Government opens investigation into adult scoliosis treatments

The federal government has launched an investigation into the treatment used in adult scoliosis.

Posted: 6:20 PM Jan 24, 2011
Reporter: Maureen McFadden




The federal government has launched an investigation into the treatment used in adult scoliosis.
Julia Epper, an adult scoliosis patient, used to backstitch, until she developed adult scoliosis.
"I've had back pain since I was 14," said Epper, “It was very frustrating and I felt very limited.”
Diagnosed at age 20 her spine curve grew from 24 degrees, to 54.

Attempts at physical therapy and injections have done nothing for her pain either.
The Hospital for Special Surgery reports that half a million people have adult scoliosis in the United States, and 40 percent will feel more pain each year.

“Many people, as the spine begins to age, and the discs degenerate, beginning to experience more back and even leg pain,” says Charles C. Edwards II, a doctor at the Maryland Spine Center.
A new study shows spinal surgery may be the only true option.

"While we may try medicines and injections first, oftentimes we will move onto surgery because those other methods just are not making a difference for them," says Edwards.

In the United States alone, $860 billion are spent on therapy, braces, and pain injections.
The study, which includes patients from 40 to 80 years old, shows operative patients saw a significant boost in function and quality of life, while non-operative patients reported no improvement at all.
Decompression and fusion surgery worked for Epper, who says, "I no longer have this sharp, burning, debilitating pain. The difference has been remarkable."
Six centers across the US are currently involved in the government's adult scoliosis study.
All six centers are currently enrolling patients with results expected in 2015.

Research Summary:
BENT OUT OF SHAPE: THE ADULT SCOLIOSIS DEBATE
REPORT # 1744

BACKGROUND: Any individual over the age of 18 who has experienced spinal deformity is considered to have adult scoliosis. Scoliosis is defined as an abnormal, side-to-side, curvature of the spine. There are varying causes of spinal deformity including; idiopathic scoliosis, congenital anomalies, degenerative scoliosis, posttraumatic scoliosis and neuro-muscular scoliosis. Idiopathic scoliosis is the most common form of spinal deformity doctors see, affecting about three percent of the general population. (SOURCE: Adult Scoliosis and Spine Associates)

THE BIRTH OF PAIN: It begins in childhood but advances in pain and deformity in adulthood. Congenital anomalies form in the uterus while degenerative scoliosis is caused by disc degeneration. As a result of spine fractures, posttraumatic scoliosis comes into existence and neuro-muscular scoliosis has been found to develop in patients with neuromuscular disorders like polio or muscular dystrophies. (SOURCE: Adult Scoliosis and Spine Associates)

SYMPTOMS OF SCOLIOSIS: Scoliosis is often painless with back pain eventually developing only as the condition progresses. Deformities may place unnecessary pressure on ones nerves and possibly even on the spinal cord. This can lead to weakness, numbness, and pain in the lower extremities. In severe, often very rare cases, pressure on the spinal cord may cause loss of coordination in the leg muscles, making it difficult to walk normally. If the chest is deformed due to scoliosis, the lungs and heart may also be affected. This can promote breathing problems, fatigue, and even heart failure. (SOURCE: www.allaboutbackandneckpain.com)

SIMPLE SCOLIOSIS TEST: Aside from experiencing back discomfort, what'll typically bring a patient to the doctor are the noticeable changes in ones back. Some signs that may lead an individual to the doctor include one shoulder or hip higher than the other, one shoulder blade higher or sticking out farther than the other, a hump in the back that sticks up when bending forward, one arm hanging longer than the other or the waist appearing asymmetrical. (SOURCE: www.iscoliosis.com)

TREATMENT: Some adult scoliosis treatment doesn't require surgery. A combination of physical therapy, exercise and Ibuprofen can serve as a recommended treatment. Steroid injections are sometimes used to treat pinched nerves. Surgery is only recommended if pain is unresponsive to non-operative treatment. (SOURCE: www.healthcentral.com)

* For More Information, Contact:
Mr. Ryan Andrews
Research Assistant
(410) 539-3434
rkandrews87@gmail.com

Issue 108: From Jordan's Desk - Bone Fat?

It sounds like a contradiction in terms, but having too much fat in the bones can lead to thinning bones. What’s more is that this negates previous research which suggested that carrying extra weight and fat protected women against bone thinning and loss.

