merchant credit card account 2

When Junior and his mother walk into the doctor's waiting room, there are two seats available: a big chair for grown-ups and a stool for kids. Junior takes the adult seat, and starts to throw a tantrum after Mom asks him to move. With resignation, she squats onto the little seat.

This scenario is not so uncommon, says Barton Schmitt, MD, a pediatrician at the Children's Hospital in Denver. In his office, he sees kids wield power over their parents at least a couple of times a week. Sometimes it's a preschooler who's emptying out his mother's purse, taking out all of her credit cards. Another day it's a tot who's stretching out her father's glasses. In each instance, the kid gets his way, even after some parental protest.

Some people may call these children spoiled.

Schmitt suspects that about 5% of kids are spoiled in that they lack discipline, are manipulative, and are generally bothersome. His estimate, however, may be far too generous, if one author's research proves accurate.

In 2000, Dan Kindlon, author of Too Much of a Good Thing, interviewed more than 1,000 parents, and roughly 650 teenagers, and found that 60% of parents thought their kids were spoiled, and 15% of teens thought they, themselves, fit the bill.

Defining "Spoiled"

Kindlon did not ask his subjects what they thought the term "spoiled" meant, but he believes that they would all have different answers -- as did many of the child-development experts interviewed by WebMD.

"A spoiled child has the 'I want, I want, I want' syndrome," says Charles L. Thompson, PhD, professor of educational psychology and counseling at the University of Tennessee in Knoxville. "His philosophy of life would sort of be 'Life is not good unless I'm getting my own way.'"

The word "spoiled" has many different meanings in different cultures, says Lane Tanner, MD, associate director, division of developmental and behavioral pediatrics at the Children's Hospital and Research Center in Oakland, Calif.

"Very often a grandparent will shake her head with a grin, and say 'My daughter is spoiling that baby so bad,' and that's praise," says Tanner.

A spoiled kid is someone who sits inside on a cold day -- sipping hot chocolate and watching TV -- while her dad shovels snow in the driveway, says Kindlon. He notes that such children often feel entitled not to have to contribute to responsibilities. They also usually have parents that emotionally indulge them -- for example, excusing them from chores because they already have a tough school schedule.

"What's spoiled for one parent may not be for another," says George Cohen, MD, a member of the American Academy of Pediatrics' committee on the psychosocial aspects of child and family health. "Many parents think what their kid is doing is okay. Others are much stricter."

Whatever one's primary definition of spoiled is, arguably, there are children who could use a bit more discipline. They usually find it hard to share, wait their turn, appreciate what they have, and accept that they cannot always get their way.

Life, for these kids, is often difficult, says Schmitt. "They are constantly in a tug of war with their environment," he explains. "They keep smashing into walls because they are living in a world that's different from the real world."

Dec. 19, 2005 -- Eating a small amount of dark chocolate improves smokers' artery function in hours, and a few squares a day may reduce the risk of hardening of the arteries.

That's the finding of a small study by Swiss researchers published in the journal Heart.

The researchers gave 20 male smokers approximately 1.4 ounces of either dark or white chocolate. In just two hours, dark chocolate significantly improved the function of endothelial cells, which line the artery walls, and reduced the activity of platelets, which help form blood clots. Smoking is known to disrupt the function of both types of cells, often leading to hardening of the arteries and heart disease.

The protective effects of dark chocolate lasted about eight hours. White chocolate had no effect on the arteries or platelets. The study did not examine the effects of chocolate in nonsmokers.

'A Small Daily Treat'

The researchers note that too much chocolate could increase the risk of heart disease by raising blood sugar levels, body fat, and body weight. But their findings suggest just a couple ounces of dark chocolate a day may reduce the risk of coronary artery disease.

How could such a small amount have such a powerful effect? The authors say it's probably because dark chocolate is so rich in antioxidants. "Dark chocolate has a much higher [antioxidant] content per gram than do other antioxidant-rich foods such as wine, tea, or berries," they write. "Therefore, only a small daily treat of dark chocolate may substantially increase the amount of antioxidant intake" and improve cardiovascular health.

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

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

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

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

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

Vitamin E Harm: Slight but Significant Risk

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

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

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

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

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

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

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

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

Is Vitamin E Dead?

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

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

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

The Real Vitamin E Harm

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

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

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

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

Thanksgiving Day is a time-honored American tradition, a time for family gatherings and a holiday meal that encourages over-the-top decadence. And for many (some 97% of us), the thought of a Thanksgiving without turkey is heresy. We gobble up roughly 45 million turkeys to celebrate the annual holiday.

To help make sure your Thanksgiving dinner is safe, nutritious, and delicious, we asked the experts for some timely turkey tips.

A Little Background

The tom turkey, the larger male bird decorated with colorful plumage, has a long wattle -- a fleshy, wrinkled fold of skin hanging down from the throat -- and is known for his trademark "gobble." The hens are smaller and less colorful than the males, and make only a clicking sound.

Both males and females are raised extensively for their excellent meat (and for eggs). The most common breeds in the United States are the Bronze, Narragansett, White Holland, and Bourbon Red.

We've all heard the legend about the first Thanksgiving: After a tough first year in America in 1621, the Pilgrims celebrated a successful fall harvest of fruits, corn, and other vegetables. They had beaten the odds, and for that, they were mighty thankful. The Pilgrims' Governor William Bradford proclaimed a day to give thanks that was shared by the new colonists and their Native American neighbors.

The tradition continued each year after the harvest, and in the late 1770s, the Continental Congress suggested a national Thanksgiving day. In 1863, President Abraham Lincoln proclaimed Thanksgiving a national holiday. (President Franklin D. Roosevelt later declared that the holiday would be celebrated on the fourth Thursday of November.)

Turkey Prep 101

For most of us, there's no doubt that a turkey will be the centerpiece of our Thanksgiving feast. The only question: Should we buy it fresh or frozen?

Frozen birds tend to be less expensive, but they require more time to defrost properly.

"If you have the room to defrost a frozen turkey in your refrigerator, plan on one day to thaw [each] 4-5 pounds," recommends culinary nutritionist Jackie Newgent. Place the wrapped bird on a tray on the bottom shelf of your refrigerator so the juices won't contaminate other foods.

Another safe method of defrosting is to submerge the bird, breast side down, in cold water, and change the water every 30 minutes. With this method, thawing takes approximately 30 minutes per pound.

"Defrosting in the sink is time-consuming, and if you don't change the water to keep it cold, you risk the chance of bacterial contamination," advises Newgent.

For purists, nothing can compare with the mouth-watering aromas of slowly roasting a turkey to golden perfection in the oven. Deep-frying is a popular alternative cooking method, though it requires the right equipment and lots of oil.

If you prefer the crispy fried version, don't worry about the extra fat calories, says registered dietitian Newgent: "Thanksgiving only happens once a year, so just go for it and enjoy!"

Newgent also shares a few basic turkey-cooking tips:

• Buy 1 pound of turkey per person. That will allow plenty for the feast and leftovers, too.
• Make sure the bird is completely thawed before cooking; otherwise, it will not cook uniformly.
• Cook the turkey to the proper temperature. A meat thermometer is the only way to ensure proper cooking to 180 degrees. Place the thermometer deep into the thigh, without touching the bone.
• Slowly cooking the turkey at 325 degrees will result in the most moist and delicious meat. Higher temperatures can overcook or dry out the bird.
• Rub the bird with olive oil and season lightly with salt, pepper, onion and garlic powders, and a little sage. The rest of the meal is so flavorful that you shouldn't overpower the bird with heavy seasonings, Newgent says.
• Baste oven-baked birds with their juices and a little butter for added moistness and rich color.
• Cover the drumsticks and breast with foil when the bird is two-thirds done to prevent drying and scorching.
• Plan to take advantage of all cooking surfaces when you prepare the meal. Use shallow baking dishes that fit on an oven shelf under the turkey. Prepare other dishes on the stovetop and in the microwave.

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

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

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

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

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

April 14, 2005 -- The yips -- a condition that makes some golfers unable to appropriately complete a golf stroke -- might be a movement disorder, according to a new study.

If so, it seems to be a task-specific problem seen with putting, says neurologist Charles Adler, MD, PhD, of the Mayo Clinic in Scottsdale, Ariz.

Adler and colleagues studied 20 right-handed, middle-aged male golfers; half had the yips. The researchers used electromyography (EMG) to monitor nerve impulses in the men's muscles while putting, holding a putter, writing by hand, sitting, and extending their arms.

The men also rated their own golf strokes, trying 75 putts at 3, 6, and 8 feet on an artificial putting surface.

Problem Only Seen During Putting

The yips only occurred during putting. Half of the men with the yips had EMG-documented contractions in their wrist muscles right before the putter hit the ball, say researchers.

Those men tended to be older, have higher current and best previous golf handicaps, and have had the yips for fewer years than those who had the yips but did not have the contractions.

The men with the yips and contractions also tended to make fewer putts and had a greater degree of error in missing the putts.

Related Conditions?

The contractions were similar to those seen in writers' cramp or musicians' cramp, says Adler in a news release. Only two men in the yip group said they'd felt the yips in the experiment, but five of them showed EMG signs of the contractions, the researchers say.

Adler's team presented their results in Miami Beach, Fla., at the annual meeting of the American Academy of Neurology. They called for larger studies of the yips.

Whether it's pounding the pavement, logging miles on the bike, or climbing those stairs that seem to go nowhere, it's all about cardio exercise. But other than a sweaty t-shirt, what do you have to show for your workout? A slimmer stomach? Killer quads? Are you exercising for the right amount of time to reap the full health benefits of cardiovascular fitness, or often enough?

?

Exercise experts, including fitness maven Denise Austin, answer cardio questions for WebMD, so you can make the most of your muscle burn.

Cardio Exercise: The Heart of the Matter

"Cardiovascular exercise is any type of exercise that increases the work of the heart and lungs," says Tommy Boone, PhD, a founding member of the American Society of Exercise Physiologists. "Walking, jogging, and running are common forms of cardiovascular, or aerobic, exercise."

?

From running and walking, to swimming, elliptical cross-training, biking, Stairmaster, and rowing -- to name a few -- the physical benefits of cardio exercise abound, explains says Len Kravitz, PhD, senior exercise physiologist for IDEA Health and Fitness Association. They include:

?

• Reduced risk of heart disease
• Improved blood cholesterol and triglyceride levels
• Improved heart function
• Reduced risk of osteoporosis
• Improved muscle mass

?

"The American College of Sports Medicine and the CDC recommend, for health, that adults should accumulate 30 minutes of moderate-intensity physical activity on most days of the week," says Kravitz, who is also a coordinator of exercise science at the University of New Mexico. "And to improve cardiovascular endurance, they recommend 20 to 60 minutes on three to five days per week."

?

Now that you know the benefits of cardio exercise, where should your heart-pumping fitness plan begin?

Getting Into the Zone

To help you make the most of your cardio exercise workout -- help your heart, increase muscle, and lose fat -- Denise Austin, fitness expert, author of seven books, including Shrink Your Female Fat Zones, and star of 50 fitness videos, gives WebMD some tips.

?

"To reap all the benefits of a cardio workout, you should sustain your workout for 20 minutes or more -- I do 30 minutes myself -- on a schedule of about three to four times per week," says Austin.

?

Not only that, but you need to get in the zone, which calculates into burning calories and fat.

?

"The best way to find out if you are burning fat is to take your pulse halfway into your cardio workout for six seconds, then add a zero to that number," Austin tells WebMD.

?

This number is your heart rate per minute.

?

Next, calculate your zone.

?

"Take the number 220, then minus your age, then calculate 70% of that number for your target beats per minute," says Austin, and that's your zone. "If your heart rate halfway through your workout is over that 70% mark take it down a level, and if under, pick up the pace."

?

Not a math wiz? There are easier ways to figure it out.

?

"Another great way to find out your zone is to get a pulse monitor, which takes the math out of it," says Austin. "Or very simply, take the talk test: while you are doing aerobics, talk a sentence. If you are too winded to finish the sentence, you are overdoing it, or if it's too easy to say, kick it up a notch!"

May 2, 2006 -- Obesity may be more common that previously thought in the U.S.

In the Journal of the Royal Society of Medicine, researchers note that national obesity statistics typically rely on self-reported weight and height, which are often wrong.

Those inaccuracies often make people sound lighter or taller than they actually are, write Majid Ezzati, PhD, and colleagues. Ezzati works at the Harvard School of Public Health.

Self-reported weight and height don't always match reality, so U.S. obesity statistics are too low, Ezzati's team argues.

The researchers recalculated America's obesity statistics, adjusting for those errors. The result: The nation's obesity estimates went up.

Corrected Obesity Statistics

Obesity is defined as a body mass index (BMI) over 30, according to the CDC.

In 2002, 28.7% of men and 34.5% of women in the U.S. were obese, Ezzati and colleagues estimate.

The uncorrected estimate for that year indicated that 16% of men and 21.5% of women were obese.

Ezzati's team based their corrections on data from two large, national surveys of U.S. adults:

• Behavioral Risk Factor Surveillance System (BRFSS): Given by telephone
• National Health and Nutrition Examination Survey (NHANES): given in person, with some participants measured and weighed afterwards

Ezzati and colleagues compared BRFSS and NHANES data for similar years. They found that people tended to report their height and weight more accurately in person than over the phone, but that all self-reports generally missed the mark.

Weight, Height, and Reality

Women tended to underreport their weight, the study shows. Men didn't do that, but men aged 20-44 tended to overestimate their height more than women, especially in telephone interviews.

After age 44, men and women overestimated height to a similar extent. Height often dips with age. Middle-aged or older adults who haven't measured their height lately may mistakenly think they're still as tall as in their youth, the researchers note.

Such errors stack the deck in favor of a lighter BMI (body mass index). BMI is calculated based on height and weight. A BMI of more than 25 but less than 30 is considered overweight, while a BMI of 30 or higher is considered obese.

There are other ways to calculate size and shape, such as comparing waist size to hip size. But researchers often use BMI to track obesity.

If height and weight aren't right, neither are BMI and obesity statistics. It's like looking in a circus mirror that makes us look taller and leaner than we really are.

Where Obesity Lives

Ezzati and colleagues identified the states (and Washington, D.C.) where obesity was most common in 2000, based on the new calculations. Here are those findings, along with the percentage of obese men or women in those areas.

Highest prevalence of obese men:

• Texas (31%)
• Mississippi (30%)

Highest prevalence of obese women:

• Alabama (37%)
• Washington, D.C. (37%)
• Louisiana (37%)
• Mississippi (37%)
• Texas (37%)
• South Carolina (36%)

Lowest prevalence of obese men:

• Colorado (18%)
• Washington, D.C. (21%)
• Montana (21%)

Lowest prevalence of obese women:

• Montana (16%)
• Colorado (24%)
• Massachusetts (27%)

April 1, 2005 -- It sounds too good to be true but an increasing number of Americans are buying into the notion that a dietary supplement called conjugated linoleic acid, or CLA, can help them both lose weight and increase muscle mass.

A new study funded by the leading manufacturer of CLA suggests just that. But experts tell WebMD that the claims about the supplement far outweigh the science. The researcher who discovered CLA says that while it can help people replace fat with muscle, it is no miracle weight loss aid.

"I have been telling people for years that this is not a weight loss product," Michael W. Pariza, PhD, tells WebMD. "If someone takes CLA to lose weight but doesn't change their diet or exercise patterns they are going to be disappointed."

The Research

CLA is a natural occurring fatty acid found in meats and dairy products, with claims of helping people lose fat, maintain weight loss, retain lean muscle mass, and control type 2 diabetes -- the type of diabetes that is often associated with obesity.

Early animal studies following its identification by Pariza and colleagues in the late 1970s raised hopes that it could be used to fight human cancer.

The popular dietary supplement is now sold in health food stores and on the Internet.

In a study published last Maystudy published last May involving 180 people who were overweight, those who took CLA for a year lost between 7% and 9% of their body fat even though they did not change their lifestyles or eating habits.

But CLA users lost only a modest amount of weight -- 4 pounds during the yearlong study. And the investigation did little to silence concerns about the long-term safety of the supplement. The volunteers taking CLA had changes in certain heart disease risk factors.

CLA users had slightly higher LDL "bad" cholesterol and slightly lower HDL "good" cholesterol than nonusers. And the CLA group had higher white blood cell counts and lipoprotein (a) levels -- also known as lipoprotein little (a). Both are markers of inflammation linked to heart disease.

In this follow-up study, 134 of the overweight participants either continued taking CLA for another year or could start taking the supplement if they had been in the placebo group. Both groups took 3.4 grams of CLA a day and continued their normal lifestyle habits. They ate what they wanted without restricting calories and continued their usual amounts of physical activity.

The study was funded by the company that markets Tonalin CLA, the largest selling brand of the supplement. The findings are reported in the April 1 issue of The Journal of Nutrition.

The group that had already been taking CLA lost no more weight or body fat, but they maintained the body fat losses seen in the previous year. People who began taking the supplement during year two of the study lost an average of 3.5 pounds and also saw reductions in overall body fat.

The safety picture for those who took the supplement for two years was somewhat reassuring. Total cholesterol and LDL cholesterol were reduced slightly, while HDL cholesterol, triglycerides, and fasting blood glucose levels remained unchanged.

But there were consistent increases in lipoprotein levels associated with CLA use. Lipoprotein levels are believed to be independent predictors of heart disease risk.

CLA use was also associated with increases in white blood cells and blood platelet counts, which suggested an inflammatory response to use of the supplement. Inflammatory responses like these are believed to lead to blood vessel damage seen in atherosclerosis and cardiovascular disease.

Researcher Jean-Michel Gaullier and colleagues concluded that the role of CLA in cardiovascular risk is still "equivocal."

"Further studies are needed to determine if there is an effect of CLA on cardiovascular risk and inflammation in humans," they wrote.

Others Agree

In a review of the CLA research, published last year, California nutritionists Lisa Rainer, MS, RD, and Cynthia J. Heiss, PhD, concluded that while the animal studies on CLA are promising, the research in humans remains inconclusive.

"The existing studies of CLA supplementation in human beings are difficult to interpret because of the different parameters measured and the variances in dosage, duration of administration, and subject characteristics," they write.

In an interview with WebMD, Rainer said she would not recommend CLA supplementation for weight control on the basis of the studies she has seen.

"More trials need to be done in human beings before we really know the long-term benefits and safety," she says.

But Pariza, who began taking CLA when it became available in supplement form almost a decade ago, believes strongly that long-term use by healthy people is not only safe but beneficial.

He says CLA may have merit as a weight loss supplement when combined with another weight-reducing treatment or may singularly promote loss of body fat and maintenance of muscle. He says the supplement also can subsequently reduce the risk of weight regain.

Aug. 13, 2004 -- James Bond may prefer his martinis, but a new study shows red wine beats gin, shaken or stirred, when it comes to heart health.

Researchers found drinking moderate amounts of both alcoholic beverages had beneficial effects in reducing inflammation in the blood, which has been linked to artery-clogging plaque buildup and heart disease. But red wine had a significantly greater effect on fighting inflammation in the blood.

"It's clear from these results that while drinking some form of alcohol lowers inflammatory markers, red wine has a much greater effect than gin," says Emanuel Rubin, MD, a pathology professor at Jefferson Medical College of Thomas Jefferson University in Philadelphia, in a news release.

Researchers say that many studies have linked drinking alcohol, especially red wine, to a lower risk of heart disease and stroke. But few studies have compared the effects of different types of alcoholic beverages in reducing risk factors for heart attack and stroke, such as inflammatory markers in the blood.

High levels of C-reactive protein and other markers of inflammation in the blood are risk factors that have been implicated in heart disease and stroke, says Rubin.

Red Wine Fights Clogged Arteries

In the study, 40 healthy men consumed 30 grams of ethanol either in the form of two glasses (about 10 ounces) of red wine (Merlot) or 3.3 ounces of gin with dinner each day for 28 days. All of the participants also followed relatively the same diet and exercise program during the study.

Researchers analyzed blood samples before and after the study, and found both wine and gin had anti-inflammatory effects.

Both groups had lower levels of fibrinogen, which clots blood and is a risk factor for heart attack. They also had lower levels of the inflammatory marker IL-1.

But those who drunk red wine also had lower levels of C-reactive protein and two other inflammatory markers.

Researchers say the antioxidant effects of the polyphenols found in red wine, but not in gin, are likely responsible for the additional heart-healthy effects. Beer and whisky also have high levels of polyphenols.

Rubin says one or two glasses of red wine a day is probably beneficial, but these results provide only indirect evidence of a protective effect against heart disease.

Nov. 26, 2003 -- Before you get too comfortable at the buffet table this holiday season, you may want to take a second look at the scale. A new poll shows many Americans may be deluding themselves about their weight.

The Gallup survey found that although more than half of those surveyed were overweight according to their BMI (body mass index, a measurement of weight in relationship to height), only about 40% think of themselves that way.

The delusion doesn't stop there. The poll found that 37% of Americans would still be classified as overweight according to standard BMI charts even if they did lose weight and reach what they think would be their "ideal" weight, including 4% who would still be considered obese at their "ideal" weight.

Americans Kidding Themselves About Their Weight

The survey, based on telephone interviews with 1,007 adults across the U.S., was conducted November 3-5. Researchers used the heights and weights that the respondents reported to calculate their BMI. They found 55% of all Americans would be classified as either overweight (35%) or obese (20%).

According to standards, BMI scores of:

• Less than 18.5 are considered underweight
• 18.5 to 24.9 are considered normal
• 25 to 29.9 suggest the person is overweight
• 30 or higher suggest the person is obese

Researchers found that men were more likely than women to be classified as overweight and obese based on their BMI -- 68% of men compared with 43% of women.

Despite those numbers, just 41% of Americans overall said they were either "somewhat" (37%) or "very" (4%) overweight.

Good Intentions Not Enough to Lose Weight

Even though fewer women were overweight than men, the poll shows women were much more motivated to lose weight than men. Despite the fact that two-thirds of men were considered overweight, only about half (51%) said they wanted to lose weight versus 68% of women who said they wanted to lose weight.

But good intentions aren't enough. Among the obese, who are most likely to suffer serious medical complications as a result of their weight, more than nine in 10 said they wanted to lose weight but only 45% were seriously trying to do so.

The same held true for overweight adults; only about half of those who said they wanted to lose weight actually were trying to do so.

With so many people wanting to lose weight, researchers say it's not surprising that about two-thirds of Americans said their ideal weight is below their actual weight. On average, men reported an ideal weight that was 14 pounds lower than their actual weight, and women reported an ideal weight almost 19 pounds lower then their current weight.

However, according to the BMI charts, researchers found that 54% of those who are overweight, but not obese, would still be overweight if they reached their ideal weight, and three-quarters of currently obese people would still be overweight if they reached their ideal weight.

Although those numbers are discouraging, researchers warn that BMI isn't everything when it comes to measuring a healthy weight. BMI is a more accurate indicator of overweight and obesity than relying on weight alone, but the National Institutes of Health cautions that BMI does not directly measure body fat.

For example, some very muscular people may fall into the overweight category when they are actually healthy and fit. In addition, some people who have lost muscle mass, such as the elderly, may be in the healthy weight category when they are actually underweight with reduced nutritional reserves.

SOURCES: Gallup Survey, conducted Nov. 3-5, 2003. News release, Gallup Organization.

Jan. 3, 2003 -- Houston is the couch potato capital of the U.S. and Honolulu is the fittest city, say the editors of Men's Fitness magazine.

The "America's Fattest City" award goes to Houston for the third year, uh, running. The ratings are based on a major city's score in several categories such as fruit/vegetable consumption, sports participation, smoking, drinking, air quality, and percentage of overweight/sedentary residents.

"Given the region's climate (hot and humid), air quality (abysmal), and relative lack of outdoor recreation, staying active presents a Texas-sized challenge," the magazine states. "And with its love of junk food, Houston is a vastrodome of bad nutrition."

If you don't live in Houston, don't let out your belt just yet. The annual ratings are meant as a wake-up call to stop what the CDC calls a national epidemic of obesity. Two in every three Americans have a serious weight problem.

Here's the magazine's list of America's 10 fattest cities:

1. Houston
2. Chicago
3. Detroit
4. Philadelphia
5. St. Louis
6. Cleveland
7. Atlanta
8. Columbus, Ohio
9. Dallas
10. Charlotte, N.C.

And its list of the 10 fittest cities:

1. Honolulu
2. Seattle
3. San Francisco
4. Colorado Springs, Col.
5. San Diego
6. Portland, Ore.
7. Denver
8. Virginia Beach, Va.
9. Tucson, Ariz.
10. Sacramento, Calif.

If you've got diabetesdiabetes, the right meal plan can help you keep blood sugar under control. Fruits and vegetables, lean protein, whole grains, and low-fat dairy products -- even sweets now and then -- all have a place in your plan.

"A meal plan provides a specific approach to controlling blood sugar," says Dianne Davis, RD, LDN, CDE, a dietitian with the Vanderbilt Eskind Diabetes Center in Nashville, Tenn. "If you have diabetes, a meal plan is necessary."

That's because a meal plan helps ensure you eat a balanced diet high in fiber and low in fats. It can also "help you lose weight, by controlling portion sizes and calories," Davis says.

Which Diabetes Meal Plan Is Right for You?

Your lifestyle and the type of diabetes treatment you're getting -- whether you're taking premeal insulin or not -- will determine the type of meal plan best for you, says Davis.

Carbohydrates, proteins, and fats are all factored into a plan. But carbs are an especially important component since they have the biggest impact on blood sugar.

