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From the time Debra Sherman and her husband, Mark Wilcox, learned through prenatal genetic tests that they were having a boy, they agonized over whether to circumcise their baby. "I didn't want the first decision we make for him to be a bad one," Sherman says.

In the end, the Chicago couple decided against taking that extra surgical snip of foreskin from their son's penis. Without overwhelming medical evidence favoring circumcision, Sherman says, it would have seemed to her like deciding to cut off his ear lobes.

"From everything we read and everyone we talked to, it seemed like there was no medical reason to do it," says Sherman, whose son, Alex, is 7 months old. "Plus, I'm not religious, Mark's not religious, and I just thought it was an awful thing to do to a baby."

The fact is, the circumcision decision is a very personal one. Experts say parents need to understand the advantages and disadvantages, then decide what's right for them. Here are the latest facts and a look at how some parents are choosing.

Vive la Difference

Locker rooms have a way of reducing each sex to its least common denominator. Peel away the Levi's and Jockeys, put aside sizes and shapes, and the equipment is all basically the same -- at least that was the case when today's generation of new dads were kids.

Parents in the United States have routinely circumcised their sons since the 1940s, in large part because doctors believed it promoted good hygiene and prevented disease. To Jews and Muslims, circumcision is a sacred ritual symbolizing their covenant with God. By the mid-1960s and early 1970s, about 90% of all boys were circumcised.

But that trend is shifting. In 1996, circumcision rates declined to about 65%, although rates differ depending on demographics: 80% in the Midwest, 68% in the Northeast, 64% in the South and 34% in the West. Among whites, the rate is 81%, compared with 65% among blacks and 54% among Hispanics.

In fact, many observers predict that by the time the first generation of boys born in the new millennium is old enough to hit the locker-room showers, the haves and have-nots may be about equally divided.

The biggest reason for the change is mounting evidence that the medical benefits aren't as compelling as once believed. In addition, anti-circumcision groups have turned up the heat on the debate. They claim the practice is cruel and unnecessary and are spreading the word via Web sites, mailings, bumper stickers, T-shirts and international conferences.

Circumcision rates are much lower in other parts of the world, including most of Europe, Asia and Latin America. Only 48% of boys in Canada, 24% in the United Kingdom and 15% of boys worldwide are circumcised.

Probably the strongest cause for pause among parents, however, came this year when the American Academy of Pediatrics issued a policy statement saying it does not endorse routine circumcision.

"There are potential benefits as well as risks, but the data wasn't sufficient for us to say every newborn male needs to be circumcised," says Dr. Carole Lannon, clinical associate professor of pediatrics and internal medicine at the University of North Carolina, Chapel Hill, and chairwoman of the task force on circumcision. "Each parent needs to make that decision."

June 2, 2006 -- Been sitting on the sidelines from exercise for awhile? Think you're past the point of no return? Think again.

New research shows that middle-aged, overweight adults who have been sedentary for six months can overcome the negative health effects of inactivity with just six months of exercise.

"Many of the detrimental effects of physical inactivity can be reversed with a similar period of exercise training," write Duke University exercise physiologist Jennifer Robbins and colleagues.

What's more, people with the steepest health setbacks from inactivity seem to reap the biggest benefits from getting back to exercise, Robbins' team reports.

Robbins presented the findings at the American College of Sports Medicine's 53rd annual meeting in Denver, this week.

Sedentary for 6 Months

In the study, Robbins and colleagues looked at 53 middle-aged, overweight people who had been sedentary for six months.

Before and after the six-month period, researchers checked participants for 17 traits, including:

• Body mass
• Minimal waist size
• Fat that is deep inside the abdomen (visceral fat)
• LDL ("bad") cholesterol
• Time to exhaustion (how long it takes to become exhausted by exercise)
• Sensitivity to insulin, a hormone that controls blood sugar

As you might guess, six months of physical inactivity weren't good for those traits.

During the sedentary period, participants' waists expanded. They added more visceral fat, became exhausted by exercise quicker, and showed more signs of the metabolic syndromemetabolic syndrome, a cluster of risk factors that makes heart diseaseheart disease and diabetesdiabetes more likely.

Getting Back in the Game

After six months of sedentary life, participants started exercising in one of three programs designed by the researchers.

Thirty-three participants stuck with their exercise program for six months. At the end of that time, they showed improvement in 13 of the 17 traits measured. Their readings for those traits either returned to where they had been before the sedentary period or became even better.

"In addition, we observed that individuals who experienced the greatest decline while inactive appeared to obtain the largest improvements during the exercise regimen that followed," wrote Robbins and her colleagues, who included other experts from Duke and from East Carolina University in Greenville, N.C.

Grueling Workouts Not Required

Participants didn't have to crank their workouts to extremes to reap the benefits.

"When looking at the group as a whole, we found that it wasn't the participants with the highest intensity of exercise who accounted for the combined beneficial effects," Robbins said, in a Duke news release.

"That should be reassuring for people to know they don't have to do a high-intensity workout to get these benefits of exercise," Robbins added.

Keep in mind that participants didn't just decide to hit the gym after a long idle period without getting medical clearance.

Anyone who's been inactive -- especially for health reasons -- should get a doctor's OK before starting a new workout program. Newcomers and long-time exercisers alike should also take care not to push themselves too hard, too soon.

Robbins' study showed that better fitness is within reach for people who decide to stop being sedentary. The keys are patience, consistency -- and making the decision to get started (with appropriate medical help, of course).

SOURCES: American College of Sports Medicine's 53rd Annual Meeting, Denver, May 31-June 3, 2006. News release, Duke University School of Medicine.

Want to be sharper at work? Feel less tired at home? Spend some quality time with your spouse? How about enjoying a cookie without guilt?

If you answered "yes" to all of these questions (and who wouldn't?), exercise is the answer.

Being physically active offers benefits far beyond the obvious. (Of course, an improved physique and a clean bill of health aren't too shabby, either.)

If you've been looking for the motivation to begin an exercise program or get back into working out regularly, here are 10 fitness facts that may help inspire you to get off the couch.

1. Exercise Boosts Brainpower

Not only does exercise improve your body, it helps your mental function, says certified trainer David Atkinson.

"Exercise increases energy levels and increases serotonin in the brain, which leads to improved mental clarity," says Atkinson, director of program development for Cooper Ventures, a division of the Cooper Aerobics Center in Dallas.

All that makes for a more productive day.

"It is clear that those who are active and who exercise are much more productive at work," says Todd A. Astorino, assistant professor of kinesiology at California State University-San Marcos.

Improved productivity not only makes you a better worker, it makes things better for everyone in the workplace. Companies with less wasted work hours and less sick time end up with lower health care costs -- and an improved bottom line, Astorino says.

2. Movement Melts Away Stress

As much as it may stress you out just to think about exercising, once you actually start working out, you'll experience less stress in every part of your life.

"Exercise produces a relaxation response that serves as a positive distraction," says Cedric Bryant, chief exercise physiologist for the American Council on Exercise. He says it also helps elevate your mood and keep depression at bay.

You're not the only person who will benefit from more happiness and less stress in your life. When you're less stressed, you're less irritable, Atkinson says -- and that could improve relationships with your partner, kids, and co-workers.

3. Exercise Gives You Energy

You might be surprised at how, say, popping in a workout tape for 30 minutes in the morning can change your whole day. When endorphins are released into your bloodstream during exercise, says Astorino, "you feel much more energized the rest of the day."

And when you improve your strength and stamina, it's easier to accomplish everyday tasks like carrying groceries and climbing stairs. This also helps you feel more energetic over the course of the day.

A common excuse among Atkinson's clients is that they're too tired to exercise, he says. While exercise may make you feel more tired at first, he says, that won't last long.

The physical tiredness you feel after working out isn't the same as everyday fatigue, he says. Besides, once your body adjusts to exercise, you'll have more energy than ever.

Aug. 3, 2005 -- Overweight people are less likely to receive recommended preventive care services, such as mammograms, Pap smears, and flu shots, according to a new study.

Overweight women are more likely to get breast and cervical cancer, and overweight elderly people have a higher risk of complications from flu, says researcher Truls Ostbye, MD, PhD, a professor of community and family medicine at Duke University, in a news release.

Despite this, overweight people are less likely to receive preventive services, he says.

