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 think that the disorder causes Type 2 diabetes, but it alerts a woman that she could be headed down that road and might be able to delay or avert Type 2 with lifestyle adjustments.

Researchers have not established the subsequent impact on the child. Hereditary factors are hard to untangle and studies difficult to accomplish. But there is concern that the condition significantly contributes to the child's eventually becoming obese or diabetic. While many mothers are conscientious about the issue, others are not and should be, said Sharon Blasi, a diabetes nurse educator in Queens. "It's almost like a looking glass," she said. "This could possibly be your future. Here's a taste of it."

Due to nonchalance or the consuming whirl of a new baby, many mothers never return after childbirth for the tests that confirm that the disorder is gone — it could actually be undiagnosed chronic diabetes — or to seek guidance to avoid permanent diabetes. Dr. Carol Levy, an assistant professor of medicine and specialist in gestational diabetes at NewYork-Presbyterian/Weill Cornell Medical Center, estimated that while as much as 70 percent of mothers who have access to specialists may receive follow-up tests, the proportion is far smaller at clinics serving poor populations. "The mothers get busy," she said. "The doctors don't remind them. I hear from patients that no one told me to do this. Is it that the doctor didn't remind them or did the patients forget?" Ms. Hackley, the nurse-midwife, said as few as 30 to 50 percent of the mothers who use the South Bronx center return for the needed follow-up care.

From birth certificates, city health officials know which mothers had gestational diabetes — most pregnant women are routinely screened for it. Yet officials have not checked on what postdelivery care those mothers get. Confronted with the surge in cases, the city plans to begin an initiative soon to tackle this issue.

There is a strong genetic underpinning to gestational diabetes, as with all diabetes, but doctors mention two trends in New York and elsewhere that seem to be colliding to push up prevalence: many women are entering pregnancy fatter, and more women are having children later.

Overweight women or those older than 25 are considered at higher risk, and there are steeper rates among African-American, Hispanic, Asian and Native American populations. Women carrying multiple babies face more risk as well. But some women with none of those factors also get it. "The problem is huge," said Dr. Robin Goland, the co-director of the Naomi Berrie Diabetes Center in New York. "We had four or five referrals of gestational diabetes yesterday. We're seeing probably a third more than we did seven years ago, when we started." Dr. Goland had treated one patient with gestational diabetes who gave birth at 57; her youngest case was 19.

Specialists suspect the caseload is greater than the city study implies, because the cases of some poor and uninsured women, who often get little or no prenatal care, go uncounted. Last October, pregnant with her first child, Ulrica Rutkove learned that she had the condition. She had never heard of it. She weighed all of 95 pounds. "I never thought I'd get diabetes," said Ms. Rutkove, a portrait artist. "I thought people who get diabetes are overweight." But she is 40, from the Philippines, and both her mother and grandmother had diabetes.

Most women with gestational diabetes give birth to healthy babies, though complications do arise. Evidence from studies of Pima Indians and experiments with rats, however, suggest that, genetics aside, a child, simply by being exposed to the intrauterine environment of a gestational mother, could be more likely to become obese and develop diabetes later in life. If the child is a girl, the same pattern might then repeat itself when she becomes pregnant. "So it's a vicious cycle," said Dr. Boyd Metzger, professor of medicine and endocrinology at Northwestern University's Feinberg School of Medicine.

In studies of the Pimas, an unusual group because of their shockingly high rates of diabetes, 80 percent of the offspring of diabetic mothers — both chronic and gestational — had diabetes by the time they were 25 to 29. Of the children of mothers without diabetes, 5 percent had diabetes at that juncture. It's difficult, though, to draw analogies with the general population.

Doctors have long disagreed over how ambitiously to regulate the conditions of mothers-to-be with gestational diabetes. Care typically involves diet change — including cutting down on carbohydrates, juices and sugared soda — and exercise. Often, the women take insulin injections and are advised to monitor their blood sugar four times a day. Some doctors substitute an oral drug, glyburide, for insulin. Jane Martinez Dowling, 37, a part-time consultant, has had gestational diabetes twice, once when she was proper weight and again now, 20 weeks into her latest pregnancy, when she feels she may be 30 pounds too heavy. After the birth, she vows on losing the weight because she said she understands the risks, and fears the prospects, of developing chronic diabetes. She has already cleansed her diet of rice and beans. "Spaghetti squash," she said, "has revolutionized my life."

Not long after disclosing that its french fries contain more trans fat than thought, McDonald's Corp. said Monday that wheat and dairy ingredients are used to flavor the popular menu item -- an acknowledgment it had not previously made.

The presence of those substances can cause allergic or other medical reactions in food-sensitive consumers.

McDonald's had said until recently that its fries were free of gluten and milk or wheat allergens and safe to eat for those with dietary issues related to the consumption of dairy items. But the fast-food company quietly added "Contains wheat and milk ingredients" this month to the french fries listing on its Web site.

The company said the move came in response to new rules by the U.S. Food and Drug Administration for the packaged foods industry, including one requiring that the presence of common allergens such as milk, eggs, wheat, fish or peanuts be reported. As a restaurant operator, Oak Brook, Ill.-based McDonald's does not have to comply but is doing so voluntarily.

McDonald's director of global nutrition, Cathy Kapica, said its potato suppliers remove all wheat and dairy proteins, such as gluten, which can cause allergic reactions. But the flavoring agent in the cooking oil is a derivative of wheat and dairy ingredients, and the company decided to note their presence because of the FDA's stipulation that potential allergens be disclosed.

"We knew there were always wheat and dairy derivatives in there, but they were not the protein component," she said. "Technically there are no allergens in there. What this is an example of is science evolving" and McDonald's responding as more is learned, she said.

While the company wanted to make consumers aware that fries were derived in part from wheat and dairy sources, she said, those who have eaten the product without problem should be able to continue to do so without incident.

Since it was posted on McDonald's Web site, the acknowledgment has stirred anger and some concern among consumers who are on gluten-free diets.

"If they're saying there's wheat and dairy derivatives in the oil, as far as anyone with this disease is concerned there's actually wheat in it," said New York resident Jillian Williams, one of more than 2 million Americans with celiac disease, an autoimmune disorder triggered by gluten.

"They should have disclosed that all along," she said. "They should never have been calling them gluten-free."

McDonald's has been reluctant to risk changing the taste of its heavy-selling fries. It pledged in September 2002 to switch to a new oil that would halve the level of harmful trans fatty acid in its fries. But it has delayed those plans, citing product quality and customer satisfaction as priorities while continuing testing.

Asked about the status of its efforts Monday, Kapica said: "It's a very high priority and we are very committed to continuing with testing and lowering the level of trans fat without raising the level of saturated fat. ... It's a lot harder than we originally thought but that is not stopping us."

McDonald's shares fell 8 cents to $36.25 in afternoon trading on the New York Stock Exchange -- up 7 percent in 2006.

Staying on a low-fat diet does not appear to reduce the risk of breast and colorectal cancer or heart disease in older women, a large American study says.

The latest bombshell from the landmark Women's Health Initiative study, released in three papers in the Journal of the American Medical Association yesterday, left health experts scrambling to try and explain the confounding results.

The new study followed almost 50,000 American women aged 50 to 79 for eight years to test the impact of a diet low in fat and high in fruits, vegetables and grains. In the end, those assigned to the low-fat diet had the same rates of breast cancer, colon cancer and heart attack and stroke as those who ate whatever they pleased, the study found.

The findings "are a bit surprising and a bit more disappointing," said Dr. Andrea Eisen, head of preventive oncology at Sunnybrook & Women's Health Sciences Centre. "Generally, people have been given advice to cut back on fat and there's a big campaign to eat more fruit and vegetables and I'm not sure it is totally justified," she said.

"These studies are revolutionary," Dr. Jules Hirsch, who has spent a lifetime studying the effects of diets on weight and health, told The New York Times. "They should put a stop to this era of thinking that we have all the information we need to change the whole national diet and make everybody healthy."

However, Ross Prentice, a co-author of the study, qualified the findings, saying that the 20,000 women in the low-fat diet group had a 9 per cent lower rate of breast cancer compared with women in the control group who continued to eat what they wanted, but that was not enough to be statistically significant.

"The bottom line is that changing to a low-fat diet may reduce breast cancer risk, especially among women who have a relatively high-fat diet to begin with," Prentice said, "but we don't view our data as strong enough at this time to make a broad recommendation that all women initiate a low-fat diet for that purpose."

In women who cut the most fat there were signs of less breast cancer, and in women who ate small amounts of the worst kind of fats, signs of less heart disease, the researchers said, adding longer follow-up may lead to more definitive results. The women also didn't reduce their fat intake as much as the diet demanded and most remained overweight, a major risk factor.

A low-fat diet had no significant impact on the incidence of stroke, heart attack, cardiovascular disease or coronary artery disease, indicating people have to do more than eat more healthfully for a number of years to avoid disease, said an accompanying editorial.

"To reduce the risk of cardiovascular disease, individuals should maintain a desirable body weight, be physically active, avoid tobacco exposure and eat a diet consistent with national guidelines," it said.

The low-fat group reduced their fat intake by an average of only 2.9 per cent and didn't distinguish between so-called "good" and "bad" fats.

"I think you can safely say that very small changes are going to lead to very small changes in cardiovascular disease," said Dr. Grant Pierce, chair of the scientific research group of the Heart & Stroke Foundation of Canada.

Women in the low-fat group aimed to reduce their fat intake to 20 per cent of their diet and to increase their consumption of fruits and vegetables to at least five servings a day and grains to six servings a day.

While they did increase their fruit and vegetable consumption by one serving a day and grains by about a half serving, "that's not a whole lot, is it?" Pierce asked. "I think you have to take that into consideration."

The study showed a trend toward higher rates of cardiovascular disease in subjects who ate higher amounts of trans fats, and a trend toward lower rates of disease in those with a higher vegetable intake, he said.

"The trends are there as we would expect, but maybe it's just a matter that you can't tinker with the diet, you need to make some real changes," Pierce said.

In interviews with more than 50 specialists conducted by ABC News, questions were raised about the study's shortcomings. The experts said:

The study was too short to detect a reduction in breast and colon cancer from dietary fat.

The amount of fat reduction was too small and was unlikely to produce meaningful benefits.

The researchers simply looked at fat intake in general and did not distinguish between healthy fats like olive oil and unhealthy fats like trans fats.

The study also suggests that dietary intervention has to take place at an early age to avoid disease developing, Pierce said.

"We know cardiovascular disease is already starting in children as young as 10 years old," he said. "If we modify their diet then, I would suspect it would have a major impact on cardiovascular disease but we really haven't done the studies yet."

When Mom or Dad told you to eat up all your fruits and vegetables “because they're good for you,” they were right — although they may not have known all the reasons why. Now researchers conclude that a daily smorgasbord of fruits and vegetables can dramatically cut the risk of suffering a stroke.

An analysis of international studies involving 257,000 people found that those who ate more than five servings of fruit and vegetables a day had a 26 per cent reduced incidence of stroke, compared with those who ate fewer than three servings daily.

Individuals who consumed three to five servings cut their stroke risk by 11 per cent, said principal investigator Dr. Feng He, a cardiovascular research fellow at the St. George's University School of Medicine in London.

“This is a finding that clearly provides strong support for the current (U.K.) recommendations to increase fruit and vegetable intake to five or more servings per day,” she said Thursday from London, noting that the average Briton eats only 2.8 servings per day.

“Based on these results, I would encourage everybody to increase their fruit and vegetable intake,” said Dr. He. Health Canada has been advising Canadians to eat five to 10 servings of fruits and vegetables per day for more than a decade, but a national average of actual consumption hasn't been determined, said Danielle Brule of Health Canada's division of nutrition policy and promotion.

A typical serving of fruit would equal one medium apple or medium banana; a single vegetable serving would consist of 125 millilitres of raw or cooked carrots or beans, for instance, or 250 millilitres of salad.

The British researchers analyzed pooled data from eight major studies that looked at the association between fruit and vegetable consumption and stroke in men and women from Europe, Japan and the United States.

Previous studies had shown that increased fruit and vegetable consumption was related to a diminished risk of stroke — both ischemic (caused by a blood clot in the brain) and hemorrhagic (bleeding in the brain) — but the strength of the association had been uncertain.

Dr. David Spence, director of the Stroke Prevention and Atherosclerosis Research Centre at the University of Western Ontario's Robarts Research Institute, agreed that the British analysis has better quantified the link between fruit and vegetable consumption and stroke reduction.

But the London, Ont., physician said Canadians shouldn't just load up on produce.

“You could do even better if in addition to increasing your intake of fruits and vegetables, you also increase your intake of whole grains and reduce your intake of cholesterol and animal fat,” said Dr. Spence, who advises his patients to follow the Mediterranean diet.

That's because research has shown that the Mediterranean diet, which is rich in whole grains, olive and canola oils as well as fruits and vegetables — but with reduced consumption of meat, chicken and fish — can diminish the risk of stroke and heart attack by about 60 per cent.

Dr. He, whose study is published in this week's edition of The Lancet, said fruits and vegetables are loaded with potassium, antioxidants like vitamin C, folate and fibre. And while researchers aren't sure which one element (or combination) is responsible for chopping the risk of stroke, she said potassium is known to lower elevated blood pressure — a major risk factor for stroke.

That doesn't mean that popping over-the-counter supplements will have the same stroke-preventing effects as eating produce, experts say.

