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Aug. 24, 2004 -- People with an inherited form of dyslexia may have less of the gray matter in the brain that's needed to process language, a new study suggests.

Researchers say the findings lend support to the notion that genetic abnormalities in the brain may contribute to the reading difficulties associated with dyslexia. Although the cause of dyslexia is unknown, the condition tends to run in families.

The study used new brain imaging techniques to show that people with dyslexia who also had a close relative with the learning disability had less gray matter volume in areas of the brain associated with language processing compared with people without reading problems.

Gray matter is the part of the brain that processes thinking skills and contains brain cells. White matter in the brain consists of nerve cells that link different areas of the brain and spinal cord and allow them to communicate with each other.

Dyslexia Tied to Brain Differences

In the study, published in the Aug. 24 issue of Neurology, researchers used an advanced testing method called voxel-based morphometry (VBM) to measure the volume of gray and white tissue in the brains of 10 people with inherited dyslexia and 11 healthy individuals without dyslexia.

Researchers say VBM is more precise than other imaging methods because it looks at the whole brain and detects volume and density differences.

The testing revealed significant gray matter abnormalities in many parts of the brain necessary for reading development among the people with dyslexia.

Researchers say previous studies that used MRI scans have suggested that intensive remedial reading therapy may help increase activity in these areas of the brain needed to process language. They say these results add further support to this view, and they recommend intensive reading therapy to correct the reading problems associated with dyslexia.

March 20, 2006 - Wary of public panic if bird flu reaches U.S. shores, Bush administration officials Monday sought to explain to Americans -- and the media -- what infected birds do and do not mean.

Top officials responsible for responding to a bird flu outbreak said they fully expect migratory birds carrying the H5N1 virus to arrive on U.S. soil. They are focusing on flyways used by birds that winter in South Asia but spend springs and summers in Alaska.

Experts expect infected wild birds to reach the U.S. "possibly as early as this year," said Interior Secretary Gale Norton. Norton said that between 20 and 100 preliminary positive tests indicating H5N1 infection could be seen by the end of the year.

Preserving Public Confidence

But officials are also keenly aware of how easily health scares can damage public confidence. Fears over a 2003 SARS outbreak devastated Asian and Canadian tourist and hospitality industries when millions of would-be travelers refused to visit.

One of the key ways migratory birds are thought to have spread H5N1 is by mixing with domestic livestock. So far bird flu has sickened at least 177 people and killed at least 98, according to the World Health Organization.

U.S. officials are trying hard to head off any potential boycott of the $29 billion-per-year American poultry industry when migratory birds finally are detected on domestic soil.

On Monday officials resorted to basic public relations methods to drive their message home. Agriculture Secretary Mike Johanns repeated a version of a single statement no less than half a dozen times while speaking to reporters.

"A detection of the highly pathogenic H5N1 virus in birds does not signal the start of a pandemic in people," he said.

But officials' concerns over public perception may be well-placed. Public health preparations that include stockpiling of drugs and vaccines are still years from completion. And while wild bird migrations can't be controlled, public fear -- at least at first -- is likely to pose a larger threat than does the flu virus.

Bird Flu Facts

On Monday officials stressed several key facts: first, most American chickens and turkeys live in factory farm enclosures that completely isolate them from wild birds. Second, plans are in place to kill or vaccinate domestic flocks should infected birds be found. Third, properly cooking poultry completely kills H5N1 viruses. Fourth, the virus still has not shown the ability to efficiently pass between people, a necessary ingredient for a human epidemic.

Health and Human Services Secretary Michael Leavitt is in the middle of a months-long national tour evaluating state and local pandemic flu readiness plans. He has called on individuals and local authorities to prepare, noting that the federal government will never be able to operate in thousands of communities at once if a pandemic does break out.

Leavitt has sounded many of the same public messages as Norton and Johanns. But he also expressed a sobering note: "No one in the world is well prepared for a pandemic."

March 26, 2007 -- Eating berries may make gastrointestinal cancers less likely, two new studies show.

The studies were presented yesterday in Chicago at the American Chemical Society's national meeting.

Both studies included tests on rats, not people.

The first study comes from scientists including Gary Stoner, PhD, of Ohio State University's internal medicine department.

In a lab, they prepared an extract made from black raspberries and added it to the diet of rats that had been exposed to a cancer-causing substance.

Those rats developed up to 80% fewer colon tumors and 40% to 60% fewer esophageal tumors than rats exposed to the same carcinogen that hadn't received the raspberry extract.

Based on the findings, the scientists have begun tests in people with Barrett's esophagus (a condition of the esophagus that increases risk of esophageal cancer) and precancerous colon polyps. The results of those tests aren't yet available.

Blueberries vs. Colon Cancer

The second study focused on pterostilbene, a compound found in blueberries, cranberries, lingonberries, and grapes.

The researchers included Bandaru Reddy, PhD, research professor of chemical biology at Rutgers, the State University of New Jersey.

They added pterostilbene to the diets of rats exposed to a cancer-causing substance. Pterostilbene reduced the formation of precancerous colon growths in those rats.

"This study underscores the need to include more berries in the diet, especially blueberries," Reddy says in an American Chemical Society news release.

The amount of pterostilbene in berries varies, Reddy notes.

Berries can be part of a healthy diet. But it's too soon to count on berries to prevent colon cancer.

The studies don't prove that berries prevent colon cancer or esophageal cancer in people, and the researchers aren't blaming cancer on diet. A mix of genetic and environmental factors likely affects cancer risk.

June 27, 2005 -- Pop quiz: Treating cancer with surgery can cause the disease to spread to other parts of the body. True or false?

If you think the statement is true, you're wrong, but you're not alone.

More than half of the people questioned in a recent American Cancer Society survey mistakenly believed that surgery can or might spread cancer. And a significant percentage also believed other common cancer myths.

ACS researchers say the findings point to a need for greater public information efforts that target the poor and undereducated populations who tend to have the most misinformation about cancer.

"Our findings confirm that many people have misconceptions about cancer that may lead them to make choices which are not in the best interests of their health," researcher Ted Gansler, MD, tells WebMD.

Hiding a Cure

The ACS telephone survey included 957 randomly selected adults from across the nation who reported that they had no history of cancer. Among the most common misconceptions identified in the survey:

• 41% said they believed surgery could spread cancer, and 13% said they didn't know if this was true.
• 27% agreed with the statement: "There is currently a cure for cancer but the medical industry won't tell the public about it because they make too much money treating cancer patients." Fourteen percent believed the statement might be true.

People who had not graduated from high school were three times as likely as college graduates to believe that a cure for cancer exists but is being withheld. In general, people who were older than 65, nonwhite, and living in the South had the most misconceptions about cancer, as did people who identified themselves as not knowing very much about the disease.

The survey results are published in the Aug. 1, 2005, issue of the ACS publication Cancer.

In a more encouraging finding, nine out of 10 people surveyed correctly disagreed with the statement, "All you need to beat cancer is a positive attitude, not treatment."

An equal number did not agree with the statement, "Cancer is something that cannot be effectively treated."

Also encouraging was that 68% of those surveyed rejected the statement, "Pain medications are ineffective against cancer pain."

Myths Influence Treatment

Gansler says the widespread notion that surgery causes cancer to spread may stem from the once common practice of operating on patients to diagnose the disease. Patients whose cancers were too advanced to be treated often declined rapidly after diagnostic surgery.

"Because [nonsurgical] imaging is so advanced these days, it is not nearly as common for people to have surgical procedures that they are not likely to benefit from," he says.

The idea that a cure for cancer is being withheld may stem from another misperception, Gansler says -- the mistaken belief that little progress has been made in treating the disease.

"Many people think in terms of a single cure for all cancers, which is highly unlikely," he says. "What they don't realize is that there are many people out there today who have been cured. A lot of progress has been made in many areas."

He points out that just a few decades ago only about 10% of children with leukemia survived the disease. Today, 80% survive.

Decisions Often Made on Bad Information

Cancer specialist Timothy Moynihan, MD, of the Mayo Clinic in Rochester, Minn., says patient misperceptions often influence their decisions about cancer treatment.

"Some people are reluctant to accept one type of therapy or another because of what they have heard," he says. "That is especially true with regard to chemotherapy and its side effects. They often don't understand that we have come a long way in making chemotherapy a whole lot easier on the patient than it used to be."

Myths about pain management are also common, he says.

"A lot of people are concerned that if they take a pain medicine now it won't work later," he says. And they worry about becoming addicted. These are both common myths."

People who harbor these cancer misconceptions may increase their risk for cancer death and disability because they may make inappropriate health care decisions or may have poor adherence to treatments, they write.

