Maternal Childhood Experience, Mate Choice, And Autism

Here is an interesting paper from several years ago, abstract:

Maternal experience of childhood abuse has been associated with offspring autism. To explore whether familial tendency towards autistic traits-presumably related to genetic predisposition-accounts for this association, we examined whether women who experienced childhood abuse were more likely to select mates with high levels of autistic traits, and whether parental autistic traits accounted for the association of maternal abuse and offspring autism in 209 autism cases and 833 controls. Maternal childhood abuse was strongly associated with high paternal autistic traits (severe abuse, OR = 3.98, 95% CI = 1.26, 8.31). Maternal and paternal autistic traits accounted for 21% of the association between maternal abuse and offspring autism. These results provide evidence that childhood abuse affects mate selection, with implications for offspring health.

In summary, the link between a history of childhood abuse of woman and rates of offspring autism may in part be due to the fact that such women tend to pick as mates men with higher levels of autistic traits.  This is based on the probability of an association between autistic traits in parents and children. So, the fact that the fathers have more autistic traits is one reason why the children may have such traits.  In other words, 21% of the association between mother's childhood abuse and offspring autism is due to the fact that the mothers pick as mates men who have more autistic traits tat are passed on to the children.

Nephrolithiasis In Children

By Robert R. Wal - http://en.wikipedia.org/wiki/Kidney_stone, Public Domain, https://commons.wikimedia.org/w/index.php?curid=3101185

Kidney/urinary stone disease is a serious disorder, and this paper discusses dietary interventions to avoid this disease in children.  As the abstract below makes clear, there hasn’t been any real positive findings apart from some limited data in favor of oral potassium citrate supplementation.  I have had kidney stones myself; that was one of the most painful experiences of my life.  Upon advice from an urologist, my own major preventive technique is drinking a lot of water during the day (up to 2 liters per day or more).  That’s inconvenient of course – what goes in must come out – and requires many bathroom visits per day.  A problem with children is that they go to school and can’t be spending much time in the bathroom, and keep in mind that drinking too much water can be a problem, and children, with smaller bodies than adults, have to be more careful with that.  The bottom line: follow your doctor’s advice on this subject, for both adults and children. Speaking only for myself as an adult, drinking water has helped, and I also eat a healthy diet as well.  Abstract:

BACKGROUND:

Nephrolithiasis, or urinary stone disease, in children causes significant morbidity, and is increasing in prevalence in the North American population. Therefore, medical and dietary interventions (MDI) for recurrent urinary stones in children are poised to gain increasing importance in the clinical armamentarium.

OBJECTIVES:

To assess the effects of medical and dietary interventions (MDI) for the prevention of idiopathic urinary stones in children aged from one to 18 years.

SEARCH METHODS:

We searched multiple databases using search terms relevant to this review, including studies identified from the Cochrane Central Register of Controlled Trials (CENTRAL, 2017, Issue 1), MEDLINE OvidSP (1946 to 14 February 2017), Embase OvidSP (1980 to 14 February 2017), International Clinical Trials Register (ICTRP) Search Portal and ClinicalTrials.gov. Additionally, we handsearched renal-related journals and the proceedings of major renal conferences, and reviewed weekly current awareness alerts for selected renal journals. The date of the last search was 14 February 2017. There were no language restrictions.

SELECTION CRITERIA:

Randomized controlled trials of at least one year of MDI versus control for prevention of recurrent idiopathic (non-syndromic) nephrolithiasis in children.

DATA COLLECTION AND ANALYSIS:

We used standard methodologic procedures expected by Cochrane. Titles and abstracts were identified by search criteria and then screened for relevance, and then data extraction and risk of bias assessment were carried out. We assessed the quality of evidence using GRADE.

MAIN RESULTS:

The search identified one study of 125 children (72 boys and 53 girls) with calcium-containing idiopathic nephrolithiasis and normal renal morphology following initial treatment with shockwave lithotripsy (SWL). Patients were randomized to oral potassium citrate 1 mEq/kg per day for 12 months versus no specific medication or preventive measure with results reported for a total of 96 patients (48 per group). This included children who were stone-free (n = 52) or had residual stone fragments (n = 44) following SWL. Primary outcomes:Medical therapy may lower rates of stone recurrence with a risk ratio (RR) of 0.19 (95% confidence interval (CI) 0.06 to 0.60; low quality evidence). This corresponds to 270 fewer stone recurrences per 1000 (133 fewer to 313 fewer) children. We downgraded the quality of evidence by two levels for very serious study limitations related to unclear allocation concealment (selection bias) and a high risk of performance, detection and attrition bias. While the data for adverse events were incomplete, they reported that six of 48 (12.5%) children receiving potassium citrate left the trial because of adverse effects. This corresponds to a RR of 13.0 (95% CI 0.75 to 224.53; very low quality evidence); an absolute effect size estimate could not be generated. We downgraded the quality of evidence for study limitations and imprecision.We found no information on retreatment rates.

SECONDARY OUTCOMES:

We found no evidence on serum electrolytes, 24-hour urine collection parameters or time to new stone formation.We were unable to perform any preplanned secondary analyses.

