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Dec. 6, 2005 - Ever-present marketing by junk food and restaurant companies is damaging the health of American children and teens and should be curtailed to promote healthier diets, the Institute of Medicine (IOM) concluded Tuesday in a report.

The study shows that food advertising targeted at kids continues to increase while promoting mostly food high in calories, fat, and sugar. Experts called for companies to substantially change their marketing practices within two years or be subject to legal intervention from Congress.

"Current food and beverage practices put kids' long-term health at risk," says J. Michael McGinnis, an IOM senior scholar and chairman of the committee that issued the report.

Ads Target Kids

Food manufacturers and fast-food restaurants spent about $10 billion advertising to children in 2004. At the same time, marketers continue to target more and more food products directly to youth, who spend an estimated $200 billion per year on consumer products.

"The turnaround required is so substantial, and the issues are so complex, that the full involvement and leadership of the food and beverage industry is essential," McGinnis says.

Experts pointed to what they said is evidence linking food marketing to people's unhealthy dietary habits and other evidence showing the direct role that high-calorie, high-fat food plays in obesity.

Nearly one-third of American children are classified as obese or overweight, a figure that public health experts warn puts tens of millions of future adults at increased risk of heart disease, diabetes, and early death. While less evidence directly ties children's exposure to food ads, the report also says that some data suggest that ads have a limited impact on causing childhood obesity.

Meanwhile, only 2% of American children regularly eat a recommended diet low in fat but high in fruits and vegetables.

"Unless we do something about it, we'll be raising the first generation of children that are sicker and live shorter lives than their parents," says Mary Story, PhD, a professor of epidemiology at the University of Minnesota and a member of the IOM panel.

Voluntary, for Now

Panelists praised the efforts of a handful of companies that have begun to alter their advertising practices and designate healthier foods on product packaging aimed at children. "There are some good-faith efforts," McGinnis says.

But the report calls on the food industry to do much more to voluntarily shift its advertising to promoting healthier foods and to alter the content of television spots aimed at minors. If it fails to do so within two years, "Congress should enact legislation mandating the shift on both broadcast and cable television," it states.

Experts also call on marketers to come up with a common national system for clearly identifying healthier foods for consumers. Companies should also limit licensing of popular cartoon characters for use in the sale of healthier foods to younger children.

Consumer groups applauded the report, saying it validates years of efforts aimed at getting marketers to alter what they see as billions of dollars of relentless messages promoting unhealthy food choices.

The report "marks the beginning of the end of junk-food marketing to kids," Margo G. Wootan, nutrition policy director for the Center for Science in the Public Interest, says in a statement. "The report sends a clear signal to food company executives and advertisers that the industry needs to completely rethink the way they do business."

Industry Reaction

Industry groups largely rejected the findings, saying that no strong evidence links advertising to obesity in kids and that marketing of junk food is on the decline.

"The shift is happening. It's happening today," says Richard Martin, chief spokesman for the Grocery Manufacturers of America. "Industry is already responding to these issues. We're interested because consumers are increasingly interested in healthier foods."

Martin called the committee's claim that television advertising was directly linked to childhood obesity "specious."

A report issued by the Federal Trade Commission shows that child-targeted food advertising on television has dropped substantially in the last several years.

But the IOM report warns of a shift to product placements, games mixing entertainment with product exposure, and so-called "stealth marketing" practices.

Those strategies are mostly outside the purview of an industry-sponsored group set up to monitor children's advertising on television. IOM experts called on industry to expand funding and jurisdiction of the group, known as the Children's Advertising Review Unit.

Spring holidays are here and sometimes we need a little something special when we gather with friends and family. Here are a few traditional recipes that I have doctored into lighter fare for you to enjoy as you celebrate Easter and Passover. Feel free to enjoy these foods but remember to limit your portions and journal them as indicated for each recipe.

In anticipation of Easter, it would be a good idea to get a little extra exercise and/or bank a few calories by eating less throughout the week prior to the holiday. If you plan ahead and exercise portion control, your won't skip a beat on your diet as you enjoy the holidays with friends and family.

Honey Wheat Buttermilk Bread or Rolls

I like to use my bread machine to make the dough and let it rise once--then I break it into rolls and let it rise overnight in my refrigerator. Then, when you are ready on Easter day, just take it out and bake! They are great right out of the oven.

1/4 cup honey
1 large egg, beaten (egg substitute can be substituted)
1 cup lowfat buttermilk
1 1/4 cups whole wheat flour
1/4 cup ground flaxseed
1 3/4 cups white bread flour (unbleached white or all-purpose flour can be substituted)
1 1/2 teaspoons salt
1/2 teaspoon ground cinnamon (optional)
3 teaspoons active dry yeast (1 packet can be used)
1 teaspoon melted butter or canola oil (optional)
1 tablespoon oats (optional)

1. Add all the ingredients to the bread machine pan in the order recommended by the manufacturer (for my machine it is in the order listed here)--the last ingredient added is usually the yeast and you make a well in the center of the flour and then add the yeast.
2. Set bread machine to the DOUGH cycle (usually 1 hour and 40 minutes) and press START.
3. When the bread machine is done, remove the dough from the pan and break or cut into 12 balls (or add dough to a loaf pan coated with canola cooking spray). Place balls on a cookie sheet that has been coated with canola cooking spray. Cover with plastic wrap that has been sprayed with canola cooking spray (so it doesn't stick to the dough) and place in refrigerator to rise overnight or while you work or play during the day (or let it rise in a warm place until doubled in size.)
4. Preheat oven to 350-degrees. Gently brush the top of the rolls or bread loaf with melted butter or canola oil then sprinkle oats over the top of the rolls if desired.
5. Bake rolls for about 15 minutes or until they are golden brown and test done (bread will take about 35 minutes to test done).

Makes 12 dinner rolls

PER ROLL: 160 calories, 6 g protein, 30 g carbohydrate,2 g fat, (.7 g saturated fat, .6 g monounsaturated, .5 g polyunsaturated fat), 18 mg cholesterol, 3 g fiber, 323 mg sodium. Calories from fat: 12 percent. Omega 3 fatty acids = .5 grams, Omega 6 fatty acids = .3 grams

Dec. 29, 2004 - Want to live longer? Start exercising regularly and melt fat away. An hour of exercise can improve fitness, but losing body fat staves off the deadly metabolic syndrome, according to new research.

The study appears in the current American Journal of Preventive Medicine.

High blood pressure, high cholesterol, elevated blood sugar, and excess belly fat are the mix of risk factors known as metabolic syndrome. This cluster of risk factors increases the risk for heart disease, diabetes, and early death.

Exercise has been recommended to reduce a variety of these risk factors. Studies have shown that exercise works to reduce body fat, especially fat around the waistline, which is one of the risk factors for the metabolic syndrome. It also helps with heart disease factors like high blood pressure and high cholesterol. But this current study looks at the broader effects of regular exercise on this mix.

The study involved 115 people aged 55 to 75. All had untreated high blood pressure; 42% already had metabolic syndrome.

"The participants, in many ways, represent the 'typical' older American with mild [high blood pressure], many of whom are overweight, and at risk for [heart disease] and diabetes," writes lead researcher Kerry J. Stewart, EdD, a cardiology researcher at Johns Hopkins School of Medicine.

Half were assigned a six-month moderate-intensity exercise program about one hour long, three days a week. However, they stuck with their regular eating habits.

The exercise regimen:

• A short stretching warm-up
• Two sets of resistance training (like hand weights), 10 to 15 repetitions each
• 45 minutes of aerobic exercise, using a treadmill, stationary cycle, or stair machine
• As fitness improved, the exercise intensity was increased to keep heart rate at target levels.

The participants also were measured for aerobic fitness, muscle fitness, and body composition.

Metabolic Syndrome Backs Off

Six months later, all volunteers had numerous tests for signs of metabolic syndrome. "Exercise training ... increased aerobic and strength fitness, reduced total and abdominal obesity, and increased lean body mass" for men and women alike, writes Stewart.

The exercisers' risk factors improved, whereas those of the comparison group didn't, he says. The exercisers lost more body and waistline fat and gained more muscle than the comparison group. Heart disease risk factors, like high blood pressure and cholesterol, also improved more in the exercisers.

After six months, 18% of exercisers and 15% of the comparison group no longer had metabolic syndrome. However, 8% of volunteers in the comparison group had developed the syndrome, Stewart reports.

