Thursday, October 23, 2014

The Surprising Secret Truth about What Pregnant Woman Should Eat

Brace yourselves, pregnant women. No, that's not the headline from Huffington Post, Time, Yahoo, WebMD, Fox News or even Natural News, at least not this time. This high drama comes from the University of Newcastle in Australia. Obviously the university pressroom made an error. It obviously should read "Study Reveals The Surprising Truth" or "Study Reveals The Secret."

So what is the surprising, heretofore unknown food pregnant women should eat or not eat. Let me guess.

High carbs
No carbs
No dairy 
Only dairy
Soy diet
Vegan diet
Paleo diet
High fructose diet
No sugar diet
Kale diet 
No fish
No peanuts
Raw food
Cooked food
No gluten

It's killing me. Please do tell! Straight from The University of Newcastle Newsroom:

No universal consensus. 

Glut of nutritional information.

Drat. Not the kind of sensationalism I expected. I had to re-read the news release to make sure I didn't get the wrong impression. I'm still waiting to hear the surprising nutrition info. As it turned out, the only surprise was that there was no surprise, no secret super pregnancy diet anyhow. After Australian researchers reviewed more than 30 years of research on maternal diet and its effect on pregnancy, neonatal and infant outcomes - this is the only thing they could come up with to tell pregnant woman:
We found there was a positive effect on birth weight and a reduced incidence of low birth weight using whole foods and fortified foods as dietary interventions. Fortified foods included foods and drinks with higher levels of nutrients. Ellie Gresham, Dietitian and PhD candidate 
Fortified food. Whole food (not processed?). 

A paltry finding in a study that overall found maternal diet didn't really matter. In typical brain dead coverage, none of this prevented the following conclusions:

"Nutrition plays a fundamental role in fetal growth and birth outcomes." The summary of the study at The American Journal of Clinical Nutrition

"Work to improve children's health should start before mother becomes pregnant." Headline,  Science Daily

The mainstream media didn't pick this one up. For once. I have to wonder if it's because the researchers didn't really find much to recommend. If it had found, say two or three more foods of interest, would the media bothered with it? Maybe. 

So here's an example of a large meta-analytic study that basically found it doesn't really matter what pregnant women eat. 

Are there other review studies that found different results. Probably. But apparently this is the largest of its kind. It might not be the best but still, it didn't make a splash in the media probably because it didn't have sensational results. Or the kind of results that persuade pregnant women to eat better. Or that health officials can use to scold women.

And thud. That's the sound of it hitting the newsroom floor in Australia before it gets swept up and put it in the trash bin. 

Friday, October 17, 2014

A Cure for Hyper-Parenting Platitudes?

Hyper-parenting landed atop the New York Time's Most Emailed this week. A Cure For Hyper-Parenting worked its way right past the chicken wings boomlet.The general, largely anecdotal parenting article comes from Pamela Druckerman, author of Bringing Up Bébé, now an authority on raising children. I agree with some of her ideas. And yet. There might be a cure for hyper-parenting. Someday. If we could agree what it is. Despite its significant pop-cultural appeal, as an empirical phenomenon it's not particularly well-studied, conceptualized or even defined. 

Who exactly are hyper-parents? 

American. Overwhelmingly. 
Stressed out.
Work-force drop-outs.
Emotionally distant. 
Helicopter parents.
Intensive parents.

All these terms have been slapped on so-called hyper-parents. In academic research it's been assessed in a number of ways too, pinned mostly on mommas, of course. Researcher Holly Schiffrin studies it as a mom meddling too much in her kid's life. No surprise she's found meddling moms and college-aged kids of meddling mommas are depressed. 

