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Mention "family bed" or "shared sleeping" at any playgroup or cocktail party, and you're likely to spark a flurry of responses, whether it's whispered confessions, raised eyebrows or plain dig-in-your-heels soapbox routines.

You won't get any less of a hodgepodge of opinion from the experts on the practice, also called co-sleeping.

The American Academy of Pediatrics (AAP), the U.S. Consumer Product Safety Commission and many doctors discourage it, mostly due to potential safety hazards, while other child-rearing experts, including pediatric guru William Sears, say the family bed is a healthy, natural setup.

"There are reasons why it's not always going to be the best thing, but it certainly is not inherently bad by any stretch of the imagination, as long as certain basic precautions are taken," says Dr. George Cohen, senior attending pediatrician at Children's National Medical Center in Washington, D.C., and editor-in-chief of the AAP's "Guide to Your Child's Sleep" (Villard, 1999).

The fact is, it's a personal choice that's right for some families and not for others. Sift through the issues and if the "Three's Company" (or Four or Five) approach fits your family, then just be sure to build in some safety measures.

The Family Bed Safety Checklist

Despite the fact that co-sleeping is the norm in almost all cultures around the world, U.S. pediatricians and parents worry most about two things: that a baby will become entrapped in bed or bedding and suffocate, or that an adult will roll over on top of an infant and injure or suffocate the child.

"As comfy and nice and bonding as it might seem, it's very dangerous for the infant," asserts Dr. Douglas Baker, chief of emergency medicine at Yale-New Haven Children's Hospital and member of the AAP's section on pediatric emergency medicine. "We've had three kids in the last three or four months who have been suffocated by co-sleeping."

The U.S. Consumer Product Safety Commission released a controversial study last year, published in the Archives of Pediatrics and Adolescent Medicine, showing an average of 64 deaths per year between 1990 and 1997 among babies under age 2 who slept in adult beds.

But many pediatricians, breast-feeding advocates and others harshly criticized the results, claiming the study was unreliable in large part because it didn't sufficiently consider underlying causes for the deaths or compare like statistics for babies who slept in cribs.

If you do want to share their bed with your children, pediatric experts recommend these safety precautions:

• Make sure your young baby sleeps on his back on a firm surface and avoid placing him on top of soft, fluffy mattresses, waterbeds or comforters and quilts. One of the major risk factors for sudden infant death syndrome (SIDS) is putting babies to sleep on their stomachs, especially on soft bedding or waterbeds.
• To avoid the risk of rolling onto your baby, never share a bed with any infant or young child if you're intoxicated or on prescription or over-the-counter medications that could interfere with your ability to awaken easily, such as antidepressants, sleeping pills and some antihistamines. Obesity is another risk factor for rollover accidents. If you are a smoker, you probably shouldn't share a bed with your baby, because infants of smokers are at increased risk of SIDS and childhood respiratory illnesses.
• Prevent your baby from falling off the bed by placing her between mom and a guardrail, or between both parents. In "The Baby Book" (Little, Brown and Company, 1993), Dr. Sears advises against the latter, saying fathers don't exhibit the same keen awareness of a baby's presence while asleep.
• Make sure the headboard and footboard don't have openings in which a baby's head or limbs could get caught.

June 8, 2005 -- Raisins may be a healthy snack for your teeth as well as your body.

Researchers have found that certain compounds contained in raisins appear to fight the bacteria in the mouth that cause cavities and gum disease.

"Our laboratory analyses showed that phytochemicals in this popular snack food suppress the growth of several species of oral bacteria associated with [tooth decay] and gum disease," says researcher Christine D. Wu, a professor at the University of Illinois at Chicago College of Dentistry.

"Raisins are perceived as sweet and sticky, and any food that contains sugar and is sticky is assumed to cause cavities," says Wu. "But our study suggests the contrary. Phytochemicals in raisins may benefit oral health by fighting bacteria that cause cavities and gum disease."

Wu presented the results at a meeting of the American Society for Microbiology in Atlanta. Her study was funded by the California Raisin Marketing Board.

Raisins: Nature's Cavity Fighters?

In the study, researchers analyzed the chemical composition of Thomas seedless raisins, a common black raisin variety.

Those analysis identified five phytochemicals -- plant antioxidants -- including oleanolic acid.

Laboratory tests showed that this phytochemical slowed or stopped the growth of two different types of bacteria commonly found in the mouth: Streptococcus mutans, which causes cavities, and Porphyromonas gingivalis, which causes gum disease.

Under scientific conditions in the lab, researchers found that oleanolic acid inhibited bacteria growth.

The study also showed that the phytochemical prevented cavity-causing bacteria from sticking to surfaces. This ability may help it prevent bacteria from sticking to teeth and forming plaques that eventually lead to cavities.

It's not clear how many raisins a person would have to eat to benefit from these cavity-fighting and gum disease-fighting benefits.

There's hardly a better time of year than fall. The heat of summer dissipates, giving way to beautiful temperatures framed by a hard, blue sky and canopies of red, gold, and orange.

The crisper smell in the air and the settling down of a busy summer are great indicators that it's time to set goals, re-establish routines, and start creating good habits for the upcoming winter.

"Fall is about gathering strength and energy to prepare for the challenges ahead," says Justin Price, named 2006 Personal Trainer of the Year by the IDEA fitness association.

Don't wait until New Year's Eve over a cocktail to make almost-sure-to-fail promises to yourself for the year ahead. Here are 10 ways you can use this upcoming season to become a fitter and better you.

1. Get fit outdoors. Hiking, mountain biking, walking, and rollerblading are all great picks for fall, says Kelli Calabrese, MS, exercise physiologist, fitness consultant, and author of Feminine, Firm & Fit.

Choose outdoor activities first, she suggests, since in some areas of the country, you'll soon be relegated to the gym and exercise videos.

Things quiet down outdoors now, with children back to school, says Price. Check out some of the parks in your area, or get out on the beach, if, like Price, you're lucky enough to be near one.

Throw the Frisbee around or do some squats and lunges in the sand, while watching the surf. Be creative. Try an outdoor boot camp class for something different.

"If you develop positive strategies now, it will be harder for you to give in to temptation as the holidays and the winter months come around," says Price.

"If you feel good and self-confidence is high, you want to treat yourself right, don't you?" asks Price. "Just by doing physical activity," he says, you'll maintain that self-confidence. "When swimsuit season comes back around, it'll to be easier to lose 10 pounds than 35," he says.

2. Exercise family-style. Pick things you can do as a family, like rock climbing, canoeing, or bowling to keep everyone striving for better health and fitness, she says.

Some of the local parks even have fitness courses you could run through together. Set a family weekend to head to a new state park and check out the foliage or go apple picking, she suggests.

Lots of activities start up in the fall, adds Calabrese, from running and cycling clubs to local classes at the YMCA.

Calabrese encourages you to try it as a family. "Start a martial art, everyone's a beginner together; you all start out as a white belt and progress from there," says Calabrese.

"Don't force family members to do things like go to the gym with you," says Price, but rather, "combine exercise with family activities you already do."

He suggests playing football, basketball, ice-skating or taking a long walk with the dog instead of sitting around the television with rental movies and video games. Join a softball league or soccer team. Take up yoga, tennis, or salsa dancing.

June 23, 2004 -- "Bulking up" your muscles could be a gene away. German researchers have identified a gene that produces a supermuscular "Mighty Mouse."

The finding, which shows promise for people with muscular dystrophy and other muscle-wasting conditions, is explained in the latest New England Journal of Medicine.

In exploring the factors involved in these muscle-wasting diseases, researchers have identified a protein called myostatin. This protein belongs to a "superfamily" of proteins that control muscle growth throughout the body, writes Markus Schuelke, MD, a neuropediatrician with the University Medical Center of Berlin.

Muscle cells with overactive myostatin will die, he explains. But take away the myostatin, and mice in laboratory studies are transformed -- into "Mighty Mouse."

In his laboratory studies, Schuelke developed mice that were stronger and more muscular than other mice. Mighty Mouse had the muscular dystrophy gene (which should have resulted in physical damage to muscles) but without myostatin. It appeared that the lack of the myostatin gene lessened or reversed the effects of the genetic mutation that causes muscular dystrophy.

Other studies involving mice have shown similar results, that when myostatin is "neutralized," muscle growth increases.

This evidence shows that myostatin "plays an important role in regulating muscle growth in adult animals," Schuelke writes.

In this new case report, he describes a German child born with unusually well-developed muscles. Through complex genetic testing, Schuelke and his colleagues identified numerous abnormalities in the myostatin gene that could account for the physical appearance (increased muscle and decreased fat tissue) of the child. The child had a nonfunctioning myostatin gene -- a mutation that has been seen in both mice and cattle produces a similar physique, he writes.

