NOVEMBER 3, 2008

DOUBLING OF PRESCRIPTION MEDICATION USE IN KIDS DURING A THREE YEAR PERIOD

There has been a dramatic increase in the number of children on prescription medications in the last few years, as Liz Szabo wrote today in USA Today "Number of kids on medication jumps alarmingly: Most of the illnesses related to obesity". From 2002-2005 there was a doubling of kids on prescription medications for Type 2 diabetes. There was also an increase in kids on medications for cholesterol, asthma, and ADHD. The article noted that diet and lack of exercise are responsible for the increase.

Kids on Prescription Medications











However, I don't think that our main stream media are giving us very good advice about what we should be doing to help our kids avoid these trends. Maybe that is because us doctors doing the research are so muddled and mucked up with our preconceived notions, conflicts of interest, and various biases. One of the mainstream medias main recommendations are that we should choose a low-fat diet, but as others have pointed out, low-fat means subsituting calories in the form of carbohydrates, which probably are worse in terms of inducing diabetes. There has been some discussion on this blog (e.g., see "The Naked Emperor and Saturated Fat" about the nature of fats, carbohydrates and cardiovascular disease and diabetes, and I have been reading some new books on the topic and will post on that later.

The Diabetes Prevention Program Research Group Study, however, did implicate diet and lack of exercise in Type 2 diabetes. The study showed that at-risk individuals who met with a nutritionist who helped them change their diet and lifestyle (more exercise, less fat and saturated fat, more fiber) cut their risk of developing diabetes by 58%, even though they only lost 8 pounds on average. Prevention of diabetes with lifestyle intervention was better than medication (metformin), with a 58% reduction in new onset diabetes in at risk patients, compared to 31% for metformin. Eleven percent of patients on placebo developed diabetes in one year, compared to 8% on metformin, and 5% with the lifestyle intervention (DPPRG 2002). Patients on metformin had more gastrointestinal side effects than the other groups.

DPPRG (2002): Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. Diabetes Prevention Program Research Group. New England Journal of Medicine 346:393-403.

The problem with these studies is that things go in tandem, e.g. exercise coincides with cutting down on sugar, and stopping smoking, etc etc.

Maybe we should do a study where people simply spend an hour every night gazing at the moon.

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Viola Vaccarino wrote on November 4, 2008

Your comment The problem with these studies is that things go in tandem, e.g. exercise coincides with cutting down on sugar, and stopping smoking, etc etc. I dont see why this is a problem. Lifestyle interventions cannot just address one component and not others. They go in tandem and probably also work in tandem. For example, you cannot do a study where you advise people about exercise and still let people smoke. It is unethical to not give them advice about smoking sessation.

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