how much should i eat?

I am a new recovering anorexic and I am trying to find out how much to eat... I was eating around 2,400 calories but I lost more weight. I am very active and I don't really want to drop my activity because it is so nice out and i'm a 15 year old kid who loves to run around. How many calories should I eat if I am trying to gain about 1-2 ibs a month (this retribution was suggested by my doctors) any help would be awesome! thanks!

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How much calories should I eat?

Hello everybody! I'm Detti, I'm 16 and I don't know how much calories should I eat one day? My aunt said 2500 is normal but I only ate 1000... what do you guys think? Please help.

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ADHD Drug Holidays: Should Your Kid Get One?

Experts debate the pros and cons of giving kids a break from ADHD drugs.

Are you considering giving your child weekends off or even a summer-long break from ADHD medications? 

It may work just fine. Your child may regain his appetite and catch up on his growth (some ADHD drugs may slow a child's height gains).

Then again, a so-called medication vacation may unleash the very behaviors that have been controlled so well by prescription drugs. That could put a strain on the child, you, and other caregivers. And there is some evidence that keeping a child on their ADHD medications will lessen symptoms better than stopping and starting.

Unfortunately, there is no one-size-fits-all answer. It comes down to what works best for you, your child, and your family. Doctors say it's easy to get on and off the stimulants that are typically prescribed for ADHD, which is characterized by hyperactivity, impulsivity, and/or inattention.

"The bottom line, it isn't harmful and it's part of personalization of care -- not to have a standard that fits all, but to have a flexible approach that meets the needs of the individual child and family," says psychiatrist Benedetto Vitiello, MD, who leads the Child and Adolescent Treatment and Preventive Intervention Research Branch at the National Institute of Mental Health in Bethesda, Md.

Here's what you need to know about the pros and cons of drug holidays.

About 5%, or around 3.5 million U.S. children aged 6-12, take stimulants such as Adderall, Concerta, Ritalin, and Vyvanse to control symptoms of ADHD, Vitiello says.

Another half million or so take nonstimulant prescription drugs -- such as Intuniv, Kapvay, and Strattera -- which work on the brain differently. Those should not be stopped, because they take longer to go to work and far longer to leave the body, says Mark Wolraich, MD, a pediatrician in Oklahoma City who helped write the latest ADHD treatment guidelines for the American Academy of Pediatrics.

If a child is taking nonstimulants, Wolraich says, ''You could do it [take a drug break] over the summer time, but not over the weekend.''

Stimulants, on the other hand, are quick acting and leave the bloodstream quickly. In other words, there are no withdrawal symptoms; so, there isn't a weaning period.

"On those meds, it's important to realize the treatments improve behavior and reduce symptoms," Wolraich says. "If you stop taking them, you revert to behaviors you saw before... stimulant medications don't build up in the bloodstream. That's why you can stop and start them.''

There are no good studies that tell how many children stop and start their medications. But of those kids who do, up to one-third "do OK with a drug holiday," Vitiello says.

You may be part of the majority of parents who notice an immediate change in your child when he's taking a break from his stimulant-type ADHD medication.

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Think You're Stressed? Maybe You Should Have Your Heart Checked

Those who thought pressure was affecting their health twice as likely to suffer heart attack, study says

By Steven Reinberg

HealthDay Reporter

THURSDAY, June 27 (HealthDay News) -- People who think stress is affecting their health may be setting themselves up for a heart attack, a new study contends.

The researchers found that these people had double the risk of a heart attack compared with people who didn't think stress was harming their health.

"People's perceptions about the impact of stress on their health are likely to be correct," said study author Hermann Nabi, a senior research associate at the Centre for Research in Epidemiology and Population Health at INSERM in Villejuif, France.

"They may need to take actions when they feel that it is the case," he added.

These findings have both clinical and theoretical implications, Nabi said.

"From a clinical perspective, they suggest that complaints of adverse impact of stress on health should not be ignored in clinical settings as they may indicate increased risk of developing coronary heart disease," he said.

From a theoretical perspective, the findings imply that the perceived impact of stress on health is a valid concept that should be considered in future studies aimed at examining the association between stress and health outcomes, Nabi added.

The report was published June 27 in the online edition of the European Heart Journal.

Dr. Gregg Fonarow, a professor of cardiology at the University of California, Los Angeles, said that "stress and reactions to stressful situations have been associated with increased risk of cardiovascular disease in many studies."