“Disease prevention might not be attributable to single nutrients, but to the interaction of nutrient and non-nutritive components in whole foods,” Dr. Lyn Steffen, an epidemiologist at the University of Minnesota School of Public Health, writes in a commentary accompanying the study. “It is likely that the combination of nutrients and compounds in foods has greater health benefits than the individual nutrient alone.”

So how many different fruits and vegetables should one eat each day?

Since vitamins, minerals and antioxidants differ from fruit to fruit and veg to veg, Dr. Spence advises his patients to put variety on their plates.

“It turns out that the antioxidants tend to be what gives each fruit or vegetable its flavour and its colour, and so eating fruits and vegetables of all different colours gives us combinations of antioxidants that are probably more effective than anything you can get in a pill.”

In case you still have doubts about eating fruits and vegetables to keep blood pressure under control, here’s more evidence that it works.

Researchers at the University of Minnesota followed 4,304 men and women between the ages of 18 and 30 for 15 years to assess the impact of their diets on their blood pressure. They found that the more plant foods (fruit, vegetables, whole grains, nuts, and legumes) and the less red meat participants consumed, the less likely they were to develop high blood pressure. These findings, published in the December 2005 issue of the American Journal of Clinical Nutrition, mirrored results from earlier studies showing that diets rich in fruits and vegetables, low in total fats, and containing low-fat dairy foods can reduce blood pressure, especially among patients with hypertension.

In the new study, the impact of dairy food consumption on the risk of high blood pressure was inconclusive. Other studies have also shown the benefit of combining regular exercise with a dietary strategy to control blood pressure.

Roll over oats: Breakfast cereals and other foods that contain barley also will be able to start claiming they can reduce the risk of coronary heart disease.

The disease kills 500,000 Americans a year.

Labels on whole barley and dry milled barley products, including flakes, grits, flour and meal, are expected to start making the claim, the Food and Drug Administration said Friday in announcing its ruling. The claim is identical to that already made on many oat products.

The FDA estimates a quarter of the hot breakfast cereals, and another 5 percent of the cold cereals, sold in the United States will start boasting their health benefits. The breakfast cereal market is worth $7.1 billion a year, according to the FDA.

Products must provide at least 0.75 grams of soluble fiber per serving to make the health claim, the FDA said. Scientists believe a high-fiber diet helps lower cholesterol levels.

The FDA took the action in response to a petition by the National Barley Foods Council, whose members produce the nation's estimated $864 million annual barley crop. A unit of Cargill Inc., the Minneapolis-based agribusiness, helped underwrite the cost of the petition, according to the council.

Roll over oats: Breakfast cereals and other foods that contain barley also will be able to start claiming they can reduce the risk of coronary heart disease.

The disease kills 500,000 Americans a year.

Labels on whole barley and dry milled barley products, including flakes, grits, flour and meal, are expected to start making the claim, the Food and Drug Administration said Friday in announcing its ruling. The claim is identical to that already made on many oat products.

The FDA estimates a quarter of the hot breakfast cereals, and another 5 percent of the cold cereals, sold in the United States will start boasting their health benefits. The breakfast cereal market is worth $7.1 billion a year, according to the FDA.

Products must provide at least 0.75 grams of soluble fiber per serving to make the health claim, the FDA said. Scientists believe a high-fiber diet helps lower cholesterol levels.

The FDA took the action in response to a petition by the National Barley Foods Council, whose members produce the nation's estimated $864 million annual barley crop. A unit of Cargill Inc., the Minneapolis-based agribusiness, helped underwrite the cost of the petition, according to the council.

A daily run, a diet rich in almonds and other healthful foods and a stimulating environment -- all may keep aging brain cells in shape, according to research out Monday.

The animal studies presented here at the 35th annual Society for Neuroscience Meeting suggest that lifestyle measures such as exercise and diet might ward off age-related forgetfulness -- and maybe even provide a shield for Alzheimer's.

"We're now finding that diet and lifestyle measures can have profound effects on the brain," says Carl Cotman, a brain expert at the University of California-Irvine.

Most people experience mild memory problems as they get older, says Karyn Frick, a researcher at Yale. She wanted to see whether a daily workout could offer a mental edge, so her team took laboratory mice and gave them either a running wheel, challenging toys, or both a wheel and toys. After four weeks, the team gave the mice a memory test.

Middle-aged mice that ran daily, either with or without the toys, did much better on this test than mice that sat around all day. These mice showed the typical age-related problems with memory, she says.

Older mice got a performance boost by running, playing or by doing both. Other studies suggest that a daily workout and mental stimulation might provide the aging brain with a cognitive reserve, new brain cells that kick in to help with memory.

If this study's findings translate to humans, and that's a big if, a daily workout, a crossword puzzle or both might help keep the aging human brain in top form, Frick says.

Previous studies have also suggested that a low-fat diet or one rich in certain foods like fish might help keep the brain healthy. A report at this meeting suggests that almonds might be another potent brain food.

Neelima Chauhan at the University of Illinois-Chicago gave mice with an Alzheimer's-like disease an almond-rich diet. The animals had already developed some of the abnormal brain deposits thought to underlie the disease. After four months, the team gave the mice a memory test.

Animals eating the almond-rich diet did much better than those fed the usual chow. Chauhan says almonds contain substances that act like cholinesterase inhibitors, drugs used to treat Alzheimer's.

The diet also reduced the number of Alzheimer deposits in the rodent brains.

Mice got that benefit by eating a relatively small amount of almonds -- the equivalent of about a handful daily. Almonds may not be able to help people suffering from advanced disease, Chauhan warns. Still, there's no harm in adding almonds to a healthy diet. In fact, such a diet may protect against memory loss, she says.

A landmark Canadian study is urging earlier and more aggressive treatment of type 2 diabetes, a disease that affects two million Canadians and may affect three million by the end of the decade. The Diabetes in Canada Evaluation (DICE) study, released yesterday, has found that one out of two Canadians who have type 2 diabetes do not have their blood-sugar levels and their disease under control

Ovarian cancer could be diagnosed earlier in some women if more doctors conducted simple tests that can, with limited reliability, detect the often fatal disease, researchers at UC Davis have concluded.

Often called the "silent killer," ovarian cancer in fact does produce symptoms, but they are vague and hard to distinguish from other, far more common ailments. That has made the disease deadlier than others because most often it is caught too late.

"Ovarian cancer is very treatable if it can be found early," said Dr. Lloyd Smith, who specializes in gynecological cancers at Davis and conducted the research. "When it is confined to the ovaries, survival is 85 to 90 percent after five years."

But 75 to 80 percent of cases are found when the disease has spread, he said, reducing the five-year-survival rate to just 15 to 20 percent.

Smith examined the Medicare claims of 1,985 California women ages 68 and older who had ovarian cancer, and compared them to women diagnosed with breast cancer and women without cancer.

He found that women diagnosed with ovarian cancer were far more likely to have complained prior to their diagnosis of bloating, gas, a feeling of fullness, abdominal pressure and pelvic pain -- all symptoms of ovarian cancer -- than the other patient groups.

The findings, published in Monday's online edition of the journal Cancer, represent the first objective analysis of ovarian cancer symptoms. Earlier studies relied on the subjective recollection of symptoms by patients already diagnosed with ovarian cancer. The authors examined specific symptom codes submitted to Medicare by doctors.

"The take-home message here is that if patients are complaining of significant symptoms, they may be indicative of an ovarian malignancy, and they should perhaps be taken more seriously than they have been in the past," said Robert Smith, director of cancer screening for the American Cancer Society, who is not related to Lloyd Smith, the study author.

Ovarian cancer advocacy groups Monday said the findings give credence to what they have known for years: that ovarian cancer is not silent, but that it can cause miserable symptoms for up to a year and that tests need to be done within weeks of symptoms, not months.

"This study tells me there is still a lot of education that needs to be done," said Dr. Judith Wolf, a gynecological oncologist at the University of Texas M.D. Anderson Cancer Center and head of the medical advisory board at the National Ovarian Cancer Coalition.

Internal medicine and family practice doctors typically rule out gastrointestinal ailments before considering a test for ovarian cancer, said Smith, the UC Davis researcher.

"It's very difficult to make a diagnosis of ovarian cancer," he said. "I don't think it's that doctors aren't looking for it.

It doesn't point to itself. It's a rare disease."

A doctor may, for example, order a colonoscopy or even a costly CT scan for a woman complaining of unexplained abdominal problems.

But Smith's research found that while tests to target ovarian cancer symptoms were frequently used within three months prior to diagnosis of ovarian cancer, relatively few patients were given them earlier, when the disease is most curable.

Specifically, the study found that four in 10 women with ovarian cancer tell their doctors about symptoms at least four months -- and up to a year -- before being diagnosed.

Although there is no screening test for ovarian cancer as there are for other malignancies such as the Pap smear for cervical cancer and mammogram for breast cancer, two tests are useful in diagnosing ovarian cancer and deciding how to approach treatment.

One is pelvic imaging, in which technicians use ultrasound to look for abnormalities in the shape of the ovaries. The other is a blood test, called CA-125 which detects proteins that show up in higher concentrations when certain cancers are present.

Unfortunately, imaging can produce false negatives and positives, which can lead to an unnecessary surgery, the researcher said. The blood test detects only about half of early stage ovarian cancers and 80 percent of later stage disease.

Specialists typically use both tests to get a firm diagnosis.

Smith, the UCD researcher, emphasized that the tests should not be used as screening tools, but only to diagnose cases when symptoms have persisted and other potential causes are ruled out.

For the first time, researchers have established how much exercise women should be able to do for their age and found that their capacity is slightly lower than men's. It also declines a bit faster than men's as they grow older.

Women whose exercise capacity was less than 85 percent of what it should be were twice as likely to die within eight years, the researchers found.

Until now, the only guidelines available were based on men and it wasn't certain whether they applied to women as well. But as more women are being included in medical research, gender differences in some diseases and other health issues are emerging.

The researchers found that to be true for fitness levels. They used the results of 5,721 exercise stress tests on women over 35 to figure out what should be considered normal for them compared to the established fitness levels for men.

"In general, women's fitness levels seem to be lower regardless of her age than for men," said Dr. Martha Gulati, a Chicago cardiologist who led the study.

While fitness declines with age for everyone, the research showed the difference between men and women becomes more pronounced with age, she said. Women lose about 1 percent of their exercise capacity per year, their study found.

"Given that we live longer, it just emphasizes the importance of fitness for women," said Gulati, who along with a fellow researcher has a patent pending for the fitness guidelines.

Their findings are reported in Thursday's New England Journal of Medicine.

Treadmill stress tests are routinely used to diagnose heart disease, often after someone complains of symptoms such as chest pains or shortness of breath. The heart's activity is monitored while the person walks on the treadmill. The tests cost about $900 at Northwestern Memorial Hospital where Gulati works.

The 5,721 Chicago area women who took the treadmill test in 1992, however, didn't have any symptoms or history of heart problems. They were given a standard stress test with the speed and incline of the treadmill increased every three minutes until they became tired or had other problems.

Their exercise capacity was estimated in metabolic equivalents (METs), based on the speed and grade of the treadmill. One MET is the amount of energy or oxygen used to sit quietly for a minute. Moderate walking burns 3 to 6 METs per minute; running consumes more than 6 METs.

Using data from the volunteers, the researchers came up with a formula to determine the normal fitness level for women. A 50-year-old woman, for example, should be able to reach 8.2 METs. For a 50-year-old man, the predicted exercise capacity is 9.2 METs, based on a different equation.

Although stress tests are relatively inexpensive, Gulati said it isn't necessary to have one to find out what MET level you are achieving. Exercise machines at health clubs do the calculation automatically.

"All of them spit out how many METs you're doing depending on how hard you're working," she said. "A lot of people don't know what it means."

Dr. Gerald Fletcher, a cardiologist at the Mayo Clinic in Jacksonville, Fla., and a spokesman for the American Heart Association, said the guidelines for women will help doctors encourage patients with poor fitness levels to get more exercise to reach their expected MET level.

"Overall, I think this is a very good guideline to be done carefully in people who are not at high risk," he said.

Gulati and her colleagues also tested their fitness equation to see how well it predicted survival during the eight years the volunteers were followed and in another group of 4,471 women with heart-disease symptoms who were followed for five years.

In both groups, women who did under 85 percent of their MET level had twice the risk of death compared to those who did more than 85 percent.

In an accompanying editorial, Drs. William E. Kraus and Pamela S. Douglas suggest that doctors should ask their patients about their exercise habits during each office visit and pay more attention to the fitness levels of those who have stress tests.

"We hope that this report will provide a stimulus to reintroduce fitness assessments into the routine clinical environment for both women and men," they wrote.

More dieters are ditching carb counts and biting into baguettes with gusto these days.

Some are eating like French women -- who never get fat, according to one best seller. Or they're taking their cues from celebrities like Suzanne Somers.

Some are counting the minutes between meals or checking a food's glycemic index. And old-school calorie counting continues to have its followers.

This week's bankruptcy filing by the late Dr. Robert C. Atkins' old company provide fresh evidence of the low-carb diet's demise, a downward spiral that began early last year. But no single new diet has filled the void.

Observers say the only sure thing -- given the boom-and-bust nature of weight-loss trends -- is that something will pop up eventually.

"There isn't one single strong contender," said Anne M. Russell, editor-in-chief of Shape magazine. "If you look at what the single largest trend is, it's weight gain."

Chapter 11 filings by Atkins Nutritionals Inc. on Monday came about a year and a half after books like "The Atkins Essentials" rode the best seller charts, bread makers were back on their heels and Burger King introduced a Whopper without a bun.