I had some issues with the Cure for Hyper-Parenting, mainly figuring out what specifically most of it had to do with hyper-parenting as opposed to regular parenting or how the French, the paragons of parenting, do it. Druckerman lists her solutions for preventing hyper-parenting from getting worse. The list is really her rather random general parenting recommendations (I've paraphrased unless I've used quotes):

1. Teach your kids manners. 

2. Enjoy free-time without your kids.

But I can't summarize the next one because I really don't get it:

3. "Don’t just parent for the future, parent for this evening. Your child probably won’t get into the Ivy League or win a sports scholarship. At age 24, he might be back in his childhood bedroom, in debt, after a mediocre college career. Raise him so that, if that happens, it will still have been worth it. A Dutch father of three told me about his Buddhist-inspired approach: total commitment to the process, total equanimity about the outcome."

Carpe diem?
Chill out?
Live in the moment?
Eat donuts for dinner?
Enjoy watching your kid do homework tonight?
Don't worry about homework tonight (or if you kid does it)?
Don't mention college to your toddler?
Embrace your child's strength and weaknesses?
Lower your expectations? 
Become a Buddhist?

 4. Get enough sleep.

5. Have less stuff and keep it neat because a messy home is stressful.

(Organized, clean, neat spaces make me nervous. I can’t live like that!)

6. "Don't worry about over scheduling your child."

Madeline Levin probably disagrees.

Alvin Rosenfeld, definitely disagrees. See his The Over-scheduled Child: How to Avoid the Hyper-Parenting Trap

There has been plenty of debate over whether kids are over-scheduled, that is, suffering from too many activities.

7. Don’t sweat the perfect work-life balance.

8. Teach emotional intelligence.

9. "Transmit the Nelson Mandela rule: You can get what you want by showing people ordinary respect." 

10. "It really is just a phase. Unbearable 4-year-olds morph into tolerable 8-year-olds." 

In other words...

Well that clears up everything. Now stop it. The hyper-parenting. 

Wednesday, October 15, 2014

More Literacy, Pleez

In case you missed it, this summer the American Academy of Pediatrics decided pediatricians should worry more about literacy. Their June policy statement declares reading the best thing a parent can do promote healthy development (i.e. brain development). Indeed, the pediatric grand poo-bahs should worry more about literacy, beginning with their own readin' and writin'.

In fact, beginning with the very first sentence of the policy statement:

That's a long one. Let me channel my high school English teacher:

I would have ignored the above if it weren't for another more pressing matter:

As written it's not clear what builds lifetime language, literacy and social-emotional skills. The "s" on builds suggests a singular subject (reading regularly, brain development, critical time, child development?). None of the available singular subjects, though, make sense either from a theoretical or a grammatical perspective.

I assume it should read "build" instead. The authors probably meant to claim both 1) optimal patterns of brain development and 2) parent-child relationships influence the lifelong outcomes. If this is the case, then the above mess reflects either 1) a typo or 2) a grammatical error (a lapse in subject-verb agreement).

Neither possibility bodes well for an official recommendation advocating more literacy and language skills.

NOTE: I'd meant to write a post on E-Books/literacy and the question of how story-time on tablets and other screens differs from reading traditional books. The AAP literacy statement didn't take on the matter because as the policy author, Dr. Pamela Highman explained, "We tried to do a strong evidence-based policy statement on the issue of reading starting at an early age. And there isn't any data, really, on e-books."

Also, the experts will have to delicately navigate how to push the early reading recommendation (and the reality of more electronic books) with their stringent NO SCREEN TIME recommendations. I cannot wait to see how they resolve that conflict. I'm also anxious for them to tell me to limit teen screen time when my daughters spend many hours both at school and at home working on their laptops. Now that dilemma, dear readers, makes toddler story-time look like a level 1 easy reader book.

Wednesday, October 08, 2014

Cracking Down on Adolescent Screen Use Studies

Last week NPR featured a story about middle schoolers and their use of smart phones, tablets and other digital devices. Last week I also happened to take smart phones away from both of my middle schoolers to rectify some off-putting habits, namely ignoring me. So when I heard even a few days without screen time improved adolescent emotional skills, I envisioned my daughters skipping down the drive later that afternoon, full of new-found appreciation and empathy for each other and their mother. In the meantime, I wandered over to the study behind the claim.

