Friday, January 30, 2015

Fast Foods that List the Amount of Exercise Needed to Burn Off the Calories: A Strategy for Healthier Eating?


By: Lewis First, MD, MS; Editor-in-Chief 

    More and more we find foods in restaurants and especially fast food restaurants listing the calories for the various items we wish to order. But what if the listing also included how much exercise is needed to burn off those calories?  Would it make a parent order even healthier options for their child? 
     Drs. Viera and Antonelli (doi: 10.1542/peds.2014-2902) conducted an intriguing national survey of 1000 parents who were randomized to receive one of four theoretical fast food menus that included a menu group with (1) no labels, (2) only calories, (3) calories plus minutes of exercise to burn off those calories and (4) calories plus miles needed to walk to burn off the calories.  
      Knowing the information on the menu, parents were then asked to order for their child as well as comment on whether putting nutritional as well as exercise information on the posted food item would promote their child to exercise more?The results do show caloric and exercise labels do make a difference—but as to which type of label works best, they all are better than just listing the food without labels but substantive differences of one type of label versus another do not seem to show statistically significant differences.  
      As to how many parents felt the label would help them promote exercise in their children, you’ll have to exercise your eyes and read the full study to glean the take-home lessons learned from this fast-food study and then digest the findings with your patients.

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Wednesday, January 28, 2015

Can the Pediatric Clinical Workforce Shortage Be Met with Pediatric Nurse Practitioners Helping Meet Patient Demands?

By: Lewis First, MD, MS; Editor-in-Chief  

Courtesy of College of Dupage

     One of the solutions to workforce shortages to assure that all children have access to high-quality pediatric care is through the growth of the pediatric nurse practitioner workforce. But is this workforce actually growing sufficiently to meet the needs of patients?  Schell et al. ( (doi: 10.1542/peds.2014-0967) ) did some strategic modeling to determine if enough students entering pediatric nurse practitioner programs will suffice in the future. 
     Sadly—the most optimistic model suggests it will take at least 13 years for the nurse practitioner workforce to satisfy the demand for these practitioner positions, although the rate would be reduced to only 5 years if the numbers going into pediatrics increased by only 4% (which is easier said than done) based on prior workforce studies published in our journal by Freed et al. ( (doi: 10.1542/peds.2012-1131) ).    
     The authors model what might happen if the pass rate on the pediatric nurse practitioner certification exam were raised (delaying the ability to meet demand) or number of graduate programs increased (increasing the rate) as well as other modeling strategies—but sadly none result in the near future in the ability of this important group of pediatric clinicians to grow sufficiently to meet the growing demands being asked of them.   
     Nonetheless, reading this study may help policy makers and the pediatric provider community consider how some of these strategies can help reduce the delay in building the workforce in sufficient numbers that will improve the care delivery to children in the United States.  Read this important modeling study and learn more.

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Tuesday, January 27, 2015

Romantic Relationships and Other Social Outcomes in Young Adults Born Preterm




      We publish many articles about the developmental outcomes of infants born premature, and over the past several decades have seen the longitudinal tracking go from early childhood to adolescence and into young adulthood.   
     As a result we can learn whether not just development differs between term and preterm infants but also whether social outcomes like romantic relationships differ in young adults born early.  Some of the most impressive databases for long-term follow-up come from Finnish birth cohorts tracked closely for two decades or more with minimal loss to follow-up.       
     Mannisto et al (doi: 10.1542/peds.2014-1345) share the results of two Finnish birth registries from the late 1980s using medical records and questionnaires to assess social outcomes like romances and independent living status in an article being early released this week.  The authors compared almost 600 preterm young adults with term adults and find that those born preterm were less likely to cohabit with a romantic partner or experience sexual intercourse by their early 20s and viewed themselves less sexually attractive than term young adults. Independent living status did not show the differences seen with romantic relationships. 
     If you want to learn more about the social outcome findings in young adults born preterm, as well as why this population might exhibit the differences in sexual relationships with partners, then link to this fascinating study and learn more.  

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