However, few studies have looked at whether an individual's perception of stress is associated with cardiovascular outcomes, he said.

And it's not clear if reducing stress would affect the risk for heart attack, Fonarow said.

"Further studies are needed to determine whether stress reduction or other risk reduction strategies can reduce cardiovascular events in men and women who perceive they are under stress that is adversely impacting their health," he said.

For the study, Nabi's team collected data on more than 7,000 men and women who took part in the Whitehall II study, which has followed London-based civil servants since 1985.

Participants were asked how much they felt that stress or pressure in their lives had affected their health. Based on their answers, they were placed into one of three groups: "not at all," "slightly or moderately," or "a lot or extremely."

Participants were also asked about their levels of stress and other lifestyle factors such as smoking, drinking, diet and physical activity.

The researchers also collected medical information, such as blood pressure, diabetes status and weight, and other data, including marital status, age, sex, ethnicity and socioeconomic status.

Over 18 years of follow-up, there were 352 heart attacks or deaths from heart attack.

After taking all of these factors into account, the investigators found those who said their health was a "lot or extremely" affected by stress had more than double the risk of a heart attack compared with those who said stress had no effect on their health.

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How should I respond when my 4-year-old tells a lie?

Posted June 27, 2013, 2:00 am

Lately my 4-year-old has started lying to me. She’ll say she didn’t break a toy, or push her brother, when I know she did. How should I handle this?

Almost all preschoolers will lie at one time or another — and it’s clear they know they’re lying, and that they shouldn’t be doing that. For example, when one child hits another and is challenged about it, here’s the usual sequence of lies: “I didn’t do it”; “I didn’t mean it”; “It didn’t hurt anyway!”

Each lie admits to the preceding lie. It’s as if the child realizes there’s no way he will get away with the lie, so his only hope is to dismiss the importance of the transgression.

Some preschoolers may not yet realize that it is wrong to lie. Now, at age 4, is the time to teach your child that lying is not acceptable. Doing so at a young age will help mold your child’s behavior as she gets older.

To encourage truthfulness when you suspect wrongdoing, be upfront but not confrontational as you question your child. For example, ask an open-ended question like, “How did your walls get crayon all over them?” rather than a closed-ended one like, “Did you scribble all over your walls?”

If your child has told a lie, keep your response short and to the point. Be sure to tell her first that you believe she has lied, and because of that, consequences will follow. If your child denies drawing on her walls, for example, you might say, “I know that you drew on your walls, as I saw you do it earlier today. It is never OK to lie to me. You won’t be able to play with your crayons for the rest of the day.” Do not ignore these seemingly small or harmless lies.

It is always helpful to praise your preschooler for being good, too. Compliment her when she tells the truth. Remind her: “I’m glad you told the truth about what happened. When you tell me the truth, I can trust you, and that makes me happy.”

Remember that children learn right from wrong by watching and listening to the adults around them, especially their parents. If they see you telling a little white lie, they will conclude that lying is acceptable. “Do as I say, not as I do” is never an effective strategy, especially when dealing with young children.

A colleague of mine at Harvard Health Publications has a daughter. We’ll call her Cleo, short for a certain very self-confident Egyptian queen. Like all kids, Cleo sometimes does things she knows she shouldn’t. And when challenged, she sometimes lies about it. But more often, she is refreshingly honest … and witty. Here’s a recent gem, as related by her mom:

Mom: “Cleo! You know you’re not supposed to throw a ball in the living room. Why on earth did you do that?”

Cleo: “I think it’s because I’m a kid, Mom.”

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Should I worry because my resting heart rate is high?

Posted June 24, 2013, 2:00 am

I’m a man in my 50s. I’m in good shape and I exercise regularly, but I have a high resting heart rate. Is this cause for concern?

Your heart rate changes from minute to minute. It depends on whether you are standing up or lying down, moving around or sitting still, stressed or relaxed. Your resting heart rate is how fast your heart beats when you are relaxed and sitting still.

To answer your question, there is cause for concern. Based on a recent study, even fit men with higher resting heart rates may have a higher risk of early death.

The study followed nearly 2,800 middle-aged men for 16 years. Men whose resting heart rates were 80 or more beats per minute died earlier, on average, than men with a resting heart rate of 65 beats per minute.

Experts have recognized the link between faster resting heart rates and heart disease and shorter lives for the past few years. Until recently, the leading explanation has been that resting heart rates in the 60 to 70 beats-per-minute range most often reflect better fitness. And with better fitness you are less likely to develop heart problems and more likely to live longer.

