A Colombian woman has received the world's first tailor-made trachea transplant, grown by seeding a donor organ with her own stem cells to prevent her body rejecting it, an international research team reported on Wednesday.

The success of the operation, performed in June using tissue generated from the woman's own bone marrow, raises the prospect that transplanting other organs may be possible without drugs to dampen the immune system, they said.

Doctors work hard to match tissue type when transplanting organs so that the body does not completely reject the new organ, but patients usually have to take immunosuppressants for the rest of their lives.

"The probability this lady will have a rejection is almost zero percent," Dr. Paolo Macchiarini, head of thoracic surgery at the Hospital Clinic, Barcelona who performed the transplant, told a news conference.

"The patient is enjoying a normal life with no signs of rejection after four months."

Claudia Castillo sought help after a case of tuberculosis destroyed part of her trachea -- the windpipe connected to the lungs -- and left her with breathing difficulties, prone to infections and unable to care for her two children.

The 30-year-old's only option other than the experimental surgery was for doctors to remove part of her lung -- a choice that would have seriously degraded her quality of life, the researchers said.

"It isn't just an issue of life, it is an issue of quality of life," said Martin Birchall, a surgeon at the University of Bristol, who helped treat Castillo.

'HYBRID ORGAN'

After finding a donor, the researchers first depleted the transplanted trachea of the donor's cells and then obtained bone marrow stem cells from Castillo they grew into cartilage cells.

Next, the team seeded these cells on the outside of the donor trachea using a device developed at Milan Polytechnic in Italy that incubated the cells. The researchers used the same device to make epithelial cells to construct the lining of the trachea.

This created a hybrid organ in a lab that Castillo's body would identify as its own and make immunosupressant drugs unnecessary, the researchers said.

Finally, the team grafted a 5 cm (1.97 inch) piece of the trachea onto Castillo's damaged left main bronchus, which connects the main windpipe to the left lung.

Castillo, who lives in Spain, had no complications from the surgery and left the hospital after 10 days. She is returning to normal activities and even called her doctors from a night club to say she had been out dancing all night, the researchers said.

"We believe this success has proved we are on the verge of a new age in surgical care," said Birchall, who predicted the technique could be applied to other hollow organs similar in structure, such as the bowel, bladder and reproductive tract.

Michael Kahn

So what does that say about the common belief that night people are more creative—the artist who stays up to the wee hours to paint or the musician who keeps a bedtime-at-dawn type schedule?

A few studies show that character traits may differ between the diurnal and the nocturnal. A Spanish researcher found that the time of day we prefer to be most active corresponds to certain personality traits. Early risers were more likely to be logical and analytical, and likely to use concrete information as sources of knowledge, whereas those that stayed up late were more imaginative and intuitive. Another study published in the February 2007 issue of Personality and Individual Differences determined that night owls scored better on creativity tests than did intermediary and morning people.

However, the research presents a bit of a chicken and egg conundrum: Does your internal clock shape your psychology or does your psychology help shape your sleeping patterns, and thus your internal clock? Many questions still remain and I’m sure there are many creative early risers and analytical late-nighters who would dispute the above studies.

Can an Owl See the Light?
Despite our preferences, we do live in a society where we pretty much follow an early riser’s schedule. If you are someone who has to conform to a regular work schedule, then there are some things you can do to help shift your sleep pattern into one. Many of them are tips on how to get a good’s night sleep in general. The National Sleep Foundation has the following recommendations:

• Don’t bring it with you.

The bed should be used for sleeping and sex, not computing, watching TV, eating, etc. Though I read before going to bed, the NSF even recommends banning books from your boudoir.

• Try to stay consistent.

Studies have shown that night owls tend to have inconsistent bed and waking times. One of the best ideas for a good’s night sleep is to try to go to bed around the same time every night. (I find this nearly impossible on the weekends.) This will not only help you sleep better, it can help shift your clock to an earlier (or later, if that’s what you want) bedtime.

• Don’t pull the shades.

Our sleep patterns are affected by light, so letting the natural stuff in each morning will help you rise. Don’t put down the blinds or shades; the brightness will help you wake up. (If not totally make you mad.) In addition, when evening rolls around, dim the lights and make sure your bedroom is dark.

• No midnight snacks or drinks.

The NSF recommends not eating two to three hours before going to bed and not drinking too close to bedtime either. Likewise, people who have a hard time falling asleep are generally told to limit late afternoon caffeine consumption.

• Exercise regularly—it can help you fall asleep.

Exercising too close to bedtime can have the opposite effect, but generally if you finish within an hour or two of hitting the hay, you should be okay.

As it turns out, although I’m normally chipper in the a.m., I’m not a true morning person—I have to set an alarm and I like to hit snooze at least two to three times. And my late-sleeping roommate has now adjusted her schedule to her new job with early hours. And she gets up all by herself.Brie Cadman

Women who have had two or more induced abortions have a reduced risk of pre-eclampsia, researchers in Norway said.

Affecting at least 5 percent to 8 percent of all pregnancies, pre-eclampsia is a rapidly progressive condition characterized by high blood pressure, the presence of protein in the urine, swelling, sudden weight gain and headaches, although some women report few symptoms. Women who have previously given birth to a child have lower risk of pre-eclampsia, the researchers said.

The study, published in the International Journal of Epidemiology, shows that women who have had two or more induced abortions reduced their risk for pre-eclampsia by 60 percent. Women who have had one abortion have an approximately 16 percent reduced risk for pre-eclampsia compared with women who have never had an abortion.

The researchers said the results indicate that every normal pregnancy, even if it ends before birth, to some degree will protect against pre-eclampsia in a later pregnancy, almost like a vaccination. >>>>

Exercise can do a lot of good for most people, but it apparently isn’t much help to those with heart failure, the fastest-growing heart problem in the United States.

The study — the largest ever of exercise in patients whose hearts don’t pump enough blood — left many doctors disappointed. Results were reported Tuesday at an American Heart Association conference.

Although there were some encouraging trends and clear benefits for certain people, exercise failed to deliver on the main goal — keeping people out of the hospital and improving their survival rates.

“It’s a shame,” said Dr. Harlan Krumholz, a quality-of-care researcher at Yale University who had no role in the study. “Exercise is not that magic elixir that we had hoped,” at least for these patients.

About 5 million Americans have heart failure. It kills more than 300,000 of them and accounts for a million hospitalizations each year. Those numbers are expected to grow as the nation’s population gets older.

The condition occurs when the heart muscle weakens over time and can no longer pump effectively. Fluid can back up into the lungs, leaving people gurgling and gasping for breath as they struggle to climb stairs or walk around the block.

Conficting findings
Exercise has long been known to help prevent the clogged arteries that develop in heart disease and to help heart attack patients recover. But smaller, previous studies have made conflicting findings about whether it helps heart failure patients or even is safe for them.

Doctors had hoped that exercise would prove as effective as drugs for these patients, sparing them the cost and potential side effects.

The study involved 2,231 people with moderate heart failure in the United States, Canada and Europe. It was led by Dr. Christopher O’Connor at Duke University.

All of the patients were getting optimal medical care, with more than 90 percent on an ideal mix of medicines. Those who needed them also had implanted heart devices to maintain good rhythm.

They were randomly placed in two groups — one given usual care and the other usual care plus an exercise training program. Exercisers were given 36 supervised training sessions lasting half an hour three times a week. After 18 such sessions, they were given a treadmill or an exercise bike to use at home, for five 40-minute sessions each week.

Three months into the study, only half were exercising at least three times a week for 40 minutes. After one year, only one-fourth were exercising five times a week.

The fact so few stuck with the exercise program made it difficult to show a positive result, O’Connor said.

There were 796 deaths or hospitalizations among those getting usual care and 759 in the exercise group — a statistical draw.

However, after doctors adjusted for factors like how long people were able to tolerate exercise, how badly damaged their hearts were and rates of depression, they did find a modest but significant benefit for exercise.

“It’s disappointing,” said Dr. Robert Eckel, a former heart association president and an exercise specialist at the University of Colorado at Denver. “You cannot make strong conclusions about subgroups.”

‘Worth your while’
Insurers now do not pay for exercise training for people with heart failure, and “this study is not going to help” convince them to start, Eckel said.

“We all would have liked to see a huge benefit to exercise,” said Dr. Lawton Cooper, medical officer at the National Heart, Lung and Blood Institute, which paid for the study.

Still, for most people, “it is worth your while,” Cooper said. “We know there are all kinds of benefits of exercise.”

Among them: quality-of-life improvements, said Dr. Ann Bolger, a heart failure specialist at the University of California in San Francisco.

“Just the fact that it’s safe is a huge deal,” she said. “Patients want to be in control and to be active,” and this shows them they can.

One study participant — Lise Coleman, 44, of Fayetteville, N.C. — said exercise dramatically improved her life.

“When I first started in the program, I was a pitiful thing. By the time I finished — you know how they time you when you walk around the track — I was the fastest walker,” she said.

Doctors in the study gave her an exercise bike, which she still rides sometimes more than once a day. Her husband also bought her a treadmill, and she bought an elliptical trainer.

“I love it. When you have heart failure, your mind wants to do more than your body is able,” she said. “I can do more than I used to.” >>>> 

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Rising risk for obese kids: middle-aged arteries

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Ultrasound imaging reveals accelerated evidence of heart disease

A glimpse inside the neck arteries of obese children and teens reveals cardiovascular systems more like those of 45-year-olds, researchers said Tuesday.

Scientists using ultrasound imaging detected fatty deposits more typical in middle-aged adults than in children as young as 10, underscoring worries about accelerated risks of heart disease decades earlier than once thought possible.

“There’s a saying that you’re as old as your arteries,” said the study’s lead author, Dr. Geetha Raghuveer, associate professor of pediatrics at the University of Missouri Kansas City School of Medicine. “These kids are showing up with arteries that show middle-aged conditions.”

In fact, more than half of the 70 youngsters ages 10 to 18 enrolled in the Children’s Mercy Hospital study had a “vascular age” about 30 years older than their actual age, putting them at risk for early heart attacks, stroke — and death. The research was presented Tuesday at the American Heart Association's scientific meeting in New Orleans.

That finding might also hold true for many more young people in the United States, where more than a quarter of kids ages 2 to 19 are considered obese.

“It kind of hammers home that the risk might be speeded up,” said Dr. Stephen Daniels, chief pediatrician at the Children’s Hospital in Denver, who was not associated with the new study. “It does kind of fit with the concept that kids with high cholesterol and other risk factors probably have premature aging factors.”

This isn't the first time aging arteries have been documented in kids. Previous studies have reported that growing numbers of children with risk factors for heart disease are showing signs of narrowing and hardening of the arteries, conditions typically associated with adults.

But Raghuveer and her colleagues used ultrasound imaging to measure the thickness of the inner walls of the carotid arteries that supply blood to the brain. Increasing carotid artery intima-media thickness, or CIMT, indicates a build-up of fatty deposits, known as plaque, in crucial arteries to the heart and brain. Plaque build-up in the arteries, which is usually affects adults, can restrict the flow of blood, causing heart attacks or stroke.

Then they plotted the measurements on a graph for adult plaque levels — because similar measures don’t exist for kids.

The children’s average CIMT was .45 millimeters, with a maximum of .75 millimeters.  One 12-year-old boy logged a CIMT of .54, which placed him smack in the middle of measurements expected to be seen in a healthy 45-year-old man — .50 millimeters to .57 millimeters.

“If I see a kid with a .54 plaque in his carotid artery, a 12-year-old kid, I’m going to be concerned,” Raghuveer said.