Several family members are reported to be unusually strong, he notes. The child's mother was a former professional athlete.

Now nearly 5 years old, the child is developing fine -- with no health problems observed thus far, he notes.

"Our results suggest the possibility that muscle bulk and strength could be therapeutically increased by the inactivation of myostatin in patients with muscle-wasting conditions," Schuelke writes.

SOURCE: Schuelke, M. New England Journal of Medicine, June 24, 2004; vol 350: pp 2682-2687.

Dec. 4, 2006 -- Calorie restriction might help the body's immune system, researchers report.

The findings are based on lab tests on monkeys, not people.

But the researchers note that other studies have linked calorie restriction and longer life in short-lived organisms including worms, flies, and spiders.

The final verdict isn't in yet on calorie restriction and human longevity.

The study was done by Janko Nikolich-Zugich, MD, PhD, of Oregon Health & Science University, and colleagues.

Nikolich-Zugich's group studied 42 monkeys ranging in age from 19 to 23. That's roughly the same as 60 to 70 in humans, the researchers note.

Fourteen of the monkeys had been on calorie-restricted diets for at least a decade. The study doesn't say exactly how much their calories had been cut, or what they weighed.

For comparison, the other monkeys had followed a normal diet their entire lives.

The researchers took blood samples from the monkeys four times over about four years, waiting at least six months between blood tests.

The scientists focused on T-cells, which are part of the body's immune system.

The blood tests showed the T-cells of the calorie-restricted monkeys were less affected by age than those of the monkeys on a normal diet.

The exact reason for the pattern isn't clear.

The study can't show whether the calorie-restricted monkeys will live longer -- or whether the findings will apply to people.

But if calorie restriction aids the immune system's T-cells, that might lead to better resistance to infection and, ultimately, to longer life, the researchers note.

July 17, 2006 -- Gastric bypass may work better, with fewer complications, than gastric banding for severely obese patients, doctors report in the Archives of Surgery.

That finding comes from Wilbur Bowne, MD, and colleagues. Bowne works in the surgery department at The State University of New York's Health Science Center of Brooklyn, N.Y.

Bowne's team studied 106 people who either got gastric bypass or gastric banding surgery. Both procedures are designed to make people eat less by limiting the amount of food the stomach can hold.

All the patients were extremely obese. Their BMI (body mass index, which relates height to weight) was greater than 50. That's 20 points higher than the BMI cutoff for obesity.

About the Operations

Both operations were done through small abdominal incisions, a technique called laparoscopy.

During the gastric bypass operation, the surgeon creates a smaller stomach pouch that holds less food than a normal stomach. The food passes from the pouch, bypassing part of the small intestine, to the rest of the digestive system.

During the gastric banding procedure, the surgeon places an adjustable band around the stomach, creating two small compartments.

Before and After Surgery

Here are details on the patients before surgery:

• Average age: about 42 years
• Average BMI: about 56
• Average weight before their procedure: 330-346 pounds
• Average amount of excess weight: nearly 200 pounds

The patients, most of whom were women, had their choice of gastric bypass or gastric banding. They got presurgery checkups and counseling about each procedure's risks.

Sixty patients chose gastric banding; the other 46 chose gastric bypass. One surgeon performed all the operations.

The researchers tracked the patients for an average of 16 months.

The gastric bypass group showed several advantages:

• Greater weight loss: BMI dropped by 26 with gastric bypass, 10 with gastric banding.
• Bigger drop in cases of type 2 diabetesand sleep apnea-- two obesity-linked conditions.
• Fewer postsurgery complications.
• Greater patient satisfaction.

The study only included people who were extremely obese, so it's not clear if the results would apply to people who want to lose less weight.

And the results don't mean gastric banding is ineffective. In fact, the researchers write that both operations yielded "satisfactory" weight loss.

The study also doesn't mean gastric bypass is risk-free. Both procedures have serious risks. The study was too short to track longevity effects, the researchers note.

Jan. 3, 2006 -- Fad diets may tell you otherwise, but eating a low-fat, high-carb diet won't make you gain weight.

In fact, women actually lost a little weight when they consistently ate few fats and lots of fruits, vegetables, and grains. The finding is yet another gem mined from the huge Women's Health Initiative study.

Barbara Howard, PhD, of MedStar Research Institute in Washington, and colleagues signed up nearly 50,000 postmenopausal women aged 50-79 for the WHI Dietary Modification Trial. The majority of the women were overweight or obese and were eating diets that got 39% of calories from fat.

Forty percent of the women got intensive training and support in eating a low-fat diet with five or more servings of fruits and vegetables and six or more servings of grains. This training included 18 group counseling sessions in the first year and four sessions per year for the rest of the study. The other 60% of the women were handed a copy of U.S. dietary guidelines.

None of the women -- in either group -- was told to eat less or exercise more. In fact, they weren't specifically told to lose weight.

Even so, in the first year the women trained to eat a healthy diet lost about 5 pounds. After seven and a half years, they still weighed about a pound less than the women in the group who did not receive special training.

"Restricting fat intake does not lead to weight gain," Howard and colleagues conclude. "Long-term recommendations to achieve a diet lower in total and saturated fat with increased consumption of fruits, vegetables, and whole grains, and without focus on weight loss, do not cause weight gain."

The findings appear in the Jan. 4 issue of The Journal of the American Medical Association.

'Underwhelming' Results

The study may well refute the claims of some popular diet gurus that a low-fat diet makes people fat. Indeed, women who ate the least fat lost the most weight.

And there was also evidence that carbs aren't all bad. Women who ate the most vegetables tended to lose more weight than those who ate the least.

But the study results are "somewhat underwhelming," write diet researchers Michael L. Dansinger, MD, and Ernst J. Schaefer, MD, of Tufts University in Boston, in an editorial accompanying the Howard team's report.

Dansinger and Schaefer note that the majority of the women in the study were obese or overweight.

"Weight loss was not a treatment goal [in the study], but perhaps it should have been," they suggest.

The editorialists note that while the study succeeded in getting women to cut their fat intake from 39% to 30% of total calories, it still fell far short of its goal of cutting fat intake to 20% of total calories.

"Is it time to admit defeat? Is U.S. society doomed to be one in which few individuals maintain normal body weight and one-third of adults are obese?" they ask. "Many believe humankind does not have the self-control to counterbalance the forces that create a predictable wave of obesity in technologically advancing societies."

As an answer, Dansinger and Schaefer point to their own recent study in which they compared several different diet plans. None worked much better than another. But they all worked -- for the relatively few people who stuck with the program.

Eating less and exercising more -- what doctors call "lifestyle change" -- really does help people lose weight. That, the editorialists say, means that all hope is not lost.

"Most able-bodied persons who can find a way to overcome the monumental logistical and psychological barriers that prevent the full application of lifestyle change can reverse obesity within months," Dansinger and Schaefer write. "The medical profession and society in general have under-dosed this potent cure by a long shot."

June 13, 2005 -- People who drink diet soft drinks don't lose weight. In fact, they gain weight, a new study shows.

The findings come from eight years of data collected by Sharon P. Fowler, MPH, and colleagues at the University of Texas Health Science Center, San Antonio. Fowler reported the data at?the annual meeting of the American Diabetes Association in San Diego.

"What didn't surprise us was that total soft drink use was linked to overweight and obesity," Fowler tells WebMD. "What was surprising was when we looked at people only drinking diet soft drinks, their risk of obesity was even higher."

In fact, when the researchers took a closer look at their data, they found that nearly all the obesity risk from soft drinks came from diet sodas.

"There was a 41% increase in risk of being overweight for every can or bottle of diet soft drink a person consumes each day," Fowler says.

More Diet Drinks, More Weight Gain

Fowler's team looked at seven to eight years of data on 1,550 Mexican-American and non-Hispanic white Americans aged 25 to 64. Of the 622 study participants who were of normal weight at the beginning of the study, about a third became overweight or obese.

For regular soft-drink drinkers, the risk of becoming overweight or obese was:

• 26% for up to 1/2 can each day
• 30.4% for 1/2 to one can each day
• 32.8% for 1 to 2 cans each day
• 47.2% for more than 2 cans each day.

For diet soft-drink drinkers, the risk of becoming overweight or obese was:

• 36.5% for up to 1/2 can each day
• 37.5% for 1/2 to one can each day
• 54.5% for 1 to 2 cans each day
• 57.1% for more than 2 cans each day.

For each can of diet soft drink consumed each day, a person's risk of obesity went up 41%.