"Older people can benefit greatly from exercise, especially to reduce their risk for developing metabolic syndrome," says Stewart in a news release. "Our results show that this population can be motivated to follow through with a moderate exercise program, and for some risk factors, such as abdominal fat, exercise can be as effective as what is accomplished today with drugs."

Other examples of moderate-intensity activities include walking briskly, recreational swimming, or bicycling 5-9 miles per hour on level terrain.

Gardening can be a great workout and boost for body and soul -- if you do it right.

Sharon Lovejoy, author of Country Living Gardener: A Blessing of Toads, tells WebMD she started gardening as an infant. Her grandmother, not her mother, was the gardener in the family. "I think it often skips a generation," she says.

The key, Lovejoy says, is to see gardening not as a punishment but a joy. "You should feel lucky to be outside in the garden," she says.

And maybe healthier, too. And not just from eating veggies you grew yourself.

Aerobic Gardening

Gardening provides all three types of exercise: endurance, flexibility, and strength.

Jeff Restuccio, author of Fitness the Dynamic Gardening Way, is a first-degree black belt but found he was getting more exercise playing in the garden with his kids. "I like gardening because it's purposeful," he tells WebMD. "With food so cheap in the stores, you may not save money growing your own, but the chances are, if you grew it, your family will eat it."

He suggests making your gardening into a structured exercise routine, alternating light activities with heavier ones, then a light one, and so on. Rake for a while, then dig holes, then prune. "Exercise 30 to 60 minutes, then quit, whether everything is planted or not," he advises.

"Stretch first!" Lovejoy begs. "You'd stretch before going to the gym, wouldn't you?"

Restuccio also recommends concentrating on deep breathing while you work -- and increasing your range of motion, exaggerating the raking motion or the digging motion. "You can use up 500 calories an hour that way," he says (official counts put gardening activities at the 100- to 200-per-hour calorie-burning level).

He also recommends raking right-handed 15 times, then left-handed 15 times.

"If you think double digging (going down a foot, turning the soil over, then down another foot, bringing that soil to the top) isn't exercise," he says, "you haven't tried it."

Gardening is something parents and kids can do together. "Never make cutting the grass or helping a punishment," she urges.

"When I go into the schools, I see so many more obese kids than I did 20 years ago," Lovejoy says. "I think parents are afraid to let them out."

You never know where those seeds, if you will pardon the expression, will fall or when they will sprout. "Many of us probably had to weed the garden," Sandra Mason, an extension educator in horticulture and environment at the University of Illinois, tells WebMD. "A lot [of people] come back to gardening later -- maybe when [they] purchase a home."

Gardening as Therapy

The American Horticulture Therapy Association concentrates on the cleansing, calming benefits of being in the natural world.

• Lovejoy says studies have shown a link between ADHD and insufficient outdoors time.
• "Hospital patients also do better when looking at a plant rather than a cinderblock wall," she says. "Maybe that is how bringing flowers to the hospital got started."
• Older people, even those with memory problems, thrive in a community gardening situation, according to the AHTA.
• Special gardens have also sprung up for the blind, the wheelchair-bound (raised beds), and people with mental disabilities.(2)

  Just walking into a fragrant, warm greenhouse can change someone's whole mood, Lovejoy points out.

Sept. 5, 2006 -- Most children who are lactose intolerant can and should eat some dairy foods to ensure they get enough calcium and vitamin D, the nation's leading pediatric group says.

In a report published today, the Committee on Nutrition for the American Academy of Pediatrics recommends against eliminating dairy products as the primary treatment for lactose intolerancelactose intolerance. The condition is extremely common among many racial and ethnic groups, including Asians, Native Americans, Hispanics, and blacks.

"Not enough kids are getting enough calcium in their diets, and one of the reasons is that parents often eliminate dairy, thinking that it is the cause of stomach pains and the other discomforts that are associated with lactose intolerance," committee member Melvin B. Heyman, MD, MPH, tells WebMD.

Instead of banning dairy foods from a sensitive child's diet, the report recommends slowly introducing them to determine the child's level of tolerance.

"Some children are able to tolerate one glass of milk, but get symptoms with a second," Heyman says. "Some can't tolerate milk, but can tolerate yogurt because the lactose is partly broken down by bacteria; and some can tolerate hard cheese."

AAP Recommendations

People often confuse lactose intolerance, in which the body has a hard time digesting milk sugar (lactose), with cow's milk protein intolerance, which is an allergic reaction triggered by the immune system.

Lactose intolerance is caused by a shortage of the enzyme lactase, which breaks down lactose in the small intestine.

Typical symptoms of lactose intolerance include abdominal pain, nausea, bloating, flatulence, and other digestive discomforts.

While uncomfortable, the symptoms do no permanent damage to the bowel, Heyman points out.

The AAP report stresses the importance of accurately diagnosing lactose intolerance.

Parents can get a good feel for their child's tolerance by systematically eliminating and then reintroducing specific dairy foods over time, carefully recording changes in symptoms.

Other recommendations include:

• Drink small portions of milk (4 to 8 ounces) with meals and other foods throughout the day.
• Try yogurt, which may produce fewer lactose intolerance symptoms.
• Choose aged cheeses, which have less lactose than other varieties.
• Drink lactose-free or lactose-reduced milk, which is easily found in most grocery stores; or take lactase-replacement capsules.

Alternate Calcium Sources

Although it is possible for children to get the calcium they need for strong bones without dairy, it isn't easy.

Broccoli, brussels sprouts, dried figs, and sardines are among the most calcium-rich nondairy foods -- but good luck getting the typical child to eat them.

Calcium-fortified cereals and orange juice may be a more realistic option. But the AAP has also warned parents to limit fruit juices, which contain a lot of sugar.

The group recommends no more than 6 ounces per day of fruit juice for children age 1 to 6, and 12 ounces for older kids and teens.

While calcium supplements may help, children on lactose-free diets appear to have a harder time absorbing calcium in this or any form.

"Recent evidence indicates that dietary lactose enhances calcium absorption and, conversely, that lactose-free diets result in lower calcium absorption," the report says.

Thus, lactose intolerancelactose intolerance (and lactose-free diets) may, in theory, predispose people to inadequate bone development.

The Racial Divide

According to the AAP report, as much as 70% of the world's population is lactose intolerant to some degree, meaning they are deficient in the lactase enzyme.

Not surprisingly, racial and ethnic groups which have historically had little exposure to dairy foods are the most intolerant, while those with the most exposure are the least.

Nearly 100% of Asians and Native Americans have a lactase deficiency, while 80% of Hispanics and 60% to 80% of blacks produce insufficient quantities of the enzyme. Only 2% of northern Europeans are lactose intolerant.

Children in high-risk ethnic groups may develop symptoms with dairy exposure as early as age 2 or 3, but white children rarely develop symptoms before 4 or 5, the report states.

While most people with lactase deficiency develop symptoms in their teens or adult years, approximately 20% of Hispanic, Asian, and black children younger than age 5 show evidence of the deficiency.

April 27, 2006 -- When our doctors tell us to lose weight, what we hear may not be a health message.

It's particularly true for black patients, a study from Yale University School of Nursing shows.

The study shows that when doctors talk about a patient's weight, they are talking about body size. But what patients hear is that the doctor has different ideas than they do about things like attractiveness, sexual desirability, body image, strength or goodness, self-esteem, and social acceptability.

Yale doctoral student Maryanne Davidson, MSN, RN, CPNP, and Kathleen A. Knafl, PhD, now at Oregon Health & Science University, report the findings in the May issue of the Journal of Advanced Nursing.

"There is such a disconnect between what we health care providers mean when we talk about obesity and overweight, and what those concepts mean to different people," Davidson tells WebMD. "We say, 'Your health is affected by the size of your body.' But patients don't necessarily connect those terms to the belief that their health is affected."

Blacks, Whites See Size Differently

Davidson and Knafl analyzed 20 papers from 18 different studies on patients' concepts of obesity and analyzed each study.

"I looked at what these researchers found when patients talked to them about obesity and overweight," Davidson says. "I looked at the differences and similarities between the groups and what that might mean for us as health care providers."

The studies consistently showed that larger body sizes are more socially acceptable -- and more desirable -- to black women and men than to white women and men.

"Black men find black women at a larger body size to be attractive, and black women feel attractive at a larger body size," Davidson says. "White women talked about feeling unattractive at a larger body size, and they did not find it socially acceptable."

