A Growing Crisis: Treating Childhood Obesity
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- Written by Joanne Wallenstein
- Category: Health
Childhood obesity is an alarming global concern that has been steadily worsening over the past few decades. The Centers for Disease Control and Prevention estimates 1 in 5 children and adolescents are affected by this condition. What’s more, the COVID-19 pandemic exacerbated the issue. “Post-COVID, obesity is especially on the rise in 6- to 11-year-olds and teens,” says Dr. Debra Etelson, a Pediatrician with White Plains Hospital Physician Associates in Somers.
There are many reasons driving this increase. First, the pandemic disrupted organized sports and unstructured activities, including outdoor playtime for kids, compounding an already prevalent problem. Among her patients, Dr. Etelson says, “I noticed a decrease in outdoor play even before the pandemic.” But, during the COVID lockdown, she says, “More kids were sitting in bed with their laptops. Eating habits also changed; intake of processed foods increased. Some of this was from boredom, or a lack of distraction from other things going on.”
Mental health also suffered, she adds, which can lead to serious physical health consequences. “More depression and anxiety from isolation can also translate to more obesity,” Dr. Etelson says.
This trend also led to a rise in diseases associated with obesity, such as hypertension and kidney disease, says Dr. Frederick Kaskel, Vice Chair, Affiliate and Network Relations, The Children’s Hospital at Montefiore, and Professor of Pediatrics, Albert Einstein College of Medicine. Dr. Kaskel, a Pediatric Nephrologist who also sees patients at Montefiore’s Pediatric Specialty Center on Davis Avenue in White Plains, says this “common ground” of obesity, Type 2 diabetes, and hypertension tends to run in families. “And there are stressors — socioeconomic, geographic, demographic, and genetic” — that may exacerbate these problems, he explains.
“Many kids live in an environment where they can’t even go out to walk. They have only bad food choices and food anxiety. It becomes a vicious cycle.” But it is not just a problem for children in less-affluent areas, he says: “It’s across the board. We are in an epidemic. This is a global health issue.”
The consequences of a lack of physical activity are lifelong. “If children are severely obese by age 6, there is an even higher chance they will be obese in adulthood. Early childhood is the time to develop good habits,” says Dr. Etelson, who has conducted research on childhood obesity and has raised two children with Type 1 diabetes. While this is different from Type 2, she understands the challenges and the importance of maintaining a healthy diet and exercise routine.
To get young children on the path to wellness, it is important that their caregivers and families be part of healthy habit formation, including ensuring they get enough physical activity and eat healthy meals and snacks. (This includes grandparents, who might help with caregiving but offer too much junk food!)
“We need early identification and community awareness,” Dr. Kaskel says. “The earlier programs are set up, the better [the outcome] is going to be.” At the Pediatric Specialty Center, Dr. Kaskel’s team screens patients for risk and then works with other specialists in Endocrinology, Cardiology, General Pediatrics, and other specialties to enact lifestyle changes — which Dr. Kaskel admits are “very easy to talk about, but very hard to do.”
In her practice, Dr. Etelson strives to develop a “therapeutic alliance with parents and caregivers,” to manage weight in children. “I like to dig in deep and find out what’s realistic” in terms of lifestyle changes, she says. “We make it a collaborative approach and see what will work with the family and other caregivers.”
Scare tactics don’t work. “It’s about setting realistic goals,” she explains. “We are not expecting dramatic changes, but we want to see progress.” She also stresses the importance of setting up and maintaining follow-up appointments. “I want families to have accountability, as this is the only way to address challenges and increase health outcomes,” she says.
Dr. Debra Etelson is a board-certified pediatrician at White Plains Hospital Physician Associates in Somers. To make an appointment, call 914-849-7075.
Health Matters: The original version of this article was published in Health Matters, a White Plains Hospital publication.
Case of Whooping Cough Reported at Scarsdale High School
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- Written by Joanne Wallenstein
- Category: Health
A case of whooping cough has been reported at Scarsdale High School. On February 1, the school alerted parents to look out for signs of Pertussis in their families as the persistent cough is known as the "cough of 100 days." Here is an email from Ken Bonamo, Principal of Scarsdale High School, telling you what you should know:
Please be advised that there has been a case of Pertussis at Scarsdale High School. Pertussis is a respiratory illness also known as "whooping cough." This a highly contagious bacterial disease that is spread through the air by cough from an infected individual. Children and adults may develop Pertussis even if they are up to date with their vaccinations, as immunity to Pertussis may lessen over time. Remaining up to date on vaccination against Pertussis, however, remains the best defense to prevent illness.
There are three stages of Pertussis infection:
Stage 1: Mild upper respiratory symptoms including low-grade fever, runny nose, sneezing, and mild, occasional cough.
Stage 2: Spasmodic coughing episodes, often at night, sometimes followed by long whooping sound and possible facial color changes or vomiting after coughing episodes. Does not appear ill between attacks.
Stage 3: Although the infection is not contagious after appropriate antibiotic treatment or 21 days from start of cough, coughing episodes may persist for weeks to months ("cough of 100 days").
