Fairmount Pediatrics and Adolescent Medicine

Health Information For You!

I've posted some handouts below that you may find interesting. Please check back, because I plan to post all my handouts. You may also want to follow my posts on facebook. Here's the Link to Facebook.

Table of Contents:

Vaccine Information

Vaccine information A link to the Vaccine Information Statements by the CDC and to the AAP information site on immunizations.

Integrative Health

Probiotics and Your Child's Health

Antioxidants and Health

Breastfeeding

Breastfeeding medical protocols: Including information on mastitis, meds to increase milk and more

General Pediatrics Topics

Babyproofing tips, including list of poisonous plants

Calorie Boosters for kids who aren't gaining weight well

Cough and Cold instructions

ITEMS YOU MAY WISH TO USE FOR A COLD:

  • Hungarian baby-nose-vacuum: This device attaches to your vacuum cleaner and sucks snot out of a baby's nose. There are videos to watch of it in use on this site.
  • Nosefrida The Snot Sucker: This one uses your own mouth to suck. There's a filter in-between the baby's nose and your mouth.
  • Baby Comfy Nose: This one also uses your own mouth to suck. You put a tissue in the plastic egg to act as a filter.

New Information about Acetaminophen, the medication found in Tylenol This very interesting article from the American Academy of Pediatrics questions the effects of acetaminophen. Worth reading before giving your child this common, OTC medication!

DERMATOLOGY: Here's a link to a great atlas of derm pictures. You may find this useful if you are trying to figure out what's going on with your child's skin. That said, please be careful. Many of these pictures are not for the faint of heart! Dermatology Atlas

Diarrhea instructions

Drowning Prevention Class

Fever instructions

FOOD ALLERGY PREVENTION: More and more studies suggest that LATE introduction of solids may lead to an INCREASED risk of food allergies, while EARLY (4-6 months) introduction may lead to a DECREASED risk. Here are some articles on this topic:

High blood pressure information

Prevent Iron Deficiency: AAP Guidelines say, start iron supplements in breastfed babies at 4 months

Migraine Information

Nanny Hiring, Health-related issues

Overweight: How to prevent it in young children

Overweight: how to lose weight

Ringworm information

Smoking: How to stop

Thrush instructions

Tuna Fish - how much is safe?

Tylenol May Not Be Safe

Vomiting instructions

Yeast diaper rash instructions

Healthychildren.org Symptom Checker: This is good, reliable information from the American Academy of Pediatrics.

 

Vaccine Information:

Before your child receives any vaccines, it is important to read the Vaccine Information Statement on each one. They can be printed out for you in the office, or you can find them at the CDC website using this link: http://www.cdc.gov/vaccines/Pubs/vis/default.htm.

Have questions about vaccines? Here's a reliable site where you can find answers:

American Academy of Pediatrics Immunization Site

From this site, here's a page explaining Vaccine ingredients, including why they are needed.

From the CDC, here's a list of vaccine ingredients, sorted by vaccine. I carry Sanofi-Pasteur and Merck vaccines, including Pentacel, Act Hib, Daptacel, and Rotateq.

Read more about Hib:

http://www.who.int/mediacentre/factsheets/fs294/en/index.html (World Health Organization)

http://www.cdc.gov/mmwr/preview/mmwrhtml/00041736.htm (Center for Disease Control)

http://www.vaccineinformation.org/hib/qandadis.asp (Vaccine Information)

Inquirer Article about children catching Hib in the context of last year's Hib vaccine shortage

Hemophilus Influenzae Background sheet

 

 

Health Information

PROBIOTICS AND YOUR CHILD’S HEALTH

What are probiotics?
Beneficial bacteria, and sometimes beneficial yeast, that live in the gut. The common ones fall into two groups, Lactobacillus or Bifidobacterium. Additionally, Saccharomyces boulardii, yeasts, are considered probiotics.
They can be taken in foods, such as yoghurt, sauerkraut, miso, and tempeh. They can also be taken, in larger doses, in supplement.s


What do they do?
A number of studies have shown that they can improve allergies, eczema, diarrhea from viruses, diarrhea from antibiotics, inflammatory bowel disease, and possibly chronic sinusitis.


