health

Families Living in Older Homes Should Check for Lead Paint

Ask the Doctors by by Eve Glazier, M.D. and Elizabeth Ko, M.D
by Eve Glazier, M.D. and Elizabeth Ko, M.D
Ask the Doctors | December 24th, 2016

Dear Doctor: We live in a charming older home, but some of the paint looks old. How worried should I be that it might contain lead?

Dear Reader: You're right to be concerned about the possible presence of lead-based paint in your home. Even in small quantities, lead is toxic to humans and animals. Children under the age of 6 and pregnant women are particularly susceptible to the ill effects of lead.

Children who have ingested lead may suffer from hyperactivity, lowered IQ, anemia, impaired growth and hearing problems. In pregnant women, the presence of lead can slow the growth of the fetus, cause nerve or brain damage to the unborn child, and even lead to premature birth.

Long-term exposure to lead can cause serious physical and neurological problems in adults as well. High levels of the toxic metal are associated with damage to the kidneys, brain, bone marrow and blood, as well as fertility problems and nerve disorders.

If your home was built before 1978, the Environmental Protection Agency warns that yes, there's a strong chance it contains lead-based paint. Homes built after 1978, the year a federal ban on lead-based paints went into effect, are considered to be safe.

The probability of finding lead-based paint in your home increases along with its age. Homes built between 1960 and 1977 have a 24 percent chance of containing lead-based paint. That number spikes to 69 percent for homes built between 1940 and 1959. Homes that predate 1940 have a whopping 87 percent probability of containing lead-based paint.

So are you and your family at risk? Fortunately, even if you've found lead-based paint in your home, there's good news.

When it's intact and in good condition, lead-based paint is usually not harmful, according to the EPA. To remain safe, you should regularly check your home for deteriorating paint and immediately address any issues. You can go a step further and, by covering lead-based paint with new paint, drywall or wallpaper, you will stabilize it and protect it from damage.

Problems arise because as it ages, lead-based paint chips, cracks, peels and crumbles. The resulting particles mix easily with household dust and get distributed throughout the house.

Since kids tend to explore the world with their mouths, the chance that they'll ingest lead from older paint that is deteriorating is high. Sweeping, vacuuming or even a breeze from an open window can make lead-filled dust go airborne where your family and pets can inhale and absorb it.

To know whether or not the paint you are worried about contains lead, you can purchase a test kit at a hardware store or hire a certified inspector. If you plan to remove the paint or to do major renovations, it's important to use a certified contractor who will know proper abatement procedures.

Federal guidelines recommend that children who live in or regularly visit a home with lead-based paint be tested for lead levels in their blood. For children, this test is performed at 12 months of age. The health effects of lead are not reversible, so vigilance is your best protection.

(Eve Glazier, M.D., MBA, is an internist and assistant professor of medicine at UCLA Health. Elizabeth Ko, M.D., is an internist and primary care physician at UCLA Health.)

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095.)

health

Small Servings of Rice Cereal Should Be Fine for Infants

Ask the Doctors by by Eve Glazier, M.D. and Elizabeth Ko, M.D
by Eve Glazier, M.D. and Elizabeth Ko, M.D
Ask the Doctors | December 23rd, 2016

Dear Doctor: I want to start feeding my baby solid food, but I read that rice cereal is contaminated with arsenic. What should I do?

Dear Reader: Your concern is understandable. The inorganic form of arsenic, found throughout nature in both the soil and water, is highly carcinogenic -- leading to an increased risk of bladder, skin and lung cancers. Areas with high levels of arsenic in the drinking water, such as Bangladesh, see higher rates of some cancers as a result.

In the United States, arsenic levels in drinking water are tightly regulated, which limits our overall risk from arsenic. That doesn't mean we're not exposed, however. Inorganic arsenic is still prevalent in our environment, and organic arsenic, which is much less toxic, can be found in most plants and animals in small amounts.

Rice poses a particular risk, as it concentrates inorganic arsenic more than other types of foods do. That's because rice is grown in stagnant water, which leads to conditions of low oxygen and allows arsenic to dissolve more easily into the water. The rice plant then more readily absorbs the arsenic. In fact, the level of uptake is 10 times that of wheat or barley.

The amount of arsenic in rice depends upon the type of rice and where it was grown. Rice grown in California appears to have less arsenic then rice grown in Texas and Louisiana. Sushi rice and basmati rice have lower amounts of arsenic, while organic brown rice concentrates more arsenic.

