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Angela and Michael watched with joy as their second child sucked its thumb and kicked up its toes. Their delight was tempered with some disappointment, however, as they couldn't completely see their baby's face.

"My placenta obstructed the view of the head, the forehead, and the eyes," says Angela, who is seven months pregnant. She and her husband went to a private ob-gyn clinic in New Jersey that performs keepsake prenatal ultrasounds.

For $180, the couple was promised four 5X7 photos and a 30-minute videotape of their little one in the womb, set to lullaby music. Plus, since they had a blurry image of the baby's face, they were offered a repeat visit at no charge.

The Souvenir Sonogram Frontier

Hundreds of parents like Michael and Angela have taken advantage of the latest ultrasound technology to get a sneak peek of their unborn children.

Compared to the traditional 2-D images, the 3-D portraits and videos offer much more detail of the fetuses' features, such as the face, fingers, toes, heart, and genitals. They also promise to highlight endearing womb activity such as yawns, winks, kicks, rubbing of noses, and thumb sucking.

Keepsake ultrasounds have become so popular that dozens of sites have opened up nationwide. The centers have names such as Little Sprout Imaging, Baby Insight, Peekaboobaby, and First Look Sonogram.

One company, Fetal Fotos, has branches in 22 states. Another firm, 3DBabyVu, has four locations in the San Francisco Bay Area and claims to perform up to 200 screenings per site each month.

The FDA and several medical organizations such as the American Institute of Ultrasound in Medicine (AIUM) have come out against the so-called entertainment sonograms, citing potential health hazards with non-medically justified ultrasound energy and possible misinterpretation of sonograms by patients and unskilled personnel.

The FDA considers it illegal for anyone to promote, sell, or lease ultrasound equipment for the purpose of making keepsake fetal videos, particularly if there is no medical prescription.

The official disapprovals have apparently not swayed some doctors and patients.

Angela, who had received an attractive brochure in the mail for prenatal portraits, was initially concerned about the controversy. But when she broached the topic with her obstetrician, he told her the ultrasound would probably do no harm to the baby. He warned her, though, that the pictures might not be as good as advertised.

Some prenatal portrait centers claim they first obtain approval from their clients' doctors before performing any ultrasounds. Others take the keepsake images after a limited diagnostic scan or conduct the entertainment screens after hours in doctors' offices.

The diverse makeup of each keepsake ultrasound business makes it difficult for the FDA to take action. In the past, officials have sent warning letters to rule breakers and seized equipment.

The federal government has limited power and staff to stem the growth of keepsake ultrasound entities, however. The agency only has the authority to regulate the sale and distribution of medical devices. Jurisdiction over ultrasound services and behavior of technicians and doctors belong to the individual states.

Nonetheless, because of the increasing number of entertainment ultrasound businesses, the government is currently reviewing its enforcement options.

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.

Aug. 31, 2006 -- Children who are very obese by age 4 may be more likely to have lower IQ scores, a new study shows.

The findings are preliminary, but, "It just raises a red flag," Daniel J. Driscoll, MD, PhD, tells WebMD.

Driscoll is a professor of pediatrics and the John T. and Winifred M. Hayward professor of genetics research at the University of Florida.

He notes "a sense of urgency to really address the obesityobesity problem -- the younger the better.

"It's right to worry about heart diseaseheart disease in 20-30 years, or hypertensionhypertension in 20 years, and diabetesdiabetes in 10 years," Driscoll says. "But there could be consequences now," he says.

Morbidly Obese by Age 4

The study by Driscoll and colleagues appears in The Journal of Pediatrics' August edition.

Driscoll's team studied 18 people who had been morbidly obese by age 4. That means they were more than 150% of the ideal weight for their height.

"We're not talking about a little baby fat," Driscoll says. "We're talking about a very select group."

At the time of the study, participants were 4-22 years old (average age: nearly 11). First, they were screened to make sure their early obesity wasn't due to known genetic disorders.

Next, they got their IQ and cognitive skills tested.

For comparison, 24 of their brothers and sisters who hadn't been obese at an early age were also studied. So were 19 children with Prader-Willi syndrome from other families.

Prader-Willi syndrome is "the most commonly-recognized genetic cause of childhood obesity" and is linked to mental retardation, the researchers write.

IQ Gap

The children with Prader-Willi syndrome and those who had been morbidly obese for unknown reasons by age 4 had the lowest test scores.

Average IQ scores were as follows:

• Prader-Willi syndrome: 63
• Early morbid obesityobesity with unknown cause: 77
• No early morbid obesity: 106

The lower scores are "not in the mentally retarded range but it's cognitively impaired, getting borderline" Driscoll says.

The gap between the morbidly obese children and those of more normal weight was about 25-30 points, Driscoll says, adding that IQ scores varied.

White Spots on Brain

Most participants also got brain scans using magnetic resonance imaging (MRI).

Those who were at least 11 years old and had been morbidly obese by age 4 tended to have spots seen by MRI in different parts of their brains. But their siblings didn't.

Those spots seen on the MRIs aren't fully understood. But they're "not a good thing," Driscoll says.

"We're trying to further investigate that with other techniques," he says.

Similar spots were also seen in the brain scans of Prader-Willi patients who were older than 18.

First Years of Life Crucial

"We're really not talking about older children, someone who gets obese at 12, or 23, or in their 40s or 50s," Driscoll says.

"I mean, there are some really brilliant people" who are obese, he notes. "But that's much different. Their brains are much more fully developed [by the time they become obese]."

The first few years of life are a critical time for brain development.

Very young children "are full of potential, but their brains are very vulnerable," Driscoll says. "We need to be more diligent now."

He and his colleagues aren't sure exactly how extreme obesity at an early age and IQ may be related.

Some children might have an unknown genetic tendency to become obese, Driscoll notes.

Hormonal and metabolic abnormalities linked to obesity might affect the developing brain, but, "We need to do more investigation," says Driscoll.

