Aetna Latest Healthy Living News

Most Parents Report Distracted Driving

Mon, 06 May 2013 00:00:00 -0400

In a new survey, nearly 90% of parents admitted to being distracted by technology in the last month while driving with their kids. The activities ranged from talking on the phone or texting to fiddling with the GPS or DVD player. And there were old-style distractions, too, such as eating or picking up a toy. The top distraction was phone calls. Nearly 75% of parents talked on the phone while driving. About 600 parents took part in the survey. They answered questions while their children were being treated for a variety of reasons in an emergency room. The children's ages ranged from 1 through 12. About 70% said they did something related to child care while driving. Examples included feeding the child or picking up a toy. Nearly as many reported self-care, such as eating or grooming. About half were distracted by seeking directions on a GPS or map. Similar numbers did something related to entertainment, such as changing a DVD. About 15% reported texting while driving. Parents who reported distractions were also more likely to have been in a car accident at some point. The study was presented at a conference. HealthDay News wrote about it May 6. What Is the Doctor's Reaction? When we think of distracted drivers, we tend to think about teenagers, or those erratic drivers in front of us who don't use their turn signals because they are holding their phones. We don't necessarily think about … parents. But, it turns out, parents can be very distracted drivers. In a study just released, researchers from Michigan did a survey of more than 600 adults. All were parents and caregivers of children ages 1 through 12 who were seen in an emergency room for any reason. Researchers asked the parents how often in the last month they had performed certain distracting activities while driving with their child in the car. Here are the rough percentages that reported doing each of these activities:

Phone calls (handheld or hands-free): 75%
Child care (feeding, picking up a dropped toy): 70%
Self-care (grooming, eating): 70%
Directions (checking navigation system or map): 50%
Entertainment (changing CD or DVD): 50%
Texting: 15%

Almost 90% said they had engaged in at least one technology-based distraction in the last month. These activities are not all equally dangerous. Munching on a pretzel or listening to your GPS system tell you to turn right is absolutely not as dangerous as texting or leaning back to grab a dropped toy. But we know that distractions can lead to accidents. Among these parents, people who used a phone or did self-care while driving were more than twice as likely to have ever been in a motor vehicle crash. Those who did child care or got directions were just under twice as likely. Drivers who had ever been in a crash were more likely to report some sort of distracted driving than drivers never involved in a crash. Another interesting finding was that parents whose children were not restrained in the car properly (according to Michigan law) more often reported child care distractions or texting. What Changes Can I Make Now? All passengers are precious cargo, but children are especially precious. They count on parents and caregivers to keep them safe. Distractions cause accidents. We talk a lot about cell phones, but anything can do it. You could be changing a radio station, or just turning to talk to the person next to you. Anything that takes your eyes and concentration off the road can lead to a crash. It's crucial that parents and caregivers understand this. It's hard not to have any distractions. But you can limit them. Here are a few things you can do:

It's best to pull over to make a phone call. If you have to make a call while driving, use a hands-free device.
If snacks or toys are needed for a ride, do some planning to make sure they are within your children's reach.
Make rules for the car. Let your kids know that you simply aren't going to fix the DVD or change the music or reach back to get something while you are driving. Then they'll be less likely to get upset and you'll be less likely to be tempted to break your rules. Don't try to explain it to them while you're in the car. Talk about it ahead of time.
Whenever possible, have another adult (or at least an older child) with you when taking long car trips with children.
Resist the temptation to do a drive-thru for meals. Stop and eat. Between eating yourself and reaching back to grab or give food, you are putting everyone at risk.
Know where you are going ahead of time. This helps avoid the distraction of figuring it out on a map or your smart phone while driving. If you need to use a GPS system, use one that tells you what to do, as opposed to one that you need to look at. If you do need to look at it, mount it on the dashboard to minimize the amount of time your eyes are off the road.

What Can I Expect Looking to the Future? If we don't work to limit distractions, what we can expect is more motor vehicle accidents. I hope that this study will be a wake-up call -- and will help save lives.

