TIME Mental Health/Psychology

This Divorce Arrangement Stresses Kids Out Most

Regarding the wellbeing of kids with divorced parents, the debate over what kind of custody arrangement is best rages on. But a new study, published Monday in the Journal of Epidemiology & Community Health, suggests that children fare better when they spend time living with both of their parents.

That goes against some current thinking that kids in shared-custody situations are exposed to more stress due to constantly moving around and the social upheaval that can come along with that. “Child experts and people in general assumed that these children should be more stressed,” says study author Malin Bergström, PhD, researcher at the Centre for Health Equity Studies in Stockholm, Sweden. “But this study opposes a major concern that this should not be good for children.”

The researchers wanted to see if kids who lived part time with both parents were more stressed than those who lived with just one parent. They looked at national data from almost 150,000 12- and 15-year-old students—each in either 6th grade or 9th grade—and studied their psychosomatic health problems, including sleep problems, difficulty concentrating, loss of appetite, headaches, stomachaches and feeling tense, sad or dizzy. They found that 69% of them lived in nuclear families, while 19% spent time living with both parents and about 13% lived with only one parent.

Kids in nuclear families reported the fewest psychosomatic problems, but the more interesting finding was that students who lived with both of their separated parents reported significantly fewer problems than kids who lived with only one parent.

“We think that having everyday contact with both parents seems to be more important, in terms of stress, than living in two different homes,” says Bergström. “It may be difficult to keep up on engaged parenting if you only see your child every second weekend.” Having two parents also tends to double the number of resources a kid is exposed to, including social circles, family and material goods like money. “Only having access to half of that may make children more vulnerable or stressed than having it from both parents, even though they don’t live together,” she says.

Girls reported more psychosomatic problems than boys did, and the most frequent problem for girls was sadness. Sleep problems were the most common in kids overall.

In Sweden, joint-custody parenting has risen dramatically in the past few decades; in the 1980s, only 1% of kids of divorced parents lived in joint-custody arrangements, but that number jumped to 40% in 2010. Shared parenting is less common in the U.S., says Ned Holstein, MD, founder and acting executive director of the National Parents Organization, and he estimates the rate is less than 20%. Still, he says that the research in favor of shared parenting for kids is overwhelming. “You’ll hear opponents say, ‘You’ll turn them into suitcase kids; they don’t want to be dragged back and forth,'” Holstein says. “Clearly, taking the suitcase back and forth once or twice a week so that you spend a lot of time with both parents is way better for the kids than the alternative of basically losing an intimate and closely loving relationship with one parent.”

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TIME Health Care

U.S. Lowers Recommended Fluoride Levels in Drinking Water

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The new, lower recommendations are the first in over 50 years

For the first time in over 50 years, the U.S. has lowered its recommendation on fluoride levels in drinking water to prevent tooth decay.

On Monday, the U.S. Department of Health and Human Services (HHS) released its recommendation for an optimal concentration of fluoride at 0.7 milligrams per liter of water. The previous recommendations, released in 1962, allowed for between 0.7 to 1.2 milligrams per liter.

U.S. states and cities began adding fluoride to water supplies in the 1940s to aid dental care and today, three in four Americans with access to public water systems get fluoridated water. But an excess of fluoride can cause white spots on teeth.

The HHS says that Americans today have many other sources of fluoride, including toothpaste and mouth wash. The agency says the new recommended level will maintain the positive effects fluoride has on tooth decay, but reduce the risk of Americans getting too much exposure.

Also on Monday, the U.S. Food and Drug Administraion (FDA) sent an industry letter recommending bottled water manufacturers, distributors and importers limit the amount of fluoride they add to bottled water to no greater than 0.7 milligrams per liter (mg/L).

“Community water fluoridation is effective, inexpensive and does not depend on access or availability of professional services. It has been the basis for the primary prevention of tooth decay for nearly 70 years,” said U.S. Deputy Surgeon General Rear Admiral Dr. Boris D. Lushniak in a statement.

 

TIME Healthcare

Teen Forced to Undergo Chemotherapy Released from Hospital

Photo shows Cassandra, a teen who does not want to give her last name, confined in a room at Connecticut Children's Medical Center in Hartford, Conn., where she is being forced to undergo chemotherapy.
Cassandra C.—AP Photo shows Cassandra, a teen who does not want to give her last name, confined in a room at Connecticut Children's Medical Center in Hartford, Conn., where she was forced to undergo chemotherapy.