Once a susceptible individual is exposed to Pertussis, it may take up to 21 days for symptoms to develop. If you observe these symptoms in your child/self, contact your health care provider and request a test for Pertussis with a special nasal-throat swab. This test is performed at either the doctor's office or hospital emergency room. Blood testing is not confirmatory for this disease. Early treatment with the appropriate antibiotic for a symptomatic individual will eliminate disease transmission and may reduce disease severity.
Antibiotic prophylaxis (preventive treatment) is recommended for high-risk asymptomatic contacts (not currently showing symptoms) including all household contacts, as well as any other close contacts who are infants, women in their third trimester of pregnancy, or immunocompromised persons at risk for severe disease. Pertussis disease is particularly dangerous to infants who are not fully immunized. Prophylaxis is not generally recommended for school contacts, but if you or your child fall into one of these high-risk categories and may have been in close contact with the ill student, please speak with your healthcare provider.
If your/ your child's health care provider suspects a diagnosis of Pertussis, orders testing and prescribes antibiotics, you/ your child should remain home until five days of the antibiotic has been completed.
For additional information on Pertussis, visit the Centers for Disease Control and Prevention website at www.cdc.gov. Parents or their physician may contact the Division of Disease Control at 914- 813- 5159 if they have any questions.
Former Scarsdale Resident Nora Patricia Walsh Passes Away at Age 87
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- Written by Joanne Wallenstein
- Category: Health
Nora Patricia WalshNora Patricia Walsh, 87, of Jenkintown, PA, died on January 19, 2024 surrounded by family.
Nora was a fiercely dedicated and loving wife, mother, grandmother, sister, aunt, and friend. Her quick wit and occasionally piercing glance are legendary. She was kind, courteous, and thorough in whatever she did. She and her husband John raised their six children to be the same.
Nora loved travel, painting (viewing and doing), apple turnovers, cooking shows, BBC mysteries, Jeopardy, and MSNBC. But the thing she loved most was spending time with the people she loved. She was loyal; if you were in need, you wanted Nora on your team.
Nora was born in NYC to Patrick and Bridget (Shea) Dowd on New Year’s Eve 1936. She was preceded in death by John, her husband of 60 years, her parents, her sister Mary Leone and her brother-in-law Jim Walsh. Nora is survived by her children Aileen Schast (David), Christopher (Corinne), Kerry Walsh Skelly (Jerry), Maura, Meghan, and Tim (Kristine); her grandsons Christopher, James, Nicholas (Ashley), and Patrick (Alysha) Walsh; her granddaughter Julia Schast; her sister Kate (Jim) Brown; her brother John Dowd; her sister-in-law Kay Walsh; 13 nieces, nephews, and godchildren; three grand cats and two grand dogs.
A proud graduate of Mt. St. Ursula in the Bronx and then the Katherine Gibbs School, Nora worked at Cook-Waite Labs in NYC and then the Youth Guidance Center in Worcester, MA, before becoming a full-time mom. When John and Nora returned to NY in 1961, they first lived in Riverdale for 11 years and then in Scarsdale for 43 years. She later worked at the Junior League in Scarsdale, NY; the Hebrew Home for the Aged in Riverdale, NY; and regional offices of ABB and finally Bayer. Nora earned a B.A. summa cum laude from Fordham University in 1990. Nora and John moved to Rydal Park in Jenkintown, PA in late 2015.
Nora’s family wishes to thank the 3rd floor staff at Rydal Park Medical Center and John Silwa and the care team from Bayada Hospice for their kind and gentle care for Nora over these past weeks.
There will be a Memorial Mass at Immaculate Conception Church at 606 West Avenue in Jenkintown, PA on Friday, February 16 at 11:30 am. In lieu of flowers, memorial donations to St. Jude’s Children’s Hospital, Shriners Hospitals for Children, Special Olympics or Catholic Relief Services would be appreciated.
How Stress Can Affect Your Blood Pressure – And What You Can Do About It
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- Written by Joanne Wallenstein
- Category: Health
Most if not all people feel stress in their lives, whether it’s at work, at home, or just getting from one place to another. Experiencing stress is a normal part of life; however, how we deal with it can make an important difference to our health.
Any time someone’s “fight or flight” instinct kicks in – a close call while driving; a sudden bark from a neighborhood dog – your blood pressure increases as stress hormones like adrenaline and cortisol are released by your brain.
Usually our blood pressure returns to its normal level after the event has passed. However, repeated stressful events – even relatively low-level ones – over time can have a negative effect on our health. The consequences of having chronic high blood pressure can include a higher risk for heart attack or stroke, risks that are made worse if you suffer from diabetes or live a sedentary lifestyle.
The answer to relieving high blood pressure (hypertension) caused by stress for many people is simple: remove the source of stress. This can of course be easier said than done, but there are a host of options that can help you relieve the effects of longer-term stress – and that may help lower your blood pressure.
Exercising on a regular basis is a great way of releasing endorphins, which can increase feelings of well-being and therefore relieve stress; I recommend 30 minutes of mild-to-moderate exercise at least five times a week. Consider the benefits of deep-breathing exercises, yoga and other self-relaxation techniques, which can have a long-term effect by providing you with the tools to overcome, or at least better manage, your stress.