"Your meal plan can also include your favorite foods," Davis adds. "No food is off-limits -- it's a matter of how much you eat, when you eat it, and what it will do to your blood sugar."

With that in mind -- and understanding you should talk with your doctor before making big changes in your diabetes diet -- here are four meal-planning systems.

The Diabetes Food Pyramid

The diabetes food pyramid is similar to the USDA food pyramid you see on food labels. It is a pyramid in which a healthy diet means eating more grains, fruits, and vegetables, and less meat, sweets, and fats.

The diabetes food pyramid's general recommendations are:

• Grains, beans, and starchy vegetables: 6 or more servings/day. One serving: 1 slice bread; 1/2 small bagel; 1/2 cup cooked cereal, pasta, rice; 3/4 cup ready-to-eat cereal; 1/2 cup cooked beans, corn, peas.
• Fruits: 2-4 servings daily. One serving: 1 medium-size fresh fruit; 1/2 cup canned fruit; 1/2 cup fruit juice.
• Vegetables: 3-5 servings a day. One serving: 1 cup raw vegetable; 1/2 cup vegetable juice.
• Meat, Fish, Cheese: 2-3 servings/day. One serving: 2-3 ounces cooked lean meat, skinless poultry, or fish; I egg; 2 tablespoons peanut butter; 2-3 ounces cheese.
• Milk and Yogurt: 2-3 servings daily. One serving: 1 cup (8 ounces) milk or yogurt.
• Fats, Sweets, and Alcohol: eat these in small amounts. One serving: 1 teaspoon butter, margarine, or mayonnaise; 1 tablespoon cream cheese or salad dressing; 1/2 cup ice cream.

Combined foods, like eggplant lasagna, for example, will include servings from several food groups (1 vegetable, 1 meat, 1 fat).

This meal system has limitations, says Davis. "When you follow the diabetes food pyramid, you are not controlling specific grams of carbs and might not be able to achieve very tight blood sugar control," she tells WebMD. "However, the pyramid helps you see which foods are carbohydrates -- to get you acquainted with them."

Indeed, the year 2000 was a very good year for wine makers -- and not just because it brought a bumper crop of cabernets, zinfandels, and chardonnays. Evidence of the far-reaching health benefits of wine continued to pour in from researchers around the world.

Here's a review of the good news for wine makers -- and wine lovers:

A Healthier Heart

Several reports in 2000 confirmed the glad tidings that wine -- in moderation, of course -- reduces the risk of cardiovascular disease and heart attacks. In the September issue of the Annals of Internal Medicine, for instance, Swedish researchers at the Karolinska Institute reported that, compared to teetotalers, light drinkers who consumed wine cut their risk of dying prematurely by almost one third, and wine drinkers as a group had significantly lower mortality from cardiovascular disease and cancer. Actually, drinking any kind of alcoholic beverage helped, the scientists found. But by far the biggest benefit accrued to wine drinkers.

What's more, scientists are beginning to understand how wine may bestow its salutary benefits. For starters, according to findings published in the January 2000 issue of European Heart Journal, this most ancient of beverages appears to dilate arteries and increase blood flow, thus lowering the risk of the kind of clots that cut off blood supply and damage heart muscles.

In addition, the fruit of the vine appears to boost levels of HDL, the "good" cholesterol, and helps prevent LDL, or bad cholesterol, from causing damage to the lining of arteries. In a study published in the May 2000 issue of the journal Pharmacology, Biochemistry, and Behavior, scientists at the Institute for Research in Extramural Medicine in Amsterdam tested 275 men and women around the age of 32. Those who imbibed the equivalent of a glass or two of wine each day had significantly higher levels of "good" cholesterol because they remove the "bad" artery-clogging LDLs before they have a chance to choke blood vessels. Indeed, wine seems to facilitate that process, making it easier for HDLs to hustle their dangerous counterparts out of the bloodstream.

Yet even when LDLs remain behind in the arteries, substances in wine called phenols appear to help prevent the bad cholesterol from causing injury. In the November 2000 Journal of Nutrition and Biochemistry, Italian researchers from the National Institute for Food and Nutrition Research reported that phenols seem to limit the oxidation of LDLs, making them less capable of damaging the linings of arteries and, therefore, less able to set the stage for cardiovascular disease, like heart disease and stroke.

A Shield Against Cancer

Wine also may protect against several forms of another common killer: cancer. It turns out that the same phenolic compounds that lower heart disease risk also may slow the growth of breast cancer cells, according to findings reported by scientists at the University of Crete in Greece in the June 2000 issue of Journal of Cellular Biochemistry. Phenols also were shown to suppress the growth of prostate cancer cells. And French scientists found evidence that an antioxidant in wine called resveratrol can put the brakes on the growth of liver cancer cells, according to a report in the July-August 2000 issue of Oncology Reports.

There also was a report that wine -- particularly red wine -- might help ward off oral cancer. Researchers from the University of Missouri School of Dentistry discovered that resveratrol and another antioxidant called quercetin may inhibit the growth of oral cancer cells. Their findings, published in the June 2000 Journal of the American Dental Association, note that red wine is loaded with a slew of other antioxidants that seem to boost its cancer-fighting abilities.

July 2, 2001 -- After Deborah Taylor-Hough's first child was born prematurely, she and her husband found themselves traveling to the intensive care nursery twice a day. "Probably what helped me most at that time is that the ladies from my church brought us two weeks' worth of frozen meals, and I didn't have to worry about what we were eating," she says.

A few years later, when her husband was working a swing shift, Taylor-Hough wanted to serve the main meal at noon, before he left. "The morning was our family time, but I also had to cook dinner then, and I felt like getting dinner ready was taking away my life," she recalls. A friend suggested she try cooking a month's food at once and storing it in the freezer.

From those small beginnings has grown a big passion. In 1998, Taylor-Hough published Frozen Assets: How to Cook for a Day and Eat for a Month, and today she has more than 2,000 people involved in her email list and online discussion group.

Bulk Cooking

Here's how it works: Once a month, she spends an hour on a Thursday night writing a shopping list. The next day, she shops. ("Never shop and cook on the same day," she advises.)

On Friday night she does the prep work, like chopping onions, grating cheese, making spaghetti sauce, and browning ground beef. On Saturday she spends a solid 6 to 8 hours cooking. By the end of the day she has a month's worth of meals in the freezer.

A big surprise for Taylor-Hough was how much money she saves. Because she was buying in bulk and eating out much less, her monthly budget for food dropped from $700 to $300 for a family of five.

Her web site is loaded with recipe ideas, cooking tips, and sample meal plans. Typical dishes include soups, meat loaf, stews, casseroles, and meat items to serve over rice.

While Taylor-Hough's first book on bulk cooking gets top marks for efficiency and price-consciousness, many recipes tend toward red meat and white flour. Her newly released sequel, Frozen Assets Lite & Easy, has more healthy, low-fat recipes, she says.

In addition, the bulk cooking system is designed chiefly for main dishes, the most time-consuming part of a meal. Of course, they should be combined with fresh fruit and salad.

Once you've grasped the basic idea of bulk cooking, you adjust it to fit your own circumstances, Taylor-Hough says. And you don't have to have a large freezer for it to work. For years, she had only a small freezer on top of the refrigerator.

"Use freezer bags, freeze them flat, and then stand them on end to make better use of your space," she says. "You can easily fit two weeks of main dishes in that space. Actually, I can do a full month."

"This is a wonderful, wonderful idea," says Lauren Groveman, who hosts a radio program on food, family, and the home. "You can plan ahead when you see a crazy week coming. When you're busiest, and feeling most tired and needy, that's the most important time to go to your own freezer and benefit from healthy, home-cooked food, instead of the drive-through line at the local fast-food place."

Many foods freeze perfectly, says Groveman, whose TV show, Cooking with Lauren Groveman, premiers this fall, especially soups, stews, and chili. "Brisket is such a tough meat it's improved by slow cooking followed by freezing. Make a big batch of stock, chill it first to skim off extra fat, and divide it into containers. When you want soups or stews you don't need to start with that powdered stuff!"

Feb. 6, 2004 -- It may be hard for pessimists to admit, but a new study shows pessimism has its benefits.

Researchers found that a healthy dose of pessimism may come in handy in many real-life situations where optimists may be overly hopeful.

For example, the study showed that pessimists tend to fare better as gamblers and know when to cut their losses rather than let it roll. Researchers say that kind of attitude may also pay off in other situations, such as playing the stock market.

Pessimism's Plus-Side

In the study, published in this month's issue of the Personality and Social Psychology Bulletin, researchers looked at the effects of a person's disposition on their gambling behavior.

Three groups of college students were given a list of questions to determine whether they were pessimistic or optimistic as well as assess their attitudes about gambling. In a series of different tests, researchers then had the students play several hands of blackjack and play a simulated slot machine game.

Throughout the tests, researchers found that optimists were more likely to believe that they expected to win at gambling. This relationship was even stronger in individuals who experienced gambling losses. This finding was consistent with the researchers theory that the optimist would reframe a negative event (gambling losses) into a positive -- the belief that they could win.

When asked about their experiences later, optimists were also more likely to remember more wins than the pessimists.

Researchers found the greatest differences between the groups emerged after losing.

"Our data show no difference in betting between optimists and pessimists after winning. But optimists are more likely to persist in the face of losses," says researcher Bryan Gibson, a social psychologist at Central Michigan University, in a news release. "They're less ready to give up hope."

The study showed that pessimists were more likely to reduce their bets if their past performance had been poor, but the optimists seemed relatively unfazed by their losses.

Researchers say this study only looked at the effects of optimism and pessimism on gambling, but their findings may apply to other situations. For example, pessimists may have the advantage in situations where resources and opportunities are limited, such as a down stock market, while optimists may fare better in situations where persistence is rewarded in the face of adversity.

July 26, 2006 -- Multitasking may make you more productive, but it also makes it harder for your brain to learn, according to a new study.

Researchers found people had a harder time learning new things when their brains were distracted by something else, like talking or listening to music.

"When distractions force you to pay less attention to what you are doing, you don't learn as well as if you had paid full attention," says researcher Russell Poldrack, PhD, and UCLA associate professor of psychology, in a news release. "Even if you learn while multitasking, that learning is less flexible and more specialized so you cannot retrieve the information as easily."

Poldrack says distractions appear to affect the brain's learning processes, and tasks that require more attention -- like learning calculus or reading Shakespeare -- are particularly hampered.

Multitasking Disrupts Learning

In the study, published in the Proceedings of the National Academy of Sciences, researchers used functional magnetic resonance imaging (fMRI) to examine brain function and activity while adults (average age, 26) learned a new task.

The 14 participants were asked to make predictions after seeing a series of clues about cards with various shapes. With one set of cards, they learned the classification task without any distractions. In the second set, they learned while listening and keeping track of a series of high and low beeps.

The results showed that multitasking didn't reduce the accuracy of the predictions immediately, but it did hurt participants' ability to remember knowledge about the task later.

Researchers found that when participants were asked questions about the cards at a follow-up session, they did much better on the task they learned without any distractions.

When asked about the task they learned with the distraction, they couldn't extrapolate, or their knowledge was less flexible about the task.

Distraction Affects Memory

The fMRIs showed that when the participants learned without distraction, an area of the brain known as the hippocampus was involved. This part of the brain is critical to the processing and storing of information.

But when they learned the task while multitasking, the hippocampus was not engaged. Instead, an area called the striatum was activated. The striatum is involved in learning new skills like riding a bicycle.

Researchers say the results show that learning while distracted or multitasking alters the brain's learning processes and changes the way people learn.

Multitasking when performing certain tasks -- like listening to music while exercising -- may be helpful. But Poldrack says tasks that distract you while you try to learn something new are likely to negatively affect your learning.

"The best thing you can do to improve your memory is to pay attention to the things you want to remember," says Poldrack.

July 9, 2003 -- Finding out how much of a little-known but artery-clogging fat your favorite snack and processed foods contain is about to get a lot easier. The FDA today announced that manufacturers will soon be required to list on the Nutrition Facts label the amount of trans fatty acids, or trans fat, in foods.

The new rule will go into effect on Jan. 1, 2006, but manufacturers will start phasing in the new labels well before that deadline. It's the first major change in the Nutrition Facts label since it was established in 1993.

"We are empowering Americans to make healthier choices about the foods they eat," says U.S. Health and Human Services Secretary Tommy Thompson, in a news release. "By putting trans fat information on food labels, we are making it possible for consumers to make better educated choices to lower their intake of these unhealthy fats and cholesterol."

Trans fats are frequently found in the same foods that contain other types of fat, such as cookies, crackers, fried foods such as french fries and chicken fried in shortening, donuts, and margarine sticks.

When a Good Fat Goes Bad

Trans fatty acids are the result of a process called hydrogenation that converts a relatively healthy, unsaturated liquid fat, such as vegetable oil, into a solid one, to make the product shelf stable and stay fresh longer. When the fat becomes solid, the body treats it more like a saturated fat, like butter or animal fat. But it is not classified as saturated fat on food labels

"Trans fat, like saturated fat and dietary cholesterol, raises LDL 'bad' cholesterol levels in the blood, which increases the risk for heart disease," says Claude Lenfant, MD, director of National Heart, Lung and Blood Institute (NHLBI), in the release. "It is therefore desirable to have food labels display all the information that can help consumers choose foods low in saturated fat, trans fat, and cholesterol as part of a healthy diet."

The new regulations will require food makers to list the number of trans fat grams a food contains in addition to the saturated and unsaturated fat content and cholesterol level.

May 28, 2002 -- Here's more good news about fruits and veggies. "Five a day" can lower your blood pressure, greatly reducing risk of heart disease.

In a six-month study involving nearly 700 people, half were asked to eat five servings of fruits and vegetables every day; half served as controls and didn't change their diet.

The results: Those who ate the good stuff had higher levels of numerous healthy antioxidants than those who didn't.

Also: "significant decreases" in blood pressure were seen in the fruit-and-veggie group, reports Andrew Neil, PhD, a public health researcher at the University of Oxford, England. His study appears in this week's issue of The Lancet.

"The falls in blood pressure in our study ... would substantially reduce cardiovascular disease," he writes. His results match those of a larger study, which showed lower rates of high blood pressure in people who followed a similar five-a-day plan.

Most of the people participating in his study were women about 46 years old, and in the upper socioeconomic classes; 16% of the study participants were smokers, he reports. Neither group was advised to reduce fat intake; and the researchers saw no change in total cholesterol levels and only a small increase in body weight, he says.

"Therefore, the fall in blood pressure achieved in our study is unlikely to be attributable to reduced fat intake or changes in physical activity," writes Neil. "The reduction in blood pressure probably resulted from increased potassium intake, and possibly from some reduction in sodium, although participants were not advised specifically to reduce salt intake."

Here are some tips adapted from the 5 A Day For Better Health program -- a national nutrition effort to encourage Americans to eat five or more servings of fruits and vegetables a day for better health:

• Wake up to fruit. Drink a glass of 100% fruit juice or incorporate a helping of fruit into your breakfast every day.
• Think "fruit" or "vegetable" when snacking. Munch on a handful of carrots or a piece of fruit when you get the urge to snack.
• Keep the pantry packed with easy-to-prepare dried, canned, or frozen fruits and vegetables.
• Make them visible. You're more likely to eat fruits and vegetables when they are easily accessible. Wash some carrots or celery sticks and keep them close at hand in the refrigerator. Put clean fruit out for the family to snack on.
• Use the microwave to your advantage. It's a great (and convenient) way to quickly prepare vegetables for meals.

Visit the 5 A Day site at http://dccps.nci.nih.gov/5aday/ for a wide variety of simple, easy-to-make recipes.

The sun is shining, temperatures are rising. Summer is the time to shed layers of clothes, as well as some pounds. You could opt for a stringent diet regime, but what about simply enjoying all the wonderful foods the season brings? You'll still slim down, and do wonders for your health.

It's a natural trend to eat lighter during the summer, and you can easily do so without feeling deprived. If you follow the U.S. government's 2005 dietary guidelines of four-and-a-half cups of fruits and vegetables and three servings of fat-free or low-fat dairy each day, you'll be getting plenty of naturally low-cal foods that are high in fiber, calcium, and important nutrients.

"Fiber helps in weight control because it promotes a feeling of satisfaction or satiety," explains Registered Dietitian Cheryl Orlansky, of the Computer Science Corporation. "High-fiber foods, eaten consistently, prevent that rebound effect of feeling full one minute and looking for something else to eat the next. It also helps modulate blood sugars by slowing down the digestion of sugars to prevent a quick surge into the bloodstream."

Much of summer's bounty has extra nutritional benefits you may not be aware of. Fruits and vegetables contain antioxidants and other phytonutrients that may slow aging, protect against cancer and stroke, improve blood pressure, and keep your heart healthy. And just about all are low-calorie, so your waistline stays in check, another big health benefit.

Ready to slim down with summer foods? Start your summer "diet" with these.

March 17, 2004 -- "Do it now," Americans like to say. But we're more likely to be talking about eating a pizza than working out.

And that's why we're so fat, argue economist John Komlos, PhD, of the University of Munich, Germany, and colleagues. In a provocative paper, the researchers find that Americans started getting fat about the same time they stopped planning for the future.

Their major evidence: As Americans began spending more and saving less of their income, their weight began to rise. The less we save for the future, the more weight we gain. People living in countries that that save more of their income are less obese. The findings appear in the current issue of the Journal of Biosocial Science.

"People have tried to look at a lot of reasons why Americans are getting so overweight. But nobody has thought about the idea of connecting it to impatience," Komlos tells WebMD. "If you are willing to forgo present satisfaction for future benefits, you are patient. If, however, you want your satisfaction right now, then you are going to have that extra dessert and that extra ice cream and you are not going to be able to forgo the pleasures of today."

Obesity: The Future Is Now

The future, said French novelist Gustave Flaubert, is the worst thing about the present. Americans solve this dilemma by simply ignoring the future. Economists would say Americans have a "high rate of time preference." In plain language, this means we ignore future health risks and maximize current consumption.

Such people are impatient, says study co-author Barry Bogin, PhD, an anthropologist at the University of Michigan-Dearborn.

"When it comes to spending money, they say, 'Let's go out and buy the stuff I want.' When it comes to food, they say, 'If they put it all in front of me now, I will eat it,'" Bogin tells WebMD.

By now, everybody knows that if you eat less and exercise more, you'll lose weight. Keep it up, and you will be more healthy. But that means valuing the future so much that you'll shove your plate aside and make time to go jogging or to work out at a gym. Fewer and fewer Americans do this.

"All you have to do is get out and exercise for an hour, but people won't do that because of their time preference," Bogin says. "They say, 'Why invest an hour? I should be writing another paper, doing more work, watching this thing on TV -- whatever seems important right now."

A widespread phenomenon such as obesity has no single cause, notes study co-author Patricia K. Smith, PhD, an economist at the University of Michigan-Dearborn.

"People have to think about how what they do now affects the future -- about what [they] will do about the future," Smith says.

And that's getting harder and harder for more and more of us. Even something as seemingly innocuous as watching television becomes part of the problem.

"We know that when people watch TV, they eat junk food more than if they were reading or listening to music," Bogin says. "It gets complex here. Does TV cause obesity? No. But a combination of poverty, low education, watching TV, the hopelessness of being poor in a rich nation, it all adds together and raises your time preference, and you say, 'Who cares about the future? I'm going to eat the whole pizza right now.'"

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

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

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

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

Emotional Feeling, Physical Effect

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

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

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

Campus Study

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

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

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

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

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

Lonely Students, Weaker Immune Response

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

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

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

Loneliness, Isolation Are Different

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

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

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

Familiar Feelings

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

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

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

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

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

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

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

March 19, 2003 -- The scent of a good man may be music to a woman's nose. Researchers say the odorless pheromones found in male perspiration can have a dramatic effect on both a woman's mind and body. A new study found exposure to male pheromones can boost a woman's mood and stimulate the release of a hormone that regulates the menstrual cycle.

In the study, researchers applied extracts of underarm secretions from male volunteers to the upper lips of 18 women between the ages of 25 and 45. None of the women knew that male sweat had been applied to their lips, and some thought they were involved in a study of alcohol or perfume or even lemon floor wax. The women then rated their moods over six hours of exposure; they consistently reported feeling less tension and more relaxed.

"Much to our surprise, the women reported feeling less tense and more relaxed during exposure to the male extract," says researcher Charles J. Wysocki of the University of Pennsylvania, in a news release. "This suggests that there may be much more going on in social settings like singles bars than meets the eye."

Each of the women received three applications of the underarm extract during the six-hour evaluation period, followed by three doses of exposure to ethanol (alcohol) over another six-hour period.

Researchers also found that exposure to the male pheromones also prompted a shift in blood levels of a reproductive hormone called luteinizing hormone. Levels of this hormone typically surge before ovulation, but women also experience small surges during other times in the menstrual cycle.

The study found that the male pheromone extract hastened the onset of these smaller surges and shortened the pauses between surges by 20%.

Researchers are now looking at individual compound that are found in male perspiration in hopes of identifying the elements responsible for these psychological and hormonal changes.

"This may open the door to pharmacological approaches to manage onset of ovulation or the effects of premenstrual syndrome or even natural products to aid relaxation," says Wysocki. "By determining how pheromones impact mood and endocrine response, we might be able to build a better male odor: molecules that more effectively manipulate the effects we observed."

SOURCE: Biology of Reproduction, June 2003. News release, University of Pennsylvania.

When Judith Orloff was a child, her doctor parents became so frustrated with her vivid premonitions -- on everything from illnesses to deaths to earthquakes -- they finally told her not to mention them again.

"I grew up believing something was wrong with me," says Orloff, now a board-certified psychiatrist, assistant clinical professor of psychiatry at UCLA, and author of Second Sight and Dr. Judith Orloff's Guide to Intuitive Healing: 5 Steps to Physical, Emotional, and Sexual Wellness. As a result, Orloff says she strayed far from her intuition (without much difficulty) as she pursued her medical studies. It wasn't until she was in private practice that she once again learned to trust her intuitive skills. Orloff recalls that she had been treating a woman for major depression who was responding well to antidepressants and conventional therapy. Seemingly out of the blue, though, Orloff had an image of the patient committing suicide.

"I didn't say anything because I had learned not to listen to myself," says Orloff. "Several weeks later the woman overdosed and was in a coma for weeks."

Fortunately, the patient recovered, and Orloff says she learned to pay attention to her own intuitive abilities.

Orloff says she believes that we all have an intuitive sense, although not everyone realizes it can be accessed. "Intuition is that still, small voice inside of you," she says. "It's your inner wisdom that can help you deal with anything from health issues to relationships to death and dying."

Orloff prefers to call herself an intuitive, rather than a psychic or clairvoyant, because she believes those terms have been too "tarnished" in our society and evoke images of sideshow acts.

In her practice -- which has a waiting list of 6,000 patients -- and in her workshops for healthcare professionals around the country, Orloff teaches people to develop their own intuition.

Nov. 11, 2004 -- Going to church may do more than bring out your spiritual side; it could make you a healthier eater, according to a new study.

Researchers found that people who regularly attend church eat 25% more of the fruits and vegetables that pack the biggest nutritional punch. These nutritional powerhouses include citrus fruits, cruciferous vegetables like broccoli and cauliflower, dark leafy greens, carrots, and cantaloupe.

"The body is your temple, and we should treat it that way," says researcher Deidre Griffith of the Saint Louis University, in a news release. "Church can be a big part of your support system for changing your diet."

Griffith presented the results of the study this week at the annual meeting of the American Public Health Association in Washington, D.C.

Church May Foster Healthy Eating Habits

In the study, researchers surveyed 315 people about their church attendance and eating habits. Most of the participants were black, 78% were female, and 32% had incomes below the federal poverty level.

The results showed that people who attended church ate 25% more of the most nutritious fruits and vegetables than those who did not go to church.

All of the participants ate the most popular fruits and vegetables, including corn, iceberg lettuce, and bananas. But the study showed that people who went to church frequently, such as choir members, participants in bible study groups, and others, ate more of the fruits and vegetables that contain the most vitamins and minerals.

Researchers say going to church may foster healthy eating habits, and the results suggest that churches should take an active role in encouraging these types of healthy behaviors.

"We're saying church membership or having that church community is one of the key links in the long chain of social support structures that help people eat better," says Griffith.

May 24, 2004 -- Obese and overweight women are at increased risk of getting suspicious results from screening mammograms, research shows.

Mammograms don't miss any more cancers in heavy women than in thin women. But the more a woman weighs, the greater the risk that her mammogram will have false positive results. That means more tests - and more anxiety.

Joann G. Elmore, MD, MPH, of the University of Washington in Seattle, and colleagues analyzed more than 100,000 mammograms from nearly 70,000 women. The report their findings in the May 24 issue of Archives of Internal Medicine.

"Compared with underweight or normal weight women, overweight and obese women were more likely to be recalled for additional tests," Elmore and co-workers write. "Obese women had more than a 20% increased risk of having a false positive mammogram result."

At the personal level, it's not a huge increase in risk. Overall, a woman faces about one in 10 chance of getting a false positive result on a screening mammogram. Obesity increases that risk from 10% to 12%.

But those extra tests add up fast. For an estimated 10 million obese women in the U.S., this means some 200,000 false positives. At $600 per retest, that adds up to an extra $120 million in U.S. health-care costs. And that doesn't even begin to measure the personal costs.

"We cannot put a quantitative value on the resultant anxiety these 200,000 women would additionally experience," Elmore and colleagues note.

Even so, obese women need mammograms more than skinny women. That's because a breast examination is more likely to miss small tumors in women with very large breasts.