Rice cereals have traditionally been used to transition infants from milk to more solid foods because, for the most part, rice is hypoallergenic and a good alternative for children with allergies or intolerance to wheat-based cereals. But no one wants to worry that the foods meant to help children grow might actually be harming them.

So what should be done? Focus on the total risk.

To that end, the European Food Safety Authority has created the benchmark lower-dose limit, meaning the dose that would increase the risk of cancer by 1 percent. Consuming more than 2 servings of rice cereal per day would equal this dose. So, if you are transitioning your child to solid foods and they're consuming 3 or 4 servings of rice cereal per day, you should reassess your child's diet. This is especially true if you feed your child organic brown rice.

A big caveat is that the specific risk of cancer from rice consumption is not known. Researchers have not studied the connection between rice consumption in infants and cancer. Although a study of 200,000 people, published in the International Journal of Cancer, found no link between rice consumption and cancer, infants can concentrate more arsenic due to their smaller size.

My sense is that if you're transitioning your child to solid foods, rice cereal at 1 to 2 servings per day should be fine. What may be better is to balance rice cereals with other types of cereals, such as barley cereal or oatmeal cereal. Even better than cereals can be foods such as bananas, egg yolks and pureed vegetables.

It may get a little messy, so be prepared.

(Robert Ashley, M.D., is an internist and assistant professor of medicine at the University of California, Los Angeles.)

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095.)

health

Eating Habits Now Will Affect How Kids Eat as Adults

Ask the Doctors by by Eve Glazier, M.D. and Elizabeth Ko, M.D
by Eve Glazier, M.D. and Elizabeth Ko, M.D
Ask the Doctors | December 22nd, 2016

Dear Doctor: My teenagers refuse to eat vegetables unless they're fried. Are they doomed to obesity and ill health?

Dear Reader: We wish we could reassure you and say it'll all be OK, but studies have long been clear on the matter. What your kids eat now will shape their health for years -- and maybe decades -- to come.

Poor eating habits have caused a spike in childhood obesity in the last few decades. Today, more than 17 percent of kids ages 2 to 17 qualify as obese. That's double what it was 20 years ago.

Being overweight has put young people at increased risk of all kinds of health problems and led to a sharp increase in the diagnosis of conditions such as diabetes, high blood pressure, elevated blood cholesterol, fatty liver, and even asthma and sleep disorders.

But before you confront your kids with a list of "don'ts," which teens are naturally primed to resist, be aware that the newest study on youth nutrition has some great news. It arms you with the information you need to right the nutritional course while encouraging your teens in a positive way.

Here's the gist: Young people who ate fruits, vegetables, lean proteins and whole grains, and who steered clear of sugar, red meat and processed foods, gained significantly less weight as they entered young adulthood.

The study, conducted by researchers at the University of Minnesota, followed the eating habits of 2,500 adolescents from the time they were 15 until they turned 25.

Researchers found that by eating well at age 15, young people developed the habit of good nutrition, and it carried on into their 20s and beyond.

The takeaway? You can guide your children to a more healthful adulthood by helping them establish good eating habits while they are in their teens.

Some strategies:

-- Stock the fridge with plenty of vegetables, fruits and whole-grain products.

-- Clear out the processed foods and the fatty, salty snacks.

-- Serve lean meats, poultry, fish, beans and legumes for protein.

-- Make sure that serving portions are a reasonable size.

-- Make the home a no-soda zone. This includes diet drinks.

-- Steer clear of sugar and sweets.

The goal is moderation, and your best chance at success is to get creative. Instead of being forbidden, let the fried foods your kids love become special-event treats. That way, they'll be less likely to feel deprived and sneak-eat. Cooking together -- scouting recipes, shopping, preparing the food and eating as a family -- can go a long way to cementing the new eating behavior.

Exercise makes a big difference, not just to teens but for adults as well. There's no better way than to lead by example. Start taking family hikes or bike rides. Pick out a local race to train for and set an in-family competition with personal goals and rewards.

If you market these changes as something that's fun for the kids and for yourself, you're far more likely to create healthy habits that will last for life.

(Eve Glazier, M.D., MBA, is an internist and assistant professor of medicine at UCLA Health. Elizabeth Ko, M.D., is an internist and primary care physician at UCLA Health.)

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095.)

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