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by Steven Reinberg

Calorie Counts Mandated at Chain Restaurants, FDA Says

Rules also apply to theater popcorn, bakeries and ice cream parlors
TUESDAY, Nov. 25, 2014 (HealthDay News) -- New rules announced Tuesday by the U.S. Food and Drug Administration will have many restaurant chains posting calorie counts on their menus, and the rules even apply to movie theater popcorn and ice cream parlor fare.
"Americans get about a third of their calories away from home, often consuming less nutritious food and underestimating the calories they eat," FDA commissioner Dr. Margaret Hamburg said during a Monday afternoon news conference.
Although listing calorie counts on menus won't solve the obesity epidemic, it should help consumers make healthy food choices, Hamburg added.
Any restaurant that's part of a chain of 20 or more locations doing business under the same name, and where outlets offer similar menus, will have to have calorie counts on menu items, according to the FDA.
These businesses will have to clearly post calorie information for standard items on menus and menu boards, right next to the name or price of the item.
Some items are exempt from the rule. Those include seasonal fare, daily specials and condiments.
The rules are required as part of the Affordable Care Act, and they also apply to vending machine companies that own 20 or more machines.
Hamburg said the rule "doesn't apply to independent restaurants, bars or grocery stores. It also doesn't apply to food trucks, ice cream trucks, food served on airplanes or other transportation vehicles."
Since these rules were first proposed in 2011, the FDA has received more than 1,100 comments that prompted the agency to focus on restaurant foods. The agency made other changes, such as allowing pizza to be labeled by the slice rather than as a whole pie.
The rules also include certain alcohol drinks listed on menus and food served in places of entertainment, such as movie theaters and amusement parks.
Calories will have to be listed for:
Popcorn purchased at a movie theater or amusement park Meals from sit-down restaurants Foods purchased at drive-through windows Take-out food, such as pizza Foods, such as made-to-order sandwiches, ordered from a menu or menu board at a chain grocery store or delicatessen Foods you serve yourself from a salad or hot food bar Muffins at a bakery or coffee shop A scoop of ice cream, milk shake or sundae from an ice cream store Hot dogs or frozen drinks prepared on site in a convenience or warehouse store
Restaurants and similar retail food stores will have one year to comply with the rule, and vending machine companies will have two years to make the changes, Hamburg said.
To help the public put calorie counts into the context of a person's daily caloric need, restaurants and vending machines will also have to display a sign saying: "2,000 calories a day is used for general nutrition advice, but calorie needs vary," she added.
Other nutritional information things such as total fat, calories from fat, saturated fat, trans fat, cholesterol, sodium, total carbohydrates, fiber, sugars and protein does not have to be included on menus. However, this information has to be supplied in written form to customers if they request it, Hamburg said.
Dr. David Katz, director of the Yale University Prevention Research Center, called the new rules, "a welcome move by the FDA. In an age of obesity in adults and children, total daily calorie intake is of clear public health relevance."
However, Katz stressed that some high-calorie foods, such as nuts, are also rich in nutrients.
That means that "a focus on calories can result in an inattention to the quality of food choices," he said. "The best way to control calorie intake without constant hunger is to improve the overall quality of food choices. Ideally, more information should also be available about nutritional quality as well."
More information
Visit the U.S. Department of Agriculture ( ) for more on healthy eating.
SOURCES: David Katz, M.D., M.P.H., director Yale University Prevention Research Center, New Haven, Conn.; Nov. 24, 2104, news conference with: Margaret Hamburg, M.D., commissioner, U.S. Food and Drug Administration
by Steven Reinberg

