A typical boy with ADHD can appear to be in perpetual motion, but that activity doesn’t guarantee a healthy weight when he grows up. A long-term study released Monday finds that men diagnosed with attention deficit hyperactivity disorder as children are twice as likely to be overweight or obese in adulthood as those who never had the disorder.

These findings, published in Pediatrics, may be surprising to parents because drugs such as Ritalin or Adderall used to treat ADHD can suppress appetite, said Dr. F. Xavier Castellanos, the study co-author and a professor of child and adolescent psychiatry at New York University.

Robert Bukaty / AP

Ritalin can suppress the appetite in children who take it for ADHD.

“It’s not uncommon for kids treated with ADHD medications to be fairly thin,” Castellanos said. Because parents often worry that thinner boys won't grow as tall, “sometimes [they] will encourage their boys to eat more.”

Instead, to help avert weight problems down the road, parents should be alert to poor eating habits. “If anything, you have to pay attention to how many times they’re having fast food, how many times they’re having fried food, whether they’re getting meals supersized," Castellanos said.

The study comes at a time when ADHD rates are rising. A new report from the Centers for Disease Control and Prevention found that ADHD is the most common mental health issue in children ages 3-17, with nearly 7 percent of kids receiving a diagnosis.

The NYU researchers followed 222 boys -- 111 with ADHD and 111 without, for an average of 33 years -- hoping to better understand the disorder's effects on the brain. The boys with ADHD, all from middle-class, white families, were diagnosed between the ages of 6 and 12.

Decades later, when some of the men returned for brain scans, many of the now 40-something adults who had ADHD as children had gained so much weight they barely fit into the fMRI machine, Castellanos said.

The researchers then asked about the body-mass index of all 222 participants, discovering that men diagnosed with ADHD as children were significantly heavier than those without the disorder. The average BMI for the ADHD participants was 30.1, compared to 27.6 among those who never had the disorder. The obesity rate among the men who’d had an ADHD diagnosis was 41.4 percent, compared to 21.6 percent among those who never had the disorder.

An adult with a BMI of 25 or higher is considered overweight, according to the Centers for Disease Control and Prevention. 

Castellanos suggested the connection between obesity and an ADHD diagnosis may be explained by some of the disorder's common symptoms: lack of impulse control; difficulty paying attention to details; and poor planning skills. These symptoms could lead to problems such as unhealthy food choices and an irregular eating patterns that continue into adulthood, he said.

While the study was only of men, Castellanos suspects that the results would hold true for women as well. 

The new study “shows exactly what I would have expected,” said child psychiatrist Dr. James McGough, director of the UCLA ADHD clinic. “People with ADHD have a terrible time delaying gratification. They’re very impulsive and they don’t think about consequences. Their problems with organization may make it more difficult to stay on a regular eating schedule which leaves them more likely to binge eat.”

Obesity expert Dana Rofey says “sneak eating and aberrant eating patterns” are common among many of her young, male patients with the disorder.

“Once they start eating, they don’t stop,” said Rofey, an assistant professor of pediatric psychiatry and psychology at the University of Pittsburgh Medical Center and weight management director at the Children’s Hospital of Pittsburgh.

Rofey hopes the study will prompt parents to help their sons develop healthful eating habits -- before they become a problem.

“That may mean tracking food intake or using a pedometer to keep track of activity, she said. “You want to encourage your child to do more outside with their friends, instead of spending hours texting or looking up their friends on Facebook.”

Related:

• New psychiatric manual stirs criticism

/

No more long monologues for Google co-founder Larry Page. The 40-year-old chief executive says both his vocal cords have some degree of paralysis, which he says was caused by a virus.

Larry Page, Google’s co-founder and chief executive, says the condition that has left his voice hoarse and raspy and made public speaking difficult was caused by a virus.

Page disclosed Tuesday that he has some degree of paralysis in both of his vocal cords. That, he said, causes breathing problems and allows him to speak only in a quiet voice.

“Thankfully, after some initial recovery I’m fully able to do all I need to at home and at work, though my voice is softer than before,” Page said in a written statement. “And giving long monologues is more tedious for me and probably the audience.

At least 5 percent of Americans have experienced paralysis of a vocal cord, although many more probably go undiagnosed, said Dr. Natasha Mirza, a professor of otolaryngology at the Perelman School of Medicine at the University of Pennsylvania.

Paralysis can result from trauma to the cords during surgery or an accident, but many cases are thought to be related to a viral infection that somehow damages the nerves that power the vocal cords, Mirza said.

When everything is working correctly, “we create a voice when the two vocal cords – strands of muscle in the throat – come together forcing air through them,” explained Dr. Martin Hopp, director of the sinus center at Cedars-Sinai Medical Center. “When the cords separate apart, we breathe.”

We each have two vocal cords – one on the right and the other on the left – of the voice box, Hopp said. “Like every other muscle, the vocal cords are driven by nerves and those nerves can be damaged,” he added.

With one cord paralyzed, the other has to work harder to close the gap between them when we want to vocalize, Hopp said. And that is what leads to a weakened voice.

While experts believe that viruses are at the root of about 40 percent of vocal cord paralyses, no one really knows for sure. It’s just a circumstantial case: A person gets a virus and, close on the heels of that, becomes hoarse.

That’s what Page says happened to him. His left vocal cord became paralyzed about 14 years ago after a viral infection. And then, recently, after another virus struck, his right vocal cord lost much of its function.