Youngsters most at risk in the study were those who were obese, with body mass index or BMI at or above the 95^th percentile, and those who had abnormally high cholesterol levels, including either too much of the so-called “bad” LDL cholesterol, or too little of the “good” HDL cholesterol. 

In addition, some children and teens had levels of fat chemicals known as triglycerides far above optimum levels.

'It was just alarming'

That group included Nick Calvert, a 17-year-old high school junior from Kansas City, Mo. His triglycerides topped out at more than 500 milligrams per deciliter, nearly triple the recommended 150 mg/dl that is considered acceptable.

“Well, it was very upsetting,” said Nick’s mother, Lisa Calvert, 41, a homemaker and mother of three who long ago stopped cooking with butter. “It was just alarming. I felt like I needed to sit down and talk to him.”

Nick was stocky, but not obese, weighing at 182 pounds on a 5-foot-9 frame. But he’s been struggling with genetically high cholesterol levels since he was 2, and a typical teen diet didn’t help.

“I’d go out with my friends and they’d eat and I’d eat, too,” said Nick, who acknowledged a fondness for burgers and pop.

When the ultrasound also detected thickening in his carotid arteries, Nick and his family got scared. He signed up with a personal trainer and started watching his diet, swapping burgers for grilled chicken and soda for water and tea.

“If I don’t do it, I could have a heart attack or stroke at a younger age,” said Nick, who has lost 20 pounds in the past few months, dropping him to 162 pounds.

That kind of proactive attitude is vital, said Dr. Samuel S. Gidding, chief of pediatric cardiology at the Alfred I. duPont Hospital for Children in Wilmington, Del.

Children and teens don’t typically suffer heart attacks, but they can be at risk for early signs of heart disease, said Gidding. He noted that Raghuveer’s work confirms previous autopsy studies that showed a strong link between budding heart disease and risk factors in young people.

JoNel Aleccia

Although sex usually is a source of great pleasure, it can also be the cause of significant stress between partners. Even if you feel fulfilled in your sex life, you may worry about your performance when you hear about what others do behind closed doors — and how often.

But a fulfilling sexual relationship isn't dependent on frequency or specific sexual behaviors. Instead it's reliant on whether the sexual experience makes both you and your partner feel good without compromising either person's health.

David Osborne, Ph.D., a psychologist at Mayo Clinic, Scottsdale, Ariz., addresses these and other issues regarding sexual health in monogamous relationships.

Many people wonder whether their sex life is "normal." Can you help people understand the full range of what constitutes "normal" sex?

It's common for people to wonder whether their frequency and variety of sexual activity are similar to those of other people. Statistics on sexual behavior can be quite misleading. For example, a couple might read that the average married couple has intercourse three times a week. They may not be aware, however, that this average includes a wide range. The frequency of intercourse might range from zero for some to 15 or 20 times a week for others. Therefore, even if their frequency of intercourse is more or less than three times a week, their behavior is within the range of normal human experience. The most important consideration isn't whether their frequency and pattern of sexual activity matches some average, but whether each partner is satisfied and comfortable with the sexual relationship.

It's difficult to arrive at a definition of normal sexual behavior. Cultural attitudes, religious beliefs and the law may all play a role in defining what is considered normal. Within these cultural, religious and legal contexts, a couple's own beliefs are crucial in determining what's "normal" for them.

Human beings may respond to a wide variety of arousing stimuli. As long as a sexual fantasy or behavior doesn't lead to emotional or physical discomfort, conflict in the relationship, or problems in other aspects of their lives, it shouldn't be a source of concern.

What questions can partners ask each other to help determine whether their needs are being met?

The best way is to observe and discuss each other's feelings. For example, does the anticipation of sexual activity produce feelings of pleasure, excitement and arousal? Or does it produce a feeling of pressure, guilt or a sense of obligation? Each partner can also consider how he or she feels after sexual activity. Is there a feeling of satisfaction, relaxation and enjoyment? Or are there feelings of guilt, resentment or anger? If the anticipation and completion of sexual activity usually produces positive feelings in both partners, then their sexual relationship is working for them. If one or both are left with negative feelings, then there's a problem.

What suggestions do you have for couples who have significantly different levels of sexual desire?

There are wide differences in the level of sexual interest and desire among people. Desire also fluctuates for each person as his or her life circumstances change. If the difference between levels of sexual desire is small, couples are generally able to negotiate their activity so that they both feel satisfied.

However, if the disparity in sexual desire is quite large, it can have a negative impact on the relationship. In these situations, the partner who has the lower level of desire often feels pressured to do something that he or she doesn't feel like doing. In the long run, this can lead to resentment, anger and a further decline in sexual desire. The partner with the higher level of desire often begins to feel unloved, deprived and desperate. Because of the increasing feeling of deprivation, the person with greater sexual desire might press for sexual activity even more frequently and more vigorously. This creates a cycle in which one partner's desire increases while the other loses all interest.

Strategies for dealing with a large disparity in sexual desire can be complex and may require the help of a therapist, especially if the problem has existed for a long time. A therapist might address the issue by suggesting that the person who has low interest in sexual intercourse shouldn't be pressured to participate. The therapist might also say that it's good for the relationship when the person with the higher level of desire feels his or her sexual needs are being met adequately. One strategy for accomplishing both of these conditions involves the partner with the lower level of desire being willing to provide sexual satisfaction for the partner in ways that don't involve sexual intercourse. The use of other techniques can avoid forcing the partner with the lower interest to experience sexual arousal when he or she doesn't feel like becoming aroused.

When this approach is used, the partner with the lower level of desire may get pleasure from pleasing the partner. The person with the higher level of desire regains the feeling that the partner does care about his or her sexual satisfaction. In some couples this leads to an increase in desire in the partner with the lower level of interest and a reduction in the pressure for more frequent sexual activity from the partner with the higher level of desire.

Some couples aren't able to accept such an approach. They might feel that they shouldn't engage in any sexual activity unless they're both aroused, or they might feel that sexual satisfaction from an activity other than intercourse is wrong.

What would you suggest to couples who experience tension because one partner requests sexual activities that don't interest or may even repulse the other person?

When a partner's preference for a specific sexual behavior is a source of conflict, the partners need to use negotiation skills to arrive at a pattern of behavior that is acceptable to both. This requires being willing to listen and avoiding blame and ridicule. It's important to consider whether the behaviors being requested are harmful.

Although people shouldn't engage in behavior they consider repulsive, if they're simply uninterested, they might want to try experimenting with the partner's fantasy or behavior to further explore their own feelings about it. If a person decides that he or she doesn't want to participate in the behavior requested by his or her partner, it's best for the partner to stop requesting that behavior. If the couple is unable to come to an agreement on this issue, it might be worthwhile to consult a psychologist, physician or marriage counselor to obtain another perspective.

What are the conditions that make it possible for a person to engage in satisfying sexual behavior?

For a person to become sexually aroused and to function normally, he or she needs to have a feeling of self-confidence, freedom from anxiety, the presence of arousing mental and physical stimulation, and the ability to focus attention on sexually arousing thoughts or behavior. Anything that interferes with these conditions can disrupt a sexual encounter. If one or more of these conditions is routinely absent, an inability to perform can become a lasting problem.

Self-confidence includes a belief that you'll be able to perform sexually, a belief that the partner finds you attractive, and a feeling that the partner has good intentions. If one of the partners routinely belittles or threatens the other, such confidence can be undermined.

Any type of anxiety can lead to an episode of sexual failure. The most common type of anxiety is performance anxiety, in which the person is afraid that he or she won't be able to become aroused and function normally. This fear of failure is self-perpetuating because the anxiety interferes with arousal. The inability to become aroused then increases the anxiety.

In order to become aroused, people generally need the mental stimulation of a partner they love or find attractive, combined with appropriate physical stimulation. The need for direct physical stimulation increases with age.

In order for stimulation to be arousing, it is necessary for a person to be able to pay attention to it. If someone is distracted by thoughts of possible failure or a lack of self-confidence or has concerns about how the partner is reacting, this will distract from the arousing sexual activity.

How can people identify whether their sexual activities or attitudes about sex might be unhealthy?

Unhealthy sexual behaviors generally involve recurrent intense fantasies, urges, or behaviors involving nonhuman objects, children or nonconsenting partners, or lead to suffering or humiliation. Some people can't become aroused unless they imagine or act out such fantasies. In these situations, consulting a health care professional is strongly advised.

Infidelity also may lead to very difficult psychological stresses and, often, a shattering of valued relationships. And sexual activities that result in a sexually transmitted disease have a direct impact on physical health.

When should people seek help for a sex-related problem?

A couple should consider seeking help if they're experiencing repeated failures in sexual performance or when there's strong disagreement about sexual practices that they can't resolve. Performance problems include difficulty getting an erection, lack of sexual desire, difficulty reaching orgasm, premature ejaculation or a lack of satisfaction from sexual activity. Since medical problems can cause sexual dysfunction, the family physician is a good starting point for discussion of these problems. A therapist might be needed to explore marital and psychological issues that could be contributing to the problem. >>>>

When a woman's not interested in sex—and would like to be—it may have something to do with her relationship, her upbringing, or something else in her experience, but there could also be a medical explanation. For instance:

1. Reduced blood flow
Diabetes and high blood pressure are among the health problems that can restrict genital blood flow.

2. Hormonal issues
Menopause, breast-feeding, birth control pills, and thyroid problems can dampen sexual desire.

3. Medication side effects
Antidepressants and chemotherapy agents such as tamoxifen are frequently to blame.

4. Nerve damage
Pelvic surgery can cause nerve damage, as can diseases such as multiple sclerosis or Parkinson's.
Other reasons for low desire might include lack of sleep or depression.

Talk to a doctor or sex therapist
If you have low desire, get checked out by your primary care doctor. Whether or not he or she finds a physical problem, a consultation with a certified sex therapist can be helpful, because physical sex problems usually create a psychological or relationship issue, as well. "It's usually not just one thing," says Marjorie Green, MD, director of the Mount Auburn Female Sexual Medicine Center in Cambridge, Mass., and a clinical instructor at Harvard Medical School.

On the other hand, if you feel your lack of desire is a physical issue and your primary care doctor is not able or willing to help, you may want to consult a sexual medicine specialist.

Treatments
These vary depending on the source of the problem, but may include switching prescription medication, taking estrogen or testosterone, taking a drug that increases dopamine levels, or trying products such as Eros Therapy, an FDA-approved prescription-only device that uses gentle suction to increase blood flow to the clitoris and vulva. Some women may also see improvement with regular exercise, sex therapy, or relationship counseling. >>>> 

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Medical Reasons for Low Libido

3 Kinds of Drugs That Can Kill Your Sex Drive

An Antidepressant Stole My Libido

Psychological Issues Can Fuel a Low Libido

Low Libido Isn't Always Normal With Aging

Can Hormone Replacement Boost My Sex Drive?

Men Can Lose Their Libidos Too

I Feel Like I'm Not a Man Right Now

Sex Drive Problems in Your Relationship?

3 Reasons for Different Sex Drives

Is Your Libido More Active Than Your Partner's?

What Kind of Doctor Treats Low Sex Drive?

Doctor Too Embarrassed to Talk About Sex?

The Brain Chemistry of Sex Drive

3 Lifestyle Habits That Can Boost Your Sex Drive

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Mother and Daughter: 10 Questions to Ask a New Partner Before Having Sex

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Before hopping into bed with a new sex partner, have an open and honest conversation about your sexual histories, risks, and the last time you were tested for HIV and other sexually transmitted diseases (STDs).