FDA Panel Says Steroid Shots for Back Pain Can Continue

Advisory group decided against any new warning label being added to the controversial medicine
TUESDAY, Nov. 25, 2014 (HealthDay News) -- An expert advisory panel to the U.S. Food and Drug Administration decided on Tuesday not to add a strong warning against the general use of steroid injections for back pain.
The shots are commonly used to treat back pain, but they have never been approved for this use by the FDA, and whether their risks outweigh their benefits has long been a matter of debate.
The new vote, from the FDA's Anesthetic and Analgesic Drug Products Advisory Committee, essentially leaves the continued use of steroid shots for back pain largely unchanged.
As reported by The New York Times, the panel of experts said that only in one type of procedure -- a specific type of neck injection -- could the risks of the shots be said to outweigh a possible benefit.
That procedure is one where the needle comes very close to a grouping of small, important arteries in the neck. Those types of injections could raise the odds of a blocked artery, and have already been abandoned by most doctors, the Times said.
However, experts have been divided for years on whether steroid shots actually ease back pain.
One study published earlier this year in the New England Journal of Medicine found that people who have lower back pain caused by spinal stenosis -- a common condition among those over the age of 60 in which the open space in the spinal canal narrows from inflammation -- are unlikely to get relief from steroid shots.
Study author Dr. Janna Friedly, an assistant professor of rehabilitation medicine at the University of Washington in Seattle, said at the time that, "These steroid injections aren't helpful. There is no added benefit to the steroid itself, so if people are considering these injections, I would recommend that they consider an alternative."
However, Dr. Houman Danesh, a specialist in pain management and rehabilitation and physical medicine at Mount Sinai Hospital in New York City, said he believes these injections are both safe and effective.
"Steroid injections have been practiced longer than we have had a vaccine for polio, and after six decades the FDA has decided to review the safety and efficacy of these injections," he noted.
Danesh believes the FDA's current interest is based on an incident in 2012, when more than 700 people contracted fungal meningitis and other infections that resulted in more than 60 deaths, all the result of a single compounding pharmacy distributing steroids contaminated with a fungus that caused these complications.
He added that effectiveness of steroid injections has been studied in multiple clinical trials in the past. "One of the first studies, in 1977, was a placebo-controlled, randomized study. This study showed up to 70 percent improvement in pain with steroid injections, compared with 43 percent with placebo," he said.
In 2008, studies showed as many as 91 percent of people getting these injections reported significant pain relief, Danesh said.
"Steroid injections are a safe and effective means of treating nerve irritation in the spine," he added.
More information
Visit the U.S. National Library of Medicine ( ) for more on steroid shots.
SOURCES: Houman Danesh, M.D., specialist, pain management and rehabilitation and physical medicine, Mount Sinai Hospital, New York City; U.S. Food and Drug Administration
by Steven Reinberg

