In a set of recent focus groups, participants were asked to rank the severity of various health problems, including cancer, heart disease and diabetes.

On a scale of 1 to 10, cancer and heart disease consistently ranked as 9s and 10s. But diabetes scored only 4s and 5s.

“The general consensus seems to be, ‘There’s medication,’ ‘Look how good people look with diabetes’ or ‘I’ve never heard of anybody dying of diabetes,’ ” said Larry Hausner, chief executive of the American Diabetes Association, which held the focus groups. “There was so little understanding about everything that dealt with diabetes.”

But diabetes is anything but minor. It wreaks havoc on the entire body, affecting everything from hearing and vision to sexual function, mental health and sleep. It is the leading cause of blindness, amputations and kidney failure, and it can triple the risk for heart attack and stroke. “It is a disease that does have the ability to eat you alive,” said Dr. John B. Buse, a professor at the University of North Carolina School of Medicine who is the diabetes association’s president for medicine and science. “It can be just awful — it’s almost unimaginable how bad it can be.”

Diabetes results when the body cannot use blood sugar as energy, either because it has too little insulin or because it cannot use insulin. Type 2 diabetes, which accounts for 90 to 95 percent of cases, typically develops later in life and is associated with obesity and lack of exercise. Type 1 diabetes, which is often diagnosed in children, occurs when the immune system mistakenly destroys cells that make the insulin.

The disconnect between perception and reality is particularly worrisome at a time when national diabetes rates are surging. Just last week, the Centers for Disease Control and Prevention announced that the number of Americans with diabetes had grown to about 24 million, or 8 percent of the population. Almost 25 percent of those aged 60 and older had diabetes in 2007. And the C.D.C. estimates that 57 million people have abnormal blood sugar levels that qualify as pre-diabetes.

To be sure, diabetes is treatable, and an array of new medications and monitoring tools have dramatically improved the quality of care. But keeping the illness in check requires constant vigilance and expensive care, along with lifestyle changes like losing weight, exercising regularly and watching your carbohydrates. Dr. Buse says patients who are focused on their disease and who have access to regular medical care have a good chance of living out a normal life span without developing a diabetes-related disability.

But some patients say they are too busy to take better care of themselves, and many low-income patients can’t afford regular care. Even people with health insurance struggle to keep up with the co-payments for frequent doctor visits and multiple medications. And to make matters worse, diabetes is associated with numerous other health problems. Last week, for example, The Journal of the American Medical Association reported that people with depression were at higher risk for Type 2 diabetes, and vice versa.

That is not surprising: according to data published last year in the journal Diabetes Care, depression tends to interfere with a patient’s self-care, which requires glucose monitoring, medications, dietary changes and exercise. Ultimately, diabetes can take a toll from head to toe. In the brain, it raises the risk not only for depression but also for sleep problems and stroke. It endangers vision and dental health. This month, The Annals of Internal Medicine is reporting that the disease more than doubles the risk of hearing loss.

Moving down the body, diabetes can lead to liver and kidney disease, along with serious gastrointestinal complications like paralysis of the stomach and loss of bowel control. Last year the journal Diabetes Care reported that in a sample of nearly 3,000 patients with diabetes, 70 percent had nonalcohol fatty liver disease. Poor circulation and a loss of feeling in the extremities, called neuropathy, can lead to severe ulcers and infections; each year in the United States, there are about 86,000 diabetes-related amputations.

Diabetes can also take a toll on relationships. By some estimates, 50 percent to 80 percent of men with diabetes suffer from erectile dysfunction. Experts say women with diabetes often lose their libidos or suffer from vaginal dryness. The challenge for doctors is to convince patients that diabetes is a major health threat. For years, the message from the American Diabetes Association has been one of reassurance that the disease is treatable. Now, beginning in 2009, the association plans to reframe its message to better communicate the seriousness of the disease.

“Our communication strategy is going to be that diabetes has deadly consequences, and that the A.D.A. is here to change the future of diabetes,” said Mr. Hausner, a former executive with the Leukemia and Lymphoma Society who came to the association 10 months ago. “It’s the word ‘deadly’ that was the potentially controversial word for the organization. In the past, people said, ‘We don’t want to get anybody scared.’ ”

The new strategy is not a scare tactic, he added. Prevention and hope will still be part of the message. “It’s not that we don’t want people to have hope,” he said. “We want people to understand this is serious.”

JULIA HENSLEY, a 41-year-old artist, got a taste of bitter cold a decade ago when she spent a winter living on a glacier near Seward, Alaska. Typical winter temperatures were 10 to 15 degrees below. “The first time it got really cold, I was scared of it,” Ms. Hensley said. “My instinct was to get a stack of books and curl up beside the wood stove.” But a boyfriend persuaded her to go out anyway, to cross-country ski or snowshoe for hours in deep snow. He taught her, she said, that as long as she kept moving, she would be fine.

It was a conclusion — that extreme cold can be safe for exercisers — that runs contrary to conventional wisdom. But in fact, said John W. Castellani, an exercise physiologist at the Army Research Institute of Environmental Medicine, it turns out that even though cold can be frightening, more people are injured exercising in the heat than exercising in the cold. Dr. Castellani was lead author of a 2006 position paper from the American College of Sports Medicine on exercising in the cold. “The big question was, ‘Is it ever too cold?’” Dr. Castellani said. “The answer is no. People go to the poles, people are out there when it’s minus-50 degrees, people do incredible things, and safely. There really isn’t a point where you can tell people it is not safe anymore.”

Dr. Timothy Noakes, an exercise physiologist at the University of Cape Town in South Africa who was a reviewer of that position paper, even supervised a swimmer, Lewis Gordon Pugh, who swam 1 km or (.62 miles) in 19 minutes at the North Pole last July, in water that was between 29 and 32 degrees. The problem with exercising in the cold, exercise physiologists say, is that people may be hobbled by myths that lead them to overdress or to stop moving, risky things to do. Some worry that cold air will injure their lungs or elicit asthma symptoms. Or they are convinced that they are more susceptible to injury when it is cold and that they have to move more slowly — forget about sprinting or running at a fast clip.

But lungs are not damaged by cold, said Kenneth W. Rundell, the director of respiratory research and the human physiology laboratory at Marywood University in Scranton, Pa. No matter how cold the air is, by the time it reaches your lungs, it is body temperature, he explained. Some people complain that they get exercise-induced asthma from the cold. But that sort of irritation of the respiratory tract is caused by dryness, not cold, Dr. Rundell said. “Cold air just happens not to hold much water and is quite dry,” he said. You’d have the same effect exercising in air that was equally dry but warm. Dr. Rundell and Tina Evans, a Ph.D. candidate, showed this a few years ago in a study designed to dispel what Dr. Rundell called the myth that cold air can induce asthma. Volunteers with exercise-induced asthma, whose airways tended to narrow after exercise in the cold, breathed cold air or room temperature air that was equally dry. Their airways narrowed in response to the dryness of the air, not its temperature, Dr. Rundell said.

People with this problem should see a respiratory specialist and take medication when they exercise in dry air, Dr. Rundell said. And, he added, “you might want to use a balaclava,” so your exhaled breath can moisten the air you breathe. Another myth is that you have to acclimatize to cold, just as you do to heat. It’s true that peoples’ bodies adapt to hot weather and that adaptation makes people feel better when they exercise in the heat. It also improves performance. With heat adaptation, you sweat more profusely, your sweat is less salty and your blood volume increases. But exercise physiologists find only modest adaptation to cold. The body’s main responses to cold — constricting blood vessels near the skin, shunting blood to the body’s core and shivering — do not improve if you spend more time in the cold. Nor are the physically fit any better at adaptation than the sedentary. “Right now, we’re not sure if there is any degree of habituation,” said Robert Kenefick, a research physiologist at the Army Research Institute of Environmental Medicine.

Of course there are hazards like frostbite and hypothermia, which occurs when the body’s core temperature drops too low. Dr. Noakes said that during Mr. Pugh’s North Pole swim, hypothermia was a real concern. Hypothermia can happen suddenly in icy water, with the swimmer’s core temperature plummeting, and the fear was that Mr. Pugh might pass out and sink before he could be rescued. Mr. Pugh, an experienced cold-water swimmer, was wearing a device to monitor his temperature, but nonetheless, Dr. Noakes was “petrified,” he said.

The biggest risk of hypothermia comes with a combination of wet and cold. That is because water transfers heat from the body 70 times more efficiently than air. Hypothermia begins to set in when the body’s core temperature falls to 95 degrees. That elicits shivering and a rise in blood pressure. But if your temperature drops to 85, you lose consciousness, and if it goes much lower, you can die. The trick to avoiding hypothermia is to keep moving, Dr. Noakes said. “As long as you keep moving you are not going to die because you generate so much heat.” One mistake winter exercisers make is wearing too much clothing. You don’t want to sweat profusely because you overdressed. “You should feel cool before you start exercising,” Dr. Castellani said. “You should not feel comfortable.”

That means, Dr. Noakes said, that even in temperatures as low as 10 to minus-20 degrees, a runner probably needs to wear no more than a track suit, mittens or gloves and a hat. The other major concern, frostbite, can come on fast, as my running partner Jennifer Davis, 37, discovered about a decade ago. It starts when the skin’s temperature drops to 82 degrees and you feel an area of skin is becoming really cold. At a skin temperature of 68 degrees, the skin starts to hurt. It may tingle or burn or ache or you may feel a sharp pain. When the skin’s temperature falls to 50 degrees, it feels numb. And when the skin’s temperature reaches 27 degrees, the skin freezes. The result is frostbite.

