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You want a trimmer body, not a slimmer wallet. But when you're cutting calories, it's not always easy to cut costs. If you're not careful, fresh salads, juicy fruits, and lean meats can add up to far more than the value meal at McDonald's or that economy-size box of macaroni and cheese. What's a cost-conscious dieter to do?

The first thing to keep in mind is this: When you count the costs of a healthier diet, don't forget to tally the costs of being overweight. Just ask the famously cheap author and radio personality Clark Howard.

It's true that fans of the Clark Howard Show tune in for Howard's cost-cutting strategies, not diet tips. "I've got the exercise part down," he tells WebMD. "I exercise every day and run a half-marathon every year. But I eat fast food."

But after Howard told his radio audience that buying fast food burgers could be cheaper than cooking at home, a doctor at the University of Virginia wrote to him to point out the medical costs of obesity, diabetes, and hypertension. The doctor wrote, "Cholesterol drugs can cost you $100 a month, and being admitted to a hospital can cost you hundreds per day. So is it really worth it to eat fast food?"

Healthier diets could save Americans more than $200 billion a year in medical costs, lost productivity, and expenses caused by death, according to the nonprofit Center for Science in the Public Interest (CSPI). Bad eating habits, combined with a lack of exercise, lead to 310,000 to 580,000 deaths each year -- about as many as smoking. Diseases linked to poor nutrition and a sedentary lifestyle include cancer, heart disease, obesity, diabetes, stroke, and high blood pressure.

Low-Cost Eating at Home

Another thing to think about when buying food is how much nutrition you're getting for your money, says M.J. Smith, author of 60 Days of Low-Fat, Low-Cost Meals in Minutes.

"French fries are cheap, but other than a little vitamin C, some energy, and a whole lot of dangerous fat in most cases, that's the contribution relative to the cost," Smith says.

In her nutritional counseling practice, Smith noticed that mothers often were comfortable splurging on name-brand cereals for the kids and expensive sodas-by-the-can for dad. Then, they had no grocery money left for healthy foods like fresh pineapple or salmon filets. "Mom will buy the sugary cereal that costs $4 a pound but will think a pineapple at $2.89 is too expensive," Smith tells WebMD.

Similarly, a 3 pound lean pork roast priced at $12 might seem out of reach. "The average consumer doesn't look at the roast and think, that's enough meat to provide three dinners for a family of four," says Smith. "They just look at the $12."

She suggests the first meal might be slices of roast pork, served with a baked potato or fresh breadsticks, and steamed broccoli or a salad. For the second and third meals, leftover pork roast can be made into chili or stew, and shredded to make barbecue sandwiches on whole-wheat buns.

Smith, who lives in Guttenberg, Iowa, tells WebMD that a lot of eating during Midwestern winters is centered on televised sporting events.

"Instead of serving a sugary soda on nights when you're providing a special beverage, pour glasses of juice," she suggests. "There are so many fun juice blends. Look at the label to make sure it's 100% juice and its vitamin C content is 100%. For example, Juicy Juice has a berry blend with added vitamin C to make it comparable to orange juice."

Dec. 11, 2003 -- This year's nasty flu bug is now widespread in 24 states, the CDC's latest figures show. That's up from 13 states just one week ago.

Deaths are mounting. In the week ending Dec. 6, an estimated 7% of all U.S. deaths were caused by pneumonia and influenza. That's still below CDC's "epidemic threshold" of 7.6% for that week.

CDC uses the term epidemic when an illness causes far more deaths than would normally be expected for that time of year. Last year's flu season never passed the epidemic threshold; but it happened for nine weeks in the 2001-2002 season and for 10 weeks during the 2000-2001 season.

It may not yet be a national epidemic, but some areas are particularly hard hit. One is Pittsburgh, says Lawrence D. Ellis, MD, director of the University of Pittsburgh Medical Center.

"Our children's hospital is overwhelmed. It's seeing more cases this year than in the last several years combined," Ellis tells WebMD. "We are seeing a lot more adult cases too."

Ellis, who's been treating flu patients for 39 years, notes that the U.S. has between 20,000 and 40,000 flu deaths every year.

"If this maps out the way people think it will, we will see a lot more than that," he says.

Fujian Flu

This year's flu vaccine offers at least some protection against all of the flu strains causing illness this year. However, there may be somewhat less protection against one of the most predominant strains -- called Fujian variant. It's impossible to tell how much less protection until after the flu season is over.

The flu vaccine also protects against others flu strains that the CDC warns may emerge later this year.

Dec. 8, 2004 -- Barley deserves a place on your plate if you're trying to curb your cholesterol, a new study suggests. The grain contains soluble fiber, the type found in many fruits, vegetables, and oats, and appears to lower cholesterol.

High cholesterol levels are a risk factor for heart disease, the leading cause of death in America. Whole grains have been studied for their impact on cholesterol, but researchers mainly focused on more popular grains, such as oats.

Barley isn't widely eaten in the U.S., although it comes in grain, flour, and flake forms.

Barley's cholesterol-lowering powers were seen in a small study of 25 people with mildly elevated cholesterol levels. Their total cholesterol ranged from 200-240. Ideally, total cholesterol should be under 200, according to the National Cholesterol Education Program of the National Heart, Lung and Blood Institute.

Participants included nine postmenopausal women, nine premenopausal women, and seven men. None were taking medicines that affect cholesterol or blood pressure. Participants had also maintained their weight for six months.

Researchers Kay Behall and colleagues led the study, which recently appeared in the American Journal of Clinical Nutrition. Behall works for the Beltsville Human Nutrition Research Center, part of the U.S. Department of Agriculture.

The study unfolded in two phases.

First, participants spent two weeks on a balanced diet devised by the American Heart Association. Next, they added barley to their fare, sampling menus with low, medium, or high levels of fiber from barley.

Beta-glucan, a soluble fiber found in many whole grains, came exclusively from barley and not supplements. The diet with the most beta-glucan used barley flakes, barley flour, and pearled barley instead of rice and wheat. Lower levels of beta-glucan mixed equal measures of barley with wheat or rice.

There were a couple of rules. Participants promised not to cheat and to eat everything the researchers gave them. They didn't have to cook even one grain of barley. All foods were either served at a lab facility or were packaged for consumption at home.

The barley-based foods made a difference. When participants ate diets with low, medium, and high levels of the soluble fiber beta-glucan, their total cholesterol dropped by 4%, 9%, and 10%, respectively.

LDL ("bad") cholesterol levels also fell. The diets with low, medium, and high beta-glucan levels cut LDL cholesterol by 8%, 13.8%, and 17.4%, respectively.

The biggest improvements in total and LDL cholesterol levels were seen in the diets with medium or high levels of beta-glucan. "The addition of barley to a healthy diet may be effective in lowering total and LDL cholesterol in both men and women," say the researchers.

The biggest gripes were that there was too much food and that subjects felt very full after their meals. Complaints about bloating and flatulence increased on the barley diets, with the most concerns voiced on the diet with the highest level of beta-glucan.

Can't stand barley? The American Heart Association diet that kicked off the study trimmed cholesterol somewhat, cutting LDL cholesterol by almost 4%. That's less than barley's results, but it's still an improvement.

Other grains, such as oats, may also help, research suggests. In general, experts recommend whole grains over processed, refined, or "instant" grains for maximum nutritional benefits.

March 18, 2002 -- Lowering your cholesterol levels -- especially the so-called "bad" or LDL cholesterol -- may not only reduce your risk of heart problems, it could keep your mind sharp. A new study found women with high LDL cholesterol levels were more likely to suffer from age-related mental decline.

The findings also suggest that cholesterol-lowering statin drugs may have a protective effect on the brain and help prevent dementia in other ways -- aside from just lowering cholesterol.

The study, published in the Archives of Neurology, looked at more than 1,000 postmenopausal women with heart disease for four years. Researchers measured mental abilities and cholesterol levels at the beginning and end of the study and tracked use of statins.

They found the elderly women with high total and LDL cholesterol levels were significantly more likely to have suffered mental decline during the course of the study and scored worse on tests of mental ability. Those women who reduced their total and LDL cholesterol over the four years had better mental functioning and about a 50% less risk of having any form of memory problems.

"These findings suggest that lowering total and LDL cholesterol levels may be a potential strategy for preventing the development of ... dementia," write the authors.

Researchers say the results of previous studies on the relationship between cholesterol and mental problems have been mixed. Some suggest high cholesterol levels are associated with an increased risk of mental problems such as Alzheimer's disease, but others have linked low cholesterol to Alzheimer's.

