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Jan. 23, 2002 -- Does monitoring the frequency of uterine contractions predict whether a woman will give birth prematurely? The question has been studied for two decades with mixed findings, but new research suggests the answer is an emphatic "no."

Researchers from the National Institute of Child Health and Human Development's Network of Maternal-Fetal Medicine evaluated the usefulness of an at-home contraction-monitoring device in a group of pregnant women at high risk for premature delivery. While there were slight differences in contraction frequency between women who later gave birth prematurely and those who did not, these differences were not useful for predicting what would happen.

The findings are published in the Jan. 24 issue of The New England Journal of Medicine.

Researchers have long been frustrated in their efforts to both predict and prevent early births. The finding from this and earlier studies suggest that the strategy of detecting contractions and suppressing them is not useful, lead author Jay D. Iams, MD, tells WebMD. Iams is a professor of obstetrics and gynecology at Ohio State University.

"This two-decades-old strategy has been discredited, and we are really going back to the drawing board in our efforts to identify women who will give birth prematurely," he says. "We do have tests that allow us to reassure high-risk women with reasonable accuracy, but when it comes to predicting who will deliver early, there is really nothing out there."

Approximately one in 10 babies in the United States is born prematurely and some 5,000 infants die each year due to complications of premature birth. Risk factors for early delivery include carrying multiples (twins, triplets, etc.), having a previous child born prematurely, and uterine bleeding during the second trimester. But only about half of women who give birth prematurely are considered to be at high risk.

Iams and colleagues found a slight increase in the frequency of uterine contractions in the high-risk study participants who later delivered prematurely, but the finding had little predictive value. Measures that were more helpful included cervical length (measured with ultrasound), and presence of a substance called fetal fibronectin in the mother's vaginal secretions.

While these two tests can help determine which women will not give birth prematurely, they do not identify those who will, says Charles Lockwood, MD, who chairs the department of obstetrics and gynecology at New York University School of Medicine. Lockwood wrote an editorial accompanying the study.

"Cervical length and fetal fibronectin are clearly more predictive than monitoring uterine activity, but they still have significantly high false-positive rates," he tells WebMD. "About half of patients who are positive with these tests do not end up delivering early. But a negative test means you can avoid inappropriate interventions that can add stress and may not work anyway."

Lockwood says he believes genetics research will soon help identify effective strategies to both predict and prevent premature births.

"We have gotten pretty good at understanding the immediate causes of preterm deliveries," he says. "I think over the next five years we will develop a progressive understanding of the genetic predispositions involved. Once we have identified the genes involved with these environmental interactions, we will probably be in a better position to prevent the causes of preterm births with specific treatments that may even be recommended before a women gets pregnant."

The nursery is ready, you're stocked up on onesies, and you've got the market cornered on diapers. You are ready for baby to come -- well, almost. Before you pack your bag and get ready for your highly anticipated trip to the hospital, pack it for a babymoon, instead.

The babymoon is the new way to describe the pre-baby vacation, before you can use the word parent to describe yourself. It's your curtain call, your last hoorah, your encore. But whether it's to Hawaii, Timbuktu, or a B&B around the corner, vacationing while with child calls for some extra consideration. Experts give WebMD traveling dos and don'ts for expectant moms.

Before You Go

Before you call the travel agent and book your trip, the first thing you should do is talk to your doctor, especially if you are in the third trimester.

"Be absolutely certain that there are no risk factors for premature pregnancy," says Thomas Ivester, MD, from the division of maternal fetal medicine at the University of North Carolina in Chapel Hill. "I think the biggest risk is that you are far from home when you deliver."

With timing in mind, the safest window of opportunity for a pregnant woman to travel is during the second trimester, or 18-24 weeks, according to the American College of Obstetrics and Gynecology (ACOG).

"While weeks 18-24 may be the safest time to travel, that doesn't exclude the rest of your pregnancy. There are just more safety issues in the first and third trimesters to consider," says Sandra Cesario, MD, from the College of Nursing at Texas Woman's University in Houston.

"Those first few weeks, you may be nauseated and tired, and it's not a good time to travel."

Also, schedule your vacation around your prenatal visits. While this trip is important, so are your trips to the doctor.

Where to Babymoon

While dashing off to an exotic location sounds nice, it's not necessarily practical. So what do you need to consider before you book a trip to the jungles of Belize while pregnant?

First, if you decide to travel internationally, you should consult with your obstetrician to evaluate both the quality of care that will be available at your exotic location of choice and what preventive measures, like vaccinations, should be taken before you go.

"If you are traveling to another country, you should check if that country requires immunizations," says Khalil Tabsh, MD, chief of obstetrics at UCLA. "If it's not a live vaccine, it is OK. If it is live, then you should check with your obstetrician." Live virus vaccines include measles, mumps, rubella, varicella, and yellow fever.

You should also consider altitude when picking your vacation spot. The CDC recommends that all pregnant women avoid altitudes higher than 12,000 feet, and in high-risk or late-stage pregnancies, avoid destinations higher than 8,200 feet -- so save the trip to Mt. Everest for another day.

Finally, do you fly or drive? The ACOG states that women can fly safely up to 36 weeks into their pregnancies.

"If you are flying, check to see if there are any restrictions with the airline you've chosen," says Cesario. "There are certain airline policies that do require a letter from your doctor that it's safe for you to travel while pregnant -- you'd hate to plan a trip and find the airline won't let you get on."

Packing Your Bag

Your doctor has given you the green light, and you are ready for the babymoon to begin. What should you do next, other than pack a pair of flip flops and a sarong?

• Check that you will have access to quality medical facilities at your travel destination, in case you need them. "I would take a complete list of contact information for your doctors," says Ivester. "I would also carry along contact information for qualified or highly-rated health-care facilities in the area where you are traveling, in case you need them."
  
  
• Ensure your health insurance is valid while abroad, and to be on the safe side, the CDC suggests getting a supplemental travel insurance policy and a prepaid medical evaluation insurance policy.
  
• Know your blood type, and find out if the blood supply where you are going is screened for HIV and hepatitis B.

May 28, 2001 -- "Having my baby at home was beautiful, inspiring, awesome!" says Jo Anne Lindberg. "I had complete freedom of movement and absolute choice in everything I wanted to do."

Lindberg actually went to the movies during early labor, and then safely delivered a 9 1/2 pound son at home. "It was a lot of work, but no pain," she says.

Being able to relax in a familiar, comfortable environment surrounded by those you love decreases anxiety, which in turn decreases pain and lets your body do its job, she explains.

As president and founder of Birthlink in Chicago, a free referral service for expectant parents considering home birth, Lindberg often refers women to Penny Shelton, MD, MPH, a general practitioner with HomeFirst, a group that has safely delivered more than 15,000 babies at home.

"Giving birth at home supports the normal physiology better," Shelton tells WebMD. "We're treating it as a normal part of life instead of a medical condition." Studies have shown that women who feel anxious or stressed release more adrenaline, a hormone that interferes with labor, she explains.

Not for Everyone

But home birth is not for everyone. Shelton says that women with uncontrolled diabetes, chronic high blood pressure, or a condition called toxemia (also known as preeclampsia) should deliver in the hospital. If labor begins before 37 weeks in a woman who's already given birth, or before 38 weeks in a first-time mom, it's safer to go to the hospital.

And if the father does not fully support the mother's decision to give birth at home, Shelton also recommends against it.

In the absence of these complications, home birth is typically safe, provided there are enough trained hands on board. Shelton prefers to work with a team that includes a midwife and nurse, but acknowledges that some well-trained certified midwives are capable of delivering without the assistance of a physician.

"Most physicians and nurse midwives are unwilling to attend home births," Martin A. Monto, PhD, chair of social and behavioral sciences at the University of Portland in Oregon, tells WebMD. He explains that most home births are attended by "direct entry" or "lay" midwives who learn through apprenticeship rather than through conventional medical training.

Their training may include skills not traditionally taught at medical or nursing school, such as gentle stretching of the tissues surrounding the birth canal to avoid having to surgically cut the tissue to allow the baby's head to pass through, a procedure called an episiotomy. Direct entry midwifery is illegal in some states, he says.

Home Birth Less 'Medical' for Most

"When comparing women with low-risk pregnancies, women who give birth at home are less likely to have episiotomies, C-sections, and all other forms of medical intervention than women giving birth in hospitals," Monto says.

Shelton carries emergency equipment, including oxygen for babies not breathing well, but seldom has to use it.

Alice Bailes has the same experience.

"I throw out my IV bags because they're expired more often than I use them," says Bailes, CMW, co-director of BirthCare and Women's Health, a service of certified nurse-midwives in Alexandria, Va. Her delivery team often includes an RN or practitioner certified in neonatal advanced life support.

To make labor more comfortable and efficient, Bailes recommends "low-tech" interventions like changing position or taking a shower. Being able to move around free of a fetal monitor, IV, and other restraints typically used in a hospital is also a major advantage, she explains, as is not being pressured to deliver within a specified timeframe.

June 2, 2005 -- Bouncing your baby to the beat of his favorite lullaby may save him from years of embarrassment on the dance floor later on.

A new study shows that movement, such as bouncing a baby on your knee or rocking in a chair, plays a critical role in how infants learn to "feel the beat" or rhythm of music.

Researchers found that babies paid attention to and listened longer to music that had the same beat as the music that they had been bounced to earlier.

They say the findings provide evidence that the experience of movement plays an important role in musical perception. This ability allows people to sense the weak and strong beats in a rhythm and eventually allows them to move and dance in time with the music.

Movement Helps Infants Feel the Beat

In the study, which appears in the current issue of Science, researchers tested how movement influenced the perception of rhythm in a group of 7-month-old infants in a series of experiments.

In the first, adults holding half of the infants bounced the babies on every second beat in a march-like rhythm and the other half bounced the babies on every third beat in a waltz-like rhythm while listening to music with no apparent rhythm pattern.

The researchers played music with various rhythm patterns for the infants. They show that the infants chose to listen longer to music containing the march or waltz rhythm that they moved to earlier.

In another test, researchers bounced to the beat while the babies watched. But without moving to the music themselves, the infants expressed no interest for any particular rhythm pattern.

Researchers say the results show that the delight infants express in being rocked or bounced to music represents a critical stage in the early development of musical perception.

Sept. 30, 2004 -- With obesity and other health concerns in mind, some school systems are reconsidering whether students should have access to on-campus soda machines.

Soft drink consumption has soared among adolescents in the last 20 years, doubling among girls and tripling among boys. Coincidental with this increase has been the rise in childhood obesity.

Besides obesity, research has shown several possible health consequences from the sugary drinks, including dental cavities, disrupted sleep from caffeine, and impaired calcium absorption -- affecting bone health at a critical time of growth.

The increase in soft drink consumption has also been accompanied by a decrease in milk drinking, which also impacts bone health.

At least one school district -- Los Angeles Unified School district, the second largest school district in the U.S. -- now bans soft drink sales in all schools during the school day, according to Simone French, PhD, a professor in the University of Minnesota's epidemiology department, and colleagues.

Should that policy be applied elsewhere?

French and colleagues recently organized six focus groups to see what parents of high school students think about the issue.

They recruited 33 parents of high school students in suburban Minneapolis. Only one parent per child was allowed to attend. Almost all were from white, middle- to upper-middle class families.

Students' Choice

High school students can decide for themselves whether or not to drink soda, according to all the focus groups. Many parents saw the issue of soft drinks consumption as more a matter of personal choice, rather than an issue of a healthful school environment, the authors write.

Choosing whether to drink soft drinks is part of learning responsibility, the parents said. High school is a time where a child starts to make decisions and take more responsibility for their actions and choices. Making beverage choices was one way parents said they saw their teen taking responsibility.

Some said students will buy sodas elsewhere if they're not available at school, depriving the schools of an income source.

However, the parents wanted more "healthy" alternative drinks to be available.

Most parents supported limiting access to the machines, but they wanted regulations to be made locally, not at a state level.

"All groups agreed that drinking soft drinks, particularly in excess, has negative physical effects," write the researchers in the October issue of the Journal of the American Dietetic Association.

While some parents expressed concerns about the health-related consequences of soft drink consumption, it wasn't a top health priority. Parents expressed major concerns about health-related consequences of the use of cigarettes, alcohol, drugs, and coffee in their children.

The study showed that many of the parents had little knowledge about the vending machines in their child's school. The researchers say the lack of knowledge reflects the low priority parents give to the issue of soft drink consumption.

July 28, 2004 -- With childhood obesity sprouting an epidemic of health problems, doctors are being asked to check for and treat high blood pressure even in kids under 3.

New guidelines reiterate earlier recommendations that doctors routinely test blood pressure in all children starting at age 3. But now, an expert panel suggests that some children should be checked even earlier and provides more specific advice for treating high blood pressure in youngsters.

It's estimated that 1% to 3% of American toddlers and school-age children already have high blood pressure. That's at least 750,000 kids.

High blood pressure is called the "silent killer" because it usually causes no symptoms but can eventually lead to very serious consequences such as heart attack and stroke.

High Blood Pressure: Not Just for Obese Kids

"The obesity epidemic in childhood is making this more of an issue," says Bonita Falkner, MD, who led the expert panel drafting the new guidelines. "But even normal-weight children can have high blood pressure."

Falkner, professor of medicine and pediatrics at Jefferson Medical College in Philadelphia, tells WebMD that the new guidelines -- unveiled in May at the American Society of Hypertension annual meeting and to be published as a special supplement to the August issue of Pediatrics -- provide more information on how doctors should evaluate and treat high blood pressure in their youngest patients and urges them to keep a closer eye for other problems that can result from it.

"Before we advised doctors to screen children for high blood pressure starting at age 3 and keep an eye out for it, but there was little specifically addressing how to evaluate and treat it," she says.

Different Set of Numbers

In adults, high blood pressure is diagnosed when the top (systolic) number of a blood pressure reading is more than 140, or when the lower (diastolic) number is more than 90.