But Atkins has been in decline since February 2004, said Harry Balzer, a food industry analyst at market researcher NPD Group. Balzer claims Atkins was one of those demanding diets that simply ran its course, going from fad to fade like so many others before it, including the Scarsdale and the cabbage soup diets.

How far and how fast did Atkins fall? By September 2004, surplus low-carb products were being shipped to food banks in Appalachia.

"I'll try that bunless burger once. I might even try it twice," Balzer said. "But boy, that ketchup just doesn't stay on lettuce like it does on bread."

People who watch diet trends say there's a lull right now -- what Dr. Christine Gerbstadt of the American Dietetic Association calls a "slump in diet trends." Thus, new strategies are flourishing.

Low-carb might be waning, but no one should write its obituary just yet. About 2 percent of adults remain on a low-carb regimen, according to NPD. And The New York Times best seller list still includes "The South Beach Diet." That diet, which limits high-sugar carbs like white bread, has celebrity sizzle thanks to adherents like President Clinton.

Also on the Times' best seller list is "French Women Don't Get Fat," in which Mireille Guiliano argues that the French are able to eat croissants and chocolate without ballooning because they take time to savor flavors and eat judiciously.

On Amazon, the No. 18 book Tuesday was "The 3-Hour Diet" from Jorge Cruise, who recommends timing meals and snacks to lose weight. Also popular is "volumetrics," which promotes eating filling foods with fewer calories, like fruits and brown rice. Bookstore shelves are loaded with celebrity-endorsed diet plans like "Suzanne Somers' Slim and Sexy Forever."

Put it all together, and the advice can seem like a muddle. Nutritionists and fitness experts still stress a good way to keep weight off is to eat less and exercise more. Many point to recent government dietary guidelines, which emphasize fruits, vegetables and whole grains -- and watching calories.

"There'll always be some weird thing about eating four grapes before you go to bed, or drinking a special tea, or buying this little bean from El Salvador," said fitness guru Richard Simmons, who struggled with a series of fad diets as a portly youngster.

"If you watch your portions and you have a good attitude and you work out every day you'll live longer, feel better and look terrific," he said.

Regardless, Simmons agrees it's only a matter of time before a new diet trend takes hold.

"I wouldn't be surprised if we bounce back to another version of low-fat, which we had in the '80s," said Prevention magazine deputy editor Amy O'Connor.

O'Connor also sees a future for diets based on the glycemic index, a rating of how quickly carbohydrates are digested and rush into the bloodstream as sugar.

Balzer notes whole-wheat foods are making gains and trans-fat is a rising concern.

Ruth Kava, director of nutrition for the American Council on Science and Health, figures it might be something like a high-protein diet.

"Somebody will come up with something new," she said. "There's a lot of creativity out there in Diet World.

Obese men may not process carbohydrates as efficiently as obese women, a condition that can, ultimately, lead to a decrease in fitness level and the development of metabolic disorders. A new study published in the July issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians (ACCP), showed that severely obese men were more carbohydrate intolerant and had less physical endurance than severely obese women, leading researchers to believe that gender plays a strong role in physical fitness and a person's ability to metabolize carbohydrates.

"Carbohydrate intolerance, the inability to metabolize sugar found in carbohydrates, may lead to a buildup of fat deposits on muscle tissue, which can cause a person to gain weight and, eventually, impair physical endurance," said study co-author Emile F. L. Dubois, MD, PhD, FCCP, Department of Pulmonary Diseases, Hospital Reinier de Graaf Groep, Delft-Voorburg, Netherlands. "It appears that carbohydrate intolerance is more common in obese men, which would cause them to be less physically fit than obese women."

Researchers from Voorburg and Groningen, Netherlands, performed exercise capacity tests on 22 severely obese men and 34 severely obese women who were scheduled for bariatric surgery. Severe obesity was classified as a body mass index (BMI) of over 40, based on guidelines from the World Health Organization. Researchers also assessed patients for carbohydrate intolerance, according to American Diabetes Society Guidelines. Results showed that patients were similar in age and BMI, but 59 percent of men had overt diabetes or were carbohydrate intolerant, as compared to 35 percent of women. Researchers note that patients with carbohydrate intolerance usually suffer from metabolic syndrome, a group of medical conditions, including obesity, diabetes, and hypertension, that can lead to cardiovascular disease. However, an obese person who is carbohydrate intolerant may not present with other medical conditions typical of metabolic syndrome.

"Obese patients whose only medical condition is carbohydrate intolerance may be good candidates for bariatric surgery, although additional testing is needed to identify underlying risk factors, such as decreased physical fitness, which also may indicate the presence of metabolic syndrome and, therefore, reinforce the need for bariatric surgery," said study co-author Dave H. Schweitzer, MD, PhD, Department of Internal Medicine and Endocrinology, Hospital Reinier de Graaf Groep.

Further assessments revealed that women performed better on exercise endurance and related lung capacity tests than men. Researchers suggest that this finding may be explained by the different distribution of body fat in men, who typically have upper-body fat, compared to women, who typically have lower-body fat. The difference in fat distribution may lead to decreased "usable lung capacity" (vital capacity), which was seen predominantly in the men, and more difficulty breathing; however, the precise mechanism is not fully understood.

"It is possible that women are better equipped for energy storage due to their inherent need to feed their offspring," added Dr. Schweitzer. "When food is abundant, such as in modern society, both genders may become obese, but men simply do not have the reserve capacity to handle excess food, which puts extra stress on their bodies, causing decreased performance and, possibly, illness."

"Obesity can lead to impaired lung function, sleep disorders, cardiovascular disease, and other health conditions. Therefore, health-care providers should encourage their obese patients to lose weight and assist them in doing so in a healthful manner," said Paul A. Kvale, MD, FCCP, President of the American College of Chest Physicians.

A new study seems to suggest that low-fat diets can help prevent a return of breast cancer in certain women, but many specialists disagreed with the conclusions, saying other factors might have played a role.

The report created a buzz at the world's largest cancer meeting, the American Society of Clinical Oncology, where it was presented on Monday and immediately made headlines on television and the Internet.

Many previous studies have failed to find that cutting fat in the diet can prevent breast cancer, so some doctors urged caution in interpreting the new information.

"There are more questions than answers," said Dr. Eric Winer, director of breast care at the Dana-Farber Cancer Institute in Boston, who had no role in the study. "What we don't want to happen is for every woman who's had breast cancer to panic if she's had a Big Mac."

The study was funded by the National Cancer Institute and involved 2,437 women at 37 sites around the country. All had surgery followed by standard chemotherapy drugs for early-stage breast cancer and five years of tamoxifen if their tumors were estrogen-receptor positive -- that is, helped to grow by estrogen.

As a group, 29 percent of their calories came from fat, already far lower than the typical American who gets up to half of calories from fat, according to what the women told doctors at the outset of the study.

Doctors told 1,462 of them to continue their normal diets. The other 975 were given intensive counseling -- eight personal, biweekly sessions with a dietitian at the outset and follow-ups every three months -- to help them cut fat and track what they ate.

The low-fat group averaged 33.3 grams of fat a day compared to 51.3 grams for the others.

Five years later, the cancer had returned in 9.8 percent of those on the low-fat diet versus 12.4 percent of those on standard diets, said Dr. Rowan Chlebowski of Los Angeles Biomedical Research Institute, who led the study. This translated to a 24 percent lower risk for the group as a whole.

However, the only women who benefited were those whose tumors were not helped to grow by estrogen. These women had 42 percent lower risk of recurrence if they ate low-fat diets, but they accounted for just 1 out of 5 women in the entire study -- similar to breast cancer cases in the general population.

Results for the other 4 out of 5 women in the study did not reach statistical significance, meaning they could have occurred by chance alone -- a point the American Cancer Society noted in a statement posted on its Web site Monday.

The advice to follow a low-fat diet to prevent breast cancer "is not something that can be taken generally" from this study's results, said the cancer society's deputy medical director, Dr. Len Lichtenfeld.

Others noted that women in the low-fat group lost on average 4 pounds, and that many studies have linked excess weight to excess breast cancer risk. The low-fat dieters also likely ate more fruits and vegetables and less red meat -- other things known to lower breast cancer risk.

"It could be any or all of those components that make up a low-fat-dietary pattern" that actually caused the benefit, said Dr. Steven Clinton, a nutrition and cancer prevention expert at Ohio State University.

"We can't separate those components out," Chlebowski admitted.

One study participant whose cancer has not returned, 76-year-old Jean Miller of Columbus, Ohio, coupled the low-fat diet with more exercise.

"I still pay attention to my fat grams," she said. But she also now walks, rides an exercise bike, uses a treadmill and even has taken up country line dancing.

Studies also suggest exercise helps prevent breast cancer.

Breast cancer is the most common non-skin cancer in American women. About 213,000 new cases and 40,870 deaths are expected in the United States this year, and about 1.15 million cases and 411,000 deaths worldwide.

Trying to eat more fish for a healthy heart? Fish sticks don't count. So says a study suggesting only fish that's broiled or baked actually protects against heart disease.

Most fish served fried are types that contain only small amounts of omega-3 fatty acids, the healthy fat that can improve cholesterol and other cardiac risk factors, scientists reported Monday at a meeting of the American Heart Association.

"All fish meals may not be equal," said Dr. Dariush Mozaffarian of the Harvard Medical School.

A diet high in fish has long been linked with lower levels of heart disease, so much so that the heart association recommends two or more weekly servings -- especially of oily fish such as salmon and tuna that are particularly high in the omega-3 fatty acids. Those healthy fats are thought to increase the so-called good HDL cholesterol and lower unhealthy triglycerides.

Scientists suspect the omega-3s may play an even broader role, so lots of research is under way to better define how fish affects heart disease and just what people should be eating to get the benefit.

Mozaffarian examined ultrasound images of the hearts of 5,000 older Americans who were given a questionnaire about their diets. After accounting for other factors that play a role in heart disease -- including other foods -- he found that people who regularly consumed broiled or baked fish were more likely to have a lower heart rate and blood pressure, and better blood flow to the heart.

In contrast, those who regularly consumed fried fish or fish sandwiches showed signs of hardening arteries and other cardiac problems.

There was little evidence of omega-3s in the blood of the fried-fish lovers, probably because the fish species that usually are served fried are cod or other lean types that are much lower in omega-3 fats than fattier fish like salmon, Mozaffarian said.

Nor is deep-frying healthy.

The study advances scientists' understanding of how fatty fish affect the heart, said Dr. Jean Olson of the National Heart, Lung and Blood Institute, which funded it. For consumers, "the bottom line is, 'Eat more fish,'" she said

Eating a lowfat diet packed with nutritious vegetables, fruit, beans and whole grains reduces levels of "bad" cholesterol twice as much as eating a lowfat diet that's heavy on prepackaged foods, a small study has found.

The outpatient study consisted of 120 adults and lasted four weeks. Researchers said it suggests that -- at least in the short term -- there's more to healthy eating than counting fat grams and more to controlling cholesterol than medications.

"The effect of diet on lowering cholesterol has been really minimized and undermined by a lot of clinicians and researchers saying, 'Yes, it has an effect but it's really trivial. It would be better to put you on drugs to control your cholesterol,'" said Christopher Gardner, lead author of the study in Tuesday's Annals of Internal Medicine.

"But we think part of the reason was that we weren't really giving diet a fair shake. We were so focused on the negative -- just what to avoid and not what to include," said Gardner, director of nutrition studies at Stanford University's Prevention Research Center.

Half the test group followed a lowfat diet that included large quantities of plant-based foods -- vegetables, fruits, legumes, soy and whole grains -- and limited amounts of meat and dairy.

The other half followed a lowfat diet that included packaged foods like reduced-fat cheeses, lunch meat, frozen dinners, diet soda and fat-free cookies. Researchers described it as a more typical lowfat diet for U.S. consumers.

The two diets were identical in total fat, saturated fat, protein, carbohydrate and cholesterol content. The people were given enough food so that their weight stayed the same and they were not allowed to increase or decrease the amount they exercised.

After a month, the plant-based diet group's bad cholesterol dropped 9.4 percent, compared to the prepared-foods diet group's reductions of about 4.6 percent.

Earlier studies have shown that plant-based diets can lower cholesterol, Gardner said. But plant-based eaters generally consume less saturated fat and cholesterol than conventional lowfat eaters, and researchers wanted to see what happened when the fat and cholesterol levels were the same for both diets.

After one month, the people who ate the diet that was heavy on plant-based foods saw bigger improvements in levels of LDL -- low-density lipoprotein, or "bad" cholesterol -- than the people who ate prepackaged dinners and snacks.

Gardner was disappointed to discover that levels of triglycerides, another fat that contributes to heart disease, were essentially the same in both groups after four weeks. The reason is unclear, but exercise levels or the study's length might factor in, he said.

In an accompanying editorial, a nutritionist not connected with the research said plant-based diets, which appear to have many benefits like reduced risks of colon and heart disease, should remain a key strategy for improving cholesterol.

"The success of diets that combine foods containing cholesterol-lowering components may make diet relevant in the age of powerful drugs like statins," said Dr. David J.A. Jenkins of the University of Toronto's Clinical Nutrition and Risk Factor Modification Center.

