Diet and nutrition counseling for virtually all overweight and obese women of childbearing age can reduce health risks linked to excess weight for mothers and children alike, as per a newly released position paper from the American Dietetic Association and the American Society of Nutrition.

The position, reported in the recent issue of the Journal of the American Dietetic Association, represents the associations' official stance on obesity, reproduction and pregnancy outcomes:

Given the detrimental influence of maternal overweight and obesity on reproductive and pregnancy outcomes for the mother and child, it is the position of the American Dietetic Association and the American Society for Nutrition that all overweight and obese women of reproductive age should receive counseling previous to pregnancy, during pregnancy and in the interconceptional period on the roles of diet and physical activity in reproductive health, in order to ameliorate these adverse outcomes.

The joint ADA/ASN position and accompanying paper were written by Anna Maria Siega-Riz, PhD, RD, LDN, assistant professor of maternal and child health at the University of North Carolina; and Janet C. King, PhD, senior scientist at Children's Hospital and Research Center, Oakland, Calif.

An estimated 33 percent of U.S. women are obese, as per the authors, who write that a long-term goal of health professionals must be to reduce the number of women who become pregnant while obese. They add that the effect of a woman's nutritional status previous to pregnancy is an issue of great public health importance.

"Among obese women, who already have aberrations in glucose and lipid metabolism, the further adjustments induced by hormonal changes in pregnancy create a metabolic milieu that enhances the risk for metabolic disorders such as gestational diabetes mellitus and preeclampsia," as per the position paper.

Infants born to obese mothers have "a higher prevalence of congenital anomalies than do offspring of normal-weight women, suggesting that maternal (obesity) alters development in the sensitive embryonic period." The authors note neural tube defects such as spina bifida and anencephaly are about twice as common among children of obese women. "Other birth defects more frequent in offspring of obese women include oral clefts, heart anomalies, hydrocephaly and abdominal wall abnormalities."

Objectives of the new ADA/ASN position are to provide guidance to nutrition professionals in becoming aware of risks and possible complications of excess weight and obesity for fertility, course of pregnancy, birth outcomes and short and long-term maternal and child health; and to commit ADA and ASN to identifying gaps in scientific research needed to improve knowledge of risks and complications and develop effective strategies "that can be implemented before and during pregnancy as well as during the interconceptional period," the authors write.

The American Dietetic Association is the world's largest organization of food and nutrition professionals. ADA is committed to improving the nation's health and advancing the profession of dietetics through research, education and advocacy. Visit the American Dietetic Association at www.eatright.org/.


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HOUSTON -- (April 16, 2009) -- "Ew." It's a word many parents hear when they serve a meal to their child. But before getting frustrated, parents should know that children taste different flavors in foods than adults do.

According to an expert at Baylor College of Medicine in Houston, exposing children to various types of foods early and often will help them develop a taste for different foods.

"Children have sensitive taste buds, and they taste what we smell," said Roberta Anding, registered dietitian with BCM and Texas Children's Hospital. "Certain foods may have a stronger taste for them than they do for adults."

Taste perceptions

This is why exposing children to various types of food at an early age is important. It starts with breast feeding, which exposes them to a variety of flavors, she said.

"Early imprinting will help alter their taste perceptions," said Anding.

Don't give up after offering a new food just one or two times, she said, because it can take 10 to 15 food exposures for a child to actually like the food. However, forcing or cajoling a child to eat a food will ruin a food experience for them, making them less likely to be willing to try the food again.

"Ask that they at least take one bite of the food," said Anding. "Try introducing the food again when the child is hungry."

Smell impacts perception

Because 80 percent of taste is smell, children might be more willing to try raw vegetables rather than cooked ones, since they don't have as strong of a smell, she said.

Getting children involved in the preparation of the food can also help. But Anding does not support another age-old tactic – hiding vegetables and fruits under sauces and toppings, most of which are unhealthy.

"This makes something that would be considered a nutritious food no longer nutritious," she said.

Rewarding children with food is also not a good idea. It elevates the status of food and makes certain foods or treats more valuable to children.

"Remember that as a parent, your reaction to food has an influence on your children," said Anding. "So if you cringe at the sight of a certain food, chances are they will too."

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HOUSTON -- (April 14, 2009) -- When it comes to sexually transmitted infections, experts at Baylor College of Medicine tout the ABCs -- Abstinence, Be faithful, and Condoms. But another letter is also important – 'S,' as in silent.

Many sexually transmitted infections are silent diseases, meaning they have no symptoms, said Dr. Peggy Smith, director of the Baylor College of Medicine Teen Health Clinic. That's why it is so important for everyone who is sexually active to be screened regularly for sexually transmitted infections.