The study also found that statin use was associated with a lower risk of memory problems or dementia, regardless of total cholesterol level. The authors say more research is needed to understand exactly how statins seem to protect the brain, but they suspect that the drugs may work by improving muscle function and reducing inflammation.

July 29, 2005 -- Researchers from a U.N. cancer agency are calling combined estrogen-progestin birth control pills and menopausal hormone replacement "carcinogenic to humans."

However, they don't dismiss either type of drug. For instance, they state that birth control pills may "slightly" raise the risk of some cancers while lowering risks of other cancers.

Women should weigh the drugs' risks and benefits with their doctors, write the researchers.

The report appears in The Lancet Oncology. The researchers included Vincent Cogliano, PhD, of the World Health Organization's International Agency for Research on Cancer (IARC).

They didn't do any new studies. Instead, they reviewed past research on the topic.

The risks are not new and are already noted on drug labels, says Candace Steele, director of global public relations for Wyeth Pharmaceuticals, which makes birth control pills and menopausal hormone therapy drugs.

Review of Birth Control Pill Studies

The researchers write that combined estrogen-progestin birth control pills may "slightly" raise breast cancer risk in women currently or recently taking those pills. But the risk seems to drop back to normal 10 years after stopping the pill, write the researchers.

The researchers note higher risks of cervical and liver cancers with combined birth control pills.

However, uterine and ovarian cancer risk is lower in women using birth control pills, they write.

Despite the slightly higher risk of some cancers, the overall risk of cancer from the pill is still low.

The IARC's assessment of cancer risk from birth control pills hasn't changed but now includes more types of cancer, write the researchers.

Net Benefit?

Because use of the pill (forms containing both estrogen and progestin) heightens risk of some cancers and reduces that of others, it is possible that there may be an overall net benefit to public health, write the researchers. More rigorous analysis is needed to show this, they add.

The researchers cite studies showing higher breast cancer risks for women using combined hormone therapy -- containing both estrogen and progestin. They note other studies showing that uterine cancer risk is higher in women taking estrogen-only therapy, compared to those taking estrogen and progestin.

When progestin is taken every day, the risk is much the same as that in women who have never used hormonal treatment, they write.

"There are both beneficial and adverse effects for oral contraceptives and menopausal therapy," states an IARC news release. Each woman who uses these products should discuss the overall risks and benefits with her doctor.

Drug Company: Nothing New Here

The IARC's change regarding combined hormone therapy "is based on data published since 1999," Steele tells WebMD.

"Estrogen and progestin data from those studies have previously been published in medical literature and have been incorporated into the product labeling for estrogen and progestin therapies," she says.

"I think it's important to note that the information in the IARC's most recent guidelines is consistent with the current clinical practice and all class labeling for our company's estrogen and estrogen-plus-progestin therapies, as well as for our oral contraceptive products," says Steele.

"The IARC last made their report in 1999, so they're just updating [it] based on new information since then. We, of course, have been updating our label all along. So the information that's included in that report is already included in our label," says Steele.

Millions of women use oral contraceptives or hormone therapies, notes Steele. "I really feel that the best source of information is a woman's physician, and that this information should be taken in context with a risk and benefit assessment made with her physician," she says.

Dec. 1, 1999 (Chicago) -- Doctors at Harvard's Beth Israel Deaconess Medical Center are tapping into patients' ability to find comfort in the subconscious before tapping into their veins with catheters, and this "new age" approach is winning enthusiasts among both patients and staff.

Elvira V. Lang, MD, associate professor of radiology and medicine at Harvard Medical School in Boston, reported a study of self-hypnosis techniques at the 85th Scientific Assembly and Annual Meeting of the Radiological Society of North America. Although her study included only 161 patients who were offered the hypnosis relaxation approach, she says that by early next year, all patients undergoing procedures in the catheterization lab at Beth Israel Deaconess Medical Center will have the option of using hypnosis to either replace or supplement traditional conscious sedation. Conscious sedation usually consists of the patient receiving one or more drugs that aid in anxiety and pain relief.

Lang tells WebMD that by using hypnotic relaxation -- basically, using a set script to lead a patient into deep relaxation by suggesting that the patient "concentrate on the sensation of floating and float to some place comfortable" -- her hospital saves more than $100 on each procedure, a potential annual savings of $1 million. The hospital is so enthusiastic that "we are currently training our entire team in the technique." She says that care nurses and technicians require about 32 hours of training. She has worked "five years to develop our standard script, and it hasn't failed us yet."

In her study, the technique was offered to 161 patients undergoing angiography, angioplasty, or kidney drainage, but she says that it can be used with any catheter-based procedure in which conscious sedation is used. "Use of the hypnotic procedure cut procedure time from 78 minutes for our standard care group to an average of 61 minutes for the hypnosis group," she says.

According to Lang, patients who undergo the technique can still receive both pain and anxiety medications and are given a bell to signal when they want to receive medication. Patients who underwent the procedures without hypnosis used "an average of 1.9 units of drugs, compared to an average drug use of 0.9 units for patients using hypnosis."

Of the 161 patients in the study, 79 patients did not undergo relaxation techniques; 82 did opt for the relaxation approach. "Forty-six percent of the patients using hypnosis used no conscious sedation, while only 18% of the patients in the standard treatment group requested no sedation," she says.

She says that patients each select a "familiar comfortable place. ... Many chose settings in nature, but one woman said she went home to can vegetables. Another woman said she sat on the clouds with her deceased relatives and floated around touring the country."

She says that the relaxation approach benefits not only the patient but the operators and cath lab staff as well. For example, she says that when she was placing a shunt in a liver, a complication occurred while the patient was using the relaxation technique. "This man had gone to New York, where he was the Statue of Liberty, which was great because statues don't move. But then we had this happen and our anxiety started to rise, so the care nurse told the man that statues often need restoration work that needs to be done by experts. She told the man that we were now calling in a team of restoration experts to work on the Statue of Liberty," she says. "It worked great because we had the chance to calm down and we realized that the situation wasn't really that bad."

She says that patients who opt to use hypnosis are generally very satisfied and report that they would be willing to use it again.

Lang says that she started using the hypnosis technique about 10 years ago when she encountered difficulty replacing "a drainage tube. It should have been very easy, but it wasn't. My technician had studied hypnotism and suggested that we try that. It worked like a charm. I am a pragmatist, when I saw that it worked, I was sold." She describes it as the "perfect combination of high technology and high touch."

Vital Information:

• Hypnosis can be an effective supplement or replacement to traditional conscious sedation in patients undergoing procedures that involve catheterization.
• The length of time needed to perform the procedure and the amount of drugs used were lower in patients who elected to undergo self-hypnosis.
• Nearly half of patients who used the relaxation technique did not ask for any sedation; this was true for only one-fifth of patients not using hypnosis.

Epilepsy and the medications used to control seizures can affect a woman's sexual health. Infertility, sexual dysfunction, higher rates of birth defects, and even osteoporosis are real issues for women with seizures.

While we may know more now than in the past about women with epilepsy, many misconceptions still persist.

"Informal surveys at both the local and national levels show that women with epilepsy consistently report a lack of knowledge about the difficulties they face," says Patricia Shafer, RN, MN, past chairman of the professional advisory board of the Epilepsy Foundation, who herself suffers from the disorder. "And a survey of health-care professionals, conducted a few years ago, revealed a lack of knowledge or uncertainty about what to do in terms of pregnancy management or problems of sexuality in such cases."

Though Shafer and other experts who spoke with WebMD agree that strides have been made in understanding the unique problems facing women with epilepsy in the past few years, they point to a new dilemma: Getting the message out to general care practitioners and their patients.

"Many women tell me they're aware of [some of the new findings]," says Shafer, who is also an epilepsy nurse specialist in the Comprehensive Epilepsy Center at Beth Israel Deaconess Medical Center in Boston. "But they don't follow through."

Alison Pack, MD, assistant professor of clinical neurology at Columbia University in New York, agrees. She and others are channeling their efforts at spreading the word on three of the main problems women with epilepsy face: reproductive health; bone health, particularly as a woman approaches menopause; and pregnancy.

Readdressing Reproductive Health

No one really knows exactly how seizures affect reproductive health, but there seems to a hormonal connection, experts say. According to Pack, the female hormones estrogen and progesterone act on certain parts of the brain where partial seizures often begin. Estrogen excites these brain cells and can increase the risk of seizures, while progesterone can inhibit or prevent seizures. Not all women with epilepsy develop seizures during their periods, and it is not clear why some women are more at risk.

"Since progesterone levels drop during menses, that may render a woman more susceptible to a seizure during that time period," she explains.

