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It's the final countdown -- fast approaching single-digit weeks -- before you get to meet your baby and coo over those tiny fingers and toes. Unfortunately, tiny isn't the word that comes to mind these days.

The homestretch can be, well, a stretch. Itchy bellies, achy backs, swollen ankles, hemorrhoids -- you name the annoyance, and some expectant mom probably feels it.

The real remedy, of course, is childbirth. But since that option is still a bit premature, we asked an obstetrician, a midwife, and a family practitioner to share their best trade secrets for surviving the common aches and pains of the third trimester.

Our experts: Owen Montgomery, MD, assistant professor of obstetrics and gynecology at University of Pennsylvania School of Medicine in Philadelphia; Stephanie Lowell, a certified nurse midwife in Phoenix, Ariz.; and. Bruce Bagley, MD, a family-practice physician in Latham, N.Y., and former president of the American Academy of Family Physicians.

Make sure to talk to your own provider about your discomforts, especially before trying any over-the-counter treatments. "These remedies are reasonable things that experienced practitioners have used for a long time, but your doctor or midwife may have a different feeling about it," says Montgomery.

Nov. 13, 2000 -- Debra Livingston is every doctor and midwife's idea of a dream patient. The 29-year-old Florida woman got down to a healthy weight, stopped drinking alcohol, and quit using birth control pills months before she started trying to conceive. "I wanted to do everything I possibly could to put the odds of having a healthy baby in my favor," says Livingston, who is now 5 months pregnant with her first child.

Today women are more able than ever to plan when they want to have a child, thanks to advances such as effective birth control and ovulation predictor kits. This means that women, like Livingston, can start preparing for their pregnancies months in advance of the actual conception -- getting their bodies and minds into the best shape possible for carrying a baby.

Some of the most critical stages occur during the first few weeks of fetal development -- often before a woman realizes she is pregnant. By taking precautions prior to conception, a woman can minimize some of the risks that contribute to many serious -- but often preventable -- birth defects, according to the March of Dimes. And while this preparation doesn't guarantee a complication-free pregnancy, a woman will know she's done all she can to provide her baby with a healthy start, says Donald Mattison, MD, medical director of the March of Dimes.

Planning Ahead

Livingston started getting her body ready for a pregnancy about a year before she attempted to conceive. She was eager to lose weight and improve her eating habits. She lost 30 lbs. and drastically improved the quality of her diet. "I started drinking more milk and eating more red meat and grains than what was normal for me. I also cut out as much junk food as possible."

According to Barak Rosenn, MD, Director of Obstetrics and Maternal Fetal Medicine at St. Luke's-Roosevelt Hospital Center in New York City, it's smart to tackle weight problems far in advance of pregnancy -- and to avoid crash dieting: "Doing so, allows a woman to achieve and maintain her weight before conceiving."

That's important because a study published in the Jan. 15, 1998, issue of the The New England Journal of Medicine reported that women who are obese (with a body mass index over 30 ) before becoming pregnant are four times as likely to have a still-born child. And the extra weight also increases the risk of gestational (present only during pregnancy) diabetes and high blood pressure, both serious complications. But because dieting can seriously harm the baby's development, you should never try to lose weight while pregnant.

Dec. 4, 2006 -- In an effort to reduce the number of deaths of teens, the American Academy of Pediatrics (AAP) has issued new guidelines for teenage drivers.

The guidelines, published in Pediatrics' December edition, include a sample teen driving contract in which teens pledge to drive safely and call home for a ride if they can't.

Highway crashes are the top cause of death for 16- to 20-year-olds, killing about 5,500 and injuring 450,000 each year, according to the AAP.

The teen accident rate is more than four times that of people age 30 to 69. Young teens have the highest crash rates; two-thirds of teens who die from accidents are male, the AAP notes.

The AAP links the high crash rate of teens to these influences:

• Lack of driver experience
• Young age at getting a license
• Failure to use safety belts
• Inadequate skills at noticing hazards
• Distractions (cell phones, food, drink, music)
• Transporting teen passengers
• Nighttime driving
• Speeding and reckless driving
• Fatigue
• Unsafe vehicle choice (smaller and older cars with fewer safety features)
• Alcohol use
• Drug or medication use
• Inadequate parental limit setting
• No license, or revoked license
• ADHD (attention deficit hyperactivity disorder).

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New Guidelines

To encourage teen driving safety, the AAP suggests pediatricians do the following:

• Alert parents and teens about high-risk situations for teen drivers
• Encourage seat belt use
• Discourage distractions when driving
• Counsel teens about the dangers of driving while impaired
• Encourage parents to make sure vehicles are safe and in good condition
• Encourage parents to set rules and control vehicle access.

The AAP supports "safe-ride" agreements, in which teens promise to call a parent for a ride if they are impaired and parents agree to drive teens home without judgment.

The AAP also recommends teens and parents sign written contracts about teen driving safety.

The guidelines come with a sample contract in which teens promise to drive safely and to ride only with drivers who haven't been drinking or using drugs.

The contract includes rules about driving at night, in bad weather, and with teen passengers -- and the consequences of breaking those rules.

The rules can be tailored by parents.

The AAP suggests parents start with strict rules, such as not letting teens drive after 9 p.m. and banning teen passengers.

Six months later, parents may consider gradually relaxing some rules, depending on the teen's maturity.

May 9, 2006 -- Want to soften your views of the people around you? You might want to follow a young child's example.

Young kids generally judge their peers as being "nice" and are slow to call them "mean," giving others "the benefit of the doubt," states a study in Developmental Psychology.

In the study, kids only needed one example of a kid acting nicely to call that child "nice." But they required about five times as much proof that the child was "mean."

Children attributed "niceness, but not meanness, on the basis of a single behavior," write the researchers, who included Wake Forest University psychologist Janet Boseovski, PhD.

Nice or Mean?

Boseovski's study included nearly 200 U.S. children aged 3-6 at day-care centers or schools. A teacher read each child stories about a fictional boy named Billy.

In the stories, Billy acts positively (sharing his Play-Doh with a classmate), negatively (stealing his classmate's toys or snacks), or neutrally (playing by himself).

The kids heard six versions of those stories. The kids either heard five positive stories and one neutral story, five neutral stories and one positive story, five negative stories and one neutral story, or five neutral stories and one negative story.

Afterwards, the teacher asked the child what they thought Billy would do in a similar situation, and what they thought of Billy. Children who didn't answer the second question were asked if Billy was "nice," "mean," "or "not nice or mean."

Benefit of the Doubt

The kids viewed Billy positively if they heard even one positive story about him. But they didn't judge Billy as being "mean" unless they heard five stories about Billy stealing other kids' toys.

Older kids were quicker to make predictions about how Billy would behave in similar situations, the study also shows.

Young kids may have a "positivity bias," the researchers write. That is, kids tend to see the good in others unless they have lots of evidence to the contrary.

In a Wake Forest University news release, Boseovski commented on the findings.

"While it is adaptive for young children to see the world in a positive way, because it encourages them to try new things and also fosters the formation of social relationships, it is also a concern that they may be too trusting of strangers and acquaintances."

The character in Boseovski's study was a child, not a grown-up. Further studies are needed to learn how kids form their views of people, the researchers write.

Nov. 21, 2005 -- Neglected babies may have lower levels of brain hormones tied to social bonding.

But those children can still develop satisfying relationships, researchers stress.

"It's extremely important that people don't think this work implies that these children are somehow permanently delayed," says researcher Seth Pollak, PhD, in a news release.

"All we are saying is that in the case of some social problems, here is a window into understanding the biological basis for why [those problems] happen and how we might design treatments," he continues.

Pollak is an associate professor of psychology, psychiatry, and pediatrics at the University of Wisconsin-Madison. He's also a researcher at the university's Waisman Center for Human Development.

The study appears in the early online edition of Proceedings of the National Academy of the Sciences.

Orphans Tested

The study included two small groups of children.

One group consisted of 18 children who had spent the first 16 months of their lives, on average, in overseas orphanages before being adopted by U.S. families.

The adopted kids had lived in typical American homes for about three years. They had been tested for fetal alcohol exposure, birth defects, and developmental disabilities.

The second group included 21 American children who were being raised by their biological parents in similar settings.

The researchers compared levels of two brain hormones -- oxytocin and vasopressin -- which are involved in social bonding.

Play Time With Mom

For the study, the kids played interactive computer games while sitting in the lap of their mother or a woman they didn't know.

