When I see babies and young children for well visits, I get many questions about sleep and napping needs. A newborn enters the world sleeping about 20 hours in a 24 hour period. Basically, this means they are usually awake to eat, then fade back to sleep again after eating. As your infant grows, they are able to have longer "awake and alert" periods as their bodies adapt to the daylight and darkness of a diurnal schedule. Sleep is important to both babies and children for many reasons. Growth hormone is mainly produced during sleep, and the immune system benefits from regular sleep intervals. During sleep, the brain processes information important in the development of memory and organizes the data that children absorb in the hours that they are awake. Regular sleep aids development, according to sleep coach Kim West, who has written a book, "The Sleep Lady's Good Night, Sleep Tight: Gentle Proven Solutions to Help Your Child Sleep Well and Wake Up Happy". Sleep deprivation, on the other hand, is linked in many studies to an increased risk of obesity. Babies who sleep fewer than 12 hours total per day have double the risk of being overweight for their age.
Sleep and nap needs vary by age. For the first two months of life, an infant will sleep 18-20 hours per day, with 3-4 naps per day totaling 6-7 hours. Between 2 and 6 months, napping intervals decrease to 3 naps per day for about 5 hours. Younger infants generally will wake every 3 hours or so to eat, but by 3-4 months of age, they are able to space out feedings and can often sleep for a longer stretch of 5-6 hours at night.
Tips for this age: limit "on the go" napping and try to establish a routine of putting your child down for a nap in a dark, quiet room in a crib or bassinet. Do this at least twice a day at regular intervals.
For older infants, 6-12 months old, a transition occurs in which they usually establish a routine of 2-3 naps a day for a total of 3 hours or so. These "big naps" should be 60-90 minutes each. This is a good age to start a bedtime and pre-nap routine for your child. Nap time should still occur in a dark, quiet place. Children at this age need to acquire the skills to be able to calm themselves to sleep, so it is important to put them in the crib when they are still awake (putting them down sleepy is ok, putting them down asleep is not).
For 12-18 month olds, naps usually occur twice a day for a total of two to two and a half hours. By 18 months, many children are ready to transition to one nap a day in the afternoon. Look for clues at 15-18 months that your child may be ready to do this: taking longer to fall asleep in the morning or taking a long nap in the morning and not being able to fall asleep in the afternoon. You can help make the switch by gradually pushing the morning nap time later and later by 30 minute intervals until you end up with the nap occurring after lunch. Once you get to this point, your child will probably sleep for a good 2-3 hours.
By age 3, most children have shortened the afternoon nap to 60-90 minutes. If your child is resistant to napping, it is important to offer "quiet time" for an hour in the afternoon. Some children won't sleep every day, but it important for them to have designated time to do so. Your child's brain is wired to recognize a missed nap by stimulating the production of cortisol, our body's "stress hormone". This is why some kids seem "wired" on days that they miss naps!
By age 4-5, most children have given up afternoon napping, though may still do well with quiet time/optional nap time in the afternoon. It is important to not let preschoolers nap too long or too late, as this may interfere with night time sleep. There should be at least 4-5 hours between when your child wakes up from their nap and bedtime.
Having a regular routine for napping, and allowing your child the time they need to "practice" this skill, are both important parts of establishing nutritive sleep.
Wednesday, February 19, 2014
Tuesday, January 7, 2014
Cyber Bullying - A Growing Issue for Teens
Social media has become an essential way that we communicate with each other these days. Over 80% of teenagers use a cell phone regularly, with ever growing access to "social" networking sites like Facebook, Instagram and Twitter. Texting others is commonplace, and some teens log multiple hours a day on their phones.
The concept of bullying is one that many schools have attempted to meet head on, but social media access has spawned a wave of online taunting and harassment now referred to as "Cyber bullying". Cyber bullying specifically refers to one individual (or sometimes, multiple people) tormenting, harassing or humiliating someone else through digital technology. Cyber bullying is usually not anonymous, as 75% of victims know the person behind the attack. Nearly 43% of kids have been bullied online. 25% have had it happen more than once. Bullying victims are 2 to 9 times more likely to consider committing suicide. If you read news regularly on the internet, you know how pervasive the problem is. If you have children and teenagers, you know how scary these statistics are.