FDA Probes Wider Caffeine Use in Food

Fri, 03 May 2013 00:00:00 -0400

Caffeine has been showing up recently in snack foods, candy and gum. Now U.S. food regulators are taking an interest. The Food and Drug Administration (FDA) says it will look at the effects of caffeinated foods on children's health and take action if necessary. The Associated Press wrote about it April 30. The announcement came in response to a new product that went on the market this week, Wrigley's Alert Energy Gum. The agency already is investigating the use of caffeine in energy drinks and energy shots. The FDA has given specific approval to the use of caffeine in a food or drink only once, for colas. That decision was in the 1950s. An official said the recent expansion of caffeine use in foods is "disturbing" and "beyond anything FDA envisioned." Other recent products that contain caffeine include Jelly Belly Extreme Sport Beans, snacks from ARMA Energy and Frito-Lay's Cracker Jack'd Power Bites. Labels say the products are for adult use only. But critics say they could be attractive to children as well. What Is the Doctor's Reaction? Hi doctor,

I'll make it short. Could you please let me know if anything in this supplement might be harmful to me? I don't use it for weight loss but just something to help me with more energy.

Thanks for your advice in this matter. I am a primary care doctor. I get questions from patients all the time about supplements, energy drinks, diet pills and herbal mixtures that have been advertised. This was a message I got last week. Many of these "energy boosters" have caffeine as their active ingredient. That was true for the supplement my patient was asking me about in this message. Each pill had the amount of caffeine that you would get from two cups of coffee. Caffeine boosters and snacks are in the news right now. This week, Wrigley started selling a caffeinated gum, calling it "the right energy, right now." Food manufacturers have also recently put caffeine into candy, chocolates, jelly beans, trail mix, chips and other snack foods. Some people are getting more caffeine through these energy snacks than they ever got from coffee. They are being marketed as a wellness product -- for more energy, better athletic performance. So are caffeinated snacks safe? In moderation, they are probably not going to do harm. However, the Food and Drug Administration (FDA) received 92 reports in 4 years about illnesses, hospital stays and deaths that came after people drank an energy drink named 5-Hour Energy. The FDA has also received reports of several deaths possibly linked to Monster Energy Drink. These reports do not prove that the caffeinated drinks actually caused the deaths. Caffeine has its effect in the body by triggering the brain to make extra adrenaline-type hormones. This can stress the heart and raise blood pressure. What Changes Can I Make Now? Caffeine is not a problem in the early part of the day, and in small amounts. But it is good for you to know the side effects of regular, heavy use of caffeine. If you want more energy, the healthiest way to get that is by exercising and by getting enough sleep, not by using caffeine:

Caffeine may be linked to an increased heart attack risk. Researchers focused on people with slow caffeine metabolism. This means that caffeine stays in their bodies for a long time. Among this subgroup, heart attacks were more likely to occur in heavy coffee drinkers. Drinking 2 to 3 cups of coffee each day seemed to be linked with a 36% increase in heart attack risk. With 4 or more cups each day, the increase appeared to be 64%. This study was not designed in a way that would tell us for sure that there is risk from caffeine.

Unfiltered coffee might ever-so-slightly increase your total cholesterol levels. Drinking 6 cups of unfiltered coffee (such as espresso) daily appears to increase total cholesterol by about 12 milligrams per deciliter. This small change is not much to be concerned about.

Heavy coffee intake might change your blood level of homocysteine. This is a substance that has been linked with heart risk. In one study, people who drank 6 cups of coffee daily had a higher level of homocysteine than people who drank no coffee.

Drinking 3 or more cups per day is linked with a higher risk of miscarriage in early pregnancy.

Caffeine can thin your bones. It causes some calcium to filter out of the body through your kidneys.

For some people, caffeine causes headaches. This is a common symptom of caffeine withdrawal. Other withdrawal symptoms are fatigue, foggy thinking and an irritated mood.

Caffeine reliably causes insomnia. This is true for caffeine consumed as early in the day as noon.

Coffee or tea with meals can make you absorb less iron from the foods you eat.

Caffeine can cause anxiety symptoms.

But there is good news, too.