Diet Soda No Smoking Gun

Fowler is quick to note that a study of this kind does not prove that diet soda causes obesity. More likely, she says, it shows that something linked to diet soda drinking is also linked to obesity.

"One possible part of the explanation is that people who see they are beginning to gain weight may be more likely to switch from regular to diet soda," Fowler suggests. "But despite their switching, their weight may continue to grow for other reasons. So diet soft-drink use is a marker for overweight and obesity."

Why? Nutrition expert Leslie Bonci, MPH, RD, puts it in a nutshell.

"You have to look at what's on your plate, not just what's in your glass," Bonci tells WebMD.

People often mistake diet drinks for diets, says Bonci, director of sports nutrition at the University of Pittsburgh Medical Center and nutrition consultant to college and professional sports teams and to the Pittsburgh Ballet.

"A lot of people say, 'I am drinking a diet soft drink because that is better for me. But soft drinks by themselves are not the root of America's obesity problem," she says. "You can't go into a fast-food restaurant and say, 'Oh, it's OK because I had diet soda.' If you don't do anything else but switch to a diet soft drink, you are not going to lose weight."

The Mad Hatter Theory

"Take some more tea," the March Hare said to Alice, very earnestly.
"I've had nothing yet," Alice replied in an offended tone, "so I can't take more."
"You mean you can't take less," said the Hatter: "It's very easy to take more than nothing." Lewis Carroll, Alice's Adventures in Wonderland

There is actually a way that diet drinks could contribute to weight gain, Fowler suggests.

She remembers being struck by the scene in Alice's Adventures in Wonderland in which Alice is offended because she is offered tea but is given none -- even though she hadn't asked for tea in the first place. So she helps herself to tea and bread and butter.

That may be just what happens when we offer our bodies the sweet taste of diet drinks, but give them no calories. Fowler points to a recent study in which feeding artificial sweeteners to rat pups made them crave more calories than animals fed real sugar.

"If you offer your body something that tastes like a lot of calories, but it isn't there, your body is alerted to the possibility that there is something there and it will search for the calories promised but not delivered," Fowler says.

Perhaps, Bonci says, our bodies are smarter than we think.

"People think they can just fool the body. But maybe the body isn't fooled," she says. "If you are not giving your body those calories you promised it, maybe your body will retaliate by wanting more calories. Some soft drink studies do suggest that diet drinks stimulate appetite."

Nov. 23, 2004 -- One of the pitfalls of dieting is that it decreases your metabolism, making it harder to burn calories. But focusing on foods that minimally affect blood sugar may be key to keeping your metabolism revved up.

A new study shows that dieters who decreased calories while concentrating on healthy fats and carbohydrates had higher metabolisms after 10 weeks of dieting. They also reported less hunger than dieters taking in the same number of calories who ate only low-fat foods.

The two groups lost similar amounts of weight. But the findings offer early evidence that eating a so-called low-glycemic diet may overcome the body's natural tendency to slow metabolism when calories are restricted. A low-glycemic diet emphasizes healthy fats and carbohydrates.

The findings are reported in the Nov. 24 issue of the Journal of the American Medical Association.

"Almost anyone can lose weight in the short term -- very few keep it off in the long term," researcher David S. Ludwig, MD, PhD, says. "That has given rise to the notion that the body has a 'setpoint' and that when you diet internal mechanisms work to restore your weight to that setpoint. A low-glycemic-load diet may work better with these internal biological responses to create the greatest likelihood of long-term weight loss."

No Bad Food Groups

The low-glycemic diet is now widely recommended for people who are at high risk for developing type 2 diabetes. Several very popular commercial weight loss plans, including the South Beach diet and Sugar Busters, are based on it.

Instead of banning whole food groups, the diet restricts carbohydrates that are rapidly digested and spike blood sugar and insulin levels. Carbohydrates, such as refined sugar, white bread, white rice, potatoes, fruit juices, and many commercial breakfast cereals are restricted on the diet. These carbohydrates are more likely to leave you feeling hungry shortly after eating.

Whole grains, fruits, vegetables, nuts, and legumes are encouraged in a low-glycemic diet. These foods typically leave you feeling full longer.

The newly published study involved 46 overweight or obese adults who reduced calories while eating either a low-fat or low-glycemic index diet. Both diets provided approximately 1,500 calories a day and were designed to produce a 10% weight loss within six to 10 weeks.

A typical breakfast for the low-fat dieters might include instant oatmeal with skim milk and raisins. Steel-cut oats with blueberries and 2% milk would be substituted for the low-glycemic-load dieters.

Thirty-nine of the dieters lost 10% of their body weight during the study. Resting metabolism of low-glycemic load dieters slowed at about half the rate of low-fat dieters. The low-glycemic group burned about 80 calories more per day than their low-fat counterparts.

The low-glycemic dieters also reported having less hunger. They also had greater improvements in risk factors associated with diabetes and heart disease, including blood pressure, triglyceride levels, and chronic inflammation.

'The Perfect Compromise'

Ludwig tells WebMD that the findings show that a healthy, balanced eating plan offers advantages over fad diets for weight loss.

"For many years we had the low-fat paradigm. It made sense that if you didn't want fat on your body you shouldn't put fat in your body. But the problem was that it didn't seem to work very well and even had some adverse side effects," he says. "In the past few years the pendulum has swung very far in the other direction with the assumption that all carbohydrates are bad."

Ludwig says that while carbohydrate-limiting diets have been proven to promote short-term weight loss, two recent studies show that these dieters tend to regain the weight they lose.

"Both the low-fat and low-carbohydrate approaches are probably too restrictive," he says. "The low-glycemic load approach is the perfect compromise. A diet based on glycemic load may work with the body's own mechanism to allow people to eat a wider range of foods and fill up sooner."

Nutritionist Karmeen Kulkarni, RD, MS, says the low-glycemic-load diet represents a healthy approach to eating. But she adds that Ludwig's study was too small and too short to confirm that it is better than other weight loss approaches. Kulkarni is president-elect of health care and education for the American Diabetes Association.

"These participants were followed very closely and all of their food was weighed and measured, so it is not surprising that they lost weight," she says. "Certainly these findings need to be confirmed in larger, longer studies that do not so closely control food intake."

Ludwig's research team is currently recruiting patients for just such a study, and he hopes to follow participants for a year and a half. Boston residents between the ages of 18 and 35 can learn more about participating in the study by calling (617) 355-2500.

Sept. 21, 2004 -- Add another item to the list of health concerns stemming from obesity. Obese trauma patients are more likely to die from their injuries and suffer multiple organ failure than those who are not obese, according to California researchers.

The finding comes from a study of 242 trauma patients at Los Angeles County and University of Southern California Medical Center in Los Angeles.

Angela Neville, MD, and colleagues noted the patients' body mass index (or BMI -- an indirect measure of body fat) and followed their post-trauma health records. A BMI of 30 or more is considered obese.

Almost 19% of the general U.S. adult population is obese. In this study, 26% of patients were obese.

All the patients were treated for blunt trauma during 2002. Most had been injured in vehicle or motorcycle wrecks, as pedestrians hit by cars, or as victims of assault.

Obesity and Mortality

The obese patients had a twofold higher death rate than nonobese patients, 32% vs. 16%.

"Obesity, as an independent risk factor, carries a nearly sixfold increase in mortality rate," write the researchers in the September issue of the journal Archives of Surgery.

In addition, obese patients had higher rates of multiple organ failure than nonobese patients. Multiple organ failure as the cause of death was twice as frequent in the obese group (35%) compared with the nonobese group (17%).

Similar Patterns

In other respects, the obese and nonobese patients had much in common.

People in both groups usually died of brain injuries or multiple organ failure. They also had "similar demographics, mechanisms of injury, and injury patterns," write the researchers.

No one knows exactly why more obese patients died and/or had multiple organ failure.

Neville's team speculates that obesity may trigger a different inflammatory response to severe trauma, but they acknowledge they just don't have specific answers yet.

However, obesity's general health risks are clear.

"It is well established that obesity predisposes patients to multiple medical conditions," write the researchers.

For instance, coronary artery disease, systemic hypertension [high blood pressure], and heart failure are linked to obesity.

Obesity can also make it tougher to breathe by reducing lung volume. Surgery is more difficult and medical imaging is less reliable on obese patients, say the researchers.

Another study on obesity and trauma is being designed at the Los Angeles County and University of Southern California Medical Center.

June 10, 2004 -- The ancient mariners had scurvy. And apparently, plenty of Americans today have it, too. We're not getting enough vitamin C, the main preventative for scurvy or vitamin C deficiency, researchers say. Could low-carb eating be to blame?

The report appears in the current issue of the American Journal of Public Health.