Cyber bullying takes many forms - a bully may pretend to be someone else in order to obtain personal information from the victim, may pretend to be their victim in online communication with others or may post unflattering photos/videos or verbal insults about the victim. Unlike face to face bullying that occurs in the school setting, online attacks persist -- comments remain once posted on the internet, and essentially may be viewed by the entire world. Girls are twice as likely to be victims of online bullying, AND also nearly twice as likely to engage in bullying behavior themselves.
Unfortunately, teenagers who are harassed via social media often do not report these events to a parent. A study I read recently stated that only 10% of teens report cyber bullying to their parents or a trusted adult.
If our teenagers don't tell us about this, how do we know what is going on? Parents should be suspicious if their child suddenly changes their social media habits, appears upset or withdrawn after being online or avoids or becomes upset at social situations they previously enjoyed. In your presence, your teen may abruptly become upset after seeing a cell phone text, or may state that they are blocking certain callers or numbers. Unfortunately, in my practice I have seen many teens who "can't help themselves" and continue to read or obsess about things that are posted about them online. I have had many parents take phones and computer access away from their children in an attempt to deal with cyber bullying.
If your teen hasn't been bullied before, they likely know someone who has -- bringing up the topic may allow you to start talking about the potential issues before they happen. Consider it as essential as discussing safe sex, drugs and alcohol with your teen.
Parents should actively monitor their children's online media use through practices like checking out their homepage or viewing password-protected areas, particularly with younger children. Teens often want privacy in their online forums, so there may have to be a discussion about what you as a parent will be doing, or will want to see. Make sure your children do not give out their passwords to others.
For children who experience cyber bullying, mental health experts recommend the following:
1. Avoid responding or retaliating directly with the bully, as this may reinforce the behavior
2. Block the bully's message or delete them without reading them
3. Work with parents to notify the media sites involved, as the service providers can internally address any bullying issues
4. Consider working with you local school system to extend their bully education campaigns to address cyber bullying as well
5. Change passwords if necessary, and do not share passwords or keep passwords in a place easily accessed by others
6. Consider keeping a log of the bullying events - this may be useful if law enforcement gets involved
Some useful online resources:
www.stopbullying.gov
www.stopcyberbullying.org
www.ncpc.org
Addendum 9/11/14:
I just saw a blurb in USA Weekend magazine quoting Janell Burley Hofmann, who wrote a book entitled "IRules: What Every Tech-Healthy Family Needs to Know about Selfies, Sexting, Gaming and Growing Up". I liked her idea about setting up rules "IRules" before giving your child a cell phone. Among them,
1. It is my phone. I bought it. I pay for it. I an loaning it to you. Aren't I the greatest?
2. I will always know the password.
3. Hand the phone to one of your parents at 7:30 pm every school night and every weekend night at 9:00 pm. It will be shut off for the night and turned on again at 7:30 am.
Couldn't agree more :)
The concept of bullying is one that many schools have attempted to meet head on, but social media access has spawned a wave of online taunting and harassment now referred to as "Cyber bullying". Cyber bullying specifically refers to one individual (or sometimes, multiple people) tormenting, harassing or humiliating someone else through digital technology. Cyber bullying is usually not anonymous, as 75% of victims know the person behind the attack. Nearly 43% of kids have been bullied online. 25% have had it happen more than once. Bullying victims are 2 to 9 times more likely to consider committing suicide. If you read news regularly on the internet, you know how pervasive the problem is. If you have children and teenagers, you know how scary these statistics are.
Cyber bullying takes many forms - a bully may pretend to be someone else in order to obtain personal information from the victim, may pretend to be their victim in online communication with others or may post unflattering photos/videos or verbal insults about the victim. Unlike face to face bullying that occurs in the school setting, online attacks persist -- comments remain once posted on the internet, and essentially may be viewed by the entire world. Girls are twice as likely to be victims of online bullying, AND also nearly twice as likely to engage in bullying behavior themselves.
