Friday, October 31, 2008

Does Your Underwear Need an Overhaul?

Behind closed lingerie drawers, even the chicest among us sometime have messy little secrets. Nothing matches. Your bra is yellow, your panties are pink and you hope you won't get hit by a taxi anytime soon. Nothing works. Yep, that's a black bra under your white shirt. And your pencil skirt needs panty-line rehab...

There's a reason they're called foundation garments: Clothes look better because you're lifted or sleeked in the right places, and your spirit is nourished by cute, stylish, seductive stuff. "People say, 'I've been married 20 years; I don't need that' or 'I'm not dating anybody now; I don't need that,'" says Sandra Saffle, national lingerie stylist for Nordstrom. "But when they put on beautiful lingerie, their faces light up and their whole posture changes."

So here it is—an intimate wardrobe able to negotiate all of life's occasions: basics that work overtime, solutions for strapless/backless dresses and gowns, practical gym gear, glamorous little bits.

Everyday:

This is your core lingerie—it doesn't shift around, it doesn't show, and it's comfy enough to handle eight hours plus at your desk. It should include plenty of black, white, and nude bras and panties—not too skimpy and preferably seamless. But Susan Nethero, chief fit stylist for Intimacy boutiques, urges a revolt against purely functional styles, suggesting richer colors, witty prints, even lace and embroidery.

Start fresh with easy-care, hard-wearing whites: an immaculate underwire bra (Hanro, $52) and teeny bikini (Gap, $13). Shirt, Jones New York Signature, $59.

Workout:

Like free weights or yoga mats, gym-friendly underwear is essential equipment. But don't shop for sports bras where you get running shoes, Nethero says: Those sold at athletic stores often compress breast tissue (unhealthy). Buy bras with cups—and, if necessary, underwire—plus thin seamless panties. Moisture-wicking fabrics no longer have that nylon-y feel, and boy, do they keep you cool and dry.

Get going with a well-engineered bra (Natori, $50) with two-ply cups and tiny shorts (Adidas by Stella McCartney, $70) with built-in mesh panties.

Evening:

When considering underthings for nighttime, the challenge is making sure that your choices stay invisible. "You don't want to plan an evening in a killer dress only to discover at the last minute that you have nothing to wear under it," says Nordstrom's Sandra Saffle. Be prepared with a convertible bra that adapts to all necklines, including strapless, plus a few lightweight shapewear pieces to address any excess.

This smoky mauve lace bra (Huit, $79) dips low, so it won't show under the scoop-neck dress (Luisa Beccaria) she's about to zip up.

Sexy:

Racy lingerie, frankly, can make some of us a little nervous—but maybe that's the point. "It's fun to explore something that pushes your boundaries," says Jennifer Duenas, former associate store manager for Kiki de Montparnasse, known for its risqué wares. Most of these flimsies are for (very) private consumption; with today's trend toward taking lingerie public, though, you never know.

This lavish set is sized for the amply endowed (Fayreform bra, 32D to 40DD, $100, and French knickers, $44). Cardigan, Pollini, $1,145.

Taking Care of Oily Skin: When Nothing Else Works continued...

Crutchfield says topical Retin A products can also help by reducing the amount of oil on the surface of skin.

One very new remedy for oily skin uses topical preparations containing the B vitamin niacinamide. Early studies have found that these preparations reduce oil production, but the results have been modest to date.

In still another study, a group of Japanese researchers found that topically applied spironolactone (the oral version is available in this country and is used to treat high blood pressure) was also found to reduce the rate of oil production in young women. This product is not available in the United States, however.

If you still feel you need more help, Crutchfield says laser treatments may be what the doctor orders.

Although oily skin will remain oily throughout your life, as you age, production does decrease. So, the older you are, the fewer treatments of any kind you will need.

Taking Care of Oily Skin: What Works

Because an oily complexion often feels moist to the touch, many people avoid using moisturizers, because they think they will only make matters worse.

Experts disagree. Crutchfield tells WebMD that oil and moisture are not the same things, and the older you are, the more you need to use a moisturizer even when skin is oily.

"The oiliness of your skin will seal in the moisture you have - but won't replace the moisture that you lose, particularly as you age, " says Crutchfield.

For even better results, try incorporating alpha hydroxy acid (AHAs) creams into your daily skin care regimen.

"There is some evidence that AHA creams increase production of collagen and hyaluronic acid which in turn helps in relation to moisture – plus they treat superficial lines and wrinkles so you also get a rejuvenating effect," says Crutchfield.

Resnik recommends using a glycolic acid or salicylic acid product coupled with a light oil-free moisturizer containing a sunscreen for best results.

"This will do a good job of gently exfoliating your skin, reducing sebum buildup and giving you a more youthful appearance," he says.

Taking Care of Oily Skin: When Nothing Else Works

If, despite your best efforts to control oil production, your skin is still gushing 24/7, there are specific treatments that can help.

Among the easiest are over-the-counter drying solutions. While they won't impact oil production, they can 'mop up' some of what is being produced so oily skin looks better.

"You can choose any topical treatment that has alcohol in it – I like solutions more than lotions, which dry the surface area of the skin," says Crutchfield.

Schlessinger says that astringents and toners can also help – although the results are temporary, so application may have to be repeated more than once a day.

Resnik suggests using oil-inhibiting products. "I recommend OC 8, which uses an absorbent technology to reduce shine and it's very effective for all skin types," he says.

Cosmetic products known as "anti shine" primers can also help by forming a layer between skin and make-up that works to absorb excess oil as it's being secreted.

If temporary measures like these don't work to control your oily skin, there are also several professional treatments that can help. These include prescription topical and oral drugs like Retin A, Differin, Tazorac or Accutane.

"Accutane works the longest and has both immediate and long-term results – the others can temporarily improve the situation, but aren't long-term solutions, " says Schlessinger. While some doctors use this medication to treat oily skin, its use for this purpose is off-label and not generally recommended.

Resnik prefers using ultra low doses of isotretinion."Although it's off-label, it's extremely effective at reducing or eliminating excess oil," he says. The dosage is limited to about 10 mg once or twice a week.

Taking Care of Oily Skin: Where To Start continued...

Taking Care of Oily Skin: Where To Start continued...

"Oil production is nature's response to irritation – so the harsher the cleansing, the more likely the body is to respond by producing more oil, " says Schlessinger.

Instead, treat oily skin with thorough but gentle cleaning.

"A good cleanser is one designed to remove excess oil while leaving intact the barrier of fatty acids to help maintain function and protect our skin," says Barry Resnik, MD, dermatologist at Memorial Regional Hospital and Joe DiMaggio Children's Hospital in Hollywood, Florida.

And don't be surprised if you find yourself needing two different cleansers depending on the time of the year. In fall and winter when skin is naturally drier, you'll benefit most from a super gentle cleanser. In warmer months, when perspiration can combine with sweat to make skin harder to clean, you may need a more thorough, deep cleaning product.

But what about cleansers specifically made for oily skin? According to Schlessinger, they're okay, as long as they don't cause any irritation.

"It's best to use the gentlest product you can find I actually put together a formula that uses a very low pH, which is effective at removing oil, and an amino fruit acid, which causes very little irritation," he says.

The one thing you want to avoid is soap, since most types strip the skin of all natural oils.

"That squeaky clean feeling people get from using soaps is derived from stripping the fatty oils from your skin and is more harmful than good," Resnik cautions.

In addition, both experts say you should never over-wash oily skin, even if your cleanser is gentle. Indeed, unless you've been mining coal or digging in the dirt, twice a day is usually enough.

Clay or mud masques can also help. Although there are no medical studies to prove that they work, many beauty experts say that these treatments can temporarily pull oil from the pores and soak it up, leaving oily skin looking fresher for several hours afterwards.

Oily Skin: Solutions That Work -- No Matter What Your Age

Although most folks associate oily skin with the teen years, age is only part of the story.

Indeed, while problems don't usually begin until around puberty, for many people, oily skin persists long after the senior prom has faded into memory. For some, oily skin can last a lifetime.

"If you have oily skin, you have oily skin – it's just something that happens to some people," says Joel Schlessinger, MD president-elect of the American Society of Cosmetic Dermatology and Aesthetic Surgery and director of LovelySkin.com in Omaha, Nebraska.