More Weight, Less Services

Researchers found that the more overweight middle-aged white women were, the less likely they were to receive mammography or Pap smears to screen for these diseases.

For example, white women of normal weight were more than 50% more likely to receive a mammogram than a severely obese white woman in 2000.

Even moderately overweight women were less likely to receive mammograms and Pap smears.

In addition, elderly obese white men and women and were less likely to get their recommended flu shots.

However, the study showed that the link between obesity and less frequent use of these three preventive care services was not found among black men or women.

The results appear in the September issue of the American Journal of Public Health.

Obese Miss Out on Cancer Screening, Flu Shots

In the study, researchers analyzed the relationship between body mass indexbody mass index (BMI, a measure of weight in relation to height used to indicate obesity) and use of the following preventive care services: mammograms to screen for breast cancer, Pap smears to screen for cervical cancer, and flu shots to reduce the risk of influenza.

Researchers found that as BMI increased, the likelihood of receiving each of the three recommended preventive care services decreased in 1995-1996 and in 2000, although overall use of these services increased during this time period.

• Mammograms. 75% of normal-weight women had received a mammogram for breast cancer screening within the last two years compared with 67% of obese women in 1996. The same trend held true in 2000, although a greater proportion of all women received screening mammograms.
• Pap tests. 73% of normal-weight women vs. 66% of obese and 54% of severely obese women (BMI over 40) received Pap smears in 2000.
• Flu shots. 78% of normal-weight men and women received flu shots in 2000 compared with 70% of moderately obese people and 56% of severely obese.

The higher a person's BMI the less likely they were to receive any of the preventive services. In other words, normal-weight people most likely received these services, followed by overweight people and then obese people.

Missing Out on Screening Risky

Researchers say delaying or avoiding cancer screening can make the difference between life and death in some cases. Earlier detection and treatment leads to better chances of survival.

In addition, failure to get a flu shot among the elderly increases the risk of potentially deadly complications from influenza.

Ostbye says the study suggests that income, education, and access to health care were not important reasons for the discrepancies in preventive care services. Instead, researchers say significant reasons may include social stigma, avoidance of health care by patients, and bias by health care providers.

They say these results present an example of the "inverse care law" in which people who need health care services the most are often the least likely to get them.

Everyone, including normal- and overweight people, needs to discuss the need for preventive services with their doctor.

Oct. 26, 2004 -- Dietitians and doctors plead with increasingly obese Americans to eat less and exercise more, often to no avail. Now, one diet researcher is pointing to growing evidence that fewer food choices could be part of the answer.

"We're all eating more calories, and you have to ask yourself why that is," says Susan Roberts, PhD, who runs dietary and metabolism research at a Tufts University in Boston.

According to Roberts, one reason for Americans' increased caloric intake -- as much as 350 more calories per day on average than 15 years ago -- is that we have too many food choices, especially of bad foods, and that animals, especially humans, find that variety irresistible.

Researchers are quick to point out that there are many proven reasons behind the 60%-plus rate of overweight and obesity in the U.S. population. In addition to eating more, technological improvements mean that we have to exercise less to work, do chores, or do just about anything else.

"Individuals are now left with a stark choice of whether or not to fill the gap with voluntary physical activity" such as joining a gym or blocking of time each day for a run, says Elizabeth Frazao, an assistant deputy director with the U.S. Department of Agriculture Economic Research Service.

But at the same time, inexpensive, high-fat, high-calorie foods abound in restaurants, vending machines, and on dinner tables. Americans love this abundance of food choices -- a stubborn fact that haunts advocates and dietitians trying to push lighter eating.

But Roberts points to evidence showing that simply limiting the variety of available foods, therefore limiting food choices, can be effective in limiting consumption.

"The more varied your diet, the more calories you consume," she told an audience at a national obesity prevention conference sponsored by the USDA.

More Food Choices Makes Us Eat More

As many as nine studies suggest that mere choice makes humans eat more, even when the food choices are seemingly meaningless. Experimenters in one trial got subjects to eat 14% more on average per meal just by offering them two different pasta shapes instead of one.

The studies have been confirmed dozens of times in animals, Roberts says. And a 2001 University of Buffalo study backed up the conclusion by analyzing 39 animal and human trials.

Part of the reason for the variety effect is that humans and other mammals just like food more when it differs from what they just ate. One study showed that people reliably ate more when sausages, bread, chocolate, and bananas were each served in four consecutive courses than when they were served four times together on a plate, the Buffalo researchers wrote.

Few suggest that asking or forcing food manufacturers to market fewer food choices is the answer. But Roberts says researchers have paid relatively little attention to effective ways of helping people design meals or tailor shopping so that their evolutionary drive to eat less kicks in.

"I think we should be putting more effort into looking at this," she says.

Feb. 11, 2004 -- Much like the controversy surrounding the health of diet guru Robert Atkins, MD, at the time of his death last April, the debate about the safety of the low-carbohydrate diet Atkins became famous for isn't likely to calm down any time soon.

Critics of low-carb approach say the high-fat content of the Atkins diet, which advocates meat, eggs, and cheese and limits bread, pasta, and fruit, raises the risk of heart disease. But low-carb devotees say the diets are safe and effective in promoting weight loss, which in turn lowers the risk of heart disease.

But researchers say the facts boil down to this: There simply isn't enough data on low-carb diets to support either argument.

"There are two extremes, but I think there is no evidence to support either extreme in terms of benefits or harmful effects of this kind of diet," says Frank Hu, MD, PhD, associate professor of nutrition and epidemiology at the Harvard School of Public Health.

Many Questions, Few Answers

The prevailing view during the last 20 years has been that a low-fat diet is the best way to achieve weight loss and reduce the risk of heart disease. But the epidemic of obesity that the U.S. is currently experiencing indicates that low-fat diets may not be the solution.

"The question now is whether the other extreme, a low-carb diet, is the answer," says Hu.

During the "induction" phase of Atkins, in which carbohydrates are most strictly limited, people typically consume as much as 60% of their calories from fat, including "bad" saturated fats from animal sources that raise cholesterol levels and "good" unsaturated fats, such as those found in olive oil and fish, which have favorable effects on cholesterol profiles.

Although the Atkins diet has never specifically prescribed recommended amounts of fat or protein, an Atkins educator recently told The New York Times that only 20% of a dieter's calories should come from saturated fat.

Hu says getting even 20% of calories from saturated fat is still too high. The American Heart Association and many other health organizations recommend a maximum intake of 10% of total calories from saturated fat in order to reduce the risk of heart disease.

"Based on what we know so far, you can expect that if you eat this kind of diet for many years, there could be harmful effects on heart disease and diabetes," says Hu. "The benefits of weight loss may outweigh the potential harmful effects of saturated fat and cholesterol within the short-term, but in the long-term we don't know."

The Evidence on Low-Carb Diets

Researchers hope studies currently underway will help answer some of those questions about the safety of low-carb diets. Until then, only short-term studies have addressed these issues.

A review of the research currently available on the safety and effectiveness of low-carb diets published last year in The Journal of the American Medical Association concluded that there was "insufficient evidence for or against the use of these diets."

"Despite the large number of Americans who have apparently adopted this approach to weight loss and/or weight maintenance, we know little of its effects or consequences," write researcher Dena Bravata, MD, of the Center for Primary Care and Outcomes Research at Stanford University and colleagues.

Some short-term studies have shown an improvement in cholesterol levels after six months on the Atkins diet. But Bravata's study showed that of the few low-carb studies that included information on cholesterol levels of the participants, there was no change in total, LDL ("bad") and HDL ("good") cholesterol levels. In contrast, the larger number of studies on higher-carbohydrate diets that included information on cholesterol levels showed a significant decline in total cholesterol levels.

Researchers say the lack of long-term data on low-carb diets severely limits their ability to evaluate their safety and effectiveness in promoting weight loss as well as reducing the risk of heart disease.

"The bottom line is that there is no single diet that is optimal for everyone," says Hu. "But if you choose the healthy sources of fats, carbohydrates, and protein, you can have many options to design a healthy diet not only for weight loss but also for the prevention heart disease and diabetes."

April 8, 2003 (New York) -- Dieters are more likely to lose pounds and keep them off when they get additional support. Researchers at a news conference say that structured weight-loss programs not only help people lose more weight but also help maintain that new weight.

