Friday, February 29, 2008

Feeling Hormonal?

WebMD Feature from "Redbook" Magazine By Aviva Patz

Hey, we all are. Hormones control just about every aspect of our physical and mental health — and when they go off-kilter, they can trigger anything from acne and insomnia to memory loss and weight gain. It's enough to ruin any woman's day. Here, 6 common side effects of hormonal flux, plus how to balance yours.

Think hormones take over your life once a month — the cramps, cravings, bloat, and mood swings that make so many of us miserable? That's giving these natural chemicals far too little credit. The reality is that our bodies produce dozens of hormones that control virtually everything we do: from how we think, eat, sleep, and cope with stress to how clear our complexions and how fit our figures are. And when levels of just one hormone fluctuate, the shift can have serious consequences for your mental, emotional, and physical health. Here, six signs your hormones may have gone awry, and what you can do to help restore a healthy balance.

Stubborn Acne

Nearly half of women suffer embarrassing breakouts during the week before their period thanks to normal hormone shifts. But if you've got acne all month long — the deep, cystic kind that no over-the-counter cream can conquer — androgens (male hormones such as testosterone) may be to blame. "A lot of people think acne comes only from diet or lack of hygiene, but it's essentially hormonal, and testosterone is always at the root of it," says endocrinologist Geoffrey Redmond, M.D., author of The Hormonally Vulnerable Woman. Testosterone stimulates excess production of sebum, or oil, that gets trapped beneath the skin's surface and mixes with acne-causing bacteria and dead skin cells, Redmond explains. The result: clogged pores and ugly blemishes. And the higher a woman's testosterone levels — or the greater her sensitivity to the hormone — the more severe her breakouts.

To restore balance: If you're not already taking birth control pills, consider starting. "Oral contraceptives lower levels of free testosterone — the type that's floating around in your blood and causing blemishes — by 50 percent," says Redmond. If you're on the Pill and it's not helping your skin, it may be the formulation. Redmond's top complexion-clearing picks: Ortho Tri-Cyclen and Yasmin, both of which have higher levels of estrogen and lower levels of androgen than certain other pills. Also, avoid any made with levonorgestrel, such as Alesse and Levlite. This synthetic form of progesterone mimics testosterone's effects and may cause breakouts.

If you'd rather not take oral contraceptives at all, spironolactone (marketed as Aldactone) may be your best bet. This drug was shown to safely clear up women's skin by blocking testosterone receptors, thus inhibiting the hormone's activity, according to research at the University of Toronto and elsewhere. Spironolactone has been approved by the FDA only for treating hypertension — not for acne — which means you'll need to find a doctor who will prescribe it off-label. (Note: You can't take it during pregnancy.)

Memory Lapses

Can't remember where you just set down your cell phone? Or what time you told your guy you'd meet him for dinner? You're too young to forget all this stuff...aren't you? Not necessarily. If you're under any amount of long-term stress — dealing daily with a micromanaging boss, staying up nights with a colicky infant, taking care of a sick loved one — your body is constantly pumping out stress hormones such as cortisol. And studies suggest that consistently high levels of cortisol can hamper your ability to learn new things and remember them later. In fact, it could permanently damage brain cells, particularly in the hippocampus, where information is tagged for long-term memory.

To restore balance: You'll like this advice. Think of your favorite healthy hobbies — solving Sudoku, walking with your pup, munching on raspberries from your garden — and simply do them more often. In a recent study, people who practiced lifestyle changes like these that were intended to help reduce stress, boost memory skills, and encourage healthy eating and physical fitness had greater powers of recall after just two weeks, possibly due to lower stress hormone levels, says lead author Gary Small, M.D., a psychiatry professor at UCLA and author of The Longevity Bible. More ways to mellow out: Try meditation, yoga, or any moderately intense aerobic exercise; express your spirituality or religious devotion (join a choir, use your rosaries, say a prayer); or simply sleep 20 minutes later in the morning — all of which have been proved to kick down cortisol. Small also recommends taking frequent relaxation breaks during the day: Just close your eyes and focus on breathing slowly and deeply for two to five minutes.

Insomnia

If you struggle to fall or stay asleep, particularly just before your period, it may be due to the sharp drop in the hormone progesterone that immediately precedes menstruation, according to Joyce Walsleben, Ph.D., associate professor in the Sleep Disorders Center at the New York University School of Medicine. Progesterone is a relaxant, so when levels plummet — as they do just before your period or after giving birth — you may feel restless and unable to sleep. (Breast tenderness, bloating, and cramps — also side effects of rapidly shifting hormones — don't help.)

To restore balance: Preventing the monthly seesaw of hormones requires actually banishing your period. Fortunately, that doesn't mean holding out for menopause, thanks to Seasonale, a form of extended-use birth control that reduces period frequency from 13 times a year to just four. If you're looking for a more natural approach, Walsleben offers this multiprong attack for reducing the side effects of hormonal swings: Drink plenty of fluids to minimize bloating, avoid caffeine after noon, and take ibuprofen before going to bed on nights you're likely to have cramps. And an hour or two before you hit the sheets, try sipping a glass of warm milk, or snack on a few slices of turkey or a handful of nuts. These foods are rich in tryptophan, a building block for the brain chemical serotonin, which helps control sleep. If you still find yourself staring at the ceiling, talk to your doctor about a prescription sleep aid. Lunesta, a new drug proved to safely summon the sandman, isn't supposed to be habit-forming — but the jury is still out, so consider taking it for no longer than a few weeks.

Nonstop Hunger

Willpower, schmillpower. Yes, it's important to maintain healthy habits, but a growing body of research is fingering a handful of hormones for the relentless hunger and overeating that makes some people feel that it's impossible to lose weight. A few under investigation: ghrelin, which stimulates appetite, and leptin and oxyntomodulin, which suppress it. In one study, volunteers who were deprived of sleep saw their levels of ghrelin soar — making them ravenous — while their levels of leptin plummeted. This may explain why people who are chronically sleep-deprived (snoozing less than seven hours nightly) tend to be more overweight than those who get plenty of z's. "Leptin normally signals the brain that your fat stores are large enough, so when levels of the hormone are low, the brain assumes you need more fat and triggers cravings for high-calorie food," says sleep and obesity researcher Gregor Hasler, M.D.

To restore balance: Getting seven to nine hours of shut-eye a night instead of scraping by on just six has been shown to lower your risk of overeating and obesity by 23 percent, in part by restoring your leptin levels. Even just one extra hour of slumber can make a difference. You should also avoid fatty foods, and not just because they're chock-full of calories! Though researchers don't yet understand why, they've found that calorie for calorie, carbohydrates and proteins are significantly more effective at suppressing appetite — and tummy rumbles — than fats. So whenever possible, swap high-fat foods for those loaded with protein and complex carbs such as oatmeal, fresh veggies, and whole grains.

Irritable Bowel Syndrome (IBS)

Some of us get headaches during stressful times, or feel just plain cranky and irritable. But if you carry stress in your stomach instead of your head, it could be because many of the same hormones and neurons are at work in both places — a fact that's led some doctors to dub the gut the body's "second brain." Take serotonin, for example. It's best known as the brain chemical that impacts mood. But 95 percent of the serotonin we produce is actually manufactured in the gut, where it plays a role in digestion. Recent studies suggest that abnormal levels of serotonin may be one cause of irritable bowel syndrome, a condition that causes chronic abdominal pain, cramping, and diarrhea and/or constipation for millions of Americans. "And since up to 90 percent of sufferers are women, some whose IBS symptoms get worse around menstruation, the flux of estrogen and progesterone may also play a role," says gastroenterologist George Arnold, M.D., a clinical professor of medicine at the University of Pittsburgh School of Medicine.

To restore balance: Paxil, a drug designed to treat anxiety and depression by upping serotonin levels in the brain, can also help relieve IBS for patients with tough-to-treat symptoms — even when they're not depressed, according to a study of 110 IBS sufferers conducted by Arnold. "Considering the amount of serotonin being produced in the intestine, we think Paxil must be doing something to the nerves in the gastrointestinal tract," he says. More than 60 percent of Paxil-takers in his study had fewer IBS symptoms — and a brighter outlook on life — compared with 26 percent of placebo-takers.

But before you call your doctor for a prescription, try increasing the fiber in your diet. In phase one of Arnold's study, one in four IBS sufferers reduced pain and bloating and felt much better after simply eating 25 grams of fiber a day, which is the USDA-recommended dose. Although fiber may or may not influence the hormones in the gut (no one knows for sure), it does help expand the diameter of the large and small intestines, which eases painful muscle contractions, according to Arnold. Try adding oatmeal and other whole grains, plus raw fruits and vegetables, to your daily diet.

Persistent Fatigue

Sure, we all have those days when we'd give anything for a midday nap — even if it meant crawling under our desks. But if you struggle daily with feeling sluggish and having zero energy — particularly if you've gained 10 to 20 pounds that you just can't shake no matter how little you eat — you could be suffering from a lack of thyroid hormone, a condition called hypothyroidism. Thyroid hormones control the body's metabolism, and when supplies are short, all systems slow down, including heart rate, mental functioning, and digestion. That's why hypothyroidism can leave a person feeling exhausted, drained, mentally foggy, even constipated. It's thought to affect at least 15 million adults nationwide, targeting 10 times more women than men, according to psychiatrist Louann Brizendine, M.D., director of the Women's and Teen Girl's Mood & Hormone Clinic at the University of California, San Francisco. And up to two thirds of cases go undiagnosed for several years because the symptoms are often dismissed as a side effect of stress.