It provides results from a large nationwide survey, showing that seniors and children get the most vitamin C in their diet. However, men and women aged 25 to 44 get the least -- and are most at risk for developing scurvy.

"A considerable number of U.S. residents are vitamin C deficient," writes researcher Carol Johnston, a professor of nutrition at Arizona State University.

Other studies have shown similar results, she writes. One U.S. study shows that 18% of adults get fewer than 30 milligrams daily of vitamin C. Another study shows that up to 20% of the 13- to 18-year-old group gets fewer than 30 milligrams daily.

Because scurvy is rarely suspected, people with the symptoms -- fatigue, limping, bleeding gums, or swollen extremities -- may not be tested for vitamin C deficiency, she explains. Very often, these patients are misdiagnosed and medicated for other disorders -- not for their vitamin deficiency.

The recommended daily allowance for vitamin C is 75 milligrams for women and 90 milligrams for men. While some people get too much vitamin C in their diets, many others get too little, she says. The body excretes excess vitamin C in the urine.

With the low-carb craze, the vitamin C-rich potato -- once the centerpiece of a healthy diet -- has been pushed aside, notes Althea Zanecosky, MS, RD, a spokeswoman for the American Dietetic Association and professor of sports and nutrition at Drexel University in Philadelphia. She agreed to comment on Johnston's study.

"Potatoes are a great source of vitamin C and other nutrients," Zanecosky tells WebMD. Other vitamin C-rich fruits are also taboo for some people adopting a low-carb diet.

Jan. 13, 2004 -- A single dose of a dietary supplement containing the recently banned ingredient ephedra and caffeine may be enough to trigger potentially deadly changes in heart rhythms.

A new study shows the popular dietary supplement Metabolife 356, which contains both ephedra and caffeine, caused almost immediate increases in blood pressure as well as changes in heart beats that could be potentially fatal.

The FDA announced a ban on the popular diet supplement ingredient ephedra, also known as Ma Huang, on Dec. 30, 2003 and warned consumers to immediately stop buying and using ephedra products.

One Dose May Be Deadly

Researchers say many people are drawn to herbal weight-loss preparations, such as those containing ephedra, because natural products are perceived as safe.

"Unfortunately, the perception of safety may be the result of a lack of data," write researcher Brian F. McBride, PharmD, of the University of Connecticut Schools of Pharmacy, and colleagues.

Questions regarding the safety of ephedra products had been raised by anecdotal cases of sudden cardiac death and stroke, but few studies have examined the safety of these products.

In the study, published in the Jan. 14 issue of the Journal of the American Medical Association, researchers looked at the effects of a single dose of Metabolife 356 containing 12 milligrams of ephedra and 40 milligrams of caffeine in 15 healthy adults. Researchers measured the participants' heart rates and blood pressure before taking the supplement or a placebo, then again one, three, and five hours afterward.

The study showed that after taking a single dose of the supplement the volunteers had higher systolic (the top number of a blood pressure reading) blood pressure (123.5 vs. 118.83 mm Hg) compared with those who took the placebo.

In addition, those who received the single dose of ephedra supplement had a longer QTc interval, which is a measured interval on an electrocardiogram. When prolonged this can lead to abnormal heart contractions.

A QTc interval of longer than 30 milliseconds has been cited as a possible cause of potentially fatal irregular heartbeats that result in sudden cardiac death. Researchers found that 53% of the participants had QTc intervals of at least 30 milliseconds while taking the dietary supplement containing ephedra and caffeine.

Researchers say that since the actual ingredients in Metabolife 356 responsible for these results are not known, people should avoid these and other similar dietary supplements until more information is known about their safety.

Aug. 28, 2003 -- It is one of those mixed health messages that drives people nuts. Experts say eating fish is good for you, but they also warn that levels of mercury in certain types of fish may be dangerous. Now a new study suggests there may be no reason to fear that tuna sandwich or grilled swordfish.

Stanford University researchers report that the chemical form of mercury in the fish we eat is different, and potentially less harmful, than previously thought. They used newly available X-ray technology to identify the specific type of mercury that is present in the muscle tissue of fish. They found that this mercury in fish contains both a carbon atom and a sulfur atom -- potentially making it less dangerous.

Their findings are published in the Aug. 29 issue of the journal Science.

Much of the mercury in fish comes from the burning of coal and mercury-tainted trash. Mercury has been linked to a wide range of nerve problems.

Cautious Optimism

Now that scientists know what is in the mercury, they are in a much better position to accurately study it's health effects, lead researcher Graham George, DPhil, tells WebMD. "Right now, there is reason for cautious optimism that the fish we thought were potentially harmful may not be, but we don't actually know this."

There are 26 different known mercury compounds, each with its own toxic profile. A compound known as methylmercury chloride has traditionally been used to study the toxic properties of mercury in fish. But George and his research team from Stanford's Synchrotron Radiation Laboratory report that the chemical structure in the commonly eaten fish they examined more closely resembled a compound known as methylmercury cysteine.

In as yet unpublished studies, the researchers found that methylmercury cysteine was much less toxic to day-old zebrafish larvae than methylmercury chloride. The next step, George says, is to determine what happens to mercury in the stomachs of mammals that have eaten fish. It is now possible to track mercury as it enters body tissue.

"We are getting ready to do these experiments, and should probably have some answers within a year," says George, who is now with the University of Saskatchewan in Saskatoon, Canada.

No Swordfish, Mackerel, or Shark

The FDA advises women of childbearing years and young children not to eat swordfish, king mackerel, tilefish, and shark -- the fish with the highest levels of mercury. There is also some concern that eating a lot of canned tuna may be harmful, but the FDA has been relatively silent on this issue. An FDA spokesperson tells WebMD that a new advisory designed to clarify the agency's guidelines on mercury in fish and how much fish is OK to eat should be made public by the end of the year.

Results from a nine-year-long human study, published in the spring of this year, should reassure those who worry about levels of mercury in fish. Researchers found no evidence of developmental damage in the offspring of mothers living off the coast of Africa who ate an average of 12 fish meals a week.

Lead researcher Gary J. Myers, MD, of the University of Rochester, says the newly published research may help explain his findings.

"We looked at people who ate about 10 times as much fish as the average American eats, and the fish they ate had mercury levels that were similar to those that Americans eat," he tells WebMD. "We found no evidence that women who eat a lot of fish during pregnancy put their unborn children at risk."

Feb. 10, 2003 -- The buzz over the health benefits of green tea still hasn't converted most die-hard coffee fans, but experts say that tide may be turning. A new taste-test shows people don't have to sacrifice flavor in order to reap the rewards of green teas, and a few simple steps can help make tea time a pleasure for all the senses.

Sales of bottled and gourmet teas have doubled since 1990, and a variety of studies have suggested that tea --especially green teas-- may provide a range of healthy benefits. Although most of these studies are observational, which means they can't prove the exact cause and effect of the tea, many experts now say tea is a good part of a healthy diet.

Tea leaves contain high levels of disease-fighting antioxidants called polyphenols that are thought to fight some types of cancer. Tea might also protect the heart by relaxing blood vessels and preventing blood clots. Finally, at least two studies have suggested that the fluoride and phytoestrogens in tea may increase bone density and reduce the risk of fractures from osteoporosis.

But now let's get down to the real nitty-gritty: the taste. In a new report in the March issue of Consumer Reports, researchers rated the flavor and aroma of 19 green teas, and laboratory tests evaluated the caffeine content of each of the brews. None of the teas scored an "excellent" rating by the taste-testers, but three were rated very good, including Tazo China Green Tips, Varietal Full Leaf (loose); TenRen Dragon Well; and Tazo China Green Tips, Varietal.

Supermarket teas such as Bigelow decaffeinated, Celestial Seasonings, Lipton and Salada were rated good, not great, and Bigelow caffeinated and Twinings Original were just fair.

Researchers say the best green teas should offer a balance of fresh tasting floral, grassy or vegetable-like "green" notes and slightly bitter or astringent qualities that can add bite and freshness. Green teas are the least processed type of tea leaves, which means they tend to be lighter in color and more delicate in taste than black teas.

Caffeine levels of green teas were generally much lower (about 14mg to 37 mg per eight-ounce cup) compared to black teas (50 mg per cup) or coffee (140 mg per cup).

Costs of the teas varied widely, but researchers say that unlike wine, even rare teas are an affordable luxury. A pound of the most treasured tea may cost up to $300 a pound, but that amount yields about 200 cups, which is less than $1.50 a cup. The top rated teas in this report ranged from 12 cents to 35 cents per cup.

