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Press releases Saturday 7 October 2006

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(1) PHYSICAL EXERCISE HAS LITTLE IMPACT ON OBESITY IN YOUNG CHILDREN

(2) PEOPLE SHOULD BE PAID FOR DONATING AN ORGAN

(3) DRUG COMPANY REPORTS SHOULD BE READ WITH CAUTION, WARN DOCTORS

(4) NEW RESEARCH QUESTIONS LINK BETWEEN BREASTFEEDING AND CHILD INTELLIGENCE

(1) PHYSICAL EXERCISE HAS LITTLE IMPACT ON OBESITY IN YOUNG CHILDREN

Online First
(Movement and Activity Glasgow Intervention in Children (MAGIC) for the prevention of obesity: cluster randomised controlled trial)http://bmj.bmjjournals.com/cgi/rapidpdf/bmj.38979.623773.55

Physical activity is unlikely to have a significant effect in reducing levels of obesity amongst pre-school children, but could lay the foundations for a healthier future, a BMJ study reveals today.

Childhood obesity has become an increasing problem over recent years (1), yet there is a lack of high quality evidence on the issue, and how it can best be tackled. A team of researchers from Glasgow undertook a large study – involving 545 pre-school children from 36 nurseries – to ascertain whether or not an increase in levels of exercise could reduce a child’s Body Mass Index (BMI).

The participating children (average age of 4.2 years) took part in a nursery based active play programme consisting of three sessions of 30 minutes each week. In addition their parents were given guidance on increasing physical play at home. BMI readings for each child were taken after six months and then again after a year, they were also assessed for movement skills and ‘habitual physical activity and sedentary behaviour’ – i.e. whether or not the increased activity led to a reduction in sedentary behaviour and/or an increase in physical activity.

The researchers found that the increased level of exercise had little effect on the BMI or on the activity behaviours of the children. However, it did help to improve the children’s motor and movement skills. The researchers say that this improvement may foster an increase in activity levels by increasing the confidence and ability of children to carry out physical activity, which could affect long-term levels of body fat.

The authors conclude that to prevent obesity in early childhood may require change not just at nursery school and home, but also in the ‘wider environment’, and that changes in diet are also necessary. They call for further research into the issue ‘to identify successful and sustainable interventions for obesity prevention and physical activity promotion in young children’.

Contact:

Professor John Reilly, Personal Professor in Paediatric Energy Metabolism, University of Glasgow Division of Developmental Medicine, Glasgow, Scotland
Email: jjr2y@clinmed.gla.ac.uk

Notes to editors:

1. Previous research showed that around 10% of 4-5 year olds in Scotland were obese and that at least 20% of Scottish children in the 11-12 age group were obese (NHS Quality Improvement Indicators: Childhood Obesity in 2001. NHS Scotland, December 2003)

(2) PEOPLE SHOULD BE PAID FOR DONATING AN ORGAN

(Payment for living organ donation should be legalised)
http://bmj.com/cgi/content/full/333/7571/746

A legalised and regulated system for paying people to donate organs should be created to help answer the large demand for transplants and prevent exploitation of poor people, says an article in this week’s BMJ.

The author – an organ transplant surgeon – has written an opinion piece arguing for payments to be made for live organ donation, saying it does not go against current ethical practice in healthcare and would help with the “desperate” need for organs.

Many people who agree to participate in medical research do so for financial reward, points out the author Amy Friedman, associate professor of surgery at Yale University School of Medicine in the USA.

“If it is reasonable, legal, and ethically justified to motivate someone using monetary reward to participate in human research, then by extension the same person should be allowed a monetary inducement or reward for donating an organ,” writes Professor Friedman.

The buying and selling of regenerative products such as human hair, blood and semen occurs and human eggs are now sought openly with a price offered for them – payment is legal in the USA.

Professor Friedman says proper supervision of a transplant process would minimise potential medical and surgical harm and might be accomplished through a centralised, multi-disciplinary panel with responsibility for determining standardised criteria for donors and recipients as well as a uniform fee.

Kidneys are covertly transplanted in third world countries at the moment from poorer people to wealthier recipients, she says, with little evidence of the outcomes.

“Bringing these activities out of the closet, by introducing governmental supervision and funding will provide equity for the poor, who will get equal access to such transplants.”