Most Americans With HIV Don't Have Virus Under Control, CDC Says

U.S. experts cite indifference, lack of access to care
TUESDAY, Nov. 25, 2014 (HealthDay News) -- Fewer than one-third of Americans living with HIV had the virus under control in 2011, with many either not receiving regular medical care or unaware they carry the virus, a new U.S. study finds.
The U.S. Centers for Disease Control and Prevention study estimates that 70 percent of the 1.2 million Americans living with HIV in 2011 did not have their virus under control, even though combination drug therapies can effectively suppress the virus before it can develop into full-blown AIDS.
A combination of indifference and lack of access to medical care appeared to outweigh ignorance as a driving factor in cases of uncontrolled HIV, researchers from the CDC's National Center for HIV/AIDS reported Tuesday.
"For people living with HIV and AIDS, it's not enough to know -- you also have to go for health care," said CDC Director Dr. Tom Frieden at a Tuesday news briefing.
"For health care systems, it's not enough to diagnose patients," he added. "You have to take accountability and responsibility for every patient diagnosed in your health center, to provide them with the most sensitive, effective, culturally appropriate care so that they will get onto treatment, stay into treatment, live longer, live healthier, stay out of the hospital and not infect others."
When used consistently, antiretroviral medication can keep HIV controlled at very low levels in the body, allowing people with HIV to live longer, healthier lives, Frieden said.
Viral suppression also reduces the likelihood that patients will transmit HIV to others. Treatment has been shown to reduce sexual transmission of HIV by 96 percent, the CDC said, and U.S. clinical guidelines recommend that everyone diagnosed with HIV receive treatment.
Among the nearly 840,000 people who had not achieved viral suppression, researchers found that:
66 percent had been diagnosed but were not engaged in regular HIV care; 20 percent did not yet know they were infected; 4 percent were getting some care but weren't prescribed antiretroviral treatment; 10 percent were prescribed antiretroviral treatment but had not been able to fully suppress their HIV.
The study did not find statistically significant differences in viral suppression by race, ethnicity or gender, which is "encouraging," said Dr. Jonathan Mermin, director of the CDC's National Center for HIV/AIDS, Viral Hepatitis, STD and Tuberculosis Prevention.
But researchers did find that young adults are at greater risk of uncontrolled HIV, with only 13 percent of people age 18 to 24 having achieved viral suppression. "More than any other group, our young people are not getting the care they need," said Mermin, also speaking at the news briefing.
This is largely because young adults are less likely to have been diagnosed with HIV. Only half of those 18 to 24 with HIV have been diagnosed, compared with more than 90 percent of people 45 and older, the report said.
"To close the age gap in viral suppression, we will need to expand efforts to reach young adults with HIV testing," Mermin said.
Mermin said that accessing HIV care can be difficult, particularly for people who are impoverished or suffering from substance abuse problems.
But even people of means can find it hard to maintain HIV treatment, Frieden said.
"Taking treatment for an infection that may have no symptoms and that you need to take for life is not easy," he said. "That's why it's so important that services for people living with HIV be sensitive, easy to access and without financial barriers."
The CDC hopes to improve HIV diagnosis and treatment through efforts launched in 2010 as part of the National HIV/AIDS Strategy, said Dr. Eugene McCray, director of the CDC's Division of HIV/AIDS Prevention, at the news briefing.
McCray said these efforts include innovative partnerships to make HIV testing simple, accessible and routine.
Additional efforts include programs to help health departments identify infected individuals who have fallen out of care. Public awareness campaigns about the importance of HIV testing and ongoing HIV treatment are also key, McCray said.
More information
For more on HIV, visit the U.S. National Institutes of Health ( ).
SOURCES: Tom Frieden, M.D., M.P.H., Director, U.S. Centers for Disease Control and Prevention; Jonathan Mermin, M.D., M.P.H., Director, U.S. National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention; Eugene McCray, M.D., Director, CDC Division of HIV/AIDS Prevention; CDC Vital Signs report, Nov. 25, 2014
by Steven Reinberg

Parents Need to Take Lead on Teen Concussion Prevention

Expert advises protective gear, and baseline concussion testing for athletes
TUESDAY, Nov. 25, 2014 (HealthDay News) -- Parents need to take an active role in protecting their children from sports concussions, an expert warns.
Parents must make sure sports-playing teens have the right protective gear and undergo standard, Dr. David Dodick, chair of the American Migraine Foundation and a professor of medicine at the Mayo Clinic College of Medicine in Scottsdale, Ariz. in an American Migraine Foundation, said in a foundation news release.
Any coach involved with teens sports needs to have appropriate training. Teen sports teams need concussion sideline and after-injury protocol, said Dodick. He also advised that there should be either a health professional available at games to evaluate blows to the head, or a safety officer who can give simple tests to determine if an athlete has suffered a concussion.
It's also important to make sure that schools forbid students with concussions from playing and don't allow them to return to play until cleared by a concussion specialist, Dodick said.
Teens need to understand how serious a concussion can be. Parents should also make sure their teen knows the signs and symptoms of concussion, which include nausea and vomiting, dizziness, confusion, headache, slowed thinking, memory loss, insomnia or excessive sleeping, irritability/depression or mood swings, and sensitivity to light and/or noise.
If your child has any of these symptoms after a head injury, see a doctor immediately, said Dodick, who noted that symptoms can worsen over hours or days.
Another way to reduce children's risk of concussion is for them to play with others who are similar in height, weight, strength and level of training.
More information
The American Academy of Family Physicians has more about concussion ( ).
SOURCE: American Migraine Foundation, news release, Nov. 19, 2014
by Steven Reinberg

