Blog Posts by Dr. Ayala

In contrast to adults, chest pain in kids is rarely of cardiac origin. A new articlein Pediatrics reassures us that an aching chest in kids, although a common complaint, was only rarely due to abnormalities of the heart.

But is the growing epidemic of childhood obesity threatening to change that? Could obesity in childhood result in heart attacks and other cardiovascular events when those children hit their 20s and 30s and even when they're still teens?

Dr. David Katz's piece in Childhood Obesity last year starts with a scary prediction, a prediction he hopes will never come true.

Katz, an internist and leading authority on nutrition, weight management and the prevention of chronic disease, director and founder of Yale University's Prevention Research Center, warns that heart disease might become a routine pediatric condition. Heart disease can follow the path of type 2 diabetes, - previously called "adult onset" diabetes because it was an affliction of adults - which

In his recent New York Times article titled "Is Junk Food Really Cheaper", Mark Bittman asserts:

"In fact it isn't cheaper to eat highly processed food: a typical order for a family of four - for example, two Big Macs, a cheeseburger, six chicken McNuggets, two medium and two small fries, and two medium and two small sodas - costs, at the McDonald's a hundred steps from where I write, about $28… In general, despite extensive government subsidies, hyperprocessed food remains more expensive than food cooked at home. You can serve a roasted chicken with vegetables along with a simple salad and milk for about $14, and feed four or even six people. If that's too much money, substitute a meal of rice and canned beans with bacon, green peppers and onions; it's easily enough for four people and costs about $9."

It's the wrong comparison, though. Jogging is a cheaper pastime than sitting on the couch and watching TV (cable packages don't come cheap), yet our affinity for leisure and

A few years ago billboards announced the arrival of "negative calorie" food. Drinking three 12-oz. cans a day of Enviga, the Coca Cola and Nestle carbonated tea drink, will burn an extra 60-100 calories daily, claimed the products' packaging.

The Center for Science in the Public Interest (CSPI) filed a lawsuit against Coke for Enviga's false weight-loss claims. Coke and Nestlé agreed to add language to the labels and marketing materials stating that the product will not promote weight loss without diet and exercise and Enviga is slowly vanishing from shelves. But supplements and foods claiming to slim you down have not - they are alive and thriving.

A new paper in Obesity Reviews looks at the dynamic market of nutritional supplements claimed to increase fat metabolism, and explores how much evidence - or lack of it - is behind some of these popular supplements.

What is a 'fat burner'?

A fat burner is a substance that is claimed to increase energy expenditure, make

Mounting evidence links sugary drink intake with rising obesity rates, but it's only recently that researchers started to sound the alarm: Sugary drinks not only cause obesity - which any food in excess will do - but may also act on our body in a uniquely harmful way. Soda intake is associated with heart disease type 2 diabetes and hypertension independent of obesity - now, how do we explain that?

Some blame the rapid and super-sized influx of refined sugar in sugary drinks, especially the fructose component of their sweeteners, and studies have shown a direct adverse effect of high fructose intake on fat metabolism and inflammation.

Sugar's not so sweet effects

A study from the University of California at Davis showed that drinking 25 percent of daily calories (which is quite a lot) in fructose for 10 weeks increased triglycerides and cholesterol, caused insulin resistance belly fat accumulation.

A recent study found that even moderate consumption of sugary drinks

It's always hard to say goodbye to summer. And what a glorious end-of-summer we've had -- days of lazing about together, good food, wonderful books (I have to mention Ann Patchett's remarkable "State of Wonder", which put me in a an utter state of wonder) and a few glorious hiking days in Yosemite and Sequoia National Parks. My kids are back in schooI and I, too, feel the beginning of a New Year - time to get focused and get a lot of work done, but also time to give some thought to reflect on education and child rearing.

The 5-a-day for raising healthy young kids

I recently came across a report from the British think tank CentreForum that pulled my attention. Drawing directly on the science of early childhood experience, the author, Chris Paterson, suggests that 5 steps are proven to be vital to kids' developing their full potential:

• Read to your child for 15 minutes- being read to regularly from a young age is extremely important to language skills, fosters bonding

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One of the best things to enjoy on a warm summer day is a cold watermelon. What could be better? Sweet, crisp, refreshing, red (what a beautiful color!) and nutritious.

My husband sees it as a personal failure when we open a watermelon and find a pinkish disappointment that tastes like a cucumber. He feels there must be a fool-proof way to pick the perfect fruit.

Alas, there's no fail-proof method, but I can offer a few tips for choosing a good watermelon:

Tapping: Tap the watermelon with the pads of your fingers. A winning watermelon will typically have a slightly hollow sound, like the sound you get when tapping your head rather than tapping your chest.

The all important yellow spot: At the bottom of the watermelon -- where it rested on the ground -- you want to find a yellow or cream-colored spot. If the spot is still white, the watermelon isn't ripe. Some say this is the most important clue to watermelon goodness.

Firmness: Press your fingers and thumbs

Why are today's kids so much heavier than kids of previous generations?

The classic answer is that kids today are taking in more calories and spending less energy: They spend less time playing outdoors and have stopped working on the farm and doing chores - but hey, haven't they stopped doing that a long time ago?

The energy expenditure side of the equation is the pet project of fast-food and junk-food makers. Oh, if we could only give kids another hour of gym! If only kids could balance their ravenous appetite for snacks with a little more outdoor play we wouldn't have to voice the unthinkable "eat less" advice.

But the numbers just don't add up. In order to eat like the TV ads suggest kids would have to increase physical activity to what amounts to no time left for homework or sleep.

I'd like to take an honest look at how sedentary activities really affect kids' waistlines.

An article in Obesity Reviews looked at the current trends of childhood pastimes, and