January 2010 Archives – News/Talk 750 WSB

ATLANTA (AP) Georgia officials are asking motorists to avoid driving on the state's icy roads, at least until daybreak. Department of Transportation spokeswoman Erica Fatima said the roads are becoming too dangerous as precipitation freezes. She says …

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Guests Eugene Mirman, Kyle MacDonald, and Brandon Bird. Eugene Mirman is one of New York's top alternative comics. He not long ago released his first CD, “The Absurd Nightclub Comedy of Eugene Mirman.” Brandon Bird is a painter, whose work has been …

TV Junkie: Leno to Be Cancelled?! John Oliver on Fallon Tonight; People's Choice

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With scientists suggesting that 1 in 4 persons has extra taste buds, people naturally want to know whether they are the 1 or the other 3. Supertasters, as those with extra taste buds are known, do not only derive more pleasure out of food. Having extra taste buds is associated with obesity and colon polyps.

Scientists hypothesize that super-sensitivity to flavors resulting from having extra taste buds may drive supertasters away from healthy but strong-flavored foods such as cruciferous vegetables and condition them to choose less intense and less healthy diets containing more fats and sweet tastes.

The British Broadcasting Corporation (BBC)'s homepage contains a simple test you can take at home to determine whether you are a supertaster with extra taste buds. All you need to perform this test is blue food coloring, cotton swabs, notebook paper hole reinforcements, and a magnifying glass. After swabbing the tip of the tongue with food coloring, place a reinforcement ring there and count the number of raised pink dots (papillae) within the ring. Those with extra taste buds will have about 30 papillae while those without will have only 15.

What groups of people might find this test most useful?

Persons with Family Histories of Polyps or Colon Cancer

If you have a personal or family history of colon polyps or colon cancer, you may want to take the test to see if you are a supertaster with extra taste buds. Whether you are or aren't, attention to diet and physician's recommendations is advisable.

It is possible to retrain your taste buds to appreciate foods they initially reject. But even without successful retraining, those extra taste buds can be denied the privilege of excessive fatty foods and required to tolerate a balanced diet that includes vegetables.

Parents of Children Who Are Picky Eaters

If your child is a picky eater, it is possible that he or she is one of the ¼ of the population that has extra taste buds. A young child will probably think taking the taste bud test is fun because he gets to turn his tongue blue with food coloring.

If you find out your child has extra taste buds, you can take care with his diet and find novel ways to increase his consumption of healthy foods whose tastes might offend him in their ordinary presentation.

Persons Who Are Overweight

An extra set of taste buds may contribute to excess weight in supertasters, who on average, weigh more than persons who are not supertasters. Understanding the role that these extra taste buds play, and their tendency to create attraction to foods that may not be the healthiest choices, may help the overweight supertaster to pay attention to his diet and overcome the influence of those extra taste buds.

Despite the link between extra taste buds and potential health problems, there is some good news for supertasters- they have a higher than average likelihood of becoming wine tasters or professional chefs.

Sources: http://www.bbc.co.uk/science/humanbody/body/articles/senses/tongue_experiment.shtml; http://amos.indiana.edu/library/scripts/supertasters.html; http://articles.mercola.com/sites/articles/archive/2003/04/12/super-taster.aspx; http://supertastertest.com/

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Are we about to see the end of the much-vaunted eurozone? | Peter Oborne

In putting financial considerations before social ones, the governments of Europe have ensured that things can only get worse It is nearly 20 years since the Conservative chancellor of the exchequer Norman Lamont made his notorious remark that unemployment was a “price worth paying” for the restoration …

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This year's CES show will again take place in Las Vegas, as usual, where visitors are welcomed from January 7 to January 10. The CES event appears to become more important every …

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The problem with individual health care today is not that it is expensive, it’s that it is focused on treating diseases for the masses rather than preventing them one individual at a time. Let’s face it: Many diseases are caused by poor nutrition, improper exercise, and pathogenic behaviors such as smoking, heredity, or external factors. Oftentimes, they are caused by a combination of several different individual health factors. At the point where the stressors outweigh the body’s ability to maintain it’s normal balancing point, disease occurs. In the natural healing modalities it’s believed that the body is intelligent and has a blueprint for optimal health. It knows how to stay healthy and it strives to maintain health. It’s only when it is overloaded with stressors that disease occurs and by then, it’s much more difficult to heal a person then if the disease had been prevented in the first place. If we want to take back our individual health care, we are going to have to learn more about who we are, what our personal stressors are, and how to prevent disease within ourselves.

Diathesis-Stress Model For Individual Health

In psychology, the debate of nature versus nurture has finally met a new paradigm: the diathesis-stress model. This model hypothesizes that although one may have an inherited vulnerability for a specific psychological disorder this alone is not sufficient to mean that a person will inherent a psychological disorder. It is only with the addition of other environmental stressors that the disorder may be triggered into being. An example of the diathesis-stress model is with the case of alcoholics who may have inherited a tendency for the disease. If someone is never exposed to severe alcohol abuse in the form of campus parties or other social events, they may never develop alcoholism despite their genetic weakness.