In his research, Stanley Heshka, PhD, compared dieters randomly assigned to either a self-help regimen or to a structured commercial weight-loss program -- in this case, Weight Watchers. The well-known company did fund the study, but investigators conducted the clinical trial independent of the firm.

After the first year of the study, researchers found that the self-help participants lost and maintained about three pounds, while the Weight Watchers group lost and maintained about 9 to 11 pounds. After two years, the self-helpers' weight went back to near normal, while the Weight Watchers set had gained a little weight but had still kept a loss of about six pounds.

The study appears in the April 9 issue of The Journal of the American Medical Association.

?

Researchers have not yet figured out the particular reasons why the commercial weight-loss program was more effective than the self-help regimen, but Heshka says the structure and assistance provided by Weight Watchers may be important factors.

"It keeps your attention focused," says Heshka, the lead researcher of the study and a research associate at the New York Obesity Research Center at St. Luke's-Roosevelt Hospital. "It may be support in a sense that others are giving you hints about what works for them, others are encouraging you, and may actually be motivating you to try harder."

The group support environment surrounding certain weight-loss programs may be more effective for women, Heshka says, because they tend to like the idea of sharing success and failure stories more than men. He points to the fact that 85% of the participants at Weight Watchers are women.

In another study published in the same issue of JAMA, researchers led by Deborah F. Tate, PhD, of the Brown University School of Medicine/Miriam Hospital in Providence, R.I., randomly assigned people who were at risk of type 2 diabetes to two different Internet weight-loss programs.

Both sets of dieters were given at least one face-to-face counseling on proper nutrition, exercise, and behavior change. They were both given a private Web site with a tutorial on weight loss, and each week, all patients received educational materials and were prompted to submit his/her weight information. Only one of the groups, however, also received at least weekly email support from a professional therapist as part of their weight-loss program.

After one year, investigators found that those who received email counseling fared better in losing and maintaining the weight loss (roughly 9 pounds) compared with their counterparts (4 pounds).

At least one expert isn't surprised about the role counseling has apparently played in both Tate's and Heshka's studies. "If you're with somebody who's encouraging you, somebody who's telling you that you look good, you're not fighting anything. You're making these people a part of your life," says Catherine D. DeAngelis, MD, MPH, editor of JAMA, who notes that lifestyle changes are proven to work for weight loss.

Another authority on weight management, however, says it's too soon to tell what exact component works best for losing and keeping off the pounds. "We don't really have the research to tease out whether it's support or physical activity or diet that's important," says Susan Z. Yanovski, MD, executive director of the National Task Force on Prevention and Treatment of Obesity with the National Institutes of Health.

Successful weight loss today, says Yanovski, involves multiple elements, including a modest decrease in caloric intake and increasing exercise -- necessary parts of any weight-loss program.

Dec. 5, 2000 -- If you're like a lot of Americans, you probably could stand to lower your cholesterol. A new study shows that the choice to do so is up to you -- well, sort of. The researchers tell WebMD that genes may have more power than sheer will in the fight against high cholesterol.

"We were looking into why people differ in their response to cholesterol lowering diets," says study leader Margo A. Denke, MD, associate professor of medicine at the University of Texas Southwestern Medical Center in Dallas. "Some people try very, very hard on a diet, but can't even budge their cholesterol levels. We were trying to determine how much of that was due to genetics."

Between 1997 and 1999, 56 families -- 92 adults and 134 children -- in the Dallas-Ft. Worth area followed two special diets.

During the study, all members of a family got their fat -- 20-25% of total calories -- in the form of either saturated fat-laden butter or margarine with unsaturated fat. For each regimen, families were provided with specially formulated breads, baked snacks, and spreadable fat for cooking. After five weeks, they went back to their normal diet for a month, then switched to the other diet for five more weeks. Cholesterol levels were measured at different intervals during the study.

The research -- which, luckily for the study participants, was halted between Thanksgiving and Christmas each year -- is published in the Dec. 6, 2000 issue of The Journal of the American Medical Association.

"In our study, 80% of people had lower cholesterol levels when they consumed margarine compared to butter," Denke, who is also at the UT Southwestern's Center for Human Nutrition, tells WebMD. Although the overall trend was for cholesterol levels to drop with less saturated fat intake, genetics definitely played a role. Parents who responded -- whose cholesterol went up and down with diet -- had children who responded as well. "And if the parents don't respond, neither do the children," she says.

People are powerless over their genes but one take home message "is that margarine is a better choice than butter, which is one of the most potent cholesterol-raising fats," says Denke. There is increasing evidence, including a recent study looking at the blood vessels of children who'd died in car accidents, that plaques that clog blood vessels begin forming much earlier than previously thought. "What you eat really is very important," she says, "and it is especially important to start out right. There will be big pay-offs as you get older for learning a good diet when you're young."

The second, less obvious point, she says, is that heavier people reap much less benefit from cholesterol-lowering diets than do thinner folks. "A person who's overweight gets into trouble for two reasons. Being overweight itself raises their cholesterol," she explains, "and even when they try to lower cholesterol by diet, they won't get as much cholesterol lowering."

People "should realize that being overweight has very major consequences, and the only way to undo those consequences is to get thin. And "the only way" to do that, says Denke, is by eating fewer calories.

Exercise is more helpful for maintaining -- rather than spurring -- weight loss, says Denke. "We can undo an hour's worth of exercise with one little cookie. People will overeat for five minutes, not realizing that it will then take them five hours to burn off those calories with exercise. We have to focus on what we're putting in our mouth. Our study shows that it's really important to make good, sensible choices."

In the struggle with genes, Denke recommends switching from higher-fat choices to lean meats and low-fat dairy products, such as 2% or lower milk and low-fat sour cream.

In today's on-the-run society, where sitting down for a meal is sometimes an impossible luxury, the emergence of nutrition bars may seem to be just what the doctor ordered. Though these pocket-sized bars once found favor primarily with serious athletes looking for a competitive edge, now anyone who feels the need for a nutritional boost may keep a few stashed in a purse or a briefcase.

In the current bar-wars environment, there are literally hundreds of these prewrapped and portable products competing for shelf space at gyms, health-food stores, and supermarkets, with names ranging from PowerBar and Luna Bar to Balance Bar and MET-Rx. But nutritionists agree that not all bars are created equal. There are high-carbohydrate bars, protein bars, energy bars, breakfast bars, brain-boosting bars, meal-replacement bars, diet bars, and women-only bars. And with so much to choose from, consumers hungering for a quick nutritional fix -- whether they're recreational athletes, workaholics tied to their desks, or overcommitted moms with barely a moment to spare -- may feel dizzy from all the product overkill and heavily hyped claims.

Digesting the Bar Facts

Without a doubt, grab-and-gobble nutrition bars are great for people who race nonstop from sunup to exhaustion. "They're a convenient alternative for someone who would otherwise be reaching for a doughnut or using the vending machines for snacks at the office," says Liz Applegate, PhD, lecturer in nutrition at the University of California at Davis. "But there's nothing magical about these bars. Most of them are fine, but some are too high in fat."

Dawn Jackson, RD, spokeswoman for the American Dietetic Association, concurs, noting that the bars are convenient, especially when you're physically active. "You wouldn't put a turkey sandwich in your pocket when you go on a bike ride, but you could easily bring one of these bars with you." However, she cautions, "some of the bars have as much sugar and as much saturated fat as a candy bar. So use them in moderation."

Steve Hertzler, PhD, RD, assistant professor of medical dietetics at Ohio State University, conducted a study showing that endurance athletes may not get the sustained energy boost that they're expecting from certain bars. In his research, he compared the effects on blood glucose levels of two popular energy bars -- the Ironman PR Bar and the PowerBar.

Hertzler found that the Ironman PR Bar provided increases in blood sugar levels that remained fairly steady, which could translate into enhanced performance for endurance athletes. By contrast, the PowerBar produced a quick rush of blood sugar, but it was followed by a rapid decline -- not much different than occurs with a Snickers bar.

The composition of the Ironman PR bar -- 40% carbohydrate, 30% fat, and 30% protein -- may have been responsible for its more sustained effect on blood glucose, says Hertzler. For endurance events, he "research shows that consuming a little bit of carbohydrate every so often during a race is going to improve performance."

Nutritionist Nancy Clark, MS, RD, points out that anything that provides calories will give you some energy. "Bananas give energy," says Clark, director of nutrition services at SportsMedicine Associates in Brookline, Mass. "Twinkies give energy. Energy bars give energy. That's because they all provide calories."