Ms. Davis got frostbite when she went out for a run early in the morning on a cold, windy day with temperatures in the teens. She ran for about an hour wearing a baseball cap. Her ears hurt for a while, then the pain went away. She took off a glove to touch her ears so she could find out just how cold they were. To her shock, one of her ears cracked. “It was sort of like semi-frozen meat,” she recalled. When she got home, she was horrified by her red and swollen ear. An ear, nose and throat specialist diagnosed frostbite and told her that her ear would be sensitive to the cold for the rest of her life. He was wrong, though. The ear was red and stuck out for weeks, but it healed. Now, Ms. Davis said, she can’t even remember whether it was her right or left ear. But ever since, she has worn a hat that covers her ears when she runs in the cold.

As for Ms. Hensley, the woman who lived in Alaska one winter, she now lives in Seattle and rides her bike in the winter rain, charging up hills. “I just remember the lesson I learned that winter,” she said. “You don’t have to stand inside and say, ‘Oh, it’s a yucky day.’ You can go out in anything. You just have to do it.”

ROBYN O’BRIEN likes to joke that at least she hasn’t started checking the rearview mirror to see if she’s being followed. But some days, her imagination gets away from her and she wonders if it’s only a matter of time before Big Food tries to stop her from exposing what she sees as a profit-driven global conspiracy whose collateral damage is an alarming increase in childhood food allergies.

Ms. O’Brien has presented her views, albeit in a less radical wrapper, on CNN, CBS and in frequent print interviews. Frontier Airlines and Wild Oats stores distribute the allergy-awareness gear she designed. Her story is one of several in a new book, “Healthy Child, Healthy World” (Dutton, March 2008), whose contributors include doctors, parents and celebrities like Meryl Streep.

Sitting at the table in her suburban kitchen, with her four young children tumbling in and out, Ms. O’Brien, 36, seems an unlikely candidate to be food’s Erin Brockovich (who, by the way, has taken Ms. O’Brien under her wing). She grew up in a staunchly Republican family in Houston where lunch at the country club frequented by George and Barbara Bush followed Sunday church services. She was an honors student, earned a master’s degree in business and, like her husband, Jeff, made a living as a financial analyst. Ms. O’Brien was also the kind of mom who rolled her eyes when the kid with a peanut allergy showed up at the birthday party. Then, about two years ago, she fed her youngest child scrambled eggs. The baby’s face quickly swelled into a grotesque mask. “What did you spray on her?” she screamed at her other children. Little Tory had a severe food allergy, and Ms. O’Brien’s journey had begun.

By late that night, she had designed a universal symbol to identify children with food allergies. She now puts the icon, a green stop sign with an exclamation point, on lunch bags, stickers and even the little charms children use to dress up their Crocs. These products and others are sold on her Web site, AllergyKids.com, which she unveiled, strategically, on Mother’s Day in 2006. The $30,000 Ms. O’Brien made from the products last year is incidental, she said. Working largely from a laptop on her dining room table, she has looked deep into the perplexing world of childhood food allergies and seen a conspiracy that threatens the health of America’s children. And, she profoundly believes, it is up to her and parents everywhere to stop it. Her theory — that the food supply is being manipulated with additives, genetic modification, hormones and herbicides, causing increases in allergies, autism and other disorders in children — is not supported by leading researchers or the largest allergy advocacy groups. That only feeds Ms. O’Brien’s conviction that the influence of what she sees as the profit-hungry food industry runs deep. In just a few dizzying steps, she can take you from a box of Kraft macaroni and cheese to Monsanto’s genetically modified seeds to Donald H. Rumsfeld, who once ran the company that created the sweetener aspartame.

Through creative use of e-mail, relentless inquiry and a persona carefully crafted around the protective mother archetype, Ms. O’Brien has emerged as a populist hero among parents who troll the Internet for any hint about why their children have food allergies. “You have changed my life ... my diet ... my health ... my spirit ... and I thank YOU,” a father who had lost his teenage daughter to anaphylactic shock told her by e-mail. Ms. O’Brien encourages people to do what she did: throw out as much nonorganic processed food as you can afford to. Avoid anything genetically modified, artificially created or raised with hormones. Don’t eat food with ingredients you can’t pronounce.

Once she cleaned out her cupboards, she said, her four children started behaving better. Their health problems, which her doctor attributed to allergies to milk and other foods, cleared up. “It was absolutely terrifying to unearth this story,” she said over lunch at a restaurant in Boulder, Colo. “These big food companies have an intimate relationship with every household in America, and they are making our children sick. I was rocked. You don’t want to hear that this has actually happened.” But has it?

Record numbers of parents are heading to doctors concerned that their children are allergic to a long list of foods. States are passing laws requiring schools to have policies protecting children with food allergies. But no one knows why the number of allergies seems to be on the rise, or even if they are rising as fast as some believe. Ms. O’Brien and leading allergy researchers agree that few reliable studies on food allergies exist. The best estimates suggest that 4 to 8 percent of young children suffer from them, though the reactions tend to grow less serious and less frequent as children grow older. The Centers for Disease Control and Prevention put the number of deaths linked to food allergies at 12 in 2004, the most recent year for which data are available. However, its statisticians point out that such figures are drawn only from doctors’ notations on death certificates. “It’s a soft number, and it might well be an understatement,” said Arialdi Miniño, a statistician at the agency’s National Center for Health Statistics. Dr. Elizabeth Gleghorn is the director of pediatric gastroenterology at the Children’s Hospital and Research Center in Oakland, Calif. She has been in practice for 20 years, and has noticed a recent increase in eczema, which can indicate food allergies. But she doesn’t think food allergies are increasing dramatically.

Often, a child might have intolerance to a food and not a true allergy. But the Internet has afforded more ways for parents to inform themselves and do their own diagnosing, which could add to the popular impression that food allergies are rising at alarming rates, Dr. Gleghorn said. Many health professionals, though, agree that something is changing. Among the amalgam of theories that weigh the effects of genetics and environment, the hygiene hypothesis intrigues many researchers. It holds that children are being exposed to fewer micro-organisms and, as a result, have weaker immune systems. “But this alone cannot account for the massive relative increase in food allergy compared with other allergic disease such as asthma,” said Dr. Marc E. Rothenberg, the director of allergy and immunology at Cincinnati Children’s Hospital Medical Center, the second-largest pediatric research facility in the country.

Could it be that a toxic food environment has made children’s immune systems go haywire? It’s hard to find an expert in the field who supports Ms. O’Brien’s theory. “I don’t think it can be proven, so I can’t say scientifically one way or the other,” Dr. Gleghorn said. Mix the lack of hard data with an increasingly complex food landscape, and you’ve got Robyn O’Brien. “Food allergies just become a focus for a broader fear about the food system,” said the author Michael Pollan, a contributor to The New York Times Magazine. Mr. Pollan, in both “The Omnivore’s Dilemma” and his new book, “In Defense of Food” (January, Penguin), shares many of Ms. O’Brien’s views about industrialized agriculture. He also has a niece with a peanut allergy. So Ms. O’Brien sent him an e-mail message, and a correspondence began.

Ms. O’Brien took his responses as an endorsement of her work, and then mentioned his support in messages to other people. Mr. Pollan, who said he has no idea if her theories are accurate, asked her to stop telling people he was working with her. Leveraging brief e-mail exchanges with notable people is an important method that Ms. O’Brien uses to build her universe. The unlikely mix includes members of Robert F. Kennedy Jr.’s staff; Mary Alice Stephenson, a host of “America’s Most Smartest Model”; and, recently, Dr. Mehmet Oz, a regular on Oprah Winfrey’s show. “The fact that people like him and Malcolm Gladwell, presidential campaigns, celebs take the time to reply means a lot as it gives me hope that people are still engaged,” she said in an e-mail message to this reporter.

While some of her contacts, like Mr. Gladwell, an author and a writer for The New Yorker, don’t remember her, the strategy has worked. Nell Newman, who runs the organic arm of Newman’s Own products, spoke up on her behalf on the national news. Deborah Koons Garcia, the widow of Jerry Garcia and director of the documentary “The Future of Food,” invited her to lunch. But her biggest asset might be a relentless drive to wind together obscure health theories, blog postings and corporate financial statements. She then posts her analyses on her Web site. She chides top allergy doctors who are connected to Monsanto, the producer of herbicides and genetically modified seeds. She asserts that the Food Allergy and Anaphylaxis Network, the nation’s leading food allergy advocacy group, is tainted by the money it receives from food manufacturers and peanut growers. Anne Muñoz-Furlong founded the network in 1991 after her daughter was found to have milk and egg allergies. She said the group now has 30,000 members and a $5.6 million budget. Although Kraft did help the organization start its Web site and other food manufacturing companies and trade groups sponsor some of its programs, that support has amounted to about $100,000. Mrs. Muñoz-Furlong said that she and doctors on her medical board do not believe that genetically modified foods cause food allergies because most children with allergies react to specific foods, like eggs or milk.

And, she said, communicating regularly with industry can help get the word to parents about potential allergens in products, and supporting research to identify causes of allergies helps consumers more than companies. She also cautioned against taking the advice of people who have no medical training or run Web sites not certified to have reliable medical information. “She’s a dot-com,” Mrs. Muñoz-Furlong said of Ms. O’Brien. “It’s completely different than a dot-org. From the very beginning our intent was education.” (Ms. O’Brien did recently start a nonprofit foundation to support research that is not tied to the food industry.) On the days when Ms. O’Brien grows discouraged at being David against the Goliath of Big Food, she turns to the people who believe her. Erin Brockovich, whose brother died of a food allergy years ago, was a legal file clerk who helped land a record judgment against the Pacific Gas and Electric Company for contaminating drinking water. She is an environmental consultant who is popular on the inspirational lecture circuit.

