Statewide Calorie Labeling Bill S.5665 Duane/A.8506 Ortiz Moving Well Through the Legislature
Governor Paterson’s calorie labeling bill introduced by Senator Duane and Assemblyman Ortiz, is moving well through both houses and we are hopeful it will pass this year. It still needs to pass through Senate and Assembly committees over the next few weeks (session ends June 22nd unless it is extended.)

If you have not contacted your local legislators and asked them to co-sponsor this bill, please do so ASAP. Your calls are making a difference as many new legislators have signed on to co-sponsor this past week.

We’re down to the wire so please make those calls!!!

To reach your Assembly member call the Assembly switchboard at 518.455.4100
To reach your Senate member call the Senate switchboard at 518.455.2800
To look up your Assembly member: http://assembly.state.ny.us/mem/
To look up your Senate member: http://www.nysenate.gov/

Senator Oppenheimer Introduces a New Healthy Schools Bill S.5785
Senator Suzi Oppenheimer, chair of the Senate Health Committee, introduced a Healthy Schools bill last week. The bill, which is a brand new compromise school nutrition bill, is definitely moving in the right direction. NYSHEPA will be putting out a supportive statement for Senator Oppenheimer’s efforts although we are not ready to support the bill just yet. We hope to tighten up some provisions before we throw our support behind the measure.

The bill addresses the issue of additional reimbursements (15 cents per meal starting in 2011-2012 school year) as well as setting school nutrition standards for the entire school day for cafeteria, a la carte and vending. I’ve attached a copy of the new bill, for your review. There is no same as in the Assembly, right now.

The Governor’s Healthy Schools Act does not seem to be moving right now, although that can always change.

Complete Streets Bills Introduced in NYS Legislature (S.5711/ A.8587) – Please sign our Memo of Support
Complete Streets bills were introduced in both the NYS Senate and Assembly recently. To read the bill, go to: http://assembly.state.ny.us/leg/?bn=a8587

Click on See Text for full bill text.

Our Memo of Support for the bill is attached. If your organization would like to sign on, please let me know ASAP.

More Local Calorie Labeling Measures Introduced in NYS
If our state bill does not pass this session, three counties will proceed to vote on strong calorie labeling laws that have been introduced. Those counties are Rockland, Nassau and Albany. NYC and three counties, Westchester, Ulster and Suffolk, have already passed strong calorie labeling measures.

WASHINGTON (Reuters) - The American Medical Association threw its weight behind legislation to ban the use of artificial trans fats in restaurants and bakeries nationwide on Monday.

The group, which represents about 240,000 doctors and medical students, said it would move away from a previous, gentler position that advised people to reduce their use and move to healthier fats and oils instead.

“Trans fats have been proven to raise LDL (low density lipoprotein), the bad cholesterol, while lowering HDL (high density lipoprotein), the good cholesterol, which significantly increases the risk for heart disease,” said AMA board member Dr. Mary Anne McCaffree.

“By supporting a ban on the use of artificial trans fats in restaurants and bakeries, we can help improve the quality of the food Americans eat and may ultimately save lives.”

The group, meeting in Orlando, Florida, said replacing trans fats would prevent up to 100,000 premature deaths each year in the United States alone.

Trans fats come from adding hydrogen to vegetable oil through a process called hydrogenation. It makes liquid oil more like butter and makes it less likely to go rancid — but in the process makes it just as dangerous to arteries as butter or lard.

New York City and California banned trans fats in July.

(Reporting by Maggie Fox; Editing by Doina Chiacu)

By State Comptroller Thomas P. DiNapoli

ALBANY - More than one million of New York’s youngest citizens face a serious health crisis — childhood obesity.
The State Department of Health estimates that one out of every four New Yorkers under 18 years of age is obese, and many more are at risk of becoming obese. For most age groups, this rate of obesity has tripled over the past 30 years; for children between six years and 11 years, the rate has quadrupled.

Obese children are at a greater risk of suffering diseases such as diabetes, heart disease, hypertension, liver disease and depression. Obese children also tend to miss school more frequently, which can hinder academic achievement.