March 3, 2004 -- If weight loss is your goal, a 15-minute walk might not be enough, one study shows.

"Fifteen minutes is good for your heart and your psyche, but not if you're not going lose weight," researcher Michael Costanza, PhD, a biostatistician at the University of Geneva in Switzerland, tells WebMD.

His paper appears in the current issue of the American Journal of Public Health.

Some researchers suggest that people could battle obesity by cutting 100 calories out of their diets -- or by burning an extra 100 calories through 15-minutes a day of a moderate or brisk walking, he says.

His study provides "a more realistic look" at the calorie burn from these recommendations. People have to walk a whole lot farther to walk off those extra pounds, Costanza tells WebMD.

In his study, Costanza uses five years of lifestyle surveys completed by 6,010 Swiss adults aged 35 to 74 years old. He then projected the calories burned by following a daily physical activity recommendation that involved walking. The participants walking program involved 15 or 30 minutes of daily walking done at a pace that was either slow, moderate, brisk or athletic-brisk -- the pace followed determine what the metabolic rate was and how many calories would be burned.

If the population as a whole followed the recommendation for physical activity his findings showed that:

• The average adult who walked 15 minutes per day at a slow pace would burn only an additional 9 calories per day.
• The average adult who walked 30 minutes a day at a slow pace would burn only an addition 25 calories per day.

Assuming that the population as a whole participated in harder levels of the physical activity, the following results would be expected:

• Walking moderately for 15 minutes per day burned 36 calories per day, where as moderate walking for 30 minutes burned only 85 calories per day.
• Walking briskly resulted in an increase in the calories burned. Fifteen minutes of a brisk walk per day resulted in 60 calories burned, whereas 30 minutes a day of a brisk walk resulted in 129 calories burned.

"If your goal is to burn 100 calories a day, 15 minutes just won't do it," says Costanza. "There's very, very little calorie burn in a slow walk. Walking briskly for longer periods will provide a fairly substantial boost in calorie burn. Then you will lose weight."

That's not true, says Madelyn Fernstrom, PhD, director of the Weight Management Center at the University of Pittsburgh Medical Center.

"You can lose 10 pounds with a 15- or 20-minute slow walk -- if you do it daily -- and even if you didn't cut back on calories," Fernstrom tells WebMD. "That 100 calories you burn will give you that 10-pound weight loss in a year's time."

What gets people into trouble is eating an extra 150 calories to compensate for all that activity, she explains. People waste their weight-loss efforts.

Fernstrom dislikes public health messages that "overwhelm" people -- messages about walking 10,000 steps, or for 45 minutes or an hour every day -- for weight loss. "People end up think nothing is good enough," she says.

She advises setting realistic goals: Start with a half-mile, 30-minute walk; then do a mile in 15 minutes; then two miles in 30 minutes. "The idea is, can you get more activity into the time you have," says Fernstrom.

For faster weight loss, cutting back on calories will also help -- "but exercise allows you to barter for a little more food," she explains. "Say you're cutting back 500 calories a day to lose 1 pound a week. If you get some exercise every day, you only have to cut out 350 calories. And let me tell you, 150 calories are really precious when you're trying to lose weight."

"Sure, you can lose weight by cutting back on eating, without the physical activity component," Fernstrom says. "There are a lot of books out there that tell you how to do it. But weight loss is much easier with physical activity."

Oct. 16, 2002 -- Cancer patients are avid users of herbal remedies and dietary supplements. They're also much more willing than others to talk to their doctor about it. And researchers say that's good news for their health.

Two new surveys show cancer patients are about 30% more likely than others to tell their healthcare provider about herbal or dietary supplement use.

"Cancer patients are very forthcoming with their doctors about everything they're taking," says researcher Jessie A. Leak, MD, of M.D. Anderson Cancer Center in Houston, in a news release. "We don't know why, but perhaps they feel the need to disclose everything about themselves to better their chances of getting well."

Leak presented the results of the surveys today at the annual meeting of the American Society of Anesthesiologists in Orlando, Fla.

Researchers say doctors are concerned about their patients' use of herbs and dietary supplements because some of the preparations have been linked to potentially hazardous drug interactions, or shown to reduce the effectiveness of cancer surgery and chemotherapy drugs.

Products linked to negative side effects include ephedra, licorice, St. John's wort, ginkgo biloba, valerian, feverfew, ginger, and echinacea. The effects of these supplements can linger long after the body has processed them.

In the first survey, researchers asked 300 cancer patients scheduled to undergo surgery about their use of alternative treatments. About 18% reported using at least one herbal or other supplement. That rate of use is roughly comparable to that seen in the general population.

But 70% of the patients said they told at least one physician about their herbal use, and that's about one-third higher than the rate at which other types of patients report herbal use to their doctors. Researchers say previous studies have shown about 40% of preoperative patients tell physicians about using herbal products.

In a second survey, researchers looked at 154 cancer patients being treated in the center's pain management clinic. They found that 43% of these patients were using herbals, and like the other group, about two-thirds said they'd informed their doctor.

Leak says the fact that the patients in the pain clinic were more than twice as likely to be using herbals may be due to the fact that they were farther along in their cancer treatment and probably had spent more time educating themselves about alternative options. -->

Thanks to the Internet, becoming a hypochondriac is much easier than it used to be.

The easy availability of health information on the web has certainly helped countless people make educated decisions about their health and medical treatment, but it can be disastrous for people who are likely to worry. Hypochondriacs researching an illness used to have to scour books and ask doctors for information. Now a universe of information is available with a few mouse clicks.

"For hypochondriacs, the Internet has absolutely changed things for the worse," says Brian Fallon, MD, professor of psychiatry at Columbia University and the co-author of Phantom Illness: Recognizing, Understanding and Overcoming Hypochondria (1996).

So far, no studies have been conducted on just how hypochondriacs use the Internet, Fallon says. But the phenomenon is common enough to have a snappy name -- "cyberchondria."

Understanding Hypochondria

The medical condition called hypochondriasis is defined as worry over an imagined illness with exaggeration of symptoms, no matter how insignificant, that lasts for at least six months and causes significant distress. It tends to develop in the 20s or 30s, and it affects men and women equally. It sometimes comes on following the illness of a friend or family member, and it can also occur as a secondary illness to depression or generalized anxiety disorder.

Although it's often seen as harmless, sufferers know that it can shift from a quirky, neurotic character trait into a devastating obsession.

"Illness often becomes a central part of a hypochondriac's identity," says Arthur Barsky, MD, of Harvard Medical School and the author of Worried Sick: Our Troubled Quest for Wellness (1988). As a result, a hypochondriac's work and relationships suffer. And those with the condition aren't the only ones who pay the price: According to Fallon, hypochondria costs billions of dollars a year in unnecessary medical tests and treatments.

Contrary to what some skeptics think, hypochondriacs are not pretending or just trying to get attention. "They're absolutely not fakers or malingerers," says Barsky. "They really feel the distress they're talking about. It's just that their feelings don't have an obvious medical basis."

"What hypochondriacs have trouble accepting is that normal, healthy people have symptoms," says Barsky. Hypochondriacs tend to be very aware of bodily sensations that most people live with and ignore. To a hypochondriac, an upset stomach becomes a sign of cancer and a headache can only mean a brain tumor. The stress that goes along with this worry can make the symptoms even worse.

Web Can Be Misleading

Hypochondriacs are often not particularly careful about where they get their health information. To many sufferers, Gray's Anatomy, a half-remembered TV movie, and a harrowing health story about your hairdresser's friend's grandmother are all equally legitimate sources.

This can lead to serious trouble for hypochondriacs using the vast and unregulated web.

"A lot of the stuff on the Internet, especially on health-related bulletin boards, is pure impression and anecdote," says Barsky, "and they just don't have a lot of scientific validity."

Even the most reputable health web sites with the most accurate information can cause trouble for the hypochondriac. "Hypochondriacs tend to latch onto diseases with common or ambiguous symptoms or that are hard to diagnose," says Fallon. For example, illnesses such as HIV or lupus, and neurological disorders including multiple sclerosis can cause vague symptoms like fatigue, swollen glands, and strange physical sensations.

With symptoms as common as these, it's easy for hypochondriacs to become convinced they're sick.