How do they work?
There are a number of theories. Since there are immune cells in the gut, it is possible that the friendly bacteria modulate those immune cells somehow. Another possibility is that having friendly bacteria in the gut makes it harder for unfriendly bacteria to get a foothold. A third possibility is that the friendly bacteria produce substances that improve health.


Tell me more about the studies.


Viral Diarrhea:
• Overall, there is the most research support for L. rhamnosus GG and B. lactis BB-12 for prevention, and L. reuteri SD2222 for treatment of viral diarrhea.

• 286 children in daycare in Taiwan took 5 capsules a day, 5 days a week, for 7 months, of a multi-probiotic preparation (12 types of beneficial bacterial strains for the large and small intestines, including 7 different species of Lactobacilli (Neoangelac® 12A Lactobacilli, Multipower Enterprise Corp, Taipei, Taiwan). One capsule of the Neoangelac 12A Lactobacilli series contained 3 types of Bifidobacteria (2.4×109 cfu B. bifidum, 2.4×109 cfu B. infantis, 2.4×109 cfu B. longum); 7 types of Lactobacilli (2×109 cfu L. casei, 1.2×109 cfu L. salivarius, 1.6×109 cfu L. brevis, 2×109 cfu L. plantarum, 1.2×109 cfu L. acidophilus, 8×108 cfu L. helveticus, 2×109 cfu L. rhamnosus); 1 type of Streptococcus (1×109 cfu S. thermophilus) and 1 type of Enterococcus (1×109 cfu E. faecium). (cfu: colony forming units, a measure of the dose of the probiotic) Compared to those who took a single strain of probiotics and those who took nothing (all together, over 500 other children), these children had less diarrhea and vomiting illnesses during the time they took the probiotics.

• 40 babies aged 6 to 36 months of age hospitalized with diarrhea were given L. reuteri (1010 to 1011 CFU) for up to 5 days or placebo. Those who took the probiotic had a shorter illness (1.6 versus 2.9 days in the placebo group). (Placebo: sugar pill or false treatment) In a related study, another group was given a lower dose of the same probiotic (107 CFU of L. reuteri SD2222). These children had shorter illnesses than those on placebo, but longer than those with the higher dose.
Diarrhea from Antibiotics or other causes:
• Overall, there is the most research support for Lactobacillus GG, Lactobacillus sporogenes, Saccharomyces boulardii at 5 to 40 billion colony forming units/day for preventing or treating diarrhea from antibiotics.
• Lactobacillus GG prevented antibiotic-associated and traveler’s diarrhea in adults.
• Undernourished, non-breast-fed, Peruvian children, aged 18-29 months, who took Lactobacillus rhamnosus strain GG preventively had fewer episodes of diarrhea than those who did not.
• Lactobacillus GG was shown to significantly reduce stool frequency and increase stool consistency during oral antibiotic therapy by the 10th day of antibiotic therapy compared with a placebo group.

Constipation and Irritable Bowel Syndrome:
44 infants aged 6-14 months with functional constipation were given lactobacillus reuteri or placebo. Those with the probiotics had increased frequency of stools, though no improvement in consistency of stool or amount of crying.

In a review of studies on children, it was found that L. casei rhamnosus Lcr35, but not L. rhamnosus GG, showed a beneficial effect.

203 children aged 4-18 with IBS were given probiotics; 82% reported improvement in symptoms after 40-50 days.

Necrotizing Enterocolitis in Premature Infants
• 180 preemies were given either placebo or lactobacillus acidophilus. Those with the probiotics had an 18% reduction in incidence of NEC, a severe gut problem common to preemies.
• 434 very low birth weight preemies were given either lactobacillus acidophilus and bifidobacterium bifidum or nothing. 4 of those who received the probiotics and 14 of those with nothing developed NEC.
• A combined analysis of all studies on NEC and preemies included 2176 participants, and showed a 30% reduction in the incidence of NEC in those receiving probiotics. Further, no significant adverse events were reported in any of these studies.
Inflammatory bowel disease:
In children and adults, a combined probiotic preparation has been used to maintain remission in ulcerative colitis and to prevent the onset of certain surgical complications. No such effect is seen in Crohn’s disease.