Unfortunately, teenagers who are harassed via social media often do not report these events to a parent. A study I read recently stated that only 10% of teens report cyber bullying to their parents or a trusted adult.
If our teenagers don't tell us about this, how do we know what is going on? Parents should be suspicious if their child suddenly changes their social media habits, appears upset or withdrawn after being online or avoids or becomes upset at social situations they previously enjoyed. In your presence, your teen may abruptly become upset after seeing a cell phone text, or may state that they are blocking certain callers or numbers. Unfortunately, in my practice I have seen many teens who "can't help themselves" and continue to read or obsess about things that are posted about them online. I have had many parents take phones and computer access away from their children in an attempt to deal with cyber bullying.
If your teen hasn't been bullied before, they likely know someone who has -- bringing up the topic may allow you to start talking about the potential issues before they happen. Consider it as essential as discussing safe sex, drugs and alcohol with your teen.
Parents should actively monitor their children's online media use through practices like checking out their homepage or viewing password-protected areas, particularly with younger children. Teens often want privacy in their online forums, so there may have to be a discussion about what you as a parent will be doing, or will want to see. Make sure your children do not give out their passwords to others.
For children who experience cyber bullying, mental health experts recommend the following:
1. Avoid responding or retaliating directly with the bully, as this may reinforce the behavior
2. Block the bully's message or delete them without reading them
3. Work with parents to notify the media sites involved, as the service providers can internally address any bullying issues
4. Consider working with you local school system to extend their bully education campaigns to address cyber bullying as well
5. Change passwords if necessary, and do not share passwords or keep passwords in a place easily accessed by others
6. Consider keeping a log of the bullying events - this may be useful if law enforcement gets involved
Some useful online resources:
www.stopbullying.gov
www.stopcyberbullying.org
www.ncpc.org
Addendum 9/11/14:
I just saw a blurb in USA Weekend magazine quoting Janell Burley Hofmann, who wrote a book entitled "IRules: What Every Tech-Healthy Family Needs to Know about Selfies, Sexting, Gaming and Growing Up". I liked her idea about setting up rules "IRules" before giving your child a cell phone. Among them,
1. It is my phone. I bought it. I pay for it. I an loaning it to you. Aren't I the greatest?
2. I will always know the password.
3. Hand the phone to one of your parents at 7:30 pm every school night and every weekend night at 9:00 pm. It will be shut off for the night and turned on again at 7:30 am.
Couldn't agree more :)
Wednesday, September 25, 2013
Nightmares vs. Night Terrors
When your child wakes up in the middle of the night, sometimes it is difficult to determine whether they have had a nightmare or night terror, and more importantly, what to do to help them get back to sleep.
Here are some key differences between nightmares and night terrors:
Nightmares are, by definition, scary dreams followed by complete awakening. They are more common in school-age children. Your child may wake you immediately to tell you about the dream. Nightmares happen during the second half of the night, when dreaming is at its most intense. Your child may be crying or fearful after waking, and may want to be comforted or calmed. Unlike night terrors, a child having a nightmare will wake to be completely lucid and will be aware of you and your presence. Fear and the accompanying "adrenaline rush" may make it more difficult for your child to get back to sleep. They likely will have an immediate memory of the dream, and may or may not want to describe it and talk about it. Use their cues to guide you, reassure them that it was just a dream, and practice calming mechanisms in order to get them back to sleep. It may help to speak softly and tell them that it was just a dream, they are safe, in their own room/bed, etc. For repeated episodes of nightmares, it sometimes helps to establish pre-bed rituals - checking for monsters, turning the pillow to the "good dream" side, hanging a dream catcher, etc.