"But for young children, there is no one number that defines high blood pressure because there is a normal rise in blood pressure with growth and development," she tells WebMD.

Instead, doctors will use charts similar to "growth tables" that place children into groups for their height and weight. These charts will have blood pressure norms based on the child's age, sex, and height.

In addition to taking blood pressure readings of all children beginning at age 3, the guidelines recommend that blood pressure be routinely measured in younger children with certain conditions, including those born prematurely or at a low birth weight, those who had a prolonged hospital stay after delivery, those with heart disease, and those taking medications that can raise blood pressure.

July 24, 2000 -- Veronica Miller was only 1 year old when her mother, Laura, first began to worry about her hearing. Veronica didn't seem to respond when her parents called out her name. And she rarely babbled or made baby talk like other kids her age. But her pediatrician said some children start to recognize speech patterns slower than others; he advised the family to wait and see what happened in a month. A month later, the doctor repeated the same advice. Frustrated, Miller took the girl to an audiologist for a hearing test and found out Veronica's hearing was profoundly impaired in both ears.

"I couldn't believe it," said the East Meadow, N.Y., mother. "I was in total denial. She always seemed like such a happy baby. It just kind of tricked us."

Many parents with hearing-impaired infants share Miller's experience -- they are simply unaware that their new baby can't hear. In fact, hearing impairment is the most common birth defect in the United States, striking three of every 1,000 babies born here. Yet at a time when new technologies can make a profound difference in a hearing-impaired child's ability to hear, only 35% of newborns receive a simple hearing test before they leave the hospital. The result: Most children who have a hearing impairment aren't diagnosed until they reach 30 months, a delay that can have lasting consequences.

Early Connections in Tiny Brains

"When a baby is born, it responds to auditory stimulation by making connections within the brain," says Karl White, PhD, director of the National Center for Hearing Assessment and Management (NCHAM) at Utah State University. "These connections are essential for language development, and if this doesn't happen within the first few months of life, it may never happen the way that it should." The longer you wait, the more damage there will be to the child's ability to process language, says White.

Prompt detection and treatment, on the other hand, can make a huge difference. When Miller's second child Samantha was born, she insisted that the girl receive a hearing test before leaving the hospital. Samantha was found to be almost completely deaf in one ear and was fitted for her first hearing aids before she was 1 month old.

In contrast, older sister Veronica didn't receive her first hearing aids until shortly after her first birthday. They failed to improve her hearing significantly, so when she was two, she received a cochlear implant -- a tiny electronic device that is surgically implanted in the inner ear. It stimulates the auditory nerve, sending sound signals straight to the brain.

Veronica is now 6, and while her hearing is normal, her speech skills have tested at one to two years behind her peers. Samantha, on the other hand, is now just over a year old and is blurting out words like an 18-month old. "That's the difference early detection can make," says Miller. "Veronica missed out on those first two years, and those years are so important."

Advances in Treatment

Most people don't realize that today's hearing aids are so effective that in all but the most serious cases, people with hearing impairments can be made to hear as well as anybody else, says White. Cochlear implants can be used in cases where the child's own cochlea (the nautilus shell-shaped organ in the inner ear that translates sound into vibrations the brain can interpret) is so damaged that hearing aids simply won't work. With the help of these advances, both of the Miller girls are now hearing at or above normal levels despite being born nearly deaf.

Having two hearing-impaired children in the same family is not unusual. While some hearing problems are caused by environmental conditions like ear infections, the vast majority are caused by congenital defects. And though 90% of children with hearing impairments are born to parents with no hearing problems at all, once a couple has a child with hearing problems, the odds are one in four that subsequent children will have similar problems, according to NCHAM researchers. And that, says Laura Miller, is why she pushed so hard to have Samantha's hearing tested.

Nov. 14, 2005 -- Arthritis sufferers may -- or may not -- benefit from a pair of popular dietary supplements, two new clinical trials suggest.

One supplement is glucosamine, derived from the shells of crabs and lobsters. The other is chondroitin, usually derived from animal cartilage. These supplements are said to help relieve arthritis pain. They are also said to prevent the arthritic joint narrowing that causes one bone to grind against another.

Do these supplements really work? That is what two clinical trials -- a 1,583 patient study in the U.S. and a 318 patient study in Europe -- tried to find out. Researchers reported results from both studies at this week's annual scientific meeting of the American College of Rheumatology in San Diego.

"The supplements were not better than the placebo," Daniel O. Clegg, MD, tells WebMD. Clegg, chief of rheumatology at the University of Utah in Salt Lake City, led the NIH-sponsored U.S. study.

Arthritis Foundation spokesman Erin Arnold, MD, has a different interpretation. Arnold, a rheumatologist with the Illinois Bone and Joint Institute in Morton Grove, Ill., notes that Clegg is focusing on the study's overall results. She says she is more impressed with the study's finding that patients with more severe arthritis pain got significant relief from the glucosamine-chondroitin combination.

"I am very encouraged by the results of this study," Arnold tells WebMD. "The data presented certainly does not deter me from encouraging patients to try glucosamine and chondroitin."

There is less controversy over the smaller, European study led by Gabriel Herrero-Beaumont, MD, of the Jiminez Diaz Foundation in Madrid, Spain.

"Our results confirm previous studies," Herrero-Beaumont tells WebMD. "They demonstrate clearly that glucosamine was able to control knee osteoarthritis pain."

Glucosamine + Chondroitin: For Bad Arthritis Pain Only?

The U.S. trial enrolled patients aged 40 and older with knee pain due to osteoarthritis. They were randomly assigned to one of five treatments:

• Inactive placebo pills
• Glucosamine hydrochloride at a dose of 500 milligrams three times a day
• Sodium chondroitin at a dose of 400 milligrams three times a day
• Combination glucosamine and chondroitin
• Celebrex at a dose of 200 milligrams per day

It is common for a pain study to show that many patients report relief from inactive placebo pills. And that happened here. Nearly 60% of patients given only placebo pills said they had less pain. So did about 67% of patients treated with combination glucosamine and chondroitin. But that isn't what scientists call a significant difference -- that is, there's more than a 5% chance the findings are just coincidence.

"I really feel the study is a negative study," Clegg says. "I would say to patients that the safety data are really reassuring, the efficacy data are not."

When Clegg's team looked only at patients with moderate to severe pain. Only 54% of these patients got relief from placebo. But 79% reported relief from combination glucosamine and chondroitin. That is a significant difference. But there's a problem, Clegg says. The study wasn't designed to look at just this group. The effect here is based on only a small number of patients.

"About 20% of the study patients have moderate to severe pain," Clegg says. "Interestingly, in that subgroup, the combination of glucosamine and chondroitin appeared to be effective in relieving pain. I think this outcome is really interesting but just from a research standpoint. It is an exploratory, hypothesis-generating finding -- not a finding on which to base treatment."

So the weather outside is frightful. Does that mean your fitness program goes on hiatus until the crocuses start blooming again?

Not a chance. With thousands of different fitness videos/DVDs available, you can choose a different activity for every day of the week -- and then some -- and never have to worry about braving the elements. Whether you're interested in aerobics, ballet, strength training, yoga, Pilates -- you name it; there's a workout video for you.

"There's so much variety when it comes to workout videos that you can certainly get a good workout ? if you can stay motivated," says Richard Cotton, an exercise physiologist in Carlsbad, Calif., and spokesman for the American Council on Exercise (ACE).

The main drawback with videos, says Cotton, is that they don't provide the energy of a live class, or the personal guidance of a fitness instructor. "It's always better to have a quality individual instructor, especially if you're going after high levels of fitness or sport," says Cotton.

But for those of us whose fitness goals are more modest, videos can indeed give a comprehensive workout. The key is to stick to the standard workout recommendations: do a routine three to four times a week, for at least 20 minutes a session, with five minutes each of warming up and cooling down.

Working Out at Home

Videos are good to use not only when you want to stay cozy inside, but also if you're too self-conscious to go to a gym, says Los Angeles yogi Marlon Braccia.

"It's OK if you don't want to work out in front of other people," says Braccia, creator of six yoga DVDs. "But working out at home still means having to get off the couch."

And for an exercise video to be effective, it needs to be at the level of the person watching it, says Braccia.

So, if you haven't budged from the sofa in the past 20 years, don't choose a video that offers an advanced workout. On the other hand, if you're a fitness fanatic who wants to supplement your regimen with some at-home workouts, don't slide by with something too easy. Not only will you not get the workout you need, you'll get bored.

To keep her viewers from losing interest once they've mastered the basics, Braccia divides her own DVD workouts into three to five sections, each more intense than the last. As you get comfortable with one section, you move on to the next. "In essence, you're becoming your own teacher," says Braccia.

Of course, yoga is just one of the workouts available on video. Most experts say you should include a variety of types in your routine.

"Cross-training is a good part of any exercise regimen, and it's no different with videos," says Michael A. Schwartz, MD, who specializes in orthopaedic surgery and sports medicine. "Different programs give you a chance to work multiple muscle groups.

He adds that a variety of workouts will also keep you from getting bored, increasing the chances you'll stick with the program.

"The key is to develop a balanced fitness program that is tailored to your own interests and needs," Schwartz says. "You can cross-train with several kinds of videos, or with a video one day, biking another, jogging a third."

Exercise videos are not only good for home use, but also for on the road. Some hotels are even making workout DVDs available in their guest rooms. Wyndham International, for example, recently introduced No Shoes? No Problem!, an in-room exercise DVD. Using desk chairs and other items found in hotel rooms, the DVD offers a 31-minute exercise routine designed to improve muscle tone.

Feb. 9, 2005 -- The latest weight loss news comes down on the side of so-called "good" carbohydrates -- the kind offering more than sweet tastes and flash-in-the-pan bursts of energy with few nutrients.

The type of carbohydrate you eat, rather than the total amount of carbohydrates in your diet, may be related to body weight, say scientists in the American Journal of Epidemiology's Feb. 15 edition.

Call it the victory of broccoli over white bread, or lentils over linguine. Carbs with a lower glycemic index were kinder to weight than those with high glycemic index.

Glycemic index is an indicator of how quickly a food affects blood sugar levels. Foods with a high glycemic index tend to be starchy, sugary, or refined and stripped of some of their natural goodness; they're often "empty" calories. In general, low-glycemic-index foods usually have more fiber and nutrients.

For instance, french fries have a higher glycemic index than grapefruit. Cakes and cookies are off the charts, compared with spinach.

Carb Craze

You may have heard of the glycemic index before. It's often mentioned in diets such as the Atkins and South Beach diets. Even if the phrase is new, you're bound to be aware of the carbohydrate consciousness of recent years.

Some people lump all carbs together, branding them as suspects in America's weight crisis. But all carbohydrates are not alike, and the new study clears the name of "good" carbs.

The study was conducted by researchers including Yunsheng Ma, PhD, MPH, of the University of Massachusetts Medical School. Participants were 572 healthy adults in central Massachusetts.

For one year, subjects gave quarterly reports on their food consumption and physical activity for seven-day periods. The data was collected between 1994 and 1998.

Is Glycemic Index the Key to Weight Loss?

The researchers looked at what the participants ate, how much they worked out, and their body mass index (BMI), a measure of total body fat. BMI is used to assess heart disease risk.

Higher BMIs were associated with diets that had higher glycemic index foods.

Daily carbohydrate intake and percentage of calories from carbohydrates didn't matter. The study indicates that the type of carbohydrate -- noted by glycemic index -- was what counted, say the researchers. Short-term weight loss studies have echoed that result, but "the long-term effect of glycemic index and total carbohydrates on body weight is currently unknown," say Ma and colleagues.

The finding is consistent with the idea that foods with a higher glycemic index trigger more insulin production and more fat storage, say the researchers. However, they don't endorse cutting all carbohydrates or focusing on glycemic load for weight loss. Instead, glycemic index was most important, say the scientists, calling for more research.

Finding Foods' Glycemic Index

The glycemic index of various foods is listed online, but it's not required on food labels. A low glycemic index is considered to be 55 or less. The medium range falls from 56 to 69. High glycemic index is 70 or higher.

However, when it comes to the glycemic index of a particular food many factors come into play. For example, what else was eaten with the food and other components of a food including the amount of proteins and fats, as well as, how a food was prepared often alters the index.

No time to research your menu? Generally, unprocessed foods such as fruits, vegetables, lean meats, and whole grains have lower glycemic indices than processed or refined items.

It might also help to expand your definition of carbohydrates. Bread, pasta, rice, cereals, sweets, and grains don't have the market cornered. Fruits, vegetables, and legumes also contain carbohydrates, and they may be the type to favor, along with fiber-rich whole grains.

If you're watching your weight, don't forget about calories. You'll still need to burn more calories than you consume to lose weight. Exercise will help with that part of the equation.

Nov. 5, 2004 - Postmenopausal women who take estrogen may not reap at least one of the potential health benefits of drinking coffee. According to a new study, postmenopausal estrogen use alters coffee's protective effect against Parkinson's disease.

Previous studies have shown that men who drink coffee regularly have a lower risk of developing Parkinson's disease than non-coffee drinkers. But female coffee drinkers don't enjoy the same health benefit.

In the study, researchers looked at the relationship between coffee and Parkinson's disease risk and found that estrogen appears to interfere with this protective effect in postmenopausal women.

Postmenopausal women who had never used estrogens and drank coffee had a lower risk of Parkinson's disease than women who didn't drink coffee. But postmenopausal women who used estrogens and drank coffee were more likely to develop the disease.

The results appear in the Nov. 15 issue of the American Journal of Epidemiology.

Estrogen Alters Coffee's Healthy Effect

In the study, researchers looked at the relationship between how much caffeinated coffee people drank and their later risk of death due to Parkinson's disease among more than 1 million people enrolled in a large cancer study from 1982 to 1998.

During this period, Parkinson's disease was listed as the cause of death in 909 men and 340 women.

