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Children who suffer a concussion don’t just have a minor head bump, but a brain injury that parents, coaches and teachers need to take more seriously, Canadian researchers warn.

Parents often believe that concussion injury is mild and doesn’t involve damage to the brain, said lead researcher Dr. Carol DeMatteo, an associate clinical professor in the School of Rehabilitation Science at McMaster University, in Hamilton, Ontario.

However, “concussion really is a brain injury — there’s no question about that,” she said.

“The term concussion is used frequently, but there are no real guidelines in using it with children,” DeMatteo said. “This means that many different types of injury of different severity can be called a concussion. This leads to misconceptions by families and coaches and teachers and children themselves.”

Instead of using the word “concussion,” these injuries should be called mild brain injuries and that may help these children get the care they need, DeMatteo added. “We only have one brain, so let’s help kids look after theirs.”

The report is published in the Jan. 18 online edition of Pediatrics.

For the study, DeMatteo’s group reviewed the medical records of 434 children seen at McMaster Children’s Hospital for a brain injury. About a third (32 percent) were diagnosed with concussion.

The researchers found that, compared with other brain injuries, children diagnosed with concussion spent less time in the hospital and fewer days out of school. They were also more likely to go back to school shortly after leaving the hospital.

If children go back to school or sports too soon after a concussion they are at an increased risk of having another head injury, DeMatteo noted. “Kids are twice as likely to have another head injury within a year if they have [already] had one,” she said.

DeMatteo believes that children should see a doctor if they are showing signs of a concussion, such as fatigue, headache, memory problems, disturbed sleep or mood changes.

These symptoms can affect school performance, and returning too soon to sports can increase the risk for another injury, she said.

Most importantly, having a subsequent head injury can boost the odds of doing permanent damage to the brain, DeMatteo noted.

Gillian Hotz, director of the Pediatric Neurotrauma Program at the University of Miami Miller School of Medicine, said parents are often relieved to hear that their child has “only” suffered a concussion.

But concussion is only a catch-all term for a spectrum of non-structural brain injury, Hotz said. “Most kids who have a concussion, rest — the headache goes away, the symptoms go away, and they’re fine,” she said.

“But, you have to be very careful,” Hotz said. “If there is damage on a CT [scan] or prolonged unconsciousness then it’s in another category, not a concussion.”

Concussions do need to be taken seriously, and injured children need to be seen by doctors before they are allowed to return to school or sports, Hotz said.

“If a kid goes down and has symptoms during a game they are pulled. They need to be cleared by a medical professional before they return to play, and not that game,” she said.

“Concussions are cumulative so we are going to have a lot more severely injured kids if we don’t start putting some of these policies into place,” Hotz said.

SOURCES: Carol DeMatteo, MSc, associate clinical professor, School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada; Gillian Hotz, Ph.D., associate research professor and director, Pediatric Neurotrauma Program, University of Miami Miller School of Medicine; Jan. 18, 2010, Pediatrics, online

If you spend time with people who exhibit self-control — resisting the death-by-chocolate cake after a restaurant meal, for instance — you can expect your own self-control to be pretty good, too, according to new research.

But the opposite seems true, too: Spending time with people with less-than-ideal self-control will influence you negatively, the researchers found.

“Before, we knew people tended to hang out with other people who were like themselves,” said Michelle vanDellen, a visiting assistant professor of psychology at the University of Georgia, who led the research, which was published online in the Personality and Social Psychology Bulletin.

“But in these studies, we actually show there is a direct effect of our friends’ behavior on our own behavior,” vanDellen said. The findings apply, she said, “not only to the people we [choose to] hang out with, but those we are forced to hang out with,” such as co-workers on the job.

The conclusions came from five studies conducted by vanDellen and her co-author, Rick Hoyle of Duke University.

The best study, she said, and the most fun, involved 71 participants and two plates of food — one stacked with carrot sticks, the other with freshly baked chocolate chip cookies. The participants either watched someone exhibit self-control by eating the carrots and leaving the cookies, or vice versa. Later, the participants took self-control tests (not involving cookies and carrots). Those who had watched a person eat cookies did less well than those who had watched someone eat carrots.

