A new study from New Zealand finds firstborn children have reduced insulin effectiveness, a known risk factor for diabetes, and higher blood pressure, compared to children who have older siblings. More research is needed to find out how these relate to risks in adulthood, since puberty and lifestyle also have an influence, say the researchers.
Wayne Cutfield, of the University of Auckland, and colleagues, write about their study, thought to be the first to find a 21% drop in insulin sensitivity among firstborn children, in the 30 January issue of the Journal of Clinical Endocrinology & Metabolism.
Wayne Cutfield, of the University of Auckland, and colleagues, write about their study, thought to be the first to find a 21% drop in insulin sensitivity among firstborn children, in the 30 January issue of the Journal of Clinical Endocrinology & Metabolism.
Cutfield tells the press in a statement released on Monday:
"Although birth order alone is not a predictor of metabolic or cardiovascular disease, being the first-born child in a family can contribute to a person's overall risk."
In many countries, women are having fewer children, which means a greater proportion of the population comprises firstborn children. This study suggests there could be important public health implications for countries like China, where the one-child policy has resulted in a significantly higher proportion of firstborns.
A study published online in Science in January 2013 suggests that China's one-child policy, which was brought in to control the country's ever-increasing population problem, may also have had some serious effects on people's behavior and attitude.
Evidence from other studies suggests firstborn children and adults are biologically different from their younger siblings.
"Although birth order alone is not a predictor of metabolic or cardiovascular disease, being the first-born child in a family can contribute to a person's overall risk."
In many countries, women are having fewer children, which means a greater proportion of the population comprises firstborn children. This study suggests there could be important public health implications for countries like China, where the one-child policy has resulted in a significantly higher proportion of firstborns.
A study published online in Science in January 2013 suggests that China's one-child policy, which was brought in to control the country's ever-increasing population problem, may also have had some serious effects on people's behavior and attitude.
Evidence from other studies suggests firstborn children and adults are biologically different from their younger siblings.
So Cutfield and colleagues set out to "assess whether birth order would be associated with changes in metabolism in childhood".
Their study, which was conducted through the University of Auckland's Liggins Institute, examined data on 85 healthy children aged from 4 to 11, including 32 firstborns.
The data included measures of fasting lipid and hormone profiles, weight, and height and body composition.
The children also had their blood pressure monitored with a 24-hour ambulatory device, and had frequent blood tests for glucose.
The results show that firstborns had a 21% lower insulin sensitivity and a 4 mmHg higher blood pressure.
"Blood lipids were unaffected by birth order," write the researchers.
They suggest the differences in insulin sensitivity and blood pressure could be due to changes that take place in the uterus during a first pregnancy, changes that increase the flow of nutrients to subsequent fetuses.
However, they urge caution in using these figures as an indication of lifetime risk, as Cutfield explains:
"Our results indicate first-born children have these risk factors, but more research is needed to determine how that translates into adult cases of diabetes, hypertension and other conditions."
He and his colleagues focused on children because puberty and adult lifestyle can influence insulin sensitivity.
There was, however, some good news for firstborn children: they tended to be taller (by an average of about 3 cm) and slimmer than later-born siblings, even after adjusting for their parents' height and body mass index.
Their study, which was conducted through the University of Auckland's Liggins Institute, examined data on 85 healthy children aged from 4 to 11, including 32 firstborns.
The data included measures of fasting lipid and hormone profiles, weight, and height and body composition.
The children also had their blood pressure monitored with a 24-hour ambulatory device, and had frequent blood tests for glucose.
The results show that firstborns had a 21% lower insulin sensitivity and a 4 mmHg higher blood pressure.
"Blood lipids were unaffected by birth order," write the researchers.
They suggest the differences in insulin sensitivity and blood pressure could be due to changes that take place in the uterus during a first pregnancy, changes that increase the flow of nutrients to subsequent fetuses.
However, they urge caution in using these figures as an indication of lifetime risk, as Cutfield explains:
"Our results indicate first-born children have these risk factors, but more research is needed to determine how that translates into adult cases of diabetes, hypertension and other conditions."
He and his colleagues focused on children because puberty and adult lifestyle can influence insulin sensitivity.
There was, however, some good news for firstborn children: they tended to be taller (by an average of about 3 cm) and slimmer than later-born siblings, even after adjusting for their parents' height and body mass index.
The advice that "smoking is bad for you" may be old news, but the American Heart Association has released a new study in their journal Stroke, which reveals women are more susceptible to certain stroke-related risks that result from smoking.
For the study, researchers analyzed data from over 80 studies worldwide from 1966 to 2013. In total, the studies included nearly four million individuals and over 42,000 cases of strokes.