After adjusting for factors like age, smoking, and alcohol intake, the study showed that men who regularly drank coffee were about a third less likely to have died of Parkinson's disease than non-coffee drinkers. This reduction in Parkinson's disease risk was about the same whether they drank three to six cups per week or more than six cups per day.

Yet among women there was no reduction in risk seen in coffee drinkers after adjusting for these factors.

Next, researchers looked at whether estrogen use might explain the difference in risk between the sexes. They found, as in men, the risk of Parkinson's disease was about a third lower in postmenopausal women who drank coffee and never used estrogens.

Their study also showed that there was no reduction in risk among women who drank coffee and had used estrogens.

Researchers say the findings suggest that it may be important to look at a possible interaction between estrogen and caffeine in the development in Parkinson's disease. These interactions might explain this potential health benefit of coffee among men and non-estrogen users.

June 12, 2003 -- People who are obese are no more likely to suffer from complications after general surgery than others, according to a new study. Researchers say the findings challenge the widely held notion among doctors that obesity itself raises the risk of complications following surgery.

One in five Americans is now considered obese. But researchers say although obesity increases the risk of serious health problems, such as diabetes and heart disease, "forcing obese patients to lose weight before surgery or to exclude obese patients from elective general surgery is not supported by our data."

The study, which appears in the June 14 issue of The Lancet, compared the prevalence of complications after surgery among 6,336 patients who underwent general elective surgeries at a hospital in Switzerland. Thirteen percent of the patients were obese, with a body mass index (BMI, a number that shows your weight adjusted for height) of more than 30, including 4% who were severely obese with a BMI over 35.

With the exception of a slight increase (4% vs. 3%) in the incidence of wound infections after an open surgery, the study found the risk of complications did not differ significantly between obese and nonobese patients.

Researchers say the higher risk of infection after open surgery in which a large incision is made might be related to the presence of excessive fat tissue, which may slow wound healing and raise the risk of infection.

But a growing number of elective surgeries, including those that are increasingly popular among obese people, such as gastric bypass procedures, are now performed laproscopically -- using several small incisions rather than one large one. Laproscopic procedures reduce the risk of infection at the surgical site.

Surgery on Obese People Isn't More Difficult

"The prejudice that obese patients face a higher risk for postoperative complications might also be related to the surgeon's perception that operating on obese patients is confounded by technical difficulties," write Daniel Dindo, MD, of University Hospital Zurich in Switzerland, and colleagues.

But the study found that operating times did not significantly differ between obese and nonobese patients, which does not support this perception of higher difficulty.

In an editorial that accompanies the study, Edward E. Mason, MD, of the department of surgery at the University of Iowa Hospitals and Clinics, says that more research is needed on long-term complications of surgery on extremely obese patients. Surgical incisions in these patients may lead to giant hernias years after an operation.

Until more is known about these types of lifelong complications, Mason says laparoscopic operations that do not require large incisions are an attractive and more comfortable option for surgery in obese patients.

Nov. 7, 2002 -- Coffee isn't exactly lauded for its nutritional value, but new research shows it could cut your risk of type 2 diabetes in half.

In type 2 diabetes, the body does not adequately respond to the effects of insulin -- the hormone that affects blood sugar level. Eventually this leads to a rise in blood sugar, which over time can cause heart attacks, strokes, kidney failure, and blindness. Type 2 diabetes accounts for more than 90% of diabetes and more commonly occurs in overweight people.

Caffeine is known to decrease the body's response to insulin. However, other ingredients found in coffee -- magnesium and chlorogenic acid -- may have beneficial effects, say the researchers.

To test the overall effect of coffee on type 2 diabetes, researchers followed more than 17,000 Dutch adults. After several years of follow-up, those who drank seven or more cups a day were half as likely to develop type 2 diabetes compared with those who drank less than two cups a day. This held true even after taking other lifestyle factors such as smoking, poor diet, and alcohol into consideration. The study is published in the November issue of The Lancet.

Tea did not appear to have any effect on risk of diabetes. Not enough people in the study drank decaffeinated coffee regularly to determine if the effects would be different.

The long-term effects of drinking too much caffeine are not known and other health issues could develop, study leader R.M. van Dam, MSc, says in a news release. More research is needed to determine the effects of long-term coffee drinking on health. The research team is with the department of nutrition and health at Vrije Universiteit in Amsterdam.

March 15, 2004 -- A powerful antioxidant found in green tea may be responsible for the beverage's heralded anticancer benefits.

New research shows that the antioxidant, known as EGCG, binds to a protein found on tumor cells and dramatically slows their growth.

Researchers say previous studies have shown that green tea helps protect against a variety of cancers, such as lung, prostate, and breast, but the mechanisms for these effects are not known.

In the study, published in the April issue of Nature Structural & Molecular Biology, researchers identified a potential target for the antitumor action of EGCG on human lung cancer cells that inhibited cancer cells' growth. By learning more about this target, researcher may be able to develop new treatments that maximize green tea's cancer-fighting potential.

Explaining Green Tea's Anticancer Benefits

In order to better understand how the antioxidants found in green tea may protect against cancer, researchers looked at how they affected a protein found on the surface of cancer cells called laminin receptor.

The study showed that when cancer cells with this protein were treated with polyphenol EGCG, the growth of the tumor cells was significantly reduced.

Researchers say the concentration of the antioxidant required to produce these anticancer effects was equivalent to those found in the body after drinking only two to three cups of green tea.

Other components found in green tea, including caffeine, had no effect on tumor cell growth.

Researchers say the results further the understanding of how antioxidants interact with cancer cells and may one day lead to more effective cancer therapies that use green tea as a dietary cancer treatment.

Jan. 1, 2001 -- Eggs and bacon for breakfast, tuna fish with mayonnaise -- hold the bread -- for lunch, two hard-boiled eggs for a snack, and a big T-bone steak for dinner. That's a typical meal plan for 27-year-old Stacy Smith, a recent convert to the fad of the moment: the low-carbohydrate diet.

?

The Portland, Ore., resident can eat unlimited amounts of meats and cheeses and other dairy foods, but few vegetables, and no fruits or grains.

?

It's almost too easy. No calorie counting. No portion sizes. Just avoid the "bad" foods, which in this case include things like pasta, bread, apples, and pears.

?

The plan, which proponents say has been adopted by more than 10 million people since the book Dr. Atkins New Diet Revolution first was published in the 1970s and republished in the late 1990s, flies in the face of conventional advice about calorie reduction and balanced nutrition. Copycat plans like Sugar Busters and The Carbohydrate Addict's Diet follow similar principles. By limiting the intake of carbohydrates, the theory goes, the body is forced to turn to stored fuel -- in other words, fat -- into energy, entering a fat-burning state called ketosis.

?

Not everyone is convinced, however. Opponents say that restricting carbohydrate intake isn't a magic formula for fat loss, feeling instead that these plans may leave you lighter in weight but with just as much body fat.

The Low-Carb Shell Game

How can a diet make you lose pounds but not fat? It's all in the way low carbohydrate diets work, says Karin Kratina, MA, RD, a nutrition therapist who specializes in treating weight and eating problems in her private practice located in Gainesville, Fla. She tells WebMD that carbohydrates are broken down into glucose by the body, which in turn either is used immediately for energy or converted into a storage form called glycogen, primarily in the cells of the liver and muscle. Such glycogen is metabolized easily back to glucose, and provides about half of the body's energy supplies daily. Everything from processing a thought to getting from point A to point B requires energy from glycogen, Kratina says.

?

"At any [given] time, we have about 1,200 calories of glycogen on board," she says. And for every gram of glycogen stored, so are three grams of water. Therefore, when carbohydrate intake is restricted and the existing stores of glycogen stores are exhausted, the body sheds the stored water, leading to an impressive water "weight loss" within a few weeks.

?

Once the glycogen is gone, the body does turn to fat as a fuel source. But in reality, fat is an inferior energy source compared to glycogen. It's like trying to run a car on lighter fluid, says John Acquaviva, PhD, assistant professor of physical education at Roanoke College in Salem, Va. "In ketosis, the body does burn a higher percentage of fat, but overall, less calories are burned," he tells WebMD.

System Shutdown

"People need to remember that there are a lot of ways to lose weight, but not all of them are healthy," Acquaviva says. "Starvation is one obvious example." As the body starts to burn stored fat, it creates byproducts called ketones, leading to the state of ketosis.

?

If the determined dieter sticks to the plan despite the unpleasant side effects of this state -- including foul acidic breath, fuzzy thinking, and fatigue -- additional pounds will come off. But like the water loss, it is an illusion. The majority of the loss is muscle, not fat, leaving the dieter with a higher body fat percentage and less lean muscle tissue, Kratina says.

?

Then the carbohydrate cravings kick in, she says. The body seeks to replace the missing glycogen and restore balance. Dieter Stacy Smith knows this feeling all too well.

?

"I'll suddenly crave things like bread, oatmeal, ice cream," she says. "I'll binge, eating three or four bowls of oatmeal at a time." When she does, her body once again stores glycogen and water, leading to a dramatic "weight" gain. The numbers on the scale quickly rise 10 to 15 pounds, reinforcing the idea that carbohydrates are to blame.

?

Smith accepts the label of carbohydrate "addict" and goes back on the plan. It becomes a vicious circle of starve, binge, starve, binge.

Jan. 1, 2001 -- Eggs and bacon for breakfast, tuna fish with mayonnaise -- hold the bread -- for lunch, two hard-boiled eggs for a snack, and a big T-bone steak for dinner. That's a typical meal plan for 27-year-old Stacy Smith, a recent convert to the fad of the moment: the low-carbohydrate diet.

?

The Portland, Ore., resident can eat unlimited amounts of meats and cheeses and other dairy foods, but few vegetables, and no fruits or grains.

?

It's almost too easy. No calorie counting. No portion sizes. Just avoid the "bad" foods, which in this case include things like pasta, bread, apples, and pears.

?

The plan, which proponents say has been adopted by more than 10 million people since the book Dr. Atkins New Diet Revolution first was published in the 1970s and republished in the late 1990s, flies in the face of conventional advice about calorie reduction and balanced nutrition. Copycat plans like Sugar Busters and The Carbohydrate Addict's Diet follow similar principles. By limiting the intake of carbohydrates, the theory goes, the body is forced to turn to stored fuel -- in other words, fat -- into energy, entering a fat-burning state called ketosis.

?

Not everyone is convinced, however. Opponents say that restricting carbohydrate intake isn't a magic formula for fat loss, feeling instead that these plans may leave you lighter in weight but with just as much body fat.

The Low-Carb Shell Game

How can a diet make you lose pounds but not fat? It's all in the way low carbohydrate diets work, says Karin Kratina, MA, RD, a nutrition therapist who specializes in treating weight and eating problems in her private practice located in Gainesville, Fla. She tells WebMD that carbohydrates are broken down into glucose by the body, which in turn either is used immediately for energy or converted into a storage form called glycogen, primarily in the cells of the liver and muscle. Such glycogen is metabolized easily back to glucose, and provides about half of the body's energy supplies daily. Everything from processing a thought to getting from point A to point B requires energy from glycogen, Kratina says.

?

"At any [given] time, we have about 1,200 calories of glycogen on board," she says. And for every gram of glycogen stored, so are three grams of water. Therefore, when carbohydrate intake is restricted and the existing stores of glycogen stores are exhausted, the body sheds the stored water, leading to an impressive water "weight loss" within a few weeks.

?

Once the glycogen is gone, the body does turn to fat as a fuel source. But in reality, fat is an inferior energy source compared to glycogen. It's like trying to run a car on lighter fluid, says John Acquaviva, PhD, assistant professor of physical education at Roanoke College in Salem, Va. "In ketosis, the body does burn a higher percentage of fat, but overall, less calories are burned," he tells WebMD.

System Shutdown

"People need to remember that there are a lot of ways to lose weight, but not all of them are healthy," Acquaviva says. "Starvation is one obvious example." As the body starts to burn stored fat, it creates byproducts called ketones, leading to the state of ketosis.

?

If the determined dieter sticks to the plan despite the unpleasant side effects of this state -- including foul acidic breath, fuzzy thinking, and fatigue -- additional pounds will come off. But like the water loss, it is an illusion. The majority of the loss is muscle, not fat, leaving the dieter with a higher body fat percentage and less lean muscle tissue, Kratina says.

?

Then the carbohydrate cravings kick in, she says. The body seeks to replace the missing glycogen and restore balance. Dieter Stacy Smith knows this feeling all too well.

?

"I'll suddenly crave things like bread, oatmeal, ice cream," she says. "I'll binge, eating three or four bowls of oatmeal at a time." When she does, her body once again stores glycogen and water, leading to a dramatic "weight" gain. The numbers on the scale quickly rise 10 to 15 pounds, reinforcing the idea that carbohydrates are to blame.

?

Smith accepts the label of carbohydrate "addict" and goes back on the plan. It becomes a vicious circle of starve, binge, starve, binge.

Are you addicted to your TiVo? Never miss an episode of CSI? Got sore thumbs from clicking from one football game to another?

If TV is a must-see for you, it's easy to let it cut into your workout time. But fitness doesn't have to mean foregoing your favorite shows. How about working in a workout in front of the tube? Even fitness experts find TV-watching workouts helpful -- and sometimes, a necessity.

Bob Prichard is so busy with his duties as director of Somax Sports, a training facility in Tiburon, Calif., that he doesn't have a lot of time to exercise. So he's made it a habit to work out whenever he watches TV.

"I have a treadmill set up in my living room and I walk at a brisk, but comfortable pace, while watching a DVD or TV," he says. "This way, I get in one to three hours of exercise per day. (I often watch golf tournaments, baseball games, etc.)"

Kinesiologist Shari Feuz, an exercise advisor with the International Council on Active Aging in Vancouver, says Prichard's approach can work well -- as long as you're working hard enough to feel it.

