Kids’ TV viewing tied to behavioral problems

If your toddler is watching a lot of TV, turn it off now and save yourself a lot of trouble later.

That’s the conclusion of a new study that suggests that the negative effects of lots of early TV viewing on children can be overcome by limiting viewing before the age of 6.

The study doesn’t confirm that television is actually bad for young kids. Nor does it show exactly how much of a cutback would help children exposed to lots of TV early in life. Still, lead author Kamila Mistry, a doctoral candidate at Johns Hopkins Bloomberg School of Public Health, said it makes a strong case for a “significant” difference in behavioral problems in kids depending on their viewing.

“It’s never too late,” Mistry said. “That’s an important message for parents as well as pediatricians, encouraging parents to turn off the TV and think about alternative activities for kids.”

Television, of course, has long been blamed for a variety of ills among children, from lethargy and obesity to shortened attention spans. The American Academy of Pediatrics discourages kids under 2 from watching any TV at all, and it says older kids shouldn’t watch more than two hours a day.

Why take another look at TV and children? According to Mistry, the new study is unusual, because it followed kids over time – from 2.5 years to 5.5 years – and measured the effects of changing levels of TV watching.

The researchers looked at the results of surveys of 2,702 families who enrolled in a national study between 1996 and 1998. The kids were followed from birth to age 5.5.

Twenty percent of parents said their kids watched at least two hours of TV a day at both 2.5 and 5.5 years. Four in 10 children had TVs in their bedrooms at age 5.5.

Even when the researchers adjusted the study results to account for factors such as income and “parental involvement,” they found that kids who watched two or more hours of TV daily at both ages were more likely to suffer from sleep, attention and aggressive behavior problems, and “externalizing of problem behaviors.” Also, those who watched more TV over time had greater problems dealing with others.

But those children who reduced TV watching between the two ages didn’t have a greater likelihood of either social or behavioral problems.

The researchers also found that kids with TVs in their bedrooms were more likely to have sleeping problems.

The findings are published in the October issue of Pediatrics.

The structure of the study didn’t allow the researchers to say how much more likely kids were to have problems depending on their viewing habits, Mistry said. She added that it’s not a cause-and-effect study. It’s possible that behavioral and social problems may contribute to TV viewing, not the other way around, she said.

The study also didn’t look at whether the children were watching educational programming, like “Sesame Street,” or other programs, such as those geared toward adults.

“I hesitate to say TV is horrible,” Mistry said, “but excessive amounts of any activity is probably not good.”

Madeline A. Dalton, director of the Hood Center for Families and Children at Dartmouth Medical School, said she’s not sure that reducing heavy early exposure to TV will eliminate the risk of problems. She thinks more research is needed to determine that and to figure out if it’s possible that “parents may be more likely to sit their children in front of the TV if they have behavioral problems.”

However, “time spent watching TV is likely to reduce the amount of time children spend interacting with adults and other children,” Dalton said. “Therefore, it is not surprising that this may have an impact on ability to interact socially.”

She added: “We are raising our children in a media-saturated world. That’s not necessarily a bad thing, but our knowledge of how media affects children – both in terms of behavior and health – has clearly lagged behind its use.”

One the Web:

www.aap.org/family/smarttv.htm, the American Academy of Pediatrics has more information about children and TV.

Photo: www.healthday.com/images/editorial/kidstv.jpg

Ozone breaks down lungs’ defenses, kills off immune cells
Ozone, a major component of urban air pollution, shuts down early immune responses in the lungs, which in turn makes the lung more vulnerable to bacteria and other foreign invaders, research shows.

It’s known that exposure to ozone is associated with increased cardiovascular and pulmonary hospitalizations and deaths, but the actual mechanisms involved haven’t been clarified. This study, by Duke University Medical Center pulmonary researchers, may provide some answers.

They found that mice exposed to unhealthy ozone levels showed amplified lung injury in response to bacterial toxins. The rodents also showed increased “programmed cell death” of the type of innate immune system cells that normally devour foreign invaders and keep the airways clear.

The innate immune system – the most primitive part of the body’s defenses – reacts indiscriminately to any invader.

“Small amounts of inhaled foreign material can be relatively harmless, since they stimulate an appropriate innate immune response that protects the lungs,” study lead author and pulmonologist Dr. John Hollingsworth, said in a prepared statement.

“However, it appears that ozone causes the innate immune system to overreact, killing key immune cells, and possibly making the lung more susceptible to subsequent invaders, such as bacteria,” he said.

The study is published in the Oct. 1 issue of the Journal of Immunology.