While heredity can play a role – if your mother or father had oily skin you might as well – so do hormones.

""Oil production is stimulated by hormone production - so anything that causes hormones to fluctuate can cause skin to become more oily," says dermatologist Doris J. Day, MD, associate professor, NYU School of Medicine in New York City.

For women, hormone changes occur not only during puberty, but at the start of each menstrual cycle, and during pregnancy and perimenopause. For both women and men, oily skin can be stimulated by any physical or emotional situation that puts hormones in a tailspin.

The good news: Regardless of cause(s) of your oily skin, there are steps you can take to control it

WebMD talked to 4 top dermatologists to gather the low-down on what works and what doesn't to keep oily skin looking great. From proper cleansing techniques and oil-targeted skin care, to treatments aimed at reducing oil production, you can replace that oily shine with a healthy glow -- in less time than you think.

Taking Care of Oily Skin: Where To Start

Regardless of your age, oil - also known as sebum – is always produced by the sebaceous glands.

Located deep within the second layer or "dermis" of the skin, these glands are most plentiful in the face, neck, chest, head and back – one reason that these areas appear to be affected by oil production the most.

To get from the glands to your skin, the oils flow into nearby follicular pores, and eventually works its way to the surface. Here it plays a vital role in the health of both skin and hair.

"It helps seal moisture in, which gives hair that healthy sheen and helps keep skin plump and hydrated," says Charles E. Crutchfield III, M.D., Clinical Associate Professor of Dermatology, University of Minnesota Medical School Medical and Director, Crutchfield Dermatology.

But in some folks too much oil is produced. Skin and hair no longer look healthy, but instead, greasy, slick and even dirty.

One way to control that is with proper cleansing. But if you think you need harsh products to scrub away the extra oil, think again. Experts say that's a big – and all too common – mistake.

Fat Injections OK for Reconstruction 'Touch-ups,' but Its Use for Breast Augmentation Needs More Study, Plastic Surgeons Say (continued)

Fat Injections for Breasts: Trials

Recruitment is under way for at least two clinical trials, both listed on the federal clinical trials Web site.

One, led by Scott Spear, MD, chief of plastic surgery at Georgetown University Hospital in Washington, D.C., is seeking 20 women, aged 20 to 50, to undergo liposuction and fat grafting to augment their breasts.

Another, led by Roger Khouri, MD, a Miami plastic surgeon, will study augmentation with fat in combination with the use of the Brava system. The system includes semi-rigid domes worn over the breasts for several hours a day to induce breast tissue growth before the injections are done.

Fat Injections for Breasts: Perspective

Using fat grafts for augmentation "needs to be looked at in a credible, scientific way," says Adams, a participant in the fat injection panel.

Adams and other experts say that aside from the need to prove fat injections for augmentation safe and effective, there are other issues for women and physicians to consider. They include:

  • Time. Breast augmentation with implants may take about an hour to an hour and a half, but breast augmentation with fat can take five or six hours, Adams says. "A lot of patients need to be re-injected," he says.
  • Expense. The average surgeon's fee for implants is about $4,000 and for liposuction about $3,000, according to the American Society of Aesthetic Plastic Surgery. But breast augmentation with fat injections can cost about $20,000, Coleman says.
  • Results. With implants, "the typical enlargement is two cup sizes," Spear says. "And 99% of the time the patient ends up with a predictably enlarged breast. The downside is, they have an implant that may not feel entirely natural and may have to be replaced in their lifetime. Fat injections rarely enlarge more than one cup size, often less than that, and the results are not predictable or guaranteed. But when it is successful, they have a breast that is their own tissue."

Are Fat Injections Safe for Breasts?

Oct. 22, 2008 -- Reshaping the breasts by injecting a woman's own fat works well for "touch-ups" after breast reconstruction, but is not yet proven effective for breast augmentation, according to plastic surgeons slated to present an update at the annual meeting of the American Society of Plastic Surgeons (ASPS) in Chicago.

"For breast reconstruction, there are some good data to support the safety and efficacy of fat injections, but for cosmetic use, it's a whole new ball game," says William P. Adams Jr., MD, a Dallas plastic surgeon and associate clinical professor of plastic surgery at the University of Texas Southwestern Medical Center, Dallas. He is among the doctors scheduled to discuss the technique at the Oct. 31-Nov. 5 meeting.

But no studies as yet prove the effectiveness and safety of fat injections for breast augmentation, Adams says.

However, such studies may soon be under way. Two clinical trials are now seeking women to help study fat injections (also called fat grafts) for breast enlargement.

And some experts seem to be warming to the idea of fat-enhanced breasts. At the meeting, a task force assigned by the ASPS to study fat injections plans to issue its conclusions. Although the task force stops short of making recommendations about fat injections, it suggests they "may be considered" for reconstruction and augmentation, says Karol A. Gutowski, MD, head of the division of plastic surgery at North Shore University Health System in Chicago and the task force chair.

In 2007, The American Society of Aesthetic Plastic Surgery and the American Society of Plastic Surgeons issued a joint statement of caution about fat injections for the breast, noting that they can be effective in enhancing breast appearance after reconstruction or to soften the appearance of implants in place, but not recommending fat injections for augmentation, citing a lack of data and the fear of hindering breast cancer detection.

Fat Injections for the Breast: What's Known?

Fat injections used to improve the contour of the breast after reconstruction typically involve small, limited areas, Adams says. Injections after reconstruction is "much more accepted" by physicians, he says, and many have done it for years.

Fat injections given to enhance the breast appearance after lumpectomy and radiation can help tissue damaged by radiation, says Sydney Coleman, MD, a New York City plastic surgeon who performs that technique and will discuss it at the meeting. The injections, he tells WebMD, can promote the growth of a blood supply in the breast area that received radiation and aid in reversing the effects of radiation damage.

Fat Injections: Task Force Findings

Among the task force conclusions, reached after its members reviewed 110 published studies and other data:

  • Fat grafts may be considered for use in the breast for augmentation and reconstruction, as well as other sites (such as hands and face), but the techniques are not standardized and may vary from doctor to doctor.
  • No specific recommendations about fat grafts for the breast can be made because of a lack of strong data.
  • Reported complications (such as tissue death) suggest the technique has associated risks.
  • No reports about increased risk of malignancy associated with fat grafts could be found.
  • Fat injections may interfere with breast physical exams, but available data suggest they may not interfere with mammograms.
  • Clinical studies are needed to look at safety and effectiveness of fat injections, as well as such factors as how long the fat will last.

The ASPS is expected to review the conclusions and decide whether to amend its 2007 statement, Gutowski says.

Nail-Biting - Topic Overview

Nail-biting (onychophagia) is a common stress-relieving habit. You may bite your nails in times of stress or excitement, or in times of boredom or inactivity. It can also be a learned behavior from family members. Nail-biting is the most common of the typical "nervous habits," which include thumb-sucking, nose-picking, hair-twisting or -pulling, tooth-grinding, and picking at skin.

You may bite your nails without realizing you are doing it. You might be involved in another activity, such as reading, watching television, or talking on the phone, and bite your nails without thinking about it.

Nail-biting includes biting the cuticle and soft tissue surrounding the nail as well as biting the nail itself.

Who bites their nails?

People of all ages bite their nails.1

  • About 50% of children between the ages of 10 and 18 bite their nails at one time or another. Nail-biting occurs most often as teens are going through puberty changes.
  • About 23% of young adults, ages 18 to 22 years, bite their nails.
  • Only a small number of other adults bite their nails. Most people stop biting their nails on their own by age 30. About 10% of men over the age of 30 bite their nails.
  • Boys bite their nails more often than girls after age 10.

Nail-biting may occur with other body-focused repetitive behaviors (BFRB) such as hair-pulling or skin-picking.

What treatments are available for nail-biting?

Several treatment measures may help you stop biting your nails. Some focus on behavior changes and some focus on physical barriers to nail-biting.