Ms. Brockovich said her new friend does a great job of arming everyday people with facts, so they can take a stand. “You don’t have to be a doctor or a scientist to look into whether our food supply is safe,” she said. “Being obsessed doesn’t mean she’s crazy. Frankly, I think it takes a little bit of being crazy to make a difference in this world.”

What’s the single best food to keep on hand in your healthy kitchen? It just might be blackberries, which will be coming into season soon in much of the country. Research published in the July, 2006, issue of the American Journal of Clinical Nutrition ranked blackberries as far and away the most antioxidant-rich food (on the basis of a typical single serving) out of 1,113 types tested. Next in line were walnuts - which had about 40 percent fewer antioxidants than blackberries - followed by strawberries, artichokes, cranberries, coffee, raspberries, pecans, blueberries and ground cloves.

Antioxidant concentration is not the only nutrition criterion that matters, of course. A healthy diet must also balance macronutrients (protein, carbohydrates and fats) and provide enough fiber, trace minerals, proper hydration and so on. But you can’t go far wrong by eating blackberries on a regular basis.

If you live in a Canadian city that has more fast food places, you are at a higher risk for obesity, new research from the University of Alberta confirms.

For every extra fast-food restaurant per 10,000 people, a city's obesity rate goes up 3%, said Sean Cash, a health economics professor who drew up an obesity map that plotted obesity rates and the density of the top 10 fast-food chains in Canada.

"The strong relationship really suggests that access to fast food may indeed be one of the issues that may explain increasing obesity rates," Mr. Cash said of the study he presented earlier this year at conferences in Denmark and Oregon.

"We were surprised by the strength of the relationship, but we weren't surprised to find that there was a relationship. "This has been a likely culprit that has been discussed quite a bit over the last few years. This provides support for that view."

Mr. Cash, colleague Ellen Goddard and graduate student Ryan Lacanilao used the 2005 Business Location Database to determine the 10 fast-food chains with the most outlets across Canada. Tim Hortons, Subway, McDonald's, Kentucky Fried Chicken, A&W, Dairy Queen, Harvey's, Wendy's, Burger King and Domino's Pizza came up as the winners.

The researchers then used obesity data from the Canadian Community Health Survey released last year and matched up the data for Canada's major metropolitan areas.

Maritime residents were generally fatter and had more fast-food outlets. St. John's, N.L., for instance, has an obesity rate of 36% and 3.5 fast-food joints per 10,000 people. Saint John, N.B., ranked close with a 35% obese rate and access to four outlets per 10,000 people.

Hamilton and Windsor in southern Ontario also ranked high in obesity and fast food outlets.

Mr. Cash found no similarly strong link between obesity levels and longer commuting distances or income levels.

"I wouldn't say our study proves anything," said Mr. Cash, noting some cities buck the trend.

Halifax, for instance, has a low 18% obesity rate, but has almost four fast-food outlets for every 10,000 people. But almost 30% of Oshawa residents were obese, though they had access to only 1.8 fast-food places per 10,000. "It doesn't mean having access to a fast-food restaurant causes obesity, but it does suggest there's a relationship that we should be taking into account if we're trying to take action to lower obesity rates in Canada."

Calgary and Edmonton were fairly similar with just over three fast-food outlets per 10,000 people, but Edmonton pulled ahead in the obesity rate, with 20% obese compared with Calgary's 26%.

"As my graduates like to say, this might explain the relative difference in the merits of Edmonton versus Calgary hockey teams," Mr. Cash said.

"I think the fact that there is similar availability of fast food, but that we have lower obesity rates in Edmonton, suggests the importance of other lifestyle factors. We have less traffic congestion here; maybe people are more active."

Mr. Cash isn't calling for a ban of fast-food restaurants, but believes city planners should make public health a factor in planning, just as they consider environmental impacts and traffic congestion.

A spoonful of buckwheat honey quells a child's nighttime chest cold coughing better than the most common cough suppressant in nonprescription medicines, researchers said on Monday.

"Honey may be a preferable treatment for the cough and sleep difficulty associated with childhood upper respiratory tract infection," a team of investigators from Pennsylvania State University said.

Honey is not recommended for children under the age of one. Buckwheat honey is a dark variety that tends to have more compounds associated with honey's antioxidant properties, the researchers said. In addition, they said honey can sooth the throat and thus help control coughing.

The report said that neither the American Academy of Pediatrics nor the American College of Chest Physician backs the use of DM for childhood cough.

In addition the substance has been implicated in drug abuse among teenagers who use cough medicine to get high.

The study, published in the Archives of Pediatric and Adolescent Medicine, comes just weeks after a government advisory panel recommended that many nonprescription cough and cold medicines in use for decades should not be given to children under 6 until their efficacy can be proven.

That move came after a group of pediatricians and public health officials petitioned the U.S. Food and Drug Administration to restrict sales for children younger than 6 because of reports of deaths, seizures, hallucinations and other problems.

Makers have said the products are safe and effective, when given as directed, to children aged 2 and older.

The new study involved 105 youngsters age 2 to 18 who had been battling upper respiratory tract infections for seven days or less. Some were given 10 milliliters -- about one tablespoon

Honey was found to make the best improvements in cough control and sleep followed by DM, while doing nothing showed the least improvement.

"Parents rated honey most favorably for symptomatic relief of their children's nocturnal cough and sleep difficulty," the study concluded.

"While our findings and the absence of contemporary studies supporting the use of DM continue to question its effectiveness for the treatment of cough associated with upper respiratory tract infections, we have now provided evidence supporting honey, which is generally regarded as safe for children older than 1 year, as an alternative," the authors said.

This is the second story in a Star series designed to provoke discussion on the diabetes epidemic and press for solutions to the modern day scourge. One in nine Torontonians is afflicted and, if current trends continue, that could rise to as many as one in five. Our culture of convenience is the at the root of this disease, but it is the poor who shoulder most of the burden. And urban planning has exacerbated the problem. There may be no cure, but diabetes can be prevented. Political will must be brought to bear before our ability to care for those who are sick is outstripped by the sheer number of new cases.

According to Health Canada, you are overweight if your Body Mass Index (BMI) is between 25 and 29.9 and obese at 30 or higher. BMI is calculated by dividing your weight in kilograms by your height in metres squared. To calculate your BMI, click here.

Diabetes is soaring because obesity is. But how to change North America's most entrenched lifestyles?

We, in North America, are the fattest people who ever walked the face of the earth.

And there is a gathering consensus that the generations now living, lounging and growing ever more obese are doomed to die in epidemic numbers from diabetes and related conditions.

The only way to avoid a health catastrophe is to target the very young with a public initiative that would fundamentally change how we have come to eat, play, think and live over the past 30 years.

It's a project that, in scale and complexity, would far surpass the successful social engineering campaign that sent smoking rates plummeting and involve nothing less than an all-out war.

And those who study the problem – whether they believe it's too late for the millions now at risk of diabetes or not — agree on this: That war should have been launched years ago.

There are no magic bullets.

That's the first thing you need to know about any campaign that would try to rein in soaring obesity rates that feed the diabetes epidemic, says Dr. John Frank, an expert in the field.

"People say, 'Oh we just have to increase (physical) activity and reduce calorie intake,' " said Frank, head of population and public health studies with the Canadian Institutes of Health Research in Toronto.

"And that's fair enough. But people both take in calories and expend energy in many different ways in our culture and the balance is clearly out of whack."More than two million Canadians have diabetes and 90 per cent of them have type 2, where the body produces insulin to regulate blood sugar levels, but the hormone is not used efficiently. The disease, which has complications that include stroke, heart disease, blindness and kidney disease, is closely associated with obesity.

It's about to get worse. In Ontario, nearly nine per cent of the population – about 850,000 people – have diabetes, far surpassing a global rate of 6.4 per cent predicted by the World Health Organization for 2030. Canada's First Nations have one of the highest rates in the world, with one in four people living with the disease at Sandy Lake, a reserve in northwestern Ontario.

Toronto is the urban epicentre. About 225,000 residents have diabetes, and the number of cases has jumped 27 per cent in the past four years and shows no signs of slowing. More alarming is the fact that the poor are disproportionately vulnerable. A groundbreaking new diabetes atlas of the city's 140 neighbourhoods by the Toronto-based Institute for Clinical Evaluative Sciences found rates in the city's poorest areas were almost triple those in more densely populated areas downtown.

Researchers say there would be no diabetes epidemic without a corresponding rise in obesity rates. And these rates have steadily increased over the past three decades, drawing sustenance from the ingrained North American lifestyle.

Suburban sprawl, a car culture, a Micky Ds on every corner. Add television, computer games and a host of obesity triggers and it's obvious the roots of the problem are planted firmly in our everyday lives.

"Every infectious disease that's carried by an insect, we say the insect is the vector for the disease," Frank said. "Well, the vector for lifestyle diseases like obesity and (being) overweight is culture. It's our culture."

And with culture as the conduit for obesity and diabetes, efforts to curb the crisis will be mammoth and involve many generations.

At roughly the same time that Canada's obesity crisis was evolving, this country was developing a successful strategy to combat another public health menace.

And the battle against smoking – which saw rates decline since the 1970s to less than 30 per cent of the adult population from a high of about 70 per cent – may offer guidance for any war on diabetes.

