Romitti to lead international birth defects clearinghouse

A portrait of Paul Romitti of the University of Iowa College of Public Health.
Paul Romitti

Paul Romitti, University of Iowa professor of epidemiology, has been appointed to a two-year term as chair of the executive committee for the International Clearinghouse for Birth Defects Surveillance and Research (ICBDSR).

The ICBDSR, a voluntary non-profit organization affiliated with the World Health Organization, brings together birth defect surveillance and research programs from around the world with the aim of investigating and preventing birth defects and lessening the impact of their consequences. Its 42 member programs lead surveillance and research into the occurrence and causes of birth defects, while the ICBDSR and its affiliates provide services such as online continuing education for clinicians, epidemiologists, and public health professionals and guiding efforts to raise awareness about birth defects prevention and treatment.

Romitti directs the Iowa Registry for Congenital and Inherited Disorders, one of the ICBDSR member organizations. Based in the University of Iowa College of Public Health, the registry conducts active surveillance to identify information about congenital and inherited disorders that occur to Iowa residents, tracks trends in these disorders, and provides data for research studies and educational activities aimed at prevention and treatment.

“I am enthusiastic for this opportunity to help guide strategies for birth defect surveillance, research, and prevention worldwide,” says Romitti.

Additional information about the International Clearinghouse for Birth Defects Surveillance and Research is available at http://www.icbdsr.org/.

Additional information about the Iowa Registry for Congenital and Inherited Disorders is available at https://www.public-health.uiowa.edu/ircid/.

RUPRI’s Richgels discusses summertime experiences of rural children

Jocelyn Richgels, director of national policy programs for the Rural Policy Research Institute, was an invited panelist at a National Academies of Sciences, Engineering, and Medicine information gathering session held Sept. 19 in Washington, D.C.

The session was convened by the Committee on Summertime Experiences and Child and Adolescent Education, Health, and Safety. Richgels contributed perspectives on the summertime experiences of children and adolescents in rural communities.

The committee, chaired by Martín Sepúlveda, IBM Fellow, CEO of CLARALUZ, LLC., and long-time member of the College of Public Health Board of Advisors, is studying how summertime experiences affect children across four areas of well-being: 1) academic learning and opportunities for enrichment; 2) social and emotional development; 3) physical and mental health and health-promoting behaviors; and 4) safety, risk-taking, and anti-and pro-social behavior.

Additional information is available at http://sites.nationalacademies.org/dbasse/bcyf/summertime/.

Healthy LifeStars program challenges childhood obesity in Iowa

An innovative program that tackles childhood obesity — the number one health problem for children — will soon be making its debut in Iowa. Aimed at elementary-age kids, the LifeStar Challenge motivates and teaches children how to live active, healthy lives now and in the future.

The program is being implemented through a partnership between Healthy LifeStars and the Iowa Institute of Public Health Research and Policy based in the University of Iowa College of Public Health. Healthy LifeStars is a national non-profit organization dedicated to ending childhood obesity through education, awareness, and changed habits to influence future generations of healthy children.

The Iowa Healthy LifeStars program will be offered at no charge, thanks to a gift from the Stead Family Foundation and Jerre and Mary Joy Stead, two former Iowans who are among the most generous donors to the University of Iowa.

Nationally, one in three children is overweight or obese. Healthy LifeStars was founded in 2003 to address childhood obesity and has reached over 35,000 kids in Arizona and Colorado. In 2018, it launched programs in Iowa and Ohio and has the goal of growing nationwide.

“We’re excited to introduce this program in Iowa and expand it statewide,” says Vickie Miene, interim director of the Iowa Institute of Public Health Research and Policy (IIPHRP) and director of the Iowa Healthy LifeStars program. “Our goal is to enroll 5,400 kids in the first three years in both urban and rural locations.”

The LifeStar Challenge will begin in Iowa this fall with several sites in the Iowa City area. The program will be delivered in before- and after-school programs and will be led in part by University of Iowa student coaches

“We will build a network of UI student volunteers who will be an integral part of getting this program off the ground in Iowa,” Miene explains. “UI students from a variety of majors have already expressed interest in volunteering as LifeStars coaches and will contribute ideas to the program through a UI student advisory council. In addition, UI students will contribute to social media articles and healthy lifestyle campaigns associated with the program.”

IIPHRP will partner with additional schools, youth-serving organizations, and health initiatives to continue to grow the program across the state.

The LifeStar Challenge teaches kids and their families the three Healthy Life Habits: setting personal health goals, taking part in vigorous physical activity every day, and eating the right foods in the right amounts. Each child receives a lanyard and chain to display reward tokens. Kids earn a colorful plastic star every time they achieve one of the goals they set for themselves. Everything organizers need to get started is included in a simple kit with additional information online.

