Children should not be given Tamiflu or Relenza for flu

Once again, medical "wisdom" goes into reverse

CHILDREN with seasonal flu should not be given antivirals such as Tamiflu because harmful side effects outweigh relatively meagre benefits, according to a study released today. In some children Tamiflu caused nausea and vomiting, which can lead to dehydration and other complications, researchers reported.

The study did not cover the current outbreak of swine flu, but its conclusions suggest that antivirals may not significantly reduce the length of illness or prevent complications in children infected with the new A(H1N1) virus, the researchers said.

Carl Henegan, a doctor at John Radcliffe Hospital in Oxford, England, and co-author of the study, said the current British practice of giving Tamiflu for mild illness was "an inappropriate strategy". "The downside of the harms outweighs the one-day reduction in symptomatic benefits," he said.

The research showed that antivirals oseltamivir and zanamivir shortened the duration of seasonal flu by up to a day and a half. But the drugs had little or no effect on asthma flare-ups, increased ear infections or the need for antibiotics.

Tamiflu, the brand name for oseltamivir, was also linked to an increased risk of vomiting. Zanamivir is marketed under the name Relenza.

The study, published in the British Medical Journal, comes 10 days after Britain's Health Protection Agency (HPA) reported that more than half of 248 students given Tamiflu after a classmate fell ill with swine flu suffered side-effects such as nausea, insomnia and nightmares. Most of the students did not have the flu when they were given the drug.

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SKIM MILK AS A DIET AID?

This is a very small trial with an atypical group. But, if replicated, it would indicate that different sources of calories have different fattening power. That seems rather unlikely on the whole. Abstract follows:

Skim milk compared with a fruit drink acutely reduces appetite and energy intake in overweight men and women

By Emma R Dove et al.

Background: Several studies show that proteins, including whey and casein, are more satiating than carbohydrates. It follows that skim milk would be more satiating than sugar-rich beverages. However, this has yet to be shown.

Objective: The objective was to investigate the effects of drinking skim milk in comparison with a fruit drink at breakfast on selfreported postmeal satiety and energy intake at lunch.

Design: In a randomized crossover trial, 34 overweight women (n = 21) and men (n = 13) attended 2 sessions 1 wk apart. At each session, participants consumed a fixed-energy breakfast together with either 600 ml skim milk (25 g protein, 36 g lactose, ,1 g fat; 1062 kJ) or 600 ml fruit drink (,1 g protein, 63 g sugar, ,1 g fat; '1062 kJ). Participants provided satiety ratings throughout the morning. Four hours after breakfast they consumed an ad libitum lunch, and energy intake was assessed.

Results: Participants consumed significantly less energy at lunch after consuming skim milk (mean: 2432 kJ; 95% CI: 2160, 2704 kJ) compared with the fruit drink (mean: 2658 kJ; 95% CI: 2386, 2930 kJ) with a mean difference of '8.5% (P , 0.05). In addition, selfreports of satiety were higher throughout the morning after consumption of skim milk compared with the fruit drink (P , 0.05) with the differences becoming larger over the 4 h (P , 0.05).

Conclusions: Consumption of skim milk, in comparison with a fruit drink, leads to increased perceptions of satiety and to decreased energy intake at a subsequent meal.

Am J Clin Nutr 90: 70-75, 2009.