CENTER UPDATE - July 2007
Welcome to Center Update, the 5th edition of the Center for Pediatric Integrative Medicine Newsletter. The purpose of this newsletter is to share with you recent practice developments, relevant research, books and websites, and any other information that may help you and your family make informed choices and be healthy.

Practice News
I returned recently from a medical conference at Hollyhock Retreat Center, on Cortes Island in British Columbia. Dr. Andrew Weil, myself, and other faculty from the Program in Integrative Medicine presented a workshop on Integrative Medicine. My talks were on the Integrative Treatment of ADHD in children and adults, and on Food Ecology and nutrition. It was great to be up there, despite the record heat wave they had. 95 degree temperatures without air conditioning were not what I expected from the Pacific Northwest!

Also, I'm excited to be speaking at the American Academy of Pediatrics annual meeting in San Francisco in October. I've been invited to be part of a panel discussing the use of Complementary, Alternative, and Integrative medicine in developmental pediatrics. This is put on by the AAP provisional section for CAM and Integrative medicine, and represents an important chance to present our point of view to conventional pediatricians at a major medical conference.

I hope some of you saw my Op Ed piece in the Daily Star concerning childhood Obesity. The main point of the article was that the increasing obesity of our children poses a tremendous health risk, and that we need to do something about it both as individual families and as a community. Let me know if you have any thoughts about how we can reverse this very dangerous trend.

I've written an article for a new book on children who have Gastrostomy Tubes. The article is called "A Pediatrician's Perspective on Homemade Blended Formulas". It is in "Homemade Blended Formula Handbook" by Klein and Morris, which should be published within the next couple of weeks. I'm going to put the article on my website soon for those who are interested.

We have some preliminary results from our Chelation Study on children with autism. As many of you know, we compared the results of 3 months of chelation therapy with DMSA to treatment with a placebo. So far, it looks like both groups showed some mild improvement after 3 months, but the group taking the DMSA did no better than the group taking the placebo. I'll wait for final results to be in, but so far the results do not indicate that 3 months of chelation caused any significant improvement in autism symptoms. I will add that there were some interesting positive results. It looks like even 1 dose of DMSA helped to normalize glutathione levels, and glutathione may be important for metabolism in autism. Also, there were no significant liver, kidney, or other significant side-effects from the DMSA, so the safety looks good.

Although we had our usual quiet spell in the early summer, the Center is quite busy again. The variety of patients we're seeing is amazing. Everything from ADHD and Autism to Cancer, Chronic Fatigue Syndrome, Asthma and Allergies, GI problems, and many children with chronic pain of one type or another.

I would like to sincerely ask everyone to avoid canceling or rescheduling appointments at the last minute if at all possible. Because each follow-up appointment is 45 minutes, last-minute cancellations leave a real hole in the schedule. This prevents others from being seen, makes it hard to keep our fees down, and harder to cover the significant overhead costs of a private medical practice. Thank you for your cooperation with appointments.

Research Corner
Organic Foods - Is buying organic foods for your child worthwhile? A recent study published in 2006 showed it might be. Researchers measured the pesticide residues in the urine of 23 children, and then placed them on a mainly organic food diet for 5 days. The pesticide residues essentially disappeared almost immediately after beginning the organic diet, and reappeared quickly as soon as non-organic foods were placed back in the diet. What does this mean? It means that children accumulate significant pesticide levels when eating food produced with pesticides, and that they don't when eating organic food. It also showed that these children did not have significant pesticide exposure, at least to the pesticides that were tested, from environmental sources such as lawns, furniture, etc. The study did not prove, however, that these pesticides caused health damage. I personally believe they do, but that is much harder to demonstrate scientifically.

But what if you can't afford the high prices?

First of all, go to a farmers market. They're all over town, and you can get Organic or at least Pesticide Free foods for very reasonable prices. I believe pesticide free fruits and vegetables are often just as good as those labeled "Organic". It's a fun outing to do with the kids and gives you a chance to talk about where food really comes from.

Second, be selective in what you buy Organic. Here's a great article from Consumer Reports on what is and isn't worth paying the extra money for.

Omega-3 Fatty Acids - a recent study published in Nutrition Journal by Edward Hallowell, a well known Omega-3 expert, once again demonstrated that treatment with Omega-3 Fatty Acids was helpful for children with ADHD. The striking part of the study though was that they used 16 grams of EPA/DHA per day. This is approximately 10 times the usual dose used for ADHD! Amazingly, there were no significant side-effects or adverse reactions. This is just one study, but it joins other studies in the literature suggesting that higher doses of the Omega-3's may be beneficial for a wide variety of conditions. I'm not ready to use that much yet, but I am going to suggest significantly higher doses for some children on an individual basis. Please feel free to come in for an appointment if you think your child could benefit.

Recommended Books and Websites

The Sneaky Chef by Missy Chase Lapine - This book is all about adding wonderfully nutritious foods, (such as fruits, vegetables, beans, etc.) to your kid's diet without their even being aware of it. There are many very simple recipes, which frequently can be prepared as several servings worth made in advance. One of my favorites is the "better breading" which can turn chicken into chicken nuggets without sacrificing good nutrition. "Breakfast ice cream" is another great one. I'd have liked to have had this book when my kids were little.

Low-Priced Supplements and Vitamins - I remain aware that supplements and vitamins can be expensive. Just as a reminder, www.vitacost.com is one of many online sites where you can get brand name supplements for significantly reduced prices. As an example, a 2 month supply of Nordic Naturals Ultimate Omega is about $36 compared to $48 retail. The shipping is $5.00 for any size order, so if you are buying a few months worth or a few supplements there are significant savings. This is just an example. Similar sites may have as good or better deals.

Nutritional Tips

Many of the children in our practice are on dairy-free diets. Although avoiding drinking milk isn't always a big problem, avoiding cheese is tough. (No pizza??!!!) We recently found a rice cheese that melts very nicely and tastes pretty good. I believe it would work fine on a homemade pizza or macaroni and cheese. It is called Lisanatti Rice Cheese, and comes as a yellow or white style cheese, in slices or blocks: mozzarella, cheddar, or jack. It is also packaged simply as "Rice" by Galaxy Nutritional Foods and is near the cheese section, but you may have to ask for its' exact location in the store. It is soy, gluten, and preservative free as well. We got it at Wild Oats but it is probably available in other places as well.

And speaking of food sensitivities, for those kids who can't eat wheat, we just found a great rice based gluten-free macaroni type noodle. It's called "Little Dreams" made by "Tinkyada". They are flat circular noodles shaped like cars, trucks, and trains. Both the taste and texture are very good. Again, we found them at Wild Oats.

Please let me know if there are any specific issues or concerns you would like me to address in the next issue of this newsletter.

Have a great rest of the summer, and enjoy the rain while it's here.