"Smoking was the public health success story," said Dr. Stewart Harris, a University of Western Ontario diabetes expert. "It was a public health approach and there's lots of great lessons to be learned that can be directly applied to trying to tackle the obesity issue."The battle against smoking began after the 1964 U.S. surgeon general's report definitively linked tobacco smoke to lung cancer.

It was a clarion call about a dire public danger, according to Diane Finegood, director of nutrition, metabolism and diabetes at the Canadian Institutes of Health Research in Vancouver.

What followed, after a decade-long attempt by the tobacco industry to refute that medical research, was a series of government and private sector initiatives that transformed smoking from a pervasive and glamorous habit to one now regarded as leprous.

There were ad bans, huge increases in tobacco taxes, workplace and public space prohibitions, strict sales regulations and labelling rules that have given us graphic photos of lung cancers or rotting teeth on every cigarette package.

"With tobacco, it was when the ... environment changed from one where it was desirable to smoke, you were cool, you fit in to one where you were in a sense a pariah if you smoked," said Finegood, a kinesiology professor at Simon Fraser University.

Though it had been deeply rooted in our culture since World War I, smoking was one lone, if highly addictive, habit.

Diabetes and obesity are far tougher nuts, involving values, lifestyle, even housing. Experts say the task would be societal in nature and reach from Parliament Hill to corporate boardrooms and right into the living rooms of Canadians.

It could include taxes on junk food and a fundamental rethinking of the way we build our cities and towns, especially the car-dependent suburbs that continue to devour the countryside.

It would include a commitment to exercise. And not just working out in the gym, but a conscious integration of walking and playing into our daily lives. That would mean less television and computer time, more pedestrian-friendly neighbourhoods, better after-school programs and more parks and community centres, especially in low-income neighbourhoods.

Finally, it would mean an overhaul of the way the health-care system approaches diabetes, with a greater emphasis on screening for early signs of the disease, a commitment to preventative weight loss and the creation of multidisciplinary teams taking exclusive aim at the ailment and its causes. Over the past 30 years, Frank said, North American culture has come to "fundamentally devalue" exercise, removing many daily opportunities to work off calories. "At the same time, it's made it easier and easier to reach out and get a snack."

Those snacks are rarely celery sticks. In another cultural shift that taps into an evolutionary craving for fat-laden foods, our society has created vast corporate empires predicated on delivering calorie-filled foods as quickly and inexpensively as possible.

"The cheapest foods are the most energy dense and least nutritious and the most expensive are the most nutrient rich and energy poor," said Finegood. Calorie-rich junk foods such as pop, potato chips and candy bars are generally cheap to produce and extremely profitable. This has drawn many players to the market, with the competition driving mass advertising campaigns that strongly sway dietary choices.

"You see very little advertising for healthy foods like fresh fruits and vegetables," she said. Junk food pressures are especially pernicious among the poor, whose financial limitations often force them to seek the cheapest available sustenance. As well, many of Canada's poorest people are new immigrants, whose genetic heritage often makes them more susceptible to obesity and diabetes when exposed to North America's fatty, calorie-rich foods.

In 2004, the World Health Organization asked member countries to help combat chronic diseases such as diabetes by developing and implementing plans under its Global Strategy on Diet, Physical Activity and Health. To date, 32 countries – including France, Germany, Italy and the United Kingdom – have submitted plans, but Canada is not among them on the WHO website.

Frank, a University of Toronto epidemiologist, believes the window of opportunity to stave off the diabetes epidemic may have already closed. The sheer number of overweight and obese people likely precludes the possibility of personal and intensive medical interventions from an already overburdened health care system. "Once you have half the population affected, you can forget, generally speaking, about clinical one-on-one approaches where you label people in medical setting and put them into weight loss." Frank thinks the solutions may be too long in coming to fundamentally change the dietary preferences and lifestyle choices for most.

"To get at this, it's going to take a whole generation ... because you have to change the way children are socialized to eat and exercise now."

As Americans carve up their Thanksgiving turkeys this year, an age-old question will come into play: dark meat or white?

Health authorities have long advocated choosing white meat, saying it contains less fat and fewer calories. But the nutritional differences between the two are not so great.

In general, what makes one cut of turkey — or any other type of poultry — darker than another is the type of muscle it contains. Meat is darker if it contains higher levels of myoglobin, a compound that enables muscles to transport oxygen, which is needed to fuel activity. Since turkeys and chickens are flightless and walk a lot, their leg meat is dark while their wing and breast meat are white.

Many people choose white meat over dark because of its lower caloric content. But according to the Department of Agriculture, an ounce of boneless, skinless turkey breast contains about 46 calories and 1 gram of fat, compared with roughly 50 calories and 2 grams of fat for an ounce of boneless, skinless thigh.

But dark meat has its benefits. Compared with white meat, it contains more iron, zinc, riboflavin, thiamine, and vitamins B6 and B12. Both have less fat than most cuts of red meat, so you can’t go wrong either way.

Ontario’s school age children are snacking on sweets instead of eating their fruits and vegetables, say researchers from the University of Waterloo.

While it might not be news to parents, the study is the most comprehensive nutrition survey of Ontario children in recent decades, says lead author Rhona Hanning, a registered dietitian and associate professor in the university’s department of health studies and gerontology.

It’s important to know how diet contributes to rising rates of obesity, she said.

The study, published this week in the Canadian Journal of Public Health, looked at more than 650 children in Grades 6, 7 and 8 across Ontario. Using a Web-based questionnaire, they were asked to record what they ate in one day. Researchers then compared it to Canada’s food guide.

Every child who filled out a questionnaire did not eat enough grains, dairy products or fruits and vegetables, and barely met requirements for the meat and alternatives group.

The average child ate four servings of fruit and vegetables, but the recommended range is between five and 10, which means kids aren’t getting many of the nutrients they need, said Hanning. More than 25 per cent of boys said they ate vegetables rarely or never.

Instead of getting calories from healthy foods, the kids got 25 per cent of their daily total from so-called “other” foods — items that don’t fit into one of the other four food groups — such as sugar sweetened beverages, high-fat and high-salt snack foods.

In 2004, Statistics Canada reported 26 per cent of Canadian youth were either overweight or obese. In the Waterloo study, researchers used height and weight to calcuate Body Mass Index, which indicated 20 per cent of males and 10 per cent of females were overweight or at risk of being overweight.

Teenagers who are overweight or obese have a greater chance of carrying that weight into adulthood and of developing a chronic disease such as Type 2 diabetes, heart disease and some cancers. That’s why it’s important to identify and address risk factors for obesity at an early age, Hanning said.

Researchers haven’t looked at dietary habits in this age group since the 1972 Nutrition Canada National Survey, said Janis Randall Simpson, a professor in the University of Guelph’s department of family relations and applied nutrition.

She said it’s helpful to know dietary intakes of school age children in order to plan nutrition education programs.

Health Canada boasts its revised guide to healthy eating is based on the latest science, but critics say it's not the best recipe after all

Canada's iconic food guide has seen substantial changes since its release during World War II, when eggs were a separate food group, a daily serving of potato was the norm, and fish oil was recommended to boost vitamin D intake.

Sixty-five years later, Health Canada is about to unveil its latest incarnation, the first revision since 1992 when the federal government introduced the signature rainbow graphic to help people decide what to eat.

The updated version is supposed to make it easier to pick a portion size and put the right types of foods on our plates.

Recommendations have changed dramatically since the last update and the new guide will encourage people to get more fibre, folate and calcium, says Susan Barr, professor of nutrition at the University of British Columbia and one of 12 members of the food guide advisory committee.

Nutrition science has leaped forward in the last six decades as researchers made links between diet and disease.

"People are looking for a way of eating that meets their nutrient needs and contributes to their overall health," she says. "The popularity of diet books and nutrition books is booming. A food guide really does provide a sound method to meet these (nutrition) goals and help people work toward a healthy weight as well."

The 2007 guide will still rely on the rainbow, but fruits and vegetables now get the spotlight and take the place of grains on the outer swath, according to a draft version from last April obtained by the Star.

The graphic has also been changed in an effort to become more relevant to ethnic and cultural groups: bok choy, couscous, naan and squid, for example, are prominently displayed on the rainbow.

Unlike its 1992 predecessor, the new food guide will be gender- and age-specific for Canadians older than 2 and it provides more information on portion sizes.

"For a boy between the ages of 9 and 13, there will be very narrow bands in terms of number of food guide servings ... There won't be those big ranges (like in the 1992 version)," says Mary Bush, director general of the office of nutrition policy and promotion at Health Canada, who has overseen development of the guide.

The eight-page draft guide also includes information on fats and oils, exercise and food shopping tips, and provides strategies on how to break down mixed foods, such as a stir fry, into the four food groups.

The new guide is based on the best available science, Bush says, and will promote a pattern of eating that will help reduce the risk of some diseases, such as heart disease and type 2 diabetes.

It has taken Health Canada almost two years, with months of delays, to get the new food guide to what Bush calls the "pre-launch" stage. She says the final guide will be in the hands of Canadians sometime later this month, or next.

Some experts say the new food guide can't replace the 1992 version soon enough.

Judy Sheeshka, a professor in the University of Guelph's department of family relations and applied nutrition, studied the 1992 guide with focus groups, including new Canadians, to see whether it was a useful tool. Some people didn't think the food guide was relevant to them because it didn't include enough ethnic foods; others thought it was useful for children to learn about nutrition, but wanted to see the guide provide weight-loss advice for adults.