Feb. 19, 2004 -- Will changes to next season's flu vaccine mean better protection? That depends on which flu we'll be dealing with.

This year's vaccine didn't work as well as had been hoped. That's because a new "drift" variant -- the Fujian flu -- appeared after the vaccine was already in production.

The FDA today completed a two-day meeting to decide on exactly which flu viruses to include in next season's vaccine. The FDA voted to tentatively accept the recommendations of the World Health Organization. Those recommendations:

• Change the vaccine's Panama type A component to Fujian-like type A.
• Change the vaccine's Hong Kong type B component to Shanghai-like type B.
• Keep the vaccine's New Caledonia type A component.

The panel will wait until the last minute -- in mid-March -- to finalize its recommendation.

Some experts say the WHO and the FDA should have put a Fujian component in last year's vaccine. But CDC officials say the Fujian strain appeared too late to be included.

Why does it take so long to make the vaccine? Current vaccine technology grows flu vaccine in hen's eggs. It takes at least several months to gather the tens of millions of eggs needed and to grow, prepare, test, license, package, and ship the vaccine.

How Well Did Last Year's Vaccine Work?

Even in a good year -- when the flu vaccine is a perfect match with the flu virus that actually circulates -- the vaccine is not 100% effective. In such years, the flu vaccine offers 70% to 90% protection. Healthy adults get the best protection, while the elderly and children vaccinated for the first time usually get somewhat less protection.

At today's session of the FDA flu vaccine meeting, CDC epidemiologist Carolyn Bridges, MD, reported on how well the 2003-2004 flu vaccine worked. Data are still coming in, but it looks as though the vaccine was neither as good as had been hoped nor as bad as had been feared.

Bridges reported very preliminary data from a study of 64-year-olds who got their flu shots as recommended. Those who came down with flu-like symptoms were tested to make sure they really had the flu.

"The range for these 64-year-olds -- and this is very preliminary data -- seemed to be about 16% to 68% for laboratory-confirmed influenza," Bridges tells WebMD. "So there was demonstrable vaccine efficacy against lab-confirmed flu. It was likely somewhat lower than if you'd had an optimal match. But it does appear that vaccination had a benefit."

June 23, 2003 -- It has long been suspected that tea helps lower cholesterol, and now new research offers some of the first evidence that this is true. But you probably won't see a benefit by drinking only an extra cup or two a day.

The study shows that people with moderately high cholesterol who took a supplement containing extracts of green and black tea for 12 weeks had mean reductions in low-density lipoprotein (LDL) cholesterol of 16%. (LDL cholesterol is the type of cholesterol in the blood that is responsible for plaque buildup in the arteries.) While this is not as large a reduction as that typically seen with statin drugs, it is comparable to many non-statin treatments, lead researcher David Maron, MD, tells WebMD.

Although an earlier study involving a green tea extract alone failed to lower cholesterol levels, Maron says it is not yet clear if the addition of the black tea extract made the difference in this trial.

Protective Properties

Tea is rich in polyphenols, which are believed to have antioxidant, anti-cancer, anti-bacterial, and anti-viral properties. Green tea has the polyphenol catechin. Black tea, which is fermented green tea, contains the pigment of polyphenols known as theaflavins that are produced during the fermentation process.

Each 375-mg capsule of the combined extract used in the study contained the amount of theaflavin and catechin equal to that in 35 cups of black tea or seven cups of green tea, respectively. The extract is marketed by Nashville, Tennessee-based nutraceutical company Nashai Biotech, Inc., which funded the study.

The trial included 240 men and women in China with moderately high cholesterol who were already following low-fat diets. Half the participants took the tea extract for 12 weeks and the other half took placebos. The study is published in the June 23 issue of Archives of Internal Medicine.

Maron, who is an associate professor of medicine at Nashville's Vanderbilt University Medical Center, says he was surprised by the large reduction in LDL cholesterol levels in the tea-extract group.

"These findings obviously have to be confirmed in larger studies with longer follow-up," he says. "But for centuries tea has been thought to have medicinal uses, and here is a study that shows an apparent therapeutic value."

Reading the Tea Leaves

Among the studies Maron would like to see are a similar trial evaluating green tea extract without theaflavins, one looking at more diverse populations, and a trial combining statins with the tea extract.

He says there are plenty of apparent health benefits to drinking green or black tea, but drinking a few cups a day probably won't impact cholesterol levels.

Researcher Mohsen Meydani, DVM, PhD, who is studying the anti-cancer properties of tea, says there is growing clinical evidence that drinking moderate amounts of tea can protect the heart. He cites a study from Boston University that concluded that drinking four cups of black tea a day can reverse abnormal blood vessel functioning that leads to heart attack and stroke.

"At this point, I think it is most prudent to recommend drinking tea rather than taking tea extract supplements to get the benefits, because we are still very early in these studies," says Meydani, who is a professor of nutrition at Tuft University's Friedman School of Nutrition Science and Policy.

"Drinking tea is an enjoyable thing, and just about everyone can drink a few cups a day."

Feb. 29, 2000 (Washington) -- Is the tobacco industry's black hat somehow turning white? The nation's leading cigarette maker, Philip Morris, says it is interested in some federal regulations over cigarettes.

This surprise announcement comes as the U.S. Supreme Court considers the industry's case against the FDA's aggressive 1995 proposal to regulate cigarettes as both drugs and medical devices.

"Our opposition to that [FDA] plan does not mean that there can't be useful and sensible regulation of cigarette manufacturers that would be good for our industry and good for smokers," Philip Morris spokesman Brendan McCormick tells WebMD.

"We need to wait for the Supreme Court to start the process," McCormick says. "There is an opening here to come up with some type of legislation or regulation that can respect an adult's right to choose to smoke while at the same time making sure there's no chance of prohibition."

President Clinton today told reporters he was "heartened" by the Philip Morris announcement. According to White House adviser Bruce Reed, the news was "a sign that sooner or later, government regulation of cigarettes is inevitable."

But the nation's public health community, a veteran of years of battle with the tobacco industry, isn't impressed with the company's newer, softer line. "Philip Morris has agreed to do nothing except change the subject," Paul Billings, a government relations official with the American Lung Association, tells WebMD.

"I'm not at all excited about it," Ron Davis, MD, director of the Henry Ford Health System's Center for Health Promotion and Disease Prevention, tells WebMD, "unless I'm told that they are willing to support FDA authority over tobacco just as FDA has over drugs and medical devices."

That is assuredly not the case, the cigarette maker says. "We want to sit down and talk about what reasonable regulation of cigarettes as cigarettes would look like," McCormick tells WebMD.

Like the pharmaceutical industry's recent softening of its posture toward a new Medicare drug benefit or United Healthcare's decision to give medical decisions back to doctors, the announcement likely has its motivations in public relations and political goals.

"I don't think this company has an altruistic bone in its body," Mary Aronson, a litigation and policy analyst for investors, tells WebMD. "It's just not in the nature of business."

And Matthew Myers, president of the Campaign for Tobacco-Free Kids, tells WebMD, "They'll give an inch to buy a decade of the status quo."

On the public relations front, Bill Godshall, executive director of Smoke-Free Pennsylvania, tells WebMD that Philip Morris is "trying to tell the public, 'We're good guys. Forget that we're the leading cause of death in this country.'" According to Godshall, "We don't feel any sincerity on the industry's part to really work for reasonable regulations that would protect the public health."

If the industry wins the Supreme Court case, as some say is likely to happen, why would it be interested in regulations?

In the realm of politics, a senior White House official tells WebMD, "If Philip Morris thinks it is inevitable that Congress is going to take this up -- good, bad, or otherwise -- they want to be in the driver's seat. Not only have a seat at the table ... but be in complete and total control of the process."

But Democratic Sen. Frank Lautenberg (N.J.) tells WebMD, "There is a degree of suspicion. They have been the leaders of the resistance movement."

Meanwhile, in states around the country, class-action and individual lawsuits are putting tobacco firms on an unprecedented defensive. "The industry wants peace," says Aronson. "Whenever there's static such as lawsuits, that causes the stocks to go up and down like rollercoasters."

Aronson predicts that the industry might be likely to make its support for regulation of cigarette marketing conditional on new liability limits or the establishment of a more predictable compensation system for individuals with grievances against the industry.

Meanwhile, the FDA says that it has garnered almost $1 million in penalties on retailers who have failed to comply with agency rules to block underage tobacco sales.