A study done by Caspi et al. (2003) tracked a group of 847 individuals for over 20 years. In this study, a genetic profile was done to determine the presence of a set of long or short gene components called allele pairs. The particular genes they were studying were mapped for influencing the transmission of serotonin in the brain. Serotonin is a neurotransmitter implicated in mood disorders, particularly depression. It was believed that people who had inherited two alleles of the long-type gene were better able to cope better with stress. And in fact, the study did substantiate that belief.

After tracking the major life events across two decades and recording the number of stressful events in each individual’s life, it was determined that the individuals who had inherited the short type of gene pair had double the risk of having a full major depressive episode after experiencing at least four stressful events as compared to the long-type individuals. If the stressful events occurred during childhood, it was further noted that the short-typed individuals who were maltreated as children doubled their risk of depression compared to other short-typed individuals who were not abused or maltreated. For long-typed individuals childhood maltreatment did not affect the incidence of depression in adulthood, which typically ran at 30% despite childhood stressors.

It can be seen from this and similar studies that although a person may inherit a genetic vulnerability to a particular disorder, its appearance is often predicated on other factors such as environmental stressors. What’s even more important is that a single occurrence of a particular stressor may not be enough to tip the balance to disease. In the previous aforementioned study, it took at least four stressful events to double the risk of a major depressive episode for the short-typed people. This clearly points to a cumulative effect of outside stressors in the final creation and appearance of a disease that may have never presented otherwise.

If we are to take this model and apply it to our own personal individual health care, we can assume that there are going to be individual stressors that may have no effect on others but can trigger disease in ourselves. Certainly, there are some that are generic but oftentimes there are just as many that are specific to our individual make-up. We cannot expect the family physician to know our biological make-up as well as we do ourselves. We must learn to pay attention to our own family history and understand how to modify our own behaviors to obtain optimal health.

Your Genetic Profile

Obviously, you can pay someone a lot of money to run a genetic profile on you. Sometimes this is advisable if your family has a history of disease that affects newborns like Down syndrome or Hemophilia. In that case, you may want to seek genetic counseling before conceiving. In addition, sometimes just belonging to a particular ethnic grouping may expose you to more risk as in the case of Tay-Sachs in Jewish Europeans, thalassemia in Asians and Mediterraneans, sickle cell anemia in African Americans, and cystic fibrosis in Caucasians. Hispanics are more susceptible to diabetes and asthma as well. However, simply knowing your family history and paying attention to it can determine much of this.

Begin by profiling your maternal and paternal grandparents. What illnesses surfaced during their lifetimes? Are they hereditary? Diseases like diabetes, heart disease, breast cancer and other types of cancer all have genetic components. Knowing what your particular family vulnerabilities are can greatly enhance your chances of preventing a disease within yourself. Do not forget to include psychological disorders in your family genetic profile. Is there evidence of alcoholism? Eating disorders? These also have genetic components.

Once you have a thorough knowledge of your family history from grandparents to present day relatives, you will know what stressors affect your individual health more than others. You can start to maintain your own health by taking a two-pronged approach: increase the behaviors and habits that impact those diseases positively and decrease those habits or behaviors that impact the risk of contracting the disease.

Internal Individual Health Stressors

Obviously, we’ve all heard about the case of the 89-year old who swears the secret of longevity is a good shot of whiskey and Cuban cigar each morning before breakfast. This individual was blessed with a lot of good genes. Your luck in that genetic lottery is probably not going to be as good as his! So, we need to take back our own health care.

Natural healing guru, Dr. Schulze, of the American Botanical Pharmacy, puts it this way: “Stop doing what makes you sick. Start doing what makes you healthy.” Dr. Richard Shulze was a man who was diagnosed with such severe heart disease that it was recommended he have open-heart surgery before the age of 20! Instead of taking their suggestions, he decided to take his own health care back and make himself better by eliminating those behaviors that made him sick and starting to do those things that made him healthy. He healed his own heart disease using herbal formulae, an organic diet, juicing, and understanding that his health was his own affair and the philosophy that to be sick or healthy was his choice. Thirty years later, his methods have worked for the many thousands that have come to him for help in his clinic. He has helped many to reclaim their individual health.

Elimination of bodily wastes and poisons are key to his program. The American diet is loaded with fats and other stressors that cause many digestive disorders and contribute to other more lethal diseases like heart disease and cancer. If it’s not being exposed to toxins in our food and our air, then sometimes the very quantity of animal fat can contribute to high cholesterol and cancer rates. Our foods are sometimes subjected to radiation, dyes, waxes, and other appearance enhancers all deemed safe by the Food and Drug Administration at low levels. The problem is that we do not know if these levels remain low in our bodies or if they accumulate the more we consume over time until that disease threshold is hit. According to wrongdiagnosis.com, a heath website, approximately, 4.4 million people experience constipation in America at any given time. Other countries, it appears don’t have such a high rate. If our cars starting chugging and choking on bad oil the way our bodies sometimes do, we’d no doubt take them in for an oil change. But, few people realize that there are natural ways to cleanse and flush the body of old wastes leaving it in a much better position to fight off new threats.

