Our Great City

Researchers have long blamed childhood obesity and diabetes, especially in poor neighborhoods, on too much food and too little exercise.

But new findings from a San Antonio study point to another explanation: Children living in poverty are obese in part because they don’t eat enough to meet the daily nutritional requirements needed for cell function and metabolism.

A 9-year-old should consume 1,400 to 2,200 calories daily to sustain growth, said Dr. Roberto Trevino, director of the nonprofit Social and Health Research Center. But in the study of 1,400 inner-city children, 44 percent were consuming less than 1,400 calories, and 33 percent were obese.

"They were not overeating," Trevino said. "This study shows these kids were not eating enough, and when they did eat it was all the wrong things."

Missing from the children’s diets were four key nutrients: calcium, magnesium, potassium and phosphorus. All play important roles, but magnesium is involved in more than 300 enzymatic reactions in the body that help to spur metabolism and cell function.

When magnesium — found in cooked spinach, black beans, bran cereal and other foods — is missing from the diet, it can predispose an individual to diabetes, Trevino said.

Nearly 7 percent of children in the study screened positive for type II diabetes, typically an adult disease, Trevino said.

Without early intervention, these children could be facing open-heart surgery at age 25 and will be on dialysis by age 35, he said.

The research, published in the November issue of the Journal of the American Dietetic Association, raises concerns in Texas, which ranks seventh in the nation for the percentage of children living in poverty.

The study brings to the forefront the urgency with which the state needs to address childhood obesity, which is a critical factor in early-onset diabetes and heart disease, said Elena Bastida, associate dean for research at the University of North Texas Health Science Center.

Some Fort Worth neighborhoods have large numbers of children who share many of the same socio-economic conditions found in the San Antonio study and are at high risk for diabetes, she said.

Last week, a 19-year-old Arlington woman died from complications of morbid obesity, according to the Tarrant County medical examiner.

An estimated 35 percent of school-age children in Texas are overweight or obese, according to the Statewide Obesity Task Force.

In the United States, 12 percent of children are overweight.

Researchers also found that a sedentary lifestyle contributed to the problem. In the study, nearly 90 percent of children scored marginal or unacceptable on physical fitness tests. On average they were watching 3.5 hours of television daily.

To address the problem in Tarrant County, the United Way, YMCA and other organizations have created programs aimed at educating families about diet and exercise.

The American Heart Association and the YMCA of Metropolitan Fort Worth recently partnered to offer the Go Healthy curriculum to 1,300 kids a week in 56 after-school facilities. The program encourages children to exercise more and eat healthy foods, but it also gets the whole family involved, said Tony Shuman, YMCA president.

"A kid can spend an hour on the treadmill, but if Mom and Dad stop to get a bucket of fried chicken on the way home, everything has just gone out the window," he said.

Also addressing the health issue is the Childhood Obesity Project at Mitchell Boulevard Elementary in southeast Fort Worth, developed by FitFuture, a Tarrant County initiative created by the United Way. The program teaches children how to live healthier lives and monitors their progress.

Addressing childhood obesity takes an ongoing commitment from people throughout the community, Shuman said.

Unhappy people watch more TV and vote less than happier people, study finds

A 30-year study of television habits published in the December issue of the scientific journal Social Indicators Research suggests that unhappy people watch considerably more TV, vote less, read fewer newspapers and are generally less socially active than happier people. The University of Maryland researchers noted that TV is more popular than many other free-time activities, considering that viewers don’t have to leave the comfort of their homes, dress up, plan or expend much energy. Perhaps it’s not surprising that TV takes up more than half of Americans’ free time. The study indicated that unhappy people watch about 20 percent more television than very happy people. — Chicago Tribune

CHICAGO — The dietary supplement ginkgo, long promoted as an aid to memory, didn’t help prevent dementia and Alzheimer’s disease in the longest and largest test of the extract in older Americans.

"We don’t think it has a future as a powerful anti-dementia drug," said Dr. Steven DeKosky of the University of Virginia School of Medicine, who led the federally funded study.