Five Days at Outdoor Education Camp Without Screens Improves Preteen Skills with Nonverbal Emotion Cues

That's the title of the study. Basically kids who spent five days at camp were better at reading emotions both in facial expressions (in photographs) and social behavior (in videos).

Now I'm a huge fan of social interaction especially when I observe kids hanging out with friends in the car, the sidewalk outside school, the yogurt store or Starbucks, texting and posting while ignoring each other. No phones are permitted at the Momma Data dinner table where conversation and social interaction are encouraged even in the form of grunts and nods. I'm a social psychologist by training after all. 

But people, don't power down yet, this is hardly tight evidence. It's a basic though clever field experiment, thus a messy, loose collection of data full of possibilities and conjectures. Yes, emotional skills were measured before and after the school camping trip. That's fortunate. However the study only involved about 100 6th-graders, 51 screen-deprived (and likely sleep-deprived) campers, and 51 of their classmates left behind with televisions, computers and phones.

The real problem - it is impossible to conclude which part of the five-day field trip produced the results.

Why were kids better able to identify emotions?

Sure it could be due to more opportunities to practice reading faces. 

It could also be due to leaving home, homesickness, living in a new environment or bunking with other kids in tight quarters. It could be due to relief from the usual academic pressures, stress or drudgery. Or sleep deprivation, camp food, the fresh air, the sounds of nature, bug spray, dirt, fear of bed bugs, sleeping in a womb-like sleeping bag, campfires, roasted marshmallows, motivation to get along and win best cabin or most camp spirit (had to be). Or a break from Youtube. It could be due to all of the above or any of the above. I suspect a little of each. Take your pick. 

At least the study authors acknowledge the possibility of "increased opportunities for social interaction" - and in the title at least, the role of the outdoors though their message is clear. It's really the screens creating the problems. 

Implications are that the short-term effects of increased opportunities for social interaction, combined with time away from screen-based media and digital communication tools, improves a preteen’s understanding of nonverbal emotional cues.

A better study would have had another 50 classmates at camp with their regular media/screen fare. Better still, add another 50 who stay at school and don't watch any screens (a nearly impossible scenario). I might propose that for the middle school trips next year. The principal should jump on that real-world learning opportunity. They could do it as a science project. The hardest part would be getting informed consent from 200 parents and getting those screens away from 50 kids stuck at home. I'd be more than happy to supervise the project from home. Just give me the word, dear principal.

As for my own middle schoolers, they didn't skip home nor did they appear any more attuned to me or my emotional state (or anyone else's) after their recent 3-day screen-free school trips. In fact my 6th-grade daughter bunked in a remote cabin and still, no observable differences unless a few comments about boys misbehaving and teachers acting weird count. Perhaps two more days would have done the trick? 

RESEARCH GEEKS:  I wonder what other measures the researchers used to assess the kids. Obviously we would have heard about them if they'd turned out significantly improved in the campers. I don't appreciate when "studies" fail to provide this relevant information. There must have been at least several other variables that didn't vary between the groups. If I'd be in charge, I'd throw in an empathy scale at the very least. 

UPDATE: This all spells a poor prognosis for online preschool. See Report: Increasing Numbers of U.S. Toddlers Attending Online Preschool (via The Onion). 

Wednesday, October 01, 2014

Early Puberty, Again.

Plenty of adolescent fare popped up in media this week including perennial favorites early puberty and the perils of screen time (in addition to smoking pot, depression and anorexia). I might have let these media darlings go but they kept re-appearing on my homepage and radio. I have two middle-schoolers, I could not not comment.

I especially couldn’t ignore the early puberty banter considering it came from a name I know well - Laurence Steinberg, a foremost adolescence expert and professor of psychology at Temple University - who just happened to pen an opinion piece published at CNN entitled Obesity,early puberty and why we should be concerned

The high obesity rate among very young children is worrisome for many reasons. One is that obesity causes children to go through puberty earlier. American children have been maturing at an increasingly younger age, and one of the reasons is that more youngsters are overweight.

