Journal Club: Adenoids, fluoride, and postpartum depression

June 1, 2009

Reviews of medical journal articles on adenoidectomy and tonsilectomy's connection to weight gain, the benefits of water over soda, and postpartum depression in moms of multiples.

A&T tied to weight gain in children

Cumulative incidence up to the age of 8 was 12% for adenoidectomy only, and 15% for tonsillectomy with or without adenoidectomy. In the latter group, 70% had both procedures during the same year, 26% had both at different ages, and 4% had only tonsillectomy. Boys were more likely than girls to have had the surgeries.

Commentary:

Children who underwent adeno/tonsillectomy were twice as likely to become obese as children who had neither. The authors hypothesize that in the preoperative period these children reset their metabolism to adjust for frequent infections, poor appetite, poor sleep quality, and difficulty breathing. When they are returned to good health, these adaptations may become liabilities, predisposing to excessive weight gain. Parents and physicians should be alert to this.

Drinking water lowers total caloric intake

Investigators analyzed 24-hour dietary recall data on two nonconsecutive days for about 3,000 youngsters from 2 to 19 years of age who were polled by the National Health and Nutrition Examination Survey. Average total energy intake (2,118 kcal) increased with age and was higher in boys than girls. A full 91% had at least one sugar-sweetened beverage on either or both recall days; older age groups tended to consume more beverages, especially those that were sugar sweetened.

Each serving of a sugar-sweetened beverage was tied to a net increased intake of 106 kcal (about an 8-oz glass of soda) on that day, with no compensatory reduction in intake of other foods or beverages. The same general principle held true for several other beverages: whole and reduced-fat milk (associated with a net increase of 169 and 145 kcal/day, respectively) and 100% fruit juice (123 kcal/day). No net increases in total energy intake were observed for water or diet drinks.

Substituting water for sugar-sweetened beverages was related to a significant decrease in total energy intake, with each 1% of replacement associated with 6.6-kcal lower total energy intake. No compensatory increases in other food or beverages negated this reduction (Wang YC et al. Arch Pediatr Adolesc Med 2009;163:336).

Commentary:

Substituting water for sugar-sweetened beverages decreases caloric intake by about 235 kcal/day. That's 85,775 calories per year!