In Boston, Andrew Herzog, MD, director of the Neuroendocrine Unit at Beth Israel Deaconess Medical Center, is working on a large National Institutes of Health-sponsored study designed to provide new answers. While final answers are still years away, preliminary evidence suggests that giving progesterone during menstruation may help to assuage hormone-related seizures.

But not all the news is good: Other studies have shown that some older epilepsy drugs, particularly valproate (sold under the brand names Depakote, Depakene, and Epivil), can interfere with ovulation, Pack tells WebMD. And that, in turn, can lead to infertility and long-term health problems, including high cholesterol levels, certain female-specific cancers, and diabetes, she says.

And the list doesn't end there: "Women taking valproate also report excess weight gain and hair growth," Pack says. Also, a recent study at Columbia University showed that women who took valproate at any time during the past three months were at increased risk of developing cysts in their ovaries.

"The bottom line," Pack says, "is that I tend not to prescribe valproate as a first-line drug for most women with epilepsy who are in their reproductive years. That's not to say that valproate is not a good drug, but with so many other choices available, [for these women] I tend to pick something that won't have these side effects."

While a variety of factors need to be considered when choosing a medication to control seizures in women with epilepsy, Pack says many neurologists have indicated a preference for Lamictal due to its relatively safe side-effect profile.

According to the Epilepsy Foundation, Lamictal neither increases the breakdown of female hormones nor interferes with the effectiveness of hormonal birth control, unlike other seizure medications.

But for women with epilepsy who also suffer from migraine headaches, Topamax is usually considered the drug of choice because of its headache-relieving properties, Pack says.

He was 27, she was 42. Those were the ages of Ashton Kutcher and Demi Moore when the couple tied the knot last year, making their highly publicized May-December romance official.

But even though their older woman-younger man relationship may be among the world's most visible, it's not that unusual anymore.

Braving "robbing the cradle" jokes, almost one-third of women between ages 40 and 69 are dating younger men (defined as 10 or more years younger). According to a recent AARP poll, one-sixth of women in their 50s, in fact, prefer men in their 40s.

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It's not what you think -- the stamina or "re-boot" ability of the younger male. The women like the flexibility and sense of adventure of their more spontaneous, younger companions, Tina B. Tessina, PhD, a licensed family therapist in practice in Long Beach, Calif., and author of The Unofficial Guide to Dating Again, tells WebMD. For their part, the men like the sophistication and life success of their older mates, she explains. The much touted idea that women peak sexually in their 30s and men in their teens does not enter into it -- most of these couples are beyond both those age periods

Other Reasons Behind This Trend

According to Tessina, other reasons underlying this expansion of everyone's dating choices include:

• Older women are looking better every day, thanks to creative medical advances and a gym on every corner.
• Women are more likely to come back on the dating market because of divorce and a longer expected life span.
• Not as many women are looking for the picket fence and two cars. Now companionship, travel, and fun are coming to the forefront.
• Women may also want a man with a less-developed career who could follow her or take care of children, if that is a factor.
• For their part, younger men often find older women more interesting, experimental, fun to talk to, financially settled, and more adept sexually.

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But what about the notion that men are "hard-wired" to seek a smooth-faced, curvy receptacle for reproduction and thus are drawn to younger women? "Humans are relatively flexible species," Michael R. Cunningham, PhD, a psychologist in the department of communications at the University of Louisville, tells WebMD. "Factors other than biological can be attractive. You can override a lot of biology in pursuit of other goals."

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Interestingly, Cunningham did an unpublished study of 60 women in their 20s, 30s, and 40s, who were shown pictures of men aged to those decades. "The women," he says, "were more interested in men their own age or older."

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As for the men, he says: "I guess it could be nice not to hang around a ditz with no knowledge of music or something like that."

Getting Over the "Shoulds"

"We have strong 'shoulds' on ways of partnering up," Kathryn Elliott, PhD, assistant professor of psychology at the University of Louisiana at Lafayette, explains to WebMD. "We are victims of inner-critic constrictedness. We think we should only weigh 120. We should marry people within two years of our age. We pathologize anything that isn't within those shoulds."

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The key to making older women/younger man relationships work, Elliott says, is to match what she calls voltages. "Choose someone who is your voltage type -- has the same level of intensity about life. If the voltages are different, one becomes the pursuer and one the distancer. This can create pain."

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Voltages are not a factor of age, she says.

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"What you don't want," she explains, "is one partner wanting to go out, the other stay in; one willing to talk, the other wanting space (and silence to enjoy it)."

Aug. 21, 2002 -- Petting zoos may seem like a harmless way to let your child get close to farm animals, but new research shows that kind of closeness also comes with some risk.

A new study in the Aug. 22 issue of TheNew England Journal of Medicine shows that direct contact with animals is becoming an increasingly common cause of E. coli infection and illness for children.

Researchers from the CDC examined an outbreak of E. coli 0157:H7 infections among 51 children who visited a Pennsylvania dairy and petting farm in 2000. They found children who petted young calves directly were most likely to have become ill from the bacteria. But frequent hand washing seemed to protect against infection.

Various strains of the E. coli bacteria are found naturally in the stomach and bowels of people and animals, and most forms of the bug are harmless. But some strains, such as E. coli 0157:H7, can cause illness or even death when humans become infected with it.

In the case of the Pennsylvania dairy farm, a larger than normal portion of the calves and young cattle (13%) were infected with this dangerous form of E. coli and passed the bacteria along to the visitors.

The study authors say the bacteria can survive in the hides of the infected animals and their environment for months, which creates a risk of infection even without direct contact with animals.

That's why they recommend that all cattle be handled as if they were infected. In addition, all cattle environments, such as petting zoos, animal exhibits at fairs, and open farms, should be approached with caution as if they were contaminated with E. coli 0157:H7.

Researchers say this type of E. coli causes an estimated 60 deaths and 73,000 illnesses each year. Most of those cases are caused by contaminated food and water, but experts say they can be prevented through safe food handling and hygiene practices.

Meat, such as ground beef, can become infected with this dangerous strain of the bacteria during the production and packing process. Unpasteurized milk and juices also can harbor the harmful bacteria.

Although anyone can become infected, young children, the elderly, and people with weakened immune systems are most at risk.

In an editorial that accompanies the study, researchers say transmission of E. coli 0157:H7 from farm animals to humans is much more important than previously thought.

"These routes of transmission must therefore be considered along with transmission through food, water and direct person-to-person contact in any strategy for prevention," write Sarah J. O'Brien, FFPHM, and Goutam K. Adak, PhD, of the Public Health Laboratory Service Communicable Disease Surveillance Centre in the U.K.

Researchers say those prevention strategies should include:

• Frequent hand washing after contact with livestock
• Controlled and supervised contact with animals
• Clear separation of food-related activities from areas housing animals

There's nothing like a fetus to keep you honest. No matter how much health sense you might choose to ignore when the consequences are only yours, it's a different ballgame with a baby on the way. So it's natural for women to shun unhealthful substances or behavior during pregnancy.

But prenatal sages have a new message these days: You'd better come clean first.

The standard pregnancy do's -- eat right, cut out cigarettes and alcohol, ease up on caffeine -- should all crank into gear three months before conception, not after the fact, experts warn. "Pregnancy is no longer nine months -- it's 12," says Dr. Robert Cefalo, a maternal-fetal medicine specialist at the University of North Carolina at Chapel Hill and coauthor of "Preconceptional Health Care: A Practical Guide."

Why all the fuss? Allowing extra prep time to deal with medical, social or environmental factors that could complicate your pregnancy is critical because it's during the very early weeks after conception -- when most couples still don't know they're pregnant -- that a baby's organs are developing. "The fetus is most sensitive to any little adverse event or drug between 17 and 56 days," Dr. Cefalo says.

If you are thinking about getting pregnant, consider these factors first.

Getting Physical

Make sure you're up-to-date on annual physical and dental exams, and schedule a preconception exam with your OB-Gyn to review any medical conditions, lifestyle habits or hereditary diseases that could complicate your pregnancy. Your doctor will want to know, for example, if you have diabetes, high blood pressure or another condition that needs to be closely monitored while you're pregnant.

"In reality, the vast majority of women are perfectly fine, but it's just a good idea to get all of this on the table beforehand to minimize anything unexpected," says Michael Zinaman, director of reproductive endocrinology at Loyola University Medical Center in Chicago.

Your doctor also will scrutinize medications you may be taking to make sure they aren't harmful because even some over-the-counter drugs, like some nasal sprays, can cause birth defects. And if you're taking birth control pills, you may be advised to use another method until you've had two normal periods before you attempt pregnancy; this will reduce the risk of miscarriage.