The new study found that higher resting heart rates meant shorter life expectancy — even in fit people. This was true even for men who exercised regularly when researchers factored in age and health habits.

Regular exercise does lower the resting heart rate. But even among regular exercisers, there are those with resting heart rates in the range of 55–75, and those with higher rates. In this study, those folks with higher rates were likely to die younger.

So what else causes a higher resting heart rate, besides not being fit? Genes and aging play a role. In my experience, there are some people who respond to the challenges of their daily lives by releasing a lot of the adrenaline hormone. Adrenaline raises heart rate, and constant high levels in the blood may make the heart more irritable.

People who smoke or drink too much alcohol generally have higher resting heart rates. Stress, medicines and medical conditions also influence heart rate.

Discuss your resting heart rate with your doctor at your next visit. In the meantime, you can start to lower your heart rate on your own:

Exercise more. When you take a brisk walk, swim or ride a bike, your heart beats faster during the activity and for a short time afterward. But exercising every day gradually slows your resting heart rate.Reduce stress. Meditation, tai chi and other stress-busting techniques can lower your heart rate over time.

There are medicines that can lower your heart rate. The most widely used are beta blockers. These medicines are effective in treating high blood pressure. In people with known heart disease, they reduce the risk of future heart problems.

To my knowledge, there are no studies of whether people who just have high resting heart rates would benefit from taking beta blockers.

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When should I expect results?

I started this process this week, after hitting an all time postpartum low of eating 20 cupcakes over the course of 24 hours... Weighing in around 156 pounds. I'm on day four after dieting and working out for a minimum of 10 minutes a day as well as exclusively breast feeding. By day 2 I was at 153.8 but now on day four it says I'm back at 156? The first few days I was so hungry I could hardly sleep at night so maybe I put myself in starvation mode? But yesterday I ate super close to my calorie Max and I weighed myself again today around 2 after working out and it says I'm back at 156? Should I be cutting more calories or is it just water weight? I'm lost... I can't cut to 1200 or anything like that because I'm nursing but even when I eat 2000 I still feel hungry all the time. Please help!

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Myth-buster: why you should definitely get a spray tan before your next holiday

I'm pretty pale. I sparkle in the light like Edward Cullen. There's nothing I love more than getting back from a holiday and having a bit of a golden glow (what better excuse to go make-up-free for a while?). But those first few days of stepping out into the sun, uncovered for the first time in a year, glowing brighter than the sun, can be terrifying. So surely a quick spray tan before your flight is the best option?

Many people think not. Several people I told I was getting a tan before my last holiday recoiled in horror. 'But won't it go streaky in the pool?' 'What if you come back paler than when you leave?' 'You know you can't tan through a spray tan, right?'

There are a lot of myths surrounding pre-holiday spray-tanning, so in the name of journalism (/wanting to be bronzed on day one of my Barbados holiday) I paid a visit to the brilliant Jules Heptonstall at St Tropez for an all-over spray of the new Sensitive tan. I boarded the plane 36 hours later looking perfectly bronzed. I was just hoping I'd come home looking exactly the same colour. 

                                                                                  ****

…I pretty much did. Maybe even more golden, in fact. And contrary to the copious warnings, my tan didn't go streaky, I did tan, and, most importantly of all, I didn't feel like Edward Cullen when I stepped out onto the beach on day one.

On previous holidays, I've felt so pale on arrival that I've been tempted to panic-tan (read: panic-burn). This is, obviously, a terrible idea. This year, because I already had a tan (whilst not real) I wasn't in such a hurry to get a bit of colour on my pasty limbs, so I was as careful as a pale-skinned English girl in Barbados should be (factor 30+ with hourly reapplication). The St Tropez colour gradually faded away while my sun tan built up underneath, switching places at an unnoticed point mid-holiday. It really was quite marvellous.

So there you have it: it isn't a bad idea to get a spray-tan pre-holiday. Need more convincing? St Tropez tanner to the stars Jules Heptonstall gives us his view on this issue (of unquestionable importance).