Page appears to be among the unfortunate ones whose vocal cords don’t recover.

A study published in Laryngoscope in 2008 found that 36 percent of vocal cords fully recover on their own, with another 39 percent experiencing partial recovery. The rest stay paralyzed, like Page’s left vocal cord.

For those with vocal cords that don’t recover, there are options, said Dr. Albert Merati, a professor and chief of the laryngology service at the University of Washington School of Medicine in Seattle. The simplest solution is to “plump up” the paralyzed cord. By doing that, doctors narrow the gap between the paralyzed cord and the healthy one, which makes it easier to speak -- but a little harder to breathe Merati explained.

It’s very uncommon to have both cords weakened after viral infections, Merati said. “There are treatments, but they come with trade-offs,” he added. “We can make the voice stronger, but the aerobic capacity and the ability to exercise goes down. Or if we have a patient who says I want more air because I love mountain biking and I don’t care what I sound like, we can open up the gap.”

/

Face transplant recipient Carmen Blandin Tarleton speaks at a news conference at Brigham and Women's Hospital in Boston, Massachusetts May 1, 2013.

Almost three months after a undergoing a full face transplant, Carmen Blandin Tarleton, the 44-year-old Vermont registered nurse horribly disfigured when her estranged husband squirted industrial strength lye all over her body, stroked her new chin with her hand and called the surgery a "wonderful gift." 

Tarleton revealed her new face – reconstructed in a 15-hour operation that transplanted a donor’s neck, nose, lips, facial muscles, nerves and tendons – Wednesday at a news conference at Brigham and Women's Hospital in Boston. Already the new tissue is molding itself to her bone structure, giving her a remarkably normal appearance. There is a barely perceptible droop on the left side, which doctors say may disappear as the newly connected nerves continue to grow. Her right eye, which was completely blinded, remains shut, while her left eye is partially open -- allowing her to see a blurry version of the world. She is legally blind.

“I’ve been on this incredible journey for the last six years,” Tarleton said Wednesday, reading from her iPad on a program that allows her to see text. “The donor and her family have given me a tremendous gift making that is making a significant difference in my quality of life at the daily level. They have relieved a significant amount of my pain and discomfort and for that I am forever grateful.”

In an unusual turn, Tarleton met the family of the donor, Cheryl Denelli Righter, whose face and organs were donated to five recipients after she suffered a sudden stroke early in early February 2013.

Righter's daughter, Marinda Righter, hugged and kissed Tarleton. “You’re beautiful,” she told Tarleton. “Yesterday after meeting you, Carmen, for the first time in a long time I felt overjoyed. For the first time I got to feel my mother’s skin, to see my mother’s freckles. And through you I get to see my mother live on.”

The surgery was performed in early February, six years after suffering what Dr. Bohdan Pomahac, director of Plastic Surgery Transplantation at Brigham and Women’s Transplantation called “some of the worst injuries I've ever seen.” She was burned over more than 80 percent of her body. Scar tissue in her mouth meant she couldn't control her lips, causing constant drooling. Scars on her neck prevented her from turning side to side.

After undergoing 55 operations over the past five years, a team of more than 30 surgeons, anesthesiologists and nurses participated in the transplant surgery.

Carmen Blandin Tarleton before the attack and in July 2011, prior to face transplant surgery.

Tarleton is the fifth person to receive a full face transplant at the Boston hospital. There have been 26 face transplant surgeries worldwide, seven in the United States, according to the Cleveland Clinic.  

About 90 percent of transplant patients experience an episode of rejection in the first year, Pomahac said. “Then it quiets down,” he added. “But by three years all of them have had an episode of rejection.”

Tarleton might have lost her new face if the medical team hadn’t taken a big gamble during recovery. In March, the transplanted face began to swell and redden, a clear sign that her body was rejecting it. Doctors feared they might have to remove the transplanted tissue, returning her damaged face to the way it was before surgery.

“It started with fairly massive swelling and continued with redness to the point that we worried that she might not be getting enough blood circulating to the face,” Pomahac told NBCNews.com.

“I told her we were at the end of our rope and there was not much else we could do,” Pomahac said. “She said, ‘I’ve gone too far, I’m not going back.’ That shocked me. She didn’t say it directly, but the implication was, ‘I’d rather die than have you take it off.

Pomahac and his colleagues considered a medication that would completely suppress Tarleton’s immune system in order to stop the tissue rejection. It would also put her at great risk for infection – for a full 30 to 60 days.

She was eventually given a one-quarter dose of the drug and her blood was run through a machine that continuously removed antibodies from it, in a process similar to dialysis.

Eventually, Tarleton’s immune system stopped attacking the new face and she’s now doing well. She'll remain on anti-rejection medications for the rest of her life.

While calling the surgery a "new beginning," Tarleton also spoke of the challenges facing the victims of the Boston marathon bombings and said she was "sending them thoughts of healing and wellness."

"There is a lot to learn in horrific events," she said. "I want others to know that they need not give up on healing themselves when tragedy strikes; instead they can make a choice to find the good and allow that to help them heal."

A charitable fund has been set up to help Tarleton with her expenses. For more information, go to Carmen's Fund.

Related:
Lye attack victim gets new face in 15-hour surgery

Americans may be heeding warnings to avoid sugary drinks, but many are still consuming way too much “added sugar” in their food, a new government report shows. 