But childhood obesity is more than a tragic health crisis — it’s also a crushing economic burden.

A recent report published by my office found that childhood obesity costs the state more than $240 million per year in public and private medical expenses. Not surprisingly, obese children are more likely to become obese adults, which causes health care costs to grow exponentially.

New York ranks second among U.S. states in adult obesity-related medical expenditures; we spend approximately $6 billion a year, and more than 80 percent of those costs are paid by Medicaid and Medicare – public tax dollars.

The good news is that in most cases, childhood obesity is preventable.

We have a good idea what’s causing the surge childhood obesity — processed foods that are high in fat and sugar, fast food meals, and high-sugar drinks coupled with decreased physical activity. Too many children are choosing television and Play Station over the playground.

Next to parents, schools can have the greatest impact on children’s choices. Schools can promote healthy weight through physical education and nutritional programs. Schools that participate in the National School Lunch Program and School Breakfast Program are required to meet federal nutrition guidelines. These guidelines call for school meals to limit fat and provide healthy levels of protein, vitamins A and C, iron, calcium and calories.

The State Education Department has also established requirements that vending machines in schools cannot dispense soda or candy prior to the end of the last lunch period.

To date, no one has determined whether New York State schools are meeting these requirements.

My office will.

Through statewide audits we’ll make sure our children are getting the nutritional meals and regular exercise required by State and federal education guidelines.

This will have to be a team effort. Parents, teachers, and communities will have to reinforce health choices for children every day. But we can, and we must work to end childhood obesity. Together, we can help our children become healthy, productive adults.

And we’ll help save tax dollars at the same time.

The obesity crisis in New York is affecting 1.1 million young people and costs the state $242 million in public and private medical expenses, according to a report (http://www.osc.state.ny.us/reports/health/childhoodobesity.pdf) issued today by State Comptroller Thomas P. DiNapoli.

“Childhood obesity is a health care issue, but it’s also a dollars and cents issue,” DiNapoli said. “This crisis translates into more serious health problems, and those problems lead to hundreds of millions of dollars in health care costs. And the costs grow exponentially as obese children become obese adults. Schools can play an integral part in reversing this epidemic through their physical education and nutritional programs. The classroom is a great place to start kids on the road to healthy adulthood and save taxpayers millions of dollars in the long run.”

According to the DiNapoli report, New York ranks second among U.S. states in adult obesity-related medical expenditures, with total spending estimated at nearly $6.1 billion – 81 percent of which is paid by Medicaid and Medicare, far exceeding the national average of 52 percent.

The report notes that the obesity rate among children has more than tripled over the past 30 years.

DiNapoli’s office has initiated statewide audits of school physical education programs and school lunch meal services to measure their effectiveness in improving students’ health. DiNapoli’s auditors are also reviewing whether students are benefiting from nutritional school meals as required by the State and federal education policy and regulations.

By AP Medical Writer Mike Stobbe

ATLANTA – The nation’s obesity epidemic is exacting a heavy toll: The rate of new diabetes cases nearly doubled in the United States in the past 10 years, the government said Thursday. The highest rates were in the South, according to the first state-by-state review of new diagnoses. The worst was in West Virginia, where about 13 in 1,000 adults were diagnosed with the disease in 2005-07. The lowest was in Minnesota, where the rate was 5 in 1,000.

Nationally, the rate of new cases climbed from about 5 per 1,000 in the mid-1990s to 9 per 1,000 in the middle of this decade.

Roughly 90 percent of cases are Type 2 diabetes, the form linked to obesity.

The findings dovetail with trends seen in obesity and lack of exercise — two health measures where Southern states also rank at the bottom.

“It isn’t surprising the problem is heaviest in the South — no pun intended,” agreed Matt Petersen, who oversees data and statistics for the American Diabetes Association.

The study, led by Karen Kirtland of the Centers for Disease Control and Prevention, provides an up-to-date picture of where the disease is exploding. The information should be a big help as the government and health insurance companies decide where to focus prevention campaigns, Petersen said.