The finding does not surprise Sheila P. Davis, PhD, professor of nursing at the University of Mississippi Medical Center in Jackson. Davis studies overweight children and their families.

"It seems as if for black women -- and I am a black woman -- obesity doesn't carry the same negative associations as it does for white women, Davis tells WebMD.

University of Cincinnati pediatrician Frank Biro, MD, associate director of adolescent medicine at Cincinnati Children's Hospital, has studied how different cultures see body size differently.

"You see in the scientific literature that African-American women are comfortable with a thicker body shape," Biro says. "That is the specific word they use -- thick. And it's a very good word. If you think about thin, someone could be thicker."

Where races differ less is in relating obesity to health. For both blacks and whites, the message isn't clear.

"When it comes to health, many African-Americans do not associate being overweight or obese with larger body size," Davidson says. "Even with white women, it was minimized. Some did not believe it. It is concerning that is so common, because health care providers only use the terms 'BMI,' 'overweight,' and 'obesity' to talk about body size."

Oct. 3, 2005 -- Want to keep extra weight off as you age? You might want to develop a strategy that lasts a lifetime.

In a lengthy study, many people who had a normal body mass index (BMI) in middle age eventually became overweight, and some became obese.

Consider these before-and-after results:

• Between a tenth and a quarter became overweight in just four years.
• More than half became overweight in 30 years.

The study appears in the Annals of Internal Medicine. The researchers included Ramachandran Vasan, MD, of the Framingham Heart Study.

Short-Term Trends

Vasan's study included more than 3,700 white men and women who were enrolled in the Framingham Heart Study.

Participants had their BMI measured at least twice, four years apart, during the 30-year study.

Middle-aged men packed on weight relatively quickly. Over four years, more than a quarter of the men with normal BMI became overweight. For men with normal and overweight BMI values, up to 9% became obese in four years.

A smaller percentage of women (14% to 19%) became overweight in four years' time. Between 5% and 7% of normal and overweight women became obese in four years, the study shows.

Long-Term Results

As the years gathered, so did the pounds. Here are the results over 30 years:

• More than half of all participants became overweight.
• About a quarter of participants became obese.
• 1 in 10 participants became severely obese.

Over the long haul, similar percentages of men and women became overweight or obese. People who were overweight when the study started were more likely to become obese.

"These estimates suggest that the future burden of obesity-associated diseases may be substantial," write the researchers. However, their report doesn't give details on participants' health.

Heart disease, some cancers, and osteoarthritis are among the conditions that have been linked to weight problems. Of course, not all overweight people have those health issues.

Study's Limits

BMI is calculated from height and weight. It isn't a perfect measure of fatness.

For instance, people often lose lean body mass as they age. That can raise body fat percentage while leaving BMI unchanged, the researchers note. Resistance training is one way to maintain or build muscle mass.

BMI also doesn't reflect shifts in the location of body fat. Past research has linked fat around the waist to health problems including heart disease and diabetes. It's not clear if that fat causes or just accompanies those problems.

The study only tracked weight gain starting in middle age. Other age groups might have different results, write the researchers.

Lastly, since all participants were white, results aren't known for other racial and ethnic groups.

Lifelong Habit

Diet crazes come and go. Many health experts recommend making lasting changes instead of following the latest diet fads.

Your doctor can give you pointers. The U.S. government recommends these general steps for healthy living:

• Get at least 30 minutes of physical activity five or more days per week.
• Choose whole grains for at least half of the grains you eat.
• Eat a mix of five to nine servings of fruits and vegetables daily.
• Favor lean sources of protein (including leaner cuts of meat and poultry, fish, and beans).
• Choose low-fat or fat-free dairy products.
• Cut back on foods containing saturated fat, trans fats, and cholesterol.

Don't forget about calories. You've got to burn more calories than you consume to lose weight, so make your choices wisely.

March 8, 2005 (Orlando) - The experimental diet drug Acomplia helps keep off unwanted pounds for up to two years, new research shows.

After two years of treatment, patients in the study maintained a 16-pound weight loss. More than a third of patients taking the drug lost 10% of their body weight.

The drug targets a pleasure center in the brain that researchers believe is linked to overeating and other behaviors such as smoking. This new research is the fourth positive study of the drug, showing that Acomplia can take off pounds and help people stop smoking.Acomplia can take off pounds and help people stop smoking.

Luc Van Gaal, MD, studied more than 1,500 overweight adults in a two-year study. He reported the findings at the American College of Cardiology 2005 Scientific Session. The study was funded by Sanofi-Aventis, a Paris-based pharmaceutical company that has been developing the drug for clinical use.

In November 2004, Douglas Greene, MD, vice president of corporate medical and regulatory affairs for Sanofi-Aventis, told WebMD that the company planned to file for approval with the FDA in the second quarter of 2005.

"We can now say that we have robust data that can be replicated that shows [Acomplia] helps people lose weight and maintain that weight loss,shows [Acomplia] helps people lose weight and maintain that weight loss," says Van Gaal, who is a professor of diabetology, metabolism, and clinical nutrition at the University of Antwerp in Belgium.

Participants in the study were randomly selected to take either low-dose Acomplia (5 mg), high-dose Acomplia (20 mg), or a placebo. Additionally, all patients were told to reduce their daily caloric intake by 600 calories. They were not given any specific dietary guidelines, nor were they given exercise recommendations.

After two years, the patients taking 20 mg lost an average of 16 pounds and kept the weight off. The patients taking lower dose Acomplia lost an average of 10 pounds. Patients taking a placebo lost an average of 5.5 pounds.

Perhaps even more encouraging, says Van Gaal, is that the patients taking Acomplia dropped inches from their waist, which is especially significant since expanding waistlines are associated with increased risk of heart disease and diabetes.expanding waistlines are associated with increased risk of heart disease and diabetes.

Van Gaal says that it looks like each 2.2 pounds of weight lost takes an inch off the waist. The average waist reduction was 3 inches for patients taking 20 mg and 1.3 inches for those on the lower dose.

After the first year of treatment, 39% of patients taking high-dose Acomplia were able to reach a goal of losing 10% of their weight. After two years, 32% of the high-dose patients maintained that level of weight loss.

This is very encouraging, says Van Gaal, because "people always say they want to lose 40 pounds, but you can achieve real health benefits by losing 10% of your body weight. This is a realistic and sustainable goal." He says other studies have reported that patients who hit the 10% goal cut their risk of developing diabetes in half.

Julius Gardin, MD, chief of cardiology at St. John Hospital in Detroit, says, "The question is that we know that the battle against obesity is more than just a two-year fight. We would like to see if this weight reduction is maintained long term." Gardin was not involved in the Acomplia study.

Nov. 8, 2004 -- Obesity not only takes its toll on men's waistlines, but it may also wind up costing them at their local pharmacy. New research shows that middle-aged obese men spend three-and-a-half times as much on prescription drugs than normal-weight men.

The study shows that obese men pay about $80 a month in prescription drug costs compared with an average of about $23 in monthly prescription drug costs among normal-weight men.

Researchers say the findings offer a new perspective on the health problems associated with obesity as well as the financial costs of treating them.

"These are what we call 'real and immediate costs.' These are not the costs associated with an operation or serious event like a heart attack that might happen at some time in the future. Rather, this is what the men, or their employers, spend month after month on their prescription drugs," says researcher Thomas G. Allison, PhD, MPH, of the Mayo Clinic in Rochester, Minn., in a news release.

The results of the study were presented this week at the American Heart Association's Scientific Sessions 2004 in New Orleans.

Prescription Drug Costs Rise With Weight

In the study, researchers compared the prescription drug costs among a group of 328 male business executives who had physical examinations as directed by their company's health plan between January 2001 and May 2002.

Researchers divided prescription drug costs into medications prescribed to treat heart disease risk factors, such as high blood pressure and cholesterol, and those used to treat other medical conditions related to weight, such as gout and erectile dysfunction.

The study showed as men's weight increased, so did their prescription drug costs.

• For normal-weight men, monthly prescription drug costs for heart disease-related drugs were $9.89 and for other drugs, $12.96.
• For overweight men, monthly prescription drug costs for heart disease-related drugs were $18.41 and for other drugs, $20.86.
• For obese men, monthly prescription drug costs for heart disease-related drugs were $42.02 and for other drugs, $38.29.

"Previous studies looking at the cost of obesity might be underestimating the toll," says Allison. "The men in this study were in a health program that exceeds the type of physical examination that a normal healthcare plan would offer."