The researchers suggest that larger mammography plates may help get better images of women with large breasts. They also suggest that weight loss may lower the likelihood of an unnecessarily traumatic experience when it's time for a routine mammogram.

July 9, 2003 -- Finding out how much of a little-known but artery-clogging fat your favorite snack and processed foods contain is about to get a lot easier. The FDA today announced that manufacturers will soon be required to list on the Nutrition Facts label the amount of trans fatty acids, or trans fat, in foods.

The new rule will go into effect on Jan. 1, 2006, but manufacturers will start phasing in the new labels well before that deadline. It's the first major change in the Nutrition Facts label since it was established in 1993.

"We are empowering Americans to make healthier choices about the foods they eat," says U.S. Health and Human Services Secretary Tommy Thompson, in a news release. "By putting trans fat information on food labels, we are making it possible for consumers to make better educated choices to lower their intake of these unhealthy fats and cholesterol."

Trans fats are frequently found in the same foods that contain other types of fat, such as cookies, crackers, fried foods such as french fries and chicken fried in shortening, donuts, and margarine sticks.

When a Good Fat Goes Bad

Trans fatty acids are the result of a process called hydrogenation that converts a relatively healthy, unsaturated liquid fat, such as vegetable oil, into a solid one, to make the product shelf stable and stay fresh longer. When the fat becomes solid, the body treats it more like a saturated fat, like butter or animal fat. But it is not classified as saturated fat on food labels

"Trans fat, like saturated fat and dietary cholesterol, raises LDL 'bad' cholesterol levels in the blood, which increases the risk for heart disease," says Claude Lenfant, MD, director of National Heart, Lung and Blood Institute (NHLBI), in the release. "It is therefore desirable to have food labels display all the information that can help consumers choose foods low in saturated fat, trans fat, and cholesterol as part of a healthy diet."

The new regulations will require food makers to list the number of trans fat grams a food contains in addition to the saturated and unsaturated fat content and cholesterol level.

When Judith Orloff was a child, her doctor parents became so frustrated with her vivid premonitions -- on everything from illnesses to deaths to earthquakes -- they finally told her not to mention them again.

"I grew up believing something was wrong with me," says Orloff, now a board-certified psychiatrist, assistant clinical professor of psychiatry at UCLA, and author of Second Sight and Dr. Judith Orloff's Guide to Intuitive Healing: 5 Steps to Physical, Emotional, and Sexual Wellness. As a result, Orloff says she strayed far from her intuition (without much difficulty) as she pursued her medical studies. It wasn't until she was in private practice that she once again learned to trust her intuitive skills. Orloff recalls that she had been treating a woman for major depression who was responding well to antidepressants and conventional therapy. Seemingly out of the blue, though, Orloff had an image of the patient committing suicide.

"I didn't say anything because I had learned not to listen to myself," says Orloff. "Several weeks later the woman overdosed and was in a coma for weeks."

Fortunately, the patient recovered, and Orloff says she learned to pay attention to her own intuitive abilities.

Orloff says she believes that we all have an intuitive sense, although not everyone realizes it can be accessed. "Intuition is that still, small voice inside of you," she says. "It's your inner wisdom that can help you deal with anything from health issues to relationships to death and dying."

Orloff prefers to call herself an intuitive, rather than a psychic or clairvoyant, because she believes those terms have been too "tarnished" in our society and evoke images of sideshow acts.

In her practice -- which has a waiting list of 6,000 patients -- and in her workshops for healthcare professionals around the country, Orloff teaches people to develop their own intuition.

Nov. 11, 2004 -- Going to church may do more than bring out your spiritual side; it could make you a healthier eater, according to a new study.

Researchers found that people who regularly attend church eat 25% more of the fruits and vegetables that pack the biggest nutritional punch. These nutritional powerhouses include citrus fruits, cruciferous vegetables like broccoli and cauliflower, dark leafy greens, carrots, and cantaloupe.

"The body is your temple, and we should treat it that way," says researcher Deidre Griffith of the Saint Louis University, in a news release. "Church can be a big part of your support system for changing your diet."

Griffith presented the results of the study this week at the annual meeting of the American Public Health Association in Washington, D.C.

Church May Foster Healthy Eating Habits

In the study, researchers surveyed 315 people about their church attendance and eating habits. Most of the participants were black, 78% were female, and 32% had incomes below the federal poverty level.

The results showed that people who attended church ate 25% more of the most nutritious fruits and vegetables than those who did not go to church.

All of the participants ate the most popular fruits and vegetables, including corn, iceberg lettuce, and bananas. But the study showed that people who went to church frequently, such as choir members, participants in bible study groups, and others, ate more of the fruits and vegetables that contain the most vitamins and minerals.

Researchers say going to church may foster healthy eating habits, and the results suggest that churches should take an active role in encouraging these types of healthy behaviors.

"We're saying church membership or having that church community is one of the key links in the long chain of social support structures that help people eat better," says Griffith.

Aug. 13, 2004 -- James Bond may prefer his martinis, but a new study shows red wine beats gin, shaken or stirred, when it comes to heart health.

Researchers found drinking moderate amounts of both alcoholic beverages had beneficial effects in reducing inflammation in the blood, which has been linked to artery-clogging plaque buildup and heart disease. But red wine had a significantly greater effect on fighting inflammation in the blood.

"It's clear from these results that while drinking some form of alcohol lowers inflammatory markers, red wine has a much greater effect than gin," says Emanuel Rubin, MD, a pathology professor at Jefferson Medical College of Thomas Jefferson University in Philadelphia, in a news release.

Researchers say that many studies have linked drinking alcohol, especially red wine, to a lower risk of heart disease and stroke. But few studies have compared the effects of different types of alcoholic beverages in reducing risk factors for heart attack and stroke, such as inflammatory markers in the blood.

High levels of C-reactive protein and other markers of inflammation in the blood are risk factors that have been implicated in heart disease and stroke, says Rubin.

Red Wine Fights Clogged Arteries

In the study, 40 healthy men consumed 30 grams of ethanol either in the form of two glasses (about 10 ounces) of red wine (Merlot) or 3.3 ounces of gin with dinner each day for 28 days. All of the participants also followed relatively the same diet and exercise program during the study.

Researchers analyzed blood samples before and after the study, and found both wine and gin had anti-inflammatory effects.

Both groups had lower levels of fibrinogen, which clots blood and is a risk factor for heart attack. They also had lower levels of the inflammatory marker IL-1.

But those who drunk red wine also had lower levels of C-reactive protein and two other inflammatory markers.

Researchers say the antioxidant effects of the polyphenols found in red wine, but not in gin, are likely responsible for the additional heart-healthy effects. Beer and whisky also have high levels of polyphenols.

Rubin says one or two glasses of red wine a day is probably beneficial, but these results provide only indirect evidence of a protective effect against heart disease.

May 24, 2004 -- Obese and overweight women are at increased risk of getting suspicious results from screening mammograms, research shows.

Mammograms don't miss any more cancers in heavy women than in thin women. But the more a woman weighs, the greater the risk that her mammogram will have false positive results. That means more tests - and more anxiety.

Joann G. Elmore, MD, MPH, of the University of Washington in Seattle, and colleagues analyzed more than 100,000 mammograms from nearly 70,000 women. The report their findings in the May 24 issue of Archives of Internal Medicine.

"Compared with underweight or normal weight women, overweight and obese women were more likely to be recalled for additional tests," Elmore and co-workers write. "Obese women had more than a 20% increased risk of having a false positive mammogram result."

At the personal level, it's not a huge increase in risk. Overall, a woman faces about one in 10 chance of getting a false positive result on a screening mammogram. Obesity increases that risk from 10% to 12%.

But those extra tests add up fast. For an estimated 10 million obese women in the U.S., this means some 200,000 false positives. At $600 per retest, that adds up to an extra $120 million in U.S. health-care costs. And that doesn't even begin to measure the personal costs.

"We cannot put a quantitative value on the resultant anxiety these 200,000 women would additionally experience," Elmore and colleagues note.

Even so, obese women need mammograms more than skinny women. That's because a breast examination is more likely to miss small tumors in women with very large breasts.

The researchers suggest that larger mammography plates may help get better images of women with large breasts. They also suggest that weight loss may lower the likelihood of an unnecessarily traumatic experience when it's time for a routine mammogram.

Nov. 26, 2003 -- Before you get too comfortable at the buffet table this holiday season, you may want to take a second look at the scale. A new poll shows many Americans may be deluding themselves about their weight.

The Gallup survey found that although more than half of those surveyed were overweight according to their BMI (body mass index, a measurement of weight in relationship to height), only about 40% think of themselves that way.

The delusion doesn't stop there. The poll found that 37% of Americans would still be classified as overweight according to standard BMI charts even if they did lose weight and reach what they think would be their "ideal" weight, including 4% who would still be considered obese at their "ideal" weight.

Americans Kidding Themselves About Their Weight

The survey, based on telephone interviews with 1,007 adults across the U.S., was conducted November 3-5. Researchers used the heights and weights that the respondents reported to calculate their BMI. They found 55% of all Americans would be classified as either overweight (35%) or obese (20%).

According to standards, BMI scores of:

• Less than 18.5 are considered underweight
• 18.5 to 24.9 are considered normal
• 25 to 29.9 suggest the person is overweight
• 30 or higher suggest the person is obese

Researchers found that men were more likely than women to be classified as overweight and obese based on their BMI -- 68% of men compared with 43% of women.

Despite those numbers, just 41% of Americans overall said they were either "somewhat" (37%) or "very" (4%) overweight.

Good Intentions Not Enough to Lose Weight

Even though fewer women were overweight than men, the poll shows women were much more motivated to lose weight than men. Despite the fact that two-thirds of men were considered overweight, only about half (51%) said they wanted to lose weight versus 68% of women who said they wanted to lose weight.

But good intentions aren't enough. Among the obese, who are most likely to suffer serious medical complications as a result of their weight, more than nine in 10 said they wanted to lose weight but only 45% were seriously trying to do so.

The same held true for overweight adults; only about half of those who said they wanted to lose weight actually were trying to do so.

With so many people wanting to lose weight, researchers say it's not surprising that about two-thirds of Americans said their ideal weight is below their actual weight. On average, men reported an ideal weight that was 14 pounds lower than their actual weight, and women reported an ideal weight almost 19 pounds lower then their current weight.

However, according to the BMI charts, researchers found that 54% of those who are overweight, but not obese, would still be overweight if they reached their ideal weight, and three-quarters of currently obese people would still be overweight if they reached their ideal weight.

Although those numbers are discouraging, researchers warn that BMI isn't everything when it comes to measuring a healthy weight. BMI is a more accurate indicator of overweight and obesity than relying on weight alone, but the National Institutes of Health cautions that BMI does not directly measure body fat.

For example, some very muscular people may fall into the overweight category when they are actually healthy and fit. In addition, some people who have lost muscle mass, such as the elderly, may be in the healthy weight category when they are actually underweight with reduced nutritional reserves.

SOURCES: Gallup Survey, conducted Nov. 3-5, 2003. News release, Gallup Organization.

July 9, 2003 -- Finding out how much of a little-known but artery-clogging fat your favorite snack and processed foods contain is about to get a lot easier. The FDA today announced that manufacturers will soon be required to list on the Nutrition Facts label the amount of trans fatty acids, or trans fat, in foods.

The new rule will go into effect on Jan. 1, 2006, but manufacturers will start phasing in the new labels well before that deadline. It's the first major change in the Nutrition Facts label since it was established in 1993.

"We are empowering Americans to make healthier choices about the foods they eat," says U.S. Health and Human Services Secretary Tommy Thompson, in a news release. "By putting trans fat information on food labels, we are making it possible for consumers to make better educated choices to lower their intake of these unhealthy fats and cholesterol."

Trans fats are frequently found in the same foods that contain other types of fat, such as cookies, crackers, fried foods such as french fries and chicken fried in shortening, donuts, and margarine sticks.

When a Good Fat Goes Bad

Trans fatty acids are the result of a process called hydrogenation that converts a relatively healthy, unsaturated liquid fat, such as vegetable oil, into a solid one, to make the product shelf stable and stay fresh longer. When the fat becomes solid, the body treats it more like a saturated fat, like butter or animal fat. But it is not classified as saturated fat on food labels

"Trans fat, like saturated fat and dietary cholesterol, raises LDL 'bad' cholesterol levels in the blood, which increases the risk for heart disease," says Claude Lenfant, MD, director of National Heart, Lung and Blood Institute (NHLBI), in the release. "It is therefore desirable to have food labels display all the information that can help consumers choose foods low in saturated fat, trans fat, and cholesterol as part of a healthy diet."

The new regulations will require food makers to list the number of trans fat grams a food contains in addition to the saturated and unsaturated fat content and cholesterol level.

Jan. 3, 2003 -- Houston is the couch potato capital of the U.S. and Honolulu is the fittest city, say the editors of Men's Fitness magazine.

The "America's Fattest City" award goes to Houston for the third year, uh, running. The ratings are based on a major city's score in several categories such as fruit/vegetable consumption, sports participation, smoking, drinking, air quality, and percentage of overweight/sedentary residents.

"Given the region's climate (hot and humid), air quality (abysmal), and relative lack of outdoor recreation, staying active presents a Texas-sized challenge," the magazine states. "And with its love of junk food, Houston is a vastrodome of bad nutrition."

If you don't live in Houston, don't let out your belt just yet. The annual ratings are meant as a wake-up call to stop what the CDC calls a national epidemic of obesity. Two in every three Americans have a serious weight problem.

Here's the magazine's list of America's 10 fattest cities:

1. Houston
2. Chicago
3. Detroit
4. Philadelphia
5. St. Louis
6. Cleveland
7. Atlanta
8. Columbus, Ohio
9. Dallas
10. Charlotte, N.C.

And its list of the 10 fittest cities:

1. Honolulu
2. Seattle
3. San Francisco
4. Colorado Springs, Col.
5. San Diego
6. Portland, Ore.
7. Denver
8. Virginia Beach, Va.
9. Tucson, Ariz.
10. Sacramento, Calif.

May 28, 2002 -- Here's more good news about fruits and veggies. "Five a day" can lower your blood pressure, greatly reducing risk of heart disease.

In a six-month study involving nearly 700 people, half were asked to eat five servings of fruits and vegetables every day; half served as controls and didn't change their diet.

The results: Those who ate the good stuff had higher levels of numerous healthy antioxidants than those who didn't.

Also: "significant decreases" in blood pressure were seen in the fruit-and-veggie group, reports Andrew Neil, PhD, a public health researcher at the University of Oxford, England. His study appears in this week's issue of The Lancet.

"The falls in blood pressure in our study ... would substantially reduce cardiovascular disease," he writes. His results match those of a larger study, which showed lower rates of high blood pressure in people who followed a similar five-a-day plan.

Most of the people participating in his study were women about 46 years old, and in the upper socioeconomic classes; 16% of the study participants were smokers, he reports. Neither group was advised to reduce fat intake; and the researchers saw no change in total cholesterol levels and only a small increase in body weight, he says.

"Therefore, the fall in blood pressure achieved in our study is unlikely to be attributable to reduced fat intake or changes in physical activity," writes Neil. "The reduction in blood pressure probably resulted from increased potassium intake, and possibly from some reduction in sodium, although participants were not advised specifically to reduce salt intake."

Here are some tips adapted from the 5 A Day For Better Health program -- a national nutrition effort to encourage Americans to eat five or more servings of fruits and vegetables a day for better health:

• Wake up to fruit. Drink a glass of 100% fruit juice or incorporate a helping of fruit into your breakfast every day.
• Think "fruit" or "vegetable" when snacking. Munch on a handful of carrots or a piece of fruit when you get the urge to snack.
• Keep the pantry packed with easy-to-prepare dried, canned, or frozen fruits and vegetables.
• Make them visible. You're more likely to eat fruits and vegetables when they are easily accessible. Wash some carrots or celery sticks and keep them close at hand in the refrigerator. Put clean fruit out for the family to snack on.
• Use the microwave to your advantage. It's a great (and convenient) way to quickly prepare vegetables for meals.

Visit the 5 A Day site at http://dccps.nci.nih.gov/5aday/ for a wide variety of simple, easy-to-make recipes.

If you've got diabetesdiabetes, the right meal plan can help you keep blood sugar under control. Fruits and vegetables, lean protein, whole grains, and low-fat dairy products -- even sweets now and then -- all have a place in your plan.

"A meal plan provides a specific approach to controlling blood sugar," says Dianne Davis, RD, LDN, CDE, a dietitian with the Vanderbilt Eskind Diabetes Center in Nashville, Tenn. "If you have diabetes, a meal plan is necessary."

That's because a meal plan helps ensure you eat a balanced diet high in fiber and low in fats. It can also "help you lose weight, by controlling portion sizes and calories," Davis says.

Which Diabetes Meal Plan Is Right for You?

Your lifestyle and the type of diabetes treatment you're getting -- whether you're taking premeal insulin or not -- will determine the type of meal plan best for you, says Davis.

Carbohydrates, proteins, and fats are all factored into a plan. But carbs are an especially important component since they have the biggest impact on blood sugar.

"Your meal plan can also include your favorite foods," Davis adds. "No food is off-limits -- it's a matter of how much you eat, when you eat it, and what it will do to your blood sugar."

With that in mind -- and understanding you should talk with your doctor before making big changes in your diabetes diet -- here are four meal-planning systems.

The Diabetes Food Pyramid

The diabetes food pyramid is similar to the USDA food pyramid you see on food labels. It is a pyramid in which a healthy diet means eating more grains, fruits, and vegetables, and less meat, sweets, and fats.

The diabetes food pyramid's general recommendations are:

• Grains, beans, and starchy vegetables: 6 or more servings/day. One serving: 1 slice bread; 1/2 small bagel; 1/2 cup cooked cereal, pasta, rice; 3/4 cup ready-to-eat cereal; 1/2 cup cooked beans, corn, peas.
• Fruits: 2-4 servings daily. One serving: 1 medium-size fresh fruit; 1/2 cup canned fruit; 1/2 cup fruit juice.
• Vegetables: 3-5 servings a day. One serving: 1 cup raw vegetable; 1/2 cup vegetable juice.
• Meat, Fish, Cheese: 2-3 servings/day. One serving: 2-3 ounces cooked lean meat, skinless poultry, or fish; I egg; 2 tablespoons peanut butter; 2-3 ounces cheese.
• Milk and Yogurt: 2-3 servings daily. One serving: 1 cup (8 ounces) milk or yogurt.
• Fats, Sweets, and Alcohol: eat these in small amounts. One serving: 1 teaspoon butter, margarine, or mayonnaise; 1 tablespoon cream cheese or salad dressing; 1/2 cup ice cream.

Combined foods, like eggplant lasagna, for example, will include servings from several food groups (1 vegetable, 1 meat, 1 fat).

This meal system has limitations, says Davis. "When you follow the diabetes food pyramid, you are not controlling specific grams of carbs and might not be able to achieve very tight blood sugar control," she tells WebMD. "However, the pyramid helps you see which foods are carbohydrates -- to get you acquainted with them."

The sun is shining, temperatures are rising. Summer is the time to shed layers of clothes, as well as some pounds. You could opt for a stringent diet regime, but what about simply enjoying all the wonderful foods the season brings? You'll still slim down, and do wonders for your health.

It's a natural trend to eat lighter during the summer, and you can easily do so without feeling deprived. If you follow the U.S. government's 2005 dietary guidelines of four-and-a-half cups of fruits and vegetables and three servings of fat-free or low-fat dairy each day, you'll be getting plenty of naturally low-cal foods that are high in fiber, calcium, and important nutrients.

"Fiber helps in weight control because it promotes a feeling of satisfaction or satiety," explains Registered Dietitian Cheryl Orlansky, of the Computer Science Corporation. "High-fiber foods, eaten consistently, prevent that rebound effect of feeling full one minute and looking for something else to eat the next. It also helps modulate blood sugars by slowing down the digestion of sugars to prevent a quick surge into the bloodstream."

Much of summer's bounty has extra nutritional benefits you may not be aware of. Fruits and vegetables contain antioxidants and other phytonutrients that may slow aging, protect against cancer and stroke, improve blood pressure, and keep your heart healthy. And just about all are low-calorie, so your waistline stays in check, another big health benefit.

Ready to slim down with summer foods? Start your summer "diet" with these.

Indeed, the year 2000 was a very good year for wine makers -- and not just because it brought a bumper crop of cabernets, zinfandels, and chardonnays. Evidence of the far-reaching health benefits of wine continued to pour in from researchers around the world.

Here's a review of the good news for wine makers -- and wine lovers:

A Healthier Heart

Several reports in 2000 confirmed the glad tidings that wine -- in moderation, of course -- reduces the risk of cardiovascular disease and heart attacks. In the September issue of the Annals of Internal Medicine, for instance, Swedish researchers at the Karolinska Institute reported that, compared to teetotalers, light drinkers who consumed wine cut their risk of dying prematurely by almost one third, and wine drinkers as a group had significantly lower mortality from cardiovascular disease and cancer. Actually, drinking any kind of alcoholic beverage helped, the scientists found. But by far the biggest benefit accrued to wine drinkers.

What's more, scientists are beginning to understand how wine may bestow its salutary benefits. For starters, according to findings published in the January 2000 issue of European Heart Journal, this most ancient of beverages appears to dilate arteries and increase blood flow, thus lowering the risk of the kind of clots that cut off blood supply and damage heart muscles.

In addition, the fruit of the vine appears to boost levels of HDL, the "good" cholesterol, and helps prevent LDL, or bad cholesterol, from causing damage to the lining of arteries. In a study published in the May 2000 issue of the journal Pharmacology, Biochemistry, and Behavior, scientists at the Institute for Research in Extramural Medicine in Amsterdam tested 275 men and women around the age of 32. Those who imbibed the equivalent of a glass or two of wine each day had significantly higher levels of "good" cholesterol because they remove the "bad" artery-clogging LDLs before they have a chance to choke blood vessels. Indeed, wine seems to facilitate that process, making it easier for HDLs to hustle their dangerous counterparts out of the bloodstream.

Yet even when LDLs remain behind in the arteries, substances in wine called phenols appear to help prevent the bad cholesterol from causing injury. In the November 2000 Journal of Nutrition and Biochemistry, Italian researchers from the National Institute for Food and Nutrition Research reported that phenols seem to limit the oxidation of LDLs, making them less capable of damaging the linings of arteries and, therefore, less able to set the stage for cardiovascular disease, like heart disease and stroke.

A Shield Against Cancer

Wine also may protect against several forms of another common killer: cancer. It turns out that the same phenolic compounds that lower heart disease risk also may slow the growth of breast cancer cells, according to findings reported by scientists at the University of Crete in Greece in the June 2000 issue of Journal of Cellular Biochemistry. Phenols also were shown to suppress the growth of prostate cancer cells. And French scientists found evidence that an antioxidant in wine called resveratrol can put the brakes on the growth of liver cancer cells, according to a report in the July-August 2000 issue of Oncology Reports.

There also was a report that wine -- particularly red wine -- might help ward off oral cancer. Researchers from the University of Missouri School of Dentistry discovered that resveratrol and another antioxidant called quercetin may inhibit the growth of oral cancer cells. Their findings, published in the June 2000 Journal of the American Dental Association, note that red wine is loaded with a slew of other antioxidants that seem to boost its cancer-fighting abilities.

March 17, 2004 -- "Do it now," Americans like to say. But we're more likely to be talking about eating a pizza than working out.

And that's why we're so fat, argue economist John Komlos, PhD, of the University of Munich, Germany, and colleagues. In a provocative paper, the researchers find that Americans started getting fat about the same time they stopped planning for the future.

Their major evidence: As Americans began spending more and saving less of their income, their weight began to rise. The less we save for the future, the more weight we gain. People living in countries that that save more of their income are less obese. The findings appear in the current issue of the Journal of Biosocial Science.

"People have tried to look at a lot of reasons why Americans are getting so overweight. But nobody has thought about the idea of connecting it to impatience," Komlos tells WebMD. "If you are willing to forgo present satisfaction for future benefits, you are patient. If, however, you want your satisfaction right now, then you are going to have that extra dessert and that extra ice cream and you are not going to be able to forgo the pleasures of today."

Obesity: The Future Is Now

The future, said French novelist Gustave Flaubert, is the worst thing about the present. Americans solve this dilemma by simply ignoring the future. Economists would say Americans have a "high rate of time preference." In plain language, this means we ignore future health risks and maximize current consumption.

Such people are impatient, says study co-author Barry Bogin, PhD, an anthropologist at the University of Michigan-Dearborn.

"When it comes to spending money, they say, 'Let's go out and buy the stuff I want.' When it comes to food, they say, 'If they put it all in front of me now, I will eat it,'" Bogin tells WebMD.

By now, everybody knows that if you eat less and exercise more, you'll lose weight. Keep it up, and you will be more healthy. But that means valuing the future so much that you'll shove your plate aside and make time to go jogging or to work out at a gym. Fewer and fewer Americans do this.

"All you have to do is get out and exercise for an hour, but people won't do that because of their time preference," Bogin says. "They say, 'Why invest an hour? I should be writing another paper, doing more work, watching this thing on TV -- whatever seems important right now."

A widespread phenomenon such as obesity has no single cause, notes study co-author Patricia K. Smith, PhD, an economist at the University of Michigan-Dearborn.

"People have to think about how what they do now affects the future -- about what [they] will do about the future," Smith says.

And that's getting harder and harder for more and more of us. Even something as seemingly innocuous as watching television becomes part of the problem.