Bush says Health Canada's advisory committees listened to stakeholders and critics alike to come up with the new guide. It's now less than eight pages, encourages people to reduce sodium intake and has more guidance on suitable daily servings of fruits and vegetables, grains, milk products, and meat and alternatives.

But politics has plagued the revision. The federal standing committee on health met with Health Canada officials in October to voice members' concerns and some Canadian physicians have vocally opposed the revision process.

According to Isra Levy, the former director of the Canadian Medical Association's office for public health, the association is concerned that the 2007 guide is not designed to address rising levels of obesity in Canada. Levy left his position at the CMA in December to take on the role of Ottawa's associate medical officer of health. "They went on a lengthy and expensive process to tell Canadians what to eat and it's completely devoid of any information about obesity and how to prevent it, let alone how to treat it."

The food guide does consider the challenge of body weight and prevention of obesity, which is clearly an issue in Canada, counters Bush. Those who are least active will have to follow the guide closely and eat a minimum of the so-called "other" foods, such as sweetened beverages, potato chips and some condiments.

Dr. Yoni Freedhoff, medical director of the Bariatric Medical Institute in Ottawa, says the updated draft version of the food guide from last April doesn't reflect current medical and nutritional science.

He believes the guide should de-emphasize red meat because of its high levels of cholesterol-raising saturated fat and strongly encourage foods made with whole grains.

The Board of Health voted Tuesday to make New York the nation's first city to ban artery-clogging artificial trans fats at restaurants -- from the corner pizzeria to high-end bakeries.

The board, which passed the ban unanimously, did give restaurants a slight break by relaxing what had been considered a tight deadline for compliance. Restaurants will be barred from using most frying oils containing artificial trans fats by July and will have to eliminate the artificial trans fats from all of their foods by July 2008.

But restaurant industry representatives called the ban burdensome and unnecessary.

"We don't think that a municipal health agency has any business banning a product the Food and Drug Administration has already approved," said Dan Fleshler, a spokesman for the National Restaurant Association.

Health Commissioner Thomas Frieden said recently that officials seriously weighed complaints from the restaurant industry, which argued that it was unrealistic to give them six months to replace cooking oils and shortening and 18 months to phase out the ingredients altogether.

The ban contains some exceptions; for instance, it would allow restaurants to serve foods that come in the manufacturer's original packaging.

Trans fats are believed to be harmful because they contribute to heart disease by raising bad cholesterol and lowering good cholesterol at the same time. Some experts say that makes trans fats worse than saturated fat.

The panel also passed another measure that has made restaurants unhappy: Some that chose to inform customers about calorie content will have to list the information right on the menu. The rule would generally apply to fast-food restaurants and other major chains.

Sheila Weiss, director of nutritional policy for the restaurant association, said the rule would be a disincentive for restaurants to provide any nutritional information.

Trans fats are formed when liquid oils are made into solid fats by adding hydrogen in a process called hydrogenation. A common example of this is partially hydrogenated vegetable oil, which is used for frying and baking and turns up in processed foods like cookies, pizza dough and crackers. Trans fats, which are favored because of their long shelf life, are also found in pre-made blends like pancake and hot chocolate mix.

The FDA estimates the average American eats 4.7 pounds of trans fats each year.

Mayor Michael Bloomberg, who banned smoking in bars and restaurants during his first term, is somewhat health-obsessed, and even maintains a weight-loss competition with one of his friends in order to stay slim.

He has dismissed cries that New York is crossing a line by trying to legislate diets.

"Nobody wants to take away your french fries and hamburgers -- I love those things, too," he said recently. "But if you can make them with something that is less damaging to your health, we should do that."

Many food makers have stopped using trans fats on their own, after the Food and Drug Administration began requiring companies to list trans fat content on labels.

Fast-food restaurants and other major chains were particularly interested in the board's decision on Tuesday, because for these companies, a trans-fat ban wouldn't just involve substituting one ingredient for another. In addition to overhauling recipes, they have to disrupt nationwide supply operations and try to convince customers that the new french fries and doughnuts will taste just as good as the originals.

Already, McDonald's Corp. has been quietly experimenting with more than a dozen healthier oil blends but has not committed to a full switch. At an investor conference last month, CEO Jim Skinner said the company is making "very good progress," at developing an alternative, and vowed to be ready for a New York City ban.

Wendy's International Inc. introduced a zero-trans fat oil in August and Yum Brands Inc.'s KFC and Taco Bell said they also will cut the trans fats from their kitchens.

Taco Bell worked for more than two years to find a substitute, conducting blind consumer taste tests and extensive research, the company said.

Chicago is also considering its own trans fat law, which wouldn't ban them outright but would severely restrict the amount that kitchens can use. The measure would apply only to large restaurants, defined as those that make more than $20 million in sales per year.

New York's move to ban trans fats has mostly been applauded by health and medical groups, although the American Heart Association warns that if restaurants aren't given ample time to make the switch, they could end up reverting to ingredients high in saturated fat, like palm oil.

by Emily GArber, RD

Life during the holiday season can be filled with endless temptations: dazzling buffets, rich hot cocoa, Christmas cookies...and seemingly endless leftovers. Not everyone finds the feasting easy to enjoy. If you're like many people whose efforts to eat healthier this year have paid off in feeling better and dropping some excess pounds, making wise food choices at the buffet table can be challenging and frustrating.

When faced with so many enticing flavors, do you say to yourself, "It's a holiday after all – shouldn't I be able to let loose and enjoy myself?" Or, are you inclined to rein yourself in and say, "Do I really want to blow it just because I'm at a party?"

But you don't have to walk away from the table stuffed with feelings of guilt or deprivation. Figure out which type of social eater you are by picking the statement below that sounds most like you. Then try the tailor-made party tips that follow.

Eager: When invited to a party, you jump at the excuse to "break your diet" and go all-out, eating the variety of delicious foods that are served, thinking, "I can indulge...it's a special occasion!"

Antisocial: The thought of going to another party makes your insides crawl – "not more smiling people" – the only attraction is the free food, so you might as well treat yourself and eat a lot to make the most of that one benefit of being there.

Pleaser: Even though you want to eat healthfully, relationships and feeling part of the group are more important to you than making healthy choices at the party so you end up eating whatever you're offered to avoid offending anyone.

Embarrassed: Whenever you're at a party it feels like all eyes are on you watching what and how much you eat – you would rather take what everyone else is than stand out as being "on a diet" and risk getting comments on it.

Balanced: You eat well most of the time and usually pass on getting seconds or dessert...but hey, after all, this is a special occasion and one day of indulgence can't be much of a set-back!

Party Tips:

Eager: You're right that you should be able to live a little and enjoy the party! Though you may want to consider these ideas when deciding how much is enough:

You certainly don't want to miss out on those special holiday foods, but could you pass on taking seconds, or choose your two favorite cookies instead of four without feeling deprived? Savor every bite and enjoy things in moderation this season ... guilt-free!

Antisocial: Sounds like you'd rather not be at the party to begin with. But if you're there and do want to eat healthfully, you can try the suggestions for Eager along with these:

If you're not sure whether you want to limit yourself at all, take a moment to consider this: Food might be the one thing at the party that isn't going to annoy you and might even make you glad to be there. But how will you feel afterwards if you overeat? Does indulging really help you feel any happier? Or does it just cover up other feelings inside?

Pleaser: You don't like to make a scene or offend anyone by turning down food they put time into making, even when you'd rather not eat it, because you don't feel comfortable making your own needs a priority. The good news is that you can do what's right for you while also helping others feel happy.

Rather than saying "No thank you." if you don't like to turn down an offer, try saying, "Thanks, that looks delicious, but I'm full." No one will take statements like that the wrong way, and you will still be able to make the healthy choices you want. You could also use the suggestions for Eager.

Embarrassed: It can be hard to make the right decisions when you're concerned about other people's comments on what you eat.

Keep in mind though that making healthy choices doesn't need to stand out; many people will be taking moderate portions.

Balanced: Your day-to-day efforts to make the right choices have been paying off – you're feeling healthier and you can easily enjoy things on special occasions since you're on track to reach your health goals. You might still want to use some of the suggestions given to Eager, but most important is just getting back into your regular routine after the holiday. Congratulations on an overall healthy lifestyle!

Here are some other useful tips no matter which approach you try:

Use a small plate (if available) and when you put food on it, try to avoid stacking it high; leave white space between each item on the plate for simple portion-control.

Either eat or talk; take a break between eating to socialize and try to avoid doing both at the same time. It distracts you from really enjoying what you're eating and often traps you into eating more than you intended.

Most of all, enjoy the party! Eat slowly and savor the flavor of each bite to get the most satisfaction from what you are eating. Remember, you don't need to eat a large amount to enjoy good food with the people you're celebrating with.

Two new studies give one more reason to eat a diet rich in fish: prevention of age-related macular degeneration, the leading cause of blindness in old age.

The omega-3 fatty acids found in fish such as salmon are already known to help the heart and brain stay healthy. The new studies, appearing Monday in the Archives of Ophthalmology, add to evidence that fish eaters also protect the eyes.

The new studies aren't the strongest level of scientific evidence, but they confirm the findings of previous studies that also link fish consumption with prevention of macular degeneration.

A study of 681 elderly American men showed that those who ate fish twice a week had a 36 percent lower risk of macular degeneration. In the other study, which followed 2,335 Australian men and women over five years, people who ate fish just once a week reduced their risk by 40 percent.

The U.S. study also found that smokers nearly doubled their risk of the eye condition compared to people who never smoked.

Macular degeneration starts with blurring in the center of what the eye sees. It progresses to blindness, slowly or quickly depending on the type of disease. Six to 8 percent of people age 75 and older have an advanced form of the disease.

