and avoid developing myopia.

Looking at things farther away may be another benefit of outdoor activities. “We know a great deal about what causes myopia in animals, including primates,” said Howland. “Images that are focused behind the retina cause the eye to grow in length, making the animal more myopic. Generally speaking, one can prevent animals from becoming myopic if they are provided with sufficient opportunity to see distant objects.”

In popular culture, bookworms and nerds are often depicted as wearing glasses. Some studies have indeed shown a connection between heavy reading and myopia, Gwiazda said. But the new research doesn’t confirm that link.

“In our study, children with more hours of outdoor activity do not necessarily spend less time reading and using computers,” Gwiazda said.

Help for Budding Couch Potatoes

September 16th, 2008

From nytimes.com
TEENAGE dropouts have long been a concern for parents and educators. But these days, the health community is increasingly worried about a different kind of dropout — teenagers who quit sports as they enter high school.

Several studies show that children’s activity levels plummet between middle school and high school, as students get busier with friends and academic pursuits. Another reason is that team sports become more exclusive, and many young people simply can’t make the team.

One of the largest and longest studies of childhood activity ever undertaken used monitoring devices to track activity among 1,000 children over a period of seven years. The data, published this summer in The Journal of the American Medical Association, showed that even the most energetic young children experience a drop in physical activity as they reach puberty. By the time a child is 15, daily activity falls to less than one-third of the level it was at age 9.

While there’s not a lot of research on ways to prevent attrition from sports, some limited studies and doctors’ own clinical experience offer suggestions.

One of the most surprising findings is that a parent’s activity level doesn’t appear to have a significant effect on whether teenagers exercise. While behavior by parents is important for setting an example on issues like smoking or eating fruits and vegetables, the problem with parental exercise is that it tends to happen apart from the family — at the gym, on the golf course or the bike trail.

“There is not a lot of strong support for the idea that if you’re active, your kid will be active,” said Alan L. Smith, director of graduate studies at the department of health and kinesiology at Purdue University. “There’s not a rubbing-off effect.”

But parents who play sports with their children may have a stronger impact, say researchers. Even more important is whether parents provide logistical support for sports pursuits. Parents who make the effort to sign up their children for sports and make sure they have a way for them to get to practice are more likely to have kids who exercise.

Another strategy is to enroll a child in a sport or dance class with a close friend. A Purdue study of nearly 200 sixth graders found that the most physically active kids were those who had a close friend also taking part in the sport.

A commentary last year in the journal New Directions for Youth Development noted that many youth sports programs allow far too much “standing around.” Some local sports programs enroll too many kids, or they don’t have enough coaches to pay attention to everyone. Some leagues sign everybody up, but the children with the best skills do all the playing. So it’s important for parents to know if their children are getting enough time on the field.

About half the children who take part in school or community sports drop out by the age of 12 because they have negative experiences like “not having fun” or “too much pressure,” said Michael F. Bergeron, director of the National Institute for Health and Performance at the Sanford University of South Dakota Medical Center in Sioux Falls.

“The key is to get each child and teen excited about sports participation, and to ensure that the learning experience and atmosphere are supportive of individual goals and development,” Dr. Bergeron said.

THE immediate benefits of teen exercise and sports participation are clear. Overall, teenagers who take part in sports earn better grades, have fewer behavior problems and are less likely to drop out of school. The benefits of sports are particularly strong for girls. Teenage girls who are athletes are less likely to smoke, use drugs or be sexually active compared with nonathletes. And early sports participation appears to benefit girls’ long-term bone health and breast cancer risk.

Despite the short-term benefits of teen exercise, it’s not clear whether active children are more likely to become active adults. Most studies have not shown a correlation. A Johns Hopkins study of more than 1,000 medical students suggested that college athletes were more likely to still be active 22 years later than their peers who didn’t take part in college sports.

The study also looked at whether the type of sport made a difference. The researchers asked college students whether they played tennis, golf, football, baseball or basketball. Notably, young men who were skilled tennis players in college had the highest level of sports participation by the time they reached their late 40s. The tennis players also had lower rates of heart disease.

But because so many variables affect lifetime sports participation, such as a person’s job, family demands and overall health, researchers say it’s virtually impossible to know whether a particular child athlete will stick with his or her sport.

“There are a lot of factors that make it difficult to predict if what we do today with our 12-year-old will translate into how they are as a 30- or 40-something,” said Dr. Smith of Purdue. “The hope is that your child sees intrinsic value in the activity and it becomes part of their life, but it’s hard to predict.”