Knowing someone’s test results isn’t enough. “Even if your partner tested negative for HIV last week, it doesn’t mean he or she isn’t HIV positive,” says Perry N. Halkitis, PhD, a psychologist specializing in HIV at New York University. “Most HIV tests can only detect the virus starting three to six months after infection—so you should ask about your partner’s sexual history for the past six months.”

Here’s what you need to find out. Of course, you probably won’t get too far down the list if you just roll out the interrogation; but these are the questions you really do need answers to, one way or another. One option: Start by sharing your own history, and see what you get back.

1. Are you HIV positive?

2. Have you ever tested positive for a sexually transmitted disease? If so, were you treated?

3. How many sex partners have you had since your last STD and HIV tests?

4. Have you had any STDs in the past six months?

5. If you have been diagnosed with herpes or genital warts, are you having outbreaks? Are you being treated?

6. Have you been at risk for HIV in the past six months?

7. Do you have any objection to using a condom?

8. Are you allergic to latex?

9. Are you on any form of birth control?

10. Which sexual activities do you want to engage in?

Nick Burns

Viagra's effect in women has been disappointing, but a new small study finds that those on antidepressants may benefit from taking the little blue pills.

The research involving 98 premenopausal women found that Viagra helped with orgasm. But the benefits did not extend to other aspects of sex, such as desire, researchers report in Wednesday's Journal of the American Medical Association.

"For women on antidepressants with orgasm problems, this may provide some wonderful relief," said psychologist Stanley Althof, director of the Center for Marital and Sexual Health of South Florida in West Palm Beach, who was not involved in the study. "But it will not improve their desire or arousal."

Antidepressants can interfere with sex drive and performance even as the drugs help lift crippling depression. Switching drugs or reducing the dose can help. But many people, men and women, stop taking them because of their sexual side effects.

The complaints are common. More than half the people who take antidepressants develop sexual problems, studies have found, especially for people taking Prozac, Paxil, Celexa and other drugs that work by increasing the chemical serotonin in the brain. Serotonin is thought to slow orgasm, perhaps by diminishing the release of another brain chemical, dopamine. Viagra increases blood flow to sex organs.

Pfizer Inc. spokeswoman Sally Beatty said the company has no plans to pursue FDA approval for using its drug Viagra as a treatment for female sexual dysfunction.

The company ended its internal research on Viagra for women in 2004. Although Viagra was found to be safe, the results were inconclusive, Beatty said in an e-mail.

The search for a Viagra equivalent for women has been disheartening. A testosterone patch was sent back for more safety study by the Food and Drug Administration. A handheld vacuum device that increases blood flow to the clitoris does have FDA approval, and BioSante Pharmaceuticals Inc. is testing a testosterone gel called LibiGel.

The new Viagra findings are based on an eight-week experiment. The 98 women were using antidepressants successfully but were having sexual problems. Their average age was 37.

The women agreed to attempt sexual activity at least once each week. Each time, they took a pill, not knowing whether it was Viagra or a matching dummy pill.

Although 72 percent of the women taking Viagra reported improvement on an overall scale, only 27 percent of the women taking the placebo reported improvement.

Althof said it's "worrisome" that 43 percent of the women on Viagra experienced headaches, compared with 27 percent of the women on dummy pills. Indigestion and reddening of skin (flushing) also were reported more often by the women taking Viagra.

Psychologist Leonore Tiefer of New York University School of Medicine said industry-funded research has oversimplified women's sexual experience. She noted that the new study, funded by a Pfizer grant, found more side effects than benefits.

"Where's the question to the women: Is it worth it?" Tiefer said.

An earlier study in men taking antidepressants found more pronounced sexual benefits with Viagra than the benefits found for women, said lead author Dr. George Nurnberg, a psychiatrist at the University of New Mexico School of Medicine in Albuquerque.

But the message for men and women who need antidepressants is that Viagra may help them stay on the drugs, he said.

"We're not talking about a lifestyle issue. We're talking about a medical necessity issue," Nurnberg said.

Pfizer had no influence on the design, findings or manuscript, Nurnberg said. He and several of the other authors disclosed financial ties to Pfizer and other drugmakers. >>>>

Sexually dysfunctional women in the United States are, well, mostly out of luck.

Unlike men, there are no approved drugs to take. If you go strictly by the rules, the best medical science has to offer is counseling, or a device that applies suction to your clitoris, or physical therapy for your vagina. While not to diminish these choices, where's that convenient, little blue pill for women?

That's what Joanne wanted to know. This isn't her real name, but she's a 26-year-old nurse at the Cleveland Clinic who felt no sex drive -- nothing, nada, zilch -- for eight years. She wasn't happy, and neither was her boyfriend.

When Joanne asked her gynecologist for help, she told her to talk to her psychiatrist. Her psychiatrist said her antidepressants were to blame -- they're known to decrease libido in about a third to a half of women, experts say.

"My psychiatrist just kind of shrugged her shoulders," Joann says. "It was just like, well, that's a side effect of the drug. That's just the way it is." Watch more on how women can get their groove back

Finally, fate intervened on behalf of Joann's sex life. Last year, the anti-depressants she was taking stopped working, and her psychiatrist had to switch her to a new one. "All of a sudden, my sex drive went through the roof. It was awesome. It was wonderful," she says.

But it wasn't perfect, or even close to it. Probably because of her long-dormant sex drive, Joanne could get sexually excited, but couldn't reach orgasm. Again, after being shuffled around to various doctors, Joanne ended up with a urogynecologist at the Cleveland Clinic.

That doctor prescribed the anti-impotence drug, Cialis. At first Joanne thought it strange to take a drug meant for a man. But she tried it, and she says it's helped somewhat. "I'm still not able to achieve orgasm, but I'm getting closer each time," Joanne says. "We're working with changing the dosage."

Getting help for women's sexual problems is often a long and complicated road. "This is an area that's highly neglected," says Dr. Sharon Parish, an internist at the Albert Einstein School of Medicine who treats sexually dysfunctional women. "Many primary care doctors have no idea what to do."

So if you want help for your sexual problems, you may have to make suggestions to your doctor. "I feel like if I hadn't aggressively pursued it, I'd still be stuck in the same spot," Joanne says.

Here are some treatments for sexual dysfunction you can discuss with your doctor.

1. Impotence drugs such as Viagra, Levitra and Cialis

Some studies, like one out this week in the Journal of the American Medical Association, show they work for some women with sexual problems; others have shown they don't work.

A woman's biggest hurdle could be finding a doctor who'll prescribe them, since they're approved by the FDA only for men.

The solution: Be frank with your doctor. Ask if he or she is willing to consider prescribing these drugs "off label." Be clear that you recognize these medicines have not been approved for women, and that you want to know about the risks and benefits.

2. Testosterone

Experts we talked to said taking testosterone has helped many of their female patients. "It not only helps with sex drive, it will also help with arousal," says Dr. Cynthia Brewer, a clinical associate at the Center for Specialized Women's Health at the Cleveland Clinic.

Testosterone, produced naturally by both men and women, boosts libido. Synthetic testosterone, however, has been approved only for use with men. In 2004, the FDA declined to approve a testosterone patch for women, saying it hadn't been thoroughly tested.

As with Viagra and its cousins, if you're interested in possibly trying testosterone, tell your doctor you know it's off label, and you'd like to discuss the benefits and risks for women -- knowing that not all the risks are fully understood.

There's one big hitch: Testosterone is available only in men's doses, which are way too high for women. You'll need a doctor who's familiar with how to fit the dose to a woman. There's no one central place to find doctors who specialize in female sexual dysfunction, but you can start at the American Urological Association, or at the International Pelvic Pain Society.

3. Arginine

Some doctors suggest using a cream with arginine, an amino acid that's supposed to increase blood flow.

"It's supposed to act like Viagra," says Brewer. "I saw one patient try it, and it had benefits. For another it didn't. Women can try it and decide for themselves."

4. Anti-stress herbs

You don't have to be Dr. Ruth to know that when you're under stress, you're not in the mood for love. "Stress levels will affect a woman's libido. We're more sensitive to stress than our male counterparts," says Dr. Esther Konigsberg, medical director of the Family Practice Center of Integrative Health and Healing in Burlington, Ontario.

Konigsberg often suggests these anti-stress herbs to her patients with sexual problems: ashwagandha, astragalus, panax ginseng. Licorice can also be used for stress, but she says your physician must monitor your potassium levels.

5. Experimental medicines

"There are a few investigational drugs in the pipeline for both pre- and post-menopausal women," says Dr. Sheryl Kingsberg, clinical psychologist and chief of behavioral medicine at University Hospitals Case Medical Center in Cleveland, Ohio.

While you can't get these on the open market, women can try to join a clinical trial. Two experimental drugs, called flibanserin and bremelanotide, work on the brain to increase arousal. A third, Libigel, is a gel that boosts testosterone.

The National Institutes of Health has a list of clinical trials for female sexual dysfunction.

And the most important rule: Don't wait for your doctor to ask you about sexual problems. "Women should feel empowered to bring up the topic first, because lots of physicians aren't comfortable bringing it up themselves," Kingsberg says.

Also, be aware that drugs won't help every woman with a sex problem. Kingsberg says drugs have helped about half of her post-menopausal patients, and about 20 percent of her pre-menopausal patients. The rest, she said, benefited from counseling.

Yesterday's Health section featured a refreshing article by a 6-months-pregnant woman grappling with the baffling array of dietary decisions a good mom's supposed to make in these nutrition-conscious days.

Writer Moira E. McLaughlin discussed her dismay at having to do without beer ("Ah, delicious summer brews! Sweet Octoberfests! Thick winter stouts!"), sushi, and blue cheese in the current cautious climate, so different from the one in which many of our own smoking, drinking mothers enjoyed when they were bearing us and our siblings.

The article mentioned caffeine only in passing. But the question of whether caffeine's safe for pregnant women and their babies continues to be examined by experts and pregnant women alike. Many experts concur that cutting caffeine altogether is the safest bet for protecting an unborn baby's health, as its consumption may increase the risk of miscarriage, a suspicion supported by research released in January.

In light of that research, the March of Dimes recommended that if a pregnant mother must have her daily hit, she limit herself to no more than 200 mg a day -- about 12 ounces of coffee's worth.

(Curious about how much caffeine you're consuming? Check this list from the Center for Science in the Public Interest, a consumer advocacy group that's been pushing the FDA to require food and beverage labels to list caffeine content.)

And now this: a study published online Monday in the British Medical Journal showed that the more coffee a pregnant woman drinks, the greater the risk of her baby's being born underweight. The association held even for those who consumed very little caffeine, less than you'd get from that single cup of coffee per day, and grew stronger with increased consumption.

In general, a certain amount of caffeine has some benefits. A study published in June in the Annals of Internal Medicine showed that consuming coffee may well offer modest protection against cardiovascular disease. Caffeine intake has also been linked to reduced risk of some forms of dementia. They keep testing caffeine consumption against different diseases, such as breast cancer, but don't seem to find many links pro or con.

But the stakes are different when you're a pregnant woman; you have to weigh whatever potential benefit to your own health caffeine might offer against the risks it might pose to your baby. What's a thinking -- or an over-thinking -- mom to do?

When I was pregnant with each of my two kids, I went cold turkey on caffeine, cutting back from several cups a day to none whatsoever. It wasn't easy: I remember many a foggy-headed morning and headachy afternoon. Looking back, I wonder whether I could have safely indulged in a daily cup of joe, but at the time it simply didn't seem worth the risk, however small.

