The Natural Advocate - Best Self USA/Health: October 2009

Sam and Bunny Sewell

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ANNOUNCING!

THE NATURAL ADVOCATE

A call in, Talk Radio program for Sentinel Radio

Friday, Oct. 9th (8-10 PM ET)The focus of this week’s program will be:

NATURALLY HEALTHY INFANTS AND CHILDREN

Other extensive wellness research at “The Natural Advocate”.

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Listen to this program online, go to: http://www.blogtalkradio.com/Sentinel_Radio

To listen by phone or to call in with questions & comments: (646) 727-2652
(We’re always eager for your feedback!)
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“We hold this truth to be self-evident; Our creator has endowed us with a laser straight path of natural thinking, feeling and behaving that has its origins in a sacred absolute reality. If we stray from that path we will experience pain. If we stay on that path we will be happy, healthy, and whole. “The Natural Advocate” will show you the guideposts and help you navigate along the centerline.
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To provide a tixic free environment for your children at home see these links.
ALWAYS GREEN-ALWAYS POWERFUL -ALWAYS SAFE
A Little Goes a Long Way and Costs Less
Cost Comparison Chart "Green" Cleaners
Cancer rate higher in home than at work
Household Toxins and the Natural Solution

For an excellent book on the subject of keeping your home safe for infants and children see:

"Green Goes With Everything" by Sloan Barnett

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See this video for a quick review of how to encourage

Naturally Healthy Infants and Children

http://bestself.myshaklee.com/us/en/whynow.html#/healthybabieskids

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Our audio guest this evening is Dr. Frank Painter talking about the supporting scientific research behind the latest products available for infants and children. www.healthquestnewsletter.com/

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Superwellness for Superkids—A Parent’s Guide

http://content.shaklee.com/shaklee/docs/health-sci/superwell_superkids.pdf

THE SCIENCE BEHIND NATURALLY HEALTHY

INFANTS AND CHILDREN

Did You Know?

During the past 25 years, consumption of milk—the largest dietary source of calcium—has
decreased 36% among adolescent girls.

The American Academy of Pediatrics recently doubled its daily vitamin D intake recommendations for babies, children, and adolescents, and recommends supplementation because most children do not get enough from diet alone.

Children who consume fast food have higher intakes of fat, saturated fat, cholesterol, and
sodium—and lower intakes of fiber, calcium, and iron—than those children who do not eat fast
food.

Breakfast is an important meal for growing children, yet many children skip breakfast.
Studies have documented a significant and positive relationship between eating breakfast
and school performance.

The U.S. Food and Drug Administration and Environmental

Protection Agency advise pregnant women, nursing mothers, and young children to avoid some types of fish because they are high in mercury, which makes getting adequate amounts of DHA through the diet alone more difficult.
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Nutrition and Fitness for a Lifetime of Health

Children grow at a much faster rate during their
first few years than at any other time in their lives,
stressing the need for parents to ensure optimal
nutrition. Of special importance are macronutrients
(carbohydrates, proteins, and fats) that provide
calories and essential vitamins and minerals
critical to proper growth, development, and
immune function—including all eight B vitamins
and vitamins C, A, and D, as well as calcium, iron,
and zinc. In addition, growing children should
achieve adequate intakes of omega-3 fatty acids
such as DHA, which is essential for early brain and
eye development.

Although specific nutrient needs vary throughout
the different stages of life, there is probably not a
more critical time for optimal nutrition than during
childhood—especially early childhood. Good
nutrition is absolutely essential for the development
of healthy bodies that will thrive with
abundant energy, healthy brain function, a
responsive immune system, and strong bones
and teeth. Healthful eating and exercise habits
established during childhood also will help reduce
the risk of obesity as well as many degenerative
and lifestyle-related diseases of adulthood, including
diabetes, heart disease, cancer, hypertension,
osteoarthritis, and other conditions related to
nutrition, weight, and lifestyle. In other words,
acquiring beneficial lifestyle habits early in life—
making nutritious and healthful food choices,
being physically active, and filling in nutritional
gaps with the appropriate dietary supplements—
can provide a strong foundation for a lifetime of
health and wellness.

Establishing Healthful Eating Habits
Establishing healthful eating habits early in life starts with parents and all caregivers of young children introducing and making available the most nutritious foods. We need to offer at all meals and snack times nutritious food choices that include a variety of age-appropriate foods, including fresh fruits and vegetables, whole-grain breads and cereals, legumes, low-fat or nonfat dairy products, poultry, lean meats, and fish that are rich in omega-3 fatty acids. This also means eliminating or at least minimizing the unhealthful choices. Fast food tends to be high in saturated fats, calories, sugar, and salt, and fairly absent in vitamins, minerals, and fiber. Children today are consuming sodas and sweetened juice drinks—which deliver excessive amounts of high-fructose corn syrup—far more frequently than milk and water, which is contributing to the rising incidence of childhood and teen obesity. Parents, let’s be responsible not only for what our children eat, but when and where as well.

Fostering healthful eating habits means setting a good example. Practicing the same healthful eating habits you preach for your children is one of the strongest learning tools a parent can offer to a child. In addition, parents should strive to make more time to eat meals at home together as a family, engage children in meal planning and food preparation, introduce new foods or recipes on a regular basis, ensure the availability of nutritious snacks, and help children make intelligent food choices when eating out. These are good habits and choices that will benefit the entire family!

Filling the Nutritional Gaps with Dietary
Supplements
Despite a parent’s best efforts to provide their child with an overall healthy and well-balanced diet, the reality is that most children are NOT getting the complete nutrition they need. National nutrition surveys confirm over and over again that children are not consuming the recommended number of food group servings based on the Food Guide Pyramid, with 63% of 2- to 9-year-olds not consuming enough fruit, 78% not consuming enough vegetables, and only 12.7% consuming two or more servings of whole grains per day.2,3 And poor eating habits appear to be starting earlier and earlier!

In a recent study, 25%–30% of infants and toddlers ages 9
months to 24 months did not eat fruits or vegetables on a
given day. In fact, French fries were the most commonly
consumed vegetable for infants and toddlers 15–24 months
of age, and an astounding 46% of 7- to 8-month-olds
consumed some type of dessert, sweet, or sweetened
beverage.4 Studies also have found that children and
adolescents may not be consuming the recommended
amounts of vitamins A, C, D, and E, as well as the minerals calcium and magnesium.5 In fact, based on the Healthy Eating Index, a tool used by the USDA to measure the diet quality of Americans, most diets of 2- to 9-year-olds were found to be “poor” or “need improvement.”6

To make matters worse, trends in food consumption indicate children are eating larger portions; drinking less milk (but more fruit juice and soda); eating more calorie-rich, nutrientpoor meals away from home; and skipping breakfast.7 These poor food choices and unhealthful eating trends are fueling the childhood obesity epidemic as well as increasing the prevalence of diseases that rarely were diagnosed in children until the past 15 years—including hypertension, elevated cholesterol, arthritis and other orthopedic problems, and a frightening increase in the diagnoses of type 2 diabetes.

Given these unhealthful eating trends and suboptimal
nutrient intakes—combined with the fact that many essential
nutrients are not stored in the body and must be supplied in
the diet on a regular basis—parents should be encouraged
to provide their infants, toddlers, and young children
with a comprehensive multivitamin-multimineral
supplement to fill in nutritional gaps caused by dietary shortfalls.
Another nutritional challenge most children face today is
getting adequate amounts of omega-3 fatty acids from the
foods they eat. Omega-3 fatty acids play an important role in
proper growth and development of the brain, eyes, and
nervous system. Many organizations, including the Institute
of Medicine’s Food and Nutrition Board, the World Health
Organization (WHO), the American Dietetics Association, and
Dietitians of Canada, recommend increased consumption of
omega-3 fatty acids in children.8,9,10 Yet studies indicate most
American and Canadian children aren’t getting much at all
from their diet.1,11 DHA—or docosahexaenoic acid, one of the
omega-3 fatty acids used most readily by the body—is found
in fatty fish, yet children consume only 20–50 mg of DHA
per day. And because of the growing concerns about
environmental contaminants in our fish supply, the FDA
and EPA advise young children to limit their fish intake.12
Supplementation with a high-quality dietary supplement
that uses highly purified fish oil offers a means for safely providing DHA to our children without worrying about the mercury and other environmental toxins present in the fatty fish that provide the food source of DHA.

Fostering Active Children
Regular physical activity in children and adolescents—as with adults—promotes health and fitness. Compared with those who are inactive, physically active children have higher levels of cardiovascular fitness and stronger muscles, perform better in school, and are less likely to suffer from anxiety and/or depression.

Physically active kids also are less likely to become overweight or obese, which is a major public health issue today.

In fact, during the past 30 years, the childhood obesity rate for preschool children ages 2–5 has more than doubled—and has more than tripled for children ages 6–11.13 Today, nearly 9 million children over 6 years of age are considered obese.

So how much physical activity do children need? Based on
the 2008 Physical Activity Guidelines for Americans, children
and adolescents should participate in at least 60 minutes or
more of physical activity each day. This activity should
include aerobic activity such as brisk walking, age-appropriate
muscle strengthening activities such as gymnastics or
push-ups, and bone-strengthening activities such as
jumping rope or running.14 It’s also important for parents to take responsibility for raising fit children by helping them participate in a variety of age-appropriate activities, establishing a regular schedule for physical activity, incorporating activity into their daily routine, keeping activities fun so children stay engaged, and setting a good example by embracing a more physically active lifestyle themselves.

Tips for Raising Active and Fit Kids
Restrict television, movies, videos, and
computer games to less than two hours a day.
If it’s safe to walk or bike rather than drive, do
so when you can. If your child is too young to
bicycle to school on their own, bicycle with
them if possible!
Set the example for your children by using
stairs instead of elevators and walking up
escalators, rather than just standing on them.
Plan family outings and vacations that involve
activities such as hiking, bicycling, skiing, and
swimming.
Give your children some age-appropriate
household chores that require physical exertion.
Mowing lawns, raking leaves, scrubbing
floors, and taking out the garbage not only
teach responsibility but can be good exercise.
Observe sports and activities your children
like, and then find out about lessons and clubs.
Some children thrive on team sports; others
prefer individual activities.
Choose fitness-oriented gifts—jump rope,
mini trampoline, tennis racket, baseball bat,
a youth membership at the local YMCA or
YWCA—and minimize the “low activity” gifts
such as video games.
Take advantage of your city’s recreation
opportunities, from soccer leagues to fun runs.
Strollers and playpens are high on convenience
but low on activity potential. Try to free
your infant from these mechanical restraints
whenever and wherever he or she can safely
move around.
When your children are bored, suggest
something that gets them moving, like playing
catch or building a snowman in the yard.

