![]() by Wei Perng, PhD Pregnancy causes remarkable changes in a women's body. Hormones surge, and circulation and metabolism change. A growing body of research suggests that a woman's physiological response to the cardiovascular and metabolic demands of pregnancy may provide a looking glass into her future health. Researchers are becoming more and more convinced that pregnancy serves as a “stress test” that unmasks risk for cardiovascular disease (CVD) later in life.
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![]() by Karen Switkowski, MS, MPH As a graduate student in nutrition with a particular interest in prenatal diet, I was confident that if I ever became pregnant I would follow a perfect diet. Then I got about six weeks into my first pregnancy. There was no way I was eating fish most days, and vegetables were a struggle. Instead, there were three things that I could reliably eat during my first trimester: pineapple, waffles, and peanut butter.
Pineapple is pretty non-controversial, and my doctor said it was perfectly fine to regularly make waffles for dinner (my husband disagreed). However, there seems to be a widespread perception that nut products should be avoided during pregnancy, or at least eaten in moderation. In 2000, the American Academy of Pediatrics advised that “no maternal dietary restrictions during pregnancy are necessary with the possible exception of excluding peanuts." ![]() by Emily Oken, MD, MPH In July, I attended a workshop on the Healthy Birth, Growth, and Development Initiative organized by the Bill and Melinda Gates Foundation. The workshop brought together experts in nutrition, growth, and statistical modeling to advise the Gates Foundation on its efforts to maximize brain development by interventions during the first 1000 days of life (conception through age 2). What will be their key measure of success?
![]() Even when guidelines are clear, doctors do not always follow national screening guidelines. So how do they behave in situations which may be too unsettled for guidelines to reign? Take the example of cholesterol screening for children. The National Heart, Lung, and Blood Institute (NHLBI) comes on strong and recommends universal screening for those ages 9 to 11 years. The American Academy of Pediatrics (AAP) toes a middle ground, and the U.S. Preventive Services Task Force (USPSTF) just doesn’t believe there’s enough evidence to recommend any pediatric lipid screening. So how often are pediatricians screening for cholesterol levels?
The short answer is not very often. ![]() Obesity is the scourge of the 21st century. Carrying extra weight in adulthood causes diabetes and heart disease. In childhood, obesity not only presages adult obesity, but it also leads to asthma, depression, orthopedic problems and other ills among children themselves. Rates of obesity in children and adults are just about as high as they can be in western societies, and they are rapidly increasing in the developing world. By 2030, close to a billion people across the globe will have diabetes or prediabetes.
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