The game included light physical contact, like counting fingers or whispering in the partner's ear. Afterwards, the kids provided urine samples, which were checked for oxytocin and vasopressin.

After physical contact with their moms, oxytocin levels rose for children living with their biological parents. The same wasn't true for children who had been neglected early in life.

Formerly neglected kids also had lower overall levels of vasopressin, the researchers note.

No hormonal differences were seen between the two groups after the kids played the computer game with unfamiliar women.

Nurturing Environment Helps

"Importantly, at the time of testing, children had experienced an average of three years in rearing in relatively stable, enriched, and nurturing family environments," write the researchers.

"However, this environmental change does not seem to have completely overridden all of the effects of early neglect," they continue.

Remember, the study just tracked the two brain hormones, not behavior or emotions. "It is critical to note that not all children who experience early neglect develop the same kinds of problems, and children with lower hormonal

reactivity may, over time, develop satisfactory relationships," write the researchers.

"It's exciting that we've taken an area of child development that has been very descriptive and can now look at it in more mechanistic way," says researcher Alison Wismer Fries, in a news release. Fries is a psychology graduate student at the University of Wisconsin.

She and her colleagues note that oxytocin and vasopressin levels varied among both groups of children.

July 19, 2005 -- Parents frequently give their children cranberry juice as an alternative treatment for recurrent urinary tract infections (UTIs), but they rarely tell their pediatrician about it.

A new study shows that nearly one in three parents have given their children cranberry juice or other cranberry products to treat or prevent recurrent UTIs, but less than one in four told their pediatrician about this practice.

"It has become clear that parents frequently use cranberry for therapeutic purposes -- occasionally in lieu of standard therapy," says researcher Kathi Kemper, MD, a pediatrician at Brenner Children's Hospital, in a news release.

Cranberry products are widely used to prevent UTIs in adults and are considered generally safe.

But researchers say their results show that new studies are needed to determine the safety and effectiveness of using cranberry products to treat healthy children with recurrent urinary tract infections.

Clandestine Cranberry Use

Researchers say UTIs are the most common serious bacterial illness treated by pediatricians. In children who suffer from recurrent urinary tract infections, the long-term complications may include high blood pressure or kidney problems.

Many doctors recommend treatment with antibiotics to prevent recurrent UTIs in children at risk. However, researchers say it's hard to get kids to take all their medicine. Using antibiotics as a preventive measure can lead to antibiotic-resistant bacteria, which makes it more difficult to treat other illnesses. Many of the antibiotics used to treat resistant bacteria can cause kidney problems.

In the study, researchers surveyed 117 parents of children treated at a pediatric nephrology (kidney treatment) clinic about their use of cranberry products in treating recurrent urinary tract infections. Their children ranged in age from 6 months to 18 years.

The results showed that 74% of the parents had heard of using cranberry products to treat UTIs, and 29% had given them to their children. Most of the parents used cranberry juice and a few used cranberry pills or dried cranberries.

About half of those who had given cranberry products to their children used them to prevent or treat urinary tract infections. The other half cited a variety of other reasons for using cranberry therapies, such as "flushing out the kidneys" or when their child seemed to be having problems with urination.

Of the parents who used cranberry therapies on their children, less than one in four discussed it with their pediatrician.

Most parents had heard about using cranberry products for treating UTIs from the media, friends, or family, and 12% were advised by a health professional to try them.

The results of the study appear in the current issue of the journal Ambulatory Pediatrics.

Urine infections affect millions of people each year. They are treated with antibiotics that fight the most common cause of urine infection -- a bacteria called E. coli. Yet doctors may suggest treatments like cranberries, which parents can take on their own to prevent infections. Though cranberry juice is the form of cranberries most widely used, other cranberry products include cranberry powder in hard or soft gelatin capsules.

The way cranberries work to prevent urine infection is not completely understood. It is believed that cranberries prevent bacteria from sticking on the bladder wall, which inhibits their growth.

March 16, 2005 - What a cuuute baaaaby. Does baaaaby want to plaaaay? It just feels natural to talk baby talk to babies, but is it a good idea?

It is clear that infants like listening to baby talk better than adult speech, and now new research from Carnegie Mellon University and the University of Wisconsin confirms that it actually helps them learn language faster.

Babies in the study were able to identify specific words from nonsense sentences more quickly when the sentences were delivered in baby talk than when they were delivered in the more monotone cadence characteristic of adult speech.

Lead researcher Erik D. Thiessen, PhD, of Carnegie Mellon University says the infants learned words about 25% faster when exposed to baby talk.

"Parents often hear that if they want their infant to grow up speaking like an adult they should talk to them like they are adults," Thiessen tells WebMD. "But it turns out that talking to babies in this special way, as mothers have been doing for centuries, is pretty effective for learning language."

Simple Sentences, Clearly Spoken

Known in language development circles as infant-directed speech, baby talk is characterized by short, simple sentences delivered in a high-pitched, sing-song voice. Vowels are also dragged out, and each word of a sentence tends to be clearly spoken.

Thiessen says baby talk and the exaggerated body language that goes along with it tends to grab an infant's attention. And the simple sentence structure and slow word delivery make it easier for infants to learn.

"It isn't that babies can't learn from adult-directed speech," he tells WebMD. "They will figure it out eventually no matter how they are talked to. They just tend to learn a little faster with infant-directed speech."

The findings may also help explain why adults have so much trouble learning a second language, even though they are able to speak their own language effortlessly, Thiessen says.

Adults tend to learn individual words of a new language easily. But they often have trouble understanding the language when it is spoken by native speakers because words tend to run together and no longer make sense.

"There may be something about the simplified way that people talk to infants that makes it easier to break into a new language and figure out what is going on," he says.

Talk Silly to Baby

The new research should help calm the fears of parents who have heard that baby talk could slow their child's verbal learning, says researcher Roberta Michnick Golinkoff, PhD.

Michnick Golinkoff directs the Infant Language Project at the University of Delaware and is co-author of the books How Babies Talk and Einstein Never Used Flash Cards.

"We know that infant-directed speech really helps babies break up the speech stream to find the individual words," she tells WebMD. "Parents should feel comfortable talking silly to their babies. Babies love it and it helps them learn."

Nov. 12, 2004 -- Looking for the safest U.S. cities for your next home or vacation? You may want to consider Minneapolis, Minn., and Seattle, according to a new Gallup poll.

Those cities ranked first and second, respectively, in the poll on perceived safety in 14 big American cities. The results don't necessarily reflect crime statistics; instead, they focus on public perception about each city.

Washington, D.C.?and Detroit didn't fare as well. They were at the bottom of the list.

More than 1,000 U.S. adults participated in the October telephone poll, rating the 14 largest cities as "safe" or "unsafe." Here's how the cities ranked in perceived safety, in order from most safe to least safe:

1. Minneapolis, Minn.
2. Seattle
3. Dallas
4. Boston
5. Houston
6. San Francisco
7. Atlanta
8. Chicago
9. Philadelphia
10. New York
11. Miami
12. Los Angeles
13. Washington, D.C.?
14. Detroit

Minneapolis, Minn., was called "safe" by 78% of respondents. The city has ranked high in past Gallup polls; since 1993, at least 70% of Americans have called Minneapolis "safe," says Gallup.

In contrast, only 33% of this year's poll-takers called Detroit "safe."

Three cities -- Philadelphia, Washington, D.C.,?and Detroit -- had declines in their perceived safety this year. However, all 14 cities rank higher than they did in 1990, says Gallup, noting a substantial drop in the nation's crime rate since then.

Aug. 19, 2004 -- The tragic mystery of sudden infant death syndrome (SIDS) is a bit closer to being solved. New research shows that genetics may play a role.

In a study appearing this month in Pediatrics Research, researchers identify genetic variations, which change the function of proteins among babies who died of SIDS. More than two-thirds were black, reports researcher Debra E. Weese-Mayer, MD, a pediatrician at Rush Children's Hospital at Rush University Medical Center in Chicago.

Public health officials have been frustrated about the still-high numbers of SIDS deaths. After the nationwide Back to Sleep campaign -- which educated parents on safe sleeping positions for infants -- the numbers of SIDS deaths did decline. Yet black infants still had the highest death rates compared with white infants, writes Weese-Mayer.

In fact, infants of all ethnic groups continue to have higher SIDS rates. This was true, even though caregivers had carefully followed all safety practices, she says.