A lot of people think that getting a spray tan before going on holiday is a bad idea - why do you think that is and is it true or false?
False. Getting a spray tan before you go on holiday gives you that summer glow before you've had your week away - my clients describe it as 'taking the edge off'. It's important to remember that a spray tan will offer no protection from the sun and as your spray tan fades, your real tan will develop if you're out in the sun. A top tip is to use St. Tropez Aftersun Lotion, £15 with a hint of self tan - its creamy texture is brilliant for soothing your skin and it's enriched with self tan so it actually gives you a deeper glow. My holiday essential!

True or false, you can't get a tan through a spray tan?
False. A spray tan offers no protection from UVA or UVB rays, so you will still tan but you will also need to wear sun cream too.

How can you stop your tan going streaky in the sea/pool?
Don't go in the pool while your self tan is still developing - it's important to make sure you've washed off all the guide colour beforehand. I try to not go in the pool on the first day and use a sun cream that's formulated to work with a spray tan and keep it topped up for longer (St.Tropez SPF 30 With Tan Enhancer For Body, £20 - formulated with melanin activating ingredient Melanobronze as well as being designed not to strip a spray tan).

Is there a risk that you'll come back paler than you left?
It all depends on how much tanning in the sun you are wanting to do! If you are tanning every single day on your holiday you'll come back with a deeper tan, but if you're holiday is more of a night time break, then you'll come back slightly paler. If it's a worry, just apply a bit of St. Tropez Self Tan Mousse, £20.43 the night before you're due to go back to work - no one will ever know the difference!

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Should You Aim To Weigh What You Did 20-30-40 Years Ago?

Here is something I have been curious about for a long time.  It relates to setting your target weight.  

The question is, should you have, as a goal, to weigh what you did when you were much, much younger?  

(Obviously, this pertains only to those of us who are well beyond the spring chicken phase of life.  Presumably no-one in their twenties has the goal of returning to their pre-teen weight.)

On the one hand, it seems logical that at 40 and 50 and 60 y/o, there is no reason why we should weigh more than we weighed at 30 y/o.  Our skeletons haven't grown much, our organs neither, and we're not often more muscular than when we were in our prime.  The numbers say, why not? 

On the other hand, when I think about what I used to weigh, it seems sort of impractical.  At 30 y/o, I weighed 162 lb.  That is 18-19 lb less than I weigh today.  In theory, I could get there - it would take being about 12-15% body fat.  In practice . . . ?  I feel like I'd have to work like hell to get there, throw out everything in my closet, and then have to whip myself daily to stay there.   

What do you think - for yourself?  Are you (again, I'm mostly talking to the more venerable among us) aiming for your weight of 1990 or 1980?  Why, or why not?  What is your decision process? 

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Should I be worried about the new kind of “bird flu” discovered in China?

Posted June 17, 2013, 2:00 am

I heard that a dangerous new kind of “bird flu” was recently discovered in China. Should we in the United States be worried?

You’re right: In March 2013, cases of a brand-new kind of bird flu were discovered in China. One of the hardest things to predict is what will happen when a new strain of the influenza (“flu”) virus first infects humans. I’m not exaggerating when I say it could turn out to pose no threat at all in the U.S., or it could be truly terrible.

The world is full of different flu viruses. Most of them infect just animals, often just one type of animal. Sometimes they are able to jump from one type of animal to another. Sometimes they are even able to jump from animals to humans.

Flu viruses are so unpredictable because they are constantly changing or mutating their genes. (Genes are sections of DNA that control specific characteristics of an agent, such as a flu virus.) They also are constantly swapping their genes with the genes of other flu viruses. When they change or swap their genes, they change their character.

There are two questions to ask about the character of every new flu virus that affects humans: how easily is it spread from one person to another, and how sick does it make the people it infects? Its assortment of genes determines the answer to those questions.

When a new virus spreads easily between people, and if it makes people very sick, there is a lot to worry about.

How bad can a flu virus be? The worst flu outbreak for which we have good records occurred in 1918. A new virus was born that spread easily between people and made people very sick. In the course of a few months, 30 percent of the people in the world caught the virus, and at least 20 million people died. That’s more than were killed in World War I.

From what we know about this new flu virus, called H7N9, it has jumped from chickens and ducks to humans in eastern China. It is not yet clear whether it has spread from one human to another. It has made some people very sick and there have been several deaths.

The latest numbers were reported by the U.S. Centers for Disease Control and Prevention (CDC) on April 29, 2013. China had reported 126 human cases of the new flu. The people affected have been older (average age in their 60s), and many have had chronic illnesses. So far, many fewer children and young adults have been infected.