Researchers say following these six steps can help bring out the best of any green tea:

• Buy a little tea at a time - Tea turns stale within six months to a year.
• Keep air out - Non-clear glass, metal or ceramic containers are best for storage. Tea can absorb other flavors and odors, so keep teas away from other spices and out of plastic containers.
• Use good water - Use cold, good-tasting tap water or bottled water. Hard water can add a mineral taste to delicate green teas, and water left sitting in a kettle overnight will dampen the tea's flavor.
• Don't boil - Green tea should be brewed at a lower temperature than black teas because it's more delicate. Pour the water just before it boils.
• Follow directions - Follow the instructions from the store or package regarding how long to steep and how much tea to use. In general use about one teaspoon of loose leaves or one bag per eight ounces of water and brew for about two to three minutes.
• Let tea breathe - The leaves need enough room to unfurl and swirl in the basket, tea infuser, or filter used. Tea balls usually don't offer enough space and an open-topped infuser is usually a better choice because it lets leaves float freely.

SOURCE: Consumer Reports, March 2003.

In the Minneapolis-St. Paul, Minn., school system, seventh graders in 16 schools who participated in a program aimed at getting them to eat more fruits and vegetables -- and eat food that had less fat -- actually changed their eating habits, reports Amanda S. Birnbaum, PhD, MPH, an epidemiologist with the University of Minnesota.

What worked? Fruit-and-veggie tasting sessions, tips in preparing healthy snacks, sessions to help kids look for fat in popular foods such as pizza, chips, and fast food. Also, student-elected "peer leaders" helped conduct the sessions. And small cash incentives -- $10 coupons -- were sent home to encourage parents to serve healthier food for dinner.

In the end, the peer leaders reported eating nearly a full extra serving of fruits and veggies daily. The other students reported almost a 1/2-serving daily increase.

However, kids who participated in a trimmed-down version of the nutrition program -- one that encouraged them to choose healthy foods in the lunchroom -- didn't make as much progress.

In the El Paso elementary school system, a three-year physical education/nutrition program had similar results -- though not as dramatic, says study author Edward M. Heath, PhD, a researcher in the Department of Health, Physical Education, and Recreation at Utah State University.

In third, fourth, and fifth grades across the school district, PE programs were beefed up to include more moderate and vigorous activity. Also, cafeteria managers were challenged to cut the fat and sodium from breakfast and lunch meals.

After one year, all schools showed significant improvements in moderate-to-vigorous physical activity. Many schools also showed reductions in fat in school breakfasts and lunches -- although not all schools made changes.

"Despite the challenges, it appears that there is a particular need for nutrition intervention for students in the middle grades, and with support, they are able to make healthful changes in their eating behavior," says Birnbaum in a news release.

Eat nine servings of fruits and vegetables a day. Choose whole-grain, nonfat, or low-fat foods. Be physically active daily. Watch calories. Limit the fat. Get enough calcium.

We live in a world with a dizzying amount of scientific research pointing to foods and habits that make for good health. In an ideal universe, that's good news. If we exercise and eat right, we give our bodies essential nourishment and movement to work at their best.

Yet our world is far from ideal. There are responsibilities, deadlines, and food or lifestyle preferences that get in the way of healthy eating. Real life happens, and in the rush to satisfy daily hunger and desires, we may succumb to less-than-healthy choices.

It doesn't always have to be that way. No matter what our lives are like, there's always room for improvement.

"There is always something positive that can be done for our health," says Sue Moores, MSRD, spokeswoman for the American Dietetic Association (ADA). "Maybe it's eating an extra fruit a day, maybe it's cooking a food a different way, or maybe it's (trying) a new food that's out that we didn't know much about because of all the ethnic influences."

Making an effort to eat healthy does not mean abandoning our lives. Find a few minutes to think about a small nutrition goal, how you think you can reach it, and what can prevent you from success. Then devise a plan.

Without this vital planning stage, all good intentions can be for naught. "People need to spend just a little bit of effort planning ahead so that they just don't wait until the last minute until they're ravenously hungry and then make poor choices," says Tara Gidus, RD, also a spokeswoman for the ADA. She says people think preparing for a healthy diet takes a lot more effort than it really does.

To make it easy for aspiring healthy eaters, WebMD has put together a list of common obstacles that get in the way of good nutrition, and asked the experts for some advice on how to overcome these road blocks.

What It Is

The Grapefruit Diet, has been around a long time -- since at least the 1930s. A short-term, quick weight loss plan also known as the Hollywood Diet or the Mayo Diet (not associated with the Mayo Clinic), the Grapefruit Diet surprisingly has survived the test of time, being circulated by word of mouth, online and in book form -- yet no one claims ownership of the plan.

The premise of the Grapefruit Diet is based on an alleged "magical" ingredient in grapefruits, that, when eaten with protein, theoretically triggers fat burning and causes weight loss. The diet is designed to promote fast weight loss; unfortunately, the weight lost is primarily from fluids and not fat and generally returns as soon as the dieter goes off the diet.

The seeds of the Atkins Diet may have been sown by the food choices of the wacky, very low calorie, low carbohydrate, high protein Grapefruit Diet.

Most versions promise a 10-pound weight loss during the 12-day diet. Dieters who want more than 12 days of monotony must wait two days before starting the diet again. Exercise is recommended in some versions and absent in others. Long-term weight control is not part of the diet plan.

What You Can Eat

In most versions of the Grapefruit Diet, a small variety of foods are required at breakfast, lunch, dinner, and at bedtime. Dieters are encouraged to drink black coffee and plenty of water throughout the day.?

Sample Meal Plan:

* Breakfast

2 eggs, 2 slices of bacon, black coffee, 1/2 grapefruit or 8 ounces grapefruit juice

* Lunch

Salad with salad dressing, unlimited meat, and 1/2 grapefruit or 8 ounces grapefruit juice

* Dinner

Red or green vegetables (except starchy ones such as peas, beans, corn, sweet potatoes) or salad, unlimited meat or fish, and 1/2 grapefruit or 8 ounces grapefruit juice

* Bedtime snack

8 ounces skim milk

In the Grapefruit Diet you can use all the butter and salad dressing you desire and prepare foods in any method, including fried. Grapefruit juice must be unsweetened. Any food or beverage not on the diet is not allowed. Snacking is only permitted after dinner. Drink 64 ounces of water daily. Eat all of the approved foods.

How It Works

This low-carbohydrate, moderate-protein diet is another low-calorie diet averaging 800-1,000 calories in most versions. Most people will lose weight -- with or without grapefruit on the Grapefruit Diet -- when calories are dramatically reduced to this level. Unfortunately, there are no explanations for how the mysterious grapefruit enzyme works and why it is only contained in grapefruit and not other citrus fruits.

No scientific studies to date substantiate grapefruit's power to burn fat.

One small study published in 2006 and funded by the Florida Department of Citrus found that the addition of a half grapefruit or 4 ounces of juice with meals resulted in an average weight loss of more than 3 pounds in 12 weeks, with some participants losing 10 pounds. Researchers suspect the addition of grapefruit to the otherwise healthy meals reduced insulin levels and promoted a small weight loss. Study participants also "slightly enhanced" their physical activity, which could also explain the weight loss.

While grapefruit is a very nutritious low-calorie fruit (66-84 calories per serving), loaded with vitamin C and fiber, it is not a mysterious fat burner. The low glycemic index, high fiber, and low calorie nature of the fruit may reduce insulin levels and help dieters feel full and eat fewer calories. Beyond that, no magic appears to be at work with the Grapefruit Diet. Experts say one small study is not enough to pin magical powers on this fruit.

May 6, 2004 -- Several large food companies are defending their roles in the nation's obesity epidemic saying that they are moving to provide healthier alternatives to a dangerously overweight U.S. population.

Representatives from some of the nation's biggest food purveyors say that their firms are responding to calls from policy makers to help America slim down, and that the moves even make good business sense.

But consumer groups remain highly skeptical, arguing that the companies are acting only to improve public relations and to avoid government action.

Businesses have been under increasing scrutiny for their role in providing high-calorie, high-fat food to an increasingly sedentary public. Federal agencies, including the FDA, have turned an eye to food labels and nutrition information, arguing that they do not do enough to alert consumers to the fat-causing effects of many foods.

Officials have been spurred by alarming reports about the size of America's obesity problem. As many as 61% of all U.S adults are classified as overweight or obese, according to federal figures. A CDC study released in March concluded that obesity is to blame for more than 400,000 deaths each year and that it would soon pass smoking as the nation's leading cause of preventable death.

Food Companies Stepping In

Food companies say now that the alarming trends have gotten their attention.

PepsiCo, which along with soft drinks sells many popular food brands, including Frito Lays potato chips and Quaker Oats, has begun a company-wide revamp designed to make some of its products healthier, says Brock Leach, the company's senior vice president for new platforms.