"We know that when people watch TV, they eat junk food more than if they were reading or listening to music," Bogin says. "It gets complex here. Does TV cause obesity? No. But a combination of poverty, low education, watching TV, the hopelessness of being poor in a rich nation, it all adds together and raises your time preference, and you say, 'Who cares about the future? I'm going to eat the whole pizza right now.'"

July 2, 2001 -- After Deborah Taylor-Hough's first child was born prematurely, she and her husband found themselves traveling to the intensive care nursery twice a day. "Probably what helped me most at that time is that the ladies from my church brought us two weeks' worth of frozen meals, and I didn't have to worry about what we were eating," she says.

A few years later, when her husband was working a swing shift, Taylor-Hough wanted to serve the main meal at noon, before he left. "The morning was our family time, but I also had to cook dinner then, and I felt like getting dinner ready was taking away my life," she recalls. A friend suggested she try cooking a month's food at once and storing it in the freezer.

From those small beginnings has grown a big passion. In 1998, Taylor-Hough published Frozen Assets: How to Cook for a Day and Eat for a Month, and today she has more than 2,000 people involved in her email list and online discussion group.

Bulk Cooking

Here's how it works: Once a month, she spends an hour on a Thursday night writing a shopping list. The next day, she shops. ("Never shop and cook on the same day," she advises.)

On Friday night she does the prep work, like chopping onions, grating cheese, making spaghetti sauce, and browning ground beef. On Saturday she spends a solid 6 to 8 hours cooking. By the end of the day she has a month's worth of meals in the freezer.

A big surprise for Taylor-Hough was how much money she saves. Because she was buying in bulk and eating out much less, her monthly budget for food dropped from $700 to $300 for a family of five.

Her web site is loaded with recipe ideas, cooking tips, and sample meal plans. Typical dishes include soups, meat loaf, stews, casseroles, and meat items to serve over rice.

While Taylor-Hough's first book on bulk cooking gets top marks for efficiency and price-consciousness, many recipes tend toward red meat and white flour. Her newly released sequel, Frozen Assets Lite & Easy, has more healthy, low-fat recipes, she says.

In addition, the bulk cooking system is designed chiefly for main dishes, the most time-consuming part of a meal. Of course, they should be combined with fresh fruit and salad.

Once you've grasped the basic idea of bulk cooking, you adjust it to fit your own circumstances, Taylor-Hough says. And you don't have to have a large freezer for it to work. For years, she had only a small freezer on top of the refrigerator.

"Use freezer bags, freeze them flat, and then stand them on end to make better use of your space," she says. "You can easily fit two weeks of main dishes in that space. Actually, I can do a full month."

"This is a wonderful, wonderful idea," says Lauren Groveman, who hosts a radio program on food, family, and the home. "You can plan ahead when you see a crazy week coming. When you're busiest, and feeling most tired and needy, that's the most important time to go to your own freezer and benefit from healthy, home-cooked food, instead of the drive-through line at the local fast-food place."

Many foods freeze perfectly, says Groveman, whose TV show, Cooking with Lauren Groveman, premiers this fall, especially soups, stews, and chili. "Brisket is such a tough meat it's improved by slow cooking followed by freezing. Make a big batch of stock, chill it first to skim off extra fat, and divide it into containers. When you want soups or stews you don't need to start with that powdered stuff!"

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

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

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

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

Emotional Feeling, Physical Effect

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

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

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

Campus Study

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

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

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

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

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

Lonely Students, Weaker Immune Response

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

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

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

Loneliness, Isolation Are Different

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

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

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

Familiar Feelings

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

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

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

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

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

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

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

Feb. 6, 2004 -- It may be hard for pessimists to admit, but a new study shows pessimism has its benefits.

Researchers found that a healthy dose of pessimism may come in handy in many real-life situations where optimists may be overly hopeful.

For example, the study showed that pessimists tend to fare better as gamblers and know when to cut their losses rather than let it roll. Researchers say that kind of attitude may also pay off in other situations, such as playing the stock market.

Pessimism's Plus-Side

In the study, published in this month's issue of the Personality and Social Psychology Bulletin, researchers looked at the effects of a person's disposition on their gambling behavior.

Three groups of college students were given a list of questions to determine whether they were pessimistic or optimistic as well as assess their attitudes about gambling. In a series of different tests, researchers then had the students play several hands of blackjack and play a simulated slot machine game.

Throughout the tests, researchers found that optimists were more likely to believe that they expected to win at gambling. This relationship was even stronger in individuals who experienced gambling losses. This finding was consistent with the researchers theory that the optimist would reframe a negative event (gambling losses) into a positive -- the belief that they could win.

When asked about their experiences later, optimists were also more likely to remember more wins than the pessimists.

Researchers found the greatest differences between the groups emerged after losing.

"Our data show no difference in betting between optimists and pessimists after winning. But optimists are more likely to persist in the face of losses," says researcher Bryan Gibson, a social psychologist at Central Michigan University, in a news release. "They're less ready to give up hope."

The study showed that pessimists were more likely to reduce their bets if their past performance had been poor, but the optimists seemed relatively unfazed by their losses.

Researchers say this study only looked at the effects of optimism and pessimism on gambling, but their findings may apply to other situations. For example, pessimists may have the advantage in situations where resources and opportunities are limited, such as a down stock market, while optimists may fare better in situations where persistence is rewarded in the face of adversity.

March 19, 2003 -- The scent of a good man may be music to a woman's nose. Researchers say the odorless pheromones found in male perspiration can have a dramatic effect on both a woman's mind and body. A new study found exposure to male pheromones can boost a woman's mood and stimulate the release of a hormone that regulates the menstrual cycle.

In the study, researchers applied extracts of underarm secretions from male volunteers to the upper lips of 18 women between the ages of 25 and 45. None of the women knew that male sweat had been applied to their lips, and some thought they were involved in a study of alcohol or perfume or even lemon floor wax. The women then rated their moods over six hours of exposure; they consistently reported feeling less tension and more relaxed.

"Much to our surprise, the women reported feeling less tense and more relaxed during exposure to the male extract," says researcher Charles J. Wysocki of the University of Pennsylvania, in a news release. "This suggests that there may be much more going on in social settings like singles bars than meets the eye."

Each of the women received three applications of the underarm extract during the six-hour evaluation period, followed by three doses of exposure to ethanol (alcohol) over another six-hour period.

Researchers also found that exposure to the male pheromones also prompted a shift in blood levels of a reproductive hormone called luteinizing hormone. Levels of this hormone typically surge before ovulation, but women also experience small surges during other times in the menstrual cycle.

The study found that the male pheromone extract hastened the onset of these smaller surges and shortened the pauses between surges by 20%.

Researchers are now looking at individual compound that are found in male perspiration in hopes of identifying the elements responsible for these psychological and hormonal changes.

"This may open the door to pharmacological approaches to manage onset of ovulation or the effects of premenstrual syndrome or even natural products to aid relaxation," says Wysocki. "By determining how pheromones impact mood and endocrine response, we might be able to build a better male odor: molecules that more effectively manipulate the effects we observed."

SOURCE: Biology of Reproduction, June 2003. News release, University of Pennsylvania.

July 26, 2006 -- Multitasking may make you more productive, but it also makes it harder for your brain to learn, according to a new study.

Researchers found people had a harder time learning new things when their brains were distracted by something else, like talking or listening to music.

"When distractions force you to pay less attention to what you are doing, you don't learn as well as if you had paid full attention," says researcher Russell Poldrack, PhD, and UCLA associate professor of psychology, in a news release. "Even if you learn while multitasking, that learning is less flexible and more specialized so you cannot retrieve the information as easily."

Poldrack says distractions appear to affect the brain's learning processes, and tasks that require more attention -- like learning calculus or reading Shakespeare -- are particularly hampered.

Multitasking Disrupts Learning

In the study, published in the Proceedings of the National Academy of Sciences, researchers used functional magnetic resonance imaging (fMRI) to examine brain function and activity while adults (average age, 26) learned a new task.

The 14 participants were asked to make predictions after seeing a series of clues about cards with various shapes. With one set of cards, they learned the classification task without any distractions. In the second set, they learned while listening and keeping track of a series of high and low beeps.

The results showed that multitasking didn't reduce the accuracy of the predictions immediately, but it did hurt participants' ability to remember knowledge about the task later.

Researchers found that when participants were asked questions about the cards at a follow-up session, they did much better on the task they learned without any distractions.

When asked about the task they learned with the distraction, they couldn't extrapolate, or their knowledge was less flexible about the task.

Distraction Affects Memory

The fMRIs showed that when the participants learned without distraction, an area of the brain known as the hippocampus was involved. This part of the brain is critical to the processing and storing of information.

But when they learned the task while multitasking, the hippocampus was not engaged. Instead, an area called the striatum was activated. The striatum is involved in learning new skills like riding a bicycle.

Researchers say the results show that learning while distracted or multitasking alters the brain's learning processes and changes the way people learn.

Multitasking when performing certain tasks -- like listening to music while exercising -- may be helpful. But Poldrack says tasks that distract you while you try to learn something new are likely to negatively affect your learning.

"The best thing you can do to improve your memory is to pay attention to the things you want to remember," says Poldrack.

When Judith Orloff was a child, her doctor parents became so frustrated with her vivid premonitions -- on everything from illnesses to deaths to earthquakes -- they finally told her not to mention them again.

"I grew up believing something was wrong with me," says Orloff, now a board-certified psychiatrist, assistant clinical professor of psychiatry at UCLA, and author of Second Sight and Dr. Judith Orloff's Guide to Intuitive Healing: 5 Steps to Physical, Emotional, and Sexual Wellness. As a result, Orloff says she strayed far from her intuition (without much difficulty) as she pursued her medical studies. It wasn't until she was in private practice that she once again learned to trust her intuitive skills. Orloff recalls that she had been treating a woman for major depression who was responding well to antidepressants and conventional therapy. Seemingly out of the blue, though, Orloff had an image of the patient committing suicide.

"I didn't say anything because I had learned not to listen to myself," says Orloff. "Several weeks later the woman overdosed and was in a coma for weeks."

Fortunately, the patient recovered, and Orloff says she learned to pay attention to her own intuitive abilities.

Orloff says she believes that we all have an intuitive sense, although not everyone realizes it can be accessed. "Intuition is that still, small voice inside of you," she says. "It's your inner wisdom that can help you deal with anything from health issues to relationships to death and dying."

Orloff prefers to call herself an intuitive, rather than a psychic or clairvoyant, because she believes those terms have been too "tarnished" in our society and evoke images of sideshow acts.

In her practice -- which has a waiting list of 6,000 patients -- and in her workshops for healthcare professionals around the country, Orloff teaches people to develop their own intuition.

Nov. 26, 2003 -- Before you get too comfortable at the buffet table this holiday season, you may want to take a second look at the scale. A new poll shows many Americans may be deluding themselves about their weight.

The Gallup survey found that although more than half of those surveyed were overweight according to their BMI (body mass index, a measurement of weight in relationship to height), only about 40% think of themselves that way.

The delusion doesn't stop there. The poll found that 37% of Americans would still be classified as overweight according to standard BMI charts even if they did lose weight and reach what they think would be their "ideal" weight, including 4% who would still be considered obese at their "ideal" weight.

Americans Kidding Themselves About Their Weight

The survey, based on telephone interviews with 1,007 adults across the U.S., was conducted November 3-5. Researchers used the heights and weights that the respondents reported to calculate their BMI. They found 55% of all Americans would be classified as either overweight (35%) or obese (20%).

According to standards, BMI scores of:

• Less than 18.5 are considered underweight
• 18.5 to 24.9 are considered normal
• 25 to 29.9 suggest the person is overweight
• 30 or higher suggest the person is obese

Researchers found that men were more likely than women to be classified as overweight and obese based on their BMI -- 68% of men compared with 43% of women.

Despite those numbers, just 41% of Americans overall said they were either "somewhat" (37%) or "very" (4%) overweight.

Good Intentions Not Enough to Lose Weight

Even though fewer women were overweight than men, the poll shows women were much more motivated to lose weight than men. Despite the fact that two-thirds of men were considered overweight, only about half (51%) said they wanted to lose weight versus 68% of women who said they wanted to lose weight.

But good intentions aren't enough. Among the obese, who are most likely to suffer serious medical complications as a result of their weight, more than nine in 10 said they wanted to lose weight but only 45% were seriously trying to do so.

The same held true for overweight adults; only about half of those who said they wanted to lose weight actually were trying to do so.

With so many people wanting to lose weight, researchers say it's not surprising that about two-thirds of Americans said their ideal weight is below their actual weight. On average, men reported an ideal weight that was 14 pounds lower than their actual weight, and women reported an ideal weight almost 19 pounds lower then their current weight.

However, according to the BMI charts, researchers found that 54% of those who are overweight, but not obese, would still be overweight if they reached their ideal weight, and three-quarters of currently obese people would still be overweight if they reached their ideal weight.

Although those numbers are discouraging, researchers warn that BMI isn't everything when it comes to measuring a healthy weight. BMI is a more accurate indicator of overweight and obesity than relying on weight alone, but the National Institutes of Health cautions that BMI does not directly measure body fat.

For example, some very muscular people may fall into the overweight category when they are actually healthy and fit. In addition, some people who have lost muscle mass, such as the elderly, may be in the healthy weight category when they are actually underweight with reduced nutritional reserves.

SOURCES: Gallup Survey, conducted Nov. 3-5, 2003. News release, Gallup Organization.

July 9, 2003 -- Finding out how much of a little-known but artery-clogging fat your favorite snack and processed foods contain is about to get a lot easier. The FDA today announced that manufacturers will soon be required to list on the Nutrition Facts label the amount of trans fatty acids, or trans fat, in foods.

The new rule will go into effect on Jan. 1, 2006, but manufacturers will start phasing in the new labels well before that deadline. It's the first major change in the Nutrition Facts label since it was established in 1993.

"We are empowering Americans to make healthier choices about the foods they eat," says U.S. Health and Human Services Secretary Tommy Thompson, in a news release. "By putting trans fat information on food labels, we are making it possible for consumers to make better educated choices to lower their intake of these unhealthy fats and cholesterol."

Trans fats are frequently found in the same foods that contain other types of fat, such as cookies, crackers, fried foods such as french fries and chicken fried in shortening, donuts, and margarine sticks.

When a Good Fat Goes Bad

Trans fatty acids are the result of a process called hydrogenation that converts a relatively healthy, unsaturated liquid fat, such as vegetable oil, into a solid one, to make the product shelf stable and stay fresh longer. When the fat becomes solid, the body treats it more like a saturated fat, like butter or animal fat. But it is not classified as saturated fat on food labels

"Trans fat, like saturated fat and dietary cholesterol, raises LDL 'bad' cholesterol levels in the blood, which increases the risk for heart disease," says Claude Lenfant, MD, director of National Heart, Lung and Blood Institute (NHLBI), in the release. "It is therefore desirable to have food labels display all the information that can help consumers choose foods low in saturated fat, trans fat, and cholesterol as part of a healthy diet."

The new regulations will require food makers to list the number of trans fat grams a food contains in addition to the saturated and unsaturated fat content and cholesterol level.

Jan. 3, 2003 -- Houston is the couch potato capital of the U.S. and Honolulu is the fittest city, say the editors of Men's Fitness magazine.

The "America's Fattest City" award goes to Houston for the third year, uh, running. The ratings are based on a major city's score in several categories such as fruit/vegetable consumption, sports participation, smoking, drinking, air quality, and percentage of overweight/sedentary residents.

"Given the region's climate (hot and humid), air quality (abysmal), and relative lack of outdoor recreation, staying active presents a Texas-sized challenge," the magazine states. "And with its love of junk food, Houston is a vastrodome of bad nutrition."

If you don't live in Houston, don't let out your belt just yet. The annual ratings are meant as a wake-up call to stop what the CDC calls a national epidemic of obesity. Two in every three Americans have a serious weight problem.

Here's the magazine's list of America's 10 fattest cities:

1. Houston
2. Chicago
3. Detroit
4. Philadelphia
5. St. Louis
6. Cleveland
7. Atlanta
8. Columbus, Ohio
9. Dallas
10. Charlotte, N.C.

And its list of the 10 fittest cities:

1. Honolulu
2. Seattle
3. San Francisco
4. Colorado Springs, Col.
5. San Diego
6. Portland, Ore.
7. Denver
8. Virginia Beach, Va.
9. Tucson, Ariz.
10. Sacramento, Calif.

May 28, 2002 -- Here's more good news about fruits and veggies. "Five a day" can lower your blood pressure, greatly reducing risk of heart disease.

In a six-month study involving nearly 700 people, half were asked to eat five servings of fruits and vegetables every day; half served as controls and didn't change their diet.

The results: Those who ate the good stuff had higher levels of numerous healthy antioxidants than those who didn't.

Also: "significant decreases" in blood pressure were seen in the fruit-and-veggie group, reports Andrew Neil, PhD, a public health researcher at the University of Oxford, England. His study appears in this week's issue of The Lancet.

"The falls in blood pressure in our study ... would substantially reduce cardiovascular disease," he writes. His results match those of a larger study, which showed lower rates of high blood pressure in people who followed a similar five-a-day plan.

Most of the people participating in his study were women about 46 years old, and in the upper socioeconomic classes; 16% of the study participants were smokers, he reports. Neither group was advised to reduce fat intake; and the researchers saw no change in total cholesterol levels and only a small increase in body weight, he says.

"Therefore, the fall in blood pressure achieved in our study is unlikely to be attributable to reduced fat intake or changes in physical activity," writes Neil. "The reduction in blood pressure probably resulted from increased potassium intake, and possibly from some reduction in sodium, although participants were not advised specifically to reduce salt intake."

Here are some tips adapted from the 5 A Day For Better Health program -- a national nutrition effort to encourage Americans to eat five or more servings of fruits and vegetables a day for better health:

• Wake up to fruit. Drink a glass of 100% fruit juice or incorporate a helping of fruit into your breakfast every day.
• Think "fruit" or "vegetable" when snacking. Munch on a handful of carrots or a piece of fruit when you get the urge to snack.
• Keep the pantry packed with easy-to-prepare dried, canned, or frozen fruits and vegetables.
• Make them visible. You're more likely to eat fruits and vegetables when they are easily accessible. Wash some carrots or celery sticks and keep them close at hand in the refrigerator. Put clean fruit out for the family to snack on.
• Use the microwave to your advantage. It's a great (and convenient) way to quickly prepare vegetables for meals.

Visit the 5 A Day site at http://dccps.nci.nih.gov/5aday/ for a wide variety of simple, easy-to-make recipes.

If you've got diabetesdiabetes, the right meal plan can help you keep blood sugar under control. Fruits and vegetables, lean protein, whole grains, and low-fat dairy products -- even sweets now and then -- all have a place in your plan.

"A meal plan provides a specific approach to controlling blood sugar," says Dianne Davis, RD, LDN, CDE, a dietitian with the Vanderbilt Eskind Diabetes Center in Nashville, Tenn. "If you have diabetes, a meal plan is necessary."

That's because a meal plan helps ensure you eat a balanced diet high in fiber and low in fats. It can also "help you lose weight, by controlling portion sizes and calories," Davis says.

Which Diabetes Meal Plan Is Right for You?

Your lifestyle and the type of diabetes treatment you're getting -- whether you're taking premeal insulin or not -- will determine the type of meal plan best for you, says Davis.

Carbohydrates, proteins, and fats are all factored into a plan. But carbs are an especially important component since they have the biggest impact on blood sugar.

"Your meal plan can also include your favorite foods," Davis adds. "No food is off-limits -- it's a matter of how much you eat, when you eat it, and what it will do to your blood sugar."

With that in mind -- and understanding you should talk with your doctor before making big changes in your diabetes diet -- here are four meal-planning systems.

The Diabetes Food Pyramid

The diabetes food pyramid is similar to the USDA food pyramid you see on food labels. It is a pyramid in which a healthy diet means eating more grains, fruits, and vegetables, and less meat, sweets, and fats.

The diabetes food pyramid's general recommendations are:

• Grains, beans, and starchy vegetables: 6 or more servings/day. One serving: 1 slice bread; 1/2 small bagel; 1/2 cup cooked cereal, pasta, rice; 3/4 cup ready-to-eat cereal; 1/2 cup cooked beans, corn, peas.
• Fruits: 2-4 servings daily. One serving: 1 medium-size fresh fruit; 1/2 cup canned fruit; 1/2 cup fruit juice.
• Vegetables: 3-5 servings a day. One serving: 1 cup raw vegetable; 1/2 cup vegetable juice.
• Meat, Fish, Cheese: 2-3 servings/day. One serving: 2-3 ounces cooked lean meat, skinless poultry, or fish; I egg; 2 tablespoons peanut butter; 2-3 ounces cheese.
• Milk and Yogurt: 2-3 servings daily. One serving: 1 cup (8 ounces) milk or yogurt.
• Fats, Sweets, and Alcohol: eat these in small amounts. One serving: 1 teaspoon butter, margarine, or mayonnaise; 1 tablespoon cream cheese or salad dressing; 1/2 cup ice cream.

Combined foods, like eggplant lasagna, for example, will include servings from several food groups (1 vegetable, 1 meat, 1 fat).

This meal system has limitations, says Davis. "When you follow the diabetes food pyramid, you are not controlling specific grams of carbs and might not be able to achieve very tight blood sugar control," she tells WebMD. "However, the pyramid helps you see which foods are carbohydrates -- to get you acquainted with them."

The sun is shining, temperatures are rising. Summer is the time to shed layers of clothes, as well as some pounds. You could opt for a stringent diet regime, but what about simply enjoying all the wonderful foods the season brings? You'll still slim down, and do wonders for your health.

It's a natural trend to eat lighter during the summer, and you can easily do so without feeling deprived. If you follow the U.S. government's 2005 dietary guidelines of four-and-a-half cups of fruits and vegetables and three servings of fat-free or low-fat dairy each day, you'll be getting plenty of naturally low-cal foods that are high in fiber, calcium, and important nutrients.

"Fiber helps in weight control because it promotes a feeling of satisfaction or satiety," explains Registered Dietitian Cheryl Orlansky, of the Computer Science Corporation. "High-fiber foods, eaten consistently, prevent that rebound effect of feeling full one minute and looking for something else to eat the next. It also helps modulate blood sugars by slowing down the digestion of sugars to prevent a quick surge into the bloodstream."

Much of summer's bounty has extra nutritional benefits you may not be aware of. Fruits and vegetables contain antioxidants and other phytonutrients that may slow aging, protect against cancer and stroke, improve blood pressure, and keep your heart healthy. And just about all are low-calorie, so your waistline stays in check, another big health benefit.

Ready to slim down with summer foods? Start your summer "diet" with these.

Indeed, the year 2000 was a very good year for wine makers -- and not just because it brought a bumper crop of cabernets, zinfandels, and chardonnays. Evidence of the far-reaching health benefits of wine continued to pour in from researchers around the world.

Here's a review of the good news for wine makers -- and wine lovers:

A Healthier Heart

Several reports in 2000 confirmed the glad tidings that wine -- in moderation, of course -- reduces the risk of cardiovascular disease and heart attacks. In the September issue of the Annals of Internal Medicine, for instance, Swedish researchers at the Karolinska Institute reported that, compared to teetotalers, light drinkers who consumed wine cut their risk of dying prematurely by almost one third, and wine drinkers as a group had significantly lower mortality from cardiovascular disease and cancer. Actually, drinking any kind of alcoholic beverage helped, the scientists found. But by far the biggest benefit accrued to wine drinkers.

What's more, scientists are beginning to understand how wine may bestow its salutary benefits. For starters, according to findings published in the January 2000 issue of European Heart Journal, this most ancient of beverages appears to dilate arteries and increase blood flow, thus lowering the risk of the kind of clots that cut off blood supply and damage heart muscles.

In addition, the fruit of the vine appears to boost levels of HDL, the "good" cholesterol, and helps prevent LDL, or bad cholesterol, from causing damage to the lining of arteries. In a study published in the May 2000 issue of the journal Pharmacology, Biochemistry, and Behavior, scientists at the Institute for Research in Extramural Medicine in Amsterdam tested 275 men and women around the age of 32. Those who imbibed the equivalent of a glass or two of wine each day had significantly higher levels of "good" cholesterol because they remove the "bad" artery-clogging LDLs before they have a chance to choke blood vessels. Indeed, wine seems to facilitate that process, making it easier for HDLs to hustle their dangerous counterparts out of the bloodstream.

Yet even when LDLs remain behind in the arteries, substances in wine called phenols appear to help prevent the bad cholesterol from causing injury. In the November 2000 Journal of Nutrition and Biochemistry, Italian researchers from the National Institute for Food and Nutrition Research reported that phenols seem to limit the oxidation of LDLs, making them less capable of damaging the linings of arteries and, therefore, less able to set the stage for cardiovascular disease, like heart disease and stroke.

A Shield Against Cancer

Wine also may protect against several forms of another common killer: cancer. It turns out that the same phenolic compounds that lower heart disease risk also may slow the growth of breast cancer cells, according to findings reported by scientists at the University of Crete in Greece in the June 2000 issue of Journal of Cellular Biochemistry. Phenols also were shown to suppress the growth of prostate cancer cells. And French scientists found evidence that an antioxidant in wine called resveratrol can put the brakes on the growth of liver cancer cells, according to a report in the July-August 2000 issue of Oncology Reports.

There also was a report that wine -- particularly red wine -- might help ward off oral cancer. Researchers from the University of Missouri School of Dentistry discovered that resveratrol and another antioxidant called quercetin may inhibit the growth of oral cancer cells. Their findings, published in the June 2000 Journal of the American Dental Association, note that red wine is loaded with a slew of other antioxidants that seem to boost its cancer-fighting abilities.