March 7, 2006 -- Baby walker injuries are way down -- but the walkers should be on the way out, a new study concludes.

Invented some 250 years ago, baby walkers make infants mobile -- too mobile, pediatricians say. From 1990 through 2001, baby walker injuries sent nearly 200,000 U.S. babies to emergency rooms. Three out of four of these babies fell down stairs. Most suffered head wounds. Some died.

In 1994, parents got an alternative: stationary activity centers that let kids bounce and swivel and tip without going anywhere. And in 1997, all U.S. walkers had to meet new design standards. Either they had to be too wide to fit through a standard doorway, or they had to have a braking feature that stops the walker at the edge of a step.

Both strategies worked, find Brenda J. Shields and Gary A. Smith, DrPH, of the Center for Injury Research at Children's Hospital in Columbus, Ohio.

"There was a 76% decrease in the number of infant-walker-related injuries that were treated in U.S. emergency departments from 1990 through 2001, with a marked decrease occurring between 1994 and 2001," Shields and Smith write.

The study appears in the March issue of Pediatrics.

Most New Injuries From Old Baby Walkers

The drop in injuries beginning in 1994 shows that parents were turning away from walkers in favor of stationary activity centers, Shields and Smith say. Until then, there had been some 23,000 baby-walker-related injuries each year.

And after 1997, a lot fewer babies were falling down stairs in their walkers -- suggesting that the design changes had an effect. In fact, most of the recent stairway falls happened with older walkers that did not meet the new standard.

But why take any risk?

"Infant walkers serve no essential purpose," Shields and Smith write. "Infant walkers do not help a child learn to walk, and, in fact, they can delay normal motor and mental development."

The researchers note that Canada now bans baby walkers. Canadian consumers face fines of up to $100,000 or six months in jail if found in possession of a baby walker, they note.

"Therefore, the U.S. government should follow the lead of the Canadian government and ban the sale, importation, and advertisement of mobile infant walkers in the United States to prevent additional infant-walker-related injuries from occurring to young children," Shields and Smith argue.

In this, they have powerful support. The American Academy of Pediatrics continues its call for a baby-walker ban.

Oct. 3, 2005 -- If you want your kids to wear bicycle helmets while biking, you ought to strap on your own helmet and ride with them.

While you're at it, make sure your kids' bike buddies are also wearing helmets, and encourage kids to have a positive attitude about it.

So says a new Canadian study in Pediatrics.

When kids ride bikes, they're much more likely to wear bicycle helmets if they're with helmeted parents or friends, report Patricia Parkin, MD, and colleagues.

Parkin works in the pediatric medicine division of Toronto's Hospital for Sick Children.

Bicycle Helmets Can Save Lives

Head injuries are the No. 1 cause of death in bicycle accidents. Bicycle helmets have been shown to reduce the risk of brain and head injury in bike accidents by 65% to 88%, the researchers note.

Most bike accidents aren't fatal. But every year, about seven out of 1,000 U.S. kids up to age 14 have a bike-related accident. There are about 51 hospital admissions and more than 1,400 emergency room visits for every bicycle-related death, write the researchers.

Still, a lot of people don't wear bike helmets. Just ask Parkin's team.

For nine years, trained observers watched kids aged 5 to 14 biking in Toronto's school yards, parks, and roads. The observers jotted down whether the kids were wearing helmets and if they were biking alone.

Half of the kids were biking on their own. Thirty-six percent were with at least one other child. The rest were with one or more adult.

Biggest Influence: Parental Example

When it came to wearing bike helmets, kids tended to follow adults' lead.

Almost all of the kids -- 95% -- wore helmets when riding with a helmeted adult. But only 41% of the kids wore helmets when riding with a nonhelmeted grown-up.

Peer pressure also mattered, but adults were more influential. Consider this:

• More than 3 out of 4 kids wore bicycle helmets when they rode with other helmeted kids.
• Only about a third of kids wore helmets when riding on their own.
• Even fewer kids (10%) wore helmets when riding with nonhelmeted kids.

Parents can serve as positive role models, and efforts should be made to improve kids' attitudes about wearing bike helmets, the researchers write.

In Denial?

Parents tend to overestimate their kids' use of bike helmets, state Parkin and colleagues, citing past studies.

These tips are based on their report:

• Make sure kids have bike helmets (if you don't have one, you can't wear it).
• Set rules requiring helmets to be worn when bicycling.
• Buy your own bike helmet, and use it every time you ride.
• Know that a biking child is more likely to wear a helmet if his or her friends do, too.
• Encourage kids to have a good attitude about wearing helmets while biking.

Choosing a Helmet

The U.S. Consumer Product Safety Commission (CPSC) offers this advice on choosing a bike helmet:

• Select a helmet that fits snugly and sits flat on the head.
• For children, use the extra padding that comes with the helmet to ensure proper fit.
• The extra padding can be removed from the helmet as the child's head grows.

The CPSC and the National Highway Traffic Safety Administration recommend that bicyclists wear helmets that comply with CPSC standards.

More Bike Safety Tips

Besides wearing a helmet every time you ride, the CPSC's bike safety tips include:

• Make sure your bike is ready to ride and properly adjusted.
• Make sure your wheels are securely fastened.
• Always check brakes before riding.
• Make yourself visible (see and be seen).
• Always be aware of traffic around you.
• Avoid biking at night.
• Stay alert; watch for obstacles in your path.
• Go with the flow of traffic.
• Learn the rules of the road and obey traffic laws.

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.

Jan. 27, 2005 -- Parents should be careful to not expose their infants to people with cough illnesses, says the CDC.

A series of whooping cough outbreaks among health care workers has prompted the CDC to issue a new warning about protecting infants from the potentially deadly illness.

Officials say special care should be taken to avoid exposing infants to anyone with a cough illness. Health care workers should be vigilant in observing precautions to avoid spreading the illness when caring for infected individuals.