Aug. 2, 2004 -- Health officials are reporting that the number of people affected by a recent salmonella outbreak continues to climb. What can you do to prevent salmonella food poisoning?

Last year, a hepatitis outbreak in the U.S. was caused by tainted green onion from Mexico. Officials have linked this year's food poisoning outbreak from salmonella to certain Roma tomatoes. So far no deaths have been reported.

What Is Salmonella?

Salmonellosis is an infection caused by salmonella bacteria. Salmonella infections are increasing in the U.S. Many types of this bacteria cause disease in animals and people. Recently, a new strain of salmonella was found in the U.S. which poses a major new threat because it is resistant to several antibiotics normally used to treat people with salmonella infections.

Salmonellosis may occur in small, contained outbreaks in the general population or in large outbreaks in hospitals, restaurants, or institutions for children or the elderly. While the disease is found worldwide, health experts most often report cases in North America and Europe.

Every year, CDC receives reports of 40,000 cases of salmonellosis in the U.S. The agency estimates that 1.4 million people in this country are infected, however, and that 1,000 people die each year with salmonellosis. Symptoms are most severe in the elderly, infants, and people with weakened immune systems. People with AIDS are particularly vulnerable to salmonellosis -- often suffering from recurring episodes. In this group, salmonella infections can be fatal.

Salmonella Transmission

Salmonella bacteria can be found in food products such as raw poultry, eggs, and beef, and sometimes on unwashed fruit. Food prepared on surfaces that previously contained raw meat or meat products can, in turn, become contaminated with the bacteria. This is called cross-contamination.

In the past few years, CDC has received reports of several cases of salmonellosis from eating raw alfalfa sprouts grown in contaminated soil. Salmonella infection frequently occurs after handling pets, particularly reptiles such as snakes, turtles, and lizards.

Salmonellosis can become a chronic infection in some people who may not have symptoms. Though they may have no symptoms, infected people can spread the disease by not washing their hands before preparing food for others. In fact, health care experts recommend that people who know they have salmonellosis not prepare food or pour water for others until laboratory tests show they no longer carry salmonella.

Salmonella has several distinct symptoms:

• Diarrhea
• Fever
• Abdominal cramps
• Headache

In most people, symptoms begin from 12 hours to three days after being infected. These symptoms, along with possible nausea, loss of appetite, and vomiting, usually last for four to seven days. Diarrhea can be severe and require hospitalization. The bacteria usually infect the intestines however it can also infect the blood and produce more severe and life-threatening symptoms such as infection of the heart valves or blood vessels.

Getting Control of Salmonella Poisoning

A health care provider can use laboratory tests to identify salmonella in the stool of an infected person.

Most cases of salmonellosis clear up within five to seven days and don't require treatment with antibiotics and intravenous fluids. People with severe diarrhea who become dehydrated may need intravenous fluids. If the infection spreads from the intestines into the bloodstream, health care providers can treat it with antibiotics.

Other Possible Problems

While most people recover successfully from salmonella, a few may develop a chronic condition called Reiter's syndrome. This syndrome can last for months or years and can lead to arthritis. Symptoms include:

• Painful joints
• Irritated eyes
• Painful urination

Unless treated properly, salmonella can escape from the intestine and spread by blood to other organs, sometimes leading to death.

Typhoid fever, a more serious disease, results from infection with a strain called Salmonella typhi. This disease, which can be fatal if untreated, is not common in the U.S. It is frequently found in developing countries, usually in contaminated water. It's also a risk in areas where flooding or earthquakes cause sewer systems to overflow.

Appropriate antibiotics are usually effective for treating typhoid fever although the incidence of antibiotic-resistant S. typhi is increasing in some parts of the world.

You can prevent salmonella food poisoning by taking some precautions:

• Drink only pasteurized milk.
• Cook poultry, ground beef, and eggs thoroughly before eating.
• Don't eat or drink foods containing raw eggs or raw unpasteurized milk, such as homemade Caesar salad dressing, cookie dough, and hollandaise sauce; or drink homemade eggnog made with raw eggs.
• Handle raw eggs carefully.
• Keep eggs refrigerated.
• Throw away cracked or dirty eggs.
• Cook poultry products to an internal temperature of 170 degrees Fahrenheit for breast meat and 180 degrees Fahrenheit for thigh meat.
• Wash all food preparation surfaces and utensils that have come in contact with raw poultry or raw eggs with soap and hot water.
• Wash hands immediately after handling raw poultry or raw eggs.
• Wash hands immediately after handling reptiles (turtles, iguanas, lizards) or come in contact with pet feces, since salmonella can be found in the feces of these animals. Even healthy reptiles are likely to harbor salmonella in their intestines.

SOURCE: National Institutes of Health.

May 24, 2004 (Orlando, Fla.) - As the number of children defined as overweight and obese continues to rise, researchers say new studies now show that obese children are more susceptible to lung damage from air pollution than lean youngsters.

"Given the epidemic of obesity in children, it might be we're developing a population more vulnerable to pollution's negative effects on the airway," says Heike Luttmann-Gibson, PhD, statistician and research associate in the Environmental Epidemiology Program at Harvard School of Public Health.

When exposed to the same amount of pollution, obese boys and girls had more trouble breathing than kids of normal weight, she reports.

Obesity's Far-Reaching Health Effects

The findings offer one more reason to put overweight and obese youngsters on a diet and exercise program. Consider the facts:

• The number of overweight and obese children has nearly tripled since the 1970s.

• There has been a tenfold increase in the number of children with type 2 diabetes over the past five years. Once called 'adult-onset' diabetes, type 2 diabetes is linked to obesity and inactivity.

• Overweight kids are more likely to become overweight adults, increasing their risk of obesity-related health conditions such as heart disease, stroke, and bone fracture.

David B. Peden, MD, MS, professor of pediatrics and center director of the Center for Environmental Medicine, Asthma and Lung Biology at the University of North Carolina in Chapel Hill, says, "Being overweight clearly causes a lot of bad things to happen. But even a modest reduction in weight can have a big effect on a child's health, including [lung problems tied to] air pollution."

Problems Expand Along With Ballooning Waistlines

In the study, 611 fourth and fifth graders, who were participating in a larger study on the long-term effects of air pollution, were tested for lung function. About one in 10 was obese. Parents of the children helped fill out questionnaires asking about general and respiratory health.

After analyzing the information, the researchers showed that the effects of air pollution on lung function were two to five times stronger for obese children than for those of normal weight, Luttmann-Gibson reports.

The researchers found that children exposed to nitrogen dioxide -- an irritant that is found in car exhaust -- had a drop in lung function. Obese kids exposed on one day had an 11% dip in lung function the following day, while lean youngsters exposed to the same levels of the pollutant had only a 2% drop in lung function.

The more obese the child, the greater the effects of air pollution on lung function, says Luttmann-Gibson. "Any decline in lung function is bad, and obesity makes it even worse."

Luttmann-Gibson says she suspects that air pollution and obesity pack a double whammy to the airways. Researchers know that chemicals relating to inflammation in the body are elevated in obese persons, she explains. "And air pollution increases inflammation in the airways. Being obese is setting you up to be more susceptible to the inflammatory effects of air pollution."

And that, researchers say, may mean that an increased risk of asthma should be added to the list of obesity-related health conditions.

Peden tells WebMD, "If obesity is resulting in more inflammation, the risk of developing asthma might be further increased, too."

Although further study is needed to prove the association, it's a link many doctors already suspect, Peden says. "It's intriguing, a new and exciting area of interest."

Nov. 11, 2003 (Orlando, Fla.) -- The real beer argument is not "Tastes great" vs. "Less filling." It's dark vs. light, and the winner, according to a University of Wisconsin heart researcher, is dark brew because it can help prevent blood clots.

John D. Folts, PhD, professor of medicine and director of the coronary thrombosis research laboratory at the University of Wisconsin in Madison, tells WebMD that dark beer is rich in flavonoids, which have powerful antioxidant effects.

"It's about color. You can see the flavonoids in products on the shelf," he says. The rich flavonoid content makes red wine more heart friendly than white wine and purple grape juice a better choice for toddlers than white grape juice, he says.

Folts presented his dark beer-light beer study at the American Heart Association's Scientific Sessions 2003. Folts and his colleagues fed dark and light beer to dogs that had narrowed arteries in their hearts, similar to the narrowing observed in people with heart disease.