Here’s the skinny on the bone fat: Women with too much fat around the middle may compromise their bone health and be at greater risk for osteoporosis. Doctors at Massachusetts General Hospital studied 50 premenopausal women with an average body mass index (BMI) of 30. The women’s bone marrow fat and bone mineral density were also measured to determine their bone mass and bone loss.

The researchers were particularly interested in visceral fat—a kind of fat that exists below the muscle tissue in the stomach—compared to fat that is located just under the skin called subcutaneous fat. Visceral fat is believed to be the more dangerous of two, as it has been implicated in greater risk of heart disease. In this case, the doctors wanted to see if there was a difference in osteoporosis risk dependent upon which kind of fat the women had more of.

The doctors used imaging tests to discover that the study’s participants who had more visceral fat also had more bone marrow fat and less bone mineral density—which translated into a greater risk for osteoporosis. Interestingly, the researchers found no significant link between subcutaneous fat or total fat and bone marrow fat or bone mineral density.

Dr. Miriam Bredella, a radiologist at Massachusetts General and assistant professor of radiology at Harvard Medical School, was the lead author of the study. She says, “Our results show that having a lot of belly fat is more detrimental to bone health than having more superficial fat or fat around the hips.”

There may be more to the story, though. Dr. Leanne Chrisman, a family medicine doctor at University Hospitals Case Medical Center in Ohio says, “The people who consume the most unhealthy carbohydrates and fats are the ones going to be the most obese, and they’re also the ones who are the most likely not to exercise. Weight-bearing exercise is associated with improved bone marrow densities. A lack of exercise is associated with being obese and low bone mass.” Additionally, says Chrisman, the more visceral fat you have, the more difficult it is for you to absorb nutrients that are crucial for good bone health, like calcium and vitamin D.

Lead study author, Dr. Bredella sums it up: “It is important for the public to be aware that excess belly fat is a risk factor for bone loss, as well as heart disease and diabetes."

So, if you need one more reason to lose that tummy…now you have it.

Are positive emotions good for your health in old age?

The notion that feeling good may be good for your health is not new, but is it really true? A new article published in Current Directions in Psychological Science, a journal of the Association for Psychological Science, reviews the existing research on how positive emotions can influence health outcomes in later adulthood.

"We all age. It is how we age, however, that determines the quality of our lives," said Anthony Ong of Cornell University, author of the review article. The data he reviews suggest that positive emotions may be a powerful antidote to stress, pain, and illness.

There are several pathways through which a positive attitude can protect against poor health later in life. For example, happier people might take a proactive approach to aging by regularly exercising and budgeting time for a good night's sleep. Alternately, these people may avoid unhealthy behaviors, such as smoking.The benefits of these healthy lifestyle choices may become more important in older adults, as their bodies become more susceptible to disease.

An optimistic outlook has also been shown to combat stress—a known risk factor for a lot of disease. Studies have found that people with stronger positive emotions have lower levels of chemicals associated with inflammation related to stress. Also, by adopting a positive attitude people may even be able to undo some of the physical damage caused by stress.

Ong, a developmental psychologist, became interested in the study of positive emotion during graduate school when he learned about what researchers call the paradox of aging: Despite the notable loss of physical function throughout the body, a person's emotional capacity seemed to stay consistent with age. Ong speculates that if positive emotions are indeed good for our health then, "one direct, measureable consequence of this should be the extended years of quality living."

Eating More Fruit and Vegetables Is Linked to a Lower Risk of Dying from Ischemic Heart Disease

A European study investigating the links between diet and disease has found that people who consume more fruit and vegetables have a lower risk of dying from ischaemic heart disease -- the most common form of heart disease and one of the leading causes of death in Europe. However, the authors point out that a higher fruit and vegetable intake occurs among people with other healthy eating habits and lifestyles, and that these factors could also be associated with the lower risk of dying from IHD.

The study is published online on January 19 in the European Heart Journal.

Data analysed from the European Prospective Investigation into Cancer and Nutrition (EPIC) Heart study has shown that people who ate at least eight portions of fruit and vegetables a day had a 22% lower risk of dying from IHD than did those who consumed fewer than three portions a day. A portion weighed 80 grams, equal to a small banana, a medium apple, or a small carrot.