"It is absolutely possible to improve your fitness level in front of the TV, if the intensity is adequate, just as it is quite possible to go to a fitness center several times per week and NOT improve your fitness level," Feuz says. Given how much TV most of us watch, exercising at the same time is not a bad idea. Studies show that American men average 29 hours a week of TV watching, while women rack up about 34 hours. That gives us a lot of time to fit in some extra activity.

"This is multitasking at its best," says Mare Petras, author of Fitness Simply, which includes a chapter titled "Here's Oprah," dedicated to fitness in front of the TV.

"We're an all-or-nothing society," says Petras. "We think that if we can't exercise for an hour at a time, that it doesn't count. But that's not true. It doesn't have to be 'black or white' with fitness. It all adds up."

Don't Touch That Dial

In fact, if you're not ready to risk losing track of the plot of that fast-moving drama by doing a full-blown workout, you can fit in fitness breaks during the commercials. This can be an especially good option for beginners.

Linda Buch, author of The Commercial Break Workout, points out that a 30-minute sitcom has about 10 minutes' worth of commercials. Instead of using this time to reach for a handful of cookies or chips, get moving!

Among Buch's suggestions:

• Pushups. If floor pushups are too difficult for you, start off by standing up with your hands on the wall, then pushing back. Do this 10 times; increase the reps as the exercise gets easier.
• Chair squats. Stand up, sit down, then stand right back up (for even more of a workout, don't sit down all the way). Do this for the length of one commercial. As it gets easier, do it again for the next commercial.
• Marching in place. Move both your arms and legs; add jumping jacks to increase the intensity.

"Little bits of exercise like these strung together add up to energy expended," says Buch.

Sept. 5, 2006 -- Eating protein triggers a natural weight-loss hormone, British researchers say.

When released in the gut, the hormone known as PYY reduces hunger. And high-protein foods set off PYY better than other foods, according to Rachel L. Batterham, MD, of University College London, and colleagues.

Recent studies suggest PYY is part of the solution to obesityobesity. Compared with a normal-weight person, for example, an obese person has to eat twice as many calories to trigger PYY.

"We've now found that increasing the protein content of the diet augments the body's own PYY, helping to reduce hunger and aid weight lossweight loss," Batterham says, in a news release.

If this sounds like the Atkins Diet, Batterham and colleagues say it's not. They note that many people on the Atkins Diet eat a lot of saturated fat as well as a lot of protein.

Obesity, Men, and Mice

Is PYY really the key to obesity? Batterham's team first looked at what kind of food best satisfies hunger. They studied nine obese men and 10 normal-weight men. After brief fasts, the men ate different meals. Each of the meals -- a high-protein meal, a high-fat meal, and a high-carbohydrate meal -- had the same number of calories.

All the men said the high-protein meal best satisfied their hunger. Interestingly, the normal-weight men found the high-fat meal more satisfying than the high-carb meal, while the obese men did not.

Measurements showed the high-protein meal triggered the most PYY in all of the men. In the normal-weight men -- but not the obese men -- the high-fat meal triggered more PYY than the high-carb meal.

Batterham's team genetically engineered a mouse strain that did not have the PYY gene. These mice ate huge amounts of food, and quickly became obese.

Normally, obese mice fed a high-protein diet will eat less and lose weight. But a high-protein diet didn't help the PYY-defective mice lose weight -- unless they also got PYY treatments.

Hunters vs. Farmers

Why does protein trigger PYY and satisfy hunger so well? It's not entirely clear. But Batterham and colleagues suggest we blame our ancestors.

The prehistoric humans whose genes we inherit had a different diet than we do. They got 19% to 35% of their energy from protein and 22% to 40% from carbs. Our modern diet gets 49% of its energy from carbs and only 16% protein.

"One potential weight loss strategy is therefore to increase the satiating power of the diet and promote weight loss through the addition of dietary protein -- harnessing our own satiety system," Batterham says. "Such a diet is perhaps more typical to that of our hunter-gatherer ancestors."

The findings appear in the September issue of the journal Cell Metabolism.

March 15, 2005 -- Vitamin E harms more than it helps, a large study shows.

Vitamin E is a powerful antioxidant, thought to clear the body of harmful oxygen compounds called free radicals. By soaking up free radicals, researchers hoped that vitamin E would prevent cancer and heart disease.

That doesn't happen, finds Eva Lonn, MD, of McMaster University in Hamilton, Ontario, and colleagues. Lonn led a seven-year-long, international study that enrolled thousands of people at high risk of heart disease. The findings added to suspicions raised by prior studies: Vitamin E isn't worth it.

"We saw definitely no benefit, and at least the potential for harm," Lonn tells WebMD. "Now the overwhelming evidence from many studies is that vitamin E provides no protection against heart disease, stroke, or cancer."

Lott and colleagues report their findings in the March 16 issue of The Journal of the American Medical Association.

Vitamin E Harm: Slight but Significant Risk

Lonn's study enrolled nearly 10,000 people with heart disease, peripheral artery disease (also commonly called poor circulation, a disease of blood flow through the arteries) or diabetes. This put them at very high risk of heart attack and stroke. All were over age 55. Half got high-dose vitamin E -- 400 IU every day (about 400 milligrams) -- and half got fake pills that looked the just the same.

After four years, those who took vitamin E had no fewer heart attacks, strokes, cancers, or cancer deaths.

But many experts wondered whether that was long enough for vitamin E to help. So Lonn and colleagues extended the study for another three years.

"But we saw no benefit at all on cancer and no benefits for heart outcomes -- a composite measure of heart attack, stroke, and heart death," Lonn says.

Unexpectedly, they did see one difference. Patients taking vitamin E had significantly more heart failure.

Vitamin E was linked to a 13% higher risk of heart failure and a 21% increased risk of hospitalization for heart failure. That's a pretty small risk. But since the vitamin did no good at all, it's a risk not worth taking.

"If there is no benefit from taking something, you shouldn't take even a small risk of harm," Lonn says.

There is no need to worry if you take a multivitamin that contains recommended amounts of vitamin E. But Lonn advises people not to take pills containing high amounts (400 IU or more) of vitamin E.

Is Vitamin E Dead?

B. Greg Brown, MD, PhD, head of the atherosclerosis research lab at the University of Washington School of Medicine, was one of the first scientists to suggest that vitamin E and other antioxidant vitamins may not work the way they were supposed to.

"Vitamin E has been very clearly shown to be of no benefit to the general problem of cancer or heart disease," Brown says. "Studies are still looking at whether vitamin E can help prostate cancer, [mouth and throat] cancer, and severe macular degeneration. But all in all, there is relatively little hope for a major effect. There's not a lot of hope for vitamin E. It's proven to be without benefit."

Brown's editorial accompanies the Lott study in the March 16 issue of JAMA.

The Real Vitamin E Harm

What worries Lonn and Brown isn't heart failure caused by vitamin E.

"The scary thing is not that vitamin E will cause harm. It's that people will take something that does no good instead of something we know will help," Lonn says. "Often people think, 'Well, I am going to be fine because I am taking a bunch of vitamins.' We see that even in people who have had two or three heart attacks already. They won't take their medications, but a bunch of vitamins they will take. That is where the damage lies rather than in the small risk from the vitamin E pill itself."

Brown, a cardiologist, says he far too often sees the same thing.

"The one thing that is really of concern is that a person will say, 'I am taking a vitamin, so I don't have to exercise or quit smoking or take a cholesterol-lowering drug," he says. "So that can be harmful in turning people away from proven therapies toward those with no benefit. Maintaining that position of zealotry can be more harmful than simply taking the vitamin itself."

May 20, 2004 -- A California company is voluntarily recalling millions of pounds of whole natural raw almonds because of reports of food poisoning with salmonella.

The almonds are sold under the Kirkland Signature, Trader Joe's, and Sunkist brands.

Below is how you can identify if you have any of the recalled almonds:

• The almonds sold under the Kirkland Signature brand, available exclusively at Costco Wholesale Inc., were marked "raw almonds" and were packaged in 3-pound, lay-flat plastic bags stamped with a "best before" date from 8/21/04 through 2/8/05.
• For Trader Joe's and Sunkist, the packages bear the "best before" dates of 8/21/04 through 3/15/05.
• The almonds sold by Trader Joe's are in a 1-pound, lay-flat plastic bag marked "nonpareil variety raw almonds" and the almonds sold by Sunkist are in a 10-ounce, lay-flat plastic bag marked "raw natural whole almonds."

Paramount Farms is taking this precautionary action after learning from the FDA that there are seven cases of illnesses from Salmonella Enteritidis in Alaska, Arizona, Oregon, Washington, and Utah.

In all of these cases, the individuals who consumed California whole natural raw almonds recovered, and, in five of these cases, the individuals purchased the almonds from Costco Wholesale Inc., in Oregon.

Salmonella is an organism which can cause serious and sometimes fatal infections in young children, frail or elderly people, and others with weakened immune systems. Healthy persons infected with salmonella often experience fever, diarrhea (which may be bloody), nausea, vomiting, and abdominal pain. In rare circumstances, infection with salmonella can result in the organism getting into the bloodstream and producing more severe illnesses such as infections of the lining of the heart and arthritis.

"While no salmonella has been found in Paramount products, we have taken this aggressive step out of an abundance of caution and to assure our customers and consumers of the quality and safety of our products," David Szeflin, vice president of operations, said in a news release. "We're working diligently with the FDA and state health officials to make sure that any product that has not yet been consumed is returned."

This is the first ever almond recall for Paramount Farms and there have never been any cases of salmonella infection in the company's history. The FDA says the company is cooperating fully with the investigation.

"We've worked hard for more than 20 years to gain the loyalty and confidence of our customers," Szeflin explained, "and we intend to safeguard that trust."

Consumers who purchased products with these best buy dates should return them to their local point of purchase for a full refund. Consumers who have questions about the recall may call Paramount Farms toll free hotline at 800-496-5168.

SOURCE: FDA.

This oil's got history going for it, that's for sure. One of the oldest known cultivated trees in the world, the olive tree is native to Asia Minor. It is thought to have spread to the Mediterranean region -- now well-known for its use of olive oil -- about 6,000 years ago.

You can buy domestic olive oil (using mostly Californian grown olives) or imported oils from France, Greece, Spain, and Italy.

This uniquely green and flavorful oil can be less green and less flavorful, depending on the type you buy. If you want to use it at high temperatures or in baking, try one of the "light" olive oils. This type goes through a fine filtration process, producing lighter-colored oil that lacks the classic olive flavor.

What if you want a fragrant and flavorful oil, for salad dressings or for adding to a dish after cooking? Olive oil that's extra-virgin and cold-pressed (a chemical-free process that involves only pressure, producing an oil with low acidity) is considered the fruitiest and finest type, according to The Food Network's online encyclopedia.

More and more people are cooking with olive oil, perhaps because Mediterranean cuisine is in vogue, or because of the oil's distinctive flavor, or its potential health benefits. How about all of the above?

"It's my metabolism!"

Sound familiar? If you're carrying some extra pounds (and having a hard time losing them), it's tempting to put the blame on a sluggish metabolism.

But is your metabolism really the reason it's often so hard to lose weight? And, more important, is there anything you can do about it?

WebMD asked experts to explore facts and myths about metabolism -- and the good news is, there are things you can do to help boost your body's calorie-burning power.

What Is Metabolism?

Your metabolism, experts say, involves a complex network of hormones and enzymes that not only convert food into fuel but also affect how efficiently you burn that fuel.

"The process of metabolism establishes the rate at which we burn our calories and, ultimately, how quickly we gain weight or how easily we lose it," says Robert Yanagisawa, MD, director of the Medically Supervised Weight Management Program at Mount Sinai Medical Center in New York.

Of course, not everyone burns calories at the same rate.

Your metabolism is influenced by your age (metabolism naturally slows about 5% per decade after age 40); your sex (men generally burn more calories at rest than women); and proportion of lean body mass (the more muscle you have, the higher your metabolic rate tends to be).

And yes, heredity makes a difference.

"Some people just burn calories at a slower rate than others," says Barrie Wolfe-Radbill, RD, a nutritionist specializing in weight loss at New York University Medical Center.

Occasionally, Yanagisawa says, a defect in the thyroid gland can slow metabolism, though this problem is relatively rare.

And here's a fact that may surprise you: the more weight you carry, the faster your metabolism is likely running.

"The simple fact is that the extra weight causes your body to work harder just to sustain itself at rest, so in most instances, the metabolism is always running a bit faster," says Molly Kimball, RD, sports and lifestyle nutritionist at the Oscher's Clinic's Elmwood Fitness Center.

That's one reason it's almost always easiest to lose weight at the start of a diet, and harder later on, Kimball says: "When you are very overweight your metabolism is already running so high that any small cut in calories will result in an immediate loss."

Then, when you lose significant amounts of body fat and muscle, your body needs fewer calories to sustain itself, she says. That helps explain why it's so easy to regain weight after you've worked to lose it.

"If two people both weigh 250 pounds, and one got there by dieting down from 350 and the other one was always at 250, the one who got there by cutting calories is going to have a slower metabolism," says Yanagisawa. "That means they will require fewer calories to maintain their weight than the person who never went beyond 250 pounds."

It's ironic that the one thing Debbie Scaling Kiley needed was the one thing that was all around her as far as the eye could see, but wasn't for the taking: water. Setting sail from Annapolis, Md., and headed for Ft. Lauderdale, Fla., the boat Kiley and her crew of four were on sank off the coast of North Carolina leaving them with no survival equipment and not a drop of fresh water.

Stranded at sea in a small life raft, the five survivors slowly started to dehydrate, and after several hours, dehydration set in.

"We sank at about 2 p.m.," says Kiley. "By the next morning, we were thirsty, but the cold was more important than the thirst. Later that day, though, the thirst started to drive us crazy. It's a longing like nothing I'd ever felt before; it's nothing like being hungry. It's torturous because there was nothing we could do, but we'd have done anything for water."