The latest news on the Alzheimer's disease/exercise connection comes from a Johns Hopkins University study that found that the more varied the activities you engage in, the better off your mind will be in the long run. Researchers followed 3,375 men and women over the age of 65 from 1992 to 2000. During the study, they asked the participants how often they engaged in 15 different types of activities and how much time they spent doing each. Included were walking, household chores, lawn mowing, raking, gardening, hiking, jogging, biking, exercise cycling, dancing, aerobics, bowling, golfing, general exercise, and swimming. All told, 480 of the study participants developed some form of dementia. Those who engaged in only one type of activity or none at all accounted for 130 of the cases while those who did four or more of the activities accounted for only 84 cases. The study was published in the April 1, 2005 issue of the American Journal of Epidemiology.

Heavy consumption of processed meats such as hot dogs and sausages increases the risk of developing pancreatic cancer, according to a study of nearly 200,000 men and women in Hawaii and Southern California.

Those who consumed the greatest amount of processed meats had a 67 percent increase in risk over those with the lowest consumption. A diet rich in pork and red meat also increased pancreatic cancer by about 50 percent, according to the study.

Results of the study were presented earlier this week at the annual meeting of the American Association for Cancer Research in Anaheim, Calif. The research was conducted by scientists from the University of Hawaii's Cancer Research Center and the University of Southern California.

The American Meat Institute disputed the study's claims in a statement Thursday, saying "processed meats are safe and wholesome foods that can be part of a healthy, balanced diet."

The Washington, D.C.-based group said the study has not been peer reviewed and contradicts previous studies.

"Unfortunately, this week's study is being reported in isolation from other peer-reviewed, published papers that conclude that higher meat consumption is not correlated with pancreatic cancer," the group said.

The study showed no heightened pancreatic cancer risk with eating poultry, fish, dairy products or eggs -- nor did overall intake of total fat, saturated fat or cholesterol cause additional risk.

"The results suggest that carcinogenic substances related to meat preparation, rather than their inherent fat or cholesterol content, might be responsible for the association," lead investigator Ute Nothlings said. "From our study, it seems it's not the fat."

Processing of the meats causes chemical reactions, which could produce carcinogens such as heterocyclic amines or polycyclic aromatic hydrocarbons, scientists said.

"The sample size allowed us to obtain statistically significant risk estimates" to support the findings, Nothlings said.

Nothlings said researchers are continuing to study the relationship between the preparation of the processed meats and cancer risk.

Researchers examined 190,545 men and women in Hawaii and Southern California of various ethnic backgrounds, including black, Caucasian, Asian, Latino and native Hawaiian starting in the early 1990s.

Participants in the study were given questionnaires between 1993 and 1996 to determine eating habits. The study followed those who took the surveys for an average of seven years, yielding 482 cases of pancreatic cancer, the study said.

There were roughly 32,000 new cases of pancreatic cancer in the United States in 2004, Nothlings said.

Eating while multitasking, whether working through lunch or watching TV while eating dinner, often leads us to eat more. On the other hand, eating "mindfully," savoring every mouthful, enhances the experience of eating and keeps us aware of how much we take in.

Our fast-food culture is one where meals have become yet another task we squeeze in during the day. It is all too common to hear of people grabbing breakfast on the run or attending a lunch meeting, where business is front and center and food is merely the bait to get people there.

Adults in the United States devote an average of 1 hour and 12 minutes per day to eating, yet spend between 2½ and 3 hours per day watching television. Our kids are rushed, too. Studies have shown that school lunch periods provide an average of seven to 11 minutes for students to consume their lunch.

The speed at which we eat isn’t the only problem. As a nation of multitaskers, we often pair eating with other activities, such as driving or working at our desks. It is rare that we’re simply eating when we’re eating. In fact, 66% of Americans report regularly eating dinner in front of the television. With obesity at epidemic proportions, it is essential that we take a closer look at not just at what we eat, but how we eat.

The Effects of Mindless Eating

It may come as a big surprise to learn that “mindless” eating, or eating without awareness, can have negative health consequences. Scientists are beginning to evaluate and better understand the complex role of the mind-body connection in eating behavior. It turns out that when our mind is tuned out during mealtime, the digestive process may be 30% to 40% less effective. This can contribute to digestive distress, such as gas, bloating and bowel irregularities.

Gas and bloating aside, overeating and obesity are perhaps the most significant health problems caused, at least in part, by mindless eating. The mind-body connection plays a pivotal role in our ability to accurately assess hunger and fullness.

While the precise mechanisms of hunger and fullness are not completely understood, we do know that the brain and central nervous system receive signals from the body when food is desired or needed. These signals can be caused by many triggers, including psychological states such as our mood. Once eating is under way, the brain has a key role to send out a signal when fullness is approaching. If the mind is “multi-tasking” during eating, critical signals that regulate food intake may not be received by the brain. If the brain does not receive certain messages that occur during eating, such as sensation of taste and satisfaction, it may fail to register the event as “eating.” This scenario can lead to the brain’s continuing to send out additional signals of hunger, increasing the risk of overeating.

How to Practice Eating Mindfully

Eating mindfully means eating with awareness. Not awareness of what foods are on your plate, but rather awareness of the experience of eating. Mindful eating is being present, moment by moment, for each sensation that happens during eating, such as chewing, tasting and swallowing. If you’ve ever practiced mindfulness in any way, (such as meditation, relaxation or breathing exercises) you are familiar with how easily our minds wander. The same happens when we eat. When you begin to practice mindful eating, one important thing to remember is not to judge yourself when you notice your mind drifting off the experience of eating. Instead, just keep returning to the awareness of that taste, chew, bite or swallow. If this concept is new, try the following exercise.

Do this exercise with a friend. You will need one small slice of an apple for each person. One person reads the instructions listed below while the other person completes the exercise.

Take one bite of an apple slice and then close your eyes. Do not begin chewing yet.

Try not to pay attention to the ideas running through your mind, just focus on the apple. Notice anything that comes to mind about taste, texture, temperature and sensations going on in your mouth.

Begin chewing now. Chew slowly, just noticing what it feels like. It’s normal that your mind will want to wander off. If you notice you’re paying more attention to your thinking than to the chewing, just let go of the thought for the moment and come back to the chewing. Notice each tiny movement of your jaw.

In these moments you may find yourself wanting to swallow the apple. See if you can stay present and notice the subtle transition from chewing to swallowing.

As you prepare to swallow the apple, try to follow it moving toward the back of your tongue and into your throat. Swallow the apple, following it until you can no longer feel any sensation of the food remaining.

Take a deep breath and exhale.

The point of this exercise is not to suggest all your meals be consumed as meticulously as this experiment. Rather, by doing this exercise you may discover some things about your own eating habits. Some people find value in doing a shorter version of this exercise with the first bite of each meal. This helps set an intention of being mindful through the course of your meal. Listed below are a few other suggestions for introducing mindfulness while eating. Try them and see what you discover!

Simple first steps toward introducing mindfulness while eating:

Eat with chopsticks.

Eat with your non-dominant hand.

Chew your food 30 to 50 times per bite.

Eat without TV, newspaper or computer.

Eat sitting down.

Put the proper portions of food on your plate and try to make the meal last at least 20 minutes.

Researchers report that happiness may be related to the functioning of the body in key processes, such as those of the cardiovascular system and those controlling hormone levels.

Previous studies have shown that depressed people often have more health problems, while happier people tend to live longer. Yet the mechanism of these effects has been unclear.

To look more closely at this psychobiological connection, Andrew Steptoe and colleagues studied emotions and health of more than 200 middle-aged Londoners in their daily lives. The authors found that those who reported more everyday happiness had healthier biological functions in a few key systems.

For one, the happier subjects had lower levels of cortisol, a stress hormone related to conditions such as type II diabetes and hypertension.

Happier individuals also showed lower responses to stress in plasma fibrinogen levels, a protein that in high concentrations often signals future problems with coronary heart disease.

Finally, happy men had lower heart rates over the day and evening, which suggests good cardiovascular health.

These results were independent of psychological distress, the authors say, which implies that positive well-being is directly related to the biological processes relevant to health.

Here’s something to add to health habits aimed at reducing your breast cancer risk: eat more beans and lentils.

A report published in the International Journal of Cancer suggests that beans and lentils can really make a difference. Researchers at the Harvard School of Public Health analyzed data from more than 90,000 women who participated in the Nurses Health Study II, which follows women who had not reached menopause when the study began in 1991. Over the course of an eight-year follow up, 710 of the women developed breast cancer. In reviewing the data the researchers found that women who ate beans or lentils at least once a week were 24 percent less likely to develop breast cancer than those who consumed these foods less than once a month.

The authors had been looking for a link between breast cancer risk and consumption of flavonols, compounds which are found in such foods as berries, grapes, parsley, spinach, onions, apples and broccoli, but no such association emerged from their analysis. Instead, they discovered a lower risk of breast cancer associated with dietary intake of beans and lentils.

Lowfat diets might be fine for adults, but at least one small study suggests grown-ups using that approach for their families could be depriving young children of vitamins they need.

University of Nebraska-Lincoln nutrition scientist Judy Driskell said her recent study of preschool children living in Lincoln found two-thirds of them lacking the recommended levels of vitamin E and one-third short on vitamin C -- a finding attributed mainly to parents sharing their eating habits with their children.

"Parents are eating a lot of lowfat and nonfat products, and we're finding they also give their children such things as skim milk," Driskell said. "The lowfat diet is probably associated with their being low in vitamin E."

Some child nutrition experts expressed shock at the study's findings, noting that vitamin deficiencies -- particularly of vitamin C -- are considered uncommon in the United States.

"It doesn't take that much fresh fruit intake ... to get a recommended daily allowance of vitamin C," said Dr. Terrill Bravender, director of adolescent medicine at Duke University Medical Center in North Carolina.

Bravender also noted debate in the medical field about how much vitamin E is needed for good health, particularly for young children.

Driskell and colleagues from the university's Institute of Agriculture and Natural Resources tested major antioxidant vitamin levels, which include vitamins and C, in children ages 2-5 at four Lincoln day care centers. They tested blood samples from 22 ethnically diverse boys and girls -- the only ones whose parents gave permission for the study.

The ideal levels of vitamins E and C were based on recommendations by the National Academy of Sciences and adjusted by Driskell for children. What the UNL researchers found was that many suffered borderline deficiencies.

"Their blood values were low, but the children did not have deficiency symptoms that would affect skin, eyes, and that kind of thing," Driskell said. "They were at the point that they could be treated using food or vitamin supplements."

Parents of the children also were interviewed about their children's diets.

Besides the parents' tendency to give the children lowfat foods, researchers found day care centers serving potato chips and other unhealthy snacks, Driskell said. Some centers reported avoiding serving fresh fruit for fear the children might suffer food allergies, she said.

Nutritionists recommend young children regularly have whole milk, nuts and seeds, regular salad dressings, and whole-grain cereals fortified with vitamins to get vitamin E. They also recommend regular consumption of fresh fruits and vegetables and small amounts -- 3 to 6 ounces -- of citrus juice.

But some like Dr. Lilian Cheung at the Harvard School of Public Health disagreed with Driskell's suggestion that children take a multivitamin, noting that supplements can't replace foods rich in vitamins and minerals.

Bravender also challenged Driskell's recommendation for children to drink fruit juice, noting that fresh fruits and vegetables provide vitamin C without the high number of calories found in juice.

"The major public health epidemic that's facing our country right now is childhood obesity, not vitamin C deficiency," Bravender said.

Peanuts, a dietary outcast during the fat-phobic 1990s, have made a comeback, with consumption soaring to its highest level in nearly two decades and more doctors recommending the nuts as part of a heart-healthy diet.

When consumption of peanut butter and snack peanuts plummeted as Americans switched to lowfat diets, the peanut industry responded with studies showing the health benefits of peanuts. "Mothers gave us peanuts and peanut butter. Now, we've figured out that mom was right. But it took a lot of researchers and universities to figure that out," said Don Koehler, executive director of Georgia's Peanut Commission.

The campaign apparently worked. Total consumption of peanuts jumped last year to nearly 1.7 billion pounds, 9.2 percent higher than the 1.5 billion pounds consumed the year before. The federal government's latest dietary guidelines now acknowledge that peanuts, which contain monounsaturated and polyunsaturated fat, can be consumed in moderation.

"Now we know that the type of fat found in peanuts is actually good for us," said Lona Sandon with the American Dietetic Association. "It doesn't clog our arteries like saturated fat. It helps keep the arteries clean." But that's only if peanuts are consumed "in moderation," and that's the part that often trips up peanut lovers. There are 14 grams of fat in one serving of peanuts, which is only one ounce. And a handful can have up to 200 calories.

"The problem is that the portions need to be low so you don't overconsume the calories, that's where the public has a disconnect," said Madelyn Fernstrom, director of the Weight Management Center at the University of Pittsburgh Medical Center. "It's a well spent 200 calories if you can limit it to that. The problem is volume. It's very hard to have a small serving of peanuts, meaning a small handful."

What American consumers seemed to overlook in the 1990s is that the humble peanut contains a respectable list of nutrients vitamin E, niacin, thiamin, riboflavin, vitamin B6, and essential minerals such as copper, phosphorous, potassium, zinc and magnesium. They also are a good source of fiber and protein. Peanuts also contain a small amount of resveratrol, the antioxidant in red wine that has been linked to the "French Paradox" a low incidence of heart disease among the French, despite their love of cheese and other high-fat foods.

Research at Penn State University, Harvard Medical School, Purdue University and the University of Florida have shown that peanuts may help prevent heart disease, that they can lower bad cholesterol and that they can help with weight loss, possibly by making people feel satisfied so they eat less overall. One of the Harvard studies showed an association between peanut butter consumption and a reduced risk of diabetes. Even the U.S. Food and Drug Administration has authorized a qualified health claim for peanuts and some tree nuts. Producers can say they may reduce their risk of heart disease by eating 1 1/2 ounces daily.