Extracts from ginkgo tree leaves have antioxidant and anti-inflammatory effects, but earlier research on ginkgo and memory showed mixed results. Annual U.S. sales of the supplement reached $107 million in 2007, according to Nutrition Business Journal estimates.

For the new study, appearing in today’s Journal of the American Medical Association, researchers recruited more than 3,000 people, ages 75 and older, from voter and mailing lists in Maryland, Pennsylvania, California and North Carolina.

Half were randomly assigned to take 120 milligrams of ginkgo biloba twice a day, a typical dose taken by people who think it may help memory. The others took identical dummy pills.

Participants were screened for dementia every six months. After six years, dementia had been diagnosed at a similar rate in both groups; 277 in the ginkgo group and 246 in the group taking the dummy tablets. When the researchers looked only at Alzheimer’s disease, that rate too was similar.

At the start, some people showed mild difficulties with thinking; ginkgo didn’t work to prevent dementia in those people, either.

Ginkgo appears relatively safe, DeKosky said. Proponents say it protects the brain by preventing the buildup of an Alzheimer’s-related protein or by preventing cell-damaging oxidative stress.

LONDON — Doctors have given a woman a new windpipe with tissue grown from her own stem cells, eliminating the need for anti-rejection drugs.

"This technique has great promise," said Dr. Eric Genden, who did a similar transplant in 2005 at Mount Sinai Hospital in New York. That operation used both donor and recipient tissue. Only a handful of windpipe, or trachea, transplants have ever been done.

If successful, the procedure could become a new standard of treatment, said Genden, who was not involved in the research.

The results were published online today in the medical journal, The Lancet.

The transplant was given to Claudia Castillo, a 30-year-old Colombian mother of two living in Barcelona who suffered from tuberculosis for years. After a severe collapse of her left lung in March, Castillo needed regular hospital visits to clear her airways and was unable to take care of her children.

Doctors initially thought the only solution was to remove her entire left lung. But Dr. Paolo Macchiarini, head of thoracic surgery at Barcelona’s Hospital Clinic, proposed a windpipe transplant instead.

Scientists at Italy’s University of Padua acquired a donor windpipe and stripped off all its cells, leaving only a tube of connective tissue.

Meanwhile, doctors at the University of Bristol took a sample of Castillo’s bone marrow from her hip. They used the bone marrow’s stem cells to create millions of cartilage and tissue cells to cover and line the windpipe.

Experts at the University of Milan then put the new cartilage and tissue onto the windpipe. The new windpipe was transplanted into Castillo in June.

"They have created a functional, biological structure that can’t be rejected," said Dr. Allan Kirk of the American Society of Transplantation. "It’s an important advance, but constructing an entire organ is still a long way off."

Castillo has shown no signs of rejection and is not taking immune-suppressing drugs, which can cause side effects such as high blood pressure, kidney failure and cancer.

"I was scared at the beginning," Castillo said in a statement. "I am now enjoying life and am very happy that my illness has been cured."

Her doctors say she is now able to take care of her children and can walk reasonable distances without becoming winded. Castillo even reported dancing at a club in Barcelona recently.

Genden said that Castillo’s progress needs to be closely monitored. "Time will tell if this lasts," he said. Genden added that it can take up to three years to know whether the windpipe’s cartilage structure is solid and won’t fall apart.

People who might benefit include children born with defective airways, people with scars or tumors in their windpipes, and those with collapsed windpipes.

The technique might even be adapted to other organs like the bowel, bladder or reproductive tract, said Martin Birchall of the University of Bristol.

Online: www.lancet.com

Researchers have long blamed childhood obesity and diabetes, especially in poor neighborhoods, on too much food and too little exercise.

But new findings from a San Antonio study point to another explanation: children living in poverty are obese in part because they don’t eat enough to meet the daily nutritional requirements needed for cell function and metabolism.