Cassandra C. had said she wanted to pursue alternative treatments

The 17-year-old Connecticut girl who was forced to undergo chemotherapy after she refused treatment for Hodgkin lymphoma is expected to be released from the hospital Monday, the Associated Press reported.

Child services removed the girl, known as Cassandra C., from her mother’s home in January to force her to undergo treatment, an action upheld by several state courts.

Cassandra had said she wanted to pursue alternative treatments to her condition and her mother vocally supported her daughter’s decision. Now, after the treatment, doctors say Cassandra’s cancer is in remission, and she has an 85% chance of survival.

“I’m at a loss for words with how happy I am that I’m finally coming home,” she told the AP in a text message. “This day seemed like it would never come. I can finally start putting my life back together, and I look forward to spending time with my mom, friends and heading back to school/work.”

Cassandra will be able to make her own medical decisions when she turns 18 in September.

Read More: When Can a Person Be Forced to Receive Medical Care?

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TIME Research

Health Stores Often Promote Diet Pills to Minors

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Elizabeth Renstrom for TIME

Despite warnings that they are intended for adults

Health store employees will often promote the use of over-the-counter body-changing supplements to minors, despite the fact that they often contain warnings that they are intended for adults.

In new research presented at the Pediatric Academic Societies meeting in San Diego, researchers had study participants call 244 health food stores in 49 states and identify themselves as 15-year-old boys and girls. The researchers discovered that even though testosterone boosters are not recommended for kids and teens under age 18 without a medical reason, 9.8% of sales associates recommended them. Testosterone boosters contain messaging indicating they are for adults only, but 41% of the sales associates told the callers they thought were 15 that they could buy them on their own.

Health store employees would frequently recommend supplements for callers posing as teen girls who said they were looking to lose weight.

“Adolescents are being enticed by flashy advertisements and promises of quick, body-shaping results,” says Dr. Ruth Milanaik of Cohen Children’s Medical Center. “In this body-conscious world, flashy advertising of `safe, quick and easy body shaping results’ are very tempting to younger individuals trying to achieve ‘the perfect body.’ It is important for pediatricians, parents, coaches and mentors to stress that healthy eating habits, sleep and daily exercise should be the recipe for a healthy body.”

Though the research is preliminary and still a relatively small study size, The National Institutes of Health (NIH) says dietary supplements have not been tested for safety or effectiveness in kids. Despite the research and warnings, though, the study authors note that it is still legal for minors to purchase these supplements in 49 states.

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TIME Research

This Is What Happens When You Read to a Child

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Reading activiates an important part of a child's brain

For years, child advocacy groups have recommended that parents read to babies, even though research hasn’t been clear on what the practice does to a child’s brain. Now, a new brain scan study explains that reading to a child early and often activates the part of the brain that allows them to understand the meaning of language.

The study, presented last weekend at a meeting of the Pediatric Academic Societies, looked at 19 preschoolers and their interactions with their parents. Nearly 40% of the children came from low-income backgrounds. Parents filled out a questionnaire that assessed their habits for raising their children and included questions asking whether the parents had taught their children skills like counting, how often the parents talked with their kids and how early and often parents read to their children.

MORE: Kindergarteners Watch More Than 3 Hours of TV a Day

Researchers then attached brain scanners to the children as they listened to stories. Reading at home with children from an early age was strongly correlated with brain activation in areas connected with visual imagery and understanding the meaning of language.

“For parents, it adds credence to the idea of reading with kids,” says study author John S. Hutton, a pediatrician at Cincinnati Children’s Hospital. “Getting a peek into the brain, there seem to be some differences there that are pretty exciting.”

MORE: 6-Month-Old Babies Are Now Using Tablets and Smartphones

The study adds to past research showing that reading has many positive effects on young children, like teaching the rules of syntax, expanding children’s vocabulary and helping children bond with their parents, Hutton says. But the new study is among the first to add real understanding of what actually happens to young brains.

Hutton says he hopes that further research will help us provide parents with guidelines on best practices for reading to children.

“This is sort of an early signal,” Hutton says. “In terms of how much and how often, that’s the kind of thing we’re hoping that future studies will look into.”

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TIME Diet/Nutrition

How to Block the Hunger Pangs When You Diet

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The hardest part of a diet are the cravings. That’s because dieting goes against the body’s developed-over-millions-of-years instinct to feed when energy levels drop. There’s a network of neurons that is exquisitely designed to sense when the body’s cells need more calories to fuel the metabolic, enzymatic, muscular, neurologic and sensory things they do. So when the body wants calories, we eat.