AUTHORS' CONCLUSIONS:

Oral potassium citrate supplementation may reduce recurrent calcium urinary stone formation in children following SWL; however, our confidence in this finding is limited. A substantial number of children stopped the medication due to adverse events. There is no trial evidence on retreatment rates. There is a critical need for additional well-designed trials in children with nephrolithiasis.

The American dream: code blue

America, its lifestyle and opportunities have been the dream for many.

America became my own salvation when the communist bloc in Eastern Europe began to fall apart, and there were no jobs, food was scarce, and electricity was sporadic. At that time, I had a newly-minted MS degree, very little English and no prospects for work. So, I studied English on my own, took the required standardized tests (for the first time in my life) and applied to PhD programs in the U.S.

I was lucky - I was accepted in one out of the three universities I applied to. I petitioned to waive my application fee; I hardly had the money to cover the fees for the standardized tests. My parents borrowed money for my airfare and for my first month of expenses in the U.S. After the first month, I had to support myself with my stipend for the work I did in the graduate school.

Looking back, I believe that America saved me from the prematurely aged, toothless and nervous wreck I could have become in my own country. The reality in a disintegrating socialist country killed many. It killed my best friend. Sometimes I doubt that I would have survived, if I had stayed home.

America gave me a PhD degree, job, and family. America gave me opportunities and hopes.

However, would America give the same to my child? What does America offer to the young generation today?

Today, college is a barrier that everyone needs to jump over, but once on the other side, there are not too many opportunities to apply the college degree to. Instead, the graduates are staring at an ugly debt.

And even when one finds a job, how many college-degree jobs are stable today? I think, none. Even my present job is about to expire within the next few years, as academia contracts into a quasi-online model that employs adjuncts, teaching assistants and an exorbitant number of administrators. This would be the end of my career as a PhD graduate.

When I look back at my parents’ trajectory, I perceive that their stories could have been the most extreme example of the American dream. The irony is that they grew up and lived in a socialist country, not in the U.S.

My father was born and raised in a remote, small village in the middle of nowhere. I wanted to visit the place a few years ago, and I was told that there were only a few houses left. His parents may or may have not attended elementary school. After leaving the village and joining the workforce at age of 14, my father survived on very little until the political changes in the country pulled him from the bottom and gave him opportunities. The socialist system helped him finish high school and vocational school, and eventually, brought him into a military academy in the USSR. My father became a skillful and knowledgeable electrical engineer, he rose to the rank of colonel and was given a high-responsibility position in the Ministry of Defense. He was considered for a general and a leader of a military factory next. However, by that time the stress and speed of rising took their toll. My father gave in to a psychosis-ridden burnout and was unable to function at his high-ranked position.

Despite this ending, my father’s story is this of tremendous success – his journey was this from a speck of a village, through numerous towns and jobs, and finally to the capital. He put lots of effort, work, diligence and determination on this path. But he was also helped by the system. If my father was to go to a grad school in the U.S. today, he would not have had a chance! You see, candidates like him are considered an unacceptable risk for the schools. Candidates like him are not offered any scholarships. Back then – more than 50 years ago, my father paid not a single penny for his education. The education in the socialist countries was free.

My mom was raised in a family that was more stable financially; however, her parents also did not have too much of a formal education. My mom graduated from a specialized college to become a highly accomplished teacher in science. Again, the education was free.

Despite their education, my parents received the standard socialist salaries – at that time everyone was receiving more or less the same amount of money for being a medical doctor, colonel, teacher, or janitor. My mom and dad never got a penny from their own parents; however, they were able to establish a home and raise two children. Both my brother and I received free education and obtained masters’ degrees. At the time of graduation, we did not have a penny of debt.

Of course, whereas the socialist system was good and helpful to some, to others, the same system turned out to be cruel and unforgiving. I met some of these people - they had been raised in affluent families, they were smart, well educated, and talented. And yet, when the socialist system was established, these people found themselves under attack. After all, their mothers, fathers and/or grandparents have served the monarch! These people were banned from certain schools, they were not given jobs. Every system has its own flaws, the socialist system had plenty.

And yet, when I look at the future of this land of opportunities, I see only shrinking ones. For me, for my husband, for my child, for the majority of the population.

I do not see the solutions that great leaders should offer the greatest nation in the world.

Where is the grand vision?

Our children are the future of this country. Our priority in visioning should be to take good care of them, give them opportunities to learn, find their interests, realize themselves and be able and free of debt to apply their talents where their hearts are.

We should also make sure that these children grow up in stable families, families in which mom and dad have jobs.

Ticking bomb: watching our children die

From http://stateofobesity.org/disparities,
accessed on November 18, 2016

Whereas chronic conditions associated with obesity such as high blood pressure, metabolic syndrome, type 2 diabetes, non-alcoholic fatty liver disease, and heart conditions may develop and present relatively fast after establishing of obesity, cancers associated with obesity may have a latency of 10 years and longer. Despite this latency, considering that overweight/obesity among our children is at its highest levels, we may witness our own children being diagnosed with, and die from, cancer before us.