The warning comes after an infant in West Virginia died in December after exposure to adult family members with undiagnosed whooping cough.

Whooping cough, known in medical terms as pertussis, is a prolonged respiratory illness that's caused by exposure to Bordetella pertussis bacteria. The illness causes violent coughing, often followed by a "whoop" sound upon inhalation.

A vaccine is available to protect against whooping cough. But young infants are still susceptible to infection until they get the third dose of the vaccine at 6 months of age.

Older children and adults are also at risk for infection if they were not fully vaccinated or have waning immunity. No whooping cough vaccine has been approved for use in adults, but two pharmaceutical companies applied for approval with the FDA in 2004.

Whooping Cough Still a Threat

In their report, published in this week's Morbidity and Mortality Weekly Report, CDC officials also describe three whooping cough outbreaks that occurred in hospitals in Kentucky, Pennsylvania, and Oregon in 2003.

They say the outbreaks illustrate the importance of complying with measures to reduce the risk of infection when evaluating and caring for patients with cough-related illnesses.

For example, in the Kentucky case, a pregnant doctor evaluated an infant with suspected whooping cough daily for five days and did not wear a mask. Thirteen days later, the doctor developed a cough and declined recommended antibiotic treatment as a preventative measure. She was later diagnosed with whooping cough.

Investigators also suspect that the source of whooping cough infection in the infant may have been one of four nurses who had a whooping cough-like illness before caring for the infant.

Researchers say despite high vaccination rates among children, whooping cough has increased from a low of 1,248 cases in 1981 to an annual average of nearly 10,000 cases per year from 1996 to 2001.

During 1996-2004, the majority of whooping cough patients were either children less than 6 months old or over age 7, which is too old to receive a whooping cough vaccine.

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.

April 27, 2004 -- If you're looking at a child who has trouble reading, you're probably looking at a boy.

Children who don't learn to read well tend to have all kinds of problems later in life. However, knowing which children are at risk might get them the help they need before it's too late.

Now it seems that merely being a boy greatly increases the odds of having a reading disability. Michael Rutter, MD, of King's College in London, and colleagues looked at four large studies of children's reading abilities. Their findings appear in the April 28 issue of The Journal of the American Medical Association.

"Reading disabilities are clearly more frequent in boys than in girls," they conclude.

The evidence seems overwhelming. Boys' risk of being in the bottom 15% of readers was:

• 319% more than girls in the Dunedin Multidisciplinary Health and Development Study. This study followed nearly 1,000 children from age 3 on. It tested them at ages 7, 9, and 11.
• 238% more than girls in the Christchurch Health and Development Study. This study looked at 900 children tested at ages 8 to 10.
• 43% more than girls in the Office for National Statistics Study. This study looked at 5,750 children aged 9 to 15.
• 39% more than girls in the Environmental Risk Longitudinal Twin Study. This study looked at 2,165 twin children tested at age 7.

"It appears that throughout the English-speaking world ... boys are more likely than girls to have a reading disability," Rutter and colleagues write.

Why is this so? The researchers don't know. They say it isn't intelligence. Even after accounting for IQ, boys' risk was still higher than girls'. Nor did they find it was the inability to pay attention or hyperactivity.

Rutter and colleagues encourage further study. They say it would be very helpful for boys -- as well as for girls with reading disabilities -- to find out what's going on.

SOURCE: Rutter, M. The Journal of the American Medical Association, April 28, 2004; vol 291: pp 2007-2012.

Jan. 5, 2004 -- When kids eat fast food, they eat more food all day long, a new study shows.

In fact, on any given day, nearly one-third of the nation's children eat fast food -- that includes boys and girls in all racial and ethnic groups, and in all regions of the country.

Over a year's time, a child can pack on 6 extra pounds because of high fast food consumption, writes researcher Shanthy A. Bowman, PhD, with the U.S. Department of Agriculture in Bellsville, Md. Her study appears in this month's issue of Pediatrics.

The fats, sugar, and salt in fast food draw kids like a magnet, largely because they appeal to a child's "primordial tastes," explains Bowman. This taste triggers more eating later in the day. And, because fast food doesn't contain much fiber, kids don't feel full afterward -- so they eat more later.

Large portion sizes served in fast-food restaurants further contribute to overeating and obesity, she notes.

Fast food compromises a child's overall diet because it takes the places of better options, Bowman says. "Children who ate fast food ... consumed more sugar-sweetened beverages, less milk, and fewer fruits and nonstarchy vegetables." These protect against weight gain because they have more fiber, less sugar, and fewer calories.

"The food industry claims their products are not the primary cause of obesity," writes Yale psychologist Kelly D. Brownell, PhD, in an accompanying editorial. "The nation's children deserve protection from damaging forces."

Fast Food Triggers More Eating

More than 6,000 children and adolescents took part in the nationwide study, completing surveys about food they ate during a typical week.

Researchers found that, on a typical day:

• 30% of children ate fast food.
• Fast food was the main food source for 29 to 38% of children.
• Among 4- to 8-year-olds, those who ate fast food ate 6% more food the rest of the day than kids who didn't eat fast food.
• Among 14- to 10-year-olds, fast-food eaters ate 17% more than other kids.
• On average, fast-food eaters ate 15% more calories than other kids.

Researchers also compared each child's diet on fast-food and non-fast-food days. Compared with kids that did not eat fast food, fast food eaters ate an average of 187 more calories a day. Among kids that ate fast food on some days, they ate 126 calories more calories on days when they ate fast food.

"Children and adolescents who ate fast food ... consumed more total and saturated fat, more total carbohydrate and added sugars, less dietary fiber, and more [calories]," writes Bowman.

Fast food seemed to contribute an additional 57 calories a day to the average child's daily diet, she reports.

At that rate, the child would gain 6 pounds each year -- if they didn't get enough exercise to burn it off, she says.

Other studies show similar results, Bowman says. She advocates limiting the marketing of fast food to children.