Diabetes was the nation’s seventh-leading cause of death in 2006, according to the CDC. More than 23 million Americans have diabetes, and the number is rapidly growing. About 1.6 million new cases were diagnosed among adults last year.

Type 2 diabetics do not produce or use insulin, a hormone needed to convert sugar into energy. The illness can cause sugar to build up in the body, leading to complications such as heart disease, blindness, kidney failure and poor circulation that leads to foot amputations.

The study involved a random-digit-dialed survey of more than 260,000 adults. Participants were asked if they had ever been told by a doctor that they have diabetes, and when the diagnosis was made. The comparisons between 1995-97 and 2005-07 covered only the 33 states for which the CDC had complete data for both time periods.

The researchers had data for 40 states for the years 2005-07.

West Virginia, South Carolina, Alabama, Georgia, Texas and Tennessee had the highest rates, all at 11 cases per 1,000 or higher. Puerto Rico was about as high as West Virginia. Minnesota, Hawaii and Wyoming had the lowest rates.

It is not entirely clear why some states were worse than others. Older people, blacks and Hispanics tend to have higher rates of Type 2 diabetes, and the South has large concentrations of all three groups. However, West Virginia is overwhelmingly white.

The report asked about diagnosed diabetes only. Because an estimated one in four diabetics have not been diagnosed, the findings probably underestimate the problem, said Angela Liese, a diabetes researcher at the University of South Carolina.

The underestimates may be particularly bad in the rural South and other areas where patients have trouble getting health care, she noted.

By KIM SEVERSON, NY TIMES
WHEN you’re young and tap dance for a living, you don’t have to think much about the caloric impact of your next meal. But when three performers who spent the day rehearsing for “Shrek the Musical” walked into a restaurant on 42nd Street recently, they saw on the menu that a Japanese-style beef bowl had 1,090 calories. They decided to head down the street for a salad.

“Counting calories is so 1980s,” said Rachel Stern, one of the dancers. “But when it’s right there, it’s kind of hard to ignore.”

For the last few decades, the most popular diets were complex formulas that promised abundant eating with just the right combinations of fat, protein and carbohydrates. Now those regimens are starting to look like exotic mortgages and other risky financing instruments. And just like a reliable savings account, good old calorie counting is coming back into fashion.

“More and more, people are looking at calories in, and calories out,” said Dr. Terry Eagan, a Los Angeles psychiatrist, who for 16 years has helped people with eating disorders and other addictions. “I know some people want something that’s sexy and different and new, but there really isn’t anything new about weight loss.”

Evidence of the calorie’s resurgence is everywhere. The makers of Coca-Cola and M&Ms will soon print calories on the front of packages. Consumers, too, are paying more attention, like the diners who discovered that some meals at Applebee’s had more calories than advertised and filed a class-action suit this fall.

New Yorkers got a harsh dose of calorie reality this summer when restaurants with 15 or more outlets were forced to post the calorie content of food next to the price. The resulting sticker shock has brought parts of a great city to its knees, often to do push-ups.

The campaign has inspired lawmakers around the country to follow New York’s lead.

Restaurants and food companies are lightening recipes and portion sizes. Starbucks, for example, claims to have saved the nation 17 billion calories since last October by swapping 2 percent milk for whole. The 100-calorie snack is this decade’s answer to the fat-free SnackWell cookie, as more brands introduce tiny portions of things like Cool Ranch Doritos and Clif bars.

Dunkin’ Donuts recently added a low-calorie egg white breakfast sandwich, Così is using low-fat mayonnaise and McDonald’s large French fries have dropped to 500 calories this year from 570 last year. Quiznos is testing smaller sizes and less-caloric sandwich fillings in its New York stores. Cathy Nonas of the New York City health department said this is all a reaction to public-health pressure.

Restaurant corporations say consumer demand, not the threat of legislation, made them change. That’s why Yum Brands, which owns KFC, Taco Bell, Pizza Hut and other fast-food restaurants, will start voluntarily posting calorie counts for individual servings in its restaurants nationwide later this year, said Jonathan Blum, a company spokesman.