The CDC and scientists at the National Institutes of Health (NIH) are working overtime to protect our health. They are doing what they can despite the fact that the funding for these two critically important federal agencies has been cut by the “sequester.” Regardless of what you think about federal spending in general, if you are against cutting funding for health research and public health, your representatives in Congress can do something about that.

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Should I go or not?

Hi,

I recently contacted a local IP centre for anorexia. I'm 16, and have a BMI of 17. I've been struggling for 2 years with this illness and I've recently been extremly depressed. I have an appointment today, and I don't know if I should take the option fo going IP if they offer it.

What I mean is, there may be people who need to go IP a lot more than I do - I'm not too underweight... I don't want to be selfish about it and take an unnecessary treatment option.

Should I go or not?

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Should I take steroids for my chronic sinus infections?

Posted June 12, 2013, 2:00 am

I have chronic sinusitis and nasal polyps. My specialist suggested trying oral corticosteroids. What do you think?

“Steroids” is short for anti-inflammatory hormones called corticosteroids, and “oral” means steroids taken in pill form. I think a short course of five to seven days of oral steroids is worth a try. That’s particularly true if your sinusitis isn’t getting any better. My colleague, Neil Bhattacharyya, an ear, nose and throat doctor and professor at Harvard Medical School, agrees. Much of what I say below is based on his advice.

As you know, sinusitis is an inflammation of the mucous membranes that line the sinuses. It often causes headaches and an uncomfortable feeling of pressure in the face. (I’ve put an illustration of how sinusitis works below.)

Sinusitis is inflammation of the mucous membranes that line the sinuses.

Chronic inflammation in the membranes of your nose and sinuses can cause fleshy growths called polyps. Not all cases of chronic sinusitis result in polyps, but when they form, polyps can block your nasal passages and sinuses. This makes breathing more difficult and can diminish your sense of smell. Polyps also make it easier for infections to start in your sinuses.

I assume you’ve tried the usual techniques for dealing with sinusitis: inhaling steam, taking extra-long showers, drinking lots of water and sleeping with your head elevated. A course of antibiotics is also often appropriate if there are clear signs of bacterial infection in your sinuses (such as green or brown discharge when you blow your nose, a fever and a rotten feeling).

Once sinusitis becomes chronic, the inflammation can take on a life of its own. Corticosteroids become an important treatment option, as they have anti-inflammatory effects.

The first type of steroid to try is one that can be inhaled into the nose. Inhaled steroids deliver the medicine directly to the inflamed tissues that need to be quieted. However, polyps can block the passage of the inhaled steroids to some of the inflamed areas.

If inhaled steroids don’t do the job, it’s worth considering a brief course of steroids in pill form. Taking an oral steroid such as prednisone for a week or so reduces the size of the polyps a little and decreases overall inflammation in the nose. Shrinking polyps and reducing inflammation allow the topical steroid to reach its target and be more effective.

The reason I and many doctors hold off on using steroids in pill form is that the medicine travels in the blood, exposing the whole body to the medication. (In contrast, topical steroids expose only the nose and sinuses.) Side effects are more likely from oral steroids than from inhaled steroids; they may include elevated pressure in the eyes (glaucoma), increased blood pressure and mood swings. But in my experience, a short course of oral steroids, such as what I’m recommending here, rarely produces serious side effects.

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To Stop Smoking, Teens Should Start Moving

FRIDAY, April 12 (HealthDay News) -- A small amount of daily exercise can help teen smokers cut down on or quit their harmful habit, according to a new study.

Researchers looked at 233 teens at 19 high schools in West Virginia, which has one of the highest smoking rates in the nation. Nearly 13 percent of people under age 18 in the state are smokers, according to the U.S. Centers for Disease Control and Prevention.

All the teens in the study were daily smokers who smoked an average of half a pack a day on weekdays and a pack a day on weekends. They also had other unhealthy behaviors.

"It is not unusual for teenage smokers to engage in other unhealthy habits. Smoking and physical inactivity, for instance, often go hand in hand," study lead author Kimberly Horn, associate dean for research at the George Washington University School of Public Health and Health Services, in Washington, D.C., said in a university news release.

The teens in the study were divided into three groups: one group took part in a smoking cessation program combined with a fitness program, another group took part in the smoking cessation program only and the third group heard only a short antismoking lecture.

All of the teens increased their amount of daily physical activity just by being in the study. Those who increased the number of days in which they did at least 20 minutes of exercise -- equivalent to a short walk -- significantly reduced the number of cigarettes they smoked.