Sept. 20, 2004 -- Fixing a defect in cancer cells makes them die a natural death, a study in mice shows.

The finding means that a series of new anticancer drugs already in development are likely to work. They may work very well indeed, the study suggests.

When normal cells reach the end of their useful life, they self-destruct. This suicide process is called programmed cell death or apoptosis. But cancer cells have a defective self-destruct program. They make too much of a molecule called BCL-2, which gobbles up the chemical messengers that activate cell suicide.

Anthony Letai, MD, PhD, Stanley Korsmeyer, MD, and colleagues at Dana-Farber Cancer Institute wondered what would happen if they stripped cancer cells of their BCL-2 armor.

"What better way to kill cancer cells than targeting the molecules that directly control their survival?" Letai asks in a news release.

To see what would happen if cancer cells didn't have BCL-2 protection, the researchers created a strain of genetically engineered mice whose BCL-2 could be switched off by a common antibiotic. The mice also carried a gene that gave them leukemia.

By the age of 7 weeks, all 28 test animals had leukemia. All 14 mice that continued making BCL-2 died of leukemia by 100 days of age. But the 14 treated animals, who received the antibiotic in drinking water, had their BCL-2 cut off. All of them had fewer leukemia cells, and their white blood cells numbers became normal within days of therapy. Five of these mice lived for more than 200 days, and one lived for more than a year.

That's exciting news. Until this experiment, nobody was sure that simply removing the barrier to cell suicide would result in cancer-cell death.

"Abnormalities in genes affecting [programmed cell death] have been found in nearly every cancer, suggesting they may be necessary to develop cancer," Letai and colleagues write in the September 2004 issue of Cancer Cell.

Several drug companies are working on treatments that would block BCL-2. BCL-2 is crucial for proper immune function. But the mouse studies suggest that humans could tolerate a temporary BCL-2 block long enough for such future drugs to have an anticancer effect.

Senior study author Korsmeyer serves on the scientific advisory board of IDUN Pharmaceuticals, which is developing cell-death therapeutics.

Dec. 7, 1999 (New York) -- A new study has found a possible link between abnormal electrical activity in the brain and violent behavior -- a topic of interest to both doctors and lawyers alike.

Electroencephalography (EEG) is a process whereby the brain's electrical activity is measured by placing electrodes on a person's head. According to a study in the fall issue of the Journal of Neuropsychiatry and Clinical Neurosciences, 13% of a group of violent criminal offenders had evidence of abnormal brain activity based on EEG readings. Those prisoners who had even more specific problems within the brain's left hemisphere committed significantly more violent offenses.

"Our findings lend some support to the concept of a connection between left hemispheric cerebral lesions and the propensity for violence. At the same time, they indicate that this association may be caused by a relatively small subgroup of subjects," write Frank Pillmann, MD, and colleagues in the department of psychiatry at Martin Luther University Halle-Wittenberg in Germany.

The investigators studied over 200 defendants seen at a university clinic for pretrial assessment and evaluation of criminal responsibility. More than 90% of the subjects were male and the average age was 30 years old (ages ranged from 15 to 77 years). Two-thirds of the group were charged with violent offenses such as murder and manslaughter, aggravated assault and battery, robbery, and sexual offenses.

Of the 151 with histories of violence, about one-third had abnormal EEGs. Twenty subjects (13%) had specific types of localized damage, 10 in the brain's right hemisphere and 10 in the left. The average number of violent offenses was slightly higher in those with EEG abnormalities than in those without abnormalities. Breaking it down even further, those who had some type of damage to their left hemisphere, in a specific region of the brain called the temporal region, had significantly higher rates of violent criminal acts than those with damage to the right hemisphere.

Can criminals with certain brain abnormalities use this kind of research as part of their criminal defense? "It's a complex area," Thomas G. Gutheil, MD, tells WebMD in an interview seeking objective commentary. "In determining criminal responsibility, the issue is criteria. You might have extremely powerful evidence that a neurological condition exists but ... the question is whether the condition impinges on a person's functioning enough so that it meets legal criteria which are usually about understanding wrongfulness and inability to control one's actions." Gutheil is with the program in psychiatry and the law at Harvard Medical School in Boston.

"In the United Kingdom, temporal lobe epilepsy is called the defense of desperate cases. No one is absolutely clear that it has, in fact, a role in criminality," says Gutheil.

Angela M. Hegarty MD, who is affiliated with NYU Medical Center and director of forensic services at the Sagamore Children's Psychiatric Center, agrees. "Just because someone has a history of seizures per se, that has minimal or no relevance to their ability at the time of the crime. Most crimes involve complex activities and behaviors. ... It would be hard to imagine a scenario where the fact that one has EEG abnormalities or seizures would actually effect [the committing of] a homicide."

"Abnormal electrical activity in the brain cannot be taken to explain alone why somebody is violent," Hegarty tells WebMD. She suggests that neurological dysfunction in general may lead to cognitive dysfunction that, in turn, may increase the likelihood that somebody would resort to violence because of frustration, inability to concentrate, or other problems.

While Hegarty believes having a history of a seizure disorder would not help an insanity defense, it might be considered as a mitigating factor. "If someone has mental retardation, seizures, and gets explosive and does something unfortunate in that context, that's clearly a very different picture than someone who calculatingly plans a homicide," says Hegarty.

Hegarty suggests that a more meaningful study would have compared focal EEG abnormalities in violent and nonviolent offenders. "The take-home message for clinicians is that neuropsychiatric studies like this one really tell us more about process than content. They tell us there is some brain dysfunction and they tell us to look further. But there are plenty of people with EEG abnormalities who are not violent and there are many people who are very violent but do not have EEG abnormalities. The EEG abnormalities per se cannot be causally linked to violence."

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Nov. 23, 1999 (Los Angeles) -- Usually considered a disease of women, osteoporosis may afflict as many two million men, says the author of a commentary in the Journal of Clinical Endocrinology & Metabolism. If fractures are used as evidence of osteoporosis, a man's lifetime risk ranges from 13% to 25%.

"This state of affairs is reminiscent of a decade ago when heart disease was considered to be primarily a disorder of males," writes John P. Bilezikian, MD, of the College of Physicians and Surgeons, Columbia University, New York. Most osteoporosis research has been conducted in women, with symptoms and risk factors presumed to be similar in men. But clinicians now know that osteoporosis in men differs in several important ways.

Although the absolute numbers are high, fewer men than women develop osteoporosis for several reasons, Bilezikian points out. Their bones tend to be larger and they acquire greater bone mass at their peak. Peak bone mass is a major determinant of osteoporosis risk, because that provides the reserve the body draws upon as aging and other forces erode the skeleton. Also, men do not lose as much bone mass as women during middle age because they have no equivalent of menopause.

Estrogen appears to play a key role in the establishment of peak bone mass, so when estrogen levels decline after menopause, a woman's risk of osteoporosis rises. Bilezikian cites cases of men with rare genetic disorders that left them with normal levels of male hormones, called androgens, but deficient in estrogen. They developed osteoporosis. He suggests that "more subtle deficiencies in estrogen action or presence could predispose some men to suboptimal achievement of peak bone mass," thus raising their risk of developing osteoporosis.

However, "one problem is that by measuring blood estrogen levels, we get only a very superficial glimpse, because [male and female hormones are metabolized] at different rates in different tissue," says Eric Orwoll, MD, professor of medicine at Oregon Health Sciences University in Portland. In an interview seeking objective comment, Orwoll tells WebMD that "there is much speculation" about the exact roles played by androgens and estrogens in the development of osteoporosis, but there is "no good way of measuring [the levels of these hormones] in bone. ... This issue is now in the forefront," he says. "We are just beginning to understand it."

Bilezikian estimates that 40-50% of all cases of male osteoporosis are due to alcohol abuse, an excess of hormones called glucocorticoids, or low levels of estrogen. However, that still means that in approximately half of the men with osteoperosis, no definite cause will be found. Doctors call this condition "idiopathic osteoporosis," which means the cause of the condition is unknown. However, after age 70, most cases of osteoporosis in men can be accounted for by aging.

Men with idiopathic osteoporosis usually present with a fracture or back pain. This presentation is different from women who often have no symptoms and are diagnosed by bone mass calculations. Once the diagnosis is made, writes Bilezikian, "all reasonable potential causes of bone loss should be considered." If the cause is known, specific measures should be taken to correct the underlying disorder. If the condition truly is idiopathic, men should be managed like women with osteoporosis: with high calcium intake (1,200 to 1,500 mg/d); adequate vitamin D; exercise, including weight training; limited alcohol intake; and smoking cessation. Research is just beginning on drugs that prevent bones from losing calcium, although one agent, called alendronate (Fosamax), is expected to be effective and should be available soon for use in men. "We just reported a large study of alendronate in men with idiopathic osteoporosis, and it looks like it helps," says Orwoll.