And most of those sugary foods are being consumed at home rather than at restaurants, said study co-author Bethene Ervin, a nutritional epidemiologist at the Centers for Disease Control and Prevention.

Current government guidelines suggest that Americans limit total discretionary calories, including added sugars and solid fats, to 5 to 15 percent of food consumed per day. Ervin and her co-author Cynthia Ogden found that added sugars make up approximately 13 percent of the average American adult’s total intake.

Ervin and Ogden found that adult consumption of added sugars declined with increasing income. So, while women in the lowest income category were consuming 15.7 percent of their calories as added sugars, those in the highest income category were consuming 11.6 percent of their calories as added sugars. The researchers found a similar trend for men.

What surprised Ervin and Ogden was the lack of an income effect on kids. No matter what income bracket the kid came from, the consumption of added sugars was the same.

“Income is often considered a proxy for education,” Ervin said. “So adults with more income and education may be making healthier lifestyle choices. But that may not be translating over for their children.

”One culprit is sugary sodas. Although other research has shown that soda consumption has been declining, if you look at individual foods and beverages, these drinks still lead the pack, Ervin said.

Many Americans may not know how much total sugar they’re consuming because the sweeteners are often hidden in prepared foods, like ketchup, experts say.

“I think people are interested in making changes and they’re heeding the warnings about sugary beverages,” said Sara Bleich, an associate professor of health policy at the Johns Hopkins School of Public Health. “But when it comes to food it’s much more complicated. Cereal, for example, has a tremendous amount of added sugar. And not everyone understands that breakfast foods like muffins and pastry, things that people don’t consider to be a desert or an indulgence, pack a lot of sugar.”

Beyond that, there’s the issue of the tricky labeling found on food packages. “It takes 4 to 5 servings to fill a normal sized bowl,” Bleich said. “And that’s an enormous amount of sugar.”

Sometimes it just comes down to convenience over health, Bleich said. “I don’t think that moms want to be buying a KFC meal every night, but there’s also no time for them to cook a three course meal,” she added.

And then there’s the issue of dealing with kids who have absorbed all the marketing of sugary products. “It’s a two-way street,” Bleich said. “When it comes to kids, the whine factor does play a role.”

If you’re wondering why all there’s all this fuss about sugar, Dr. David Heber is happy to explain.

Too much added sugar, especially fructose, can lead to a multitude of chronic illnesses, said Heber, a professor of medicine at the University of California, Los Angeles, and director of the UCLA Center for Human Nutrition.

We’re genetically engineered to consume fats and sweets because we evolved on the savannah where food was scarce, so you ate as much as you could when you could, Heber explained. But in times of plenty, we can wreak havoc on our bodies, he added.

Fructose can convert to fat, which can not only make us heavier, but can also lead to a fatty liver – which is one of the leading causes of liver transplants, Heber said. Too much sugar can also lead to inflammation, which can raise the risk of heart disease.

Part of the problem is the ubiquity of added sugars. “Breads, for example, have a lot of sugar,” Heber said. “It’s in all kinds of places you’re not expecting to find it, even foods like ketchup.”

Heber suggests steering clear of processed foods. “You want a diet that his high in protein and low in fat with two thirds of your plate taken up by fruits and vegetables,” he said. 

Related stories:

Just one daily soda can raise diabetes risk

Nutrition experts: Despite ruling, soda ban still a great idea

Courtesy Christopher Briscoe

Jennifer Margulis (shown with Leone, 17 months; Etani, age 6; Hesperus, 10; and Athena, 8) delivered her oldest child in a hospital and the other three at home.

Back in 2001, when Jennifer Margulis decided to give birth to her second baby in the comfort of her own home, most doctors were stridently opposed to any deliveries outside the hospital. They’d wag their fingers and lecture women on the dangers of home birth, often implying that anyone who refused to give birth in a hospital was a bad mother.

But that stance seems to have softened – at least a little bit - in the intervening decade. In a 2011 position statement, the American College of Obstetricians and Gynecologists said that while it still views the hospital as the safest place to deliver, it “respects the right of a woman to make a medically informed decision about delivery.”

In response to that statement - and the growing number of home births in the U.S.- the American Academy of Pediatrics released a set of guidelines Monday for the care of infants born at home. The guidelines were published in the AAP’s journal, Pediatrics.

“We felt that it needed to be stated that no matter where a baby was born, the care needs to adhere to the same standards,” said the guideline’s lead author Dr. Kristi Watterberg, a professor of pediatrics and a neonatologist at the University of New Mexico. “One thing we feel very strongly about is that there needs to be one person present at the birth whose primary responsibility is care of the baby. While it’s uncommon for both the mom and the baby to get into trouble, it does happen.”

The guidelines detail the care and monitoring an infant should receive in the first hours and days after delivery. For example, babies born larger or smaller than expected should be tested for high blood sugar; caregivers should make sure breastfeeding is going without a hitch; blood should be drawn and screened for genetic abnormalities like cystic fibrosis.

The fact that the AAP has issued guidelines doesn’t mean the group supports home births, Watterberg said. “We concur with ACOG that hospitals and birthing centers appear to be the safest settings for birth in the U.S., but respect the right of women to make their own decisions about delivery,” she added.

Simply telling pregnant women not to choose a home birth “doesn’t work and isn’t helpful or constructive.” she said.

When it comes to care of the infant after delivery, the guidelines closely follow what is done in the hospital. Watterberg and her colleagues hope they will help standardize the care babies born at home get, whether that care is provided by a pediatrician, a family practitioner, or a midwife.