  • Keep your nails trimmed and filed. Taking care of your nails can help reduce your nail-biting habit and encourage you to keep your nails attractive.
  • Have a manicure regularly or use nail polish. Men can use a clear polish. Wearing artificial nails may stop you from biting your nails and protect them as they grow out.
  • Try stress-management techniques if you bite your nails because you are anxious or stressed.
  • Paint a bitter-tasting polish, such as CONTROL-IT or Thum, on your nails. The awful taste will remind you to stop every time you start to bite your nails.
  • Try substituting another activity, such as drawing or writing or squeezing a stress ball or Silly Putty, when you find yourself biting your nails. If you keep a record of nail-biting, you will become more aware of the times when you bite your nails and be able to stop the habit.
  • Wear gloves, adhesive bandages, or colored stickers whenever possible to remind you not to bite your nails.
  • Snap a rubber band on the inside of your wrist when you start to bite your nails so you have a negative physical response to nail-biting.

Children may bite their nails more often when they are having problems at school or with friends. Talk with your child or his or her teacher about any new stress at school. Children are more likely to stop biting their nails when they understand what may trigger it. It is also important for your child to help choose a treatment method so he or she can use the treatment successfully.

What problems can develop from nail-biting?

Nail-biting can cause your fingertips to be red and sore and your cuticles to bleed. Nail-biting also increases your risk for infections around your nailbeds and in your mouth. Dental problems and infections of the gums can be caused by nail-biting.

Long-term nail-biting can also interfere with normal nail growth and cause deformed nails.

Rarely, nail-biting may be a symptom of obsessive-compulsive disorder (OCD). OCD symptoms are usually treated with medications.

Calcium Is Vital

Calcium is as important for men as it is for women, according to Agnew and Marin. They say that men's need for calcium is one "often-overlooked similarity between men's and women's nutritional needs." Osteoporosis tends to be looked at as a "woman's disease," but this is not always the case. In fact, they say, "one in four men over age 50 will have an osteoporosis-related fracture in his lifetime."

Age Affects Men's Nutrition

Metabolic rates decrease as age increases, and physical activity also decreases with aging, thus, energy needs tend to be reduced with aging," says Flakoll. "However, good quality protein and vitamin and mineral needs continue to be very important."

It is important for diets to be more nutrient dense as men age, Flakoll notes. Quality nutrients are important to maintain men's immune function and overall health, as well as preventing bone loss, eyesight loss, and muscle loss, he says, adding that "prevention of oxidative damage and maintenance of tissue health via antioxidative vitamins and minerals become more important as men age."

Agnew and Marin agree, saying, as we age, lean muscle mass is gradually replaced by fat. As the body composition shifts towards more body fat, calorie requirements decline. That's why if you keep your same eating pattern in your 40s as you did in your 20s, you will most likely gain weight.

They added that exercise must be part of the regimen to help maintain lean muscle mass. Part of the reason we may see less lean muscle mass among older men, may be because there is also a decrease in the number of men who do weight training as they age. Exercise can help maintain muscle mass and help maintain a "fast" metabolism as we age.

And although there are many supplements out there that promise to help men as they age, Heber says he's seen little convincing evidence.

"The benefits of hormone or pre-hormone supplements has not been proven in the literature," he says. "Certainly, it may seem to make sense to use these types of hormones to make up for deficits as men age. However, publications of good clinical trials that provide valid assessments of risks and benefits are lacking in peer-reviewed journals."

More Protein continued...

Agnew and Marin say that to determine your optimal protein needs, divide your weight in pounds by 2.2. The ending figure is a good upper figure for the amount of protein you need. For example, they say, a 32-year-old man who weighs 180 pounds who wanted to increase lean muscle mass should eat up to 82 grams (his weight in kilograms) daily.

"We have this idea that it's easy to get too much protein, but really men who are active and want to maintain muscle mass need to eat more protein than they might think they need," say Philip Goglia, PhD, a nutritionist and founder of Performance Fitness Concepts, a testing center for sports training in Venice, Calif.

"Too often we turn to carbohydrate-heavy meals in the evening. Carbohydrates are satisfying and taste good, but men are better off eating the majority of their protein at dinner, which helps their bodies rebuild muscle tissues overnight," adds Goglia, who also is the author of Turn Up The Heat, Unlock the Fat Burning Power of Your Metabolism.

More Protein

Men and women need good sources of protein in their diets. However, men's protein needs may be proportionally greater, especially if a man is physically active.

To build muscle mass, men might want to increase their protein levels above the regular daily requirements, according to Rachel Agnew, RD, and Sandra P. Marin, MPH, RD, who are members of the professional education team at the Nature Made company, a manufacturer of nutritional supplements based in Mission Hills, Calif.

More Calories

[Men's] calorie needs are greater," says David Heber, MD, director of the UCLA Center for Human Nutrition in Los Angeles. "Those needs are dependent on the amount of lean body mass and average about 14 calories per pound of lean body mass per day at rest with additional calories for exercise."

For example, Heber added, a typical 180-pound man who has 17% body fat would have 150 pounds of lean muscle and would need 2,100 calories per day at rest. A woman who weighs 130 pounds with 100 pounds of lean body mass at about 23% body fat would need 1,400 calories at rest.

"You might add 300 to 500 calories per day for physical activity," Heber notes. "However, the differences are quite large, as you can see."

In large part, these differences are driven by reproductive hormones, Heber says. In men, testosterone is responsible for muscle mass differences from women and this hormone accounts for the extra muscle driving extra protein and calorie requirements.

But there are subtler differences, also.

"Even if you take differences in size and weight out of the equation and express nutritional needs per body weight or lean body mass, there are still differences between men and women," says Paul J. Flakoll, PhD, professor of nutritional physiology and director of the Center for Designing Foods to Improve Nutrition at Iowa State University in Ames, Iowa. "Obviously, there are differences during life events specifically related to women, such as pregnancy and lactation, which men do not experience."

Normal levels of circulating red blood cells are higher in men than in women, which may have nutritional implications, Flakoll says, adding that men do not tolerate low levels of plasma glucose, or hypoglycemia, as well as women.

Men Have Special Nutritional Needs, Too Men need to pay attention to their health and nutritional needs.

The ways in which men and women differ are innumerable. Now you can add nutritional needs to the list.

While women would seem to have more special nutritional needs than men, given the demands that biology puts on them, men need to pay attention to their own set of nutritional demands as well.

Many problems caused in part by nutrition are common to both men and women, such as cardiac disease, obesity, and diabetes. In general, absolute nutritional requirements in men are greater than in women, simply because men as a population are larger and have more muscle mass than women.

More Iron, Please continued...

"Women need to eat a diet rich in meat, fish, and poultry," says Spalding. "For vegetarian women it may be harder to get iron from dietary sources because the iron from plant foods is not absorbed as well."

According to the American Dietetic Association, most grain foods we eat, such as cereals, pasta, and bread, are now fortified with iron. Some foods that are naturally high in iron include spinach, chard, beans (pinto, kidney, black), lentils, and split peas.

Increase the amount of iron you absorb from food by eating vitamin C-rich foods -- orange juice, broccoli, tomatoes -- along with foods high in iron.

And remember, Turner notes, "women can be iron deficient and not be anemic. Being iron deficient can keep women from performing optimally."

Calcium and Folate

Another area to watch is calcium.

"Women build bone into their mid-20s, and they need to eat calcium-rich foods to promote bone density," says Spalding. "More calcium may be needed for women in menopause since with estrogen declines, calcium may 'leak' from the bones."

The daily calcium recommendations are 1,000 milligrams a day for women under 50, and 1,500 milligrams a day for women 51 and older. Oddly enough, these are the same requirements for men, who are much less prone to osteoporosis than women. But the recommendation takes into account the fact that women are smaller than men. Thus the amount of daily calcium is greater for women on a proportional basis.

Both women and men need folate, or folic acid. At proper levels, it has been linked to better heart health and possible protection from colon cancer.

But for women in their childbearing years, getting enough of this B-vitamin can greatly reduce the chances of neurological birth defects. The Institute of Medicine recommends 400 micrograms daily for people over age 14. Pregnant women need 600 micrograms daily, and women who are breastfeeding need 500 micrograms daily.

"It's difficult to overstate the need for women to get sufficient folate before and during pregnancy," says Turner. "It's important for overall good health, but for the developing fetus, it can make all the difference in the world."

John Casey is a freelance writer in New York City.

Originally published Oct. 4, 2004.

Medically updated August 2006.