Oh I'm concerned. Very. His central argument rests on the assumption that girls and boys are entering puberty at increasingly younger ages:

Just how much has the age of puberty fallen? At the beginning of the 20th century, the average American girl got her first period sometime between the ages of 14 and 15. Today, it is closer to 12. The first signs of puberty -- like "breast budding" -- are visible even earlier. In 1960, the average age of breast budding was 13. By the mid-1990s, it had fallen below 10.

It sounds so plausible. Unfortunately, the evidence is limited and far from conclusive, mainly because the baseline data is practically non-existence. Granted, there is better evidence for earlier breast development though this research only started in the past few decades, mostly in the US. It’s anyone’s guess how early colonial girls needed training bras. Cotton Mather didn’t mention it.

As for age at first period, the jury is still out. Those “average American girls” Steinberg refers to? I believe he's referencing a small group of northern European girls living in the rural US circa 1900 who stumbled upon a country doctor who took notes on menstruation. There is some evidence suggesting no historical shifts occurred and yes, even some suggesting increasing age of first menarche. Also note, the Tanner Scales, the current reigning medical benchmark of pubertal development (still in use today!) comes from observations of British youth living in orphanages in the 1950s and 60s, war orphans. Enough said. I’ve written about the evidence related to increasing earlier puberty before and won’t get into it here.

The obesity claim. Yes there is some evidence but it is mixed. Even news-ish sources like WebMD, the fine purveyor of medical knowledge, don't pretend obesity is the single, overwhelmingly most important factor of early puberty. Fortunately someone there decided to list at least a few other potential risk factors like ethnicity and international adoption.

Oh Steinberg does mention a few others:

The high rate of childhood obesity over the past 40 years is not the only reason our children are maturing earlier sexually. Children's exposure to chemicals called "endocrine disruptors" -- substances found in foods and in many consumer products, from plastics to cosmetics that throw off normal hormonal functioning -- is probably playing a role.

There is also speculation that increased exposure to light—including artificial light emitted by computers, tablets, and smartphones—may be a contributor. CNN

So the esteemed psychologist mentions not the familial or socio-cultural factors linked to earlier puberty, the ones studied for decades and decades, but targets plastics and artificial light. Does anyone else find this slightly odd? 

He ignores in this article hereditary factors, family discord, absence of a father and other chronic social stressors linked to earlier puberty. So light from tv might cause girls to sprout breasts but not living with chronic stress. Light bad, elevated cortisol levels, okay? For love of PMS, he edited the first volume of The Handbook of Adolescent Psychology published in 2009. The chapter on puberty addresses the issue of earlier onset of puberty including many risk factors.

To speak of obesity as if it is definitely driving youth into puberty earlier than ever does not fit the facts. To speak of it as a done deal is not accurate. So of course I was curious why Steinberg latched on to obesity and earlier puberty. Frankly I'm still not clear but he took to the media (including NPR) to promote his new book:
In Age of Opportunity, Steinberg leads readers through a host of new findings — including groundbreaking original research — that reveal what the new timetable of adolescence means for parenting 13-year-olds (who may look more mature than they really are) versus 20-somethings (who may not be floundering even when it looks like they are). He also explains how the plasticity of the adolescent brain, rivaling that of years 0 through 3, suggests new strategies for instilling self-control during the teenage years. Packed with useful knowledge, Age of Opportunity is a sweeping book in the tradition of Reviving Ophelia, and an essential guide for parents and educators of teenagers. Amazon.

That small paragraph is remarkable.

New timetable of adolescence

Plasticity of the adolescent brain...

…rivaling that of years 0 to 3

Reviving Ophelia

Translation: Parents, don’t relax now. You have one more chance in adolescence to mess up your child for good. 

The book received rave reviews from big names in and out of academia. Martin Seligman, yes that guy (positive psychology etc. etc.), called it "simply the best book I have ever read on adolescence." Carol Dweck (praise effort not ability or intelligence) and Angela Duckworth (grit) loved it. As did my fave Madeline Levine (Teach Your Children Well). Jennifer Senior too (All Joy and No Fun), now that she's a parenting expert. 