By the third day, they were semidelusional, and that night, two of the men on the raft drank seawater to quench their thirst. The next day, in a delusional state, both men jumped overboard.

"By the fifth day, we were so thirsty, we were overwhelmed by it," says Kiley. "We were at the point of believing we were going to die of dehydration. I've been told the human body can last absolutely no longer than seven days, but in many cases, as I believe was the case with us if we had stayed out there longer, a person can only last five or six days."

On the fifth day, Kiley and one other survivor were rescued. They were immediately given ice cubes to suck on and IV fluids to re-hydrate them. Her story, compelling in so many ways, illustrates to the extreme the importance of water and fluids in our lives.

Water: Why We Need It

"Hydration is important because the body is comprised mostly of water, and the proper balance between water and electrolytes in our bodies really determines how most of our systems function, including nerves and muscles," says Larry Kenney, PhD, a professor of physiology and kinesiology at Penn State.

Drinking fluids serves a range of purposes in our bodies, such as removing waste through urine; controlling body temperature, heart rate, and blood pressure; and maintaining a healthy metabolism.

Without it, the body begins to shut down, as seen in Kiley's experience at sea. Symptoms of severe dehydration include altered behavior, such as severe anxiety, confusion, or not being able to stay awake; faintness that is not relieved by lying down; an inability to stand or walk; rapid breathing; a weak, rapid pulse; and loss of consciousness.

While striking a water balance in our bodies is something that happens naturally as we consume three meals a day coupled with beverages, most people aren't aware that the body is only one or two percentage points away from a problem.

"Very slight changes in body water may create some performance issues in sports; as little as a 2% decrease in body water can lead to dehydration and performance detriments in sports," says Kenney. "When your water levels decrease by higher levels like 3% or 4%, there are physiological changes that occur that may have health consequences, such as increased heart rate and body temperature."

May 2, 2005 -- Loneliness may hamper the immune system, which is needed to fight off illness.

That's what Carnegie Mellon University psychology graduate student Sarah Pressman, MS, and colleagues found when they studied college freshmen coping with their first semester away from home.

The freshmen who felt the loneliest and most socially isolated had the weakest immune response to one component of the flu virus, says Pressman.

The results -- published in May's Health Psychology -- show that loneliness and social isolation can have an impact and that the first semester of college can be "really stressful," Pressman tells WebMD.

Emotional Feeling, Physical Effect

College students aren't the only ones whose health may suffer with those feelings. "Loneliness and social isolation have previously been associated with immune detriments," says Pressman.

"As you get older, the immune system doesn't work as well," she says, noting that older people's social networks sometimes thin as friends and family move away or die.

A study of 180 senior citizens found an association between loneliness and heart disease. That report appeared in the December 2002 issue of the Annals of Internal Medicine.

Campus Study

Pressman's study included 83 first-semester college students. All were healthy and got their first-ever flu shots on campus, along with the rest of their class.

Researchers often use students' response to flu shots as a measure of immunity. "The nice thing is it's a bit more relevant than a blood draw and looking at circulating antibodies," says Pressman.

Two days before the flu shot, the students were given palm-held computers that prompted them to rate how lonely and isolated they were feeling at that moment on a scale of one to four. The computer tests popped up four times each day for about two weeks.

The students also wrote down the initials of all the people they had contact with at least once every two weeks.

Pressman and colleagues grouped the students in two ways: by degree of loneliness (low, medium, or high), and by social-network size (smaller, medium, or larger).

Lonely Students, Weaker Immune Response

Blood samples showed that the loneliest and most isolated students had weaker immune responses to the flu vaccine.

The weakest immune response was seen in students who were both lonely and isolated, says Pressman. Results were similar for male and female students, she says.

Loneliness and isolation seemed to work independently, says Pressman. Loneliness was also associated with poorer sleep habits and less sleep; Pressman is currently writing a paper about that.

Loneliness, Isolation Are Different

Ever feel lonely in a crowd or content with few people around? It's possible to feel lonely but not isolated and vice versa, says Pressman.

"Social network size wasn't correlated with loneliness," she says. The number of people the students reported having contact with "had nothing to do with how lonely they felt."

"It's not so much the number of people; it's the level of closeness that you feel," Pressman continues. "It really is your perception. If your social network is meeting your needs, then you won't feel lonely."

Familiar Feelings

Pressman says she "absolutely" can relate to the feelings expressed by the students in her study. She remembers feeling that way when she moved far from home to go to college.

Her solution was to get involved on campus, becoming the vice president of her class, joining the psychology society, and participating in dorm activities.

"I really think that helped me," she says. "The faster you can make those connections, the faster you can alleviate those feelings."

Staying in touch with friends and family at home can also help, she says.

People tend to keep the same levels of social integration, says Pressman. In other words, well-connected high school students often build a strong network in college.

"Obviously, there's a period where you have to build those things up," says Pressman.

Others can learn the same skills. "You've got to work on it and get yourself out there," she says. "If you've got people around you, it does seem to buffer this immune detriment."

Feb. 9, 2005 -- The latest weight loss news comes down on the side of so-called "good" carbohydrates -- the kind offering more than sweet tastes and flash-in-the-pan bursts of energy with few nutrients.

The type of carbohydrate you eat, rather than the total amount of carbohydrates in your diet, may be related to body weight, say scientists in the American Journal of Epidemiology's Feb. 15 edition.

Call it the victory of broccoli over white bread, or lentils over linguine. Carbs with a lower glycemic index were kinder to weight than those with high glycemic index.

Glycemic index is an indicator of how quickly a food affects blood sugar levels. Foods with a high glycemic index tend to be starchy, sugary, or refined and stripped of some of their natural goodness; they're often "empty" calories. In general, low-glycemic-index foods usually have more fiber and nutrients.

For instance, french fries have a higher glycemic index than grapefruit. Cakes and cookies are off the charts, compared with spinach.

Carb Craze

You may have heard of the glycemic index before. It's often mentioned in diets such as the Atkins and South Beach diets. Even if the phrase is new, you're bound to be aware of the carbohydrate consciousness of recent years.

Some people lump all carbs together, branding them as suspects in America's weight crisis. But all carbohydrates are not alike, and the new study clears the name of "good" carbs.

The study was conducted by researchers including Yunsheng Ma, PhD, MPH, of the University of Massachusetts Medical School. Participants were 572 healthy adults in central Massachusetts.

For one year, subjects gave quarterly reports on their food consumption and physical activity for seven-day periods. The data was collected between 1994 and 1998.

Is Glycemic Index the Key to Weight Loss?

The researchers looked at what the participants ate, how much they worked out, and their body mass index (BMI), a measure of total body fat. BMI is used to assess heart disease risk.

Higher BMIs were associated with diets that had higher glycemic index foods.

Daily carbohydrate intake and percentage of calories from carbohydrates didn't matter. The study indicates that the type of carbohydrate -- noted by glycemic index -- was what counted, say the researchers. Short-term weight loss studies have echoed that result, but "the long-term effect of glycemic index and total carbohydrates on body weight is currently unknown," say Ma and colleagues.

The finding is consistent with the idea that foods with a higher glycemic index trigger more insulin production and more fat storage, say the researchers. However, they don't endorse cutting all carbohydrates or focusing on glycemic load for weight loss. Instead, glycemic index was most important, say the scientists, calling for more research.

Finding Foods' Glycemic Index

The glycemic index of various foods is listed online, but it's not required on food labels. A low glycemic index is considered to be 55 or less. The medium range falls from 56 to 69. High glycemic index is 70 or higher.

However, when it comes to the glycemic index of a particular food many factors come into play. For example, what else was eaten with the food and other components of a food including the amount of proteins and fats, as well as, how a food was prepared often alters the index.

No time to research your menu? Generally, unprocessed foods such as fruits, vegetables, lean meats, and whole grains have lower glycemic indices than processed or refined items.

It might also help to expand your definition of carbohydrates. Bread, pasta, rice, cereals, sweets, and grains don't have the market cornered. Fruits, vegetables, and legumes also contain carbohydrates, and they may be the type to favor, along with fiber-rich whole grains.

If you're watching your weight, don't forget about calories. You'll still need to burn more calories than you consume to lose weight. Exercise will help with that part of the equation.

Nov. 5, 2004 - Postmenopausal women who take estrogen may not reap at least one of the potential health benefits of drinking coffee. According to a new study, postmenopausal estrogen use alters coffee's protective effect against Parkinson's disease.

Previous studies have shown that men who drink coffee regularly have a lower risk of developing Parkinson's disease than non-coffee drinkers. But female coffee drinkers don't enjoy the same health benefit.

In the study, researchers looked at the relationship between coffee and Parkinson's disease risk and found that estrogen appears to interfere with this protective effect in postmenopausal women.

Postmenopausal women who had never used estrogens and drank coffee had a lower risk of Parkinson's disease than women who didn't drink coffee. But postmenopausal women who used estrogens and drank coffee were more likely to develop the disease.

The results appear in the Nov. 15 issue of the American Journal of Epidemiology.

Estrogen Alters Coffee's Healthy Effect

In the study, researchers looked at the relationship between how much caffeinated coffee people drank and their later risk of death due to Parkinson's disease among more than 1 million people enrolled in a large cancer study from 1982 to 1998.

During this period, Parkinson's disease was listed as the cause of death in 909 men and 340 women.

After adjusting for factors like age, smoking, and alcohol intake, the study showed that men who regularly drank coffee were about a third less likely to have died of Parkinson's disease than non-coffee drinkers. This reduction in Parkinson's disease risk was about the same whether they drank three to six cups per week or more than six cups per day.

Yet among women there was no reduction in risk seen in coffee drinkers after adjusting for these factors.

Next, researchers looked at whether estrogen use might explain the difference in risk between the sexes. They found, as in men, the risk of Parkinson's disease was about a third lower in postmenopausal women who drank coffee and never used estrogens.

Their study also showed that there was no reduction in risk among women who drank coffee and had used estrogens.

Researchers say the findings suggest that it may be important to look at a possible interaction between estrogen and caffeine in the development in Parkinson's disease. These interactions might explain this potential health benefit of coffee among men and non-estrogen users.

June 12, 2003 -- People who are obese are no more likely to suffer from complications after general surgery than others, according to a new study. Researchers say the findings challenge the widely held notion among doctors that obesity itself raises the risk of complications following surgery.

One in five Americans is now considered obese. But researchers say although obesity increases the risk of serious health problems, such as diabetes and heart disease, "forcing obese patients to lose weight before surgery or to exclude obese patients from elective general surgery is not supported by our data."

The study, which appears in the June 14 issue of The Lancet, compared the prevalence of complications after surgery among 6,336 patients who underwent general elective surgeries at a hospital in Switzerland. Thirteen percent of the patients were obese, with a body mass index (BMI, a number that shows your weight adjusted for height) of more than 30, including 4% who were severely obese with a BMI over 35.

With the exception of a slight increase (4% vs. 3%) in the incidence of wound infections after an open surgery, the study found the risk of complications did not differ significantly between obese and nonobese patients.

Researchers say the higher risk of infection after open surgery in which a large incision is made might be related to the presence of excessive fat tissue, which may slow wound healing and raise the risk of infection.

But a growing number of elective surgeries, including those that are increasingly popular among obese people, such as gastric bypass procedures, are now performed laproscopically -- using several small incisions rather than one large one. Laproscopic procedures reduce the risk of infection at the surgical site.

Surgery on Obese People Isn't More Difficult

"The prejudice that obese patients face a higher risk for postoperative complications might also be related to the surgeon's perception that operating on obese patients is confounded by technical difficulties," write Daniel Dindo, MD, of University Hospital Zurich in Switzerland, and colleagues.

But the study found that operating times did not significantly differ between obese and nonobese patients, which does not support this perception of higher difficulty.

In an editorial that accompanies the study, Edward E. Mason, MD, of the department of surgery at the University of Iowa Hospitals and Clinics, says that more research is needed on long-term complications of surgery on extremely obese patients. Surgical incisions in these patients may lead to giant hernias years after an operation.

Until more is known about these types of lifelong complications, Mason says laparoscopic operations that do not require large incisions are an attractive and more comfortable option for surgery in obese patients.

Nov. 7, 2002 -- Coffee isn't exactly lauded for its nutritional value, but new research shows it could cut your risk of type 2 diabetes in half.

In type 2 diabetes, the body does not adequately respond to the effects of insulin -- the hormone that affects blood sugar level. Eventually this leads to a rise in blood sugar, which over time can cause heart attacks, strokes, kidney failure, and blindness. Type 2 diabetes accounts for more than 90% of diabetes and more commonly occurs in overweight people.

Caffeine is known to decrease the body's response to insulin. However, other ingredients found in coffee -- magnesium and chlorogenic acid -- may have beneficial effects, say the researchers.

To test the overall effect of coffee on type 2 diabetes, researchers followed more than 17,000 Dutch adults. After several years of follow-up, those who drank seven or more cups a day were half as likely to develop type 2 diabetes compared with those who drank less than two cups a day. This held true even after taking other lifestyle factors such as smoking, poor diet, and alcohol into consideration. The study is published in the November issue of The Lancet.

Tea did not appear to have any effect on risk of diabetes. Not enough people in the study drank decaffeinated coffee regularly to determine if the effects would be different.

The long-term effects of drinking too much caffeine are not known and other health issues could develop, study leader R.M. van Dam, MSc, says in a news release. More research is needed to determine the effects of long-term coffee drinking on health. The research team is with the department of nutrition and health at Vrije Universiteit in Amsterdam.

Feb. 20, 2002 -- Need to lose weight? You may know you're not alone. What you may not know: you're not bad or crazy, but you need help.

The surest way to lose weight is to eat a little less and exercise more. If you take in just 500 to 1,000 fewer calories than it takes to keep your current weight, you'll lose 5% to 10% of your weight in four to six months. If you add exercise to your new moderate diet, you'll keep the weight off.