Dr Francesca Crowe of the Cancer Epidemiology Unit at the University of Oxford, UK, and the first author of the paper by the EPIC study collaborators, said: "This study involved over 300,000 people in eight different European countries, with 1,636 deaths from IHD. It shows a 4% reduced risk of dying from IHD for each additional portion of fruit and vegetables consumed above the lowest intake of two portions. In other words, the risk of a fatal IHD for someone eating five portions of fruit and vegetables a day would be 4% lower compared to someone consuming four portions a day, and so on up to eight portions or more."

Ischaemic heart disease (IHD) is characterised by reduced blood supply to the heart; people suffering from it can develop angina, chest pains and have a heart attack.

The EPIC study started in 1992 and recruited participants from a total of ten European countries* until 2000. For the analysis of IHD deaths, data from eight countries for people aged between 40 and 85 were used. Participants answered questions about their diet at the time of entry to the study and other questions about health, socio-economic status and life-style, such as smoking, drinking and exercise habits. They were followed-up for an average of nearly eight and a half years.

The researchers found that the average intake of fruit and vegetables was five portions a day; people in Greece, Italy and Spain ate more, and those in Sweden ate less.

When analysing the data, the researchers made allowances for confounding factors such as differences in lifestyles and eating habits. However, the study could be limited by errors in measuring correctly people's fruit and vegetable intake as well as other aspects of their diet. In addition, the study had a higher proportion of women, which might not be generalisable to the wider European population.

Dr Crowe said: "The main message from this analysis is that, in this study, people who consume more fruits and vegetables have lower risk of dying from IHD. However, we need to be cautious in our interpretation of the results because we are unsure whether the association between fruit and vegetable intake and risk of IHD is due to some other component of diet or lifestyle.

"If we could understand, by means of well-designed intervention studies, the biological mechanisms that could underlie the association between fruits and vegetables and IHD, this might help to determine whether or not the relation between fruit and vegetables with IHD risk is causal."

In an accompanying editorial, Professor Sir Michael Marmot, director of the University College London (UCL) International Institute for Society and Health, head of the UCL Department of Epidemiology and Public Health, and chairman of the Commission on Social Determinants of Health, writes that it is difficult to reach firm conclusions about causation from results that show a 22% lower risk of dying from IHD (an odds ration of 0.78) in people who eat eight portions of fruit and vegetables a day.

He continues: "Such an odds ratio is, however, of huge practical importance. Cardiovascular disease is the most common cause of death. A reduction of 22% is huge. But... this reduction in mortality comes with consumption of eight portions a day, or 640g. Such a high consumption was found in only 18% of the men and women in these eight cohorts. There would need to be big shift in dietary patterns to achieve this healthy consumption of eight portions a day. It is worth trying to move in that direction. Reductions in cancers of several sites, in blood pressure and stroke, would add to this reduction in fatal CHD. Moving to a diet that emphasises fruit and vegetables is of great importance to public health."

*The ten countries include: Denmark, France, Germany, Greece, Italy, The Netherlands, Norway, Spain, Sweden and the United Kingdom. For the Heart component of the study, data from France and Norway were excluded due to the small number of IHD deaths at the end of the follow-up period.

Healthy gums may lead to healthy lungs

CHICAGO – January 18, 2011 – Maintaining periodontal health may contribute to a healthy respiratory system, according to research published in the Journal of Periodontology. A new study suggests that periodontal disease may increase the risk for respiratory infections, such as chronic obstructive pulmonary disease (COPD) and pneumonia. These infections, which are caused when bacteria from the upper throat are inhaled into the lower respiratory tract, can be severely debilitating and are one of the leading causes of death in the U.S.

The study included 200 participants between the ages of 20 and 60 with at least 20 natural teeth. Half of the participants were hospitalized patients with a respiratory disease such as pneumonia, COPD, or acute bronchitis, and the other half were healthy control subjects with no history of respiratory disease. Each participant underwent a comprehensive oral evaluation to measure periodontal health status.

The study found that patients with respiratory diseases had worse periodontal health than the control group, suggesting a relationship between respiratory disease and periodontal disease. Researchers suspect that the presence of oral pathogens associated with periodontal disease may increase a patient's risk of developing or exacerbating respiratory disease. However, the study authors note that additional studies are needed to more conclusively understand this link.