To restore balance: Ask your doctor about getting your thyroid hormone levels checked, and be proactive about getting thyroid hormone replacement therapy if you need it. "There is some disagreement among doctors about treating subclinical hypothyroidism, since in past generations thyroid hormone was overprescribed, and too much of it can aggravate any underlying heart conditions," says Brizendine. "But in my experience, if you have symptoms of fatigue, depression, and anxiety that coincide with abnormal thyroid levels, you should seek treatment." Finding a doctor who will take these (and any other) mysterious symptoms seriously can deliver much-deserved relief

Tuesday, February 26, 2008

Men as well as women need bone tests

By LAURAN NEERGAARD, AP Medical Writer Mon Feb 25, 4:18 PM ET

WASHINGTON - Bone tests aren't just for women anymore. New guidelines are calling for older men to get a routine check for bone-thinning osteoporosis.

There's news for women, too: A new computerized tool uses more than bone-density tests to predict who is at highest risk of breaking a bone in coming years — by adding in such important risk factors as whether a parent ever broke a hip.

It's an effort to better target who really needs treatment and who can safely skip it, even before someone's bones become thin enough to be officially labeled an osteoporosis patient.

And it promises a major shift in bone care.

"You treat the people who have high risk, and you would reassure the women at low risk and ask them to come back for a re-check in a few years," explains Dr. Ethel Siris of Columbia University and president of the National Osteoporosis Foundation, which issued the new guidelines last week.

Moreover, the new work stresses that a disease long associated with little old white ladies actually can strike anyone as they age. The biggest change: The NOF guidelines recommend a bone-mineral density X-ray test for all men 70 and older, just like women 65 and older have long been urged to get. (Men and women may need the tests sooner if other factors put them at high risk.)

"There's a recognition more so now than in the past that men are at risk," says Dr. Jay Magaziner of the University of Maryland medical school, who has long researched hip fractures — osteoporosis' most-feared break.

Don't misunderstand. Postmenopausal women are still at greatest risk of osteoporosis, when bone-strengthening estrogen plummets. But a quarter of hip fractures occur in men, and as men live longer, the number who break a hip is steadily rising, Magaziner told a recent meeting of the American Academy of Orthopaedic Surgeons.

Screening men "as we do with women can have some real payoffs in terms of prevention," he says.

Another conundrum: More than half of fractures due to bone loss occur in people whose bones are thinning but aren't quite thin enough to be labeled osteoporosis. They're in a gray zone known as osteopenia.

In the U.S. alone, some 10 million people have osteoporosis but 34 million are estimated to have osteopenia. With the population rapidly aging, the government estimates half of Americans over 50 will be at risk of fractures from too-thin bones by 2020.

The World Health Organization funded a Web-based tool called FRAX, unveiled last week, that helps calculate the odds of a hip, wrist, shoulder or spine fracture within the next 10 years for anyone 40 or older in nine different countries — regardless of whether they have full-fledged osteoporosis or just low bone mass.

Both geography and ancestry matter for bone health. Consider differences such as diet, exercise and exposure to Vitamin D-making sunlight, and odds of a break differ dramatically from China and Japan, to France and Spain, and on to the highest-risk U.S. and Sweden. Here, white women have the highest risk and black women the lowest. FRAX lets users take all that into account.

How? Researchers at Britain's University of Sheffield used data from 60,000 people in developed countries — where life expectancy is long enough for osteoporosis to be an issue — to determine factors that play the biggest role in an individual's odds of thinning bones as they age.

Breaking a bone during adulthood that's not the result of, say, a bad car crash is one risk factor. A parent who broke a hip suggests a genetic risk. Smoking also thins bones, as does heavy alcohol consumption and long-term use of steroid-containing medicines.

Plug in a patient's score from a bone-density measurement of the hip for the final calculation.

That number alone doesn't say whether someone needs bone-building treatment. So in the U.S., the National Osteoporosis Foundation went a step further. It used the FRAX predictions to update guidelines on who needs bone-density testing, and to calculate when fracture risk becomes high enough that bone-building drugs would be cost-effective.

In addition to a routine bone check for older men, the guidelines recommend:

_Treat postmenopausal women and men 50 and older who have thinning bones, but not osteoporosis yet, if they have at least a 20 percent risk of any major fracture in the next decade, or at least a 3 percent risk of a hip fracture.

_Check for osteoporosis risk factors in postmenopausal women and men 50 and over, to see who needs a bone test before their senior years.

_A bone test for anyone who has any type of fracture after age 50, or who has conditions associated with bone loss, such as rheumatoid arthritis.

_For adults over 50, 1,200 milligrams a day of calcium and 800 to 1,000 international units a day of Vitamin D, more D than the government recommends.

_Do regular weight-bearing and muscle-strengthening exercise.

___

EDITOR's NOTE — Lauran Neergaard covers health and medical issues for The Associated Press in Washington.

On the Net:

FRAX Web site: http://www.shef.ac.uk/FRAX

Saturday, February 23, 2008

5 Things Super-Happy Couples Do Every Day

WebMD Feature from "Redbook" Magazine By Ty Wenger

Lord knows this is not the sort of thing guys brag about. But my wife and I have a ridiculously happy marriage. Really, it's almost disgusting.

We paw each other in public. We goof around like a pair of simpletons. We basically act like giddy newlyweds in the middle of happy hour. Sometimes we'll do something so revolting, like sitting on the couch and drawing smiley faces on the bottoms of each other's feet, that we're forced to make hacking, gagging noises to maintain our dignity. Actually, this happened just last week.

See, I told you it was disgusting.

It hasn't always been this way. In fact, I'm not ashamed to admit that our current marital bliss is the result of almost a year of counseling, a desperate effort undertaken several years ago, when we appeared destined for doom. What we learned then is something all happy couples eventually discover: A good marriage is a bit like a pet boa constrictor: either you feed it every day or bad things happen. Daily habits are extremely helpful in forging solid marriages, says couples therapist Tina Tessina, author of How to Be a Couple and Still Be Free. "If you're really interested in making your relationship work, little rituals are a great way to do it."

Want examples? Look no further than Tessina and her husband, Richard, who have developed an array of daily relationship builders during their 19 years of marriage: Every morning, they repeat their wedding vows to each other; they hold regular state-of-the-union meetings; and (my personal favorite) Tina routinely leaves Post-it Notes for Richard ("Hi, honey! Have a great day!") stuck to the underside of the toilet seat (think about it).

"Every marriage has what I call a relationship reservoir, or the stored-up emotional energy of the relationship," says Tessina. And although these daily habits are all very simple things, they help fill that reservoir. When there's a lot of positive energy there, you give each other a little pat on the butt or say, "I'm so glad I'm sharing my life with you," and you're storing it up. Then when the relationship is under stress, you'll have the energy you need to get through.

We asked happy couples across the United States to tell us about marriage-strengthening solutions they've developed. Try your hand at incorporating a few into your daily life and maybe you can be as ridiculously, embarrassingly, revoltingly happily married as I am.

Want to know the one thing that's most important to a successful marriage? That's easy. Walk up to your husband and surprise him with this one-question relationship quiz:

You: "Honey, what do you think is the one thing most important to a successful marriage?"

Him: "Umm, uh did you say something?"

And, well, there you have it.

Happily married couples typically say their relationships work better when they can sit down and gab one-on-one, like thinking, feeling adults. But who's got time for that? Actually, anybody who sleeps at night, if you follow the lead of Julie and Thom and their nightly visits to their "igloo."

"It all started one winter night years ago, when Julie had had a really bad day," says Thom, 33, a marketing director in Columbus, Ohio. "We were huddled under the covers of our bed, and Julie was describing how all the people who made her day miserable were 'bad polar bears' and how she didn't want any of the bad polar bears coming into the bedroom and how the bed was our refuge from them. You realize how embarrassing it is to admit this, right? Anyway, that's when we started calling the bed the igloo."

"The igloo is a place to retreat to," says Julie, 31. "It's our little sanctuary; only nice things happen in the igloo."

Eventually Julie and Thom began holding a powwow in the igloo at the end of every day, making a nightly excursion that Julie says has become a vital part of their five-year marriage.

"It's funny, because I always thought that when you lived with somebody, you'd automatically know everything that was going on," she says. "But we find that if we don't take that time to connect with each other, it's really easy for life to get in the way. The igloo offers one of the few times in the day where there's not a whole heck of a lot else going on, so you're able to focus on each other in a deeper way."

Of course, you don't need to christen major pieces of furniture with cute nicknames to improve the communication in your marriage. You simply have to set aside a few minutes every day to remind each other of why you got married in the first place. And there are as many ways to do that as there are marriages in America.

Lori and Joe, who are happily married in Philadelphia, have a nightly ritual they call crook time. That's when Lori cuddles up in the "crook" of Joe's shoulder and they talk. "The name's a little sappy," Lori admits, "but it's always a nice way for us to catch up."

Every night, Angie and Bob walk their pet Chihuahua, Chachi, through the streets of Brookline, Massachusetts. In addition to keeping Chachi from picking dogfights he could never win ("He has a bit of a Napoleon complex," Bob says), they use the time to strengthen their 11-year marriage.