But I still don’t see why all the fuss about obesity and puberty. Maybe nutrition is Steinberg’s side project. Maybe he is fixated on childhood obesity. Maybe he's been invited to Michelle Obama's vegetable garden. Maybe this is an excerpt from the book (I hope not). Does he feel the need to convince parents that kids are developing earlier so they (we) have more time to worry? I haven't read it yet, it will arrive on my doorstep tomorrow.

In any event it doesn’t justify the use of shoddy historical data or misrepresenting the so-called “causes” of early puberty. 

This mess certainly doesn't help this parent of two adolescents who is trying to navigate the complexities of screen time, homework-related screen usage, the screen-related social demands of adolescence or the new school requirement that each middle schooler bring a very expensive, fragile, highly addicting laptop to school every day. 

Oh well, there goes my Visiting Fellowship at Temple University. 

Next up: Save some of your screen time for adolescence and screen time/media use.

Correction: Steinberg edited the first volume of the Handbook of Adolescent Psychology not Social Psychology, the latter hefty tome sits collecting dust in my office. My bad. 

Update: Laurence Steinberg wrote to say that he did cover the many other factors involved in early puberty in the book, in fact, he was the first to publish evidence showing a relationship between adolescent-parent conflict and earlier puberty. He also noted the tight word limit. Indeed, readers here are all too familiar with the constraints of the new media including not enough space for the finer details and nuance. 

Wednesday, September 24, 2014

Artificial Sweeteners Are Bad For You?

A clutch of new studies published in Nature suggest artificial sweeteners might contribute to obesity and diabetes or as the Wall Street Journal so elegantly phrased it "trigger unwanted changes." At least some people appear more at risk but who can tell with news coverage like this:
The scientists performed a multitude of experiments, mostly on mice, to back up their assertion that the sweeteners alter the microbiome, the population of bacteria that is in the digestive system. New York Times
Multitude of experiments? (i.e...... 4).

Mostly on mice. 

Scientists doing studies to back  up their assertions. (As opposed to studies that don't back up their assertions.)

Microbiome (i.e. instant credibility, instant anxiety for you and me). 

The experts must have some grand theory if not evidence as to why fake sugar wrecks havoc with gut bacteria:
Researchers aren't sure about the exact mechanisms causing the imbalance in the gut bacteria populations. Wall Street Journal
At present, the scientists cannot explain how the sweeteners affect the bacteria or why the three different molecules of saccharin, aspartame and sucralose result in similar changes in the glucose metabolism. New York Times 
NBC News wrote about bacterias Bacteroides and Clostridiales, as if you or I care, but proceeded to dispense with all science and reason in the headline: 
How Can Diet Sodas Make You Fat? Study May Explain It. 
Some study indeed might explain it but not this one.   

I should cut the media a break because even Nature, the organization that published the study, forgot what the study really studied:
Sugar substitutes linked to obesity. Nature 
They forgot the study assessed gut bacteria, not obesity. Thank goodness they didn't drag out diet soda too. 

USA Today didn't stop at obesity, diabetes or even artificial sweeteners. They couldn't resist giving an expert the chance to haul out other public health nuisances:
In trying to understand why certain diseases like food allergies and diabetes have been increasing, Nagler said she looks to things that change gut microbes, such as the introduction of antibiotics, changes in diet, Cesarean-section births, the introduction of formula and the elimination of infectious diseases. Cathryn Nagler, University of Chicago
Girlfriend got cut off before mentioning screen time, cyber-bulling and early puberty. In any event there seems to be a growing consensus among experts that artificial sweeteners should be taken off the shelf:
“I think the validity of the human study is questionable.” - Dr. Frank Hu, a professor of nutrition and epidemiology at the Harvard School of Public Health.  New York Times
An unbiased expert? 