Contact:

Amy Friedman, Associate Professor of Surgery, Yale University School of Medicine, Connecticut, USA
Email: amy.friedman@yale.edu

(3) DRUG COMPANY REPORTS SHOULD BE READ WITH CAUTION, WARN DOCTORS

Online First
(Cochrane reviews compared with industry-supported meta-analyses and other meta-analyses of the same drugs: systematic review)
http://bmj.bmjjournals.com/cgi/rapidpdf/bmj.38973.444699.0B

A study published on bmj.com today has found that reviews of drugs which are supported by the pharmaceutical industry are less transparent, and are more likely to reach favourable conclusion on drugs, than independent reviews.

According to the authors, bias in drug trials is common and often favours the trial-sponsor’s product. To balance this effect, independent reviews – which can have a more critical and systematic approach - are essential to ensure doctors and other health professionals have the information they need on drugs.

The authors, based in Denmark, compared the results of 24 pairs of reviews conducted by different people on the same drugs. Compared to reviews supported by the pharmaceutical industry, reviews undertaken by the Cochrane Collaboration – an independent body – were of a higher quality and were more likely to address the potential for bias in the review.

Of seven industry-supported reviews, all recommended the experimental drug without reservation, whilst none of the corresponding Cochrane reviews reached the same conclusion. Six of the eight Cochrane reviews analysed had reservations about the quality or relevance of the trials or their findings and two of them noted that the effect decreased with increasing number of patients in the trial. Seven mentioned higher cost of the experimental drug as a problem. In contrast, none of the industry-supported reviews mentioned higher cost as a problem, and two claimed that the experimental drug was cost-effective.

The researchers also found that the reviews with not-for-profit support or no support had similarly cautious conclusions as the Cochrane reviews.

The authors conclude that industry-supported reviews should be read with caution. They also want greater transparency, including the inclusion of more information on methodology and the estimated effects of the drugs, in order to allow readers to judge the reliability of drug reviews. Contact: Dr Peter Gøtzsche, Director, Nordic Cochrane Centre, Copenhagen, Denmark
Email: pcgh@cochrane.dk

(4) NEW RESEARCH QUESTIONS LINK BETWEEN BREASTFEEDING AND CHILD INTELLIGENCE

Online First
(The effect of breastfeeding on offspring intelligence: prospective study, sibling-pairs analysis and meta-analysis)
http://bmj.bmjjournals.com/cgi/rapidpdf/bmj.38978.699583.55

Breastfeeding has little or no effect on a child’s intelligence, finds a BMJ study.

The link between breastfeeding and children’s intelligence has been studied since 1929, but the relationship between the two remains unclear. Many of the studies that have found a link between breastfeeding and increased child intelligence have failed to consider other factors, particularly maternal intelligence. Researchers from the Medical Research Council Social and Public Health Sciences Unit in Glasgow, undertook the largest ever study – involving 5,475 children and their mothers in the USA – to re-examine the effect of breastfeeding taking into account maternal intelligence and other aspects of the child’s background.

The findings showed that when considered in isolation, breastfeeding did appear to have a beneficial effect on a child’s intelligence. However, once other factors were considered – including maternal intelligence, home environment and socio-economic status - breastfeeding made less than half a point difference to children’s intelligence scores. When the data were re-analysed, and maternal intelligence omitted, the effects of breastfeeding were at least double that when tested with maternal intelligence – highlighting the fact that failing to take into account mothers’ intelligence can ‘seriously overestimate the effects of breastfeeding’.

The research also compared the data on siblings within the sample group – one of whom had been breastfed and another who had not – and this supported the finding. There was no significant difference between the intelligence of the child who had been breastfed and the child who had not.

An increase of one standard deviation (15 points) in a mother’s intelligence score more than doubled the odds the child would be breastfed. According to the data, mothers who breastfed were also more likely to be older, to have more education and to provide a more stimulating home environment. They were less likely to be in poverty or to smoke.

The authors note their ‘surprise’ at the fact that maternal intelligence has been overlooked as a factor in other research, ‘given the heritability of intelligence and the known association of maternal intelligence with both the initiation and duration of breastfeeding.’ They conclude that whilst breastfeeding does not enhance child intelligence, it remains important for the healthy growth and development of infants and has many advantages for both mother and child.

Contact

The Medical Research Council (MRC) press office at press.office@headoffice.mrc.ac.uk

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