Other studies have provided "strong evidence" pointing to a gene that controls the hormone serotonin, Weese-Mayer says. Serotonin influences a wide range of functions, such as regulating breathing, blood circulation, heart rate, body temperature, and the sleep-wake cycle. Indeed, SIDS infants have had profuse sweating, high temperature, and irregular heartbeat.

She and her colleagues examined genetic material from brain tissue from 92 SIDS infants -- both white and black infant girls and boys. They compared the results with genetic material obtained from the blood of 92 white and black infant girls and infant boys.

They found:

• 11 rare gene variations in 14 of the SIDS infants -- 15% of SIDS infants
• One gene variation in two of the non-SIDS infants
• Of SIDS infants with these rare variations in genes that control serotonin, 71% were black

Similar analyses of brain DNA has helped clarify the genetic basis for a deadly disorder similar to SIDS -- a breathing disorder called congenital central hypoventilation syndrome (CCHS), she explains. Families with genes for CCHS have more cases of SIDS.

SOURCE: Weese-Mayer, D. Pediatric Research, August 2004; vol 56.

May 18, 2004 -- Exercise may counter the effects of obesity on the hearts of children and help reduce their future risk of heart disease, a new study suggests.

Researchers say tests show that obese but otherwise healthy adolescents have abnormal blood vessel function, which could be an early sign of heart disease. But after participation in an eight-week exercise program, their test results matched those of normal-weight children even though they were still obese.

"We were able to essentially normalize endothelial function [blood vessel] in a short period using the exercise training program," says researcher Daniel J. Green, PhD, of the University of Western Australia, in a news release.

Endothelial function tests measure how well blood vessels expand and contract in response to changes in blood flow. Impaired endothelial function is considered an early sign of atherosclerosis, or hardening of the arteries.

"This paper adds another piece to the jigsaw puzzle which says that exercise is beneficial not only because it may improve your risk factors, like lipids [cholesterol] and blood pressure, but it also probably has a direct effect on your blood vessels that makes them more fit," says Green.

Exercise May Counter Effects of Obesity

In the study, published in the May 19 issue of the Journal of the American College of Cardiology, researchers compared the effects of exercise in a group of 19 obese adolescents who ranged in age from 12 to 15 and weighed an average of 212 pounds.

All of the children had normal blood pressure and cholesterol levels and were not on any medications. However, compared with a group of similarly matched non-obese children, the obese children had impaired endothelial function.

The obese children were then enrolled in an eight-week exercise program consisting of one-hour exercise sessions three times a week using a stationary bicycle and strength training with light weights.

The study showed that after participation in the exercise program, the endothelial function of the obese children matched that of the lean children. Researchers say it's important to note that the children had not lost weight, but their body composition had changed in a healthy way.

"We found a decrease in abdominal obesity in this group. And the reason that they didn't lose weight, even though they lost body fat, is that their lean muscle mass went up," says Green. "So we were really seeing a very beneficial change in the composition of the body without changes in gross measures like body weight."

Green says the results suggest that focusing on weight loss alone may be doing a disservice to obese individuals. This study shows that exercise may produce heart healthy benefits even if it doesn't produce rapid weight loss.

But the study also showed that although the healthy effects of exercise were immediate, they may disappear just as fast. Eight weeks after the obese children ended the exercise program, the benefits of exercise on blood vessel function were gone.

Feb. 25, 2004 -- Thin infants face serious health problems if they gain a lot of weight after the age of 2 years.

Several studies have linked a low birth weight to a particularly high risk of diabetes and heart disease in adulthood. Now a report in the Feb. 26 issue of The New England Journal of Medicine suggests that the problem begins in childhood.

A research team followed some 1,400 men and women in Delhi, India, from birth until they were 26 to 32 years old. The main finding: Being thinner than average in early childhood and becoming fatter than average after the age of 2 years tended to increase the risk of developing glucose intolerance and/or diabetes.

"This is a continuing process after the age of 2 years," study co-author Harshpal Singh Sachdev, MD, a professor at Maulana Azad Medical College in New Delhi, India, tells WebMD. "However, most of the association [is seen in those who cross from low- to high-weight categories] between 2 to 12 years of age. Thus, category crossing at any age after 2 years is associated with development of disease. The earlier one detects it, the better it would be for initiating interventions."

Childhood Obesity, Adult Health Trouble

Sachdev says it's the same story all over the world. Kids don't get enough exercise -- and they eat too much "energy-dense" food. Translation: too much TV, too many computer games, too much fast food, too many sugary drinks, and too little physical activity.

His advice to kids -- and adults -- is short if not sweet.

"Avoid getting fatter relative to yourself, particularly if you were thin as an infant," Sachdev says. "Possibilities for this include optimal physical activity and nutrition."

Chubby children used to be thought of as healthy, notes Matthew W. Gillman, MD, an associate professor at Harvard Pilgrim Health Care and Harvard Medical School in Boston.

"I think that we are slowly coming to a consensus that overfeeding during infancy and early childhood -- which may have been seen as healthy decades ago -- can't be seen that way any more," Gillman tells WebMD. "It may be predicting the kinds of health outcomes that are the scourge of the modern world."

Gillman says it's now well known that lower birth weight is linked to risk of obesity, diabetes, and even heart disease and stroke. The Indian study, he says, adds to this body of knowledge.

"What is underlying these associations between lower birth weight and poor health outcomes? Where this particular article helps is it shows us that accelerated weight gain during childhood seems to be one of the culprits," he says.

Unfortunately, there is no quick fix. Sachdev and Gillman agree that ways must be found to encourage children to exercise more and to eat more nutritious foods. Public awareness is a necessary first step.

"Maybe years ago a fat child was a healthy child," Gillman says. "But today, in the developed world, that is not as big an issue as what will happen to these children in the future."

Jan. 3, 2002 -- When a child can't behave, it may be time for the parents to head back to class for a little remedial work. A new study shows that parenting classes can help mom and dad improve both the behavior and mental health of their child.

British researchers found that enrolling the parents of children with behavioral problems in a nurturing parenting program significantly improved the child's conduct in both the short- and long-term. The classes also benefited the parents and reduced their own level of anxiety and depression for at least a short time.

For the study, researchers from the Institute of Health Sciences in Oxford, UK recruited the families of about 100 children between the ages of 2 and 8. The children had a variety of behavioral problems that ranged from bed-wetting and difficulty with friends to temper tantrums and fighting. About half of the parents participated in a parenting program delivered by trained professionals and the other half had no assistance.

The study appears in the December issue of the Archives of Disease in Childhood.

The parenting program consisted of a two-hour session held once a week for 10 weeks. In the classes, parents participated in a variety of activities such as watching instructional videos of parent-child interactions, group discussions, engaging in role-play, rehearsal of parenting techniques, and home practice.

The specific parenting techniques taught included:

• Encouraging positive interaction and play with the child
• Giving clear commands
• Setting limits
• Ignoring undesirable behaviors
• Praising and rewarding desirable behaviors
• Following through on discipline

The behavior and mental health of the child as well as the stress level and mental health of the parents were measured through questionnaires before, immediately after, and six months following the program.

The researchers found that the classes were most effective at improving the child's conduct compared with the children whose parents did not participate in the program. Improper conduct reduced immediately after and at the six-month follow-up point. The child's overall behavior was also improved six months after the program.

Some mental health benefits were also found among the parents themselves. Mothers who took part in the classes had lower levels of anxiety immediately after the program than those who didn't participate.

The researchers say that although more study is needed, their results suggest that parenting classes may be a low-cost and drug-free alternative to preventing child behavior problems.

SOURCE: Archives of Disease in Childhood, December 2002. -->

Wintertime. Ice, snow, and, perhaps worse, lots of "snow days" with the kids in the house. Are you and your family "winterized"?

Preparing for unexpected campouts in your living room is not exactly akin to preparing for a terrorist attack, but some of the same precautions apply. Ice can put weight on electrical lines and cut off power, so have the following on hand:

• Flashlights and batteries; candles are not a wise choice, because in bad weather you can have a fire and no one can reach you.
• Plenty of blankets.
• A safety kit for your car, consisting of shovel, sand or cat litter for traction, tire chains, booster cables, a cell phone, extra warm clothing or boots, an ice scraper, small tools, winter sleeping bag or blankets, snack food, water, flashlight with good batteries, matches and newspapers, games and toys, zip-top bags (for elimination if stranded), and a 12-volt adapter coil heater that can plug into the lighter to heat water.
• Salt or sand for treacherous sidewalks.
• Safe, radiant space heater (no open coils).
• Fan for fireplace that blows heat into the room and does not suck it up the chimney.
• Supplies of medication to last a few days at least.
• The phone numbers of older or disabled neighbors, just in case.