Only dogs fed dark beer had less stickiness of their blood clotting cells, says Folts. This was true even though the blood alcohol level in the dogs was the same.

He says he is currently conducting similar tests in humans. In that study, volunteers drink two bottles of either light or dark beer a day. Early indications are that dark beer again is more active at fighting blood clots than light beer, he says.

"We are also testing purple grape juice and non-alcoholic red wine," he says. In each case, the dark beverage demonstrates superiority to light colored beverages.

Are Flavonoids the Key?

Valentine Fuster, MD, PhD, director of the cardiovascular institute at Mount Sinai Medical Center in New York, says he is not convinced that flavonoids add anything to the already well-known heart protective effect of alcohol. "We know alcohol works," he tells WebMD. In order to prove that flavonoids add anything to the alcohol benefit, human studies are needed.

Also, Fuster, who was not involved in the study but who has studied the relationship between alcohol and reduced risk for heart disease, says all alcohol studies should be approached with caution. "There is always the risk that the data will be misinterpreted and people will consume too much. Any more than two drinks a day is too much."

For those who are dark beer drinkers -- or drinkers of red wine or purple grape juice -- Folts says they can gain the maximum heart benefit by "drinking these beverages with meals" so that they can fight the increase in free radicals that occurs when the body begins to metabolize food. Free radicals trigger oxidative stress, which has been linked to heart disease and inflammation, says Folts.

June 30, 2003 -- Daily injections of low-dose growth hormone may help overweight people lose body fat while maintaining muscle mass, according to early research from St. Louis University. Obese patients who got the injections lost modest amounts of weight, but researchers caution that it is too soon to know if the findings are significant.

The research was presented at the 85th annual meeting of the Endocrine Society in Philadelphia.

In the study, 59 people who averaged 40% above their ideal body weight were told to follow a calorie-restricted diet and exercise program. They also got either daily self-administered shots of low-dose growth hormone or placebo injections.

One third of the original participants dropped out during the six-month treatment phase, but only one patient left the study because of side effects. The rest did not want to follow the lifestyle guidelines or give themselves the daily injections.

In earlier studies using higher doses of growth hormone, potentially serious side effects were commonly seen. These side effects included arthritis and insulin resistance, which can lead to diabetes.

Modest Weight Loss

At the end of the study, the people who got the growth hormone had lost an average of five pounds of body fat, while those who did not receive the hormone lost nothing. The growth hormone group saw a 19% improvement in HDL, or good, cholesterol levels with no change in LDL, or bad, cholesterol levels.

Lead researcher Stewart Albert, MD, says he does not believe growth hormone was directly responsible for the weight loss but it might have made it easier for people to maintain a healthier lifestyle.

"If the growth hormone had any benefit, it was to allow people to continue with the diet and exercise," Albert tells WebMD. "It may be that growth hormone has a beneficial effect on appetite control or that because people didn't lose muscle mass they were able to exercise more. It will take much larger studies to answer these questions."

Clinical endocrinologist Lawrence Frohman, MD, tells WebMD that the high dropout rate in the study and the moderate weight reductions in the growth hormone group make him skeptical about the clinical potential of this treatment.

There are numerous over-the-counter products marketed as growth hormone for weight loss, sold over the Internet or in health stores. Frohman says the products are not growth hormone and they have not been subjected to clinical scrutiny to determine if they are safe.

"Anything that is sold over the counter cannot be growth hormone, because growth hormone is regulated by the FDA," he says. "It is hard to get the actual content of what is in these products, but they are of limited to no value."

Nov. 19, 2002 (Chicago) -- Fire up the barbee! Researchers from Duke University say that six months on the high-fat, low-carbohydrate Atkins Diet adds up to more weight loss and better cholesterol than a low-fat, high-carbohydrate diet.

And if that isn't surprising consider this: Those researchers delivered the burger-friendly news at the American Heart Association's Scientific Sessions 2002.

Eric Westman, MD, Duke University obesity researcher, says he decided to study the Atkins Diet after treating several patients who were "losing significant weight using the Atkins diet." But Westman says he didn't expect the high-fat regimen to do better than "the standard low-fat, high-carbohydrate diet that we use at the Duke Diet Center." The study was funded by the Robert Atkins Foundation.

Westman assigned 120 obese volunteers -- 75% of them women -- to either the Atkins diet or to a low-fat diet that restricts fat to less than 30% of total calories. The participants following the Atkins diet got less than 10% of calories from carbohydrates, while 60% came from fat. The Atkins diet also includes the use of fish oil, borage oil, and flaxseed oil supplements.

After six months the Atkins diet group lost about 14% of their starting weight or an average of 30 pounds, which was considerably better than the 20-pound or 9% loss for the low-fat dieters.

Moreover, the Atkins group posted an impressive 11% increase in HDL "good" cholesterol compared to just a 1% improvement for people on the low-fat diet. At the same time triglycerides -- another blood fat and suspected risk factor for heart disease -- decreased a whopping 49% on the Atkins diet.

Neither diet had any significant effect on LDL "bad" cholesterol.

Westman tells WebMD that he thinks the Atkins diet "works" because people stay on it and lose more weight. Weight, he says, appears to be the real key to reducing heart disease risk factors. But he says that he still doesn't recommend the Atkins diet. "We really need a large, well designed study," he says. The National Institutes of Health is expected to start such a study early next year.

Nutritionist Alice H. Lichtenstein, DSc, senior scientist and director of the Cardiovascular Nutrition Research Program at Tufts University and a member of the AHA's nutrition committee, says she still has real doubts about the value of the Atkins diet. She pointed out, for example, that "only the people on the Atkins diet received fish oil supplements." The AHA recommends fish oil as part of its heart healthy lifestyle plan.

"If this really worked, we would have at least a dent in the obesity epidemic. Everyone would be on it," says Lichtenstein, who adds that a "calorie is a calorie and losing weight is all about calories." She says that people who lose weight on the Atkins diet simply take in fewer calories.

She says, too, that there are no data about the long-term effects of high-fat, high-protein diets.

Lichtenstein says the high-fat/low-fat battle has heated up since mid-summer when a widely read article in The New York Times Magazine touted the value of high-fat regimens like the Atkins diet.

But Lichtenstein says the AHA dropped its support for a low-fat diet a few years ago and now supports a well-balanced diet that includes lots of fruits, vegetables, whole grains, and at least two servings a week of fish -- fatty fish. But "it isn't just diet. We promote a healthy lifestyle that means a good well balanced diet, exercise and no smoking."

March 25, 2002 -- Eating more protein could help your body absorb calcium, possibly putting a halt to bone-thinning osteoporosis, says a new study.

High-protein diets, such as the Atkins plan, have been controversial, since studies have shown that they can cause bone loss. Yet elderly people are supposed to eat more protein, to help wound healing and maintain muscle mass.

The study shows that -- when the body is already getting adequate amounts of calcium -- a high-protein diet can actually repair bone loss.

"Our results suggest that a higher calcium intake is going to be protective against any adverse effects of protein on bone, and may allow protein to have a positive effect," says lead author Bess Dawson-Hughes, MD, senior scientist and chief of the Calcium and Bone Metabolism Laboratory at Tufts University.

The 342 men and women over age 65 each took either a 500 mg calcium-and-vitamin-D supplement or a placebo daily. During the three-year study, researchers kept track of the volunteers' diets, specifically their calcium and protein intake and bone mineral density.

The supplement group -- particularly those who ate a diet high in protein -- had significantly better bone mass density -- an accurate measure of bone loss. Those who took the placebo, however, had less calcium absorbed into their bloodstream when they consumed more protein.

Whether protein comes from a vegetable or animal source did not make a difference, but the amount did count, researchers say.

The recommended protein intake for a healthy person is between 40-60 grams per day, although the study volunteers had an average protein intake of 79 grams per day.

As for calcium, dietitians recommend 1,200 mg of calcium per day for people over 50, which is readily available in one 500 mg supplement, one cup of fat-free milk, one 8 oz. serving of yogurt, and a 1 oz. slice of cheese. -->

As if dieting wasn't challenging enough, the sheer number of fat-buster guides out there may be reason enough to just forget the whole thing. But, alas, the unforgiving mirror or those too-tight jeans serve as good reminders of the pudgy enemy. So onward the march to join the infamous fight against flab.