The few extra months can help because some conditions are more difficult -- or even impossible -- to resolve during pregnancy. Vaccination for rubella (German measles), for instance, must be administered at least three months before getting pregnant. Even minor surgeries or X-rays, which may take time to schedule, are safer to get out of the way before conception, says Dr. John Queenan, chairman of the department of obstetrics and gynecology at Georgetown University School of Medicine and author of "A New Life" and "Preconceptions: Preparation for Pregnancy." It also takes time to quit smoking and drinking, and to rid the body of harmful toxins.

Nov. 10, 2006 -- Massage may help infants relax, sleep better, and cry less, shows a study in The Cochrane Library.

The researchers included Angela Underdown, MSc, associate professor at the Institute of Education at England's University of Warwick.

They reviewed 23 studies on infant massage, mainly in newborns.

The reviewers note "some evidence of benefits on mother-infant interaction, sleeping and crying, and on hormones influencing stress levels" in massaged babies.

For instance, massaged babies had lower urine levels of certain stress hormones than babies that didn't get massage.

"Given the apparent effect of infant massage on stress hormones, it is not surprising to find some evidence of an effect on sleep and crying," Underdown says in a University of Warwick news release.

The studies varied in length and massage style. So it's not clear what type of baby massage or how many sessions work best.

Baby massage didn't affect infant growth and didn't appear harmful, the reviewers note.

Underdown and colleagues say their findings support infant massage, but they aren't ready to recommend massage for all babies.

The reviewers call for more studies on infant massage. Meanwhile, if you're interested in massage for your baby, talk to your doctor.

May 1, 2006 -- The Internet may be a help or a hazard when kids go online, new research shows.

Some of those risks and benefits are highlighted in a special issue of the journal Developmental Psychology. Among the findings:

• Message boards about self-injurious behavior (such as cutting) included social support and risky content.
• Kids' age is a big factor in how well they understood the Internet.
• Low-income kids got better grades and test scores in reading after being given home Internet access.
• In online chat rooms, youths were less likely to curse or engage in sexual talk if the chat room had a monitor.
• Sexual health information was a popular Internet topic for teens in the African nation of Ghana.

Self-Harm and Message Boards

Message boards about self-harm, such as cutting oneself, was the topic for Cornell University's Janis Whitlock, PhD, MPH, and colleagues.

Whitlock's team identified 400 message boards about self-harm and did an in-depth study of 10 of those message boards. They focused on sites that weren't highly moderated, in order to avoid censors.

The boards had between 70 and more than 6,600 members. When membership information was available, most members claimed to be young women in their teens and 20s.

Over two months, the researchers studied more than 3,200 postings on the message boards. Most of those messages -- more than one in four -- offered informal support, such as, "We're glad that you're here" or "Just try to relax and try to breathe deeply and slowly."

But 9% of the messages mentioned ways to conceal self-harm and its effects (such as scars) and nearly as many mentioned the "addictiveness" of self-harm.

Those message boards may have provided "essential social support for otherwise isolated adolescents," write Whitlock and colleagues.

However, the researchers also voiced concern that some content on the boards might reinforce or promote self-harm.

A larger, longer study would help, the researchers note. Meanwhile, they stressstress that "it is very important for adults to know something about what adolescents, particularly vulnerable adolescents, encounter in the virtual communities they inhabit."

Age Is Important

"Age matters" in how well kids understand the Internet, writes Zheng Yan, EdD.

Yan is an assistant professor at the University of Albany's School of Education. He studied 322 elementary and middle-school kids in New England.

The students answered questions about the Internet's technical and social complexity, including:

• "What is the Internet?"
• "If you could walk into the Internet, what would it look like?"
• "What kinds of good things can happen to us when we go to web sites?"
• "What kinds of bad things can happen to us when we use email?"
• "Do you need to be careful when you go to the WWW?"

In terms of understanding the Internet, kids' age was more important than gender, history of Internet use, frequency of Internet use, and participation in informal classes, Yan found.

He suggests using highly restricted filtering programs and kid-oriented sites for very young kids, with less restrictive filters for older children.

Nov. 9, 2005 -- Seven in 10 television shows watched by teens now contain some form of sexual content, while each show contains more sexual references than they did a few years ago, according to a survey released Wednesday.

The study found that American teens, who spend an average of three hours per day watching television, now see an average of six sexual scenes per hour when watching in prime time. That's significantly more than the 4.4 scenes per hour teens saw during the same study in 2002.

In all, the number of sexual scenes contained in about 1,000 shows sampled nearly doubled from 1,930 in 1998 to 3,780 in 2005, the study found. The study included shows on cable and broadcast television.

Impact on Teens

According to researchers, the study clearly shows that American children and teens are exposed to an increasing level and range of sexual TV content. But the impact of that exposure is still largely unknown.

One federally funded study pegged repeated media depictions of sex as an important determinant of how early teens start having sex. But the increase in sexual TV content comes at a time when rates of teen pregnancy and sexual activity are down from the last decade.

Still, 750,000 teenagers become pregnant each year, while an estimated 4 million contract sexually transmitted diseases.

"We are not saying that TV is to blame for this problem. But research is saying TV has an impact and has an opportunity to help," said Victoria Rideout, who co-authored the study for the Henry J. Kaiser Family Foundation.

Reaction on Capitol Hill

The study sampled a wide range of sexual content, including conversational references to sex, implied sex acts, and depicted sexual intercourse.

Researchers found that just 14% of shows depicting sex also contained references to risk or to safe sex. That's down from 15% in 2002 but was still a significant rise from 9% in 1998, according to the study.

Increasing exposure to TV sex and violence has lead to threats from Congress to more strictly regulate TV networks. Those threats often run up against concerns that they might infringe on the First Amendment's guarantee of free speech. But in response, many networks have submitted to voluntary ratings systems while promoting the use of parental control technologies like the V-chip.

Networks Under Scrutiny

Nearly seven in 10 parents in a 2004 Kaiser Foundation survey said that they were "very concerned" about the amount of sexual content their kids see on TV.

Fox president and CEO Tony Vinciquerra said that his network uses voluntary content ratings and has spent "tens of millions of dollars" promoting them to parents.

Nearly all cable and satellite television services come with channel or program lock-out functions, Vinciquerra said. "It's a five-minute exercise. It's not difficult and parents do need to take that responsibility."

Rebecca Collins, PhD, a RAND corporation researcher who conducted the separate federal study completed in 2004, said the amount of sexual content teens view was found to be one of the most important influences on how early they start having sex.

Single-parent homes and spending time with mostly older friends were stronger influences, but time spent watching sexual content was third, she said.

"It's hard to quantify exactly what the effect of TV is," Collins said. Still, "12-year-olds who watched a lot of sex looked like 14-to-15-year-olds" in their sexual behavior.

Complex Influences

Others cautioned that television is just one aspect of youth culture that includes family, peers, school, and religion, as well as the Internet, movies, and music.

"Media absolutely is important, but let's not pretend it's the only thing," said Sarah Brown, president of the National Campaign to Prevent Teen Pregnancy.

Sen. Barak Obama (D-Ill.) told reporters and others that Congress could still consider pushing legislation that tightens regulations on broadcasters.

"Let's start by turning off our TV sets once in a while," he said.

Nov. 11, 2004 -- Before you go to bed tonight, make sure your home has working smoke detectors. It's one of the best things you can do protect yourself from dying in a fire, says the National Fire Protection Association (NFPA).

Smoke alarms can save lives. The NFPA estimates that 70% of home fire deaths in the U.S. occur in homes that don't have a working smoke detector.

"Having a smoke alarm reduces your risk of dying in a home fire by 50%," says the NFPA in its new report, "U.S. Experience with Smoke Alarms and Other Fire Detection/Alarm Equipment."

The first step is getting a smoke detector. Most American homes already have at least one. As of 2004, 96% of U.S. homes with telephones had at least one smoke detector, says the NFPA.

However, the homes without smoke detectors account for 40% of home fires reported to U.S. fire departments, says the NFPA.

If you already have a smoke detector, check that it's working.

In one in five American homes with at least one smoke detector installed, not a single one was working, one 1992 survey quoted in the report shows. Despite an increase in home smoke detector use, the devices didn't work in 25% of reported fires in homes with them, says the NFPA.

The NFPA also says the percentage of nonworking smoke detectors has "leveled off," but more improvement is needed.

Smoke Detector Battery Check

Most often, the problem is dead, missing, or disconnected batteries.

Some people deliberately remove or disconnect the batteries to avoid "nuisance" activations, says the NFPA. In other cases, forgetfulness may let too much time go by between changing the batteries.

Batteries for conventional smoke detectors should be replaced according to the manufacturer's guidelines, which is typically "at least once every year," says the NFPA.