March 17, 2004 -- "Do it now," Americans like to say. But we're more likely to be talking about eating a pizza than working out.

And that's why we're so fat, argue economist John Komlos, PhD, of the University of Munich, Germany, and colleagues. In a provocative paper, the researchers find that Americans started getting fat about the same time they stopped planning for the future.

Their major evidence: As Americans began spending more and saving less of their income, their weight began to rise. The less we save for the future, the more weight we gain. People living in countries that that save more of their income are less obese. The findings appear in the current issue of the Journal of Biosocial Science.

"People have tried to look at a lot of reasons why Americans are getting so overweight. But nobody has thought about the idea of connecting it to impatience," Komlos tells WebMD. "If you are willing to forgo present satisfaction for future benefits, you are patient. If, however, you want your satisfaction right now, then you are going to have that extra dessert and that extra ice cream and you are not going to be able to forgo the pleasures of today."

Obesity: The Future Is Now

The future, said French novelist Gustave Flaubert, is the worst thing about the present. Americans solve this dilemma by simply ignoring the future. Economists would say Americans have a "high rate of time preference." In plain language, this means we ignore future health risks and maximize current consumption.

Such people are impatient, says study co-author Barry Bogin, PhD, an anthropologist at the University of Michigan-Dearborn.

"When it comes to spending money, they say, 'Let's go out and buy the stuff I want.' When it comes to food, they say, 'If they put it all in front of me now, I will eat it,'" Bogin tells WebMD.

By now, everybody knows that if you eat less and exercise more, you'll lose weight. Keep it up, and you will be more healthy. But that means valuing the future so much that you'll shove your plate aside and make time to go jogging or to work out at a gym. Fewer and fewer Americans do this.

"All you have to do is get out and exercise for an hour, but people won't do that because of their time preference," Bogin says. "They say, 'Why invest an hour? I should be writing another paper, doing more work, watching this thing on TV -- whatever seems important right now."

A widespread phenomenon such as obesity has no single cause, notes study co-author Patricia K. Smith, PhD, an economist at the University of Michigan-Dearborn.

"People have to think about how what they do now affects the future -- about what [they] will do about the future," Smith says.

And that's getting harder and harder for more and more of us. Even something as seemingly innocuous as watching television becomes part of the problem.

"We know that when people watch TV, they eat junk food more than if they were reading or listening to music," Bogin says. "It gets complex here. Does TV cause obesity? No. But a combination of poverty, low education, watching TV, the hopelessness of being poor in a rich nation, it all adds together and raises your time preference, and you say, 'Who cares about the future? I'm going to eat the whole pizza right now.'"

July 2, 2001 -- After Deborah Taylor-Hough's first child was born prematurely, she and her husband found themselves traveling to the intensive care nursery twice a day. "Probably what helped me most at that time is that the ladies from my church brought us two weeks' worth of frozen meals, and I didn't have to worry about what we were eating," she says.

A few years later, when her husband was working a swing shift, Taylor-Hough wanted to serve the main meal at noon, before he left. "The morning was our family time, but I also had to cook dinner then, and I felt like getting dinner ready was taking away my life," she recalls. A friend suggested she try cooking a month's food at once and storing it in the freezer.

From those small beginnings has grown a big passion. In 1998, Taylor-Hough published Frozen Assets: How to Cook for a Day and Eat for a Month, and today she has more than 2,000 people involved in her email list and online discussion group.

Bulk Cooking

Here's how it works: Once a month, she spends an hour on a Thursday night writing a shopping list. The next day, she shops. ("Never shop and cook on the same day," she advises.)

On Friday night she does the prep work, like chopping onions, grating cheese, making spaghetti sauce, and browning ground beef. On Saturday she spends a solid 6 to 8 hours cooking. By the end of the day she has a month's worth of meals in the freezer.

A big surprise for Taylor-Hough was how much money she saves. Because she was buying in bulk and eating out much less, her monthly budget for food dropped from $700 to $300 for a family of five.

Her web site is loaded with recipe ideas, cooking tips, and sample meal plans. Typical dishes include soups, meat loaf, stews, casseroles, and meat items to serve over rice.

While Taylor-Hough's first book on bulk cooking gets top marks for efficiency and price-consciousness, many recipes tend toward red meat and white flour. Her newly released sequel, Frozen Assets Lite & Easy, has more healthy, low-fat recipes, she says.

In addition, the bulk cooking system is designed chiefly for main dishes, the most time-consuming part of a meal. Of course, they should be combined with fresh fruit and salad.

Once you've grasped the basic idea of bulk cooking, you adjust it to fit your own circumstances, Taylor-Hough says. And you don't have to have a large freezer for it to work. For years, she had only a small freezer on top of the refrigerator.

"Use freezer bags, freeze them flat, and then stand them on end to make better use of your space," she says. "You can easily fit two weeks of main dishes in that space. Actually, I can do a full month."

"This is a wonderful, wonderful idea," says Lauren Groveman, who hosts a radio program on food, family, and the home. "You can plan ahead when you see a crazy week coming. When you're busiest, and feeling most tired and needy, that's the most important time to go to your own freezer and benefit from healthy, home-cooked food, instead of the drive-through line at the local fast-food place."

Many foods freeze perfectly, says Groveman, whose TV show, Cooking with Lauren Groveman, premiers this fall, especially soups, stews, and chili. "Brisket is such a tough meat it's improved by slow cooking followed by freezing. Make a big batch of stock, chill it first to skim off extra fat, and divide it into containers. When you want soups or stews you don't need to start with that powdered stuff!"

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

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

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

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

Emotional Feeling, Physical Effect

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

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

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

Campus Study

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

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

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

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

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

Lonely Students, Weaker Immune Response

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

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

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

Loneliness, Isolation Are Different

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

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

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

Familiar Feelings

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

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

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

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

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

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

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

Feb. 6, 2004 -- It may be hard for pessimists to admit, but a new study shows pessimism has its benefits.

Researchers found that a healthy dose of pessimism may come in handy in many real-life situations where optimists may be overly hopeful.

For example, the study showed that pessimists tend to fare better as gamblers and know when to cut their losses rather than let it roll. Researchers say that kind of attitude may also pay off in other situations, such as playing the stock market.

Pessimism's Plus-Side

In the study, published in this month's issue of the Personality and Social Psychology Bulletin, researchers looked at the effects of a person's disposition on their gambling behavior.

Three groups of college students were given a list of questions to determine whether they were pessimistic or optimistic as well as assess their attitudes about gambling. In a series of different tests, researchers then had the students play several hands of blackjack and play a simulated slot machine game.

Throughout the tests, researchers found that optimists were more likely to believe that they expected to win at gambling. This relationship was even stronger in individuals who experienced gambling losses. This finding was consistent with the researchers theory that the optimist would reframe a negative event (gambling losses) into a positive -- the belief that they could win.

When asked about their experiences later, optimists were also more likely to remember more wins than the pessimists.

Researchers found the greatest differences between the groups emerged after losing.

"Our data show no difference in betting between optimists and pessimists after winning. But optimists are more likely to persist in the face of losses," says researcher Bryan Gibson, a social psychologist at Central Michigan University, in a news release. "They're less ready to give up hope."

The study showed that pessimists were more likely to reduce their bets if their past performance had been poor, but the optimists seemed relatively unfazed by their losses.

Researchers say this study only looked at the effects of optimism and pessimism on gambling, but their findings may apply to other situations. For example, pessimists may have the advantage in situations where resources and opportunities are limited, such as a down stock market, while optimists may fare better in situations where persistence is rewarded in the face of adversity.

March 19, 2003 -- The scent of a good man may be music to a woman's nose. Researchers say the odorless pheromones found in male perspiration can have a dramatic effect on both a woman's mind and body. A new study found exposure to male pheromones can boost a woman's mood and stimulate the release of a hormone that regulates the menstrual cycle.

In the study, researchers applied extracts of underarm secretions from male volunteers to the upper lips of 18 women between the ages of 25 and 45. None of the women knew that male sweat had been applied to their lips, and some thought they were involved in a study of alcohol or perfume or even lemon floor wax. The women then rated their moods over six hours of exposure; they consistently reported feeling less tension and more relaxed.

"Much to our surprise, the women reported feeling less tense and more relaxed during exposure to the male extract," says researcher Charles J. Wysocki of the University of Pennsylvania, in a news release. "This suggests that there may be much more going on in social settings like singles bars than meets the eye."

Each of the women received three applications of the underarm extract during the six-hour evaluation period, followed by three doses of exposure to ethanol (alcohol) over another six-hour period.

Researchers also found that exposure to the male pheromones also prompted a shift in blood levels of a reproductive hormone called luteinizing hormone. Levels of this hormone typically surge before ovulation, but women also experience small surges during other times in the menstrual cycle.

The study found that the male pheromone extract hastened the onset of these smaller surges and shortened the pauses between surges by 20%.

Researchers are now looking at individual compound that are found in male perspiration in hopes of identifying the elements responsible for these psychological and hormonal changes.

"This may open the door to pharmacological approaches to manage onset of ovulation or the effects of premenstrual syndrome or even natural products to aid relaxation," says Wysocki. "By determining how pheromones impact mood and endocrine response, we might be able to build a better male odor: molecules that more effectively manipulate the effects we observed."

SOURCE: Biology of Reproduction, June 2003. News release, University of Pennsylvania.

July 26, 2006 -- Multitasking may make you more productive, but it also makes it harder for your brain to learn, according to a new study.

Researchers found people had a harder time learning new things when their brains were distracted by something else, like talking or listening to music.

"When distractions force you to pay less attention to what you are doing, you don't learn as well as if you had paid full attention," says researcher Russell Poldrack, PhD, and UCLA associate professor of psychology, in a news release. "Even if you learn while multitasking, that learning is less flexible and more specialized so you cannot retrieve the information as easily."

Poldrack says distractions appear to affect the brain's learning processes, and tasks that require more attention -- like learning calculus or reading Shakespeare -- are particularly hampered.

Multitasking Disrupts Learning

In the study, published in the Proceedings of the National Academy of Sciences, researchers used functional magnetic resonance imaging (fMRI) to examine brain function and activity while adults (average age, 26) learned a new task.

The 14 participants were asked to make predictions after seeing a series of clues about cards with various shapes. With one set of cards, they learned the classification task without any distractions. In the second set, they learned while listening and keeping track of a series of high and low beeps.

The results showed that multitasking didn't reduce the accuracy of the predictions immediately, but it did hurt participants' ability to remember knowledge about the task later.

Researchers found that when participants were asked questions about the cards at a follow-up session, they did much better on the task they learned without any distractions.

When asked about the task they learned with the distraction, they couldn't extrapolate, or their knowledge was less flexible about the task.

Distraction Affects Memory

The fMRIs showed that when the participants learned without distraction, an area of the brain known as the hippocampus was involved. This part of the brain is critical to the processing and storing of information.

But when they learned the task while multitasking, the hippocampus was not engaged. Instead, an area called the striatum was activated. The striatum is involved in learning new skills like riding a bicycle.

Researchers say the results show that learning while distracted or multitasking alters the brain's learning processes and changes the way people learn.

Multitasking when performing certain tasks -- like listening to music while exercising -- may be helpful. But Poldrack says tasks that distract you while you try to learn something new are likely to negatively affect your learning.

"The best thing you can do to improve your memory is to pay attention to the things you want to remember," says Poldrack.

When Judith Orloff was a child, her doctor parents became so frustrated with her vivid premonitions -- on everything from illnesses to deaths to earthquakes -- they finally told her not to mention them again.

"I grew up believing something was wrong with me," says Orloff, now a board-certified psychiatrist, assistant clinical professor of psychiatry at UCLA, and author of Second Sight and Dr. Judith Orloff's Guide to Intuitive Healing: 5 Steps to Physical, Emotional, and Sexual Wellness. As a result, Orloff says she strayed far from her intuition (without much difficulty) as she pursued her medical studies. It wasn't until she was in private practice that she once again learned to trust her intuitive skills. Orloff recalls that she had been treating a woman for major depression who was responding well to antidepressants and conventional therapy. Seemingly out of the blue, though, Orloff had an image of the patient committing suicide.

"I didn't say anything because I had learned not to listen to myself," says Orloff. "Several weeks later the woman overdosed and was in a coma for weeks."

Fortunately, the patient recovered, and Orloff says she learned to pay attention to her own intuitive abilities.

Orloff says she believes that we all have an intuitive sense, although not everyone realizes it can be accessed. "Intuition is that still, small voice inside of you," she says. "It's your inner wisdom that can help you deal with anything from health issues to relationships to death and dying."

Orloff prefers to call herself an intuitive, rather than a psychic or clairvoyant, because she believes those terms have been too "tarnished" in our society and evoke images of sideshow acts.

In her practice -- which has a waiting list of 6,000 patients -- and in her workshops for healthcare professionals around the country, Orloff teaches people to develop their own intuition.

Sept. 14, 2004 -- In a study of people with heart disease, results show that high doses of the popular cholesterol-lowering drug Zocor may not prevent heart disease deaths and heart attacks -- and may cause muscle damage. But experts say that the new adage of "lower is better" still holds true when it comes to cholesterol.

The study results were presented last month at the European Society of Cardiology Congress 2004 and appear in the new issue of The Journal of the American Medical Association.

High doses of Zocor were associated with increased rates of muscle damage. Nonetheless, study researcher Michael Blazing, MD, said at a news conference at the meeting that doctors should still consider starting treatment at a higher dose and to be more aggressive when prescribing Zocor and other cholesterol-lowering drugs in its class, known as statins. Blazing is with Duke University Medical Center in Durham, N.C.

Asked to clarify that statement, Blazing told WebMD that he and his study colleagues recommend a 40 mg dose, rather than an 80 mg dose of Zocor.

Blazing added that studies of other statins -- notably recent studies of high-dose Lipitor -- suggest that the high-dose statins are both safe and effective.

His study looked at nearly 4,500 patients who had severe chest pain or a heart attack. The researchers were trying to determine if there was any benefit to starting Zocor right away. Half the patients received early aggressive treatment -- 40 mg of Zocor for a month (started within an average of three to four days) followed by 80 mg Zocor -- or conservative treatment with four months of placebo followed by 20 mg of Zocor.

The study did show that early aggressive Zocor treatment appeared to slightly decrease the risk of heart disease death, heart attack, and stroke. However, the study findings were not strong enough to be considered significant. All patients also received other traditional heart disease treatments, including aspirin.

In those treated with placebo first, LDL "bad" cholesterol levels increased by 11% during the initial placebo phase. LDL then decreased 31% from baseline after four months of 20 mg Zocor. However, in those that took Zocor for the entire study, LDL cholesterol decreased by 39% over the first four months. LDL then decreased an additional 6% following the increase to 80 mg of Zocor.

Christopher P. Cannon, MD, associate professor at Harvard Medical School, tells WebMD that "the real message of this study is that it confirms the 'lower is better' message" when it comes to cholesterol.

Cannon, who did not participate in the current study, was principle researcher of a previous study that showed high-dose Lipitor was associated with an approximately 50% reduction in LDL "bad" cholesterol, reducing LDL down to approximately 62 mg/dL. Moreover, aggressive Lipitor treatment reduced the risk of death, heart attack, severe chest pain, or stroke by 16%.

Cannon's findings were closely followed by a change in cholesterol guidelines for patients at highest risk of dying from heart attacks and strokes. The National Cholesterol Education Program (NCEP) reduced target LDL levels from 100 mg/dL to 70 mg/dL for those at the very highest risk of heart disease. This includes people who already have heart disease in addition to diabetes, poorly controlled high blood pressure, or metabolic risk factors including obesity, high triglycerides, and low HDL "good" cholesterol. Smokers with heart disease also fall into this category.

The lead researcher of the current study, James de Lemos, MD, tells WebMD he does not doubt that the high-dose Zocor regimen is beneficial. Nonetheless, de Lemos says his study does support new guidelines that contend lower is better. He is assistant professor at the University of Texas Southwestern Medical Center in Dallas.

Asked if doctors will be reluctant to prescribe high doses of Zocor because of the reported safety concerns, both Cannon and de Lemos declined to speculate.

But not everyone is so reluctant. In a JAMA editorial that accompanies the study, Steven Nissen, MD, of The Cleveland Clinic in Ohio, points out that high-dose Lipitor packs a double punch. Studies indicate that it not only reduces LDL "bad" cholesterol, but also sharply decreases blood levels of an inflammatory marker called C-reactive protein (CRP). Research has shown that signs of inflammation, such as a high CRP, are associated with an increased risk of heart disease.

Patients in the current study treated with high-dose Zocor did not have similar declines in CRP. In the previous study, high-dose Lipitor decreased CRP by 38%, while high-dose Zocor reduced CRP by just 17% in the current study. More research is needed to determine if these differing CRP results stand true.Zocor and Muscle Damage

As for the increased risk of muscle damage, Nissen, who was lead researcher for another favorable high-dose Lipitor study, writes that the increased risk of muscle damage applies only to a specific dose of a single drug and should not tarnish this remarkable class of drugs. It must also be emphasized that Zocor in doses up to 40 mg per day has shown excellent safety and effectiveness in a series of clinical trials, he adds. For now, though, he says, the 80 mg daily dose of Zocor should be used with caution, particularly because other effective drugs are available.

But David Faxon, MD, professor of medicine at the University of Chicago and former president of the American Heart Association, tells WebMD that the safety concerns of the high-dose Zocor are not surprising. "I think muscle pain with statin therapy is more common then the studies indicate." Moreover, Faxon, who was not involved in the study, agrees that the take-home message from the current study "does support our 'lower is better' message."

In June 2004, the FDA advised doctors to be careful about how they prescribe the statin Crestor. This was in response to reports of serious toxicity in some patients taking the drug. The FDA and the drug's manufacturer say Crestor is safe when given to the right patients at the right dose. Patients should promptly call their doctor if they have signs of muscle damage: muscle pain or weakness, feeling weak or sick, fever, dark urine, nausea, or vomiting.

July 7, 2005 -- Detecting oral cancer may one day be as easy as spitting into a cup, a new study suggests.

Researchers found people with oral cancer have higher levels of certain types of bacteria, and screening for these bacteria may offer a new way to diagnose the disease before it's too late.

Oral cancer is one of the deadliest forms of cancer with only slightly more than half of those with the disease living up to five years after their diagnosis. Most oral cancers are within the lining of the mouth. As they progress they spread to deeper layers of the lining of the mouth. The American Cancer Society estimates that about 29,000 cases of oral cancer will be diagnosed and about 7,000 people will die of this cancer in 2005.

However, early detection and treatment of oral cancer can increase cure rates by up to 80% to 90%.

Tobacco and drinking alcohol are the two biggest risk factors for oral cancer, but some people with the disease have no known risk factors.

Saliva Test May Screen for Oral Cancer

Cancerous tumors in the mouth and throat often cause no symptoms, and researchers say there is a need for an easy-to-use screening test to detect oral cancer.

The American Cancer Society recommends that doctors and dentists examine the mouth and throat for potentially cancerous growths during routine cancer-related checkups.

In the study, which appears in the current issue of the Journal of Translational Medicine, researchers looked at whether the bacteria found in people with oral cancer differed from those found in people without oral cancer.

Researchers analyzed saliva samples from 45 people with oral cancer and 45 healthy people. The groups were similar in age, sex, and smoking status.

Of the 40 different bacteria analyzed, the study showed that six common bacteria were found at significantly higher levels in people with oral cancer.

When researchers used three species of these bacteria to screen for oral cancer in the saliva samples, the tests correctly predicted more than 80% of the oral cancer cases.

Researchers say these findings may form the basis for the development of a noninvasive and inexpensive saliva test for diagnosing oral cancer.

April 27, 2000 -- If you have seasonal allergies or know someone who does, you know the misery associated with a high pollen count: sneezing, itchy eyes, and increased asthma problems. Even if you felt like dying, you probably wouldn't think of these pollen-heavy days as deadly.

Think again, say Dutch investigators who found more death due to heart disease and certain respiratory conditions on days with high pollen counts.

"Pollen is a well-known trigger of allergies, especially hay fever and asthma," the authors write. "However, deaths related to these conditions are extremely rare, and cannot account for the associations seen in this study." They likened the association to the one between air pollution and death, noting that a 5% to 10% increase in death is seen on high-pollution days. The new study was published in the journal The Lancet.

"The association is a bit like the link between [death] and very warm or very cold weather, which are also known to increase [death]," lead author Bert Brunekreef, PhD, tells WebMD. "Similar findings have been reported repeatedly for air pollution." Brunekreef is an epidemiologist in the Netherlands.

The authors looked for relationships between pollen counts and death due to heart disease, pneumonia, and chronic obstructive pulmonary disease (COPD), a chronic lung disease. They obtained statistics for the total number of daily deaths from the Netherlands' Central Bureau of Statistics over an eight-year period. The investigators then related these statistics to corresponding data for airborne pollen concentrations.

During this period, there was an average of more than 330 deaths per day. Of these, there was an average of about 140 deaths per day due to cardiovascular disease, 16 for COPD, and 10 for pneumonia.

When the researchers looked at the number and rate of deaths and the amount of Poacae, a common pollen found in the Netherlands, they found that the days with the highest pollen counts were associated with an increase of about 6% in death from heart disease, 15% in death from COPD, and 17% in death from pneumonia.

The authors write that, in other research, certain indicators of allergies are linked to increased death due to heart disease and COPD, and that their study seems to support pollen's contribution to the death rate. They caution, though, that their findings should be replicated in other studies before this link can be confirmed.

People with COPD should be less worried about the pollen outdoors than they are about the smoke indoors, according to a respiratory disease expert. "We have no proof that any of the people who died were allergic. The vast majority of patients with COPD, for example, do not have allergies," Eric Schenkel, MD, tells WebMD.

In severe allergic reactions, the body secretes histamine, a compound that can have an effect on the heart. In severe asthma, lack of oxygen can also cause heart rhythm problems, he says.

"There's no evidence whatsoever that inhalation of pollution causes cardiac problems, though." Schenkel is an allergist who focuses on COPD and is the director of Valley Clinical Research Center in Easton, Pa. He is also a clinical assistant professor of medicine at MCP/Hahnemann University School of Medicine in Philadelphia.

The study was funded by the Ministry of the Environment in the Netherlands.

Vital Information:

• A new study shows that people are more likely to die from heart disease and certain respiratory conditions on days with high pollen counts.
• Pollen is known to trigger allergies, but deaths related to this are extremely rare and unable to account for the findings.
• Other studies have shown a similar increase in the death rate related to air pollution, very warm weather, and very cold weather.

?

Dec. 28, 1999 (Atlanta) -- The most popular medication to treat nighttime bed-wetting in children maintained its effectiveness over a one-year period, according to a study in the November issue of the European medical journal Acta Paediatrica.

Known as desmopressin, the drug is a synthetic formulation of the natural hormone vasopressin, which balances the body's regulation of water and urine production. It is prescribed as a nasal spray or in pill form to absorb higher amounts of water from the kidney into the body, which decreases urine production.

The study, conducted primarily at a children's hospital in Stockholm, Sweden, followed 399 children aged 6 to 12. After receiving the drug for six weeks, 61% achieved at least a 50% reduction in nighttime episodes of bed-wetting. Those who experienced a reduction continued in the study on a maintenance dose for one year. By the end of one year, the study reports that episodes had decreased from an average of 5.3 per week prior to treatment to 0.8 during the final three months.

But according to Douglas Husmann, MD, an associate professor of urology at the Mayo Clinic, desmopressin should not be considered a cure for the condition, known as primary nocturnal enuresis.

"Desmopressin works very well if patients are monosymptomatic, meaning all they have is nighttime wetness," says Husmann. "Our experience has been the kids will do very well on the medication, but after they are weaned off only a certain percentage will remain dry."

In more complicated cases, genetics, hormone deficiencies, abnormal bladder capacity, stomach disorders, or sleep disorders could be the cause. In those cases, Husmann says, desmopressin alone will not be effective. Symptoms of polysymptomatic enuresis include control problems during the day or problems with needing to urinate "suddenly at the last minute," he says.

Husmann says desmopressin is best prescribed in cases of children taking trips or sleeping over with friends, for example. In a study Husmann authored in the September 1996 issue of Mayo Clinic Proceedings, he found that only 10% of patients remained dry after tapering off the drug.

Comparatively, the Stockholm study found that only nine of 39 patients remained dry after being tapered off the drug at the end of the yearlong study.

Husmann says the best results found at the Mayo Clinic involved combining desmopressin with behavioral treatment using nighttime alarms to awaken children when urination has begun.

"This has by far shown the best results, but you have to stress [to the parents] there's about a minimum of three weeks before the alarm works," he says. During the initial period where children are learning to respond to the need to urinate, desmopressin can lower the episodes to make it easier for families to complete the program.

Husmann found that after six months, 56% of patients remained dry after use of the alarm was stopped.

According to Shelly Morris, director of the Enuresis Treatment Centers in Farmingham, Mich., sleep disorders can often be an underlying cause of nighttime incontinence.

"People sleep so deeply the brain and the bladder don't communicate," she says. "People can outgrow bed-wetting, but they can't outgrow a sleep disorder. It's important to determine if that [or anything else] is the cause before simple drug therapy is undertaken."

Husmann cautions that definitive enuresis should not be diagnosed until a child is between four and five years old. He says by age five, 85% of children will have outgrown the problem by achieving voluntary control of the bladder.

