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This Month in Archives of Pediatrics & Adolescent Medicine
Arch Pediatr Adolesc Med. 2006;160:463.
Estimate of the Commercial Value of Underage Drinking and Adult Abusive and Dependent Drinking to the Alcohol Industry
Individuals who begin drinking before the age of 15 years are 4 times more likely to become alcohol dependent than those who do not drink before the age of 21 years. Foster et al examined underage drinking, the amount of drinking, and the cash value from this consumption to the alcohol industry. Forty-seven percent of underage youth are current drinkers and 25% met the criteria for alcohol abuse and dependence. The total cash value of underage drinking was $22.5 billion in 2001, accounting for 17.5% of total consumer expenditures for alcohol. Early initiation of alcohol use provides substantial financial value to the alcohol industry. Restricting alcohol advertising can have a substantial effect on this problem.
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Systematic Review of the Relationship Between Early Introduction of Solid Foods to Infants and the Development of Allergic Disease
Current recommendations advise the introduction of solid foods to infants after the age of 4 to 6 months. This systematic review sought to examine the evidence that early solid feeding before the age of 4 months increases the risk of allergic disease. Of the 13 studies that met inclusion criteria, only 1 study was a controlled trial. Five studies found an association between early solid feeding and eczema, while 4 studies found no association. There was a lack of strong evidence that early solid feeding increases the risk of persistent asthma, persistent food allergy, allergic rhinitis, or dander allergy.
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Prevalence of Diabetes and Impaired Fasting Glucose Levels Among US Adolescents: National Health and Nutrition Examination Survey, 1999-2002
Because the prevalence of being overweight among youth has dramatically increased in the United States during the last decade, a corresponding increase in the prevalence of diabetes is expected. In this national sample, 0.5% of adolescents reported having been diagnosed with diabetes, 71% of whom had type 1 diabetes and 29% had type 2. Among nondiabetic youth, 11% had impaired fasting blood glucose levels, 42% of whom were overweight or at risk for being overweight. Based on this sample, 39 000 adolescents in the United States have type 2 diabetes, and 2.8 million have impaired fasting glucose levels. These data have important implications for public health because of the high rate of conversion from impaired fasting glucose levels to type 2 diabetes.
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Figure 1. Prevalence of impaired fasting glucose (IFG) level as a function of body mass index (BMI) percentile among 1496 US adolescents. Gray-shaded bars indicate prevalence estimates using a fasting plasma glucose cut-point value of 5.6 mmol/L (100 mg/dL) to define impaired fasting glucose level, and blue-shaded bars indicate prevalence estimates using a cut-point value of 6.1 mmol/L (110 mg/dL).
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Improved Asthma Outcomes in a High-Morbidity Pediatric Population: Results of an Emergency Department–Based Randomized Clinical Trial
Appropriate care of children with asthma continues to be problematic. This study took a different approach by randomizing emergency department patients with asthma to usual care or to a scheduled visit 2 to 15 days after emergency department discharge to a specialized asthma clinic located in the emergency department. Of those randomized to the intervention, 70% attended. In the subsequent 6-month follow-up period, the intervention patients had significantly fewer unscheduled visits, although there was no impact on the number of hospitalizations. There was significant improvement in asthma symptoms. This study may have important implications for the future role of the urban emergency department in asthma care.
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Figure 2. Cox proportional hazards regression of cumulative risk of having 1 or more emergency department visits during the 6-month follow-up period.
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