Quick and Healthful Snack Ideas
1. Peel a banana and dip it in yogurt. Roll in
crushed cereal and freeze.
2. Spread celery sticks with peanut butter or low-fat
cream cheese. Top with raisins.
3. Make snack kabobs. Put cubes of low-fat cheese
and grapes on pretzel sticks.
4. Blend low-fat milk, a scoop of protein powder,
frozen strawberries, and a banana in a blender
for a delicious smoothie.
5. Sprinkle grated Monterey jack cheese over a
corn tortilla. Fold in half and microwave for 20
seconds. Top with mild salsa.
6. Toast a whole-grain waffle and top with low-fat
vanilla yogurt and sliced peaches.
7. Make a mini pizza by drizzling tomato sauce on a
toasted English muffin. Sprinkle with shredded
part-skim mozzarella cheese.
8. Spread natural peanut butter on a fresh sliced
apple.
9. Microwave a cup of tomato or vegetable soup
and serve with whole-wheat crackers.
10. Mix together ready-to-eat cereal, raisins, and
nuts and place in a sandwich bag for an on-thego
snack.
Key References
1. Madden SM, Garrioch CF, Holub BJ. Diet quantification indicates low intakes of (n-3) fatty acids in children 4 to 8 years old. J Nutr. 2009;139:528-32. 2. Position of the American Dietetic Association: Dietary guidance for healthy children ages 2 to 11 years. JADA 2004;104:660-77.
3. Harnack L, Walters SA, Jacobs DR. Dietary intake and food sources of whole grains among children and adolescents: Data from the 1994-96 continuing survey of food intakes by individuals. JADA 2003;103:1015-19. 4. Fox MA, Reidy K. Novak T. Sources of energy and nutrients in the diets of infants and toddlers. J. Am Diet Association. 2006;106:S28-S24. 5. Report card on the diet quality of children. Nutrition Insights: A publication for the USDA Center for Nutrition Policy and Promotion. October 1998. 6. Report card on the diet quality of children. Nutrition Insights: A publication for the USDA Center for Nutrition Policy and Promotion. October 1998. 7. Report card on the diet quality of children. Nutrition Insights: A publication for the USDA Center for Nutrition Policy and Promotion. October 1998. 8. National Academy of Sciences Institute of Medicine—Food and Nutrition Board. Dietary reference intakes for energy, carbohydrate, fiber, fat, fatty acids, cholesterol, protein and amino acids. 2002-05.
9. Information obtained on 3.13.09 from: www.issfal.org.uk/recommendationsof-
others.html.
10. American Dietetics Association. Position of the American Dietetics Association and Dietitians of Canada: Fatty acids J Am Diet Assoc. 2007;107:1599-1611.
11. Ervin RB, Write JD, Wang C. et al. Dietary intake of fats and fatty acids for
the United States population: 1999-2000. Advanced Data. Vital and Health Statistics, Number 348, 2004.
12. Obtained on 3.24.09 at http://www.epa.gov/waterscience/fish/files/
MethylmercuryBrochure.pdf.
13. Institute of Medicine. Childhood obesity in the United States: Facts and Figures. September 2004.
14. U.S. Department of Health and Human Services. Physical activity guidelines advisory committee report. Washington, D.C.: U.S. Department of Health and Human Services, 2008.
15. Borrud C et al. What we eat in America: USDA surveys food consumption changes. Food Reviews 1996;14-19.
16. Wagner CL, Greer FR et al. Prevention of rickets and vitamin D deficiency in infants, children, and adolescents. Pediatrics 2008;122:1142-52. 17. Position of the American Dietetic Association: Dietary guidance for healthy children ages 2 to 11 years. JADA 2004;104:660-77.
18. Simeon DT, Grantham-McGregor S. Effects of missing breakfast on the cognitive functions of school children of differing nutritional status. AJCN 1989;49:646-53.
19. Kleinman RE et al. Diet, breakfast, and academic performance in children.
Ann Nutr Metab 2002;46(suppl 1):24-30.

Nutrition & Immune Function
A healthy immune system is a concern for all people,
but especially for infants, toddlers, and young
children. That’s because, by nature, infants have
immature immune systems, in part because you
must first be exposed to pathogens to develop
antibiodies that provide resistance to viruses and
bacteria that cause illness. Infants are born with
what is called “passive immunity”—this refers to
the antibodies they have received from Mom via
the umbilical cord while in utero. These antibodies
last for up to six months, but “active immunity”
occurs through their exposure to viruses, bacteria,
and other allergens. So infants and toddlers are
potentially quite vulnerable to infections as they
develop this active immunity. Young children often
are in close contact with one another at day care
or school, and this certainly facilitates the spread
of germs. According to the Centers for Disease
Control and Prevention (CDC), children experience
six to 10 colds a year on average, compared with
two to four in adults. In families with school-aged
children, the number of colds per child can be as
high as 12 per year.1 Although the common cold
is usually mild with symptoms lasting one to two
weeks, it is a leading cause of doctor visits and
missed school days. The flu, on the other hand,
can be a very serious illness in young children. In
fact, children are two to three times more likely
than adults to develop complications from
influenza and are more likely to spread the virus
to others.2 The CDC estimates that 10%–20% of
Americans come down with influenza each flu
season and, on average, 20,000 children under
age 5 are hospitalized because of complications
associated with the flu.3

Immune System Primer
So before we talk about what we, as parents, can do to support our children having a healthy immune system, a brief understanding of the immune system may be helpful. The immune system is an exceedingly complex network of cells that activate and secrete an array of chemicals. Its mission is to protect the body against invading pathogens and other foreign substances. The cells in the immune system have the ability to recognize something as either “self” or “invader,” and will try to get rid of anything that is an invader. Many different kinds of cells—and hundreds of different chemicals—must be coordinated for the immune system to function smoothly.

Components of the Immune System
Key Components of the Immune System Function
T lymphocytes, or “T cells” Attack virus-infected cells by producing cytokines, which are proteins that regulate the body’s response to potential infection.

Natural killer cells Play a role in destroying cancer cells as well as virus-infected cells by releasing proteins that cause cell death.
Phagocytes (macrophages and neutrophils) A first line of defense against infection. Cells that engulf and destroy “invaders.”
B lymphocytes, or “B cells” Manufacture and secrete antibodies.
Antibodies or immunoglobulins Proteins made by B cells that can recognize and attach to specific sites on “invaders” to block their ability to infect.Interferon Protein produced by T cells and other cells in response to viral infection.
Lactoferrin A protein found in human breast milk as well as cow’s milk that supports the growth of bifidobacteria, lactoferrin plays a role in the activation of specific immune cells such as macrophages and neutrophils, and may inhibit the cellular attachment and replication of viruses.