Some cancers seem to grow less if you consume caffeine.
Caffeine can stimulate a bowel movement. Morning coffee helps people to stay "regular."
Sometimes, caffeine can take away a migraine headache.
Caffeine is linked with a slightly lower diabetes risk.

What Can I Expect Looking to the Future? The Nurses' Health Study and the Physicians' Health Study each included tens of thousands of people. These studies showed no difference in diabetes or heart risk even for people drinking five cups of coffee per day. That is very reassuring about caffeine as a safe product. But now caffeine is being packaged in a way it can be just popped into your mouth. So it is possible to get a much bigger dose of caffeine at one time. The FDA is talking about restricting whether ads for caffeinated products may target children. Mostly, caffeine seems safe in moderate quantities. But we don't yet understand a "latte" about the full spectrum of risks or hazards of caffeine.

Kids Get Warts at Home, Study Finds

Mon, 22 Apr 2013 14:34:00 -0400

Kids mostly get warts from family members and classmates, not from public places, a new study suggests. The authors said advice on preventing warts may need to change. The study included about 1,000 schoolchildren. They were 4 to 12 years old when the study began. A medical student examined their hands and feet. Nearly one-third had warts. Parents answered questions about the history of warts for the child, family members, classmates and friends. Parents also were asked whether the child used public pools or showers. A different medical student examined the children for warts 11 to 18 months later. Warts occurred twice as often among white children and those who had other family members with warts. Having classmates with warts also increased risk somewhat. Using a public swimming pool appeared to increase risk. But the difference was so small it could have been caused by chance. Wart prevention now focuses on exposure in public places, such as advice to wear flip-flops in public showers. The authors said keeping warts covered with bandages at home might help more. The journal Pediatrics published the study. MedPage Today wrote about it April 22. What Is the Doctor's Reaction? Warts are really common. Children get them all the time. Do not believe the old wives' tale that touching frogs or toads causes warts. The human papillomavirus (HPV) causes warts. The wart virus is contagious (passed person to person). It spreads by directly touching it (close physical contact). This also means touching something that someone with a wart recently used, such as a towel or surface. The virus then may make its way onto the body through tiny scrapes or cuts in the skin. Current public health advice focuses on the spread of warts in public places, such as swimming pools and public showers. Children should wear flip-flops in communal showers and cover warts with waterproof bandages while swimming. In a study just published in the journal Pediatrics, researchers looked more closely at the way warts are spread among schoolchildren. They checked the hands and feet of children from three Dutch grade schools to see if they had warts. A year later, the researchers returned to check the same children again for warts. At each of these study visits, the parents filled out a survey. It focused on whether or not their child had factors that would increase their risk of getting warts. Some of the questions parents were asked included:

Has your child had a wart before?
Do any of your family members currently have warts?
Does your child walk barefoot at home?
Do your child's classmates have warts?
Do your child's closest friends have warts?
Does your child use public swimming pools?
Does your child use public showers?
Does your child practice sports barefoot?

The results of this study were a bit of a surprise. Children are more likely to get warts from their classmates or family members. They do not always get them in public places. Being exposed to HPV in public showers or swimming pools did not put children at higher risk of warts. The authors suggest that wart prevention strategies should focus more on protecting children at home and at school. For example, children should cover their warts with bandages even while at home. What Changes Can I Make Now? There is no way to totally prevent warts. But it is always a good idea to encourage kids to wash their hands and body regularly. If your child gets a cut, be sure to clean the area with soap and water. An open cut or scratch can allow warts and other germs to enter the body. Thankfully, warts do not cause serious problems for your child's health. They sometimes can be uncomfortable. This is most true when they are on the soles of the feet or another part of the body that gets bumped or touched a lot. Warts also can be embarrassing for older children. People do not like the way they look. Warts often will go away by themselves. However, your pediatrician may suggest these ways to treat them more quickly:

Place a piece of duct tape over the wart and change it daily.
Remove the wart surgically by:
- Scraping
- Cauterizing
- Freezing (with liquid nitrogen)

Do not forget that the 3-dose HPV vaccine series is recommended for all boys and girls when they turn 11. Genital warts can be spread during genital, oral and anal sex with a partner who is infected. When warts occur on the genitals, they are considered a sexually transmitted disease. There also is a link between genital warts and cervical cancer. If your teenage daughter has genital warts, she should have a Pap smear. This test is used to check for abnormal cells in the cervix (a warning sign for cervical cancer). What Can I Expect Looking to the Future? You can expect researchers will continue to look for better ways to prevent the spread of warts among children. The pediatrician will recommend that your child keep a wart covered with a bandage at school and at home (not just in public places). This will help limit the spread of the virus. You can learn more about warts and how to treat them from the patient website of the American Academy of Pediatrics.

