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Feb. 27, 2002 -- Fussiness and spitting up after eating is a common problem for infants, but for some babies these painful episodes may be caused by gastroesophageal reflux (GERD) -- a problem their heartburn-suffering parents can relate to. But new research shows many of the treatments frequently recommended by doctors to ease GERD in infants without drugs or surgery may be of little help.

When an infant has GERD, the contents of his stomach backs up into the esophagus, and he may vomit, have breathing problems, and fail to gain weight. Most infants grow out of the condition once their digestive systems mature by age 1, and many doctors are reluctant to prescribe medications or surgical procedures to correct the problem.

Instead, pediatricians commonly rely on conservative measures to reduce the symptoms of GERD such as adjusting the position of the infant, altering pacifier use, or changing baby formulas. But a review of studies on these methods now shows that few are proven to be effective.

The review, published in the Archives of Pediatric and Adolescent Medicine, found no clinical evidence that placing an infant upright in an infant seat reduced the amount of reflux. In addition, one study found that positioning the child at a 60-degree incline, as often recommended, increased the problem.

Other measures the review found have not been shown to reduce GERD include:

• Elevating the head of the infant while sleeping
• Changing pacifier use
• Changing the composition of formula

Several studies examined in the review looked at whether thickening baby formulas with rice flour or carob bean gum had any effect on GERD. Although neither method was found to significantly reduce reflux, researchers say thickening formula did reduce the frequency of vomiting.

Another measure shown to have at least some benefit was using a more dilute fluid. The review found that a drink containing 5% dextrose (a sugar) in water resulted in less reflux than one containing 10% dextrose.

Researchers say many medical textbooks continue to recommend these treatments even though they have not been shown to be effective, but the reasons may be psychological more than practical.

"Many pediatricians and pediatric gastroenterologists prescribe these therapies despite their lack

of evidence, often as a means of including parents in the treatment plan when reassurances seem insufficient," write the authors.

If the GERD becomes persists, pediatricians may prescribe Zantac or similar medications, such as Tagamet. These drugs, available in an infant-strength liquid, block the production of the irritating stomach acids that may be regurgitated into the esophagus, thus relieving baby's heartburn-like symptoms.

Dec. 3, 2001 -- You're not fighting a losing battle when it comes to your kids and cigarettes, according to a new study. Researchers have found that turning up the pressure can actually do the trick -- even if you smoke.

Teen smoking has continued to climb and peer pressure is as strong as ever. But researchers at Dartmouth Medical School, in Hanover, N.H., have shown that parental pressure is an effective weapon in the fight against teen smoking.

The researchers performed three separate surveys over three years. Each time, about 700 kids from fourth to 11th grade were asked, "How do you think your mother (father) would react if you were smoking cigarettes and she (he) knew about it?"

A response of "S/he would tell me to stop and be very upset" was considered an indication of strong parental disapproval.

Close to 70% of the kids felt that both parents would disapprove of smoking. About 17% thought that neither parent would mind.

And good news for parents -- adolescents who felt that their parents would strongly disapprove were less than half as likely to smoke compared with kids who said their parents would not strongly disapprove.

The researchers also found that those adolescents who'd never smoked when the study began, and who perceived strong disapproval of smoking from both parents, were less than half as likely as other students to have taken up the habit by the end of the three-year study period.

And these results show that it's important to continue to let your kids know how you feel about smoking. When kids perceived their parents as becoming more lenient with time, they were significantly more likely to start smoking.

Even if you smoke, all hope is not lost for your kids. The researchers found that your disapproval of smoking could overcome the effect your habit might have on your kid's future smoking. The consequence of parental disapproval, in fact, was equally as strong among parents who smoked as among parents who didn't.

Your kids' peers won't give up their relentless efforts to get your adolescent to jump on the smoking bandwagon -- and neither should you. In fact, the researchers found that your strong disapproval gives your children more power to say no when their friends turn on the pressure.

"These findings contrast with the widespread notion that there is little parents can do to prevent their adolescents from becoming smokers," the researchers write.

June 17, 2005 - Serve your preschoolers supersized food portions and you'll likely wind up with supersized kids.

A new study shows that, unlike some calorie-conscious adults, children don't eat less at dinner if they eat a big lunch and are more likely to eat whatever portion size is put on their plate.

Researchers say those findings suggest that parents and caregivers may bear a greater responsibility for controlling children's weight and preventing childhood obesity than some realize.

"We found that the more food children are served, the more they eat, regardless of what they've eaten previously in the day, including how big their breakfast was," says researcher David Levitsky, professor of nutritional sciences at Cornell University, in a news release. "We also found that the more snacks children are offered, the greater their total daily food and calorie intake."

Portion Size Matters to Kids' Weight

In the study, which appears in the June issue of Appetite, researchers monitored how much 16 preschool children, aged 4-6, ate for about a week in day care centers and had their parents keep food diaries of what they ate at home in the evenings and on weekends.

The results showed that how much food was served to the children had the biggest impact on how much they ate in a meal or snack, regardless of the calorie or fat content of that meal or other meals eaten within the previous 24 hours.