Nutrients Needed for a Strong
Immune System
Good nutrition is absolutely critical for a healthy immune response. Protein and essential amino acids are critical to every component of the immune system because the body cannot defend itself without producing new proteins. Vitamin A promotes the growth, differentiation, and activation of all cells, including immune cells, and vitamin C acts as a potent antioxidant that protects immune cells from free radical damage. Vitamin C also appears to have a direct effect on immune-cell function, and a deficiency of this essential nutrient has been linked to impaired immune response. Additionally, deficient intake of vitamin C decreases the ability of phagocytic cells to migrate to sites where an inflammatory process is occurring, which may allow the spread of an otherwise localized infection.4 B vitamins also are important for immune function, with vitamins B6, B12, and folic acid being critical because of their role in DNA, RNA, and protein synthesis. Inadequate intake of any of these B vitamins can impair DNA, RNA, or protein synthesis, which can result in a decrease in the production, multiplication, and repair of immune cells. This can then lead to the body not being able to create the antibodies necessary to initiate a response to an infection.4 Minerals such as iron, zinc, copper, and selenium also support immune function.
During the immune response, the need for oxygen increases
as immune cells proliferate and perform their functions, and
iron is required for the production of hemoglobin, which
helps transport oxygen in the blood. Zinc is needed by over
200 different enzymes, including many involved in protein
and DNA synthesis. Like zinc, copper is needed by many
enzymes to function and is specifically important for
the functioning of antibody-forming cells—neutrophils,
T lymphocytes, and macrophages. The trace mineral
selenium is needed for the proper function of a number of
different immune cells but—like vitamin C—supports
immune function by its antioxidant action. If protected from
free radical damage, the cells of the immune system are
less easily destroyed during an immune response, thus
increasing their number and effectiveness.4
The Immuno-Supportive Effects
of Lactoferrin
There is new and interesting research related to the effects
of a compound called lactoferrin, a unique and biologically
active milk protein found naturally in breast milk, tears,
and other body fluids. Lactoferrin has been shown to
activate multiple components of the immune system
and is believed to be one of the components of breast
milk responsible for the immuno-protective effects
associated with breast-feeding. The mechanisms by which lactoferrin may offer immuno-protection are numerous. Studies suggest that lactoferrin serves as a prebiotic, or food to fuel the growth of beneficial bifidobacteria, which in turn support a healthy digestive tract—and a healthy digestive system is one of the body’s first lines of defense against pathogenic invaders.5 Research also indicates that lactoferrin has anti-adhesion characteristics that can inhibit the cellular attachment and replication of viruses. In one recent study, lactoferrin inhibited the adhesion of adenovirus (the common cold virus) by 95%.6 In addition, lactoferrin may activate specific immune cells such as macrophages and neutrophils. These cells are somewhat similar to little “Pac-Men,” gobbling up foreign materials such as killed bacteria and viruses, and digesting them so they are no longer harmful to the body (a process called phagocytosis).
In laboratory studies, lactoferrin was found to enhance the
rate of phagocytosis in human neutrophils.7
Prebiotics and Probiotics for Digestive
and Immune Health in Infancy
Newborns are first exposed to bacteria at the time of birth. Before that time, the infant’s gastrointestinal tract is completely sterile. Bacteria rapidly colonize the small and large intestine, and the intestinal immune system learns to recognize these bacteria as desirable residents of the intestinal tract. A number of factors influence the process of colonization and the types of organisms that establish residency.
These factors include the mother’s diet, the mother’s use of probiotics during pregnancy, the type of birth (vaginal vs. Cesarean), gestational age of the newborn, as well as the overall health of the newborn.
10 Nutrition & Immune Function Shaklee Health Sciences After delivery, environmental exposure and diet begin to play an important role in this colonization process. Depending on whether a baby is breast-fed or bottle-fed, the types of organisms that take up residency early in life may differ.
Studies suggest that breast-fed babies have higher initial
counts of bifidobacteria than formula-fed babies—and we
know that bifidobacteria are beneficial to the function of the
digestive system. However, once solid foods are introduced,
the microflora readjust, and by the end of the first few
months of life, bifidobacteria levels are similar in both the
breast-fed and formula-fed babies.8 By 1–2 years of age,
the bacterial population in infants resembles that of an
adult—both in terms of number and composition of
microorganisms.
It has been proposed that the high oligosaccharide
(carbohydrate) content of breast milk may be responsible for its bifidogenic effect. This has lead to the addition of prebiotics—fibers such as inulin and fructo-oligosaccharides—
to infant foods and formula with the purpose
of selectively stimulating the growth and activity of
beneficial bifidobacteria and lactobacilli in the large intestine. In fact, prebiotics have been added to infant foods and formula in Japan for over 20 years, and in Europe since the early 2000s.9 The concept of adding prebiotics to infant foods and formula has grown in popularity and acceptance. This is due to an increasing understanding of the role intestinal microflora play in postnatal development of gastrointestinal function, including the development of the gut-associated immune system.10 It is thought that the immaturity of the intestinal barrier in newborns facilitates antigen (foreign invader) transfer, causing intestinal inflammation. In turn, this inflammation is thought to lead to an increased permeability of the intestinal wall and impairment in the balance of microflora—factors thought to be involved in the initial development of food allergies in infants.11 A bifidus-dominated microflora is considered protective for infants as it may activate the immune system and inhibit invading pathogens, lessening their likelihood of getting infections and decreasing the development of food allergies.
A number of studies have attempted to evaluate the effects of prebiotic consumption—specifically inulin and oligofructose—on both the digestive and the immune function in infants and toddlers. In one study, researchers evaluated the effects of a prebiotic (an inulin-enriched oligofructose) that was added to weaning foods and consumed by toddlers attending day care. Results indicated that toddlers who were fed up to three grams a day of prebiotic-enriched foods experienced softer stools; less vomiting, regurgitation, and perceived gastrointestinal discomfort; as well as fewer incidences of fever.12 In a similar study, toddlers attending day care and taking two grams a day of prebiotics for three weeks experienced a protective effect against illness.
Toddlers experienced fewer infectious episodes requiring antibiotics, fewer episodes of diarrhea and vomiting, and had less flatulence. Microbial analysis also confirmed a bifidogenic effect during the supplementation period.13 In addition to the health benefits associated with prebiotics for infants and toddlers, the use of probiotics (i.e. the direct supplementation with beneficial microflora—bifidobacteria and lactobacillus) also has been shown to produce beneficial health effects. Probiotics help support and maintain a healthy balance of intestinal microflora and are believed to do this by several mechanisms, such as increasing the production of compounds that inhibit or destroy pathogenic bacteria and competing for receptor-cell binding sites or for available nutrients needed by pathogenic organisms.
One of the primary areas of probiotic research in children has been in the treatment or prevention of diarrhea, especially diarrhea associated with antibiotic use. Several studies indicate that supplemental lactobacilli and bifidobacteria species during antibiotic therapy reduce the incidence of diarrhea and loose stools.14,15 In addition to digestive health benefits, research also indicates that probiotics may play a role decreasing food-related allergies. Preliminary research suggests that probiotic supplementation may reduce markers of intestinal inflammation and decrease intestinal permeability16,17, two benefits that may prove to be beneficial in reducing symptoms related to food allergy.
Filling in Nutritional Gaps with
Immune-Supporting Supplements
Proper nutrition plays a critical role in the development and maintenance of a strong and healthy immune system—from infants to children of all ages. Therefore, it is a parent’s responsibility to provide children with healthful, age-appropriate food choices that provide an array of immune-supporting nutrients. But despite a parent’s best intention, ensuring their child gets all the nutrition they need from diet alone is a challenge. The toddler years, in particular, can be quite challenging. Children ages 1–2 years can become picky eaters as they transition to eating table food and accepting new tastes and textures, which may potentially limit the variety of foods they eat. Nutrition surveys confirm over and over that young children—even infants and toddlers—are 11 Nutrition & Immune Function Shaklee Health Sciences NOT getting the nutrition they need. In fact, researchers found in a recent study that poor eating habits start early—on any given day, 25%–30% of infants and toddlers ages 9–24 months did not eat any fruit, and 20%–25% did not eat any vegetables.18 And because most vitamins and minerals are not stored in the body and need to be supplied on a regular basis, supplementation with a comprehensive multivitamin-multimineral supplement to fill those nutritional gaps just makes good sense. Also, look for products that include ingredients such as lactoferrin, prebiotics, and probiotics—all of which can provide additional immune support for your child!
Key References
1. Information obtained at http://www3.niaid.nih.gov/topics/commonCold/
overview.htm.
2. Information obtained at www.nlm.nih.gov/MEDLINEPLUS/ency/
article/000678.htm.
3. Information obtained at http://www.cdc.gov/flu/protect/preventing.htm.
4. Kline, DA. Nutrition and Immunity Part 1: Immune components and nutrients. 2nd Edition. October 1992: pgs 74-88.
5. Petschow, B. W., and Talbott, R. D. 1991. Response of bifidobacterium species to growth promoters in human and cow milk. Pediatr Res 29: 208. 6. Pietrantoni A et al. Bovine lactoferrin inhibits adenovirus infection by interacting with viral structural polypeptides. Antimicro Agents Chemother 2003;4:2688.
7. Miyauchi, H., Hashimoto, S., Nakajima, M., et.al. Bovine lactoferrin stimulates the phagocytic activity of human neutrophils: Identification of its active domain. Molecular Imunology 1998;187:34.
8. Star PL, Lee A. The microbial ecology of the large bowel of breast-fed and formula-fed infants during the first year of life. J Med Microbiol. 1982;15:
189-203.
9. Ghisolfi J. Dietary fiber and prebiotics in infant formulas. Proceedings of the Nutrition Society 2003;62:183-5.
10. Fanaro S, Boehm G, Garssen J et al. Galacto-oligosaccharides and long-chain fructo-oligosaccharides as prebiotics in infant formulas: A review. Acta Pediatrica 2005;94(Suppl 449):22-6.
11. Fanaro S, Boehm G, Garssen J et al. Galacto-oligosaccharides and long-chain fructo-oligosaccharides as prebiotics in infant formulas: A review. Acta Pediatrica 2005;94(Suppl 449):22-6.
12. Saaverdra JM, Tschernia A. Human studies with probiotics and prebiotics: clinical applications. Br J Nutr. 2002;87:S241-6.
13. Waligora-Dupriet AJ et al. Effect of oligofructose supplementation on gut microflora and well being in young children attending a day care center.
Int J Food Microbiol. 2007;113(1):108-13.
14. Arvola T et al. Prophylactic Lactobacillus GG reduces antibiotic-associated diarrhea in children with respiratory infections: a randomized study. Pediatrics 1999;135:564-8.
15. Vanderhoof JA, Young RJ. Current and potential uses of probiotics.
Ann Allergy Asthma Immunol. 2004;93(Suppl 3):S33-S37. 16. Majamaa H, Isolauri E. Probiotics: a novel approach in the management of food allergy. J Allergy Clin Immunol 1997;99:179-85. 17. Rosenfeldt V. et al. Effect of probiotic Lactobacillus strains in children with atopic dermatitis. J Allergy Clin Immunol 2003;111:389-95. 18. Fox MK., Pac S. Devaney B. et al. Feeding Infants and Toddlers Study:
What foods are infants and toddlers eating? J Am Diet Assoc. 2004;104:
S22-S30.
12 Building Strong Bones Starts Early—And the Latest News About Vitamin D!! Shaklee Health Sciences
Building Strong Bones Starts Early—
And the Latest News About Vitamin D!!
When it comes to concerns about your child’s
health, helping them to have strong bones may
not be at the top of your list! But there is much
that parents should know about bone health—
even when your children are very young.
Building strong bones by adopting healthy nutritional
and lifestyle habits in early childhood is
critically important in helping to prevent osteoporosis
later in life. Osteoporosis, a condition of
thinned bones that are prone to fractures, has