Night terrors are more common in younger children between the ages of 2 and 6. With a night terror, your child will partially awaken from a very deep sleep. They will not be very aware of you or your presence, and may physically push you away, screaming and thrashing more if you try to restrain them. Parents often describe their children as "out of it" during this period of agitation. Children may sit up in bed, thrash or show unusual movements, cry, scream, moan or talk nonsensically. Physically, you may notice bulging eyes, a fast heart rate or sweating. Night terrors occur early in the night, usually within 1-4 hours of falling asleep. After the initial event is over, your child will be calm and will usually return to sleep rapidly without completely waking up. Your child will have no memory of the event. Night terrors may last 10-30 minutes. You can speak to your child reassuringly; they may not recognize your presence or want any physical contact. Do not try to wake your child from a night terror, just standby until they are able to go back to sleep.
Here are some key differences between nightmares and night terrors:
Nightmares are, by definition, scary dreams followed by complete awakening. They are more common in school-age children. Your child may wake you immediately to tell you about the dream. Nightmares happen during the second half of the night, when dreaming is at its most intense. Your child may be crying or fearful after waking, and may want to be comforted or calmed. Unlike night terrors, a child having a nightmare will wake to be completely lucid and will be aware of you and your presence. Fear and the accompanying "adrenaline rush" may make it more difficult for your child to get back to sleep. They likely will have an immediate memory of the dream, and may or may not want to describe it and talk about it. Use their cues to guide you, reassure them that it was just a dream, and practice calming mechanisms in order to get them back to sleep. It may help to speak softly and tell them that it was just a dream, they are safe, in their own room/bed, etc. For repeated episodes of nightmares, it sometimes helps to establish pre-bed rituals - checking for monsters, turning the pillow to the "good dream" side, hanging a dream catcher, etc.
Night terrors are more common in younger children between the ages of 2 and 6. With a night terror, your child will partially awaken from a very deep sleep. They will not be very aware of you or your presence, and may physically push you away, screaming and thrashing more if you try to restrain them. Parents often describe their children as "out of it" during this period of agitation. Children may sit up in bed, thrash or show unusual movements, cry, scream, moan or talk nonsensically. Physically, you may notice bulging eyes, a fast heart rate or sweating. Night terrors occur early in the night, usually within 1-4 hours of falling asleep. After the initial event is over, your child will be calm and will usually return to sleep rapidly without completely waking up. Your child will have no memory of the event. Night terrors may last 10-30 minutes. You can speak to your child reassuringly; they may not recognize your presence or want any physical contact. Do not try to wake your child from a night terror, just standby until they are able to go back to sleep.
Wednesday, April 24, 2013
Insect Repellents - A Comparison
I recently read an article comparing insect repellents published by The Medical Letter. I have decided to summarize that information, since insect season is fast approaching.
The CDC recommends insect repellents to prevent West Nile virus infections, as well as to protect against ticks which transmit Lyme disease.
DEET - the topical insect repellent with the highest documented effectiveness; varies in concentration of DEET between products. DEET is considered safe in children and infants over the age of 4 months, and the AAP recommends using formulations containing no more than 30% DEET in children. A long-acting formulation originally developed for the Armed Services contains 34% DEET and has been shown to be effective for 6-12 hours (Ultrathon lotion). Sawyer manufactures controlled release products in both 20% and 30% concentrations, and states that the 30% Liposome Controlled Release product protects up to 11 hours. DEET can cause side effects of skin rash and irritation; serious side effects are rare. DEET can damage clothes made from synthetic material, plastics and watch crystals. Obviously, one should wash hands well after applying.
Picaridin - pesticide used against flies, mosquitoes, chiggers and ticks; studies have shown 19.2% picaridin was as effective as Ultrathon with 34% DEET in preventing mosquito bites. Picaridin does not cause as many local reactions on the skin as DEET, and does not damage fabric or plastic.
IR3535 - Available in concentrations of 7.5% and 20% in combination with sunscreen (includes Avon Skin So Soft Bug Guard Plus IR 3535 and Bull Frog Mosquito Coast). Several studies found the 7.5% concentration to be ineffective, and the 20% concentration to be effective for several hours. The CDC does not recommend its use because of the included sunscreen, which would need to be applied more often for sun protection. IR3535 is effective for both mosquitoes and ticks.