Making Your Kitchen Ready for Winter

Larrian Gillespie, MD, author of The Goddess Diet, tells WebMD that winter is all about comfort. "Soups, soups," she chants. "You want to stock your larder for those unexpected snow days. It's hard to make a bad soup. Just add the flavor with herbs and spices and avoid carbs that raise blood sugar such as pasta. Instead use barley and chunky root veggies, such as carrots and turnips. If you use meat, cool the soup first and remove the hardened fat, then reheat."

What else should you load up on?

• Steel cut oats, for oatmeal, Gillespie says
• Frozen berries. Great in that oatmeal for any meal of the day
• Peanut butter
• Tuna
• Garbanzo beans
• Canned juices
• Crackers/bread
• Long-keeping milk
• Vitamins
• Baby food. And don't forget diapers, towelettes, bottles, ointment, and the rest.
• Pet food
• Carrots, squash, and apples. Keep apples in the fridge, she says; they last a month that way.
• Raisins and nuts
• A slow cooker

The Department of Homeland Security recommends three days' worth of food.

For those long afternoons out sledding, set the slow cooker to make herb chicken. Put rough-cut celery, onions, and carrots in your pot, add pieces of a cut-up fryer, and bring the water up half-way. Cook for several hours. After a day's winter activity, add some barley and salt and pepper and cook a few minutes before serving.

When pent-up kids need a diversion, cut out bread into stars with a cookie cutter and toast it. Let the kids mix up tuna salad out of mayo, dill, and mustard and spread it onto every point.

If the kids are still bouncing off the walls, mix up some fake Play-Doh: 3 cups of flour, 1.5 cups of salt, 6 teaspoons of cream of tartar, and 3 cups of water. Mix the dough until it balls up and can be handled. Then set the "energy bunnies" to sculpting animals and little cars. If you are the brave type, add food coloring.

Feb. 16, 2007 -- Got a recipe that involves cooking garlic? You might want to crush the garlic first.

That may be the best way to preserve the herb's healthy compounds during cooking, a new study shows.

Garlic contains compounds shown to help prevent blood clots. But most garlic studies have tested raw garlic, and cooking can damage those anticlotting compounds.

Crushing garlic may help prevent that damage, report the researchers, who include Claudio Galmarini, PhD, of the agricultural sciences faculty at Argentina's Universidad Nacional de Cuyo.

Galmarini's team found that garlic cooked three minutes in boiling water or in an oven at about 400 degrees Fahrenheit has the same amount of the anticlotting compounds as raw garlic.

But cooking uncrushed garlic for six minutes "completely suppressed" those compounds' anticlotting effects, the researchers write.

Galmarini's team then tried crushing the garlic by putting it through a garlic press before cooking.

That helped preserve the compounds, although they still lost much of their anticlotting effects after three to six minutes.

The study appears in the Journal of Agricultural and Food Chemistry.

April 19, 2005 -- Mercury levels from eating fishMercury levels from eating fish have been linked to problems in developing brains. But older adults don't appear to be affected.

A new study in The Journal of the American Medical Association shows no strong evidence of a link between mercury levels and older adults' performance on mental tests.

The study touches on three hot topics: concern about mercury levels in fish, the health benefits of eating fish, and the effects of toxins like mercury on the aging brain.

Older adults are often advised to eat fish for omega-3 fatty acids,omega-3 fatty acids, which have been linked to better heart health and might offer some protection against Alzheimer's disease, say the researchers, who included Megan Weil, MHS, of the Johns Hopkins Bloomberg School of Public Health.

But the aging brain is "more sensitive" to toxins, write Weil and colleagues. So, what's a senior citizen or an aging baby boomer to do -- eat fish or avoid it because of mercury?

How Mercury Makes It to Your Plate

Mercury is found throughout the environment. It enters the food chain at the lowest rung --microorganisms. That's where mercury is converted to methylmercury, which builds up in some seafood.

"Consumption of certain fish and crustaceans is the primary source of methylmercury in the general population," says Weil's study.

"Fish are important in a healthy diet," says a fish advisories web site from the Environmental Protection Agency (EPA). "Nearly all fish and shellfish contain traces of mercury. For most people, the risk from mercury by eating fish and shellfish is not a health concern."

Government cautions on fish consumption are targeted to womencautions on fish consumption are targeted to women of child-bearing age and young children.

The "acceptable" range for blood mercury levels is 5.8 micrograms per liter or less, say the researchers, citing the EPA and the National Research Council.

That number is based on risk assessments for children and women of child-bearing age, writes Weil. Does it also apply to seniors?

To investigate, Weil's team tested the blood mercury levels of 474 Baltimore residents aged 50-70.

Participants took 12 tests covering memory, manual dexterity, intelligence, verbal skills, and other traits. They also completed a food questionnaire that included fish intake for the past year. Smoking, body mass index (BMI),body mass index (BMI), alcohol use, and other factors were noted, too.

No 'Strong Evidence' of Mercury Trouble

No solid pattern of mercury-related brain problems was seen.

Overall, the data do not provide strong evidence that blood mercury levels are associated with worse performance on mental function tests, say the researchers.

For instance, mercury levels were associated with worse performance on a visual memory test. But mercury levels were also linked to better performance on a finger-tapping manual dexterity test.

"We cannot exclude the possibility that associations were due to chance," write the researchers.

Extra Sensitivity for Elders?

Participants' average blood level of mercury was 2.1 micrograms per liter. That's well within the government's "acceptable" range. As far as the researchers could tell, there was no sign that older adults were affected by a lower blood level of mercury.

Since the study only involved one blood test, more work should be done to confirm the findings, say the researchers.

"Some fish and shellfish contain higher levels of mercury that may harm an unborn baby or young child's developing nervous system," says the EPA's site.

"Therefore, the FDA and EPA are advising women who may become pregnant, pregnant women, nursing mothers, and young children to avoid some types of fish and eat fish and shellfish that are lower in mercury.avoid some types of fish and eat fish and shellfish that are lower in mercury."

Here is the EPA's and FDA's advice for those people:

• Do not eat shark, swordfish, king mackerel, or tilefish because they contain high levels of mercury.
• Eat up to 12 ounces (two average meals) a week of a variety of fish and shellfish that are lower in mercury. Five of the most commonly eaten fish that are low in mercury are shrimp, canned light tuna, salmon, pollock, and catfish.
• Another commonly eaten fish, albacore ("white") tuna, has more mercury than canned light tuna. When choosing your two meals of fish and shellfish, you may eat up to six ounces (one average meal) of albacore tuna per week.
• Check local advisories about the safety of fish caught by family and friends in your local lakes, rivers, and coastal areas. If no advice is available, eat up to six ounces (one average meal) per week of fish you catch from local waters, but don't consume any other fish during that week.
• Follow the same advice with smaller portions for children.

A glass of wine a day keeps the doctor away. Could this be true? WebMD talks to experts to learn how we can get the health benefits of wine or alcohol while keeping our weight in check.

Do Like the French?

The French diet is often used as an example of how wine can improve heart health. The French have a fairly high-fat diet but their heart disease risk is relatively low. And some have attributed this to red wine.

But there are so many differences between the lifestyle of the French and Americans from their activity levels to the foods they eat. You cannot isolate red wine as the magic bullet for disease prevention says Alice Lichtenstein, DrS, Gershoff Professor at Tufts University.

Choose whichever alcoholic beverage you enjoy, drink it in moderation and try to have it with meals, advise Lichtenstein and Eric Rimm, DrS, a Harvard researcher.

Arthur Agatston, MD, cardiologist and creator of the popular South Beach diet, encourages patients who enjoy alcohol to also drink it with meals.

"Alcohol can stimulate the appetite so it is better to drink it with food. When alcohol is mixed with food, it can slow the stomach's emptying time and potentially decrease the amount of food consumed at the meal," asserts Agatston. His alcohol of choice is red wine due to the antioxidant resveratrol. However, he agrees that any alcohol in limited quantity will provide the same health benefit.

There is a misperception that red wine is abundant in antioxidants. "It does contain some, but they are not always well absorbed. If you want antioxidants, you are better off eating a spinach salad with vegetables than drinking a glass of red wine," Rimm tells WebMD.