"It's good news that people are realizing that some fat is OK and fat in moderation can even work well with a weight management program," a researcher said. "The fats in peanuts are healthy fats. ... It all comes back to balance and moderation."

Some people say that the latest Dietary Guidelines for Americans from the U.S. Department of Agriculture ask too much. Yet these guidelines explain what we want to know: How we can avoid nutritional deficiencies, promote our health and decrease the risk of chronic diseases like cancer and heart disease.?

Since the majority of our population is overweight and lifestyle-related diseases take a larger toll in North America than in many other Western nations, we need to make significant changes in our eating and exercise habits to meet the new guidelines. But do we have to make ourselves miserable, as some claim?

Some people who have tried adjusting their diets to the new guidelines complain of hunger. But hunger usually results from only partially following the guidelines.

If you cut back on meat portions and nutrition-poor desserts and snacks and forget to eat more hunger-satisfying fruits, vegetables, whole grains and beans, hunger is a possible consequence. When people fully implement the whole new style of eating, their hunger tends to be completely satisfied. Trying to eat more vegetables and fruits, however, is a formidable barrier for many people.

After more than ten years of hearing the “five-a-day” message, the average consumption of produce is no closer to that target. At the same time, research has revealed important benefits to virtually every aspect of health from the substances in these plant foods. The new guidelines set a target to aim for: 7 to 10 servings a day for the average adult.

People who wait until dinner to eat any fruits and vegetables will almost surely fail to meet this target. An easy way to succeed is to adopt habits that make vegetables and fruits part of every meal and snack. For the average American, that will mean eating two more pieces of fruit and one more cup of vegetables each day. By choosing fruit instead of chips or cookies for a snack or dessert, including fruit at breakfast, and adding a vegetable at lunch, the typical person can fulfill the new recommendations.

Trying to eat three or more servings of whole grains each day may seem like another major hurdle for some people, especially since the average American now gets only one. But the goal is to replace refined grains with whole-grain products and decrease the consumption of refined grains by two or three servings. Don’t try to eat whole grains on top of what you already eat. Good replacements are choosing whole-grain cereals, using whole-grain breads for sandwiches, ordering brown rice or whole wheat pasta, or purchasing whole-grain crackers. For a snack instead of cookies, try whole-grain cereal or popcorn. Instead of a doughnut for breakfast, grab a whole-wheat English muffin.

Complete change of habits Some people mistakenly think that the guidelines require complex calculations. You can eat healthfully without any calculations and still meet the guidelines. Simply follow the New American Plate eating style advocated by the American Institute for Cancer Research. Start by limiting animal protein to one-third of your plate or less at each meal. Fill the rest of your plate with plant foods: vegetables, fruits, whole grains and beans. Your plate should have at least a cup to a cup-and-a-half of vegetables and fruits. If you always opt for low-fat meat and dairy choices and low-sugar drinks and snacks, you won’t have to calculate how to make up for less-nutritious choices.

And if you eat portions just large enough to satisfy your hunger, you won’t have to count calories. The new guidelines ask a lot of us: Eating for good health and disease prevention may be best accomplished with a complete change of habits. But we should be happy to embrace this change. The typical food choices of an American, the overwhelming portions and sedentary lifestyles are keeping us from living the healthy lives we could have.

Can animal genes be jammed into plants? Would tomatoes with catfish genes taste fishy? Have you ever eaten a genetically modified food? The answers are: yes, no and almost definitely. But according to a survey, most Americans couldn't answer correctly even though they've been eating genetically modified foods -- unlabeled -- for nearly a decade.

"It's just not on the radar screen," said William Hallman, associate director of the Food Biotechnology Program at the Rutgers Food Policy Institute, which conducted the survey.

Today, roughly 75 percent of U.S. processed foods -- boxed cereals, other grain products, frozen dinners, cooking oils and more -- contain some genetically modified, or GM, ingredients, said Stephanie Childs of the Grocery Manufacturers of America. Despite dire warnings about "Frankenfoods," there have been no reports of illness from these products of biotechnology. Critics note there's no system for reporting allergies or other reactions to GM foods.

Nearly every product with a corn or soy ingredient, and some containing canola or cottonseed oil, has a GM element, according to the grocery manufacturers group. In the Rutgers survey, less than half the people interviewed were aware GM foods are sold in supermarkets. At the same time, more than half wrongly believed supermarket chicken has been genetically modified.

So far, non-processed meat, poultry, fish and dairy products, and fruits and vegetables (both fresh and frozen) are not genetically modified.

GM food first hit supermarkets in 1994, with the highly touted Flavr Savr tomato, altered to give it a longer shelf life and better flavor. It flopped, in part due to disappointing taste, and disappeared in 1997, said Childs. By 1995, farmers in several countries had planted millions of acres of GM corn and soybeans, and processed products containing them were in grocery stores.

Genetic modification of crops involves transferring genes from a plant or animal into a plant. Nearly all GM changes so far are to boost yields and deter insects and viruses, cutting the use of pesticides, thus making farming more productive and affordable -- a particular aid to developing nations.

More than 80 percent of the soy and 40 percent of the corn raised in this country is a GM variety. Global plantings of biotech crops -- mostly corn and soybeans and much of it for animal feed -- grew to about 200 million acres last year, about two-thirds of it in the United States.

The one billionth acre will be planted this spring, according to the Biotechnology Industry Organization. Experts say within several years there will be new GM foods with taste and nutrition improvements: cooking oils with less trans fat, tastier potatoes and peanuts that don't trigger allergies.

At North Carolina State University, one of the biggest U.S. plant breeding programs, scientists are developing drought-tolerant wheat and are a couple years from field testing GM peanuts that have no life-threatening allergens, said Steven Leath, associate dean for health research. At Rutgers University's agricultural college, plant biology professor Nilgun Tumer and colleagues modified potatoes to better keep their flavor when processed as french fries and to limit browning when sliced, but she said farmers haven't adopted the new varieties. Now her team is trying to give tomatoes a gene to make a compound that helps prevent cancer and osteoporosis.

Lisa Lorenzen, a liaison to the biotech industry at Iowa State University, said most Americans haven't worried about GM foods because they trust the regulatory system. She said many Europeans oppose GM foods because they don't trust governments that wrongly insisted for years that the beef supply, tainted by mad cow disease, was safe.

Opponents say genetically modified foods could cause allergic or toxic reactions and harm the environment. Worries include the mixing of GM crops with regular ones either by handlers, or pollen -- already documented -- and GM foods being sold where they're not approved.

On Tuesday, a Swiss biotech company said it mistakenly sold U.S. farmers an experimental, unapproved GM corn seed, and tons of the resulting corn was sold between 2001 and 2004. U.S. government agencies say there was no health or environmental risk.

In 2000, recalls, lawsuits and public uproar followed disclosure that StarLink GM corn, approved only for animal use, had gotten into taco shells and chips. University plant scientists, industry, the Food and Drug Administration and numerous European science agencies say GM foods are safe. "Nobody's been able to prove that anyone's even gotten the sniffles from biotechnology," Childs said.

But Margaret Mellon of the Union of Concerned Scientists, said there's no system to track health problems caused by GM foods. Her group, along with the Center for Science in the Public Interest, has long pushed for labeling -- only required when GM products have properties different from ordinary foods, such as a higher nutrient content. They contend consumers deserve a choice if they want to avoid GM foods and they also want government regulation.

Currently, companies developing GM foods voluntarily send their data to the FDA, but there's no official approval before products go on sale. "It's left up to the good nature of Monsanto or DuPont or other companies to do the right thing," said Gregory Jaffe, director of the biotechnology project at CSPI.

The report, to be published Thursday in The New England Journal of Medicine, says the prevalence and severity of obesity is so great, especially in children, that the associated diseases and complications - Type 2 diabetes, heart disease, kidney failure, cancer - are likely to strike people at younger and younger ages.

The report, which wades into several controversial aspects of public health, is likely to stir debate on both scientific and political grounds. The health effects of being obese depend on many factors, like one's fitness level. And estimating these effects could alter the expected cost of medical care and the size of pension payouts.

The report says the average life expectancy of today's adults, roughly 77 years, is at least four to nine months shorter than it would be if there were no obesity. That means that obesity is already shortening average life spans by a greater rate than accidents, homicides and suicides combined, the authors say.

And they say that because of obesity, the children of today could wind up living two to five years less than they otherwise would, a negative effect on life span that could be greater than that caused by cancer or coronary heart disease.

"Obesity is such that this generation of children could be the first basically in the history of the United States to live less healthful and shorter lives than their parents," said Dr. David S. Ludwig, director of the obesity program at Children's Hospital Boston, and one of the authors of the report. "We're in the quiet before the storm," Dr. Ludwig said. "It's like what happens if suddenly a massive number of young children started chain smoking. At first you wouldn't see much public health impact." He added, "But years later it would translate into emphysema, heart disease and cancer." "There is an unprecedented increase in prevalence of obesity at younger and younger ages without much obvious public health impact," Dr. Ludwig said. "But when they start developing heart attack, stroke, kidney failures, amputations, blindness, and ultimately death at younger ages, then that could be a huge effect on life expectancy."

Longevity projections are notoriously slippery and politically charged, with consequences for issues like Social Security, pension plans, health insurance and health care costs. Some demographers and obesity experts question whether the authors' estimate is alarmist.

"Yes, it is almost certain that the risks of these various diseases will rise as obesity rises in the population, but you also have to assume that the medical sciences will get better at treating some of these complications," said Dr. Rudolph L. Leibel, an obesity researcher at Columbia University. "Certainly doing that is going to end up costing more, but it may not end up stripping months or years off life."

An editorial in the same issue of The New England Journal, written by Dr. Samuel H. Preston, a demographer at the University of Pennsylvania, raises similar questions. It suggests that the predictions of decreased life expectancy might be "excessively gloomy," given potential advances in medicine and genetic engineering, and the reduction of harmful behaviors like smoking.

Dr. Preston concludes, however, that "the rising prevalence and severity of obesity are capable of offsetting the array of positive influences on longevity."

The report's lead author, Dr. S. Jay Olshansky, a professor of public health at the University of Illinois, Chicago, said he considered the report's projections of reduced life expectancy to be "very conservative, and I think the negative effect is probably greater than we have shown."

"Hopefully, we can fix obesity so that our projections are wrong," Dr. Olshansky added. "But we're seeing such large increases in obesity in the last couple of decades that it's hard to imagine that we're going to be able to work fast enough."

Estimating the number of obesity-related deaths is controversial, too. Last November, the Centers for Disease Control and Prevention said its earlier estimate that 400,000 people die annually from obesity was inflated. A revised, lower estimate is expected soon. The New England Journal report uses an estimate of 300,000 deaths, which some experts contend is still too high.

The report projected life expectancy by calculating how much longer people would live if "everyone who is currently obese were to lose enough weight to maintain an optimal" body-mass index, a measure of the relationship between a person's height and weight. The authors believe it is more accurate than other projections.

The report comes at a time when the country is embroiled in a debate over Social Security. While the report's authors say they started their research long before the current debate, they write that "the U.S. population may be inadvertently saving Social Security by becoming more obese" and dying sooner, but that "this 'benefit' will occur at the expense of the economy in the form of lost productivity before citizens reach retirement and large increases in Medicare costs associated with obesity and its complications."

But Dr. Rolf Halden of the Johns Hopkins School of Public Health said another substance that gives many plastics their flexibility, called plasticizers, can migrate into food in small amounts.

Plasticizers, unlike dioxins, are not known to be toxic. To be on the safe side, however, the Food and Drug Administration recommends that consumers use only plastic containers or wraps specifically intended for microwaves (usually indicated on the product or packaging). Further, they should never put fast-food trays or margarine tubs in the microwave and should avoid reusing TV dinner dishes.

When covering a container with plastic wrap, Dr. Halden said, always leave a little room between the food and the wrap before heating it. "Plasticizers won't kill you," he said. "But why expose yourself to any chemicals you can easily avoid?"

THE BOTTOM LINE Plastic wraps and containers will not expose you to dioxins, and they are safe in the microwave when used properly.

David Jenkins of St. Michael's Hospital and the University of Toronto and colleagues created what they called a diet "portfolio" high in soy protein, almonds, and cereal fiber as well as plant sterols -- tree-based compounds used in cholesterol-lowering margarines, salad dressing and other products.

They tested their diet on 34 overweight men and women, comparing it with a low-fat diet and with a normal diet plus a generic statin drug, lovastatin. Each volunteer followed each regimen for a month, with a break in between each treatment cycle. Writing in the American Journal of Clinical Nutrition, Jenkins and colleagues said the low-fat diet lowered LDL -- the low-density lipoprotein or "bad" cholesterol -- by 8.5 percent after a month. Statins lowered LDL by 33 percent and the "portfolio" diet lowered LDL by nearly 30 percent.

The portfolio was rich in soy milk, soy burgers, almonds, oats, barley, psyllium seeds, okra and eggplant. The Almond Board of California helped fund the study, as did several food makers and the Canadian Natural Sciences and Engineering Research Council of Canada. They also included a plant sterol margarine product. Several of these have been proven to lower cholesterol.

The researchers said nine volunteers, or a quarter of the group, got their lowest LDL levels from being on the portfolio diet. The volunteers all felt full on the diets although the "portfolio" diet resulted in more bowel movements, the researchers said.