In another study, the researchers found that 36 participants randomly assigned to think of a friend with good self-control persisted longer on a handgrip test used to measure self-control than did the participants assigned to think about a friend with bad self-control.

Another study involved assigning 42 people to list the names of friends with good and bad self-control. As the participants took a test designed to measure self-control, a name was flashed very briefly on a computer screen. Those who saw the name of a friend with good self-control did better on the test than those who saw the name of a friend with poor self-control.

The researchers also assigned 112 people to write about a friend with good self-control, a friend with bad self-control or an outgoing friend. Those who wrote about a friend with good self-control did best on a test of self-control, those who wrote about a friend with bad self-control did worst and those who wrote about an outgoing friend scored in between the others.

In the fifth study, 117 people were randomly assigned to write about friends with good or bad self-control. Those who wrote about a friend with good self-control did better on word identification tests related to self-control, the researchers found.

“I think the message is really two-fold,” vanDellen said of the research. “The first is, one way you can improve your behavior is by finding social networkers that support you.” It makes sense, she said, to seek out people you know have self-control if you want to boost your own.

The other message, she said, is accountability. The research suggests that others aren’t just watching your behavior when you show a lack of self-control but might actually be influenced by it. If a woman’s husband is trying to lose weight, for instance, the last thing she should do is act like a lazy person who doesn’t exercise in front of him, she said.

The research findings make sense, said Connie Diekman, director of university nutrition at Washington University in St. Louis. “Surrounding yourself with motivated, healthy people improves your odds of staying in control,” she said.

Diekman said that’s certainly the case with healthy eating. “When it comes to making healthy choices, we know that it is easier to skip dessert, limit portions or purchase the right foods if others we are with support these behaviors,” she said.

SOURCES: Michelle R. vanDellen, Ph.D., visiting assistant professor of psychology, University of Georgia, Athens; Connie Diekman, R.D., director, university nutrition, Washington University, St. Louis; Dec. 15, 2009, Personality and Social Psychology Bulletin, online

People with severe forms of the inflammatory skin disease psoriasis are more likely to die of heart-related causes and stroke than those without the condition, new research shows.

In fact, for people with the severe form of psoriasis, the condition is a bigger risk factor for heart- and stroke-related death than high blood pressure, Dr. Joel M. Gelfand of the University of Pennsylvania School of Medicine in Philadelphia, one of the researchers on the study, told Reuters Health.

The findings “should be a very strong message” for people with severe psoriasis to get other risk factors like high blood pressure, high cholesterol, and excess weight under control, Gelfand said.

In psoriasis, cells build up on the skin surface and form itchy and sometimes painful scales and red patches. Joint inflammation may also occur. Up to one in 25 of adults have psoriasis, and about one in five of those have severe disease that warrants treatment with powerful inflammation-suppressing drugs like methotrexate.

Because such drugs carry a high risk of side effects, Gelfand noted, most people with severe psoriasis actually go untreated. “In the last 10 years or so there’s been an explosion in new drugs approved for psoriasis,” he added. “They’re too new to know what their full use will be in the psoriasis population.”

Gelfand and his colleagues first reported in 2006 that severe psoriasis upped a person’s heart attack risk. The illness has since been linked to an increased risk of stroke.

In the current study, he and his colleagues matched 3,603 patients with severe psoriasis to 14,330 people who were free from the disease and followed them for about three years, on average. Three percent (108) of those with severe psoriasis died of heart- or stroke-related causes, compared with about two percent (301) of those without psoriasis.

People with severe psoriasis were nearly 60 percent more likely to die of causes related to heart disease or stroke than those without the disease, the researchers found.

Even once Gelfand and his team accounted for smoking, high blood pressure, and diabetes, the psoriasis patients’ risk of death due to these causes was still 57 percent higher, suggesting that the skin disease in and of itself was the link.

This meant that there was one extra death per 283 people with severe forms of psoriasis per year, compared to those without the disease.