"There's a lot going on in our product portfolio. A lot of it is about reducing calories and reducing sugar," he told an audience at a nutrition conference sponsored by the Consumer Federation of America.

PepsiCo has moved to lower sugar content in some juices under its Tropicana brand and has lowered calories in some of its oatmeal bars. The company is also trying to eliminate trans fats from its products, though, "it's hard" with its large line of potato chips, Leach says.

The product changes are less a result of social conscience and more one of business opportunity, he says. Sales of foods the company classifies as "good for you" or "better for you" grew 10% last year, more than twice as quickly as "indulgence" foods of little or poor health value.

Fast-food giant McDonalds is also adding healthier choices to its menus and trying to encourage customers to exercise more, says Shelly Rosen, senior director of the company's "Eat Smart" program.

The company's phase-out of super-sized meals in 13,000 U.S. restaurants will be complete by December, she says. In addition, restaurants will soon begin allowing customers to choose fruit instead of high-fat French fries in combination meals. The company today is launching "adult" Happy Meals in Dallas that include a salad, a pedometer, and an exercise guide.

"What we're trying to do is create a social awakening on how important it is to have energy balance," Rosen says.

Advocates Are Skeptical

Industry critics remain skeptical of the moves. Consumer groups have long called for tougher regulation of nutrition labeling and curbs on food advertising directed at young children, moves they say are still lacking.

Michael Jacobs, executive director of the Centers for Science in the Public Interest, says that major food and restaurant companies continue to stonewall on changes key to addressing the obesity epidemic. Fast-food restaurants have mostly resisted calls to place easy-to-read calorie information on menu boards, and many food processors continue to spend billions marketing aggressively to young children who are still forming dietary habits, he argues.

"Much of what the food industry is doing is simply public relations," he says. "What the industry is trying to do is respond to all the public criticism. Their efforts will disappear as soon as the criticism disappears."

Carol Tucker Foreman, head of food policy at the Consumer Federation of America, praised the efforts of some companies, but said firms still encourage Americans to overeat.

"You barrage American consumers with constant advertising, especially children," she says.

Leach said that his company already does not direct advertising to pre-school-aged children and the company is reviewing its marketing practices.

Michael Mudd, Kraft's executive vice president for global corporate affairs, suggests that industry has yet to address the issue adequately. "I think the marketing practices question is less resolved. It's critical," he says.

Most women reach a point where they taper off eating cheese fries and fix salads instead -- but nutritionists say there is more to "eating your age" than that.

People of any age need certain core foods, points out Miriam E. Nelson, PhD, director of the Center for Physical Activity and Nutrition at Tufts University in Boston. These are fruit, vegetables, whole grains, protein, and certain fats. They provide vitamins, minerals, antioxidants, and phytochemicals that build strong bodies and stave off diseases such as cancer and heart disease.

How to get these -- and how much of them to eat -- depends on age and level of activity. You must eat less as a grownup than you did when you were younger.

In the teen years, most girls are pretty active. "Even though they are still growing, most American teens get enough protein," says Samantha Heller, MS, RD, senior clinical nutritionist at New York University Medical School, pointing to an otherwise regrettable intake of hamburgers.

Calcium is important during the teen years because the bones that will support you for a lifetime are being built up. "Some kids, especially girls, do not get enough calcium," says Audrey Cross, PhD, assistant clinical professor of nutrition at the Columbia University School of Public Health. "They need four servings a day of dairy or dark green vegetables such as spinach, broccoli, kale, or collards." Cereal with milk, a colorful salad at lunch, rice tossed with red and yellow peppers, chicken, a glass of milk with dinner, maybe a bowl of frozen yogurt later -- it adds up. "But some girls think dairy is 'fattening,' forgetting about skim milk and nonfat yogurt. Teens should drink skim milk instead of soda."

"Kids do not get enough vegetables," Heller agrees. "The best way to be sure kids eat enough is have veggies in the house and set a good example. Kids need to see parents eating a couple of vegetables [as well as beans, tofu, and nuts] with their meals." The beauty part of this is once the kids get "the habit," they will carry it over and show their own kids how it's done.

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.

Sept. 2, 2004 -- Being in a bad mood may make you a better eyewitness than someone who is happy, according to a new study that shows mood may have a powerful effect on memory.

Researchers found that being in a good mood made people more likely to include misleading details in eyewitness accounts. But being in a bad mood allowed them to give a more accurate account of events.

"It shows that our recollection of past events are more likely to be contaminated by irrelevant information when we are in a positive mood," says researcher Joseph Forgas, a professor at the University of New South Wales in Australia, in a news release. "A positive mood is likely to trigger less-careful thinking strategies."

Researchers say remembering personally witnessed events involves a series of complex processes that are open to a variety of influences and distortions, and this study shows that mood may play a major role in these processes and affect critical thinking skills.

"The finding makes sense in evolutionary terms," says Forgas. "Animals that are wary of their environment are more likely to perceive threats to their survival."

"This supports the idea that mood states are evolutionary signals about how to deal with threatening situations. That is, a negative mood state triggers more systematic, more attentive, more vigilant information processing," says Forgas. "By contrast, good moods signal a benign, nonthreatening environment where we don't need to be so vigilant."

Bad Moods May Improve Memory

In the study, researchers tested the ability of people to recall events under experimental conditions and in different mood states.

The results are scheduled to appear in an upcoming issue of the Journal of Experimental Social Psychology.

In one experiment, researchers had students witness a staged hostile exchange between a teacher and an intruder in a lecture hall. One week later, researchers used short, 10-minute videotapes to induce happy, neutral, or sad moods among the students. They were later asked to answer a questionnaire about the episode they witnessed that either did or did not contain misleading information. The researchers found they were more likely to recall the incident accurately a week later if they watched the sad videotapes than the happy one.

In another experiment, researchers put participants in a good or sad mood and then asked them to write down an argument in favor of a particular proposition. When the researchers analyzed the arguments for quality and persuasiveness, they found those written by students in a negative mood were far more effective than those penned by people in a happy mood.

Although the study showed that happy people made less-reliable witnesses, it also showed that being in a good mood increased people's confidence in the accuracy of their memory. Researchers say this finding shows that people are unaware of the effect their mood may have on how their mind may interpret or recall events.

Researchers say the study shows that being in a good mood increases the likelihood that false information will later be remembered as true and may have implications for forensic science and judicial proceedings that rely on eyewitness accounts.

June 18, 2003 -- All FDA approved drugs for Alzheimer's disease are used to treat memory loss and other symptoms of the condition. But a new study involving one of the drugs -- Exelon -- suggests for the first time that they may also slow disease progression.

Researchers found that Alzheimer's patients who dropped out of one of three 26-week trials evaluating Exelon had delayed deterioration in mental function, even though they only took the medication for a few months. Their disease progressed more slowly than patients in the placebo arm of the study who never took Exelon, lead researcher Martin Farlow, MD, of the Indiana University School of Medicine, tells WebMD.

Farlow says the findings suggest a possible effect in delaying the biological progression of Alzheimer's disease. The study appears in the June issue of the journal Archives of Neurology.

"This study clearly shows that even exposure for a short time -- two, three, or four months -- can have an impact on disease progression," he says.

More than 4 million Americans have Alzheimer's disease, and that number could increase to more than 14 million over the next few decades, according to the Alzheimer's Association.

Although the trial only involved the Novartis Pharmaceutical's drug Exelon, other FDA-approved drugs for Alzheimer's -- Pfizer's Aricept, Warner Lambert's Cognex, and Janssen Pharmaceutica's Reminyl -- have similar mechanisms of action. All of these drugs boost levels of the neurotransmitter acetylcholine, which is instrumental in brain function, and all are approved for people with mild-to-moderate disease.

"It makes scientific sense that these drugs which impact acetylcholine levels would delay disease progression, but we haven't had the clinical data to tell us for sure if this is the case," Alzheimer's Association Vice President for Medical and Scientific Affairs Bill Thies, PhD, tells WebMD.

"This research is an interesting way to look at the question, but I don't think that it settles the matter at all. It certainly doesn't change the fact that none of these medications stop the progression of Alzheimer's disease."

Other Drugs in the Pipeline

But research is looking at other drugs for battling Alzheimer's disease. The FDA is considering approval of one of the first in a different class of Alzheimer's drugs. If approved, the drug memantine would be the first treatment available for patients who are in the later stages of Alzheimer's disease. Already approved in Europe, memantine targets a chemical in the brain known as glutamate.