It may be going a bit far to emulate Tim and Jill, a Connecticut couple who somewhat sheepishly admit that they check in with each other from work "six, maybe seven times a day," Tim says, "sometimes a dozen times when we're really being crazy." (Jill says, slightly more defiantly, "He's just my best friend, and our marriage is a great partnership, and there's no one I'd rather talk to.")

Then again, if you've been married 10 years and still want to talk to each other 10 times a day, you must be doing something right.

Back when you were 14 years old, you probably figured that once you got married, you'd have sex just about every day. (Well, maybe teenage girls don't think that way. But let me tell you, 14-year-old boys sure do.) And why not? Sex is free. It's fun. And it doesn't require the purchase of any equipment, besides the occasional bottle of vegetable oil and about 20 feet of nylon rope.

But as they get older, most couples realize that having sex every night isn't possible, let alone a worthy goal. Indeed, a 1994 University of Chicago survey of Americans' sexual habits found that only about a third of adults have sex more than once a week. Granted, that number might have been higher if all the couples having sex more frequently had stopped to take the surveyor's phone call, but clearly, sex for most married couples is far from a daily reality.

That doesn't mean, though, that you can't at least talk sexy every day, and that's the approach that Ed and Stephanie have taken in the more than six years they've been together.

"It's funny," says Ed, a 33-year-old San Francisco cab driver, "because we know plenty of married couples who fight, a lot, about how often they have sex. The wife's upset because all he ever wants to do is have sex; the husband's upset because he doesn't think they have sex enough. But this has never really been a problem with us, and I think it has a lot do with the fact that we're always talking sexy to each other."

"Absolutely," says Stephanie, a 32-year-old massage therapist. "We're always complimenting each other, tossing out fantasies, telling each other we're hot. He gets to feel like he can have sexual feelings, and I feel like I don't have to have sex all the time to appear attractive.

"Let's put it this way: The way I see it, sex is like chocolate cake. After five days of eating chocolate cake, even chocolate cake doesn't taste that great."

"Right," Ed says, "but after five days of talking about chocolate cake?"

"That cake tastes damn good."

Eavesdrop on a conversation between Bob and Angie concerning their favorite shared pastime.

"We are so disgusting. This is so pathetic. It's like a sickness."

"But it makes us happy!"

"It's so stupid it makes us laugh."

"We're yelling at people. High-fiving each other."

"Look, we get a kick out of it because it's so ridiculous. It's our guilty pleasure."

Forgive them if they seem somewhat shy, but they're merely ashamed to admit that the daily ritual that brings such joy to their 12-year marriage is none other than reality TV. That's right. They lived and died with Survivor. They've adopted Big Brother. Who Wants to Be a Millionaire? They do. Not to mention TemptationIsland, The Weakest Link, The Real World, Chains of Love, Fear Factor, The Mole (yes, really, The Mole)

"Honestly, I think we just need to be dumb for a while," says Bob, 37, a shoe designer for Reebok in Boston. "We're both very into our careers.

And when you're at work, with any job there's going to be a certain amount of professional stress. You like to come home sometimes and, for that lousy hour or whatever, kick back and relax."

Or as Angie, 36, a marketing executive, says, "Life is serious enough, isn't it? Sometimes you need to do something stupid. And if you can't be stupid with your husband, who can you be stupid with?

So hold on, then: Is domestic joy found in partners smothering each other in obsessive daily rituals ("Honey, don't forget, at 7:15 we have our nightly cuddle, followed by the affirmation of our vows, our 7:35 spontaneous flirtation, and then, of course, a new episode of Moesha at eight")?

Hardly. In fact, Tessina says that sleepwalking through a series of hollow routines (although probably an apt description of your day job) is worse for your marriage than having no routines at all. The solution, she says, is to also make a daily habit of getting away from each other.

"You know that old saying, 'How can I miss you if you don't go away?'" Tessina asks. "Doing things separately gives you a chance to fill in the blanks that your partner can't fill in for you, for example, one of you likes classical music, the other one likes sports. Plus, taking a break from each other gives you more things to talk about, because when you're joined at the hip, what's to talk about? You've already seen it all."

The point, naturally, is not to make space for each other in that I-can't-wait-to-get-away-from-you sort of way but to pursue your own hobbies and interests. It's a distinction that Joe tried hard to make to Lori during their delicate pre-engagement negotiations four years ago.

"As a woman, you get this message that when you get married, you spend every single waking second with your husband and you're so unbelievably happy," says Lori, 34. "And my parents actually do spend every single waking second together, and oddly enough, they are happy. So that's how I grew up thinking you were supposed to be. But when I told him this, Joe was like, 'I-don't-think-so.'"

"Because I watched my parents," says Joe, 29, whose parents divorced when he was 22, "and yeah, they spent every moment together, but they spent every moment together at each other's throats."

"So Joe had to convince me that having our own lives was a good idea," Lori explains. "I'm thankful he did."

These days Lori and Joe are practically poster children for the power of independence. Joe, who works for a nonprofit agency, spends his nights taking painting classes, building youth centers, and recording his guitar sessions. Lori, a college professor, spends hers directing community-theater musicals and indulging in trashy movies on cable television, a passion that Joe (go figure) doesn't seem to share

"It all brings a freshness to our marriage because we both continue to grow as people," Joe says.

"Plus," says Lori, "getting out of the house and out of each other's hair keeps us from going crazy."

And — we asked the experts, so we know — going crazy is definitely not one of the secrets of a happy marriage.

In another University of Chicago survey, this one of married couples, 75 percent of the Americans who pray with their spouses reported that their marriages are "very happy" (compared to 57 percent of those who don't). Those who pray together are also more likely to say they respect each other, discuss their marriage together, and — stop the presses — rate their spouses as skilled lovers.

Not to say that prayer is a cure for all that ails you (were that the case, my beloved Oakland Raiders would have won the Super Bowl years ago). But whether they're talking about a simple grace at dinnertime or some soul-searching meditation, couples routinely say that a shared spiritual life helps keep them close. And as Doug and Beth say, even couples who are on different sides of the theological fence can benefit from praying together daily.

"We have been married for seven years, but praying together is something we didn't start doing until about a year ago," says Doug, a 32-year-old Salt Lake City biochemist. "In the past, whenever we faced big decisions, we'd have discussion after discussion about them, but we'd never really come to a resolution."

After two 1,000-mile moves, the birth of three children, and two job changes, all in the past four years, those difficult decisions had begun to take a toll. So when Beth asked Doug, a nonreligious and self-proclaimed man of science, to try praying with her, he figured they had nothing to lose.

"I soon found that praying together brings out a real sense of selflessness and humility," Doug says. "When you're praying for each other, not yourself, you're focused together and speaking from the heart on a whole different level. I would never have predicted this for us, but it really works."

"As bad as any problem may seem at that moment," agrees Beth, "prayer always helps us see beyond it. It doesn't have to be a long-drawn-out scripture reading, just a few minutes a day. When we pray, it brings another level of honesty to our conversations. I think it's the most intimate thing you can do with another person."

Now they pray together every night, once the "urchins" are in bed, which puts them in the company of the 32 percent of American married couples who say they pray together regularly. It also puts them in the company of Julie and Thom, when the other couple isn't holed up in their igloo, of course.

"It's pretty short and not at all scripted," says Julie about their giving thanks before each meal. "We just join hands and let it rip. Whether we're asking for forgiveness or giving thanks, saying it out loud holds a lot of power.

"Besides, regardless of religion or spiritual preference, I think that most marriages require a ton of faith," Julie sums up. "You've got to believe that somehow the two of you are going to make it through things. You've got to believe that you're being blessed with this person. And even if the power we feel just comes from the strength of our love, even if we don't believe that it's God who is helping us, I still think that it's good to acknowledge that there's a force between the two of us that's helping us out."

Thursday, February 21, 2008

10 Ways to Catch a Liar

Experts have 10 tips that can let you know if someone isn't telling you the whole truth.
By Heather Hatfield
WebMD Feature
Reviewed by Louise Chang, MD

J.J. Newberry was a trained federal agent, skilled in the art of deception detection. So when a witness to a shooting sat in front of him and tried to tell him that when she heard gunshots she didn't look, she just ran -- he knew she was lying.

How did Newberry reach this conclusion? The answer is by recognizing telltale signs that a person isn't being honest, like inconsistencies in a story, behavior that's different from a person's norm, or too much detail in an explanation.

While using these signs to catch a liar takes extensive training and practice, it's no longer only for authorities like Newberry. Now, the average person can become adept at identifying dishonesty, and it's not as hard as you might think. Experts tell WebMD the top 10 ways to let the truth be known.

Tip No. 1: Inconsistencies

"When you want to know if someone is lying, look for inconsistencies in what they are saying," says Newberry, who was a federal agent for 30 years and a police officer for five.

When the woman he was questioning said she ran and hid after hearing gunshots -- without looking -- Newberry saw the inconsistency immediately.

"There was something that just didn't fit," says Newberry. "She heard gunshots but she didn't look? I knew that was inconsistent with how a person would respond to a situation like that."

So when she wasn't paying attention, he banged on the table. She looked right at him.

"When a person hears a noise, it's a natural reaction to look toward it," Newberry tells WebMD. "I knew she heard those gunshots, looked in the direction from which they came, saw the shooter, and then ran."

Sure enough, he was right.

"Her story was just illogical," says Newberry. "And that's what you should look for when you're talking to someone who isn't being truthful. Are there inconsistencies that just don't fit?"