Oil of Lemon Eucalyptus (OLE) - In studies against mosquitoes, may provide up to 6 hrs of protection; should not be used in children under age 3. Several sources suggest OLE may be effective against ticks as well, and I found one study that concluded that 30% OLE was as effective as 10-15% DEET in preventing mosquito bites.
Citronella - provide short-term protection against mosquitoes, and are probably not effective against ticks.
Essential Oils - including clove, geraniol and patchouli, provide limited and variable protection against mosquitoes.
Permethrin - A contact insecticide used commonly in head lice remedies, it is used on clothing, mosquito nets, tents and sleeping bags for protection against mosquitoes and ticks. It remains active for several weeks, through repeat laundering.
The CDC recommends insect repellents to prevent West Nile virus infections, as well as to protect against ticks which transmit Lyme disease.
DEET - the topical insect repellent with the highest documented effectiveness; varies in concentration of DEET between products. DEET is considered safe in children and infants over the age of 4 months, and the AAP recommends using formulations containing no more than 30% DEET in children. A long-acting formulation originally developed for the Armed Services contains 34% DEET and has been shown to be effective for 6-12 hours (Ultrathon lotion). Sawyer manufactures controlled release products in both 20% and 30% concentrations, and states that the 30% Liposome Controlled Release product protects up to 11 hours. DEET can cause side effects of skin rash and irritation; serious side effects are rare. DEET can damage clothes made from synthetic material, plastics and watch crystals. Obviously, one should wash hands well after applying.
Picaridin - pesticide used against flies, mosquitoes, chiggers and ticks; studies have shown 19.2% picaridin was as effective as Ultrathon with 34% DEET in preventing mosquito bites. Picaridin does not cause as many local reactions on the skin as DEET, and does not damage fabric or plastic.
IR3535 - Available in concentrations of 7.5% and 20% in combination with sunscreen (includes Avon Skin So Soft Bug Guard Plus IR 3535 and Bull Frog Mosquito Coast). Several studies found the 7.5% concentration to be ineffective, and the 20% concentration to be effective for several hours. The CDC does not recommend its use because of the included sunscreen, which would need to be applied more often for sun protection. IR3535 is effective for both mosquitoes and ticks.
Oil of Lemon Eucalyptus (OLE) - In studies against mosquitoes, may provide up to 6 hrs of protection; should not be used in children under age 3. Several sources suggest OLE may be effective against ticks as well, and I found one study that concluded that 30% OLE was as effective as 10-15% DEET in preventing mosquito bites.
Citronella - provide short-term protection against mosquitoes, and are probably not effective against ticks.
Essential Oils - including clove, geraniol and patchouli, provide limited and variable protection against mosquitoes.
Permethrin - A contact insecticide used commonly in head lice remedies, it is used on clothing, mosquito nets, tents and sleeping bags for protection against mosquitoes and ticks. It remains active for several weeks, through repeat laundering.
Monday, April 15, 2013
Roseola
It's April, and flu season (for the most part) is behind us. Starting in the Spring and Summer, another family of viruses visit us causing fevers and rashes, particularly in younger children. Most of these viruses belong to a larger group called Enteroviruses, though Roseola belongs to the herpes virus family.
Roseola, also called Exantema subitum, "Sixth's disease" or "Three day fever", typically affects children under the age of two. Roseola is caused by two human herpes viruses (predominantly HHV-6, and sometimes HHV-7) - these are not the herpes viruses that cause fever blisters or genital herpes.
Infection with Roseola viruses tends to occur more often in children between the ages of 6 months and 2 years. The infection begins with a sudden fever, which can be quite high (102-104 degrees). The abrupt rise in body temperature may cause a febrile seizure, but in most cases, the children otherwise appear normal, with no other associated symptoms. After a few days of daily fever (classically 5 days), the fever subsides THEN a red or pink bumpy rash develops. The rash begins on the trunk, may be more noticeable after a bath, and then spreads to the arms and legs. The rash is not itchy and may last several days.