Social Networks Linked to Vaccine Decisions

Mon, 15 Apr 2013 14:25:00 -0400

If your friends don't follow standard vaccine schedules, chances are you won't either. That's the conclusion of a study that surveyed 196 parents. All of them had children 18 months old or younger. They took online surveys that asked their opinions on vaccines and what schedules they followed for their kids' shots. They also were asked about their sources of vaccine information and what the sources recommended. In all, 70 people skipped some recommended shots for their children, or delayed some of them. Researchers called this group "nonconformers." They tended to ask more people for advice than conformers (those who followed standard schedules) did. About 72% of the nonconformers' advice networks recommended skipping or delaying vaccines. Only 13% of the conformers' networks gave this advice. Networks included spouses, doctors, other health professionals, friends, family and work colleagues. Most people also had other information sources. These included books, pamphlets and the Internet. However, the study showed that people had a stronger influence on decisions than other sources did. The journal Pediatrics published the study online. HealthDay News wrote about it April 15. What Is the Doctor's Reaction? When it comes to making decisions about vaccines for children, parents listen to their friends. This is understandable, of course. Part of the reason we choose our friends is that we value their opinions about things. But the problem is that friends don't always have the best information. That's especially true when it comes to medical subjects such as vaccination. Pediatrics, the journal of the American Academy of Pediatrics, just published a study about vaccines and social networks. The study was done in King County, Washington. Researchers asked first-time parents of children less than 18 months old to fill out online questionnaires. They asked the parents which people and which other sources they looked to when they were making decisions about vaccines. The parents then ranked those sources. Parents also were asked about their current vaccination decisions and what they thought about vaccines and vaccine-preventable diseases. Here's what the study found: What most predicted the parents' vaccination decisions was the percentage of people in their social networks who recommended either not giving vaccines or giving them on a different schedule. If their friends gave vaccines according to the schedule doctors recommend, the surveyed parents most likely did, too. If their friends didn't follow the schedule, they were more likely not to as well. The researchers called parents who didn't follow doctors' vaccine advice "nonconformers." It's interesting that these parents had more people in their networks than those who did follow doctors' advice. What Changes Can I Make Now? All parents should do three important things:

Get informed about vaccines. The thoughts and opinions of your friends are important. But it's also important that you get information from the most medically complete and up-to-date sources. The one I recommend most is the Centers for Disease Control and Prevention (CDC). The CDC vaccination website has everything you might want to know about vaccines and vaccine-preventable diseases.

If you have any questions or concerns about vaccines, talk to your doctor. Sometimes people feel intimidated, or they think the doctor might be upset if they question vaccines. But your doctor is there to help you. That includes helping you with your questions and concerns.

If you think that vaccines are a good idea, and your children are immunized, spread the word! The anti-vaccine community tends to be more vocal than the pro-vaccine community. This contributes to low vaccination rates. So speak up! Talk about why you've made the decisions you've made, and about your experience with vaccination. It's particularly important to talk to prospective parents -- friends who are pregnant or thinking about getting pregnant -- so that you can help influence their decisions.

What Can I Expect Looking to the Future? We have been seeing outbreaks of diseases, such as measles and pertussis, that vaccines can prevent. Sometimes the results have been deadly. That's one of the very real problems with hesitating to get vaccines. When children who are not immunized get sick, they endanger other children. Particularly at risk are children who can't get vaccines. They may be too young to get vaccinated (pertussis can be deadly for newborns, for example) or may have a medical problem that prevents it. When people choose not to vaccinate their children, they are putting other children at risk as well. This study tells us that if we want to encourage people to immunize their children, it's not enough to have doctors and health organizations lead the effort. Other parents -- and grandparents and day care providers and neighbors and community members -- need to help too. It takes a village to raise a child, they say. It may just take the village to get children immunized, too.