Vital Information:

• Although osteoporosis is often considered a woman's disease, the condition affects approximately 2 million men.
• In about half of all cases of osteoporosis, the cause is unknown, while other cases are due to alcohol abuse, an excess of glucocorticoids, or low levels of estrogen.
• Symptoms of idiopathic osteoporosis in men include fracture or back pain, which are different in women, who usually are diagnosed through tests.

Love and marriage may "go together like a horse and carriage," but most newlyweds set off without a shared road map. Each partner comes to the journey with their own set of directions including -- assumptions about roles, expectations about how to spend time and money, and deeply held beliefs about children. Then there's also -- baggage. Experts say it takes desire, honest communication, and hard work to move a relationship from the romantic stage through the power struggles to a loving marriage based on shared meaning. Get off to a good start by avoiding these five major pitfalls:

1. My family does it this way.
2. Marriage will make me happy.
3. My partner will change once we're married.
4. Talking about issues like his rowdy friends, her credit card debt, when to have kids, and who should clean the toilet, will take the bloom off romance.
5. We should avoid conflict at all costs.

My Family Does It This Way

His family sits down together around the dining room table for dinner every night. Her family scatters and grabs dinner on the run.

Couples often underestimate the influence of their families. "People go into marriage with expectations that are engrained almost subconsciously," says Addie Leibin, MS, LMHC, a private mental health counselor in Winter Park, Fla. "They think, I'll get married, and I'll do it like my family did it. But you can't build a house with two sets of blueprints. The whole object is to come up with your own set of plans. It's not your mom and dad's house."

Mark Freeman, PhD, agrees with Leibin that families operate on both conscious and subconscious levels. He counsels couples and teaches a class called "Marriage and the Family" in his roles as director of personal counseling and instructor at Rollins College, also in Winter Park. On a conscious level, he says, when there's interference from one of the spouse's family members or a person doesn't have total allegiance to his or her spouse that creates problems within a person's marriage.

On a subconscious level, families provide the frame-of-reference that individuals bring to the marriage regarding money, gender roles, and other important issues. "Know each other well enough to find out what the stated expectations are, and recognize sometimes there are unconscious expectations. For example, you could say 'I'm open and like to deal with things,' but in your own family when conflict arose, you shut down. So it's the stated vs. the unconscious. Sometimes we have the best intentions to be one way, but then a coping strategy from our own family comes up and violates the thing we are. We're human, not perfect."

Marriage Will Make Me Happy

He's lonely and has no friends. She feels inferior to her prettier, smarter, and wealthier sister. Both believe marriage will make them happy.

"In the early stages of a relationship, everything is beautiful," says Leibin. "Couples have to understand that love is never enough, and marriage doesn't make you happy. Happiness is a do-it-yourself job."

According to a 15-year survey reported in the Journal of Personality and Social Psychology, an individual's level of happiness before marriage is the best predictor of happiness after marriage.

Jan. 31, 2006 -- The FDA and The First Years, a subsidiary of RC2 Corporation, have announced a voluntary recall of liquid-filled infant teethers due to a possible bacterial contamination of the liquid inside.

The fluid inside the teethers may be contaminated with bacteria known as Pseudomonas aeruginosa and Pseudomonas putida. If the teether is punctured -- and the potentially contaminated liquid is ingested -- it can cause serious illness in children.

No illnesses have been reported so far. However, the bacteria have been known to cause serious respiratory, urinary, and blood infections.

A company news release says consumers should stop using the recalled products immediately.

The recall applies to six different styles of liquid-filled teethers for infants (at least 3 months old) and includes the following products:

• Disney Days of Hunny Soft Cool Ring Teether -- Style# Y1447
• Disney Soft Cool Ring Teether -- Style# Y1470
• Disney Soft Cool Ring Teether -- Style# Y1490
• The First Years Cool Animal Teether/Fish, Zebra, and Dinosaur designs -- Style# Y1473
• The First Years Floating Friends Teether -- Style# Y1474
• Sesame Beginnings Chill & Chew Teether -- Style# Y3095

All six teethers have the same general construction with a vinyl exterior and clear liquid prefilled inside. Some of the teethers have designs on the exterior while others have floating characters inside the liquid-filled teether.

The teethers have been sold nationwide from July 2005 to January 2006 for $2.99 to $3.99.

The First Years says consumers should put the teether in its current condition into a sealed plastic storage bag, place in an envelope, and return to: Parent Service Center, RC2/The First Years, 100 Technology Center Drive, Stoughton, MA 02072. Consumers should include their mailing address in the envelope to receive a replacement teether and gift.

For additional information and photos of the teethers, visit www.thefirstyears.com. Or call The First Years Parent Service Center at (866) 725-4407.

Dec. 10, 2004 -- Moms who experience soiling, or stool incontinence, after delivering vaginally can have the problem for years, say Swedish researchers.

Despite having surgery to repair severe vaginal tears that occur during delivery of a baby, many women continue to suffer from this form of incontinence. The researchers say that their study shows that soiling and involuntarily passing of gas persists for a few years and having children in the future worsens the problem.

Women are particularly vulnerable if the vaginal tear, which involves the anal sphincter, occurs while delivering their first child. Having more children and becoming mothers at an older age are also risk factors.

Johan Pollack, MD, and colleagues from the Karolinska Institutet Danderyd Hospital in Stockholm, announced the findings in the December issue of Obstetrics and Gynecology. They studied 242 first-time moms for five years.

All the women gave birth vaginally and 36 had severe vaginal tears involving the anal sphincter during their first delivery.

Sphincter tears are rare. They're usually reported in less than 3% of births, but first-time mothers have a higher risk of the problem, say the researchers. Doctors immediately try to repair the damage with surgery, but the results aren't always perfect.

The researchers defined anal incontinence as involuntarily passing gas or incontinence of solid or loose stools. Even mild involuntary, sporadic cases of passing gas (less than once a week) were classified as anal incontinence.

Flatulence was the most common type of anal incontinence. Stool incontinence (or soiling) was rare, affecting a total of 16 women during the course of the study.

Forty-four percent of women with sphincter tears reported anal incontinence nine months after giving birth. All cases were flatulence, and most happened less than once a week. Five years after delivery more than half of these women continued to have symptoms.

A quarter of all women without sphincter tears also reported anal incontinence at nine months. Most cases were mild flatulence occurring less than once a week. At five years, about a third of these women complained of anal incontinence.

Again, most cases were flatulence. Eleven women with sphincter tears also reported fecal incontinence less than once a week.

Women who had more children were more likely to be affected. Among moms without sphincter tears, the five-year incontinence rate was 34% for those who had more babies, compared with 25% for women with one child.

Age also mattered. A 30-year-old woman has twice the risk of developing anal incontinence as a 20-year-old, the researchers say.

If women were incontinent at nine months after delivery the problem wasn't likely to go away and often worsened, say the researchers. That was particularly true for women with anal sphincter tears. They were almost eight times as likely to have symptoms at five years if they'd had the problem nine months after delivery.

March 5, 2003 -- Childbearing increases a woman's risk of urinary incontinence later in life. If she has a cesarean section, she increases her risk some. If she has a vaginal birth, risk jumps even higher.

A large study of women in Norway sheds some light on the relation between childbirth and "urinary accidents," or urinary stress incontinence. Vaginal birth has often been cited as a main contributing factor, possibly because of damage to important muscle tissue or nerves, writes lead researcher Guri Rortveit, MD, with the University of Bergen.

However, only a few small studies have examined whether vaginal births caused more urinary problems than cesarean births, Rortveit writes. And these studies have been inconclusive.

His study appears in the March 6 issue of TheNew England Journal of Medicine.

Bergen and colleagues studied more than 15,000 women, all under age 65. Each was asked about incontinence and -- if they had ever given birth -- about method of delivery. The researchers also looked at other factors associated with an increased risk of urinary incontinence such as age, weight, and number of previous pregnancies.

Women who had delivered by cesarean section were at higher risk for incontinence than were women who had not given birth at all. But those who had had vaginal deliveries had even higher risk.

These results suggest that the mechanical strain during labor may add to the incontinence risk that comes with childbearing itself, Bergen writes. However, this evidence is not strong enough to increase the practice of cesarean delivery.

SOURCE: The New England Journal of Medicine, March 6, 2003.

Oct. 11, 2002 -- Extreme skateboarding might be all the rage, but a growing number of skateboarders are finding themselves in the emergency room with a raging injury. A new study shows skateboarding injuries doubled between 1993 and 1998, and they continue to grow by an average of 16,500 fractures, sprains, and cuts each year.