A growing body of science is linking sweet drinks, natural or otherwise, to a host of child health concerns, everything from bulging bellies to tooth decay.

"All of these beverages are largely the same. They are 100 percent sugar," Dr. David Ludwig, an expert on pediatric obesity at Children's Hospital Boston, said recently. "Juice is only minimally better than soda."

The trouble is that parents who are quick to limit a child's soft drink consumption often overlook or even encourage juice indulgence thanks to the beverage's good-for-you image. But that image can be overstated. Though healthy in moderation, juice essentially is water and sugar. In fact, a 12-ounce bottle of grape soda has 159 calories. The same amount of unsweetened grape juice packs 228 calories.

The $10 billion juice industry maintains that a conclusive link between its products and obesity has yet to be established, but researchers say sugar is sugar, and sweet drinks of any kind must be consumed with care. Overuse of juice is a relatively recent phenomenon. Before the rise of soda, juice and other sweetened drinks during the latter half of the 20th century, water and milk were children's primary beverages. In a nation where nearly a third of children are either overweight or at risk of becoming overweight, health officials now say high-calorie beverages have little place in a young child's diet.

"With the possible exception of milk, children do not need any calorie containing beverages," Ludwig says. "What is needed to replace fluid loss and satisfy thirst is the same beverage we've been drinking for millions of years, and that's water." The danger of juice is that too much can throw off the balance of calories and nutrients children need, according to Dr. Terrill Bravender, director of adolescent medicine at Duke University Medical Center. In very young children, too much juice cuts the appetite for nutritionally superior breast milk or formula. In older children, it often supplements other foods, potentially adding hundreds of excess calories.

Part of the problem is that the calories in juice are so concentrated. Just half a cup (4 ounces) of apple juice has 60 calories, the same as a whole apple, but without the fiber that makes fruit filling.

While juice can be a healthy way to occasionally get picky children to consume more fruit, researchers say using it too often can exacerbate bad eating habits by training kids to prefer -- and hold out for -- something sweet. Dr. William Dietz, with the division of nutrition and physical activity at the Centers for Disease Control and Prevention, says parents need to be firm -- thirst is satisfied with water, hunger with solid foods. Caloric beverages can blur that line.

Ludwig also is critical of juice marketing efforts, saying parents are easily misled into thinking they are making healthy choices. He was particularly critical of one bagged juice beverage's claim that it "hydrates kids better than water." "This is an example of how children's diets can be perverted by the unbridled actions of the food industry when it places private profit ahead of public health," he says.

"We were really surprised just how clear-cut the benefits is of using a combined therapy," lead investigator Bill Milgram, a psychology professor who specializes in aging research, said in a prepared statement.

He and his team studied the impact that four combinations of behavioral enrichment and supplementation of diet with antioxidants had on the learning ability of beagles over a period of two years. The first group of beagles received a regular diet and regular experience, the second group received a regular diet and enriched experience, the third group received an enriched diet and regular experience, and the fourth group received an enriched diet and enriched experience. The study found that providing enriched diet and enriched experience offered a statistically significant benefit.

"Since humans and dogs have many biological and behavioral parallels, I predict similar results would be attained in people," Milgram said.

What many don't realize is that lung cancer is the leading cancer killer of women, responsible for 27 percent of all cancer deaths, ahead of breast and colorectal cancer, according to the latest federal statistics. And women may be more susceptible to the disease than men, research suggests, a fact many women -- and their doctors -- may not realize.

"Lung cancer causes more deaths among women than breast, uterine and ovarian cancers combined, but I don't think this is on women's radar screens at all," said Dr. Jyoti Patel, an oncologist at Northwestern Memorial Hospital in Chicago, and a specialist in women's lung cancer. "Women who smoked when they were young, stopped 30 years ago and did all the right things since are underestimating their risk for lung cancer," added Patel, who co-authored an April 2004 report in the Journal of the American Medical Association on the risks of lung cancer in women.

That lack of awareness is often compounded by ill-informed doctors, she said. "When I was in medical school, we were taught that lung cancer is a disease for men 60 years and older who smoke, and most interns today still think that is typical," Patel said. The result: Many doctors don't talk to their female patients about the risks of lung cancer.

But the facts are quite different. More than one in four cancer deaths among women in 2003 were due to lung cancer. An estimated 70,000 women died from lung cancer in the United States, compared to approximately 39,000 women who died from breast cancer, according to the American Cancer Society. There are myriad reasons for both the prevalence of lung cancer among women and the high death rate from the disease, health professionals said.

The main culprit, predictably, is smoking. "If you ask me for the top 10 causes for lung cancer, I'd say nine of them are smoking," said Patel. Nearly one out of five women smoke, and many more are former smokers, she noted.

"The risk of developing lung cancer remains for 20 years after quitting, and then the risk drops by half," said Viviana Simon, director of scientific affairs for the Society for Women's Health Research, in Washington, D.C. But for women, there are other factors linked to the disease that are gender-based, she said.

Non-smoking women are more likely to get lung cancer than non-smoking men, Simon said. More women than men develop small-cell lung cancer, which is more aggressive than other lung cancers and harder to cure. There is some evidence that men's and women's hormonal differences could affect the course of the disease. And women, no matter what stage of lung cancer they have, live longer than men at the same stage of disease, she said. Yet there's little research into why these gender differences exist and what they could mean for treatment of the disease.

"Women who have smoked marginalize themselves," Patel said. This sense of guilt often leads them to be lax about their health care, and to think they're getting what they deserve. "I say to my patients that they made one bad choice, but I don't think anyone would say that one bad choice means they deserve cancer," she said.

"If women feel a lump in their breast, they go to the doctor quickly," she said, and the same sound approach should apply to lung cancer risk. Patel recommends paying attention to a cough. Coughs can signal lots of problems, from post nasal drip to a cold. But a cough that "changes character" in any way, in frequency or severity, means you should see a doctor. Similarly if you have shortness of breath, are awakened at night by coughing or have blood in your sputum, you should see a doctor and tell him about your concerns, she said.

Now, a new review of previously published studies claims that diet provides the protection.

"It's the diet itself, and it is clearly the diet of choice for people who want to get their blood pressure under control," said Dr. Neal D. Barnard, president and founder of the Physicians Committee for Responsible Medicine and co-author of the report, which appears in the January issue of Nutrition Reviews.

Barnard, a nutritionist and author of the book Breaking the Food Seduction: The Hidden Reasons Behind Food Cravings and Seven Steps to End Them Naturally, concluded that a person who suffers from hypertension and has yet to switch to a vegetarian diet is "really trying to fight their condition with one arm tied behind their back."

Barnard and committee nutritionist Susan Berkow analyzed 80 scientific studies, including observational studies of individuals on vegetarian diets compared with non-vegetarians and randomized, controlled trials in which outcomes of people who switch to a plant-based diet were compared with control subjects. "The purpose of our review was to bring together what is known about the effect of the diet, but also what we know about the mechanism and try to explain why this occurs," Barnard explained.

Overall, the randomized controlled trials included in the review found that blood pressure is lowered when animal products were replaced with vegetable products in both people with normal blood pressure and those who are hypertensive.

And because vegetarian diets are generally high in fruits and vegetables, people who follow this diet consume more potassium than those who eat a diet of meat and vegetables. The analysis cites two reviews involving a total of 52 randomized clinical trials showing potassium supplementation significantly lowered blood pressure in people with normal and elevated blood pressure.

There are those who disagree with the finding, however. Dr. Lawrence J. Appel, a nutrition specialist at the Johns Hopkins Bloomberg School of Public Health, said the paper fails to establish a clear cause-and-effect relationship between consuming a plant-based diet and lowering one's blood pressure. "It's a good review, but there are still unanswered questions," he said.

He said, it remains unclear whether a vegetarian diet alone is responsible for lowering blood pressure or whether some aspect of a vegetarian regimen -- such as eating lots of fruits and vegetables rich in potassium and fiber while maintaining a desirable body weight -- could have the same effect. And then there there is the fact that not everyone who has high blood pressure eats poorly or is overweight; genetic factors significantly influence a person's risk for hypertension.

Still, Barnard insists a vegetarian diet is healthy for everyone, whether or not they have high blood pressure. He offers this caveat for people taking blood pressure medication: "Don't throw your medication in the trash." High blood pressure is a serious medical condition requiring immediate medical attention. Even if you switch to a vegetarian diet to trim down, you won't lose the weight overnight, he said. It could take more than a year for a person who is 60 pounds overweight to drop that excess baggage. Barnard hopes the review will prompt more doctors to recommend a vegetarian diet. Many are reluctant to do because they fear that patients won't stick with it, but there's no reason to believe patients would be less likely to go vegetarian than to comply with other diets, he said.

Elaine Holmes, a chemist with the Imperial College London, and her team used German chamomile, also called manzanilla, whose flowers and leaves are brewed as a flavorful tea. Fourteen volunteers each drank five cups of the tea daily for two weeks.

"There have been many studies on the effects of individual ingredients of chamomile in animal models, but there have been very few studies on the effect of chamomile on human metabolism so far," Holmes said.

Daily urine samples were collected and tested before, during and after the study. A significant increase was found in urinary levels of hippurate, a breakdown product of plant-based compounds known as phenolics. Some of those have been associated with increased antibacterial activity, and this might explain why the tea seems to fight infections associated with colds, the researchers said.

Drinking the tea was also linked with an increase in urinary levels of glycine, an amino acid that has been shown to relieve muscle spasms. That might be why the tea seems to ease menstrual cramps, the researchers said. Glycine also can act as a nerve relaxant, perhaps explaining the tea's sedative value, they added.

Holmes' group found that the levels of both hippurate and glycine remained elevated for up to two weeks after the subjects stopped drinking the tea, so the compounds might work their magic for some time. Oxford Natural Products, a pharmaceutical, nutraceutical and technology company, funded the study.

The report appears in the Jan. 26 issue of the Journal of Agricultural and Food Chemistry.

In other research, scientists have found that tea may have anticancer properties and may help lower cholesterol, among other health benefits.

"Other types of tea may work as well," Holmes said. "We don't know as yet." The chamomile appears to be altering the gut microflora, which leads to an increase in urinary hippurate and glycine, she explained. "One of the most interesting findings was that the effect of the chamomile tea lasted at least two weeks after the volunteers had stopped drinking the tea," she noted.

The findings are probably a true reflection of the science, said Hasan Mukhtar, a researcher at the University of Wisconsin who has studied green tea and its role in stemming the spread of prostate cancer.

Lack of sleep changes the circulating levels of the hormones that regulate hunger, boosting appetite and a person's preference for high-calorie, high-carbohydrate foods, University of Chicago researchers report in the Dec. 7 issue of the Annals of Internal Medicine.

Echoing other recent research that has found a link between lack of sleep and the risk of weight gain, the new study is believed to be the first to show that sleep is a major regulator of the hormones leptin, which tells the brain when it doesn't need more food, and ghrelin, which triggers hunger. "That is the major finding, that we identified the mechanism by which sleep loss affects appetite. The changes in hunger are proportional to the changes in the hormones," said study author Eve Van Cauter, a professor of medicine at the University of Chicago.

For the study, Van Cauter and her colleagues measured the circulating levels of both hormones in 12 healthy men in their 20s. Then they measured the levels after two nights of four hours in bed, with an average sleep time of 3 hours, 53 minutes; and again after two nights of 10 hours in bed, with an average sleep time of 9 hours, 8 minutes. Then the researchers asked the men to complete questionnaires about their hunger and the desire for different types of food. When the subjects slept only four hours nightly, leptin levels decreased by 18 percent and ghrelin levels increased 28 percent. What's more, their reported hunger increased by 24 percent, and they craved calorie-packed foods with high carbohydrate content, such as candy, cookies and cake, the researchers said.

Sleep deprivation is a fact of life for many North Americans. Sleep duration among U.S. adults has decreased by up to two hours a night since the 1960s, according to the National Sleep Foundation. In 2002, more than 37 percent of young adults said they slept less than seven hours a night, compared to about 16 percent in 1960. Another expert who has studied the effect of sleep loss on weight said the new study adds to the growing body of research on the subject.

"This, to my knowledge, is the first real experimental study of sleep deprivation on food intake and regulatory hormones," said Dr. Steven B. Heymsfield, a professor of surgery at Columbia University and St. Luke's-Roosevelt Hospital Center in New York City. While the study had a small number of participants and wasn't lengthy, it was "very well-designed and controlled," Heymsfield said.

In a recent study, Heymsfield found that people who slept four hours or less a night were 73 percent more likely to be obese than those who slept seven to nine hours nightly. Why a lack of sleep affects the hunger hormone levels isn't known, Van Cauter said. Some studies have suggested that sleep loss is tied to an increase in sympathetic nervous system activity, which can inhibit the release of leptin, the hormone that tells you to stop eating. For future research, Van Cauter said she wants to investigate whether sleep duration affects how well people adhere to a diet, and whether the success of a weight-loss plan is based on the amount of sleep a person gets. She said she also wants to study whether some people might be immune to sleep loss and an increase in appetite.

Meanwhile, her advice: "Know how much sleep you need, know when you are running a sleep debt, and pay it." Heymsfield added: "If you have a weight problem to begin with, watch out for periods of sleep deprivation. You will be vulnerable to weight gain."

In an animal study, rats fed a fat-rich diet produced more of an appetite-stimulating hormone than carbohydrate-fed rats, leading them to get hungrier quicker after eating.