"Pulmonary diseases can be severely disabling and debilitating," says Donald S. Clem, DDS, President of the American Academy of Periodontology. "By working with your dentist or periodontist, you may actually be able to prevent or diminish the progression of harmful diseases such as pneumonia or COPD. This study provides yet another example of how periodontal health plays a role in keeping other systems of the body healthy."

Periodontal disease is a chronic inflammatory disease that affects the gum tissue and other structures supporting the teeth. Previous research has associated gum disease with other chronic inflammatory diseases such as diabetes, cardiovascular disease, and rheumatoid arthritis.

Dr. Clem stressed the importance of routine oral care in helping to prevent periodontal disease. "Taking good care of your periodontal health involves daily tooth brushing and flossing. You should also expect to get a comprehensive periodontal evaluation every year," he advised. A dental professional, such as a periodontist, a specialist in the diagnosis, treatment and prevention of gum disease, can conduct a comprehensive exam to assess your periodontal disease status.

Four Cups of Coffee a Day Slash Diabetes Risk in Half

Drinking four cups of coffee every day can decrease a woman's risk of developing Type 2 diabetes by more than half, according to a new study.

And the researchers say they've uncovered the reason why the new findings and other research have suggested a link between java and diabetes. They found that coffee raises the amount of sex hormone-binding globulin (SHBG) in the blood, and higher levels of SHBG are known to lower the risk of developing Type 2 diabetes.

It's likely something in the coffee besides the caffeine — or something about coffee drinkers that confers these protective effects, said James D. Lane, an associate research professor at Duke University Medical Center, who was not involved with the study.

Although, "it's impressive to find these new things," Lane told MyHealthNewsDaily, more research is needed to confirm the link.

The study is published in this month's issue of the journal Diabetes.

The more you drink, the lower your diabetes risk

In the new study, researchers from the University of California, Los Angeles, compared the medical histories and coffee-drinking habits of 359 women who had diabetes with those of 359 healthy women over 10 years. They used information from the Women's Health Study, run by the National Institutes of Health.

Women who drank four cups of caffeinated coffee a day had higher levels of SHBG and were 56 percent less likely to develop Type 2 diabetes than women who don't drink coffee, the researchers found.

And the more coffee the women drank, the more their risk of developing Type 2 diabetes dropped, the study said.

Furthermore, when the researchers took into account the women's SHBG levels, they found that it was coffee's effect on SHBG levels that was making the difference in diabetes risk. SHBG regulates the levels of sex hormones in the blood.

Previous work had suggested a link between SHBG and diabetes. A 2009 study in the New England Journal of Medicine, done by one of the researchers of the new study, showed that higher levels of SHBG in the blood were associated with a lower risk of developing Type 2 diabetes.

Past evidence of protection

A causal link between SHBG, diabetes and coffee — which contains many compounds — is not clear, Lane said. For example, he pointed to a 2004 study in journal Diabetes Care, which showed that caffeine is harmful to people with Type 2 diabetes, because it hinders the breakdown of glucose.

But other past studies have shown that something in coffee seems to have a protective effect against Type 2 diabetes, he said.

A 2006 study in the journal Archives of Internal Medicine of 28,812 women found that those who drank six cups of decaffeinated coffee a day had a 22 percent lower risk of developing Type 2 diabetes than those who don't drink any coffee. Caffeinated coffee also seemed to have a protective effect, though not as strong as that of decaffeinated coffee, the researchers said.

And a 2009 study in the same journal showed that each daily cup of coffee or tea cut the risk of developing diabetes by 7 percent.

Curcumin may relieve pain, inflammation for osteoarthritis patients

A study published in Alternative Medicine Review shows that Meriva, an Indena proprietary formulation of curcumin with soy phospholipids, has been shown to relieve pain and increase mobility in patients with osteoarthritis as well as reduce a series of inflammatory markers.

In the study, 100 patients with X-ray confirmed osteoarthritis (OA) were divided in two groups. The first one was managed using the “best available treatment” and the second group used the best available treatment plus Meriva, at a dosage corresponding to 200 mg curcumin/day.

The results showed that the Meriva-treated group had a statistically significant reduction in all primary clinical end-points, the Western Ontario and McMaster Universities (WOMAC) score, the Karnofsky Performance Scale, and the treadmill walking performance test. These results were complemented by the evaluation of a series of inflammatory markers, soluble vascular cell adhesion molecule (sVCAM)-1, and erythrocyte sedimentation rate [ESR]), which also showed a marked reduction in the Meriva-treated group, while no significant variation was observed in the “best available treatment” group.