ER Visits on the Rise, Study Reports

About 96 percent of patients need medical care within two hours
TUESDAY, Nov. 25, 2014 (HealthDay News) -- The number of emergency department visits in the United States rose from about 130 million in 2010 to a record 136 million in 2011, according to the U.S. Centers for Disease Control and Prevention.
The findings also showed that fewer people were going to ERs with non-urgent medical needs: 96 percent of patients were identified as needing medical care within two hours of arriving at the ER. In 2010, that number was 92 percent, according to the research.
Sixty percent of patients arrived at the ER after normal business hours (after 5 p.m. on weekdays). One-third of visits were for patients on either end of the age spectrum -- younger than 15 or older than 65, the researchers found.
Almost 30 percent of visits were for injuries. The highest injury rates were among patients 75 and older, the study noted.
"The report also finds that there are large numbers of admitted patients who wait long times for inpatient beds," Dr. Michael Gerardi, president of the American College of Emergency Physicians (ACEP), said in an ACEP news release.
"Nearly two-thirds of patients waited two or more hours for beds in 2011, and nearly three-quarters of hospitals continued to board patients, even when the emergency department was critically overloaded. Hospitals must move admitted patients out of the emergency department faster to make room for the increasing number of people coming," he said.
It's believed that there will be about 140 million ER visits in 2014, according to the ACEP.
"The growth in patient demand aligns with what emergency physicians have been seeing and predicting: demand is going to increase," Gerardi said.
"Given that our nation's population is aging, and emergency departments have a critical role as the front line of responding to disasters and infectious disease outbreaks in America, such as what we saw with Ebola, we need to prepare for increased numbers of patients," he added.
Despite increasing use of ERs, most hospitals had not expanded their ERs as of 2011 and had no plans to expand them in the following two years, according to Gerardi.
"Emergency departments are essential to every community and must have adequate resources," he said. "They continue to be under severe stress and face soaring demands, despite the efficiency of caring for more than 136 million of the sickest patients each year using only 4 percent of the nation's health care dollar. This report is more evidence that we are going to need more resources, not less, in the future."
More information
The U.S. National Library of Medicine has more about emergency medical services ( ).
SOURCE: American College of Emergency Physicians, news release, Nov. 20, 2014
by Steven Reinberg

Brain Abnormality Spotted in Many SIDS Babies

But finding is too preliminary to say it causes the deadly condition, experts say
TUESDAY, Nov. 25, 2014 (HealthDay News) -- A brain abnormality may be responsible for more than 40 percent of deaths from sudden infant death syndrome (SIDS), a new study suggests.
The abnormality is in the hippocampus, a part of the brain that influences breathing, heart rate and body temperature. This abnormality may disrupt the brain's control of breathing and heart rate during sleep or during brief waking that happens during the night, the researchers report.
"This abnormality could put infants at risk for SIDS," said lead researcher Dr. Hannah Kinney, a professor of pathology at Harvard Medical School in Boston.
Kinney can't say for sure that this abnormality is a cause of SIDS. "We don't know at this stage. This is the first observation of this abnormality," she said. "It's just an observation at this point."
Before this brain abnormality can be called a cause of SIDS, Kinney said, they have to find out what causes this abnormality and determine if it alone can cause SIDS.
For the study, Kinney's team examined sections of the hippocampus from 153 infants who died suddenly and unexpectedly between 1991 and 2012. The deaths were classified as unexplained -- which includes SIDS -- or from a known cause, such as infection, accident, murder or lack of oxygen.
Kinney's group found that 41.2 percent of infants who died for an unexplained reason compared with 7.7 percent of those whose death was explainable had an abnormality in the part of the hippocampus known as the dentate gyrus.
Among the 86 infants whose death was classified as SIDS, 43 percent had this abnormality, the researchers added.
This change in the dentate gyrus suggests there was a problem in development at some point late in the life of the fetus or in the months after birth, Kinney said.
Kinney added that this abnormality has only been seen under the microscope after death, so a child cannot be tested for the abnormality.
"There are no signs or symptoms that predict SIDS or warn families that this problem is there or that SIDS is going to occur," she said.
The report was published online Nov. 24 in the journal Acta Neuropathologica.
"Until we understand more about this abnormality, parents should follow the safe sleep recommendations of the American Academy of Pediatrics," Kinney said.
The recommendation is to place an infant alone in a crib on the back without toys or pillows as bolsters. "The same messages we have always had are still applicable," she said.
SIDS is the leading cause of death of infants younger than 1 year of age in the United States, the researchers said.
Dr. Sayed Naqvi, a pediatric neurologist at Miami Children's Hospital, noted that this brain abnormality has been found in epilepsy, but this is the first time it has been linked to SIDS.
"This needs to be confirmed and more research done to say this is a cause of SIDS," he said.
Marian Willinger, a special assistant for SIDS at U.S. National Institute of Health's Eunice Kennedy Shriver National Institute of Child Health and Human Development, said in a statement, "The new finding adds to a growing body of evidence that brain abnormalities may underlie many cases of SIDS."
"The hope is that research efforts in this area eventually will provide the means to identify vulnerable infants so that we'll be able to reduce their risk for SIDS," she added.
More information
Visit the U.S. Centers for Disease Control and Prevention ( ) for more on SIDS.
SOURCES: Hannah Kinney, M.D., professor, pathology, Harvard Medical School, Boston, Mass.; Sayed Naqvi, M.D., pediatric neurologist, Miami Children's Hospital, Miami, Fla.; Nov. 24, 2014, Acta Neuropathologica, online
by Steven Reinberg