Peptic Ulcer disease with Helicobacter Pylori:
In adults, 991 patients with ulcer disease and infection with helicobacter pylori were given antibiotics to eradicate the infection. 1/3 were also given Saccaromyces boulardi. 72% of those just given antibiotics and 80% of those with the probiotics were cleared of infection.


Eczema:
• 230 infants with eczema were given Lactobacillus GG or a placebo. At 4 weeks, those infants with positive skin or blood tests for allergy-associated eczema who took the probiotic were improved, compared to the others.
• 62 pregnant and lactating mothers were given probiotics or placebo. Children of those who took the probiotic were less likely to develop eczema during the first two years of life.

• 132 pregnant mothers with a relative with allergies or asthma, and their babies, after birth until 6 months of age, were given either two capsules containing 1010 Lactobacillus sp. strain GG or placebo. The babies who took the probiotic were much less likely to develop eczema.


Respiratory infections:
• Over 250 pre-schoolers who took L. casei rhamnosus containing 1×108 cfu twice a day, five days a week, for 3 months over the winter, had fewer doctor-diagnosed viral infections and fewer respiratory infections than those who took nothing.

• 479 healthy adults were supplemented daily with vitamins plus minerals with or without probiotic lactobacilli and Bifidobacteria. There was no effect on how often they got the common cold but those on probiotics had shorter and less severe colds.

• 281 daycare attenders were randomized to receive either Lactobacillus GG or placebo; Those who took probiotics had nearly half the number of upper respiratory infections as the placebo group.
Other infections:
• Over 1000 Finnish children under age 6 were put in two groups, with one group taking Lactobacillus rhamnosus strain GG three times a day, five days a week, with snacks for 7 months, over the winter . The group with the probiotic had no fewer days spent with diarrhea or respiratory symptoms, but did have fewer numbers of days absent from day care, and fewer complications such as otitis media, and fewer antibiotic prescriptions.
• Over 250 pre-schoolers who took L. casei rhamnosus containing 1×108 cfu /g twice a day, five days a week, for 3 months over the winter, had fewer doctor-diagnosed bacterial infections (such as ear infections) than those who took nothing.

Bacterial vaginosis and UTI in adult women:
• Daily oral intake of 109 to 1010 L. rhamnosus GR-1 and L. fermentum RC-14 leads to transfer of the organisms from the rectum to the vagina as well as an overall decrease of unfriendly organisms (coliforms and yeasts) in the vagina
• Once-weekly vaginal administration of a suppository containing 109 L. rhamnosus GR-1 and L. fermentum B-54 for 1 year lowered women’s rate of UTI compared to their own rate the year before.
• Daily ingestion of capsules containing L. rhamnosus GR-1 and L. fermentum RC-14 by 19 women with a bacterial vaginosis led to normalization in 81% of cases, compared to 50% in women given placebo
Future areas:
A study was recently completed evaluating the L.rhamnosus R0011 strain in treating patients with chronic sinusitis. Results are pending.
Probiotics have been proposed as possible treatments or preventive measures for dental cavities, chronic diarrhea, Chrohn’s disease, and other diseases.

Is this a sure thing?
No. Many of the studies are too small to be definite. Many of the studies use different doses, and are conducted in different ways, so combining them (to get a larger number) isn’t possible. Very few of the studies were done in children. There are strong placebo effects in many of the studies. More research is needed!
Are probiotics safe to use?
Probably, for most people. When you take in bacteria, you do have a theoretical risk of getting infected by the bacteria, rather than having it live happily in your gut helping you out. There have been 2 cases of babies getting badly infected by probiotics, and 2 cases of adults getting infected as well. In each case, the person who got infected was already immunocompromised, meaning their immune systems were not working, or debilitated in some way. There have been no cases of healthy people getting sick from probiotics. So, if a child has HIV, or gets recurrent bacterial infections (meaning, perhaps, they have an undiagnosed immune deficiency), it would be wise to be cautious about using probiotics. On the other hand, probiotics have been given to people with HIV without problems.
Another theoretical risk: Probiotics could possibly cause unhealthy metabolic activities, too much stimulation of the immune system, or gene transfer (insertion of genetic material into a cell). This has not been proven.
What about side effects?
The most common are gas and bloating. Most people have no side effects.