With the winter holidays coming, it's especially timely to check smoke detectors. Some of the season's coziest customs -- lit fireplaces and candles, decorations, and holiday cooking -- can be fire hazards.

For instance, December is the worst month for candle fires. Christmas Day, New Year's Day, and Christmas Eve are the three worst days of the year for candle fires, according to a recent NFPA report.

Taking Precautions

The NFPA offers these fire safety tips:

• Choose smoke detectors bearing the label of a recognized testing laboratory.
• Install smoke detectors on every level of the home and outside all sleeping areas.
• For added safety, install smoke detectors in every room where people sleep.
• Consider hiring an electrician to install hard-wired, interconnected alarms, which all sound together and have a power source that's usually more reliable.
• Install a new battery in conventional smoke detectors at least once a year.
• Immediately replace batteries if the alarm "chirps," signaling a low battery.
• Replace smoke detectors with extended-life batteries when they die. The batteries in these units can't be replaced.
• Replace all smoke detectors when they are 10 years old.
• Test smoke detectors monthly.
• Install special strobe light smoke detectors for people with hearing problems.
• Be prepared. Have a plan ready to get everyone out of the house quickly if a fire occurs.
• Practice your plan. Make sure everyone can hear the smoke detector and knows what to do.
• Get out immediately, if a fire occurs. Stay low on your way out of the home to avoid smoke.

Feb. 18, 2004 -- Video games rated as appropriate for teens may often contain additional content that could surprise or shock many players and their parents, according to a new study.

Researchers found rating labels issued by the Entertainment Software Rating Board (ESRB) don't always accurately describe the content of the video game.

For example, the study showed video games rated "T" (for teen) by the ESRB frequently contained violence, profanity, or sexual conduct that wasn't mentioned on the rating label.

"These findings suggest the need for greater clarity and transparency in the use of ESRB content descriptors and in the overall rating process," says researcher Kevin Haninger, a doctoral student at Harvard University, in a news release.

Video Game Ratings Lacking

In the study, published in today's Journal of the American Medical Association, researchers examined the content of a random sample of 81 of the 396 T-rated video games available on the market by April 1, 2001.

Each game was played for an hour, and researchers evaluated depictions of the following types of content:

• Violence
• Blood
• Sexual themes
• Gambling
• Alcohol, tobacco, or other drug use
• Whether injuring or killing characters is rewarded or required to advance in the game
• Use of profanity in dialogue, lyrics, or gestures

Researchers then compared the content encountered during play and compared it to the content descriptors assigned by the ESRB.

In their sample of 81 games, researchers found 51 instances where the video game content could warrant such a descriptor but the ESRB had not assigned one.

More than 95% of the action, adventure, fighting, and shooting games viewed by the researchers contained violence, so parents can reasonably assume that T-rated video games will contain violence, say the researchers.

Yet they also found the following:

• Thirty-four of the 81 video games contained depictions of blood, but only 22 games had received the blood content descriptor.
• Twenty-two of the 81 video games depicted sexual themes, but only 16 games had a content descriptor for sexual themes.
• Twenty-two games contained profanity, but only 14 video games had profanity content descriptors.
• Twelve games depicted substance use, but only one game had received a content descriptor for it.

The study also showed that 90% of games rewarded or required the player to injure characters, and 69% rewarded or required the player to kill characters. Researchers say those types of details are not relayed on the content labels, which only list those types of content as "violence."

Researchers say their observations matched the ESRB's content descriptors for violence in 95% of the cases, for blood in 27%, for sexual themes in 20%, for profanity in 17%, and for substance use in 1%.

They say their findings suggest that more accurate and descriptive content ratings are needed for video games.

"More uniform and complete information about game content will enable parents to make more informed decisions, and greater transparency in the rating process will help maintain confidence in the rating system," says Haninger.

Dec. 2, 1999 (Indianapolis) -- More kudos for the classic Mediterranean diet: researchers in the December issue of the American Journal of Clinical Nutrition report that diets high in both olive oil and cooked vegetables lessen the risk of developing rheumatoid arthritis. The debilitating disease can cause joint pain and muscle stiffness.

"This study confirms the findings of our previous study in Greece, which showed that the risk of [rheumatoid arthritis] is inversely associated with consumption of olive oil ... up to the time of diagnosis," says Christos Mantzoros, MD, from the division of endocrinology at Beth Israel Deaconess Medical Center in Boston. Mantzoros, the study's lead researcher, says that the results also extend those previous observations by showing the link between the disease and lifelongconsumption of olive oil and cooked vegetables.

The researchers studied 145 rheumatoid arthritis patients and 188 people without the disease in southern Greece who provided information on age, sex, and socioeconomic variables, prior medical and family history, and present disease status. The participants were also given questionnaires asking how often they ate more than 100 food items.

The researchers then calculated statistics for the development of rheumatoid arthritis in relation to consumption of olive oil, fish, and vegetables.

They found that the risk of developing the disease was less only in relation to cooked vegetables and olive oil. The more of these two things a person ate, the less likely they were to have rheumatoid arthritis.

Graciela Alarcon, MD, MPH, professor of medicine at the University of Alabama School of Medicine in Birmingham, tells WebMD that there are a number of concerns with the methods these researchers used to gather data. She notes that the patients were questioned about their dietary habits of many years earlier; most people cannot remember exactly how they ate years before. Thus, these conclusions should be viewed with caution.

"I think there is a suggestion that there may be something here," says Alarcon, who was not involved in the study. "However, any effect that is seen by diet is very mild at best. If you have a strong family history of [rheumatoid arthritis] and the other known triggers, you might reduce your chances by a few percent."

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????????Mark Salter, executive chef at the Inn at Perry Cabin in St. Michaels, Md., looks forward to spring and summer when he can visit the local farmers markets on Maryland's Eastern Shore and buy fresh produce such as locally grown asparagus, wild watercress, mixed salad leaves, sweet white corn, vine-ripened tomatoes, and ripe peaches.

"When you can buy produce that has just been picked, it tastes so much better," says Salter, who changes his menu seasonally to take advantage of the freshest ingredients. "That's one reason so many chefs like to have their own garden ... you get to use the produce at its best."

Salter also likes buying at farmers markets because he knows that the produce is grown "as naturally" as possible. "There's someone there to vouch for the quality," he says.

Seasonal Produce Available to All

You don't have to be a professional chef, however, to enjoy the fruits -- literally and figuratively -- of the season. And if there are no farmers markets near you, not to worry, says Claudia Gonzalez, RD, a spokeswoman for the American Dietetic Association. "Most of the produce we get in the United States is good," she says. "Of course, the fresher the better, but if you have to go to the grocery store and not a produce stand or farmers market, that's not a problem."

What's in season varies with location and weather, but in general, the following fruits and vegetables are at their peak during the spring and summer.

Spring:

Vegetables

• Asparagus
• Beets
• Broccoli
• Cabbage
• Cauliflower
• Fiddleheads
• Garlic greens
• Greens
• Arugula
• Beet
• Bok choy
• Chard
• Collards
• Cress
• Dandelion
• Kale
• Mizuna
• Mustard greens
• Sorrel
• Tat soi
• Turnip
• Lettuce
• Mushrooms
• Parsnips
• Peas -- snap and snow
• Radishes
• Rhubarb
• Spinach
• Sprouts

Fruits

• Apples
• Strawberries

Seasonings

• Chives
• Cilantro
• Dill
• Marjoram
• Mint
• Oregano
• Parsley
• Sage
• Thyme

Summer:

Vegetables

• Beets
• Broccoli
• Cabbage
• Carrots
• Cauliflower
• Celery
• Cucumbers
• Eggplant
• Endive
• Fennel
• Garlic
• Green beans
• Kohlrabi
• Lettuce
• Mushrooms
• Okra
• Onions -- red and yellow
• Peppers -- hot and sweet
• Potatoes -- new
• Radicchio
• Scallions
• Sprouts
• Summer squash
• Sweet corn
• Tomatoes

Fruits

• Apricots
• Blackberries
• Cherries
• Currants
• Elderberries
• Gooseberries
• Melons
• Nectarines
• Peaches
• Plums
• Raspberries

Seasonings

• Basil
• Cilantro
• Dill
• Marjoram
• Mint
• Parsley
• Rosemary
• Savory
• Tarragon

July 25, 2005 -- Our fitness levels naturally begin a slow decline after our 20s and plummet once we reach our 70s, according to a new study.

But the good news is that regular exercise may compensate for some of those natural losses and help your body feel years younger.