Could Popular Heartburn Drugs Upset Your 'Good' Gut Bugs?

Study suggests class of meds upset healthy balance of bacteria in the gut
TUESDAY, Nov. 25, 2014 (HealthDay News) -- Heartburn drugs such as Prilosec and Nexium may disrupt the makeup of bacteria in the digestive system, potentially boosting the risk of infections and other problems, a small new study suggests.
The research doesn't confirm that these changes make it more likely users will become ill, and study authors aren't recommending that anyone stop taking the so-called proton pump inhibitors.
However, these antacids "should be used at the lowest dose that provides adequate relief of symptoms, and attempts to discontinue their use should be considered periodically," said study co-author Dr. John DiBaise, professor of medicine at the Mayo Clinic in Scottsdale, Ariz.
According to Harvard Medical School, billions of dollars are spent annually on antacid drugs in an attempt to combat heartburn, ulcers and gastroesophageal reflux disease, also known as GERD. Old standbys such as Maalox and Mylanta have been supplanted by more effective, more expensive drugs, including proton pump inhibitors. These include Prevacid (lansoprazole) and Protonix (pantoprazole) in addition to Prilosec (omeprazole) and Nexium (esomeprazole).
"Despite years of safe and effective use, in recent years there have been an increasing number of reports suggesting potentially harmful effects and harmful associations with their use," DiBaise said.
Long-term use of proton pump inhibitors has been linked to infection with a germ called Clostridium difficile, which causes severe diarrhea, he said. Researchers have also connected the medications to vitamin deficiencies, bone fractures and pneumonia, among other conditions.
In the new study, researchers sought to understand what happens to the trillions of germs in the digestive system when people take omeprazole, the generic name for the drug best known as Prilosec.
Ten participants, aged 18 to 57, took 20 or 40 milligrams of the drug a day for 28 days. Researchers analyzed the study participants' stool samples to understand the germs in their guts.
"These microbes have evolved with us to participate in our normal development and metabolism, and perform certain functions that we would not be able to accomplish without their help," DiBaise said. Many scientists believe that people's risk of disease goes up when their normal germ makeup changes, he said.
The researchers found evidence that the medications disrupted the balance of bacteria in the digestive systems of the participants, and the changes lasted for at least a month after they discontinued the drug. It didn't seem to matter whether they took the higher or lower dose, DiBaise said.
DiBaise cautioned that the study doesn't prove that the drug causes users to become more vulnerable to C. difficile infections. However, it shows that the drug "creates a situation in the gut microbial environment that may increase an individual's susceptibility," he said.
The researchers suggest additional research is needed with a larger group of study participants.
What should users do for now? According to DiBaise, proton pump inhibitors are "the most effective medications to treat gastroesophageal reflux disease." If patients don't have the most severe symptoms, he said, other types of heartburn drugs might help. Also recommended: eating smaller portions, losing weight, not lying down for two hours after eating, and avoiding alcohol, cigarettes and "trigger" foods.
Dr. David Johnson, chief of gastroenterology at Eastern Virginia Medical School, said patients shouldn't become alarmed about "the safest class of therapy I've used in the 34 years being a doctor."
The new research won't stop him from prescribing the drugs, Johnson said, adding he's "hesitant to make too much out of this." Even so, "the key message is that patients should talk to their care provider and discuss the need for these medications and justify their continued use."
The study was published Nov. 24 in the journal Microbiome.
More information
For more about proton pump inhibitors, visit the U.S. National Library of Medicine ( ).
SOURCES: John DiBaise, M.D., professor, medicine, Mayo Clinic, Scottsdale, Ariz.; David Johnson, M.D., chief, gastroenterology, Eastern Virginia Medical School, Norfolk, Va.; Nov. 24, 2014, Microbiome
by Steven Reinberg