If I want to give probiotics to my child, which ones should I give and how much?
Since there are no studies that test the dose needed for children to get a beneficial effect, to some extent, this answer has to be a guess. Most clinicians, when giving probiotics to children, give half an adult dose, and when giving to infants, give a quarter of the adult dose. But, since there aren’t dose studies in adults either, this, too, is a guess. (Again, more research is needed!)
As far as which to give, certain strains have been shown to help with certain disease states, while other strains have been shown to have no effect. So, check the strains used in the studies listed above, whether in a supplement or yoghurt, depending on the effect you hope to have.


What if my child isn’t sick, but I want to promote health with probiotics?
Using a low dose, such as that found in yoghurt, is certainly safe. Using a supplement on a weekly or twice weekly basis is probably also safe, and, perhaps, would be beneficial.


References

Cabana MD, Shane AL, Chao C, et al. Probiotics in primary care pediatrics. Clin Pediatr (Phila) 2006 Jun; 45(5):405-10.


Reid G, Jass J, Sebulsky MT, et al. Potential uses of probiotics in clinical practice. Clin Microbiol Rev 2003 Oct; 16(4):658-72.


Boyle RJ, Robins-Browne RM, Tang ML Probiotic use in clinical practice: what are the risks? Am J Clin Nutr 2006 Jun; 83(6):1256-64; quiz 1446-7.
Reid G The potential role of probiotics in pediatric urology. J Urol 2002 Oct; 168(4 Pt 1):1512-7.


Johnston BC, Supina AL, Ospina M, et al. Probiotics for the prevention of pediatric antibiotic-associated diarrhea. Cochrane Database Syst Rev 2007; (2):CD004827.


Jun-Song Lina,1, Yi-Han Chiub,d,1, Nien-Tsung Linc, Chia-Hsiang Chua, Kuo-Chin Huangb,Kuang-Wen Liaob, Kou-Cheng Pengd ,Different effects of probiotic species/strains on infections in preschool children: A double-blind, randomized, controlled study, , Vaccine 27 (2009) 1073–1079

Michael de Vresea, Petra Winklera, Peter Rautenbergb, Timm Harderc, Christian Noahb, Christiane Lauea, d, Stephan Otte, Jochen Hampee, Stefan Schreibere, Knut Hellerf and Jürgen Schrezenmeira, Probiotic bacteria reduced duration and severity but not the incidence of common cold episodes in a double blind, randomized, controlled trial , Vaccine, Volume 24, Issues 44-46, 10 November 2006, Pages 6670-6674

Helicobacter pylori therapy in children: overview and challenges.Chiesa C, Pacifico L, Anania C, Poggiogalle E, Chiarelli F, Osborn JF.
Int J Immunopathol Pharmacol. 2010 Apr-Jun;23(2):405-16. Review.


Lactobacillus reuteri (DSM 17938) in infants with functional chronic constipation: a double-blind, randomized, placebo-controlled study.Coccorullo P, Strisciuglio C, Martinelli M, Miele E, Greco L, Staiano A.J Pediatr. 2010 Oct;157(4):598-602. Epub 2010 Jun 12.


Comparison between killed and living probiotic usage versus placebo for the prevention of necrotizing enterocolitis and sepsis in neonates.Awad H, Mokhtar H, Imam SS, Gad GI, Hafez H, Aboushady N.Pak J Biol Sci. 2010 Mar 15;13(6):253-62


Updated meta-analysis of probiotics for preventing necrotizing enterocolitis in preterm neonates.Deshpande G, Rao S, Patole S, Bulsara M. Pediatrics. 2010 May;125(5):921-30. Epub 2010 Apr 19.


Update on the role of probiotics in the therapy of pediatric inflammatory bowel disease.Guandalini S.
Expert Rev Clin Immunol. 2010 Jan;6(1):47-54. Review.


Probiotics: preventing antibiotic-associated diarrhea.Jones K.J Spec Pediatr Nurs. 2010 Apr;15(2):160-2.