More Iron, Please

For women of childbearing age, blood loss through menstruation can lead to iron deficiency. The Institute for Medicine of the National Academies recommends a daily allowance of 18 milligrams of iron for women aged 19 to 50. During pregnancy a woman's requirements are even greater. Men in that same age range need just 8 milligrams daily.

"Iron is one of the few things women need way more of than men," Spalding says.

Most men get all the iron that they need from the food they eat. For many women, it's often not so easy, because they have lower calorie needs.

Women Need Fewer Calories

"A woman and man of the exact weight and percentage of fat would burn the same amount of calories for the same amount of exercise," says Sharon B. Spalding, MEd, CSCS, professor of physical education and health at Mary Baldwin College in Staunton, Va. "However men are usually larger with a higher lean weight and will burn more calories."

Body composition comes into the picture, she says, because we know that muscle takes more calories to maintain -- even when you're not exercising -- than fat.

So women need fewer calories than men in part because they tend to be smaller and have higher fat percentages than men. That means women have to be choosier about what they eat. If you need fewer calories, the calories you take in need to pack a lot of nutritional punch.

In general, women need around 1,200 calories every day and men need a few hundred calories more. If you exercise you'll need much more depending on how active you are.

"Remember that to determine caloric expenditure one must take into consideration the intensity and duration of the activity, as well as the body weight of the person exercising," said Spalding.

Women's Nutrition Needs Special Attention

Women need fewer calories but more nutrients than men to be at their best. See how women's needs differ in part 1 of our two-part series.

According to the old nursery rhyme, little boys and little girls are made of very different things. While you can fault the rhyme for not being factually accurate, it does highlight an interesting point. In some respects, men and women have different nutritional needs, largely due to differences in male and female hormones.

But we don't start out all that differently, nutritionally speaking.

"If you look at the current federal dietary guidelines for kids, there is no difference in nutritional needs for males and females until age 9," says Elaine Turner, PhD, RD, associate professor in the department of Food Science and Human Nutrition at the University of Florida in Gainesville.

Once we hit puberty, however, she added, everything changes. And women's unique role as the bearers of children tends to drive their special nutritional needs.

Those Extra Calories

Alcohol is fairly high in calories, but provides few essential nutrients.

The benefits of moderate drinking do not outweigh the risks of being overweight, says Theresa Nicklas, DrPh, a member of the dietary guidelines advisory committee. So if you have a drink, you should budget it into what the U.S. dietary guidelines call your "discretionary calories" -- the ones you have left over after you eat all the nutritious foods you need.

The problem, says Nicklas, is that most Americans are sedentary, so their calorie needs are relatively low. For example, someone on an 1,800-calorie eating plan only has 195 discretionary calories per day -- the equivalent of one 9-ounce glass of wine (and that leaves no room for sweets or other treats).

And, of course, when you drink too much alcohol, it's hard to get all the nutrients you need without taking in too many calories. Heavy drinkers who substitute alcohol calories for nutritious foods run the risk of malnutrition.

Another problem, according to National Institutes of Health researcher Rosalind Breslow, PhD, is that "liquid calories from alcohol do not satisfy hunger." She notes that drinks made with high-calorie mixers, like pina coladas and white Russians, can have as many as 400 calories apiece.

The best bet for people who want to enjoy a drink most days is to get more physical activity, Nicklas says. She points out that the benefits of regular physical activity are much greater than those of moderate drinking, and she advises everyone to strive for at least 30 minutes daily.

The Bottom Line

More research remains to be done on the relative risks and benefits of drinking alcohol.

But the bottom line is that to get any health benefits from alcohol, we must drink responsibly. That means having no more than 1-2 drinks per day, having them at mealtime and as part of an overall healthy diet, and making sure you aren't exceeding your calorie needs.

Alcohol's Advantages continued...

n fact, moderate drinking can increase "good cholesterol" levels by as much as 20%, if it's accompanied by a healthy diet and regular physical activity, says Harvard researcher Eric Rimm, DrS.

That's similar to the improvement you might see by taking cholesterol medication or running a half-marathon, Rimm says. (He's quick to point out that exercise has many other health benefits and that alcohol should never replace exercise.)

Research has also suggested that moderate drinking can increase insulin sensitivity, which can reduce the risk of diabetes, among other things. But the empty calories in alcohol can be a problem, as there is a link between type 2 diabetes and excess weight.

Rimm, who has reviewed several large studies, has found a delicate balance between the risks and benefits of alcohol and its impact on diabetes. However, he says, "there appears to be a reduction in risk of type 2 diabetes in adults who consume moderate amounts of alcohol."

Recent research also suggests that women who enjoy a little alcohol may be more likely to keep their minds sharp as they age.

A study published in The New England Journal of Medicine in 2005 evaluated the mental abilities of 12,480 women aged 70-81. The researchers found that moderate drinkers had a 23% reduced risk of mental decline compared with nondrinkers.

What Type, How Much, and When?

According to the experts, it doesn't make too much difference whether you prefer wine, beer, or spirits.

"The research evidence points to ethanol -- or the alcohol component -- of beer, wine, or spirits as the substance that can help lower cholesterol levels, increase HDL (good cholesterol), and improve insulin sensitivity in overweight individuals," Rimm says.

It's how much you drink that really matters. The U.S. Dietary Guidelines and the American Heart Association define moderate drinking as one drink for women and two for men per day -- not averaged over the week. (One drink is defined as 5 ounces of wine, 12 ounces of beer, or 1.5 ounces of 80-proof distilled spirits such as vodka.)

When you drink is also important, says Alice Lichtenstein, DrS, a professor at Tufts University. If you do consume alcohol, it's best to have it with meals, she says.

Some studies have suggested that drinking alcohol without eating raises the chance of developing high blood pressure.

Also, "alcohol can stimulate the appetite, so it is better to drink it with food," says Arthur Agatston, MD, a cardiologist and author of the popular book The South Beach Diet. "When alcohol is mixed with food, it can slow the stomach emptying time and potentially decrease the amount of food consumed at the meal."

And what about people who don't drink at all? The experts agree that, though alcohol has some health benefits, it's not a good idea to start drinking if you don't already.

The new U.S. dietary guidelines point out that there are many ways to reduce the risk of chronic diseases besides moderate drinking, including:

  • Eating a healthy diet
  • Exercising
  • Quitting smoking
  • Maintaining a healthy weight

Blood Pressure and Alcohol: Should You or Shouldn't You? How drinking affects your health

Has a daily drink replaced the apple a day as a way to keep the doctor away?

Scientists have long touted the heart benefits of drinking small amounts of alcohol. Newer studies have credited moderate drinking with everything from helping to keep our minds sharp as we age to lowering our risk of developing diabetes.

In fact, the new U.S. dietary guidelines give many of us official permission to enjoy one to two drinks daily.

This is great news for folks who follow the French lifestyle of sipping a glass of wine with dinner, or who enjoy an evening cocktail. But what about teetotalers -- should they start drinking? Are there some people who shouldn't drink, under any circumstances? And how do you balance the health effects of alcohol with its high calorie count?

Does It Help or Hurt?

Drinking alcohol can be good for your health, but it can also be harmful. It all depends on how much you drink, your age, and other factors.

There's no denying that too much alcohol can lead to serious problems. Excess alcohol can increase your risk of:

  • Liver disease
  • High blood pressure
  • High blood fats (triglycerides)
  • Heart failure
  • Stroke
  • Fetal alcohol syndrome (if you're pregnant)
  • Certain cancers
  • Injury, violence, and death

And, of course, drinking too much alcohol piles on the calories, which can lead to obesity and a higher risk for diabetes.

For some segments of the population, alcohol can lead to many health problems. Those who should not drink include:

  • Pregnant and breastfeeding women
  • People at risk for certain cancers
  • People with family histories of alcohol abuse
  • Children and adolescents
  • People taking medications that can interact with alcohol
  • Those with health conditions such as liver problems or ulcers
  • Anyone requiring skill or coordination to perform a task
  • People who have a history of pancreatitis (inflammation of the pancreas)

According to the U.S. Dietary Guidelines, in middle-aged and older adults, moderate consumption is associated with the lowest all-cause mortality (that is, the rate of death from all causes). But in younger adults, alcohol consumption provides little, if any, health benefits, according to the guidelines. Instead, it's associated with a higher risk of serious injury or death.