At Starbucks, a new set of “nutritional guardrails” were put in place over the last year not because of legal mandates but because customers wanted it, said Katie Thomson, the company’s nutritionist.

Products were reviewed for calorie and fat content. Bakers were encouraged to substitute healthier ingredients or, if that would compromise taste, to reduce portions, as the company did with its butter croissant. Starbucks also considered how much satiety items would provide, something increasingly important as people cut back on calories, she said.

For some establishments, having their menus exposed by the New York law forced some caloric housecleaning. At Le Pain Quotidien, which has 17 outlets in New York, several items were changed or taken off the menu, said Jack Moran, a vice president.

The popular quiche Lorraine was trimmed to 6 ounces from 11, with extra salad filling out the plate. Sweets like brownies may shrink, too.

But consumers who think smaller portions will mean smaller prices are likely out of luck. The prices on some of the chain’s newly slimmed down items haven’t dropped, but that doesn’t seem to be affecting sales.

“Everything we consider to have a good caloric rating is marching up the charts,” Mr. Moran said.

The Atlantic smoked salmon tartine, with 350 calories, was always a good middle-of-the-pack seller among the 15 open-face sandwiches that are a specialty at the chain. After the calorie counts were posted, it became a top seller, edging out the longstanding favorite, the grilled chicken and smoked mozzarella tartine, which has 690 calories and costs about $3 less.

Reducing calories is now a company-wide quest, and the chain is posting calorie counts in its restaurants in Washington and Los Angeles.

If reduced portion sizes remain popular with customers, it could help restaurant operators who have been bearing big jumps in food costs this year, Mr. Moran and other restaurateurs said.

Public health officials acknowledge that people rarely change their eating habits overnight, and that there is a lot more to good nutrition than simply counting calories. Still, they are trying to make sure consumers stay calorie conscious. Just to hammer the point home, the New York City health department earlier this month put signs inside subway cars pointing out that most people need only about 2,000 calories a day.

The number of calories in food shocked most New Yorkers, according to a September survey by the health department. A Starbucks blueberry scone delivers 480 calories. A Quiznos regular tuna melt is 1,270 calories. Wraps, the refuge for low-carb sandwich lovers, can top 800 calories. Bagels pack more calories than doughnuts. A large bucket of buttered movie popcorn has more than half the calories anyone should eat in a day.

Even people for whom nutrition is a way of life had no idea how many calories they were eating. Kate Adamick, a consultant who helps corporations and school districts improve their food, took a hard look at her Starbucks habit, which included bran muffins and chocolate cookies.

“Just because I work in the food world, I am not immune from this human tendency to self-delude,” she said. “I can look at a cookie that is the size of a man’s hand and think it’s only twice as big as a regular cookie, but it actually has the caloric content of four or five cookies.”

Posting calories on menus is a kind of Hail Mary pass for health officials trying to slow rates of diabetes and obesity. But it is catching on fast. California last month became the first state to require calorie counts, although that law is less restrictive than New York’s.

In all, nearly three dozen states, cities and counties have passed or introduced laws that would require calorie posting in some form. More are in the works, said Margo Wootan, director of nutrition policy for the Center for Science in the Public Interest, which frequently criticizes the food industry.

Two proposals moving through Congress would make calorie postings uniform nationwide. One, the Labeling Education and Nutrition Act, is backed by the restaurant industry and would give restaurants and grocery stores selling prepared foods a choice of labeling formats, including posters near the cash register or disclosures on the back of the menu. It would pre-empt tougher laws, like New York’s.

A second proposal, the Menu Education and Labeling Act, is supported by public health advocates and more closely mirrors New York’s law. It would not pre-empt more stringent local laws.

Of course, for the calorie’s comeback to be sustained, people who are not already focused on a healthy diet will have to begin paying attention.

At a Chipotle near Brooklyn Borough Hall, Daniela Castillo, 18, dishes up carnitas between classes at Brooklyn College. The customers talking calories, she said, are mostly women, and mostly slimmer older women. Men, especially the younger ones, just ask for everything, and often ask her to double the portions.