The study also showed that children who were offered snacks between meals did not eat less at subsequent meals.

Researchers say these findings conflict with earlier studies that suggested that children may be better than adults at regulating their food intake. But they say those studies were done under laboratory conditions and may not represent how children eat under real-life conditions.

"We found that portion size is, by far, the most important factor in predicting how much a child will eat," says Levitsky. "These findings suggest that both the onus of controlling children's weight -- both in causing overweight in children as well as in its prevention -- must rest squarely in the hands of parents and other caregivers."

Feb. 17, 2005 -- It's a basic principle of driving safety: Take care when you back up. But it's time for a reminder -- and new solutions, says the CDC.

The CDC has issued its latest count of nonfatal motor vehicle injuries involving children aged 1-14 years. During 2001-2003, an estimated 7,475 children went to hospital emergency rooms for those injuries, says the CDC in its Morbidity and Mortality Weekly Report. That's nearly 2,500 cases per year.

The numbers are based on 168 back-over injuries. CDC researchers used census data to project national figures.

The accidents happened when the children were hit or rolled over by a motor vehicle moving in reverse. Thankfully, most kids (78%) were treated and released from the emergency departments with minor injuries.

Greatest Danger for Youngest Kids

Little kids are harder for drivers to see and can dart behind cars without realizing the danger, compared with older children. Preventive measures can be taken to reduce these risks, says the CDC.

Overall, most children had minor cuts and scrapes (56%). Those were more common for older children, rising from nearly half of injured children aged 1-4 to about 63% of those aged 10-14.

Four in 10 had more serious injuries, such as fractures or internal injuries. Fewer older children had those problems (17% of those aged 10-14 yet and 40% of those aged 1-4).

More than half of back-over injuries affected the arms and legs (54%), while 28% were on the head, face, or neck.

Child Pedestrians at Higher Risk

Most of the hurt children (86%) were on foot. Young pedestrians sustained back-over injuries six times as often as those on bicycles or tricycles.

About six in 10 back-over accidents happened at home (47%) or on public property (32%). At least 40% of the accidents occurred in driveways or parking lots, says the CDC.

Safety Tips

To help protect kids from back-over injuries, the CDC offers this advice:

• Adults should supervise kids around motor vehicles. That includes children playing near parked cars.
• Drivers should look carefully for children before and while backing up.
• Park in garages or driveways and keep the keys out of children's reach.

It's also possible to make cars and driveways safer, says the CDC. Options include:

• Fencing off driveways
• Changing straight driveways to a curved path, eliminating the need to back up
• Fencing off play areas away from driveways and streets
• Updating cars with new technology. Back-up warning alarms, sensing devices, and cameras can alert drivers to out-of-sight objects such as small children, says the CDC.

Parenting is no walk in the park, especially on the days when your little angel, whether he's 6 or 16, decides to act like a demon.

If it's the temper tantrum in the toy store over the latest video game, or the daily fight over math homework, or the food fight in a restaurant on Friday night, parents have a choice: To react in a way that will only make matters worse when the bell rings for round two, or respond like the calm, cool, and collected parents we see on TV shows like Nanny 911 -- after weeks of live-in, televised therapy.

What is the secret to their success, other than public humiliation?

"Overall, with any scenario, the worst thing a parent can do that helps bratty behavior blossom is to not set clear expectations and not have consequences to a child's behavior," says Jenn Berman, PhD, a psychologist in private practice in Beverly Hills who specializes in family therapy.

Experts offer advice on the top 10 parenting pitfalls that will help you raise a well-behaved child -- instead of a brat.

The TV Toy

It's Saturday morning, you're doing laundry, the kids are watching their morning cartoons, and it happens: Your middle child sees the toy of his dreams on TV, starts in with the begging, and doesn't let up.

Brat-building response: "A lot of kids see things on TV -- games, food, or dolls -- and then they start nagging until they get it," says Berman. "If you run to the store to buy your child exactly what they want, then you've taught them that nagging is an effective tool for getting their way."

Angel-building response: "You can say, 'It's a cool toy. Let me find out how much it is, and I can help you save your allowance for it,'" says Berman. "You are teaching your child to work toward a goal --instead of giving in. It helps the child learn about goals, saving money, and it's a good response for both parent and child."

The Bribes

You're having your boss over for dinner on Friday night, and while you begged your sister to watch the kids for the evening, no such luck. Is it time to start bribing them to be quiet with expensive sneakers or the latest handbag from Dolce & Gabbana?

Brat-building response: "Parents often try to buy good behavior by getting their kids expensive gifts," says Berman. "And then they say, 'I don't understand why she isn't better behaved? I get her everything she wants!'" These cool gifts lose their meaning and the child feels entitled and less well behaved."

Angel-building response: "Allow the child the opportunity to earn what you give them, and set limits around their expectations," says Berman. "Tell them, 'You can get one pair of shoes within this amount of money.' Teach them early on how to make choices."

The Sleepover

Her bags are packed and she's ready to go to the sleepover, except for one thing: She forgot to ask for your permission.