The Stockholm study was supported by Ferring Pharmaceuticals.

Vital Information:

• Desmopressin is the most widely used treatment for nighttime bed-wetting, and the drug maintains its effectiveness over a one-year period, according to a new study.
• The drug is best used for when children are sleeping away from home or in conjunction with a behavioral treatment that uses alarms, because children do not remain dry once weaned from the drug.
• By age 5, about 85% of children will outgrow the problem of nighttime bed-wetting.

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

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

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

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

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

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

Vital Information:

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

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

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

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

Putting tNOX to the Test

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

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

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

It passed with flying colors, he says.

Test Predicts Prostate Cancer Progression

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

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

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

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

Test Spots Lung Cancer

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

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

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

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

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

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

tNOX May be Useful in Other Cancers, Too

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

This year, Mikio plans to write a letter to Santa Claus, as he's done since he can remember, and leave his North Pole visitor some milk and cookies.

"He's a man with a white beard who delivers presents and flies with reindeer," says the 8-year-old. "I think he's a cool guy."

Mikio is one of millions of children who eagerly anticipate the jolly old soul's magical trip around the world. Every December, kids hear the story of a red-clad, robust man who enters homes through chimneys and doles out gifts to well-behaved youngsters.

No doubt the tale has generated excitement in many households. A brief review of comments from some online message boards, however, reveals that the Santa notion also elicits its share of cringes:

• "I will never teach my children about the myth of Santa, because he is not the reason we celebrate Christmas."
  
  
• "You teach your kids not to lie and yet we lie to them right away about Santa and the Easter Bunny."
  
  
• "The truth is some kids get nothing for Christmas, because there really is no Santa and some parents cannot scrape up the extra dough. The child that gets told Santa loves and gives to everybody will wonder what is wrong with them."
  
  
• "Why would anyone want to make the nice gesture of buying and wrapping the perfect gift, only to give the credit to a fictional character?"

Roberto, a San Francisco Bay-area father, says family and friends have already told his 2-year-old daughter about Santa Claus. Yet he does not plan to further promote the story because the consumerism produced by the holidays bothers him.

"When Christmas or Fourth of July comes around, these figures symbolize that holiday, but they also propagate sales," he says. "To have Abraham Lincoln be responsible for a President's Day sale is ludicrous."

The 32-year-old father says he won't stop his daughter from believing in Santa Claus if she chooses to, but he wants her to know that holidays can be engineered to encourage spending. Instead of focusing on Santa Claus during the holidays, he says he will encourage his daughter to cherish family time.

Any thought of hooking Santa Claus away from the holiday stage is enough to make some parents roll their eyes or throw up their hands in outrage.

"Why on earth are we in such a hurry to take away the innocence and magic that exists in childhood?" says one parent in an online message board.

"Let children be children for as long as possible!" says another parent.

Like-minded mothers and fathers say they would never deny their kids the joy brought on by belief in Kris Kringle. There are those who declare that Christmas wouldn't be the same without good ole St. Nick.

Who's right and who's wrong? Could the Santa Claus tale actually hurt kids? Or is it harmless fun? WebMD placed Santa on the naughty or nice checklist and asked child psychology and development experts what they thought about the twinkle-eyed gent.

Oct. 25, 2006 (Atlanta) -- The new childhood vaccine schedule now includes vaccines against genital warts and a major cause of diarrhea.

The CDC's Advisory Committee on Immunization Practices (ACIP) today officially approved the 2007 childhood vaccination schedule.

The ACIP in June recommended that all girls age 11 to 12 years receive Merck's Gardasil, a vaccine against HPV or human papillomavirus. The sexually transmitted virus causes genital wartswarts and promotes cervical cancercervical cancer.

And in April, the ACIP recommended that all infants receive three doses of Merck's RotaTeq oral rotavirus vaccine at 2, 4, and 6 months of age. Rotavirus is the world's leading cause of severe intestinal illness in infants and young children.

The schedule has a new look this year. For easier reference, it's been divided into two parts. The first part, for children up to age 6 years, is intended to help pediatricians focus on the vaccines kids need to see them through kindergarten.

The second part of the schedule is intended to see kids through their teen years. There's also a two-part section on catch-up vaccines to help doctors know what to do for kids who've missed some of their shots.

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

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

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

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

Children's Mental Health Problems Have Wide Effect

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Aug. 2, 2004 -- Girls who are overweight may be more likely to start kindergarten with behavioral problems already established than their non-overweight peers, according to a new study.

But contrary to popular belief, researchers found being overweight doesn't increase the risk of developing new behavior problems among both boys and girls during the early elementary school years.

Researchers say psychological problems are among the most serious consequences of being overweight during childhood. Overweight children who are teased or ridiculed may suffer from low self-esteem and poor social skills.

Despite these well-known problems, researchers say most studies on the relationship between overweight and mental health have focused on older children and adolescents.

"There has been considerable attention on overweight status recently, often under the assumption that this can cause psychological problems for children and prevent learning," write researcher Ashlesha Datar, PhD, and colleagues at RAND in Santa Monica, Calif. "However, our results show that overweight girls already have more behavior problems before kindergarten; therefore, focusing on mental health and overweight is important in the early years."

Weight-Related Behavior Problems Start Early

In the study, researchers looked at the relationship between overweight and behavior problems in young children as they entered kindergarten and whether they developed more problems over time.

Information on height, weight, and parent- and teacher-reported behavior problems were collected three times during the first two years of elementary school for nearly 10,000 children.

The study showed that about one in 10 kindergarteners was overweight when he or she started school in 1998. The percentage of overweight boys was slightly higher than girls (11.7% vs. 10.6%).

Researchers found that overweight boys were no more likely to have behavior problems at the start of kindergarten compared with non-overweight boys.

However, overweight girls were much more likely to have behavior problems, as reported by parents or teachers, at the beginning of kindergarten compared with girls who were not overweight.

Researchers say that may be at least partially due to other factors such as the fact that overweight girls were less likely to be white and more likely to have a family income of less than $25,000, have mothers with a high school diploma or less, have fewer siblings, come from single-parent families, and have a higher birth weight than their non-overweight peers.

In particular, overweight girls had an 81% increased risk in teacher-reported externalizing behavior problems, such as arguing, getting angry, or disturbing class. Overweight girls also had an about 50% increased risk of teacher- and parent-reported internalizing behavior problems, such as anxiety, feeling sad, and low self-esteem.

But Weight Doesn't Increase Risk of Developing Problems

When researchers looked at the risk of developing behavioral problems over time, they found no proof that being overweight increased the likelihood of developing new behavior problems in either boys or girls.

Instead, they found that low family income and having a mother who was depressed were much stronger risk factors for children developing new behavior problems by the end of the first grade.

For example, the odds of developing externalizing behavior problems during the first two years of school were three times greater for girls whose family incomes were in the lowest quarter compared with girls whose family incomes were in the highest quarter.

The results of the study appear in the August issue of the Archives of Pediatric & Adolescent Medicine.

Jan. 21, 2004 -- The SSRI class of antidepressants don't increase suicide in children and teens, a medical group says.

SSRIs -- selective serotonin reuptake inhibitors -- include the popular antidepressant drugs Prozac, Paxil, Zoloft, and Celexa.

Reports of suicide in young people treated with these drugs last October led to an FDA warning about the drugs. The FDA's warning followed a stronger action by the U.K. Medicines and Healthcare Products Regulatory Agency. The British agency advised doctors not to use the drugs in children and teens.

Both the U.S. and U.K. are currently studying the issue. An FDA advisory panel will consider the issue at a Feb. 2 meeting.

But the American College of Neuropsychopharmacology -- an expert group of psychiatrists and pharmacologists -- convened its own task force on the issue. That task force today released its own findings. Its co-chair, J. John Mann, MD, is professor of psychiatry and radiology at Columbia University and chief of the neuroscience department at New York State Psychiatric Institute.

"Our conclusion is that when you look at the SSRIs as a group, there is evidence they are effective for treating depression in children and adolescents," Mann tells WebMD. "Instead of being a risk for suicidal behavior, they are potentially therapeutic. Doctors must go on treating depression, and SSRIs appear to be a reasonable choice."

"No SSRI/Suicide Report" Still Preliminary

The ACNP task force looked at all available published information. But the panel stresses that it did not have access to "a substantial amount" of unpublished data -- including detailed findings held by drug companies -- that will be made available to the FDA panel.

Mann will be a member of the FDA panel. He says he's keeping an open mind.

"The FDA is examining the data we looked at plus it is examining in more detail the data provided from pharmaceutical companies in terms of the type of suicidal behaviors that have occurred," Mann says. "That is new evidence. Based on how that is assessed, the FDA is attempting to look in a uniform way across seven or eight kinds of antidepressants. That will offer a unique opportunity to look at the data individually and collectively."

Still, Mann says, there's a critical need for more research. People enrolled in clinical trials tend to be less suicidal -- and given much better, much more detailed care -- than those treated in real-world settings.

"What are needed are new studies of the efficacy of SSRIs in depressed kids who are suicidal," Mann says. "Most studies actually excluded kids with suicidal behavior. So we must study the effect of SSRI treatment on those suicidal thoughts and behaviors in a way that's up front in the design of the clinical trials."

When Junior and his mother walk into the doctor's waiting room, there are two seats available: a big chair for grown-ups and a stool for kids. Junior takes the adult seat, and starts to throw a tantrum after Mom asks him to move. With resignation, she squats onto the little seat.

This scenario is not so uncommon, says Barton Schmitt, MD, a pediatrician at the Children's Hospital in Denver. In his office, he sees kids wield power over their parents at least a couple of times a week. Sometimes it's a preschooler who's emptying out his mother's purse, taking out all of her credit cards. Another day it's a tot who's stretching out her father's glasses. In each instance, the kid gets his way, even after some parental protest.

Some people may call these children spoiled.

Schmitt suspects that about 5% of kids are spoiled in that they lack discipline, are manipulative, and are generally bothersome. His estimate, however, may be far too generous, if one author's research proves accurate.

In 2000, Dan Kindlon, author of Too Much of a Good Thing, interviewed more than 1,000 parents, and roughly 650 teenagers, and found that 60% of parents thought their kids were spoiled, and 15% of teens thought they, themselves, fit the bill.

Defining "Spoiled"

Kindlon did not ask his subjects what they thought the term "spoiled" meant, but he believes that they would all have different answers -- as did many of the child-development experts interviewed by WebMD.

"A spoiled child has the 'I want, I want, I want' syndrome," says Charles L. Thompson, PhD, professor of educational psychology and counseling at the University of Tennessee in Knoxville. "His philosophy of life would sort of be 'Life is not good unless I'm getting my own way.'"

The word "spoiled" has many different meanings in different cultures, says Lane Tanner, MD, associate director, division of developmental and behavioral pediatrics at the Children's Hospital and Research Center in Oakland, Calif.

"Very often a grandparent will shake her head with a grin, and say 'My daughter is spoiling that baby so bad,' and that's praise," says Tanner.

A spoiled kid is someone who sits inside on a cold day -- sipping hot chocolate and watching TV -- while her dad shovels snow in the driveway, says Kindlon. He notes that such children often feel entitled not to have to contribute to responsibilities. They also usually have parents that emotionally indulge them -- for example, excusing them from chores because they already have a tough school schedule.

"What's spoiled for one parent may not be for another," says George Cohen, MD, a member of the American Academy of Pediatrics' committee on the psychosocial aspects of child and family health. "Many parents think what their kid is doing is okay. Others are much stricter."

Whatever one's primary definition of spoiled is, arguably, there are children who could use a bit more discipline. They usually find it hard to share, wait their turn, appreciate what they have, and accept that they cannot always get their way.

Life, for these kids, is often difficult, says Schmitt. "They are constantly in a tug of war with their environment," he explains. "They keep smashing into walls because they are living in a world that's different from the real world."

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

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

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

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

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

Vitamin E Harm: Slight but Significant Risk

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

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

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

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

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

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

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

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

Is Vitamin E Dead?

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

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

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

The Real Vitamin E Harm

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

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

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

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

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

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

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

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

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

"It's my metabolism!"

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

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

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

What Is Metabolism?

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

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

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

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

And yes, heredity makes a difference.

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

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

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

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

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

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

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

Oct. 2, 2006 -- Obese people's desire to eat triggers the same brain action as addicts' desire for drugs, say researchers at Brookhaven National Laboratory.

The finding is based on seven morbidly obese people treated for up to two years with a gastric stimulator. The implanted device makes the stomach expand by giving tiny electric jolts to the vagus nerve. This, say Gene-Jack Wang, MD, and colleagues, signals the brain to make a person feel less hungry.

The seven study participants lost an average 11.6% of their original body weight. At the time of the study, six of the seven still weighed at least 5% less than they used to.

When the device is turned on, Wang and colleagues now report, it stimulates a part of the brain linked to emotional eating -- that is, eating to soothe emotional distress. The participants reported less desire for emotional eating when the device was turned on.

"The brain regions activated by gastric stimulation overlap with those reported during craving responses in addicted subjects, supporting the commonalities in the [brain circuits] that underlie compulsive food intake and compulsive drug intake," Wang and colleagues conclude.

The findings appear in the Oct. 17 issue of the Proceedings of the National Academy of Sciences.

Oct. 18, 2005 -- How much exercise does it take to lose extra weight?

Provided you're not consuming too many calories, any amount of exercise may help. About five hours of weekly exercise may bring the biggest weight loss for obese adults who are also watching their intake of fat and calories.

So say researchers including John Jakicic, PhD. Jakicic leads the University of Pittsburgh's health and physical activity department.

Jakicic and colleagues studied nearly 200 obese women for two years. Their results were presented in Vancouver, Canada, at the North American Association for the Study of Obesity's annual scientific meeting.

Exercise Plans

The women in Jakicic's study were about 37 years old. Their average body mass index (BMI) was 32. A BMI of 30 or more is considered obese.

The women all agreed to exercise. They were randomly assigned by the researchers to one of four workout plans:

• Moderate amount of moderate-intensity exercise
• Moderate amount of vigorous exercise
• A lot of moderate-intensity exercise
• A lot of vigorous exercise

Moderate amounts of exercise were designed to burn 1,000 calories per week. The plans requiring lots of exercise were designed to burn 2,000 calories weekly.

Rules for Eating

The golden rule of weight loss is that calories burned must exceed calories consumed. The study tackled both ends of that equation.

Besides exercising, the women also limited their intake of calories and fat.

They were told to consume 1,200 to 1,500 calories per day. Fat was to account for 20% to 30% of those calories.

Remember, the study lasted for two years. It wasn't a short exercise blitz or crash diet. Most women completed the study (172 women, or 90%).

Who Lost Weight?

All of the women who finished the study lost a significant amount of weight.

Those who lost the most weight reported logging 270 to 300 minutes of exercise per week. That's 4.5 to 5 hours weekly.

Here are the average percentages of body weight lost by each group:

• Moderate amount of moderate-intensity exercise: 4.9%
• Moderate amount of vigorous exercise: 3.7%
• A lot of moderate-intensity exercise: 6.5%
• A lot of vigorous exercise: 7.2%

Higher Bar for the Obese

The CDC recommends that all adults get at least 30 minutes of moderate exercise five times a week. That adds up to 150 minutes per week.

That amount wasn't designed with weight loss in mind. "More intense or longer periods of physical activity may be needed to control body weight," states the CDC's web site.

Jakicic agrees. "Clearly, overweight individuals have different exercise needs than the general public when it comes to increasing their energy expenditure," he says in a news release.

"Energy expenditure" means calories burned.

"To maximize weight loss and minimize weight regain, it appears that overweight individuals should supplement dietary changes with approximately 300 minutes of exercise each week, which is twice the amount recommended for health in the general public," Jakicic continues.

Next Steps

If Jakicic's results are on track, what do they mean in the real world?

Should someone exercise 45 minutes a day, six days a week, for a total of 270 minutes per week? Or would five, one-hour workouts do? Can each day's minutes be split into several shorter sessions?

Jakicic and colleagues call for more work to sort out the details.

Consult a doctor before starting a weight loss or exercise plan.

Nov. 11, 2004 -- Going to church may do more than bring out your spiritual side; it could make you a healthier eater, according to a new study.

Researchers found that people who regularly attend church eat 25% more of the fruits and vegetables that pack the biggest nutritional punch. These nutritional powerhouses include citrus fruits, cruciferous vegetables like broccoli and cauliflower, dark leafy greens, carrots, and cantaloupe.

"The body is your temple, and we should treat it that way," says researcher Deidre Griffith of the Saint Louis University, in a news release. "Church can be a big part of your support system for changing your diet."

Griffith presented the results of the study this week at the annual meeting of the American Public Health Association in Washington, D.C.

Church May Foster Healthy Eating Habits

In the study, researchers surveyed 315 people about their church attendance and eating habits. Most of the participants were black, 78% were female, and 32% had incomes below the federal poverty level.

The results showed that people who attended church ate 25% more of the most nutritious fruits and vegetables than those who did not go to church.

All of the participants ate the most popular fruits and vegetables, including corn, iceberg lettuce, and bananas. But the study showed that people who went to church frequently, such as choir members, participants in bible study groups, and others, ate more of the fruits and vegetables that contain the most vitamins and minerals.

Researchers say going to church may foster healthy eating habits, and the results suggest that churches should take an active role in encouraging these types of healthy behaviors.

"We're saying church membership or having that church community is one of the key links in the long chain of social support structures that help people eat better," says Griffith.

May 24, 2004 -- Obese and overweight women are at increased risk of getting suspicious results from screening mammograms, research shows.

Mammograms don't miss any more cancers in heavy women than in thin women. But the more a woman weighs, the greater the risk that her mammogram will have false positive results. That means more tests - and more anxiety.

Joann G. Elmore, MD, MPH, of the University of Washington in Seattle, and colleagues analyzed more than 100,000 mammograms from nearly 70,000 women. The report their findings in the May 24 issue of Archives of Internal Medicine.

"Compared with underweight or normal weight women, overweight and obese women were more likely to be recalled for additional tests," Elmore and co-workers write. "Obese women had more than a 20% increased risk of having a false positive mammogram result."

At the personal level, it's not a huge increase in risk. Overall, a woman faces about one in 10 chance of getting a false positive result on a screening mammogram. Obesity increases that risk from 10% to 12%.

But those extra tests add up fast. For an estimated 10 million obese women in the U.S., this means some 200,000 false positives. At $600 per retest, that adds up to an extra $120 million in U.S. health-care costs. And that doesn't even begin to measure the personal costs.

"We cannot put a quantitative value on the resultant anxiety these 200,000 women would additionally experience," Elmore and colleagues note.

Even so, obese women need mammograms more than skinny women. That's because a breast examination is more likely to miss small tumors in women with very large breasts.

The researchers suggest that larger mammography plates may help get better images of women with large breasts. They also suggest that weight loss may lower the likelihood of an unnecessarily traumatic experience when it's time for a routine mammogram.

July 9, 2003 -- Finding out how much of a little-known but artery-clogging fat your favorite snack and processed foods contain is about to get a lot easier. The FDA today announced that manufacturers will soon be required to list on the Nutrition Facts label the amount of trans fatty acids, or trans fat, in foods.

The new rule will go into effect on Jan. 1, 2006, but manufacturers will start phasing in the new labels well before that deadline. It's the first major change in the Nutrition Facts label since it was established in 1993.

"We are empowering Americans to make healthier choices about the foods they eat," says U.S. Health and Human Services Secretary Tommy Thompson, in a news release. "By putting trans fat information on food labels, we are making it possible for consumers to make better educated choices to lower their intake of these unhealthy fats and cholesterol."

Trans fats are frequently found in the same foods that contain other types of fat, such as cookies, crackers, fried foods such as french fries and chicken fried in shortening, donuts, and margarine sticks.

When a Good Fat Goes Bad

Trans fatty acids are the result of a process called hydrogenation that converts a relatively healthy, unsaturated liquid fat, such as vegetable oil, into a solid one, to make the product shelf stable and stay fresh longer. When the fat becomes solid, the body treats it more like a saturated fat, like butter or animal fat. But it is not classified as saturated fat on food labels

"Trans fat, like saturated fat and dietary cholesterol, raises LDL 'bad' cholesterol levels in the blood, which increases the risk for heart disease," says Claude Lenfant, MD, director of National Heart, Lung and Blood Institute (NHLBI), in the release. "It is therefore desirable to have food labels display all the information that can help consumers choose foods low in saturated fat, trans fat, and cholesterol as part of a healthy diet."

The new regulations will require food makers to list the number of trans fat grams a food contains in addition to the saturated and unsaturated fat content and cholesterol level.

Nov. 26, 2003 -- Before you get too comfortable at the buffet table this holiday season, you may want to take a second look at the scale. A new poll shows many Americans may be deluding themselves about their weight.

The Gallup survey found that although more than half of those surveyed were overweight according to their BMI (body mass index, a measurement of weight in relationship to height), only about 40% think of themselves that way.

The delusion doesn't stop there. The poll found that 37% of Americans would still be classified as overweight according to standard BMI charts even if they did lose weight and reach what they think would be their "ideal" weight, including 4% who would still be considered obese at their "ideal" weight.

Americans Kidding Themselves About Their Weight

The survey, based on telephone interviews with 1,007 adults across the U.S., was conducted November 3-5. Researchers used the heights and weights that the respondents reported to calculate their BMI. They found 55% of all Americans would be classified as either overweight (35%) or obese (20%).

According to standards, BMI scores of:

• Less than 18.5 are considered underweight
• 18.5 to 24.9 are considered normal
• 25 to 29.9 suggest the person is overweight
• 30 or higher suggest the person is obese

Researchers found that men were more likely than women to be classified as overweight and obese based on their BMI -- 68% of men compared with 43% of women.

Despite those numbers, just 41% of Americans overall said they were either "somewhat" (37%) or "very" (4%) overweight.

Good Intentions Not Enough to Lose Weight

Even though fewer women were overweight than men, the poll shows women were much more motivated to lose weight than men. Despite the fact that two-thirds of men were considered overweight, only about half (51%) said they wanted to lose weight versus 68% of women who said they wanted to lose weight.

But good intentions aren't enough. Among the obese, who are most likely to suffer serious medical complications as a result of their weight, more than nine in 10 said they wanted to lose weight but only 45% were seriously trying to do so.

The same held true for overweight adults; only about half of those who said they wanted to lose weight actually were trying to do so.

With so many people wanting to lose weight, researchers say it's not surprising that about two-thirds of Americans said their ideal weight is below their actual weight. On average, men reported an ideal weight that was 14 pounds lower than their actual weight, and women reported an ideal weight almost 19 pounds lower then their current weight.

However, according to the BMI charts, researchers found that 54% of those who are overweight, but not obese, would still be overweight if they reached their ideal weight, and three-quarters of currently obese people would still be overweight if they reached their ideal weight.

Although those numbers are discouraging, researchers warn that BMI isn't everything when it comes to measuring a healthy weight. BMI is a more accurate indicator of overweight and obesity than relying on weight alone, but the National Institutes of Health cautions that BMI does not directly measure body fat.

For example, some very muscular people may fall into the overweight category when they are actually healthy and fit. In addition, some people who have lost muscle mass, such as the elderly, may be in the healthy weight category when they are actually underweight with reduced nutritional reserves.

SOURCES: Gallup Survey, conducted Nov. 3-5, 2003. News release, Gallup Organization.

Jan. 3, 2003 -- Houston is the couch potato capital of the U.S. and Honolulu is the fittest city, say the editors of Men's Fitness magazine.

The "America's Fattest City" award goes to Houston for the third year, uh, running. The ratings are based on a major city's score in several categories such as fruit/vegetable consumption, sports participation, smoking, drinking, air quality, and percentage of overweight/sedentary residents.

"Given the region's climate (hot and humid), air quality (abysmal), and relative lack of outdoor recreation, staying active presents a Texas-sized challenge," the magazine states. "And with its love of junk food, Houston is a vastrodome of bad nutrition."

If you don't live in Houston, don't let out your belt just yet. The annual ratings are meant as a wake-up call to stop what the CDC calls a national epidemic of obesity. Two in every three Americans have a serious weight problem.

Here's the magazine's list of America's 10 fattest cities:

1. Houston
2. Chicago
3. Detroit
4. Philadelphia
5. St. Louis
6. Cleveland
7. Atlanta
8. Columbus, Ohio
9. Dallas
10. Charlotte, N.C.

And its list of the 10 fittest cities:

1. Honolulu
2. Seattle
3. San Francisco
4. Colorado Springs, Col.
5. San Diego
6. Portland, Ore.
7. Denver
8. Virginia Beach, Va.
9. Tucson, Ariz.
10. Sacramento, Calif.

If you've got diabetesdiabetes, the right meal plan can help you keep blood sugar under control. Fruits and vegetables, lean protein, whole grains, and low-fat dairy products -- even sweets now and then -- all have a place in your plan.

"A meal plan provides a specific approach to controlling blood sugar," says Dianne Davis, RD, LDN, CDE, a dietitian with the Vanderbilt Eskind Diabetes Center in Nashville, Tenn. "If you have diabetes, a meal plan is necessary."

That's because a meal plan helps ensure you eat a balanced diet high in fiber and low in fats. It can also "help you lose weight, by controlling portion sizes and calories," Davis says.

Which Diabetes Meal Plan Is Right for You?

Your lifestyle and the type of diabetes treatment you're getting -- whether you're taking premeal insulin or not -- will determine the type of meal plan best for you, says Davis.

Carbohydrates, proteins, and fats are all factored into a plan. But carbs are an especially important component since they have the biggest impact on blood sugar.