“I think it’s kind of a middle-age thing, counting calories,” she said.

People might be changing their eating habits, but some restaurant owners remain skeptical — especially those who have already offered lower calorie food only to see those items languish.

“We talk skinny and eat fat,” said Tim Ryan, president of the Culinary Institute of America.

And it has been that way for a century.

The first calorie-centric weight-loss guide, “Diet and Health, With a Key to the Calories” by Dr. Lulu Hunt Peters, was published in 1918 to great acclaim. Her weight-loss formula? Eat in 100-calorie portions, and no more than 1,200 a day.

One might wonder where all the calories end up. The answer is: our collective belly-fat supplies. The obesity rate stayed constant in only 13 states last year, while the other 37 states saw an increase. This big fat growth — which stretches over 75 percent of America — is due in no small part to our propensity to eat full meals before we eat full meals. (It’s not uncommon anymore to take in two days’ worth of calories in one meal at one of our favorite restaurants.)

To help you wrap your arms around the problem, we’ve gathered the most gluttonous pre-meal binges in America. If this list doesn’t make you hungry, then you’re already ahead of most of us.

CHILI’S
Texas Cheese Fries w/ Jalapeno-Ranch Dressing
2,070 calories
160 g fat (73 g saturated)
3,730 mg sodium

Fat Equivalent: Like eating 16 Taco Bell Crunchy Tacos!

After we identified Chili’s Awesome Blossom in our investigative report here on The 20 Worst Foods in America, the chain’s 203 fat grams of deep-fried onion disappeared from the menu. Unfortunately that’s like taking a kiddie shovel to a menu that needs to be cleared with a front loader. The Texas Cheese Fries with jalapeno-ranch dressing has nearly two days’ worth of sodium in this one starter — and nearly four days’ worth of saturated fat.

ON THE BORDER
Grande Fajita Nachos – Mesquite-Grilled Steak
1,970 calories
127 g fat (54 g saturated)
3,780 mg sodium

Fat Equivalent: Like eating an entire package of Oreos!

Even if you’re only one of four people working on these nachos, you’ll still bludgeon your belly with half a day’s worth of fat. The same is true for the Border Sampler. Opt instead for the 500-calorie basket of Chips & Salsa.

OUTBACK STEAKHOUSE
Aussie Cheese Fries with Ranch
2,030 calories
??? g fat
??? mg sodium

Calorie Equivalent: Like eating as many as 21 White Castle Hamburgers!

Consider this one of America’s most questionable appetizers. That’s because Outback doesn’t provide full nutritional data for any of its products, forcing diners to guess exactly how many day’s worth of fat and sodium must really be crammed into this cheesy mess.

Earlier estimates from nutritional analysis groups put the pile at 2,900 calories with close to 200 grams of fat; even with Outback’s more conservative calorie counts, these frightening fries should be avoided at all costs.

PIZZA HUT
Taters (full order)
1,580 calories
104 g fat (20 g saturated)
4,160 mg sodium

Sodium Equivalent: Like eating more than two full bags of Ruffles Original Potato Chips!

A bag of Ruffles has about 11 servings, which means these tater-tot miscreants carry the heart-taxing sodium load of 22 servings of potato chips. Throw these over your shoulder for good luck; you’ll avoid nearly two days’ worth of sodium that come with this one side. And to discover other salty foods you should steer clear of, check out these 20 foods your cardiologist won’t eat! They’re among America’s worst.

ROMANO’S MACARONI GRILL
Romano’s Sampler (fried calamari, fried mozzarella, tomato bruschetta, garnish)
1,640 calories
98 g fat (22 g saturated)
4,000 mg sodium

Calorie and Sodium Equivalent: Like eating more than 10 Extra Crispy Drumsticks from KFC!

This sampler is a roundup of the worst offenders on the menu: fried calamari, fried mozzarella, and tomato bruschetta. The only massive calorie bomb they bypass is the 980-calorie Shrimp Artichoke Dip. With a menu as heavy as Macaroni Grill’s, you’d be better off skipping the starters altogether.