Brat-building behavior: Even though she's screaming bloody murder, if you let her get away with it once, she'll do it again, and again and again. "You've taught your child that screaming long enough will get her what she wants, and now you've created your own private hell," Berman tells WebMD.

Angel-building behavior: "As a parent, it is always considerate and helpful to let a child know your thinking, so your child knows why you don't want her to go to the sleepover, so it doesn't seem like you are being unreasonable," says Berman. "But if you shared your reasoning, and she keeps yelling, you have to stand your ground."

Sept. 18, 2000 -- My daughter is 4 years old, and I knew it was time to worry. She's beautiful and trusting and weighs 30 pounds. Would she have any idea what to do if someone tried to overpower her? Would she muster the courage to scream and kick?

Those are the kinds of questions that haunt parents these days, and I knew it was high time to do something about my concerns. But where to start? Every day, it seemed, there were "teachable moments," yet so far I'd done no conscious teaching. What about all those personal safety tips that children should be drilled in -- "Don't talk to strangers" and the like? Instead, I was worried about what I might be teaching without thinking about it -- my polite exchanges, for instance, with the male stranger in the supermarket checkout and the panhandler on the street?

What messages was my daughter taking away from such encounters?

FBI statistics indicate that last year 2,100 juveniles were reported missing every single day -- that's 750,000 for the year. Of these, the National Center for Missing and Exploited Children listed more than 114,000 cases involving physical threats or harm and nearly 32,000 cases as involuntary kidnappings or abductions. Our children are at risk. And, like me, most parents worry endlessly but feel uncertain about what to teach our children and how to protect them without scaring them to death.

It's hard for parents, says Donna Chaiet, president and founder of Prepare and Impact Personal Safety, a national series of hands-on child safety programs, because they are so uncertain about their own ability to protect their children. "Parents aren't nervous about showing a child how to safely use scissors or cautiously cross the street, because we know how to do those things," she says. "But when it comes to child [personal] safety, we have enormous anxiety about how to do it right."

Rethinking Some of the Old Rules

Talking to people like Chaiet, I realized that I needed to relearn some things myself. A lot of what I was taught when I was young has since been reconsidered.

Take the old notion of "stranger danger." It turns out that of all children that are reported as kidnapped in the United States each year, fewer than 100 of them were the victims of someone they didn't know at all, according to Gavin de Becker, a leading expert on predicting violent behavior and the author of the best-selling book "Protecting the Gift." Besides, "stranger" isn't an easy concept for a young child to grasp. At what point in a conversation does someone cease being a stranger? What about that man in the grocery store line?

De Becker says that the real safety issue isn't strangers, but strangeness -- inappropriate behavior and a child's vulnerability to the process of being persuaded. Rather than concentrating on the distinction between stranger and friend, says the new thinking, we should educate our children about common lures and ploys; teach them to trust their own feelings when something isn't quite right; and reassure them that it's OK to say no to adults -- including those they may know well -- who do or say something that makes them feel uncomfortable or scared (see Your Children Can Help Protect Themselves).

June 7, 2005 -- Skipping exercise for a week or two may cramp your mood, says a study that turned regular exercisers into couch potatoes.

"We were able to measure negative results from withdrawal of exercise in just two weeks," says researcher Ali Berlin, MS, in a news release. Berlin works at the military's Uniformed Services University of the Health Sciences. She presented her findings in Nashville, Tenn., at the American College of Sports Medicine's annual meeting.

Stick to It

The take-home message: Once you start exercising, keep it up. That doesn't mean becoming a slave to the Stairmaster or a fanatic about any particular workout. Adjustments may be necessary from time to time.

For example, "if someone is a regular jogger or bicyclist and find they cannot do the activity for a short time, they need to do something else like walking until they can resume their preferred activity," says Berlin.

Forced to Take a Break

Berlin's study included 40 regular exercisers. "We were not looking at elite athletes; the study participants were people who are regularly active at a moderate level," says Berlin.

First, the participants took mood and fitness tests. Next, half were forbidden from exercising for two weeks. The others were told to follow their normal fitness routine.

The tests were repeated one and two weeks later. The results showed that the forced exercise "vacation" didn't recharge anyone's batteries. Instead, it left the former exercisers feeling worse than before.

It's one of those strange-but-true health facts: The more active you are, the more energy you have. That is, as long as you're not ill or engaging in ridiculous amounts of exercise that push the body too hard.

The CDC recommends that adults get at least 30 minutes of moderate-intensity physical activity five or more days per week.

No Exercise, Crummy Mood

"After one week we began to see changes," says Berlin. After two weeks, those changes had deepened. Two weeks of slothfulness had pushed the former exercisers into a grim state.

By then, they were significantly more tense, tired, and less vigorous. The more out of shape they became, the more their mood and energy level worsened. "What this tells us is that any interruption in a regular fitness routine can have a negative [impact]," says Berlin.

So what's a person to do when the weather is miserable or time seems scarcer than usual? Get creative. Tweak your routine, choosing other activities to stay physically and mentally fit, Berlin suggests.

Health care workers may also want to keep an eye out for depression symptoms in exercisers who get sidelined by injury or illness, she says.

