Children’s health

Posted on Children's health, Multiple Sclerosis

Are health care disparities tied to worse outcomes for kids with Multiple Sclerosis?

Happy Children

–People who develop multiple sclerosis (MS) as children and grow up in less advantaged neighbourhoods may have a larger volume of inflammation and brain tissue loss on imaging than those who grow up in more advantaged neighbourhoods.

MS rarely develops in children. About 5% of people with MS are diagnosed before age 18.

In addition to neighbourhood location, worse brain imaging outcomes were also seen among people who self-identified as Black or Latino, those from families where the parents had lower education levels, and those who had public health insurance, which is used as a marker of low household income.  

“Our findings suggest that social disadvantage in childhood can have lasting effects on MS severity,” said study author Kimberly A. O’Neill, MD, of New York University Grossman School of Medicine. “Childhood is a critical time for exposure to environmental factors associated with increased susceptibility to MS, such as passive smoke, pollution and low sunlight exposure. More studies are needed to understand which and how factors in disadvantaged neighbourhoods increase the risk for MS severity in young people.”

The study involved 138 people with an average age of 20 who were diagnosed with MS before age 18, known as pediatric-onset MS. They had been diagnosed with MS for an average of four years.

All had brain scans to measure areas of brain inflammation and injury due to MS and brain volume loss. Researchers collected information on social factors that may impact a person’s health, including self-reported race and ethnicity, type of health insurance, parents’ education level, and the degree of neighbourhood advantage or disadvantage.

Social factors associated with disadvantage correlated with greater volume of inflammatory lesions in the brain’s white matter and greater black hole volume, which is a sign of irreversible loss of brain tissue. The identified social factors accounted for 26% of the difference in white matter lesion volume and 23% in black hole volume among participants.

Once all factors were taken into account, having public health insurance was the strongest predictor of greater inflammation and tissue loss. People with public health insurance had an average white matter lesion volume larger than people with private insurance. They also had average black hole volumes larger than those with private insurance.

The researchers found that the differences were not explained by how soon a neurologist saw children, how quickly they were started on medication for MS or how compelling their medications were at slowing their disease progress.

“This suggests that access to health care does not explain the more severe disease burden shown in the brain scans of people in disadvantaged groups in our study,” O’Neill said. “While these are associations and not causes, many of these groups have historically been underrepresented in MS research, and our work here is just beginning.”  

Posted on ADHD, Autism, Children's health, Obesity

Obesity in mums doubles the possibility of autism in babies? Does this research chime with your experience?

When screening pregnant women for gestational diabetes, casual blood glucose testing misses 70% of the cases. This Kobe University study should encourage obstetricians to depend on more reliable tests to help prevent pregnancy complications and the development of type II diabetes in mothers and children.
Children born to mothers with obesity before and during pregnancy have a higher possibility of neuropsychiatric and behavioural conditions, such as autism and attention deficit hyperactivity disorder (ADHD), according to new research from the University of South Australia. 


Funded by the Centre of Research Excellence in Health in Preconception & Pregnancy and conducted in partnership with Curtin University, Monash University, SAHMRI, and a team of national institutions, the systematic review and meta-analysis of more than 3.6 million mother-child pairs across 42 epidemiological studies found that obesity during pregnancy: 

Increases the chance of ADHD in children by 32%.
Doubles the chance of developing autism in children (by 2.23 times).
Increases the possibility of conduct disorders by 16%

 
The study also found that maternal pre-conception obesity or overweight was linked with an increased risk of ADHD, autism, conduct disorder and psychotic disorder, as well as a 30% increased risk in both externalising symptoms and peer relationship problems.
 
 
“Maternal obesity has long been associated with a range of adverse perinatal outcomes, including preterm birth, low birth weight, stillbirth, and it is also linked with macrosomia or high birthweight,” Dr Duko says.
 
“In this study, we examined maternal overweight and obesity before and during pregnancy, finding that both are significantly linked with psychiatric and behavioural problems in children later in life, specifically autism, ADHD and peer relationship problems.
 
“Given the rising global obesity rates among women of reproductive age, and the growing numbers of children identified with neurodiverse conditions, it’s important that we acknowledge the potential long-term consequences of maternal adiposity on child mental health.”
 
In Australia, approximately 1 in 150 people are autistic , and more than 8% of children aged 4-11 are diagnosed with ADHD. Globally, 1 in 8 people live with obesity.

Posted on Children's health, Diabetes

New blood test could be an early warning for child diabetes

Antiphospholipid syndrome
Antiphospholipid syndrome

A new type of blood test using lipids could make it easier to identify children at risk of complications around obesity, including type two diabetes, liver and heart disease, say scientists.

A new study from King’s College London, published in Nature Medicine, reveals a new relationship between lipids and diseases impacting metabolism in children. This relationship could serve as an early warning system for conditions like liver disease.

The researchers suggest using machines that test blood plasma in babies already in hospitals to help doctors spot early signs of disease in children quicker and help them access the right treatment.

The findings also contest the common idea that cholesterol is a leading cause of complications related to obesity in children, identifying new lipid molecules that contribute to health risks like blood pressure but are not only correlated with a child’s weight.

Lipids have traditionally been considered fatty acids in the body, either good or bad types of cholesterol or triglycerides, fats found in the bloodstream that is the most common in the human body. Recent studies from the same scientists have suggested that the picture is more complex.

Current evidence, using a technique associated with chemistry called mass spectrometry, estimates the thousands of different lipids present in the body, each with a separate function.