Daily Physical Activity May Help Lower Parkinson's Risk

Six hours a week of household chores or commuting seem protective, study finds
TUESDAY, Nov. 25, 2014 (HealthDay News) -- A moderate amount of physical activity in your daily life may reduce your risk of Parkinson's disease, according to a new study.
"We found that a medium level of daily total physical activity is associated with a lower risk of Parkinson's disease," study author Karin Wirdefeldt, of the Karolinska Institute in Stockholm, said in a news release from the journal that published her study, Brain: A Journal of Neurology.
While the study found a link between exercise and a reduced risk of Parkinson's disease, it's important to note that it wasn't designed to prove that exercise was the definitive cause of this lower risk.
The research included more than 43,000 women and men in Sweden who were followed for an average of more than 12 years. None had Parkinson's disease when they enrolled. Nearly 300 had been diagnosed with the disorder by the end of the study.
Those who got more than six hours a week of physical activity through household tasks and commuting to work had a 43 percent lower risk of Parkinson's than those who got fewer than two hours a week of such activities, the researchers found.
The researchers also noted that men with a medium level of total physical activity were 45 percent less likely to develop Parkinson's than those with a low level of total physical activity.
Leisure time exercise alone was not associated with a lower risk of Parkinson's, according to the study.
More information
The Parkinson's Disease Foundation has more about Parkinson's disease ( ).
SOURCE: Brain: A Journal of Neurology, news release, Nov. 18, 2014
by Steven Reinberg

Early Puberty Linked to Increased Risk of Depression in Teens

Researchers find odds raised in both boys and girls developing sooner than peers
TUESDAY, Nov. 25, 2014 (HealthDay News) -- Youngsters who enter puberty early are at increased risk for depression, a new study suggests.
Early puberty was linked with a number of factors associated with depression, such as poor self-image and high anxiety levels, according to the researchers. Early puberty was also linked to social problems, such as conflict with family and peers, and having friends who were prone to getting into trouble, the study found.
Although the study found an association between early puberty and these factors, it's important to note that the study wasn't designed to show that early puberty was the cause of these issues.
"Only some teens are vulnerable to the effects of early maturation, particularly those with more disruption in their families and less support in their peer relationships," study leader Karen Rudolph, a psychology professor at the University of Illinois, said in a university news release.
The study also found that early puberty was associated with an increased risk of depression in boys as well as girls.
"It is often believed that going through puberty earlier than peers only contributes to depression in girls," Rudolph said. "We found that early maturation can also be a risk for boys as they progress through adolescence, but the timing is different than in girls," she added.
"In girls, early maturation seems to trigger immediate psychological and environmental risks and consequent depression," Rudolph said. "Pubertal changes cause early maturing girls to feel badly about themselves, cope less effectively with social problems, affiliate with deviant peers, enter riskier and more stressful social contexts and experience disruption and conflict within their relationships."
Initially, boys who entered puberty early had much lower rates of depression than girls, but had similar rates by the end of the study's fourth year.
"While early maturation seemed to protect boys from the challenges of puberty initially, boys experienced an emerging cascade of personal and contextual risks -- negative self-image, anxiety, social problems and interpersonal stress -- that eventuated in depression as they moved through adolescence," Rudolph said.
The study followed 160 youth for four years. It was published online in the journal Development and Psychopathology.
More information
The American Academy of Family Physicians has more about depression in children and teens ( ).
SOURCE: University of Illinois, news release, Nov. 19, 2014
by Steven Reinberg