Researchers measured the decline in maximum exercise capacity -- as measured by VO2 max, which measures the amount of oxygen the body consumes during peak exercise performance. While age per se results in a decrease in maximum exercise capacity, age-related decreases in the amount of muscle and vigorous physical activity also contribute to this decline, write the authors.

As maximum exercise capacity declines, physical activity and fitness levels generally decline as it takes more effort to exercise or walk up a flight of stairs, and a person becomes more easily exhausted.

"This study does not mean that older people can't improve their fitness," says researcher Jerome L. Fleg, MD, a cardiologist at the National Heart, Lung, and Blood Institute in Bethesda, Md., in a news release.

"Over time, your aerobic capacity (exercise capacity) will decline, but at any given age someone who exercises will have a higher capacity than someone who is a couch potato," says Fleg. "By participating in a training program, you can raise your aerobic capacity 15% to 25%, which in our study would be equivalent to being 10-20 years younger."

Aerobic Capacity Drops in Old Age

In the study, researchers followed the change in aerobic capacity in more than 800 men and women aged 21 to 87 over a period of nearly eight years. Researchers calculated the participants' maximum exercise capacity during treadmill tests about every four years.

The results showed that aerobic capacity declined each decade in men and women but at a much greater rate in the older age groups.

For example, aerobic capacity declined 3% to 6% each decade in the 20s and 30s, but after age 70 the rate of decline accelerated to more than 20% per decade.

The study also showed that after age 40, men's fitness levels declined at a faster rate than women, regardless of their level of physical activity.

"These results are even more striking given that we were looking at the best-case scenario," says Fleg. "Participants were required to have no previous heart attack or stroke and to be healthy and agile enough to walk on the treadmill. The rate of decline in the population-at-large is probably somewhat greater than what we observed here, because many older people will have disease-related deficits in addition to those brought on by age."

The accelerated rate has substantial implications with regard to functional independence and quality of life, not only in healthy older persons, but particularly when disease-related deficits are superimposed, they write.

Given the importance of aerobic capacity in activities of daily living, efforts to increase and maintain higher levels of VO2 max, in addition to strength training, in older adults would likely improve their ability to live independently with a higher quality of life, they conclude.

Jan. 4, 2002 -- Still smoking? Pregnant? Here's a new reason to quit: your child risks early adult diabetes.

The findings come from a study of some 17,000 British children born in early 1958. Researchers checked on the kids at ages 7 and 16 and again at 33.

Some of these young adults already had diabetes. Scott M. Montgomery and Anders Ekbom of Sweden's Karolinska Institute found that risk of diabetes was linked to how much a person's mother smoked during the last five months of pregnancy. They reported the findings in the Jan. 5 issue of The Lancet.

The more a mother smoked, the higher the risk.

Adult children of heavy-smoking mothers -- more than 10 cigarettes a day -- had 4.5 times more diabetes than those whose moms didn't smoke. Those whose mothers smoked a lot on some days and less on other days ran nearly as high a risk.

"Smoking during pregnancy should always be strongly discouraged," Montgomery and Ekbom conclude.

Still, not all of the diabetes risk could be blamed on moms. Regardless of whether their mother smoked, risk of early diabetes was higher in people who themselves smoked cigarettes.

Can you do anything to make your child smarter -- before he or she is born? Some say it's possible. Here's why they think so.

Nature Versus Nurture

Remember the old "nature versus nurture" debate from biology class? In a nutshell, we're stuck with whatever talents nature gives us, but our environment can nurture -- or hinder -- those gifts.

How important is heredity to intellect?

"Intelligence emerges from the interaction of a person's genetic makeup and the environment in which they develop," Thomas J. Darvill, PhD, tells WebMD. "We have little control over nature's contribution, but the uterine environment is of critical importance and often overlooked by new parents."

Prospective parents with a family history of genetic diseases may benefit from screening and counseling, says Darvill, chairman of psychology and associate director of the Center for Neurobehavioral Effects of Environmental Toxics at Oswego State University in New York.

Biological signs of intelligence suggest, but don't prove, that heredity is an important determinant of IQ, explains Linda Gottfredson, PhD, a professor of education at University of Delaware in Newark.

When it comes to the biological basis of intelligence, size and speed matter. Larger hat size is loosely linked to IQ, although the largest human brain on record belonged to someone with severe mental retardation. Faster reaction time, impulse transmission in nerves, and response of brain waves to unusual sounds are all linked to higher intelligence.

Research by Richard Plomin, PhD, at the Institute of Psychiatry at King's College in London, has identified specific genes predicting high intelligence, reading disability, and mental retardation.

The extent to which genetics accounts for differences in IQ increases with age from about 40% in the preschool years to about 80% in adulthood. "To increase the chances of having a smart baby, marry someone smart!" Gottfredson says.

First, Do No Harm

Perhaps the best practical advice for how to have a smarter baby is not to hinder nature's miracle-in-progress. Even before conception, the mother and probably the father should avoid drugs, alcohol, tobacco, and caffeine, says Stephen J. Schoenthaler, PhD, a professor of nutrition and behavior at California State University in Long Beach.

"Most devastating developmental conditions result from prenatal damage," Darvill says. "If Mom drinks alcohol or uses other recreational drugs, she should stop."

Brain cells depend on chemical signals to tell them where to go, how to connect, and which genes to turn on or off. "Any foreign substance that interferes with the clear transmission of these chemical messages can impact negatively on development," says Darvill.

"Any kind of drug use -- running the gamut from caffeine to heroin -- has the potential to limit the later intellectual development of the unborn child," Shawn K. Acheson, PhD, tells WebMD.

While the evidence is most clear-cut for alcohol, pregnant women should avoid all drugs, says Acheson, an assistant professor of psychology at Western Carolina University in Cullowhee, N.C.

"It's commonsense stuff, but I still see incredibly intelligent pregnant women who should know better continuing to smoke," she says.

Potential Dangers

Less obvious enemies can be equally deadly to the developing brain. One of these is lead from old paint and plumbing. Families living in older homes should have their air and water tested, Darvill says.

Seafood from contaminated waters may harbor brain toxins such as PCBs, methyl mercury, lead, cadmium, and pesticides. Warnings by authorities against eating local fish should be taken seriously by pregnant women, says Philippe Grandjean, MD, professor of environmental health at Boston University School of Public Health. The FDA says moms-to-be should avoid swordfish, king mackerel, tilefish, and other large ocean fish that tend to concentrate toxic chemicals.

Especially during the first trimester, infections like German measles or toxoplasmosis, which is caused by a parasite that can be contracted through contact with infected cat feces, can wreak havoc on the embryonic brain. So pregnant women should stay away from sick children and avoid changing the litter box whenever possible.

Thyroid disease is another culprit that can sneak up unnoticed, says endocrinologist John Lazarus, MD. Babies born to women with low thyroid function are more likely to have low IQ. To determine whether thyroid replacement in similar women might help, his group at the University of Wales College of Medicine in Cardiff has started a seven-year clinical study.

Oct. 7, 2003 -- Altering the natural mother and child bonding process soon after birth may have a lasting impact on the child's brain.

A new study shows that baby rats that were briefly separated from their mother in the days following birth behaved differently than others in response to stress as adults.

Researchers say the findings suggest that the immature brain is extremely sensitive to changes in its environment and separation of mother and child may have enduring effects on brain function and development.

Separation May Affect Brain Function

The study, published in the Proceedings of the National Academy of Sciences, tested the effects of separating rat pups from their mother for 30 minutes on the day after birth and 6 hours on the following day.

Researchers found these two episodes of brief separation and handling were enough to produce permanent changes in brain function.

In this case, the study showed that adult rats that had been separated as pups had an increased response to a stressful situation (a swimming test and water maze) compared with normally raised rats. The rats that experienced the separation had an immature brain system that helps handle stressful situations.

Researcher Tu-Chin Hsu, of the Children's Hospital of Philadelphia, and colleagues say the findings show that changes at the molecular and cellular level may occur after neonatal separation and handling that extend well into adulthood and merit further study in other animals, such as humans.

They've tossed it on its side and added a rainbow of colors. But that's just the beginning of the changes for the U.S. government's new Food Pyramid.

But if you're like many of us, you may be wondering, "What was wrong with the old pyramid?" And is everything they told us before no longer true?

The good news is that experts say the new guidelines themselves are quite similar to the old, with the graphic changes in the pyramid simply being more representational of what those guidelines are.

"There was nothing wrong with the old pyramid, except that it left too much open for interpretation; the new pyramid is more specific and more reflective of what the guidelines actually say," says nutritionist Cathy Nonas, MS, RD, director of diabetes and obesity programs at North General Hospital in Harlem, N.Y.