Lifestyle Individual Health Stressors

America is the land of the automobile. Sidewalks are sometimes not visible for miles in some states. With this vehicular lifestyle comes the additional stressor of a sedentary lifestyle. To overcompensate, gyms have sprung up in practically every strip mall trying to make up for the lack of genuine opportunities we have to exercise within our busy corporate world. The physical trainers will insist that you don’t start burning fat until after 20 minutes of aerobic exercise. This may be true, but if the point is simply to maintain your health oftentimes you don’t need strenuous exercise to cut fat. If you’re already at your optimal weight, simply walking for 20 minutes a day is enough to put some movement back in your life. How hard is that? However, if you are overweight, this can lead to a substantial stress on your system and should be taken into account. Achieving a normal weight for your height is one way to increase your longevity.

Other lifestyle stressors are alcohol and illegal substance abuse. In addition, even prescribed medications can have side effects on every major organ in your body, not to mention affecting your cholesterol and blood sugar levels. Read the side effects that come with each of your prescriptions and decide: Is this prescription vital for my health or can I do without it? If we had taken this approach with antibiotics, we wouldn’t now be seeing strains of viruses that are immune to these supposed miracle drugs. For every prescribed drug there is often a natural alternative. Take a moment to research it and decide whether your health is worth a few minutes of your time. Many times the doctors and health care professionals are not familiar with the natural alternatives and would not think to mention them.

If your family has a history of diabetes, it’s important to start maintaining a good body weight early. Every pound of extra weight you carry increases your risk of contracting this disease, particularly if you already have a genetic predisposition to it. Maintain good blood sugar levels by eating many small meals during the day rather than the normal large meals three times a day. Perhaps, instead of sugar, one can use some of the natural alternatives like Stevia to promote one’s individual health, which is a food supplemnt believed to actually help the pancreas function better. By doing the things that keep you healthy and eliminating those habits that could potentially make you sick, you stand a much better chance of never needing treatment for a disease.

A family history of cancer will also make diet very important. The little known secret is that many cancers are diet-related. They may not be caused by diet, but diet was one of the stressors that made the hereditary vulnerability present itself. If your family has a history of mouth, liver, or breast cancer then your consumption of alcohol needs to be monitored and limited. It goes without saying, that if you drink, smoke, have a high fat and low fiber diet, you have just added multiple stressors to your potential creation of cancer. If you also have a hereditary vulnerability, you might want to lay odds with a Vegas bookie that you will get cancer in your lifetime. The American Cancer Society has a wonderful web page at their main site, cancer.org, on the effects of diet on cancer.

Environmental Factors That Affect Your Individual Health

Environmental factors do play more and more of a role in our health as we experience global changes in our weather patterns. There are known increases in the rates of skin cancer and more asthma cases due to increased pollution and ozone depletion. Along with weather changes, we have numerous artificial materials and chemicals in existence today that were not around a couple of decades ago. Everyone’s heard the cancer horror stories from asbestos-lined schools and chemical-dumping corporations. These are proof positive that our environment is no longer as benign as it used to be. What can we do about it?

Simply being aware of where you live and who is in your neighborhood goes a long way to making sure you aren’t exposed to unnecessary toxins or carcinogens. The Environmental Protection Agency requires states to monitor sites it knows are harmful to the general public. These can be located in the state’s superfund category. Using a website called scorecard.org, one can locate the superfund sites in your neighborhood by simply typing your zip code into their database.

When you buy a home, some states require a lead inspection and others do not. Some states have more stringent rules on environmental hazards like lead, radon, underground heating oil tanks, and asbestos containing construction materials than others. Knowing your genetic predispositions, you may want to add additional environmental testing to the home to maintain your own individual health. Is the home you are buying close to areas where chemical spraying is prevalent? Again, consider whether this is a stressor in your health make-up and whether you wish to take on that risk.

Also, don’t forget that environmental factors aren’t just limited to chemicals. They can take the form of noise pollution from large airports, magnetic fields from high wire power transmission lines, and living in a high crime rate. These are all factors that can prove to be additionally stressful to your mental as well as physical health.

Finally, your occupation and home can be the sources of numerous environmental stressors. The typical cleaning cupboard in the house is home to multiple carcinogens. Many products used for cleanliness can also cause adverse reactions in people who have allergic reactions and asthma. Pets can also be a stressor if heredity points to allergies or asthma. If you work as a miner, obviously, you would not want a history of lung cancer in your family. The sad fact is that we will be exposed to a chemical soup of carcinogens and pathogens daily, but we can surely be more judicious about the levels and length of time we are in exposure of hazardous elements as well as the types of exposure we receive. Knowing what our hereditary weaknesses are goes a long way to preventing exposure that might have more of an effect on creating disease within our body versus someone else’s.