Current moms, did you consume caffeine while pregnant? To any ill effect? And moms-in-the-making, how are you sorting out all the nutrition information, including that about caffeine, that's strewn in your path?

Jennifer Huget

Postmenopausal women who have lost interest in sex may be able to bring their libidos back to life with a testosterone patch, according to new research published this week in The New England Journal of Medicine.

However, the use of the male hormone to boost sex drive in women may not be risk-free. Out of the 814 women in the study, four women who were taking testosterone developed breast cancer, but none of the women on placebo did. It's not clear whether this was a statistical blip or a warning sign that excess testosterone could cause or spur the growth of a malignancy. Some women also reported excess hair growth, although none stopped using the hormone for this reason.

Susan R. Davis, M.D., Ph.D., of Monash University in Australia, and colleagues in the United States, Canada, and Sweden, evaluated two different doses of testosterone delivered by Procter & Gamble Pharmaceuticals' Intrinsa patch. In 2004, a U.S. Food and Drug Administration (FDA) panel gave Intrinsa the thumbs down and called for larger, longer studies to ensure that the medication was safe, in addition to proving that it actually helped women's sex lives.

As the new findings show, it did. Wearing the higher-dose testosterone patch boosted a woman's "satisfying sexual experiences" by an average of 2.1 times every four weeks, compared to an increase of just 0.7 such experiences for women taking a placebo. Both testosterone doses used in the study seemed to increase desire and decrease distress.

"Although the change in activity is modest, that's something that is appropriate and I think most women would be more than happy with it," says study co-author Sheryl A. Kingsberg, Ph.D., chief of behavioral medicine at University Hospitals Case Medical Center in Cleveland, Ohio. "They wanted to return to the level of desire they had in their premenopausal years, and that's what they got." Before starting treatment, the women in the study had been having satisfying sex about twice a month on average, Kingsberg points out; the higher-dose patch increased that to once a week.

"For most women and providers of health care for women, that modest benefit is clinically meaningful," agrees North American Menopause Society president JoAnn V. Pinkerton, M.D., a professor of obstetrics and gynecology at the University of Virginia, in Charlottesville, who did not participate in the study.

Some women lose interest in sex during and after menopause, due in part to the drop in estrogen that comes with the "change of life." While taking estrogen can increase lubrication and possibly restore a woman's sex drive, hormone replacement is now understood to raise the risk of heart disease and stroke. Many physicians prescribe testosterone instead, although there is currently no testosterone product that's FDA-approved for treating women with "hypoactive sexual desire disorder." The European Union has approved Intrinsa, but only for women who have had their ovaries removed, a procedure also known as surgical menopause. Read more on the medical reasons why some women don't want sex

In the current study, 814 women who had undergone either surgical menopause or natural menopause were randomly assigned to use daily a placebo patch or an Intrinsa patch containing either 150 or 300 micrograms of testosterone. The trial lasted for a year, and a subset of women was followed for an additional year. Procter & Gamble Pharmaceuticals sponsored the study and helped design the trial as well as collect and analyze the data.

"Based on these data and other studies we've conducted, we are continuing our talks with [the] FDA to explore new opportunities and pathways forward," says Procter & Gamble spokesperson, Tom Milliken.

One of the women on the 300-microgram dose was found to have breast cancer three months after the study ended; three others in the testosterone groups learned they had the disease between four and 12 months after treatment began.

"We do not know if the testosterone patch contributed to proliferation or metastasis of the breast cancer in women diagnosed in the earlier months of the study, potentially affecting their long-term survival," says Leslie R. Schover, Ph.D., a behavioral scientist at the University of Texas M.D. Anderson Cancer Center, in Houston, who recently wrote an article analyzing research on testosterone for low libido. "A valid safety study needs at least a five-year follow-up period in a large, randomized trial. If women use Intrinsa without such a trial, I believe they are risking their lives to gain a very modest increase in sexual desire." Learn why birth control is safer than ever (and sometimes it's even good for you)

But Dr. Davis says she is not concerned about the increased breast cancer risk seen in the study. Four breast cancer diagnoses among 814 women during a two-year period "is not unexpected," she says, and given that twice as many study participants were taking testosterone than were on placebo, "it is probably a chance finding that they were in the two treatment groups."

Many doctors who treat postmenopausal women -- and prescribe testosterone off-label to some of them -- say a treatment tailored to women is sorely needed and would probably be safe with short-term use. "We don't have enough safety data to say it's safe for long-term use, but I think short-term, the benefits clearly outweigh the risks," Dr. Pinkerton says. Read more: 10 questions to ask a new partner before having sex

But some experts warn that a pill or patch isn't always the answer to a sexual problem.

"For women there are so many other things that can contribute to sexual issues, starting from the fact that the most important sex organ is the brain," says Marcie Richardson, M.D., director of the Harvard Vanguard Menopause Survey in Boston. "I'm glad that people are trying to sort this out with good objective evidence, but I hope we don't fall victim to the notion that this is all about medication, because it's not."

Anne Harding 

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Testosterone makes women friskier -- but should it be prescribed?

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Testosterone ramps up women's sexual desires, according to a study just published in the New England Journal of Medicine.

The Procter & Gamble-funded study -- with the acronym APHRODITE -- involved 814 women treated at 65 different locations in the U.S., Canada, Australia, Sweden and the U.K. All of the women had what is medically referred to as "hypoactive sexual desire disorder" -- a chronic lack of interest in sexual activity. Study participants received 150 micrograms or 300 micrograms of testosterone a day delivered via a patch, or a placebo patch with no testosterone in it. Nobody (clinicians or women) knew who got what until the end of the study.

Other stats: The study ran for 52 weeks, and the effectiveness of the treatment was evaluated up to 24 weeks into it. The scientists gauged effectiveness as a change in frequency of "satisfying sexual episodes" within four-week periods. Safety was monitored for the entire 52 weeks and a subset of the women were tracked for even longer. None of the women took estrogen; all had passed menopause.    

The results: The group given 300-microgram patches experienced an uptick in satisfying sexual episodes that was measurable as early as the second month of treatment. They had, on average, 2.1 more such episodes per four-week period (compared with 0.7 more for the placebo group)--almost a doubling. But both testosterone groups said they felt more sexual desire than the placebo group did, as well as less distress. The results, to the authors, indicated a "modest but meaningful improvement in sexual function" for the 300-microgram group.

That doesn't mean the patch should be handed out willy nilly. There do appear to be some side effects: irritation where the patch is applied, and when the patch contained testosterone, increased facial hair growth. Four patients getting testosterone developed breast cancer, but the authors say it's not clear that this was due to chance or was related in some way to the hormone: one of the woman had symptoms before she began the trial.

Earlier studies had shown that testosterone can increase sexual desire in women taking estrogen: this one shows that it helps for those who do not. This was a longer trial than most have been as well.

In a related editorial, Julia R. Heiman of the Kinsey Institute for Sex, Gender, and Reproduction at Indiana University writes that the sexual improvements were "good news" and notes that the facial hair side effects didn't seem to lead to women dropping out of the trial. But the breast cancer cases are of concern, she says. "The apparent excess of cases in the testosterone groups could simply be due to chance (the size of the groups is too small to allow for analysis) but this potentially worrisome signal cannot be ignored," she says. She suggests a "need for caution in using testosterone until we understand more about its possible link with breast cancer and are better able to predict which patients are more likely to be subject to negative effects."

Heiman's editorial also mentions that estimates of low sexual desire prevalence in women range from 25% to 53%. She also notes that it's not always a problem for those who report it. How many do get upset? Here's a recent blog entry on a study examining that. >>>> 

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Improving a Woman's Love Life

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There's new evidence that women may be able to safely improve their love lives--by taking the principal male sex hormone, testosterone.

Studies indicate that a lot of women have problems with their love lives -- a Harvard study involving more than 31,000 women in this month's issue of the journal Obstetrics and Gynecology, for example, found that 40 percent of women have sexual problems. Previous studies have suggested that testosterone can boost a woman's libido and help make sex more pleasurable. But most of those studies also involved giving women the hormones estrogen and progestin as well and did not follow women for long periods to see if the treatment was safe.

In the new study, published in today's New England Journal of Medicine, Susan Davis of Monash University in Australia asked 814 postmenopausal women with low sex drives to wear a patch that delivered either one of two doses of testosterone or a placebo for a year.

After six months, the women who were getting the testosterone reported a big improvement in their sex lives. Either dose of testosterone significantly increased the women's sex drive, and those getting the higher doses reported a big increase in the frequency of "satisfying sexual episodes" each month -- from about two a month before the treatment to more than four. They also reported more orgasms and pleasure.

There were some downsides. One third of those getting the high dose of testosterone reported the growth of body hair (compared to 23 percent of those on placebo). And even more worrisome, four women were diagnosed with breast cancer, compared to none of those who recived placebo. Researchers say it's unclear whether that had anything to do with the testosterone.

In an editorial accompanying the study, which was sponsored by testosterone patch maker Proctor & Gamble, Julie Heiman of the Kinsey Institute for Sex, Gender and Reproduction at Indiana University said that while the new study provides encouraging new data that testosterone can help women improve their sex lives, more research is needed to make sure it doesn't come at the cost of more breast cancers.

Rob Stein

Although rice is considered to have a low potential for causing allergic reactions, it can trigger a severe form of gut inflammation in some infants, new study findings confirm.

The reaction is known as "food protein-induced enterocolitis syndrome," or FPIES -- an inflammatory response of the digestive system to certain food proteins, including those in cow's milk, soy, meat and grains. Infants with FPIES usually suffer vomiting and diarrhea within roughly 2 hours of eating the culprit food.

While FPIES is similar to a standard food allergy, it does not involve a response from immune system antibodies. And unlike a true food allergy, FPIES usually causes only gastrointestinal symptoms.

Rice, because of its low potential for triggering an allergic response, is generally recommended as the first solid food for infants. However, the grain is increasingly being recognized as a cause of FPIES.

In the new study, Australian researchers found that over 16 years, 14 children came to their hospital with 26 episodes of rice-related FPIES. During the same period, FPIES caused by cow's milk or soy -- considered the most common triggers of the condition, occurred in 17 children who had 30 episodes.

Amy Norton

Think achy joints are the main reason we slow down as we get older? Blame the brain, too: The part in charge of motion may start a gradual downhill slide at age 40. How fast you can throw a ball or run or swerve a steering wheel depends on how speedily brain cells fire off commands to muscles. Fast firing depends on good insulation for your brain's wiring.

Now new research suggests that in middle age, even healthy people begin to lose some of that insulation in a motor-control part of the brain — at the same rate that their speed subtly slows.

That helps explain why "it's hard to be a world-class athlete after 40," concludes Dr. George Bartzokis, a neurologist at the University of California, Los Angeles, who led the work.

And while that may sound depressing, keep reading. The research points to yet another reason to stay physically and mentally active: An exercised brain may spot fraying insulation quicker and signal for repair cells to get to work.

To Bartzokis, the brain is like the Internet. Speedy movement depends on bandwidth, which in the brain is myelin, a special sheet of fat that coats nerve fibers.

Healthy myelin — good thick insulation wound tightly around those nerve fibers — allows prompt conduction of the electrical signals the brain uses to send commands. Higher-frequency electrical discharges, known as "actional potentials," speed movement — any movement, from a basketball rebound to a finger tap.

Consider someone like Michael Jordan. "The circuitry that made him a great basketball player was probably myelinated better than most other mortals," Bartzokis notes.

But while myelin builds up during adolescence, when does production slow enough that we fall behind in the race to repair fraying, older insulation?