The CDC has reported that excessive drinking causes more than 75,000 deaths from various causes in the U.S. each year. And what exactly is "excessive"? For men, it's an average of more than two drinks daily, or more than four drinks at one time, according to the CDC. For women, it's an average of more than one drink per day or more than three drinks at one time.

Alcohol's Advantages

Alcohol's effects on the heart -- for both men and women -- are well documented. Studies have shown that moderate drinking can raise levels of "good cholesterol," which helps prevent harmful blood clots and helps keep blood flowing smoothly through our bodies, reducing risks of heart attack and stroke.

Nutrition Quiz

These days, we know better than to fall prey to food folklore, such as the myths that vitamins provide energy and snacking on chocolate is healthy -- right? Or did you think these two were true? Take this quick quiz to see how much know about eating healthfully.

  1. Nibbling on chocolate may actually be healthy.
  2. Cottage cheese isn't a particularly good source of calcium.
  3. Butter and margarine have about the same number of calories.
  4. Popeye was right: Spinach builds strong muscles!
  5. Snacking doesn't always make you fat.
  6. Canned or frozen fruits and vegetables contain fewer nutrients than the fresh fruits and vegetables.


Label Reading on the Run

On your way home from work you stop at the grocery store to pick up dinner. Researching labels isn't a priority. You want to grab the goods and go. Here's a label-reading shortcut. First, ignore the "sell" on the front. Go straight to the back and look at %DV. According to the FDA, you should look for nutrients you want, such as fiber, to represent 20%DV or more, and nutrients you should limit, such as fat, to represent 5% or less. Next look at serving size. If you'll eat twice that amount, then double the %DV numbers, or if you'll eat half the amount, then halve the %DV numbers. Remember that DV is based on 2,000 calories a day. In general a diet containing 1,000 to 1,200 calories per day is what is recommend for most women trying to lose weight and a diet containing between 1,200 and 1,600 should be chosen for most men trying to lose weight.

When you're in a hurry, maybe the best you can do is compare three brands of the same product, such as chili. Thankfully, manufacturers tend to standardize serving sizes. For chili, it's 1 cup. So when you check the different brands for %DV it's easy to see which packs more of the nutrients you want and less of those you don't want.

The Important Term That's Not on Labels

A desire to lose weight may be the main reason you pay attention to what you eat. But eating to promote good health should be a consideration as well. Labels can help. In 1993, the FDA required manufacturers to list saturated fat and cholesterol on nutrition labels. Now the issue is trans fats.

Studies show these trans fats sabotage good cholesterol and boost bad cholesterol, triglycerides, and lipoproteins that clog arteries and cause heart disease. They're also suspected of playing a role in diabetes and cancer. But you won't find trans fat listed on many nutrition labels, at least not yet. The FDA has given manufacturers until January 2006 to list them. Some manufacturers have already complied. Meanwhile, the code words to watch for in the label's ingredients list are "partially hydrogenated."

Trans fats are everywhere you find processed foods. McLeod, who lives in Gainesville, Fla., reads -- and understands -- nutrition labels. But she didn't always. "I thought I was eating nutritious foods." She was shocked when she pulled the packaged foods from her pantry and refrigerator. "I threw out most of it. Trans fat was in almost every single packaged food item in my house."

Vitamins and Minerals

Vitamins and minerals are listed by %DV only. Pay particular attention to vitamin A, vitamin C, calcium, and iron. They're listed first. The FDA says most Americans don't get enough in their diets.

Ingredients

Ingredients are listed in order from the greatest amount to the least. Just how much of a "fruit breakfast bar" is fruit? McLeod advises leaving the product on the shelf if the terms "enriched wheat flour" or "sugar" appear before "fruit." She also offers this rule of thumb: the fewer the ingredients, the better. "If there's a long list of scary ingredients you can't pronounce, you might want to put it back." Some labels also show you the total recommended daily allowances of nutrients for a 2,000-calorie diet.

Nutrients by Weight and Percentage of Daily Value (%DV)

If you're counting fat or carbohydrate grams, you're familiar with this part of the label. It shows how much of each nutrient is in a single serving by weight in grams and by %DV. This symbol refers to the recommended daily allowance for a nutrient based on a 2,000-calorie diet (you'll see that some nutrients, such as sugar and protein, don't have a %DV). Fats are listed as "Total Fat" and also broken down so you can see how much is saturated fat, i.e., the kind you especially want to limit. Unfortunately, the label doesn't distinguish between natural sugars, such as those found in fruit, and added sugar. The U. S. Food and Drug Administration (FDA) Center for Food Safety and Applied Nutrition says the first nutrients listed on the label --total fat, cholesterol, and sodium -- are the ones most Americans get enough of or too much of in their diets. And one of the most overlooked nutrients essential for good health is fiber.

Calories and Calories From Fat

Next you'll see how many calories are in a serving and how many of those calories come from fat. A 2-ounce serving of tuna has 60 calories, 5 of which come from fat. If you eat the whole can, multiply these amounts by 2.5 for a total of 150 calories and 12.5 fat grams.

The Nutrition Facts Label

Serving Size

Start your label reading adventure by looking at the "serving size" printed right under "nutrition facts." Portion control is an important part of weight management, but don't expect food manufacturers to make it easy for you. Pop-Tarts, for instance, come two to a package. The label says one serving is 200 calories. The catch is that's for "one pastry."

Label reading is easy when a package states there are one or two servings. It's the fractions that will send you to the calculator. For example, the label on a 6-ounce can of StarKist Tuna in water says one serving is 2 ounces (drained) so you might think the can holds three servings. But because you drain off some weight, the can actually contains 2.5 servings.

And how realistic are those printed serving sizes anyway? The South Beach diet recipe for South Beach Chopped Salad With Tuna calls for a 6-ounce can of water-packed tuna, and that's for a single serving of salad.

Beware of the Front Label Tease

"Heart Healthy!" "Enriched With Calcium and Vitamins!" "Low fat!" The front label is where manufacturers can say whatever they want. But when you look at the nutrition facts on the back you might wonder if the two labels refer to the same product. "Speed read the front label and go straight to the nutrition facts," says Kerry McLeod, author of The Last Diet Book Standing. She tells WebMD why the following front label terms should be red flags:

  • Fortified, enriched, added, extra, and plus. This means nutrients such as minerals and fiber have been removed and vitamins added in processing. Look for 100% whole-wheat bread, and high-fiber, low-sugar cereals.
  • Fruit drink. This means there's probably little or no real fruit and a lot of sugar. Instead look for products that say "100% Fruit Juice."
  • Made with wheat, rye, or multigrains. These products have very little whole grain. Look for the word "whole" before the grain to ensure that you're getting a 100% whole-grain product.
  • Natural. The manufacturer started with a natural source, but once it's processed the food may not resemble anything natural. Look for "100% All Natural" and "No Preservatives."
  • Organically grown, pesticide-free, or no artificial ingredients. Trust only labels that say "Certified Organically Grown."
  • Sugar-free or fat-free. Don't assume the product is low-calorie. The manufacturer compensated with unhealthy ingredients that don't taste very good and, here's the kicker, have no fewer calories than the real thing.

How to Read a Nutrition Label

Remember being a kid and tearing open the cereal box to get the special decoder ring? Today's cereals should come with a ring you can use to crack the code of their nutrition labels. For those who understand its secrets, the nutrition label holds valuable information for winning the war on fat. Since there is no special ring, we'll give you the skinny on reading nutrition labels.

Thursday, October 30, 2008

Medication Safety Tips: Dos and Don'ts

Medication Safety Tips: Dos and Don'ts

Do you take a long list of medications to manage serious health problems? Or do you simply reach for an over-the-counter medication from time to time? Either way, there's a lot you can do to make sure you get the most benefit from the medication-and stay safe in the process. These medication safety tips are a good place to start.

Medication Safety Tips: Know Your Medications

What you don't know CAN hurt you. The more you know about any medication you use, the better you can be sure you're using it properly. For each medication you take, whether it's a prescription medication or an over-the-counter drug, you can fill in this chart to be sure you understand what the medication does and how to use it. If you can't find the information on the medication bottle or in the patient information that came with the medication or have trouble understanding the information, be sure to ask your doctor or pharmacist.