Tip No. 2: Ask the Unexpected

"About 4% of people are accomplished liars and they can do it well," says Newberry. "But because there are no Pinocchio responses to a lie, you have to catch them in it."

Sir Walter Scott put it best: "Oh what a tangled web we weave, when first we practice to deceive!" But how can you a catch a person in his own web of lies?

"Watch them carefully," says Newberry. "And then when they don't expect it, ask them one question that they are not prepared to answer to trip them up."

Tip No. 3: Gauge Against a Baseline

"One of the most important indicators of dishonesty is changes in behavior," says Maureen O'Sullivan, PhD, a professor of psychology at the University of San Francisco. "You want to pay attention to someone who is generally anxious, but now looks calm. Or, someone who is generally calm but now looks anxious."

The trick, explains O'Sullivan, is to gauge their behavior against a baseline. Is a person's behavior falling away from how they would normally act? If it is, that could mean that something is up.

Tip No. 4: Look for Insincere Emotions

"Most people can't fake smile," says O'Sullivan. "The timing will be wrong, it will be held too long, or it will be blended with other things. Maybe it will be a combination of an angry face with a smile; you can tell because their lips are smaller and less full than in a sincere smile."

These fake emotions are a good indicator that something has gone afoul.

Tip No. 5: Pay Attention to Gut Reactions

"People say, 'Oh, it was a gut reaction or women's intuition,' but what I think they are picking up on are the deviations of true emotions," O'Sullivan tells WebMD.

While an average person might not know what it is he's seeing when he thinks someone isn't being honest and attribute his suspicion to instinct, a scientist would be able to pinpoint it exactly -- which leads us to tip no. 6.

Tip No. 6: Watch for Microexpressions

When Joe Schmo has a gut feeling, Paul Ekman, a renowned expert in lie detection, sees microexpressions.

"A microexpression is a very brief expression, usually about a 25th of a second, that is always a concealed emotion," says Ekman, PhD, professor emeritus of psychology at the University of California Medical School in San Francisco.

So when a person is acting happy, but in actuality is really upset about something, for instance, his true emotion will be revealed in a subconscious flash of anger on his face. Whether the concealed emotion is fear, anger, happiness, or jealousy, that feeling will appear on the face in the blink of an eye. The trick is to see it.

"Almost everyone -- 99% of those we've tested in about 10,000 people -- won't see them," says Ekman. "But it can be taught."

In fact, in less than an hour, the average person can learn to see microexpressions.

Tip No. 7: Look for Contradictions

"The general rule is anything that a person does with their voice or their gesture that doesn't fit the words they are saying can indicate a lie," says Ekman. "For example, this is going to sound amazing, but it is true. Sometimes when people are lying and saying, 'Yes, she's the one that took the money,' they will without knowing it make a slight head shake 'no.' That's a gesture and it completely contradicts what they're saying in words."

These contradictions, explains Ekman, can be between the voice and the words, the gesture and the voice, the gesture and the words, or the face and the words.

"It's some aspect of demeanor that is contradicting another aspect," Ekman tells WebMD.

Tip No. 8: A Sense of Unease

"When someone isn't making eye contact and that's against how they normally act, it can mean they're not being honest," says Jenn Berman, PhD, a psychologist in private practice. "They look away, they're sweating, they look uneasy ... anything that isn't normal and indicates anxiety."

Tip No. 9: Too Much Detail

"When you say to someone, 'Oh, where were you?' and they say, 'I went to the store and I needed to get eggs and milk and sugar and I almost hit a dog so I had to go slow,' and on and on, they're giving you too much detail," says Berman.

Too much detail could mean they've put a lot of thought into how they're going to get out of a situation and they've crafted a complicated lie as a solution.

Tip No. 10: Don't Ignore the Truth

"It's more important to recognize when someone is telling the truth than telling a lie because people can look like they're lying but be telling truth," says Newberry.

While it sounds confusing, finding the truth buried under a lie can sometimes help find the answer to an important question: Why is a person lying?

These 10 truth tips, experts agree, all help detect deception. What they don't do is tell you why a person is lying and what the lie means.

"Microexpressions don't tell you the reason," says Ekman. "They just tell you what the concealed emotion is and that there is an emotion being concealed."

When you think someone is lying, you have to either know the person well enough to understand why he or she might lie, or be a people expert.

"You can see a microexpression, but you have to have more social-emotional intelligence on people to use it accurately," says O'Sullivan. "You have to be a good judge of people to understand what it means."

Extra Tip: Be Trusting

"In general we have a choice about which stance we take in life," says Ekman. "If we take a suspicious stance life is not going to be too pleasant, but we won't get mislead very often. If we take a trusting stance, life is going to be a lot more pleasant but sometimes we are going to be taken in. As a parent or a friend, you're much better off being trusting rather than looking for lies all the time."

Tuesday, February 19, 2008

How to Get More Friends

WebMD Feature from "Health" By Denene Millner

If friends are so good for us, why do we have few? Here’s how to get more.

It’s been almost two years since my family and I moved from New Jersey to the South in search of a more peaceful, more meaningful lifestyle. For the most part, we’ve found what we were looking for. Still, save for a few new acquaintances, I have about as many friends as a pimply-faced nerd on her first day of high school. I crave the camaraderie I shared with my girls up north.

I’m not alone. Recent research shows that adult Americans’ circle of friends has decreased by a third over the last 19 years. The problem isn’t just that we don’t have dinner dates; it’s that we don’t have people to turn to when we’re sick, when we’re stressed, or when we’re otherwise in crisis. We miss the health benefits of having a strong social network, which can do everything from boost your immune system to protect you from heart disease, cancer, depression, and anxiety, says Marla Paul, author of The Friendship Crisis: Finding, Making, and Keeping Friends When You’re Not a Kid Anymore.

“People tend to think of friendship as something you fit in when all the important stuff is done,” she says. “But friends are not a luxury; they’re an essential nutrient.”

Here are five easy ways to make—and keep—the kind of friends who will make your life happy and healthy.

1 Talk to strangers.
You may have a lot in common with the person you see every day on the train. Angelou Ezeilo of Snellville, Georgia, struck up a conversation one day with fellow commuter Jennifer White and discovered that they both were three months pregnant with boys, had a mutual love for Southern cooking and interior design, and lived in the same neighborhood. A friendship was born.

2 Google your old best friend.
You may have fallen out of touch since graduation, but your former buddy might still have all the wonderful qualities that made you like her in the first place. “If she was a good friend before, she might be an even better friend now,” says Sally Horchow, co-author of The Art of Friendship: 70 Simple Rules for Making Meaningful Connections.

3 Host an each-one-bring-one party.
Ask a few friends each to invite someone you don’t know to a low-key evening of food and conversation. Dorothy Ashford of Cornelius, North Carolina, hosts this kind of gathering every Fourth of July. “I make sure that everyone connects with those they haven’t met,” she says. Try a fun icebreaker to get guests talking. Ashford suggests putting out a sign-in book so you can keep in touch with guests who tickled your fancy.

4 Make a friendship “date.”
If, for instance, a mom you chat with when you drop your kids off at school mentions she likes cooking, invite her to a local cooking class where the two of you can learn a new dish—and dish!—together. It’s a no-pressure way to take a passing acquaintance to the next level.

5 Do something new
Try something you love, so you can meet others who love it, too. Join a group, and you’re bound to find potential friends you can bond with over similar interests. “You’ll be seeing the same faces over and over, so your introduction is not quite so cold,” author Marla Paul says. Or simply change your routine. For example, Horchow suggests, instead of eating lunch by yourself at work, one day a week join co-workers you’d like to know better

Monday, February 18, 2008

Is Your Sex Life Normal?

WebMD Feature from Oprah.com
Psychotherapist Rachel Morris, sex journalist Sarah Hedley and general practitioner Sarah Humphery are the sex editors of the UK edition of Cosmopolitan. Dr. Lana Holstein is a sex expert and oversees programs addressing intimacy and sexuality issues at the Miraval Resort in Arizona. They have the answers to some very intimate questions.

He Wants More
Question: My wife and I have been married two years. We have sex about once a week. She says I'm not romantic and that she sometimes has sex out of obligation. She also says that if I would help out around the house she'd be more into having sex. But I don't see the relationship between housework and sex. I worry she no longer finds me attractive and that maybe we were meant to be just friends. Is it normal for me to expect to have sex every day with my wife?

Answer: Mismatched sex drive is one of the most common problems with couples, says general practitioner Sarah Humphery. "It's interesting you say that you don't understand how getting more involved in the housework is going to help," Humphery says. "She's going to be less tired, she's going to be preoccupied, she's going to feel less like a sort of housewife — you've got to make her feel sexy." For the woman, Humphery says sometimes, she will have to do it out of obligation. Men — more often than women — are aware of their bodies, whereas women — "we don't have that connection to 'down below.'"

She Wants More
Question: My husband and I are newlyweds and I can't keep my hands off him. I initiate sex 85 percent of the time. He usually says "no" because he is tired. Am I being selfish because I want sex more often? Is it normal for the woman to be the initiator most of the time?

Answer: Psychotherapist Rachel Morris says the first question to ask yourself is whether there are any other times — apart from when you're having sex — where he gives you his "entire, full, unadulterated attention." "If the answer is no," Morris says, "it may be that you're confusing the desire to have sex with the desire to have him all to yourself — the reassurance that you're still loved. Intimacy and sex aren't necessarily the same things. So pushing him to have sex, when really what you want is intimacy, probably means that you're getting neither.