“I suppose we as a society are moving towards a spirit of tolerance,” said Dr. Dennis Woo, an associate clinical professor at the David Geffen School of Medicine at the University of California, Los Angeles, and former chief of pediatrics at the UCLA Medical Center, Santa Monica.

If new parents are going to opt for a home birth, there are some things they need to consider, he said. “The article makes the point that the pregnancy should be low risk, that there should be an experienced, certified midwife in attendance, and there should be a Plan B ready as a back-up.”

Though still relatively uncommon, home births have been on the rise. Between 2004 and 2009, home births rose by 29 percent, according to the National Center for Health Statistics. The increase was driven mostly by a 36 percent increase for non-Hispanic white women. Among this group of women, one out of every 90, about 1.1 percent, will choose to have her baby at home.

Many doctors argue that moms who choose to give birth at home are putting themselves and their babies at risk. If labor becomes obstructed, both the mother and the baby can be at risk. And though it is rare, a woman can hemorrhage and, in some cases, lose blood so quickly that in minutes she can go into shock and suffer organ failure, said Dr. Sindhu Srinivas, director of obstetrical services at the Hospital of the University of Pennsylvania and a professor of maternal-fetal medicine at the Perelman School of Medicine at the University of Pennsylvania.

At least one midwife group, the Midwives Alliance of North America, welcomed the new guidelines.

“We are very happy to see that these new guidelines overlap completely with the standard of care that is expected of certified professional midwives,” said Melissa Cheyney, chair of the division of research at  MANA and an associate professor at Oregon State University as well as a practicing midwife. “It’s clear that [AAP] supports birth centers and hospitals, but they also acknowledge that home birth is on the rise and they state that if a woman chooses homebirth, this is the standard of care she should expect.”

Cheyney agreed that a woman should expect two midwives to attend the birth, one to focus on the mom and one to focus on the baby. “Having two at the birth is essential,” she said. “The mother may need something at the same time as the baby. If the baby needs to be resuscitated, that requires two individuals.”

Margulis said that when she had her first baby in a hospital, she felt the experience was impersonal and insensitive. “There was a labor and delivery nurse who was physically rough with me,” said the 43-year-old Ashland, Ore., mother of four. “I was in labor for over 22 hours and she made us feel so rushed and stressed – and then we were left to sort of fend for ourselves. It was a joyless situation.”

After her health baby girl, Hesperus, was born, she was whisked away from her parents. “The staff insisted on taking the baby away from me and my husband,” Margulis said. “They took her to the nursery to wash her off and locked my husband out. But he saw how they were handling the babies – like they were little footballs.”

She was sure there had to be a better way. “The thing I wanted was for my babies to experience love and gentleness in the moments after they were born,” said Margulis, a senior fellow at the Schuster Institute at Brandeis University and author of “The Business of Baby.”  

Margulis has had three babies at home and feels she made the exact right choice in all three cases. “At home I felt totally at ease and comfortable,” she said. “No one was telling me what to do and I could just listen to my body and move around freely.” 

Shayna Marie Perkinson echoes those sentiments. The 27-year-old Ashland, Ore., mom, who gave birth at home to her son Milo 4 months ago, said “I felt like being at home I would be able to just allow the experience rather than being told what to do.”

One thing that made Perkinson comfortable with home birth was the family’s proximity to medical care: there is a hospital just five minutes away. The situation might be different if the hospital was a lot further away, she said, adding “I know families [who decided on home birth] who have come to stay with friends when the time was close so they’d be near the hospital.”

Watterberg and other doctors can understand how moms get turned off.

“Hospitals are where the vast majority of women give birth,” Watterberg said. “We need to continue to work on our hospitals to make the experience more gentle.”

Related links:

Home births rise nearly 30 percent, new report says

Childbirth takes 2 hours longer than 50 years ago

Repeat C-sections may be safer options for moms, babies

Pregnant women need whooping cough shot, CDC advises

Gettty Images/Stock

Adding a patient's photo to an X-ray could cut the rate of medical errors caused by mix-up, a new study finds.

Although it’s relatively rare, mix-ups of patients’ X-rays can lead to dire consequences.

One way to get around the problem of such “wrong patient” errors is to take a photo of the patient’s face at the same time the X-ray is shot, a new study suggests.

If a doctor is looking at the wrong X-ray, the fallout could be catastrophic, said Dr. Srini Tridandapani, the author of the study presented at the annual meeting of the American Roentgen Ray Society.

“The patient could be diagnosed with cancer and then get an operation he shouldn’t have while the patient who should have gotten the cancer diagnosis isn’t getting the surgery. So you could be affecting two patients,” said Tridandapani, an assistant professor of radiology and imaging sciences at Emory University.

No one knows exactly how many times patients are matched with the wrong X-ray each year, said Tridandapani, who conducted the study jointly with the Georgia Institute of Technology. But it’s estimated that these kinds of identification errors occur in 1 out of every 10,000 patients.

While that may seem like a small number, companies like Motorola aim to have no more than one chip in a million fail, Tridandapani noted.

“I think human beings are more precious than chips, so I don’t accept a rate of 1 in 10,000,” he added. “I think we need to get beyond 1 in a million.”

Tridandapani came up with the idea of adding patient photos to X-rays after he answered a call and the image of the caller appeared on his phone.