Lower Your Cholesterol

Alcohol also can have a very powerful effect and increase HDL "good" cholesterol by 20% if used moderately and in the context of a healthy diet along with regular physical activity, says Rimm. Higher HDL levels are linked to lower risks of heart disease.

"The research evidence points to ethanol, or the alcohol component, of beer, wine, or spirits as the substrate that can help lower cholesterol levels, increase 'good' HDL cholesterol," he says.

Boost Your Brain

A recent study shows a boost in brain power for women who enjoy a little alcohol. The study, published in the Jan. 20 issue of The New England Journal of Medicine, evaluated more than 12,000 women aged 70-81. Moderate drinkers scored better than teetotalers on tests of mental function. Researchers found a boost in brainpower with one drink a day. Moderate drinkers had a 23% reduced risk of mental decline compared with nondrinkers.

With Alcohol, Moderation Is Key: Easy Does It

Just as you shouldn't eat a 12-ounce steak daily, you need to watch your portion sizes of alcohol as well.

What is one drink?

• 5 ounces of wine
• 12 ounces of beer
• 1.5 ounces of 80-proof distilled spirits, such as vodka

The 2005 Dietary Guidelines 2005 Dietary Guidelines recommend one drink a day for women and two a day for men. This doesn't mean to can save them up for a weekend party and expect to get the same benefits.

Did you ever notice that all fast food joints have the same "smell"? Hot oil mixed with eau de onion? Some people have even half-jokingly suggested there may be a secret addictive chemical pumped in.

"[The sense of taste] is in a bad way," Steven A. Witherly, PhD, president and CEO of Technical Products Inc., a food consulting firm in Valencia, Calif., tells WebMD. "Fast food has ridiculously high levels of salt, fat, and sugar -- and the brain likes salt, fat, and sugar."

Everyone has about 10,000 taste buds on his or her tongue (although these may thin as people grow older). "Fast food does not so much dull the taste buds as affect how the brain processes that taste as pleasurable or unpleasant," Witherly says. Hormones such as insulin and leptin also affect the brain's impression of a given food. "Snack food is affecting how we process food."

Sense of Taste Deceptively Simple

Traditionally, scientists have said the sense of taste can detect salty, bitter, sour, and sweet. Now, Witherly says, a fifth taste found to be directly received by the tongue is umami (pronounced "ooo-mommy"), which is the monosodium glutamate (MSG) taste. Parmesan cheese is huge on this, 1% by weight; soy sauce is also 1%. Umami is tied to a protein found in breast milk that the brain is attracted to.

Witherly also says the human sense of taste can recognize the hot pepper taste and another he calls the fatty acid taste.

Marcia Levin Pelchat, PhD, a psychologist and research scientist with the Monell Chemical Senses Center in Philadelphia, tells WebMD the hot pepper taste is more of a skin irritation signal in the inner cheek rather than a taste. (Carbonation, she says, provides a similar irritation that can be studied by taste researchers.)

Whatever triggers them, your sense of taste picks up the signal and sends it to the brain for interpretation and combination with other tastes.

Certain sensations -- like salt, sugar, and to some extent, the sensation of fat -- become an expectation. People want to experience them. "I have seen people's brain scans light up in the pleasure centers when fat passes over their tongue," Witherly says.

In fact, researchers at Yale University, led by Linda A. Bartoshuk, PhD, have discovered that about 35% of white women and 15% of white men are "supertasters," people with an exaggerated sense of taste, compared with the rest of us mortals. These souls inhabit a more limited food universe because their sense of taste is so much more intense. For one thing, they tend to eat fewer bitter vegetables, the kinds that are thought to ward off cancer. On the good side, supertasters also spurn fatty foods more often and thus develop less heart disease.

"Fast food," Bartoshuk tells WebMD, "does not physically affect taste buds, but it may affect appetite and food preferences."

June 30, 2005 -- The weather in your area may be a plus or a minus when it comes to exercise.

Sure, you can exercise year-round inside. And many people brave hot, cold, rainy, or snowy conditions to be active. But the weather can still make a difference, new research shows.

The CDC advises getting at least half an hour of moderate intensity physical activity five or more days per week. According to the CDC, moderate-intensity physical activity includes walking at a brisk pace, biking on a level terrain, using a stationary bicycle, aerobic dancing, or water aerobics.

Ray Merrill, PhD, MPH, and colleagues aren't offering new excuses to slack on fitness. Instead, they looked at the weather's effects on workout habits.

Merrill is an associate health sciences professor at Brigham Young University. His report appears in the American Journal of Health Behavior.

Prime Exercise Conditions

Looking for the best weather for exercise? Head to "big sky" country.

Here are the five top-ranked areas, with the percentage of people meeting moderate physical activity guidelines:

• Montana: 60.9%
• Utah: 59.2%
• Wisconsin: 57.9%
• New Hampshire: 55.9%
• Vermont: 55.6%

The five with the lowest percentages were:

• Puerto Rico: 30.9%
• Hawaii: 36.4%
• North Carolina: 37.4%
• Kentucky: 37.6%
• Mississippi: 38.4%

For the complete list, click here.

Montanans are most likely to meet physical activity recommendations, says Merrill. People living in Puerto Rico are the least likely to do so, he writes.

You don't need radar to tell the difference between those climates.

The highest-ranked regions for physical activity also had the most dry, moderate days. Those at the bottom 25% of the list had the highest percentage of sticky, steamy, tropical days.

Seasonal Shifts

The time of year also affected activity. Activity peaked with:

• Moist, moderate winters
• Dry "polar" springs
• Dry, tropical summers
• Dry "polar" falls

Why the Difference?

The researchers suggest three reasons for the patterns:

• Some active people may consider climate in choosing where to live.
• Some older people may not feel comfortable in gyms. They may wait for good weather to be active.
• Good weather is often considered safer and more pleasant.
• Walking and cycling, two popular activities, are more convenient in good weather.

Data Sources

Physical activity data came from a 2003 phone survey done by the CDC and U.S. states or territories.

A total of 355 counties were involved. Surveys included adults aged 18 and older living in the community.

Weather information came from 255 weather stations.

Full List

1. Montana: 60.9%
2. Utah: 59.2%
3. Wisconsin: 57.9%
4. New Hampshire: 55.9%
5. Vermont: 55.6%
6. Maine: 55.1%
7. Idaho: 54.8%
8. Washington: 53.9%
9. Nevada: 53.8%
10. Wyoming: 53.4%
11. Rhode Island: 53.2%
12. Connecticut: 53%
13. Colorado: 52.8%
14. Washington, D.C.: 52.2%
15. Oregon: 52.2%
16. Massachusetts: 51.5%
17. Minnesota: 51%
18. Arizona: 50.8%
19. North Dakota: 50.7%
20. New Mexico: 50.2%
21. Pennsylvania: 49.2%
22. California: 49.1%
23. Maryland: 49.1%
24. Virginia: 48.5%
25. South Carolina: 47.9%
26. Ohio: 47.4%
27. Indiana: 47.2%
28. South Dakota: 45.7%
29. Texas: 45.7%
30. Missouri: 45.6%
31. New Jersey: 45.1%
32. New York: 45.1%
33. Delaware: 45%
34. Nebraska: 44.7%
35. Illinois: 44.2%
36. Michigan: 43.4%
37. Kansas: 42.4%
38. Georgia: 42.2%
39. Alabama: 41.7%
40. West Virginia: 41.5%
41. Iowa: 41.4%
42. Oklahoma: 40.1%
43. Florida: 39.4%
44. Arkansas: 39.1%
45. Louisiana: 39%
46. Tennessee: 39%
47. Mississippi: 38.4%
48. Kentucky: 37.6%
49. North Carolina: 37.4%
50. Hawaii: 36.4%
51. Puerto Rico: 30.9%

Results were not listed for Alaska.

Before starting any exercise program, speak with your doctor. Together you can find an activity that is safe for you and one that fits your needs.

March 10, 2004 -- People who take the over-the-counter supplement DHEA to increase testosterone may get less, and more, than they bargain for. New research suggests that instead of raising testosterone levels, the supplement raises levels of a hormone that promotes prostate problems.

Classified as a nutritional supplement in 1994, dehydroepiandrosterone, or DHEA, is used by athletes and body builders to build muscle mass because it is broken down into various steroid hormones, including the male sex hormone testosterone. But scientific evidence supporting it's effect on enhancing athletic performance is scant. Homerun slugger Mark McGwire sparked interest in hormone supplements like DHEA a few years later when he acknowledged using them during his record-setting season.