The relationship among factors that increase heart and blood vessel disease risk and psoriasis is very complex, Gelfand noted; for example, smoking and obesity both boost psoriasis risk, while people with psoriasis are known to be more likely to develop diabetes, which in turn ups heart disease risk.

Genes that make people susceptible to psoriasis have been linked to heart disease as well, he added, and the type of inflammation associated with heart- and stroke-related disease is very similar to that involved in psoriasis.

Teasing out the reasons for the link, and figuring out whether treating psoriasis could reduce heart disease risk, will require more research, he and his colleagues conclude.

SOURCE: European Heart Journal

Videos that depict different options for end-of-life care may help terminally ill cancer patients decide on what they want, a new study suggests.

Research shows that only a minority of cancer patients complete documents on advance care planning — and that even when doctors and patients have discussions on end-of-life care, poor communication and patients’ lack of medical knowledge remain significant obstacles.

“There are well known communication barriers in the patient-doctor relationship,” Dr. Angelo E. Volandes, the senior researcher on the new study, told Reuters Health in an email.

Using video to supplement end-of-life discussions “helps surmount some of these barriers,” said Volandes, of Harvard Medical School and Massachusetts General Hospital in Boston.

For their study, Volandes and his colleagues randomly assigned 50 patients with malignant glioma — a form of brain cancer with a typically poor prognosis — to one of two groups. Patients in one group were given only a verbal description of their options for care once their cancer had become “very advanced,” while those in the other group also watched a video.

The video depicted images of three general choices for end-of-life care. One was life-prolonging care, which aims to extend patients’ lives “at all costs,” including giving cardiopulmonary resuscitation (CPR) for cardiac arrest and using a mechanical ventilator when patients can no longer breathe on their own.

A second option was basic medical care — which includes, for example, antibiotics to treat infections and hospitalization if needed, but no extraordinary measures to save the patient’s life.

The third option was “comfort care,” where patients are given pain medication, supplemental oxygen and other measures to make them comfortable in their last days — usually outside of a hospital, and often at home.

Volandes and his colleagues found that patients who received verbal information alone were fairly divided on what they wanted. Just over half preferred basic medical care, while one-quarter wanted life-prolonging measures, and only 22 percent preferred comfort care.

In contrast, 91 percent of patients in the video group said they would want comfort care. None preferred life-prolonging care, the researchers report in the Journal of Clinical Oncology.

In addition, the researchers found, patients in the video group showed greater gains in their knowledge of their care options and had higher scores on a measure that gauged patients’ certainty in their choices.

Both of those measures, Volandes said, “support the conclusion that patients had more knowledge when they were making their decisions. And when people had more knowledge of the goals of care, they preferred less aggressive care.”

Videos may help patients’ decision-making simply because pictures often speak louder than words, according to Volandes.

“Videos give more accurate pictures of what these interventions entail and of their success rates,” he noted. “Words often do not capture the clinical reality. Pictures often do speak a thousand words.”

The study findings come at a time when the costs of end-of-life care are being debated. A study earlier this year in the Archives of Internal Medicine found that terminally ill cancer patients who had end-of-life discussions with their doctors typically chose fewer aggressive measures and had lower healthcare costs near the end of life than those who did not have such discussions.

The researchers said that as U.S. policy makers look for ways to rein in healthcare costs, end-of-life care deserves a closer look. They estimated that if half of the U.S. adults who died of cancer in 2008 had an end-of-life discussion with their doctors, the projected savings would be at least $77 million.

Whether videos ultimately facilitate more of those doctor-patient conversations remains to be seen. Larger clinical trials of patients with different forms of cancer and more-diverse backgrounds are needed, Volandes said.

He and his colleagues will launch such a study next year.

American teens believe that smoking cigarettes is riskier than using illicit drugs or binge drinking, a new government report shows.

That perception may increase the likelihood that they’ll experiment with alcohol or illegal substances, the report authors said.