Teens were more likely to quit smoking if they took part in the combination smoking cessation and fitness program and increased the number of days in which they did at least 30 minutes of exercise, according to the study, which was published online April 9 in the Journal of Adolescent Health.

"This study adds to evidence suggesting that exercise can help teenagers who are trying to quit smoking," Horn said.

-- Robert Preidt
Copyright © 2013 HealthDay. All rights reserved. SOURCE: George Washington University, news release, April 9, 2013

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ADHD: 7 Life Skills Your Teen Should Master

You probably take some life skills for granted, like knowing when to wake up for work or take your medicines, and how to balance your checkbook. Yet to a teen with ADHD, those tasks can become huge hurdles.

Kids with ADHD tend to be much slower than their peers to learn how to organize, plan, and prioritize, says Cindy Goldrich, EdM, ACAC. She is a certified ADHD coach and parenting specialist with PTS Coaching in Long Island, N.Y.

Kids and teens with ADHD know what they need to do. They just have trouble doing it.  

"This is not a challenge of intelligence, this is a challenge of performance," Goldrich says. "They need more structure and more skill support."

With college or a first job on the horizon, here are seven life skills you need to start teaching your child today.

You may have gotten used to doing everything for your teen. Break that habit.

"The teen years need to involve a gradual shift of responsibility to the teen," says Kathleen Nadeau, PhD. She is a clinical psychologist and director of the Chesapeake ADHD Center of Maryland.

Let your child start doing things for herself now, like doing the laundry, cooking dinner, or setting her own dentist and haircut appointments. She'll need those skills in a few years when she's out on her own.

Kids with ADHD have a false sense of time. "They don't always accurately judge how long things should take," Goldrich says.

During middle or high school you make sure he finishes his homework. Once he gets to college, you won't be there to do that.

Goldrich recommends teaching time management skills with a timer. Figure out how long it takes your child to finish each assignment. Then, break up the total time into chunks.

"Set the timer for 20 minutes and take a 5-minute break. Do that a few times and then take a longer break," Goldrich says.

Use the timer on your smartphone to help him remember other tasks, such as when to wake up for school, take a shower, and eat lunch.

Resist the temptation to pick up the piles of clothes, books, and other messes in your child's room.

"If you keep organizing their room, they will not learn what works and what doesn't," Goldrich says.

Find a system that works for your child, such as bins or a bucket to hold their school supplies and shelves for their books.

Nadeau suggests keeping a "launching pad," a spot to put things kids regularly use, such as their keys and phone, if they have one.

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Should I count my labor-heavy work as exercise?

On the weekends, I have a job that requires me to be really physically active. For about 5-6 hours I'm constantly standing, moving around, and lifting heavy boxes. On these days, I'm usually too tired to work out when I get home. Can I just count this as my exercise for the day? How many calories would I burn doing this? 

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How many calories should I eat to lose weight?

I'm 15. My height is 5'2 and my weight is 119. I eat a lot sometimes so I'm trying to measure out the amount of calories I should eat to lose weight at a healthy rate. Could someone please tell me?

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how many calories should i be eating and i need a workout buddy!

I'm 21 year old female 5'6 and 300 pounds.

Does anyone know the healthy weight for my age and how many calories I should be eating? This will help so much!

Also i need a workout buddy to help me when i lose motivation! I haven't yet, but maybe i will!

My problem is not working out, it's eating better and more healthy!

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Should Short Boys Take Growth Hormone?

If they're healthy, probably not, experts say

By Amy Norton

HealthDay Reporter

WEDNESDAY, March 27 (HealthDay News) -- Parents often worry when their child, especially a son, is much shorter than average. But as long as there is no medical cause, parents can rest easy, experts say.

Writing in the March 28 New England Journal of Medicine, two pediatric endocrinologists describe a scenario pediatricians see all the time: Parents bring in their 11-year-old son because he's substantially shorter than his classmates, and his growth seems to have slowed in recent years.

Their concern is reasonable, said Dr. David Allen, co-author of the article and a professor of pediatrics at the University of Wisconsin School of Medicine and Public Health in Madison.

In the vignette, Allen and Dr. Leona Cuttler describe a boy whose height was in the third percentile at age 9 years. (That means he was shorter than 97 percent of boys his age.) But his growth rate slowed further, so that he is now in the first percentile for height.