Efforts are underway to remove "fast food, snack food, and soft drinks from schools, curbing food advertising directed at children, and enhancing opportunities for physical activity," Brownell explains.

Lunch often gets lost in the hustle and bustle of getting kids off to school in the morning. You may prefer to give your child money for lunch rather than pack a midday meal. But it's worth reconsidering bag lunches because they often far healthier than standard cafeteria fare.

To make sure your child actually eats the healthy lunches you provide, try this advice from Hillary Wright, MEd, RD, a Boston-based nutritionist at Harvard Vanguard Medical Associates and the mother of three boys.

Make the Grade With Lunch

"The most nutritious lunches include foods from at least three food groups, but that doesn't mean children must have the traditional sandwich, fruit, and milk for good health," says Wright. As long as youngsters eat a balanced and varied meal, it's perfectly fine to pack hummus, whole-grain crackers, and yogurt or leftovers from last night's dinner every day, as well as sandwiches.

The key is to respect your child's eating style and preferences. Some kids derive comfort from eating the same foods day in and day out while others balk at it. Work with your child, Wright says, and your child is less likely to drop lunch in the playground trash bin.

Get Kids Involved

Allowing children to choose and prepare their own lunch piques interest in the meal and makes it more likely kids will eat their own creations. Let your young child help make lunch the night before school for greater ease in the morning. You can help guide your children to the proper portions and healthy choices of whole grains, protein, and produce. Keep in mind, most elementary school-aged children are allowed a midmorning snack. Account for that when considering the amount of food you provide for lunch.

Make sure you have healthy fare on hand for your child to choose:

• Whole-grain breads or crackers
• Peanut and almond butters
• Light canned tuna fish
• Raw vegetables that can be cut into slices
• Fruits
• Encourage the kids to make sandwiches with whole-grain breads or bagels; tortillas; or colorful wraps. Try different sandwich fillings, such as tabouli mixed with feta cheese in a pita pocket, or a veggie burger.

For even greater buy-in, Wright recommends these simple steps:

• Let your children pick out their own lunchbox.
• Consider insulated lunch bags with room for a small freezer pack that allows you to send foods that must be kept cold, such as dip for fresh vegetables, yogurt, and orange juice.
• Or use larger lunch bags to avoid squishing foods.
• Have on hand small sturdy plastic containers for cut fruit, vegetables, dip, and lunch foods other than sandwiches.

Practical Lunch Tips

A sandwich made with lean meat, light tuna fish, or peanut butter and jelly; fruit or vegetables; and milk or 100% juice is a fine meal for a growing child's lunch. You can boost nutrition and tantalize a child's taste buds by adding shredded carrot, chopped celery, or water chestnuts to egg salad or tuna salad. Combine chopped grapes with diced chicken and mayonnaise for a tasty chicken salad. And don't forget this popular standby: Add a sliced banana or apple to peanut butter sandwiches.

Here are some other yummy and easy lunches that use foods from at least three of the food groups:

• Tortilla wraps with shredded cheese, chopped chicken, and cut vegetables
• Egg salad, whole-wheat bagel, and fruit
• Whole-grain roll with butter or margarine, 2 hard boiled eggs, and carrot sticks
• 8 ounces of low-fat yogurt, whole-wheat crackers, and fruit
• 1-2 tablespoons of peanut butter, whole-grain crackers or bagel, and fruit or vegetables
• 1/2 cup low-fat cottage cheese or hummus, whole-grain crackers, and cherry tomatoes
• Bean-based soup or stew in a thermos, whole-grain roll with butter or margarine, and dried fruit
• 1-2 slices leftover thin crust cheese pizza and fruit or vegetables

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."

Feb. 24, 2005 -- A consumer group has filed suit against the Food and Drug Administration for failing to make good on a 20-year-old promise to consider regulating salt in the food supply.

Americans continue to consume dangerously high levels of salt despite repeated calls from health authorities and experts to reduce the amount of sodium in their diets.

According to the Center for Science in the Public Interest, the watchdog group behind the lawsuit, salt consumption for adults in America has drifted upwards over the past three decades. The group estimates that the daily consumption of salt is near 4,000 mg per day -- nearly twice the recommended amount.

In the U.S., poor diet is linked to many major chronic diseases including heart disease and high blood pressure. The 2005 dietary guidelines, to promote health and disease prevention, recommend the amount of salt be limited to about 1 teaspoon a day -- 2,300 mg. However certain groups -- those with high blood pressure, the elderly, and African-Americans -- should limit their intake even more, to 1,500 mg a day.

The CSPI says that packaged food nutrition labels have failed to reduce Americans' sodium intake to recommended levels, and that cutting the nation's sodium intake could substantially reduce the incidence of health problems associated with high blood pressure.

"Those innocent-looking white crystals are causing tens of thousands of premature deaths every year," Michael F. Jacobson, PhD, the group's executive director, told reporters Thursday.

More than 65 million Americans have hypertension, a major cause of heart disease and stroke, according to federal health statistics. Another 45 million have prehypertension, a risk for heart disease. Excessive sodium intake has been identified as a contributor to high blood pressure, and several federal agencies, including the National Institutes of Health, have issued recommendations urging people to lower their sodium consumption.

A study released in the American Journal of Public Health in 2004 estimated that blood pressure reductions -- attainable by halving individual sodium consumption -- could prevent 150,000 deaths per year.

Jacobson contends that packaged food labeling required by law since 1994 has helped Americans moderate their sodium intake, but that food companies and restaurants continue to have high salt levels that make it difficult for most Americans to meet recommendations.

Restaurants: How Big a Contribution to Salty Diets?

According to the report, processed foods and restaurant foods contribute almost 80% of sodium to the diet. Thousands of processed foods, such as frozen dinners and soups, contain between 500 and 1,000 mg of sodium per serving.

"Considering the ubiquity of salt-laden foods, it's virtually impossible to consume [the recommended amount in a] diet," he says.