“We are on the right track with cigarette smoking and need to keep raising awareness among teens about the dangers of other substances,” Pamela S. Hyde, administrator of the Substance Abuse and Mental Health Services Administration (SAMHSA), said in a news release from the agency. “Understanding that perception of harm is a strong predictor of potential substance use among young people can help guide the development of substance prevention messages.”

Responses from 44,979 adolescents, aged 12-17, who took part in the 2007 and 2008 SAMHSA National Survey on Drug Use and Health showed that teens’ perception of cigarette-related risk was constant among all groups, but there was considerable age- and gender-related variation in perception of risk associated with other types of substances.

Among the key findings:
Nearly 70 percent of all respondents believed smoking one or more packs of cigarettes per day posed a major health risk.
Only 40 percent of participants believed binge drinking (having five or more drinks of alcohol once or twice a week) posed a major risk, and only 34.2 percent thought smoking marijuana once a month posed a major risk. Using cocaine once a month was seen as highly risky by 49.7 percent of the adolescents, while 50.9 percent believed using LSD once or twice a month was highly risky.
Girls were more likely than boys to associate great risk with smoking one or more packs of cigarettes a day, having five or more drinks of alcohol once or twice a week, and smoking marijuana once a month.
Boys were more likely than girls to perceive great risk from trying heroin once or twice.

Scientists have indentified all the changes in cells of two deadly cancers to produce the first entire cancer gene maps and say the findings mark a “transforming moment” in their understanding of the disease.

The studies by international scientists and Britain’s Wellcome Trust Sanger Institute are the first comprehensive descriptions of tumour cell mutations and lay bare all the genetic changes behind melanoma skin cancer and lung cancer.

“What we are seeing today is going to transform the way that we see cancer,” Mike Stratton of the Sanger Institute’s cancer genome project told a briefing in London. “We have never seen cancer revealed in this form before.”

The scientists sequenced all the DNA from both tumour tissue and normal tissue from a melanoma patient and a lung cancer patient using a technology called massively parallel sequencing. By comparing the cancer sequences with the healthy ones, they were able to pick up all the changes specific to cancer.

The lung tumour carried more than 23,000 mutations and the melanoma had more than 33,000.

Peter Campbell, also of the Sanger Institute, said the lung cancer study suggests a typical smoker develops one mutation for every 15 cigarettes smoked and the damage starts with the first puff. Lung cancer kills around 1 million people worldwide each year and 90 percent of cases are caused by smoking.

“These catalogues of mutations are telling us about how the cancer has developed — so they will inform us on prevention — and they include all the drivers, which tell us about the processes that are disrupted in the cancer cell which we can try and influence through our treatments,” Stratton said.

But the scientists said identifying all the drivers — the mutations that cause cells to become cancerous — would take far more work and it could be several years yet before any new targets are found for the development of new cancer drugs.

“Somewhere among the mutations we have found lurk those that drive the cells to become cancerous,” said Andy Futreal, who worked on the research published in the Nature journal. “Tracking them down will be our major challenge for the next few years.”

Scientists have already identified some genetic mutations linked to cancers — mutations of a gene called BRAF are found in melanoma and new drugs to block its cancer-causing activity are already in development. Drugs such as Roche AG’s Herceptin and AstraZeneca’s Iressa also target tumour cells that carry specific mutations.

Stratton said the aim now was to produce genetic maps of all types of cancer. There are more than 100 cancers in all, and each genome mapping process requires several months of work and costs tens of thousands of dollars.

The first 50 cancers are to be mapped by scientists in the International Cancer Genome Consortium, launched in 2008, which includes the U.S. National Institutes of Health and groups from Australia, Canada, China, France, India, Japan and Singapore.

Experts said this was a first glimpse of the future of cancer medicine. With ever improving technology to map genomes, and costs falling fast, the scientists said in future each cancer patient could have a complete genome catalog to help doctors pick the right treatments for individual cases.

“As more cancer genomes are revealed by this technique, we will gain a greater understanding of how cancer is caused and develops, improving our ability to prevent, treat and cure cancer,” Elizabeth Rapley of the Institute of Cancer Research said in a statement.

