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Increased use of computed tomography (CT) in pediatrics raises concerns about cancer risk from exposure to ionizing radiation. In a retrospective observational study, Miglioretti and colleagues quantified trends in the use of CT in pediatrics and the associated cancer risk. Use of CT doubled for children younger than 5 years of age and tripled for children 5 to 14 years of age between 1996 and 2005, remained stable between 2006 and 2007, and then began to decline. Nationally, 4 million pediatric CT scans of the head, abdomen/pelvis, chest, or spine performed each year are projected to cause 4870 future cancers. An accompanying editorial by Schroeder and Redberg discuss ways to decrease unnecessary imaging in children.
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Nonpharmacological management of hypercholesterolemia in children is challenging, with few available options. Wong and colleagues conducted a randomized clinical trial to determine the safety and efficacy of dietary flaxseed supplementation in the management of hypercholesterolemia in children. The intervention had no significant benefit for cardiovascular risk in reducing lipid levels but was associated with a significant decrease in high-density lipoprotein cholesterol level and an increase in triglyceride levels.
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Given the importance of developing healthy eating patterns during early childhood, policies to improve the elementary school food and beverage environments are critical. Chriqui and colleagues examined the association between district and state policy and/or law requirements regarding competitive food and beverages and public elementary school availability of foods and beverages high in fats, sugars, and/or sodium. Both district and state policies and/or laws have the potential to reduce in-school availability of high-sugar, high-fat foods and beverages. Given the need to reduce empty calories in children’s diets, they found that governmental policies at all levels may be an effective tool.
Diet and exercise represent the mainstays of obesity treatment. Ho and colleagues compared the effects of diet-only intervention with those of diet plus exercise or exercise only on weight loss and metabolic risk reduction in overweight children. The addition of exercise to dietary intervention led to greater improvements in levels of high-density lipoprotein cholesterol, fasting glucose, and fasting insulin over 6 months than diet alone, but it had not additional effects on body mass index than diet alone. In their editorial, Crume and Harrod discussed promising approaches that future interventions and research should explore.
Highlights. JAMA Pediatr. 2013;167(8):685. doi:10.1001/jamapediatrics.2013.2155