Many companies sell prepared food brands with lowered sodium levels, which are often more expensive than regular varieties.

The group issued a report highlighting dozens of foods it says are contributing to overconsumption of salt. For example, a single package of popular Maruchan Ramen Noodles contains 1,400 mg of sodium, more than half the recommended level for younger adults. The report also singles out restaurants, which it says rarely provide nutrition information on menus but use high levels of salt to flavor foods.

"Clearly most companies have not been making an effort, certainly restaurants have not been making an effort," Jacobson says.

Robert Earl, senior director for nutrition policy at the Food Products Association, a lobbying group for the processed food industry, says in an interview that his industry has gradually cut sodium levels over time, even in traditionally high-salt foods such as pretzels and potato chips.

He also says that grocery store packages alert consumers to sodium content and that increasing consumption of fresh fruits and vegetables is a widely known method of cutting sodium consumption.

"The [U.S.] dietary guidelines recommend a food pattern that if Americans were motivated to follow it would reduce their sodium," he says.

Case in Court

CSPI filed a lawsuit Wednesday in federal court, urging a judge to order the FDA to determine whether salt is a safe food additive. The group alleges that the FDA pledged in 1984 to issue conclusions on salt's safety but never completed the review.

Jacobson said that "not a single" FDA scientist is dedicated to reviewing sodium levels in the U.S. food supply, despite the mineral's probable contribution to heart disease and strokes.

"Without the court's intervention, the FDA will almost certainly continue to delay. Because the millions of Americans at risk of hypertension and cardiovascular disease are paying for the FDA's delay with their health, the court should compel FDA to take prompt action," the complaint states.

The FDA "is currently evaluating CSPI's report on salt, including the recommendations," says FDA spokeswoman Kathleen Quinn. She declined to comment on the lawsuit.

?

Matzo-Lemon Sponge Cake

For a smaller cake (with 6 servings) you can cut the recipe in half and line the bottom of a loaf pan with parchment paper to make a pound cake-shaped cake.

8 egg whites
4 egg yolks
1/2 cup lemonade
1 1/2 cups sugar
pinch of salt
grated rind and juice of 1 lemon
1 cup sifted matzo cake meal (in a pinch, grind regular matzo meal for a minute in a food processor, then sift and measure 1 cup)
strawberries (optional)

1. Preheat oven to 350-degrees. Line just the bottom of 10-inch springform pan with parchment or waxed paper (or line the bottom of 2 loaf pans). Beat egg whites until stiff; set aside.
2. Beat egg yolks and lemonade until light. Add sugar and beat for a minute. Add a pinch of salt, the lemon juice and rind, and the matzo cake meal, and beat on low until nicely blended. On low speed, gently beat in the egg whites (or fold in with a spatula)
3. Once well mixed, pour into prepared pan(s) and bake until golden (about 45 minutes for the springform pan or around 20 minutes for loaf pans).
4. Invert pan until cake is cool. Use knife to cut around edges and remove cake from pan. Cut with serrated knife into layers if desired. Serve with strawberries between the layers if desired.

Makes 12 servings

PER SERVING (not including strawberries): 171 calories, 4.5 g protein, 36 g carbohydrate, 1.8 g fat, .5 g saturated fat, 70 mg cholesterol, .5 g fiber, 41 mg sodium. Calories from fat: 9 percent.

Potato Latkes

Serve these hot with applesauce, fat free or light sour cream and chopped green onions if desired. The original recipe called for 3 eggs and 1/2 cup peanut oil, and I used 1 egg, 6 tablespoons egg substitute, and 2 to 3 teaspoons canola oil. I also decreased the salt from 1 1/2 teaspoons to 1 (but you can cut it down further or leave it out if you are cooking for someone on a low sodium diet. These were delicious and real easy to make!

Original recipe contains 121 calories, 7 grams fat, and 63 mg cholesterol per latke.

2 cups peeled and shredded Russet potatoes, firmly packed (about 1 pound)
1/4 cup grated or finely chopped onion
1 large egg
6 tablespoons egg substitute
2-3 tablespoons low sodium matzo meal (a little less than 1 matzo, processed into fine crumbs)
1 teaspoon salt
2 to 3 teaspoons canola oil

1. Place the potatoes in a cheesecloth or double thickness of paper towels and wring to extract as much water out of the potatoes as possible
2. In medium bowl, stir the potatoes, onion, egg, egg substitute and matzo meal and salt together well.
3. In a large heavy-bottomed non stick skillet over medium-high heat, heat the oil until hot. Make sure the oil is spread evenly over the bottom of the skillet. Place 1/4 cup (level measure) of potato mixture into the hot oil, pressing down on them to form 1/4 to 1/2 inch thick patties. Spray tops with canola cooking spray. Brown on one side about 3 minutes, turn over and brown the other side (about 3 minutes).
4. Serve these hot with applesauce, fat free or light sour cream and chopped green onions.

Makes 10 latkes

PER LATKE (if 2 teaspoons of canola used): 71 calories, 3 g protein, 12 g carbohydrate, 1.5 g fat (.2 g saturated fat, .7 g monounsaturated fat, .4 g polyunsaturated fat), 21 mg cholesterol, 1 g fiber, 237 mg sodium. Calories from fat: 19 percent.

Jan. 17, 2007 -- You may not want to put coffee in your sports bottle just yet, but a new study suggests drinking the equivalent of two cups before exercise may reduce postworkout muscle pain by nearly 50%.

Researchers say that's more muscle pain relief than commonly found with pain relievers like aspirin.

"A lot of times what people use for muscle pain is aspirin or ibuprofen, but caffeine seems to work better than those drugs, at least among women whose daily caffeine consumption is low," researcher Patrick O'Connor, of the department of kinesiology at the University of Georgia, Athens, says in a news release.

But caffeine's pain-relieving perks may not apply to those who regularly drink coffee and other beverages containing caffeine. Instead, researchers say caffeine appears to work best in people who don't regularly consume caffeine or exercise.