Your Individual Health Tune-Up

Along with eliminating stressors, there are behaviors that can increase anyone’s chance of defending against a disease. These are the health tune-ups that won’t hurt you and can certainly help you. They are the generic natural healing programs that are good for everyone.

They include:

1. Colon cleanses,
2. Nutritional supplementation,
3. Exercise,
4. At least 7 to 8 hours sleep a night,
5. Water daily (preferably filtered)

Colon Cleanses

Dr. Schulze’s offers an herbal colon cleanse called Formula Number 1 and Number 2 as wonderful ways to cleanse the colon. The first formula loosens the stool and the second uses bentonite to suck all of the impurities out with the wastes. Bentonite is clay used in the environmental field to provide a barrier to keep contaminants from reaching pure groundwater zones. It has the ability to absorb heavy metals and multiple chemicals and toxins. It was also used by Native Americans as a digestive cleanser which when taken internally absorbed toxins in the body and then passes through the digestive system as waste.

This is just one way to cleanse wastes out of your system. Others prefer colonics, which is a form of cleansing done by irrigating the lower intestinal tract by a trained professional. Yet another way is an enema. At any rate, a colon cleanse when one’s energy is low is a good way to cleanse and flush the old wastes out of our bodies. This can be done yearly or quarterly, just like a car tune-up. Every 3 months think about doing a colon cleanse.

Food

If your diet is a typical America diet, then you are not receiving sufficient nutrition. Nutrition in this case is not calories; it’s the essentials vitamins and minerals necessary to maintain optimal health. Taking vitamin supplements aren’t a cure-all either as solid forms of vitamins are hard to digest or often won’t make it totally into your bloodstream. Liquid forms are better. The best boost to nutrition is through juicing. Buy a juicer and begin to learn how standard vegetables and fruits can make delicious juices. Fresh-juiced carrot and pineapple juice is delicious! Adding beetroot to your fruit juices also adds a bit of depth to the drink and essential vitamins and minerals. Juicing is not only healthy; it’s fun and delicious.

The produce that you buy can always be bought fresh instead of canned or frozen. This simple switch in lifestyle will boost the number of vitamins and minerals you receive in your diet. This is because the heating process in canning can kill up from 30% to 50% of the nutritional value of certain vitamins and minerals in fruits and vegetables. Nutrients also decrease the longer a food item is stored. If you start with a low vitamin and mineral content and reduce it more every month that can or bag of frozen veggies sits in your freezer, what do you have left? At least when you buy fresh, you are starting with the highest source of vitamins and minerals that food has to offer. The sensible thing to do is to buy your produce at a local farmer’s market and eat it quickly! If you make a conscious choice to go organic, you will also reduce the level of harmful pesticides and additives that are placed in the food chain by large marketers of produce.

If you don’t want to juice there are nutritional supplements like Dr. Shultz’s Superfood, which is a powdered form that can be mixed in store-bought organic juices. The powdered form of nutritional supplements is at least better than the solid form of standard vitamin tablets because the nutrients are more available to be digested and absorbed through the bloodstream.

Exercise

Exercise doesn’t have to be like the gym marathons we see in “The Biggest Loser.” Exercise can be simply switching your habits to include more activity. Instead of parking near the front of the grocery store, park at the back and walk. That’s at least five more minutes of exercise you got in your day! Walk up the stairs, instead of taking the elevator and maybe you get another five minutes! If you stop at the mall, make it a point to go all the way around at least one floor. In fact, there are many mall-walkers out now that go to the mall prior to the stores opening just to have a place to walk away from traffic. Take the bus every now and then. Walk to your lunch appointment. Walk after your lunch appointment. Odds are if you aren’t willing to make these simple changes, you aren’t going to benefit from a gym membership anyway. It takes willpower to exercise and not just paying someone some bucks to join a gym. We know what our day is like. To maintain our individual health, we must seek ways to add exercise to our daily routines which are specific to our daily activities.

Sleep

The evidence is in now: if you get too little sleep, your risk of becoming overweight increases! So, it’s not just about exercise. Columbia University ran a study where 18,000 individual’s sleep habits were monitored. The results were that those that got less than four hours of sleep a night were 73 percent more likely to be obese than those who got at least seven to nine hours of sleep.

Sleep deprivation can affect your mood. If depression is rampant in your family, you might want to think about getting a full night’s sleep. If you deprive people too long of sleep, they get hallucinations and can die. Sleep is very important to our health. It is as important as food and water.