Probiotic treatment of irritable bowel syndrome in children.Martens U, Enck P, Zieseniss E.Ger Med Sci. 2010 Mar 2;8:Doc07.


Role of Lactobacillus in the prevention of antibiotic-associated diarrhea: a meta-analysis.Kale-Pradhan PB, Jassal HK, Wilhelm SM.
Pharmacotherapy. 2010 Feb;30(2):119-26.


Systematic review of randomised controlled trials: probiotics for functional constipation.Chmielewska A, Szajewska H.
World J Gastroenterol. 2010 Jan 7;16(1):69-75. Review.


Lactobacillus GG in the prevention of gastrointestinal and respiratory tract infections in children who attend day care centers: a randomized, double-blind, placebo-controlled trial.Hojsak I, Snovak N, Abdović S, Szajewska H, Misak Z, Kolacek S.
Clin Nutr. 2010 Jun;29(3):312-6. Epub 2009 Nov 5.


Hung-Chih Lin, Chyong-Hsin Hsu, Hsiu-Lin Chen, Mei-Yung Chung, Jen-Fu Hsu, Rey-in Lien, Lon-Yen Tsao, Chao-Huei Chen, and Bai-Horng Su Oral Probiotics Prevent Necrotizing Enterocolitis in Very Low Birth Weight Preterm Infants: A Multicenter, Randomized, Controlled Trial Pediatrics, Oct 2008; 122: 693 - 700.


Girish Deshpande, Shripada Rao, Sanjay Patole, and Max Bulsara
Updated Meta-analysis of Probiotics for Preventing Necrotizing Enterocolitis in Preterm Neonates
Pediatrics, May 2010; 125: 921 - 930.

 

Antioxidants

Presented by Alexis Lieberman, M.D.

Fairmount Pediatrics and Adolescent Medicine

What are Free Radicals?

A byproduct of cellular metabolism are free radicals. These are molecules with only one electron, not two. The most common form of free radical is oxygen with only one electron, not with two electrons that are bonded together which is the normal form of oxygen.

Free radicals scavenge for other molecules to bond with. In the process, they damage cells. They can destroy cellular compounds and damage proteins, lipids, and DNA, and lead to cell death - especially in the brain which generates more oxidative by products than other organs of the body. This process is called oxidative stress.

What kind of damage can be done by free radicals?

The following diseases are caused or aggravated by free radicals:

  • Alcoholic liver and heart conditions
  • Arteriosclerosis
  • Arthritis
  • Autoimmune diseases
  • Cancer
  • Cataracts
  • Circulation disturbances
  • Coronary heart disease
  • Diabetes
  • Emphysema of the lung
  • Inflammatory reactions
  • Liver Cirrhosis
  • Malaria
  • Multiple Sclerosis (MS)
  • Neuronal Lipofuscinosis
  • Parkinson's Disease
  • Porphyria
  • Premature Ageing
  • Retinal Diseases
  • Rheumatoid diseases
  • Senile Dementia
  • Side-effects of medicines

What are antioxidants?

Antioxidants are substances that may protect cells from the damage caused by unstable molecules known as free radicals. Antioxidants interact with and stabilize free radicals and may prevent some of the damage free radicals might otherwise cause.

What are examples of antioxidants?

L-Carnosine

 

L-Carnosine is a multi-potent super-antioxidant which stabilizes and protects the cell membrane. Specifically, as a water-soluble free radical scavenger it prevents lipid peroxidation within the cell membrane.

Carotenoids/  Beta-carotene

Carotenoids are perhaps best known for their ability to be converted to vitamin A, which is essential for healthy vision and reproduction, and for maintaining body tissues. Carotenoids are also powerful antioxidants on their own right. They are found in many foods that are orange in color, including sweet potatoes, carrots, cantaloupe, squash, apricots, pumpkin, and mangos. Some green, leafy vegetables, including collard greens, spinach, and kale, are also rich in beta-carotene.

Co-Enzyme Q10

Co Q10 is involved in the body's metabolic processes, particularly in the release of energy from food, and is a potent antioxidant.