But what if it were possible to fool the body into thinking that it was full — without eating a bite?

Now scientists say you may be able to have your cake and not eat it — at least a little more easily. They worked with mice, but their findings could lead to new obesity treatments for people as well. In two papers published in Nature and Nature Neuroscience, researchers from different groups culminate a 15-year search for the specific nerve circuits in the brain responsible for hunger and satiety.

Scott Sternson, a researcher and group leader at the Howard Hughes Medical Institute’s Janelia Research Campus, investigated the signals that prompt us to eat. Do we eat to silence the negative sensations we get when we’re hungry? Or do we eat simply because we like the taste of food? Previous studies in animals suggests the latter, and the fact that we eat even when we’re not hungry also supports the idea.

But Sternson reports in Nature that his team found evidence it’s the desire to get rid of the unpleasant feelings associated with hunger that drives eating. Something called agouti-related peptide neurons (AgRP) are critical for regulating when animals eat. When calories dwindle and energy drops, AgRP are active, fueling appetite. “When we start to lose 5%, or 10% of body weight, that’s when these neurons are kicking in. And they are a big part of why most diets fail even though people do succeed in initially losing weight,” he says.

That may explain why diets go awry too. Sternson says AgRP nerves may not be active at the start of the diet, but as we lose weight, and the body senses that fewer calories are coming in, the neurons become more active, compelling us to fill up the missing calories and making us feel unpleasantly hungry all the time.

Sternson gave recently-fed mice mice different flavored capsules. Those flavors were associated each with either turning on or turning off the AgRP; when the mice were offered the flavored capsules again, they tended to favor the flavor they associated with when AgRP was turned on, and they felt hungry.

But when they did the same test on mice who hadn’t eaten in a while, the animals tended to favor the flavor linked to when AgRP was turned off — that’s when they didn’t feel the hunger pangs and the physical pain associated with hunger. Indeed, when they did more experiments that allowed them to peer inside the animals’ brains and see which nerves were active, the AgRP neurons started to quiet down as soon as the animals saw food, even before they began eating. But if the mice did not eat after seeing the food, the neurons would rev up again and remind the animals — painfully — that they hadn’t eaten.

But simply interrupting AgRP neurons wouldn’t be the safest way to support weight loss, says Dr. Bradford Lowell, professor of medicine at Harvard Medical School and Beth Israel Deaconess Medical Center and senior author of the other paper, published in Nature Neuroscience. Not only do AgRP neurons regulate appetite by driving animals to eat, but it also tries to conserve what energy remains by helping the body burn fewer calories. It signals the sympathetic nervous system, which controls things such as heart rate and blood pressure, to work less efficiently. And that could have negative effects on the heart.

The ideal situation would be to find something downstream of AgRP’s signaling that can be manipulated more safely. And that’s what Lowell spent the past 15 years doing. In his latest paper, he reports on a cluster of cells in the hypothalamus that might be just such a target. Unlike the neurons that trigger the heart-related symptoms when AgRP is activated, these nerves act as the hunger hub. Called melanocortin 4 receptor cells (MC4) hey are responsible, Lowell found, for feelings of satiety. Activating AgRP normally turns these cells off, so animals will feel the uncomfortable symptoms of hunger and start eating.

But one question that Lowell was keen on answering was whether animals eat to quiet down the hunger pangs of whether they simply eat because it activates reward and pleasure centers in the brain. By using the latest laser-technology that can activate specific neurons, they studied hungry mice and turned the MC4 cells on in one room and off when the mice wandered into another room, essentially tricking them into thinking they had just eaten, even if they hadn’t. Not surprisingly, the mice tended to spend more time in the room where the cells were turned on, and they felt “full.” “They were not eating any food but the mice chose to hang out in the room where their satiety signals were turned on. And they really liked it,” says Lowell.

But when they repeated the study with mice that had dined on chow, the results were different. This time, the mice didn’t show any preference and the satiety signals didn’t seem to affect them. That means that the animals ate mainly to get rid of the hunger pangs, and that given a choice, they would rather feel full.

That’s the same with people, and explains why diets are so hard to keep up. It’s a challenge to constantly fight the instinctive desire to quiet those hunger calls. But, says Lowell, it may be possible to manipulate the MC4 cells and fool the body into feeling the same satisfaction that comes with a full belly. “If we artificially turn on the downstream neurons of MC4, we are countering the adverse effect caused by AgRP being active. We are artificially removing the effect of the AgRP neurons on them,” he says.