"We have a longer life expectancy so the prevalence and burden related to age-related macular degeneration will continue to increase," said Dr. Johanna Seddon of the Massachusetts Eye and Ear Infirmary in Boston, lead author of the U.S. study.

The proper balance of essential fatty acids was crucial to preventing eye disease in the study, Seddon said. The men who ate not only more omega-3 fatty acids, but also fewer omega-6 fatty acids, found in vegetable oils and baked goods, got the most benefit.

Both studies on the effect of fish were based on participants' recall of what they ate. The studies were observational, meaning they observed people's behavior and health. Although the researchers tried to account for other risk factors, the people who ate more fish may have had other healthy habits that lowered their risk.

Stronger evidence may come in five or six years with results from a large, randomized study of how fish oil and another nutrient, lutein, affect macular degeneration, said Dr. Emily Chew of the National Eye Institute, who is heading that study.

Volunteers will be assigned randomly to get either fish oil, lutein, or both -- or placebos.

Researchers don't yet know why eating fish seems to protect the eyes. Omega-3 fatty acids may neutralize free radicals in the eye, preventing the formation of new blood vessels, reducing inflammation or all three, Chew said.

Dr. Yu Guang He of the University of Texas Southwestern Medical Center said the new studies confirm findings from other research and will give doctors even more confidence as they advise patients what they can eat to protect their eyesight.

"I always tell them if you like fish, if you enjoy fish, eat more fish. Some people don't like the flavor. I would encourage those people to take (fish oil) supplements," he said.

Cortisol is a hormone secreted by the adrenal glands in response to stress, and research does suggest that there may be a tie between cortisol levels in women and the accumulation of excess weight in the abdominal area. A study at Yale University in 2000 compared stress reactions among women who had a high waist-to-hip ratio (because their fat tended to be in the belly) with those among women with a low waist-to-hip ratio (indicating more fat storage in the hips than the waist).

The researchers noted that diseases caused by high levels of cortisol (Cushing's Syndrome is one) are characterized by excessive amounts of fat in the abdominal area, an unhealthy distribution that increases the risk of high blood pressure, heart disease, and diabetes. In addition to the link to weight gain, elevated cortisol levels can have adverse effects on the immune system, memory, and sugar metabolism.

In the Yale study women were given tests (involving puzzles and speech designed to stimulate stress) to see how they responded. The researchers found that women with a high waist-to-hip ratio, whether they were overweight or slim, secreted more cortisol under stress and also reported more stress in their daily lives than women with low waist-to-hip ratios. Results of the study were published in the September/October 2000 issue of Psychosomatic Medicine.

As far as caffeine is concerned, a study published in the July/August 1998 issue of Psychosomatic Medicine showed that caffeine can elevate levels of cortisol and another stress hormone, ACTH (adrenocorticotropic hormone) in men prone to high blood pressure as well as in men at low risk for this disease. I doubt that caffeine has much impact on weight gain as a result of any effect on cortisol levels.

While these findings are interesting, it would be a mistake to blame all weight gain on cortisol. Heredity plays a role, too, as well as such lifestyle factors as smoking, alcohol consumption and lack of exercise. If you want to decrease the impact of stress in your life, which may result in lower cortisol levels, be sure to get regular exercise and sufficient sleep. Incorporate meditation and relaxation techniques into your daily routine. My breathing exercise will help bring calmness throughout your body. Do it at least twice a day, and try it every time you feel anxious or upset.

On a mission to whip herself into shape, Kate Kowalczyk tossed out the junk food and stocked up on her idea of good-for-you staples like yogurt and low-fat cookies.

Despite her persistence, the 35 pounds she was trying to shake wouldn't budge.

It turns out those "healthy" foods were just as fattening as the chips and soda they replaced: The yogurt was filled with Reese's Pieces and the low-fat cookies were brimming with sugar that kept her hunger on razor's edge.

As concerns grow over rising obesity rates, so does confusion about the difference between what is healthy and what aids weight loss -- with many believing the two are interchangeable.

"That's why so many people just give in and so many diets fail," said Christine Gerbstadt, spokeswoman for the American Dietetic Association.

Foods with wholesome images -- nuts, yogurt and granola -- are often consumed with abandon by dieters and end up sabotaging them, she said. Many brands of granola, for example, can be packed with up to 600 calories per cup and are loaded with more sugar than a cup of Cap'n Crunch.

While foods like granola and yogurt are certainly more nutritious than a bag of Cheetos, it's important to pick the lower-calorie brands that are not loaded with sugar or fat.

"When you have different choices and brands, just look for the ones with lower calories," Gerbstadt said.

Still, some weight watchers manage to convince themselves blueberry pie has its place in a diet -- simply because it features a fruit, said Marlene Clark, a registered dietitian at Cedars Sinai in Los Angeles.

"Just because the basic thing is healthy doesn't mean it's a healthy dish," Clark said.

That's true for fish and vegetable dishes, too, which may have been prepared with loads of butter, cream, or breading, she said.

According to a survey by the Washington-based Food Marketing Institute, 59 percent of shoppers were trying to eat a healthier diet last year, up 14 percent from 2000. Forty-two percent of those shoppers said losing weight is a health goal that influences their purchases.

But confusion is rampant about what healthy means; the same survey found 20 percent of respondents didn't know what "organic" meant, except that it was "better for you." But even foods labeled organic or "natural" can have just as many calories.

An ounce of Pringles potato chips contains 160 calories, for example, while potato chips made by the organic food company Barbara's Bakery have 150 calories for the same serving size.

Frito Lay's Tostitos Natural Blue Corn Tortilla Chips and the brand's Restaurant Style Tortilla Chips each have 160 calories per serving.

Yet people seem to binge on "natural" snacks free of guilt, even though there is virtually no calorie difference in many instances, Clark said.

Although there are no figures tracking the growth of "natural" foods, health experts say they are seeing a growing abundance of such products riding on the coattails of the booming organic food market -- which grew 13 percent to $18.4 billion in 2004, according to FMI.

"It's all in the advertising -- you see this bright packaging that says it's good for you," said Kowalczyk, 34, of Troy, N.Y.

Since joining a weight-loss support group at work last month, Kowalczyk has learned to look beyond the veneer of "healthy" products and pay attention to calories.

"Rather than using all the marketing claims, the best thing to do is turn the product over and look at the nutritional facts to check the caloric content -- and pay attention to the serving size," Gerbstadt said.

When scaling back calories, Gerbstadt said it is important to get as many vitamins and nutrients as possible since less is being eaten. Making substitutions -- like an apple instead of applesauce -- is a good way to keep calories down and nutrition up, she said.

Colorectal cancer doesn't develop overnight. It takes many years, as long as two decades, for normal cells that line the lower intestine or rectum to transform into cancer. Before the emergence of full-blown cancer, these cells must first evolve into growths called polyps. Screening for colon cancer works by detecting these polyps before they become deadly.

It Begins In The DNA

A polyp begins as a small nubbin (lump) invisible to the naked eye. Over many years, it grows into a bump. As the bump gets bigger, it may stop growing. Polyps that remain small, about 0.5 cm (¼ inch) or less in diameter, are usually benign and remain so. However, the polyp may continue to enlarge.

From Polyp To Cancer Most polyps that continue to enlarge are of a type called adenomas. Ninety-nine percent of adenomas remain benign. But if not removed, they may become malignant. Once cells become malignant, they increase more rapidly. During this stage, the body produces no warning signs.

Screening for colon cancer works by detecting the presence of polyps before cancer develops and before signs and symptoms appear. For example, sometimes polyps bleed. A fecal occult blood test is designed to discover the "occult" or hidden blood in your bowel movement that may indicate polyps. With a more advanced test called colonoscopy, the doctor looks directly for polyps.

Once A Polyp Is Found

During a colonoscopy, if the doctor finds one polyp, he or she will look through the entire colon and rectum for more. The doctor removes the polyps and sends them to the pathology lab for evaluation. A lab report gives details about the specimen, providing information about the degree of cancer risk. If an adenoma is removed completely, it will not become cancerous, even if there are a few cancer cells at the tip.

If a person has an adenoma, even a benign one, his or her risk of developing a new polyp increases substantially. About 35 percent of people with one polyp will develop a second polyp within five years. Therefore, a repeat colonoscopy is recommended in one to five years, depending on the size and appearance of the polyp.

The Bottom Line About Screening

Screening doesn’t really prevent most types of cancer. Instead, screening is intended to find cancer when it is at an early, highly curable stage. But screening for colon cancer is different: Finding and removing precancerous polyps can actually prevent cancer from developing. Screening for colorectal cancer will also help to find cancerous tumors when they are small and can be removed completely.

A new report suggests restaurants should dish food and fight fat at the same time, meaning menus with more fruits and vegetables, smaller portions and better nutritional information.

With burgers, fries and pizza the Top 3 eating-out favorites in this country, restaurants are in prime position to help improve people's diets and combat obesity. At least that's what is recommended in a government-commissioned report being released Friday.

The report, requested and funded by the Food and Drug Administration, lays out ways to help people manage their intake of calories from the growing number of meals prepared away from home, including at the nation's nearly 900,000 restaurants and other establishments that serve food.

The 136-page report prepared by The Keystone Center, an education and public group based in Keystone, Colo., said Americans now consume fully one-third of their daily intake of calories outside the home.

And as of 2000, the average American took in 300 more calories a day than was the case 15 years earlier, according to Agriculture Department statistics cited in the report. Today, 64 percent of Americans are overweight, including the 30 percent who are obese, according to the report. It pegs the annual medical cost of the problem at nearly $93 billion.