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Dec. 9, 1999 (Urbana, Ill.) -- Extracts of the herb St. John's wort can safely help mildly depressed people beat the blues, according to research to be published in the Dec. 11 issue of the British Medical Journal. But while the herb extract was more effective than placebo, it fared no better than imipramine, a tricyclic antidepressant used widely in Europe that is available only by prescription.

Depression affects nearly one in ten Americans each year, costing the nation up to $44 billion in treatment costs and lost productivity. The American Psychiatric Association estimates that depressed individuals have a greater than 80% chance of being successfully treated.

But some people don't seek medical help because of the stigma involved, and seek to self-medicate with St. John's wort and other remedies. In addition, extracts of the herb are widely prescribed in Europe, and in Germany they are prescribed more than any other antidepressant. But clinical trials that have purported to demonstrate the effectiveness of St. John's wort remain disputed because some researchers say they were not properly designed.

To settle the question, Karl-O Hiller of the Steiner Arznelmeitel in Berlin and his colleagues compared the effects of St. John's wort extracts, imipramine, and a placebo on 263 moderately depressed people.

The patients took three capsules a day of the herb extract, the prescription drug, or a sugar pill, and all pills were adjusted to look and taste the same. After eight weeks, the doctors judged the extent of the patient's depression using a questionnaire called the Hamilton depression rating scale that measures depressive symptoms.

St. John's wort extract eased depressive symptoms significantly more than placebo pills and to about the same extent as imipramine, the authors write. And both the herbal remedy and the drug improved the patients' scores on a questionnaire that gauged quality of life. According to the researchers, St. John's wort extract "may thus be considered as an alternative first choice treatment in most cases of mild to moderate depression without psychotic symptoms."

Other experts called the study encouraging, but in some ways inconclusive. "What's important is the fact that St. John's wort is better than placebo after eight weeks, and that certainly is encouraging for concluding that St. John's wort extract is effective in [treating] depression, at least for the short term," says Benedetto Vitiello, MD, of the National Institute for Mental Health, who is coordinating a study comparing St. John's wort with the antidepressant Zoloft (sertraline hydrochloride).

Vitiello also notes that the St. John's wort used in the study may not even be available in the U.S. In Germany, St. John's wort extracts and other herbal remedies are carefully regulated by government agencies. But no such controls exist in the U.S. because of a 1994 law that forbade the FDA regulating so-called natural products like St. John's wort.

"It's like tea or coffee -- there is a different concentration of ingredients," Vitiello says. "That is the major risk for the consumer -- they don't know what they're buying."

Vital Information:

• In a European study, extracts of the herb St. John's wort worked just as well as a tricyclic antidepressant in treating mild depression.
• Current trials in the U.S. are examining how St. John's wort fares against the widely prescribed antidepressant, Zoloft.

Dec. 14, 2005 -- Increasing use of cell phones and pagers may be blurring the boundaries between work and home and raising stress levels at both places.

A new study shows use of cell phones can cause work worries to spill over into home time for both men and women. But only women seem to suffer from the opposite effect with cell phones carrying family concerns into the office.

The results showed that ongoing use of mobile communications technology such as cell phones and pagers -- but not email -- was linked to heightened psychological distress and reduced family satisfaction.

Researchers say the findings suggest that cell phone technology may make people more accessible but at a psychological cost.

Cell Phones Raise Stress Levels

In the study, researchers analyzed data from a survey of working couples to determine if increasing spillover between work and home caused by new technology was linked to any changes in psychological distress or family satisfaction over time.

The results, published in the Journal of Marriage and Family, showed that increasing use of cell phones and pagers was linked to a decrease in family satisfaction and increased stress over a two-year period.

Researchers found work worries carrying over into home life caused by cell phone use had negative consequences for both men and women, but only women suffered from the opposite effect with carryover from home causing increasing stress at work.

The results suggest that for women, spillover from both work and family worries and responsibilities negatively affects their level of stress and family satisfaction.

But researchers say as use of cell phones and pagers becomes increasingly prevalent, the line between family and work life may continue to blur.

"The question of 'blurred boundaries' may become an irrelevant one for the next generation of workers, spouses, and parents because they cannot imagine life any other way," says researcher Noelle Chesley, assistant professor of sociology at the University of Wisconsin at Milwaukee, in a news release. "Even so, worries about the implications for technology users are not likely to disappear."

Jan. 8, 2002 -- Two groups report that hundreds of thousands of pregnant women are at risk of birth defects and miscarriages from contaminated tap water.

The Environmental Working Group and U.S. Public Interest Research Group say that the problem is due to byproducts that form when adding chlorine to the tap water.

They admit that adding chlorine to tap water saves thousands of lives each year by reducing the number of harmful bacteria in the water. However, they say that this process itself actually creates hundreds of toxic chemicals called "chlorination byproducts," or CBPs.

According to the report, chlorine added to water interacts with organic matter, particularly the soil and plant material that comes from run-off by agriculture and urban sprawl.

And the problem seems to affect large and small cities alike. They note that a handful of large cities with a history of high CBP levels account for a large portion of the women at risk -- suburban Washington, D.C., and Pittsburgh, as well as urban centers like Philadelphia and San Francisco.

But more than 1,100 small towns (with fewer than 10,000 people) have also reported potentially dangerous levels of CBPs in their tap water over the past six years, according to the report.

They write that pregnant women living in small towns supplied by rivers and reservoirs are more than twice as likely to drink tap water with elevated levels of CBPs than women in large communities.

In total, the investigators list 42 cities across the U.S. -- both large and small -- that expose more than 500 pregnant women each year to trihalomethanes (THM), the most common chlorination byproduct.

A new standard put forth by the Environmental Protection Agency went into effect just this month that will lower the allowed levels of chlorination byproducts, including THMs.

However, the investigators list multiple cities with lower levels of THM in tap water that they say still expose thousands of women to potentially dangerous toxins for an entire trimester.

"It's not a big surprise," Joel Schwartz, PhD, tells WebMD. He is an associate professor of environmental epidemiology at the Harvard School of Public Health in Boston.

Schwartz says a number of recent studies have linked chlorine byproducts to reproduction risks. His group, for example, has found the substances could affect a baby's birth weight. Other research has pointed to risk of birth defects and miscarriage.

"There is potential to cause harm. But there are things we can do to reduce the risk," he says, adding that the following measures won't drop your risk to zero, but they can make things safer:

• First, don't kid yourself with the bottled water. There may be no way to tell how long it has been since the company last tested it.
• You may want to install filters on the sinks you use for your drinking water. Products that use charcoal can filter out the chlorine byproducts. The more charcoal a particular filter uses, the more contaminants can be sifted from the water before you drink it.
• You also may want something for your shower, since these contaminants could evaporate in the steam and be inhaled.

But Schwartz adds there are much bigger issues here that need to be handled at the community level. First, people need to decide how the water will be used. All the water going into your house doesn't really need to be fit to drink, when a lot of it is used to flush toilets, water the lawn, or do the wash. If a town doesn't have to pay to make all household water drinkable, it can then free up some resources to do a better job treating water that people will drink.

Getting rid of chlorine is not the answer, Schwartz says. But communities can use it more responsibly. It's helpful when treatment plants can tailor the amount of chlorine they use according to how much is actually needed. And if more of the particles and debris can be filtered out, germs have fewer hiding places and are easier to kill. That also means less chlorine.

It's also a good idea to clean the plumbing that brings water from the treatment center to your home. The pipes can get crusty with gunk. So facilities have to keep some chlorine in the water to treat it as it makes its way to you. But cleaner pipes mean less chlorine.

"These measures will not be free," Schwartz says. "But there are things we can do that will not bust the bank that will make things better."

The groups are calling for the federal government to take immediate action to clean up the lakes and rivers that provide tap water by reducing the soil erosion and the nutrient and animal waste from farms and feedlots that increase the need for chlorination. The farm bill currently being debated in Congress, they say, would be one step towards protecting America's tap water.

With reporting by David Flegel, MS

June 23, 2000 -- Eating Grape Nuts didn't help naturalist Euell Gibbons find the Fountain of Youth. He died at 64, although he did help introduce the world to more natural foods.

Ponce de Leon also never found the Fountain of Youth, dying somewhere around the age of 61, but he did discover Florida.

