Does Sodium Intake Affect Mortality and CV Event Risk?

Sodium intake may not be associated with mortality or incident cardiovascular events in older adults, according to a study published Jan. 19 in the JAMA: Internal Medicine.

In the Health, Aging and Body Composition (Health ABC) Study, initiated in 1997, researchers assessed self-reported sodium intake from 2,642 Medicare beneficiaries, ages 71-80 years old. Participants were excluded for difficulties with walking or activities of daily life, cognitive impairment, inability to communicate, and previous heart failure (HF). At the first annual follow-up visit, researchers recorded food intake as reported by participants, specifically examining sodium intake. After 10 years, 34 percent of patients had died, while 29 percent and 15 percent had developed cardiovascular disease and HF, respectively.

The results of the study showed that there was no association between participant-reported sodium intake and 10-year mortality, incident HF or incident cardiovascular disease. Further, there was no indication that consuming less than 1,500 mg/d of sodium benefitted participants any more than consuming the recommended amount (1,500-2,300 mg/d). However, the study showed a slight potential for harm when participants had a sodium intake of greater than 2,300 mg/d, especially in women and African Americans.

The authors note that while the food frequency questionnaire used by participants at the first annual follow-up has limitations in its accuracy, “self-reported adoption of a low-salt diet was not associated with significantly higher risk for [any] events.” They conclude that moving forward, there is a need for further research and stronger evidence in order to create better recommendations for older adults.

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Abdominal Pain in Childhood Linked to Anxiety, Depression in Young Adulthood.

Children with medically unexplained “functional abdominal pain” face increased risks for anxiety and depression in adolescence and young adulthood, according to a Pediatrics study.

Researchers prospectively followed some 330 children with functional abdominal pain and 150 age-matched controls without pain into adolescence and young adulthood (mean age at follow-up, 20 years). They found that children who’d had abdominal pain at baseline were significantly more likely than controls to meet criteria for lifetime anxiety disorders (51% vs. 20%) and current anxiety disorders (30% vs. 12%) at follow-up. In most cases, anxiety preceded the onset of abdominal pain. In some cases, anxiety persisted after pain had resolved.

The pain group was also more likely than the control group to meet criteria for lifetime depression at follow-up (40% vs. 16%); depression usually began after abdominal pain.

“These data underscore the importance of a biopsychosocial approach to [functional abdominal pain] that includes screening for anxiety and depression,” the researchers conclude.

Source: Pediatrics

Physical punishment in childhood increased odds for CVD, obesity in adulthood.

Children who were punished with pushing or hitting, independent of severe child abuse, may have increased odds for developing adult CVD, arthritis and obesity, according to researchers.

In a recent study conducted by Tracie Afifi, PhD, of the departments of community health sciences, psychiatry and family social sciences at the University of Manitoba in Winnipeg, Canada, potential associations between harsh physical punishment (i.e., pushing, grabbing, shoving, slapping and hitting) independent of severe child maltreatment (i.e., physical abuse, sexual abuse, emotional abuse, physical neglect, emotional neglect and exposure to intimate partner violence) and various health conditions were examined.

 “The findings from the current study are novel and support the hypothesis that harsh physical punishment in the absence of child maltreatment is associated with higher odds of several adult physical health conditions,” researchers wrote.

They extracted 2004 and 2005 data from the National Epidemiologic Survey on Alcohol and Related Conditions (n=34,226) which represented US adults aged 20 years or older.

According to data, harsh physical punishment was associated with greater probability of developing CVD with borderline significance, arthritis andobesity. These associations were consistent after adjustments for sociodemographic variables, family history of dysfunction and Axis I and II mental disorders, with odds ratios ranging from 1.20 to 1.30.

“Child maltreatment compared with no harsh physical punishment or child maltreatment was associated with high odds of all physical health outcomes,” researchers wrote. “Notably, when harsh physical punishment and child maltreatment categories were compared, no statistically significant differences were found for any of the eight physical conditions.”

According to researchers, these findings are consistent with the current literature. Afifi and colleagues recommend positive parenting approaches and nonphysical disciplinary methods to promote healthy child development.


Source: Endocrine Today

Physical Punishment of Children Linked to Obesity, Arthritis in Adulthood.

Harsh physical punishment in childhood is associated with adverse physical health outcomes in adulthood, according to a cross-sectional study in Pediatrics.

Researchers surveyed over 30,000 U.S. adults about whether they had experienced harsh physical punishment (e.g., pushing, grabbing, shoving, slapping, or hitting) as children. After adjusting for education, family history of dysfunction and mental disorders, and other variables, adults who reported receiving harsh physical punishment as children were at increased risk for having arthritis (adjusted odds ratio, 1.25) and obesity (OR, 1.20). The risk for cardiovascular disease was of borderline significance. Past studies have found that childhood mistreatment is linked to dysregulation of the body’s stress response system.

For physicians advising parents about discipline, the authors write: “It is recommended that physical punishment not be used with children of any age.” They instead recommend “positive parenting approaches and nonphysical means of discipline.”

Source: Pediatrics

Chronic Conditions Found in Nearly All Childhood Cancer Survivors.

Nearly all survivors of childhood cancer have chronic health conditions in adulthood, according to a JAMA study.

Researchers systematically screened 1700 adults (median age, 32) who were diagnosed with cancer as children. Roughly 25 years after diagnosis, 98% had a chronic health problem. Two thirds had a disabling or life-threatening condition. The most prevalent impairments were pulmonary abnormalities, cardiac problems, endocrine disorders, hearing loss, and neurocognitive impairment. Hematopoietic, hepatic, skeletal, and urinary tract dysfunction were less common.

The authors conclude, “These data underscore the need for clinically focused monitoring, both for conditions that have significant morbidity if not detected and treated early, such as second malignancies and heart disease, and also for those that if remediated can improve quality of life, such as hearing loss and vision deficits.”

Source: JAMA