Therefore, they say, the findings may be most help to people new to exercise -- who also tend to experience the most muscle soreness.

"If you can use caffeine to reduce the pain, it may make it easier to transition from that first week into a much longer exercise program," says researcher Victor Maridakis, of the University of Georgia, in the news release.

Caffeine's Pain-Relieving Perk

In this small study, researchers studied caffeine's effects on postworkout muscle soreness in nine female college students who were not regular caffeine users and did not regularly engage in resistance training. The results appear in The Journal of Pain.

The women received tablets containing either the equivalent of two cups of coffee or a placebo 24 and 48 hours after a resistance-training session designed to produce muscle soreness.

An hour after taking the pills, the women were asked to perform two different exercises using their sore quadricep (thigh) muscles. The results showed that one hour after taking caffeine, the women experienced up to 48% less muscle pain than the placebo group.

In comparison, O'Connor says previous studies of drugs containing naproxen (the active ingredient in Aleve) produced a 30% reduction in muscle soreness, and those using aspirin showed a 25% reduction.

Researchers say more study is needed to examine caffeine's effects on muscle pain.

They recommend that people use caution when using caffeine before a workout. Too much may produce side effects like jitteriness, heart palpitations, and sleep disturbances.

"It can reduce pain," says Maridakis, "but you have to apply some common sense and not go overboard."

Dec. 10, 2004 -- A new gel may someday help speed the recovery of football players, runners, and other athletes who often suffer from painful and slow-healing torn cartilage injuries.

A new animal study shows the experimental gel may have the potential to be more effective and less invasive than currently available treatments. The injectable gel stimulates the formation of new cartilage and may also have the potential to repair worn cartilage damaged by arthritis.

"Using a patient's own cartilage-producing cells, our goal is to place the cells into our new gel and inject them back into the injury site so that cartilage grows where it is needed," says researcher Jason A. Burdick, PhD, a postdoctoral fellow at the Massachusetts Institute of Technology, in a news release. "The gel itself won't initially replace damaged cartilage, but will provide an optimum growth environment for implanted cartilage-producing cells so that new cartilage can be formed and help restore function."

Torn cartilage is a common sports injury that usually occurs as a result of football tackles or other traumatic injury. It usually affects the knee but can affect any joint.

Current treatments for torn cartilage include rest, pain medication, and sometimes invasive repair surgery. But the injury is difficult to treat and involves a long, painful recovery process because cartilage does not regenerate on its own.

New Treatment for Torn Cartilage in the Works

In the study, which appears in an upcoming issue of Biomacromolecules, researchers tested the gel in a small group of mice.

The gel material itself is made of a natural substance known as hyaluronic acid that is combined with light-sensitive molecules.

During the procedure, the injectable liquid is inserted in the affected joint and then exposed to ultraviolet light, which turns the liquid into a gel.

After three months, researchers found the material produced progressively higher amounts of healthy new cartilage in the mice.

Although the results are promising, researchers say it should take at least five years before the gel could be available for treating torn cartilage in humans.

"We would eventually like to make a material that is as strong as cartilage in order to bear the load of the joint immediately after implantation," says Burdick. "But we're not quite there yet."

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.

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.

April 12, 2006 -- You may get more trans fat in chicken nuggets and french fries bought at McDonald's and KFC restaurants in New York City than in France, London, or Russia, doctors report in The New England Journal of Medicine.

In a letter to the journal, Steen Stender, MD, and colleagues show that trans fat levels vary worldwide -- and sometimes within the same country -- for McDonald's and KFC chicken nuggets and french fries.

Stender works at Gentofte University Hospital in Hellerup, Denmark. While traveling for other reasons between November 2004 and September 2005, Stender and colleagues ordered a large serving of french fries (171 grams) and chicken nuggets (160 grams) at McDonald's or KFC restaurants in 43 U.S. and international locations.

The researchers analyzed the foods' total fat and trans fat content.

Tracking Trans Fat

Trans fat, or trans fatty acids (TFA), are fats found in foods such as vegetable shortening, some margarines, and many processed foods made with or fried in partially hydrogenated oils.

Trans fat, like saturated fat and dietary cholesterol, raises the LDL (or "bad") cholesterol that increases your risk for heart disease, according to the FDA.

"It is recommended that the consumption of trans fat be as low as possible," write Stender and colleagues.

Stender's team writes that "the content of trans fatty acids varied from less than 1 gram in Denmark and Germany, to 10 grams in New York (McDonald's) and 24 grams in Hungary (KFC)."

Those numbers combine trans fat content for the chicken nuggets and french fries.

Trans Fat Levels Varied

For the McDonald's items, the top three locations for trans fat content were New York, Peru, and Atlanta. The results for McDonald's restaurants didn't include other U.S. cities.

For the KFC foods, the top three locations for trans fat content were Hungary, Poland, and Peru, the study shows. The only U.S. location on the list -- New York -- ranked eighth.

"The cooking oil used for French fries in McDonald's outlets in the United States and Peru contained 23% and 24% trans fatty acids, respectively, whereas the oils used for French fries in many European countries contained only about 10% trans fatty acids, with some countries as low as 5% (Spain) and 1% (Denmark)," the researchers write.

What about french fries in France? Trans fat content was in the middle of the range (15% for McDonald's fries and 8% for KFC fries).

The study doesn't cover every restaurant in every location. The findings may not apply in other cities or restaurants. The study didn't do a head-to-head comparison of McDonald's and KFC foods.

McDonald's Replies

WebMD called the media relations offices of McDonald's Corporation and KFC for their comments.

McDonald's replied by emailing a statement the company attributed to Catherine Adams, PhD, RD, McDonald's vice president of Worldwide Quality Systems, Food Safety & Nutrition.

"McDonald's takes the matter of trans fatty acids seriously," the statement reads. "In fact, it is important to note that this Letter to the Editor itself draws heavily from information provided by McDonald's web site -- a clear example of our commitment to transparency on this issue."