Some overweight people can do this. Most can't. That's why weight loss usually doesn't work without help to develop healthy thinking habits, healthy eating habits, and healthy exercise habits.

A minority of people needs something more. For some, surgery is the answer. Others need drug therapy.

The road to weight loss drugs is scattered with failures and frauds. Now, however, researchers are closing in on new drugs that just might do the trick.

A review article by National Institutes of Health researchers Susan Z. Yanovski, MD, and Jack A. Yanovski, MD, PhD, appears in the Feb. 21 issue of The New England Journal of Medicine. It looks at the past, present, and future of weight loss drugs.

An overview of the article follows. Here's the bottom line: weight loss drugs are not the answer for most people. They're only for people who can't lose weight any other way -- even though they've tried -- and whose obesity threatens their health.

No FDA-approved weight loss drug has been tested for more than two years. The drugs usually don't lead to dramatic weight loss -- on average, people lose about 5% of their body weight. And there are side effects. These can be very serious. Never take weight loss drugs without a doctor's supervision.

Where We've Been

Remember fen-phen? Studies published in 1992 revolutionized the field of weight loss research when it showed that this combination of two very different drugs could help people sustain weight loss for as long as three-and-a-half years.

Unfortunately, continued fen-phen treatment turned out to be associated with serious heart disease. The treatment was withdrawn from the market -- but obesity research forever was changed. Doctors began to see obesity not as a moral failure but as a condition they could treat.

"For a minority of obese patients who have substantially increased medical risk and for whom [nondrug] treatments alone prove unsatisfactory, weight-loss medications may be useful adjuncts to behavioral treatments," the Yanovskis write.

Jan. 1, 2001 -- Eggs and bacon for breakfast, tuna fish with mayonnaise -- hold the bread -- for lunch, two hard-boiled eggs for a snack, and a big T-bone steak for dinner. That's a typical meal plan for 27-year-old Stacy Smith, a recent convert to the fad of the moment: the low-carbohydrate diet.

?

The Portland, Ore., resident can eat unlimited amounts of meats and cheeses and other dairy foods, but few vegetables, and no fruits or grains.

?

It's almost too easy. No calorie counting. No portion sizes. Just avoid the "bad" foods, which in this case include things like pasta, bread, apples, and pears.

?

The plan, which proponents say has been adopted by more than 10 million people since the book Dr. Atkins New Diet Revolution first was published in the 1970s and republished in the late 1990s, flies in the face of conventional advice about calorie reduction and balanced nutrition. Copycat plans like Sugar Busters and The Carbohydrate Addict's Diet follow similar principles. By limiting the intake of carbohydrates, the theory goes, the body is forced to turn to stored fuel -- in other words, fat -- into energy, entering a fat-burning state called ketosis.

?

Not everyone is convinced, however. Opponents say that restricting carbohydrate intake isn't a magic formula for fat loss, feeling instead that these plans may leave you lighter in weight but with just as much body fat.

The Low-Carb Shell Game

How can a diet make you lose pounds but not fat? It's all in the way low carbohydrate diets work, says Karin Kratina, MA, RD, a nutrition therapist who specializes in treating weight and eating problems in her private practice located in Gainesville, Fla. She tells WebMD that carbohydrates are broken down into glucose by the body, which in turn either is used immediately for energy or converted into a storage form called glycogen, primarily in the cells of the liver and muscle. Such glycogen is metabolized easily back to glucose, and provides about half of the body's energy supplies daily. Everything from processing a thought to getting from point A to point B requires energy from glycogen, Kratina says.

?

"At any [given] time, we have about 1,200 calories of glycogen on board," she says. And for every gram of glycogen stored, so are three grams of water. Therefore, when carbohydrate intake is restricted and the existing stores of glycogen stores are exhausted, the body sheds the stored water, leading to an impressive water "weight loss" within a few weeks.

?

Once the glycogen is gone, the body does turn to fat as a fuel source. But in reality, fat is an inferior energy source compared to glycogen. It's like trying to run a car on lighter fluid, says John Acquaviva, PhD, assistant professor of physical education at Roanoke College in Salem, Va. "In ketosis, the body does burn a higher percentage of fat, but overall, less calories are burned," he tells WebMD.

System Shutdown

"People need to remember that there are a lot of ways to lose weight, but not all of them are healthy," Acquaviva says. "Starvation is one obvious example." As the body starts to burn stored fat, it creates byproducts called ketones, leading to the state of ketosis.

?

If the determined dieter sticks to the plan despite the unpleasant side effects of this state -- including foul acidic breath, fuzzy thinking, and fatigue -- additional pounds will come off. But like the water loss, it is an illusion. The majority of the loss is muscle, not fat, leaving the dieter with a higher body fat percentage and less lean muscle tissue, Kratina says.

?

Then the carbohydrate cravings kick in, she says. The body seeks to replace the missing glycogen and restore balance. Dieter Stacy Smith knows this feeling all too well.

?

"I'll suddenly crave things like bread, oatmeal, ice cream," she says. "I'll binge, eating three or four bowls of oatmeal at a time." When she does, her body once again stores glycogen and water, leading to a dramatic "weight" gain. The numbers on the scale quickly rise 10 to 15 pounds, reinforcing the idea that carbohydrates are to blame.

?

Smith accepts the label of carbohydrate "addict" and goes back on the plan. It becomes a vicious circle of starve, binge, starve, binge.

Feb. 10, 2005 -- As devastating as illness can be, it doesn't have the power to permanently steal every ounce of happiness. But healthy people sometimes overlook happiness, while their ailing peers are more attuned to it.

That's what Jason Riis and colleagues found in comparing 49 kidney dialysis patients with 49 healthy people. Riis, now research assistant at Princeton University, was a University of Michigan graduate student when he worked on the study.

The kidney patients were just about as happy as healthy participants -- and they were more aware of their own happiness, too.

The Happiness Experiment

The dialysis patients had end-stage renal disease, a chronic condition in which the kidneys don't work properly. Most patients need dialysis sessions three times per week. Each session lasts three hours. Patients can often participate in normal activities, but they usually have a strict diet and can feel tired if they miss treatment for several days, say the researchers.

Each patient had been on dialysis for at least three months. They were compared with healthy people of the same age and gender. All were given personal digital assistants (PDAs) such as Palm Pilots to carry for seven days.

The PDAs beeped at random times throughout the day, quizzing participants about their feelings at that moment. The goal was to create a series of emotional snapshots.

Participants also imagined themselves in someone else's shoes. Healthy subjects predicted how they would feel if they needed dialysis. Kidney patients had the reverse question, pondering how freedom from dialysis and kidney problems would affect their mood.

Estimating Happiness

The kidney patients weren't any unhappier than the healthy people.

"They do not appear to be much, if at all, less happy than people who do not suffer from kidney disease or from any other serious health condition," write the researchers in The Journal of Experimental Psychology.

What's more, healthy people slightly understated their moods, shortchanging their happiness.

The dialysis patients didn't do that. Their happiness estimates were right on track. Apparently, they had largely adapted to their condition, say the researchers.

The kidney patients weren't deluded. They knew their condition was much worse than that of healthy people. But they didn't seem to be exaggerating their moods, say Riis and colleagues.

Grass Greener ... or Not?

The dialysis patients seemed unaware of how well they had adjusted. "They believe they would be happier if they had never been sick, yet they appear to be incorrect in this belief, as they are already about as happy as healthy people," say the researchers.

Healthy people also misjudged the emotional impact of illness. They imagined that dialysis would wreck their moods much more than it did for the real-life kidney patients.

"Healthy people expect dialysis to lead to a much more miserable life than it, in fact, does," say the researchers. "But this misperception will be a difficult one to correct. Even dialysis patients, who have themselves experienced adaptation, seem not to appreciate the extent of their own adaptation."

Misguided Consequences

The study isn't saying that a chronic condition is a light burden. Instead, it shows the potential to adapt emotionally, given time and experience.

Healthy people might want to keep that in mind, should they ever need to make important medical decisions for themselves, say the researchers. "For most of us, it would take a lot more than we think to make us permanently miserable," they write.

Nov. 7, 2002 -- Coffee isn't exactly lauded for its nutritional value, but new research shows it could cut your risk of type 2 diabetes in half.

In type 2 diabetes, the body does not adequately respond to the effects of insulin -- the hormone that affects blood sugar level. Eventually this leads to a rise in blood sugar, which over time can cause heart attacks, strokes, kidney failure, and blindness. Type 2 diabetes accounts for more than 90% of diabetes and more commonly occurs in overweight people.

Caffeine is known to decrease the body's response to insulin. However, other ingredients found in coffee -- magnesium and chlorogenic acid -- may have beneficial effects, say the researchers.

To test the overall effect of coffee on type 2 diabetes, researchers followed more than 17,000 Dutch adults. After several years of follow-up, those who drank seven or more cups a day were half as likely to develop type 2 diabetes compared with those who drank less than two cups a day. This held true even after taking other lifestyle factors such as smoking, poor diet, and alcohol into consideration. The study is published in the November issue of The Lancet.

Tea did not appear to have any effect on risk of diabetes. Not enough people in the study drank decaffeinated coffee regularly to determine if the effects would be different.

The long-term effects of drinking too much caffeine are not known and other health issues could develop, study leader R.M. van Dam, MSc, says in a news release. More research is needed to determine the effects of long-term coffee drinking on health. The research team is with the department of nutrition and health at Vrije Universiteit in Amsterdam.

Feb. 20, 2002 -- Need to lose weight? You may know you're not alone. What you may not know: you're not bad or crazy, but you need help.

The surest way to lose weight is to eat a little less and exercise more. If you take in just 500 to 1,000 fewer calories than it takes to keep your current weight, you'll lose 5% to 10% of your weight in four to six months. If you add exercise to your new moderate diet, you'll keep the weight off.

Some overweight people can do this. Most can't. That's why weight loss usually doesn't work without help to develop healthy thinking habits, healthy eating habits, and healthy exercise habits.

A minority of people needs something more. For some, surgery is the answer. Others need drug therapy.

The road to weight loss drugs is scattered with failures and frauds. Now, however, researchers are closing in on new drugs that just might do the trick.

A review article by National Institutes of Health researchers Susan Z. Yanovski, MD, and Jack A. Yanovski, MD, PhD, appears in the Feb. 21 issue of The New England Journal of Medicine. It looks at the past, present, and future of weight loss drugs.

An overview of the article follows. Here's the bottom line: weight loss drugs are not the answer for most people. They're only for people who can't lose weight any other way -- even though they've tried -- and whose obesity threatens their health.

No FDA-approved weight loss drug has been tested for more than two years. The drugs usually don't lead to dramatic weight loss -- on average, people lose about 5% of their body weight. And there are side effects. These can be very serious. Never take weight loss drugs without a doctor's supervision.

Where We've Been

Remember fen-phen? Studies published in 1992 revolutionized the field of weight loss research when it showed that this combination of two very different drugs could help people sustain weight loss for as long as three-and-a-half years.

Unfortunately, continued fen-phen treatment turned out to be associated with serious heart disease. The treatment was withdrawn from the market -- but obesity research forever was changed. Doctors began to see obesity not as a moral failure but as a condition they could treat.

"For a minority of obese patients who have substantially increased medical risk and for whom [nondrug] treatments alone prove unsatisfactory, weight-loss medications may be useful adjuncts to behavioral treatments," the Yanovskis write.

March 15, 2004 -- A powerful antioxidant found in green tea may be responsible for the beverage's heralded anticancer benefits.

New research shows that the antioxidant, known as EGCG, binds to a protein found on tumor cells and dramatically slows their growth.

Researchers say previous studies have shown that green tea helps protect against a variety of cancers, such as lung, prostate, and breast, but the mechanisms for these effects are not known.

In the study, published in the April issue of Nature Structural & Molecular Biology, researchers identified a potential target for the antitumor action of EGCG on human lung cancer cells that inhibited cancer cells' growth. By learning more about this target, researcher may be able to develop new treatments that maximize green tea's cancer-fighting potential.

Explaining Green Tea's Anticancer Benefits

In order to better understand how the antioxidants found in green tea may protect against cancer, researchers looked at how they affected a protein found on the surface of cancer cells called laminin receptor.

The study showed that when cancer cells with this protein were treated with polyphenol EGCG, the growth of the tumor cells was significantly reduced.

Researchers say the concentration of the antioxidant required to produce these anticancer effects was equivalent to those found in the body after drinking only two to three cups of green tea.

Other components found in green tea, including caffeine, had no effect on tumor cell growth.

Researchers say the results further the understanding of how antioxidants interact with cancer cells and may one day lead to more effective cancer therapies that use green tea as a dietary cancer treatment.

Jan. 1, 2001 -- Eggs and bacon for breakfast, tuna fish with mayonnaise -- hold the bread -- for lunch, two hard-boiled eggs for a snack, and a big T-bone steak for dinner. That's a typical meal plan for 27-year-old Stacy Smith, a recent convert to the fad of the moment: the low-carbohydrate diet.

?

The Portland, Ore., resident can eat unlimited amounts of meats and cheeses and other dairy foods, but few vegetables, and no fruits or grains.

?

It's almost too easy. No calorie counting. No portion sizes. Just avoid the "bad" foods, which in this case include things like pasta, bread, apples, and pears.

?

The plan, which proponents say has been adopted by more than 10 million people since the book Dr. Atkins New Diet Revolution first was published in the 1970s and republished in the late 1990s, flies in the face of conventional advice about calorie reduction and balanced nutrition. Copycat plans like Sugar Busters and The Carbohydrate Addict's Diet follow similar principles. By limiting the intake of carbohydrates, the theory goes, the body is forced to turn to stored fuel -- in other words, fat -- into energy, entering a fat-burning state called ketosis.

?

Not everyone is convinced, however. Opponents say that restricting carbohydrate intake isn't a magic formula for fat loss, feeling instead that these plans may leave you lighter in weight but with just as much body fat.