"When a child falls off the growth curve like that, it's appropriate for parents to be concerned and have him evaluated," Allen said.

The potential medical causes include growth hormone deficiency, certain genetic disorders or an underactive thyroid gland. Fortunately, though, most short kids are healthy.

The "conundrum," Allen said, is that parents are often still worried, especially when that child is a boy. And, in the United States, human growth hormone is approved to treat so-called idiopathic short stature -- that is, short stature with no known medical cause -- when a child is below the first percentile for height.

So parents may want costly treatment even if their child has a clean bill of health.

Dr. Patricia Vuguin, a pediatric endocrinologist at Cohen Children's Medical Center in New Hyde Park, N.Y., said some doctors will recommend doing nothing. And, "some will say, let's try growth hormone," she said.

But both Vuguin and Allen said it's important for parents to have realistic expectations of growth hormone. For short, healthy children, studies predict that growth hormone will deliver an extra 1 to 3 inches as an adult. And that's the average; other factors come into play.

If both parents are short, that limits what growth hormone therapy can do. "We can't modify your genetic potential," Vuguin said.

The fictional family in Allen's report fit that scenario. The mother was 5 feet tall, while the dad stood at 5 feet 6 inches. Their son's predicted height, with no intervention, was 5 feet 5 inches -- the lower end of "normal."

"You have to think, how important is an inch or two of extra height in the big picture?" Vuguin said. "Is the difference between 5 feet 5 inches and 5 feet 6 inches that important?"

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Should I take extra folic acid to boost my immune system?

Posted May 28, 2013, 2:00 am

I’m a healthy woman in my 40s. Should I take extra folic acid to boost my immune system?

Folic acid is, essentially, a vitamin. We all need vitamins. Indeed, the word “vitamin” was coined to refer to a substance that was essential to human life. The natural form of folic acid, folate, occurs in some foods, including vegetables, fruits, and dried beans and peas.

Each of us is a collection of about 13 trillion cells. If our cells get sick, we get sick. If our cells get old, we get old. Folate is essential for the production and maintenance of our cells. That’s especially true during rapid periods of growth, such as pregnancy and infancy. Folate is needed to make DNA and RNA, the genetic material that dictates how our cells function, and it helps prevent mutations to DNA that may lead to diseases, including cancer.

Our immune system cells, which are white blood cells, are always in a rapid period of growth. These cells don’t live very long, so they constantly need to be replaced. Folate deficiency can cause anemia — inadequate production of red blood cells. But it doesn’t weaken the immune system sufficiently to make us more vulnerable to infections, for example.

Over the past 30 years, many studies have found that people with high blood levels of a natural substance called homocysteine are at higher risk for heart disease. One easy way to reduce homocysteine levels is by taking folic acid supplements. Studies have not shown that taking folic acid supplements protects most people from heart disease. The exception is people born with a genetic defect that causes high homocysteine levels. I’m one of them; I take folic acid every day.

For most healthy adults, the Recommended Dietary Allowance (RDA) of folate is 400 micrograms (mcg) a day. Pregnant women should take more: 600 mcg a day. The extra folate helps to reduce the risk of neural tube defects, a serious malformation of the spine, skull or brain in the baby.

Experts advise against getting more than 1,000 mcg per day of folic acid from supplements or fortified foods. You’re unlikely to suffer any ill effects even if you exceed that limit, because your body excretes excess folic acid in the urine. Still, there might be long-term health effects that we don’t yet know about.

On the other hand, there’s no health risk associated with getting plenty of naturally occurring folate from foods. Get as much of your daily requirement as you can from a healthy diet. Good food sources of folate include spinach, asparagus, rice, green peas, broccoli and great northern beans. Many breads, cereals, flours, cornmeal, pastas, rice and other grains are enriched with folic acid.

If you’re not getting enough folate from foods, take a multivitamin that contains 400 mcg of folic acid.

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Should I gain?

I used to be frequent on here but not so much anymore. Im 14 and I have anorexia. I gained from 88 to where I am now at 111. Im 5'6.5 so Im still underweight. I was eating 3000+ from November from about a month. But I stopped because I thought I was binging. I gained and lost from then to about March. Where I sit at 111. I dont know if I should gain the last amount. I drink alot of water before my appointments so my doctor thinks I weigh 117. What should I do? and if I should gain how many calories hould I be eating?

P.S In the last 3 months I have also developed bulimia, nobody knows that though

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