Clinical Briefs

Am Fam Physician. 2001 Oct 1;64(7):1279-1280.

AAP Statement on the Use of Fruit Juice in Children

The Committee on Nutrition of the American Academy of Pediatrics (AAP) has issued a statement on the use and misuse of fruit juice in infants and young children. The AAP committee reports that while fruit juice consumption in childhood has some benefits, it also has potential detrimental effects. The statement appears in the May 2001 issue of Pediatrics.

Based on a review of the literature, the AAP committee has reached the following conclusions:

  • Fruit juice offers no nutritional benefits for infants younger than six months.

  • Fruit juice offers no nutritional benefits over whole fruit for children older than six months.

  • Juice that is 100 percent fruit juice is an acceptable part of a well-balanced diet. Fruit drinks, however, are not nutritionally equivalent to fruit juice.

  • Juice is not appropriate in the treatment of dehydration or management of diarrhea.

  • Excessive juice consumption can lead to malnutrition, diarrhea and tooth decay.

The AAP committee makes the following recommendations:

  • Juice should not be given to infants before six months of age.

  • Infants should not be allowed to consume juice throughout the day. Infants should not be given juice at bedtime.

  • For children one to six years of age, juice should be limited to 4 to 6 oz per day. For children seven to 18 years of age, juice should be limited to 8 to 12 oz or two servings per day.

  • Children should be encouraged to eat whole fruits to meet their recommended daily fruit intake. Infants, children and adolescents should not consume unpasteurized juice.

  • If children are being evaluated for overnutrition or undernutrition; chronic diarrhea, excessive flatulence, abdominal pain and bloating; or dental caries, physicians should determine the amount of juice being consumed.

  • Physicians should routinely discuss the use of fruit juice and fruit drinks with parents.

Resistance Training in Older Adults

The American College of Sports Medicine (ACSM) has released an official statement on resistance training in the older adult. The statement appears in the ACSM's Current Comments, April 2001.

According to the ACSM statement, the health benefits of appropriately prescribed long-term resistance training in adults 65 years of age and older include improvements in muscle strength and endurance, increased muscle mass and improved bone density.

When developing resistance training programs for older adults, the ACSM recommends that the following training-related variables be considered: frequency, duration, exercises, sets, intensity, repetitions and progression. Older adults should train two to four days per week for 20 to 45 minutes per session. Each exercise should involve more than one joint and weight machines are recommended over free weights.

The muscle groups that should be included in the program are the chest, shoulders, arms, back, abdomen and legs. Older persons should do one to two exercises per muscle group, training the larger muscle groups before the smaller groups. The ACSM recommends that older adults perform an average of two sets of each exercise with 10 to 15 repetitions and a two- to three-minute rest period between sets. The intensity of the program should be low to moderate (65 to 75 percent of the maximum).

Because older adults often have orthopedic and cardiovascular problems that may contraindicate resistance training, the ACSM recommends that they receive approval from their physician before participation. Proper supervision of the resistance training program is also highly recommended.

Current Comments are official statements by the ACSM concerning topics of interest to the public at large. More information may be obtained by calling 317-637-9200 or by writing to the ACSM, P.O. Box 1440, Indianapolis, IN 46206-1440.

Topical Solution for Nail Fungus

The U.S. Food and Drug Administration (FDA) has approved ciclopirox (Penlac Nail Lacquer) topical solution, 8 percent, for the treatment of onychomycosis. Ciclopirox is the first topical treatment for nail fungus approved by the FDA.

Ciclopirox penetrates the nail to specifically target the infected area. The most common side effect of ciclopirox is mild redness around the nail bed.

According to the manufacturer, the topical solution may be safer than systemic treatments in some patients who are at risk for possibly dangerous drug interactions. For more information on ciclopirox, visit the FDA Web site at http://www.fda.gov.

Paroxetine Approved for Generalized Anxiety

The U.S. Food and Drug Administration (FDA) has approved paroxetine (Paxil) for the treatment of generalized anxiety disorder. This debilitating, chronic condition is characterized by excessive anxiety and worry, and affects more than 10 million persons in the United States. Paroxetine is currently approved for the treatment of depression, panic disorder, obsessive-compulsive disorder and social anxiety disorder.

In two double-blind, placebo-controlled studies involving 897 patients, those taking paroxetine had a reduction of nearly 60 percent in anxiety symptoms as measured by the Hamilton Anxiety Scale.

According to the manufacturer, the most common side effects of treatment with paroxetine are asthenia, infection, sweating, nausea, dry mouth, constipation, decreased appetite, somnolence, dizziness, insomnia, tremor, nervousness, yawn and sexual side effects. For more information on paroxetine, visit http://www.gsk.com or call the manufacturer's customer information line (888-825-5249).

SAMHSA Brochures on Substance Abuse in Adolescence

The Center for Substance Abuse Prevention (CSAP) of the Substance Abuse and Mental Health Services Administration (SAMHSA) has released three updated and two new pamphlets in its Tips for Teens series. CSAP has released the following brochures: “The Truth About Hallucinogens,” “The Truth About Steroids,” “The Truth About Heroin,” “The Truth About HIV/AIDS” and “The Truth About Methamphetamine.”

According to CSAP, this series provides young persons and their parents with timely and valuable information on topics that impact today's youth. The pamphlets are designed to help young persons better understand the dangers of substance abuse, so they will be able to make well-informed choices about these issues.

The pamphlets state relevant facts and risks associated with substance abuse. Each brochure provides statistics, answers frequently asked questions and dispels myths surrounding illicit drug use. The brochures also contain a list of resources, including Web site addresses and toll-free telephone numbers in both English and Spanish that can be easily accessed for additional information.

For free copies of these brochures, call 800-729-6686. The entire Tips for Teens series, including these recent brochures, can be previewed and downloaded from the Internet at http://www.samhsa.gov (click on clearinghouses, then go to Prevline).

FDA Approval of Pulse Dye Lasers to Treat Psoriasis

The U.S. Food and Drug Administration (FDA) has granted marketing clearance for pulse dye laser technology in the treatment of psoriasis. Pulse dye lasers have been used to treat spider veins on the face and legs, port wine birthmarks, warts, rosacea, stretch marks and scars.

According to the manufacturer of the newly approved treatment, psoriasis affects 6 million persons in the United States. About 70 percent have mild plaque psoriasis, which affects 5 to 10 percent of body areas, typically in visible areas such as elbows, knees and hands.

In clinical trials of the pulse dye laser technology, 73 percent of patients experienced more than 70 percent clearance of psoriasis after only five to six treatments with remissions that lasted an average of 14 months. In some patients, remission lasted three years.

For more information on the laser treatment, visit the manufacturer's Web site at http://www.cynosure-laser.com.


Copyright © 2001 by the American Academy of Family Physicians.
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