Farlow and colleagues reported the results of a study combining memantine and Aricept three months ago at the annual meeting of the American Academy of Neurology in Hawaii. They found that patients on the combination treatment fared better over the six-month trial period than patients treated with Aricept alone, and they also tolerated the therapy better.

Thies says the combination approach is likely to be the first-line treatment for Alzheimer's disease as soon as memantine wins government approval.

"Because these drugs have different mechanisms of action, my guess is that they will be used together very quickly," he says. "One reason for this is that memantine seems to ease the gastrointestinal distress that is a common side effect of the other drugs. It may be a matter of patient preference as much as anything else."

Dec. 5, 2000 -- Nausea and vomiting -- never a lot of fun -- can be among the most distressing and disabling side effects of chemotherapy for breast cancer patients. Now, researchers at the NIH have shown that a variation of the traditional Oriental medical practice of acupuncture, along with commonly used medications, may help.

"The results of our study suggest that among patients receiving high-dose chemotherapy, electroacupuncture was more effective in controlling vomiting than just medication alone," says Joannie Shen, MD, MPH, research associate at the NIH, whose study appears in the Dec. 6, 2000 edition of TheJournal of the American Medical Association. Electroacupuncture uses a mild electric current passed through traditional acupuncture needles placed lightly into specific points on the body.

However, it's not known from the study whether acupuncture would be as effective in women receiving standard dose-chemotherapy, she tells WebMD.

In the study, over 100 breast cancer patients receiving high-dose chemotherapy all received drugs commonly used to control nausea and vomiting. But one group of women also received electroacupuncture in addition to the drugs, and another group received drugs and minimal needling -- a kind of "sham" acupuncture intended to mimic the real thing. A third group received only the drugs and no acupuncture, according to the report.

Shen and her colleagues found that those women who had received electroacupuncture had fewer vomiting episodes than the women who only received drugs. Even the women who got the "minimal needling" did somewhat better than the women who only got drugs, she reports.

That suggests that some of the response to acupuncture could be explained by the "placebo effect" -- the concept that some patients will get better even without getting the real treatment, perhaps just from receiving more attention from caregivers. However, the acupuncture and the minimal needling was terminated at five days, and when Shen and colleagues went back to look at how the patients were faring on the ninth day, there were no longer significant differences between the three groups.

That's important, Shen says, because it supports the idea that acupuncture really had an effect on the body. "We were skeptical at the beginning, thinking that maybe it was just the extra attention, so that's why we did the follow-up," Shen tells WebMD. "It's the strongest part of our study."

Still, Shen notes that the placebo effect cannot be entirely dismissed. As for the physical effects of acupuncture, Shen says scientists believe that the ancient Chinese practice may have effects on neurotransmitters -- chemicals in the brain that control the body's response to substances that can cause vomiting.

Shen's study adds to a growing body of evidence. A 1997 NIH Consensus Statement on Acupuncture stated that "promising results have emerged" showing effectiveness of acupuncture in easing nausea and vomiting after surgery and chemotherapy.

Ian Cyrus, director of acupuncture and oriental medicine at the center for integrative medicine at Thomas Jefferson Hospital in Philadelphia, says the study corroborates what he has learned in his own practice treating cancer patients receiving chemotherapy, and that is that acupuncture works.

"It definitely makes a difference in the quality of life with respect to controlling vomiting," says Cyrus, who has treated thirty chemotherapy patients this year.

"The study clearly demonstrates the benefits of acupuncture when compared to those who are not receiving it," Cyrus tells WebMD. "The key here is that acupuncture does work, and patients receiving acupuncture and drugs receive extra benefit. This should be considered part of the entire treatment strategy for cancer patients receiving chemotherapy."

Cyrus tells WebMD that he believes acupuncture is no longer considered eccentric or out of the mainstream, but has arrived in American medicine. And he says acupuncture alone does not convey the scope of what Oriental medicine has to offer American medicine and western patients. "Acupuncture is only one modality in a family of modalities offered by Oriental medicine," he tells WebMD.

But he says that with conditions like chemotherapy-induced vomiting, it's best used in combination with western style medicine. "Studies like this clearly illustrate that acupuncture does have a significant benefit when used in conjunction with other western pharmaceutical approaches," Cyrus says. "That's the key, it is complementary."

Thumbsucker, an indie movie that generated a lot of buzz at this year's Sundance Film Festival, is the story of a boy trying to kick his thumb-sucking habit at age 17. Walter Kirn, upon whose novel the film is based, has admitted that the story is to some extent autobiographical.

He was a teenaged thumb sucker, but now, in his 40s, he no longer indulges habitually.

That's not the case for Harvey, who at age 55 still enjoys sucking his thumb. Harvey, a retail store owner in Long Island, N.Y., prefers not to disclose his last name for fear of ridicule.

Adult thumb suckers are not big babies, Harvey says. "There's a lot of them who are quite successful, with adult responsibilities," he tells WebMD.

But people are likely to see adults who suck their thumbs as immature. After all, most of us abandon the practice by age 8, according to the American Academy of Pediatrics.

Shame and Tolerance

"There is a sense of embarrassment and humiliation from it," says Alan Manevitz, MD, a specialist in family psychiatry at Weill Cornell Medical College and New York-Presbyterian Hospital in New York City.

"The question is, why do we feel so strongly about this? I think people react to this similarly to the way they feel when they see public breastfeeding, or when they hear that parents sleep with the kids beyond a certain age," he tells WebMD.

Some adults who suck their thumbs aren't afraid to flaunt it, like Lindsey Boyes, 22, of Marietta, Ga. "For a while there, around middle school and high school, it was kind of embarrassing," he tells WebMD.

Even then, his friends came to accept it, and he has since gotten over any shame. It hasn't interfered with his love life, either. His wife, he says, "actually finds it quite cute."

Both Harvey and Boyes say they don't want to quit.

"It's just a very comforting and calm feeling," Boyes says. "Nothing else I've ever done or experienced can give me that same feeling."

"Most people who describe the sucking feel that it soothes them, calms them, gives them comfort, focuses them," Manevitz says.

What's the Harm in Thumb Sucking?

Manevitz says there is nothing inherently pathological about thumb sucking. An adult or adolescent thumb sucker is not necessarily any more deranged than a pen chewer or a nail biter.

"If somebody bites their nails, we may say that's a bad habit, or even that it's disgusting, but we don't see it as psychologically so damaging," he says.

But it can be a problem, he says, "if it's used in the way any habit is used to isolate somebody or restrict somebody from intimacy and other connections."

Everyone, except perhaps some Zen masters, clings to one thing or another for comfort. Thumb sucking is arguably a healthier means of seeking solace than polishing off a quart of ice cream or a pack of cigarettes.

Thumb sucking causes dental problems for some, but not all those who do it for a long time. The teeth may move and flare out where the thumb is habitually placed, but whether or not that happens depends on how hard and how often the person sucks.

"I had an overbite for a long time, and I had braces to correct it," Boyes says. The overbite was a direct result of thumb sucking, and it came back after his braces came off.

June 23, 2004 -- "Bulking up" your muscles could be a gene away. German researchers have identified a gene that produces a supermuscular "Mighty Mouse."

The finding, which shows promise for people with muscular dystrophy and other muscle-wasting conditions, is explained in the latest New England Journal of Medicine.

In exploring the factors involved in these muscle-wasting diseases, researchers have identified a protein called myostatin. This protein belongs to a "superfamily" of proteins that control muscle growth throughout the body, writes Markus Schuelke, MD, a neuropediatrician with the University Medical Center of Berlin.

Muscle cells with overactive myostatin will die, he explains. But take away the myostatin, and mice in laboratory studies are transformed -- into "Mighty Mouse."

In his laboratory studies, Schuelke developed mice that were stronger and more muscular than other mice. Mighty Mouse had the muscular dystrophy gene (which should have resulted in physical damage to muscles) but without myostatin. It appeared that the lack of the myostatin gene lessened or reversed the effects of the genetic mutation that causes muscular dystrophy.

Other studies involving mice have shown similar results, that when myostatin is "neutralized," muscle growth increases.

This evidence shows that myostatin "plays an important role in regulating muscle growth in adult animals," Schuelke writes.

In this new case report, he describes a German child born with unusually well-developed muscles. Through complex genetic testing, Schuelke and his colleagues identified numerous abnormalities in the myostatin gene that could account for the physical appearance (increased muscle and decreased fat tissue) of the child. The child had a nonfunctioning myostatin gene -- a mutation that has been seen in both mice and cattle produces a similar physique, he writes.

Several family members are reported to be unusually strong, he notes. The child's mother was a former professional athlete.

Now nearly 5 years old, the child is developing fine -- with no health problems observed thus far, he notes.