Reuters had to go all the way to Glasgow to dig up an expert who wasn't very impressed: 
"Animal data for many experiments do not show the same effect in humans, which can sometimes be quite the opposite," and "current epidemiological data in humans do not support a meaningful link between diet drinks and risk for diabetes, whereas sugar rich beverages do appear to be associated with higher diabetes risk." - Naveed Sattar, University of Glasgow
Favorite new public health term: unsupervised use of artificial sweeteners.

FNPHT: Courtesy of lead author, Eran Elinav, a physician-immunologist at Israel's Weizmann Institute of Science, via Wall Street Journal. 

Wednesday, September 17, 2014

Quack Child Psychology: The experts are not fooled by pseudoscience

A recent study polled child mental health experts on the credibility of questionable psychological practices. The experts, mainly child psychologists, rated assessments and treatments on a scale ranging from "not at all discredited" to "certainly discredited" or in lay terms, "not too bad" to "utter b.s." 

Many finely honed psychological instruments such as Enneagrams, biorhythms, handwriting analysis and the Fairy Tale Test did not pass muster with the professionals. The Rorschach, in comparison, received mixed reviews. Treatments that got the skeptical side-eye include but are not limited to past life regression therapy, crystal healing, and withholding food or water. I can only hope, since I’ve yet to read the entire study, that Conversion Therapy got skewered in the hot mess of harmful and hateful cures.

Anti-Pseudoscience SuperHero and Certified Quack-Busting Therapist, Gerald Koocher (photo credit: DePaul University)
No one here is surprised the research team could piece together over 100 questionable mental health protocols. I am slightly surprised however and disappointed the media ignored this story. A quick Google search revealed no mainstream or really much of any media save those content-gobbling curators picked this one up. Not even Natural News.

It is fabulous starting with lead author, Gerald Koocher, dean of the College of Science and Health at DePaul University, past president of the American Psychological Association and author of the not-published-soon-enough book, Psychoquakery. He should step out into the media spotlight more often and not just because he rocks nerd better than Bill Gates or any Brooklyn hipster.

The Huffington Post and others should heed his advice:

There are several signs that a psychological assessment or therapy is “quack,” said Koocher. First, it addresses a challenging or hard-to-treat problem by proposing an overly simple solution. Psychoquackery also is usually in sync with the spirit of the times and is often promoted by a charismatic expert. Science Daily

Be still my heart.

Charismatic expert. Psychoquackery. Spirit of the times.

...paging Dr. All-Natural, Organic, Neuro-Imaging, Lactating, Brain-Training, Endocrine-Disrupting, You’ve Already Messed Up Your Kid So You Must Be Vigilant In The Small Remaining Time You Have Left…

Fortunately Koocher got to the other clues you should forget recovered memories and other psychobabble that give psychologists a bad rep:

“Parents must be able to ask the right questions. ‘What studies have been done to show the effectiveness of this?’ And if someone says to you, ‘Medical science is keeping a lid on this because it’s too powerful and will put them all out of business,’ that’s a strong sign that a treatment is too good to be true,” Koocher said.

It might also be a sign someone is either sociopathic or delusional. No, I'm not a licensed clinical psychologist so I can't accept third party payments or charge you for that totally accurate diagnostic assessment-atizing. I can however keep this on my website because of that disclaimer below.  

Now if you’ll excuse me I need to go delete "Certified on the Fairy Tale Test" from my LinkedIn profile.

UPDATE: My third-grader came home from school and reported he was an Orange. Naturally he took this as confirmation he should play as many sports as possible. Rest assured, the True Color Personality Test is somehow based on the Meyers-Briggs and as I am clearly a Green l will spare you any links to the no doubt highly valid and reliable online proliferations of the test.

Gerald P. Koocher, Madeline R. McMann, Annika O. Stout, John C. Norcross. Discredited Assessment and Treatment Methods Used with Children and Adolescents: A Delphi Poll. Journal of Clinical Child & Adolescent Psychology, 2014; 1 DOI: 10.1080/15374416.2014.895941