Enter the new research. First, Bartzokis recruited 72 healthy men, ages 23 to 80, to perform a simple test: How fast they tapped an index finger. Anyone can do this; it doesn't depend on strength or fitness.

Researchers counted how many taps the men made in 10 seconds, recording the two fastest of 10 attempts. Then, brain scans checked for myelin in need of repair in the region that orders a finger to tap.

Strikingly, tapping speed and myelin health both peaked at age 39. Then both gradually declined with increasing age, the researchers reported last month in the journal Neurobiology of Aging.

That doesn't mean the rest of the brain is equally affected. Bartzokis has some evidence that myelin starts to fray a decade or so later in brain regions responsible for cognitive functions — higher-level thinking — than in motor-control areas.

So back to his example of Jordan, who last played professionally at age 40: "Even he started getting older. That circuitry started breaking down a little," contends Bartzokis. "He can become Michael Jordan the big-shot businessman ... but not be Michael Jordan the super-duper basketball player anymore."

Bartzokis isn't looking to build a better athlete. His ultimate goal is to fight Alzheimer's disease. The connection: Building memories requires high-frequency electrical bursts, too, and Bartzokis' earlier research suggests an Alzheimer's-linked gene may thwart myelin repair.

But the new research has broader implications because it sheds light on normal aging, says Dr. Zoe Arvanitakis, a neurologist at Chicago's Rush University Medical Center.

"We knew at some age you peak and there's a sense it would disintegrate as you grow older. But we didn't have a sense of where that age would be," says Arvanitakis, who next wants to see if myelin and cognitive functions show a similar trajectory.

Bartzokis' research supports a recent report from German scientists, that with age comes a weakening of the system that's supposed to repair broken myelin, adds Dr. Bradley Wise of the National Institute on Aging.

"Any disruption in these neural circuits and networks will have problems for functioning," says Wise, who says the two reports are spurring increased interest into myelin's role in aging. Until recently, most myelin research has focused on multiple sclerosis, where myelin doesn't gradually degrade but disappears.

While much more research is needed, Bartzokis has some practical advice:

_Keeping active and treating high blood pressure, high cholesterol and diabetes already are deemed important for good brain health. But physical and mental activity also may stimulate myelin repair, while unused neural pathways wouldn't send out a "help" signal, he says.

"Remember, these are average people I tested," Bartzokis says. "Someone that's really practicing could make it (myelin) last longer because you're sending the signals to repair, repair, repair."

_Stress hormones, however, may hurt myelin.

_He's also testing whether consumption of omega-3 fatty acids — the oils, found in fatty fish, already recommended for cardiovascular health — might help maintain myelin.

LAURAN NEERGAARD

Heart attack rates appear to be increasing during the daylight saving time according to a study by Swedish researchers. How is that possible? Well, according to the study, sleeping an hour less might affect cardiovascular rhythm in persons having heart problems.

On the other hand, the number of heart attacks dipped on the Monday after clocks were set back an hour, possibly because people got an extra hour of sleep, Dr. Imre Janszky of the Karolinska Institute and Dr. Rickard Ljung of Sweden’s National Board of Health and Welfare said. Their findings were presented in a letter published in the Oct. 30 issue of New England Journal of Medicine.

For the study, Dr. Janszky and Dr. Ljung analyzed data on heart attacks for a period of 20 years between 1987 and 2006 and found that the rate of heart attacks increased 5 percent in the first week with 6 percent increase on Monday and Wednesday and 10 percent increase on Tuesday after clocks were set forward one hour in the spring. Oppositely, when clocks were set back one hour, the rate of heart attacks dipped 5 percent on Monday although the rate for the first week remained pretty much the same.

Sleep deprivation has long been shown to be bad for the human body, especially for the heart, as it leads to high blood pressure and high rate which can cause dangerous clots. About 1.5 billion people are affected by daylight saving time shifts across the globe. Daylight saving time is commonly used in the northern hemisphere to add an hour of daylight to the afternoons.

According to the National Sleep Foundation, seven to nine hours of sleep each night should be enough to feel rested the second day and avoid health problems.
Anna Boyd

Public Health Experts Urge Efforts to Curb Dangerous Disease-Spreading Trend

At any given time, a significant percentage of men are engaging in multiple sexual partnerships with women -- a situation that may facilitate the spread of sexually transmitted infections, including HIV.

Researchers looked at The National Survey of Family Growth, a national database that interviewed 4,928 men in the United States.

In the survey, men reported the first and last date they had sexual intercourse with each of their sexual partners during the year before the interview.

Though the actual reported rate of such behavior in the study is 6.6 percent, the authors of the study estimate from adjusted measurements that up to 11 percent of men may have been involved with multiple sexual partners at some point during the previous year.

Concurrent sexual relationships may have huge implications when it comes to the spread of sexually transmitted disease.

"Concurrent partnerships are an important sexual network characteristic because of the way they connect people to each other," says lead study author Dr. Adaora Adimora, clinical associate professor of epidemiology at the University of North Carolina at Chapel Hill School of Public Health.

"These kinds of relationships can spread HIV through a population faster than the same number of monogamous relationships."

This quicker spread is, in many ways, a simple function of time.

"For example, three concurrent partnerships will spread HIV faster than three monogamous relationships back-to-back, because if a person only has sequential partners and he gets HIV, he won't give it to another partner until he ends his relationship and strikes up a new one," Adimora explains. "If the individual has concurrent partnerships, he can immediately give the next partner HIV without waiting to end the first relationship."

Some public health experts hope the study will offer a new direction for efforts to stem the spread of HIV.

"I think that this study is highly significant," says Bruce Dezube, associate professor of medicine at Beth Israel Deaconess Medical Center in Boston, Mass. "It's amazing to me how much progress we have made with HIV drugs -- we have over 30 drugs available and 5 different mechanisms to treat patients -- but the one thing we haven't figured out is human behavior."

Not all infectious disease experts agree, however, that the results of the study are a surprise.

"There is nothing significant about this study that was not known before it was published," says Dr. Richard Spark, associate clinical professor of medicine at Harvard Medical School in Boston, Mass.

And Dezube says that even though the research will likely help improve efforts to curb infectious disease spread, he notes that he is "not surprised that the rate of concurrent sexual relationships is so high."

"I'd like to quote the surgeon general Coop who said that 'the majority of people who get HIV get it through mechanisms that the majority of people wouldn't understand,'" he says.

Race, Behaviors May Contribute to Trend

Adimora says race appears to have much to do with the chances a given man is involved in concurrent relationships -- a finding that could help public health experts design strategies to combat the trend.

"We found that concurrent relationships were more common among men who were black, Hispanic, or had been incarcerated in the last year," she said, adding that this correlation could be due to a number of factors, including higher death rates among men in certain racial groups and higher rates of incarceration among black men.

But Eli Coleman, professor and director of the Program in Human Sexuality at the University of Minnesota Medical School in Minneapolis, says the underlying factors go further than race alone.

"Certain groups are more at risk for HIV infection than others," he conceded. "However, racial differences obscure the underlying factors which lead to poor sexual health.

"Poverty, stigma and discrimination, lack of access to health care, education might be more of a common denominator among white, black and Hispanic groups -- these factors deserve more investigation."

Adimora agrees that other factors could be at play, as men who engaged in concurrent sexual relationships also seemed to have other behaviors in common.

"Men who did have concurrent relationships were more likely to be intoxicated on drugs and alcohol, to have relationships with women who had multiple partners, and to have had sexual relationships with men in the past," she said.

Solving the HIV Epidemic

Coleman says that in order to stem the spread of sexually-transmitted infections, public health experts must develop a holistic approach -- one which takes into account a number of factors that seem to increase the chances of a spectrum of unhealthy behaviors.

"We need approaches that will remove health disparities caused by poverty, stigma and discrimination, poor access to health care and education," Coleman said. "We need to develop a sexual health approach to HIV infection which will provide sexuality education, access to sexual health care, all which is culturally sensitive and relevant."

Central among these factors, he says, is poverty.

"HIV is probably more a risk among poor and disenfranchised groups," Coleman said. "Prevention programming needs to better target these groups ... This is a vicious cycle that needs to be broken."

And Kate Wachs, a clinical psychologist in Chicago, Ill. and author of the book "Relationships for Dummies," says women can take an important cue from the research.

"Hopefully, the general public will start to be more cautious," she says. "Women need to start thinking, 'How many partners do I have? How many partners have my partners had? How many of those were men? How many wore condoms?'

"People are not as safe as they thought they were, and women have to be careful here."

DAN CHILDS and CARLA WILLIAMS

Once-daily dose of the ED drug delayed disease progression, researchers found

Cialis (tadalafil), a drug used to treat erectile dysfunction, appears effective in treating pulmonary hypertension, researchers report.

Pulmonary hypertension is caused by high blood pressure in the arteries that supply the lungs with blood. People who suffer from the condition can become tired, dizzy and short of breath, because the arteries feeding the lungs constrict and reduce the supply of oxygenated blood being circulating throughout the body.

But Cialis "was found to improve exercise capacity, health-related quality of life, delay time to clinical worsening, and improve hemodynamic [blood-linked] parameters of disease severity," said lead researcher Dr. Robyn J. Barst, a professor of pediatrics at Columbia University College of Physicians & Surgeons in New York City. The drug was also well-tolerated, she added.

The report was to be presented Tuesday at the American College of Chest Physicians annual meeting, in Philadelphia.

For the study, Barst's team randomly assigned 405 pulmonary hypertension patients to Cialis or placebo once a day, or to Cialis and bosentan (Tracleer) a common treatment for pulmonary hypertension.

The researchers found that over 16 weeks, Cialis increased patients' six-minute walk distance and delayed their time to clinical worsening, which included death, hospitalizations, worsening functional class and the need for adding new pulmonary arterial hypertension therapy.

In addition, Cialis increased heart output and reduced pulmonary artery pressures compared with those measures at the start of the trial, Barst's group found.

"We would anticipate that tadalafil will be reviewed and approved by the regulatory agencies as an additional therapy available for the treatment of pulmonary hypertension," Barst said. "It is useful for the treatment for pulmonary hypertension, as for many other diseases, to have more than one drug per class approved, due to individual patient responses and side effects," she added.

Dr. Gregg C. Fonarow, a professor of cardiology at the University of California, Los Angeles, noted that pulmonary hypertension is a progressive disease which results in substantial morbidity and mortality.

"Prior studies have shown that the oral phosphodiesterase type 5 inhibitor, sildenafil (Viagra, Revatio) improves exercise capacity in patients with pulmonary arterial hypertension," Fonarow said. "This medication is currently FDA-approved for this indication, but must be taken three times daily."

This new study of Cialis, taken once daily, demonstrates that the drug substantially improves functional capacity, improves quality of life, and also results in less clinical worsening in patients with pulmonary arterial hypertension, Fonarow said.

"These are impressive findings," Fonarow said. "Tadalafil represents a very promising new therapy for patients with pulmonary arterial hypertension, that may be used alone or in combination with other treatments such as bosentan."

Steven Reinberg

It offers cardiovascular protection, but this pill is more nuanced than most of us might think—for better or for worse

Tomatoes genetically modified to be rich in antioxidants called anthocyanins appeared to extend the life spans of cancer-prone mice, a European study finds.


The modified tomatoes were created by adding two genes (Delila and Rosea1) from the snapdragon flower. The anthocyanins, which belong to the flavonoid class of antioxidants, gave the tomatoes a peculiar purple color.


"The two genes we have isolated are responsible for flower pigmentation and, when introduced in other plants, turned out to be the perfect combination to produce anthocyanins, the same phytochemical found in blueberries," study author Eugenio Butelli, of the FLORA project, said in a news release.