“It occurred to me that we should be adding a photograph to every medical imaging study,” he said. 

Errors could be reduced simply by adding photos to patient X-rays, he thought.  To test his theory, Tridandapani rounded up 200 pairs of X-rays (one pair per patient) that he gave to 10 radiologists to read.

Each radiologist got 20 pairs of X-rays. Each set of X-rays contained a few pairs that were actually from different patients. The first time he ran his experiment, the radiologists got only the X-rays. The second time, the X-rays came with photos of the patients.

When there was no photo, the group of radiologists caught only three out of 24 mismatches – about 13 percent.  When photos were included with the X-rays, they caught 16 out of 25 errors – or 64 percent.

Part of the problem is that doctors don’t expect to get the wrong X-ray and they often don’t recognize the mistake when it happens, Tridandapani said. They might try to explain away disparities instead of recognizing the errors.

Dr. Albert Wu, who has studied near-misses in medicine, said the new method might, indeed, avoid some dangerous mix-ups.

“This study, on its face makes a lot of sense to me,” said Wu, a professor of health policy and management at the Johns Hopkins Bloomberg School of Public Health and an attending physician at the Johns Hopkins Hospital. 

“If you have the wrong films for someone about to have a procedure you could have a terrible result,” Wu said.

Still, Wu said, there are possible downsides.  When you add photos, radiologists might take longer to read X-rays. And there’s also a question of privacy -- people might not want photos of themselves included in their medical files. Overall, he said, the added safety probably outweighs these concerns.

“I think it’s a pretty neat way to improve patient safety,” said Dr. Ashish Jha, a professor of health policy at the Harvard School of Public Health. “I see very little downside to it, other than the possibility that a physician might read the X-rays differently if it was a man or a woman  -- and I think in general that’s unlikely.”

Even though Dr. Mitchell Schnall believes that the new method makes sense, he’s not sure that his colleagues will jump at the chance to implement it. 

“There’s a lot of pressure on radiology in terms of efficiency,” said Schnall, a professor and chair of the department of radiology at the University of Pennsylvania. “Anything that adds to the workload gets looked at with some skepticism.”

Schnall said radiologists will worry that the addition of photos will mean that each case will take longer to analyze.  But, he added, the photos might actually speed things up.

“For example,” Schnall said, “when you’ve got a patient in the ICU setting there are many tubes and wires in the patient, an external photo would help us know whether those are internal or external.”

Related stories: 

• Why patients don't report medical errors
• Cancer doctor reveals the very dark side of medical mistakes

Low levels of melatonin, a hormone involved in the regulation of sleep, may boost the risk of diabetes, a new study suggests.

Over a 12-year period women, with the lowest levels of melatonin were more than twice as likely to develop type 2 diabetes, compared to those with the highest levels of the hormone, according to a report published in the Journal of the American Medical Association Tuesday.               

While the researchers expected to find some association between melatonin and diabetes risk, they were surprised by the magnitude of what they saw, said the study’s lead author, Dr. Ciaran McMullan, a research fellow at Harvard’s Brigham and Women’s Hospital.

“What we don’t yet know is whether you can change the risk of diabetes by increasing melatonin secretion,” McMullan said.

For the new study, researchers compared 370 diabetic women to 370 women without the disorder. The women came from a larger, ongoing project known as the Nurses’ Health Study. At the beginning of that study, all participants filled out surveys that questioned them about lifestyle habits, including diet, exercise, smoking history, and sleep patterns. The women were also asked to submit a urine sample, which provided a baseline melatonin level. None of the women had type 2 diabetes at the beginning of the study.

Even after the researchers accounted for lifestyle factors, including hours of sleep, women with the lowest melatonin levels were 2.2 times as likely to develop diabetes compared to those with the highest levels.

Although melatonin was found to be a predictor of diabetes risk independent of number of hours of sleep, the hormone does have an impact on the body's daily rhythms, peaking right before a person falls asleep and declining during the night. 

It's unknown whether low melatonin levels actually caused diabetes, but other research suggests that might be the case, McMullan said. Studies have shown that melatonin supplements given to diabetes-prone rats can help stave off the disease, while also improving cholesterol and triglyceride levels. 

Receptors for melatonin are found all over the body, including the pancreas, which makes insulin, he added. The presence of the hormone receptors in the pancreas suggests melatonin might have an impact on insulin production, as well as insulin resistance, McMullan said.

Still, more research is needed before recommending melatonin supplements for people with high blood sugar levels, McMullan said.

It’s entirely possible that the melatonin levels are simply an indicator of how well a person’s internal clock is working, said Dr. Mitchell Lazar, a professor of medicine and director of the Institute for Diabetes, Obesity and Metabolism at the Perelman School of Medicine at the University of Pennsylvania.

“We’ve increasingly realized that aspects of our sleep-wake cycle, our behavioral and circadian rhythms are environmental factors that contribute to the risk for diabetes,” Lazar explained. “For example, it’s been shown in many studies that people on shift work have an increased incidence of diabetes.

“Now it could be that low melatonin causes diabetes, but it could also be possible that diabetes causes low melatonin.”

The melatonin connection to diabetes is important, “but it’s just one piece of the puzzle,” Lazar said.

Related:

'Amazing' results for diabetes patients after surgery

A new study adds to years of research showing that childhood vaccines do not cause autism, despite worries among a growing number of parents that their young children receive “too many vaccines.”