Many people are so stressed they can’t sleep. They turn to sleeping aides like Ambien or Lunesta. The media has reported cases of people on Ambien who get up and while still sleeping begin to drive their cars. Other cases of sleep-sex are also being reported. These pills appear to have some severe side effects if used improperly. There is a natural sleeping aide supplement called Melatonin. Melatonin is the same hormone secreted by your pineal gland that regulates your sleep cycle. It’s very useful for people with jet lag and insomnia. It one must seek help to sleep, why not seek a natural alternative with few side effects?

The simplest way to fall asleep, obviously, is to learn how to relax. Our culture prizes the ability to cope with stress to such extremes that the thought of relaxing seems almost counter-culture. Take a tip from the East and learn how to meditate. It’s quite simple and doesn’t cost a penny.

Water

It seems no one drinks eight glasses of water a day anymore. Eight glasses does seem a bit excessive. But, we have to realize that 80% of the human body is made up of water, and then it becomes clear that drinking this much can flush impurities from system daily. Liquid can be found in your juices as well as water. Anything that hydrates the body can be counted, except alcohol, which dehydrates the body. Some of us short people have trouble drinking eight glasses of liquid a day. It’s possible we don’t need as much to maintain our own individual health simply because we aren’t as tall and heavy as the average American. Most studies are done based on an average profile and many of them haven’t even included women as a gender subtype. Try starting with at least four glasses and work your way up. If you find yourself bloated, just decrease the number of glasses you are drinking. Your body knows what it needs. Your body is very intelligent. Listen to it. If it is thirsty, it needs water.

It’s important not to trust your water supply. Your water contains varying levels of chlorine and fluoride that aren’t necessary to ingest daily. Buying a tap filter is not such a bad investment. There are all kinds of water filters that can keep heavy metals and excessive chemicals from entering your body. They include charcoal, reverse osmosis, distiller, ionized, and ultraviolet water filters. Some require more space on your countertop than others. Or, you can simply buy purified water at your local health food store.

Natural Individual Health Summary

Natural Individual health does not have to be complicated. It isn’t about being a geneticist or a trained physician. It’s about taking back responsibility for our own health by understanding our own medical history and disease triggers. It’s about being willing to research natural alternatives and saying no to the latest pill that pops on the market if it is not right for you. It is about learning the simple daily and yearly tricks to take care of your body, so when the chips are down, your immune system takes care of you.

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2009 a year to remember for movies – Memphis Commercial Appeal

Did more than 500 feature films actually screen for the public in Memphis in 2009, at theaters, museums, the Orpheum and other venues? According to my records, yes — making the past year the most movie-packed of the first decade of our new century …

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Human Growth Hormone for Bodybuilding

Increased HGH levels can show improvement in: Lean body mass, muscle tone, skin thickness, memory, energy level, and more. Human Growth Hormone (HGH)

With steroids, you gain mostly water weight; with human growth hormone, you gain only lean muscle mass. Human growth hormone also forces your body to burn fat for energy.

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Short stature may be the normal expression of genetic potential, in which case the growth rate is normal, or it may be the result of a condition causing growth failure with a lower-than-normal growth rate. Growth failure is the term that describes a growth rate below the appropriate growth velocity for age. 

A child is considered short if he or she has a height that is below the fifth percentile; alternatively, some define short stature as height less than 2 standard deviations below the mean, which is near the third percentile. Thus, 3-5% of all children are considered short. Many of these children actually have normal growth velocity. These short children include those with familial short stature or constitutional delay in growth and maturation. In order to maintain the same height percentile on the growth chart, growth velocity must be at least at the 25th percentile. When considering all children with short stature, only a few actually have a specific treatable diagnosis. Most of these are children with a slow growth velocity. 

Pathophysiology: The most rapid phase of human growth is intrauterine. Following birth, a gradual decline in growth rate occurs over the first several years of life. The average length of an infant at birth is about 20 inches, the length at 1 year is approximately 30 inches, the length at 2 years is approximately 35 inches, and the length at 3 years is approximately 38 inches. After age 3 years, linear growth proceeds at the relatively constant rate of 2 inches per year (5 cm/y) until puberty.

Normal growth is the result of the proper interaction of genetic, nutritional, metabolic, and endocrine factors. To a large extent, growth potential is determined by polygenic inheritance, which is reflected in the heights of parents and relatives. Secretion of growth hormone (GH) by the pituitary is stimulated by growth hormone-releasing hormone (GHRH) from the hypothalamus. Another signal, which is stimulated by certain growth hormone-releasing peptides (GHRPs), may exist; the receptor for the GHRPs has been identified, but a possible natural ligand for these receptors has been determined recently (see below). Somatostatin secreted by the hypothalamus inhibits GH secretion. 

When GH pulses are secreted into the systemic circulation, insulinlike growth factor (IGF)-1 is released, either locally or at the site of the growing bone. GH circulates bound to a specific binding protein (GHBP), which is the extracellular portion of the GH receptor. IGF-1 circulates bound to one of several binding proteins (IGFBPs). The IGFBP that is most dependent upon GH is IGFBP-3. 