"Your meal plan can also include your favorite foods," Davis adds. "No food is off-limits -- it's a matter of how much you eat, when you eat it, and what it will do to your blood sugar."

With that in mind -- and understanding you should talk with your doctor before making big changes in your diabetes diet -- here are four meal-planning systems.

The Diabetes Food Pyramid

The diabetes food pyramid is similar to the USDA food pyramid you see on food labels. It is a pyramid in which a healthy diet means eating more grains, fruits, and vegetables, and less meat, sweets, and fats.

The diabetes food pyramid's general recommendations are:

• Grains, beans, and starchy vegetables: 6 or more servings/day. One serving: 1 slice bread; 1/2 small bagel; 1/2 cup cooked cereal, pasta, rice; 3/4 cup ready-to-eat cereal; 1/2 cup cooked beans, corn, peas.
• Fruits: 2-4 servings daily. One serving: 1 medium-size fresh fruit; 1/2 cup canned fruit; 1/2 cup fruit juice.
• Vegetables: 3-5 servings a day. One serving: 1 cup raw vegetable; 1/2 cup vegetable juice.
• Meat, Fish, Cheese: 2-3 servings/day. One serving: 2-3 ounces cooked lean meat, skinless poultry, or fish; I egg; 2 tablespoons peanut butter; 2-3 ounces cheese.
• Milk and Yogurt: 2-3 servings daily. One serving: 1 cup (8 ounces) milk or yogurt.
• Fats, Sweets, and Alcohol: eat these in small amounts. One serving: 1 teaspoon butter, margarine, or mayonnaise; 1 tablespoon cream cheese or salad dressing; 1/2 cup ice cream.

Combined foods, like eggplant lasagna, for example, will include servings from several food groups (1 vegetable, 1 meat, 1 fat).

This meal system has limitations, says Davis. "When you follow the diabetes food pyramid, you are not controlling specific grams of carbs and might not be able to achieve very tight blood sugar control," she tells WebMD. "However, the pyramid helps you see which foods are carbohydrates -- to get you acquainted with them."

Indeed, the year 2000 was a very good year for wine makers -- and not just because it brought a bumper crop of cabernets, zinfandels, and chardonnays. Evidence of the far-reaching health benefits of wine continued to pour in from researchers around the world.

Here's a review of the good news for wine makers -- and wine lovers:

A Healthier Heart

Several reports in 2000 confirmed the glad tidings that wine -- in moderation, of course -- reduces the risk of cardiovascular disease and heart attacks. In the September issue of the Annals of Internal Medicine, for instance, Swedish researchers at the Karolinska Institute reported that, compared to teetotalers, light drinkers who consumed wine cut their risk of dying prematurely by almost one third, and wine drinkers as a group had significantly lower mortality from cardiovascular disease and cancer. Actually, drinking any kind of alcoholic beverage helped, the scientists found. But by far the biggest benefit accrued to wine drinkers.

What's more, scientists are beginning to understand how wine may bestow its salutary benefits. For starters, according to findings published in the January 2000 issue of European Heart Journal, this most ancient of beverages appears to dilate arteries and increase blood flow, thus lowering the risk of the kind of clots that cut off blood supply and damage heart muscles.

In addition, the fruit of the vine appears to boost levels of HDL, the "good" cholesterol, and helps prevent LDL, or bad cholesterol, from causing damage to the lining of arteries. In a study published in the May 2000 issue of the journal Pharmacology, Biochemistry, and Behavior, scientists at the Institute for Research in Extramural Medicine in Amsterdam tested 275 men and women around the age of 32. Those who imbibed the equivalent of a glass or two of wine each day had significantly higher levels of "good" cholesterol because they remove the "bad" artery-clogging LDLs before they have a chance to choke blood vessels. Indeed, wine seems to facilitate that process, making it easier for HDLs to hustle their dangerous counterparts out of the bloodstream.

Yet even when LDLs remain behind in the arteries, substances in wine called phenols appear to help prevent the bad cholesterol from causing injury. In the November 2000 Journal of Nutrition and Biochemistry, Italian researchers from the National Institute for Food and Nutrition Research reported that phenols seem to limit the oxidation of LDLs, making them less capable of damaging the linings of arteries and, therefore, less able to set the stage for cardiovascular disease, like heart disease and stroke.

A Shield Against Cancer

Wine also may protect against several forms of another common killer: cancer. It turns out that the same phenolic compounds that lower heart disease risk also may slow the growth of breast cancer cells, according to findings reported by scientists at the University of Crete in Greece in the June 2000 issue of Journal of Cellular Biochemistry. Phenols also were shown to suppress the growth of prostate cancer cells. And French scientists found evidence that an antioxidant in wine called resveratrol can put the brakes on the growth of liver cancer cells, according to a report in the July-August 2000 issue of Oncology Reports.

There also was a report that wine -- particularly red wine -- might help ward off oral cancer. Researchers from the University of Missouri School of Dentistry discovered that resveratrol and another antioxidant called quercetin may inhibit the growth of oral cancer cells. Their findings, published in the June 2000 Journal of the American Dental Association, note that red wine is loaded with a slew of other antioxidants that seem to boost its cancer-fighting abilities.

July 2, 2001 -- After Deborah Taylor-Hough's first child was born prematurely, she and her husband found themselves traveling to the intensive care nursery twice a day. "Probably what helped me most at that time is that the ladies from my church brought us two weeks' worth of frozen meals, and I didn't have to worry about what we were eating," she says.

A few years later, when her husband was working a swing shift, Taylor-Hough wanted to serve the main meal at noon, before he left. "The morning was our family time, but I also had to cook dinner then, and I felt like getting dinner ready was taking away my life," she recalls. A friend suggested she try cooking a month's food at once and storing it in the freezer.

From those small beginnings has grown a big passion. In 1998, Taylor-Hough published Frozen Assets: How to Cook for a Day and Eat for a Month, and today she has more than 2,000 people involved in her email list and online discussion group.

Bulk Cooking

Here's how it works: Once a month, she spends an hour on a Thursday night writing a shopping list. The next day, she shops. ("Never shop and cook on the same day," she advises.)

On Friday night she does the prep work, like chopping onions, grating cheese, making spaghetti sauce, and browning ground beef. On Saturday she spends a solid 6 to 8 hours cooking. By the end of the day she has a month's worth of meals in the freezer.

A big surprise for Taylor-Hough was how much money she saves. Because she was buying in bulk and eating out much less, her monthly budget for food dropped from $700 to $300 for a family of five.

Her web site is loaded with recipe ideas, cooking tips, and sample meal plans. Typical dishes include soups, meat loaf, stews, casseroles, and meat items to serve over rice.

While Taylor-Hough's first book on bulk cooking gets top marks for efficiency and price-consciousness, many recipes tend toward red meat and white flour. Her newly released sequel, Frozen Assets Lite & Easy, has more healthy, low-fat recipes, she says.

In addition, the bulk cooking system is designed chiefly for main dishes, the most time-consuming part of a meal. Of course, they should be combined with fresh fruit and salad.

Once you've grasped the basic idea of bulk cooking, you adjust it to fit your own circumstances, Taylor-Hough says. And you don't have to have a large freezer for it to work. For years, she had only a small freezer on top of the refrigerator.

"Use freezer bags, freeze them flat, and then stand them on end to make better use of your space," she says. "You can easily fit two weeks of main dishes in that space. Actually, I can do a full month."

"This is a wonderful, wonderful idea," says Lauren Groveman, who hosts a radio program on food, family, and the home. "You can plan ahead when you see a crazy week coming. When you're busiest, and feeling most tired and needy, that's the most important time to go to your own freezer and benefit from healthy, home-cooked food, instead of the drive-through line at the local fast-food place."

Many foods freeze perfectly, says Groveman, whose TV show, Cooking with Lauren Groveman, premiers this fall, especially soups, stews, and chili. "Brisket is such a tough meat it's improved by slow cooking followed by freezing. Make a big batch of stock, chill it first to skim off extra fat, and divide it into containers. When you want soups or stews you don't need to start with that powdered stuff!"

Feb. 6, 2004 -- It may be hard for pessimists to admit, but a new study shows pessimism has its benefits.

Researchers found that a healthy dose of pessimism may come in handy in many real-life situations where optimists may be overly hopeful.

For example, the study showed that pessimists tend to fare better as gamblers and know when to cut their losses rather than let it roll. Researchers say that kind of attitude may also pay off in other situations, such as playing the stock market.

Pessimism's Plus-Side

In the study, published in this month's issue of the Personality and Social Psychology Bulletin, researchers looked at the effects of a person's disposition on their gambling behavior.

Three groups of college students were given a list of questions to determine whether they were pessimistic or optimistic as well as assess their attitudes about gambling. In a series of different tests, researchers then had the students play several hands of blackjack and play a simulated slot machine game.

Throughout the tests, researchers found that optimists were more likely to believe that they expected to win at gambling. This relationship was even stronger in individuals who experienced gambling losses. This finding was consistent with the researchers theory that the optimist would reframe a negative event (gambling losses) into a positive -- the belief that they could win.

When asked about their experiences later, optimists were also more likely to remember more wins than the pessimists.

Researchers found the greatest differences between the groups emerged after losing.

"Our data show no difference in betting between optimists and pessimists after winning. But optimists are more likely to persist in the face of losses," says researcher Bryan Gibson, a social psychologist at Central Michigan University, in a news release. "They're less ready to give up hope."

The study showed that pessimists were more likely to reduce their bets if their past performance had been poor, but the optimists seemed relatively unfazed by their losses.

Researchers say this study only looked at the effects of optimism and pessimism on gambling, but their findings may apply to other situations. For example, pessimists may have the advantage in situations where resources and opportunities are limited, such as a down stock market, while optimists may fare better in situations where persistence is rewarded in the face of adversity.

July 26, 2006 -- Multitasking may make you more productive, but it also makes it harder for your brain to learn, according to a new study.

Researchers found people had a harder time learning new things when their brains were distracted by something else, like talking or listening to music.

"When distractions force you to pay less attention to what you are doing, you don't learn as well as if you had paid full attention," says researcher Russell Poldrack, PhD, and UCLA associate professor of psychology, in a news release. "Even if you learn while multitasking, that learning is less flexible and more specialized so you cannot retrieve the information as easily."

Poldrack says distractions appear to affect the brain's learning processes, and tasks that require more attention -- like learning calculus or reading Shakespeare -- are particularly hampered.

Multitasking Disrupts Learning

In the study, published in the Proceedings of the National Academy of Sciences, researchers used functional magnetic resonance imaging (fMRI) to examine brain function and activity while adults (average age, 26) learned a new task.

The 14 participants were asked to make predictions after seeing a series of clues about cards with various shapes. With one set of cards, they learned the classification task without any distractions. In the second set, they learned while listening and keeping track of a series of high and low beeps.

The results showed that multitasking didn't reduce the accuracy of the predictions immediately, but it did hurt participants' ability to remember knowledge about the task later.

Researchers found that when participants were asked questions about the cards at a follow-up session, they did much better on the task they learned without any distractions.

When asked about the task they learned with the distraction, they couldn't extrapolate, or their knowledge was less flexible about the task.

Distraction Affects Memory

The fMRIs showed that when the participants learned without distraction, an area of the brain known as the hippocampus was involved. This part of the brain is critical to the processing and storing of information.

But when they learned the task while multitasking, the hippocampus was not engaged. Instead, an area called the striatum was activated. The striatum is involved in learning new skills like riding a bicycle.

Researchers say the results show that learning while distracted or multitasking alters the brain's learning processes and changes the way people learn.

Multitasking when performing certain tasks -- like listening to music while exercising -- may be helpful. But Poldrack says tasks that distract you while you try to learn something new are likely to negatively affect your learning.

"The best thing you can do to improve your memory is to pay attention to the things you want to remember," says Poldrack.

When Judith Orloff was a child, her doctor parents became so frustrated with her vivid premonitions -- on everything from illnesses to deaths to earthquakes -- they finally told her not to mention them again.

"I grew up believing something was wrong with me," says Orloff, now a board-certified psychiatrist, assistant clinical professor of psychiatry at UCLA, and author of Second Sight and Dr. Judith Orloff's Guide to Intuitive Healing: 5 Steps to Physical, Emotional, and Sexual Wellness. As a result, Orloff says she strayed far from her intuition (without much difficulty) as she pursued her medical studies. It wasn't until she was in private practice that she once again learned to trust her intuitive skills. Orloff recalls that she had been treating a woman for major depression who was responding well to antidepressants and conventional therapy. Seemingly out of the blue, though, Orloff had an image of the patient committing suicide.

"I didn't say anything because I had learned not to listen to myself," says Orloff. "Several weeks later the woman overdosed and was in a coma for weeks."

Fortunately, the patient recovered, and Orloff says she learned to pay attention to her own intuitive abilities.

Orloff says she believes that we all have an intuitive sense, although not everyone realizes it can be accessed. "Intuition is that still, small voice inside of you," she says. "It's your inner wisdom that can help you deal with anything from health issues to relationships to death and dying."

Orloff prefers to call herself an intuitive, rather than a psychic or clairvoyant, because she believes those terms have been too "tarnished" in our society and evoke images of sideshow acts.

In her practice -- which has a waiting list of 6,000 patients -- and in her workshops for healthcare professionals around the country, Orloff teaches people to develop their own intuition.

When Judith Orloff was a child, her doctor parents became so frustrated with her vivid premonitions -- on everything from illnesses to deaths to earthquakes -- they finally told her not to mention them again.

"I grew up believing something was wrong with me," says Orloff, now a board-certified psychiatrist, assistant clinical professor of psychiatry at UCLA, and author of Second Sight and Dr. Judith Orloff's Guide to Intuitive Healing: 5 Steps to Physical, Emotional, and Sexual Wellness. As a result, Orloff says she strayed far from her intuition (without much difficulty) as she pursued her medical studies. It wasn't until she was in private practice that she once again learned to trust her intuitive skills. Orloff recalls that she had been treating a woman for major depression who was responding well to antidepressants and conventional therapy. Seemingly out of the blue, though, Orloff had an image of the patient committing suicide.

"I didn't say anything because I had learned not to listen to myself," says Orloff. "Several weeks later the woman overdosed and was in a coma for weeks."

Fortunately, the patient recovered, and Orloff says she learned to pay attention to her own intuitive abilities.

Orloff says she believes that we all have an intuitive sense, although not everyone realizes it can be accessed. "Intuition is that still, small voice inside of you," she says. "It's your inner wisdom that can help you deal with anything from health issues to relationships to death and dying."

Orloff prefers to call herself an intuitive, rather than a psychic or clairvoyant, because she believes those terms have been too "tarnished" in our society and evoke images of sideshow acts.

In her practice -- which has a waiting list of 6,000 patients -- and in her workshops for healthcare professionals around the country, Orloff teaches people to develop their own intuition.

Sept. 2, 2003 -- New research shows that prevention -- with a flu shot -- may be key to keeping costs down for treating the flu in older adults.

This is the first study that looks at which method gives the most bang for the buck when it comes to treating seniors with the flu. It points out that treating seniors with available anti-flu drugs is cost-effective, but giving the flu shot -- to stop the virus before it starts -- does even more good. The findings are published in the September 2 issue of Annals of Internal Medicine.

The flu shot decreases both the chances of contracting flu and the severity of the virus -- thus decreasing hospitalizations and deaths from the flu.

In this study, researchers compared seniors who got flu shots with those who didn't.

For high-risk patients over 65 who hadn't received the flu shot, using a newer, anti-flu drug called Tamiflu without first testing for flu was the most cost-effective treatment. For vaccinated or low-risk patients, rapid testing followed by treatment with Tamiflu for patients who tested positive for the flu virus was most cost-effective.

Researchers say, however, that older, less expensive, anti-flu drugs, which only fight influenza A (and not B) are good alternatives if a patient can't afford more expensive, newer drugs. Costs for new drugs can range from $48 to $60 for five days of treatment, the study shows.

Prevention Best Option

Researchers found that -- as in younger people -- anti-flu drugs are cost-effective for treating older flu patients but say prevention is still the best option.

"The best advice for older adults is to get a flu shot every year because vaccination decreases the probability of getting the flu and reduces the severity of the illness," says Michael Rothberg, MD, MPH, internist at Baystate Medical Center, Springfield, Mass.

Typically, health professionals recommend an annual flu shot for people most vulnerable to illness, including:

• Adults over 65
• Children younger than 4
• People with lung or heart diseases or heart failure
• People with medical conditions that weaken their immune system

Most of the people who die from the flu are older than 65, the study reports.

"Doctors are often hesitant to prescribe anti-flu drugs because they're expensive and won't work if the patient has a virus other than influenza," Roth says. "But for people over age 65, influenza is so dangerous that treatment with antiviral drugs is very cost-effective, even when the doctor isn't sure of the diagnosis," he says.

Sept. 14, 2004 -- In a study of people with heart disease, results show that high doses of the popular cholesterol-lowering drug Zocor may not prevent heart disease deaths and heart attacks -- and may cause muscle damage. But experts say that the new adage of "lower is better" still holds true when it comes to cholesterol.

The study results were presented last month at the European Society of Cardiology Congress 2004 and appear in the new issue of The Journal of the American Medical Association.

High doses of Zocor were associated with increased rates of muscle damage. Nonetheless, study researcher Michael Blazing, MD, said at a news conference at the meeting that doctors should still consider starting treatment at a higher dose and to be more aggressive when prescribing Zocor and other cholesterol-lowering drugs in its class, known as statins. Blazing is with Duke University Medical Center in Durham, N.C.

Asked to clarify that statement, Blazing told WebMD that he and his study colleagues recommend a 40 mg dose, rather than an 80 mg dose of Zocor.

Blazing added that studies of other statins -- notably recent studies of high-dose Lipitor -- suggest that the high-dose statins are both safe and effective.

His study looked at nearly 4,500 patients who had severe chest pain or a heart attack. The researchers were trying to determine if there was any benefit to starting Zocor right away. Half the patients received early aggressive treatment -- 40 mg of Zocor for a month (started within an average of three to four days) followed by 80 mg Zocor -- or conservative treatment with four months of placebo followed by 20 mg of Zocor.

The study did show that early aggressive Zocor treatment appeared to slightly decrease the risk of heart disease death, heart attack, and stroke. However, the study findings were not strong enough to be considered significant. All patients also received other traditional heart disease treatments, including aspirin.

In those treated with placebo first, LDL "bad" cholesterol levels increased by 11% during the initial placebo phase. LDL then decreased 31% from baseline after four months of 20 mg Zocor. However, in those that took Zocor for the entire study, LDL cholesterol decreased by 39% over the first four months. LDL then decreased an additional 6% following the increase to 80 mg of Zocor.

Christopher P. Cannon, MD, associate professor at Harvard Medical School, tells WebMD that "the real message of this study is that it confirms the 'lower is better' message" when it comes to cholesterol.

Cannon, who did not participate in the current study, was principle researcher of a previous study that showed high-dose Lipitor was associated with an approximately 50% reduction in LDL "bad" cholesterol, reducing LDL down to approximately 62 mg/dL. Moreover, aggressive Lipitor treatment reduced the risk of death, heart attack, severe chest pain, or stroke by 16%.

Cannon's findings were closely followed by a change in cholesterol guidelines for patients at highest risk of dying from heart attacks and strokes. The National Cholesterol Education Program (NCEP) reduced target LDL levels from 100 mg/dL to 70 mg/dL for those at the very highest risk of heart disease. This includes people who already have heart disease in addition to diabetes, poorly controlled high blood pressure, or metabolic risk factors including obesity, high triglycerides, and low HDL "good" cholesterol. Smokers with heart disease also fall into this category.

The lead researcher of the current study, James de Lemos, MD, tells WebMD he does not doubt that the high-dose Zocor regimen is beneficial. Nonetheless, de Lemos says his study does support new guidelines that contend lower is better. He is assistant professor at the University of Texas Southwestern Medical Center in Dallas.

Asked if doctors will be reluctant to prescribe high doses of Zocor because of the reported safety concerns, both Cannon and de Lemos declined to speculate.

But not everyone is so reluctant. In a JAMA editorial that accompanies the study, Steven Nissen, MD, of The Cleveland Clinic in Ohio, points out that high-dose Lipitor packs a double punch. Studies indicate that it not only reduces LDL "bad" cholesterol, but also sharply decreases blood levels of an inflammatory marker called C-reactive protein (CRP). Research has shown that signs of inflammation, such as a high CRP, are associated with an increased risk of heart disease.

Patients in the current study treated with high-dose Zocor did not have similar declines in CRP. In the previous study, high-dose Lipitor decreased CRP by 38%, while high-dose Zocor reduced CRP by just 17% in the current study. More research is needed to determine if these differing CRP results stand true.Zocor and Muscle Damage

As for the increased risk of muscle damage, Nissen, who was lead researcher for another favorable high-dose Lipitor study, writes that the increased risk of muscle damage applies only to a specific dose of a single drug and should not tarnish this remarkable class of drugs. It must also be emphasized that Zocor in doses up to 40 mg per day has shown excellent safety and effectiveness in a series of clinical trials, he adds. For now, though, he says, the 80 mg daily dose of Zocor should be used with caution, particularly because other effective drugs are available.

But David Faxon, MD, professor of medicine at the University of Chicago and former president of the American Heart Association, tells WebMD that the safety concerns of the high-dose Zocor are not surprising. "I think muscle pain with statin therapy is more common then the studies indicate." Moreover, Faxon, who was not involved in the study, agrees that the take-home message from the current study "does support our 'lower is better' message."

In June 2004, the FDA advised doctors to be careful about how they prescribe the statin Crestor. This was in response to reports of serious toxicity in some patients taking the drug. The FDA and the drug's manufacturer say Crestor is safe when given to the right patients at the right dose. Patients should promptly call their doctor if they have signs of muscle damage: muscle pain or weakness, feeling weak or sick, fever, dark urine, nausea, or vomiting.

March 30, 2007 -- Cancer experts may have found a new way to curb cancer: halting cancer cells in their tracks.

That tactic is called senescence. In senescence, cells don't divide, which means a cancer could not grow.

Triggering senescence in certain cells appears to hamper the growth of some tumors, according to lab tests done on mice.

The tests were done by researchers at the University of Texas M.D. Anderson Cancer Center in Houston, including Sandy Chang, MD, PhD, an assistant professor of molecular genetics.

Their study appears online in EMBO Reports, a publication of the European Molecular Biology Organization (EMBO).

Cancer-Fighting Gene

Chang and colleagues focused on the p53 gene, a gene within cells that works to nip cancer in the bud.

The p53 gene springs into action within DNA-damaged cells. Such damage can happen as cells age but can also be triggered by cancer risk factors.

Normally, the p53 gene within a DNA-damaged cell orders the cell to die -- a sort of cell suicide -- or to become senescent.

But p53 gene mutations can make that process go awry, promoting cancer instead of suppressing it, Chang tells WebMD in an email interview.

In their study, Chang's team looked at mice with a p53 gene mutation that only allowed the p53 gene to order senescence, not apoptosis (or self-destruction).

That is, the mutated p53 gene could prevent DNA-damaged cells from dividing, but it couldn't make the cells die.

DNA Damage

The researchers damaged the mice's DNA by shortening the telomeres (the tips of the chromosomes) in some intestinal cells.

In response to that DNA damage, the mice's mutated p53 gene swung into action. Since it couldn't order DNA-damaged cells to die, it ordered them to become senescent.

The senescence helped stop tumor development in the intestinal cells, the study shows.

Chang says senescence ordered by the p53 gene is "extremely important" in suppressing tumor formation and is as important as apoptosis.

But in some cancers, senescence might not be enough to halt cancer, the researchers found.

When they exposed mice with the p53 mutation to substances that cause a type of skin cancer (squamous cell skin cancer), senescence alone couldn't stop the mice from developing the skin cancer.

Perhaps apoptosis is more important than senescence in fully suppressing some types of cancer, the researchers conclude.

July 7, 2005 -- Detecting oral cancer may one day be as easy as spitting into a cup, a new study suggests.

Researchers found people with oral cancer have higher levels of certain types of bacteria, and screening for these bacteria may offer a new way to diagnose the disease before it's too late.

Oral cancer is one of the deadliest forms of cancer with only slightly more than half of those with the disease living up to five years after their diagnosis. Most oral cancers are within the lining of the mouth. As they progress they spread to deeper layers of the lining of the mouth. The American Cancer Society estimates that about 29,000 cases of oral cancer will be diagnosed and about 7,000 people will die of this cancer in 2005.

However, early detection and treatment of oral cancer can increase cure rates by up to 80% to 90%.

Tobacco and drinking alcohol are the two biggest risk factors for oral cancer, but some people with the disease have no known risk factors.

Saliva Test May Screen for Oral Cancer

Cancerous tumors in the mouth and throat often cause no symptoms, and researchers say there is a need for an easy-to-use screening test to detect oral cancer.

The American Cancer Society recommends that doctors and dentists examine the mouth and throat for potentially cancerous growths during routine cancer-related checkups.

In the study, which appears in the current issue of the Journal of Translational Medicine, researchers looked at whether the bacteria found in people with oral cancer differed from those found in people without oral cancer.

Researchers analyzed saliva samples from 45 people with oral cancer and 45 healthy people. The groups were similar in age, sex, and smoking status.

Of the 40 different bacteria analyzed, the study showed that six common bacteria were found at significantly higher levels in people with oral cancer.

When researchers used three species of these bacteria to screen for oral cancer in the saliva samples, the tests correctly predicted more than 80% of the oral cancer cases.