"All kinds of athletes, including high-school kids, are using DHEA, often at much higher doses than are recommended," University of Southern California researcher Rebecca Z. Sokol, MD, MPH, tells WebMD. "Yet most of the research has looked at the effect of this drug on aging men. It has hardly been studied at all in young men who are taking it to improve athletic performance."

Unexpected Findings

Sokol and colleagues recruited 12 men between the ages of 18 and 42 for their study, which is published in the March issue of the journal Fertility and Sterility. The men took either 50 mg of DHEA, 200 mg of DHEA, or a placebo every day for six months, and their blood levels of various hormones were tested at intervals throughout the trial.

The researchers expected to see increases in testosterone, but blood levels of this hormone stayed the same. But circulating levels of a hormone known as ADG, which is a byproduct of testosterone, did increase.

"Our findings suggest that DHEA is quickly turned into testosterone, and then just as quickly turned into [another hormone] DHT, and finally ADG," Sokol says.

Long-Term Risks Unknown

Studies have linked ADG to prostate enlargement, a condition that is almost universal among older men but rarely seen in men under the age of 40. Prostate enlargement was not seen among the study participants taking DHEA, but Sokol says the study follow-up period may have been too brief to detect a change.

"The concern is that young men who take this supplement long term will end up with enlarged prostates at younger ages than they ordinarily would," she says. "I am not of the school that thinks no one should ever take an anabolic steroid. That is absolutely not my perspective. But the fact is, we don't know much about the long-term risks of this drug."

Supplement expert and American College of Sports Medicine spokesman Doug Kalman, MS,RD, agrees, but says the USC study was far too small to offer definitive answers. He adds that elite athletes have all but abandoned the supplement because there is also little evidence that it helps build muscles.

"I am pretty sure that you would find that less than 1% of baseball players or football players at the professional or college level take this stuff," he says. "Most of the studies that have found positive uses for DHEA have been in older men, older women, or people who are HIV positive. No study has ever found a benefit among athletes."

For Tour de France winner Floyd Landis, the results of his doping test mean the difference between glory and disgrace. For sports doctors, the issue may be a coldly scientific one: Can a night of drinking dramatically alter results of a steroid test? (And how accurate are these tests anyway?)

Meanwhile, fans watching from the sidelines have been left a bit confused by all the talk of testosterone ratios and what might affect them. WebMD went in search of some of the answers.

Question: What is testosterone?

Answer: Testosterone is the "male" hormone, accounting for strength and endurance. It occurs naturally in men and in smaller amounts in women. For every molecule of testosterone produced by the body, another molecule of a substance called epitestosterone, which does not enhance performance, is made.

In a normal male body, the ratio of testosterone to epitestosterone, the T/E ratio, is about 1:1. But variation can occur in individuals, and the World Anti-Doping Code has deemed 4:1 as the threshold for a positive test.

Question: What is synthetic testosterone?

Answer: This anabolic steroid is a form of testosterone usually produced from soy or yams in factories, not the human body. It can be introduced into the body by injection, with patches, or other means.

Question: What happens to the body when it is introduced?

Answer: Gary Wadler, MD, chairman of the Prohibited List and Methods Committee of the World Anti-Doping Agency (WADA), says this would be a deliberate attempt to increase muscle strength and mass, shorten recovery time from vigorous exercise, and keep muscle tissue from breaking down (catabolism) when pushed to the extreme.

Steroid Abuse

Question: How common is "doping" with anabolic steroids?

Answer: Of every 100,000 samples from athletes analyzed at 24 labs around the world for the International Olympic Committee, 1.6% come up positive -- 65% of those for anabolic steroids.

Question: Does synthetic testosterone kick right in and provide an immediate boost?

Answer: This has doctors puzzled in the Landis case. Apparently, the contender did poorly on one leg of the race, went out to drown his sorrows, and then had a miraculous recovery the next day to win. Wadler says this is not typical of how synthetic testosterone works. "Most effects surface after a few weeks," Hellman says, "not a few hours."

Question: Don't the tests tell the story?

Answer: Remember the 1:1 ratio between naturally occurring testosterone and epitestosterone? Landis apparently came up with a 4:1, or some even say 11:1, ratio in tests done after he won.

According to Hellman, adding synthetic testosterone shuts down the body's manufacture of both the natural products. So the ratio can soar as the synthetic steroid's level rockets past production of the natural epitestosterone. Landis says his test was off because he had been drinking the night before, was dehydrated, and had a lot of testosterone in his body naturally.

Nov. 8, 2006 -- Critics of low-carbohydrate diets claim that they promote heart disease, but one of the first studies to examine the long-term effects of low-carb eating suggests otherwise.

Researchers from the Harvard School of Public Health found no evidence of an association between low-carbohydrate diets and increased cardiovascular risk, even when these diets were high in saturated animal fats.

Low-carb eating even seemed to be protective against heart disease when vegetables were the main sources of fat and protein in the diet.

The study, which appears tomorrow in the New England Journal of Medicine, included almost 83,000 female nurses in the Nurses' Health Study who provided detailed information about their eating patterns once per year for more than 20 years. The nurses were not asked to follow any particular diets.

A clear message from the research was that extreme diets, which severely restrict either fats or carbohydrates, are not the best choices for cardiovascular disease prevention, researcher Thomas L. Halton, ScD, tells WebMD.

Pros and Cons

"Neither a very low-fat diet or a very low-carbohydrate diet proved to be ideal," he says. "There were pros and cons to both of these diets."

Low-fat diets are by definition low in saturated fats, which is good for the heart, Halton says. But they also tend to be higher in refined carbohydrates like sugar and white flour, which spike blood sugar levels.

"Americans tend to pick the wrong carbohydrates," he says. "So the benefits of eating lower amounts of saturated fat and cholesterol are offset to some degree by the poor quality of the carbohydrates they eat."

The most protective diet, in terms of heart disease risk, was a low-carbohydrate that was also low in saturated fats and cholesterol where vegetables were the main sources of fats and protein.

"The vegetable-based low-carbohydrate diet combined the best features of low-fat and low-carbohydrate eating," Halton says.

Following this diet was associated with a 30% reduction in heart disease risk over 20 years.

"The quality of fat and carbohydrate is more important than the quantity," says study researcher Frank Hu, MD, PhD. "A heart-healthy diet should embrace healthy types of fat and carbohydrates."

The Glycemic Load

Hu was talking about carbohydrates that are slow to convert to sugar, or so-called low-glycemic-load foods.

Most fruits, vegetables, whole grains, and nuts have low glycemic loads. Refined white flour and sugar, as well as white rice and potatoes, have high glycemic loads.

Women in the study whose diets had the highest glycemic loads had a 90% increased risk of developing heart disease during the 20 years of follow-up, compared with women whose diets had the lowest glycemic loads.

"This is just one study, but the findings suggest that eating a high-glycemic-load diet may be even more harmful than eating a diet that is high in saturated fat and cholesterol," Halton says.

Frank Sacks, MD, also studies diet and heart disease risk at the Harvard School of Public Health, but he was not involved with the study by Halton and colleagues.

His research also suggests that following a strictly low-fat diet is less protective against heart disease than following a diet that includes fat from vegetable sources like olive and canola oil.

He is currently assessing the cardiovascular risks and benefits of some of the most widely promoted commercial diets, including Atkins, the South Beach Diet, and the Zone.

"One problem with very restrictive diets is that people don't stay on them very long," he says. "It doesn't matter how good they are or how protective they are if people don't follow them."

June 12, 2006 - Want a big fat belly? Eat lots of trans fats.

Trans fats make you fatter than other foods with the same number of calories -- but that's not all. Researchers at Wake Forest University find that trans fats increase the amount of fat around the belly. They do this not just by adding new fat, but also by moving fat from other areas to the belly.

"Trans fat is worse than anticipated," Wake Forest researcher Lawrence L. Rudel, PhD, says in a news release. "Diets rich in trans fat cause a redistribution of fat tissue into the abdomen and lead to a higher body weight even when the total dietary calories are controlled."

Rudel colleague Kylie Kavanagh, DVM, reported the findings at this week's annual meeting of the American Diabetes Association in Washington.

In the study, researchers fed 51 male vervet monkeys a western-style diet -- that is, 35% of their diet was fat. Half the monkeys got a lot of trans fat, totaling 8% of their diet. The other monkeys were fed unsaturated fats such as olive oil.