Study: Kids Take, Eat More with Big Plates

Mon, 08 Apr 2013 13:57:00 -0400

Kids eat more food when it's served on larger plates, a new study suggests. The study included 42 first graders. They were served lunch at their school cafeteria. Half got their food on smaller plates and half on larger plates. The menu was either chicken nuggets or pasta with meat sauce. Side dishes were applesauce, mixed vegetables and bread. The drink was milk. On average, kids using larger plates served themselves about 90 more calories. They didn't eat all of the extra food, but they did eat about half. Overall, they consumed more calories than kids using smaller plates. The children served themselves more fruit and more of the main dish on larger plates, but not more vegetables. The journal Pediatrics published the study. HealthDay News wrote about it April 8. What Is the Doctor's Reaction? Things these days just seem to be BIG. Huge sports utility vehicles (SUVs) are a common sight on the road. Large drinks are on the menu at restaurants. Big screen TVs are in many homes. So have you noticed the size of the dishes being used now? Americans are even using larger plates and bowls. Studies have shown that adults using larger dishes serve themselves more food, and eat more. Does the same thing happen with children? In a new study, researchers created an experiment to find out. They studied 42 first-grade children at a school in Philadelphia. The researchers observed the children during school lunch on 8 different days. The children were given either child-size or adult-size dishes. The menu had chicken nuggets for 4 of the days and pasta with meat sauce for the other 4 days. The rest of the menu was the same:

Applesauce and mixed vegetables as the side dishes
A drink of milk
A portion of bread

The researchers found something very interesting. Compared with children who used child-size dishes, those first graders who used the adult-size bowls and plates:

Served themselves more calories
Ate almost half of the extra calories they served themselves
Ate more total calories
Chose to take more chicken nuggets, pasta with meat sauce, and fruit
Did not take more vegetables

The main finding was that children ate more calories when they used the larger adult-size dishes. It did not make a difference how old the children were or whether they were boys or girls. Results were similar no matter how much the children weighed or what their body mass index (BMI) was. What Changes Can I Make Now? It is important to control portion sizes for your children. As this study showed, using child-size plates and bowls at home can help. You also can learn more about portion sizes. Oversized portions lead to weight gain. Here is a guide from the Academy of Nutrition and Dietetics to help you (and your children) see what the right serving size is.

Food	Average Serving Size	What It Looks Like
Meat	2 to 3 ounces	Deck of cards
Pasta or rice	1/2 cup	Tennis ball
Bread	1 slice	Stack of 3 CDs
Peanut butter	2 tablespoons	Ping pong ball
Vegetables	1/2 cup	Tennis ball
Cheese	1 ounce	4 dice

There are lots more ways parents can help to make sure their children keep a healthy weight:

Encourage physical activity. Insist on playtime! Make physical activity fun for your child. The American Academy of Pediatrics (AAP) recommends at least one hour a day for children.

Be good role models. Parents play a key role in helping their children become more physically active. If you are active, your children will follow your example.

Form healthy eating habits. Create a home where healthy choices are on hand and encouraged. The AAP recommends:
- Cooking healthy meals together as a family
- Regularly eating meals together as a family
- Eating breakfast every day
- Eating five servings of fruits and vegetables every day
- Eating low-fat dairy products such as yogurt, milk and cheese
- Limiting fast food, take-out food and restaurant meals
- Eating a diet rich in calcium
- Eating a high-fiber diet

Limit screen time. Children spend too much time watching TV, using the computer or playing video games. The more time your child spends in front of the screen, the less time he or she is outside being active. The AAP recommends keeping total screen time to no more than two hours per day.

Avoid sugared drinks. Sugar-sweetened drinks add too much sugar to the diet and too many calories with little (or no) nutritional value. Instead, encourage a child who is age 2 or older to drink water and low-fat milk. Some 100% fruit juices are OK, too. The AAP recommends that children have NO sugared drinks.