The Low-Carb Shell Game

How can a diet make you lose pounds but not fat? It's all in the way low carbohydrate diets work, says Karin Kratina, MA, RD, a nutrition therapist who specializes in treating weight and eating problems in her private practice located in Gainesville, Fla. She tells WebMD that carbohydrates are broken down into glucose by the body, which in turn either is used immediately for energy or converted into a storage form called glycogen, primarily in the cells of the liver and muscle. Such glycogen is metabolized easily back to glucose, and provides about half of the body's energy supplies daily. Everything from processing a thought to getting from point A to point B requires energy from glycogen, Kratina says.

?

"At any [given] time, we have about 1,200 calories of glycogen on board," she says. And for every gram of glycogen stored, so are three grams of water. Therefore, when carbohydrate intake is restricted and the existing stores of glycogen stores are exhausted, the body sheds the stored water, leading to an impressive water "weight loss" within a few weeks.

?

Once the glycogen is gone, the body does turn to fat as a fuel source. But in reality, fat is an inferior energy source compared to glycogen. It's like trying to run a car on lighter fluid, says John Acquaviva, PhD, assistant professor of physical education at Roanoke College in Salem, Va. "In ketosis, the body does burn a higher percentage of fat, but overall, less calories are burned," he tells WebMD.

System Shutdown

"People need to remember that there are a lot of ways to lose weight, but not all of them are healthy," Acquaviva says. "Starvation is one obvious example." As the body starts to burn stored fat, it creates byproducts called ketones, leading to the state of ketosis.

?

If the determined dieter sticks to the plan despite the unpleasant side effects of this state -- including foul acidic breath, fuzzy thinking, and fatigue -- additional pounds will come off. But like the water loss, it is an illusion. The majority of the loss is muscle, not fat, leaving the dieter with a higher body fat percentage and less lean muscle tissue, Kratina says.

?

Then the carbohydrate cravings kick in, she says. The body seeks to replace the missing glycogen and restore balance. Dieter Stacy Smith knows this feeling all too well.

?

"I'll suddenly crave things like bread, oatmeal, ice cream," she says. "I'll binge, eating three or four bowls of oatmeal at a time." When she does, her body once again stores glycogen and water, leading to a dramatic "weight" gain. The numbers on the scale quickly rise 10 to 15 pounds, reinforcing the idea that carbohydrates are to blame.

?

Smith accepts the label of carbohydrate "addict" and goes back on the plan. It becomes a vicious circle of starve, binge, starve, binge.

June 12, 2003 -- People who are obese are no more likely to suffer from complications after general surgery than others, according to a new study. Researchers say the findings challenge the widely held notion among doctors that obesity itself raises the risk of complications following surgery.

One in five Americans is now considered obese. But researchers say although obesity increases the risk of serious health problems, such as diabetes and heart disease, "forcing obese patients to lose weight before surgery or to exclude obese patients from elective general surgery is not supported by our data."

The study, which appears in the June 14 issue of The Lancet, compared the prevalence of complications after surgery among 6,336 patients who underwent general elective surgeries at a hospital in Switzerland. Thirteen percent of the patients were obese, with a body mass index (BMI, a number that shows your weight adjusted for height) of more than 30, including 4% who were severely obese with a BMI over 35.

With the exception of a slight increase (4% vs. 3%) in the incidence of wound infections after an open surgery, the study found the risk of complications did not differ significantly between obese and nonobese patients.

Researchers say the higher risk of infection after open surgery in which a large incision is made might be related to the presence of excessive fat tissue, which may slow wound healing and raise the risk of infection.

But a growing number of elective surgeries, including those that are increasingly popular among obese people, such as gastric bypass procedures, are now performed laproscopically -- using several small incisions rather than one large one. Laproscopic procedures reduce the risk of infection at the surgical site.

Surgery on Obese People Isn't More Difficult

"The prejudice that obese patients face a higher risk for postoperative complications might also be related to the surgeon's perception that operating on obese patients is confounded by technical difficulties," write Daniel Dindo, MD, of University Hospital Zurich in Switzerland, and colleagues.

But the study found that operating times did not significantly differ between obese and nonobese patients, which does not support this perception of higher difficulty.

In an editorial that accompanies the study, Edward E. Mason, MD, of the department of surgery at the University of Iowa Hospitals and Clinics, says that more research is needed on long-term complications of surgery on extremely obese patients. Surgical incisions in these patients may lead to giant hernias years after an operation.

Until more is known about these types of lifelong complications, Mason says laparoscopic operations that do not require large incisions are an attractive and more comfortable option for surgery in obese patients.

Nov. 7, 2002 -- Coffee isn't exactly lauded for its nutritional value, but new research shows it could cut your risk of type 2 diabetes in half.

In type 2 diabetes, the body does not adequately respond to the effects of insulin -- the hormone that affects blood sugar level. Eventually this leads to a rise in blood sugar, which over time can cause heart attacks, strokes, kidney failure, and blindness. Type 2 diabetes accounts for more than 90% of diabetes and more commonly occurs in overweight people.

Caffeine is known to decrease the body's response to insulin. However, other ingredients found in coffee -- magnesium and chlorogenic acid -- may have beneficial effects, say the researchers.

To test the overall effect of coffee on type 2 diabetes, researchers followed more than 17,000 Dutch adults. After several years of follow-up, those who drank seven or more cups a day were half as likely to develop type 2 diabetes compared with those who drank less than two cups a day. This held true even after taking other lifestyle factors such as smoking, poor diet, and alcohol into consideration. The study is published in the November issue of The Lancet.

Tea did not appear to have any effect on risk of diabetes. Not enough people in the study drank decaffeinated coffee regularly to determine if the effects would be different.

The long-term effects of drinking too much caffeine are not known and other health issues could develop, study leader R.M. van Dam, MSc, says in a news release. More research is needed to determine the effects of long-term coffee drinking on health. The research team is with the department of nutrition and health at Vrije Universiteit in Amsterdam.

The belt has to go up a notch; your underwear elastic is forming a geometric pattern on your waist; the dryer seems to be shrinking everything. It's weight gain! ?

And if you're like many folks, the scale can tip as much as 10 pounds before you even realize it's happening.

"Some people gain weight any time there is a change in their normal routine. Whatever they are doing just isn't allowing them to eat the way they did before, so the extra pounds start to creep up," says Susan Kraus, MS, RD, a clinical nutritionist at Hackensack University Medical Center in New Jersey.

But whether it's the result of overdoing restaurant dinners, a few too many laps around the cruise ship pastry table, or because you've been sidelined with a fitness injury, if you eat more or move less, weight gain will result.??

And, experts say, if you don't lose those extra pounds right away, you could be in for an even bigger surprise down the road.

"People wonder how they gained 50 pounds between age 20 and age 50. But if you add just two or three pounds a year, every year -- there are those extra pounds, and you don't even realize how it happened," Kraus tells WebMD.?

Another point in favor of catching that weight gain early? The longer you keep it on, the harder it is to take it off.

"The longer you are at a certain weight, the greater chance your body will perceive that weight as normal -- so when you try to diet it's going to perceive that as abnormal and send signals to correct it, like hunger and cravings," says Robert Yanagisawa, MD, director of the Weight Management Program at Mt. Sinai School of Medicine in New York.?

Even if your weight gain doesn't spiral out of control, sometimes adding just five or 10 extra pounds is enough to put your health at risk, Yanagisawa says.

"It all depends on where you are at when you gain the weight," he says. "If your BMI (body mass index) is already high; if you have high blood pressure, or diabetes, for example; if the gain causes a jump in your waist size; then even a small amount of extra weight could jeopardize your health."

Checking Weight Gain: Where to Start

If you've had a break in your normal eating routine -- because of the holiday season or a vacation, for example -- you may only need to return to your previous eating habits to lose the extra weight, Yanagisawa says.

"You may not even have to diet, per se, but if you just start eating like you did before you gained the weight and if you do it right away, you might be able to drop those extra pounds without too much trouble," says Yanagisawa.

At the same time, he cautions, this might not be as easy as it sounds.

"Once you've been overeating for several weeks it's easy to say, 'What's one more cookie or one more piece of chocolate?' ?When you're in the mindset of eating more, it's easy to keep eating more and not return to how you ate before you gained the weight," he says.

If you find this is the case for you, a more formal diet may be necessary, even for just a few weeks.

"Some people just need the mindset of being on a diet in order to stick with an eating plan," he says.

When choosing a diet, says weight management expert Abby Aronowitz, PhD, look for one that's balanced, but focuses on a lower calorie intake than what you have been eating.

"The most important tool for weight loss isn't the foods you eat, but that you burn up more calories than you have taken in," she says.

Aronowitz suggests taking pen to paper and figuring out how many calories you were eating before you gained the weight, then choosing an eating plan that falls a little below that number.Checking Weight Gain: Where to Start

March 15, 2004 -- A powerful antioxidant found in green tea may be responsible for the beverage's heralded anticancer benefits.

New research shows that the antioxidant, known as EGCG, binds to a protein found on tumor cells and dramatically slows their growth.

Researchers say previous studies have shown that green tea helps protect against a variety of cancers, such as lung, prostate, and breast, but the mechanisms for these effects are not known.

In the study, published in the April issue of Nature Structural & Molecular Biology, researchers identified a potential target for the antitumor action of EGCG on human lung cancer cells that inhibited cancer cells' growth. By learning more about this target, researcher may be able to develop new treatments that maximize green tea's cancer-fighting potential.

Explaining Green Tea's Anticancer Benefits

In order to better understand how the antioxidants found in green tea may protect against cancer, researchers looked at how they affected a protein found on the surface of cancer cells called laminin receptor.

The study showed that when cancer cells with this protein were treated with polyphenol EGCG, the growth of the tumor cells was significantly reduced.

Researchers say the concentration of the antioxidant required to produce these anticancer effects was equivalent to those found in the body after drinking only two to three cups of green tea.

Other components found in green tea, including caffeine, had no effect on tumor cell growth.

Researchers say the results further the understanding of how antioxidants interact with cancer cells and may one day lead to more effective cancer therapies that use green tea as a dietary cancer treatment.

Dec. 1, 1999 (Baltimore) -- First-time mothers don't need to worry that instruments possibly being used during delivery will injure their infants, according to a study published in the Dec. 2 issue of TheNew EnglandJournal of Medicine. "In spite of reports in the popular media showing injured babies from the use of vacuum extractors or forceps, our study shows that they are safe," says Dena Towner, MD, assistant professor of obstetrics at the University of California, Davis, and lead author of the study, in an interview with WebMD. "Of course experience counts, but in the right hands I think they're very appropriate instruments."

This study analyzed data from the births of over 583,000 infants in California from 1992 to 1994. All the babies were born to first-time mothers and were of average weight. Several possible injuries to the infants were looked for, from scalp injury to the most serious one, called intracranial hemorrhage, or bleeding inside the baby's skull.

"We found that the rate of intracranial hemorrhage among infants where either forceps or vacuum extractors were used was the same as that when a cesarean section was done after the mother had been in labor," says Towner. "What this seems to suggest is that when injury occurs, it may be due to a problem during labor itself, not to the use of instruments. If the problem was the instruments, we would have expected the rate of injury following cesarean section to be much lower."

Another very important finding in the study was that more babies were injured when both forceps and vacuum extractors were used one after another, says Thomas Benedetti, MD, professor of medicine at the University of Washington in Seattle, who wrote an editorial accompanying the study. "This tells us that if one type of instrument has failed, another should not be tried," he says in an interview with WebMD.

Towner concurs, saying, "When one instrument has failed, using another increases the risk to the baby. Perhaps that's because of the possible labor abnormality."

Benedetti says that this study illustrates three levels of risk of injury to the infant associated with birth. "The lowest risk is if you have a spontaneous delivery," he says. "The next level of risk seems to be forceps or vacuum extraction delivery or a cesarean section following labor, and the last is the use of more than one instrument. As a first-time mother, I would be reassured by this paper that instruments used during delivery would not result in a greater likelihood that my infant would be injured."

Vital Information:

• The use of instruments, such as forceps or vacuum extractors, is safe for the babies of first-time mothers.
• When one of the instruments is used, but fails, a second type of instrument should not be used, as this will increase the risk of injury to the child.
• Researchers hypothesize that problems with labor itself, and not the use of instruments, are responsible for injuries, such as intracranial hemorrhage.

Sept. 13, 2006 (Chicago) -- Researchers have identified a protein in the blood present only in people with cancer that may help doctors spot cancer early.

The protein, called tNOX, is the first tumor marker for all cancers ever described, says D. James Morre, PhD, distinguished professor of medicinal chemistry at Purdue University in West Lafayette, Ind.

"If tNOX is present, cancer is present," he tells WebMD. "Presumably, the more there is, the worse the disease."

Putting tNOX to the Test

Normal cells have the NOX enzyme only when they are dividing in response to growth hormone signals. In contrast, cancer cells have NOX activity at all times.

This overactive form of NOX, known as tNOX -- for tumor-associated NOX -- has long been thought to be vital for the growth of cancer cells because drugs that inhibit tNOX activity also block tumor cell growth.

In two new studies presented here at a meeting of the American Association for Cancer Research, Morre and colleagues put the protein to the test.

It passed with flying colors, he says.

Test Predicts Prostate Cancer Progression

The first study involved 19 men with advanced metastatic prostate cancer.

The researchers found that the nine men whose prostate cancer continued to progress -- based on their PSA levels, a blood test elevated in most men with prostate cancer -- had 60% more tNOX in their blood compared with the 10 men with stable or falling PSA levels.

"It's the first demonstration that we have, assuming that PSA levels indicate major tumor burden in some fashion, that there is a really good correlation between tNOX levels and response to therapy," Morre says.

He believes the test will be even more useful than PSA. The reason: A man can have high PSA levels and not have cancer. The tNOX enzyme, on the other hand, is only present if there is cancer.