Full-Day Preschool Beats Part-Day for School Preparedness

Full-time program for youngest tots boosts test scores, attendance: study
TUESDAY, Nov. 25, 2014 (HealthDay News) -- Children who attend a full-day preschool program are better prepared for elementary school success than children who attend a part-day program, a new study has found.
Chicago preschoolers who went the whole day rather than a half-day had higher scores on measures of school readiness skills, including language, math, social development and physical health, researchers from the University of Minnesota reported.
"We found that about 80 percent of children with full-day preschool were at or above national norms in terms of school readiness, compared with 58 percent of children at a part-day program," said Arthur Reynolds, a professor at the University of Minnesota Institute of Child Development.
Full-day preschool gave kids a jump on nearly all skill sets equal to an additional three to four months of learning, the researchers found. "These are sizable benefits," Reynolds said.
The full-day preschoolers also had better attendance and fewer instances of chronic absence, the researchers reported in the Nov. 26 issue of the Journal of the American Medical Association.
The findings are good news for parents juggling heavy workloads, said Dr. Andrew Adesman, chief of developmental and behavioral pediatrics at Cohen Children's Medical Center of New York, in New Hyde Park, N.Y.
"These findings are likely comforting and reassuring for households where the work commitments of the primary caregivers necessitate placing their child in a full-day preschool program," Adesman said. "Although the findings from this methodologically rigorous study need to be replicated, the results cannot be ignored until then."
Nationally, about half of children who enter kindergarten aren't properly prepared for K-12 school, Reynolds said.
Reynolds and his colleagues wanted to see whether attending a full day at a high-quality preschool program could better prepare children for K-12 than just going for half-days.
The study focused on nearly 1,000 predominantly low-income, ethnic minority children enrolled in the Midwest Child-Parent Center Education Program at 11 Chicago schools for the 2012-2013 school year. Of the children, 409 attended full-day preschool and 573 attended a part-day program.
At the end of preschool, researchers evaluated school readiness skills of the children. They found that full-day preschool participants had higher scores than part-day peers on a range of skills, and also had better school attendance. Scores for literacy and mental development were not significantly different.
"It's good to see that more exposure to a good thing does better than less exposure," said Lawrence Schweinhart, former president of the HighScope Educational Research Foundation in Ann Arbor, Mich.
A full day of preschool gives teachers a chance to engage with the kids on a variety of important subjects, Reynolds said.
"In a part-time program, we find most of that time is devoted to language development or reading," Reynolds said. "There isn't time in two-and-a-half or three hours to cover math, science, social-emotional learning and other skill sets that will help children prepare for school."
Parents also are more likely to encourage attendance with a full-day program, he added.
"If you're only there for a couple of hours, it's easy to miss a day," Reynolds said. "But in a seven-hour day there's a lot going on, so if you miss a day you miss a lot. It's a packed day, but a nurturing day. Parents see the value of a full day and they see their child growing at a higher level, and they don't want to miss that."
However, children likely will not reap these benefits if they go to a low-quality preschool that acts more like a day care center than an educational program, said Schweinhart, who wrote an editorial accompanying the study.
"The key is that you've got a good program you're getting more of," Schweinhart said. "I think sometimes people have so-so programs and they expand them from part-day to full-day and then say, 'We're not seeing any benefits.' Well, you probably weren't seeing any benefits to begin with."
More information
The American Academy of Pediatrics has more about preschool growth and development ( ).
SOURCES: Arthur Reynolds, Ph.D., professor, University of Minnesota Institute of Child Development, Minneapolis, Minn.; Andrew Adesman, M.D., chief of developmental and behavioral pediatrics, Cohen Children's Medical Center of New York, New Hyde Park, N.Y.; Lawrence Schweinhart, Ph.D., former president, HighScope Educational Research Foundation, Ann Arbor, Mich.; Nov. 26, 2014 Journal of the American Medical Association

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