And doing that, says Sternson, could help people who start a diet to stick with it. “We think it’s critical to understand all we can about these neurons, and how they control hunger when we start to loose weight. The more we understand the proteins that these neurons express, the more intelligently we can conceive potential treatment strategies,” he says. And those therapies might even make it possible to be hungry without feeling hungry, making them them the ultimate diet enabler.

TIME Diet/Nutrition

5 Ways to Get Slim on Autopilot

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Streamline your day-to-day diet decision making

“Just tell me what to eat.” Weight-loss experts say that’s the number one thing they hear from women who are trying to slim down. And no wonder: Whether it’s the endless aisles of food at the grocery store or a seemingly harmless salad bar, research shows that the more options you have, the more likely you are to blow your calorie budget.

The culprit? Decision fatigue. When faced with lots of choices, the regions of your brain responsible for willpower and regret become overstimulated, upping the odds that you’ll make poor decisions—and feel less satisfied with the selections you make even when they’re good ones.

“We think choice makes us happy, but the truth is, it can cause a lot of unnecessary anxiety,” says Judith Beck, PhD, author of The Diet Trap Solution and president of the Beck Institute for Cognitive Behavioral Therapy in Philadelphia. Most of your eating habits should be automatic, similar to putting on a seat belt when you get into a car, she says: “Making choices in advance helps you stay on track because it eliminates the ‘Should I? Shouldn’t I?’ struggle every time you need to decide something.” (Like when your co-worker brings in brownies—again.)

Here are five ways to streamline your day-to-day decision making so you can drop a few and feel less stressed in the process.

No. 1: Forget your “free day”
It’s a popular allowance among conscientious eaters, many of whom chronicle their mouthwatering splurges (waffles and whipped cream!) with #cheatday. But chowing down on whatever strikes your fancy as a reward for sensible eating the rest of the week can undo your hard work. Data from the National Weight Control Registry shows that people who lost a significant amount of weight are more likely to regain it if they allow themselves to eat with abandon on weekends and holidays. Even one day of chasing fries and cake with bottomless margaritas can more than double your regular calorie intake—and those calories add up. “When you step on the scale on Monday and see you’ve gained, you’ll probably feel discouraged, which undermines your resolve to keep eating healthy,” Beck notes. Plus, she adds, “it’s difficult to get back on track after a day- or weekend-long blowout. Normal eating feels like deprivation.”

No. 2: But treat yourself every day
Beck tells her patients to enjoy just one indulgent food a day. “Cookies, chips, fudge: Everything is fair game, provided you choose your treat in advance and stick to a moderate portion that fits into your daily calorie allotment,” she explains. If you’re going to have some chocolate after dinner, it’s easier to turn down a tempting cupcake at your nephew’s birthday. (And if it pains you to pass on the cupcake, you can make that the next day’s treat.)

No. 3: Say yes to soup Sunday
Or Tuna Taco Tuesday, or a big salad with protein as your go-to weekday lunch.

Self-control is like a muscle: The more you exert it (burger or branzino? Candy bar or nutrition bar?), the more fatigued it becomes, until you almost unconsciously make the decision you normally wouldn’t (burger and a candy bar, please!). Willpower is overrated,” says Jane Burrell Uzcategui, RD, instructor of nutrition at Syracuse University. “If you’re constantly relying on your brain to make the right choice, you’re constantly going to be disappointed.”

Having default snacks and meals reduces the number of decisions you make on any given day—so you’re more likely to eat well at other times. “I tell clients to have 5 to 10 staple recipes and switch them up: Make a different cut of meat one night, or try a new sauce in your weekly stir-fry,” says New York City dietitian Lauren Slayton, RD, author of The Little Book of Thin.

No. 4: Have backup meals at the ready
Don’t let an insanely busy day or burned dinner send you straight into the arms of the Papa John’s deliveryman. Instead, stock up on a few fast-fix meals that fit your diet criteria, so you’re prepared when things go awry.

Preplanned meals are smart even when you’re not crazed. In a recent study, researchers at ConAgra Foods asked people to have a light (270-calorie) frozen meal in place of their usual lunch three days a week for a month. Not only did folks report feeling satisfied hours later, they consumed 500 fewer calories per day.

“Having to measure portions or calculate calories can be tedious, and if you’re tired, it’s not going to happen. The reason frozen meals worked is because they offer options but eliminate guesswork,” explains Kristin Reimers, RD, whose study inspired a wellness program that helped more than 2,000 employees lose as many as 2 pounds a week by eating a microwave meal with under 450 calories at least once a day.