Chemical tests revealed that the "purple tomato has a very high antioxidant activity, almost tripled in comparison to the natural fruit," making it very useful to study the effect of anthocyanins, Butelli said.


The researchers fed a powder obtained from the purple tomatoes to mice that lacked the p53 gene, which helps protect against cancer. These mice had an average life span of 182 days compared to 142 days for p53-deficient mice fed a standard diet.


The findings were published in the Oct. 26 issue of Nature Biotechnology.


The study authors emphasized this is a preliminary study, and much more research needs to be done before there's any possibility of human trials.

Yah

Millions of children will need to take their vitamin D supplements each day to meet the new recommendation of the American Academy of Pediatrics. The academy has doubled its recommendation for a daily dose of vitamin D in children and adolescents in an attempt to prevent rickets and other diseases, ranging from cardiovascular disease to cancer, osteoporosis, and multiple sclerosis.

Pediatricians are recommending that children receive double the usually suggested amount of vitamin D, which was recommended by the academy in 2003. The amount recommended back then was 200 units daily for people up to age 50, 400 units for adults ages 51 to 70 and 600 units for those 71 and older. The new recommendation is to get at least 400 international units (IU), according to the new guidelines released by the American Academy of Pediatrics.

The recommendation is especially important for breastfed babies who are at an increased risk of vitamin D deficiency, as mother’s milk isn’t rich in vitamin D. Breastfed babies need to receive the recommended dose of vitamin D even from the first day of their lives.

“We are doubling the recommended amount of vitamin D children need each day because evidence has shown this could have life-long health benefits. Supplementation is important because most children will not get enough vitamin D through diet alone,” said Dr. Frank Greer, of the American Academy of Pediatrics, which released the new guideline recommendations at a meeting in Boston.  

The agency’s decision follows a number of recent research studies that have shown that vitamin D is playing a crucial role in helping our immune system fight back diseases. The deficiency of vitamin D during childhood and adolescence has outcomes later in life like the risk of dying from cardiovascular disease, the risk of developing cancer disease, or osteoporosis. Previous studies have also linked low levels of vitamin D with high blood pressure, diabetes and obesity.

Pediatricians say that supplementation is important because children will not get the necessary amount of vitamin D through diet alone. It is known that vitamin D, the so-called “sunshine vitamin,” is found in many dietary sources such as fish, eggs, fortified milk and cod liver oil. Besides supplements and dietary sources, vitamin D can be taken from direct exposure to the sun rays. On a sunny day, just 10 minutes of exposure to the sun rays will generate enough vitamin D to reach higher levels found protective in the study. Improper diet and lack of sun may contribute to vitamin D deficiency.

Earlier this year, researchers at Children’s Hospital Boston found “suboptimal” levels of vitamin D in 40 percent of 380 otherwise healthy infants and toddlers. Children who do not get enough vitamin D are at risk for rickets, a bone-softening disease that result in stunted growth and skeletal deformities if not corrected while the child is young. The disease is rare in the United States, the Centers for Disease Control and Prevention said, but there were reports in 2000 and 2001 of rickets among breastfed infants. Vitamin D is essential for absorbing calcium from food and building bones.

Alice Carver

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Vitamin D Linked To Parkinson’s

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The reasons for which pediatricians recommended doubling the daily dosage of vitamin D in children’s diets seem to be increasing by the minute. Rickets seemed to be the primary concern of doctors – a skeletal disease which softens the bones and can lead to skeletal deformities. The recommended dosage was raised to 400 international units, as children have less and less natural sources of vitamin D. For instance, direct sunlight is a viable source, but prolonged exposure raises the risk of skin cancer.

As recent studies conducted by the Emory University School of Medicine in Atlanta show, people who suffer from Parkinson’s disease have a vitamin D deficiency. The researchers held the study on 100 patients with Parkinson’s, 97 patients with Alzheimer’s and 99 people with no ailments. All the patients had to be of approximate age and meet several factors cardinal for the relevance of the study’s results.

The results showed that the vitamin D levels in patients with Parkinson’s disease superseded those in healthy patients and patients with Alzheimer’s disease. The exact data shows that in a patient with Parkinson’s the average vitamin D concentration was of 31.9 nanograms/milliliter, while in a patient with Alzheimer’s – 34.8 and 37 in a healthy patient.

Although the findings are significant, researchers need to conduct a larger series of studies to solution the dilemma regarding the prevention of Parkinson. Doctors are uncertain whether increasing the vitamin D average can improve locomotion of Parkinson patients. One of the study’s conclusions is that routine checks of 25(OH)D levels in the elderly are crucial to early diagnosing osteoporosis, cancer and autoimmune disorders. >>>>

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Parkinson’s Disease Linked to Vitamin D Insufficiency

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A new study by US researchers has found that Parkinson’s sufferers have insufficient levels of vitamin D compared to healthy people or Alzheimer’s patients. A team of researchers from the Emory University School of Medicine in Atlanta compared vitamin D levels in 100 Parkinson’s patients, 97 Alzheimer’s patients, and 99 healthy people of the same age.

The main purpose of the study was to determine whether Parkinson’s and Alzheimer’s may be linked to vitamin D deficiency.

More than half of patients with Parkinson’s had low levels of vitamin D, compared to 41% of the Alzheimer’s patients and 10% of the group of healthy people. The average vitamin D concentration among Parkinson’s patients was 31.9 nanograms per milliliter, compared with 34.8 nanograms among Alzheimer’s patients, and 37 nanograms among healthy people. The proportion of patients with the lowest levels of vitamin D (vitamin D deficiency) was “significantly” higher among patients with Parkinson’s.

The study was published in the journal Archives of Neurology.

“We found that vitamin D insufficiency may have a unique association with Parkinson’s which is intriguing and warrants further investigation,” said study author Marian Evatt from Emory University in Atlanta, Georgia. Dr. Evatt explained that the part of the brain affected by the disease has a high number of vitamin D receptors, which may suggest a possible association with low levels of vitamin D in Parkinson’s sufferers.

At present there is no cure for Parkinson’s disease, a degenerative disorder of the central nervous system that impairs the sufferer’s motor skills and their speech. Parkinson’s disease is both chronic and progressive. Parkinson’s occurs when the brain cells that produce dopamine are slowly destroyed. But there are several therapies and drugs that provide significant relief from its symptoms, including deep brain stimulation, which is a surgical treatment involving the implantation of a medical device called a brain peacemaker. Deep brain stimulation is one surgical treatment option available for patients who do not experience relief from medications. For many patients, the device called a neurostimulator provides considerable relief.

The most common symptoms of Parkinson’s are tremour, stiffness and slowness of movement, normally caused by the insufficient formation and action of dopamine, which is produced in the dopaminergic neurons of the brain. Secondary symptoms may include high level cognitive dysfunction and subtle language problems. Other symptoms include disorders of mood, behaviour, thinking and sensations. The smell problems were also associated with the onset of the disease, like other known early signs such as more coffee consumption, smoking, less frequent bowel movements, lower cognitive function and excessive daytime sleepiness. It appears that olfactory problems precede the onset of Parkinson’s by around four years.

Vitamin D, also known as the “sunshine vitamin,” helps the body absorb calcium and is considered important for bone health. Vitamin D3 is produced when the skin is exposed to sunlight. It protects the bones and works like a natural anti-cancer agent. Vitamin D is also found in many dietary sources such as fish, eggs, fortified milk and cod liver oil.

It is estimated that 50 to 60 percent of people do not have the satisfactory vitamin-D status. People older than 50 need a higher dose because the body’s ability to convert the vitamin D into its active form (cholecalciferol) begins to decline at age 50.

Previous studies have shown that vitamin D deficiency is associated with a higher incidence of several forms of cancer, high blood pressure, diabetes, obesity and the risk of developing osteoporosis and multiple sclerosis.

Alice Carver

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American Academy Of Pediatrics Urges Doubling Vitamin D For Children

The deficiency of vitamin D during childhood and adolescence has outcomes later in life like the risk of dying from cardiovascular disease, and risk of developing cancer disease, osteoporosis, and multiple sclerosis. Previous studies have linked low levels of vitamin D with high blood pressure, diabetes and obesity, which can contribute to heart disease.

Millions of children will need to take vitamin D supplements each day to meet the new recommendation of the American Academy of Pediatrics. Pediatricians are recommending that children receive double the usually suggested amount of vitamin D. This means infants, children and teenagers will need to get 400 units IU a day, beginning in the first few days of life because it may help reduce the risk of serious diseases.

Vitamin D might lower blood pressure, reduce calcification of coronary arteries, regulate inflammation, affect the heart muscle, or reduce respiratory infections during the winter time.

Vitamin D, also known as “sunshine vitamin,” helps the body absorb calcium and is considered important for bone health. On a sunny day, just 10 minutes of exposure to sun will generate enough vitamin D to reach the higher levels found protective in studies.

On the other hand, too much sun, as we all know, is a risk factor for skin cancer.

Actually, vitamin D is a generic name for a group of prohormones (precursors to hormones). Of interest are especially vitamin D2 (or ergocalciferol) and vitamin D3 (or cholecalciferol). The latter is the actual “sunshine vitamin” which is produced in skin exposed to sunlight, specifically ultraviolet B radiation. Improper diet and lack of sun contribute to vitamin D deficiency.

Vitamin D is also found in many dietary sources such as fish, eggs, fortified milk and cod liver oil. The type of vitamin D added to milk is ergocalcifernol, known as D2. Vitamin D2 has to be converted to vitamin D3 that protects the bones and works like a natural anti-cancer agent.

It is estimated that 50 to 60 percent of people do not have the satisfactory vitamin-D status. Earlier this year, researchers at Children’s Hospital Boston found “suboptimal” levels of vitamin D in 40 percent of 380 otherwise healthy infants and toddlers.

Researchers at Harvard University concluded that neither milk nor calcium is enough to maintain bone health and that taking vitamin D supplements is a good idea. A Harvard study of 72,337 women over 18 years found that women who consumed about 500 IU units a day in food and supplements had a greatly lowered risk of broken hips. But the real amount of vitamin D needed to prevent bone loss is even higher, probably closer to 1000 IU per day.

The amount the academy recommended in 2003 was 200 units daily for people up to age 50, 400 units for adults ages 51 to 70 and 600 units for those 71 and older. People older than 50 need a higher dose, because the body’s ability to convert the vitamin into its active form begins to decline at age 50.

The new recommendations will be published in the November issue of the journal Pediatrics.

Alice Carver

Ayde Gonzales's mother was surprised when she insisted that her newborn son must sleep on his back, not on his side. Her mother was mystified when Gonzales said no stuffed animals in the crib with young Victor Lee.

And now that Gonzales plans to turn on a fan in her son's room when he is sleeping, she knows her mother will roll her eyes.

Using a fan in a baby's room while the infant is sleeping is the latest recommendation from research on sudden infant death syndrome. Earlier findings have helped reduce the incidence of SIDS 56 percent.

"It's very different now than when she was raising me," said Gonzales, who lives in Fremont with her husband and five-month-old son. Her mother cares for Victor Lee while Gonzales is at work.

Findings of the Kaiser Permanente study released Monday suggest that using a fan while a baby is sleeping can reduce SIDS risk by 72 percent, athough the fan is to be used in conjunction with recommendations from earlier studies, such as having babies sleep on their backs.

Conducted by the Division of Research of Kaiser Permanente Northern California, the study included 497 infants in 11 counties, including Santa Clara, Alameda, San Mateo and Monterey. There were 185 SIDS death cases in the study.