Researchers say that compared with other sports, skateboarding is relatively safe. But they warn that a lack of standards for safety equipment and the growing popularity of extreme forms of the sport have caused the rate of skateboarding-related injuries to grow faster than the number of people who start skateboarding.

"Changes in the nature of the sport could account for the increased rate of injury," says researcher Flaura K. Winston, MD, PhD, of The Children's Hospital of Philadelphia, in a news release. "In the 1990s, the sport transitioned from a 1980s style known as 'vert,' which used 10-foot-high ramps, to 'street skating.' Street skating uses lower ramps and increasingly complex stunts and tricks. As its name suggests, this style encourages people to literally skate in the streets."

The study found injuries requiring hospitalization were 11 times more likely to have been caused by contact with a vehicle than those that were less serious.

The findings appear in the October issue of the Journal of Trauma.

The researchers say it's the first study to compare injury rates from skateboarding with other popular youth sports. They found the number of skateboarding-associated injuries treated in emergency rooms across the U.S. in 1998 per 1,000 participants was twice as high as that found for in-line skating, but only half as high as basketball.

The study looked at federal statistics on product-related injuries as well as surveys from the National Sporting Goods Association.

The statistics show that the rate of skateboard-related injuries actually dropped significantly between 1987 and 1993, but this period was followed by a steep rise, especially among young adults and adolescents. Researchers say males had the highest rates of injuries and the most common types of injuries were wrist fractures, ankle strain/sprain, face cuts, and wrist strain/sprain.

Because the most common skateboarding-associated injuries are similar to in-line skating injuries, the researchers say they can be prevented. The use of wrist guards in in-line skating has reduced injuries in this sport yet currently there are no standards in place for protective equipment in skateboarding. The researchers urge the development of such standards to help reduce injuries.

They recommend the following safety measures:

• Communities should develop skateboarding parks and encourage youth to use them.
• Skateboards should not be ridden near traffic.
• Holding on to a moving vehicle should never be done while skateboarding.
• Use of a helmet, wrist guards, elbow pads, and kneepads should be strongly encouraged.
• Children under age ten should not use skateboards without close supervision by an adult.
• Children younger than age five should not use a skateboard at all.

April 14, 2006 -- New research shows that self-harm and attempted suicide may be more common among youths who strongly identify with the "Goth" subculture.

"'Goth' could be described as a subgenre of punk with a dark and sinister aesthetic, with aficionados conspicuous by their range of distinctive clothing and makeup and tastes in music," the researchers write in BMJ Online First.

The study was done in western Scotland. It included 1,258 teens who were 19 years old. Participants had joined a larger survey of health and lifestyles in 1994, when they were 11 years old. They took follow-up surveys at ages 13, 15, and 19.

At age 19, participants were asked if they had ever tried to kill or deliberately hurt themselves. They were also asked if they identified (past and present) with 15 different subcultures, including Goth, punk, skater, hip hop, and pop subcultures.

Study's Results

The vast majority of participants said they didn't identify at all with the Goth subculture.

However, 15 youths said they were Goths or "heavily" identified with the Goth subculture. Eight of those participants (53%) reported ever deliberately trying to harm themselves and almost as many reported ever attempting suicide (47%).

Adjusting for other factors -- including social class, parents' marital status, smoking, drug use (not counting alcohol), and past depression -- didn't change the results.

Self-harm involved cutting, scratching, or scoring the skin. The 15 students who heavily identified with the Goth subculture or called themselves Goths were more likely to report ever harming themselves than their peers who were heavily into the other subcultures, such as punk, which were also associated with self-harm.

Researchers' Comments

With relatively few participants who strongly identified with the Goth subculture, the researchers aren't jumping to any conclusions. Self-harm and suicide attempts certainly aren't limited to any particular group of youths, and stereotyping never helps.

Robert Young, a University of Glasgow research scientist who worked on the study, commented on the findings in a news release.

"Although only fairly small numbers of young people identify as belonging to the Goth subculture, rates of self-harm and attempted suicide are very high among this group," Young says.

"One common suggestion is they may be copying subcultural icons or peers. But since our study found that more reported self-harm before, rather than after, becoming a Goth, this suggests that young people with a tendency to self-harm are attracted to the Goth subculture," he continues.

"Rather than posing a risk, it's also possible that by belonging to this subculture, young people are gaining valuable social and emotional support from their peers. However, the study was based on small numbers and replication is needed to confirm our results," Young says.

May 11, 2004 -- Lawmakers called on the film industry to use its rating system to warn parents of depictions of smoking in movies, amid growing evidence that the portrayals make children an adolescents more likely to smoke.

Lawmakers say that they will not consider banning smoking in films frequented by young people, citing First Amendment concerns. But republicans and democrats, backed by health experts, are leaning on movie makers to do more to combat the portrayals and to make sure that movie studios and producers are not making product-placement deals with tobacco companies.

"We're calling for personal restraint. We're calling for personal responsibility," says Sen. John Ensign, R-Nev., a member of the U.S. Commerce, Science, and Transportation Committee.

A 2003 study of 600 popular films showed smoking was portrayed in 85% of them, including in about half of G-rated films.

The study also showed that adolescents who viewed the most smoking portrayals in movies were 2.7 times more likely to try smoking than those who viewed the least amount of smoking. The finding held even when researchers factored out other influences such as age, sex, personality characteristics, or whether the child's parents smoke, says Madeline A. Dalton, PhD, a pediatrics researcher at Dartmouth Medical School in Lebanon, N.H.

"We conclude that eliminating or reducing adolescents' exposure to smoking in movies could significantly reduce the number of adolescents who initiate smoking," Dalton told lawmakers.

Ensign and other lawmakers called on movie industry representatives to use their familiar rating system to alert parents when smoking is included in a film. Some activists want films containing smoking to carry an "R" rating that restricts viewing to kids 17 and older.

"It would cost nothing and it would not represent anyone's infringing on anything," says Stan Glantz, MD, a professor of medicine at the University of California, San Francisco, and an antitobacco activist.

Jack Valenti, president of the Motion Picture Association of America, resists the calls. Valenti tells lawmakers that curbing smoking could hamper directors' freedom of artistic expression, though he does support more education to influence directors to avoid "gratuitous" depictions of smoking, he says.

Valenti, who invented the movie rating system in response to concerns over foul language and other content in the late 1960s, says that changing the system to warn of smoking would invite calls to alter it further for portrayals of drinking, drug use, and even other damaging behaviors such as overeating.

"I cannot tell you how many people want to be recognized in the ratings system. We want to make sure this rating system doesn't get cluttered up," he says.

Meanwhile, activists charge that paid placements of brand-name cigarette products in films continue, despite a prohibition in the 1996 state tobacco settlement. Glantz urged movie studios to certify at the end of their films that no money was paid to install cigarette brands in the movie.

Valenti says that he doesn't have "one jot" of evidence that the product placements still occur.

But Sen. Ron Wyden, D-Ore., said that companies still are not complying with the agreement's bans on cigarette advertising to children. "If it was a piece of cheese, it would have a lot of holes in it," he says.

Wyden suggested that movie studios should think about curbing smoking in films, either with ratings changes or self-imposed bans. "After people think about it, there ought to be some consequences for it as well," he says.

Jan. 30, 2004 -- Overweight kids suffer. Their health suffers. Their self-esteem suffers. And new research shows their schoolwork suffers as well.

Problems typically start when an overweight kid enters kindergarten, a RAND study shows. Ashlesha Datar, PhD, and colleagues analyzed data from a U.S. Department of Education study tracking a nationally representative sample of 11,192 kids who started kindergarten in 1998.

Some of the kids were overweight. This means that based on their height and weight, they were more massive than 95% of other kids their age. If they were adults, they would be called obese. But researchers don't use that word when they're talking about kids.

Datar found that when they started school, the overweight children scored significantly lower on tests of verbal and math skills. They did learn at pretty much the same rate as other children. But at the end of first grade, the overweight children still lagged well behind their less heavy peers.

"What we find is most of this is explained by sociological factors," Datar tells WebMD. "The overweight kids tend to come from poorer families with not-so-educated mothers. So when we control for these factors, this relationship between overweight and poor academic performance gets wiped out."

Datar and colleagues report their findings in the January issue of Obesity Research.

Family Factors

Being very much overweight, Datar says, is what researchers call a marker for family factors that are truly behind kids doing less well in school. But that doesn't mean that obesity isn't a problem.

"If you're an overweight kid, your friends don't understand you aren't doing well because you don't have a mother who can read to you at home," Datar notes. "In kindergarten, your friends see you as fat and performing low. There may be some social stigma."