People with schizophrenia and other psychotic disorders are more likely to die of heart disease than mentally healthy individuals, a study in US veterans indicates.

While the fact that people with psychosis were more likely to smoke and be inactive accounted for much of the difference, it didn’t explain all of it; it’s likely that the isolating, debilitating nature of the mental illness itself is also a factor, Dr. Amy M. Kilbourne of the VA Ann Arbor Health System in Michigan, the lead author of the study, told Reuters Health.

People with serious mental illness die decades earlier than their mentally healthy peers, Kilbourne and her team note in their report. To understand the role of heart disease in shortening the lifespan of mentally ill individuals, they looked at nearly 150,000 vets who had completed a 1999 survey.

Just 11 percent had never been diagnosed with a mental disorder, while 15.5 percent had schizophrenia, 10 percent had bipolar disorder, 5 percent had psychotic symptoms but hadn’t been diagnosed with schizophrenia, 24 percent had major depression, and 34.5 percent had other types of depression.

Within 8 years, 8 percent of the study participants had died of heart disease. Individuals with psychosis were nearly twice as likely to die of heart disease during follow-up compared to those who’d never been diagnosed with a mental disorder.

People with schizophrenia, depression and bipolar disorder also were at increased risk of dying from heart disease, but for individuals with depression or bipolar illness, behavioral factors such as smoking and lack of physical activity accounted for all of the excess risk.

But even after these factors were taken into account, people with schizophrenia were still 17 percent more likely to die of heart disease, while people with other psychotic disorders were at 30 percent greater risk.

The individuals who had psychotic symptoms — indicating a loss of touch with reality — but who didn’t have schizophrenia may have been suffering from dementia or had experienced episodes of delusions or hallucinations for other reasons, Kilbourne noted.

“Just having an unstable life … because of psychotic symptoms really gets in the way of people living a full life,” the researcher said. “Having symptoms of psychosis really puts people in a vulnerable situation. It’s really difficult for them to navigate a health care system, to talk to a health care provider about what their needs are, to take care of themselves.”

To help people with serious mental illness, Kilbourne added, it’s important to offer them a “medical home,” a place where all their health care needs can be met. This care must address the whole person, she said, not just his or her mental problems, and should also include health behavior change education. The VA is currently implementing all of these approaches in caring for vets with mental illness, the researcher said.

In a Health Behavior News Service release accompanying the study, Dr. Eric Goplerud, director of the Center for Integrated Behavioral Health Policy in Washington, said the issue of cardiovascular disease in this population is “huge.”

“As we look at national health reform, it is absolutely critical that people with mental illness and addictions be included — they are dying of preventable medical conditions,” Goplerud said.

Combining the antacid Prilosec with the popular blood thinner Plavix (clopidogrel) can cut the effectiveness of Plavix by half, putting patients at risk for heart attack or stroke, U.S. health officials said Tuesday.

“These recommendations are based upon recently submitted studies by the manufacturer of clopidogrel [Sanofi-Aventis and Bristol-Myers Squibb],” Mary Ross Southworth, deputy director for safety with the U.S. Food and Drug Administration’s Division of Cardiovascular and Renal Products, said during a morning press conference.

“The results of those studies are to avoid the combination of those two medications,” she said, adding that the tandem should be avoided even if the two drugs are taken hours apart.

Combining the two drugs is common because Plavix can upset the stomach. The FDA said patients taking Plavix can take alternatives to Prilosec, such as Mylanta, Maalox, or Zantac, Southworth said.

Prilosec is in a class of drugs called proton-pump inhibitors (PPIs). Prilosec was singled out because it was the only PPI tested in studies submitted by the manufacturer of Plavix, Southworth said.

However, proton-pump inhibitors similar to Prilosec — such as Aciphex, Nexium, Prevacid and Protonix — should also be avoided when taking Plavix, Southworth said.