Consumer advocates increasingly have heaped some of the blame on restaurant chains like McDonald's, which bristles at the criticism while offering more salads and fruit. The report does not explicitly link dining out with the rising tide of obesity, but does cite numerous studies that suggest there is a connection.

The report encourages restaurants to shift the emphasis of their marketing to lower-calorie choices, and include more such options on menus. In addition, restaurants could jigger portion sizes and the variety of foods available in mixed dishes to reduce the overall number of calories taken in by diners.

Bundling meals with more fruits and vegetables also could improve nutrition. And letting consumers know how many calories are contained in a meal also could guide the choices they make, according to the report.

Just over half of the nation's 287 largest restaurant chains now make at least some nutrition information available, said Margo Wootan, director of nutrition policy for the Center for Science in the Public Interest. "If companies don't tell them, people have no way of knowing how many calories they are being served at restaurants. And chances are, they are being served a lot more than they realize," said Wootan, adding that Congress should give the FDA the authority to require such disclosure. But the report notes that the laboratory work needed to calculate the calorie content of a menu item can cost $100, or anywhere from $11,500 to $46,000 to analyze an entire menu. That cost makes it unfeasible for restaurants, especially when menus can change daily, said Sheila Cohn, director of nutrition policy for the National Restaurant Association.

Instead, restaurants increasingly are offering varied portion sizes, foods made with whole grains, more diet drinks and entree salads to fit the dietary needs of customers, Cohn said. Still, they can't make people eat what they won't order. "It's not really the responsibility of restaurants to restrict the foods that they offer," Cohn said. Survey data suggest that consumers are sticking to old standbys, even when offered healthier fare.

When Americans dined out in 2005, the leading menu choices remained hamburgers, french fries and pizza, according to The NPD Group, a market research firm. The presumably healthier option of a side salad was the No. 4 choice for women, but No. 5 for men, according to the eating pattern study. Government officials, scholars, industry representatives and consumer advocates contributed to the report.

Doctors have known for years that healthful diets help prevent heart disease. But proving that particular foods protect against cancer has been difficult, says Walter Willett, a professor at the Harvard School of Public Health who spoke Monday at the annual meeting here of the American Society of Clinical Oncology.

Scientists long have been intrigued that people in developing countries, who tend to eat more plant foods and fish, have lower cancer rates than those in countries whose diets are dominated by fats and red meat, Willett says. Recent studies, however, have dashed hopes for a variety of proposed anti-cancer strategies: reducing fat to prevent breast cancer, increasing fiber to ward off colon tumors and filling up on fruits and vegetables to avoid cancer in general, Willett says. These studies are convincing because they followed participants over time and in some cases randomly assigned people to follow particular diets.

Science has crushed enthusiasm for some dietary supplements as well. Beta carotene pills, for example, actually increased the risk of cancer in clinical trials.

Studies found vitamin E failed to reduce cancer risk. Though these studies may have disappointed many people, doctors have learned a lot about cancer prevention: ·

Early experiences may matter most. Many long-term studies, such as the Women's Health Initiative, involved mostly women over 60. But midlife may be too late for people to reduce their risk of cancer through diet. "If you are 50 years old and have a cancer diagnosis and you suddenly start eating well, that is not going to do anything," says Barrie Cassileth, chief of integrative medicine at New York's Memorial Sloan-Kettering Cancer Center, who will speak about nutrition at the meeting today. Breast tissue may be most susceptible to outside influences before puberty. Older Japanese women exposed to nuclear radiation in 1945 did not develop breast cancer, but young girls did, Willett says. Carcinogens may do the greatest damage early in life, so diet may play its most important role during childhood, Willett says.

· The amount of food may be more important than the type. A number of studies strongly show that people who burn more calories than they consume are less likely to develop cancer, Willett says. Evidence strongly links obesity to colon cancer, pancreatic cancer, postmenopausal breast cancer, liver cancer and others. Though eating vegetables may not reduce a cancer patient's risk of death, losing even a few pounds may benefit people with certain tumor types, Willett says.

Researchers continue to study nutritional factors that may increase the risks of cancer, such as high intake of dairy products and low intake of folic acid, calcium, vitamin D and lycopene, which is found in tomatoes. Like many dieters, Janet Bright of Hendersonville, N.C., says she is often confused by the latest nutritional news. "They say things like 'This is good' and 'This is bad,' and six months later they change their minds," says Bright, 62, a breast cancer survivor. "I just eat as healthily as I can and hope for the best."

Childhood obesity is growing at an alarming rate, but experts say parents are more powerful than they imagine at helping kids fight the problem.

About 17 percent of U.S. children and teens, aged 2 to 19, are overweight, according to the U.S. National Center for Health Statistics. But three studies presented at this week's Pediatric Academic Societies' annual meeting in San Francisco offer ways to help kids get to healthier weights.

Mothers in families where food is sometimes scarce due to money problems have a tendency to give their children high-calorie foods to boost overall calories or foods to stimulate the appetite -- two practices they should avoid if they want their child to remain at a healthy weight, says Emily Feinberg, an assistant professor of maternal and child health at Boston University School of Public Health and an assistant professor of pediatrics at Boston Medical Center.

In her study, Feinberg interviewed 248 mothers of normal and overweight black and Haitian children, aged 2 to 12. She found that 28 percent of them had shortages of food from time to time. When that happened, 43 percent used nutritional drinks such as high-calorie instant breakfast drinks, and 12 percent used substances to stimulate appetite, such as traditional Haitian teas, in a well-meaning effort to be sure the children got adequate nutrition.

Instead, Feinberg says, these low-income mothers should "try in general not to focus as much on calories but on the quality of the diet. Instead of a nutritional drink supplement, we would recommend increasing the intake of fruits and vegetables."

Helping your child have good self-esteem can also motivate him or her to lose weight, says Kiti Freier, a pediatric psychologist at Loma Linda University in Loma Linda, Calif., and director of the Growing Fit Program there. When she interviewed 118 overweight children participating in a 12-week program, she found that good self-image was even more important than how much excess weight they carried in predicting whether they were ready to lose excess weight.

"Their readiness to change relates to whether they felt supported, not how big they were," she says. The message for parents of chubby children is clear: Don't point out how overweight they are. Instead, try something like this: "We love you so much.

We want you to be healthy and have a long life," Freier says. Then offer them a plan and support.

Other parents may have the mistaken belief that a child is not overweight, when he or she actually is.

Dr. Elena Fuentes-Afflick, an associate professor of pediatrics at the University of California, San Francisco, tracked the attitudes of Latina mothers with preschool-age children on their kids' weight. She analyzed data from interviews with 194 women and children taking part in the Latino Health Project. The women were recruited during pregnancy and then interviewed annually for three years.

By the time they were three years old, more than 43 percent of the children were statistically overweight. But "in the group of kids overweight by our measure, three-quarters of those mothers thought their child's weight was just fine," Fuentes-Afflick says.

"We are living in a society where two-thirds of adults in the U.S. are overweight or obese," she says. "What concerns me is the risk that we are normalizing overweight body images."

The studies provide valuable information for researchers and parents, according to Connie Diekman, a registered dietitian and director of university nutrition at Washington University in St.

Louis, Mo. The first study on scarce food, "provides some support to why the prevalence (of overweight) is higher" in poorer populations, she says.

The study relating a child's self-esteem to their readiness to lose weight also makes sense, Diekman says. "Self-esteem is a major factor in the establishment of healthy behaviors and (a lack of it) can contribute to overeating and eating disorders."

Finally, the last study confirms the key role mothers play in determining what a child eats and weighs, Diekman says.

You may not be able to tear your boss' hair out, but you can snatch the weeds from your flowerbeds.

You may not have the desire to schlep to your gym's power-lift class, but you can lug bags of soil and push your wheelbarrow around.

You may not be able to dictate what your office looks like, but you can have flowers and trees in your yard that directly reflect your personality.

And then there's the control -- all those little plant lives are in your hands.

With warmer weather here, more people are charging into their yards and gardens, or maybe thinking about it. And health experts couldn't be happier.

There are oodles of benefits, both physical and mental, that come from the range of activities associated with gardening.

The most obvious benefit is exercise, says Dr. Julie Roth of the Wellness Institute at Northwestern Memorial Hospital in Chicago.

And anyone who has planted trees, created a flowerbed from bare lawn or hauled slate to design a walking path will tell you that dominating Mother Nature is hard work.

"It's going to give you a good way to burn calories that's an enjoyable activity for most people," Roth says, adding that studies show working in your yard or garden can burn between 250 calories and 500 calories an hour, depending on your level of activity.

Diane Relf, a professor emeritus with Virginia Tech's Department of Horticulture, says trimming shrubs or trees requires about the same amount of exertion as walking at a moderate pace. Raking the lawn takes as much energy as a leisurely bike ride or water aerobics. And mowing the lawn with a push mower or tilling a garden can equal the exertion you would expend swimming laps, she says.

"Gardening is moderate -- and sometimes strenuous -- exercise that incorporates many important elements of accepted exercise regimes, such as stretching and stance, repetition and movement," Relf says. "Some gardening even involves resistance principles similar to weight training."

And while some people just can't bring themselves to climb on a treadmill for an hour, it might help to know that when you "feel the burn" in your garden, you've actually produced something in the end besides a toned backside. Beyond physical exertion, gardening also offers a level of serenity that can help a person's mental health, experts say. "For a lot of people, it's a very soothing activity," Roth says. "You're out in nature, which is a very soothing location.