Both types of diets were calorie-controlled. In theory, the monkeys should not have gained weight.

But they did.

Over six years -- what would, in humans, be a 20-year span -- the monkeys who ate unsaturated fats upped their body weight by 1.8%.

Those fed trans fats packed on 7.2%. In humans, that would be enough weight gain to significantly increase risk of diabetes and heart diseaseheart disease.

"Trans fatty acid consumption increases weight gain," Kavanagh says in a news release. "In the world of diabetes, everybody knows that just 5% weight lossweight loss makes enormous difference. This little difference [of weight gain seen in the study] was biologically quite significant."

Trans fats are found in vegetable shortenings, some kinds of margarine, and in manufactured baked goods such as cookies, crackers, and snack foods. A major source of trans fat in American diets is fast food fried in the stuff.

Nov. 16, 2005 -- Diet drugs can help you lose weight, and so can cutting calories and making other lifestyle changes. But combining the two approaches is far more effective than either approach alone, new research shows.

In the study, obese people who modified their eating and exercise habits and took the drug Meridia lost far more weight than people who relied on either lifestyle modification or medication.

"We found that a combination of the two approaches produced approximately twice the weight loss of either intervention used alone," says researcher Thomas A. Wadden, PhD.

The study appears in the Nov. 17 issue of The New England Journal of Medicine.

Many Rely on Drugs Alone

There are two FDA-approved prescription weight loss drugs being sold in the U.S.: Abbott Laboratories' Meridia and Roche's Xenical. Meridia works by suppressing appetite, while Xenical works in the digestive system to block the absorption of fats.

Both drugs are intended for use as part of a comprehensive program that includes diet, exercise, and behavior therapy. But all too often patients are sent home with prescriptions alone, Wadden says.

"Certainly, the doctors who prescribe these medications recommend that their patients cut calories and increase physical activity, but these recommendations may be left at the office door," Wadden tells WebMD.

In an effort to better understand the effectiveness of the different treatment approaches, Wadden and colleagues followed 224 obese men and women on different weight loss regimens for a year.

One group was prescribed standard doses of Meridia with scheduled 10-15 minute office visits with primary care providers. They received minimal lifestyle recommendations, which consisted of an initial pamphlet and "general encouragement." A second group did not take the drug but did participate in an intensive group lifestyle modification program. These patients attended 30, 90-minute group education and support sessions over the course of a year. They also kept daily records of the foods they ate and their physical activity.

A third group received a combination of the drug, brief visits with a primary care provider, and intensive lifestyle modification group sessions similar to the second group. A fourth group took the diet drug and received additional counseling during regularly scheduled office visits. They also kept food and exercise journals, which were reviewed during their office visits with the primary care provider.

This fourth group was added, Wadden says, to see if doctors can provide enough lifestyle counseling to have an impact on weight loss within the confines of the typical brief office visit.

Diet and Lifestyle Changes Get Best Results

At the end of a year, the patients who took the diet drug and participated in the intensive lifestyle modification program lost the most weight, averaging 26.6 pounds.

The Meridia plus brief, doctor-delivered counseling group lost 16.5 pounds. The group that participated in the intensive program but took no Meridia lost 14.7 pounds, and the Meridia-only treatment group lost 11 pounds.

Wadden says drugs and lifestyle modification complement each other because they address different issues. Support and education programs teach people the tools they need to achieve a healthy weight and the drugs help them take in fewer calories.

Can Doctors Do It?

The findings also suggest that doctors can provide meaningful lifestyle counseling, even during rushed office visits, Wadden adds. Having patients keep daily food and exercise journals, and helping them develop a weight loss plan that met their individual needs were two important components of this counseling.

But Howard Eisenson, MD, who has been on both sides of the issue, is skeptical.

He tells WebMD that he didn't have a lot of success getting patients to lose weight as a private practice family doctor. But he has seen plenty of success stories in his current job as director of Duke University Medical Center's well-known Diet and Fitness Center.

"We have a team approach that includes dietitians, fitness specialists, and behavioral therapists in addition to physicians," he says. "These are people who are very important to the process. I think the physician's role is primarily to be a cheerleader -- to show confidence in the patient's ability to make lasting changes and to follow up."

May 17, 2005 -- Work fatigue and overtime hours may raise the risk of gaining weight, new research shows.

Does that mean that people are seeking solace at the vending machine for their job frustrations? Are they too exhausted to exercise and cook healthy meals in their free time? Do extra pounds mean it's time to update your resume or structure a more balanced life?

Those are big questions, and the answers aren't clear yet. The cycle of eating, emotions, and energy is complex and can reinforce itself. Dissatisfaction in one part of life can spill into other areas and vice versa.

For some people, job angst and long hours may be one piece of the puzzle, suggests a new study in the International Journal of Obesity.

When Work Is a Burden

The study included more than 7,000 women and about 1,800 men working in government jobs in Helsinki, the capital of Finland.

The bureaucrats were asked if they'd gained weight in the last year. They also reported the number of hours they worked and rated their "worker fatigue."

Curious about how you would rate? See how many of these statements you agree with:

• I feel totally worn out after a day at work.
• I feel tired in the morning when I have to get up and go to work.
• I have to work too hard.
• I feel like I'm totally exhausted.
• My work is definitely too stressful.
• I worry about my work even when I'm off duty.

Agreeing with four or more of those statements qualified as high work fatigue. Intermediate work fatigue was defined as agreeing with up to three of those statements. Overtime was working more than 40 hours per week.

Fatigue, Overtime, and Work Dissatisfaction Increase Weight

High work fatigue and working overtime were associated with weight gain in both sexes. The association wasn't stronger for major weight gain (more than 11 pounds), says the study.

Work fatigue was high in 15% of the women and 13% of the men. Overtime was reported by one in five men and 13% of the women.

Almost a quarter of all women (24%) and 19% of men said they had gained weight in the last year.

Women who reported dissatisfaction with their balance between work and home were also more likely to gain weight than women reporting complete or some satisfaction with work.

Among men, those with less demanding jobs were less likely to gain weight.

Unanswered Questions

The researchers -- who included Tea Lallukka of the University of Helsinki's public health department -- say they don't know if their findings apply to other groups of people.

They also don't know what the participants ate or how much they exercised. Perhaps people burning the midnight oil eat more snacks and fast food, write Lallukka and colleagues.

"Those reporting work fatigue might also be too tired to consider a healthy diet and prepare healthy meals, instead replacing them with industrial snacks, fast food, and sweets, behavior associated with weight gain," says the study.

"This same group may be too tired to engage in regular physical exercise, thereby gaining weight," write the researchers.

Since exercise has been shown to help people cope with stress, working out might help smooth out the workday, easing some of that job angst while keeping weight in check.

Nov. 17, 2004 -- Eating slowly may help overweight people lose weight after all, according to a new study that tested the commonly held belief.

The study showed that overweight men and women actually ate less when they ate a slower than usual pace.

Researchers say the study shows that eating slower may assist overweight men and women in their weight loss efforts. Their results were presented this week at the annual meeting of the North American Association for the Study of Obesity in Las Vegas.

Eat Slow, Lose Weight

In the study, 28 overweight men and women ate a lunch of chicken nuggets at their normal pace in order for researchers to establish their habitual eating pattern.

Then over the course of three lunches, researchers varied the pace of the same meal by instructing the participants to take a bite when they heard a computer beep.

In the first lunch, they ate a prolonged meal in which the pace of the entire meal was slowed by 50%. In the second, they ate a decelerated meal in which the pace of only the last half of the meal was decreased by half, and in the final meal they ate at a steady pace.

The participants were told that the computer beeping would last indefinitely and they could eat as much or as little as they wanted.

The study showed that all of the participants ate more during the steady meal than in either of the slower meals. The difference between each of the three meals was largest among the men. However, researchers say only a small number of men were involved in the study (six), and more research is needed to confirm this result.

But they say this study shows that a slower rate of eating results in people eating less, which may help them lose weight.

Aug. 30, 2004 -- The new food pyramid will be out soon, and it's looking very lean.

The government has released the Dietary Guidelines for Americans -- as it does every five years -- to shape the nation's long-standing nutrition advisory, the food pyramid.

"The focus is very clear ... achieving a healthy weight and maintaining it," says Cindy Moore, MS, RD, director of the nutrition therapy department at The Cleveland Clinic and a spokeswoman for the American Dietetic Association.