Whether you're eyeing a 5K, 10K, half marathon, or even a marathon, one thing is for sure -- your next race promises to be your farthest and your fastest.

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Nervous? Excited? Don't know where to start? Don't fret, we are here to help. Follow our expert-approved, 10-step plan to train for your next long-run.

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Good luck!

Step 1. Pick a race, any race.

"The first step is to pick the race that you want to enter," says fitness trainer Kathy Kaehler of Hidden Hills, Calif. "This way you have a date in mind, a time frame to train within and a goal," she tells WebMD. Find out about local races by visiting your local roadrunner's club. Not sure if you have one? Visit the Road Runner's Club of America website at http://www.rrca.org for a list of local clubs. Click on your state for a list of local races.

Step 2. Get a physical before you get physical.

"Before you begin, it's a good idea to see your doctor and get a thorough physical examination -- particularly if you have not had one in several years or if until now you have been fairly sedentary," says Lewis G, Maharam, MD, medical director of the New York City Marathon and NYC Triathlon, among others. "This exam should include an exercise stress test (preferably done on a treadmill) to try and make sure that you have no obvious heart problems that might surface if you exercise too hard."

Step 3. Find a running partner or group

Once your doctor has given you the 'all-clear,' the next step is to find someone to train with. "Partners and groups are motivating because you are accountable to a group and pushed by people -- some of whom are better than you," Kaehler says. "If you can't find a club, then try to find a running partner who is equivalent to your fitness level." Local running stores and your local runner's club can help you find groups. Many major road races, particularly marathons, also have classes for the benefit of runners training for their event. The park and recreation departments in many cities often provide jogging programs for interested parties. In addition, many charity organizations, notably The Leukemia & Lymphoma Society's Team In Training, offer training programs and help runners raise money for the cause.

Step 4. Dress for success

Though clothes do not make the runner, there is no substitute for the right running shoe, Maharam tells WebMD. "There should be about a thumbnail's length between the longest toe and the end of the shoe. Without this much space, you can lose your toe nails," he cautions. Your best bet is to go to a specialty shop to buy running-specific shoes because the staff will better trained at fitting them. Replace your running shoes every 350 to 500 miles because they lose shock absorption and other protective qualities with use. What's more, "make sure you choose synthetic socks," Maharam says. "Unlike cotton, synthetic material wicks away moisture and fluid; preventing blisters and the wearing away of your feet."

Step 5. Train to train

"Most people start running with a health or fitness goal in mind such as losing weight or being healthier rather than a specific race," says master's champion runner and coach Gordon Bakoulis, author of How to Train for and Run Your Best Marathon. "You should really be doing a base of 10 to 20 miles a week before you start training for your first long run." Once you have established a baseline, then training can begin. Remember that the amount of time it takes to train for a race depends on the distance as well as your fitness level, she says. In general, marathon training can take anywhere from six months to a year.

May 12, 2006 -- New research offers more evidence that weight loss surgery has a dramatic impact on the hormones that drive hunger, and the findings could help advance the search for better drugs to treat obesity.

The study involved nine morbidly obese patients who had gastric bypass surgery.

Just six weeks after surgery, secretions of the hunger-reducing hormones peptide YY (PYY) and glucagons-like peptide 1 (GLP-1) were significantly altered in the patients. Although patients had lost weight, they "were still markedly obese," write the researchers.

Surgery and Satiety

PYY and GLP-1 have been shown to play a role in appetite control by signaling the body that it is no longer hungry after meals.

Blood tests were done to check the levels of PYY and GLP-1 after fasting and also after drinking a liquid test meal. Prior to surgery, the researchers found that secretions of the two hormones were not increased in response to the liquid test meal as would be expected.

Six weeks after surgery, the hormones were significantly elevated in the nine patients after they consumed the same test meal. PYY and GLP-1 hormonal responses after meals were twice as great in the surgically treated patients as in obese patients who did not have the surgery, even though the subjects in both groups had similar BMIs.

The fasting levels of PYY and GLP-1 six weeks after surgery were not significantly increased from the levels before surgery.

Participants' hunger ratings were lower after surgery compared with before surgery. The ratings were especially lower after consuming the test meal.

The findings, reported in the May issue of The Journal of Clinical Endocrinology and Metabolism, suggest that it is the surgery itself that drives the hormonal changes and not the weight loss that results from it.

"We know that something is going on with hunger following weight loss surgery, and we believe that it is related to hormones," researcher Josep Vidal, MD, PhD, tells WebMD. "But we probably don't have the whole picture yet."

Investigating Hunger Hormones

Just a few years ago, most research was focused on the appetite-stimulating hormone ghrelin. Studies showed dramatic differences in ghrelin secretions among obese patients who had undergone gastric bypass operations and those who had other types of surgery or no surgery at all.

But it quickly became clear that ghrelin did not tell the whole story, and research efforts have broadened to include other appetite-regulating hormones like PYY and GLP-1.

At least one GLP-1-like substance is under investigation as an appetite suppressant.

Vital and colleagues say their findings, if confirmed, could lead to the development of new weight loss drugs that mimic the hormonal changes seen with surgery.