Test Spots Lung Cancer

The second study looked at tNOX levels in 421 volunteers, including people with lung cancer, smokers who had not been diagnosed with lung cancer, and healthy individuals.

Among the 104 people with lung cancer, 103 tested positive for tNOX. In smokers older than 40, 12% were positive, which Moore says is about the normal rate of lung cancer picked up with high resolution CT scanning.

But, in contrast, none of the 25 healthy people tested positive.

Morre says he envisions using a tNOX test as a screening tool for the early detection of lung cancer in high-risk people. Currently, there is no test able to reliably diagnose lung cancer early, when it is most treatable.

"All heavy smokers over age 50 should be tested for tNOX," he tells WebMD. Those who test positive would then be followed up with a medical examination and further tests.

A weak signal would indicate early cancer at a stage where it is potentially curable, he adds.

tNOX May be Useful in Other Cancers, Too

The next step is to look at tNOX levels in people with other types of cancer, the researchers say.

Lorraine O'Driscoll, PhD, a cancer researcher at Dublin City University in Ireland, says that while the test could be extremely useful, she imagines tNOX will be used as part of a panel of markers to detect cancer and monitor its progression.

"There are so many potential candidates out there that I doubt any one will prove to be the one answer," she tells WebMD. "Rather, we will probably use a combination of markers and tNOX could certainly prove to be one of them."

As the hot, humid days of summer give way to cool autumn breezes, most folks breathe a sigh of relief. But this may not be the case if you suffer from psoriasis -- a chronic condition affecting the skin and joints of upwards of 4.5 million adults, as well as many children.

Indeed, as fall ushers in colder, drier air, psoriasis can worsen -- sometimes inviting more of the dry, scaly, itchy red patches associated with this condition to develop.

"The lack of humidity in the air allows the skin to retain moisture less well, and when that occurs, tiny cracks or fissures can develop on the surface of the skin," says Bruce Strober, MD, director of the Psoriasis and Psoriatic Arthritis Center at NYU Medical Center in New York City.

Psoriasis most commonly appears on the scalp, knees, elbows, and torso but can develop more readily in areas where skin is traumatized or "broken." Strober says anything that causes that to happen -- like cool, dry air -- can also exacerbate the disease.

According to the National Psoriasis Foundation, this irritating skin condition comes in several different forms with varying levels of severity. In nearly all cases, however, it begins when the normal system of cell turnover goes awry.

"Normally the top layer of skin makes itself over every 28 to 30 days -- the old cells are microscopically shed, while the new ones take their place," says Mark Lebwohl, MD, PhD, chairman of the department of dermatology at the Mt. Sinai Medical Center in New York City. In psoriasis, however, Lebwohl says that this natural process is sped up dramatically.

"In psoriasis, cells turn over as quickly as every two to three days," says Lebwohl.

The old cells don't shed off normally and new cells multiply so quickly they stick together and form lesions called patches or plaques. In the most common form of this condition, the end result can be dry, scaly, red, and sometimes itchy patches of skin. And the drier your skin gets, the worse the patches can look -- and feel.

The good news: Judicious use of moisturizer can make a huge difference -- particularly as the seasons change. Not only can this help keep tiny cracks in the skin from forming, it can also help the dry patches already there look and feel better.

"Continued use of a good penetrating moisturizer, as well a bath oil, is absolutely vital to controlling psoriasis in any weather, but particularly during dry, cold weather," says Milton Moore, MD, assistant professor of dermatology at the Baylor College of Medicine in Houston.

In fact, getting moisture deep into the skin is so important that Moore used his degrees in pharmacy and medicine to develop a patent-pending pretreatment lotion known as "Hydroglide Pre Application Lotion." When applied to psoriatic plaques first, he says, studies presented before the American Academy of Dermatology showed it can help almost any moisturizer or topical medication penetrate more deeply.

Other doctors say any bland but greasy moisturizer will work it's way into the skin as well, as long as you apply a lot of it and use it often, particularly after bathing.

June 15, 2006 -- Girls with an older boyfriend at a young age may be more likely to have sex by ninth grade.

And those with a serious boyfriend by seventh grade are also more likely to have had sex two grades later.

So says a study in June's issue of Perspectives on Sexual and Reproductive Health. Researchers included Barbara Marin, PhD, a consultant at the CDC's violence prevention division.

In their study, Marin and colleagues found that seventh grade girls who have had a serious boyfriend their own age are three times as likely to have sex by ninth grade as their less precocious classmates.

What's more, girls who'd had an older boyfriend by seventh grade were twice as likely to have had sex by ninth grade as those who'd had a same-age boyfriend by seventh grade.

'Cause for Concern'

So, the researchers want parents to take young love seriously. The findings suggest that "any 'serious' relationship in seventh grade should be cause for concern," they write.

And older boyfriends are of special concern. "Parents should be warned of the risks of interactions between middle-school females and older boyfriends, even when those boyfriends are only two years older," they write.

"Programs and parents need to find creative ways to address the risks of having an older boyfriend without making such activities appear more attractive than they already are," Marin's team continues.

About the Study

Marin's study included more than 2,200 middle-school students (1,070 boys and nearly 1,200 girls) in Northern California.

From grades six-nine, the students took annual surveys on topics including relationships and sex. The surveys varied a bit from year to year.

The sixth-grade survey asked girls if their menstrual periods had started. The researchers used that information as a marker of puberty. They didn't have a benchmark for boys' sexual maturity.

The seventh-grade survey included these questions:

• Have you ever had a serious boyfriend or girlfriend?
• How old was your oldest serious boyfriend or girlfriend?

The word "serious" didn't mean just sexual relationships. In fact, all the seventh-graders in Marin's study said they had never had sex.

Early 'Serious' Relationships

And, "In seventh grade, about half of both males and females reported never having had a serious boyfriend or girlfriend," the researchers write.

That means about half the students had had what they considered a serious relationship.

Most of those students reported having relationships with people their own age. Of the boys who'd had a serious girlfriend, 47% said their girlfriend was their age. Among girls who'd had a serious boyfriend, 31% said their boyfriend was their age.

When there was an age difference, girls were more likely to be the younger person. Eighteen percent of girls reported having had a boyfriend at least two years older than they were. About 6% of the boys reported having a girlfriend that much older than they.

Sex by 9th Grade

In the ninth-grade survey, students were asked, "Have you had sex in the last 12 months?" defining sex as a "man's penis in woman's vagina."

Most students answered "no" to that question. But those who had had a serious relationship by seventh grade were more likely to report having sex in the year leading up to the survey.

"One in 10 males and females who reported no relationship in seventh grade said that they had had sex in the 12 months before the ninth-grade interview, compared with at least one in five who reported in seventh grade having had a same-age or older girlfriend or boyfriend," write Marin and colleagues.

The survey didn't ask students to identify their sexual partner or that partner's age. So the researchers don't know exactly when, or with whom, students started having sex.

Boys, Girls & Age

Among boys, those with a serious girlfriend by seventh grade were twice as likely to have had sex in the year before the ninth-grade survey -- compared with the girls, who were three times as likely.

And while girls with a serious older boyfriend by seventh grade were twice as likely to have had sex as those who'd had a same-age boyfriend, no such pattern was seen between boys and older girlfriends. However, those couples were rare, which might make it hard to spot trends in that group.

Physical & Emotional Maturity

Girls who hit puberty early (menstrual periods by sixth grade) were more likely to have an older boyfriend by seventh grade.

"This finding is of concern because young females are experiencing menarche (the start of menstrual periods) at increasingly early ages," the researchers write.

They add that since physical maturity doesn't always come with emotional maturity, girls who start puberty early may need advice about handling sexual attention, especially from older boys.

Dec. 23, 2003 -- Time spent in sports keeps kids from getting sick -- and it melts body fat, all of which improves children's health, a new study shows.

It's another reason to get children away from computers and TV, and send them outside for exercise.

Habitual physical activity of more than three hours a day gives children the best defense against infections such as colds and flu, writes researcher Thomas J. Cieslak, with Brock University in Ontario, Canada. His study appears in the current Journal of Applied Physiology.

Exercise has positive impact on the immune system, the body's defense against infection, writes Cieslak. Studies show that moderate exercise and physical activity enhance immunity and reduce the rates of upper respiratory infections such as colds. . Moreover, stress and obesity suppress the immune system -- although studies have mostly looked at this in adults, he explains.

"It has long been suspected that the younger the individual, the less effective the immune defense," writes Cieslak. However, a child's immunity is still developing until the ages of 9 to 11, he says. Also, studies of children's health and immunity haven't taken into account diet, climate, and living in densely populated areas.

Effects of the child's physical activity level have also not been studied. However, one recent study found that teens that spend less time in sports activities have more colds and flu, writes Cieslak.

Canadian Fifth Graders Tell the Tale

In this study, Cieslak looked at immunity, physical fitness levels, stress levels, and body fat in a group of fifth graders -- all 10 and 11 years old -- while they were in school from May through June. This is a moderate to high infection season in Canada.

Researchers found that 22% of boys reported getting less than three hours physical activity daily, compared with 32% of girls.

Also, children's health was affected:

• Children getting less than three hours a day had significantly lowered immune system, more body fat, and reported more sick days than more fit and active children.
• 40% of these less-active children had more than 25% body fat; they also reported more colds and flu than other kids.

The results mirror findings in studies of teens and adults -- that less activity increases susceptibility to infections. "The results of the present study suggest that this may also be true in children," writes Cieslak.

Child's Immune System Complex

However, because a child's immune system is more complex, other factors such as time of day or year -- or whether they're in school or not -- could also affect their immune systems, he says. Winter or colder temperatures may lower a child's immunity.

In fact, physical activity may play a greater role than stress in a child's immunity. Other studies point to different effects from exercise and stress on immunity, he explains.

Nevertheless, the study shows that children who spend more time in sports and other high-aerobic activities report fewer sick days, he says. And obese kids have many more sick days. Parents who want to improve children's health must get them involved in regular physical activity.

SOURCE: Cieslak, T. Journal of Applied Physiology, December 2003; vol 95: pp 2315-2320.

Oct. 7, 2005 -- Emotional or behavioral problems may make it more difficult for children to get the health care they need. The consequences may have disrupting effects on the entire family, according to a new report.

CDC researchers found that children with chronic emotional, behavioral, or developmental problems, including attention deficit hyperactivity disorder (ADHD) and learning disabilities, have more difficulty finding and receiving the health care they need than children with chronic medical conditions like diabetes with reported emotional, behavioral, or developmental problems.

Researchers say overall about 13% of American children have special health care needs. Of those included in this study, about 4% of all children were reported by parents as suffering from emotional, behavioral, or developmental problems compared with about 29% of children with special health care needs.

Compared with children with other chronic medical conditions, the study shows that children with emotional or behavioral health issues were more than twice as likely to be affected by their conditions and these conditions often created financial problems at home.

Children's Mental Health Problems Have Wide Effect

In the study, researchers analyzed information from a 2001 survey of the parents or guardians of nearly 40,000 children with special heath care needs.

Of children with reported emotional, behavioral, or developmental problems, the most commonly reported conditions were attention deficit disorder (ADD) or ADHD (53.5%), a learning disability (51.7%), anxiety or depression problems (43.5%), and autism (6.8%).

The study showed that compared with other children with special health care needs, children with these problems were more likely to have:

• Health conditions that affected their daily activities
• Missed 11 or more days of school in the last year
• No or inadequate health insurance
• Unmet needs for health care services
• Difficulty getting health care referrals
• More than $1,000 in annual out-of-pocket medical expenses

In addition, family members of children with emotional, behavioral, and developmental problems were more likely to have:

• Experienced financial problems related to the child's health
• Reduced work hours or stopped working to care for the child
• Spent 11 or more hours per week providing or coordinating health care for the child

Researchers say the results show that a child's mental health problems can have a ripple effect on the health and welfare of the child and his or her family.

Feb. 1, 2005 -- Children with Down syndrome are more likely to get leukemia. But they also respond better to treatment. Now scientists know why.

For children with Down syndrome, leukemia treatment is more successful than for other kids. It's likely due to a genetic mutation found only in Down syndrome children, new research shows. However, the same mutation also increases the kids' leukemia risk.

The study appears in this week's edition of the Journal of the National Cancer Institute.

Children's cancer researchers have consistently reported the pattern. A specific type of acute myeloid leukemia (AML) called acute megakaryocytic leukemia (AMkL) is the most common type of AML in young children with Down syndrome.

Following chemotherapy treatments, Down syndrome kids fare better than other kids treated for AMkL.

The Down syndrome children have substantially higher survival rates and lower relapse rates than the other kids, writes lead researcher Yubin Ge, MD, with the Experimental and Clinical Therapeutics Program at the Barbara Ann Karmanos Cancer Institute in Detroit.

Recent studies have identified a genetic mutation in virtually all Down syndrome children who have AMkL. Non-Down syndrome kids with AML don't have this mutation. The mutation, known as the 40-kDa GATA1 protein, may be responsible for the survival difference, he writes.

Ge and his colleagues investigated this mutation in a series of laboratory experiments. They found that the GATA1 mutation seems to contribute to the Down syndrome kids' greater sensitivity to a specific cancer fighting drug, called cytosine arabinoside, which is used in treating AMkL.

Cells with the normal GATA1 protein were 8 to 17 times less sensitive to the chemotherapy drug, reports Ge. They were also 15 to 25 times less sensitive to gemcitabine, another leukemia drug.

Tests of cells taken from 16 newly diagnosed Down syndrome children (including 12 AMkL patients) and 56 non-Down syndrome children with AML showed that 14 of 16 Down syndrome kids had the GATA1 mutation.

This GATA1 mutation is a double-edged sword. It may increase a child's risk for leukemia, but it may also contribute to the high survival and low relapse rates of this unique group of Down syndrome patients, writes Ge.