And science has yet to discover the silver bullet that cures all that ails us and offers the promise of ever-longer, or never-ending, life. But that doesn't mean there aren't plenty of ideas out there to fill the void. Here are just a few, from history past and present.

The quest for immortality has probably been around since man realized he could die. Greek mythology has Sibylla, who was given everlasting life by Apollo. The only problem was that the deal didn't include eternal youth, and Sibylla ended up small, shriveled, and in a bottle begging to die.

In Gulliver's Travels, satirist Jonathan Swift created the Struldbruggs, who also were immortal. Once again though, beware of what you wish for, because they too had to live in increasing decrepitude.

Sometimes truth is stranger than fiction. In a method that dates back thousands of years, some holy men in India -- and others in China, Egypt, and elsewhere -- have been tapping a fountain of youth that's no more than an arm's length away. It can be ingested over fruit, or even over Grape Nuts, for that matter. Or you can drink it fresh and warm, as some modern-day proponents of the practice preach. It's called urine therapy, and there are books and believers on the topic.

They do not say urine promises everlasting life, but instead that the "water of Shiva" can cure a bevy of ills, from the flu to Kaposi's sarcoma, and it can also deter aging. Some women supposedly use it for bathing to improve their skin. Of course, you must only use your own urine, not someone else's.

From the esteemed British Medical Journal comes a study of 918 Welsh men suggesting that sex may help extend life. Over 10 years of follow-up, the risk of heart attack among the group of men who had two orgasms or more per week was less than half that in the men who had less than one orgasm per month.

According to The New England Journal of Medicine, The Lancet, and other journals, there is one scientifically proven method of extending life span that has worked in all non-human species tested so far. Cutting calories over a lifetime can extend life expectancy by 35% or more. That would theoretically increase the life span of an American male from 72 years to 99 years, and of an American female from 79 years to 106 years!

Or, you could just cut to the chase and place special magnets on your fingers and feet, which balance out the negative and positive forces in your cells, leading to perpetual reconditioning, according to some believers.

If your faith in science is such that no cures will be found before you die, then put yourself on ice. There are cryonic freezing companies around the country that will store your frozen body until a cure comes along, or just your head, with the understanding that science will find a way to regrow your body.

And there's always mind over matter. Herb Bowie, who looks surprisingly like Dick Clark, was the former editor of Forever Alive magazine. He has also written a book called Why Die? A Beginner's Guide to Living Forever. Basically, his mantra is: have faith that you're not going to die.

In his article "Seven Steps to Physical Immortality," Bowie writes "I'm promoting staying healthy and youthful indefinitely ... the next step is to eliminate any mistaken beliefs that science has found some reason we can't live forever."

If all else fails, rely on jelly donuts and fried sandwiches for everlasting life. It's worked for Elvis.

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May 26, 2006 -- The FDA has approved Seasonique, an extended-cycle birth control that gives women four periods per year instead of 12 (one per month).

Seasonique is "the next generation" of Seasonale, an extended-cycle birth control pill launched in 2003, states a news release from Barr Pharmaceuticals, the parent company of Duramed Pharmaceuticals, which makes Seasonique and Seasonale.

Seasonique will be available by prescription in July, states a Barr Pharmaceuticals news release announcing the drug's approval. Seasonique is more than 99% effective at preventing pregnancy when taken as directed, states Barr Pharmaceuticals' news release.

Seasonique was tested in a study of about 2,500 U.S. women aged 18-40 who took the drug for 12 months (four cycles, each lasting 91 days), the news release states. Side effects were similar to those seen in trials of other oral contraceptives, according to Barr Pharmaceuticals.

Seasonique vs. Seasonale

What's the difference between Seasonique and Seasonale? Both drugs are designed to give women four periods per year instead of 12. With Seasonale, women take inactive pills during their four yearly periods. With Seasonique, they get a low dose of estrogen during their period, which may provide benefits including less breakthrough bleeding, Barr Pharmaceuticals spokeswoman Carol Cox tells WebMD.

Users of extended-cycle birth control pills may be more likely to experience bleeding or spotting between periods; such bleeding and spotting tends to decrease during later cycles as women keep taking the drug.

"Oral contraceptives are not for every woman," states Barr Pharmaceuticals' news release.

"Serious as well as minor side effects have been reported with the use of hormonal contraceptives," the release continues. "Serious risks include blood clots, strokestroke, and heart attackheart attack. Cigarette smoking increases the risk of serious cardiovascular side effects, especially in women over 35 years."

Oral contraceptives don't protect against HIV -- the virus that causes AIDS -- or other sexually transmitted diseases, the news release also notes.

July 6, 2004 -- The fight to stop child obesity begins before a child is born, a new study shows.

Children are twice as likely to be obese if their mother was obese during pregnancy, reports Robert C. Whitaker, MD, MPH. Whitaker, now with Mathematica Policy Research Inc. in Princeton, N.J., performed the study while at Cincinnati Children's Hospital Medical Center.

"Maternal obesity in early pregnancy more than doubles the risk of [a child's] obesity at 2 to 4 years of age," Whitaker writes in the July issue of Pediatrics.

To be defined as obese, these kids had to be seriously overweight. They are not just heavier than average -- they had more body fat than 95% of other kids their age.

Whitaker studied data on nearly 8,500 children from low-income households enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children -- commonly known as the WIC program.

By the age 4, one in four children born to obese mothers was obese. That's true for fewer than one in 10 kids born to normal-weight mothers.

Viewed one way, the data show that kids born to obese mothers may be in trouble from birth. But Whitaker stresses a more optimistic view.

"The time before a mother conceives, during her pregnancy, and in the early years of her child's life may provide important opportunities to prevent obesity," he writes.

He notes that the WIC program is already taking steps to intervene. It now allows income-eligible children to get WIC help if they are born to mothers who were obese during pregnancy.

SOURCE: Whitaker, R.C. Pediatrics, July 2004; vol 114: pp e29-e36.

May 19, 2003 -- More new mothers are breastfeeding, but they're stopping earlier than most doctors feel is optimal for the baby's health. The longer a baby nurses, the greater the benefits of breastfeeding, experts say.

That's the finding from a new CDC study, appearing in the May issue of Pediatrics.

The study shows that during the past decade, the number of mothers that start breastfeeding has indeed risen -- from 54% in 1994 to 65% in 2001.

However, a random survey conducted in 2001 shows that breastfeeding is largely short term. The survey focused on U.S. households with children between 19 and 35 months old -- a total of 727 babies -- finding that only 27% (up from 22%) were still breastfed at 6 months old and 12% (up from 9%) were still breastfed at 12 months old.

At one week, almost 60% of infants were exclusively breastfed, but only 8% were still breastfed exclusively at 6 months old.

Though the great majority of infants get some breast milk in their early months, when it's time for mom to go back to work -- when baby is 2 or 3 months old -- she quits breastfeeding, reports lead researcher Ruowei Li, MD, PhD, an epidemiologist with the CDC.

"We really encourage mothers to breastfeed for at least one year," she tells WebMD. "The longer the baby is breastfed, the greater the benefit."

Society still frowns on breastfeeding, she says. "Breastfeeding is influenced by lifestyle factors. Women think they can't do it in public; they feel embarrassed. In other countries, it's acceptable and natural for a woman to breastfeed in public."

She recites the benefits of breastfeeding: "Cow's milk is for cows. Breast milk is the most nutritious food for babies. Breast milk is a living thing, with enzymes and antibodies, specifically made for humans."

Scientists have tried to reproduce breast milk, but have been unable to copy all the nutrients it contains, she says.

Among the benefits of breastfeeding: Mother's milk protects against diarrhea and infectious diseases such as ear and respiratory infections, says Li. Also, new studies indicate that breastfed babies are much less likely to be obese in later life and less likely to develop diabetes.

The special bond that develops between mother and baby is important for the baby's emotional and intellectual development, she says. Breastfeeding is associated with a decreased risk of developing premenopausal breast cancer in the mother. Also, women who breastfeed return to their prepregnancy weight more quickly, says Li.

"There are very few medical reasons why women can't breastfeed," says Debra Bogen, MD, a pediatrician Children's Hospital of Pittsburgh. She agreed to talk to WebMD about Li's study.

Bogen suggests that women interview pediatricians about the breastfeeding support they provide. "Breastfeeding is not always intuitive," Bogen tells WebMD. "I help anticipate problems, so the mother knows what to expect. Unless we provide good supportive care, we see what this article shows -- that women will quit."