Obesity researcher Nana Gletsu, PhD, of Atlanta's Emory University School of Medicine, tells WebMD that future weight loss drugs will probably target hormones in the brain and the hunger hormones found in the gut.

But she adds that there is more to hunger than hormones.

"Hunger and satiety are very complex," she says, "Hormones certainly influence hunger, but so do mental and environmental factors, such as time of day and stress levels. You may have hormones from your stomach telling you that you are hungry or full, but they are not the only signals you are receiving."

Oct. 24, 2005 (St. Louis) -- Obesity is not only an epidemic in this country, it is a global explosion. Researchers say "globesity" is out of control, and the health care community has ideas to help stem the tide of expanding waistlines.

A panel of experts shared ideas at the American Dietetic Association Food and Nutrition Conference and Exhibition on how to put a dent in the obesity problem.

Panel members Jim Hill, PhD, John Foreyt, PhD, and W. Phillip James, MD, DSc, all agreed that the environment needs to change if we are to have an impact on the serious consequences of obesity and turn strategies into solutions. There is no simple solution to this very complex problem; taking small steps to tackle the problem is a great beginning.

Causes and Consequences

The trend of increasing numbers of adults with excess weight continues. According to the 1999-2000 National Health and Nutrition Examination Survey (NHANES), more than 64% of U.S. adults are either overweight or obese.

The U.S. is not alone. Australia, the U.K., Germany, Croatia, Greece, Finland, and many other countries have a high prevalence of overweight adults, according to the International Obesity Task Force web site.

"The cause of the obesity epidemic around the globe is multifaceted and complex," says James. "Developed countries have spent large sums of money to provide mechanical, electronic, and physical aids to remove the need to do any physical activity so people burn fewer calories each day."

According to James, "this is further compounded by intense marketing and availability of inexpensive food that is high in calories, fat, and sugar."

Well-known health consequences of obesity include type 2 diabetes, cardiovascular disease, sleep apnea, liver abnormalities, and negative psychological consequences.

These conditions are not limited to adults and are being seen in the growing number of overweight and obese children.

Excess weight has been associated with an increased risk of some cancer.

In men and women, being obese or overweight has been linked with an increased risk for kidney cancer. In women, breast, ovarian, cervical and uterine cancer risk all increase with excess body weight.

According to NAASO, The Obesity Society, obese women have a 1.5-fold greater risk for endometrial cancer and a twofold greater risk for postmenopausal breast cancer.

One Small Step at a Time

"We need to focus our attention on health, well-being, and the improvement of the quality of life that small changes can achieve," says Foreyt. Don't think of a diet-and-exercise overhaul; think small steps to halt weight gain and then move on to weight loss.

"If we could simply stop gaining weight, it would be a substantial first step toward reducing globesity" says Hill, one of the founders of America on the Move, which popularized the pedometer.

His advice: make small changes that add up to at least 100-200 fewer calories daily. Eat one less cookie, leave a few bites of the fast-food burger, and walk 2,000 more steps each day to help weight maintenance.

Pedometers keep track of how far a person walks or runs. They also keep track of the number of steps a person takes. That -- plus advice to take 10,000 steps a day -- seems to help motivation for people who don't like to exercise.

Changing behavior is admittedly one of the most difficult tasks health care professionals face, panel members told the audience of registered dietitians. "Taking small steps seem to be the most reliant way for doctors and dietitians to help get people to change the way they eat and exercise," says Foreyt.

Everyone is looking for the magic bullet but it does not exist, he says. "It starts and ends with personal responsibility."

Dec. 8, 2003 -- Television may be killing children's eating habits. A new study shows that the more television children watch, the fewer healthy fruits and vegetables they eat.

The results indicate that watching TV not only contributes to children's bulging waistlines by making them less physically active, but it also negatively affects their food choices.

Researchers say that children spend more time watching television than engaging in any other activity except sleep. On average, children between 2 and 17 watch an average of 22 hours of television a week.

Although prior studies have linked TV viewing to childhood obesity, researchers say that until now little was known about how television affects children's eating choices

TV Kills Kids' Fruits and Veggies

The study, published in the December issue of Pediatrics, tracked the TV viewing and fruit and vegetable consumption of 548 seventh grade public school students for 19 months from 1995 to 1997.

At the start of the study, the children reported eating an average of 4.23 servings of fruits and vegetables per day, which is below the recommended five servings per day. The children also reported watching an average of more than three hours of television per day.

Researchers found that after adjusting for other factors, such as frequency of sit-down dinners and physical activity, the number of fruit and vegetables servings the children ate per day decreased by 0.16 with every additional hour of television viewing reported at the start of the study. That translates to one less serving every six days.

In addition, the number of fruits and vegetable servings decreased by another 0.14 servings per day for each hour increase in TV watching reported at the end of the study.

Researchers say that means the average child who watched three hours per day of television at the start of the study and increased his or her television viewing by one hour per day over the course of the study had 2.25 fewer servings of fruits and vegetables per week or up to 110 fewer servings per year than those who did not watch television.