It's a tricky problem. Targeting a child's weight isn't going to solve the problem.

"If you change kids' overweight status, you are not going to make them do better at school," Datar says. "Other interventions that get to these family characteristics might do more."

Nancy Cahir, PhD, an Atlanta-based child and family psychologist, sees obesity in children as a sign of parental neglect.

"Usually if the kid is overweight there is a cluster of stuff going on: depression, family problems, parents who aren't listening to the kid's needs," Cahir tells WebMD. "When you're seeing kids get overweight it's a sign their parents aren't watching out that they eat proper foods, that they get more exercise, that they watch less television. It is a case of parents ignoring kids emotional needs."

How to Help

Help for these children, Datar says, has to start at home. A focus on the child's home environment will do more than a focus on the child's weight.

"If you want to find a helpful intervention, go back to the home," she says. "We want to say, 'Read more to your kids, provide a more enriching home environment.' Obesity is just a marker that these things are missing."

In Woody Allen's movie Sleeper, a nerdy storeowner (played by Allen) is cryogenically frozen and defrosted after 200 years only to find that smoking, cream pies, and hot fudge, among other things, are actually healthy for you. And it seems that such an alternative universe is one that Steven Johnson, author of the controversial new book Everything Bad Is Good for You: How Today's Popular Culture Is Actually Making Us Smarter, would be comfortable and revered in.

Johnson contends that video games, certain violent TV shows like 24, and reality TV shows such as Survivor and The Apprentice are actually making kids smarter and more savvy, not more violent, aggressive, or phobic as others have suggested. He even dubs this phenomenon "the sleeper curve" as a nod to Allen's 1973 flick because just as in the movie, some of the most criticized components of society may actually be beneficial.

While some are quick to call Johnson's ideas heresy, others tend to agree with at least some of what he has to say about the learning potential of video games and television games.

In his new book, Johnson says that video games such as Tetris and SimCity actually force players to make decisions, choose, and prioritize; shows like 24 prompt viewers to make sense of what they are seeing by filling in information that is withheld or deliberately vague. What's more, certain reality shows boost emotional intelligence and teach viewers valuable lessons about what is and isn't effective at work, at home, and at play.

Pop Culture and Intelligence

"There are a number of indications that pop culture is making us smarter," Johnson tells WebMD. "The most powerful of which is the long-term trend in all modern media societies towards rising intelligence quotients (IQs)."

Johnson says that a person with an above average IQ 50 years ago would be merely average today. "A number of scholars believe that part of that increase has to do with the increased complexity of the media environment we all inhabit," he says. "Think of the kind of problem-solving and pattern recognition you have to do to operate a modern computer, compared to, say, switching channels on a radio."

Johnson says "all the major simulation games [such as] SimCity, The Sims, Age of Empires, Railroad Tycoon, etc. -- where you're simultaneously tracking dozens and dozens of shifting variables, trying to manage an entire system -- are a great cognitive workout."

"On television," Johnson notes, "it's shows like Lost, Alias, The Simpsons, Arrested Development, The West Wing, and ER that have the most challenging narrative structures."

"There is a clear trend towards increased complexity in the popular culture [including] more narrative threads (plots) per episode in a television show, more complicated social networks, increasingly layered and multivariable problems in the games and more participatory media online," he says.

For example, while Dallas, a popular 1980s nighttime soap opera chronicled the misadventures of one family, the show 24 actually tracks four families. And instead of fighting for control of the family business as they did on Dallas, the characters of 24 are trying to simultaneously save or destroy the president or the world.

Johnson has two boys, aged 2 and almost 4. "They like to watch DVDs -- all the Pixar movies, for instance, plus the classics such as Winnie The Pooh and Mary Poppins, but mostly they just want to play with their Thomas the Tank Engine train set," he says.

"In some ways, what they're doing now with the Thomas trains is what they'll be doing in a few years with their video games: mastering a complex system, learning all the different characters, building an environment, and exploring it together," he tells WebMD.

"Compared to the popular culture 30 years ago, you have to 'think' more to engage with today's entertainment: you have to make decisions, express your own ideas, analyze more complicated storylines," he says. "It's a kind of mental exercise, not unlike the mental exercise you get from, say, playing chess," Johnson says.

Dec. 2, 1999 (Washington) -- Just as drugs for prostate and heart problems were found to spur hair growth, researchers in Texas have discovered that some cholesterol-lowering medications produce new bone. If tests on humans prove as successful, the medications, called statins, may be effective in treating osteoporosis, which causes pain and fractures in an estimated 30 million Americans.

Researchers tested more than 90,000 chemical and natural compounds to see if any would activate a particular gene that stimulates the growth of bone cells. They were about at the end of their list when one -- Mevacor (lovastatin) -- came up a winner, so they tested it and three other statins in a series of experiments in mice and rats. There are six statins on the market today for the treatment of high cholesterol; they are sold under names such as Zocor (simvastatin) and Pravachol (pravastatin).

They added lovastatin and four others in the same statin class to the cells of mice, injected them into the skin covering the skull of mice, and gave them orally to rats, including some whose ovaries were removed to simulate menopause. The most dramatic result came from injections, which caused bone cells to grow by nearly 94%, while the other methods produced an increase in bone mass and cell volume of up to three times what existed before the statins were added.

The researchers were led by Gregory Mundy, MD, PhD, professor of medicine and chief of the endocrinology division at the University of Texas Health Sciences Center at San Antonio. He completed the research with colleagues at the university and at Osteo Screen, a 15-employee, for-profit research firm he established in 1996. Mundy tells WebMD he's now at work on a patch that can deliver statins more directly to bone.

"I think we have enough data now that it would be worth doing [studies on humans,] but I would prefer that that be done by somebody separate from me," says Mundy, adding that trials would require tens of millions of dollars. "What I'm hoping is that this will stimulate others to do the trials. Our next step is to optimize the current statins to get them effectively to bone. ... We've just got to find the most optimal ways," including topical agents like a transdermal patch. "People don't want to take injections, and they are expensive as well."

The bones in people with osteoporosis, particularly postmenopausal women, become fragile and brittle. Physicians today have several osteoporosis treatments at hand, but some produce gastrointestinal side effects severe enough for patients to abandon the therapy, and none causes more than a modest increase in new bone growth. Medications approved today -- including estrogen, Foxamax (alendronate), and Evista (raloxifene) -- work by halting bone loss or reabsorption. A recent study showed Actonel (risendronate) increased bone density and reduced fractures with fewer side effects. Now used to treat Paget's disease of the bone, where bones become both thickened and softened, risendronate is expected to win FDA approval for treatment of osteoporosis in spring 2000.

Nelson B. Watts, MD, is lead author of a study appearing two months ago in The Journal of the American Medical Association that showed the effectiveness of risendronate in reducing fractures. He lauded the results of this new study. "It looks good to me," says Watts, who reviewed the study for WebMD. "All of us have been eagerly awaiting a drug that we can use clinically that will stimulate new bone formation. It is still a long way from [testing on humans] but it is still a very impressive result that begs to be pursued."

The volume of new growth observed "is really quite impressive," says Watts, who is with Emory University. "It would be awfully nice to have drugs that increase the bone density more than the 5-10% we have now."

Vital Information:

• Some cholesterol-lowering medicines, called statins, may also be effective in treating osteoporosis, according to a recent animal study.
• There are several approved medications for osteoporosis, but their effect on bone growth is modest and side effects can be so severe that patients stop taking them.
• Statins had a more dramatic effect on bone mass, but these results are preliminary and further testing should be done.

Look and Feel Great at Any Weight

"I am a size 14, I'm curvaceous, I work out every day, and I feel great," says Elaine Magee, MPH, RD, author of more than 20 books and a WebMD Weight Loss Clinic consultant. And not only can larger-size women be healthy and feel terrific, they can look every bit as stylish as their size-6 friends, says full-figured supermodel Emme (who knows all about looking fabulous).

It is possible to have a body image like Magee's or Emme's -- one that's healthy and positive -- even if you aren't skinny.

Why, then, do so many full-figured women feel so bad about their bodies, even when they're at a weight that's healthy for them? And how can they, like Magee and Emme, start to like what they see in the mirror?

Several body image experts interviewed by WebMD offer practical tips for feeling good about your body. And Emme has style hints that will help you dress to look your best.

Getting Over the Norm

"As we develop and grow, we begin to place a value on what we see in the mirror -- which is based on experiences but also on the cultural norm, with a thin body being the preferred type," says Kathy Kater, LSW, a psychotherapist in St. Paul, Minn., who specializes in body image and eating and weight disorders.

But the problem with the cultural norm in America is that human beings aren't meant to be one size or one shape.