On the Web:

www.yourlunghealth.org/healthy(UNDERSCORE)living/pollution, the American Association for Respiratory Care has more information about ozone air pollution.

Drug plus psychotherapy called best treatment for depressed teens
A combination of cognitive behavior therapy plus antidepressant drugs is the best way to ease depressive symptoms and suicidal thoughts and behavior in depressed teens, new research shows.

The Duke University-led study is published in the October issue of the journal Archives of General Psychiatry.

The 36-week multicenter study of 327 teens, ages 12-17, examined the effectiveness of the antidepressant Prozac (fluoxetine hydrochloride) and cognitive behavior therapy (CBT) alone or in combination.

After 12 weeks, all treatment groups showed decreased depression, with the greatest reduction (71 percent response rate) noted in the group of teens receiving combination therapy. After 18 weeks, the combination therapy group had an 85 percent response rate, compared with 69 percent for Prozac alone and 65 percent for CBT alone.

After 36 weeks, teens receiving the combination treatment had a response rate of 86 percent, compared with 81 percent each for Prozac or CBT alone, the study said.

The researchers said their findings point to the potential benefits of combination therapy – Prozac for recovery from depressive symptoms and CBT to equip teens with coping skills.

“Depression among teenagers is a significant public health problem, and there has been a tremendous need to identify treatments that work and are also safe,” lead investigator Dr. John March, chief of child and adolescent psychiatry at Duke University, said in a prepared statement.

“While many questions remain about the safest and most beneficial course of treatment for adolescents, this data provides a significant step forward,” he said. “It provides an evidence-based option that has been found to improve depression through medication used together with cognitive behavioral therapy.”

On the Web:

http://kidshealth.org/teen, the Nemours Foundation has more about teens and depression. Click on “Your Mind” in the left rail.

Study links education level to Alzheimer’s risk

People who don’t complete high school are more likely to develop dementia and Alzheimer’s disease than those with more education, Finnish researchers report.

The finding, from a study of almost 1,400 people, found that this association was independent of lifestyle factors such as occupation, income, physical activity and smoking.

The study participants were divided into three groups – five or less years of education (low), six to eight years (medium), and nine or more years (high). The researchers tracked their outcomes through middle age and late life, for an average of 21 years.

Compared with people with a low education level, those with a medium level were 40 percent less likely to develop dementia, and people with a high level of education had an 80 percent lower risk, the study found.

“Generally speaking, people with low education levels seem to lead unhealthier lifestyles, which could suggest the two work concurrently to contribute to dementia or Alzheimer’s disease, but our results showed a person’s education predicted dementia on its own,” study author Dr. Tiia Ngandu, of the University of Kuopio, said in a prepared statement.

“It may be that highly educated people have a greater cognitive reserve, which is the brain’s ability to maintain function in spite of damage, thus making it easier to postpone the negative effects of dementia. Additionally, unhealthy lifestyles may independently contribute to the depletion of this reserve,” Ngandu said.

The findings are published in the Oct. 2 issue of the journal Neurology.

On the Web:

www.ninds.nih.gov/disorders/dementias, the U.S. National Institute of Neurological Disorders and Stroke has more information about dementia.

Family problems can boost kids’ asthma

Poor family support and bad neighborhoods can aggravate asthma symptoms in kids, Canadian research suggests.

Edith Chen and colleagues at the University of British Columbia in Vancouver examined the degree of support that 78 children with asthma received from family and peers. They also looked at social problems, such as crime and violence, in the children’s neighborhoods.

They then assessed the children’s lung function, asthma symptoms, and certain behaviors that can affect asthma.

The results indicated a correlation between social environment and asthma symptoms and lung function. Children who reported less family support and lived in worse neighborhoods experienced greater asthma symptoms, the team said. Those who reported less family support had poorer lung function.

Further analysis revealed that low levels of family support were associated with greater lung inflammation that, in turn, was associated with poorer asthma outcomes. Family support did not appear to influence behaviors that can affect asthma.

The researchers also concluded that living in worse neighborhoods was associated with higher rates of child smoking and exposure to smoke, which is associated with poorer asthma outcomes.

“Poor family relations may foster psychological experiences with direct physiologic consequences, whereas problematic neighborhoods may operate by providing the role models for maladaptive behaviors,” the study authors wrote.

Peer group support had no significant effect on asthma symptoms or lung function. The study was published in the first issue for October of the American Journal of Respiratory and Critical Care Medicine.

On the Web:

www.lungusa.org, the American Lung Association has more information about childhood asthma.

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