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One of the more popular weapons of choice has been a program that claims to use food as a drug for overall good health, weight loss, and the prevention or management of heart disease and diabetes. In the book The Zone, Barry Sears, PhD, explains how the right ratio of carbohydrates to proteins and fats can control levels of insulin in the bloodstream. Too much of the hormone, he says, can increase fat storage and inflammation in the body -- conditions that are associated with ailments such as obesity, type 2 diabetes, and heart disease.

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Sears' theories resonate with a significant number of people who become devotees of The Zone Diet. Many of them enthusiastically talk about "40-30-30," and about "being hormonally correct."

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To the outsider, it may seem as if they have gone off to some other zone, but some health experts say the plan may produce good health and weight loss for some people. The Zone's recommendations supposedly don't stray far from the USDA's dietary guidelines.

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So where does The Zone stand among other popular diet plans? WebMD asked Sears and a couple of health experts.

The Zone's Boundaries

In The Zone, Sears writes that you can better regulate your metabolism with a diet of 40% carbohydrates, 30% protein, and 30% fat (now widely known as the 40-30-30 plan).

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In a recent conversation, however, the diet's founder says he rues the day he specified those exact figures. Rather, he would prefer to give a range for better hormonal balance. Everyone is different, he says, and there's no magical percentage for all in managing insulin levels.

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"The Zone is a diet that contains no more than 30% of calories from fat, the amount of protein ranges from 25% to 35%, and the amount of carbohydrates ...would be between 35% and 45%," says Sears.

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The diet does not prohibit any foods, but severely restricts those high in fat and carbohydrates such as grains, starches, and pastas. Fruits and vegetables are the favored source of carbs. Protein is limited to low-fat fare that's no bigger and no thicker than the palm of one's hand. And as far as fat is concerned, monounsaturated fats such as olive oil, canola oil, almonds, macadamia nuts, and avocados are preferred over other kinds of fats.

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For a simple interpretation of The Zone, Sears suggests filling one-third of a plate with low-fat protein, and then piling the rest with fruits and vegetables. You may choose to add a monounsaturated source of fat such as olive oil.

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To then determine whether a meal is hormonally correct, Sears offers the following test: "Eat a meal and see how you feel four hours later. If you have no hunger and you have peak mental acuity, the composition of the meal was hormonally correct for your biochemistry."

They used to say that Chicago stockyard workers used "everything but the squeal." If you use everything but the gobble, you need to remember several important rules to make sure that table full of lukewarm, breathed-on food is safe to eat later.

William Stallings, MS, RD, clinical dietitian at Temple University Hospital in Philadelphia, says to remember the "2-2-4" formula. This means:

• 2 hours. Store all leftovers in the refrigerator or freeze no more than two hours after cooking. If food has been out more than two hours, toss it.
  
  
• 2 inches. Use shallow containers, about two inches deep, to store food. This will allow it to cool quickly and evenly, foiling pesky bacteria.
  
  
• 4 days. Eat leftovers within four days. Holiday food kept longer than that should be thrown out. Freeze anything that is not going to be used within four days.

It also is important to keep the fridge at 34 to 40 degrees at all times. Don't forget, while preparing the feast, you probably opened it a lot. The setting may need to be lowered a little at least temporarily.

It is also important during prep time, Stallings tells WebMD, to wash your hands frequently and avoid preparing raw meat on a porous surface, such as a wooden cutting board, that might soak up contaminated juices and transfer them to other foods.

Some Foods Keep Better Than Others

Constance Garrett, RD, MS, MA, nutrition and family consumer science adviser at the University of California Cooperative in San Bernardino, tells WebMD that stuffing doesn't keep well. At the very least, it should be removed from the turkey cavity if some of it was placed there. While inside, the dressing may flavor the turkey -- and be flavored by it -- but it might not get hot enough to thoroughly scourge harmful bacteria.

These days, many people put an onion and herbs inside the turkey and prepare the dressing in a separate pan as a side dish.

Stallings says it's OK to cook the stuffing inside, though, if you use a meat thermometer and make sure the stuffing reaches 165 degrees Fahrenheit.

"People also put a lot of delicate stuff in mashed potatoes at Thanksgiving," Garrett says. "They can be risky to keep unrefrigerated."

Sweet potatoes, however, contain sugar and are also prepared using sugary ingredients (such as those excellent little marshmallows). "Sugar," Garrett notes, "acts as something of a preservative."

What about that creamy greenbean/onion ring casserole? "It only contains three-fourths of a cup of milk," Garrett says, "so it keeps fairly well."

She also recommends that some dishes be prepared ahead, frozen or refrigerated, and then microwaved, giving you another shot at zapping harmful bugs. "This keeps the food safe a little longer."

May 8, 2000 -- The ancient pyramids have long conjured up visions of King Tut, golden statues, and the dusty sands of Egypt. Our own homegrown version of the pyramid symbolizes something a little less exalted: good nutrition. Even so, the U.S. Department of Agriculture's (USDA) Food Guide Pyramid, the nation's official advice on diet, promises the key to a long and healthy life.

But in an age of ethnic and fusion cuisines, when was the last time you saw tortillas and jalape?os on the pyramid? Or bok choy and edamame soybeans? They don't appear, of course, which is just one reason why critics have complained recently about the official guidelines. Instead of reflecting the fast-changing face of America, they charge, the pyramid remains culturally biased. Worse yet, it's out of touch with current nutrition research. Some critics say that the pyramid places too much emphasis on dairy and meat products. Others worry that it encourages people to eat more meat than is healthy.

Most Minorities Can't Take Lactose

More immediate are the severe cramps, diarrhea, and gas that millions of lactose-intolerant Americans can suffer from eating the dairy products emphasized on the pyramid. Without the ability to digest the sugars in milk, people with lactose intolerance, including 90% of Asians, 70% of African-Americans and Native Americans, and 50% of Latinos, aren't likely to get enough bone-strengthening calcium. They avoid dairy products without substituting other foods that are also rich in calcium.

To remedy that situation, the Physicians' Committee for Responsible Medicine (PCRM), a pro-vegetarian advocacy group, is currently lobbying health officials to list other calcium-rich foods on the pyramid. Broccoli, collards, and other dark-green leafy vegetables are great sources of calcium, says Milton Mills, MD, an associate director of preventive medicine at PCRM.

Other good alternatives are lactose-free dairy products, available in many grocery stores, and yogurt or buttermilk. Though these last two are officially dairy foods, both contain bacteria that digest lactose.

No Limits Needed on "Good" Fats

Another disagreement centers on how much fat a healthy diet should contain. The USDA Dietary Guidelines proposed for the year 2000 recommend that no more than 30% of the day's total calories should come from fat. But people who follow the traditional heart-healthy Mediterranean diet typically consume as much as 45% of their daily calories as mono- and polyunsaturated fats.

In the days of lard and tropical oils, it made sense to cut back on total fat. But if you use unsaturated oils like canola and safflower oils, says Meir Stampfer, MD, professor of epidemiology and nutrition at the Harvard School of Public Health, there's no need to fret about how much you consume.

"I wanted them to get rid of the restriction on 'total fat' entirely," Stampfer says. It is true that saturated fats are directly linked to elevated cholesterol levels. He goes on to explain that mono- and polyunsaturated fats, like those found in olive and canola oils, have been shown to prevent blood cholesterol levels from climbing.

Yet even those findings may require slight refinement. Recent work presented at the March 2000 meeting of the American College of Cardiology in Anaheim, Calif., comparing canola, fish, and olive oils found that olive oil, unlike the other two types that continued to show heart-healthy benefits, may be nearly as dangerous as saturated fats when it comes to clogging arteries. See: Best Heart Benefits From Canola and Fish Oils -- Not Olive Oil.

At the moment it would appear that, unless you have a weight problem and need to cut back on calories, you can't go wrong by adding salmon, mackerel, soybeans, nuts, and avocados -- all rich in unsaturated fats -- to your diet. Consider avoiding olive oil in favor of canola and fish oils, and go easy on saturated fats such as palm and coconut oils, and animal fats, such as lard, butter, and cream.

March 12, 2004 -- You've seen them -- those diet ads with "before-and-after" pictures of obese people. They only perpetuate hurtful stereotypes, according to a new study.

"Given that these ads reach millions of people every day, their potential for harm is vast," writes researcher Andrew Geier, a psychology graduate student at the University of Pennsylvania. His study appears in the current issue of Eating and Weight Disorders.

"Significant social stigma and weight discrimination occur in many important areas of life, including employment, medical care, and education," he says.