"The research on body diversity is conclusive: Even if we all ate the same optimal, wholesome diet and exercised to the same high degree of physical fitness, we would still be very diverse in our shapes," says Kater. "Some quite thin and some quite big, but most in the middle."

Of course, she's not promoting obesity, which brings health risks. But many of us can be quite healthy even if we wear a plus size. So how can you accept the fact that your body is meant to be a certain size -- even if that size isn't skinny -- and feel good about it?

First, accept the fact that big doesn't mean bad.

"The most common body image complaint for women, and increasingly for men, is the 'I feel fat' body-image distortion," says Kater. "It's a learned perspective that says to be bigger is a bad thing. But it's not. And actually, it's quite possible to be big without being unhealthy."

People of all sizes and shapes, explains Kater, should learn to define health by making healthy choices rather than by their size or weight.

In fact, if full-figured is your natural body shape, you're better off sticking to what you were born with than depriving yourself to reach what can be a dangerous goal.

"Everyone has a natural body weight," says Ruth Kava, PhD, RD, director of nutrition at the American Council on Science and Health in New York. "If you have to starve yourself to get where you think you should be, you may be doing damage because you may not be getting appropriate nutrition."

That doesn't mean you should give up on a healthy diet -- or on exercise. In fact, the experts say, exercise is key to good health and a healthy body image.

"Exercise always helps," says Kava. "It may not change your absolute body weight, but you will feel better about your body, improve your self-esteem, and improve your attitude."

But if you're a beginner, don't get carried away.

"If you're someone who doesn't exercise, you need to start slowly," says Kava. "And don't get discouraged, even when life intervenes. This is a lifelong commitment to yourself that you have to make."

When it comes to buffets, diners have their choice these days: mom-and-pop ethnic eateries, national chain buffets, and splashy Las Vegas casino spreads complete with seafood bars and sumptuous desserts.

With all-you-can-eat prices dipping as low as $7 or $8 in some cities, buffets tempt both the palate and the wallet. In 2005, Americans spent more than $1.5 billion at the nation's 5,630 cafeteria and buffet-style restaurants, according to Technomic, a restaurant research firm in Chicago.

But how safe are these serve-it-yourself restaurants?

As long as buffet operators take proper precautions, they're generally safe, experts say. Occasional outbreaks at buffets have made headlines. But though the CDC collects information on food-borne illnesses at restaurants, it doesn't track the type of establishment involved. So there's no hard evidence that compares the risk at buffets to other types of eateries.

Buffets do present a couple of special challenges.

First, foods rest in steam tables, ice baths, or salad bars. If improperly tended, these buffet stations can allow disease causing bacteria and viruses to flourish.

Second, customers can come into contact with food: the man who sneezes into his palm and then handles the serving tongs, the woman who grabs a few strawberries with her bare hand, the child who pokes a slobbery finger into the tuna salad.

"If food is not handled properly; if people cross-contaminate food; if you have little kids touching the salad prior to service; the likelihood of food-borne illness is much higher," says Timothy Ong, a San Francisco Public Health Department senior inspector who has checked hundreds of buffet restaurants in his 24-year career.

WebMD quizzed Ong and other restaurant inspectors and food scientists about ways to maximize your chances of eating safely at buffets. Does the Place Look and Smell Good?

Much of food safety happens in the kitchen -- out of your line of vision. But you can still get a sense of a restaurant's attention to hygiene.

"Look at the overall cleanliness of the establishment. While that's not a definitive clue, it's an indicator that things are being done properly," says Robert Gravani, MS, PhD, a Cornell University food science professor. Are buffet areas, floors, tabletops, and bathrooms clean? Do employees look neat? Do they wear gloves while handling food? Do they wipe away spills? Is the restaurant free of unpleasant odors?

Also note how much attention employees pay to the food. "Look to see if the wait staff is coming around and maintaining the food, checking the temperature, stirring the food, replacing the food when the pans are nearly empty," says Carol Chase, senior public health sanitarian with the Tompkins County Health Department in upstate New York. Instead of pouring new food into old pans, employees should be switching out containers to prevent traces of old food from remaining on the buffet too long, she adds.

Look, too, for warning signs that food is being neglected. That dried-out pork or browned, wilted salad? Not good.

March 21, 2003 -- Some women swear they have memory lapses during pregnancy. But new research challenges that notion -- finding that it's just not true. They're likely just feeling a bit overwhelmed by new responsibilities, says one expert.

Magazine articles, childcare books, midwives -- even pregnant women themselves have contributed to the belief that women's memories weaken after they learn they are pregnant.

While some studies have suggested there may be mild memory loss during pregnancy, other studies have been contradictory, writes lead author Ros Crawley, PhD, a psychologist with the University of Sunderland.

Crawley focused her studies on women in the second and third trimesters, and in the first year after their child is born. Her report appears in the latest issue of Psychology and Psychotherapy.

In her first study, Crawley tested 15 pregnant women and 14 non-pregnant women for their ability to remember words (known as verbal memory). She also tested all the women on their focus attention -- that is, their ability to concentrate on one thing while something else is going on, like reading while the TV is on. And she tested their ability to do two things at once -- called divided attention -- like listening to the radio while cooking.

In the four times Crawley tested the women, they showed no significant differences in their functioning.

However, when women asked to rate their own mental acuity, there was one exception. The pregnant women rated their abilities worse than six months earlier when they were not pregnant.

In her second study, Crawley included 25 pregnant women and 10 non-pregnant women. Each was asked to record a daily rating on general memory, memory for anything read that day, focused attention, and divided attention. Pregnant women then provided daily ratings for seven consecutive days during pregnancy and after the child was born -- with non-pregnant women noting their ratings at similar intervals.

At trimester three, more pregnant women reported mild impairments in their focused and divided attention abilities and in their ability to remember what they had read, compared to non-pregnant women. However, there was no difference in trimester two or postpartum.

Together, the studies show that pregnant women indeed perceive themselves as having memory and attention problems, says Crawley. However, there was no evidence of any actual impairment in the tests they were given.

The "impairments" represent a stereotype that has been attributed to women at other points of her life -- including her menstrual cycle and menopause. People are not very good at estimating their own mental acuity. In fact, women are likely being influenced by negative stereotypes, she adds.

Even when pregnant women rated their own abilities, they were only slightly lower than those of non-pregnant women, she says.

While changes in estrogen levels may affect memory abilities, it is unlikely that hormones are responsible, Crawley adds. There may be an underlying mild attention deficit disorder that is to blame. Or, it could be that there are no impairments during pregnancy -- not even mild ones -- and the women's low self-ratings may reflect depression or the effects of stereotypes.

John Thorp, MD, an ob-gyn at the University of North Carolina, spoke with WebMD about this phenomenon. "Most definitely, women tell me they begin having some memory problems, forget things. They tell me, 'I don't think as clearly as I once did.' I remember my wife telling me, 'I'm having to think how to shift gears when I drive the car.' And she'd been driving a clutch for years."

In fact, women seem to have even more "thinking problems" afterwards, he says.

"What's most intriguing about this study, is the perception of decline," Thorp says. "I think patients will find it reassuring -- that even though you feel this way, it's not the onset of Alzheimer's. I think what women experience is competition for their attention. Suddenly, they've got more going on. They're responsible for this other entity. But I don't think it's anything to worry about. This study showed that women are functioning just fine, even though they don't think they are."

Oct. 29, 2002 (San Francisco) -- Could part of your teenager's lunch money or wages from an after-school job be going to lottery tickets and poker games? Probably, according to a telephone survey of teenagers in Florida. And if your teenager is gambling, you should be concerned -- nearly 4% of teens who gamble have the behaviors and signs of problem or pathological gambling.

Despite its illegal status for minors, most teenagers do gamble, according to Martin Lazoritz, MD, associate chair of psychiatry at the University of Florida in Gainesville. "We need to know that teenagers gamble, just as adults do," Lazoritz tells WebMD. "They play cards with their friends; they buy lottery tickets. We also need to know that underage gambling is linked to several at-risk behaviors, such as cigarette smoking, and with alcohol and drug use."

Lazoritz presented findings at the 49^th annual meeting of the American Academy of Child and Adolescent Psychiatry in San Francisco.

He and his colleagues wanted to determine how common gambling-related behaviors and problems were among adolescents age 13 to 17. More than 1,000 Florida teens were interviewed over the telephone in December 2001. They were asked whether they participated in various gambling activities and about various problems associated with gambling such as preoccupation with gambling, borrowing money for gambling, and relationship problems. The study also looked at involvement with drugs and alcohol, and mental health.