Scientists still do not know the exact mechanisms that cause SIDS, but this study suggests that a fan circulating air while the baby is sleeping reduces the risk of SIDS primarily because the carbon

dioxide the baby breaths out is recirculated around the room and not reinhaled by the baby.

The findings are the latest step in research that has helped reduce the incidence of SIDS by 56 percent between 1992 and 2003. There are still about 2,500 SIDS deaths in the U.S. each year, according to the American SIDS Institute.

Dr. De-Kun Li, the same researcher who found that using a pacifier can also help reduce risk of the syndrome, was lead author of the Kaiser study.

The results are the first to link use of a fan with SIDS prevention but "are consistent with all previous" research findings that "sleep environment matters," Li said.

Li said parents should follow earlier study findings, in addition to this one. That includes having babies sleep on their backs, avoiding soft bedding, using a pacifier and not sharing a bed with other children.

"A fan is not a replacement for the other recommendations," he said.

Linda Gardner of San Mateo is the mother of three sons -- aged 9, 6 and six-months-old -- and said she will consult with her pediatrician before deciding to use a fan. Kaiser recommends the same thing.

"As the parent of an infant, SIDS is the biggest fear I have," Gardner said. "I can take all of the precautions that are recommended but ultimately there's a piece of it out of your control. Once they go to sleep, you really don't know what's going to happen."

Li said most of the SIDS deaths are infants less that six months old.

"We're at a turning point to demystify SIDS," he said, adding that more research is needed to determine which babies are more likely to be predisposed to develop the syndrome.

When Victor Lee was a newborn, Gonzales said she found herself checking on her son about every 15 minutes.

"I'd touch his belly to make sure he was sleeping. Now my husband checks on him more than I do."

Linda Goldston

Some breakfast cereals marketed to U.S. children are more than half sugar by weight and many get only fair scores on nutritional value, Consumer Reports said on Wednesday.

A serving of 11 popular cereals, including Kellogg's Honey Smacks, carries as much sugar as a glazed doughnut, the consumer group found.

And some brands have more sugar and sodium when formulated for the U.S. market than the same brands have when sold in other countries.

Post Golden Crisp made by Kraft Foods Inc and Kellogg's Honey Smacks are more than 50 percent sugar by weight, the group said, while nine brands are at least 40 percent sugar.

The most healthful brands are Cheerios with three grams of fiber per serving and one gram of sugar, Kix and Honey Nut Cheerios, all made by General Mills, and Life, made by Pepsico Inc's Quaker Oats unit.

"Be sure to read the product labels, and choose cereals that are high in fiber and low in sugar and sodium," Gayle Williams, deputy editor of Consumer Reports Health, said in a statement.

Honey Smacks has 15 grams of sugar and just one gram of fiber per serving while Kellogg's Corn Pops has 12 grams of sugar and no fiber.

Consumer Reports studied how 91 children aged 6 to 16 poured their cereal and found they served themselves about 50 to 65 percent more on average than the suggested serving size for three of the four tested cereals.

Consumers International, which publishes Consumer Reports, said it would ask the World Health Organization to develop international guidelines restricting advertising and marketing of foods high in sugar, fat or sodium to children.

However, the group noted that breakfast cereal can be a healthful meal and said adults and children alike who eat breakfast have better overall nutrition, fewer weight problems, and better cognitive performance throughout the day.

Kellogg said it was working to make its food more nutritious.

"Kellogg recently reformulated a number of our cereals including Froot Loops, Corn Pops, Rice Krispies, Cocoa Krispies and Apple Jacks in the U.S. with improved nutritional profiles," a company spokeswoman said by e-mail.

"To put Consumer Reports' information in perspective, yogurt contains more sugar and sodium than a serving of Honey Smacks cereal (25 grams of sugar vs. 15 grams of sugar in Honey Smacks)."

Consumer Reports, like other groups, compares the sugar content of food with its fiber, mineral and vitamin content. Many cereals are fortified with vitamins and minerals.

Maggie Fox; Eric Walsh

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Eat This, Not That

It’s hard to overestimate the importance of eating breakfast. Studies show that people who take time for a morning meal consume fewer calories over the course of the day, have stronger cognitive skills, and are 30 percent less likely to be overweight or obese. Beyond that, people who skip breakfast are more likely to drink alcohol and smoke, and they’re less likely to exercise.

But just because breakfast is the most important meal of the day doesn’t grant you permission to go into a feeding frenzy. But that’s exactly what many of the country’s most popular breakfast joints are setting you up for, by peddling fatty scrambles, misguided muffins, and pancakes that look like manhole covers.

These foods are loaded with unhealthy fats, added sugars, and refined carbohydrates, which catapult your blood sugar, sap your energy levels, and tell your body to store fat.
 
To help you avoid the morning mishaps, we searched out the good, the bad, and the greasy, and uncovered some of the worst breakfast foods in America. We’ve presented a sampling of the worst offenders below. It’s like a lineup down at the local police station, except in this case, they’re all guilty as charged.

Worst Side Dish
Burger King Hash Browns (large)
620 calories
40 g fat (11 g saturated; 13 g trans)
1,200 mg sodium
60 g carbs
 
Yes, you’re ingesting more than a meal’s worth of calories from a side dish, but the real cause for concern here is that these little potato cakes pack seven times more trans fats than you’re supposed to eat all day! Until BK learns to cut out the partially hydrogenated oils, avoid encounters with potatoes of any kind at that fatty food joint.
 
Eat This Instead!
Burger King Egg & Cheese Croissan’wich
300 calories
17 g fat (6 g saturated; 2 g trans)
740 mg sodium
26 g carbs

Worst Breakfast Sandwich
Hardee’s Monster Biscuit
710 calories
51 g fat (17 g saturated)
2,250 mg sodium
37 g carbohydrates
 
When they say “Monster,” they mean it. This 700-calorie behemoth should be enough to scare anyone: It contains nearly a full day’s worth of sodium and saturated fat. Instead try the Sunrise Croissant with Bacon. It’s not exactly diet-friendly, but if you’re stuck at Hardee’s, it’s a way to escape without too much damage.
 
Eat This Instead!
Hardee’s Sunrise Croissant with Bacon
450 calories
29 g fat (12 g saturated)
900 mg sodium
28 g carbs

Worst Kids Meal
Denny’s Big Dipper French Toastix with margarine and syrup
770 calories
71 g fat (13 g saturated)
107 g carbs
 
As important as it is for mom and dad to eat a good breakfast each morning, it’s even more critical that their kids do. After all, breakfast affects their energy levels, metabolism, and performance in school. Better think twice before feeding them these dubious little sticks. For more healthy kids’ choices, check out Eat This, Not That! for Kids.

Eat This Instead!
Kid’s D-Zone Smiley Alien Hotcakes
340 calories
12 g fat (5 g saturated)
49 g carbs
 
Worst Pastry
Cinnabon Classic Cinnamon Roll
813 calories
32 g fat (5 g trans fat)
117 g carbs
 
You wouldn’t start your day with three brownies, would you? As far as your body knows, that’s exactly what you’ll be doing if you wake up with this cinnamon-swirled disaster area. In fact, because Cinnabon offers no healthy alternatives, you’ll have to  invite friends (or enemies?) to share the risky roll, or steer clear of Cinnabon altogether.
 
Worst Smoothie
Smoothie King Grape Expectations II (40 oz.)
1,102 calories
256 g sugars
740 mg sodium
 
Why Smoothie King would even offer a 40 oz. serving size is beyond us. With more than half the calories you need in a day and the sugar equivalent of 12 Haagen Dasz ice cream bars, this “drink” should be renamed "diabetes in a glass." Just goes to show you the importance of drinking responsibly.
 
Drink This Instead!
Smoothie King Low Carb Strawberry Smoothie (20 oz.)
268 calories
3 g sugars
176 mg sodium
 
Worst Combo Meal
McDonald’s Deluxe Breakfast
1,360 calories
64 g fat (22 g saturated)
2,325 mg sodium
160 g carbs
49 g sugars
 
With four vehicles for refined carbohydrates (biscuit, hash browns, hotcakes, syrup), this “deluxe” disaster will send your blood sugar soaring. Why blow nearly an entire day’s calories under the arches, when a perfectly satisfying Egg McMuffin will save you more than 1,000 calories?

Eat This Instead!
McDonald’s Egg McMuffin with coffee
310 calories
12 g fat (5 g saturated)
820 mg sodium
30 g carbs
3 g sugars

Worst Omelet
IHOP Big Steak Omelet
1,490 calories
(No additional nutrition information available)
 
IHOP doesn’t provide nutritional information aside from calorie counts, but with a boatload of steak, a bucket of cheese, and handfuls of hash browns, this omelet’s fat and sodium numbers are surely just as appalling.

Eat This Instead!
IHOP For Me Garden Scramble
440 calories

The Worst Breakfast in America
Bob Evans Stacked and Stuffed Caramel Banana Pecan Hotcakes
1,543 calories
77 g fat (26 g saturated; 9 g trans)
2,259 mg sodium
198 g carbs
109 g sugars

It’s not a good sign when it takes you nearly five seconds to spit out the name of your breakfast. This bad boy packs in more than 75 percent of your calories for the day, along with more sugar and fat than nine glazed Dunkin’ Donuts, and nearly as much sodium as five Bloody Marys.
 
Eat This Instead!
3 Scrambled Egg Beaters with 2 slices of bacon and fresh fruit
314 calories
19.5 g fat (5 g saturated)
700 mg sodium
21 g carbs
18 g sugars

To steer clear of the quickest way to pack on pounds — by sipping them through a straw — check out the 20 Unhealthiest Drinks in America.

David Zinczenko, with Matt Goulding

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Apples: The Live Longer Fruit

The beginning of autumn means that we're entering apple season, which will be a time of cider, desserts, and the crisp, wholesome goodness of the fruit freshly picked from your local orchard. Apples have been a staple of healthy eating for many years, and the often-repeated line of an apple a day keeping the doctor away is far from a myth. Apples really do have a wonderful variety of nutritional benefits, and are a tasty addition to any diet of good health and longevity.

Of all of the fruits we eat, apples are the best source of pectin, a natural fiber that has several health benefits. Apples also contain phytochemicals, quercetin, tannins, and antioxidants, all of which have different healthy properties. Below is a list of the top five benefits of making apples a standard part of your daily diet.

1. Apples improve the bowels. Pectin is a source of dietary fiber and a very handy nutrient to have in one's diet. While it is also found in citrus fruits, plums, and other fruits, apples have the highest concentration of them all. Pectin works to increase the stool's volume and resistance of fluids and is therefore helpful in treating constipation, diarrhea, and generally improving the health of the bowels. Studies have also found that apple pectin reduces the incidence of colon tumors, and that has been demonstrated to reduce the risk of colon cancer.

2. Apples lower cholesterol. A study on nutrition and heart disease found that eating three apples a day for three months can help you to drop your cholesterol by at least 20 points. How does this happen? Apple pectin, that miraculous source of dietary fiber, helps to draw bad LDL cholesterol out of the system. Not only that, but the antioxidant quercetin that is found in apples inhibits the LDL cholesterol from even accumulating in the body's bloodstream. When it comes to lowering one's cholesterol, apples provide a cocktail of nutritional benefits that are hard to pass up.

3. Apples reduce the risk of cancer. Apples do not stop at merely preventing colon cancer. The high amounts of quercetin, other flavonoids, and phytochemicals found in this fruit deliver potent antioxidant activity to all who eat an apple, and with that inhibit the actions of free radicals. In addition, the phytochemicals may act against carcinogens, which will likewise help to prevent cancer. This means that apple eating prevents cancer of the prostate and lung, as well as other parts of the body.