How TV Affects Children's Eating Habits

Researchers say the commercials children are exposed to may be to blame for the negative impact of TV on their eating habits. Children 2 to 11 years old are exposed to an average of 150 to 200 hours of commercial messages or 20,000 commercials a year.

Previous studies have shown that more than half of those commercials are for food, and little of this marketing is aimed at fruits and vegetables. Many of the commercials targeted at kids also contain misleading messages of about the nutritional value of the foods advertised.

For example, one study showed that more than 90% of cereal advertisements asserted that the food was part of a "balanced" or "complete" breakfast.

Researchers say that kids may also be turned off by food commercials that tout the nutritional content of the food and are encouraged to replace fruits and vegetables with other products that are marketed as "nutritious" but are in fact of little nutritional value.

July 30, 2003 - An employee's waistline can greatly affect a company's bottom line on health-care spending, according to a new study. It shows that overweight staffers are more absent and have higher health-care costs than leaner employees.

The study appears in the July/August issue of the American Journal of Health Behavior.

The research shows the body mass index (BMI), a measure of weight in proportion to height, predicted higher health-care costs and greater absenteeism among workers. The average medical costs for city employees got larger as the employees got bigger. In this analysis done on almost 500 municipal workers in the city of Dallas:

• Normal-weight employees (BMI <25) cost $114.00 per year.
• Overweight employees (BMI 25-30) cost $513.00 per year.
• Obese employees (BMI >30) cost $620.00 per year.

Overweight and obese employees were more likely to have more hours absent than normal-weight employees. A normal-weight employee averaged 27 hours of missed work, while overweight and obese employees missed 30 and 35 hours, respectively. An obese person was also more than four times likely to be assigned to a group that had higher health-care costs than the normal-weight employee.

"In order to decrease health-care costs, efforts to prevent overweight and obesity and to transform the overweight and obese to normal weight should be taken," researcher Timothy Bungum, PhD, suggested in a news release.

Overweight Employees Cost Companies Billions

Researchers say health-care spending on American employees and dependents exceeds $900 billion and counting each year. Direct and indirect absenteeism costs are believed to be as high as $25 billion per year. Researchers aimed to target the source of some of these rising costs.

Bungum's team surveyed 500 municipal employees in Dallas, which was ranked the "fifth fattest city in America" by Men's Fitness magazine in 2002. Questionnaires asked about certain variables including age and education. Respondents were 61% men, 55% white, 31% black, and 11% Hispanic. The average age was 43, and the average BMI was 28. Normal BMI is under 25, according to government standards.

"Age, gender, race, educational attainment, and smoking all failed to predict obesity-related health-care costs. The lone significant predictor of health-care costs was BMI," Bungum says.

Though researchers say their findings show that the relationship between obesity and company health-care costs needs addressing, they also say that more research needs to be done before cause-and-effect inferences can be drawn.

Do you find it hard to gain weight? If so, you're probably the envy of family and friends. It seems as if you can eat as many cheeseburgers and chocolate bars as you would like, and still not register an ounce.

Yet little do people know how much you'd love to put meat on your bones, perhaps to feel less lanky, to be able to wear certain clothes without appearing scrawny, or to just be healthier.

Ken Chuk is one such person. He is a 32-year-old finance manager who wishes he could put on a business suit without looking like he just got out of college. His fast metabolism and tendency to feel full with smaller portions, however, make it hard for him to add anything to his 5' 11", 140-pound frame. He's tried to lift weights, suck down protein shakes, and stuff himself with ice cream, cookies, or cereal at bedtime -- all to no avail.

"Everyone in my family is thin," explains the New York native. "I've given up trying to gain weight because I figure it will happen eventually."

Chuk is right in that all of us will tend to become heavier as we age, but health experts say there are plenty of things people can do now to build critical mass.

The Skinny on the Underweight

What's so wrong with being too thin when it seems to be a non-problem compared with obesity? The truth is that being underweight has its own risks.

Those who are extremely lean tend to have weaker immune systems, making them prone to infections, surgical complications, and slower recovery times for illness. They tend to have low muscle mass, and less than ideal hair, teeth, and skin composition. They may have disruptions in the ability to regulate hormones and protect bone health, and women could become unable to menstruate.

All of this could be avoided by maintaining a healthy weight, a measure that obviously differs from person to person. As a rough rule of thumb, women should be at least 105 pounds for the first five feet of height, and another five pounds per inch after that; men should be at least 106 pounds for the first five feet, and an added six pounds per inch, says Dan Heinemann, MD, a board member of the American Academy of Family physicians.

Another gauge could be an individual's body mass index (BMI), which is a system to categorize size based on a person's height and weight. The National Heart, Lung, and Blood Institute reports that people with normal weight have a BMI of 18.5-24.9. Anything below that is underweight, and anything above is overweight (25-29.9) or obese (30 or greater).

Why So Thin?

There are many reasons why people may find it hard to gain weight. Genetics can obviously play a role, but individual personalities and the environment can be strong factors.