A Celibate Marriage
Question: In the last two years, my husband and I have had sex once. We've been married 14 years, run a business together and have a daughter. I'm only 38 years old — it's not that I don't have a high sex drive. We just don't know how to get back to being sexual together. Is it normal to have a marriage that becomes more like a brother and sister relationship?

Answer: Dr. Lana Holstein says most couples do need a sexual tune-up. Many times "it just fades a little bit — they're paying attention to their finances or to their kids — but they forget that they could pay attention to their sexual connection. "

She says although many people believe in "spontaneity," couples should really treat sex and relationships like a business. "I call it 'The Good Sex Division.' It needs everything a new division of the company would need." Couples should set a mission statement that includes goals, capital — a statement of a perfect sex life.

Dr. Holstein also recommends setting a regular time for sex. "It's the only way. Our lives are so busy — you won't get to it often." For a deep, soulful connection, Dr. Holstein suggests the woman sit on the man's lap, face-to-face, and gaze into each others eyes. "When you sit together, you hold hands, you look into one another's eyes, you remind yourself, 'Why am I with this person?' All of a sudden it starts to change."

Sunday, February 17, 2008

10 Secrets to a Better Love Life

Have a great bonk holiday ... follow Deidre's tips to spice up your sex life
Too much boredom in your bedroom? Revitalize your sex life with these 10 tips.
By R. Morgan Griffin
WebMD Feature
Reviewed by Louise Chang, MD

Most of us can remember the hot -- and frequent -- spicy moments when the romance was new with our partner. But eventually the fire of a good love life may die down. Over time, the sexy nightie languishes hidden in the sock drawer, the massage oil gathers dust next to the athlete's foot powder in the medicine cabinet, and you and your partner have what feels like a humdrum sexual life.

So what is the secret to a better love life that lasts? We asked for some suggestions from two experts on sexuality -- Michael Castleman, author of Great Sex: A Man's Guide to the Secret Principles of Total-Body Sex, and Louanne Cole Weston, PhD, a board certified sex therapist and resident expert for WebMD's "Sex Matters®" message boards.

Make Dates

Castleman and Weston are in firm agreement that couples that have been together for a while need to plan time for sex.

"Make a date for sex," says Castleman, a health journalist who previously answered questions about sexuality submitted to the Playboy advisor. "Don't let it be an afterthought," he tells WebMD. "Do whatever you like to do beforehand, go to a movie or dinner, take a walk, have a glass of wine by candlelight, whatever the couple likes to do as a couple. But set aside that time."

But, you might cry, isn't scheduling unromantic? Isn't sex supposed to be spontaneous? Rare is the lover with a daily planner fetish, after all.

But Castleman has a blunt response. "Grow up," he says. "What's the problem with making a date for sex? People make plans for other things they enjoy, like ski trips or dinners out."

Weston agrees. "I think most people, especially couples with kids, have to plan ahead because they already have so much jammed into their schedules," she says. "Sure there are times when things spontaneously fall together, but those are happy accidents."

Get Out of the House

One good suggestion for a better love life is to take regular nights away from home.

"For couples that have been together for a while, sex can become routine," says Castleman. "You're worn out by the end of the day, after the job, the laundry, the kids' soccer games, and the errands.

"And instead of champagne and oysters on the half shell with a sweeping view of Lake Tahoe as your reward, you've got your same old crummy house and peanut butter and jelly and that's about it," he says. It's not exactly conducive to an exciting sex life.

It can be hard to give into the moment when you're having sex in your all-too-familiar bedroom. Your mind wanders. Did I remember to set the alarm clock? How much will it cost to repair that water damage on the ceiling?

"Lovemaking is, fundamentally, a present moment experience," says Castleman. "The best sex comes when you're not thinking about the past or the future, but only the present. And that can be hard in a room where you've always got grandma's picture smiling down on you."

Castleman recommends getting away to a place that is stripped of these reminders of everyday life. It doesn't have to be a fabulous spot by the ocean, or at least it not every time. A non-descript place off the Interstate might be just fine.

Redecorate the Bedroom

Of course, having a sex life that's wholly dependent on trysts at hotels and overnight babysitters may be a problem if you're not fabulously wealthy, childless, and unemployed. So in addition to some trips away, make some changes at home.

"The bedroom does build up a lot of mundane associations," says Weston. "But if you can do anything to transform your bedroom into something new and different, that can make a big difference."

And a better love life doesn't require installing a revolving bed or ceiling mirrors. "You don't need to do something that will freak out the kids or the housekeeper," says Weston.

Lighting some candles is an obvious suggestion. But maybe getting a nicer set of sheets and a new bedspread will make a difference. Also, removing some of the junk -- the kids' toys, the piles of laundry -- that tends to accumulate in a bedroom out can have an effect. Think about ditching the bedroom TV, too, or at least trying life without it for a while

Figure Out What You Really Want

Everyone's got sexual fantasies of one sort or another. But for some people, those fantasies can be buried pretty deep. If your partner were to turn to you tonight and say, "What's your ultimate sexual fantasy?" or "What do you want to change about how we have sex?" do you know what you'd say?

If you're not sure, you're not alone. "Some people have to do a little work at figuring out what really arouses them," says Weston. But figuring out what you want is key to having a better love life.

So give it a little effort. Weston observes that there are plenty of tools out there to help: books, magazines, videos, and so on. Once you've come up with some ideas, telling your partner about them could be fun for both of you.

Find Out What Your Partner Wants

And then there's the flip side: You need to ask your partner the same questions that you've asked yourself. What does your partner want from your love life?


According to Weston and Castleman, one of the most common complaints they hear is that one partner wants to have sex more than the other.

Some people may huffily assume that they just have higher sex drives than their partners do. But maybe your partner is looking for something different out of your love life but hasn't felt able to ask. So bring up the subject. Talking openly might bring you closer to one another, and that's likely to make sex more interesting for both of you.

Try Something New

Trying something new in the bedroom is a pretty obvious suggestion for attaining a better love life, but it's one that many people have trouble following.

"For a lot of couples, the longer they're together, the more they play it safe sexually," says Weston. "You think it would go the other way, that as people get more comfortable in a relationship they feel more secure to try new things. But that's not the case."

Castleman agrees. "People resist change, especially intimate change," he says. "If you're in an established relationship, you may feel like you have more to lose. You don't want to rock the boat."

But both Castleman and Weston recommend resisting the impulse to play it safe. This can mean all sorts of things -- maybe lingerie, massage, sex toys and so on -- and trying something new doesn't have to be outrageous.

"People have a lot of crazy notions about what a sexual fantasy should be," says Castleman. "They think it must mean S&M or sex on a Ferris wheel. But there are a lot less wild ways of experimenting with something new."

Weston agrees. "One small change that can have a big effect is to interrupt the pattern to how you usually have sex," says Weston. "If you're usually the shy one who waits for the other person to begin things, try starting it yourself. Just take a risk, even if it's a little one."

Don't Ignore Sexual Problems

Sexual problems are a much more open secret now than they once were. For instance, thanks to the efforts of pharmaceutical companies and late night comics, there aren't many people left in the country who aren't aware of medications for erectile dysfunction.

Of course, that doesn't mean that everyone who needs help is getting it.

"People who have sexual problems do often shy away from sexuality because they don't want to face failure," says Weston. "But these problems need to be addressed head on."

Erectile dysfunction has received the most attention, but there are plenty of other issues too, such as premature ejaculation, a loss of libido, or difficulty reaching orgasm caused by medications or medical conditions

Weston reports that women are coming forward in larger numbers and reporting sexual problems too, such as pain during intercourse or an inability to orgasm. According to Castleman, many women complain about vaginal dryness during sex, which can be painful.

"Lubrication is important," says Weston. "Because in terms of how aroused a person is, lubrication for a woman is the equivalent of an erection for a man."

Some sexual problems may need medical attention, while others can be solved by trying different sexual techniques or buying a $5 bottle of lubricant. But the important thing is not to muddle through with problems that are making your sex life worse. Don't settle for a mediocre sex life.

And finally, Weston is quick to point out that no matter what you've heard, drugs for erectile dysfunction do nothing to increase a person's sex drive.

Go Slowly

Some couples find that, the longer they're together, the briefer and more businesslike their sexual encounters can become.

Castleman likens it to navigating a new neighborhood. When you move to a new place, you're always trying out different routes to get to the supermarket or the hardware store. But after time, you decide on the fastest route and only take that one. No more meandering. The same thing happens to couples as they become more familiar with each other sexually.

But the fastest, most efficient route is definitely not what you want in the bedroom. Focusing on the destination -- and only the obvious parts of the anatomy -- is the worst thing you can do, he says.

"The best sex emerges from whole body sensuality -- leisurely, playful, creative," says Castleman. "It has no real direction, a little of this, a little of that."

Castleman argues that men especially have a tendency to go too fast, something that's encouraged by the down-and-dirty efficiency of sex in pornography. But Castleman says that many men find that their sexual problems -- such as premature ejaculation -- subside when they learn to take their time.

"Leisurely love-making benefits everyone," says Castleman. "Women get more turned on and enjoy sex more, while men have fewer sexual problems and feel more confident about themselves in bed. Everybody wins."

Don't Worry About What Everyone Else Is Doing

According to Weston and Castleman, one of the most common questions they get is, "How much should we be doing it?" The question implies that the answer is obvious: more than I am now.