Commenting on the results of the study, Giovanni Appendino, Professor of Organic Chemistry at the University of Eastern Piedmont and Indena Scientific Advisor, said “this study represents the most ambitious attempt, to date, to evaluate the clinical efficacy and safety of curcumin as an anti-inflammatory agent. Although no direct comparison study of Meriva versus NSAIDs (nonsteroidal anti-inflammatory drugs) has been conducted, the decreased use of these drugs observed in the treatment group provides a rationale for evaluating whether the biochemical improvement in the inflammatory status associated with Meriva could eventually translate to a phase out of NSAIDs use, at least for mild-to-moderate OA.”

Lifting a Veil of Fear to See a Few Benefits of Fever

Fever is common, but fever is complicated. It brings up science and emotion, comfort and calculation.

I know fever is a signal that the immune system is working well. And as a parent, I know there is something primal and frightening about a feverish child in the night.

So those middle-of-the-night calls from worried parents, so frequent in every pediatric practice, can be less than straightforward. A recent paper in The Journal of the American Medical Association pointed out one reason, and a longstanding discussion about parental perceptions reminds us of the emotional context.

The JAMA study looked at over-the-counter medications for children, including those marketed for treating pain and fever: how they are labeled, and whether the droppers and cups and marked spoons in the packages properly reflect the doses recommended on the labels.

The article concluded that many medications are not labeled clearly, that some provide no dosing instrument, and that the instruments, if included, are not marked consistently. (A dosing chart might recommend 1.5 milliliters, but the dropper has no “1.5 ml” mark.)

“Basically, the main message of the paper is that the instructions on the boxes and bottles of over-the-counter medications are really confusing,” said the lead author, Dr. H. Shonna Yin of New York University Medical Center, who is a colleague of mine and an assistant professor of pediatrics.

Too small a dose of an antipyretic (fever medicine) may be ineffective; too much can be toxic. But the dose depends on the child’s weight, which of course changes over time, and on the concentration of the medicine, which depends on whether it is acetaminophen or ibuprofen, children’s liquid or infant drops.

“We always make them get the bottle,” said Kathleen Martinez, a pediatric nurse practitioner who is clinical coordinator of the After Hours Telephone Care Program at the Children’s Hospital in Aurora, Colo. “What do you have at home? Is it the ibuprofen infant drops or the children’s? Have the bottle in hand and verify the concentration.

“And then we have to verify the instrument, and then we give the right dose based on weight. It’s time-consuming, and then of course it changes with the weight, so the poor parents have to call back.”

Concerns about fever — how worried should I be, and how much medicine should I give? — account for many of the calls that parents make at night to their children’s doctors. For me, these tricky measurement questions evoke memories of many conversations, often from a crowded, noisy place (my own child’s Little League game, the supermarket), trying to answer a question about a small child with fever.

One recent night, I talked to the mother of a toddler with fever and abdominal pain. I was more worried about the pain, and about whether he was drinking enough to stay hydrated; she was more worried about the fever, and no matter what I asked she kept coming back to that number on the thermometer.

Finally, I got so worried the child was dehydrated that I told her to go to the emergency room. And when she got there, she told them she was scared because the child had a high fever.

Fever can indeed be scary, and any fever in an infant younger than 3 months is cause for major concern because of the risk of serious bacterial infections. But in general, in older children who do not look very distressed, fever is positive evidence of an active immune system, revved up and helping an array of immunological processes work more effectively.

Of course, that may not be reassuring to a parent whose child’s temperature is spiking at midnight. (Fevers tend to go up in the late afternoon and evening, as do normal body temperatures.)

In 1980, Dr. Barton D. Schmitt, a professor of pediatrics at the University of Colorado School of Medicine, published a now classic article about what he termed “fever phobia.” Many parents, he wrote, believed that untreated fevers might rise to critical levels and that even moderate and low-grade fevers could have serious neurological effects (that is, as parents we tend to suspect that our children’s brains may melt).

A group at Johns Hopkins revisited Dr. Schmitt’s work in 2001, publishing a paper in the journal Pediatrics, “Fever Phobia Revisited: Have Parental Misconceptions About Fever Changed in 20 Years?” Their conclusion was that the fears and misconceptions persisted.