been called “a pediatric disease with geriatric
consequences” because the bone mass attained
during childhood and adolescence is the most
important determinant of long-term skeletal
health. In other words, the eating habits, activity
levels, and supplement usage in your kids today
may very well make or break their bones as
they age.
Childhood and Adolescence: Building
the Bone Bank
Bone is living tissue that changes throughout life. There is a continuous remodeling occurring, with a balance between bone formation and bone resorption.1 This critical balance between the breakdown and formation of bone changes as we age. During childhood there is a higher amount of bone formation than bone breakdown and, thus, it is during this critical time that your child’s bones increase in both size and density. In fact, by the time girls reach age 18 and boys reach age 20, up to 90% of peak bone mass has been acquired.2 Once we reach about age 30, the rate of bone breakdown and formation are relatively equal—although there is still an ongoing remodeling of bone that requires the support of all the bone nutrients. At the time of menopause for women and beginning in the 60s for most men, bone breakdown exceeds bone formation, which can result in loss of bone mass. For women, the first five years after menopause are the most critical for potential loss of bone density and the development of osteopenia and osteoporosis. But back to kids!! Because your child is going to achieve most if not all of their peak bone mass by age 20, what they do in childhood, adolescence, and the teen years is critically important for their long-term bone health.
What Are the Essential Nutrients for Strong Bones?
Many nutrients play a role in proper bone development. For example, the minerals calcium, phosphorous, and magnesium all are incorporated into and form the matrix of bone; the nutrients zinc, copper, and manganese are trace minerals that serve as catalysts for metabolic reactions involved in building bone; vitamin D assists with the intestinal absorption of calcium; and vitamin K assists in the creation and proper function of a protein produced by bone-forming cells during bone matrix formation. Although all are essential to developing strong bones, the two nutrients of particular concern for growing infants and children are calcium and vitamin D.
Calcium
Calcium is the most abundant mineral in the body with more
than 99% occurring in bones and teeth, where it is the central
“support structure.” Therefore, it’s critically important that
children of all ages optimize their calcium intake every day to
13 Building Strong Bones Starts Early—And the Latest News About Vitamin D!! Shaklee Health Sciences
ensure proper development of bones and teeth. Calcium is found in many foods, but the most common source is milk and other dairy products. One 8-ounce glass of milk provides 300 mg of calcium, which is 33% of the recommended daily intake for younger children and about 25% of the recommended intake for teens. Based on the USDA Food Guide Pyramid, individuals ages 2 and older should consume two to three servings of dairy products per day, with a serving size being equivalent to 1 cup (8 ounces) of milk, 8 ounces of yogurt, or 1.5 ounces of natural cheese. Calcium also can be found in fortified foods such as tofu, soy milk, and some juices—as well as in dark, leafy green vegetables such as kale, broccoli, and spinach. However, to get the same amount of calcium in one 8-ounce glass of milk, a child would have to consume 21/4 cups of cooked broccoli or 8 cups of spinach!
The recommended daily intake of calcium for infants and children ranges between 210 mg and 1,300 mg a day, depending on the age of the infant or child (refer to Table 1). However, national nutrition surveys have shown downward trends in the consumption of milk, and increased consumption of sugar-rich juices and sodas3 among adolescents and teens. Other studies confirm that many children aren’t getting enough calcium from diet alone. In one such study, 44% of boys and 58% of girls ages 6–11, and 64% of boys and 87% of girls ages 12–19, did not meet their recommended intake for calcium.4 Inadequate calcium intake, during such a critical time, can prevent children from achieving optimal peak bone mass, ultimately increasing their risk for osteoporosis and bone fractures later in life. So the take-home message is to assess your child’s dietary intake of calcium and vitamin D (see below) and be sure to provide a supplement that delivers adequate amounts of both calcium and vitamin D to fill any gaps that may exist in their diets.
Table 1. Recommended Calcium Intake
for Infants, Children, and Young Adults*
Age Amount of Calcium
Infants
Birth to 6 months 210 mg
6 months to 1 year 270 mg
Children/Young Adults
1–3 years 500 mg
4–8 years 800 mg
9–18 years 1,300 mg
*Source: National Academy of Sciences’ Institute of
Medicine (Food and Nutrition Board), 1997
Vitamin D
Vitamin D is a fat-soluble vitamin needed by the body to help maintain normal blood levels of calcium and phosphorus. By assisting the body with calcium absorption, vitamin D helps to create and maintain strong bones. Without adequate levels of vitamin D, bones can become thin, brittle, and misshapen. Vitamin D can be obtained through the skin after exposure to sunlight or from our diets, but very few foods provide vitamin D naturally—with the exception of fatty fish such as salmon.5 In fact, fortified foods provide most of the vitamin D in the American diet.6 For example, almost all of the U.S. milk supply is fortified with 100 IU of vitamin D per cup. But again, we know that milk consumption in children is down and juice and soda consumption is up!!
Growing Concerns About Vitamin D
Deficiency
Rickets, an extreme form of vitamin D deficiency that affects
infants and small children and is characterized by soft and
deformed bones, was nearly eliminated in the United States
when vitamin D fortification of milk was introduced in the
1930s.6 However, concerns about vitamin D status in the
United States recently have resurfaced because of an
increasing number of reports of insufficient dietary intake and signs of deficiency—both in children and in adults. Based on findings from the National Health and Nutrition Examination Survey (NHANES), children living in the United States consume about 300 IU of vitamin D per day, on average, from both food sources and dietary supplements.
7 In a fairly recent study published in the American
Journal of Clinical Nutrition, researchers analyzed blood levels of vitamin D in 382 healthy children and adolescents.8 They found that 55% of the children had lower-thanrecommended serum concentrations of vitamin D. They also noted that vitamin D blood concentrations dropped during the winter months as a result of reduced sun exposure.
Overall, 68% of children had inadequate levels of the
vitamin in their blood during the colder months when they
spent more time indoors. In another study involving 380
healthy infants and toddlers, the prevalence of actual
vitamin D deficiency was found to be 12%—but 40% of
infants and toddlers had blood levels of vitamin D
considered to be suboptimal.9
Risk factors for vitamin D deficiency in children include
inadequate dietary intake of vitamin D; spending more time
indoors, thus reducing their sun exposure; use of sunscreens,
which block the synthesis of vitamin D; and other
risk factors such as having a dark complexion or having been
exclusively breast-fed during infancy.10
14 Building Strong Bones Starts Early—And the Latest News About Vitamin D!! Shaklee Health Sciences
Recommended Intakes of Vitamin D
in Infants and Children
In 1997, the National Academy of Sciences’ Panel for Vitamin
D—along with the Institute of Medicine—recommended a
daily intake of 200 IU of vitamin D to prevent deficiency in
healthy infants, children, and adolescents. At the time, this
recommendation was endorsed by the American Academy
of Pediatrics (AAP). However, nutrition experts, researchers,
and pediatricians are faced with an emerging mass of
scientific studies linking insufficient levels of vitamin D in the
blood not only to bone demineralization and reduced calcium
absorption, but to a wide variety of other health issues,
including insulin resistance, impaired immune response, and
other metabolic consequences—including a higher risk of
certain cancers. In fact, based on evidence from more recent
clinical trials and a long history of safe use of vitamin D
supplements, the AAP recently issued its own recommended
daily intake for vitamin D that exceeds the National
Academy of Sciences’ recommendation.11 The AAP now
recommends that infants and children of all ages
get 400 IU of vitamin D per day, doubling previous
recommendations. As part of these recommendations, the AAP also acknowledges that, given the dietary practices of many children and adolescents today, getting 400 IU of vitamin D from diet alone is difficult to achieve. So to help infants and children meet their need for this important bonehealth nutrient, the AAP recommends daily use of a vitamin D-containing multivitamin supplement. The group also acknowledges that there is an ongoing debate among health experts as to what constitutes vitamin D “sufficiency,” “insufficiency,” and “deficiency” in infants and children. It is also recognized that children at significant risk for vitamin D deficiency may require even higher amounts to achieve and maintain optimal vitamin D status. How much higher? Well, more research is needed, but studies conducted in adults have found that supplemental intakes of 400 IU a day have only a modest effect on blood concentrations of vitamin D and, in people with suboptimal blood levels of vitamin D, as much as 2,000 IU a day is needed to raise blood concentrations to an optimal level.12 Until more children’s data are available, we believe that 400 IU of vitamin D per day for infants and children under age 4 and 600 IU per day for older children are reasonable and well within safe levels of consumption.
Physical Activity and Bone Strength
Building strong bones during childhood and optimizing bone health throughout life involves not only getting one’s daily requirement for all bone health nutrients, but it also entails getting regular exercise. Exercise, specifically “weightbearing” activities such as jumping rope, walking, dancing, and playing organized sports (e.g. gymnastics, basketball, soccer, and hockey) stimulate bone-building cells, which ultimately will help increase bone size and mass. Therefore, one of the most important things you can do as a parent is to encourage your children to participate in weightbearing activity for at least 30 minutes a day most days of the week. And while they are out there playing—go join them!! It will be good for your bones as well!
Optimizing Bone Health with
Supplementation
Helping children build strong bones and teeth starts early. Parents should begin by offering and making available a variety of healthful food choices rich in essential bone-health nutrients, paying special attention to calcium, magnesium, zinc, copper, and manganese, as well as vitamins D and K. Dairy products provide the best source of calcium, and many of the other bone-health nutrients can be found in whole grains, nuts, seeds, dark-green vegetables, lean meats, poultry, and seafood. However, because national surveys consistently show that most children fail to achieve the recommended intake of calcium or vitamin D, parents are making a wise decision by providing their children with a comprehensive multivitamin that contains at least 400 IU to 600 IU of vitamin D, 200 mg of calcium, as well as the other nutrients listed above to add to the nutrients already being provided in their diets.
Give your child the best chance to achieve optimal bone mass during one of the most critical periods in life by investing now in your child’s bone health. Not only will you be helping them to keep their bones strong, but you’ll be helping them to reduce their risk of developing osteoporosis later in life.
Important Food Sources of Bone-Health
Nutrients
Calcium: milk, cheese, yogurt
Magnesium: dark, leafy greens; nuts; seeds
Vitamin D: fortified milk, salmon, eggs
Vitamin K: kale, spinach, broccoli
Manganese: whole grains, nuts, peas
Zinc: beef, chicken, pork, fortified cereal
Copper: seafood, nuts, seeds
15 Building Strong Bones Starts Early—And the Latest News About Vitamin D!! Shaklee Health Sciences
Key References
1. Institute of Medicine, Food and Nutrition Board. Dietary Reference Intakes:
Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride. Washington, D.C.: National Academy Press, 1997.
2. National Institute of Arthritis and Musculoskeletal and Skin Disorders.
Kids and their Bones: A Guide for Parents. NIH Pub. 06-5186. August 2002.
Revised December 2005.
3. U.S. Department of Agriculture. Results from the United States Department of Agriculture’s 1994-96 Continuing Survey of Food Intakes by Individuals/Diet and Health Knowledge Survey. 1994-96.
4. Borrud C et al. What We Eat in America: USDA Surveys Food Consumption
Changes. Food Rev. 1996;14-19.
5. Institute of Medicine, Food and Nutrition Board. Dietary Reference Intakes:
Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride. Washington, D.C.: National Academy Press, 1997.
6. Calvo MS, Whiting SJ. Prevalence of vitamin D insufficiency in Canada and the United States: Importance to health status and efficacy of current food fortification and dietary supplement use. Nutr Rev 2003;61:107-13.
7. Moore CE, Murphy MM, Holick MF. Vitamin D intakes in children and adults in the United States differ among ethnic groups. J Nutr. 2005;135:2478-85.