The Rainbow of Colors

These specifics include brightly colored vertical stripes, each representing one of six food groups: grains (orange -- and the widest stripe), vegetables (green), fruits (red), oils (yellow -- and the thinnest stripe), milk -- including most foods made from milk (blue), and meat & beans (purple).

The stripes are also engineered to be wider at the bottom and narrower at the top, ostensibly to drive home the idea that not all foods within that group are of the same value.

"The idea is to make us aware of not only food groups, but choices within those groups," says Nonas, who points out that an apple pie and an apple might fall within the same food group but not have equal nutritional value.

Unfortunately, make just one visit to www.mypyramid.gov and you'll soon discover that making your food choices might seem like it's easier said than done. Indeed, among the criticisms that surfaced since the pyramid debuted is that the new system is simply too confusing to be of much use.

"The new design does not clearly communicate which foods Americans should be eating more of (fruits, vegetables, whole grains, low-fat dairy, lean meat, and beans) and which foods Americans should be eating less of (refined grains, whole milk, cheese, hamburgers, and soda)," was just one of the statements about the new food pyramid released by the Center for Science in the Public Interest.

At the same time, other experts say that by mastering just a little bit of a learning curve, all Americans can gather some vital data from the pyramid; information that just might help us turn some unhealthy eating habits, as well as our burgeoning obesity epidemic, around.

"I think it's immediately more confusing and a little hard for some people, but I think that years down the road it will prove beneficial," Nonas tells WebMD.

Oct. 17, 2005 -- A hormone best known for its role in preparing mothers for motherhood may also help both men and women establish trusting relationships.

A new study shows male and female mice that lacked a receptor for the hormone oxytocin had problems establishing trust and normal social relationships.

Researchers say the hormone appears to play a key role in social bonding and the results may offer new clues about the biological causes of social disorders in humans like autism.

Hormone Builds Trust

Previous studies have shown that the hormone oxytocin is involved in preparing mothers for the physical aspects of childbirth, such as stimulating uterine contractions and breast lactation.

It's also been shown to play a role in social aspects of mating and reproduction, including the promotion of bonding between mothers and offspring and between mates.

In this study, published in the Proceedings of the National Academy of Sciences, researchers showed the hormone's receptor may also facilitate the formation of trust demonstrated through social bonding. A hormone uses a receptor to bind to a cell and perform its duties.

The results showed that male and female mice that lacked the oxytocin receptor had problems forming trust and establishing normal social relationships.

For example, female mice lacking the oxytocin receptor had impaired nurturing abilities and were slow to retrieve their pups when they wandered off.

Male mice lacking the receptor tended to be more aggressive toward other males and had "social amnesia" when separated and reintroduced to a female. The males also had less vocalized calls and a greater tendency to move around and explore.

Researchers say other hormones may sometimes compensate for a lack of oxytocin, but this hormone appears to play a key role in social bonding and the formation of trust.

June 23, 2000 -- When traveling to foreign countries, the last souvenir a tourist wants to pick up is diarrhea. But intestinal illness caused by contaminated food and drink is the most common malady afflicting international travelers, particularly in developing countries. Results of a new study show that although travelers' diarrhea is common, changes in the diet can help prevent the illness, and the nausea and bloating that often accompany it.

The popular travelers' creed "Cook it, peel it, or leave it" might not be the best advice, according to researchers from the Centers for Disease Control and Prevention (CDC) in Atlanta.

The study's lead researcher, Barbara Herwaldt, MD, MPH, tells WebMD that the most important message for travelers in general is to "avoid potentially risky foods and beverages." Herwaldt is a medical epidemiologist in the division of parasitic diseases at the CDC.

In this month's issue of the journal Annals of Internal Medicine, Herwaldt's team highlights what happened when diarrhea struck a group of healthy, young Peace Corps volunteers in Guatemala. Researchers found that several factors influenced whether the volunteers developed diarrhea.

Diarrhea was more likely when volunteers:

• Drank water from an unknown source
• Ate foods prepared by a Guatemalan friend
• Ate at a small, working-class restaurant and ate fruit peeled by someone else
• Drank an iced beverage
• Ate ice cream, ice milk, or flavored ices

The CDC suggests that all overseas travelers select food and beverages with care. Any raw food could be contaminated, especially in areas of poor sanitation. And food from street vendors could be suspect.

Foods of particular concern include:

• Salads
• Uncooked vegetables and fruit
• Unpasteurized milk and milk products
• Raw meat
• Shellfish

If you peel fruit yourself, it is generally safe, as well as food that has been cooked and is still hot.

Although most episodes of travelers' diarrhea resolve in a few days, it is best to consult a physician rather than attempt self-medication because of the risk of dehydration. You should seek medical help if diarrhea is severe or bloody or does not resolve within a few days. You should also seek medical help if the diarrhea is accompanied by fever or chills, or if you are unable to keep fluids in.

No effective vaccines are currently available to guard against diarrhea, so precautions need to be taken once you arrive at your destination, Robert Edelman, MD, tells WebMD. The best advice for the general tourist, he says, is: "Drink bottled water and beverages with labels on them." He says carbonated beverages are best because they inhibit the growth of bacteria. Edelman is director of the Travelers Health Clinic at the University of Maryland in Baltimore.

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But how does the typical globetrotter compare with Peace Corps volunteers? Not very closely, according to Edelman. "Peace Corps volunteers integrate themselves into the environment as much as possible," he says. "As a result, they eat and drink things that a tourist on a four-star jaunt ... surrounded by a cocoon of preventive, trained guides, would not be exposed to."

Still, "we can take a lesson from this study," Edelman says. If Peace Corps volunteers can get sick, anyone can. "Being informed before traveling about good food and water hygiene" is essential.

Good advice. After all, an ideal trip abroad should send you searching for landmarks and castles, not restrooms.

Vital Information:

• It is common for people who travel to foreign countries, especially developing countries, to suffer from diarrhea.
• To protect yourself, avoid raw foods such as salad, uncooked vegetables, and fruit (unless you peel it yourself), unpasteurized milk or milk products, raw meat, and shellfish, and be sure to drink bottled water or other beverages with a label on it.
• If diarrhea is severe or bloody, lasts for several days, or is accompanied by fever or chills, you should seek medical attention.

April 24, 2000 -- Add the macadamia to the growing list of healthy nuts. A study from the University of Hawaii shows that a diet containing the high-fat nuts can actually improve cholesterol levels.

"The conventional wisdom still is that macadamia nuts are so good that they must be bad for you," says Curb. "This study indicates that its preconception is not true and that macadamia nuts can actually be part of a healthy diet," lead researcher J. David Curb, tells WebMD. Curb is a professor of geriatric medicine and clinical epidemiology at the University of Hawaii School of Medicine and chief of the Division of Clinical Epidemiology in Honolulu. Similar benefits have also been reported with walnuts, almonds, and pecans.

"Macadamia nuts have a bad reputation for having a lot of fat, but our research shows the fats they contain, especially monounsaturated fatty acids, don't adversely impact cholesterol," he says.

One ounce of macadamia nuts contains 20.9 grams of fat per once, and 88% of the calories come from fat, according to the U.S. Department of Agriculture. By comparison, pecans contain 19.2 grams of fat, almonds contain 14.8, walnuts contain 17.6, and peanuts contain 13.8 grams of fat per ounce.

Researchers in the new study, which appears in the April 24 issue of the journal Archives of Internal Medicine, compared three diets. One diet, classified as a "typical American" diet, contained 37 percent of calories from fat. The second diet was similar but with the fat calories derived from macadamia nuts. The third was the American Heart Association's "prudent diet," with 30% of the calories from fat. In the study, 15 men and 15 women, 18-59 years old, ate each of the three diets for four weeks. Calories were adjusted to maintain constant weight levels, and menus contained common local foods. All meals were prepared and eaten in the college cafeteria.

Blood fat analysis showed cholesterol levels after the macadamia nut diet were similar to the low-fat diet and lower than the typical American diet. The macadamia nut diet produced lower levels of triglycerides, an important form of blood fat, than either of the other diets. Despite an increase in the proportion of fat in their diets, volunteers showed no significant change in weight or cholesterol levels.

Researchers saw no negative side effects from eating the macadamia nuts, and, according to Curb, these results were similar to findings from an earlier study he conducted in which volunteers ate a diet containing large quantities of ground macadamia nuts for one month.

Curb says macadamia nuts are high in oleic acid, a monounsaturated fatty acid also found in olive oil and canola oil, which is believed to be beneficial in cutting cholesterol. Also, the nuts are the only food to also contain significant amounts of palmitoleic acid, another monounsaturated fatty acid.