Recently, a new peptide hormone that stimulates GH release, named ghrelin (from the word ghre, a root word in Proto-Indo-European languages for grow), has been described. This hormone is unique in that it is a small polypeptide modified at the third amino acid (serine) by esterification of n-octanoic acid. Ghrelin appears to be made in the stomach and stimulates GH secretion by binding with its own receptor, which had previously been known to bind synthetic GHRPs. Ghrelin may play a role in regulation of GH at the hypothalamic level, permitting an adequate energy supply for maintenance, growth, and repair.
Frequency:

In the US: In 1994, Lindsay et al studied 114,881 school children in Utah. After 1 year, 79,495 of the original group were available for evaluation. Of these, 555 (0.7%) had heights that were below the third percentile and a growth rate that was fewer than 5 cm/y. When examined further, causes for short stature within this group of children included familial short stature (37%), constitutional delay (27%), a combination of familial short stature and constitutional delay (17%), other medical causes (10%), idiopathic short stature (5%), GH deficiency (3%), Turner syndrome (3% of girls), and hypothyroidism (0.5%).

Internationally: Several studies have been conducted to determine the frequency of various causes of short stature. In 1974, Lacey and Parkin evaluated children in Newcastle upon Tyne in England. They studied 2256 children, of whom 111 were below the third percentile in stature. Of the 98 children that they were able to examine, only 16 had evidence of organic disease causing their short stature. Diagnoses included Down syndrome, cystic fibrosis, chronic renal insufficiency, GH deficiency, juvenile rheumatoid arthritis (treated with glucocorticoid), and Hurler syndrome.

Mortality/Morbidity: 

Short stature has been shown to have far-reaching effects on psychological well-being, including poor academic achievement (despite normal intelligence, healthy family dynamics, and high socioeconomic status) and behavioral problems (eg, anxiety, attention-seeking actions, poor social skills). Morbidity related to the underlying cause of the growth failure may also be present. 

Mortality rates in children with growth failure relate to the underlying cause of the growth failure. Mortality is not related to growth failure itself; rather, it is related only to the cause of the growth failure. 

History: History of those with short stature should focus on the following areas: 

Birth weight and birth length: One of the issues in the differential diagnosis is intrauterine growth retardation, which should be apparent from the birth history. 

Parents' heights: In order to evaluate a child's genetic potential, calculation of the sex-adjusted midparental height (ie, target height) is helpful. The sex-adjusted midparental height is calculated by adding 2.5 inches to (for boys) or subtracting 2.5 inches from (for girls) the mean of the parents' heights; it represents the most statistically probable adult height for the child, based on parental contribution. By calculating the percentile for this midparental target height, one can determine at what percentile a child's height is expected to fall. 

Timing of puberty in parents: Constitutional delay in growth and maturation may have a family history. Most mothers can remember their age at menarche (average age, 12-12.5 y). To elicit pubertal history from a father is more difficult because no specific landmark exists. Evidence of delayed puberty may include continuing to grow after high school or not shaving until age 20 years or older. 

Previous growth points 

The most useful part of a workup for growth failure is observing the growth pattern. Previous growth data may be obtained from physicians' offices, schools, or marks that have been kept on a door or wall at home. 

If the growth rate is normal (~ 2 in/y [5 cm/y] from age 3 y to puberty), the cause of the child's short stature is likely 1 of the normal variants, and the child does not actually have growth failure. 

If the growth rate is low, growth failure exists, and a pathological cause for the growth failure is more likely.
Children with constitutional delay in growth and maturation often appear to be growing slowly just before the pubertal growth spurt; they may be confused with children who have actual growth failure. 

The child's general health: Ruling out a chronic disease or poor nutrition as a cause of growth failure is important. Worldwide, malnutrition is probably the most likely cause of growth failure. 

Physical: The following items in the physical examination are targeted toward assessing growth failure:
Height (or length) and weight: A determination of weight is not difficult; height (standing) or length (lying down) should be measured with care. Using a single steady stadiometer and obtaining more than 1 measurement provides accurate values (see below). 

Taking accurate measurements of length requires attention to the following points: 

An accurate measuring device should be used. For infants, the device should consist of a board with a yardstick attached (or embedded), a stationary head plate, and a movable footplate. 

Stretch the child gently. The heels, buttocks, shoulders, and the back of the head should touch the base of the device, and the soles of the feet should be perpendicular to the base of the device. 

Repeating the measurement 2-3 times (and taking an average of these measurements) improves the accuracy of the measurement. 

When taking height measurements, the following should be addressed: 

Always have the child barefoot or in stocking feet. The heels, buttocks, and shoulders should be in contact with the wall or the measuring device. 