"Despite no clear relationship between certain character traits and weight, negative judgments are routinely made about those who are overweight." writes Grier.

A major contributor to the stigma is the impression that individual can easily control their weight and that there is a lack of self-discipline and personal failure that are responsible for excess weight. Societal messages can enhance these stigmas and contribute to antifat attitudes, he writes.

In Geier's study, 59 female college psychology students aged 18-21 completed a few questionnaires about their life satisfaction and life experiences.

Then, they were shown various advertisements. One set was a "before-and-after" diet type of ad with side-by-side pictures of obese people and slim people. The other type was a "joy of gardening" ad featuring a well-groomed, pleasant-looking person who was either obese or slim. Volunteers were not told the study involved obesity -- although a few said they suspected it was. His intention was to see the impact of exposure to "before-and-after" diet ads.

The volunteers then assigned various adjectives to subjects in each ad: lazy, motivated, ugly, good, blameless, bad.

• Overall, volunteers showed a "strong" antifat bias.
• Having a close friend or relative who was obese appeared to have a lessening effect on general antifat attitudes but it did not influence the belief that weight is controllable.
• Those who indicated greater satisfaction in their own lives showed less negativity toward the obese people in the ads.

Studies of racial stereotyping have found a similar effect -- that negativity is greatest among those who are less satisfied with their own lives, writes Geier.

His study also found that:

• Subjects rated the woman in the 'before' picture as more attractive when she was in the before-picture-only ads than when she was in the 'before-and-after-picture' ads.
• They found that the students also rated 'after' pictures as more attractive in the 'after' pictures only ads than in the 'before-and-after' ads.

One explanation for this, writes the author, is what is termed 'the caterpillar to butterfly' effect'. Once a subject has witnessed the appealing future, the present suddenly emerges as more attractive, says Geier.

"Most agree that stigma is wrong, but fewer appreciate how damaging stigma can be on the psyche and the physical health of the targeted individual," he says.

One thing that should be obvious is that shaming obese people is not the same as helping them, Geier concludes.

SOURCE: Geier, A. Eating and Weight Disorders, December 2003; vol 8: pp 282-288.

Sallie Elizabeth has always had large breasts and a big bottom, and she has accepted them as part of her genetic makeup. But when cellulite appeared in the back of her upper leg, she "freaked out" and resolved to do something about it.

A friend recommended endermologie, a deep massage treatment using a motorized device with two adjustable rollers and controlled suction. The device is said to improve the look of cellulite by gently folding and unfolding the skin for smooth and regulated deep-tissue movement.

The cellulite is "less visible," she says, noting her smoother, softer skin. "I feel healthier. My circulation has improved ... and I feel more relaxed."

To keep up the effects, the 20-something model visits Smooth Synergy, a cosmedical spa in Manhattan, once or twice a week for 35-minute sessions with the endermologie machine and a technician.

Elizabeth may be enjoying her cellulite-busting experience, but experts raise eyebrows at many tools or treatments purported to reduce the appearance of cellulite, trim fat in specific areas, shed pounds, or build muscle -- particularly if they claim to replace exercise and good nutrition.

"They're a waste of money," says Richard Cotton, a spokesman for the American Council on Exercise and chief exercise physiologist for myexerciseplan.com.

If that is the case, then a sizeable chunk of currency could be going down the drain. According to a Federal Trade Commission (FTC) weight loss advertising trend report, in the year 2000 alone, consumers spent an estimated $34.7 billion on weight-loss products and programs.

While it is not known how much of that accounts for sales of unproven or fraudulent merchandise, an FTC study of weight loss ads from different media shows that nearly 40% of ads make at least one false claim, and an additional 15% make at least one claim that is very likely false, or lacks proof.

To add to the number soup: Results from a national health survey conducted between 1999 and 2000 indicate that more than six out of every 10 Americans are overweight or obese, a figure that has increased dramatically in recent years.

Another recent survey that looked at the attitudes of Americans adults toward their own weight found that despite the fact that two-thirds of men were considered overweight, only about half (51%) said they wanted to lose weight versus 68% of women who said they wanted to lose weight.

Put it all together and there are arguably more people wanting to use weight loss products, and according to the government's trend report, the "marketplace has responded with a proliferating array of products and services, many promising miraculous, quick-fix remedies."

There are, indeed, numerous therapies, including weight loss programs and dietary supplements. Then there are the popular treadmills, bun and ab rollers, the body bow, and bun and thigh max.

For this piece, however, WebMD looked only into passive exercise devices such as electrical muscle stimulators and toning tables, cellulite reduction therapies, and gels, creams, eyeglasses, earrings and similar doodads marketed for weight loss, and muscle-building.

Granted, not all remedies may be the same, but health professionals say far too many of them can't be trusted.

Feb. 17, 2005 -- Marital strain is a home wrecker that can endanger the heart. So says a 10-year study of 3,000 men and women aged 18 to 77.

All participants were married or living in a "marital situation." The researchers collected data on marital discord. Health was tracked for a decade to see who developed heart disease or died of any cause during the study.

For both men and women, marital strain affected their health.

Marital Strain and the Married Couple

The worst health risk was seen in women who hushed up when conflicts arose with their spouse. They said they usually or always silenced themselves in such situations.

Those women might have thought they were keeping the peace, but they paid dearly for it. Women who kept mum in marital conflicts had four times the risk of dying during the study, compared with women who spoke their minds.

For men, emotional expression wasn't the issue. Instead, their hearts suffered when they saw their wives come home from work burdened by job stress.

"Men reporting that their wives' work was disruptive to their lives were 2.7 times more likely to develop heart disease," say the researchers, who included Elaine Eaker, ScD, of Wisconsin-based Eaker Epidemiology Enterprises. The findings were reported in Orlando, Fla., at the Second International Conference on Women, Heart Disease, and Stroke.

A Health Perk for Husbands

Married men were about half as likely as single men to die of any cause during the study. That finding held true after adjusting for blood pressure, body mass index, smoking, diabetes, and cholesterol.

Single men were more likely than husbands to be smokers, says Eaker, in a news release. Past studies have also shown a health advantage for married men.

For women, marital status wasn't linked to heart disease or dying. The connection emerged when Eaker used more contemporary measures of marital strain, such as "self-silencing" behavior.

What's a Couple to Do?

Learning to handle conflict and defuse stress is a healthy idea for everyone. Counseling can help with that, with therapists available for individuals and couples. Doctors may also want to ask their patients about stress and make counseling referrals as needed, says Eaker.

Dec. 3, 2003 -- Did you hear the one about the guy who couldn't take a joke? The problem was a real no-brainer. His brain was just wired funny.

Thanks to new imaging techniques, researchers are now learning more about how the brain processes humor and may one day be able to help people who have lost their sense of humor due to depression or other psychological disorders.

Although researchers have long known that a good sense of humor has many healthy benefits, relatively little is known about how humor is handled by the brain.

But a new study shows that humor may give people a natural high by activating the same reward centers in the brain that have previously been linked with happiness and drug-induced euphoria.

Funny Business in the Brain

In the study, published in the Dec. 4 issue of Neuron, researchers used magnetic resonance imaging (MRI) to study how the brains of 16 healthy adults responded to funny vs. non-funny cartoons. The brain scans were used to detect areas of the brain that were activated when the subject found the cartoon funny.

The study showed that in addition to activating areas of the brain involved in language processing, humor also stimulated regions of the brain known as reward centers, such as the amygdala, which releases dopamine. Dopamine is a powerful chemical that plays a vital role in the brain's pleasure and reward system.

Researchers say the findings help explain the hedonistic aspects of humor and may also lead to new treatments for depression.

"Loss of one's appreciation of the rewarding aspects of humor is a frequent and fairly specific symptom of depression," says researcher Allan Reiss, MD, of the department of psychiatry and behavioral sciences at Stanford University, in a news release. "We believe that utilizing studies such as this may be one way to more specifically identify individuals at risk for depressive disorders as well as early response to treatment in persons who are already depressed."

Dec. 4, 2002 -- Vacations and leisure time usually provide welcome relief from the stresses of everyday life, but for some people free time may make them sick. For the first time, a new study shows "leisure sickness" may be a real issue for a significant number of adults.

Until now, Dutch researchers say only occasional references have been made to the phenomenon of leisure sickness, which they say can best be described as frequently feeling ill during weekends and/or vacations. To get a first look at the nature of the condition how common it is, they surveyed about 2,000 men and women about whether they fit that description of weekend and vacation sickness.