This scenario is not a product of my imagination.

A recent report revealed that colorectal cancer incidence has increased among 20- to 34-year olds in the past 35 years and, if the trend continues, there will be up to a 90% increase in colon cancer and 124.2% in rectal cancer incidence in this age group by 2030 (Bailey CE, et al. Increasing Disparities in the Age-Related Incidences of Colon and Rectal Cancers in the United States, 1975-2010 JAMA Surg 150: 17-22; 2015).
 
The authors of the study have suggested that the dramatic shift in age of incidence is likely due to the increasing obesity among children and adolescents (Ogden CL, et al. Prevalence of childhood and adult obesity in the United States, 2011-2012. JAMA 311: 806-14; 2014; Singh KE, et al. Colorectal cancer incidence among young adults in California. J Adolesc Young Adult Oncol 3:176-184, 2014). 

Above is the diagram of how many of our children were overweight or obese in 2012.
 
Indeed, considering that colon cancer progression takes 5 to 20 years, a simple calculation suggests that colon cancer diagnosed at age of 20 to 34 might be initiated in school-age children.

Additional reports on the increasing incidence of colon cancer among the younger generation support the findings of Bailey et al. (Mozes A. Colon cancer rates rising among Americans under 50. Health Day, January 30, 2015; Myers EA, et al. Colorectal cancer in patients under 50 years of age: A retrospective analysis of two institutions’ experience. World J Gastroenterol 19: 5651-5657, 2013).  

Most recently, a statistically significant correlation between the increasing obesity according to New York State data (1987-2013) and the increasing colorectal cancer incidence in the New York State Cancer Registry (taking into account a 10-year latency period) was reported (Gdoura B, Richardson H, Yang J, Sardo Molmenti CL. 25th AICR conference 2016, Washington DC Obesity and young onset colorectal cancer: a review and time-trend analysis).  

By the way, obesity does not increase the risk for colorectal cancer only. There are 13 other types of cancer that are associated with obesity, and among them are liver, pancreatic, thyroid, esophageal, kidney, endometrial, ovarian, gallbladder cancer, and others.

Therefore, there is an urgent need to implement a policy that helps our children to maintain a healthy weight. However, as previously discussed, waiting for the government to help you is not wise. 

It is better to educate yourself and take steps.
 
Here are the four anti-obesity rules by Dr. Robert Lustig for children:

1. Get rid of every sugared liquid in the house. Children should drink only water. 

2. Provide at least five servings of vegetables and/or fruit a day (this equals about five handfuls). This rule increases fiber in the diet.

3. Serve individual portions. Serve a second portion only if the child still claims to be hungry after waiting for 20 minutes.
 
4. Children should have at least 60 minutes of physical activity every day.

If you would like to know the reasoning behind these recommendations, watch “Sugar, the bitter truth”, a presentation by Dr. Lustig available on YouTube.

Also, my advice to you, mom and dad, is to be an example for your children. Therefore, the rules above apply to you as well.

JUST NOTHING: Mind the human limits

We all know and feel the physical limits of our bodies; however, we rarely recognize and admit to the limits of our brains. 

We, as adults, make this mistake, and what is worse, we expect that our children should do the same - they should sit in school for eight hours a day without losing their focus. At the same time, we are certain that after one to two hours of intense physical activity the same kids are tired, and need at least 20 minutes of rest. So, why cannot we apply the same logic to any intensive brain activity?  

According to this article, our brains have two modes: the “focused mode,” which we use when we learn, write, calculate, or analyze something, and the “diffuse mode,” which is relaxed, day-dreaming mode when we do not think (hard). Contrary to our expectations, it seems that our intellectual potential is not achieved without the diffuse mode. In fact, the diffuse mode correlates with increased activity in the brain, as revealed by functional magnetic resonance imaging (the images show how the brain “lights up” during the diffuse mode).  

The daydreaming/diffuse mode has been utilized by scientists and artists in the past when they needed to solve  problems. For example, Thomas Edison, known for his many inventions, tried to relax to overcome a problem in his work. He would do this by switching to diffuse brain mode by getting into a state of almost falling asleep: he would doze while clutching a handful of ball-bearings. As soon as he went into too deep a sleep, his hand would relieve the grip and the noise of the falling ball-bearings would wake him up. In this relaxed state he would frequently find whatever solution he was searching for. 

Similarly, the artist Salvador Dali took a spoon in his hand when he relaxed on a chair; the moment he went napping, the spoon would fall and wake him up. This was the time when he could resume his creative work with fresh images and ideas.  Even we sometimes unintentionally benefit from the diffuse brain mode: probably all of us have had an eureka moment while relaxing under the shower or when waking up from sleep.  

There are different recommendations on how much time of diffuse mode we need per hour of focused mode, but it seems that the human brain thrives on one hour on, and 15 minutes off schedule.   Who knew that doing nothing, thinking about nothing, buying nothing, and even eating nothing is so beneficial?  

Actionable 
Allow yourself to daydream and do nothing.