A 9-year-old should consume 1,400 to 2,200 calories daily to sustain their growth, said Dr. Roberto Trevino, director of the Social and Health Research Center, a nonprofit organization. But in the study of 1,400 inner-city children, 44 percent were consuming less than 1,400 calories, and 33 percent were obese.

"They were not overeating," Trevino said. "This study shows these kids were not eating enough, and when they did eat it was all the wrong things."

Missing from the children’s diets were four key nutrients: calcium, magnesium, potassium and phosphorus. All play important roles, but magnesium is involved in more than 300 enzymatic reactions in the body that help to spur metabolism and cell function.

When magnesium — found in cooked spinach, black beans, bran cereal and other foods — is missing from the diet, it can predispose an individual to diabetes, Trevino said.

Nearly 7 percent of children in the study screened positive for type 2 diabetes, typically an adult disease, Trevino said.

Without early-age intervention, these children could be facing open-heart surgery at age 25 and will be on dialysis by age 35, he said.

The research, published in the November issue of the Journal of the American Dietetic Association, raises concerns in Texas, which ranks seventh in the nation for the percentage of children living in poverty.

The study brings to the foreground the urgency with which the state needs to address the critical problem of childhood obesity, which is a critical factor in early onset of diabetes and heart disease, said Elena Bastida, associate dean for research at the University of North Texas Health Science Center.

There are neighborhoods in Fort Worth with large numbers of children who share many of the same socio-economic conditions found in the San Antonio study and are at high risk for diabetes, she said.

Last week, a 19-year-old Arlington female died from complications of morbid obesity, according to the Tarrant County Medical Examiner.

An estimated 35 percent of school-age children in Texas are overweight or obese, according to the Statewide Obesity Task Force.

In the United States, 12 percent of children are overweight, compared with 33 percent in the San Antonio study.

Researchers also found a sedentary lifestyle contributed to the problem. In the study, nearly 90 percent of children scored marginal or unacceptable on physical fitness tests. On average they were watching 3.5 hours of television daily.

To address the problem in Tarrant County, the United Way, YMCA and other organizations have created programs aimed at educating families about diet and exercise.

The American Heart Association and the YMCA of Metropolitan Fort Worth recently joined together to offer the Go Healthy curriculum to 1,300 kids a week, in 56 after-school facilities. The program encourages children to exercise more and eat healthy foods, but it also gets the whole family involved, said Tony Shuman, president of the YMCA of Metropolitan Fort Worth.

"A kid can spend an hour on the treadmill, but if mom and dad stop to get a bucket of fried chicken on the way home, everything has just gone out the window," he said.

Also addressing the health issue is the Childhood Obesity Project at Mitchell Boulevard Elementary in southeast Fort Worth, developed by FitFuture, a Tarrant County initiative created by the United Way. The program, which teaches children how to live healthier lives, also monitors their progress.

Addressing the childhood obesity issue takes an ongoing commitment from people throughout the community, Shuman said.

Had JPS been equipped to serve critically ill patients in Arlington, Barbara Perkins may have lived to see her next birthday, her daughter believes.

On April 3, Perkins went to JPS Diagnostic & Surgery Hospital in Arlington after having a fever and cough for several days. Doctors diagnosed pneumonia, although a chest X-ray did not confirm it. What it did show was atherosclerosis of the aorta, a hardening of the heart’s arteries.

The 54-year-old Arlington woman was sent home with a prescription for antibiotics, said her daughter, Regina Thompson.

She died just hours later.

"If they diagnosed pneumonia and suspected it," Thompson said, "they should have admitted her."

JPS officials say patients wouldn’t typically be admitted with the symptoms that Perkins had, and they don’t believe that she died of pneumonia.

But the officials agree that the facility doesn’t have the equipment or personnel to handle seriously ill patients.

A committee of nine Arlington physicians and JPS officials says it wants to change that. The committee, appointed by County Judge B. Glen Whitley, is recommending to county commissioners that the facility be expanded into a full-service hospital.