You can turn on whatever music you want. It's a good way to break away from the daily rigor we all go through." Relf says just spending time in your garden can provide health benefits.

She notes a study from Memorial Sloan-Kettering Cancer Center in New York City, which found that women recovering from breast-cancer surgery discovered that walks in the garden helped restore their ability to concentrate and reduced their depression.

"After a hard, tense day at the office, a slow cruise around the yard will do wonders to restore your perspective," Relf says.

"As you discover seedlings emerging, flower buds opening, even the damage of the tomato hornworm, you forget about the day's worries."

And don't underestimate the stress relief that comes from spending time outdoors after sitting at a desk in an office all day.

There are several theories why time spent gardening is so soothing, Relf says.

It might be that plants provide a simple aesthetic joy, or that people are responding to ingrained psychological and physical cues borne of thousands of years of evolution. It also may be that caring for plants satisfies the human instinct to nurture and provide support, rewarding good gardeners with colorful and fragrant flowers or luscious, ripe fruits and vegetables.

Which leads to the last reason why gardening is such a health activity: When it's all said and done, you benefit from a diet of fresh fruits and vegetables.

"It gives you direct access to healthy food," Roth says.

"Whatever you put in there, one way or another, it's going to be good for you."

According to a new article published in the New England Journal of Medicine, researchers from Harvard and Wageningen University in the Netherlands presented evidence of fatty acids at both the physiological and cellular levels.

They concluded that trans fatty acids raise serum levels of LDL, or "bad," cholesterol; reduce levels of HDL, or "good," cholesterol; promote inflammation; can cause endothelial dysfunction; and influence other risk factors for cardiovascular diseases. The researchers noted that from a nutritional point of view, "the consumption of trans fatty acids results in considerable potential harm but no apparent benefit."

Replacement in the food industry has already taken place in Denmark and is now occurring in the U.S., with many food packages now touting "0 Trans Fats."

A: Prewashed, ready-to-eat salad kits and their ilk are terrific ways to get us closer to our goals of eating more fruits and vegetables, virtually eliminating prep time. As with any produce, however, eating them raw is never completely risk-free, since it’s the heat of cooking that kills disease-causing bacteria, such as E. coli and Salmonella. Does that mean you shouldn’t enjoy their convenience? We vote to keep them in your basket.

Foodborne-illness outbreaks caused by produce have been increasing—and lettuce is the vegetable most frequently named, including pre-washed, bagged types. However, “there is no evidence to suggest that washing lettuce or any produce in your own kitchen is any safer than buying it already prewashed,” says Stephen Swanson, M.D., an epidemic intelligence service officer with the Centers for Disease Control (CDC). The risk of pathogens, he adds, “may even be smaller.”

Why? Bagged precut vegetables are washed multiple times in chlorinated water to kill pathogens. Such a washing is often more thorough than the quick rinse typical of your average household kitchen, notes Swanson. “Cross-contamination, where bacteria are transferred from one food to another during food preparation, can also occur in home kitchens.” (Washing the sink, cutting boards, utensils, countertops and your hands with hot soapy water between handling different foods can help prevent this, as well as keeping raw meat and poultry separate from fresh produce; more tips at www.foodsafety.gov.)

We believe the many benefits of eating fresh fruits and vegetables far outweigh the minimal risk of exposure to foodborne pathogens, and so does Swanson. “A diet high in fresh fruits and vegetables is vital to a healthy lifestyle,” he says. “Eat and enjoy the health benefits of fresh produce, whether it’s ready to eat out of the bag, or prepared in your own kitchen.”

Q: How can some brands of peanut butter claim “zero trans fats,” but still list hydrogenated oil in the ingredients list?

A: With the new trans-fat nutrition-labeling rules, products labeled “0 trans fats” can still contain up to half a gram of trans fat per serving. You can assume that “trans-free” peanut butter still contains a small amount of trans fat if partially hydrogenated oil is listed as an ingredient.

Trans fats help make peanut butter shelf-stable, smooth and creamy. But now that trans fats’ heart-damaging effects are widely known, many peanut butter manufacturers are replacing them with palm oil. While palm oil is trans-fat-free, about half of its fat is saturated, adding about 1.5 grams sat fat to each 2-tablespoon serving.

Have we traded one “bad fat” for another? Could be. While you may have heard that palm oil has less of a cholesterol-raising effect than other tropical oils, the research isn’t conclusive. Your best bet is to choose natural peanut butters that contain neither added palm oil nor trans fats.

Five reasons why you need Vitamin C and ideas on how to fit it in everyday

Restricting your intake of calories may not only help people live longer, as but also help them lose weight, say the scientists behind a clinical trial. Previous studies have reported that calorie-restricted diets could prolong the lives of rodents and other short-lived species, but until now no such human study had been undertaken to investigate the effects of such diets on markers of human aging.

It has long been something of a quirk in the grim universe of diabetes: a small number of pregnant women would become temporarily diabetic. With proper care, the consequences were often thought to be mild. The babies were usually healthy. And the condition would vanish after the delivery, like a cough or a headache.

But, not unlike the wider expansion of diabetes, this disorder is now growing, and indications are that it is growing fast. In New York, so-called gestational diabetes has risen by nearly 50 percent in about 10 years.

There is also broader recognition that in the lives of many pregnant women, the arrival of the condition is significant and its impact can be grave: not only does it identify those women at particularly high risk to develop permanent diabetes, but it may contribute to their babies' eventually getting diabetes as well.

Health care officials worry that insufficient attention is being paid to the rising number of cases, apparently being propelled by genetically susceptible women entering pregnancy too fat. The inattention, the officials say, is allowing young mothers to be saddled with a harrowing lifelong disease and increasing the risk to their children of ultimately sharing that troubling destiny. It is hard to say just how alarming this will become. But those who study the diabetes epidemic are concerned that it's one more time bomb.

"It's really disturbing to us that women come into their pregnancies obese and then leave them even more obese," said Barbara Hackley, a certified nurse-midwife at the health center of the Children's Health Fund and Montefiore Medical Center in the South Bronx. "I've seen weight gains during pregnancies of 50 to 60 pounds. We've had 11- and 12-pound babies that are very dangerous to deliver."

Gestational diabetes, like other forms of diabetes, is characterized by dangerously high levels of sugar in the blood. Many women who develop it have never even heard of the disorder. Afterward, they never think much about it, unless visited by its potential legacy, Type 2 diabetes, a progressive, potentially fatal illness that can produce a barrage of complications, from strokes to decaying limbs.

In 2001, the latest year researchers have studied, there were 4,200 cases of gestational diabetes in New York among women who gave birth to a single baby. Experts believe wider education about the condition might allow some heavy women, through better diet and exercise, to avert it before they become pregnant.

Furthermore, experts say, many mothers are inadequately counseled after delivery by busy clinicians — or are unable to absorb the message — about the need to monitor their weight and blood sugar, as well as their child's, because of the danger of chronic diabetes. A surprising number, doctors say, never even bother to confirm that the gestational diabetes went away. Take the weight narrative of Andrea Reyes. At 21, pregnant with her first child, she weighed 153 pounds. She tacked on just seven pounds during the pregnancy, because the baby came early. But instead of shedding her baby fat, she said, "I ate the same food; but I ate more." Four years later, pregnant with her second child, she weighed 190. During her pregnancy, doctors found that she had gestational diabetes, which usually shows up 24 to 28 weeks into pregnancy. She had no idea what it was. The baby was fine, and the diabetes disappeared, but it was resurrected during her third pregnancy, in 2001. She weighed 193. Her son was large — 9 pounds, 9 ounces — and had low blood sugar, complications of the condition. Again, the diabetes subsided. But her doctor cautioned her that if she did not diet and exercise, she might acquire permanent Type 2 diabetes. In May 2004, after fitful progress, that's what happened. She is now 32, a sprightly woman with dark hair knotted in a ponytail who lives in the South Bronx and peddles fruit salads in the summers. She takes pills and insulin, and sometimes finds herself dizzy. Though she winnowed her weight down to 180, she has put on five pounds in the past month. "I know," Ms. Reyes said sheepishly, "too much." Her doctors have advised her that she needs to keep an eye on her son, whose weight is now normal. "I know," she said. "I worry."

The dimensions of gestational diabetes are imprecise, and there is considerable disagreement about how vigorously to treat it, especially milder cases, and how much difference treatment makes. The disorder is not tracked regularly in the city or nation. Estimates are rooted in scattered studies. In its first attempt to measure the problem, the New York City Department of Health and Mental Hygiene, in a paper last September in the American Journal of Public Health, said that a review of births between 1990 and 2001 found that the prevalence had leapt to 3.8 percent, or about 4,200 pregnant women in 2001, from 2.6 percent.

There was a pronounced increase among younger women and Asians, who tend to get diabetes at lower weights. With South and Central Asian mothers, prevalence hit 11.1 percent, one of the highest documented levels in the country. An increase of more than 75 percent occurred among women delivering before age 35. Although the study did not track the weights of mothers, it concluded that obesity was probably the principal force because it has been driving increases in Type 2 diabetes.

Other regional studies suggest prevalences of 4 percent to 8 percent. Dr. Michael Engelgau, head of the diabetes division of the United States Centers for Disease Control and Prevention, said that rates are rising significantly throughout the nation, and even touching teenagers. The American Diabetes Association uses a 4 percent level for the country, or 135,000 cases a year.

Estimates are that as many as 20 to 50 percent of the women who develop gestational diabetes will get Type 2 within 5 to 10 years. Scientists do not t