Carbohydrate Type, Not Amount, Linked to Obesity
American Journal of Epidemiology, February 15; 2005.

When it comes to carbohydrates, it's not how much you eat, but which kind, that makes a difference to your bathroom scale, new research shows. People who are overweight do not appear to eat more carbohydrates overall than people who weigh less, the researchers report in the American Journal of Epidemiology. However, they found that overweight people tend to eat more refined carbohydrates, such as white bread and pasta, which cause a rapid spike in blood sugar.

According to the study done by researchers at the University of Massachusetts Medical School: total amount of carbohydrate is not related to body weight, it's the type of carbohydrate that's important. These findings suggest that low-carbohydrate diets, which recommend people cut back on all carbohydrates, are missing the mark. Refined carbohydrates are often found in processed foods that contain a lot of sugar. This type of carbohydrate has what's called a high glycemic index, meaning it causes a rapid increase in blood sugar. The body stores that sugar in muscle, but if it is not used, it becomes fat. In contrast, whole grains, fruits and vegetables have carbohydrates that don't have such high glycemic index.

The researchers measured the height and weight of 572 healthy people, and asked them to regularly report what carbohydrates they ate. The researchers followed study participants for one year. They found that people with a higher body mass index -- a measure of weight that factors in height -- tended to eat carbohydrates with a higher glycemic index. The amount of carbohydrates people ate had no influence on body mass index.

Dr. Sears comments: Having lost 30 pounds using a low carb diet, this story caught my eye. Patients are asking me what I think of a low carb diet. I think it is more important to have a RIGHT carb diet. Sure a low carb diet is fine for a very short time, but then you need to shift into a diet that has some healthy complex carbs, while still avoiding the junk refined carbs. This will help ensure success and maintain a healthy body weight. This is actually the subject of our next book – still trying to think of a good name for it – any suggestions?

Fight Against Polio Launched in Ivory Coast
DANANE, Ivory Coast (Reuters) - On foot and by bicycle, an army of 28,000 people advanced through towns and remote villages in Ivory Coast Sunday to vaccinate children against polio to try and finally defeat the crippling disease.

Ivory Coast was polio free in 2001 but the outbreak of civil war a year later wreaked havoc with immunization campaigns and 17 cases were recorded last year in the West African country, still divided by a buffer zone manned by U.N. peacekeepers.

This weekend's mission in Ivory Coast and neighboring Liberia is part of a continent-wide campaign to vaccinate more than 100 million children in 22 west and central African nations against polio in the space of a few days.

The World Health Organization said Friday the disease was spreading across Africa and 13 out of 14 previously polio-free countries to record cases are in the world's poorest continent.

Dr. Sears comments: People in this country often forget the ravages of polio since it’s been eradicated from America for some time now. Most new parents are too young to remember how devastating a disease this can be. Many parents today are opting to not vaccinate their children due to safety concerns and I often hear comments like, “they don’t need polio vaccine… my child won’t catch that.” I encourage parents to be well informed about vaccine decisions, and this story is a reminder that Poliovirus is still in existence, and is just a plane ride away. If parents are choosing to delay vaccines, I would remind them of the importance of getting immunized against polio – especially before traveling abroad.

No Evidence Flu Jabs Work for Under-2s - Study
LONDON - There is no evidence that vaccinating children under 2 years old against influenza reduces deaths or complications from the illness, researchers said on Friday.

They reviewed 25 studies that looked at the impact of vaccines in cutting the number of cases of influenza and its symptoms in children up to 16.

"Immunization of very young children is not lent support by our findings," said Dr Tom Jefferson, of the Cochrane Vaccines Field in Rome, part of the international Cochrane Collaboration that evaluates medical research.

"We recorded no convincing evidence that vaccines can reduce mortality, admissions, serious complications and community transmission of influenza," he added in a report in The Lancet medical journal.

U.S. and Canadian health officials have recommended that children aged 6-23 months should be immunized. Last year the American Academy of Pediatrics updated its guidelines, saying healthy babies under 2 should be routinely immunized against the virus. It followed recommendations from the U.S. Centers for Disease Control and Prevention.

Each year, influenza kills an average of 36,000 Americans and puts 114,000 in hospital.

"In young children below the age of 2, we could find no evidence that the vaccine was different from a placebo," Jefferson told Reuters.

He added that the findings do not mean vaccinations do not work in young children but they found no evidence that it does. There was no indication the vaccines caused any harm or reason to believe they were unsafe.

Dr. Sears comments: Flu shots have been a major headache for parents and pediatricians for the past few years. Each fall we are inundated with news stories about the dangers of the flu and the importance of getting a flu shot – but changing recommendations and vaccine shortages have left parents scrambling and confused. Many parents are worried because they could not find a flu shot for their child. Hopefully this story can put them at ease a bit. Other preventative measures can be highly effective: washing hands, keeping hands away from your face, avoiding crowds, and staying home when you are ill are all important for curbing the flu epidemics. The flu hit early during the 2003-2004 season. The early arrival of the flu was actually good, because just a few weeks into it, Christmas vacation came, and everybody stayed from school and work – and that seemed to be the end of it. This year (2004-2005) has been mild so far. I would not worry about missing out on a flu shot this year unless you are at high risk with a compromised immune system. For more flu discussion, click here.

FDA cautions doctors on use of drugs Elidel and Protopic for eczema
WASHINGTON (AP) - The Food and Drug Administration issued an advisory to doctors Thursday urging caution in prescribing two drugs for eczema, because of the possibility of cancer.

The drugs Elidel and Protopic will receive new label warnings pointing out that an increased risk of cancer may be associated with their use, the agency said. Elidel and Protopic are applied to the skin to control eczema by suppressing the immune system. But animal tests have shown an increase in cancer associated with the drugs and a small number of cancers have been reported in children and adults treated with the drugs, the FDA said in its advisory. The FDA said the manufacturers of the products have agreed to do further tests to determine the actual risk. The agency said it is developing a medication guide for patients. It urged physicians considering prescribing the drugs to consider the following:

-Elidel and Protopic are approved only for short-term and intermittent treatment of eczema in patients who don't respond to or cannot tolerate other treatments.

-These drugs are not approved for use in children younger than two-years-old because the long-term effect on the developing immune system is not known.

-These drugs should not be used continuously. The long-term safety of these products is unknown.

-Children and adults with a weakened or compromised immune system should not use Elidel or Protopic.

-Use the minimum amount needed to control symptoms. The animal data suggest that the risk of cancer increases with increased exposure.

Dr Sears Comment: Most pediatricians (myself included) have been using these creams for a few years thinking they were very safe – even using them under two years of age (only approved down to 2 years). They have been tremendously effective in treating eczema and other skin irritation without the typical side effects of the steroid creams such as thinning skin. Most experts still feel that the cream is safe and will continue to use Elidel and Protopic; however, they will probably do so more cautiously. In our office we will probably discontinue use in children under age 2 until more safety research is done.