"That was something we all had in mind," JPS Board President Steve Montgomery said. "The direction is, let’s grow this into a full-sized hospital."

County commissioners are expected to hear the committee’s report this month. At issue will be whether tax dollars should be used to expand the Arlington facility and whether John Peter Smith Hospital in Fort Worth is at capacity. Officials have not yet estimated the cost of such an expansion or what the facility would look like.

"Nobody should think this is going to be quick and easy," committee Chairman Wes Jurey said. "It’s going to take some time and some commitment."

The JPS facility has been a longstanding point of contention in the Arlington medical community.

The 30 beds at the hospital, part of the taxpayer-financed Tarrant County Health District, have been mostly empty since JPS acquired it. That’s because the hospital doesn’t have an intensive care unit, won’t accept transfers of critically ill patients and can’t admit women in labor.

Signs at its entrance urged patients to go to an "emergency room" in the back of the building; however, patients who went there were told to go to other Arlington hospitals. As their emergency rooms overflowed, physicians at those hospitals began to wonder why the public hospital wasn’t treating needy patients.

"Really, what’s happening at local hospitals in Arlington is that we are providing a tremendous amount of care for JPS-eligible patients" who qualify for discounts, said Dr. Cynthia Simmons, medical director for Arlington EMS. "We think JPS Hospital has a responsibility to provide that care themselves, and the local hospitals should not be taxed with providing that care."

Arlington has fewer doctors and hospital beds per capita than the North Texas average, studies show. Yet the load of its needy patients is growing. Census reports show that 41 percent of Arlington families would qualify for the county’s discount program.

Montgomery said that JPS had not expected such demand when it purchased the hospital on New York Avenue three years ago. Officials believed that the hospital would draw privately insured patients, he said, and JPS had aimed a marketing campaign at such patients.

"What took us by surprise was how big a need [for indigent care] there was out there," he said. "It took us a couple of years to figure that out."

The hospital has largely provided outpatient services, such as scheduled radiological procedures. From November 2007 to January 2008, a total of 10 inpatients were admitted. It now is averaging about 19 patients a month, JPS said.

To ease pressure on other Arlington hospitals, Montgomery said that JPS is trying to expand care at its Arlington clinics. An urgent-care clinic opened next to the hospital in March, and officials planned to expand it. However, urgent-care clinics are not required to treat every patient who arrives, regardless of ability to pay. Federal law requires emergency rooms to do so.

WASHINGTON — Scientists are baffled by one of humankind’s most annoying problems — itching — an almost universal misery for which there is, as yet, no adequate explanation or treatment.

"Why we can’t stop scratching remains a big puzzle for researchers," said Zhou-Feng Chen, a neuroscientist at Washington University in St. Louis.

Matthias Ringkamp, a researcher at Johns Hopkins University in Baltimore, said: "Itch can be devastating to patients and lead to extensive loss of quality of life. Unfortunately, the treatment of itch is often unsatisfactory."

The recent discovery of an "itchy gene," however, may offer hope for better treatments, Chen said. A drug to block that gene might relieve the distress of itching.

Specialists on pruritus — the scientific term for itching — described their work Monday at the annual meeting of the Society for Neuroscience in Washington.

They distinguished between two major types of itch: a mild form that can be treated with common antihistamines such as Benadryl and a severe form that cannot.

"The second type is often severe and very common, since more than 50 diseases and conditions can cause it," said Glenn Giesler, a neuroscientist at the University of Minnesota in Minneapolis. "There are no treatments currently available for this latter type of itch."

As many as 10 percent of people in the world endure chronic itching, said Ben Maddison, a researcher at Unilever, a multinational consumer-product corporation.

The itch-related gene identified by Chen is labeled GRPR for gastrin-releasing peptide receptor. When he injected it under the skin of laboratory mice, they "scratched like crazy," he said.

"The discovery of the first itchy gene in the spinal cord raises the hope that it may be possible to relieve itchiness in patients by blocking the GRPR function," Chen said.