RUBY TUESDAY
Grand Sampler (fire wings, southwestern spring rolls, fried mozzarella, and chicken tenders)
1,644 calories
100 g fat

Calorie Equivalent: Like eating 5 McDonald’s Cheeseburgers!

There’s enough fried food here to feed an entire Little League baseball team, so unless you’re taking them to Ruby’s (and you have signed permission slips) after the game, I’d recommend avoiding a swing at this bad pitch.

T.G.I. FRIDAYS
Jack Daniel’s Sampler (Jack Daniel’s glaze over fried shrimp, Sesame Jack Chicken Strips, and Baby Back Pork Ribs)
2,330 calories
??? g fat
??? mg sodium

Calorie Equivalent: Like eating more than 8 Steak Fajita Hot Pockets!

Thanks to new legislation in New York City, chain restaurants were forced to post their calorie counts on their menus. As a result, what Fridays’ patrons discovered was that they’ve been unwittingly paying for a clobbering with a big, greasy fat stick. More than half the appetizers top 1,000 calories.

UNO CHICAGO GRILL
Pizza Skins (full order)
2,400 calories
155 g fat (50 g saturated)
3,600 mg sodium

Calorie Equivalent: Like eating a Large Domino’s Hand-Tossed Sausage Pizza!

Would you ever think of saying to a waiter: “Why don’t you start us off with a large meat pizza?” If you’re ordering for a party of more than 5 it might be OK, but for smaller groups, it’s tilting toward gluttony gone wild. Order the Thai Vegetable Pot Stickers instead — the only item carrying fewer than 800 calories.

By LAURIE TARKAN, NY TIMES
To the great surprise of parents, kidney stones, once considered a disorder of middle age, are now showing up in children as young as 5 or 6.

While there are no reliable data on the number of cases, pediatric urologists and nephrologists across the country say they are seeing a steep rise in young patients. Some hospitals have opened pediatric kidney stone clinics.

“The older doctors would say in the ’70s and ’80s, they’d see a kid with a stone once every few months,” said Dr. Caleb P. Nelson, a urology instructor at Harvard Medical School who is co-director of the new kidney stone center at Children’s Hospital Boston. “Now we see kids once a week or less.”

Dr. John C. Pope IV, an associate professor of urologic surgery and pediatrics at the Monroe Carell Jr. Children’s Hospital at Vanderbilt in Nashville, said, “When we tell parents, most say they’ve never heard of a kid with a kidney stone and think something is terribly wrong with their child.”

In China recently, many children who drank milk tainted with melamine — a toxic chemical illegally added to watered-down milk to inflate the protein count — developed kidney stones.

The increase in the United States is attributed to a host of factors, including a food additive that is both legal and ubiquitous: salt.

Though most of the research on kidney stones comes from adult studies, experts believe it can be applied to children. Those studies have found that dietary factors are the leading cause of kidney stones, which are crystallizations of several substances in the urine. Stones form when these substances become too concentrated.

Forty to 65 percent of kidney stones are formed when oxalate, a byproduct of certain foods, binds to calcium in the urine. (Other common types include calcium phosphate stones and uric acid stones.) And the two biggest risk factors for this binding process are not drinking enough fluids and eating too much salt; both increase the amount of calcium and oxalate in the urine.

Excess salt has to be excreted through the kidneys, but salt binds to calcium on its way out, creating a greater concentration of calcium in the urine and the kidneys.

“What we’ve really seen is an increase in the salt load in children’s diet,” said Dr. Bruce L. Slaughenhoupt, co-director of pediatric urology and of the pediatric kidney stone clinic at the University of Wisconsin. He and other experts mentioned not just salty chips and French fries, but also processed foods like sandwich meats; canned soups; packaged meals; and even sports drinks like Gatorade, which are so popular among schoolchildren they are now sold in child-friendly juice boxes.