"Sometimes people think they just have a fast metabolism, but that's not always the case," says Cindy Moore, MS, RD, director of nutrition therapy at the Cleveland Clinic Foundation, and a spokeswoman for the American Dietetic Association (ADA). "They just might be more physically active."

For example, there are people who tend to move around more, burning more calories than they take in. They're either always the first ones to volunteer to pick up after a spill, to do the chores, to walk everywhere, or to play a lot of sports. This level of physical activity is not a bad thing, says Moore, but being aware of it is important in understanding the factors affecting one's weight.

Then there are others who lose their appetite, experience a change in metabolism, and/or lose poundage and muscle mass fast because of various reasons, including illness, chronic pain, depression, stress, and side effects from drugs.

In children, the inability to gain weight may signal a condition known as "failure to thrive," which means a kid is not growing appropriately for his/her age. This may be caused by an illness, or eating patterns dictated by a parental idiosyncrasy. According to Wahida Karmally, DrPH, RD, spokesperson for the ADA, there have been kids who have not developed properly because they did not receive enough nutrients from being on a raw food, macrobiotic, or vegan diet.

April 2, 2004 -- "Burn Fat While You Sleep." "Lose 10 Pounds in 10 Days." We all know the ads are too good to be true, but Americans still spend billions each year on unregulated pills and potions promising weight loss.

While we may want to believe the hype, is there any scientific evidence to back it up? According to findings from a newly published analysis, the answer is a qualified no.

Two researchers from England's Universities of Exeter and Plymouth reviewed studies evaluating weight loss among people taking a dozen supplements commonly found in unregulated weight control preparations. They concluded that there was "little convincing evidence that any specific dietary supplement is effective in reducing body weight."

Study co-author Max H. Pittler, MD, would not go so far as to say that people are wasting their money when they buy unregulated diet drugs, but he did tell WebMD that there is "not much concrete evidence showing them to be effective."

Modestly Effective

Of the 12 dietary supplements included in the review, only two -- ephedra and chromium picolinate -- proved to be more effective than placebo.

According to Pittler, the most rigorous review showed ephedra use to be associated with modest, short-term weight loss. But the supplement is also known to speed the heart rate and constrict blood vessels, and heart palpitations were common among the participants in the ephedra studies.

Earlier this year, the FDA issued a ruling prohibiting the sale of dietary supplements containing ephedra because it presents an unreasonable risk of illness or injury.

The ruling, which requires ephedra to be removed from all unregulated products sold in the U.S., will become effective by the end of this month. It is the first time the agency has banned a dietary supplement.

The other supplement shown to be modestly effective for weight loss was the trace mineral chromium picolinate, which is touted as enhancing insulin's activity and reducing body fat. But the researchers concluded that the weight loss effect of the supplement was minimal.

The review was published in the April issue of the American Journal of Clinical Nutrition.

Other Supplements

Other supplements found to have little or no effect on weight loss included:

• Chitosan -- A marine-derived starch found in the skeletons of shrimp, crab, and other shellfish. The supplement is used in products promising to keep dietary fats from being absorbed by the body. But the researchers concluded that "the evidence available in the literature indicates that there is considerable doubt that chitosan is effective for reducing body weight."
• Garcinia cambogia -- One of the main ingredients in one of the best-selling supplemental weight loss aids, Hydroxycut. The researchers concluded that "the evidence for G. cambogia is not compelling."
• Pyruvate -- Formed by the body during breakdown of carbohydrates, it's touted as a booster of metabolism and an appetite suppressant, but Pittler and Ernst reported that "the case of pyruvate as an aid to body-composition changes and weight loss is weak."

Buyer Beware

The clinical evidence was scant for other supplements sold as weight-loss aids, including the evergreen tree-derived herbals Yerba mate and Yohimbe and the fiber psyllium, but the researchers concluded that "none of the reviewed dietary supplements can be recommended for over-the-counter use."

Weight loss specialist Madelyn Fernstrom, PhD, says it is not surprising that the evidence does not support the claims that dietary supplements lead to quick and easy weight loss. Fernstrom is director of the weight management center at the University of Pittsburgh Medical Center.

"There is no magic pill," she tells WebMD. "If you are looking to try and moderate your weight loss with the help of a pharmacologic agent, get a prescription medication."

She adds that it is important for people to understand that a supplement isn't necessarily safe because it is unregulated. She cites the products now being sold as "ephedra free," which may be just as dangerous as those containing ephedra.

"There is already a supplement out there that is just as dangerous taking ephedra's place in these products, and it is called bitter orange," she says. "People have to be careful. Just because it comes from the food supply doesn't mean it's safe."

Do you find it hard to gain weight? If so, you're probably the envy of family and friends. It seems as if you can eat as many cheeseburgers and chocolate bars as you would like, and still not register an ounce.

Yet little do people know how much you'd love to put meat on your bones, perhaps to feel less lanky, to be able to wear certain clothes without appearing scrawny, or to just be healthier.

Ken Chuk is one such person. He is a 32-year-old finance manager who wishes he could put on a business suit without looking like he just got out of college. His fast metabolism and tendency to feel full with smaller portions, however, make it hard for him to add anything to his 5' 11", 140-pound frame. He's tried to lift weights, suck down protein shakes, and stuff himself with ice cream, cookies, or cereal at bedtime -- all to no avail.