One of the five footnotes in the researchers' letter to the journal cites McDonald's nutritional information.

"McDonald's continues to work diligently on ways to reduce TFA levels in our fries," McDonald's statement continues. "Our reduction in the U.S. is taking longer than anticipated, as we have previously announced. However, we continue to progress in our testing and we are determined to get it right for our customers."

KFC sent an email to WebMD stating that "our product offerings vary from country to country to reflect local taste preferences, and we do make nutritional information available to our customers."

Oct. 11, 2005 -- The muscles of obese people may welcome fat with open arms, new research shows.

Severely obese people have three times as much of a fat-building enzyme called SCD1 in their muscle cells than lean people, scientists report.

That could be one reason why it's often hard to permanently lose weight through diet alone.

"While these findings may be somewhat discouraging news for those wishing to reverse obesity through dietary interventions, they also highlight the importance of exercise," says researcher Deborah Muoio, PhD, in a news release.

Exercise is known to produce big changes in muscle metabolism, explains Muoio. She works at Duke University's Sarah W. Stedman Nutrition and Metabolism Center.

The study appears in Cell Metabolism.

Fat-Friendly Muscle

The researchers studied muscle cells from lean and obese women. The obese patients were matched to lean patients of the same age and race.

The lean women had a BMI (body mass index) of 25 or less. The obese women in the study had a BMI of 35 or more. According to CDC provides guidelines for BMI, 18.5 to 24.9 is normal, 25.0 to 29.9 is overweight, and 30 or more is considered obese.

First, the researchers checked SCD1 levels in participants' muscles. They found three times as much SCD1 in the muscles of the obese women studied.

Next, the scientists did some lab tests that made the lean women's muscle cells produce more SCD1. That pushed those muscle cells towards fat accumulation, the study shows.

Gene Link

Exactly why obesity and SCD1 went hand in hand isn't known. It's not clear which came first, the obesity or the rise in SCD1. Did the obesity cause SCD1 to rise, or vice versa?

The researchers outline one possibility.

The body's recipe for making SCD1 is stored in genes. Becoming obese might switch on those genes, ramping up SCD1 production and programming muscles to fatten up.

Once those genes are on, they may stay on, the researchers note, citing studies of animals and research on big groups of people (epidemiological studies).

Possible Solutions

It might be possible to create drugs that target muscle SCD1, the researchers note. They also want to see if physical activity can help lower SCD1 or modify its effect in obese people.

If you don't want to wait for those results, know that physical activity is recommended across the board for many reasons besides lowering weight (including heart and bone health). Get your doctor's blessing before starting a new fitness program, especially if you've been overweight or idle.

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.

July 27, 2004 -- Eating your salad or carrot sticks with a little fatty salad dressing may actually be better for your health than pouring on the fat-free stuff.

A new study shows that eating fresh vegetables with a little fat, such as oil-based salad dressings or cheese, helps the body absorb valuable nutrients found in vegetables, such as lycopene and beta-carotene, which have been shown to help prevent heart disease and cancer.

In contrast, eating a salad without any fat in it may deprive your body of these healthy nutrients, which are known as carotenoids.

"We're certainly not advocating a high-fat diet, or one filled with full-fat salad dressing," says researcher Wendy White, associate professor of food science and nutrition at Iowa State University, in a news release. "Our findings are actually consistent with U.S. dietary guidelines, which support a moderate diet, rather than one very low, in fat."

"But what we found compelling was that some of our more popular healthful snacks, like baby carrots, really need to be eaten with a source of fat for us to absorb the beta carotene," says White. "If you'd like to stick with fat-free dressing, the addition of small amounts of avocado or cheese in a salad may help along the absorption."

Researchers say that the popularity of fat-free and low-fat salad dressings has grown in the last 10 years, and 20% of men and 33% of women say they always choose low-calorie rather than full-calorie salad dressings.

Fat Helps the Body Absorb Nutrients

Vegetables commonly found in salads are essentially fat-free and are a rich source of healthy carotenoids. In order for these carotenoids to be absorbed by the human digestive system, fat is needed. But researchers say exactly how much fat is needed to provide optimal absorption of these nutrients is not clearly defined.

In the study, which appears in the August issue of the American Journal of Clinical Nutrition, researchers compared nutrient absorption after eating salads with varying levels of fat.

Seven healthy men and women ate salads of spinach, romaine lettuce, cherry tomatoes, and carrots topped with Italian dressings containing 0, 6 (0.2 ounces), or 28 grams (almost 1 ounce) of canola oil on different occasions during a 12-week period. Hourly blood samples were taken for 11 hours after the meal and tested for nutrient absorption.

The study found that only negligible amounts of alpha- and beta-carotene and lycopene were detected in the blood after eating a salad with fat-free dressing. Significantly more of these substances, known as carotenoids, were detected in the blood after eating salads with reduced-fat dressing or full-fat dressings.

Researchers say this study shows that the minimum amount of fat required for optimal absorption of these nutrients from the salads is more than 6 grams of added fat. But because salads are often consumed with other items that contain fat, the use of a reduced-fat salad dressing may still allow the body to reap the maximum nutritional benefits of fresh vegetables.

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.

Nov. 7, 2003 -- Can fried chicken actually be healthy and help America lose weight?

Critics are crying "fowl" over two new KFC television ads, saying that they seek "to persuade the public that they can enjoy fried chicken as part of a healthy, balanced diet."

The Center for Science in the Public Interest (CSPI) has filed a complaint about KFC's ads to the Federal Trade Commission (FTC). The CSPI is asking that the nationally run ads be taken off the air, saying that the ads are deceptive and misleading.

"KFC's ads are so outrageous that an experienced observer of the advertising industry has characterized them as 'naked nonsense,'" writes Michael Jacobson, CSPI executive director, in his letter to the FTC.

