Be Well

Less wheezing in babies with high vitamin D

January 3, 2011

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A new study links higher vitamin D levels at birth to lower rates of respiratory infections and wheezing in early childhood.

Dr. Carlos Camargo Jr. of Massachusetts General Hospital led a study following 922 newborns, whose umbilical cord blood was tested for signs of vitamin D. Parents were asked about illnesses at 3 and 15 months and annually up to age 5.

Children who had had the lowest levels of vitamin D were twice as likely as those with the highest to develop respiratory infections. Wheezing was also less likely in children who had the highest levels at birth. There was no difference in incidence of asthma.

BOTTOM LINE: Newborns with higher vitamin D levels were less likely to have respiratory infections or wheezing early in life than those with lower levels; there was no difference in who was diagnosed with asthma.

CAUTIONS: The study linked vitamin D and respiratory infections and wheezing, but can’t say one caused the other.

WHAT’S NEXT: Randomized clinical trials will measure mothers’ vitamin D levels during pregnancy and children’s levels after birth to see if they are directly related to children’s respiratory infections, wheezing, or asthma.

WHERE TO FIND IT: Pediatrics, January

Team approach in study trumps usual care

An intense primary-care-based program in which nurses and physicians worked together helped more patients with chronic illnesses than usual care, a new study has found.

Dr. Wayne Katon and his colleagues at the University of Washington School of Medicine randomly divided more than 200 patients with depression and poorly controlled diabetes, heart disease, or both into two groups. One got the usual care, meaning they were advised to consult their doctors about their conditions. In the other, a nurse working with the patient’s doctor came up with a plan for each patient to meet goals for blood sugar, blood pressure, cholesterol levels, and depression scores. Patients in this group visited the clinic every two or three weeks. Nurses met with a primary care doctor, a psychiatrist, and a psychologist weekly to discuss.

After a year, 37 percent of the patients in the care-coordination group improved their scores compared with 22 percent in the usual care group.

BOTTOM LINE: People with poorly controlled depression and diabetes or heart disease or both whose care was coordinated by nurses working in teams improved their health more than people under usual care.

CAUTIONS: The study took place in one large, integrated health care system. Results might be different in other settings.

WHERE TO FIND IT: New England Journal of Medicine, Dec. 30