Researchers from the Centers for Disease Control and Prevention concluded that even when multiple inoculations are given on the same day, children are at no higher risk of developing autism, according to the report published in the Journal of Pediatrics Friday.

“This study looked into the concern that receiving too many vaccines at one doctor’s visit or too many vaccines during the first two years of life may be linked to the development of autism,” the report’s lead author, Dr. Frank DeStefano told NBC chief medical editor Dr. Nancy Snyderman. “We found they’re not related.” 

The CDC researchers conducted the study by reviewing the vaccination histories collected between 1994 and 1999 of 256 children with autism and 752 children who did not have the disorder. They calculated the number of antigens – the substances in a vaccine that stimulate disease-fighting antibodies – that infants are exposed to either on one doctor’s visit or overall during the first two years.

“We did not find any relationship between the number of antigens and the risk of autism,” said DeStafano, Director of the Immunization Safety Office at the CDC.

The CDC study comes amidst reports that increasing numbers of parents are delaying or skipping childhood inoculations, fearing side effects or the risk of autism and other learning disabilities.

A 2012 study, which examined medical records for 97,711 Portland, Oregon children, found an almost four-fold increase between 2006 and 2009 in the percentage of parents who delayed or skipped vaccinations, researchers reported in the journal Pediatrics. Experts say that by delaying certain vaccinations, parents may be putting their children -- and those of others -- at a far greater risk of contracting deadly diseases, such as pneumonia and whooping cough, also known as pertussis. In 2012, the US experienced the worst epidemic of whooping cough in 50 years

That’s a real concern for Dr. Tanya Altmann, an assistant clinical professor at Mattel Children’s Hospital at UCLA.

“Some parents ask about waiting on vaccines and using an alternative or delayed schedule,” because of worries about autism, Altmann told Snyderman.

Altmann tries to remind parents that while they may worry about the unknown, there are real risks to skipping vaccinations or delaying them: outbreaks of severe, sometimes deadly, illnesses.

“The bottom line for parents is that these outbreaks are real and they will come back,” Altmann said.  “These are serious illnesses, meningitis, whooping cough. This study is just one more piece of evidence to reassure parents that vaccines are safe.”

Although inoculation contents and schedules have changed since the study data was collected, Snyderman sees the findings as applicable to today's children since CDC researchers tallied the total amount of antigens  -- bits of protein in a vaccine that spark an immune response -- that each child was exposed to.

“While the CDC now recommends more vaccinations than it did in the 90s, the level of antigens in today’s vaccines is markedly lower than it was when this data was collected,” Snyderman said.

DeStefano hopes the new research will convince parents that it’s safe to follow CDC vaccination schedules.

“The number of vaccines in the current immunization schedule is what’s needed to protect children,” he said. “It’s not too many for a child’s immune system.”

 Related:

Despite evidence, parents' fears of HPV vaccine grows

This year's flu kills at least 110 children; most weren't vaccinated

Quality prekindergarten programs can boost children’s school skills whether the kids come from poor or well-off homes, a new study shows.

While most previous studies had focused only on kids from underprivileged backgrounds, in the new study Harvard researchers found that regardless of family income children who got a year of quality prekindergarten did better in reading and math than kids who spent the year in daycare, with relatives, or in some other kind of preschool, according to the report which was published in Child Development. 

As a further benefit, the kids who spent a year in preschool developed better “executive functioning.”

That means is that they had developed the skills needed to take advantage of what is being taught in school, said the report’s lead author Christina Weiland, a researcher at Harvard when the study was done and currently an incoming assistant professor at the University of Michigan.

“For example, they’ve learned that they need to raise their hands before yelling out an answer,” she explained. “They’ve gotten better at keeping numbers in their heads when doing a math problem and remembering the teacher’s instructions. They’ve gotten better at shifting their attention from a distracting peer to what the teacher is saying.”

Those kinds of self-regulatory behaviors are highly predictive of how well you do later in life, Weiland said. 

There were some kids who benefited more than others from prekindergarten: Latino children, and to a lesser extent, Asian and African American children.

Weiland was able to study the impact of preschool in a sort of “natural” experiment. In Boston, kids qualify for a free, full-day preschool program during the school year if they turn 4  by Sept. 1.

Children born after that date must wait a year before they are eligible.

For the study, Weiland tested 969 kids who'd finished a full school year of preschool in 2008-2009 and compared them 1,049 kids who weren't quite old enough to have made the previous year's cutoff and so were just starting preschool. (Many of them had spent that year in daycare and being cared for by relatives or in other preschool programs.)

Experts unaffiliated with the new research welcomed the new report.

“I think this is a very important study since the effects weren’t just in children at a lower economic level,” said Patrick Tolan, a professor in the Curry School of Education and director of the Youth-Nex Center at the University of Virginia. “Just as important, though, is the implication that the boost in skills may very much depend on having high quality staff and using programs that have been empirically tested.”

Matia Finn-Stevenson, a research scientist and associate director of the Zigler Center in Child Development and Social Policy and director of the School of the 21st Century at Yale University, agreed that the quality of the program is all important.

“In this study the children were in a high-quality educational environment with teachers with masters degrees, teachers receiving coaching, etc.,” she said. “I know parents who are not satisfied with their PreK and they have told me they simply have to look the other way and not make waves because they have no alternatives.”

How can parents figure out whether their PreK program is good?