What Can I Expect Looking to the Future? Expect your child's doctor to point out the importance of living a healthy, active lifestyle. This includes both good eating habits and regular exercise. Expect schools also to encourage a healthy lifestyle. Schools should offer only healthy foods and drinks in the cafeteria and in vending machines. They also should promote healthy physical activity before, during and after school.

Study: Teen Habits Put Hearts at Risk

Wed, 03 Apr 2013 14:10:00 -0400

More than 8 out of 10 U.S. teenagers have unhealthy diets, a new survey has found. About 3 out of 10 boys and more than 5 out of 10 girls don't get enough exercise, the survey found. Nearly one-third have abnormal cholesterol levels. And similar numbers are overweight or obese. Researchers said these results show that many of today's teens may be at risk of early heart disease. The nationwide study included 4,600 teenagers. The American Heart Association says that 7 factors lead to optimum heart health. They are a healthy diet, healthy weight, regular exercise, not smoking and having ideal levels of cholesterol, blood pressure and blood sugar. Only half of the teens surveyed met 5 or more of these 7 criteria. The journal Circulation published the study. HealthDay News wrote about it April 1.
What Is the Doctor's Reaction? Good habits begin early. And bad habits that begin in childhood can turn into real problems when kids become adults. This is especially true for heart disease. Being exposed to risk factors for heart disease at an early age can increase the chance of developing heart disease later in life. We are seeing more and more children and young adults who do not have good health habits. This can lead to obesity, diabetes and eventually heart disease and death. So how are today's teenagers doing when it comes to heart health? First, how do we define good heart health? The American Heart Association defines it based on seven good health behaviors and health factors. These include:

Not smoking
A healthy body mass index (BMI)
A healthy diet (plenty of fruits and vegetables, fish and whole grains, but limited salt and sugar-sweetened drinks)
Regular physical activity
Normal blood pressure
Normal blood sugar levels
Normal blood cholesterol levels

Researchers looked at information from a nationwide study called the National Health and Nutrition Examination Study (NHANES). This is a national research study that aims to look at the overall health and well-being of children and adults in the United States. Here were some of the worrisome findings about teenagers:

More than 8 out of 10 had a poor diet. Fewer than 1 out of 100 teenagers achieved an ideal diet.
More than 5 out of 10 girls and 3 out of 10 boys did not get enough physical activity.
Nearly 3 out of 10 had abnormal total cholesterol levels.
About 3 out of 10 did not have an ideal body mass index, a measure of obesity.

But there was some encouraging news as well. More than half of teenagers had never tried a cigarette. What Changes Can I Make Now? Heart health at a younger age is a major predictor of heart health later in life. So it's never too early to start forming good habits. Most heart disease is preventable and caused by factors we can change, such as poor eating, physical inactivity and smoking. The new study shows that U.S. teen health is not ideal and may well lead to obesity, diabetes and heart disease. What can we do now to prevent this?

Get started on healthy eating habits early in life. Kids are born with ideal heart health. Help them avoid forming bad habits. Make sure that kids eat lots of fruits and vegetables, fish and whole grains. And put tight limits on sugar-sweetened drinks.

Get moving. Physical activity is critical and has a strong effect on preventing heart disease. It also helps to prevent obesity, diabetes, and high blood pressure, which increase heart-disease risk. Turn off the TVs, hand-held devices and computers and get outside. It's good for you and good for your kids.

Be a good role model. Don't smoke, get active and eat well.

Push for better diets and more physical activity at school. Tight budgets have led many schools to limit recess time, physical activities and sports programs. Healthier meals at school may cost more money as well. We need to convince public officials that healthy meals and exercise in schools are worthwhile investments.

What Can I Expect Looking to the Future? The American Heart Association has set a goal of improving U.S. heart and blood vessel health 20% by 2020. In order to stand a chance of reaching that goal, we need to focus our efforts to help improve heart health in teenagers. Improving heart health in our younger population will make a huge difference in preventing heart disease in adults. The rates of obesity and diabetes in children have already risen. If we don't change the trends now, we will see tremendous increases in heart disease in 10, 20 and 30 years. Now is the time to change and get our kids healthy.