Roseola is self-limited, there is no vaccine and no specific treatment is necessary. Tylenol (Acetaminophen) or Ibuprofen may be used to decrease your child's fever, and you should make sure your child is drinking plenty of fluids.
Here are pictures of the typical Roseola rash on the trunk:
Roseola, also called Exantema subitum, "Sixth's disease" or "Three day fever", typically affects children under the age of two. Roseola is caused by two human herpes viruses (predominantly HHV-6, and sometimes HHV-7) - these are not the herpes viruses that cause fever blisters or genital herpes.
Infection with Roseola viruses tends to occur more often in children between the ages of 6 months and 2 years. The infection begins with a sudden fever, which can be quite high (102-104 degrees). The abrupt rise in body temperature may cause a febrile seizure, but in most cases, the children otherwise appear normal, with no other associated symptoms. After a few days of daily fever (classically 5 days), the fever subsides THEN a red or pink bumpy rash develops. The rash begins on the trunk, may be more noticeable after a bath, and then spreads to the arms and legs. The rash is not itchy and may last several days.
Roseola is self-limited, there is no vaccine and no specific treatment is necessary. Tylenol (Acetaminophen) or Ibuprofen may be used to decrease your child's fever, and you should make sure your child is drinking plenty of fluids.
Here are pictures of the typical Roseola rash on the trunk:
Monday, March 25, 2013
Update on High Fructose Corn Syrup and Sugar
I previously posted about the health dangers associated with High Fructose Corn Syrup, a "super sweetener" used in everything from pastries to sweetened beverages, breakfast cereal and even ketchup. It is ubiquitous it seems.
My house is HFCS-free, and thankfully all the kids like to drink water. We have orange juice, and make our own fruit smoothies. I don't keep any other fruit juice in the house, and don't do juice boxes. I am alarmed at how much juice some of the children I see at my office drink. Children of any age should not be drinking more than 6 oz. of juice daily; it is even better if they DON'T drink juice at all. Unfortunately, there is a huge industry pandering juice boxes and pouches to families with children. Some parents mistakenly feel that the "Capri Sun Roarin' Water" is good for their children because it is mostly water -- these beverages may actually be WORSE than juice because they are all sweetened with high fructose corn syrup.
My husband recently e-mailed me an article entitled "9 Reasons to Avoid Sugar As If Your Life Depended On It". Pretty catchy, but is a good summary about the dangers of sugar. Both sugar and HFCS contain fructose. Simple glucose is easily digested and eliminated by the body, but the same is not true of fructose. Fructose is metabolized by the liver; since our liver is busy maintaining normal blood sugar levels in our blood, "extra" fructose is converted into fat -- for us to use later. Too much fructose being diverted this way leads to excess deposition in the liver. Over time, "fatty liver" develops. As we ingest more sugar, our body has a harder time struggling to keep blood sugar levels stable, and our pancreas will make more and more insulin to keep blood sugar levels in a normal range. This "hyperinsulinemia" leads to obesity and increases in fat deposition throughout the body, as well as increases in cholesterol.
Studies looking at people who ingested 25% of their calories in glucose or fructose-sweetened drinks showed that these people had increased levels of LDL ("bad cholesterol"), triglycerides (another blood fat), higher fasting blood sugar and insulin levels and, worse, decreased insulin sensitivity. Increasing amounts of insulin resistance leads to obesity, type two diabetes and metabolic syndrome.
What can be said additionally to all of the above mentioned science is that sweetened beverages add empty calories, calories devoid of nutritional value.
Fructose-sweetened beverages have also been shown to interfere with the normal satiety reflex - fructose drinkers felt less satisfied and were still hungry. Fructose ingestion also did not lessen the body's level of ghrelin - the "hunger hormone". The higher the level of ghrelin, the hungrier one is. Fructose also causes resistance to leptin, another hormone that is released by our fat cells after we have eaten. Leptin basically tells the body, "I am full; stop eating". Obviously, in someone leptin resistant, this signal does not function as intended.