The child should be standing with heels together, feet slightly spread. The child should look straight ahead. This is called having the head in the Frankfurt horizontal plane, which is a plane represented in the profile by a line between the lowest point on the margin of the orbit and the highest point on the margin of the auditory meatus. 

At the time of the measurement, have the child hold a deep breath. 

Use proper equipment. The ideal device for height measurement is a stadiometer, which may be mounted on the wall, with an arm that moves vertically. The arm is placed on the head, and the height can be read from a counter or from a ruler on the wall. If a stadiometer is not available, good height measurements may be obtained from a yardstick (or meter stick) attached to the wall and a device that makes a right angle with the wall and the child's head. The floppy arm devices mounted on weight scales are inherently variable and frequently yield inaccurate measurements. A height measurement can be determined using this device, but even more attention is required. 

For precise height determinations, measure the child 2-3 times and take the mean. If the first 2 measurements agree, they should be considered accurate. 

In order to minimize diurnal variation in height, always measure the child at the same time of day.
Proportionality: Inspect the child for proportionality of limbs and trunk. If disproportion is suspected, the following measurements may be taken: 

Arm span: Measure outstretched arms from fingertip to fingertip. In children of European origin, the arm span should approximate the height. In comparisons of people of Asian, European, and African heritage, Asians had proportionally shorter arms, Europeans had intermediate-length arms, and Africans had significantly longer arms. 

Lower segment (LS): Measure from the symphysis pubis to the floor. 

Upper segment (US): Subtract the LS from the height. 

The US/LS ratio is calculated by dividing the US by the LS. In children of European origin, this ratio is about 1.7 at birth and decreases to 1.0 at about age 10, where it remains throughout adulthood. In comparisons of people of Asian, European, and African heritage, Asians had proportionally shorter legs (therefore, larger US/LS ratios), Europeans had intermediate length legs, and Africans had significantly longer legs. 

Pubertal status: Puberty should be staged using the Tanner staging system. In constitutional delay as well as many pathological causes of short stature (including GH deficiency), puberty is delayed. 

Look for signs of specific syndromes: A number of specific syndromes exist that include short stature and slow growth velocity. 

For Turner syndrome, look for webbing of the neck (pterygium colli), a wide carrying angle (cubitus valgus), a low hairline, a high-arched palate, short fourth metacarpals, and multiple nevi. 

Noonan syndrome and Russell-Silver syndrome, among others, should be considered. 

Examine for disproportion of limbs to trunk when considering the possibility of skeletal dysplasias.
Other syndromes exist as well. 

Causes: The following are possible causes of growth failure (slow growth velocity): 

Familial short stature: Children with familial short stature have a history of parents with short stature. They have a normal growth velocity (thus, they do not exhibit true growth failure). Bone age is not delayed. These children have puberty at a normal time and most often finish their growth with a short adult height. 

Constitutional delay in growth and maturation: This entity is sometimes called delayed puberty. Children with constitutional delay have a normal birth weight, and during the first year of life, their growth slows. For most of the period of linear growth (approximately age 3 y to puberty), they maintain an adequate growth velocity. Bone age is usually delayed, and puberty is late, giving a longer time for prepubertal growth, which usually results in a normal adult height. Children with constitutional delay may have a family history of the same. Usually, these children do not exhibit growth failure (a slow growth velocity); however, a period of slow growth velocity usually occurs during the first year of life, and, just before the onset of puberty, growth velocity is again slow (especially when compared to peers who are in the midst of their pubertal growth spurt). 

Malnutrition: Worldwide, malnutrition is probably the most common cause of growth failure and usually is poverty related. In developed countries, nutritional deficiencies more often are the result of self-restricted nutrient intake. Often, poor weight gain is more striking than short stature. 

Chronic disease, systemic disorders 

Nervous system: Microcephaly may be a feature. 

Circulatory system: Cyanotic heart disease may be present. 

Gastrointestinal system: Gluten enteropathy, ulcerative colitis, or regional enteritis (Crohn disease) may be present. In inflammatory bowel disease (in particular, Crohn disease), the growth failure may be apparent before other symptoms appear. 

Liver, chronic renal failure: People with renal tubular acidosis may present with growth failure without any other features.
Lungs: Cystic fibrosis may be present. 

Connective tissue: Dermatomyositis may be present.
Psychosocial dwarfism 

Chromosomal abnormalities: In particular, Turner syndrome (45,X) and Down syndrome (trisomy 21) have growth failure as a part of the syndromes. Growth charts specific for these syndromes are available. 

Other syndromes (nonchromosomal): Syndromes that have growth failure as a feature include Noonan syndrome, Russell-Silver syndrome, and Prader-Willi syndrome. 

Target tissue defects 

Intrauterine growth retardation: The category of intrauterine growth retardation describes children who have birth weights less than 5.5 lb at full term or who are small for gestational age (SGA) if born preterm. Numerous etiologies for this condition are contained in this category, including fetal alcohol syndrome and placental insufficiency syndromes. In some of these conditions, spontaneous “catch-up” growth occurs, while in others, growth rate remains slow. 