"Our results suggest the possibility that muscle bulk and strength could be therapeutically increased by the inactivation of myostatin in patients with muscle-wasting conditions," Schuelke writes.

SOURCE: Schuelke, M. New England Journal of Medicine, June 24, 2004; vol 350: pp 2682-2687.

Dec. 4, 2006 -- Calorie restriction might help the body's immune system, researchers report.

The findings are based on lab tests on monkeys, not people.

But the researchers note that other studies have linked calorie restriction and longer life in short-lived organisms including worms, flies, and spiders.

The final verdict isn't in yet on calorie restriction and human longevity.

The study was done by Janko Nikolich-Zugich, MD, PhD, of Oregon Health & Science University, and colleagues.

Nikolich-Zugich's group studied 42 monkeys ranging in age from 19 to 23. That's roughly the same as 60 to 70 in humans, the researchers note.

Fourteen of the monkeys had been on calorie-restricted diets for at least a decade. The study doesn't say exactly how much their calories had been cut, or what they weighed.

For comparison, the other monkeys had followed a normal diet their entire lives.

The researchers took blood samples from the monkeys four times over about four years, waiting at least six months between blood tests.

The scientists focused on T-cells, which are part of the body's immune system.

The blood tests showed the T-cells of the calorie-restricted monkeys were less affected by age than those of the monkeys on a normal diet.

The exact reason for the pattern isn't clear.

The study can't show whether the calorie-restricted monkeys will live longer -- or whether the findings will apply to people.

But if calorie restriction aids the immune system's T-cells, that might lead to better resistance to infection and, ultimately, to longer life, the researchers note.

Jan. 3, 2006 -- Fad diets may tell you otherwise, but eating a low-fat, high-carb diet won't make you gain weight.

In fact, women actually lost a little weight when they consistently ate few fats and lots of fruits, vegetables, and grains. The finding is yet another gem mined from the huge Women's Health Initiative study.

Barbara Howard, PhD, of MedStar Research Institute in Washington, and colleagues signed up nearly 50,000 postmenopausal women aged 50-79 for the WHI Dietary Modification Trial. The majority of the women were overweight or obese and were eating diets that got 39% of calories from fat.

Forty percent of the women got intensive training and support in eating a low-fat diet with five or more servings of fruits and vegetables and six or more servings of grains. This training included 18 group counseling sessions in the first year and four sessions per year for the rest of the study. The other 60% of the women were handed a copy of U.S. dietary guidelines.

None of the women -- in either group -- was told to eat less or exercise more. In fact, they weren't specifically told to lose weight.

Even so, in the first year the women trained to eat a healthy diet lost about 5 pounds. After seven and a half years, they still weighed about a pound less than the women in the group who did not receive special training.

"Restricting fat intake does not lead to weight gain," Howard and colleagues conclude. "Long-term recommendations to achieve a diet lower in total and saturated fat with increased consumption of fruits, vegetables, and whole grains, and without focus on weight loss, do not cause weight gain."

The findings appear in the Jan. 4 issue of The Journal of the American Medical Association.

'Underwhelming' Results

The study may well refute the claims of some popular diet gurus that a low-fat diet makes people fat. Indeed, women who ate the least fat lost the most weight.

And there was also evidence that carbs aren't all bad. Women who ate the most vegetables tended to lose more weight than those who ate the least.

But the study results are "somewhat underwhelming," write diet researchers Michael L. Dansinger, MD, and Ernst J. Schaefer, MD, of Tufts University in Boston, in an editorial accompanying the Howard team's report.

Dansinger and Schaefer note that the majority of the women in the study were obese or overweight.

"Weight loss was not a treatment goal [in the study], but perhaps it should have been," they suggest.

The editorialists note that while the study succeeded in getting women to cut their fat intake from 39% to 30% of total calories, it still fell far short of its goal of cutting fat intake to 20% of total calories.

"Is it time to admit defeat? Is U.S. society doomed to be one in which few individuals maintain normal body weight and one-third of adults are obese?" they ask. "Many believe humankind does not have the self-control to counterbalance the forces that create a predictable wave of obesity in technologically advancing societies."

As an answer, Dansinger and Schaefer point to their own recent study in which they compared several different diet plans. None worked much better than another. But they all worked -- for the relatively few people who stuck with the program.

Eating less and exercising more -- what doctors call "lifestyle change" -- really does help people lose weight. That, the editorialists say, means that all hope is not lost.

"Most able-bodied persons who can find a way to overcome the monumental logistical and psychological barriers that prevent the full application of lifestyle change can reverse obesity within months," Dansinger and Schaefer write. "The medical profession and society in general have under-dosed this potent cure by a long shot."

Nov. 23, 2004 -- One of the pitfalls of dieting is that it decreases your metabolism, making it harder to burn calories. But focusing on foods that minimally affect blood sugar may be key to keeping your metabolism revved up.

A new study shows that dieters who decreased calories while concentrating on healthy fats and carbohydrates had higher metabolisms after 10 weeks of dieting. They also reported less hunger than dieters taking in the same number of calories who ate only low-fat foods.

The two groups lost similar amounts of weight. But the findings offer early evidence that eating a so-called low-glycemic diet may overcome the body's natural tendency to slow metabolism when calories are restricted. A low-glycemic diet emphasizes healthy fats and carbohydrates.

The findings are reported in the Nov. 24 issue of the Journal of the American Medical Association.

"Almost anyone can lose weight in the short term -- very few keep it off in the long term," researcher David S. Ludwig, MD, PhD, says. "That has given rise to the notion that the body has a 'setpoint' and that when you diet internal mechanisms work to restore your weight to that setpoint. A low-glycemic-load diet may work better with these internal biological responses to create the greatest likelihood of long-term weight loss."

No Bad Food Groups

The low-glycemic diet is now widely recommended for people who are at high risk for developing type 2 diabetes. Several very popular commercial weight loss plans, including the South Beach diet and Sugar Busters, are based on it.

Instead of banning whole food groups, the diet restricts carbohydrates that are rapidly digested and spike blood sugar and insulin levels. Carbohydrates, such as refined sugar, white bread, white rice, potatoes, fruit juices, and many commercial breakfast cereals are restricted on the diet. These carbohydrates are more likely to leave you feeling hungry shortly after eating.

Whole grains, fruits, vegetables, nuts, and legumes are encouraged in a low-glycemic diet. These foods typically leave you feeling full longer.

The newly published study involved 46 overweight or obese adults who reduced calories while eating either a low-fat or low-glycemic index diet. Both diets provided approximately 1,500 calories a day and were designed to produce a 10% weight loss within six to 10 weeks.

A typical breakfast for the low-fat dieters might include instant oatmeal with skim milk and raisins. Steel-cut oats with blueberries and 2% milk would be substituted for the low-glycemic-load dieters.

Thirty-nine of the dieters lost 10% of their body weight during the study. Resting metabolism of low-glycemic load dieters slowed at about half the rate of low-fat dieters. The low-glycemic group burned about 80 calories more per day than their low-fat counterparts.

The low-glycemic dieters also reported having less hunger. They also had greater improvements in risk factors associated with diabetes and heart disease, including blood pressure, triglyceride levels, and chronic inflammation.

'The Perfect Compromise'

Ludwig tells WebMD that the findings show that a healthy, balanced eating plan offers advantages over fad diets for weight loss.

"For many years we had the low-fat paradigm. It made sense that if you didn't want fat on your body you shouldn't put fat in your body. But the problem was that it didn't seem to work very well and even had some adverse side effects," he says. "In the past few years the pendulum has swung very far in the other direction with the assumption that all carbohydrates are bad."

Ludwig says that while carbohydrate-limiting diets have been proven to promote short-term weight loss, two recent studies show that these dieters tend to regain the weight they lose.

"Both the low-fat and low-carbohydrate approaches are probably too restrictive," he says. "The low-glycemic load approach is the perfect compromise. A diet based on glycemic load may work with the body's own mechanism to allow people to eat a wider range of foods and fill up sooner."

Nutritionist Karmeen Kulkarni, RD, MS, says the low-glycemic-load diet represents a healthy approach to eating. But she adds that Ludwig's study was too small and too short to confirm that it is better than other weight loss approaches. Kulkarni is president-elect of health care and education for the American Diabetes Association.

"These participants were followed very closely and all of their food was weighed and measured, so it is not surprising that they lost weight," she says. "Certainly these findings need to be confirmed in larger, longer studies that do not so closely control food intake."

Ludwig's research team is currently recruiting patients for just such a study, and he hopes to follow participants for a year and a half. Boston residents between the ages of 18 and 35 can learn more about participating in the study by calling (617) 355-2500.