Feeling like you "should" be having a better love life is probably universal. It explains the vast number of titles about sex in the self-help section of the bookstore, and the constancy of articles about sex advertised on magazine covers at the checkout counter (or why so many people click on articles with titles like, say, "10 Secrets to a Better Love Life.")

Castleman observes that the culture we live in -- and especially its films, whether Hollywood romances or pornography -- encourages us to think that we're not living up.

So how often "should" you have sex? "There's no answer to that," says Weston. "Stop trying to decide how much sex you should have and decide how much you want."

Keep Trying

Having a better sex life will take some work. It's like this: for many people, life is an unremitting guerilla war with those extra 10 pounds that ambush you when you're not paying attention. In the same way, people can fall into a sexual rut, a "blah" love life, unless they're making an effort to keep things exciting.

You should expect that some attempts will fall flat. A stab at a sexual role-play may be rendered ridiculous by an ill-timed call and rambling answering machine message from your mother-in-law. Or maybe the aromatic candles make you sneeze violently. Trying something new is always putting you at risk of failure.

But the important thing is to keep trying anyway. Don't let self-consciousness make you play it safe. You should never accept a just average love life.

So there they are: the 10 secrets to a better love life. But, you may exclaim, I think I've heard some of these before. It's a fair point. For instance, upon reading that communication is important for a healthy love life, there is no person in America who will smack her forehead and say, "Golly, and all this time I thought not communicating was the right idea!"

Admittedly, these suggestions are not secrets. Or at least they aren't secrets like the purpose of Stonehenge or the fate of Amelia Earhart. We've read the magazines, and watched the daytime talk shows. Many of us know what we're supposed to do to have a better love life.

But if we already know this stuff, why do we keep buying the magazines and watching the TV shows that tell us what we already know? Ultimately, our good intentions fail and we lapse back into lazy habits. We let the other stuff in life take over.

So the most important suggestion for a better love life is probably the last one: Just keep trying. Making a consistent effort is the key.

"If someone says that they don't have time or energy for a good sex life, then they can't expect to have a good sex life," says Castleman. "It's that simple."

Saturday, February 16, 2008

Your Guide to Never Feeling Tired Again


WebMD Feature from "Redbook" Magazine By Nancy Rones

22 ways to tackle life's biggest energy zappers.

Every day, 2.2 million Americans complain of being tired. Most of us chalk it up to having too much to do and not enough time to do it in, especially during extra-busy periods. But often the true culprits are our everyday habits: what we eat, how we sleep, and how we cope emotionally. Read on for some simple, recharging changes that can help you tackle all of the energy stealers in your life.

Energize Your Diet

Why is it that filling up on pasta or Chinese food for lunch leaves us snacky and sleepy an hour later? Or that falling short on fluids makes us forgetful and foggy? Fact is, eating habits play a powerful role in how well we function on every level. Below, six top fatigue-fighting nutrition strategies to chew on.

  • Have breakfast... even if you don't feel hungry. You'll be a lot perkier: Studies show that people who eat breakfast feel better both mentally and physically than those who skip their morning meal. British researchers at Cardiff University even found that spooning up a bowl of breakfast cereal every morning is associated with lower levels of the stress hormone cortisol.
  • Eat every three to four hours. Having three smallish meals and two snacks throughout the day can keep your blood sugar and energy levels stable all day long, says Roberta Anding, R.D., a spokesperson for the American Dietetic Association (ADA). Note the word "smallish." Supersized meals demand more of your energy to digest, which can leave you feeling lethargic. At each mini-meal, get a mix of carbohydrates (which the body uses for energy), protein (which helps sustain energy if needed), and healthy fats like those found in fish, nuts, and olives -- these fats and protein contribute to meal satisfaction, so you don't go hunting for sweets an hour later and wind up with a short-lived sugar high and subsequent crash. A few meal ideas: a low-fat yogurt parfait with berries and a couple of tablespoons of whole-grain granola; salmon over mixed greens with whole-grain crackers; and beef tenderloin with a baked sweet potato and asparagus.
  • Fill up on more fiber. Fiber has a time-releasing effect on carbs, so they enter your bloodstream at a slow and steady pace, giving your energy staying power, says Anding. When choosing your mini-meals (see above), include fiber-filled options that add up to the daily recommended 25 to 30 grams of fiber (the average person gets only between 10 and 15 grams). Some suggestions: a bowl of raisin bran (5 grams of fiber per cup); black beans and cheese wrapped in a multigrain tortilla (beans have 7.5 grams per 1/2 cup; one tortilla has 5 grams); air-popped popcorn (3.6 grams per 3 cups); an apple with the skin (3.3 grams); and whole-wheat spaghetti (6.3 grams per cup).
  • Fuel your brain with omega-3s. Found in fatty fish (such as tuna and salmon), walnuts, and canola oil, these essential fatty acids play a role in keeping brain cells healthy and helping you feel mentally alert. Another potential bonus: Omega-3s encourage the body to store carbs as glycogen — the storage form of glucose (blood sugar) and the body's main source of stored fuel — rather than as fat.
  • Stay hydrated. Water makes up the majority of your blood and other body fluids, and even mild dehydration can cause blood to thicken, forcing the heart to pump harder to carry blood to your cells and organs and resulting in fatigue. Also, ample fluids keep energy-fueling nutrients flowing throughout the body, says Nancy Clark, R.D., author of Nancy Clark's Sports Nutrition Guidebook. To gauge your hydration, Clark recommends monitoring how often you urinate. You should be going every two to four hours, and your urine should be clear or pale yellow in color. Tip: Besides drinking more, you can also consume foods that naturally contain water, such as yogurt, broccoli, carrots, and juicy fruits, like watermelons, oranges, and grapefruits.
  • Watch caffeine intake after noon. Typically, consuming a moderate amount of caffeine — 200 to 300 mg, the amount found in two to three cups of coffee — can make you more energetic and alert in the hours following, says Anthony L. Komaroff, M.D., a professor of medicine at Harvard Medical School. But when caffeine is consumed in large quantities — or anytime in the afternoon or evening — the quality of your sleep that night can take a nosedive, leaving you with heavy eyelids the next day. One caution for those who are highly sensitive to caffeine: Although switching to a decaf latte in the afternoon sounds like the answer, researchers at the University of Florida found that out of 22 decaffeinated coffee beverages tested, all but one contained some caffeine

Energize Your Spirit

  • We're all familiar with physical exhaustion, but mental strain — sadness, boredom, worry, anger, and general stress (the biggie) — can take an even heavier toll on vitality, completely wearing you out. Life happens, and these difficult emotions will, too. But if you react wisely, your brain and body will rebound — along with your vim and vigor.
  • Splash some water on your face or take a shower when you're feeling burned-out. Some 55 percent of study participants reported using these types of "water therapy" to successfully increase their energy, according to findings in the Journal of Personality and Social Psychology. Apparently, a little H 2 O refresher can instantly help take the edge off when you're feeling overwhelmed.
  • Suit up in a "power" outfit to beat the blahs. Fight the tendency to throw on sweats when you're feeling sluggish. Although it may seem counterintuitive to slip into the skirt you save for special occasions, it helps to look in the mirror and see an energizing image — not a deflating one that confirms and reinforces your internal state, says Alice D. Domar, Ph.D., founder and executive director of the Domar Center for Complementary Healthcare in Waltham, MA. Dressing for success will give you a big mental boost every time you catch sight of your reflection (or receive a compliment) throughout the day.
  • Vent your feelings. Keeping fear, anxiety, and stress pent up inside may seem like a grown-up way to deal with these emotions. But discussing negative feelings with another person can ease them far better than keeping them bottled up; by airing them, you reduce their ability to sap your stamina, says Komaroff, who is also the editor-in-chief of the Harvard Health Letter.
  • Turn on some tunes. Listening to music is one of the most effective ways to change a bad mood, decrease tension, and increase energy. Consider this: Runners in one study who listened to music while on the treadmill ran faster than those who jogged in silence — no matter how loud the volume or how fast the tempo, according to new findings in the journal Ergonomics. Other research suggests that music effectively distracts you from feeling fatigue. Try burning a CD of your favorite songs and playing it anytime you need a pick-me-up. (If you exercise, so much the better — but the music will move you either way.)
  • Let go of grudges. Nursing a grudge prompts your mind and body to react as if they're under chronic stress, increasing your heart rate and blood pressure and potentially resulting in an impaired immune system and exhaustion over time, according to a study in the journal Psychological Science. On the other hand, practicing empathy and forgiveness after you've been wronged makes you feel as if you're back in control, which keeps the body's stress responses in check. The next time you find yourself harboring ill feelings, repeat a stress-relieving mantra to yourself, such as, "Forgiveness makes me a happier and stronger person."
  • Take belly breaths. When we're under stress, we're prone to take "chest breaths" — short, shallow ones, says Domar. Chest breathing brings less air into the lungs and reduces the supply of energizing oxygen to the body and brain, leaving you physically and mentally drained. The goal is deep, diaphragmatic breathing — like that of a sleeping infant: When you breathe in, your belly should round and fill like a balloon; on an exhale, your belly should slowly deflate. Of course, remembering to practice deep breathing isn't the first thing on your mind when you're under the gun, so as a visual reminder, try posting a tranquil picture (such as a pool of water or your kids smiling) with the word "breathe" next to your computer, or anywhere you tend to feel on edge.
  • De-clutter a corner. Go through that teetering pile of papers or overflowing closet and clear it out. Clutter can make you feel out of control and overwhelmed, especially when you're already feeling stressed or down. Plus, simply accomplishing a goal, no matter how seemingly minor, can be energizing, says Domar.
  • Do some good. Acts of altruism can lend a little pep to your step. In fact, one study in the Journal of Health and Social Behavior found that volunteer work can boost your energy in six ways: It enhances happiness, life satisfaction, self-esteem, sense of control over life, physical health, and mood. Find short- and long-term volunteer opportunities at volunteermatch.org and charityguide.org.