Bone and cartilage disorders: The most common disorder of bone and cartilage is achondroplasia, which is recognizable by frontal bossing, lumbar lordosis, and short limbs. Other skeletal disorders are less easily recognized, such as hypochondroplasia, which may be diagnosed radiologically. Patients with hypochondroplasia also have short limbs, but the disproportion is subtle and may be apparent only with careful measurements of arm span and US and LS. Both of these disorders are due to mutations of the fibroblast growth factor receptor 3. 

Endocrine causes 

Thyroid hormone deficiency (hypothyroidism): Thyroid hormone is absolutely necessary for normal growth. With hypothyroidism, the growth rate is extremely slow, and with replacement of thyroid hormone, catch-up growth is rapid. Although hypothyroidism is often suspected based on history and physical examination findings, cases also exist in which the signs and symptoms are subtle. Because of the possibility of subtle signs, evaluation of thyroid hormone levels in all children with slow growth is advised. 

GH deficiency: Children who are GH deficient have normal proportions but may appear younger than their age. They have delayed skeletal maturation. Although GH deficiency may be suspected because of damage or malformation of the pituitary gland, in most children diagnosed with GH deficiency, the etiology is idiopathic. 

GH insensitivity (IGF-1 deficiency): Sometimes called Laron dwarfism, this disorder appears to be similar to GH deficiency, except that large amounts of GH are produced but levels of IGF-1 are low. This is a rare condition, except in populations where the gene is present with a greater frequency (eg, in Ecuador). 

Glucocorticoid excess (Cushing syndrome, Cushing disease): Children with glucocorticoid excess almost always have growth failure as part of the presentation. 

Androgen excess: When prepubertal children are exposed to excessive amounts of androgen, the growth velocity increases in the short term, but epiphyseal fusion occurs early, resulting in premature slowing of growth velocity, usually resulting in a short adult height. Causes of androgen excess include exposure to exogenous androgen, precocious puberty, and congenital adrenal hyperplasia. 

Lab Studies:

Thyroxine (T4) and thyroid-stimulating hormone (TSH): T4 and TSH levels are important to rule out hypothyroidism and to screen for panhypopituitarism as a cause for short stature and growth failure. 

Serum electrolytes: A low bicarbonate level may indicate renal tubular acidosis, which can result in growth failure. Electrolyte levels out of the reference range may indicate renal failure. Hypokalemic alkalosis may indicate Bartter syndrome. 

CBC count and sedimentation rate: These tests may be helpful if inflammatory bowel disease is suspected. 

IGF-1 and IGFBP-3: Both IGF-1 and the binding protein IGFBP-3 are GH dependent. Low values suggest GH deficiency. However, they are also sensitive to other factors such as nutritional state, so a low value alone is not diagnostic of GH deficiency. 

Karyotype: Girls with otherwise unexplained short stature should have karyotype determined to rule out Turner syndrome. Although Turner syndrome is diagnosed in many girls from signs present on physical examination, some girls with Turner syndrome have short stature as the only recognizable feature. In particular, girls with mosaic karyotypes or karyotypes with isochromosomes tend to exhibit fewer signs specific to Turner syndrome.
Imaging Studies:

MRI of the head: Patients who are diagnosed with GH deficiency should undergo MRI of the head to rule out a brain tumor, such as a craniopharyngioma. As many as 10% of children diagnosed with a craniopharyngioma present with growth failure as the only sign. Also, approximately 15% of patients with GH deficiency have an abnormality of the pituitary gland, such as an ectopic bright spot, an empty sella, or a small sella. 

Bone age determination: A radiograph of the left wrist can be compared to standards to provide an estimation of skeletal maturation. Bone age also provides a determination of growth potential (predicted adult stature may be estimated from the tables of Bayley and Pinneau).
Other Tests:

GH provocative testing: GH response to insulin is considered the most reliable test for GH deficiency. For recognition of the diagnosis of GH deficiency, many insurance companies require documenting a failure to demonstrate a GH response (with a GH level >10 ng/mL) to 2 provocative stimuli. Provocative stimuli include insulin-induced hypoglycemia, arginine, levodopa (L-dopa), clonidine, and glucagon. 

Medical Care: Treatment is directed at the cause of the growth failure. If the child is diagnosed with hypothyroidism, treatment is thyroid hormone replacement. Likewise, if the child is diagnosed with GH deficiency, the treatment is GH replacement therapy. In 2003 the FDA approved the use of GH for children who are not GH deficient but who are at least 2.25 SD below the mean for height, unlikely to have an adult height above -2SD, and have no explanation for their short stature. This disorder has been termed idiopathic short stature (ISS). 

Consultations: Although a primary care physician often initiates the workup, the child is usually referred to an endocrinologist for a more detailed investigation of possible causes for growth failure.

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