Their report appears in the current issue of Psychotherapy and Psychosomatics.

They found 3.2% of both men and women identified themselves as suffering from vacation illness, but more men than women (3.6% vs. 2.7%) said they suffered from weekend illness.

The most commonly reported symptoms of leisure illness included headache/migraine, fatigue, muscular pains, and nausea. Viral infections, such as cold or flu, were also frequently reported in relation to vacations.

Most people with the condition had suffered from it for more than 10 years, and the onset of the illness was often stress-related. Sufferers attributed their illness to difficulty making the transition from work to leisure as well as the stress associated with travel and vacations

Although researchers found few lifestyle differences between those with leisure sickness and those without, the study suggests people with a large workload, high need for achievement, and a strong sense of responsibility with respect to work may be especially vulnerable to the problem.

Study author J.J.M. Vingerhoets, of the department of clinical health psychology at Tilburg University in The Netherlands, and colleagues write that future studies should look at the causes of this mysterious condition and investigate potential treatments.

SOURCE: Psychotherapy and Psychosomatics, 71, 2002.

June 25, 2001 -- For 10 years, Los Angeles resident Vicky O'Toole experienced severe cramping, bloating, and nausea related to her period.

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"Doctors kept telling me it was just PMS, but finally I learned I had endometriosis," a condition in which uterine tissue grows abnormally outside the uterus, she says. "I kept a careful list of all my symptoms for two months, and when they occurred. That convinced my doctor to listen to me. I hope other women will realize these symptoms can be a sign of significant illness. Discuss them seriously with your doctor, and be sure to get a thorough exam."

Alexander Shifrin, MD, agrees.

When patients arrive in his office saying they experience premenstrual syndrome, he first asks them to fill out a detailed questionnaire about their symptoms, including exactly what the symptoms feel like and when they occur. Then he takes a medical history, with a focus on previous obstetrical, gynecological, neurological, and psychological issues. Finally, he does a thorough physical exam.

"You want to rule out anatomical abnormalities such as fibroids and, of course, a disease such as endometriosis, which can masquerade as PMS. It is particularly important to look at the patient as a whole person, not just focus on gynecological symptoms," says Shifrin, an ob-gyn, associate director of residency programs at Long Island College Hospital in Brooklyn, and assistant clinical professor at the State University of New York-Brooklyn.

Your heart and mental health may depend on your ability to reduce hurt and anger, even at yourself. So effective is forgiveness -- if we could find a way to learn and teach it -- that Stanford University is undertaking a project to learn how forgiveness can enhance health and relationships and even prevent disease.

But first, you might have to forgive yourself. Did you cheat on your spouse? Hit a child in anger? Steal something? Go off the wagon? The list of potential human misdeeds is long.

If someone else did these things, you might learn to forgive them or at least let go of the anger. That's because it's easier to forgive others. After all, they don't live in your head, reading you the same old riot act. All the world's major religions preach the power of forgiveness. But forgiveness is such an elusive act, quicksilver in its ability to be strongly felt one moment and then dart away beyond reach the next.

According to Stanford's call for volunteer subjects, the definition of forgiveness is a simple one, not a near-impossible requirement that a person apply for sainthood. "Forgiveness," it says, "consists primarily of taking less personal offense, reducing anger, and the blaming of the offender, and developing an increased understanding of situations that lead to hurt and anger."

When You Need to Try to Forgive Yourself

Sharon A. Hartman, LSW, a clinical trainer at the Caron Foundation, a drug and alcohol treatment center in Wernersville, Pa., deals with the need to forgive every day. "These are such shame-based diseases," she says. "Forgiving oneself is of the more difficult parts of recovery."

A chronic state of anger and resentment interferes with life, Hartman points out. Countless studies also show stress and anger can cause or worsen diseases, such as cancer, heart disease, and various autoimmune disorders. "When resentment is interfering with your life, it's time to forgive yourself," she says. "So many people have a constant, critical voice in their heads narrating their every move." She says she calls her critical voice "Gertrude" and tries to counteract Gertrude's eternal litany with positive affirmations -- that she is getting better, that she is less angry. "Forgiving doesn't mean not being angry with yourself, but not hating yourself.

"No one," Hartman adds, "can beat us up better than we beat ourselves up."

Forgiving Requires Specificity

"I think people often try to forgive themselves for the wrong things," says Joretta L. Marshall, PhD, a United Methodist minister and professor of pastoral care at the Eden Theological Seminary in St. Louis. "We think we ought to forgive ourselves for being human and making human mistakes. People don't have to forgive themselves for being who they are -- gay or lesbian, or having some kind of handicap. Forgiveness means being specific about what we did that needs forgiving."

"I think forgiveness is often confused with condoning or lack of accountability," Hartman says. "This is a world with high performance standards. People think they need to be perfect. Yet people do things -- intended or not -- that hurt others. You may not intend to harm, but the other person is no less hurt." That's when you need to stop at some point and forgive yourself.

Hanging on to Resentment Can Have Advantages

"It's about relinquishing a source of pain and letting go of resentment. People think forgiving yourself means you are letting yourself get away with whatever it was you did," Hartman goes on. "The pain and anger you are feeling are supposed to be your punishment."

People want to feel pain and resentment? "Oh," exclaims Hartman, "resentment is a very attractive way of putting a barrier around yourself as protection against being hurt again."

Do You Need a Therapist?

If toting around self-loathing like a heavy backpack has advantages, how do you set it down?

It can be done without formal therapy, Marshall says. "But not without community of some kind. It is in the context of our relationships (whether with therapists, pastors, counselors, churches, families, and friends) that we experience the grace of being forgiven and forgiving others." Grace, of course, is a peace of mind bestowed regardless of whether we deserve it or not.

"You need to talk to someone as a rule," Hartman says.

Dec. 29, 2004 - Want to live longer? Start exercising regularly and melt fat away. An hour of exercise can improve fitness, but losing body fat staves off the deadly metabolic syndrome, according to new research.

The study appears in the current American Journal of Preventive Medicine.

High blood pressure, high cholesterol, elevated blood sugar, and excess belly fat are the mix of risk factors known as metabolic syndrome. This cluster of risk factors increases the risk for heart disease, diabetes, and early death.

Exercise has been recommended to reduce a variety of these risk factors. Studies have shown that exercise works to reduce body fat, especially fat around the waistline, which is one of the risk factors for the metabolic syndrome. It also helps with heart disease factors like high blood pressure and high cholesterol. But this current study looks at the broader effects of regular exercise on this mix.

The study involved 115 people aged 55 to 75. All had untreated high blood pressure; 42% already had metabolic syndrome.

"The participants, in many ways, represent the 'typical' older American with mild [high blood pressure], many of whom are overweight, and at risk for [heart disease] and diabetes," writes lead researcher Kerry J. Stewart, EdD, a cardiology researcher at Johns Hopkins School of Medicine.

Half were assigned a six-month moderate-intensity exercise program about one hour long, three days a week. However, they stuck with their regular eating habits.

The exercise regimen:

• A short stretching warm-up
• Two sets of resistance training (like hand weights), 10 to 15 repetitions each
• 45 minutes of aerobic exercise, using a treadmill, stationary cycle, or stair machine
• As fitness improved, the exercise intensity was increased to keep heart rate at target levels.

The participants also were measured for aerobic fitness, muscle fitness, and body composition.

Metabolic Syndrome Backs Off

Six months later, all volunteers had numerous tests for signs of metabolic syndrome. "Exercise training ... increased aerobic and strength fitness, reduced total and abdominal obesity, and increased lean body mass" for men and women alike, writes Stewart.

The exercisers' risk factors improved, whereas those of the comparison group didn't, he says. The exercisers lost more body and waistline fat and gained more muscle than the comparison group. Heart disease risk factors, like high blood pressure and cholesterol, also improved more in the exercisers.

After six months, 18% of exercisers and 15% of the comparison group no longer had metabolic syndrome. However, 8% of volunteers in the comparison group had developed the syndrome, Stewart reports.

"Older people can benefit greatly from exercise, especially to reduce their risk for developing metabolic syndrome," says Stewart in a news release. "Our results show that this population can be motivated to follow through with a moderate exercise program, and for some risk factors, such as abdominal fat, exercise can be as effective as what is accomplished today with drugs."

Other examples of moderate-intensity activities include walking briskly, recreational swimming, or bicycling 5-9 miles per hour on level terrain.