4. Apples slow the aging process. There may have been many generations of explorers that sought the fountain of youth, but all they had to do was fight the daily stresses of life with a tasty apple! The phytochemicals that come from the bright colors you find in the skins of your favorite apple variety, along with aiding the apple's ability to lower cholesterol and fight cancer, also inhibits the onset of diabetes, hypertension, heart disease, and other conditions that lead to potentially debilitating situations in old age.

5. Apples help to prevent hair loss. If keeping a full head of hair will help you to age more gracefully, then chow down on some apples. Chinese medicine considers hair loss to be a sign of a depleted kidney essence, and apples are on the list of fruits and vegetables that will help you to restore this essence and nourish the blood that flows to your hair follicles.

I hope you eat your apples, and that you really do keep the doctors away. As always, I encourage you to share your own favorite longevity foods and other tips with me.

May you live long, live strong, and live happy!

Dr. Mao

Acupressure helps calm anxious children right before they get anesthesia for surgery, without the nausea and other side-effects caused by sedatives, U.S. researchers reported on Tuesday.

Taping an acupressure bead between the eyebrows reduced anxiety noticeably in the children, compared to a similar sham treatment, Dr. Zeev Kain of the University of California Irvine and colleagues reported.

"Anxiety in children before surgery is bad because of the emotional toll on the child and parents, and this anxiety can lead to prolonged recovery and the increased use of analgesics for postoperative pain," Kain said in a statement.

"What's great about the use of acupressure is that it costs very little and has no side effects."

Acupressure and acupuncture both are based on the theory of lines of energy running through the body. With acupressure, a fingertip or a bead is used to press a specific pressure point, while needles are used in acupuncture.

Several studies have shown both treatments may stimulate the release of hormones known as endorphins, which can relieve stress, pain and nausea.

Kain's team tested 52 children aged 8 to 17 who were about to have stomach surgery. Half got a bead taped to the Extra-1 acupoint -- one of the points used to reduce stress in both acupuncture and acupressure therapy.

The other half got a similar patch on a spot above the left eyebrow that had no reported clinical effects.

After half an hour, the treated children were less anxious, while the young patients who got the sham treatment were clearly more anxious, Kain's team reported in the journal Anesthesia & Analgesia.

"As anesthesiologists, we need to look at all therapeutic opportunities to make the surgical process less stressful for all patients," Kain said. "We can't assume that Western medical approaches are the only viable ones, and we have an obligation to look at integrative treatments like acupressure as a way to improve the surgery experience."

Maggie Fox; Will Dunham and Peter Cooney

In a decision that could set the stage for a test of the supremacy of a longstanding federal labor law, a panel of federal judges found Tuesday that San Francisco had the right to charge employers to help pay for its universal health care plan, the first in the nation.

The ruling, by a three-judge panel of the United States Court of Appeals for the Ninth Circuit, affirms a January decision by the same panel that required all but the smallest businesses in the city to contribute to employees’ health care costs or pay a fee to help the city provide care.

San Francisco officials hailed the decision as a major victory for its plan, called Healthy San Francisco, to provide health care for some 73,000 uninsured residents.

“We’re very gratified,” said the city attorney, Dennis Herrera. “We think our arguments are right on the law, and we really provided a road map as to how states and localities can provide comprehensive health care coverage.”

The question at the heart of the case is whether the San Francisco law, passed by the Board of Supervisors in 2006, violates a 1974 federal law, the Employee Retirement Income Security Act, or Erisa, which is meant to guarantee uniformity and minimum standards among local, state and federal benefit plans.

Other federal courts have found that similar state or local laws requiring employer contributions violated Erisa, including a Maryland law that was struck down by an appeals court in 2007. In December 2007, a district judge had stopped the San Francisco plan, saying it conflicted with the federal law.

But Judge William A. Fletcher of the Ninth Circuit, joined by Judges Alfred T. Goodwin and Stephen Reinhardt, said their task was to decide whether the law’s fee violated Erisa, not whether the law itself was a good one. “We hold that it does not,” Judge Fletcher wrote.

Under the San Francisco plan, employers with more than 20 employees are required to contribute $1.17 to $1.76 per employee per hour for health care. This money can be paid in a variety of ways, including health savings accounts, employer-provided insurance, reimbursement directly to the employee or contributions to Healthy San Francisco. About 30,000 residents have signed up for the plan, which offers services through city clinics.

Opponents of such “pay or play” plans said the impact of the court’s decision could be widespread. “This decision opens the floodgates to every state and locality seeking to develop its own version of health reform, creating an impossible environment for major employers,” said James A. Klein, the president of the American Benefits Council in Washington, which lobbies for corporate providers of benefits.

Daniel Scherotter, the president of the Golden Gate Restaurant Association, which filed suit against the fee, said the group would probably appeal to the full circuit court or the United States Supreme Court.

“This is the first decision ever in an Erisa case going in that direction,” Mr. Scherotter said. “I think if you ask anyone, even Dennis Herrera, they would think that he would lose.”

Mayor Gavin Newsom, a former restaurateur, said that his administration recognized that some extra expense was falling on businesses but that he was proud the city was a trailblazer.

“By thinking outside the box,” he said, “every city and state in this country can provide health care if they are willing to challenge the conventional wisdom.”

Some of San Francisco’s well-known restaurants have added small fees to bills, often with a note explaining that the charge goes to pay for health care.

Mr. Scherotter, who runs an Italian restaurant, adds such a fee. He said the law had added to his costs and his administrative workload. “It’s a lot of tedious arithmetic,” he said.

JESSE McKINLEY

Bottled water — already a more than $10 billion industry — is the fastest-growing beverage category in the U.S. But is it good for you? Here's the pure truth.

MYTH #1:
BOTTLED WATER IS BETTER THAN TAP.
Not necessarily. While labels gush about bottled water that "begins as snowflakes" or flows from "deep inside lush green volcanoes," between 25 and 40 percent of bottled water comes from a less exotic source: U.S. municipal water supplies. (Bottling companies buy the water and filter it, and some add minerals.) That's not really a bad thing: The Environmental Protection Agency oversees municipal water quality, while the Food and Drug Administration monitors bottled water; in some cases, EPA codes are more stringent.

MYTH #2:
PURIFIED WATER TASTES BETTER.
The "purest" water — distilled water with all minerals and salts removed — tastes flat; it's the sodium, calcium, magnesium, and chlorides that give water its flavor. The "off" taste of tap water is the chlorine; if you refrigerate it in a container with a loose-fitting lid, the chlorine taste will be gone overnight.

MYTH #3:
BOTTLED WATER WITH VITAMINS, MINERALS, OR PROTEIN IS MORE HEALTHY THAN REGULAR WATER.
"Vitamins, color, herbs, protein, and all the other additions to water — those are a marketing ploy," says Marion Nestle, Ph.D., professor of nutrition studies at New York University. Plus, the additives are usually a scant serving of the vitamins you really need in a day, adds Amy Subar, Ph.D., a nutritionist with the National Cancer Institute. Enhanced waters usually contain sugars and artificial flavorings to sweeten the deal and can pack more calories than diet soda. When it comes to providing fluoride, tap water usually wins, though that element is increasingly being added to bottled waters.

MYTH #4:
YOU NEED EIGHT UNCE GLASSES OF WATER EACH DAY.
The Institute of Medicine recommends about 91 ounces (a little more than 11 unce glasses) of fluid daily for women. But here's the thing: It expects 80 percent of that to come from water, juice, coffee, tea, or other beverages and the remaining 20 percent from food. That means if you drink a 12-ounce cup of coffee and a 12-ounce can of diet soda, you only need 48 more ounces (three 16-ounce glasses, or four soda cans' worth) for the day.

MYTH #5:
AFTER AN INTENSE WORKOUT, BOTTLED WATER IS BEST.
There's a reason volunteers hand out Gatorade during marathons. If your workout lasts longer than an hour, you need to replace the water and electrolytes, such as sodium and potassium, that you've lost (that's what sports drinks generally do). For less intense workouts, regular water is fine.

MYTH #6:
WATER BOTTLES ARE EASY ON THE ENVIRONMENT BECAUSE THEY CAN BE RECYCLED.
Wouldn't it be nice? And it's not just the bottles. Eco-costs include manufacturing, trucking, shelving, and marketing. And meeting the annual U.S. demand for plastic bottles requires enough oil to keep 100,000 cars on the road for a year, says Janet Larsen of the Earth Policy Institute. Sure, the 70 million empty water bottles the U.S. produces per day can be recycled, but the sad truth is, about 86 percent of them end up in the trash. Hardly worth it, for what flows out of the tap and into a reusable glass for free. >>>>

The drug allopurinol, which lowers uric acid levels, appears to reduce blood pressure in adolescents with newly diagnosed hypertension, according to a preliminary report in the August 27 issue of JAMA.

Hypertension is commonly associated with hyperuricemia (elevated blood level of uric acid, a by-product of normal chemical processes in the body and found in the urine and blood). Early research suggested uric acid had a causal role in hypertension, but an elevation of uric acid in hypertension could be a consequence of several factors, and hyperuricemia is not considered a true risk factor for hypertension, according to background information in the article. Recent studies have challenged this belief, including evidence supporting a causal role of uric acid in hypertension, as indicated from experimental studies in laboratory animals.

Daniel I. Feig, M.D., Ph.D., of the Baylor College of Medicine, Houston, and colleagues conducted a randomized, placebo-controlled "crossover" trial to determine whether lowering uric acid levels with the drug allopurinol would reduce blood pressure (BP) in hyperuricemic adolescents (age 11-17 years) with newly diagnosed hypertension. Thirty patients were randomly assigned to receive either allopurinol or placebo, twice daily for four weeks. This was followed by a two week "washout" period during which the patients received neither allopurinol nor placebo, after which they received the other therapy (allopurinol or placebo) they had not received earlier, for four more weeks.

Allopurinol treatment was associated with a significant decrease in casual and ambulatory systolic and diastolic BP. The average decrease in casual BP during allopurinol treatment was −6.9 mm Hg for systolic and −5.1 mm Hg for diastolic BP; for placebo, the respective changes were −2.0 and −2.4. The average changes in 24-hour ambulatory BP during allopurinol were −6.3 mm Hg, systolic; −4.6, diastolic BP. Systolic BP increased slightly during the placebo phase by 0.8 mm Hg and diastolic BP slightly decreased by 0.3. The decrease in ambulatory BP directly correlated with allopurinol treatment. Twenty of the 30 participants achieved normal BP by casual and ambulatory criteria during the allopurinol phase, whereas only 1 of 30 achieved normal BP during the placebo phase.

"The results of this study represent a potentially new therapeutic approach, that of control of a biochemical cause of hypertension, rather than nonspecifically lowering elevated BP. Although not representing a fully developed therapeutic strategy, this study raises an alternative strategy that may prove to be more effective than currently available options," the authors write.

"Despite these findings, this clinical trial is a small one and allopurinol is not indicated for the treatment of hypertension in adolescents or other populations. The potential adverse effects of allopurinol, including gastrointestinal complaints and especially Stevens-Johnson syndrome [a severe, allergic reaction], make allopurinol an unattractive alternative to available antihypertensive medications. More clinical trials are needed to determine the reproducibility of the data and whether it can be generalized to the larger hypertensive population. Nevertheless, the observation that lowering uric acid can reduce BP in adolescents with newly diagnosed hypertension raises intriguing questions about its role in the pathogenesis of hypertension," the researchers conclude. >>>>