When you have a lot to do (um...always), usually the first thing to get squeezed off your agenda is sleep. But miss out on shut-eye and your energy, positivity, productivity, and memory are sure to suffer. And nearly a quarter of American adults aren't getting enough rest, which has led to an epidemic of daytime sleepiness, according to a poll by the National Sleep Foundation. The key to bucking this trend is to brush up on sleep hygiene. Try these steps for starters.

  • Cut back on TV and computer time after 8 p.m. If you're already a night owl (you go to bed late and sleep in on weekends), the bright light emitted from television and computer screens can make falling asleep at a decent hour even harder. The reason: Light suppresses the production of melatonin, a hormone secreted at sunset that tells the brain that it's nighttime, explains John Herman, Ph.D., director of the training program in sleep medicine at the University of Texas Southwestern Medical School at Dallas. And when melatonin levels are low, your brain is fooled into thinking that it's still daytime — and remains raring to go. Whenever possible, wait until the next morning to tune in and/or log on. If you must use light-emitting technology at night, try to turn it off an hour or two before hitting the sack.
  • Hide your alarm clock. Watching the clock to see how long it's taking you to drift off or how much time you have left before your alarm goes off can result in a poor night's sleep, says Kelly A. Carden, M.D., medical director of the Sleep Health Center Affiliated with Hallmark Health at Medford in Medford, MA. This hypervigilance keeps the brain awake and alert and prevents you from slipping into deep, restorative sleep. The easy fix: Set your alarm clock, then either face the numbers away from you or put it on the floor, in a drawer, or across the room.
  • Give your pet his own separate sleeping space. At night, pets snore, jiggle their tags, move around a lot, and even hog the covers and bed space. It's no wonder that 53 percent of pet owners who sleep with their pets in the bedroom have some type of disrupted sleep every night, according to a study from the Mayo Clinic Sleep Disorders Center in Rochester, MN. Consider relocating your furry friend's sleeping quarters to another area, even if it's just his own bed in your bedroom.
  • Lower the thermostat. For a good night's sleep, make sure your room is comfortably cool — enough so that you need a light blanket. This ensures that your environment is in sync with your body's internal temperature, which naturally drops during the night, according to the National Sleep Foundation. Studies suggest the ideal sleeping temperature is between 54 and 75 degrees; anything cooler or warmer may cause you to wake up.
  • Skip the nightcap. Alcohol depresses the nervous system — the system of cells, tissues, nerves, and organs that controls the body's responses to internal and external stimuli. So while sipping a glass of wine before bed may help you nod off, the sedative effects wear off as your body metabolizes the alcohol, which may cause you to wake up in the middle of the night and have trouble falling back to sleep. Alcohol has also been shown to interfere with the body's natural 24-hour biorhythms, causing blood pressure to rise and heart rate to race at night when it's normally calm and relaxed. You don't have to give up that evening cocktail entirely to achieve sound sleep — just try to avoid alcohol within two to three hours of bedtime.
  • Get your exercise. While scientists don't yet understand why, aerobic exercise has been proved to help you fall asleep faster at bedtime, spend more hours in deep sleep, and wake up less often throughout the night, says Komaroff. At the same time, vigorous exercise can act like a stimulant (which is a great daytime energizer), so schedule your workouts in the morning or afternoon, when you need a boost the most.
  • Follow the 15-minute rule. If you can't fall asleep, or if you wake up and can't get back to sleep within about 15 minutes, get out of bed and do something relaxing that will help clear your head, such as reading, meditating, or knitting (but not watching TV or surfing the Web). Then, once you feel sleepy again, go back to bed. If you stay put and fret about being awake, you'll only make yourself more anxious — and less likely to catch the z's you need.
  • Write down your worries. During the day, jot down any stressors that are weighing on you, says Carden. Then, do some mental problem-solving before your head hits the pillow — or, if you're falling short on solutions, tuck your list away and resolve to brainstorm ideas during your morning shower or commute to work. Just knowing you've established a plan for tackling your to-do's will make you feel like you've made some progress, allowing you to relax, drift off — and wake up the next morning ready to take on the day.

We Tested and Reviewed the Latest Pick-Me-Uppers

H 2 O Plus Energize Spa Collection: "I'm not sure if it was the citrus scent of the body wash and scrub or just the warm water, but I did feel more awake after my shower." (h2oplus.com)

TravelSox Odyssey socks: "I was skeptical, but I wore these socks during a five-hour flight, and they really made my legs feel more alive and less cramped than usual." (travelsox.com)

LifeWave Energy Enhancer patch: "It may have been psychosomatic (or what I ate for lunch), but after I put these on, my heart started to race and I felt queasy and sweaty." (lifewave.com)

FOOSH Energy Mints: "I enjoyed the strong, minty taste, but I didn't notice a significant difference in my energy. But I'm not sensitive to caffeine, which is the active ingredient." (vroomfoods.com)

G Pure Energy drink: "The ginger ale taste was nice, and while I wasn't ready to leap tall buildings, it gave me a second wind to tackle some work when I got home from the office." (gpureenergy.com)

Friday, February 15, 2008

Seven Things You Can Stop Worrying About Right Now!

WebMD Commentary from Oprah.com

By Suzan Colon

Whatever's keeping you up at night; enough already! We check in with a bunch of experts who'll convince you to give peace of mind a chance. Rethink these seven situations, and give your mind a break.

I have a bad feeling. I'm never going to lose this weight.

You can’t put all your emotional eggs in the weight loss basket. People say, “I’ll be happy when I reach this size” but that’s a problem, because either you don’t reach the goal, or you do; and you’re no happier than you were 40 pounds ago. Then you ask yourself why you did all this work, you go back to the way you were before, and the lose-gain-lose cycle begins.

Instead of worrying about the future, work toward leading a fulfilled life today. That will naturally make you want to be healthy. Eating right and exercising are my two fields, but when I meet with a client, I ask her about the things that really hold the secret to her success; what the most important areas of her life are, and how she feels about each one.

So do a little self-discovery. Look at what brings you joy and what isn’t going so well. Have a life plan as opposed to a weight plan. Next, figure out how active you’re willing to be and how much time you can devote to exercise. Then balance the calories; but don’t deprive yourself. I’ve never found anyone who should be eating fewer than 1,500 calories.

Finally, set realistic goals, or you’re bound to fail. Adjust your thinking about what’s healthy for you, given your genetics. Some of the healthiest people on the planet are heavier than what we claim is the ideal. Being realistic is not only important, it’s empowering.

Bob Greene, author of The Best Life Diet

I worry that my husband will cheat on me and I won't be able to forgive him. And I'm not even married yet!

You’re probably worried that your spouse will have extramarital sex or an emotional affair. But there are many ways to cheat: neglect, indifference, spite, refusal of physical intimacy, lack of respect. “Cheating” fails to describe the multiple ways people let each other down.

Before thinking about whether you’d be able to forgive him, it’s important to understand what violations of trust mean to a relationship. Forgiveness doesn’t mean acceptance but rather understanding, the ability to come to terms with a certain reality, and a willingness to live with it while it finds its place in our lives.

I once worked with a couple who had been together since high school. The man had an affair after his father died because he wanted to break loose from the constrictions he felt had been imposed on him by his father, and to rebel against being dutiful and responsible. While the wife was no less hurt, understanding that the affair had very little to do with her gave it a different meaning. The couple also gained new insights into each other: This strong woman showed a vulnerable side her husband hadn’t been aware of, and this bold man was not the husband she thought she knew.

The thought that a partner can leave is not a baseless worry; it’s a fact of love. There is no love without the fear of loss. Rather than becoming anxious about the possibility of your spouse cheating on you, think of your concern as an awareness that is part of being in a relationship.

Esther Perel, author of Mating in Captivity

The clock is ticking, but I'm not sure I want a child; yet I worry that if I don't have one, I'll regret it when it's too late.

There are parts of life where you can compromise, but not here: You either have a child or don’t.

The fear of regretting that you didn’t have a child is not the best reason to have one. That said, rarely have I seen a patient who regretted becoming a mother, because once the baby is in the world, the woman loves it. Usually, the woman wants to be a parent and it’s her spouse who isn’t sure; he goes along with it because he listens to her fear of regret. Yet when the baby is born, he doesn’t regret it either; he loves it, too.

On the other hand, I have had patients who’ve regretted not having children. The good news is, there are so many ways you can rectify that, including adoption and IVF.

Dr. Gail Saltz, psychiatrist and author of Anatomy of a Secret Life

Cancer runs in my family. Am I destined to get it, too?

Not necessarily. The top three things you can do to tip the odds in your favor are to maintain a waistline that’s generally less than half your height in inches, eat low on the food chain, and not be a toxic dump; avoid exposure to cigarette smoke and asbestos, things like that. You can’t control your genes, but they aren’t as significant as how you affect them with risk factors you can control, such as smoking and obesity.