Children also tend not to drink enough water. “They don’t want to go to the bathroom at school; they don’t have time, so they drink less,” said Dr. Alicia Neu, medical director of pediatric nephrology and the pediatric stone clinic at Johns Hopkins Children’s Center in Baltimore. Instead, they are likely to drink only once they’re thirsty — but that may be too little, too late, especially for children who play sports or are just active.

“Drinking more water is the most important step in the prevention of kidney stones,” Dr. Neu said.

The incidence of kidney stones in adults has also been rising, especially in women, and experts say they see more adults in their 20s and 30s with stones; in the past, it was more common in adults in their 40s and 50s.

“It’s no longer a middle-aged disease,” Dr. Nelson said. “Most of us suspect what we’re seeing in children is the spillover of the overall increase in the whole population.”

The median age of children with stones is about 10.

Many experts say the rise in obesity is contributing to kidney stones in children as well as adults. But not all stone centers are seeing overweight children, and having a healthy weight does not preclude kidney stones. “Of the school-age and adolescent kids we’ve seen, most of them appear to be reasonably fit, active kids,” Dr. Nelson said. “We’re not seeing a parade of overweight Nintendo players.”

Dr. Slaughenhoupt has seen more overweight children at his clinic. “We haven’t compared our data yet,” he said, “but my sense is that children with stones are bigger, and some of them are morbidly obese.”

Dr. Pope, in Nashville, agreed. His hospital lies in the so-called stone belt, a swath of Southern states with a higher incidence of kidney stones, and he said doctors there saw two to three new pediatric cases a week.

“There’s no question in my mind that it is largely dietary and directly related to the childhood obesity epidemic,” he said.

Fifty to 60 percent of children with kidney stones have a family history of the disease. “If you have a family history, it’s important to recognize your kids are at risk at some point in their life,” Dr. Nelson said. “That means instilling lifelong habits of good hydration, balanced diet, and avoiding processed high-salt, high-fat foods.”

There is also evidence that sucrose, found in sodas, can also increase risk of stones, as can high-protein weight-loss diets, which are growing in popularity among teenagers.

A common misconception is that people with kidney stones should avoid calcium. In fact, dairy products have been shown to reduce the risk of stones, because the dietary calcium binds with oxalate before it is absorbed by the body, preventing it from getting into the kidneys.

Children with kidney stones can experience severe pain in their side or stomach when a stone is passing through the narrow ureter through which urine travels from the kidneys to the bladder. Younger children may have a more vague pain or stomachache, making the condition harder to diagnose. Children may feel sick to their stomach, and often there is blood in the urine.

One Saturday last February, 11-year-old Tessa Cesario of Frederick, Md., began having back pains. An aspiring ballerina who dances en pointe five nights a week, she was used to occasional aches and strains. But this one was so intense that her parents took her to the doctor.

The pediatrician ordered an X-ray, and when he phoned with the results, her parents were astonished.

“I was afraid he was calling to say she pulled something and wouldn’t be able to dance,” said her mother, Theresa Cesario. Instead, they were told that Tessa had a kidney stone.

“I thought older men get kidney stones, not kids,” Ms. Cesario said.

The treatment for kidney stones is similar in children and adults. Doctors try to let the stone pass, but if it is too large, if it blocks the flow of urine or if there is a sign of infection, it is removed through one of two types of minimally invasive surgery.

Shock-wave lithotripsy is a noninvasive procedure that uses high-energy sound waves to blast the stones into fragments that are then more easily passed. In ureteroscopy, an endoscope is inserted through the ureter to retrieve or obliterate the stone.

Tessa Cesario is taking a wait-and-see approach. Her stone is not budging, so her parents are putting off surgery until they can work it into her dance schedule. In the meantime, she has vastly reduced her salt intake by cutting back on sandwich meats, processed soups and chips.

And, her mother said, “she drinks a ton more water.”

By NICOLE NEROULIAS

WHITE PLAINS

IF you knew how many calories came with that chicken burrito and tall vanilla latte, would you order something else, start cutting back on fast food, or shrug it off? Read More…

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By Barbara O’BrienNEWS STAFF REPORTER

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