If you face the same stressors each day – battling traffic during a long commute, for example – you may want to look into how to better manage your time. There may be a way to avoid peak commuting time by going to and from work a little earlier or later.
It should be noted that the “usual suspects” can also cause high blood pressure. Use of nicotine and alcohol, eating unhealthy foods, and (the not necessarily disconnected issue of) lack of good sleep can all play a role.
There are also many medications available for those with high blood pressure that can be helpful, depending on what your BP numbers are. If your blood pressure is consistently higher than 140/90, you will likely need to take medication. Even then, you should observe healthy habits to lower your risk for heart attack and stroke.
“Just relax” can itself be a stressful thing to hear. But it can be an effective way to combat hypertension, if you have the discipline and an approach that is right for you.
Dr. Gregory Pontone is a noninvasive cardiologist and the Associate Medical Director of Ambulatory Quality and Physician Services at White Plains Hospital. To make an appointment, call 914-849-4800.
Health Matters
The original version of this article was published in Health Matters, a White Plains Hospital publication.
Hearing Loss in Children: Avoidable, Yet Treatable
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- Written by Joanne Wallenstein
- Category: Health
The following was submitted by Dr. Michel Nassar, Pediatric Otolaryngology at White Plains Hospital.
“Turn it down!” has been a regular refrain from parents at least since the dawn of rock ‘n’ roll. But evidence shows that adolescents should indeed be taking care when listening to, or playing, music at excessive volumes.
Obviously loud noises can have an impact on one’s hearing, especially if it is repeated regularly; that is why wearing noise-canceling headphones is recommended when leaf-blowing, working certain construction jobs, and so on. Listening to music is meant to be a pleasurable experience, but that pleasure can lead to pain if one isn’t careful.
Last year, the World Health Organization estimated that more than a billion people, aged 12 to 35, stand at risk of losing their hearing due to prolonged and excessive exposure to loud music, among other recreation factors. Meanwhile, the CDC estimates that 12.5% of children and adolescents aged 6–19 years (approximately 5.2 million) and 17% of adults aged 20–69 years (approximately 26 million) have suffered permanent damage to their hearing from excessive exposure to noise.
Younger children, whose bodies are still developing, face an especially significant risk of long-lasting damage; the popularity of ear buds (and concomitant, if inadvertent, lack of attention paid to their use by parents) has only exacerbated the problem. Hearing loss can affect a child’s ability to develop speech, language, and social skills – which in turn, if not treated, can lead to various difficulties in adolescence and even adult life.
How Loud Is Too Loud?
The rule of thumb used to be that, if you could hear the music from someone’s headset, it was probably too loud. But with advances in headphone technology, that rule may no longer be reliable.
Sounds at or below 70 decibels, which is in the range of normal conversation, are generally thought of as safe and unlikely to cause hearing loss. Headphone users often listen to music at 105 decibels, while concertgoers are typically exposed to music in the 104 to 112 decibel range. Swedish heavy metal/punk band Sleazy Joe prides itself on its decibel delivery and is generally accepted as the “loudest” band around, once topping 143 decibels on its home turf.
Obviously not everyone is listening to Sleazy Joe, but the threat of hearing damage at even an “average” rock concert is real.
“If it’s too loud, you’re too old” is another cliché. However, permanent damage is a very real possibility. Tinnitus, the familiar “ringing in the ears” sensation, can present during and for a limited time after exposure to loud music; whether brief or chronic, it is often a sign of inner ear cell damage.
In addition, sensorineural hearing loss caused by exposure to loud sounds is often irreversible. Teenagers who have a life expectancy of 60-80 years should avoid this problem that may affect them for the rest of their lives.
Discuss with your children the following approaches that, while perhaps not making you popular now, could result in gratitude as they grow older:
Lower the volume and the duration of your exposure. Keeping the volume on your headset, stereo, or even television at the 50%-60% capacity level is recommended, and keeping your exposure to about 60 minutes – admittedly difficult at a live event – can also be beneficial.
Wear earplugs at live events. Thankfully, following this advice no longer disqualifies the always image-conscious teen as someone who’s cool; in fact, earplugs are nearly undetectable by others unless they’re specifically looking for them.
People of all ages should also be aware that cochlear implant surgery can help in some cases; in fact, many recipients of cochlear implants can still go to concerts and enjoy the music of their choice.
The fact remains, however, that the earlier children with hearing loss (brought on by whatever reason) can begin receiving professional treatment, the more likely they are to realize their full potential. If you suspect that you or a family member may be facing hearing loss, consult with a physician as soon as you can.
Michel Nassar, MD, MSc, is Director, AeroDigestive Program at The Children’s Hospital at Montefiore, and Co-Director, 
CranioFacial Clinic and Associate Professor of Otolaryngology at the Montefiore Medical Center. He sees patients at White Plains Hospital’s Pediatric Specialists, located at 600 Mamaroneck Avenue in Harrison. To make an appointment, call 914-849-KIDS.