Finn-Stevenson suggests that “parents should look for a place that allows parents to come in at any time to see the PreK in action. Look for staff continuity – how long have they been at the school/program? How often and in what ways do they interact with the children? What is the overall atmosphere? How are the children interacting?”

One thing that’s unclear at this point is whether the gains in PreK will carry over into later years. That’s a topic that still needs to be researched, Tolan said.

Most mothers may be starting their infants on solid foods months sooner than specialists recommend, mistakenly believing their children are old enough to graduate from breast milk or formula – but many say they’re simply following doctors’ orders, according to a study published today.

Parents should wait until their little ones are at least 6 months old before offering them solid foods, say many child-nutrition experts, including the American Academy of Pediatrics.

But researchers at the Centers for Disease Control and Prevention – who surveyed 1,334 new moms – discovered that almost 93 percent of those women had introduced solid foods to their infants before 6 months, that 40 percent did it before the 4-month mark, and that 9 percent had offered solids to their babies before they were even four weeks old, according to the study, published today in Pediatrics.

“Fifty percent said that their health care provider told them it was time to introduce solid food,” said Kelley Scanlon, a co-author of the study and lead epidemiologist in the nutrition branch in the division of nutrition, physical activity and obesity at the CDC.

“That, for us, indicates that health care providers need to provide clearer guidance and really support women in carrying out the recommendation,” Scanlon said.

Physicians' groups settled on the 6-month cut-off after earlier research determined that children who get solid food at too early might be at a greater risk for developing chronic diseases, such as diabetes, obesity, eczema and celiac disease, Scanlon said.

The mothers who volunteered for the CDC study filled out food diaries and questionnaires designed to ferret out their opinions on why and when solid foods should be offered.

Among the moms offering solid foods to infants younger than 4 months, the most commonly cited reasons for doing so included: “My baby was old enough;” “My baby seemed hungry;” “I wanted to feed my baby something in addition to breast milk or formula,” “My baby wanted the food I ate;” “A doctor or other health care professional said my baby should begin eating solid food;” and “It would help my baby sleep longer at night,” researchers reported.

What’s more, moms who fed their babies formula were far more likely to start solids too early versus those who exclusively breast-fed (53 percent versus 24 percent), the study showed.

One food expert unaffiliated with the CDC study suggested that some health-care providers may simply be unfamiliar with current baby-feeding recommendations.

“I think this is worrisome,” said Ann Condon-Meyers, a pediatric dietician at the University of Pittsburgh Medical Center and Children's Hospital of Pittsburgh. “I think it may show that word isn’t getting out that … it is 6 months before solid foods should be offered.”

Still, the study’s findings didn’t surprise Condon-Meyers, who added: “I work in pediatrics and we see a lot of early introduction of solid foods when we do patient histories.”

In addition to possibly boosting, a child’s risk for contracting certain chronic diseases, introducing solid foods too early often means babies don’t drink an adequate amount of breast milk or formula, and that can translate into poorer nutrition, Condon-Meyers said.

Breast milk and formula have all the nutrients and vitamins a baby needs and in the right proportions, Condon-Meyers said.

“If you start giving solid food too early then you are diluting the nutritional intake,” she said. “You’re getting more calories, but less of the nutrients a baby needs to grow.”

Related:

Most parents don't follow doctors' orders
Peanuts, eggs and milk OK for young babies, report claims
Child food allergies may be twice as common as thought

In a sign that experts are taking sports concussions more seriously, new guidelines released today suggest that players be pulled from games even if there is only a suspicion that there’s been a head injury. Further, updated  American Academy of Neurology guidelines state that an athlete shouldn’t be allowed to return to play until a specialist gives the OK.

“The message we’re sending is that any time a concussion is suspected, even if you’re not sure, you should sit that player out until there has been an evaluation by a medical provider with concussion expertise,” said the guidelines’ lead author, Dr. Christopher Giza, an associate professor of pediatric neurology and neurosurgery at the David Geffen School of Medicine and the Mattel Children’s Hospital at the University of California, Los Angeles.

“We say:  ‘If in doubt, sit them out’.”

Olivia Brandy and her family certainly wish that those guidelines had been in effect when she suffered her first concussion. It happened back when Olivia was a high school freshman soccer player.

Brandy family

Olivia Brandy, now 19, suffered her first concussion during a soccer game when she was a freshman in high school. Now an elite player, she has had five concussions, but continues to play under a doctor's care. New guidelines say players should be pulled from play at the first sign of head injury.

“The problem started when I hit heads with a girl going up for a ball in a game,” said Olivia, now 19. “I remember feeling totally different when I got up, like somebody had tied a rope around my waist and was holding me back as I ran. I had no idea what the problem was. I just pushed through it and at the end of the game I was in severe pain.”

It took a week before anyone diagnosed the Pittsburgh-area teen with a concussion and that delay cost her six months of school and playing time -- which came as a shock to her parents.

“My husband’s a physician and I’m a nurse and though we knew about concussions, we didn’t appreciate how serious they were, or how much they could affect a young person’s life,” said Trina Brandy, 50. “We had our eyes opened by this.”

The guidelines also take into account new research showing that it’s almost impossible to immediately to predict how long concussion symptoms will plague a player. Earlier guidelines released by the AAN in the late 90s contained a concussion grading system that linked the severity of the hit with suggested recovery times.

Over the past two decades, however, researchers have learned that hard hits don’t necessarily correlate with long recovery times, Giza said. “We have all seen players knocked flat and unconscious who are able to pass our tests in a week,” he explained. “Others may hit their heads on the locker door and be out for weeks.”