8. Weng FL, Shults J, Leonard MB. et al. Risk factors for low serum
25-hydroxyvitamin D concentrations in otherwise healthy children and adolescents. Am J Clin Nutr 2007;86:150-8.
9. Gordon CM, Feldman HA, Sinclair L. et al. Prevalence of vitamin D deficiency among healthy infants and toddlers. Arch Pediatric Adolesc Med 2008;162(6):505-12.
10. Holick MF. Vitamin D deficiency. N Engl J Med. 2007;357:266-81.
11. Wagner CL, Greer FR, and the Section on Breast-Feeding and
Committee on Nutrition. Prevention of rickets and vitamin D deficiency in infants, children, and adolescents. Pediatrics 2008;122:1142-52.
http://www.aap.org/new/VitaminDreport.pdf.
12. Vieth R. Bischoff-Ferrari H., Boucher BJ et al. The urgent need to recommend an intake of vitamin D that is effective. Am J Clin Nutr 2007; 85:649-50.
Factors Affecting Peak Bone Mass
Gender: Bone mass or density generally is higher
in men than in women. Before puberty, boys and
girls develop bone mass at similar rates, but after
puberty, boys tend to acquire greater bone mass
than girls.
Race: For reasons not well understood, African-
American girls tend to achieve higher peak bone
mass than Caucasian girls. And girls of Asian
descent tend to have the lowest bone mass. However,
because all women—regardless of race—are at
significantly higher risk for osteoporosis, girls of all
races need to build as much bone mass as possible
to help protect against this disease.
Hormones: Sex hormones, including estrogen and
testosterone, are essential for the development
of bone mass. Girls who start to menstruate at an
earlier age typically have greater bone density. Girls
who have been diagnosed with anorexia as well as
female athletes who have very low body-fat levels
and abnormal menses are at greater risk of not
achieving optimal bone density.
Nutrition: Calcium in particular is essential for bone
health. In fact, calcium deficiencies in young people
can account for 5%–10% lower peak bone mass and
may increase the risk of bone fractures later in life.
A well-balanced diet including adequate amounts of
vitamins D and K, as well as the minerals calcium,
magnesium, zinc, copper, and manganese, also are
essential to bone health.
Physical Activity: Important for building healthy
bones, weight-bearing activities that stimulate bone
growth—such as running and jumping rope—are
especially important.
16 Omega-3 Fatty Acids and Children’s Health Shaklee Health Sciences
Omega-3 Fatty Acids and Children’s Health
Omega-3 fatty acids, also known as polyunsaturated
fatty acids, are essential to human health but
cannot be made by the body. For this reason, they
must be obtained from the foods we eat. Good
sources of omega-3s include fatty fish and
certain plant foods, including olive oil, flaxseed,
and walnuts.
There are three major types of omega-3 fatty
acids consumed in foods and used by the body:
alpha-linolenic acid (ALA), eicosapentaenoic acid
(EPA), and docosahexaenoic acid (DHA). The body
converts ALA to EPA and DHA, which are the two
omega-3 fatty acids used most readily by humans.
However, because this conversion is fairly
inefficient (less than 5%), dietary consumption of
both DHA and EPA is highly recommended—
especially in young children in order for them to
meet their significant need for these important
omega-3 fatty acids. Research continues to
validate the important role these omega-3 fatty
acids play in normal growth as well as in the early
development of a child’s brain and eyes.
Early Brain and Visual Development
DHA and EPA are best known for their beneficial role in
protecting adults’ cardiovascular health and in lessening
inflammatory conditions. However, emerging science
suggests that DHA in particular plays an important role
in early brain and visual development in growing infants
and children. In fact, DHA is the most abundant omega-3
long-chain fatty acid in the brain and, during the last trimester
of pregnancy and continuing throughout the first few years of
life, it is rapidly incorporated into nervous tissue of the retina
and brain.1 Supplementation of infant formula with DHA has
been shown to aid growth, development, and vision in
premature infants, and prenatal and infant deficiencies of
DHA have been shown to lead to brain abnormalities.1
Cognitive and Behavioral Function
Beyond early development and throughout life, DHA is
believed to continue to influence brain function by playing an important role in brain-cell membrane structure, brain-cell receptor activity, and the production of neurotransmitters and other brain chemicals.2 This has lead to considerable interest in the potential role DHA may have on cognitive development and behavioral function during childhood. A number of research studies have examined the relationship between the levels of omega-3 fatty acids in the body and a variety of childhood disorders, including autism and attention deficit hyperactivity disorder (ADHD).
Attention Deficit Hyperactivity Disorder
Attention deficit hyperactivity disorder is one of the most common childhood disorders and it affects 5%–10% of school-age children, or 4.4 million youths ages 4–17. Symptoms include difficulty staying focused and paying attention, difficulty controlling behavior, and a general inability to sit still or tendency to be hyperactive. The Centers for Disease Control (CDC) estimate that 2.5 million of these children receive some type of medication to treat this disorder and, to make matters worse, this condition can continue throughout life, with as many as 70% of children diagnosed with ADHD suffering from the disorder into adolescence and adulthood.3 Studies suggest that children with ADHD may have low levels of certain essential fatty acids (including DHA) in their bodies. In a clinical study of nearly 100 boys, those with lower levels of omega-3 fatty acids demonstrated more learning and behavioral problems—such as temper tantrums and sleep disturbances—than boys with normal omega-3 fatty acid levels.4 In animal studies, low levels of omega-3 fatty acids have been shown to lower the concentration of certain brain chemicals—such as dopamine and serotonin—related to attention and motivation.5 Randomized clinical trials assessing the effects of omega-3 supplementation on symptoms of ADHD have been published. Some studies indicate supplementing a child’s diet with a combination of long-chain fatty acids including DHA and EPA may be beneficial for reducing symptoms of inattention and hyperactivity when compared with a placebo6,7, while other studies have found no benefit.8 17 Omega-3 Fatty Acids and Children’s Health Shaklee Health Sciences Because of the diversity of findings, more research is needed and, as of today, firm conclusions are difficult to draw. However, researchers have proposed that future studies be designed to: 1) better understand the mechanism of action of omega-3 fatty acids in ADHD, 2) identify which children with ADHD might benefit from omega-3 supplementation, 3) determine which fatty acids—and how much—to supplement with, and 4) pinpoint the optimal time for intervention (e.g. prenatal, infancy, or at time of diagnosis).9 However, until then, consumption of foods and supplements high in omega-3 fatty acids is a reasonable approach for someone with ADHD.
Autism
Autism is one of a group of disorders known as autism
spectrum disorders (ASDs). Autism usually is diagnosed by
age 3 and lasts throughout a person’s life. Children with autism
or other ASDs can suffer a wide array of developmental
disabilities that can cause substantial impairments in social
interaction and communication, as well as unusual behaviors
and interests. Many children with ASDs also have unusual
ways of learning, paying attention, and reacting to different
sensations, and there is significant variability in severity—
some children are high functioning while others can be quite
severely affected. Recent data from the CDC’s Autism and
Developmental Disabilities Monitoring Network indicate that
about 1 in 150 8-year-olds living in the United States has an
ASD. Scientists think there may be many causes that can
lead to the development of an ASD—and both genes and the
environment appear to play a role.10
There is some evidence that alterations in fatty acid
metabolism may play a role in the pathophysiology of autism. In one study, researchers compared the levels of fatty acids in the blood of a group of autistic children with those in a group of mentally challenged control subjects. Results indicated a 23% reduction in levels of DHA in the children with autism, resulting in significantly lower levels of total omega-3 fatty acids—without a reduction in total omega-6 fatty acids.11 The reasons for the lower concentrations of DHA are not well understood, but several hypotheses have been proposed. It may be that children with autism have insufficient dietary intakes of DHA, may have less ability to convert ALA to DHA, and/or have an enhanced breakdown of DHA in cell membranes.11 Dietary Intake of Omega-3s—Are Children Getting Enough? The growing evidence in support of a positive relationship between omega-3 fatty acids and many health outcomes in children (and adults as well, for that matter!) have fueled the realization that relatively recent changes in the diet of Americans has dramatically changed the type of fat consumed, resulting in a significant shift in the ratio of omega-6 fatty acids to omega-3 fatty acids, thereby potentially changing the fatty acid composition of the brain. Omega-6 fatty acids such as linoleic acid (LA) are abundant in our diet, with a major source coming from vegetable oils, which tend to be much higher in omega-6 than omega-3 fatty acids. In the days of hunters and gatherers, the dietary ratio of omega-6 to omega-3 fatty acids was believed to be in the range of 1:1 to 2:1. However, over the past 50–100 years, intakes of omega-3 fatty acids such as DHA and EPA have declined while the intake of omega-6 fatty acids has increased, such that the ratio of omega-6s to omega-3s is now estimated in the range of 15:1 to 25:1.12 This ratio is important because the omega-6 fatty acid LA and the omega-3 fatty acid ALA compete for the same enzymes that convert ALA to DHA and EPA. Therefore, it is believed that both excessive intakes of omega-6 fatty acids and lesser amounts of omega-3s may actually diminish DHA availability in the brain. In addition, the decreased overall intake of omega-3s means less DHA and EPA are available for incorporation into brain-cell membranes. Both the American Dietetics Association and Dietitans of Canada recommend an increase in dietary intakes of omega-3 fatty acids13, and recommended intakes for omega-3 fatty acids to support optimal neuronal functioning and overall health of children have been established by various internationally recognized organizations.14 Although specific dietary requirements for DHA and EPA in children have not been established, the National Academy of Sciences’ Institute of Medicine has established a recommended intake for total omega-3 fatty acids as ALA (see Table 1, Page 18)15, with DHA and EPA contributing 10% toward the recommended intake. For example, the recommended intake of total omega-3 fatty acids for children ages 4–8 is 900 mg a day, of which 90 mg may come from DHA and EPA.
18 Omega-3 Fatty Acids and Children’s Health Shaklee Health Sciences
Table 1: Recommended Adequate
Intakes (AI) for Omega-3 Fatty Acids in
Infants and Children*
Life Stages Age (Mg/Day)
Infants 0–12 mos 500 mg
Children 1–3 yrs 700 mg
Children 4–8 yrs 900 mg
Children 9–13 yrs 1,200 mg
Note: 10% of the above amounts (AI values) may be in the form of DHA and EPA.
*Source: Food and Nutrition Board, USA, 2005
Given these recommendations, the question remains as to
whether children are consuming adequate amounts of
omega-3s, especially DHA and EPA. Based on the most
current national nutrition survey findings, most infants and
children are not. Data collected from the 1999–2000
National Health Examination Survey estimated that
intakes of DHA among children 11 years old and younger to be only 20–40 mg a day16, and in a recent study published in the Journal of Nutrition, researchers quantified the omega-3 fatty acid intake in a group of Canadian children ages 4–8. The mean dietary intake of DHA in these children, according to this study, was only 54 mg per day.17 Because of the ever-growing and emerging body of literature demonstrating the importance of omega-3 fatty acids in proper growth and development, early brain and visual development, and possibly in childhood conditions such as ADHD and autism, this dietary gap should be readily filled with an increased consumption of foods rich in DHA such as fish and seafood. However, increased fish consumption poses additional concerns. Nearly all fish and shellfish contain traces of mercury—and some may contain other environmental pollutants that may pose harm to an unborn baby or to a young child’s developing nervous system. In fact, the Food and Drug Administration (FDA) and the Environmental Protection Agency (EPA) advise women who may become pregnant, pregnant women, nursing mothers, and young children to avoid some types of fish and eat only fish and shellfish that are lower in mercury.18 Concerns about the safety of fish consumption coupled with inadequate dietary intakes suggest that most children would benefit from taking a high-quality dietary supplement that uses a pharmaceutical-grade, highly purified fish oil to deliver omega-3 fatty acids, including plenty of DHA to support the proper development and function of the brain and eyes.
2004 EPA and FDA Advice For:
Women Who Might Become Pregnant