A report in the September 1999 issue of the journal Circulation says some studies have found that monounsaturated fats may make platelets -- clotting components in the blood -- less sticky and less likely to form clots in blood vessels, helping to prevent a heart attack or stroke.

The macadamia study is just the latest research on the benefits of eating tree nuts. In 1999, French researchers reported that people in the Dauphine region of France who frequently consumed walnuts or walnut oil -- typically used in salad dressings -- had higher levels of HDL-cholesterol and apo A1 -- a beneficial compound that circulates with blood fat -- than did people who never ate walnuts.

Also, the American Heart Association (AHA) reports that in a 12-year study of more than 22,000 doctors in the Physicians Health Study, men whose diets contained high quantities of nuts had a decreased risk of dying from heart disease. And last February, researchers at New Mexico State University announced eating pecans lowered low-density lipoprotein (LDL) -- the "bad" cholesterol -- linked to heart disease.

The American Dietetic Association agrees that nuts are very nutritious. The ADA points out that all are rich in protein, potassium, zinc, vitamin E, magnesium, carbohydrates, and folic acid. The ADA suggests mixing the nuts with other foods to harness the nutrition and flavor of nuts.

Curb says longer studies and studies using differing proportions of other nutrients, such as protein and carbohydrates, are needed to better characterize the potential benefits of a macadamia-based diet high in monounsaturated fat. "After that, high monounsaturated fat diets appropriate for long-term consumption in populations need to be developed and tested," he says.

Funding for the study came from the U.S. Army Medical Research Acquisition Activity in Frederick, Md.

Vital Information:

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• A new study shows that people who consume a diet containing high-fat macadamia nuts have the same cholesterol levels as those on a low-fat diet.
• Monounsaturated fats in nuts may produce several health benefits, including improved blood fat profiles and reduced risk of heart disease.
• The American Dietetic Association agrees that nuts can be very nutritious but advises people to choose portions that keep the amount of fat low.

Feb. 29, 2000 (Tuscaloosa, Ala.) -- A health assessment questionnaire known as 'Baby Check' might help identify seriously ill babies at risk of sudden death, particularly those who are at high risk, according to a study on sudden infant death syndrome (SIDS) in the February issue of the British medical journal Archives of Disease in Childhood.

SIDS is a term used to describe the sudden death by unknown cause of an apparently healthy infant during the first year of life.

"This paper gives clear evidence that Baby Check could be a useful tool to empower parents to make informative decisions regarding their child's health," says lead researcher Peter S. Blair, of the Royal Hospital for Children in Bristol, England.

Kevin Winn, a leading SIDS expert not affiliated with the study, tells WebMD that the study is important because it shows that "these babies are different at birth, are different after hospital discharge, and are different from normal babies in the 24 hours prior to their deaths. Those differences show up in Baby Check scores."

"The results are striking," continues Winn, a pathologist at Emory University School of Medicine and a member of the governing board of the American SIDS Institute. "We can't look at any one, two, or even three of these signs or symptoms for a definitive diagnosis, but parents and trained health care providers can use this knowledge to determine which babies might be most at risk."

The journal article describes a large scientific investigation designed to compare SIDS babies -- as well as other infants whose deaths were explained but unexpected -- with a large number of infants who did not die. The object of the study was to determine if recognizing specific signs or symptoms might have led to earlier recognition of the infants' illnesses.

The study included all sudden, unexpected deaths of infants ages 7 to 364 days during the three-year study period. There were 456 unexpected infant deaths, of which 363 were classified as SIDS.

Trained interviewers visited bereaved families within days of their baby's death and came back within two weeks to complete a detailed questionnaire -- a modified form of the Baby Check. For each of these cases, researchers also questioned the parents or caregivers of four other infants of about the same age who did not die.

The Baby Check is based on seven symptoms and 12 signs, each of which receives a score.

"We discovered that three of the 19 signs and symptoms occurred in a significantly greater proportion of infants who died of SIDS than in the living babies studied as a control group," explains Blair. "Those signs or symptoms included [infants] being drowsy most of the time when awake, infants wheezing, and infants taking less than half the normal amount of fluids in the last 24 hours before their deaths."

Both Blair and Winn agree that, by themselves, these symptoms are not sufficient to make a diagnosis of illness. "Although these symptoms are statistically significant in the British study, they are not 'house burning down' warning symptoms," says Winn. "The infants didn't have an obvious illness, but they are worthy of attention."

Blair says that if parents note these or the other symptoms in the Baby Check survey, they should add up the scores. If the scores meet the criteria listed in the Baby Check instructions, he encourages parents to contact their health care provider.

"The Baby Check score, as a means of quantifying acute illness, can be used by parents to help them decide whether to seek medical attention," explains Blair. "It can be used by health professionals as a tool to discriminate more reliably between those babies who should be assessed in hospital and those who need not be."

Another sign revealed by the study was that SIDS babies were more than five times more likely than babies who did not die to have had a "life-threatening event," as defined by their parents.

"These events are usually associated with a change in skin color, a type of pallor or bluish discoloration of the skin so the baby looks blue and appears not to be breathing, or the baby look[s] pale and appear[s] not be breathing," Winn says. "Whether or not these events are [actually] 'life threatening' is often a matter of semantics, but for the purposes of this study, this type of event was defined as life threatening."

While experiencing such an event by itself does not necessarily predict SIDS -- it happens to healthy babies also -- Winn still says parents "ought to at least seek advice from their health care provider" if their baby experiences such an event.

Copies of the Baby Check scoring system can be obtained via the following address or telephone number:
Baby Check, P.O. Box 324, Wroxham, Norwich NR12 8EQ. Phone 01603 784400.

Vital Information:

• A new study shows that a simple, 19-question scored checklist may be able to determine which babies are at risk of sudden death.
• The Baby Check checklist is based on many symptoms and signs that may not be significant individually, but which taken together may signify a risk of death.
• Questions on the checklist include:
  In the last 24 hours:
  Has the baby vomited at least half the feed after each of the last three feeds?
  Has the baby had any bile-stained (green) vomiting?
  Has the baby taken fewer fluids than usual in the last 24 hours?
  Has the baby passed less urine than usual?
  Has the baby been drowsy (less alert than usual) when awake?
  Has the baby had an unusual cry (sounds unusual to mother)?
• The complete checklist may help parents and health care professionals determine when a baby needs serious medical attention.

Dec. 2, 1999 (Baltimore) -- About 750,000 strokes occur each year in the U.S., according to a study appearing in the December issue of the journal Stroke, a publication of the American Heart Association. That's up from a previous estimate of 500,000 per year.

The fact that the number of strokes occurring in this country is so much higher than previously thought is important from a public health standpoint, Rhys Williams, MS, the study's lead author, said in an interview with WebMD. "As the elderly population continues to grow, the stroke burden in this country will also grow unless something is done. The key point is that stroke has several modifiable risk factors, so it's possible to prevent much of the incidence of stroke we're seeing."

People can modify their risk of stroke in many ways, according to the American Heart Association, including quitting smoking, getting adequate exercise, consuming healthier foods, and checking blood pressure regularly. They must also be aware of the signs and symptoms of stroke. Williams says, "Stroke needs to be treated in an optimal fashion. That means getting to an emergency room as quickly as possible if a stroke is suspected."

This study confirms earlier findings that the incidence of stroke increases dramatically with age, but it also points out a new finding: the number of recurrent strokes in elderly patients is much higher than previously thought. "Total stroke incidence in people aged 65-74 is 1.5 times higher than first-ever stroke incidence, in those aged 74-84 it is twice as high, and in those aged 85 and older it is three times as high. This suggests that for those over 75, the majority of their strokes are recurrences," says Williams, who is director of the Department of Health Outcomes Management and Research of Knoll Pharmaceuticals in Mount Olive, N.J.

Williams says, "We need to educate the elderly and their caregivers to realize that strokes do recur, and to recognize the signs and symptoms of stroke so action can be taken right away."

Steven Levine, MD, professor of neurology at Wayne State University, commented on the study for WebMD. He says, "It's not surprising that the incidence of stroke is higher than we previously thought. This seems to confirm research already done, which included more minorities and also found a much higher incidence of stroke."

"We clearly need to emphasize more public education efforts related to stroke, and we need more dedicated stroke people the way there are dedicated cancer people," Levine continues. "Neurologists may not be as aggressive as they could be about risk factor modification and acute treatment."

Vital Information:

• Although previous estimates said that 500,000 strokes occur in the U.S. each year, new data show that number is probably closer to 750,000.
• With the elderly population continuing to grow in this country, people should take steps to lower their risks and become aware of the signs and symptoms of a stroke.
• The risk of stroke increases substantially as a person ages, and many strokes in the elderly are recurrences.