Almost 70% of the respondents reported gambling during their lifetime and 43% had done so in the past year, even though gambling is illegal in Florida for individuals who are under 18. The study reported that the average age at which gambling started was 12.5 years old.

Despite an age requirement for lottery ticket purchases, nearly 20% of the participants said that they've bought a State of Florida lottery ticket, and 12.5% did so within the past year.

"Based on established psychiatric criteria, 3.8% of the respondents were problem or pathological gamblers," Lazoritz tells WebMD. "In other words, those respondents were more likely to be preoccupied with gambling, to use gambling to escape, and to 'chase their losses' by continuing gamble in order to recover prior gambling-related losses."

Other warning signs that problem gambling is brewing are a sense of losing control while gambling, risking important relationships, and needing to borrow money from others to pay gambling-related debts, he says.

He and his colleagues also found that adolescent problem gamblers were more likely to drink, smoke cigarettes, use marijuana, abuse prescription medications, and use crack or powder cocaine, as well as other stimulants.

"Several aspects of our culture put teenagers at risk, and gambling is one of them," Dr. Lazoritz said. "Parents are often unaware of teenagers' participation in gambling. We need to be more aware of the possibility of problem gambling in teenagers, because of its hazards, and because it is associated with other risky behaviors."

"This study supports the idea that risk behaviors occur together," Lynn E. Ponton, MD, professor of child and adolescent psychiatry at the University of California-San Francisco, tells WebMD. "For example, gambling occurs with substance abuse. We know that risk behaviors occur in a cluster. A lot of parents don't understand how these behaviors show up together, but we know that they do."

Ponton, who was not involved in the study, encourages parents to include gambling in the mix when they talk to their teenagers about risk-taking behavior, and to be concerned sooner rather than later.

"Be alert when one or two risk-taking behaviors show up," says Ponton, author of the book The Romance of Risk. "If the teenager starts smoking marijuana, staying out late, and driving too fast, gambling may be part of that cluster."

Then, if a problem behavior is identified, search out the right type of help for the problem. "If your son or daughter has a problem with gambling or another risk-taking behavior, get help," she says. "If other family members have struggled successfully with a similar problem, talk to your teenager about that." -->

Oct. 17, 2006 -- The weight loss drug Acomplia hasn't been approved by the FDA, but it's already drawing attention from the public and scientists.

The latest Acomplia headlines appear online in The Cochrane Library.

The researchers included graduate student Cintia Curioni, MSc, of Brazil's University of Rio de Janeiro.

They reviewed four studies on Acomplia's use in more than 6,600 overweight and obese adults.

For one or two years, participants either took Acomplia in higher or lower doses (20 milligrams or 5 milligrams daily) or pills containing no medicine (placebo).

But they didn't just pop pills. They also shaved about 600 calories off their daily diet.

Pounds Shed, Waists Slimmed

The studies' key question: Who lost the most weight?

The answer: Participants taking the higher dose of Acomplia.

In a year's time, they lost about 11 more pounds, on average, than those taking the placebo.

Dieters taking the lower Acomplia dose lost nearly 3 pounds more in a year than those taking the placebo, on average.

Both Acomplia groups trimmed their waists: by an inch and a half with the higher dose and half an inch with the lower dose.

People taking the higher dose also showed more improvement in blood pressure and cholesterol than those taking the lower dose or the placebo.

But the higher Acomplia dose may have come with more risks.

People taking the higher Acomplia dose were more likely to have adverse effects, "especially of nervous system, psychiatric, and gastrointestinal origin," Curioni's team writes.

Reviewers: More Studies Needed

On the one hand, "even modest amounts of weight loss may be potentially beneficial," write Curioni and colleagues.

They note that people taking the higher dose of Acomplia had "modest weight loss of about 5%" of their body weight.

But on the other hand, the reviewers call for caution in interpreting the review's results.

They note that about 40% of the participants quit the studies early and none of the studies met the reviewers' highest standards.

Curioni's team calls for longer, more rigorous studies before making definitive recommendations about the drug's use in overweight and obese patients.

Meanwhile, the reviewers say drug-free methods "should remain the cornerstone of obesityobesity therapy" in people who want to lose extra weight.

That may sound simple. But diet and exercise are often easier said than done.

If you're interested in losing weight, consult your doctor to start a healthy weight loss plan.

Acomplia, which has been approved in Europe, is made by the drug company Sanofi-Aventis. Sanofi-Aventis has not settled on the drug's U.S. name pending FDA approval. Sanofi-Aventis is a WebMD sponsor.

July 20, 2005 -- When it comes to child health, how are America's kids doing?

"Overall, the health of America's children is certainly good to excellent," says Edward Sondik, PhD, director of the National Center for Health Statistics.

"But the disparities that we've seen in the past continue to persist, and there's a considerable challenge there," he says.

Sondik and colleagues summed up the government's new report, "America's Children: Key National Indicators of Well-Being 2005," in a media teleconference.

Report's Health Highlights

Among the report's findings:

• 83% of parents said their kids were in "excellent" or "very good" health.
• Teen births are at an all-time low: 22 live births per 1,000 girls aged 15-17.
• Childhood immunization (for children aged 19 months to 35 months) is at a record high: 81% of kids get recommended shots.
• The death rate continues to drop for kids aged 1-4 and 5-14.
• Only 2% of U.S. kids aged 1-5 have high blood lead levels -- down from 89% 20 to 25 years ago.

Infant Deaths, Low-Birth Weight Babies Rose Slightly

Infant mortality, while still near a record low, rose from 6.8 per 1,000 live births in 2001 to 7.0 per 1,000 live births in 2002. That was mainly due to an increase in babies weighing less than 2 pounds at birth, states a news release.

The number of low-birth-weight babies also rose slightly from 2002 to 2003 (from 7.8% to 7.9%).

How Many Kids Are There?

There were 73 million kids aged 17 and younger in the U.S. in 2003. They have made up a smaller slice of America's population since the mid-1960s.

Those numbers are stabilizing. By 2020, kids should account for 24% of the U.S. population, according to the report.

Asthma a 'Real Concern'

About one in eight (13%) of U.S. kids have ever been diagnosed with asthma. About 9% have asthma today, the report states.

About two-thirds of those with asthma have had one or more attacks in the previous year. Asthma is being diagnosed more often, says Sondik.

"This is a real concern because this is one of the areas where hospitalization rates have increased, and actually, mortality rates have increased for asthma in the past," says Duane Alexander, MD.

Alexander also took part in the teleconference. He directs the National Institute of Child Health and Human Development.

"This is something we're just starting to get under control with better medication, better follow-up, [and] better treatment for kids with this condition," says Alexander.

Asthma statistics have been "pretty steady" for the last decade, says Alexander.

Weighty Issue

Sixteen percent of U.S. kids were overweight in 1999-2002, states the report. That's up from around 11% in 1988-1994.

Those numbers aren't new, but they're "very important," Alexander says.

Alcohol, Cigarettes, Illegal Drug Use

The report includes figures on alcohol, cigarettes, and illegal drug use by 12th graders:

• 29% reported drinking at least 5 alcoholic drinks in a row in the past two weeks.
• 16% had smoked cigarettes daily in the past 30 days.
• 23% had tried illicit drugs in the past 30 days.

Those figures were "relatively stable" this year, says Sondik.

Racial, Economic Differences

Some patterns stood out:

• More white 12th graders had used alcohol, cigarettes, and illegal drugs than black or Hispanic 12th graders.
• Teen births are at least twice as common among black and Hispanic teens as among whites.
• Asthma is more common in urban areas and with poverty.

"What we find in almost all of our statistics is that there's a difference here in terms of whether the children are living in poverty or not in poverty, and also by race," says Sondik.

"Black and Hispanic children, in general, don't fare as well as white children," he says.

April 6, 2007 -- Moisture from a leaky roof and a faulty sprinkler system caused the recent peanut butter salmonella outbreak that sickened more at least 425 people from 44 states.

That news comes from ConAgra Foods, which made the affected peanut butter.

ConAgra Foods spokeswoman Stephanie Childs tells WebMD that the problems have been fixed and that a "thorough cleanup" has been done at the plant.

In February, ConAgra Foods recalled all varieties of its Peter Pan and Great Value peanut butter with the product code "2111" printed on the lid because of possible salmonella contamination.

Salmonella are bacteria that cause food poisoning. Typical symptoms include diarrhea, fever, and abdominal cramping.

Most cases fade within four to seven days without treatment, but complications or severe cases may require hospitalization. Elders, infants, and people with impaired immune systems are the most likely to have severe illness from salmonella.

The CDC got reports of 71 people who were hospitalized because of the peanut butter salmonella outbreak. No deaths have been linked to the outbreak.