What may be most important is the kind of symptoms kids experience right after the hit, Giza said.

Dr. Micky Collins, a specialist unaffiliated with the new guidelines  -- and Olivia Brandy’s doctor --  agreed.

“Concussions are like snowflakes -- each one is different,” said Collins, program director of the Sports Medicine Concussion Program at the University of Pittsburgh Medical Center. “What we’ve learned is that seemingly mild ones can become severe and severe ones can turn out to be mild. Players who have a loss of consciousness may not have any worse outcome. Dizziness on the field seems to be the only symptom that predicts poor outcome.  Players who experience dizziness are more likely to have a month or more of recovery time.”

Symptoms aside, the biggest factor controlling recovery time, both Giza and Collins agree, is quick diagnosis and proper management  --  which means rest for the recuperating brain.

That’s certainly been the case for Olivia. She’s experienced more concussions since the one that disabled her for six months during her freshman year. Recovery time has been much shorter for the most part, which she believes is due to her realization that play must stop as soon as she feels any symptoms.

She advises other kids, “If you feel different in any way [after a hit] you should come right out. The problem of post-concussion syndrome comes when you keep pushing yourself hard and your brain can’t handle it. That’s when you really hurt your brain.”

Even after five concussions, Olivia has continued to play soccer at the elite level because it’s her passion. This summer she’ll head off to Penn State where she’s already got a commitment for a spot on the school’s top-ranked soccer team.

But she says she’ll not only keep a close eye out for concussion symptoms, but she’ll also try to play smarter. “I’ve learned from my mistakes and I’m not a foolish player,” she said. “If I don’t think I’m going to win that 50-50 ball, I’m not going to go up for it.”

While happy for her daughter’s success, Trina Brandy has mixed feelings about playing with the continued threat of more concussions. Not long ago she asked her daughter’s doctor straight out: “I think it’s time for us to talk to her about quitting, don’t you?” But, she said, Collins said, “It’s not time yet.”

From Collins' perspective, with proper care, kids can continue to enjoy the sports they love. While some do need to be “retired,” when it looks like they’ve reached a point where the next concussion might throw them into long term, if not permanent, symptoms, most can keep playing.

 “My message to parents is that concussions can be managed safely,” Collins said. “Sports are a wonderful thing for kids.”

Related stories: 

• Second concussion can be devastating, even after clear CT scan
• Contact sports leave pattern of brain injuries, study finds
• Opinion: Youth hockey injuries border on child abuse

Getty Images stock

Women who take a regular dose of aspirin may get a side benefit – a reduction in their risk of melanoma, a new study suggests. 

And the more years women take the over-the-counter-medication, the lower the risk, according to the study which was published online today in Cancer.

“We think our results are very exciting and that they add to the growing body of evidence suggesting that aspirin may have some real anti-tumor and anti-cancer properties,” said study co-author Jean Tang, an assistant professor of dermatology at Stanford University.

Tang and her colleagues scrutinized data from 59,806 Caucasian women who were taking part of the Women’s Health Initiative study. The women, who were between 50 and 79 years old at WHI’s outset, were followed for an average of 12 years. The researchers chose to concentrate on Caucasian women because melanoma is much more common among them.

At the beginning of the study, the women were asked which medications they were taking, what they ate and what activities they participated in. 

The women in the asprin group took a dose of aspirin at least twice a week at baseline. When they were asked about aspirin use again three years later, 60-70 percent of the group were still taking it at least twice a week, Tang says.

Overall, women who used aspirin had a 21 percent lower risk of melanoma compared to those who eschewed the medication. The longer women used aspirin, the lower the rate of the potentially fatal skin cancer. So, those who had used aspirin for one to four years had an 11 percent reduction in risk, as compared to 30 percent among those taking aspirin for five or more years.

In their calculations, the researchers took into account numerous melanoma risk factors, including differences in pigmentation, tanning practices, sunscreen use.

The researchers don’t know how aspirin lowers melanoma risk, but they’ve got some theories.

“Aspirin reduces inflammation,” Tang said. “Cancer cells with a lot of inflammation grow more and are more aggressive." Tang added that cancer cells tend to produce in excess the very same substance that aspirin and other NSAIDs knock back. 

The researchers failed to find a reduction in risk with other NSAIDs, however.

The new study, coupled with earlier evidence, makes a good case for aspirin’s anti-cancer properties, experts said.

Still, the effect may not be strong enough to counter aspirin’s possible side effects for people who have been told they shouldn't take the medication, said Dr. Robert Stern, a professor of dermatology at Harvard Medical School and chief of dermatology at the Beth Israel Deaconess Hospital. Stern co-authored a study published in 2011 that also found that aspirin reduced melanoma risk by 50 percent.

But for those who are sitting on the fence as to whether they should take aspirin for prevention of heart disease, this new research might be enough to push them over the edge since the benefits would now potentially be two-fold.

“I think it is too early to tell women to change their behavior, unless they would be taking it for the cardiovascular benefit also,” said Dr. Jenny Kim, an associate professor of dermatology at the David Geffen School of Medicine at the University of California, Los Angeles. “Before we can recommend that patients start taking aspirin to prevent melanoma we need to have some randomized controlled trials.”

 Related:

Daily aspirin may protect against melanoma

 Colonoscopy isn't just for high-risk people