The rat study, reported in the November issue of the journal Endocrinology, examined the impact of fat or carbohydrates on the production of the hormone ghrelin. Produced in the stomach, ghrelin has been shown to trigger appetite and is believed to play a key role in regulating body weight. Levels of the hormone generally rise before meals and quickly decline after eating. Ghrelin levels were high in the rats following 14 hours of fasting, but they dropped when the animals were fed either fat- or carbohydrate-based food. Among the fat-fed rats, however, hormone levels rose again within 45 minutes of eating. Ghrelin levels remained low in the carbohydrate-fed rats.

Many Factors Drive Hunger

Whatever the studies show, Kaufman says ghrelin is undoubtedly just one of many factors that drive human hunger. Feeling full is an incredibly complex phenomenon and there are clearly a number of regulators, she says. "The study of hunger in humans is still in its infancy, but it is hard to imagine that there will be one magic bullet to control it. If we were able to modulate ghrelin in some way, that probably wouldn't be enough."

Leptin is a widely studied hormone, thought to be the secret to obesity. Produced by fat cells, our leptin levels tell the brain when the body does or doesn't need more food.

Sleep deprivation plays an important role in regulating our leptin levels and in controlling appetite, explains senior researcher Eve van Cauter, PhD, a diabetes researcher with the University of Chicago. Her study appears in The Journal of Clinical Endocrinology & Metabolism this month.

A few earlier studies have investigated the effects of sleep deprivation on leptin levels, since sleep regulates hormones and other body processes. During sleep, leptin levels normally rise. But leptin levels are also markedly dependent on sleep duration, she says.

According to the researchers, sleep deprivation results in a triggering of hormones of the nervous system, which can lower leptin levels. These low levels of leptin have been associated with obesity. Other hormones that control metabolism are also triggered by sleep deprivation and may affect leptin levels.

During periods of sleep deprivation, "low leptin levels tell the brain there is a shortage of food and increase appetite," van Cauter tells WebMD. "When leptin levels are higher, satiety levels are higher, which tells the brain that the body is getting enough food."

In their study, van Cauter's research group investigated sleep deprivation's effects more closely.

The study involved 11 healthy 22-year-old men who spent 16 consecutive nights in the University of Chicago's sleep laboratory. For six days they got four hours of sleep -- their week of sleep deprivation.

The men's food and activity levels were strictly regulated and hormone levels were taken during the day and while they slept. Their sleep was also monitored to make sure they followed the study's guidelines.

One year later, the men returned for a six-day study with an 8-hour sleep period, so they served as their own comparison group, van Cauter explains.

The results: After their six-day sleep deprivation period, volunteers had a leptin decrease ranging from 19% to 26%, she reports.

The decrease appears to send an erroneous signal from the brain that more food is needed when, in fact, enough food has been eaten, says van Cauter.

This suggests that during periods of sleep deprivation, we tend to overeat," van Cauter tells WebMD. Since the men were getting the same amount of calories and activity, leptin levels and appetite control should not have changed. "But, in fact, they changed in a major way."

It's true, a decrease in leptin increases appetite, as van Cauter showed during sleep deprivation, Kalra says. However, her study is by no means conclusive, he says. A few other studies have shown that sleep deprivation creates eating disorders.

The urge to binge eat may stem from the same area of the brain that helps control emotions and learning, according to new study. ,p>Researchers found that a part of the brain known as the amygdala appears to regulate how the brain responds to high-fat food and control binge eating. The amygdala also is responsible for emotions such as fear and anger.

When that part of the brain was deactivated in rats, the study showed that the rats lost their normal desire to pig out and binge eat fatty foods.

The results show that if this area of the brain was turned off in humans, it may allow people to resist temptation, such as overindulging in fatty but tasty foods such as ice cream.

"Given the current epidemic of obesity, understanding how these networks in the brain control the desire for food is extremely important," says researcher Matthew Will, assistant professor at the University of Missouri-Columbia, in a news release.

"This research demonstrates that a specific brain region may be responsible for feeding beyond the basic metabolic needs signaled by hunger, such as those instances when you can't turn down that delicious chocolate chip cookie, or when you simply need an emotional boost from a bowl of ice cream," says Will.

Binge Eating Tied to Brain

Researchers say previous studies have shown that the release of pleasure chemicals in the brain -- called opioids -- control the desire to eat very tasty or highly palatable foods. These chemicals can increase the drive to eat fatty or sugary foods by up to 300%.

Using this reaction as a model for binge eating, researchers studied the effects of deactivating the area of the brain that controls emotions and motivation, the amygdala, in rats.

The tests showed that when this area was turned off, a surge of opioids in the brain had no effect on how much fat the rats ate and prevented the binge eating of fatty foods that normally accompanies the release of these euphoric chemicals.

In contrast, rats that had an intact amygdala and got a dose of opioids ate three times more than those given saline solution. But there was no binge eating among the rats with deactivated amygdalas that were given a shot of opioids.

Moderate exercise helped mice survive the flu in a recent lab test done by researchers at University of Illinois at Urbana-Champaign. They presented their findings at the 2004 American Physiological Society Intersociety Meeting in Austin, Texas.

After exposing mice to the flu virus, Jeffrey Woods, PhD, and colleagues randomly assigned some rodents to a four-day workout program with 20-30 minute daily exercise sessions. The mice stopped exercising when flu symptoms appeared, simulating typical human behavior. For comparison, another group of flu-exposed mice didn't exercise at all.

The exercising mice were twice as likely to survive the flu as the sedentary group: 59% of exercising mice survived the flu, compared with 29% of those that did not exercise.

Mature exercisers (age 20 weeks) fared best. Eighteen out of 22 mature exercising mice survived the flu, compared with only 10 out of 22 sedentary mice of the same age. The protective benefit of exercise wasn't seen in younger mice aged 11-16 weeks.

It's worth noting that the mice weren't hard-core rodent "athletes." They only exercised moderately for a handful of days; none exercised regularly before the experiment.

"Our work has shown that moderate exercise for four consecutive days post-infection significantly increased survivability to influenza infection," write the researchers.

They plan to do follow-up studies with animals that had been exercising regularly, according to a news release.

The researchers also want to learn how exercise exerts its protective effect against the flu.

Meanwhile, a large clinical trial with human participants is underway at the University of Illinois' physical fitness laboratory, examining whether moderate exercise training can boost immunity (including responses to flu vaccine) in older adults, according to a news release.

Oily fish such as salmon and mackerel contain omega-3 fats which are vital for healthy brain function and have been shown to lift depression. Aim for two 100g (equivalent to a small salmon fillet) servings a week. If you are vegetarian, flaxseed or walnuts are both rich in omega-3s.Chocolate is a comfort food, but the benefits aren't only psychological. Just a couple of squares are enough to release endorphins, hormones that create a natural high. It also contains caffeine, phenylethylamine and magnesium, which are known to lift the spirits. Just don't overdo it - getting a fat bum will probably wipe the smile off your face.

Peas are a good source of vitamin B1 (thiamin), a powerful mood influencer. Too little leads to irritability and depression. If you drink, tuck into peas regularly, as alcohol rapidly depletes vitamin B1 levels.

Brazil nuts are packed with feel-good selenium, a mineral many of us don't get enough of. People suffering from depression are often found to be chronically deficient - 3 or 4 nuts a day will put you back on track.

Bananas contain tryptophan, which is converted into the feel- good hormone serotonin. One banana will boost your serotonin levels. Other tryptophan- rich foods include oats, beans, poultry, fish and seeds.

RELAXING FOOD

Oats work as a sedative, so try a small bowl of hot porridge as a late-night snack if you are having trouble drifting off. It's all down to raised levels of serotonin - by day, these make you feel good, by night they help you sleep.

Lettuce has been used since Roman times to calm the nerves. It contains latucin, a chemical that soothes anxiety and promotes sleep.

Asparagus is often thought of as a sexy food, thanks to its rather suggestive shape, but herbalists actually recommend it for palpitations and panic attacks, as it contains a compound reputed to have a calming effect on the heart muscle.

Chicken contains the amino acids glutanime and glutamic acid, which help your body make nature's answer to Valium, GABA. This chemical neutralises the stress hormones cortisol and adrenaline and helps you feel chilled and in control. Other GABA helpers include lamb, beans, grains, nuts and seeds - eat a little regularly to keep your levels topped up.

Spinach is rich in magnesium, which calms the brain and nerve cells. It also helps relax muscles and ease cramps or spasms.

SEXY FOOD

Strawberries have been called Viagra for girls because the seeds are rich in zinc, which increases levels of the horny hormone testosterone. Oysters are also high in zinc, hence their saucy reputation - but we know which we'd rather be hand-fed in bed.

Pumpkin seeds are particularly rich in the amino acid arginine, which boosts sex drive in both men and women. They also contain essential fats which are necessary for the production of sex hormones.

Garlic, unlikely as it seems, is a potent aphrodisiac as it boosts circulation, increasing blood to those all-important extremities. It also stimulates production of nitric oxide, an enzyme involved in the erection process. Just make sure you've both eaten the same supper or it could have the opposite effect.

Chilli can spice up your performance in bed, as eating it triggers the release of endorphins, making you feel good.

Avocado is a great source of vitamin E, which is important for female lubrication. It is also the most nutritious fruit on the planet, packed with beta carotene, potassium, protein, folic acid and vitamins, which will help fuel your passion sessions.

Soya helps keep female libido high as it contains plant oestrogens that mimic the lust-enhancing effect of oestrogen produced by our own body. Levels of natural oestrogen drop as we get older, but soya can act as a substitute.

ENERGY FOOD

Seaweed is one of the best sources of iodine, which is vital for thyroid health. A sluggish thyroid is linked to tiredness, weight gain and lethargy.

Marmite is definitely your mate if you want to beat slumps. It's rich in the mineral chromium, which helps stabilise blood sugar levels and keep your energy on an even keel.

Wholegrain bread is a great choice for lunchtime as it releases its energy much more slowly than white bread, which is highly processed. This helps to avoid the blood sugar lows that cause mid- afternoon energy slumps. It's also very rich in the B vitamins which are responsible for energy production.

Eggs are a far better breakfast booster than coffee, which will wear out your adrenal glands and drain your energy. Eggs contain an amino acid called tyrosine which is converted into catecholamine, a chemical that acts as a natural stimulant. Vitamin D helps this process take place, so have some milk or yoghurt too.

Fresh fruit is the perfect sugar delivery system, as the energy it provides comes packaged with fibre for a slow, sustained release rather than a quick hit. Citrus fruit, apples, bananas and apricots are also extremely rich in potassium, which is important for strong nerves and muscles, plus antioxidants to ward off energy-sapping infections.

DOES ATKINS GIVE YOU THE BLUES?

We all know the Atkins diet can give you foul breath, but it may also put you in a foul mood too. A study from the Massachusetts Institute of Technology found your serotonin levels dip when you deprive your body of carbohydrates, leaving you feeling fed-up, lethargic and prone to mood swings. Too little serotonin also makes it harder to control your appetite, as this hormone is responsible for telling your brain to stop eating before your stomach is stretched to the max. Although poultry and fish both contain the serotonin precursor, tryptophan (see 'happy food', left), it needs to be eaten with carbs for it to be absorbed by the brain and converted into the happy hormone.

The compound, pterostilbene, has the potential to be developed into a nutraceutical for lowering cholesterol, particularly for those who don't respond well to conventional drugs used for this purpose, the researcher says. Findings were described at the 228th national meeting of the American Chemical Society, the world's largest scientific society.

"We are excited to learn that blueberries, which are already known to be rich in healthy compounds, may also be a potent weapon in the battle against obesity and heart disease, which are leading killers in the U.S.," says study leader Agnes M. Rimando, Ph.D., a research chemist with the USDA's Agricultural Research Service (ARS). She works at the ARS' Natural Products Utilization Research Unit in Oxford, Miss.

Researchers have suspected for some time, based on anecdotal studies, that blueberries may play a role in lowering cholesterol, says Rimando.

Pterostilbene is an antioxidant that is similar to resveratrol, another antioxidant identified in grapes and red wine that is also believed to lower cholesterol. Other researchers have found pterostilbene in grapes, but this is the first time it has been found in blueberries, says Rimando. She and her associates earlier showed that this compound may help fight cancer. Pterostilbene has been reported previously by others to have anti-diabetic properties as well.

In this new laboratory study using rat liver cells, Rimando and her collaborators, Rangaswami Nagmani and Dennis Feller, of the University of Mississippi's School of Pharmacy, exposed the cells to four other compounds found in blueberries. Of the four compounds, pterostilbene showed the highest potency for activating the cells' PPAR-alpha receptor, which in turn plays a role in reducing cholesterol and other lipids.

Pterostilbene was similar in activity to ciprofibrate, a commercial drug that lowers LDL (bad) cholesterol and triglycerides. But ciprofibrate, whose mechanism of action on cells is less specific, can have side effects such as muscle pain and nausea. Pterostilbene, which targets a specific receptor, is likely to have fewer side effects, Rimando says, adding that the compound did not show any signs of cell toxicity in preliminary studies.

Until studies are conducted in humans, no one knows how many blueberries a person needs to eat to have a positive effect at lowering cholesterol, Rimando cautions. Her study adds to a growing list of health benefits attributed to the little antioxidant-rich fruit, including protection against aging, heart disease and cancer, as well as acting as a memory booster.

Agnes M. Rimando, Ph.D., is a research chemist with the USDA's Agricultural Research Service. She works at the ARS' Natural Products Utilization Unit in Oxford, Miss. Rangaswamy Nagmani, Ph.D., and Dennis R. Feller, Ph.D., of the University of Mississippi School of Pharmacy in University, Miss., are collaborators of Dr. Rimando on this project.