Women who are pregnant, nursing mothers, and
young children
1. Do not eat shark, swordfish, king mackerel, or tilefish because they contain high levels of mercury.
2. Eat up to 12 ounces (two average meals) a week of a variety of fish and shellfish that are lower in mercury.
a. Five of the most commonly eaten fish that are low in mercury include shrimp, canned light tuna, salmon, pollock, and catfish.
b. Another commonly eaten fish, albacore
(“white”) tuna, has more mercury than
canned light tuna. So when choosing your
two meals of fish and shellfish, you may
eat up to 6 ounces (one average meal) of
albacore tuna per week.
3. Check local advisories about the safety of fish
caught by family and friends in your local lakes,
rivers, and coastal areas. If no advice is available,
eat up to 6 ounces (one average meal) per week
of fish you catch from local waters, but don’t
consume any other fish during that week.
4. Follow these same recommendations when feeding fish and shellfish to your young child, but serve smaller portions.
19 Omega-3 Fatty Acids and Children’s Health Shaklee Health Sciences
Key References
1. McCann JC, Ames BN, Is docosahexaenoic acid, an n-3 long-chain polyunsaturated
fatty acid, required for development of normal brain function? An overview of evidence from cognitive and behavioral tests in humans and animals. Am J Clin Nutr 2005;82:281-95.
2. Eilander A. et al. Effects of n-3 long-chain polyunsaturated fatty acid supplementation
on visual and cognitive development throughout childhood: A review of human studies. Prostaglandins, Leukotrienes and Essential Fatty Acids 2007;26:189-203.
3. Information obtained 3.11.09 from: http://www.cdc.gov/ncbddd/adhd/.
4. Stevens LJ, Zentall SS, Abate ML, Kuczek T, Burgess JR. Omega-3 fatty acids in boys with behavior, learning and health problems. Physiol Behav. 1996;59(4/5):915-920.
5. Vancassel S et al. n-3 polyunsaturated fatty acid supplementation reverses stress-induced modifications on brain monoamine levels in mice. J Lipd Res. 2008;49(2):340-348.
6. Sinn N, Bryan J. Effect of supplementation with polyunsaturated fatty acids and micronutrients on learning and behavior problems associated with child ADHD. Dev Behav Pediatr 2007;28:82–91.
7. Stevens L, Zhang W, Peck L, Kuczek T, Grevstat N, Mahon A. EFA supplementation in children with inattention, hyperactivity and other disruptive behaviours. Lipids 2003;38:1007-1021.
8. Voigt RG, Llorente AM, Jensen CL, Fraley JK, Berretta MC, Heird WC.
A randomized, double-blind, placebo-controlled trial of docosahexaenoic acid
supplementation in children with attention-deficit hyperactivity disorder. Journal
of Pediatrics 2001;139:189-196.
9. Busch B. Polyunsaturated fatty acid supplementation for ADHD? Fishy, facinating, and far from clear. J Dev Behav Pediatr 2007;28:139-144.
10. Information obtained 3.11.09 from: http://www.cdc.gov/ncbddd/autism/ overview.htm.
11. Vancassel S. et al. Plasma fatty acid levels in autistic children.
Prostaglandins, Leukotrienes and Essential Fatty Acids 2001;85(1):1-7.
12. Simopoulos AP. Evolutionary aspects of diet, the omega-6/omega-3 ratio and genetic variation: Nutritional implications for chronic diseases. Biomed
Pharmacother 2006;60(9):502-507.
13. American Dietetics Association. Position of the American Dietetics Association and Dietitians of Canada: Fatty acids J Am Diet Assoc. 2007;107:1599-1611.
14. Information obtained on 3.13.09 from: www.issfal.org.uk/ recommendations-of-others.html.
15. National Academy of Sciences Institute of Medicine, Food and Nutrition Board. Dietary reference intakes for energy, carbohydrate, fiber, fat, fatty acids, cholesterol, protein and amino acids. 2002-2005.
16. Ervin RB, Write JD, Wang C. et al. Dietary intake of fats and fatty acids for the United States population: 1999-2000. Advanced Data. Vital and Health Statistics, Number 348, 2004.
17. Madden SM, Garrioch CF, Holub BJ. Diet quantification indicates low intakes of (n-3) fatty acids in children 4 to 8 years old. J Nutr. 2009;139:528-532.
18. http://www.epa.gov/waterscience/fish/advice/.
20 Obesity and Overweight: A Preventable Public Health Crisis Shaklee Health Sciences
Obesity and Overweight: A Preventable
Public Health Crisis
Childhood obesity is a serious public health
epidemic. During the past several decades,
obesity rates have soared among all age groups,
increasing 400% among children ages 6–11 since
the 1970s.1 Today, nearly one-third of children and
adolescents are overweight or obese—that’s more
than 23 million kids and teenagers! Preventing
obesity during childhood is absolutely critical
because habits learned in childhood are carried
into adulthood. Research shows that obese
adolescents have up to an 80% chance of becoming
obese adults.2 This is particularly alarming
given the knowledge that being overweight to
obese increases one’s risk for many diseases,
including cardiovascular disease, cancer, hypertension,
and diabetes—all of which are causes of
premature death. If these trends are not reversed
soon, we will be in danger of raising the first
generation of American children who will have
more health challenges AND die younger than the
generation before them.
Parents play an essential role in fostering healthful
eating habits and physical-activity routines among
children and adolescents. In many ways, parents
shape their children’s dietary practices, physical
activity, sedentary behaviors, and, ultimately, their
weight. A parent’s knowledge and understanding
of nutrition; influence over food selection, meal
structure, and eating patterns; and control over
time spent watching TV, playing video games, or
sitting at the computer all influence a child’s
development of lifelong habits that contribute to
either a healthy weight or to overweight
and obesity.
*Sex- and age-specific BMI > 95th percentile based on the CDC growth charts.
†Source: National Health and Nutrition Examination Survey
Prevalence of Obesity* Among U.S. Children and Adolescents† (Ages 2-19 Years)
Survey Period
Percent
20.0%
15.0%
10.0%
5.0%
0.0%
NHANES I 1971-1974 NHANES II 1976-1980 NHANES III 1988-1994 NHANES 2003-2006
Ages 2-5 years Ages 6-11 years Ages 12-19 years
5.0% 4.0% 6.1% 5.0%
6.5%
5.0%
7.2%
11.3% 10.5%
12.4%
17.0% 17.6%
21 Obesity and Overweight: A Preventable Public Health Crisis Shaklee Health Sciences
Consequences of Obesity
Being overweight or obese as a child can lead to a variety of
health consequences. Overweight and obese children are
at higher risk for a host of serious health issues,
including heart disease, stroke, asthma, and certain
types of cancer.3 And many overweight to obese children
already are being diagnosed with health problems that
previously were considered “adult” illnesses such as type
2 diabetes and high blood pressure. In one study, 60% of
obese children ages 5–10 already had at least one risk factor
for cardiovascular disease—such as elevated cholesterol
and/or triglycerides, hypertension, or insulin resistance—and
25% already had two or more of these risk factors.4 The
latest statistics show that boys born in the United States in
the year 2000 have a 30% lifetime risk of being diagnosed
with type 2 diabetes, and girls have a 40% lifetime risk.5
Many overweight and obese children also suffer emotional
consequences. Emotional stress from social stigmatization
resulting in low self-esteem can hinder both academic and
social functioning, which can lead to underperformance and
underachievement as they move into adulthood.6
The Culprits: Poor Eating Habits and
Physical Inactivity
Childhood obesity is the result of an imbalance between the calories a child consumes and the calories he or she uses to support normal growth and development, metabolism, and physical activity. In other words, if your child consumes more calories than they use each day, they will gain excessive weight in the form of body fat. Left unchecked, continual excessive weight gain will lead to overweight or obesity. The causes of childhood overweight and obesity are multifactorial.
Although genetic and socioeconomic factors can
contribute, children become overweight because they
eat too much food, they eat the wrong types of foods,
and they generally are not active enough. Let’s explore each of these issues.
Poor Eating Habits
Over the past several decades, it has become increasingly evident that the eating patterns of just about everyone in North America have changed—leading to an obesity epidemic that knows no geographical or socioeconomic barriers.
Today, children eat more meals away from home, drink
more sugar-sweetened beverages, and snack more often than they used to.7 Portion sizes also have increased—
contributing to excessive calorie consumption8—and
children often skip breakfast, an eating pattern also
linked to obesity.9
Frequent consumption of food away from home, especially fast food, can increase a child’s risk of becoming overweight or obese. Studies show that children who consume fast food two or more times a week consume larger portions, more calories, and, overall, consume lower-quality foods (i.e. more fat, added sugars, and soda, and less milk, fiber, and fruits and vegetables). Fast food presents a “double whammy” by providing excessive amounts of what you don’t need—saturated fat, salt, sugar, and preservatives—while also being deficient in vitamins, minerals, fiber, and antioxidants.
Children who regularly consume fast food also are more
likely to have a higher body mass index (BMI)—a measure of
overweight in children.10 Sweetened-beverage consumption
has increased steadily among children, and studies suggest
that children who consume two servings of sweetened
beverages per day are three times more likely to become
overweight compared with children who don’t drink sweetened
beverages.11 Although not all snacks are unhealthful,
many children snack on foods that are high in fat and calories
but low in essential nutrients. In a recent study, 88% of
children surveyed regularly consumed high-calorie, lownutrient
foods such as muffins, cakes, cookies, candy,
French fries, chips, and buttered popcorn.12
Skipping breakfast has been shown to negatively impact
weight in both adults and children. In a study conducted by
researchers at the University of Minnesota School of Public
Health, children who ate breakfast on a regular basis were
less likely to be overweight. The study examined the relation
between the frequency of breakfast consumption and
the five-year change in body weight in more than 2,200
adolescents, and the results indicate that daily breakfast
eaters consumed a healthier diet and were more physically
active than breakfast skippers. Five years later, the daily
breakfast eaters also tended to gain less weight and have
a lower BMI than those who had skipped breakfast as
adolescents.13
22 Obesity and Overweight: A Preventable Public Health Crisis Shaklee Health Sciences
Tips for Promoting Healthful Eating
Start the day right by ensuring your child eats
a healthful breakfast
Eat meals together as a family as often as
possible
Carefully cut down on the amount of bad fats
and empty calories in your family’s diet
Don’t place your child on a restrictive diet—
instead focus on a healthful breakfast, limiting
snacking, and stocking your home with fruits,
vegetables, protein bars, and other healthful
choices
Avoid using food as a reward or withholding
food as punishment
Encourage your children to drink water and
to limit the intake of beverages with added
sugars, such as soft drinks and fruit-juice
drinks
Stock the refrigerator with fat-free or low-fat
milk, and fresh fruits and vegetables instead
of soft drinks or snacks that are high in fat,
calories, and added sugars, and low in
essential nutrients
Aim to have your child eat at least five servings
of fruits and vegetables each day
Discourage eating meals or snacks while
watching television
Lack of Physical Activity
Regular physical activity, fitness, and exercise are critically important for the health and well-being of people of all ages, including children and teens. Compared with children who are inactive, physically active children and teens have higher levels of cardiorespiratory fitness and stronger muscles.
They also can have lower body fat, stronger bones, and less
anxiety and depression. However, despite the well-known
benefits of physical activity, many children lead sedentary
lifestyles. Today, children and teenagers spend far too much
time watching television, using the computer, and playing
video games. It is estimated that children in the United
States spend 25% of their waking hours watching television,
and children who watch television most have the highest incidence of obesity.14 Watching television, using the computer, and playing video games increases the likelihood of obesity in children, not only because these activities require little energy output but because they displace the amount of time children could spend participating in physical activity. Watching television—which can lead to increased snacking—also has been found to promote increased calorie consumption because exposure to ads promoting junk food can influence children to make unhealthful food choices;
TV exposure has even been shown to lower a child’s
metabolic rate.15,16
Unfortunately, children also may be spending less time
engaged in physical activity at school. Daily participation in
school P.E. among adolescents dropped from 41% in 1991
to 28% in 2003.17 And the situation appears to be worse as
children get older. Less than one-third of high school
students meet current recommended levels of physical
activity.18
In 2008 the federal government issued new Dietary Guidelines
for Americans, and within those guidelines they made