The team took a control sample of 1,300 children with obesity and assessed their blood lipids. Afterwards, 200 of them were put on the HOLBAEK model for a year, a lifestyle intervention popular in Denmark for people with obesity.

Subsequent readings showed that among the intervention group, lipid counts tied to diabetes risk, insulin resistance, and blood pressure decreased despite limited improvements in some children’s BMI.

Dr Cristina Legido-Quigley, a group leader in Systems Medicine at King’s College London, Head of Systems Medicine at the Steno Diabetes Centre Copenhagen (SDCC) and principal author, said: “For decades, scientists have relied on a classification system for lipids that have split them into good and bad cholesterol, but now with a simple blood test we can assess a much broader range of lipid molecules that could serve as vital early warning signs for illness. In the future, this has the potential to be an entirely new way to evaluate someone’s risk of disease, and by studying how to change lipid molecules in the body, we could even prevent metabolic diseases like diabetes altogether.”

Obesity continues to be a risk factor for conditions like fatty liver disease, but the team hope that doctors can use these measurements to treat children when they are at risk and not just a little larger than their peers.

Dr Karolina Sulek, who participated in the study and performed analysis at the SDCC, said: “Early recognition of children at risk for these life-threatening diseases is crucial. The study provides strong evidence of the great need for obesity management and gives parents confidence to intervene more compassionately in their children’s lives, helping them to lose weight.”

Posted on Children's health, Multiple Sclerosis

Multiple sclerosis – Early high-efficacy treatment reduces disability in children

New research presented today at ECTRIMS 2024 reveals that initiating monoclonal antibody therapy during childhood, rather than delaying treatment until early adulthood, significantly reduces long-term disability in multiple sclerosis (MS) patients.1
New research reveals that initiating monoclonal antibody therapy during childhood, rather than delaying treatment until early adulthood, significantly reduces long-term disability in multiple sclerosis patients.

The study used data from the French MS Registry, Italian MS Register, and the global MSBase Registry to analyze the outcomes of 282 patients with pediatric-onset MS. These patients began experiencing symptoms before the age of 18. They were divided into two groups based on when they started monoclonal antibody treatment: between the ages of 12 and 17 or 20 and 22.

To ensure an accurate comparison of the groups, the researchers used inverse probability treatment weighting based on propensity scores. This method took into account the initial differences between the groups in factors such as gender, age at symptom onset, time from onset to clinically definite MS, and the number of relapses. This approach allowed for a clear evaluation of how the timing of starting high-efficacy therapy influences disability outcomes for individuals aged 23 and older.

In a study using the Expanded Disability Status Scale (EDSS) to measure and monitor disability progression in MS, it was found that patients who started treatment between the ages of 12 and 17 (39% of the study group) had an average increase of only 0.40 points on the EDSS. In comparison, those who began treatment later (61% of the study group) had a 0.95-point increase on the EDSS.rease on the EDSS.

Between the ages of 23 and 27, the increase in EDSS scores from baseline was 0.57 points lower in the early treatment group compared to the late treatment group. The benefits of early treatment persisted throughout the median follow-up period of 10.8 years. Dr. Sifat Sharmin, research fellow in the Clinical Outcomes Research (CORe) Unit at the University of Melbourne and leader of the study, states, “The substantially lower risk of progressing to higher disability levels in the early treatment group was particularly evident in the moderate disability range, where further progression was reduced by up to 97%.”

“This study emphasizes the critical importance of early intervention in pediatric-onset MS,” emphasizes Dr. Sharmin. “Our findings indicate that starting high-efficacy therapies like ocrelizumab, rituximab, or natalizumab during childhood can significantly improve long-term outcomes, preserving neurological function and reducing disability progression.”

Posted on Cardiovascular disease, Children's health, Exercise

A sedentary lifestyle puts strain on young hearts.

Sedentary lifestyle puts strain on young hearts

A sedentary lifestyle puts strain on young hearts CREDIT University of Jyväskylä.

According to a recent Finnish study, high levels of sedentary behaviour and physical inactivity from childhood strain the heart in adolescence. High cardiac workload predicts heart failure and other heart diseases. In light of the findings, increasing moderate and vigorous physical activity from childhood onwards is particularly important in preventing heart diseases.

In a collaborative study by the Faculty of Sport Sciences at the University of Jyväskylä and the Institute of Biomedicine at the University of Eastern Finland, sedentary behaviour and physical activity were followed from childhood to adolescence for eight years. The study showed that adolescents accumulating high levels of sedentary behaviour and low levels of moderate to vigorous physical activity from childhood onwards had a higher cardiac workload in adolescence. Cardiac workload was particularly high in adolescents, who accumulated low vigorous physical activity levels. 

In addition, high levels of sedentary behaviour and low levels of physical activity were associated with a higher total body fat percentage. Body fat percentage partly explained the associations between sedentary behaviour, physical activity, and cardiac workload. Light physical activity was not associated with cardiac workload. 

The results emphasise the importance of increasing physical activity, especially moderate and vigorous activity, reducing sedentary behaviour, and preventing overweight from childhood to prevent heart diseases. 

“Youth spend nine to ten hours a day being sedentary,” says Dr Eero Haapala from the Faculty of Sport and Health Sciences at the University of Jyväskylä, “and only one in ten adolescents accumulated 60 minutes of daily moderate to vigorous physical activity. These are worrying figures.” 

“High levels of daily moderate to vigorous physical activity should be a normal part of childhood and adolescence as it improves heart health, but also general well-being,” Haapala emphasises.