No. 5: Cut yourself off
Willpower can be weakest at night—which is why it’s so easy to intend to have just a little ice cream before bed, only to look down and discover that you’ve emptied half the pint. An easy fix: Tell yourself, “I don’t eat after 9 p.m.” (or a similar time that makes sense for your schedule). Says Beck, “Rules work, even when they’re self-imposed.”

What’s more, knowing that the kitchen is closed may make it easier to hit the hay—and being well-rested bolsters your willpower so you can make wise, waist-friendly food choices tomorrow.

This article originally appeared on Health.com.

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TIME Addiction

Hawaii Set to Become First State to Raise Smoking Age to 21

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Elizabeth Renstrom for TIME

The bill covers both cigarette and e-cigarette use

Hawaii is set to become the first state to pass a law banning the sale, use and possession of cigarettes and e-cigarettes to people under the age of 21.

If a bill approved by Hawaii lawmakers on Friday is signed into law by Gov. David Ige, adolescents will be prohibited from smoking, buying and possessing both conventional cigarettes and e-cigarettes. First-time offenders will be fined $10, and after that they can be charged a $50 fine or be required to complete community service, the Associated Press reports.

Some local governments have raised the smoking age to 21 in certain counties and cities — New York City among them — but if the bill becomes law, Hawaii will be the first state to do so.

Though the rates of high school age smokers have dropped in recent years, some 2.3 million children and young adults started smoking in 2012. In addition, a recent report from the U.S. Centers for Disease Control and Prevention (CDC) revealed that e-cigarette use among middle school and high school students tripled in one year.

If the Hawaii bill passes, it will go into effect Jan. 1, 2016.

[AP]

TIME Obesity

Kindergarteners Watch More Than 3 Hours of TV a Day

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With more screen time, the effects add up fast

For kids as young as kindergarten-age, watching even a small amount of TV daily is linked to obesity and overweight, finds a new study. Kids who watched an hour of television a day were more likely to be overweight or obese than kids who watched less than an hour of TV per day.

Presented at the Pediatric Academic Societies annual meeting, the study looked at data from more than 10,000 kindergarteners and followed them through first grade.

Kindergarten students in the U.S. spent an average of 3.3 hours watching TV every day, the study finds, and that screen time comes at a high price. Kids who watched 1-2 hours of TV per day had an increased odds of obesity 47% above the group that watched less than an hour a day, and an increased odds of overweight 43%.

“Television is a very passive activity,” says study author Mark D. DeBoer, MD, associate professor of pediatrics at the University of Virginia. Combine the ill effects of sitting with TV-related behaviors like more snacking and exposure to commercials selling unhealthy food, and the effects can add up.

It took very little TV time to have a big effect on weight; DeBoer says he didn’t see much difference in the weights of children who watched 1-2 hours a day versus those who watched more than two hours.

That’s likely because kids miss out on physical activity when they’re plopped in front of the tube. “In this age range, when you’re not sitting and doing something, you’re running around,” DeBoer says. “As much as they don’t go out and jog, kindergarteners are still at an age when they are frequently, if not constantly, on the move.”

DeBoer says he hopes his study can help shift guidance from the American Academy of Pediatrics, which currently recommends that children spend no more than two hours a day watching screens. Instead, he says, parents should be encouraged to cut TV time even more and replace it with activities like reading to their children, going to museums and visiting other educational destinations. “This may be a step toward changing that recommendation in the future,” he says.

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TIME Cancer

New Documentary Chronicles One Dad’s Effort to Honor His Son’s Short Life

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"The game has given me a way to grieve and mourn"

When a Colorado man’s one-year-old was diagnosed with brain cancer in 2010, he decided to create a video game that would both honor his son’s life and give others a peek into the family’s reality of living with a child who would die too young.

Ryan Green told TODAY that his game, called That Dragon, Cancer and set in the family’s house and with hospital scenes, would help his family remember Joel and prompt a larger discussion about death and mourning. The game’s website states it allows players to”relive memories, share heartache, and discover the overwhelming hope that can be found in the face of death.” Poems and spiritual messages appear throughout the game, Green said, and it even includes Joel’s laugh.

Joel died in March 2014 at age 5, but Green continues to spread his message. The documentary Thank You for Playing, which screened this month at the Tribeca Film Festival, chronicles the making of the game, which is due to be released later this year.

“Life moves on,” Green, who lives with his wife and four other children, said. “The game has given me a way to grieve and mourn. We have been open with the kids and when grief strikes, we can talk about it.”

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