physical activity recommendations for both adults and
children. Based on their recommendation, children ages 6
and older should get 60 minutes or more physical activity
every day. Activities should include a combination of aerobic
activities (e.g. running and brisk walking), muscle-strengthening
activities (e.g. gymnastics and push-ups), and bonestrengthening activities (e.g. jumping rope and running).They also stress the importance of encouraging children to participate in a variety of activities that are age-appropriate and enjoyable.
Tips for Promoting Physical Activity
Embrace a healthier lifestyle; be a role model
by being physically active yourself
Plan family activities that provide everyone
with exercise and enjoyment
Help your child participate in a variety of
activities that are age appropriate
Provide a safe environment for your children
and their friends to play actively; encourage
swimming, biking, skating, ball sports, and
other fun activities
Advocate for more physical-activity programs
in schools and in your community
Reduce the amount of time you and your
family spend performing sedentary activities
such as watching television or playing video
games; limit TV time to less than two hours
a day
23 Obesity and Overweight: A Preventable Public Health Crisis Shaklee Health Sciences Taking Action to Prevent Childhood Obesity As a parent, you can make a huge difference in your child’s life by helping to prevent overweight or obesity at every stage of their development. Even before an infant is born, certain aspects of a mother’s pregnancy can put the child at risk of overweight in childhood or later in life. Poor nutritional habits during pregnancy can lead to an unfavorable intrauterine environment, and can increase a growing fetus’ risk of developing obesity, high blood pressure, and type 2 diabetes in the future.19 Children of mothers with diabetes, gestational diabetes, undernutrition, and overnutrition during pregnancy are at particular risk for obesity later in life.20 During infancy, when a child is first beginning to establish a lifetime foundation of nutritional habits, choosing to breast-feed your baby can have a protective effect against obesity.21 Researchers believe that breast-feeding may help infants better regulate their food intake than bottle-feeding. In fact, encouraging bottle-fed babies to empty their bottles may make it more difficult for a baby to recognize and attend to his or her own feelings of satiety.
As toddlers and preschoolers develop their eating and
exercise habits, parents can shape their early environments
in ways that encourage healthful lifestyle practices. Offering
young children a variety of healthful food choices and
exposing them early to nutritious foods such as fresh
fruits and vegetables, whole grains, low-fat or nonfat
dairy products, lean meats, poultry, fish, legumes, nuts, and seeds can help a child establish food preferences for healthful foods. Parents also should be mindful of the effect strict control of unhealthful food choices can have on their child. Being too controlling can often backfire on a parent, increasing a child’s desire for high-fat, calorie-rich foods and contributing to an inability of the child to innately selfregulate hunger and satiety.
Being a positive role model by leading an active lifestyle
can influence your child’s activity level. Studies have shown that adolescents whose parents watch television more than two hours a day are more than twice as likely to be physically inactive as those children whose parents watch less.22 In the Framingham Children’s Study, when both parents were active, children were almost six times more likely to be active than children with two sedentary parents.23 And as children transition from childhood to adolescence and into the teen years, parents can continue to encourage their children to be active. Participating in team sports, joining a gym, or participating in structured exercise programs can help older children maintain a healthy body weight and active lifestyle.
Parents absolutely play a crucial role at home in preventing childhood obesity—with their role changing as the child grows up to be a healthy adult. By better understanding your own role in influencing your child’s dietary habits, physicalactivity tendencies, sedentary behaviors, and, ultimately, their weight, you as a parent can learn to create a healthful environment, provide opportunities for physical activity, and discourage or place reasonable limits on sedentary behaviors such as watching television. Preventing childhood obesity starts with you!
24 Obesity and Overweight: A Preventable Public Health Crisis Shaklee Health Sciences Did You Know?
Children eat nearly twice as many calories
(770) at restaurants as they do during a meal at
home (420).
According to a national study, 92% of elementary
schools do not provide daily physical
education classes for all students throughout
the entire school year.
The typical American child spends about 44.5
hours per week using media outside of school.
At least 30 minutes of moderate physical activity
on most days of the week is the recommended
minimum. However, nearly 23 percent
of children and nearly 40 percent of adults get
no free-time physical activity at all.
Studies have shown that, between 1977 and
1996, portion sizes and corresponding calories
per serving grew markedly in the United
States. One study of portion sizes for typical
items showed that:
Salty snacks increased from 132 calories to
225 calories.
Soft drinks increased from 144 calories to
193 calories.
French fries increased from 188 calories to
256 calories.
Hamburgers increased from 389 calories to
486 calories.
Key References
1. Ogden CL, Carroll MD, Curtin LF et al. Prevalence of overweight and obesity in the United States 199-2004. JAMA 2006;295:1549-55. 2. Whitaker, RC. Wright JA. Pepe MS, et al. Predicting obesity in young adulthood from childhood and parental obesity. N Eng J Med 1997;37(13):
869-73.
3. Dietz W. Health consequences of obesity in youth: Childhood predictors of adult disease. Pediatrics 1998;101:518-25.
4. Institute of Medicine of the National Academy of Sciences. Childhood Obesity in the United States: Facts and Figures. September 2004. 5. Institute of Medicine of the National Academy of Sciences. Childhood Obesity in the United States: Facts and Figures. September 2004. 6. Swartz MB and Puhl R. Childhood obesity: a societal problem to solve.
Obesity Reviews 2003;4(1):57-71.
7. Borrud C et al. What We Eat in America: USDA Surveys Food Consumption
Changes. Food Rev. 1996;14-19.
8. Fisher JO et al. Children’s bite size and intake with an entrée are greater with large portions than with age-appropriate and self-selected portions.
ACJN 2003;77:1162-70.
9. Siega-Riz Am et al. Trends in breakfast consumption for children in the United States from 1965-1991. AJCN 1998;67(4):248s-756s. 10. Ritchie LD, Welk G, Styne D. Family Environment and pediatric overweight:
What is a parent to do? JADA 2005;105:105:S70-S79. 11. Ludwig DS, Peterson KE, Gortmaker SL. Relation between consumption of sugar-sweetened drinks and childhood obesity. Lancet 2001;357:505-08. 12. Briefel R, Wilson A, Gleason P. Consumption of low-nutrient, energy-dense foods and beverages at school, home, and other Locations among school lunch participants and non-participants JADA 2009;109:S79-S90. 13. Timlin MT, Pereira MA, Story M, Neumark-Sxtainer D. Breakfast Eating and Weight Change in a 5-Year Prospective Analysis of Adolescents: Project Eat (Eating Among Teens). Pediatrics 2008;121:e638-e645.
14. Robinson, TN. Television viewing and childhood obesity. Pediatric Clinics of
North America, 2001:48(4), 1017-25.
15. Francis LA, Birch LL. Does eating during television viewing affect preschool children’s intake? JADA 2006;106:598-600.
16. Klesges et al. Effects of television on metabolic rate: potential implications for childhood obesity. Pediatrics. 1993; 91:281-86.
17. Lowry R et al. Participation in high school physical education—United States, 1991-2003. MMWR 2004;53(36):844-47.
18. Eaton DK, Kann L, Kinchen S. et al. Youth Risk Behavior Surveillance—
United States 2005. MMWR Surveillance Summary 2006;SS-5(55).
19. Dietz WH. Critical periods in childhood for the development of obesity.
AJCN 1994;59:955-59.
20. Whitaker RC and Dietz WH. Role of the prenatal environment in the development of obesity. Journal of Pediatrics 1998;132:768-76. 21. Heidger MLP et al. Association between infant breast-feeding and overweight in young children. JAMA 2001;285:2453-60.
22. Fogelholm M. Parent-child relationship of physical activity patterns and obesity. International Journal of Obesity 1999;23:1262.
23. Moore LL et al. Preschool physical activity level and change in body fatness
in young children: the Framingham Children’s Study. American Journal of Epidemiology 1995;142:982-88.24. Zoumas-Morse C, Rock CL, Sobo EJ, Neuhouser ML. Children’s patterns of macronutrient intake and associations with restaurant and home eating. JADA 2001;101-923-25.
25. School Health Policies and Programs Study. Journal of School Health 2001;71.
26. Generation M: Media in the Lives of 8-18 Year-Olds. Menlo Park, Calif.:
Kaiser Family Foundation, 2005.
27. Physical activity levels among children aged 9-13 years—United States, 2002. MMWR 2003;52(33):785-8. and National Center for Health Statistics. National Health Interview Survey, 1999-2001.
28. Nielsen SJ, Popkin BM. Patterns and trends in food portion sizes,
1977-1998. JAMA 2003;289:450-53.
25 Environmental Health Hazards Shaklee Health Sciences
Environmental Health Hazards
Children are particularly susceptible to environmental
hazards that are surfacing in everyday
environments. Potentially toxic chemicals show up
in our food, as contaminants in air and water, in
common household and personal care products,
in packaging, and in furniture. It has been estimated
that the average home may contain 1,500
compounds that may be eroding our vitality and
increasing our health costs. Although children
should be the first to be protected from environmental
hazards, the truth is they are at the
greatest risk for chemical exposures. As parents
and caregivers, we need to do a better job of
screening and choosing household and personal
care products to reduce our children’s exposures.
Infants and Children are at Greater Risk
for Chemical Exposures
It’s no secret that infants and children are highly vulnerable to chemical toxins. Infants and young children spend a lot of time putting things in their mouths, raising their risk of ingesting chemical residues. Pound for pound, children drink more water, eat more food, and breathe more air than adults.1 So children are likely to have substantially greater exposures than adults to potential toxins in the water we drink, the food we eat, and the air we breathe. And yet, so many of the popular and most trusted brands of household cleaners, personal care products, and even baby care products continue to include harsh chemicals.
An immature immune system and metabolic pathways affect a baby’s ability to metabolize, detoxify, and excrete chemicals and counteract toxic challenges. In an adult, a blood-brain barrier insulates the brain from many of the potentially harmful chemicals circulating through the body. But in an infant, that barrier isn’t fully developed, so early exposures may be especially risky.
Children also have more time to develop chronic diseases triggered by early chemical exposures. Some diseases related to environmental toxins may require decades to develop, so exposure during childhood may increase health risks later in life. Some scientists also believe that a mother’s exposure to toxic chemicals during pregnancy can have developmental consequences on the fetus. Because growth is so rapid at this time, early toxic exposures may have a significant impact on development.
Risks of Child Exposures to Skin Care
Products and Plastics
Phthalates are synthetic, man-made chemicals of increasing public importance and concern because of potential toxic effects to the developing endocrine and reproductive systems. Phthalates have been found in food products and may enter the food supply during processing and packaging.
They are used in the manufacture of toys, plastic shower
curtains, and lubricants, and as chemical stabilizers in cosmetics, infant care products, and personal care products.Infants, toddlers, and young children are uniquely vulnerable to phthalate exposures because of their hand-to-mouth behavior, extensive playing on floors, and undeveloped nervous and reproductive systems. These factors also may help explain why phthalate metabolite concentrations tend to be higher in young children compared to other age groups. To date, the pathways of childhood phthalate exposure have not been well characterized, but of particular concern for children are personal care products applied directly to the skin.
Researchers at the University of Washington measured
phthalate metabolites in urine in 163 infants born in the years
2000–2005. In 81% of the infants, multiple phthalate metabolites
were detected. Surprisingly, the authors of this study
conclude that infant phthalate exposure is widespread and
that infant exposure to baby lotion, baby powder, and baby
shampoo is closely associated with increased urinary
concentrations of phthalate metabolites; additionally, associations
increased with the number of products used, and the
association was strongest in infants.2