  

Lutein

 

 

Lycopene

 

best known for its association with healthy eyes, is abundant in green, leafy vegetables such as collard greens, spinach, and kale.

 

A potent antioxidant found in tomatoes, watermelon, guava, papaya, apricots, pink grapefruit, blood oranges, and other foods. Estimates suggest 85 percent of American dietary intake of lycopene comes from tomatoes and tomato products.

Vitamin A

A fat-soluble vitamin involved in the formation and maintenance of healthy skin, hair, and mucous membranes. Vitamin A helps us to see in dim light and is necessary for proper bone growth, tooth development, and fertility and has been well documented for decades. It is also an important antioxidant. Vitamin A is found in three main forms: retinol (Vitamin A1), 3,4-didehydroretinol (Vitamin A2), and 3-hydroxy-retinol (Vitamin A3). Foods rich in vitamin A include liver, sweet potatoes, carrots, milk, egg yolks, and mozzarella cheese.

Vitamin B

It has been recently discovered that several of the B vitamins have antioxidant effects and that they stimulate the activity of the immune system.

Vitamin C

Vitamin C is an important antioxidant, and is also part of the cellular chemistry that provides energy and for making the collagen protein involved in the building and health of cartilage, joints, skin, and blood vessels. Vitamin C is also called ascorbic acid, and can be found in high abundance in many fruits and vegetables and is also found in cereals, beef, poultry, and fish.

Vitamin E

Alpha-tocopherol is the most active form of vitamin E in humans, and is a powerful biological antioxidant. Vitamin E, also known as alpha-tocopherol, is found in almonds, in many oils including wheat germ, safflower, corn, and soybean oils, and is also found in mangos, nuts, broccoli, and other foods.

Selenium

Selenium is a mineral, not an antioxidant nutrient. However, it is a component of antioxidant enzymes. Plant foods like rice and wheat are the major dietary sources of selenium in most countries. The amount of selenium in soil, which varies by region, determines the amount of selenium in the foods grown in that soil. Animals that eat grains or plants grown in selenium-rich soil have higher levels of selenium in their muscle. In the United States, meats and bread are common sources of dietary selenium. Brazil nuts also contain large quantities of selenium.

Zinc

Zinc is vital to about 200 different enzymes, to the formation of bone tissue, in the healing of wounds and sores, to the production of proteins, the regulation of ribosomal, ribonucleic acid synthesis and insulin and in the carbohydrate metabolism. Zinc is also an antioxidant.

Can antioxidants prevent cancer?

Considerable laboratory evidence from chemical, cell culture, and animal studies indicates that antioxidants may slow or possibly prevent the development of cancer. However, information from recent clinical trials is less clear. In recent years, large-scale, randomized clinical trials reached inconsistent conclusions.

How might antioxidants prevent cancer?

Antioxidants neutralize free radicals as the natural by-product of normal cell processes. Free radicals are molecules with incomplete electron shells which make them more chemically reactive than those with complete electron shells. Exposure to various environmental factors, including tobacco smoke and radiation, can also lead to free radical formation. In humans, the most common form of free radicals is oxygen. When an oxygen molecule (O2) becomes electrically charged or “radicalized” it tries to steal electrons from other molecules, causing damage to the DNA and other molecules. Over time, such damage may become irreversible and lead to disease including cancer. Antioxidants are often described as “mopping up” free radicals, meaning they neutralize the electrical charge and prevent the free radical from taking electrons from other molecules.

What does research show about how antioxidants help promote health?