There are also many studies that suggest that the high sugar, western diet can lead to "sugar addiction" or at least a form of sugar toxicity leading to the above medical problems.
As parents, we are responsible for setting examples for our children. If we stress activity and exercise, our children will be active and exercise. If we stress healthy eating habits, our children will be healthier. Beware the dangers of high fructose corn syrup - limit or eliminate fruit juice, and get into the habit of reading labels. Know what you are eating and drinking, eat more fruits and vegetables and limit processed foods.
My house is HFCS-free, and thankfully all the kids like to drink water. We have orange juice, and make our own fruit smoothies. I don't keep any other fruit juice in the house, and don't do juice boxes. I am alarmed at how much juice some of the children I see at my office drink. Children of any age should not be drinking more than 6 oz. of juice daily; it is even better if they DON'T drink juice at all. Unfortunately, there is a huge industry pandering juice boxes and pouches to families with children. Some parents mistakenly feel that the "Capri Sun Roarin' Water" is good for their children because it is mostly water -- these beverages may actually be WORSE than juice because they are all sweetened with high fructose corn syrup.
My husband recently e-mailed me an article entitled "9 Reasons to Avoid Sugar As If Your Life Depended On It". Pretty catchy, but is a good summary about the dangers of sugar. Both sugar and HFCS contain fructose. Simple glucose is easily digested and eliminated by the body, but the same is not true of fructose. Fructose is metabolized by the liver; since our liver is busy maintaining normal blood sugar levels in our blood, "extra" fructose is converted into fat -- for us to use later. Too much fructose being diverted this way leads to excess deposition in the liver. Over time, "fatty liver" develops. As we ingest more sugar, our body has a harder time struggling to keep blood sugar levels stable, and our pancreas will make more and more insulin to keep blood sugar levels in a normal range. This "hyperinsulinemia" leads to obesity and increases in fat deposition throughout the body, as well as increases in cholesterol.
Studies looking at people who ingested 25% of their calories in glucose or fructose-sweetened drinks showed that these people had increased levels of LDL ("bad cholesterol"), triglycerides (another blood fat), higher fasting blood sugar and insulin levels and, worse, decreased insulin sensitivity. Increasing amounts of insulin resistance leads to obesity, type two diabetes and metabolic syndrome.
What can be said additionally to all of the above mentioned science is that sweetened beverages add empty calories, calories devoid of nutritional value.
Fructose-sweetened beverages have also been shown to interfere with the normal satiety reflex - fructose drinkers felt less satisfied and were still hungry. Fructose ingestion also did not lessen the body's level of ghrelin - the "hunger hormone". The higher the level of ghrelin, the hungrier one is. Fructose also causes resistance to leptin, another hormone that is released by our fat cells after we have eaten. Leptin basically tells the body, "I am full; stop eating". Obviously, in someone leptin resistant, this signal does not function as intended.
There are also many studies that suggest that the high sugar, western diet can lead to "sugar addiction" or at least a form of sugar toxicity leading to the above medical problems.
As parents, we are responsible for setting examples for our children. If we stress activity and exercise, our children will be active and exercise. If we stress healthy eating habits, our children will be healthier. Beware the dangers of high fructose corn syrup - limit or eliminate fruit juice, and get into the habit of reading labels. Know what you are eating and drinking, eat more fruits and vegetables and limit processed foods.
Thursday, March 21, 2013
Sleep Tips for Teens
I have previously written about sleep issues in toddlers, and have been seeing more older children and teens with sleeping issues lately - specifically, the inability to fall asleep at night or get adequate amounts of sleep.
In studies addressing sleep and children, researchers have found that over 15 million kids get poor sleep. Not getting adequate sleep can lead to poor school performance, daytime sleepiness and mood changes. As parents, sometimes we recognize the cranky, moody, irritable symptoms and blame those on lack of sleep -- even teens sometimes don't have the insight to recognize sleep deprivation as the cause.
