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In This Issue of JAMA Pediatrics
December 2014


Author Affiliations

Copyright 2014 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.

JAMA Pediatr. 2014;168(12):1085. doi:10.1001/jamapediatrics.2013.3381

Physical activity (PA) has been cited in numerous reports as a potential moderator in reducing the risk for clinical depression; however, the evidence for such an effect is less than clear-cut. Toseeb and colleagues investigate the association between objectively measured PA and depressive symptoms in the ROOTS longitudinal cohort study of adolescents over a 3-year period. Neither depressive symptoms nor major depressive disorder diagnoses at 3-year follow-up were significantly predicted by any of the 4 PA measures at baseline. Although it is important to promote PA because of its well-documented effect on physical health, during adolescence, PA may not serve as a strong protective factor of developing depressive symptoms or disorders.

Provisions in the Affordable Care Act (ACA) to increase insurance coverage among young adults have the potential to improve their health through increased access to health care and preventive care in particular. Lau and colleagues use the Medical Expenditure Panel Survey to examine rates of preventive care following the initial implementation of the ACA in 2010 and determine whether changes in insurance coverage accounted for any changes in the rates of preventive care. After the ACA, young adults had significantly higher rates of receiving a routine examination, blood pressure screening, cholesterol screening, and annual dental visit but not an influenza vaccination. Insurance status fully accounted for the pre- and post-ACA differences in routine examination and blood pressure screening and partially accounted for increases in cholesterol screening and annual dental visits.

While honey has been found to improve cough symptoms in children, it is not used in infants younger than 1 year because of concerns of infant botulism. Paul and colleagues conduct a randomized clinical trial in 2- to 47-month-old children with acute cough using pasteurized agave nectar, which has not been associated with botulism. Significant differences in symptom improvement were detected between the study groups, with agave nectar and a grape-flavored water placebo proving to be superior to no treatment, but no significant differences for any outcome were found when comparing agave nectar against placebo. An editorial by Taylor and Opel discusses the placebo effect both in research and in clinical practice.


Journal Club and Continuing Medical Education

As yet, there is little evidence to show whether early gains in fat mass, fat-free mass, or both are associated with susceptibility to later obesity. Elks and colleagues conduct a meta-analysis of 4 contemporary birth cohort studies to examine associations between early-life growth and an obesity susceptibility multiple allele score of genetic variants associated with obesity in adults. The score was not associated with size at birth but was associated with postnatal fat mass and lean mass in the first 5 years of life. These findings suggest that symmetrical rapid growth may identify infants with high lifelong obesity susceptibility.