Disease Label Increases Interest in Medicine

Mon, 01 Apr 2013 14:41:00 -0400

People think something with a disease label needs a medicine, even if the medicine won't work. That's one conclusion of a new study of 175 parents. People waiting in a child health clinic were asked to read about a fussy baby and respond as if they were the parents. They read that the baby cried and spit up a lot, so they went to the doctor. The doctor explained the cause and said it probably would go away on its own. Half of the parents read that this condition was called gastroesophageal reflux disease (GERD). The others did not get such a label. All of the parents read that there was a medicine for this problem. But half of them read that it probably would not help. The others got no information about whether the medicine would work. People who were told that the problem was GERD were more likely to want medicine. This was true even if they were told that it wouldn't help. The journal Pediatrics published the study online. HealthDay News wrote about it April 1.
What Is the Doctor's Reaction? When kids have a medical label, their parents are more likely to want medicine for them, even when they are told it probably won't work. That's the finding of a new study published in Pediatrics, the journal of the American Academy of Pediatrics. Researchers from the University of Michigan did the study. They asked parents in a primary care waiting room to imagine they had a fussy 1-month-old who spit up a lot. The baby wasn't getting better despite everything they tried, so the parents brought the baby to the doctor. All the parents got the same description. All of the parents also read a similar explanation of what happened at the doctor's office. They read that the doctor said the baby had a problem with the stomach not emptying properly. This would cause the breast milk or formula to go back up. The problem generally went away by itself. For half of the parents, this was simply referred to as "a problem." For the other half, it was described as gastroesophageal reflux disease, or GERD. The researchers then further divided up the parents. All of them read that the doctor said there was a medicine available for this problem. (Remember, all of them had already read that it would go away by itself.) Some parents read that the medicine probably wouldn't help, which is what the medical evidence shows. Half were not told this. So in total there were four groups:

Given GERD label, not told medicine wouldn't work
Given GERD label, told medicine wouldn't work
Not given GERD label, not told medicine wouldn't work
Not given GERD label, told medicine wouldn't work

Here's what the researchers found:

Parents who got the GERD label were more interested in medicine, and more interested in using it.
Parents who got the GERD label were interested in using medicine even when they were told that it probably wouldn't help.
Parents who didn't get the GERD label were interested in medicine, too -- but not when they were told it probably wouldn't help.

Researchers also asked the parents if they appreciated the doctor offering medicine. If they got the GERD label, they appreciated it. But if they didn't hear the GERD label, they didn't appreciate the offer of medicine -- especially when they were told it wasn't likely to work. Parents who got the GERD label didn't think the condition was more serious. That wasn't what the researchers found. The results suggested that simply getting the label made parents think that medicine was a good idea -- even if it probably wouldn't work! What Changes Can I Make Now? GERD is often overdiagnosed. In fact, it may or may not actually be a condition. It is likely just something that happens to some babies and will pass over time. It doesn't need medicine, but it worries and upsets parents, since life with a fussy, "spitty" baby can be hard. So doctors, in a generally well-meant attempt to do something, may suggest medicine. Yet studies show the medicine isn't likely to do anything at all. GERD isn't the only condition like this. In the fascinating Choosing Wisely Initiative, medical specialty organizations have made lists of diagnoses and tests that doctors and patients should question. From chest X-rays before surgery to antibiotics for sinusitis, there are many things we shouldn’t be doing as much as we do. This study tells us that one way to reduce unnecessary tests and treatments is stop labeling things as diseases when they really aren't. You have an important role to play, too. Ask your doctor questions, such as:

Is this really a medical problem?
Why are you ordering this test or treatment?
Is it necessary?
Are there other options?

What Can I Expect Looking to the Future? Medical costs are getting out of control. This is costing our society money that could be going to things like education and job creation. Higher costs also make it harder for people to afford health insurance, which is something everyone should have. This study shows us that simply not labeling something could cut down on medicine use. That would help bring down costs. It also improves care. I hope to see more studies like this one, and have more conversations about how we can be more responsible and thoughtful in how we deliver care.