"KFC takes what could be a perfectly good food, and makes it almost as bad for you as possible, short of covering it in melted cheese or cream sauce," Jacobson says in a news release. "These ads don't tell the truth. These ads take the truth, dip it in butter, and deep fry it. Colonel Sanders himself would have a hard time swallowing this ad campaign."

Fat, Sodium, and Cholesterol

In one ad, a bucket of KFC fried chicken is presented as one couple's attempt to begin "eating better," says the CSPI release. A bucket of fried chicken has 3,090 calories along with "vast amounts" of saturated fat, cholesterol, and sodium, the CSPI adds.

Most KFC outlets fry chicken in hydrogenated shortening, which results in harmful trans fats, says the CSPI.

The ad displays nutrition information for smaller amounts of fried chicken, including -- "laughably," says the CSPI -- pieces with the skin removed.

A second ad gives the impression that eating fried chicken is responsible for a man's "fantastic" looks, presumably due to weight loss, since the ad indicates that fried chicken is for those who are "watching carbs," according to the CSPI.

Both ads flash "brief, tiny, low-contrast, and virtually illegible" disclaimers "confessing" that fried chicken "is not a low fat, low cholesterol, low sodium food," says the CSPI.

KFC Takes The Heat

WebMD unsuccessfully tried to contact KFC for comment. However, a statement was posted on the company's web site.

"We want to set the record straight," says Scott Bergren, KFC's executive vice-president, in the statement. "Consumers should no longer feel guilty about eating fried chicken as part of a healthy, balanced diet. Of course, they should eat all foods in moderation, and balance that with an appropriate amount of exercise -- it's always energy in, energy out."

A KFC Original Recipe Chicken Breast has 19 grams of fat and 380 calories, compared with a Burger King Whopper with 43 grams of fat and 710 calories, the statement says. Removing the skin and breading reduces the fat to 3 grams, zero grams of trans fat, and 140 calories.

Serving Up Mixed Message?

"It concerns me that consumers may yet be getting another mixed message. They may end up confused with who to believe," says Cindy Moore, MS, RD, spokeswoman for the American Dietetic Association.

"Clearly, they're not getting the whole picture -- if the disclaimers are that hard to read," Moore, who is also director of nutrition therapy at The Cleveland Clinic, tells WebMD.

Sure, she says, "chicken can be a healthy food, but if you bread it and fry it in oil, you're going to be adding more calories from fat, and it's likely that trans fats will be in that fat."

'Colonel' of Truth?

It's true, fried chicken fits into the Atkins diet -- because fat is not limited in that diet. The high-protein and low-carb components of Atkins are fine for most people, but it's the unlimited fat that concerns nutritionists.

"Most nutritionists prefer the South Beach diet because it limits fats," Moore tells WebMD. "What these KFC ads may be perpetuating is Atkins, but under the guise that it's healthful."

Certainly, all foods can fit into a healthy diet, she adds. "But it has to be balanced with other foods they are eating. If they're eating a variety of fruits and vegetables, whole grains, low-fat dairy products, that's one thing. But are they eating french fries, biscuits?"

Most of all, she says, "I would hate people to get the mistaken impression that some reformulation of fried chicken makes it a healthful choice now."

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.

At 36 years old, Nicola Myrie received a stern warning from her doctor. Lose weight or risk a cardiac event in six or seven years. The New York City accountant immediately went on her own diet of watchful eating. After four months, she despaired at shedding only 6 of her weight loss target of at least 40 pounds.

Then her cardiologist suggested The South Beach Diet, a multistage approach to weight loss starting with a low-carb plan and later allowing the addition of "good carbs." In three months, Nicola dropped 22 pounds and found significant improvements in her blood pressure, cholesterol, and homocysteine levels - a blood chemical linked to inflammation and heart disease.

"I feel fantastic, like I'm in my 20s again," says Nicola, remarking on her renewed confidence and energy. Once she loses 20 more pounds, she vows to maintain some of the South Beach Diet's principles of eating throughout her life.

Friend or Fad?

If health and food experts are right, Nicola's lifelong plan may not materialize.

Hundreds of studies have shown that restrictive diets like the low-carb plan don't keep the weight off in the long run, says Mark Kantor, PhD, associate professor of nutrition and food science at the University of Maryland. He predicts that the popularity of low-carb diets will last no more than five years.

A spokeswoman for the American Dietetic Association agrees. "Anything that you have to adhere to has to be un-adhered to at some point," says Lisa Dorfman, MSRD. "People live normal lives. They go to vacation; they go to parties; they have social lives. The problem is that many of those [low-carb] programs don't accommodate those natural and normal life needs."

Dorfman sees the low-carb craze waning and likens it to the low-fat fad of the '90s. A decade ago, the low-fat trend created a stir that not only demonized fat, but also produced hundreds of products that reduced or eliminated it.

Low-carb advocates beg to differ. "To call it a fad is to ignore history," says Matthew Wiant, senior vice president and chief marketing officer for Atkins Nutritionals Inc. "Low-carb diets were popular for the first couple of million years people were on the planet. It's only been since the advent of agriculture and refined food products that higher-carb diets have become the norm."

Wiant points to several short-term studies that show the benefits of low-carb diets: quick weight loss and improved cholesterol levels. To counter the naysayers, he says there have been long-term studies (12 months long) of the diet that demonstrate sustained weight loss without increasing their risk of heart disease.

Yet Kantor expects research to someday catch up with the ills of low-carb diets. "In the long term, there is no question that low-carb diets will be shown to be dangerous," he says, noting that hundreds of epidemiological studies around the world have demonstrated that high-carbohydrate foods such as fruits, vegetables, and whole grains reduce risk of heart disease and prevent cancer.

Wiant responds in defense of low-carb diets. "It's irresponsible to conclude, based on the data out there, that the long-term studies will show some kind of huge reversal of [improved cholesterol] numbers," he says.

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."

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.

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.

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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.

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.

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.