In fact, fever does not harm the brain or the body, though it does increase the need for fluids. And even untreated, fevers rarely rise higher than 104 or 105 degrees.

As many as 5 percent of children are at risk for seizures with fever. These seizures can be terrifying to watch but generally are not harmful and do not cause epilepsy. Still, a child who has a first febrile seizure should be checked by a physician. (These seizures tend to run in families, and children who have had one may well have another.)

“Parents are telling us that they’re worried that fever can cause brain damage or even death in their children,” said Dr. Michael Crocetti, an assistant professor of pediatrics at Johns Hopkins and lead author of the 2001 study. “I’ve been doing this for a long time, and it seems to me that even though I do a tremendous amount of education about fever, its role in illness, its benefit in illness, it doesn’t seem to be something they keep hold of from visit to visit.”

Dr. Janet Serwint, another author of the study and a professor of pediatrics at Johns Hopkins, agreed. “I personally think there should be much more education about this at well visits,” she told me, adding that parents need to understand “the helpfulness of fever — how fever actually is a well-orchestrated healthy response of our body.”

Other studies have looked at attitudes among medical personnel, who can be just as worried about fever as parents.

Statins may raise stroke risk in some: study

(Reuters) - People who have had a type of stroke caused by bleeding in the brain should avoid taking cholesterol-lowering drugs known as statins, U.S. researchers said on Monday.

Although statins are commonly used to prevent heart attacks and strokes, they said the drugs could increase the risks of a second stroke in these patients, outweighing any other heart benefits from the drugs.

"Our analysis indicates that in settings of high recurrent intracerebral hemorrhage risk, avoiding statin therapy may be preferred," Dr. Brandon Westover of Massachusetts General Hospital and Harvard Medical School and colleagues wrote in the Archives of Neurology.

That was especially true of people who had strokes in one of the brain's four lobes - frontal, parietal, temporal, or occipital - which recur more frequently than such strokes that occur deep in the brain.

Westover said people who have had this type of stroke have a 22 percent risk of a second stroke when they take statins, compared with a 14 percent risk in people who are not taking a statin.

The findings are based on a mathematical model based on data from two clinical trials.

The researchers said it is not clear how statins increase the bleeding risk in these patients. It may be having low cholesterol increases the risk of bleeding in the brain, or it may be that statins affect clotting factors in the blood that increase the risk of a brain hemorrhage in these patients.

Statins lower low-density lipoprotein or LDL, the bad kind of cholesterol that can lead to blood clots that increase the risk of heart attacks and strokes.

They are among the best-selling drugs in the world, fueled by many studies showing they reduce the risk of heart attacks and strokes.

Dr. Larry Goldstein of Duke University and Durham VA Medical Center in North Carolina said in a commentary the findings do not prove that statins increase the risk. But he said in the absence of high-quality clinical trial data, they may help doctors make better decisions about which patients with heart risks will benefit from taking statins.

Coronary heart disease is the leading cause of death in the United States, killing one in five adults.

Pfizer's Lipitor or atorvastatin has global sales of $11 billion a year while AstraZeneca's Crestor has global sales of more than $5 billion.

Excess sugar may cause heart attacks later

Teenagers fond of too much of sugar in their diet are likely to face a higher heart attack risk as adults.

A study found that teens who consume elevated amounts of added sugars in drinks and foods are more likely to have poor cholesterol and triglyceride profiles which may lead to heart disease later in life.

It also found that overweight or obese teens with the highest levels of added sugar intake had increased signs of insulin resistance - a precursor to diabetes, the journal Circulation reports.

Added sugars are caloric sweeteners added to foods or beverages in the manufacturing process or by the consumer, according to the American Heart Association.

Adolescents are eating 20 percent of their daily calories in sugars that provide few if any other nutrients,` said Jean Welsh, study author and post-doctoral fellow in paediatric nutrition at Emory University School of Medicine, according to its release.

`We know from previous studies the biggest contributors of added sugars to the diet are sugar-sweetened beverages such as sodas, fruit-flavoured drinks, and sweetened coffees and teas.`

This is the first study to assess the association of added sugars and the indicators of heart disease risk in adolescents, Welsh says.

The National Health and Nutrition Survey of 2,157 teenagers (aged 12 to 18) found the average daily consumption of added sugars was 119 grams (28.3 teaspoons or 476 calories), accounting for 21.4 percent of their total energy.