Medication name (both brand and generic)
Size, color & imprint on pill
Dosage
Common side effects
What to do for side effects
When to call your doctor
Other special instructions

Medication Safety Tips: Remember These Dos and Don'ts

These 10 medication DOs and DON'Ts can help you make sure that your medication works safely to improve your health.

5 Medication DOs...

  • DO take each medication exactly as it has been prescribed.
  • DO make sure that all your doctors know about all your medications.
  • DO let your doctors know about any other over-the-counter medications, vitamins and supplements, or herbs that you use.
  • DO try to use the same pharmacy to fill all your prescriptions, so that they can help you keep track of everything you're taking.
  • DO keep medications out of the reach of children.

5 Medication DON'Ts...

  • DON'T change your medication dose or schedule without talking with your doctor.
  • DON'T use medication prescribed for someone else.
  • DON'T crush or break pills unless your doctor instructs you to do so.
  • DON'T use medication that has passed its expiration date.
  • DON'T store your medications in locations that are either too hot or too cold. For example, the bathroom cabinet may not be the best place for your medication.

Get Your Children to Read

Dr. Seuss wrote, "The more that you read, the more things you will know. The more that you learn, the more places you'll go." Use these suggestions to get your kids excited about reading!

  • Make a field trip to the library. "Make a big deal about getting a library card!" Oprah says.
  • Try to get children hooked on a favorite author or series. Oprah loved Lois Lenski while growing up.
  • According to the July 2000 issue of Good Housekeeping, 77 percent of elementary school students return to school with a reading level below or at the level they had when they left the previous year. Make sure you have books available at home to read.
  • Have your child read aloud so you can gauge their progress.
  • Set a good example. Children need to see you reading, too!
  • Teach kids that reading is about pleasure. Don't measure their progress by the number of books read, but the time spent reading.
  • Help designate a special reading spot just for your child. Joke books, comics, newspapers, magazines and maps make good reading, too.
  • Read the same book along with your child—let them recommend a book to you!

Why Children Dislike School

When Rabbi Shmuley was a young boy, he didn't care for school very much because he felt like it was a popularity contest and he wasn't learning anything. But when Rabbi Shmuley was 14 years old, he asked his mother to let him change schools. Once he got to the new school, his outlook brightened. "I was with kids who were more serious and loved learning, and I started learning in a different way," he says. "All of a sudden, I really started to love studying."

Rabbi Shmuley says that these are some reasons children might not like going to school:

They see no point.

It's not the work aspect of school, but that they can't see the purpose. "We, as parents, do a very poor job of connecting the dots. We say, 'Go to school so you can have a better future,' when they know tons of people who succeed without a formal education," Rabbi Shmuley says. Parents need to show their children that school is about one thing—loving learning.

They are bored.

Rabbi Shmuley says the biggest threat to children's educations is boredom. Parents should try to get children to love learning at home too." Ask yourself: Is your home a place where learning is valued?

They are tired.

Children need to get a good night's sleep. Make sure your children are getting enough sleep on a regular schedule, Rabbi Shmuley says.

They're intimidated.

Rabbi Shmuley says there's nothing wrong with taking your children into school on the first day or driving them to high school. "Make it like you're involved in it; ask them questions about how they feel," he says.

They're in the wrong school.

Finding the right school is important for children, so if they feel another school might be better, pay attention, Rabbi Shmuley says. Also, get to know the teachers and make parent-teacher conferences a priority.

They feel like schoolwork will never end.

Rabbi Shmuley thinks children today have too much work. "Take an interest in the school and make sure your children aren't so overloaded with homework that they stop loving learning," he says.

They feel like they're on their own.

Communicate with your children about what they are doing in school, and make studying more of a family activity, Rabbi Shmuley says.

Originally published on August 18, 2008

10. Take an Attitude Break

Thirty seconds is enough time to shift your heart's rhythm from stressed to relaxed, Rozman says. The way to do that: Engage your heart and your mind in positive thinking. Start by envisioning anything that triggers a positive feeling -- a vision of your child or spouse, the image of your pet, that great piece of jewelry you're saving up to buy, a memento from a vacation -- whatever it is, conjuring up the thought will help slow breathing, relax tense muscles and put a smile on your face. Rozman says that creating a positive emotional attitude can also calm and steady your heart rhythm, contributing to feelings of relaxation and peace.

9. Try a Musical Detour

Music can calm the heartbeat and soothe the soul, the experts say. So, when the going gets rough, take a musical stress detour by aligning your heartbeat with the slow tempo of a relaxing song. And you might want to make that a classical tune. Research shows that listening to 30 minutes of classical music may produce calming effects equivalent to taking 10 mg of Valium.

8. Take a Time-Out

Adults need time-outs, too. So when you sense your temper is about to erupt, Jeff Brantley, MD, author of Five Good Minutes In the Evening, suggests finding a quiet place to sit or lie down and put the stressful situation on hold. Take a few deep breaths and concentrate on releasing tension and calming your heartbeat. Quiet your mind and remember: Time is always on your side, so relax. The stress can wait.

7. Try Self-Massage

When your muscles are tense and you've no time to visit a pro, try this simple self-massage technique from Darrin Zeer, author of Lover's Massage and Office Yoga. Relax, and travel straight to Zen-land.

  • Place both hands on your shoulders and neck.
  • Squeeze with your fingers and palms.
  • Rub vigorously, keeping shoulders relaxed.
  • Wrap one hand around the other forearm.
  • Squeeze the muscles with thumb and fingers.
  • Move up and down from your elbow to fingertips and back again.
  • Repeat with other arm.

6. Show Some Love

Induce the relaxation response by cuddling your pet, giving an unexpected hug to a friend or family member, snuggling with your spouse, or talking to a friend about the good things in your lives, says psychologist Deborah Rozman, PhD, co-author of Transforming Stress. When you do, you'll be reducing your stress levels.

Why? Experts say social interaction helps your brain think better, encouraging you to see new solutions to situations that once seemed impossible, she says. Studies have also shown that physical contact -- like petting your dog or cat -- may actually help lower blood pressure and decrease stress hormones.

5. Drink Hot Tea

If you're a coffee-guzzler, consider going green. Coffee raises levels of the notorious stress hormone, cortisol, while green tea offers health and beauty, says Nicholas Perricone, MD, author of 7 Secrets to Beauty, Health, and Longevity.

Chamomile tea is a traditional favorite for calming the mind and reducing stress. And black tea may be a stress-fighter, too, researchers from University College London report. Participants who drank regular black tea displayed lower levels of cortisol, and reported feeling calmer during six weeks of stressful situations than those who drank a placebo with the same amount of caffeine.

4. Look Around You

"Mindfulness is the here-and-now approach to living that makes daily life richer and more meaningful," says Claire Michaels Wheeler, MD, PhD, author of 10 Simple Solutions to Stress. It's approaching life like a child, without passing judgment on what occurs. Mindfulness means focusing on one activity at a time, so forget multi-tasking! Staying in the present-tense can help promote relaxation and provide a buffer against anxiety and depression.

Practice it by focusing on your immediate surroundings. If you're outdoors, enjoy the shape and colors of flowers, hear a bird's call or consider a tree. In the mall, look at the details of a dress in the window, examine a piece of jewelry and focus on how it's made, or window-shop for furniture, checking out every detail of pattern and style. As long as you can keep your mind focused on something in the present, stress will take a back seat.

2. Picture Yourself Relaxed

Is your mind too talkative to meditate? Try creating a peaceful visualization, or "dreamscape." To start, simply visualize anything that keeps your thoughts away from current tensions. It could be a favorite vacation spot, a fantasy island, that penthouse in New York City -- or something "touchable," like the feel of your favorite silk robe or cozy sweater.

The idea is to take your mind off your stress, and replace it with an image that evokes a sense of calm. The more realistic your daydream -- in terms of colors, sights, sounds; even touch and feel -- the more relaxation you'll experience.