“All of the tools are available on-line and the program is flexible, so it’s easy to implement in a variety of settings,” says Miene.

For more information about the program, visit https://www.public-health.uiowa.edu/healthy-lifestars/.

UI analysis finds significant increase in number of US children diagnosed with ADHD over 20 years

The number of children in the United States diagnosed with Attention Deficit/Hyperactivity Disorder (ADHD) increased from 6.1 percent to 10.2 percent from 1997 to 2016, according to an analysis from the University of Iowa published in the Journal of the American Medical Association (JAMA) Network Open.

A portrait of Assistant Professor Wei Bao of the Department of Epidemiology in the University of Iowa College of Public Health.
Wei Bao

This upward trend cut across all demographic subgroups, says Wei Bao, assistant professor of epidemiology in the UI College of Public Health and study co-author.

“Our findings indicate a continuous increase in the prevalence of diagnosed ADHD among U.S. children and adolescents,” says Bao.

The study analyzed the health information of more than 186,000 children and adolescents gathered by the U.S. National Health Interview Survey (NHIS), an annual survey of American households conducted by the U.S. Centers for Disease Control and Prevention. The data were collected annually from 1997 to 2016.

The analysis found that 1,243 children age 4 to 17 were reported to have ADHD in the 1997–98 survey, representing 6.1 percent of U.S. children and adolescents. That increased to 1,880 reported cases in 2015–16, representing 10.2 percent of U.S. children and adolescents.

The analysis also found this upward trend across gender, racial, family, and geographic lines. However, it found that not all increases were uniform, and that there were distinct differences within groups.

For instance, in the gender subgroup, the research showed 14 percent of boys were diagnosed with ADHD in 2016, up from 9 percent in 1997. However, only 6.3 percent of girls were diagnosed with ADHD in 2016, up from 3.1 percent in the 1997 survey.

While the number of Hispanic children diagnosed with ADHD jumped from 3.6 percent to 6.1 percent, they are still far less likely to receive a diagnosis than children from other racial groups. White children in the survey were diagnosed with ADHD at a 12 percent rate in 2016, up from 7.2 percent in 1997; 12.8 percent of African American children were diagnosed with ADHD in 2016, up from 4.7 percent in 1997.

The survey also found incidences of the disorder varied significantly by geography. Children in the Western region of the United States were less likely to be diagnosed with ADHD—7 percent in 2016—compared to the Northeast, Midwest, or South, all of which exceeded 10 percent. In 1997, 5 percent of children in the Western states were diagnosed with ADHD, while other regions ranged from 5.5 percent to 6.9 percent.

The NHIS survey did not attempt to find a cause for the increase, but the authors offered some possible factors, such as increased awareness of ADHD and a diminished social stigma for ADHD. Changes that expanded the definition of the disease also may have contributed to the increase.

The authors also say that previous studies also support a role of environmental risk factors, such as exposure to lead or certain pesticides or chemicals during pregnancy and the postnatal period, as well as nutritional deficiencies. Prenatal and perinatal risk factors, including pre-term birth, low birth weight, maternal cigarette smoking, and use of certain medications or illicit substances during pregnancy also have been associated with ADHD risk in previous studies.

The study, “Twenty-year trends in diagnosed attention deficit/hyperactivity disorder among US children and adolescents, 1997–2016,” was published in the Aug. 31 issue of JAMA Network Open. It was first-authored by Guifeng Xu in the UI College of Public Health and co-authored by Lane Strathearn of the UI Roy J. and Lucille A. Carver College of Medicine, Buyun Liu of the UI College of Public Health, and Binrang Yang of Shenzhen Children’s Hospital in China.

The study can be found online at http://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2018.1471

This story originally appeared in Iowa Now

Additional Media Coverage

ADHD numbers are rising, and scientists are trying to understand why (Washington Post)
https://www.washingtonpost.com/national/health-science/adhd-numbers-are-rising-and-scientists-are-trying-to-understand-why/2018/09/07/a918d0f4-b07e-11e8-a20b-5f4f84429666_story.html

About 10 percent of US children are diagnosed with ADHD (CNBC)
https://www.cnbc.com/2018/08/31/adhd-diagnosed-in-about-10-percent-of-us-children-study-finds.html

10% of US children diagnosed with ADHD, study finds (CNN)
https://www.cnn.com/2018/08/31/health/adhd-trends-study-partner/index.html