Here are some tips to get your older child or teen sleeping better:
1. Aim for an adequate amount of sleep each night - this may vary person to person, although research suggests teens should get 9 hours a night.
2. Maintain a regular sleep-wake cycle -- go to bed the same time every night (weeknight or weekend) and wake up at the same time every morning. This should not vary by more than an hour (as far as bedtime) and one should set an alarm on weekend mornings. This allows you to "jump start" your normal circadian rhythm and biological clock.
3. Sleep in a dark, comfortable room. Maintain a cool room temperature (about 68 F), close all blinds and curtains at night, and open the blinds on waking in the morning. Turn on lights when you wake up in the morning.
4. Use the bed only for sleep -- no computer, cellphone or TV watching in bed. Period.
5. Relaxing bedtime routine - eliminate screen time 30-45 min. before bed. Again, this means no cell phone, e-mail, texting, computer use, video games or TV. Listening to relaxing music is ok, as well as reading.
6. Include a warm bath or shower at night to help relax your child. Soothing scents in the bath or bedroom may also help - try orange blossom, majoram, lavender or chamomile. Chamomile or Valerian herbal teas may also be used prior to bedtime, since they may help you fall asleep easier.
7. No caffeine dinnertime or later; no nicotine/smoking cigarettes.
8. Don't go to bed hungry. Have a late night snack before bed if needed - milk, a glass of cereal, fruit or crackers. Avoid a heavy meal within 1-2 hours of bedtime since this can interfere with sleep.
9. Exercise regularly - 30-40 min. 4-5 times per week; exercise when it makes sense for you/your family but try to avoid any exercise within 2-3 hours of bedtime (as this can interfere with sleep).
10. No naps as a general rule; if your child needs to nap while adjusting to a better sleep schedule, limit the nap to 20-30 min. Napping for a long period or later into the evening will make it harder to fall asleep at night.
In studies addressing sleep and children, researchers have found that over 15 million kids get poor sleep. Not getting adequate sleep can lead to poor school performance, daytime sleepiness and mood changes. As parents, sometimes we recognize the cranky, moody, irritable symptoms and blame those on lack of sleep -- even teens sometimes don't have the insight to recognize sleep deprivation as the cause.
Here are some tips to get your older child or teen sleeping better:
1. Aim for an adequate amount of sleep each night - this may vary person to person, although research suggests teens should get 9 hours a night.
2. Maintain a regular sleep-wake cycle -- go to bed the same time every night (weeknight or weekend) and wake up at the same time every morning. This should not vary by more than an hour (as far as bedtime) and one should set an alarm on weekend mornings. This allows you to "jump start" your normal circadian rhythm and biological clock.
3. Sleep in a dark, comfortable room. Maintain a cool room temperature (about 68 F), close all blinds and curtains at night, and open the blinds on waking in the morning. Turn on lights when you wake up in the morning.
4. Use the bed only for sleep -- no computer, cellphone or TV watching in bed. Period.
5. Relaxing bedtime routine - eliminate screen time 30-45 min. before bed. Again, this means no cell phone, e-mail, texting, computer use, video games or TV. Listening to relaxing music is ok, as well as reading.
6. Include a warm bath or shower at night to help relax your child. Soothing scents in the bath or bedroom may also help - try orange blossom, majoram, lavender or chamomile. Chamomile or Valerian herbal teas may also be used prior to bedtime, since they may help you fall asleep easier.
7. No caffeine dinnertime or later; no nicotine/smoking cigarettes.
8. Don't go to bed hungry. Have a late night snack before bed if needed - milk, a glass of cereal, fruit or crackers. Avoid a heavy meal within 1-2 hours of bedtime since this can interfere with sleep.
9. Exercise regularly - 30-40 min. 4-5 times per week; exercise when it makes sense for you/your family but try to avoid any exercise within 2-3 hours of bedtime (as this can interfere with sleep).
10. No naps as a general rule; if your child needs to nap while adjusting to a better sleep schedule, limit the nap to 20-30 min. Napping for a long period or later into the evening will make it harder to fall asleep at night.
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