More employers would support breastfeeding mothers if they understood the benefits of breastfeeding, she says. "When women breastfeed, it's cost-effective for employers. Children are less likely to get ill, so mothers don't have to take as much time off work."

If you listen to a lot of the stories in the media, you might believe that losing weight and keeping it off is virtually impossible. The common wisdom is pretty discouraging. Sure, you can lose weight, but what's the point, since you'll just put it on again sooner or later? And since your body type is determined by your genes, why bother trying anyway?

Well, here's the encouraging news: Regardless of body type or genetics, all sorts of people are successfully losing weight and keeping it off. While it may take some hard work and dedication, you can as well.

The National Weight Control Registry

In 1993, we started the National Weight Control Registry as a way of studying the behaviors of people who successfully lost weight and kept it off. We wanted to see what methods these people had in common, since they could help us discover the best strategies for weight maintenance.

To enroll in the Registry, a person must have maintained at least a 30-pound weight loss for at least a year. However, on average, members of the Registry have lost 67 pounds and kept it off for six years. Those are inspiring figures.

Looking at the data, we haven't seen evidence to confirm the idea that our genes make our destiny when it comes to weight. If people really had a genetic "set point" weight as some argue, why would the average weight of Americans be getting heavier each year? While genes certainly play a role, they don't predetermine what your weight will always be. Instead, they provide a range of weights that are possible depending on your diet and amount of exercise. So you have more control over your weight than you might think.

By looking at the behavior of the 4,200 people in the Registry, we've identified four common characteristics of those who've lost weight and are now keeping it off. These suggestions don't make up a diet program. But if you're looking for ways to keep weight off, adopting these behaviors isn't a bad way to start.

Eat a Low-Fat, High-Carbohydrate Diet

Although a lot of people may think of only pasta and bread when they hear the word "carbohydrates," complex carbohydrates are in many foods, not only grains but also in beans and many vegetables. People in the Registry say they get about 56% of their calories from such carbohydrates, and only about 19% of calories from protein. Fat makes up about 25% of their diet. People in the Registry also say they consume 1,300 to 1,400 calories a day on average, but that number is probably lower than what they actually eat.

Remember that a good diet probably isn't one that makes you outlaw certain types of food. Being too strict can make it hard to stick to a healthy eating plan. The problem for most people is not so much that they're eating the wrong things, but that they're eating too much. Moderation is important.

But what about protein diets? People using protein diets can and often do lose weight. The fact is that you can probably lose weight on any of the major diet plans, and Registry members slimmed down employing all sorts of different approaches.

However, what we've found is that people who are successful at maintaining their weight loss eat a low-fat and high-carbohydrate diet. So while a protein diet may be good for losing weight, it may not be the best for long-term weight maintenance.

Nov. 21, 2002 -- For desperate teenagers overwhelmed with emotions that they cannot express, deliberate self-injury is becoming an increasingly popular and dangerous form of self-expression.

A British study of nearly 6,000 students shows that over their lifetime, 13% of 15- and 16-year-olds have carried out an act of deliberate self-harm. Within the past year, an act of deliberate self-harm occurred in about 400 of the students. Only 50 students went to the hospital, which suggests that the problem may be even more widespread. American experts say those numbers aren't surprising, but until now there has been relatively little research on the issue.

The study, which appears in the Nov. 23 issue of the British Medical Journal, was based on a survey conducted in England from fall 2000 to spring 2001.

Wendy Lader, PhD, co-author of the book Bodily Harm, says an estimated 1% of the U.S. population as a whole resorts to physical self-injury to cope with extreme emotional distress, but that rate is much higher among adolescents and females.

Lader says the phenomenon of self-harm has been around forever, but not at the level it is now. She says that not only are people talking about it more but it's also becoming more common as teens search for a new way to rebel and express themselves.

"It's harder for kids to get noticed as individuals, and they don't have the words for it," says Lader, who is also clinical director of the SAFE (Self-Abuse Finally Ends) Alternatives program at Linden Oaks at Edward Hospital in Naperville, Ill. "So they show it -- even if it's just to themselves because it makes it real for them. It's almost like their body becomes a bulletin board on which to notch their pain."

For some, hurting themselves is a form of suicidal behavior. In fact, nearly half of the students surveyed who engaged in the behavior said they had wanted to die. But for others, Lader says self-injury is a survival method.

"It's a coping strategy to deal with intolerable pain, but it works for them so it's a way of surviving," says Lader. But she says there is always the risk that once the method stops working for them, they could commit suicide -- either accidentally or purposefully.

Researchers say girls seem to be especially prone to self-injurious behavior, and the study found acts of self-harm were four times more common among girls than boys.

Lader says that when girls have a strong emotional response, they tend to act inward rather than outward because it's not "feminine" to be that angry.

"Girls will act on themselves and tend to say that they would rather hurt themselves than anyone else -- not realizing that no one needs to get hurt," says Lader. Coupled with the fact that girls tend to be very body conscious and more dissatisfied with their bodies, she says it's not a stretch for some girls to take their anger out on their body.

David Fassler, MD, a child and adolescent psychiatrist in private practice in Burlington, Vt., says the study's findings are important because they show that there is a significant number of adolescents both in this country and elsewhere in world who have either suicidal or other self-destructive thoughts, plans, and impulses who actually engage in these acts.

"These are kids that are calling out for help, and we need to do a better job at recognizing the warning signs and getting these kids the help that they need," says Fassler, who is also a spokesman for the American Academy of Child and Adolescent Psychiatry.

Warning signs of self-injurious behavior may include the following:

• A history of emotional problems, abuse, or exposure to violence (even if the child was not physically abused)
• Drug or alcohol abuse
• Anxiety
• Impulsive behavior
• Low self-esteem

Fassler says emotional events such as a breakup with a girlfriend or boyfriend or being kicked out of class or a sports team may also act as a trigger for this type of activity. He says many of the adolescents that resort to harming themselves suffer from undiagnosed depression or other mental disorders that require evaluation and treatment by a trained professional.

As the study authors conclude, "In many cases, self harming behaviour represents a transient period of distress; in others it is an important indicator of mental health problems and risk of suicide.

"Our findings support the need for development and evaluation of school based programmes for the promotion of mental health," write study author Keith Hawton, professor of psychiatry at the Centre for Suicide Research at Warneford Hospital in Oxford, England, and colleagues.

Jan. 26, 2004 -- Fish really may be brain food after all. A new study shows the omega-3 fatty acids found in fish can help fight the effects of aging on the brain and may reduce the risk of Alzheimer's disease.

But other types of saturated fats that raise cholesterol levels may actually increase the risk of age-related declines in mental performance.

The study showed that middle-aged men and women who ate a lot of fatty fish, such as tuna and salmon, were less likely to suffer from declines in mental performance. But those who had a high-fat diet had a higher risk of these declines.

Researchers say subtle declines in mental performance can be found at middle age, years before more serious symptoms of Alzheimer's develop.

Omega-3 Fatty Acids Protect the Brain

Researchers say few studies have looked at the relationship between eating fish and mental performance, especially in middle-aged people. The study, published in the January issue of Neurology, looks at the effects of fatty acid and fish consumption on mental performance in a group of 1,613 men and women aged 45 to 70.

The participants went through extensive mental performance testing, including tests that assessed their memory, thought processing speed, and mental flexibility, in order to pick up mild declines in brain function, and filled out questionnaires about their diet.

Researchers found that the participants' risk of mental decline was decreased for those who ate more fatty fish.

Specifically, the risk of impaired brain function and processing speed decreased by 19% and 28% for every increase in the amount of omega-3 polyunsaturated fatty acids they ate.

Cholesterol Raises Brain Risks

But when researchers looked at overall fat and saturated fat intake, they found a significant association between an increased risk of impairment and higher intakes of fat and cholesterol in the diet.

For example, the risk of impairment in memory, speed, and flexibility increased by 15% to 19% for each increase in saturated fat the participants ate.

The risk of impaired memory and flexibility also increased by 27% and 26%, respectively, for each increase in the amount of dietary cholesterol in the diet.

Researchers say eating more fish has already been shown to reduce the risk of heart disease, and the next step will be to determine if those dietary changes might actually help prevent age-related diseases of the brain, such as dementia and Alzheimer's disease.