This Week in Pediatrics
JAMA Pediatrics – The Science of Child and Adolescent Health
Explore the latest in child health including food and nutrition, Kawasaki disease and C difficile, effects of media, and more. Formerly Archives of
Professional Corner: Pediatricians Call for New Border Protections, AMA Awards $1 Million in Grants and More
The AHA opens its health tech competition, AMA awards $1 million in community grants, and pediatricians call for stronger protections for children at the US border.
Early Antiviral Therapy Linked to Reduced Risk for Influenza-Related Hospitalization in Children
Antiviral treatment started within 48 hours of symptom onset is linked to a reduced risk for hospitalization among pediatric patients with influenza.
Research of the Day
School Start Times and Adolescent Mental Health: A Natural Experiment
This natural experiment followed 50,000 high school students before and after a district-wide shift to later school start times (8:30am vs 7:15am). Students gained an average of 45 minutes of sleep per night and showed significant improvements in mental health markers over the 2-year study period.
Key findings: (1) 27% reduction in depressive symptoms; (2) 34% decrease in suicidal ideation reports; (3) Improved academic performance and attendance. Effects were most pronounced in students getting 8+ hours of sleep.
These data support advocating for developmentally appropriate school start times. Middle and high school students need 8-10 hours of sleep—counsel families on sleep hygiene and the importance of adequate rest for mental health.
Popular Beliefs
Vaccines cause autism
What the evidence shows: This thoroughly debunked claim originated from a fraudulent 1998 study. Multiple large-scale studies involving millions of children have found no association between vaccines and autism. The original study was retracted and its author lost his medical license. Vaccines are safe and essential.
Sugar makes children hyperactive
What the evidence shows: Multiple double-blind, placebo-controlled studies have found no significant effect of sugar on behavior or cognitive performance in children, even in those reportedly 'sensitive' to sugar. The perceived hyperactivity is often due to the context (parties, holidays) or parental expectations. However, limiting added sugars remains important for dental health and nutrition.
Chocolate causes acne
What the evidence shows: The relationship between diet and acne is complex. Some studies suggest high-glycemic diets and dairy may worsen acne, but chocolate specifically has not been definitively proven to cause breakouts. Individual responses vary—advise patients to observe their own triggers.
Behaviors
Family Meal Frequency and Obesity Risk: Systematic Review and Meta-Analysis
This meta-analysis synthesized 45 studies examining the relationship between family meal frequency and childhood obesity. Children who shared regular family meals had significantly lower obesity risk and healthier eating patterns.
Key findings: (1) 3+ family meals/week associated with 12% lower overweight/obesity; (2) Higher fruit/vegetable intake and lower fast food consumption; (3) Protective effect independent of family structure or income.
Encourage family meals as part of healthy lifestyle counseling. Even a few shared meals per week make a difference. Focus on the ritual and connection, not just nutrition.
Genetics
Familial Hypercholesterolemia Screening in Childhood: Cascade Screening Effectiveness
Cascade screening for familial hypercholesterolemia starting in childhood identifies affected relatives and enables early statin therapy. Children identified through family screening had better outcomes than those diagnosed after cardiac events.
Key findings: (1) Each identified case led to 3 additional diagnoses in relatives; (2) Early statin therapy (age 8+) reduced lifetime cardiovascular risk; (3) Universal lipid screening at ages 9-11 complementary to cascade screening.
Take family history of premature heart disease seriously. Screen children in affected families by age 2. Universal lipid screening should occur at 9-11 years per AAP guidelines.