Over Past 20 Years, The Percentage Of Children With ADHD Nearly Doubles (California Healthline)
https://californiahealthline.org/news/over-past-20-years-the-percentage-of-children-with-adhd-nearly-doubles/

ADHD Rates Rising Sharply in U.S. Kids (WebMD)
https://www.webmd.com/add-adhd/childhood-adhd/news/20180831/adhd-rates-rising-sharply-in-us-kids#1

New study finds children’s ADHD diagnoses on the rise (CBS2Iowa)
https://cbs2iowa.com/news/local/new-study-finds-childrens-adhd-diagnoses-on-the-rise

Study links food allergy to autism spectrum disorder in children

A portrait of Assistant Professor Wei Bao of the Department of Epidemiology in the University of Iowa College of Public Health.
Wei Bao

A new study from the University of Iowa finds that children with autism spectrum disorder (ASD) are more than twice as likely to suffer from a food allergy than children who do not have ASD.

Wei Bao, assistant professor of epidemiology at the UI College of Public Health and the study’s corresponding author, says the finding adds to a growing body of research that suggests immunological dysfunction as a possible risk factor for the development of ASD.

“It is possible that the immunologic disruptions may have processes beginning early in life, which then influence brain development and social functioning, leading to the development of ASD,” says Bao.

The study analyzed the health information of nearly 200,000 children gathered by the U.S. National Health Interview Survey (NHIS), an annual survey of American households conducted by the U.S. Centers for Disease Control and Prevention. The children were between the ages of 3 and 17 and the data were gathered between 1997 and 2016.

The study found that 11.25 percent of children reportedly diagnosed with ASD have a food allergy, significantly higher than the 4.25 percent of children who are not diagnosed with ASD and have a food allergy.

Bao says his study could not determine the causality of this relationship given its observational nature. But previous studies have suggested possible links—increased production of antibodies, immune system overreactions causing impaired brain function, neurodevelopmental abnormalities, and alterations in the gut biome. He says those connections warrant further investigation.

“We don’t know which comes first, food allergy or ASD,” says Bao, adding that another longitudinal follow-up study of children since birth would be needed to establish temporality.

He says previous studies on the association of allergic conditions with ASD have focused mainly on respiratory allergy and skin allergy, and those studies have yielded inconsistent and inconclusive results. The new study found 18.73 percent of children with ASD suffered from respiratory allergies, whereas only 12.08 percent of children without ASD had such allergies, and 16.81 percent of children with ASD had skin allergies, well above the 9.84 percent of children without ASD.

“This indicates there could be a shared mechanism linking different types of allergic conditions to ASD,” says Bao.

Bao says the study is limited in that the NHIS depends on respondents to voluntarily self-report health conditions, so the number of children with ASD or allergies may be misreported by those taking the survey. But he says the large number of respondents and ethnic and gender cross-representation of the survey are major strengths.

The study, “Association of Food Allergy and Other Allergic Conditions with Autism Spectrum Disorder in Children,” was published online in the June 8 issue of JAMA Network Open. The first author is Guifeng Xu, PhD candidate in the UI College of Public Health and graduate research assistant in the UI Roy J. and Lucille A. Carver College of Medicine. Additional co-authors include Linda G. Snetselaar, professor of epidemiology in the UI College of Public Health; Jin Jing, professor of maternal and child health at the Sun Yat-Sen University in China; Buyun Liu, postdoctoral researcher in the UI College of Public Health; and Lane Strathearn, professor of pediatrics in the Carver College of Medicine.

This story originally appeared in Iowa Now

Additional Media Coverage

American Journal of Managed Care
http://www.ajmc.com/newsroom/is-there-a-link-between-autism-food-allergies-study-offers-hint-but-no-answers

Express News
http://expressdigest.com/children-with-autism-twice-as-likely-to-have-had-food-allergies/

HealthDay
https://consumer.healthday.com/cognitive-health-information-26/autism-news-51/allergies-more-common-in-kids-with-autism-734691.html

Healio
https://www.healio.com/family-medicine/pediatrics/news/online/%7B95efa83e-fbe7-4394-985c-75a11948d613%7D/food-allergies-common-in-children-with-autism

Dermatology News
https://www.mdedge.com/edermatologynews/article/167673/pediatrics/allergies-linked-autism-spectrum-disorder-children

MD Magazine
http://www.mdmag.com/medical-news/autism-rates-nearly-tripled-in-children-with-food-allergies

Medscape
https://www.medscape.com/viewarticle/897833

MedicalResearch.com
https://medicalresearch.com/mental-health-research/autism/food-allergies-more-common-in-children-with-asd/42234/