1. Meditate

If you're thinking meditation means twisting your body into an uncomfortable position and uttering "oohs" and "omms" for an hour, guess again. Any repetitive action can be a source of meditation, says Herbert Benson, MD, author of The Relaxation Response anddirector emeritus, Benson-Henry Institute for Mind Body Medicine in Chestnut Hill, Massachusetts. This includes walking, swimming, painting, knitting -- any activity that helps keep your attention calmly in the present moment.

When you catch yourself thinking about your job, your relationship or your lifelong to-do list, experts say to simply let the thought escape, and bring your mind back the repetition of the activity. Try it for just 5 to 10 minutes a day and watch stress levels drop.

Blissing Out: 10 Relaxation Techniques To Reduce Stress On-the-Spot

The kids need a ride to school, your husband can't find his shorts, your boss has just scheduled an online meeting, and your best friend desperately needs your help -- all at the same time.

Is it any wonder that you can't find a minute for relaxation? In fact, if you're like most women, you may have even forgotten how to relax.

And while experts say that some stress is good for you -- it can sharpen your senses and your mind -- too much stress is bad for your mental and physical health. At the same time, relaxation can do wonders to restore balance in your life -- and may even reduce some of the health risks associated with stress.

WebMD talked to the experts to learn more about relaxation -- and how to attain it. What follows are 10 on-the-spot techniques you can use -- any time and almost anywhere -- to reduce the tension in your life.

PBDEs

(polybrominated diphenyl ethers), flame retardants added to plastics, foams, and fabrics, are found in some TVs, computers, and furniture. Exposure can cause brain and reproductive problems in developing animals.

  • Do This Clean with a damp rag to avoid stirring up dust (which may contain PBDEs) and cover or replace exposed foam pads in cushions.

PHTHALATES

are chemicals used to disperse scents and make plastic flexible. Found in detergents, air fresheners, vinyl flooring, and vinyl shower curtains, they're linked with reproductive and developmental problems and, studies indicate, an increased risk for asthma and allergies.

  • Do This Switch to phthalate-free detergents (like Seventh Generation products), use baked lemons as natural fragrance, and hang hemp or cotton shower curtains (from $35, greenhome.com).

CARBON MONOXIDE

nitrogen dioxide, and tiny, sootlike floaters called particulate matter can seep out from improperly maintained stoves, fireplaces, and chimneys. Low-level exposure to carbon monoxide leads to headaches and nausea; high levels are deadly. Nitrogen dioxide can cause eye, nose, and throat irritation. Particulate matter can damage lung tissue.

  • Do This Snag a carbon monoxide detector ($20, lowes​.com). Use a fan when cooking with a gas stove, and make sure the flame tip is blue. (Yellow indicates that pollution emissions are too high; call your gas company to adjust the burner.)

Got gas?

Your house sure does--and it's bad for your health


We humans breathe in 3,000 gallons of air daily--65 percent of it indoors. Not exactly great news. Why? Because indoor air pollution can be two to five times as high as levels in the great outdoors, according to the EPA. Blame building materials, fuel-burning appliances, and stuff you use to clean your castle: They all emit pollutants that over time can contribute to health problems like asthma, headaches, fatigue, heart disease, and even cancer, says Helen Suh MacIntosh, Sc.D., of the Harvard School of Public Health. Snuff out these bad guys and breathe easier:

Childhood Lung Problems Increase Adult Asthma

Underscoring the importance of early-childhood events for later asthma is a study from the University of Arizona, Tucson.

Fernando D. Martinez, MD, director of the Arizona Respiratory Center at the University of Arizona, and colleagues followed 849 children from birth to age 22.

Those with adult asthma were:

  • 7.4 times more likely to have had childhood asthma
  • 14 times more likely to have had persistent wheezing as children
  • 3.6 times more likely to have had a childhood mold allergy
  • Twice as likely to have had low airway function at age 6

More than 70% of the adults who had adult asthma were women.

"We conclude that asthma that apparently develops early in adult life affects mainly women and is commonly the clinical expression of latent changes of airway responses that are present in the preschool years," the researchers conclude.

The Beasley and Martinez studies, and Barr's editorial, appear in the Sept. 20 issue of The Lancet.

Does Acetaminophen Cause Asthma? continued...

"This is a major public health concern," Barr tells WebMD. "Given the widespread use of acetaminophen and ibuprofen among kids -- and asthma being the disease of greatest burden in kids -- this would seem to be an important topic for further study."

Barr notes that previous studies have linked acetaminophen, but not ibuprofen, to asthma and have linked use of acetaminophen during pregnancy to childhood asthma.

Barr's own research team previously found that high-level acetaminophen use raised women's risk of adult-onset asthma.

"There is still a lot of uncertainty about this," he says. "There might be something going on, but do we have a clear public health recommendation at this time? I don't think we do

Does Acetaminophen Cause Asthma?

The Beasley study, in which parents are asked to recall their use of acetaminophen after the fact, cannot prove acetaminophen causes asthma.

However, Beasley and colleagues note that there are several reasons to suspect this is so:

  • The link between acetaminophen and asthma is strong.
  • The more acetaminophen a child uses, the higher that child's risk of severe asthma.
  • Acetaminophen is linked to asthma in many different cultures with different medical practices.
  • Acetaminophen use came before asthma symptoms appeared.
  • Asthma prevalence shot up in the same years acetaminophen use became widespread.

In an editorial accompanying the study, Columbia University researcher R. Graham Barr, MD, DrPH, agrees with Beasley that while the study does not prove acetaminophen causes asthma, a clinical study is urgently needed.

Baby Acetaminophen Tied to Asthma

Sept. 18, 2008 - Babies who get acetaminophen -- Tylenol is one brand -- have an increased risk of childhood asthma.

Acetaminophen, often given to treat fevers in the first year of life, also upped the risk of eczema and having a runny nose and itchy eyes.

The finding, from an international study of 205,487 children in 31 countries, does not prove acetaminophen causes asthma, eczema, or nose/eye problems.

But it raises important safety concerns about the most commonly used drug in the U.S.: the fever-reducing painkiller acetaminophen (also known as paracetamol), the main ingredient in Tylenol.

People should think twice about using acetaminophen, but nobody should stop taking it or giving it to children with high fevers, says study leader Richard Beasley, DSc, a professor at the Medical Research Institute of New Zealand.

"[Acetaminophen] use might be a risk factor for the development of asthma in childhood. This issue urgently requires randomized controlled trials," Beasley tells WebMD in an email interview. "In the meantime, [acetaminophen] remains the preferred drug for relief of pain and fever in childhood, and for use by both children and adults with asthma."

Beasley recommends that parents give children acetaminophen only when they have a fever of more than 101 degrees Fahrenheit.

The study shows:

  • A 46% increased risk of asthma at ages 6-7 years in kids who got acetaminophen for fever in their first year of life.
  • A 48% increased risk of runny nose and red, itchy eyes at ages 6-7 in kids who got acetaminophen for fever in their first year of life.
  • A 35% increased risk of eczema at ages 6-7 in kids who got acetaminophen for fever in their first year of life.
  • A threefold higher risk of current asthma symptoms in 6- to 7-year-olds who took acetaminophen at least once a month compared with those who did not take the drug.
  • 22% of severe childhood asthma is linked to acetaminophen use during the first year of life.
  • 38% of severe childhood asthma is linked to acetaminophen use later in childhood.

Tracking Asthma Symptoms: Key to Control

Asthma symptoms are like the weather -- they change often and may seem unpredictable. But also like the weather, careful tracking of asthma symptoms can help identify patterns and what they may say about your asthma control.

Research has shown that tracking and rating your asthma symptoms are key steps in successfully managing asthma. One study even found that it helps keep kids with childhood asthma out of the emergency room.

Most asthma action plans track your “peak flow” (measured by a portable, hand-held meter used at home to gauge asthma severity). Based on “peak flow” results, the plans divide how you’re feeling into green, yellow, and red zones.

  • Green is optimal -- at your goal and nearly free of asthma symptoms.
  • Yellow means that you’ve had some increase in symptoms, a decrease in lung function, and your asthma control is worsening. You’ll need to adjust your medications.
  • Red indicates that your asthma is not under control and your medications are failing to control your symptoms. You’ll need to use medications to help open the airways and get your peak flow measures back to the yellow and green zones. The red zone may signal that emergency care is needed.