Other drugs that may also interact with Plavix, making it less effective include: cimetidine (Tagamet), fluconazole (Diflucan), ketoconazole (Nizoral), voriconazole (Vfend), etravirine, felbamate (Felbatol), fluoxetine (Prozac), fluvoxamine (Luvox), and ticlopidine (Ticlid), according to the FDA.

Results of a study presented Monday at the American Heart Association’s annual meeting in Orlando, Fla., also found that people taking the acid reflux drugs Prilosec or Protonix in combination with blood thinners such as Plavix had a higher risk for death after angioplasty than people who didn’t take the two popular antacids.

In January, Sanofi and Bristol-Myers updated Plavix’s labeling to advise against using it in combination with certain heartburn drugs, the Associated Press reported.

On Tuesday, Sanofi spokeswoman Noelle Boyd said the company had bolstered that language labeling. “We’ve strengthened the label to say that these drugs should be avoided altogether, not just discouraged,” she said.

The good news is that a new report shows the percentage of American adults with high LDL cholesterol, the “bad” kind that clogs arteries, decreased by about one-third between 1999 and 2006.

The bad news is that too many of those who have dangerously high levels of LDL cholesterol don’t know it, said study author Dr. Elena V. Kuklina, an epidemiologist and senior service fellow at the U.S. Centers for Disease Control and Prevention. Her research is published in the Nov. 18 issue of the Journal of the American Medical Association.

“In the group with high LDL cholesterol, 60 percent of these people do not know they have this condition,” Kuklina said. “They are in two major groups — those who have never been screened, and those who have been screened but not diagnosed.”

It is not as easy to test for LDL, rather than total blood cholesterol levels, including “good” HDL, Kuklina said. An LDL test requires fasting for the previous eight hours, “and if you are not prepared for this test, it is not going to be correct,” she said. But testing someone and then not informing that person of a dangerously high LDL cholesterol level is not easy to explain, she said.

While many studies have found that overall cholesterol levels in American adults are decreasing, there has not been much information on LDL levels, Kuklina said. The study she did with colleagues at the CDC used data from consecutive results of the National Health and Nutrition Examination Survey. It found that overall prevalence of high LDL cholesterol levels decreased from 31.5 percent in 1999-2000 to 21.2 percent in 2005-2006.

But there is no single definition of high LDL, the report noted. For persons at high risk of major problems because they have diagnosed heart disease, stroke or other cardiovascular conditions, the desired LDL level is 100 milligrams per deciliter of blood. For those at intermediate risk because they have two or more risk factors, such as diabetes, high blood pressure, smoking or a family history of heart trouble, the desired level is 130. For those at low risk because they have no more than one risk factor, the desired level can be as high as 160.

A troubling finding was that the greatest incidence of dangerously high LDL cholesterol is in the high-risk group. The prevalence of high LDL did decrease in that group, but only from 69.4 percent in the first survey to 58.9 percent in the last survey, the study authors reported.

As for the cause of the overall reduction, “we don’t know why, we can only speculate,” Kuklina said. It could be changes in lifestyle, such as better diet, or it could be more widespread use of cholesterol-lowering medications such as statins, she said.

“But we still have many people we could put on statins,” Kuklina noted.

It’s important to remember that LDL cholesterol is just “one of many risk factors for cardiovascular disease,” said Dr. Thomas A. Gaziano, an assistant professor of medicine at Harvard Medical School and an associate physician at Brigham and Women’s Hospital, and co-author of an accompanying editorial.

Doctors must consider all the risk factors when dealing with cardiovascular disease, Gaziano said. “We recommend simplifying how the risk is calculated,” he said. “Once the risk is determined, therapy should be based on overall risk, not just on cholesterol.”

There are different recommendations about the age at which cholesterol screening should begin, Kuklina noted. The CDC, the National Heart, Lung and Blood Institute and the American Heart Association recommend that screening tests should start at age 20, she said.

“I don’t think it unreasonable to get screened once in the 20s, and then with increasing frequency in the 30s,” Gaziano said.

Surging obesity rates, especially among children, may be putting the brakes on progress made in the past few decades against heart disease, researchers report.