"As soon as a person becomes sexually active, he or she should start including regular screenings for sexually transmitted infections as part of a good health care routine," said Smith, who is also professor of obstetrics and gynecology at BCM. "These screenings can be done quickly and easily and should be performed at least annually or any time there has been potential exposure to such an infection."

Bacterial infections

Screenings can be done for both bacterial and viral sexually transmitted infections. Bacterial infections include gonorrhea and chlamydia, which is the most common sexually transmitted infection in girls ages 15 to 24. It usually has no apparent symptoms.

"The good news about bacterial infections is that they are highly curable, but if ignored, they can have devastating consequences, including infertility in women," said Smith.

Viral infections

Common viral infections include the human papillomavirus (HPV), herpes and HIV. Smith noted that cases of HIV diagnosed at the Baylor Teen Health Clinic increased from 2007 to 2008.

The best advice for young people is to delay their sexual debut, Smith said.

"We urge them to be abstinent until they can make good decisions," she said. "But if they are not, it is imperative to use a condom every time. Condoms provide significant protection against both bacterial and viral infections."

The number of teens who report using condoms is increasing, but Smith noted that many people stop using them if they have a consistent partner.

"This is a mistake, because when you have sex with someone, it's like you have sex with whomever your partner has had sex with. You're putting yourself at a lot of risk."

April is Sexually Transmitted Infection Awareness Month.

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HOUSTON -- (April 10, 2009) -- The so-called purple pill, known popularly as Nexium and esomeprazole to physicians, did not reduce asthma symptoms in patients who did not have symptoms of heartburn, said researchers, including one from Baylor College of Medicine, in a report that appears today in The New England Journal of Medicine. The study may change the common practice of prescribing these drugs to asthma patients even when they have no heartburn symptoms.

"I was surprised," said Dr. Nicola Hanania, associate professor of medicine – pulmonary, at BCM. "It was disappointing for us, but that is why we do research." Hanania is principal investigator at the BCM site.

Heartburn drugs have no effect

For at least two decades, physicians have prescribed proton pump inhibitors (drugs that block the production of gastric acid) for patients with poorly controlled asthma, whether they had symptoms of heartburn or not. They believed that acid reflux, whether recognized or not, could trigger some asthma symptoms such as wheezing, coughing or breathlessness.

Now a 20-center study involving 402 patients with asthma poorly controlled on the usual drugs shows that such treatment has no effect. The patients were randomly assigned to one of two groups. One group took 40 milligrams of the heartburn drug twice daily for six months. The others took an inactive pill called placebo.

Members of each group had the same number of episodes of poor asthma control during that period, indicating the heartburn medicine had no effect on improving asthma control.

About half the patients had a positive test for excess acid in their gastrointestinal tract when tested with a special probe, which indicates they might have reflux, said Hanania. However, even in these patients, the heartburn drugs appeared to have no effect.

Discuss findings with physician

"Each year, people with asthma are spending as much as $10 million dollars on prescription heartburn medication believing it will help control attacks of wheezing, coughing and breathlessness," said Dr. Norman H. Edelman, American Lung Association chief medical officer. "Now we know with confidence that silent acid reflux does not play a significant role in poor asthma control. Talk with your doctor before discontinuing any medication, as each patient's specific needs will vary."

A study of the effect of these drugs in children is currently underway, Hanania said. Asthma appears to affect children differently, and the researchers feel that study should continue.

The study demonstrates the benefit of the Asthma Clinical Research Centers, a 20-center network that works together to test treatments and answer common questions related to this disease, said Hanania.

Funding for this work came from the National Heart, Lung and Blood Institute, the American Lung Association and Astra/Zeneca (Nexium's maker that provided the drug).

For more information on research at Baylor College of Medicine, please go to From the Labs or Findings.

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HOUSTON -- (April 8, 2009) -- Dr. Stuart C. Yudofsky, the D.C. and Irene Ellwood Professor and Chair of the Menninger Department of Psychiatry and Behavioral Sciences at Baylor College of Medicine in Houston, has been selected as the first recipient of the Joan and Stanford Alexander Annual Award in Psychiatry.

From left: Stuart C. Yudofsky, M.D., Stanford Alexander, Joan Alexander and William T. Butler, M.D.

The award honors a mental health professional who has made shaping contributions in research, education and clinical or community service for people suffering from severe and persistent mental illness. The award consists of an annual prize and lecture of international scope.

Yudofsky's research and clinical practice focuses on psychopharmacology, the use of medicines to treat mental illness, and neuropsychiatry, the assessment and treatment of the psychiatric aspects of people with neurological illnesses.

For his lecture, Yudofsky spoke on "The Stigmatization of the Mentally Ill: Origins, Implications, and Remediation."

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