Researchers say these findings may form the basis for the development of a noninvasive and inexpensive saliva test for diagnosing oral cancer.

Sept. 13, 2004 -- Cancer survivors may not receive the care they need to protect themselves from complications arising from other common medical problems, such as heart disease and diabetes.

A new study shows that people who survive cancer are less likely to receive recommended screening tests and care for other diseases and health issues than those who never had cancer. Researchers say the findings show that a history of cancer may shift the attention of both patients and health care providers away from other potentially deadly threats.

The number of cancer survivors has grown to more than 9.6 million in recent years and is expected to continue to rise, thanks in part to improved treatments for the disease.

Researchers say most people diagnosed with cancer today will not die from it, which means preventive care and treatment of other medical conditions is also important for cancer survivors.

Cancer Survivors Undertreated for Other Illnesses

In the study, published in the Sept. 13 online edition of the journal Cancer, researchers compared Medicare claims from more than 14,000 colon cancer survivors with those from a similarly matched group of people who never had cancer.

Researchers found that colorectal cancer survivors were less likely than healthy people to receive the recommended care for managing their other medical conditions.

For example, of 63% of cancer survivors with heart disease (stable angina, or chest pain upon exertion) had their cholesterol levels checked regularly by their health care provider compared with 69% of noncancer survivors.

Cancer survivors with diabetes were also less likely to have regular follow-up visits and annual vision exams.

In addition, the study showed that cancer survivors were less likely to receive recommended preventive care, such as:

• Eye exams
• Flu shots
• Cholesterol screening

Female cancer survivors were also less likely to receive cervical cancer screening and bone density testing to screen for osteoporosis.

Researchers say cancer survivors who were followed by both a primary care physician and an oncologist (cancer doctor) were more likely to receive the recommended care; those followed by only an oncologist were least likely to get adequate noncancer care.

"Having a prior cancer diagnosis may shift attention away from important noncancer problems," write researcher Craig Earle, MD, of the Dana-Farber Cancer Institute in Boston, and colleagues. "In addition, cancer survivors may use specialists as their personal physicians, yet these providers may not always be aware that they are expected to provide increasingly complex primary care."

April 27, 2000 -- If you have seasonal allergies or know someone who does, you know the misery associated with a high pollen count: sneezing, itchy eyes, and increased asthma problems. Even if you felt like dying, you probably wouldn't think of these pollen-heavy days as deadly.

Think again, say Dutch investigators who found more death due to heart disease and certain respiratory conditions on days with high pollen counts.

"Pollen is a well-known trigger of allergies, especially hay fever and asthma," the authors write. "However, deaths related to these conditions are extremely rare, and cannot account for the associations seen in this study." They likened the association to the one between air pollution and death, noting that a 5% to 10% increase in death is seen on high-pollution days. The new study was published in the journal The Lancet.

"The association is a bit like the link between [death] and very warm or very cold weather, which are also known to increase [death]," lead author Bert Brunekreef, PhD, tells WebMD. "Similar findings have been reported repeatedly for air pollution." Brunekreef is an epidemiologist in the Netherlands.

The authors looked for relationships between pollen counts and death due to heart disease, pneumonia, and chronic obstructive pulmonary disease (COPD), a chronic lung disease. They obtained statistics for the total number of daily deaths from the Netherlands' Central Bureau of Statistics over an eight-year period. The investigators then related these statistics to corresponding data for airborne pollen concentrations.

During this period, there was an average of more than 330 deaths per day. Of these, there was an average of about 140 deaths per day due to cardiovascular disease, 16 for COPD, and 10 for pneumonia.

When the researchers looked at the number and rate of deaths and the amount of Poacae, a common pollen found in the Netherlands, they found that the days with the highest pollen counts were associated with an increase of about 6% in death from heart disease, 15% in death from COPD, and 17% in death from pneumonia.

The authors write that, in other research, certain indicators of allergies are linked to increased death due to heart disease and COPD, and that their study seems to support pollen's contribution to the death rate. They caution, though, that their findings should be replicated in other studies before this link can be confirmed.

People with COPD should be less worried about the pollen outdoors than they are about the smoke indoors, according to a respiratory disease expert. "We have no proof that any of the people who died were allergic. The vast majority of patients with COPD, for example, do not have allergies," Eric Schenkel, MD, tells WebMD.

In severe allergic reactions, the body secretes histamine, a compound that can have an effect on the heart. In severe asthma, lack of oxygen can also cause heart rhythm problems, he says.

"There's no evidence whatsoever that inhalation of pollution causes cardiac problems, though." Schenkel is an allergist who focuses on COPD and is the director of Valley Clinical Research Center in Easton, Pa. He is also a clinical assistant professor of medicine at MCP/Hahnemann University School of Medicine in Philadelphia.

The study was funded by the Ministry of the Environment in the Netherlands.

Vital Information:

• A new study shows that people are more likely to die from heart disease and certain respiratory conditions on days with high pollen counts.
• Pollen is known to trigger allergies, but deaths related to this are extremely rare and unable to account for the findings.
• Other studies have shown a similar increase in the death rate related to air pollution, very warm weather, and very cold weather.

?

March 3, 2000 (Washington) -- One of medicine's longer-running controversies may have been put to rest with the release of a major study Friday showing that high-dose chemotherapy along with immune boosting bone marrow transplantation doesn't prolong the lives of women with metastatic breast cancer, at least not when compared with conventional treatment.

"Though the outcome is not worse when you do a transplant, it is not clearly a benefit," Edward Stadtmauer, MD, an investigator with the Philadelphia Bone Marrow Transplant Group at the University of Pennsylvania Medical Center, tells WebMD.

In an unusual move, The New England Journal of Medicine made the results of the study by Stadtmauer and colleagues available prior to its original publication date of April 13, because of their significance to doctors and their patients. The study of 553 women compared standard dose chemotherapy with those receiving high-dose chemotherapy, followed by a bone marrow transplant built from primitive or "stem" cells previously removed from the patient.

The idea is to wipe out the cancer with a highly toxic drug regimen, but then restore the patient's ravaged immune system from the ground up. Small studies of this approach in the late '80s looked promising, with 20% of patients staying relatively healthy. But in spite of its growing popularity, the technique had not been subjected to research in a large number of patients.

However, in this study, 553 women were followed for approximately three years. In the final analysis, 32% survived in the transplantation group versus 38% of those in conventional therapy, which did not reveal any significant difference.

"[O]ur data show that this treatment [bone marrow transplant] was unlikely to be associated with even a moderate improvement (e.g., a 6-month increase in survival, from 24 months to 30 months)," write the authors, even though the study was designed to show just this effect with high-dose chemotherapy.

The debate over high-dose chemotherapy reached full bloom last spring with the release of five studies at the annual meeting of the American Society of Clinical Oncology. Four of the reports showed no benefit from the treatment. Only a South African study heralded a positive result. However, that study has since been discredited for allegedly containing falsified data.

"Our results contradict those of an earlier, single-center trial. ... This [South African] study is now under review as part of a misconduct investigation," write Stadtmauer and colleagues.

It's estimated some 10,000 American women get high-dose chemotherapy followed by bone marrow transplant, in spite of the fact that it's painful, risky, and expensive. The cost runs between $60,000-120,000. However, since the announcement of the findings last spring, experts tell WebMD, demand for the treatment has fallen off dramatically.

"Before, women were coming in being told by their doctors their only hope of cure was a transplant, and when you're dealing with that kind of rhetoric, it's impossible to have an intelligent discussion," Lee Newcomer, MD, senior vice-president of United Health Group, tells WebMD.

Newcomer says his 13 million-member HMO will still cover the high-dose approach because some patients want it. However, he feels bone marrow transplantation for breast cancer has been oversold. "Actually, we were deceiving cancer patients. The folks who said this is a cure were deceiving them," says Newcomer.

However, breast cancer expert Marc Lippman, MD, does not share that view. "The disappointing results with high-dose chemotherapy plus bone marrow transplantation for metastatic breast cancer in no way indicate that variations on this [treatment] may prove unsuccessful," writes Lippman in an editorial accompanying the research. Lippman is with the Lombardi Cancer Research Center at Georgetown University in Washington, D.C.

In fact, Stadtmauer says he has studies underway to determine whether women with cancer that has advanced to the lymph nodes short of spreading to other organs might benefit from high-dose chemotherapy. Ultimately, he says there may still be a role for high-dose chemotherapy plus transplantation for certain patients.

?

Dec. 28, 1999 (Atlanta) -- The most popular medication to treat nighttime bed-wetting in children maintained its effectiveness over a one-year period, according to a study in the November issue of the European medical journal Acta Paediatrica.

Known as desmopressin, the drug is a synthetic formulation of the natural hormone vasopressin, which balances the body's regulation of water and urine production. It is prescribed as a nasal spray or in pill form to absorb higher amounts of water from the kidney into the body, which decreases urine production.

The study, conducted primarily at a children's hospital in Stockholm, Sweden, followed 399 children aged 6 to 12. After receiving the drug for six weeks, 61% achieved at least a 50% reduction in nighttime episodes of bed-wetting. Those who experienced a reduction continued in the study on a maintenance dose for one year. By the end of one year, the study reports that episodes had decreased from an average of 5.3 per week prior to treatment to 0.8 during the final three months.

But according to Douglas Husmann, MD, an associate professor of urology at the Mayo Clinic, desmopressin should not be considered a cure for the condition, known as primary nocturnal enuresis.

"Desmopressin works very well if patients are monosymptomatic, meaning all they have is nighttime wetness," says Husmann. "Our experience has been the kids will do very well on the medication, but after they are weaned off only a certain percentage will remain dry."

In more complicated cases, genetics, hormone deficiencies, abnormal bladder capacity, stomach disorders, or sleep disorders could be the cause. In those cases, Husmann says, desmopressin alone will not be effective. Symptoms of polysymptomatic enuresis include control problems during the day or problems with needing to urinate "suddenly at the last minute," he says.

Husmann says desmopressin is best prescribed in cases of children taking trips or sleeping over with friends, for example. In a study Husmann authored in the September 1996 issue of Mayo Clinic Proceedings, he found that only 10% of patients remained dry after tapering off the drug.

Comparatively, the Stockholm study found that only nine of 39 patients remained dry after being tapered off the drug at the end of the yearlong study.

Husmann says the best results found at the Mayo Clinic involved combining desmopressin with behavioral treatment using nighttime alarms to awaken children when urination has begun.

"This has by far shown the best results, but you have to stress [to the parents] there's about a minimum of three weeks before the alarm works," he says. During the initial period where children are learning to respond to the need to urinate, desmopressin can lower the episodes to make it easier for families to complete the program.

Husmann found that after six months, 56% of patients remained dry after use of the alarm was stopped.

According to Shelly Morris, director of the Enuresis Treatment Centers in Farmingham, Mich., sleep disorders can often be an underlying cause of nighttime incontinence.

"People sleep so deeply the brain and the bladder don't communicate," she says. "People can outgrow bed-wetting, but they can't outgrow a sleep disorder. It's important to determine if that [or anything else] is the cause before simple drug therapy is undertaken."

Husmann cautions that definitive enuresis should not be diagnosed until a child is between four and five years old. He says by age five, 85% of children will have outgrown the problem by achieving voluntary control of the bladder.

The Stockholm study was supported by Ferring Pharmaceuticals.

Vital Information:

• Desmopressin is the most widely used treatment for nighttime bed-wetting, and the drug maintains its effectiveness over a one-year period, according to a new study.
• The drug is best used for when children are sleeping away from home or in conjunction with a behavioral treatment that uses alarms, because children do not remain dry once weaned from the drug.
• By age 5, about 85% of children will outgrow the problem of nighttime bed-wetting.

Dec. 7, 1999 -- For many older folks, a good night's sleep is but a dream. They have trouble falling asleep and awaken after only a few hours. Their daytime fatigue may be so overwhelming that they can't drive or participate in other normal activities.

About half of those who complain to their doctors about poor sleep end up with a prescription drug. Not only are these unnecessary but they also are habit-forming and can cause side effects, according to sleep researcher Michael Vitiello, PhD, a professor of psychiatry and behavioral sciences at the University of Washington in Seattle.

It is far better for people to consider what simple changes could be made to improve their sleep -- and to understand how sleep patterns change with age, Vitiello writes in the November/December 1999 issue of the journal Gerontology.

Common -- and normal -- sleep problems, which plague up to 40% of the elderly, include light sleep, frequent waking, and daytime fatigue. Among older people, there is also a decrease in the deep-sleep stage and an increase in periods of wakefulness during the night. "Compared with younger adults, even carefully screened noncomplaining older adults exhibit the sleep pattern changes described," writes Vitiello.

While many seniors complain of poor sleep, relatively few have true sleep disorders and even smaller numbers need commonly prescribed sleep medications. Sleep disorders in the elderly include apnea (a temporary cessation of breathing which can also affect younger people) and periodic limb movement, which can take the form of periodic leg movements during sleep (PLMS) or restless leg syndrome. In this syndrome, the person is gripped by strong urges to move his or her legs repeatedly before sleep, which prevent him or her from falling asleep.

Before a physician can diagnose a sleep disorder, he or she should perform a thorough medical examination, review medications the person is taking, and speak to the person's spouse or bed partner about their sleeping habits.

Sometimes medication is prescribed, but "although these drugs may be useful in the management of [short-term] insomnia, they fail to provide long-term relief from chronic sleep disturbances. Hypnotics [medications] can worsen existing sleep disturbances by inducing drug-dependency insomnia and, when the drug is discontinued after intermediate to long-term use, rebound insomnia and nightmares," Vitiello says.

Apnea can be treated by behavior modifications to lessen sleeping on the back, oral appliances that enhance the airway, weight loss, and elimination of medications that depress breathing. Sometimes respiratory stimulants, such as Diamox (acetazolamide); continuous positive airway pressure, which is administered through a mask the person wears at night; and surgery are also effective. Treatments for periodic limb movement disorders are less than ideal, according to the report. Although medications called benzodiazepines, including Klonopin (clonazepam) and Restoril (temazepam), can be used, they also cause daytime sedation and have little effect on the leg movements themselves, Vitiello writes.

Often the most effective approach to improving slumber is to ensure proper sleep "hygiene," which refers to "all the daily practices or routines that can either promote or impede nighttime rest." Some activities that help induce sleep are sticking to a regular bedtime, establishing pre-sleep rituals such as bathing, a light snack, or reading, exercising regularly but not within four hours of bedtime, refraining from caffeine within six hours of bedtime, avoiding smoking close to bedtime, taking a midafternoon nap, and avoiding alcohol and sleeping pills.

In reviewing this report for WebMD, Alon Avidan, MD, a neurologist at the University of Michigan Sleep Disorders Center in Ann Arbor, had high praise for Vitiello's suggestions to improve sleep hygiene. "The guidelines for good sleep hygiene should really be emphasized because this is exactly what we tell people who come to the sleep clinic," Avidan says. "If patients would follow some of these guidelines we could eliminate half of the visits to the clinic. Some of them have very bad sleep habits."

He also supported Vitiello's position that medications are overused. "The vast majority of people I see are on some sort of [benzo]diazepine and that is not a good thing. I try not to use Klonopin or narcotics because they generally disturb the sleep [patterns] and can exacerbate the apnea." However, he disagreed with Vitiello's medication suggestions for restless leg syndrome. "I have had good results with pramipexole, a dopamine 3 agonist," a medication that also sells as Mirapax.

In describing his approach to sleep problems, Avidan says, "We tell patients that [sleep changes] are physiological and that there are certain guidelines that they can follow that will help them. We help with relaxation techniques. ... What we are doing is treating the underlying medical problem causing the insomnia, reducing the drugs that they don't need to take, having them reduce alcohol to no more than half a glass."

Vital Information:

?

• As people age, their sleep patterns naturally change, which can lead to complaints of light sleep, frequent awakenings, and daytime fatigue.
• These changes are considered normal, and in most cases medications are inappropriate because they are habit-forming and can have serious side effects.
• To alleviate sleep problems, people can make behavior modifications including having a regular bedtime, establishing pre-sleep rituals, exercising regularly, and avoiding caffeine, smoking, and alcohol before bedtime.

Updated April 2002 and reviewed by Michael W. Smith, MD, April 2002

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

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

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

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

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

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

Vital Information:

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

Nov. 23, 1999 (New York) -- Many women experience improvements in sexual functioning as a result of having a hysterectomy, a large study in the November 24th issue of the Journal of the American Medical Association finds. Benefits of the surgery include increased frequency of sexual relations, increased desire for sex, and a decrease in painful or uncomfortable intercourse.

Researchers led by Julia C. Rhodes, MS, of the department of epidemiology and preventive medicine at the University of Maryland in Baltimore, suggest that in addition to improvements resulting from the removal of the unhealthy uterus, women may also have an improved quality of life following hysterectomy that translates to a better sex life. Freedom from vaginal bleeding as well as from fear of pregnancy also may play a role.

"There's a perception in the general public that sexual function is impaired by hysterectomy," Rhodes tells WebMD. "But if you actually look at the scientific literature, many of the previous studies agree with our findings that sexual functioning actually improves after hysterectomy."

The 1,299 women participating in the Maryland Women's Health Study were interviewed prior to hysterectomy and at three, six, 12, 18, and 24 months after surgery. In all cases, hysterectomy was indicated for benign conditions. During the interviews, women were asked about frequency of sexual relations in the past month, frequency of pain during sexual relations, frequency and intensity of orgasms, incidence of vaginal dryness, and desire for sex. Most participants were between the ages of 35 and 49, were white, and were either married or living with a partner.

Overall, the frequency of sexual relations increased from twice a month before hysterectomy to approximately three times per month at both 12 and 24 months after the hysterectomy. Prior to hysterectomy, the incidence of painful or uncomfortable intercourse was 41%. At 12 and 24 months after hysterectomy, this percentage dropped dramatically to almost 20% and almost 15%, respectively. Frequency of orgasm also increased from about 63% prior to hysterectomy to about 72% at both 12 and 24 months afterwards. Likewise, strength of orgasm rose from 45% of women experiencing strong orgasms before hysterectomy to almost 60% and over 57% reporting strong orgasms at 12 and 24 months.

Approximately 37% of women reported no vaginal dryness prior to hysterectomy. At 12 and 24 months posthysterectomy, approximately 47% reported no vaginal dryness. However, 9% of women who did not have vaginal dryness before hysterectomy reported this problem after surgery and 35% of women with vaginal dryness before hysterectomy reported persistence of the problem. Use of hormone replacement therapy or lubricants can alleviate vaginal dryness and should be discussed with patients prior to hysterectomy so they can be prepared should vaginal dryness develop, the researchers say.

Frequency of sexual desire increased significantly, with more than 70% of women who reported low libido before hysterectomy reporting an increase in desire at 12 months. Very few women with normal libido before hysterectomy reported a decreased desire for sex. Of 325 women who reported no sexual activity prior to hysterectomy, over 140 were sexually active in the months prior to the 12-month interview and almost 150 were sexually active in the months prior to the 24-month interview.

Rhodes says the findings will not be a surprise to physicians who perform hysterectomies because most have known for years that the majority of women have good outcomes in terms of sexual functioning. "One of the things this study can be used for is to help many of those physicians reassure their patients by showing that indeed, this large group of women did feel better after hysterectomy," she says.

Another significant finding was that women who were depressed prior to having a hysterectomy had less improvements in sexual functioning than nondepressed women. Rhodes and colleagues suggest future research should examine whether giving antidepressants prior to hysterectomy improves symptoms as well as sexual outcomes.

Vital Information:

• After having a hysterectomy, many women experience an improvement in sexual functioning, including increased frequency of sex, increased desire, and a decrease in painful or uncomfortable intercourse.
• There is a general perception that a hysterectomy may actually impair sexual function, but now physicians have scientific data to reassure patients that this is not the case.
• Women who were depressed prior to hysterectomy showed less improvement than those who were not depressed.

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

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

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

Putting tNOX to the Test

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

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

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

It passed with flying colors, he says.

Test Predicts Prostate Cancer Progression

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

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

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

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

Test Spots Lung Cancer

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

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

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

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

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

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

tNOX May be Useful in Other Cancers, Too

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

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

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

May 4, 2004 -- Two popular anemia drugs are under scrutiny by an FDA advisory panel because of ongoing concern that the medications may lead to early death in some patients with cancer and other diseases.

Experts met with drug makers and FDA officials in an effort to monitor several studies involving the drug erythropoietin (EPO). The drug, which raises red blood cell counts, is popular with cancer patients who develop anemia, or low red blood cells, during chemotherapy. Many doctors favor the drugs because they can help combat the fatigue associated with anemia while avoiding the need for blood transfusions.

Meanwhile, makers of Procrit and Aranesp, two EPO drugs available in the U.S., defended their products as relatively safe and suggested that the drugs may even extend patients' lives. They pledged to move quickly on several ongoing clinical studies aimed at answering lingering safety questions.

"We have these evolving safety concerns. They cannot be dismissed," says Harvey Luksenburg, MD, a medical officer in the FDA's division of therapeutic biological oncology products.

Experts are most concerned about a handful of large European studies showing that EPO drugs may cause cardiovascular problems or even worsening cancers in patients on chemotherapy.

One study performed on 940 women on chemotherapy for breast cancer showed a 2.3% rate of fatal blood clots or other fatal cardiovascular events in women taking Eprex, an EPO drug available in Europe but not in the U.S. Women taking placebo pills had a 0.4% rate of the fatal events, nearly six times lower. The study was planned to last a year but was stopped after just four months because of the safety problems.

In another European study in 2003, cancer patients taking the EPO drug NeoRocormon had an 11% rate of dangerous cardiovascular events such as stroke, hemorrhage, or blood clots, while those on placebo had a 5% rate.

Results from that study also showed that patients on placebo were less likely to see their cancers progress, suggesting that EPO could be having a cancer-promoting effect.

Other studies showed no risk of dangerous heart problems with the drug and no signs that the drugs promote cancer. Overall FDA reviewers found four studies showing a higher risk of heart problems with EPO and three showing no increased risk.

Drug manufacturers defend their products, noting that large scale trials conducted in Europe show that EPO drugs have no impact on the overall survival rates of patients with lung cancer, lymphatic cancer, and other malignancies. While many studies have indicated an increased risk of blood clots in patients taking EPO, patients' overall life spans were not affected, says David Parkinson, MD, vice president for oncology clinical development for Amgen, Inc. The company makes the EPO drug Aranesp.

"We believe that our detailed examination confirms the safety profile of Aranesp," he says.

Parkinson referred to "a significant amount" of preliminary evidence showing that the drug could pose a measurable benefit to anemic patients on chemotherapy.

Both company and government officials agreed that more studies are needed to determine what effect EPO has on patients with different kinds of cancers, and whether or not the drug could actually have an effect directly on cancer cells, possibly causing them to grow.

American Volunteers Needed

Still, regulators and experts remain concerned that most if not all of the large EPO studies were performed in Europe and not the U.S. Officials expressed worry that American patients and their doctors may continue to shy away from signing up for trials where they could be randomized to take EPO or a placebo.

"The real question is, will they be willing to be randomly assigned," says Musa Meyer, a consumer advocate and member of the FDA's advisory panel for oncologic drugs. "I think there are physicians for whom it will be an issue."

Company officials said that several trials testing EPO drugs in patients with lung cancer, breast cancer, lymphoma, and head and neck cancers are continuing to recruit hundreds of patients. But those studies are all continuing in Europe.

"We will have those data very shortly," says Martine George, vice president for hematology and oncology research for Procrit maker Johnson and Johnson. Trials in the U.S. have largely ground to a halt because researchers have had trouble getting patients to sign up.

"We believe the findings should absolutely be applicable to United States practice," Parkinson says of the European research.

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

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

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

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

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

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

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

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

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

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

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

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

Dec. 17, 2004 -- Recent research suggesting that birth control pills slightly lower women's risk of heart disease was flawed, says the National Heart, Lung, and Blood Institute (NHLBI).

It also announced that it doubts the validity of a separate study that suggests birth control pills reduce breast cancer risks.

The two studies in question were presented by experts from Wayne State University at the American Society of Reproductive Medicine's annual meeting in October. Data for the study came from the Women's Health Initiative (WHI). Yet according to the NHLBI, the findings bear no relationship to the findings from the WHI.

Senior WHI statisticians reviewed the two studies after their presentation. They found no evidence that oral contraceptives lower heart disease risk and said the breast cancer results might also have been misleading.

The findings are considered "exploratory" and "should not be used to reassure women about oral contraceptive use," Barbara Alving, MD, WHI director and acting NHLBI director, says in a news release.

The studies conflicted with past research.

"There is a large and reputable body of higher scientific evidence linking current oral contraceptive use to future increases in risk of stroke and heart attack, especially in older women and in smokers," Alving says.

Likewise, previous studies have linked recent use of birth control pills to an increased breast cancer risk. However, some types of oral contraceptives may cut the risk of ovarian cancer and slightly lower endometrial (uterine) cancer risk.

What was the problem with the studies? Design and interpretation flaws, Alving says.

The data came from postmenopausal women who were 50-79 years old when they enrolled in the WHI study. Results relied on the women's memories about their past oral contraceptive use and diseases they had developed. That doesn't always make for solid evidence.

"Because people can forget details, the best studies try to collect these data as close to the event as possible and to confirm any report of disease with hospital records," says Alving.

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

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

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

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

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

'Cause for Concern'

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

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

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

About the Study

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

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

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

The seventh-grade survey included these questions:

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

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

Early 'Serious' Relationships

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

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

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

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

Sex by 9th Grade

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

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

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

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

Boys, Girls & Age

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