"The guidelines emphasize the type of calories you consume -- fruits, vegetables, whole grains, lower-fat milk products -- and that makes a lot of sense," Moore tells WebMD. "What's near and dear to my heart, it's educating people on wise carb choices. Not all carbs are villains. Many are in fact very good."

Americans are asked to cut back on sugars, but mostly to help with weight control.

In fact, physical activity and weight control take prominent spots in this year's guidelines. For the first time, the body mass index (BMI) takes a front-and-center spot. So does physical activity.

The food guide's specific messages:

1. To make sure you get all the nutrients and other healthful substances you need, choose the recommended numbers of daily servings from each of the five major food groups.
2. Control calorie intake to manage body weight. Check your weight on WebMD's BMI Calculator. A healthy BMI is between 18.5 and 25.
3. Be physically active every day. Adults need at least 30 minutes of moderate physical activity each day. Children need 60 minutes. Moderate physical activity is any activity that requires about as much energy as walking two miles in 30 minutes.
4. Eat plenty of fruits and vegetables of different kinds -- at least two servings of fruits and three servings of vegetables each day. Certain fruits and vegetables provide more nutrients. Choose whole or cut-up fruits and vegetables rather than juices, which contain little or no fiber.
5. Eating plenty of whole grains, such as whole-wheat bread or oatmeal, can help protect against many chronic diseases, and the fiber in these foods can help you feel full longer. Aim for at least six servings of grain products, including whole grain, per day. Older children or teens, adult men, or active women may need more.
6. All fats are not created equal. Fats supply energy and essential fatty acids, and they help you absorb the fat-soluble vitamins A, D, E, and K. Limit saturated fats because they increase the risk of heart disease. However, unsaturated fats do not raise cholesterol and thus are healthier. Choose from a variety of healthy fats, vegetable oils, fish, and dairy products.
7. Keep saturated fats to less than 10% of your calories and total fat intake to no more than 30% of calories. This will also help you keep the amount of cholesterol you eat each day to less than 300 mg. Choose from low-fat and lean foods to help cut back on saturated fat.
8. Limit daily sodium intake to less than 2,300 mg to reduce the chance of developing high blood pressure. People with high blood pressure and people at higher risk of developing high blood pressure, such as blacks and older adults, may need to cut back even more.
9. Limit foods containing added sugars, which provide extra calories but few vitamins and minerals. Watch out for foods that have added sugars in them.
10. If you drink alcohol, do so in moderation. This means one drink per day for women and two for men. One drink is 12 ounces of regular beer, five ounces of wine, or 1.5 ounces of 80-proof distilled spirits. Drinking more than this can raise the risk of high blood pressure, stroke, and certain types of cancer.

These recommendations will be prepared as reports for the secretaries of Agriculture and Health and Human Services. When approved, they will be used to update the food pyramid.

June 3, 2004 -- Need another reason to eat your fruits and veggies? How about a 40% lower risk of stroke?

Researchers say it's no surprise that fruits and vegetables help prevent stroke, but a new study suggests that it's a particular group of antioxidant vitamins that might be responsible for the foods' healthful effects.

The study showed that men who had the lowest levels of the antioxidants found in fruits and vegetables had the highest risk of ischemic stroke. Ischemic stroke is the most common type of stroke and is caused by a blood clot.

Antioxidant Vitamins Lower Stroke Risks

In the study, researchers compared antioxidant levels in the blood of 297 men who had a stroke to an equal number of men who did not have a stroke. All of the men were participants in the Physician's Health Study and provided blood samples at the start of the study in 1982.

Researchers measured levels of a family of antioxidants found in fruits and vegetables known as carotenoids, which includes vitamin A, alpha-carotene, beta-carotene, lycopene, and lutein, and tocopherols, such as vitamin E.

The study showed that men who were in the bottom fifth for levels of alpha-carotene, beta-carotene, and lycopene had the highest risk of stroke.

Men who were in the top four-fifths had a 40% lower risk of having a stroke than those in the lower fifth in the 13 years that the men were followed.

Researchers say the study provides additional evidence that a diet rich in fruits in vegetables appears to help prevent stroke, but it doesn't necessarily prove that eating fruits and vegetables caused the lower risk.

Jan. 5, 2004 -- Whether your weight-loss strategy espouses carbs with no fat or protein with few carbs, there is one thing your plan most certainly recommends -- water. From the veggie-based Ornish diet to steak-loving Atkins (and virtually all diets in between) "drink lots of water" is part of the mantra.

Now comes scientific evidence that H₂O really does help you lose weight. Researchers in Germany report that water consumption increases the rate at which people burn calories. The impact is modest and the findings are preliminary, but the researchers say their study could have important implications for weight-control programs.

Eight Glasses a Day

Despite the fact that most diets call for drinking at least eight, 8-ounce glasses of water a day, few studies have been done to determine if the practice actually speeds weight loss. In an effort to answer this question, Michael Boschmann, MD, and colleagues from Berlin's Franz-Volhard Clinical Research Center tracked energy expenditures among seven men and seven women who were healthy and not overweight.

After drinking approximately 17 ounces of water, the subjects' metabolic rates -- or the rate at which calories are burned -- increased by 30% for both men and women. The increases occurred within 10 minutes of water consumption and reached a maximum after about 30 to 40 minutes.

The study also showed that the increase in metabolic rate differed in men and women. In men, burning more fat fueled the increase in metabolism, whereas in women, an increased breakdown of carbohydrates caused the increase in metabolism seen.

The researchers estimate that over the course of a year, a person who increases his water consumption by 1.5 liters a day would burn an extra 17,400 calories, for a weight loss of approximately five pounds. They note that up to 40% of the increase in calorie burning is caused by the body's attempt to heat the ingested water. The findings are reported in the December issue of The Journal of Clinical Endocrinology and Metabolism.

"Very, Very Small Effect"

The researchers write that up to 70% of the increase in metabolism, "cannot be attributed to the heating of the ingested water," but exercise physiologist Daniel Moser, PhD, tells WebMD that it is unclear from this small study if this is the case.

"Larger studies are clearly needed to confirm this extremely modest weight-loss effect," he tells WebMD.

Nutritionist and American Dietetic Association spokeswoman Leslie Bonci, MPH-RD, says even if the findings are confirmed the clinical implications are slight.

"Obviously people are looking for ways to increase metabolism, but this is an very, very, small effect," she tells WebMD. "We are talking about just a few calories a day."

Bonci says the standard weight-loss plan dictates encouraging people to drink more water stems from the belief that the liquid fills the gut to make people feel fuller.

"Some plans say that drinking water flushes fat out of your system, which is absolutely ridiculous," she says.

Aug. 8, 2003 -- A mother's eating patterns influence her daughter's diet, especially when it comes to eating high-fat foods, a new study shows.

The study, appearing in the August issue of American Journal of Health Behavior, suggests that mothers who are behaving in health-enhancing or health-compromising ways are teaching these behaviors to their children. The studyshows that there is a significant link between the amount of fat that mothers and their adolescent daughters eat. On the flip side, a mother's fiber intake had no influence on how much fiber her daughters ate.

"Limiting consumption of high-fat snack foods and fast foods may be an important dietary behavior that girls choose to emulate in their mothers in an attempt to diet and control their weight, whereas fiber consumption may not be an area women target when trying to lose weight," Cassandra Stanton, PhD, of Brown University says in a news release.

Stanton's team looked at the diet of 400 mother-child pairs in rural areas of New York and Virginia. The mothers and daughters tracked their daily food intake in a diary during a two-year process. Afterward, researchers calculated the number of grams of fat and fiber in each reported food they ate. Researchers also took into consideration demographics and home environment factors.

Black Children Most Influenced by Mother's Diet

The link between what mothers ate and what their children ate was noticeable only with daughters. The findings showed that the strongest influence was among black mothers and daughters.

The tie between mother-daughter eating habits still leaves some unanswered questions. For instance, if one daughter eats 100 grams of fat a day and another daughter eats 75 grams of fat a day, only 25% of the difference could be related to their mother's fat consumption, while 75% may be caused by other factors.

Researchers say recent evidence shows that only 1% of American children have diets that meet current dietary guidelines, and as much as 45% of children's energy intake comes from sugar and fat. The authors say that there is a "clear need to understand the home environment and it's impact on the establishment of eating behaviors among youth that may put them at risk for life-threatening disease in adulthood."