26 Environmental Health Hazards Shaklee Health Sciences You may have heard about the potential harmful effects of bisphenol-A (BPA), a chemical modifier commonly used in some plastic baby bottles, plastic containers, and the linings of some canned foods. A major study published in 2008 in the Journal of the American Medical Association (JAMA) linked higher urinary BPA levels with higher prevalence of cardiovascular disease, diabetes, and liver enzyme abnormalities.
3 This research reaffirms the importance of choosing
BPA-free packaging as a part of your commitment to
infant and child safety.
Children’s Bath Products May Contain
Formaldehyde and/or 1,4-Dioxane
Despite marketing claims such as “gentle” and “pure,” dozens of top-selling children’s bath products appear to be contaminated with formaldehyde and 1,4-dioxane, chemicals that are known to cause cancer in animals and listed as probable human carcinogens by the Environmental Protection Agency. A March 2009 report from the Campaign for Safe Cosmetics (CSC) documents the widespread presence of both formaldehyde and 1,4-dioxane in baby shampoos, bubble baths, and baby lotions—products made specifically for infants and children.4 The CSC is a national coalition attempting to protect consumer health by requiring the personal care products industry to phase out the use of chemicals linked to cancer, birth defects, and other health concerns. The CSC commissioned an independent laboratory to test top-selling children’s products for 1,4-dioxane and formaldehyde. Test results showed that:
61% contained both formaldehyde and 1,4-dioxane
82% contained formaldehyde at levels ranging from
54 ppm to 610 ppm
67% contained 1,4-dioxane at levels ranging from
0.27 ppm to 35 ppm
There are no regulatory standards that limit contamination of formaldehyde, 1,4-dioxane, or many other toxic chemicals in personal care products sold in the United States. But formaldehyde is banned from such products in Japan and Sweden, and the European Union bans 1,4-dioxane from personal care products. Although some believe that U.S. regulators are beginning to recognize the risks associated with these chemicals, our current cosmetics laws are woefully out of date and need to be updated.
Accidental Child Poisonings in the Home
So just how large is the toxic exposure risk from common products and chemicals found in the homes of children in the U.S.? In a recent study published in Pediatrics5, Consumer Product Safety Commission (CPSC) researchers suggested that “despite advances in recent years, unintentional child poisonings remain an important public health concern.” Each year, there are over 1 million phone calls to U.S. Poison Control Centers for potentially toxic product ingestions in children younger than 5. According to the study findings from an estimated total of 86,194 child poisoning incidents treated in U.S. hospital emergency departments in 2004, over 25,000—or nearly 30% of the cases—were related to household cleaning products or other chemicals and substances commonly found in homes.
Most household cleaners are not subject to the same child-resistant packaging requirements as drugs and other products despite the fact that there were an estimated 11,386 child poisonings involving cleaning products in 2004. Household bleach was the cleaning product most frequently cited for child ingestions, accounting for roughly 40% of reported poisonings. Other frequently reported ingestions included laundry products, automatic dishwasher detergents, and general household cleaners.
This may be a surprise, but personal care products including perfumes, soaps, and nail and hair care products were involved in an estimated 4,048 poisonings, and an additional 8,432 poisonings were attributable to other categories of products found in homes—including auto and marine chemicals, and pesticides. Mouthwashes, oven cleaners, drain cleaners, and turpentine resulted in an additional 1,391 child poisonings.
Household Cleaners and Asthma Risk
in Children
The prevalence of asthma in the U.S. increased by 75% from 1980–1994, and the asthma rates in children younger than 5 increased more than 160% during that same period, according to the Centers for Disease Control and Prevention. An average of one out of every 13 school-aged children—or 9 million U.S. children under age 18—have been diagnosed with asthma. It’s the most common chronic childhood disease in the developed world and has become even more commonplace in the past three decades.
In a 2004 study evaluating the risk of asthma development in children, researchers concluded that “domestic exposure to volatile organic compounds (VOCs) at levels below currently accepted recommendations may increase the risk of childhood asthma.” VOCs are found in many household products and also may be embedded in the house itself as part of the paint, flooring, or furniture.6 Another study of nearly 14,000 children found that the more frequently household chemicals such as bleach or window cleaner were used during pregnancy, the higher the risk that the young child would have persistent wheezing.7 More troubling was that the relationship between household chemicals and wheezing remained even after factors such as parental smoking and family history of asthma were taken into account.
27 Environmental Health Hazards Shaklee Health Sciences
Although there’s no cure, asthma often can be controlled
by avoidance of triggers, appropriate dietary and
supplement strategies, and, of course, medication as
prescribed. Exclusive breast-feeding is believed to be effective in reducing subsequent development of allergies and may reduce the the risk of asthma in children.
Antioxidants in the diet, including selenium and vitamins C
and E, may have a protective effect. Probiotics are promising
as they may produce changes in the gut that stimulate
the immune system. And preliminary research has shown
that omega-3 fatty acid supplementation may decrease the
inflammatory response, including the production of
inflammatory mediators in asthmatic patients.
Other Health Hazards Related to
Cleaning-Product Ingredients
Asthma and related conditions are not the only risks associated with ingredients in common household products.
Butyl cellosolve, often found in all-purpose cleaners, abrasive, and glass cleaners, is a potentially toxic chemical in the glycol-ether family of chemicals. Ingesting large amounts of butyl cellosolve may cause breathing problems, low blood pressure, low hemoglobin levels, acidic blood, and blood in the urine.
Exposure to high levels of ammonia, found in glass cleaners, may be irritating to the skin, eyes, throat, and lungs, and it can cause coughing and burns. Also, asthma sufferers may be more sensitive to breathing ammonia than others.
Hypochlorite, found in common household bleach and automatic dishwasher detergents, causes more poisoning exposures than any other household cleaning substance and was the source of over 50,000 poisonings in 2005 alone, according to a report from the Poison Control Center’s National Poisoning and Exposure Database.8 Drain cleaners, oven cleaners, and toilet bowl cleaners are some of the most dangerous products in our homes. Drain and oven cleaners may contain lye or sodium hydroxide, which can cause severe corrosive damage to eyes, skin, mouth, and stomach if swallowed. Toilet bowl cleaners may contain chlorine or hydrochloric acid. Even brief exposure to low levels of hydrochloric acid vapor can result in throat irritation, and increased exposure can result in rapid breathing, narrowing of the bronchioles, blue coloring of the skin, accumulation of fluid in the lungs, and even death.
There’s a long list of dangerous chemicals that are under
most sinks in this country—they’re even in some products
that claim to be green. For more detailed information about
the chemicals used in household products, visit the National
Library of Medicine and the National Institutes of Health
(NIH) Web site at www.householdproducts.nlm.nih.gov.
Keep Your Home Environment Green
and Your Children Safe
What can you do as a parent or caregiver to protect a child’s health against home-based environmental chemical exposures? We recommend that you first build a healthier, safer home environment and try to take simple, everyday steps to minimize chemical exposures from common household and personal care product ingredients. Be an informed consumer and look for safe and effective alternatives to traditional products without sacrificing your children’s long-term health:
1. Build a Safer and Healthier Home Environment Keep the dirt outside. Most of the dirt in our homes is tracked in through the front door or the garage. Get a good doormat and leave your shoes at the door.
Keep windows open to allow fresh air in and keep toxins flowing out.
Select home furnishings made from natural fibers.
Select carpets, pads, bedding, and furniture made from wool, cotton, hemp, and wood.
Avoid wall-to-wall carpeting and choose a powerful vacuum cleaner to help minimize indoor pollution. Use area rugs instead of wall-to-wall carpeting.
Avoid phthalates. These plastic softeners are found in polyvinyl flooring, wall coverings, shower curtains, toys, and even in baby care products and personal care products.
Avoid BPA found in reusable clear polycarbonate plastic water bottles, baby bottles, and food containers (labeled #7) that may leach BPA into food and drink.
2. Make Smart Choices in Household Cleaners
Replace chemical-filled household cleaners with
natural, safe, multipurpose cleaners that work on a variety of surfaces.
28 Environmental Health Hazards Shaklee Health Sciences Choose cleaning products from a company committed to product safety, efficacy, and sustainability;
one that offers nontoxic, natural cleaning product
choices that are safe, powerful, green, and smart.
Look for nontoxic cleaning choices and hypoallergenic products free of harmful fumes, volatile organic compounds, phenol, lye, hydrochloric acid, sulfuric acid, petroleum distillates, ammonia, sodium hydroxide, butyl cellosolve, or formaldehyde.
3. Make Smart Choices for Personal Care Products
Designed for Infants and Children
Choose safer products. Search for safer products that are clinically tested and free of synthetic fragrance or dyes, parabens, 1,4-dioxane, sodium lauryl sulfate (SLS), formaldehyde, phthalates, PEG-100 stearate, and ceteareth-20.
Look for gentle products that are pediatrician tested, sensitivity tested, natural- and organic-ingredient based, hypoallergenic, and pH balanced Look for healthy products free of synthetic fragrances and artificial colors; products with BPA-free packaging, no phthalates, or toxic inks.
And don’t forget that good nutrition and fitness are essential for healthy growth and development of infants and children. Be sure to promote regular exercise, encourage healthful eating habits, and provide a balanced and nutritious diet rich in fresh fruits and vegetables, whole-grain cereals, low-fat dairy products, and lean meats, poultry, and fish. For nutritional insurance, consider additional sources of antioxidants, probiotics, and omega-3 fatty acids for optimal health and vitality.
To find safety information on specific household
products, visit the National Institutes of Health
Household Products Database at www.householdproducts.
nlm.nih.gov/
Visit the link below to read the Campaign for Safe
Cosmetics report: No More Toxic Tub, Getting
Contaminants out of Children’s Bath and Personal
Products, http://www.safecosmetics.org/downloads/
NoMoreToxicTub_Mar09Report.pdf#page=8
Key References
1. Landrigan PJ, Garg A. Chronic effects of toxic environmental exposures on children’s health. J Toxicol Clin Toxicol. 2002;40(4):449-562. 2. Sathyanarayana S, Karr CJ, Lozano P, Brown E, Calafat AM, Liu F, Swan SH.
Baby care products: possible sources of infant phthalate exposure. Pediatrics.
2008 Feb;121(2):e260-8.
3. Lang IA, Galloway TS, Scarlett A, Henley WE, Depledge M, Wallace RB, Melzer D. Association of urinary bisphenol-A concentration with medical disorders and laboratory abnormalities in adults. JAMA. 2008 Sep 17;300(11):1303-10.
4. Campaign for Safe Cosmetics Report; No More Toxic Tub, Getting Contaminants out of Children’s Bath and Personal Products, March 2009 http://www. safecosmetics.org/downloads/NoMoreToxicTub_Mar09Report.pdf#page=8.5. Franklin RL, Rodgers GB. Unintentional child poisonings treated in United States hospital emergency departments: national estimates of incident cases, population-based poisoning rates, and product involvement. Pediatrics. 2008 Dec;122(6):1244-51.
6. Rumchev K, Spickett J, Bulsara M, Phillips M, Stick S. Association of domestic exposure to volatile organic compounds with asthma in young children. Thorax. 2004 Sep;59(9):746-51.
7. Sherriff A, Farrow A, Golding J, Henderson J. Frequent use of chemical household products is associated with persistent wheezing in preschool-age children. Thorax. 2005 Jan;60(1):45-9.
8. Annual Report of the American Association of Poison Control Centers’ National Poisoning and Exposure Database, 2005.
©2009 Shaklee Corporation. Distributed by Shaklee Corporation, Pleasanton, CA 94588. 09-047 (New 5/09)

Acknowledgement
The creation of this booklet would not have been possible without the hard work and dedication of the Shaklee Health Sciences staff. A special thanks to Pamela Manning, MS, RD, Senior Manager of Health Sciences, for taking the lead in this project; as well as Les Wong, VP of Health Sciences; Torrance Rogers, Health Sciences Product Specialist; and Nel Prentiss, Medical Affairs Coordinator, for their contributions and support. It is because of their efforts that this booklet provides a compilation of essential health information to help you raise children who are healthy, happy, and safe!

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