Results show that compared with non-smokers, both men and women who smoke have a 60-80% increased risk for having any type of stroke. Smoking also causes a 50% greater risk of ischemic, the most common one - caused by a blood clot - in both men and women.
But further results show that the risk for the most deadly kind of stroke - hemorrhagic stroke, which is caused by a brain bleed - is 17% higher for female smokers than for male smokers.
The researchers suggest that the reason this risk may be higher in women comes down to hormones and how nicotine can impact blood fats. They say that fats, cholesterol and triglycerides tend to increase more in women who smoke, compared with their male smoker counterparts.
This combination of elevated blood fats and smoking in females can increase the risk for coronary heart disease more so than for men, researchers say.
Additional findings from the study reveal that compared with male smokers, the stroke risk for female smokers in Western countries is 10% higher than it is in Asian countries, which researchers suggest is due to a "greater cumulative exposure to smoking."
The researchers say that the study also found evidence that quitting smoking can "significantly reduce their stroke risk."
Lead author Rachel Huxley says:
"Cigarette smoking is a major risk factor for stroke for both men and women, but fortunately, quitting is a highly effective way to lower your stroke risk. Tobacco control policies should be a mainstay of primary stroke prevention programs."
"Cigarette smoking is a major risk factor for stroke for both men and women, but fortunately, quitting is a highly effective way to lower your stroke risk. Tobacco control policies should be a mainstay of primary stroke prevention programs."
An August 2013 BMJ study revealed that a UK-based "stop smoking" program successfully saved 25,000 years of life.
The American Heart Association provides guidelines for how to deal with urges to smoke while quitting, including:
Identifying triggers that make you want to smoke
Selecting ways of coping with your trigger situations
Putting your plan into action and being ready to act if you feel the urge to smoke.
Other recommendations include taking deep breaths, going for a walk, trying to relax, calling a friend and cutting back on caffeine.
Children who take medication to treat deficit hyperactivity disorder (ADHD) don't appear to be at increased stroke risk, according to a study presented at the American Stroke Association's International Stroke Conference 2014.
In a study of 2.5 million 2- to 19-year-olds over a 14-year period, researchers compared stimulant medication usage in children diagnosed with ischemic or hemorrhagic stroke to stimulant usage in children without stroke.
Researchers found no association between stroke risk and the use of ADHD stimulant medications at the time of stroke or at any time prior to stroke.
Children with ADHD experience more adversities than those without ADHD
When children struggle with focusing on tasks, staying organized, controlling their behavior and sitting still, they may be evaluated for attention-deficit/hyperactivity disorder (ADHD). Clinicians, however, shouldn't stop there, according to a study presented at the Pediatric Academic Societies (PAS) annual meeting in Vancouver, British Columbia, Canada.
Researchers found that many children with ADHD also face challenges such as poverty, divorce, neighborhood violence and substance abuse among family members.
"Our findings suggest that children with ADHD experience significantly higher rates of trauma than those without ADHD," said lead author Nicole M. Brown, MD, MPH, MHS, FAAP. "Providers may focus on ADHD as the primary diagnosis and overlook the possible presence of a trauma history, which may impact treatment."
Dr. Brown and her colleagues analyzed data from the 2011 National Survey of Children's Health. They identified 65,680 children ages 6-17 years whose parents answered questions regarding ADHD diagnosis, severity and medication use as well as nine adverse childhood experiences (ACEs): poverty, divorce, and death of a parent/guardian, domestic violence, neighborhood violence, substance abuse, incarceration, familial mental illness and discrimination.
About 12 percent of the children were diagnosed with ADHD. Their parents reported a higher prevalence of all of the adverse events than parents of children without ADHD.
Parents of children with ADHD also reported a higher number of adverse childhood experiences compared to children without ADHD; 17 percent of children with ADHD had four or more ACEs compared to 6 percent of children without ADHD.
Children dealing with four or more adverse experiences were almost three times more likely to use ADHD medications compared to children with three or fewer adverse experiences. Children with four or more adverse experiences also were more likely to have a parent rate their ADHD as moderate to severe compared to children with three or fewer ACEs.
"Knowledge about the prevalence and types of adverse experiences among children diagnosed with ADHDmay guide efforts to address trauma in this population and improve ADHD screening, diagnostic accuracy and management," said Dr. Brown, assistant professor of pediatrics, Division of General Pediatrics, The Children's Hospital at Montefiore, Albert Einstein College of Medicine, New York.
"Pediatric providers should consider screening for adverse childhood experiences in children who they suspect may have ADHD and/or those who carry the diagnosis, and initiate evidence-based treatment/intervention plans for children who screen positive for ACEs," she concluded.