Along with your peak flow measures, here are some of the asthma symptoms you should be tracking daily -- or helping your child track if they have childhood asthma:

  • Coughing
  • Wheezing
  • Chest tightness
  • Headaches
  • Decreased appetite
  • Shortness of breath
  • Decreased physical activity
  • How often you’re using your inhaler
  • Dark circles under the eyes

Take note of when these symptoms occur and what triggers you were exposed to. Also note what asthma medications you took and how your asthma symptoms responded. And keep in mind that these asthma action plans should be personalized for you or your child. You shouldn’t be comparing your asthma symptoms with someone else’s.

“Everybody coughs, everybody wheezes,” says Shirley Joo, MD, an asthma specialist at Washington University of St. Louis School of Medicine. “But the levels vary by patient, and there’s an expected range based on a lot of factors and tests that we do in the office. You’re striving for your personal best.”

Even if you’re not actually coughing or wheezing, it’s also important to note if you can’t be as physically active as you’d like. If your child has asthma, you may have to watch this carefully.

“Kids, of course, will not come to their parents and say that they think their asthma feels worse, so look at their activity level,” says Joo. “Are they playing as much as usual, or are they sitting on the sidelines or coming in earlier than they used to?” Children should be able to go as fast as they want. When they can’t keep up with their friends, that’s an indicator that doctors should take a look at how well their asthma is controlled.

Treating Asthma: Personalized Medicine

But it's not so straightforward for most people. Every case of asthma is different and the disease can take many forms. So each person's treatment needs to be different too. The medicines that work for your relative or your friend or your neighbor may not work for you. "Every person who has been dia

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HFA Asthma Inhalers: Making the Switch

By Jan. 1, 2009, millions of Americans with asthma and those with chronic obstructive pulmonary disease will have to make the switch from CFC-propelled inhalers to HFA-propelled inhalers, if they haven't already. The change comes as a result of a federal ban on CFC (chlorofluorocarbons) albuterol in

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Wheezing With Colds Raises Risk of Asthma

Oct. 1, 2008 -- Infants and toddlers who wheeze when they are sick with colds have a big risk of developing asthma later in childhood, a new study shows. Wheezing with rhinovirus infection during the first three years of life was associated with a tenfold increase in asthma risk by age 6, researcher

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It's Peak Season for Kids' Asthma Care

Oct. 27, 2008 -- October, November, and December are the peak months for children's asthma care, according to a study presented today in Philadelphia at Chest 2008, a meeting held by the American College of Chest Physicians. The researchers, who included Kristen Levine, MSPH, of the University of No

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News and Features Related to Asthma 1. Tai Chi May Help Control Asthma

Oct. 29, 2008 -- Asthma sufferers may be able to better control their breathing and improve their exercise performance with some training in tai chi, new research indicates. Tai chi is a method of traditional Chinese exercise involving coordinated breathing and body movements. Scientists in Thailand

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Grape-Enriched Diet

The researchers studied several groups of rats and assigned each group of 12 to various combinations of salty foods, grape powder, and hydralazine. All the rodents were fed the same weight of food daily, with powdered grapes making up 3% of the diet for the animals that received grapes as part of either a low-salt or high-salt diet. Rats receiving hydralazine lapped it up in their water supply.

After looking at various factors, including molecular indicators of cardiac stress, the researchers still found that the rats in the high-salt grape and high-salt hydralazine groups developed high blood pressure over time but had lower systolic blood pressures than the high-salt rats deprived of grape powder.

"Though it's true that your mom told you to eat all your fruits and your vegetables, and that we are learning a lot about what fruits, including grapes, can do ... we would not directly tell patients to throw all their pills away and just eat grapes," Bolling says.

The researchers say the study suggests that a grape-enriched diet can have broad effects on hypertension, but that more work is needed to see if the beneficial effects will apply to humans.

They write that the findings "may have particular importance to our aging population, which has reduced intake of both fruit and vegetables."

According to recent data, only 35% of women and 39% of men over age 60 consumed two servings of fruits per day, and only 6% of both women and men met the goal of three servings daily of vegetables.

The study was funded in part by the California Table Grape Commission, but the authors note that the commission had no involvement in study design, data analysis, or manuscript preparation.

Grapes May Fight High Blood Pressure

Oct. 29, 2008 -- A hardy helping of grapes may fight high blood pressure and heart disease if you eat a salty diet, a new University of Michigan study shows.

Because black, green, and red grapes contain high levels of naturally occurring antioxidants, the fruits may reduce hypertension that can lead to heart failure, shows the study, published in the October issue of the Journal of Gerontology: Biological Sciences.

Scientists including Mitchell Seymour, MS, report that flavonoids -- found in abundance in the skin, flesh, and seeds of grapes -- may be the substances that provide the beneficial effects they found in their study of laboratory rats.

Grapes and High Blood Pressure

The researchers studied the effects of regular table grapes -- a blend of green, red, and black fruits -- that were fed to rats in powdered form.

After 18 weeks, rats that ate the grape-enriched powder had lower blood pressure, better heart function, and reduced inflammation throughout their bodies than comparable rodents that didn't receive the mixture. Rats on salty diets plus hydralazine, a blood pressure medicine, had lower blood pressure, but their hearts weren't as protected from damage as the animals fed grapes.

"These findings support our theory that something within the grapes themselves has a direct impact on cardiovascular risk, beyond the simple blood-pressure-lowering impact that we already know can come from a diet rich in fruits and vegetables," says Seymour, who manages the University of Michigan Cardioprotection Research Laboratory.

Steven Bolling, MD, who heads the program, says the rats in the study were in a similar situation as millions of Americans who have high blood pressure related to their diets and who develop heart failure because of prolonged hypertension.

"The inevitable downhill sequence to hypertension and heart failure was changed by the addition of grape powder to a high-salt diet," Bolling says. "Although there are many natural compounds in the grape powder itself that may have an effect, the things that we think are having an effect against the hypertension may be the flavonoids, either by direct antioxidant effects, by indirect effects on cell function, or both."

Such naturally occurring substances already have been shown to reduce other potentially harmful molecular and cellular activity, the researchers say in a news release.

The study notes that grapes and other fruits high in antioxidant phytochemials show promise, as does research on the impact of red wine on heart health.

Still, the best advice for people with blood pressure problems is to cut down on the amount of salt they get, Bolling says.

"There is, as we know, a great variability, perhaps genetic even, in sensitivity to salt causing hypertension," he says. "Some people are very sensitive to salt intake, some are only moderately so, and there are perhaps some people who are salt resistant. But in general we say, 'Stay away from excess salt.'"

Red Really Is the Color of Romance Study Shows That Men Are Attracted to Women in Red

By Kelley Colihan
WebMD Health News
Reviewed by Louise Chang, MD

Oct. 28, 2008 -- A new study shows the color red may make women more attractive to men.

Researchers at the University of Rochester, led by Andrew J. Elliot, PhD, carried out five experiments to see if what they call the "red-sex link" was for real.

The participants were undergraduate students whose average age was about 20.

In the first experiment, photos of women with white or red backgrounds were presented to male students. Women's photos with a red background were judged to be more attractive than those with a white background.

The second experiment involved both male and female students. Although male students found a woman's image on a red background more attractive than a white background, the female students did not.

In the next three experiments, male students were shown pictures of women on a red or different-colored background (gray, green, or blue) and asked to rate how attractive the women were.

The participants were also asked questions that went a little deeper, such as are you sexually attracted to this woman?

The women in red scored higher in being attractive and being sexually attractive; men also said they would spend the more money on the women in red than those in other colors.

It seems that color -- red or otherwise -- did not play a role in how likable, kind, or intelligent men perceived the women in the photos to be.

"It's only recently that psychologists and researchers in other disciplines have been looking closely and systematically at the relationship between color and behavior. Much is known about color physics and color physiology, but very little about color psychology," Elliot says in a news release. "It's fascinating to find that something as ubiquitous as color can be having an effect on our behavior without our awareness."

However, researchers write in an article presented with the findings that the "red-sex link" could be solely societal conditioning.

Red has long been associated with love, lust, and desire in history and literature. Images of the "red-light" district, red Valentine's hearts, and more come to mind. And as far back as ancient Egypt women have painted their lips red to appear more attractive.

The study is published online in the Journal of Personality and Social Psychology.