  • Studies have linked dietary antioxidants and asthma incidence/severity
  • Subjects with a high exposure to oxidative air pollutants have shown short-term protective effects of antioxidants on lung function
  • Antioxidant supplementation (50 mg/d of vitamin E and 250 mg/d of vitamin C) might modulate the impact of ozone exposure on the small airways of children with moderate to severe asthma living in Mexico City
  • Observational studies suggest a role of a healthy antioxidant diet for the prevention of coronary heart disease and cancer
  • A number of observational studies in adults have found an association between low fruit intake and asthma or lower lung function
  • Eating apples twice or more in a week, compared with eating them less than once a month, was negatively associated with wheezing
  • Intake of bananas, but not other fruits, was negatively associated with wheeze. Bananas have a higher content of water soluble phenolic acids than other fruits, including apples, and could plausibly reduce asthma inflammation. Furthermore, bananas have been shown to increase the absorption of other nutrients and are rich in pro-vitamin A carotenoids.
  • Vitamin C has been shown in several case-control and cross-sectional studies to be associated with a reduced risk of asthma, but in the only available substantive longitudinal study, vitamin C intake had no effect on asthma incidence.
  • One report suggesting protection by flavones against markers of COPD
  • Fatty acid effects: Intake of omega-3 polyunsaturated fatty acids from fish oils, which is potentially beneficial, while omega-6 and trans-fatty acids, which may be detrimental to asthma
  • 18 737 children aged 6-7 years living in Italy. Intake of citrus fruit or kiwi fruit was a highly significant protective factor for wheeze in the last 12 months
  • 598 Dutch children aged 8–13 years. Our findings suggest that a high intake of whole grain products and fish may have a protective effect against asthma in children.

Which foods are rich in antioxidants?

Antioxidants are abundant in fruits and vegetables, as well as in other foods including nuts, grains, and some meats, poultry, and fish.

The highest ranked foods in four major categories are as follows:

Fruits: blueberries, cranberries, and blackberries.

Vegetables: beans, artichoke hearts, and surprisingly, russet potatoes.

Nuts: pecans, walnuts, and hazelnuts.

Spices: cinnamon, oregano, and ground cloves.

Here's the list of the top 20 food sources of antioxidants, based on their total antioxidant capacity per serving size:

Rank

 

Food item

 

Serving size
Total antioxidant capacity per serving size

1

Small Red Bean (dried)

Half cup

13727

2

Wild blueberry

1 cup

13427

3

Red kidney bean (dried)

Half cup

13259

4

Pinto bean

Half cup

11864

5

Blueberry (cultivated)

1 cup

9019

6

Cranberry

1 cup (whole)

8983

7

Artichoke (cooked)

1 cup (hearts)

7904

8

Blackberry

1 cup

7701

9

Dried Prune

Half cup

7291

10

Raspberry

1 cup

6058

11

Strawberry

1 cup

5938

12

Red Delicious apple

One

5900

13

Granny Smith apple

One

5381

14

Pecan

1 ounce

5095

15

Sweet cherry

1 cup

4873

16

Black plum

One

4844

17

Russet potato (cooked)

One

4649

18

Black bean (dried)

Half cup

4181

19

Plum

One

4118

20

Gala apple

One

3903

While some foods are high in antioxidants, they may not be well-absorbed. Researchers also found that cooking method also had a significant effect on the antioxidant content of the foods tested, but those effects were not consistent.

For example, cooked Russet and red potatoes had much lower antioxidant levels than those found in raw potatoes. Boiling also decreased antioxidant levels in carrots, but cooking tomatoes increased their antioxidant content.

Here’s another listing, by antioxidant ORAC test results (another method of measuring antioxidant strength):

Goji Berries

Dark chocolate

25,300

13,120

Milk chocolate

6,740

Prunes

5,770

Raisins

2,830

Blueberries

2,400

Blackberries

2,036

Kale

1,770

Strawberries

1,540

Spinach

1,260

Raspberries

1,220

Brussels sprouts

980

Plums

949

Alfalfa sprouts

930

Broccoli

890


REFERENCES:

Tricia M. McKeever and John Britton, Pulmonary Perspective, Diet and Asthma American Journal of Respiratory and Critical Care Medicine Vol 170. pp. 725-729, (2004)

B. J. Okoko, P. G. Burney, R. B. Newson, J. F. Potts and S. O. Shaheen, Childhood asthma and fruit consumption

Eunyoung Cho, ScD; Johanna M. Seddon, MD; Bernard Rosner, PhD; Walter C. Willett, MD, DrPH; Susan E. Hankinson, ScD , Prospective Study of Intake of Fruits, Vegetables, Vitamins, and Carotenoids and Risk of Age-Related Maculopathy Arch Ophthalmol. 2004;122:883-892.

National Cancer Institute fact sheet on antioxidants