Dr. Mehmet Oz, co-author of You: On a Diet

I don't think I'll ever swim out from under the pile of work I have at the office!

You’re right. The reality is that you’ll never get to the bottom of your to-do list. The way our work world has evolved, it isn’t humanly possible anymore. It’s not just information overload; it’s opportunity overload; there are always a million things to do. And please, forget multitasking. It doesn’t increase efficiency at all, and it taxes brain cells in the frontal cortex, which has a terrible impact on performance.

Julie Morgenstern

I don't have enough money to travel! I'm afraid I'll never see French Polynesia, China, and other places I dream of.

Waiting to have enough money will keep you securely ensconced at home. Consider the wonders
of America that can be yours for a weekend and the price of a tank of gas (expensive, yes, but still cheaper than plane tickets). Tourists come from all over the globe to see our national treasures, but how many New Yorkers don’t personally know the beauty of the historic Hudson Valley? How many Seattleites have never visited the Walla Walla wine region? How many folks in Dallas have yet to two-step their way through the old-time dance halls of Texas’s Hill Country?

If you’re still hungry for something exotic, you can find that frisson of foreign travel right here in North America. You can hear Cajun spoken in southern Louisiana, and French in the historic neighborhoods of Old Montreal and Old Quebec. The past is very much alive in the Gaelic culture of Nova Scotia and in the Amish communities of Indiana, Ohio, and Pennsylvania.

But don’t give up your dream of a larger trip. Make a plan, and make it happen. Commit to a specific departure date, and put aside money regularly. Time passes quickly; better to spend
it looking forward to your trip than allowing regrets to build.

Patricia Schultz, author of 1,000 Places to See in the U.S. and Canada Before You Die

I'm so afraid of terrorism, I can't sleep. How unsafe are we?

Terrorism is violence calculated to create an atmosphere of fear and alarm. It often works.

Terrorist attacks are deadly, dramatic, and visual; how many times have we watched the World Trade Center’s towers fall? And the terror is reinforced by a relentless message of fear in the form of Washington’s color-coded alerts and announcements of imminent attack.

The terrorist threat is real, but we must distinguish between threats to our national security and danger to individual citizens - us. The threat we face as individuals is minuscule compared with the everyday risks we accept. Each year the average American has about a one in 7,000 chance of dying in a motor vehicle accident, and a one in 18,000 chance of being murdered, most likely by a relative or friend. Compare that to about a one in 600,000 chance of dying at the hands of terrorists. Yet, are we ready to toss the keys to the car? Avoid the family picnic? No.

As a nation, we will combat terrorism. As individuals, it is up to us to combat terror; our own; by putting terrorist fears in perspective.

Brian Michael Jenkins, senior advisor on terror and homeland security for the RAND Corporation

Originally published on August 1, 2007

Thursday, February 14, 2008

Yogurt Maker Sued Over Health Claims

Lawsuit Accuses Dannon of Deceptive Ads for Probiotic Activia and DanActive; Nutritionists Weigh In
By Miranda Hitti
WebMD Medical News
Reviewed by Louise Chang, MD

Jan. 25, 2008 -- A class action lawsuit has been filed against the yogurt company Dannon over its marketing for yogurt products Activia and DanActive.

Activia is a yogurt marketed as being "clinically proven to help regulate the digestive system when eaten daily for two weeks," according to Activia's web site.

DanActive is a drink marketed as being "clinically proven to help strengthen the body's defense systems," states DanActive's web site.

Those claims focus on probiotics, which are healthy gut bacteria. There are many strains of probiotics; Activia and DanActive tout trademarked probiotic strains.

The lawsuit alleges a "massively deceptive" advertising campaign about those products' "clinically" and "scientifically" proven health benefits not available in other yogurts, states a news release from Coughlin Stoia Geller Rudman & Robbins LLP, the San Diego law firm that filed the lawsuit earlier this week.

Dannon countered with its own news release, in which Dannon says it "vigorously challenges this lawsuit" and "proudly stands by the claims of its products and the clinical studies which support them."

Nutritionists' Views

"Does this make yogurt a bad thing? No. If people want to eat yogurt, by all means, they should because you're getting nutrients in yogurt that you're not going to get in a pill," Leslie Bonci, MPH, RD, director of sports nutrition at the University of Pittsburgh Medical Center, tells WebMD.

WebMD Director of Nutrition Kathleen Zelman, MPH, RD, LD, agrees.

"Yogurt is good for you," Zelman says. She suggests that people who buy yogurt look for products that contain "live and active cultures or are enriched with additional healthy bacteria because there's sound science to document the healthfulness of those products."

But Bonci and Zelman say consumers shouldn't expect any yogurt to cure digestive disorders by itself.

Everybody probably won't find all their digestive problems solved by eating specialized yogurt products for two weeks, and "that may not be the yogurt's fault," Bonci says. "What else are they doing in their diet?

"I think if people are looking to maximize their digestive health, it's probably going to take more than a container of something that's in your refrigerator," she says.

Consuming enough fluids and fiber, being physically active, and controlling stress are also important for good digestive health, Bonci says

Tuesday, February 12, 2008

Blame Sweet Soda for Gout?

Soft Drinks Worse Than Hard Liquor for Gout, but Diet Sodas OK
By Daniel J. DeNoon
WebMD Medical News
Reviewed by Louise Chang, MD

Jan 31, 2008 -- For gout, sweetened soft drinks are worse than hard liquor -- and nearly as bad as beer -- doubling the risk for heavy drinkers. Diet sodas, however, don't affect gout risk.

The findings come from a huge study of 46,393 male health professionals in Canada who filled out detailed questionnaires about their health and their diet every four years for 12 years. Over that time, 755 of the men developed gout.

Compared with men who almost never drank sugar-sweetened soft drinks -- fewer than one per month -- frequent soft-drink drinkers were significantly more likely to suffer gout:

  • Two or more soft drinks each day upped gout risk by 85%.
  • One soft drink each day upped gout risk by 45%.
  • Five or six soft drinks each week upped gout risk by 29%.

The men who drank the most soft drinks had twice the gout risk of the men who drank the fewest soft drinks.

That's comparable to the gout risk of men who drink two to four alcoholic beverages a day.

Beer raises gout risk by 49% per daily serving. A daily serving of spirits raises gout risk by 15%. Sweetened soft drinks, find University of British Columbia researcher Hyon K. Choi, MD, PhD, and colleagues, raise gout risk by 35% per serving.

"This is the first study -- and a very large one -- linking these commonly consumed products to this common disorder," Choi tells WebMD. "We find that if you have high consumption of fructose your gout risk is doubled. And that is due to easily available sugary beverages."

It's a surprising finding, says Karen Atkinson, MD, MPH, chief of rheumatology at the Atlanta VA Hospital and assistant professor of medicine at Emory University.

"It is a shock," Atkinson tells WebMD. "Most of us think of purine-rich foods as those that increase gout risk because they feed directly into the uric acid pathway. Certainly fructose processed by the liver can affect that pathway, but this is not what we usually think of."

Atkinson warns that while the Choi study definitely links soft drinks to gout risk, it does not prove that cutting back on soft drinks will lower that risk.

"But most doctors would agree that high-fructose carbonated beverages don't have any nutritional benefit. You don't want to be pouring high-fructose soft drinks into your body," she says.

Gout Risk: Food and Drink vs. Family History

Gout is an extremely painful form of arthritis in which uric acid crystals accumulate in the joints. It most often affects the big toe but commonly affects other joints in the leg. Men are more likely to suffer gout than are women, although women's risk greatly increases after menopause. Choi says about one in 10 people over the age of 60 develops gout.

"When it occurs you suffer really a lot for a week to two weeks," says Choi, a rheumatologist. "It is very severe pain. Just putting your bed sheet on the joint hurts. Gout causes intense swelling and pain, one of the worst pains you can suffer."

Foods already known to cause gout have high levels of purine compounds. Such foods include red meat, organ meats, and shellfish. But diet isn't the only cause of gout. Many gout sufferers inherit a tendency to generate too much uric acid; others inherit an inability to efficiently eliminate uric acid in the urine.

That's why the American Beverage Association, which supports the soft drink industry, takes a dim view of the Choi findings. Maureen Storey, PhD, the association's senior vice president for science policy, says the Choi study failed to account for family history of gout.

"The most important risk factor for whether a person develops gout or not is family history," Storey tells WebMD. "All of the research that has been conducted on gout over the last century or so has shown that foods and beverages high in purines -- such as alcoholic beverages, beer, gravies, and certain kinds of meat -- are strongly linked to development of gout. Soft drinks don't have that in them."

What soft drinks do contain is high-fructose corn syrup. Unlike glucose, the sugar our bodies uses for fuel, fructose raises uric acid levels. High levels of uric acid are linked to gout. But Choi agrees with Storey that his study is the first to link fructose to gout.

Strengthening Choi's fructose hypothesis is his finding that diet sodas -- which don't have fructose -- don't alter gout risk. Moreover, Choi and colleagues find that people who eat lots of sweet fruits, such as apples and oranges, also up their gout risk.

"We find a similar level of increased gout risk from apples and oranges as from sweetened soft drinks, but the caution is misplaced here because these fruits offer benefits against other major disorders such as stroke, diabetes, and certain cancers," Choi says. "There may be certain limited situations, such as treatment-resistant severe gout, where reducing all sources of fructose may be of use. But overall, fruits are beneficial."

Choi and colleagues report their findings in the Jan. 31 online issue of the journal BMJ.