Moisture Problem

The peanut butter was made at ConAgra Foods' plant in Sylvester, Ga.

"The company believes that moisture inadvertently entered the production process and allowed the growth of low levels of dormant salmonella in the environment that were likely present from raw peanuts or peanut dust," states ConAgra Foods in a news release.

The broken sprinkler system and the plant's roof, which leaked during an August 2006 rainstorm, are believed to be the sources of that unwanted moisture, Childs says.

"We are truly sorry for any harm that our peanut butter products caused," ConAgra Foods CEO Gary Rodkin says in the news release.

ConAgra Foods says it will begin shipping Peter Pan Peanut Butter to retailers this summer.

Some go for the pizza blot, others favor the soup skim, and then there are those who swear by the sugared-soda switch out. But which calorie-shaving tips give you the biggest payoff for your dieting diligence? And which ones really aren't worth the effort?

Whether you're trying to lose weight or maintain a healthy weight, there are some simple ways to cut the fat and calories without giving up the foods you love. The trick is finding places to trim calories without leaving you wanting more as a result.

For example, ordering a diet soda instead of a regular one with meals is a good place to start, and saves you about 100 calories per serving. But if you then use it as a rationale to add on a slice of apple pie, you're not doing yourself any favors, says Cindy Moore, MS, RD, spokeswoman for the American Dietetic Association.

A Little Here, a Little There ...

To lose a pound a week, a person needs to lose 3,500 calories a week through a combination of diet and exercise, which translates to a reduction of 500 calories a day.

"That's a lot try to do at one meal, and some people might resort to unhealthy practices like skipping a meal," says registered dietitian Leigh Ann Kowalsky, of the University of Texas Southwestern Medical Center in Dallas.

Instead, Kowalsky says it's usually easier and healthier to cut 100 calories here or 50 calories there to add up to about 250 saved calories at the end of the day and then work off the remainder through exercise.

"Doing a little here and there throughout the day makes a big difference if you're trying to lose weight," says Kowalsky.

When it comes to cutting calories, she says it also helps to know where to look. Protein and carbohydrates both contain about 4 calories per gram, but fat has more than twice that at 9 calories a gram, which means trimming even small amounts of fat from your diet can offer substantial calorie savings.

Cut the Fat

Perhaps the most famous fat-cutting technique with fast foods is "the pizza blot," using a napkin or paper towel to blot excess fat from the surface of a slice of pizza. The same technique can also be applied to fried foods and greasy burgers.

Although this method might save a few fat grams if there is visible grease, Moore says the problem is that you don't always know exactly what you're blotting off. It may just be moisture from the toppings on the pizza or the hamburger, and if the food has been sitting around for a while most of the fat has already been absorbed.

A more effective strategy would be to skip the fatty pizza toppings such as pepperoni or sausage and opt for a plain or veggie slice, which guarantees you at least 100 saved calories. By opting for mushrooms, tomatoes, peppers, onions, or other vegetables as toppings, Moore says you'll also feel fuller longer because the vegetables provide fiber and other nutritional benefits.

Other quick fixes for cutting the fat in fast food include:

• Have mustard rather than mayonnaise on sandwiches (savings of about 100 calories per tablespoon).
• Skip the cheese (100 calories a slice) and opt for lettuce, tomato, onion, and pickles on burgers and sandwiches.
• Use cocktail sauce or lemon to season fish and seafood rather than tartar sauce (150 calories per 2-tablespoon serving).
• Skim extra fat and oil off soups by running an ice cube across the surface and letting the fat stick to it (calorie savings vary).

Adolescence is a time of tremendous change. As teens mature, they make more food choices on their own, often in the company of influential peers.

But even as teens become more autonomous, it's still up to their parents to provide them with good examples and nutritious foods. Here are some tips on how to go about doing that.

Help Teens Make Good Choices

Deciding what to eat and how much to exercise is part of growing up. But too often, a child's choices give health the short shrift. Teens may lack the skills and motivation to do what they should to stay healthy.

"Balancing school, sports, social activities, and work presents a major challenge to eating healthy," says Kendrin Sonneville, MS, RD, who specializes in teen nutrition at Children's Hospital in Boston.

On-the-go adolescents may squander opportunities for good nutrition by skimping on foods that help fuel their growth and development. Skipping meals, especially breakfast, and choosing processed and convenience foods over fresh translates into too much fat, sodium and sugar, and not enough of the fiber, vitamins, and minerals essential to a teen's health now and later.

Calcium is Critical

Calcium, critical to bone development and density, is one of the nutrients that can easily fall through the cracks.

Calcium needs are higher than ever during the teen years -- 1,300 milligrams a day. Yet calcium consumption often drops off in teenagers as they replace milk with soft drinks. Research shows that 9th- and 10th-grade girls who drink soft drinks are three times as likely to suffer a bone fracture than those who do not drink them.?

In addition to being naturally rich in calcium, milk is fortified with vitamin D, which also helps to shore up bones. Certain yogurts contain vitamin D; check the label to be sure. While they're calcium-rich, hard cheeses lack vitamin D.

Teens require the calcium equivalent of about four 8-ounce glasses of milk daily. Here are some other foods that supply as much calcium as a glass of milk:

• 8 ounces yogurt
• 1 1/2 ounces hard cheese
• 8 ounces calcium-added orange juice
• 2 cups low-fat cottage cheese.

Girls Need Extra Iron

Iron, as a part of red blood cells, is necessary for ferrying oxygen to every cell in the body. It's crucial to a teen's brain function, immunity, and energy level. Girls aged 14 to 18 need 15 milligrams per day. Boys in the same age range need 11 milligrams.

Iron deficiency is common in adolescent females and people who limit or eschew meat. Menstruating young women are at increased risk for an iron shortfall because their diets may not contain enough iron-rich foods to make up for monthly losses.

Iron is found in both animal and plant foods. The iron in animal foods is better absorbed by the body, but consuming a vitamin-C rich food along with plant iron increases uptake. Serve these iron-rich animal foods to your teen as part of a balanced diet (shoot for 4-6 ounces a day):

• Beef
• Poultry
• Pork
• Clams
• Oysters
• Eggs

Good non-meat sources of iron include:

• Vegetables (including spinach, green peas, and asparagus)
• Beans
• Nuts
• Iron-fortified breads, cereal, rice, and pasta.

A multivitamin with 100% or less of the Daily Value for iron, vitamin D and other nutrients fills in the gaps in less-than-stellar diets. But multivitamins do not contain enough calcium to make up for inadequate consumption of calcium-rich foods. Your child may need a calcium supplement too

April 27, 2004 -- What causes obesity? Blame blood fats, a new study suggests.

Your body has a very effective way to keep you slim: It tells you to stop eating. It does this by sending out a chemical signal -- a hormone called leptin. When leptin reaches the brain, your brain says, "Enough." Hunger goes away.

But high levels of blood fats -- technically, triglycerides -- block this signal before it gets to the brain, report William A. Banks, MD, of the VA Medical Center in St. Louis and Saint Louis University, and colleagues. This is the cause of obesity, they suggest in the May issue of Diabetes.

"We figured out how obesity occurs," Banks says in a news release. "This is a big deal. We now know what is keeping leptin from getting to where it needs to go to do its work."

Evolution and Modern Man

Starvation -- not obesity -- was our ancestors' main problem during most of evolution. That explains why the body has a built-in system for keeping its hunger switch in the "on" position.

When a person badly needs food, levels of blood fats get high. This blocks leptin and keeps a person hungry and looking for food.

Unfortunately, having plenty to eat causes a new problem -- one for which we haven't yet evolved a natural solution. Obese bodies also have a lot of fats in the blood. This, too, keeps a person hungry and looking for food.

"We feel that we now understand what part of the system is broken -- why leptin isn't working," Banks says. "We have a better understanding of why people are becoming obese."

Fighting the Cause of Obesity

In their experiments, Banks' research team showed that triglycerides do indeed keep leptin out of the brains of obese mice. The more triglyceride fats they ate, the less leptin reached their brains. Vegetable triglycerides did not block leptin, but animal triglycerides did.

A triglyceride-lowering drug -- Lopid -- reversed this leptin-blocking effect in the obese mice. Such treatments might work in humans, suggests John Morley, MD, director of geriatric medicine at Saint Louis University and a member of Banks' research team.

"If you lower triglycerides, you should theoretically help the body's own leptin to work better so people can get skinnier," Morley says in a news release.

Eating a low-fat diet is a natural way to lower your blood fats. It's not clear that Lopid or other drugs will help, but much more study is needed before such treatments can be used to treat obesity.

And even if Lopid did work this wonder, it's no magic potion. A person taking the drug has to be on a low-fat diet.