White Coat Notes

Kids eat up Dora, Scooby-Doo, and Shrek

June 28, 2010

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Put Dora the Explorer, Scooby-Doo, and Shrek on snack packages, and preschoolers will say they taste better than the same food in plain wrapping, a new study from Yale reports. A Boston University nutrition professor suggests harnessing that marketing power to promote healthy food.

Christina Roberto and her colleagues from the Rudd Center for Food Policy and Obesity at Yale University tested the influence of licensed cartoon characters by offering identical snacks of graham crackers, gummy fruit, and carrots to 40 children who were 4 to 6 years old. First, the children were asked to take a bite from pairs of snacks presented either in plain packages or packages festooned with a cartoon character. The children were asked if the items tasted the same, or if not, to point to the one that tasted better. Then, the children rated the snack and said which one they would choose if they had to pick one.

Overall, the children preferred the taste of all three snacks in cartoon-decorated packages. They were also more likely to choose graham crackers and gummy fruits with cartoon characters, but the difference was not statistically significant for carrots. The authors of the article, which appeared last week in Pediatrics, wondered if children were more accustomed to seeing cartoon characters on foods that were less nutritious, citing research that shows the vast majority of licensing deals involve junk foods.

Joan Salge Blake, a registered dietitian and professor of nutrition at Boston University, agrees that kids could be less familiar with cartoon characters on vegetables. (She was not involved in the Yale study.) But she also voiced support for first lady Michelle Obama’s task force on child obesity, which recently urged media companies to license their characters’ images only to healthy products.

“We see the impact it could potentially have on food choices,’’ she said in an interview, recalling the dairy industry’s successful “Got Milk?’’ campaign in the 1990s. “If there was a sticker with Scooby-Doo on bananas and if I go food shopping and I hear kids screaming for Scooby-Doo on bananas, it would be music to my ears.’’


A checkup for primary care physicians

Even with thousands of newly insured patients seeking health care in Massachusetts, primary care doctors usually see their patients for urgent appointments quickly, but they are less prompt at providing routine care and help after normal office hours.

According to new data from the Massachusetts Health Quality Partners, a coalition that includes doctors, hospitals, and health plans, 83 percent of adult patients said when they called their doctor’s office for care they needed right away, they always or almost always got an appointment quickly.

Fewer patients — 78 percent — reported that they always or almost always got an appointment for a routine checkup or after-hours help as soon as they needed it.

The results, based on surveys of 80,000 commercially insured patients in 2009, were largely unchanged from findings in the group’s 2007 survey, which was done before the state’s mandatory health insurance law was fully implemented.

Still, said Barbra Rabson, the group’s executive director, the survey showed slight declines in patient access to their doctors, which could be a warning sign of growing strain in the system. “We need to watch this very carefully,’’ she said.

The coalition is posting results from its 2009 patient experience survey on its website: Consumers can look up results for more than 500 primary care offices in Massachusetts.

Patients reported overall improvements in several aspects of the doctor-patient relationship, including communication and physicians’ knowledge of their patients. They rated these areas higher than access to doctors. Ninety-two percent of adult patients, for example, said their doctor explained things clearly, listened carefully, and provided clear instructions.

However, many primary care doctors fell short when it came to coordination between themselves and specialists. Rabson said patients have a right to expect their doctors to be up to date about their care, although physicians work in an increasingly fragmented health care system. The group’s website gives tips for helping doctors do so, including advising patients to tell their primary care doctors about all specialist visits. LIZ KOWALCZYK

Fit and lean is good, but fit and fat comes close. That’s what researchers at Tufts University discovered when they evaluated 564 freshmen on the Medford campus from 2000 through 2007.

The scientists measured height and weight, collected blood, and conducted step tests to gauge how fit the students were. A team led by Jennifer Sacheck of Tufts’ Friedman School of Nutrition Science and Policy found that 60 percent of the freshmen had more body fat than ideal. Overall, that translated into higher cholesterol levels among men and more fatty triglycerides and less good cholesterol among women.

But fitness appeared to reduce some of the negative effects of body fat. Women with higher body fat who did well on the step test had lower triglycerides and more “good’’ cholesterol, while their male counterparts had lower blood-sugar levels than their less-fit peers.

These findings can have health consequences: The lower the levels of cholesterol and blood sugar, the lower the risk of heart disease, strokes, and diabetes. “If someone is overweight or obese and unfit, they are clearly so much worse off. Someone who is physically fit and has a low body mass index clearly has the best health effect, but in between there still is a benefit,’’ Sacheck said in an interview which appears in the journal Medicine & Science in Sports & Exercise. E.C.