But these discoveries should not lead us to focus only on famous antioxidants, like vitamins C and E. A new study supports the advice of health organizations, including the American Institute for Cancer Research, that vegetables and fruits are preferable to supplements for harnessing antioxidant power.

In this recent study, participants ate the same basic diet that excluded all vegetables and fruits. One group, however, was also given about six servings of fruits and vegetables a day. A second group received a vitamin and mineral supplement in place of the vegetables and fruits. Before and after the 25-day program, researchers tested the participants for their levels of oxidation damage, as well as antioxidant nutrients and defense systems.

This study indicates that vegetables and fruits provide more antioxidant protection than supplements alone. The group that ate vegetables and fruits showed significantly less oxidation damage than the others. The group that took supplements showed a reduction in oxidation damage, but not as much. Levels of an enzyme system vital for antioxidant defense increased only in the group eating fruits and vegetables. The researchers concluded that vegetables and fruits offer sources of antioxidant protection not available from vitamin and mineral supplements alone.

In an earlier study, participants who had been eating an average of five servings of fruits and vegetables per day over the previous year were put on a diet that maintained their starting weight, but increased fruits and vegetables to a total of ten servings a day. Their antioxidant intake and antioxidant capacity measured by blood tests increased substantially. The researchers believe the increase in antioxidant power probably came from more antioxidants, like beta-carotene, lycopene and vitamin C, as well as more flavonoids and other phytochemicals that act like antioxidants. They also observed that the body's antioxidant capacity seemed to level off at about ten to twelve fruit and vegetable servings a day.

While research shows that vegetables and fruits are vital sources of antioxidants, the plant-based diet recommended by the American Institute for Cancer Research is the most complete approach to healthy eating. Whole grains, beans and nuts also contain antioxidant vitamins and phytochemicals. Spices and herbs add even more.

It cannot be stressed enough that antioxidants are only part of the health benefits of a plant-based diet. Nonantioxidant properties of phytochemicals are another important part. For example, test tube studies at Cornell University ranked the ability of different vegetables to control the growth of one type of cancer cell. The results differed from the vegetables' antioxidant content, probably reflecting the additional anti-cancer effects of phytochemicals.

To obtain phytochemicals – hundreds of which are known to exist – you need to eat a wide variety of vegetables, fruits, whole grains and beans. This is a major reason why supplements can't supply the benefits of a plant-based diet.

"Low-carb diets have steered people toward whole grains," said Bonnie Liebman, the director of nutrition for the Washington-based Center for Science in the Public Interest, "and made millions of people cut back on things made with white flour, like white bread, hamburger buns, megamuffins, 400-calorie bagels, pizza crusts, cakes, cookies, doughnuts and other sweets, even pasta and white rice.

"If you were asked to compare the impact of the South Beach diet with dietary guidelines, there would be no contest."

Now if only consumers could distinguish between grains that are refined and grains that are whole. Just because bread is brown and has specks of something in it, does not mean it is whole grain.

Whole grains (and foods made from them) consist of the entire grain seed, usually referred to as the kernel. The kernel is made of three components: the bran, the germ and the endosperm.

Refined grains have neither the bran nor the germ, which means that most of the B vitamins, certain minerals and the fiber have been stripped from them. In enriched products, some of the B vitamins are added back.

All grains are chiefly carbohydrates, but generally whole-grain cereals have three to seven times more fiber to a serving than refined cereals.

When the grain has been refined, destroying much of the fiber, the carbohydrates turn to glucose quickly and enter the bloodstream. In whole grains, with their fiber intact, carbohydrates are not absorbed quickly. This helps to regulate blood sugar, increase satiety and delay the return of hunger. That is why low-carb food labels emphasize the terms "effective carbs" or "net carbs," meaning the number of remaining carbohydrates after fiber has been subtracted from the total.

Being satiated is the point. Because, no matter the source, calories count: the only way to lose weight is to eat fewer calories than you burn up.

Food manufacturers do not make it easy to figure out which grains are whole and which are not. Color is no clue: brown bread may contain molasses or caramel food coloring, but no fiber. Some whole grains, like oats, are light in color.

Terms like multigrain, cracked wheat, seven grain, stone-ground, 100 percent wheat, enriched flour and degerminated cornmeal are not whole grain. Pumpernickel is made with rye and wheat flours, but they are seldom whole grain.

The list of whole grains, however, is long. Some of them are well known in this country: whole wheat (wheat berries), bulgur wheat, whole oats and oatmeal, whole rye, barley, buckwheat (kasha or buckwheat groats), whole corn and nondegermed cornmeal, brown, wild and other whole rices and popcorn. (Yes, popcorn.) Others are little used here: grano (lightly pearled wheat), farro (another form of wheat), kamut, quinoa, amaranth, millet, sorghum, spelt (similar to farro) teff and triticale.

Botanically, a few of these grains are not real cereals — amaranth, buckwheat and quinoa — but only botanists are likely to notice.

The healthiest cereal has a label that says 100 percent whole grain. For a cereal to be high in whole grain, the first ingredient must be whole wheat, whole rye or the like. The second best products are those that contain at least 51 percent whole grain ingredients. For all of those, the Food and Drug Administration permits a health claim related to the reduction of risk of heart disease.

While the 2000 dietary guidelines, a joint effort of the Agriculture Department and the Health and Human Services Department, recommend "a variety of grains daily, especially whole grains," it is not until Page 20 of the guidelines brochure that the reader learns why whole grains are better than refined grains. Even less helpful than the dietary guidelines, with which few people come in contact, is the food pyramid, the triangle that is generally recognized by Americans as a nutrition guide and is found on packages of food and in marketing and advertising. Even though grains make up the base of the pyramid, the phrase "whole grains" is nowhere to be found on it. So any refined product, whether it is white bread or white rice, can use the pyramid to proclaim its health benefits.

Now the committee at Health and Human Services responsible for the new dietary guidelines, due out at the beginning of next year, appears to be ready to put more emphasis on whole grains.

There is pretty good science to back that decision. A number of studies show that in addition to making you feel fuller on fewer calories, the fiber in whole grains (along with fruits and vegetables) may reduce the risk of cancer, heart disease, diabetes, high blood pressure and stroke.

"The committee has discussed recommending that most Americans increase their intake of whole grains," said Kathryn McMurry, the co-executive secretary of the dietary guidelines advisory committee. "One of the bases for recommending whole grains is that they are naturally a good source of dietary fiber, which has many health benefits. Generally, food sources of fiber also contain other nutrients that promote health," like vitamins, minerals, antioxidants and phytochemicals (protective plant substances).

The base of "the healthy eating pyramid," produced by the Harvard School of Public Health, is whole grains. Refined grains are at the top of the pyramid, along with red meat butter and sweets.

According to the National Academy of Sciences, men 50 and younger should consume 38 grams of fiber a day; women, 25 grams; men over 50, 30 grams; and women, 21 grams. Current recommendations are for 20 to 35 grams of fiber a day, but the average American eats only 5 to 13. It is true that whole grains take longer to cook than refined grains, but it is often only 20 minutes. For those that take longer, soaking will cut down considerably on the cooking time.

* Weigh yourself just once a week. Sometimes what you think is a plateau is a normal fluctuation in weight.

* Have reasonable expectations. People lose weight at different rates. In general, the more you have to lose, the faster it will come off.

* Exercise, but not too much. As soon as you start eating less, your metabolism slows down, reducing the rate at which you burn calories. If you restrict calories too much or exercise excessively, your body will start hoarding calories and fat to prevent starvation.

That's the finding of new research published online this week in the British Medical Journal.

The study examined New Zealand census data on adults who had never smoked and were 45 to 74 years old at the time of either the 1981 or 1996 census. The participants provided information on the smoking status of all household members aged 15 and older. The participants' death rates were monitored for three years after each census.

This study's results are consistent with previous research findings but offer a more precise measurement because these results are based on a large study, the authors said in a prepared statement.

The new findings contribute to the evidence of harm caused by secondhand smoke and lend support to efforts to reduce people's exposure to it, the authors concluded.

Mayo Clinic researchers found that the component, called epigallocatechin-3-gallate (EGCG), destroys leukemia cells by interrupting the communication signals they need to survive. The research appears online in the journal Blood.

CLL is most often diagnosed in people in their mid-to-late 60s. Chemotherapy is used to treat the most severe cases, but there is no cure for CLL.

In this study, the Mayo scientists found that EGCG prompted leukemia cells to die in eight of 10 patient samples tested in a laboratory.

"We're continuing to look for therapeutic agents that are nontoxic to the patient but kill cancer cells, and this finding with EGCG is an excellent start," study leader Dr. Neil E. Kay said in a prepared statement. "Understanding this mechanism and getting these positive early results gives us a lot to work with in terms of offering patients with this disease more effective, easily tolerated therapies earlier."

Previous studies have produced conflicting evidence on the risks or benefits of ejaculation in connection with the development of prostate cancer. Some found that increased sexual activity lowers the risk of the tumors, the second most common form of cancer in American men. Others found just the opposite.

The new study, appearing in the April 7 issue of the Journal of the American Medical Association, followed almost 30,000 doctors, dentists, and other health professionals participating in a long-term look at cancer and chronic disease. The men ranged in age from 46 to 81.

As part of the research project, the men, who were mostly white, were asked about their sex life, specifically how frequently they ejaculated -- a question meant to capture not only intercourse but masturbation and nocturnal emissions -- during their 20s, their 40s and in the previous year.

"Not only did [frequent ejaculation] not pose an adverse risk factor, but it possibly could be associated with a lower risk of prostate cancer," said Dr. Michael Leitzmann, an epidemiologist at the National Cancer Institute and the leader of the study.

Men who reported between four and seven ejaculations a month over their adult lifetime had an 11 percent lower chance of developing prostate cancer than those who ejaculated no more than three times a month. Every three-ejaculations-per-week increase across a man's lifetime was associated with a 15 percent drop in prostate cancer risk.

The modest effect of occasional ejaculation could simply illustrate that it doesn't raise the risk of prostate cancer, Leitzmann and his colleagues said.

But men who ejaculated at least 21 times a month had a 33 percent lower chance of developing prostate cancer, suggesting that frequent ejaculation does indeed protect the prostate from growing tumors.

However, the number of cancer cases in this small group was itself small -- only 60 out of the 1,449 cases overall, undercutting the strength of the finding.

Men who reported such frequent ejaculation in the year before entering the study got even more protection against cancer. Again, however, the number of tumor cases in this group was tiny.

How frequent ejaculation might protect the prostate, a walnut-sized gland that provides the liquid medium for sperm during emission, isn't known. The researchers suggest that ejaculation could help purge the prostate of cancer-causing chemicals or stunt the formation of crystalloids that have been linked to tumors in some men.

Another, more speculative, possibility is that the relief of stress associated with ejaculation could lead to hormonal activity that's less likely to promote cancerous changes in the gland.

Until scientists learn more about how the prostate benefits from frequent ejaculation, Leitzmann said, it's too early to recommend that men step up their sexual activity. "Our study should stimulate progress toward [understanding the mechanism] as opposed to putting out a public health recommendation," he said.

Dr. Graham Giles, an Australian cancer researcher who has looked at sexual activity and prostate cancer risk, said the latest study "goes a long way to confirm" his own group's findings that frequency of ejaculation and prostate tumors are inversely connected.

"Very few studies, like this one and ours, have measured total ejaculations," Giles said. "Most have relied solely on the frequency of sexual intercourse, and therefore probably missed measuring a lot of male sexual activity."

Neither Giles' study nor the most recent one looked at the ejaculation frequency during adolescence -- a period that's worth considering, both Giles and Leitzmann said. "These [years] may be crucial" in dictating the fate of the prostate, Giles said. "It is very possible that the risk of developing cancer later in life is set up much earlier in life, when the gland is developing."

Meanwhile, another new study finds that a common screening test for prostate cancer can help predict whether the disease will return in men who were initially treated with hormonal therapy.

Researchers at Brigham and Women's Hospital in Boston found that different rises and falls in levels of the blood test -- protein-specific antigen, or PSA -- are key.

The study of 1,454 men with prostate cancer, which appears in the April 7 issue of the Journal of the National Cancer Institute, found that the risk of death from the disease was 13 times higher in those whose PSA levels rose quickly and then fell slowly after hormonal therapy compared to those whose levels rose slowly and fell quickly.

1. Plan the party. If you’re usually not comfortable with the restaurant choices made by others, then offer to pick the place yourself.

2. Do a background check. If someone else makes the plans, call the restaurant to explain your needs and ask what options are available.

3. Be as flexible as possible. If you can’t have lactose, say to the server, "I don’t eat any dairy. What do you recommend?" And even if you’re a vegetarian at a steakhouse, there is always the salad and baked potato that come with every order.

4. Make arrangements. If you are going to the home of a close friend for dinner, you can tell them ahead of time that wheat is off-limits for you. Then offer to bring along a veggie tray as a “thank you” to them for accommodating to your restrictions.

5. Know when to say when. If eating something isn’t going to endanger your health, there are times when you should just let go.

- Women aged 20-45 don’t have time to plan, purchase and prepare healthy foods.

- Cost and difficulty catering to family needs are also challenges.

- The findings were similar to those of a survey by Dietitians of Canada, which observed that lack of basic cooking skills and the lure of fast food and restaurants are another big challenge.

- The health benefits of fruit and vegetable consumption were not well known among participants.