And it doesn’t help that many obese or overweight Americans still consider their weight “normal,” as one study found.

One of several studies on the subject of obesity presented Tuesday at the American Heart Association (AHA) annual meeting in Orlando, Fla., found that adults’ blood pressure and blood sugar levels are continuing to rise, fueled in large part by expanding waistlines.

This is swamping recent heart-health improvements such as lowered blood levels of LDL (”bad”) cholesterol or fewer people smoking, experts said.

Poring over government data between 1988-1994 and 2005-2006, researchers found that adult Americans’ average body mass index (BMI) rose from 26.5 to 28.8 over that time span. To put that in context, a BMI of 25 marks the beginning of overweight, while doctors use a BMI of 30 as the threshold for obesity.

More people did achieve optimal LDL levels (22 percent versus 28 percent) and were non-smokers (rising from 45 percent to 50 percent) during the same time period, but those gains were outweighed by fewer people having good blood pressure (48 percent versus 43 percent) or blood sugar control (falling from 67 percent to 58 percent).

In fact, “many people feel the decline in [heart] risk factors is leveling off and there will be an acceleration of cardiovascular disease,” said AHA spokesman Dr. Roger Blumenthal, professor of medicine in the division of cardiology at Johns Hopkins School of Medicine in Baltimore.

Things don’t bode well for the next generation, either: U.S. Centers for Disease Control and Prevention statistics now put the number of obese children and teens in the United States at about one-third.

“The prevalence of obesity and oversight in the U.S. and all developed countries is on the rise and reaching epidemic proportions among both adults and children,” said Dr. David Crowley, lead author of a study on child obesity and a cardiology fellow at Cincinnati Children’s Hospital. “In the course of the past three decades, the prevalence of obesity has doubled or in some cases tripled across all pediatric age groups.”

Not only have children and teens become heavier, their hearts have become unhealthily thicker, as measured by left ventricular mass (LVM), indicating a higher risk for heart disease down the line.

“Left ventricular mass is a marker of stress on the heart and a predictor of heart attack and stroke,” Crowley explained.

Between the mid-1980s and today, average BMIs in this sample of children went from 18.1 to 19.9, while LVM jumped from 31.4 to 32.7. Males and blacks fared worse than their female and/or white peers.

There were nearly twice as many overweight and obese children in the later period compared to the earlier era: 35 percent versus 20 percent. And the number of children with abnormally thick hearts more than doubled, Crowley reported.

“The obesity epidemic is indeed having adverse effects on the hearts of children compared to two decades ago,” he said. “Today’s children have higher BMI and higher LVM and therefore are at a higher risk of heart attack and stroke. If we do not get a handle on this in this country, if kids continue to get heavier, their hearts will inevitably get thicker and kids will be at higher risk of heart attacks and stroke.”

Simple denial may be a component of this disaster, speculated a third study. It found that a large proportion of obese people believe their body size is normal and that they don’t need to shrink. Some even believe they could safely gain more weight.

Almost one in 10 surveyed said they were okay with the size of their bodies after picking from a series of silhouettes the one they felt best represented their image of themselves.

This same group also thought they were healthy, even though many of them had risk factors for heart disease such as diabetes or high blood pressure.

Ironically, individuals who were actually average or thin thought they were larger than they really were.

“Obesity is not benign,” noted study lead author Dr. Tiffany Powell, a cardiology fellow at the University of Texas Southwestern Medical Center in Dallas. “This underscores the need for us as physicians to understand that we not only need to target those who have misperceptions in clinical settings, but we also need to do work at developing community programs targeting those who avoid the health-care system,” Powell said.

“From our data, it looks like those who have misperceptions of body size are much less likely to be seen by physicians,” she added.

Two other groups of researchers at the AHA meeting presented yet more reasons to lose weight. In one study, obese patients who lost weight saw a healthy normalization of the chambers in the right side of the heart (although it’s unclear if this results in decreased risk for actual heart problems). And in another study, weight-loss surgery reduced the size of enlarged hearts. Enlarged hearts carry with them the risk of heart failure.