"Everyone in my family is thin," explains the New York native. "I've given up trying to gain weight because I figure it will happen eventually."

Chuk is right in that all of us will tend to become heavier as we age, but health experts say there are plenty of things people can do now to build critical mass.

The Skinny on the Underweight

What's so wrong with being too thin when it seems to be a non-problem compared with obesity? The truth is that being underweight has its own risks.

Those who are extremely lean tend to have weaker immune systems, making them prone to infections, surgical complications, and slower recovery times for illness. They tend to have low muscle mass, and less than ideal hair, teeth, and skin composition. They may have disruptions in the ability to regulate hormones and protect bone health, and women could become unable to menstruate.

All of this could be avoided by maintaining a healthy weight, a measure that obviously differs from person to person. As a rough rule of thumb, women should be at least 105 pounds for the first five feet of height, and another five pounds per inch after that; men should be at least 106 pounds for the first five feet, and an added six pounds per inch, says Dan Heinemann, MD, a board member of the American Academy of Family physicians.

Another gauge could be an individual's body mass index (BMI), which is a system to categorize size based on a person's height and weight. The National Heart, Lung, and Blood Institute reports that people with normal weight have a BMI of 18.5-24.9. Anything below that is underweight, and anything above is overweight (25-29.9) or obese (30 or greater).

Why So Thin?

There are many reasons why people may find it hard to gain weight. Genetics can obviously play a role, but individual personalities and the environment can be strong factors.

"Sometimes people think they just have a fast metabolism, but that's not always the case," says Cindy Moore, MS, RD, director of nutrition therapy at the Cleveland Clinic Foundation, and a spokeswoman for the American Dietetic Association (ADA). "They just might be more physically active."

For example, there are people who tend to move around more, burning more calories than they take in. They're either always the first ones to volunteer to pick up after a spill, to do the chores, to walk everywhere, or to play a lot of sports. This level of physical activity is not a bad thing, says Moore, but being aware of it is important in understanding the factors affecting one's weight.

Then there are others who lose their appetite, experience a change in metabolism, and/or lose poundage and muscle mass fast because of various reasons, including illness, chronic pain, depression, stress, and side effects from drugs.

In children, the inability to gain weight may signal a condition known as "failure to thrive," which means a kid is not growing appropriately for his/her age. This may be caused by an illness, or eating patterns dictated by a parental idiosyncrasy. According to Wahida Karmally, DrPH, RD, spokesperson for the ADA, there have been kids who have not developed properly because they did not receive enough nutrients from being on a raw food, macrobiotic, or vegan diet.

April 2, 2004 -- "Burn Fat While You Sleep." "Lose 10 Pounds in 10 Days." We all know the ads are too good to be true, but Americans still spend billions each year on unregulated pills and potions promising weight loss.

While we may want to believe the hype, is there any scientific evidence to back it up? According to findings from a newly published analysis, the answer is a qualified no.

Two researchers from England's Universities of Exeter and Plymouth reviewed studies evaluating weight loss among people taking a dozen supplements commonly found in unregulated weight control preparations. They concluded that there was "little convincing evidence that any specific dietary supplement is effective in reducing body weight."

Study co-author Max H. Pittler, MD, would not go so far as to say that people are wasting their money when they buy unregulated diet drugs, but he did tell WebMD that there is "not much concrete evidence showing them to be effective."

Modestly Effective

Of the 12 dietary supplements included in the review, only two -- ephedra and chromium picolinate -- proved to be more effective than placebo.

According to Pittler, the most rigorous review showed ephedra use to be associated with modest, short-term weight loss. But the supplement is also known to speed the heart rate and constrict blood vessels, and heart palpitations were common among the participants in the ephedra studies.

Earlier this year, the FDA issued a ruling prohibiting the sale of dietary supplements containing ephedra because it presents an unreasonable risk of illness or injury.

The ruling, which requires ephedra to be removed from all unregulated products sold in the U.S., will become effective by the end of this month. It is the first time the agency has banned a dietary supplement.

The other supplement shown to be modestly effective for weight loss was the trace mineral chromium picolinate, which is touted as enhancing insulin's activity and reducing body fat. But the researchers concluded that the weight loss effect of the supplement was minimal.

The review was published in the April issue of the American Journal of Clinical Nutrition.

Other Supplements

Other supplements found to have little or no effect on weight loss included:

• Chitosan -- A marine-derived starch found in the skeletons of shrimp, crab, and other shellfish. The supplement is used in products promising to keep dietary fats from being absorbed by the body. But the researchers concluded that "the evidence available in the literature indicates that there is considerable doubt that chitosan is effective for reducing body weight."
• Garcinia cambogia -- One of the main ingredients in one of the best-selling supplemental weight loss aids, Hydroxycut. The researchers concluded that "the evidence for G. cambogia is not compelling."
• Pyruvate -- Formed by the body during breakdown of carbohydrates, it's touted as a booster of metabolism and an appetite suppressant, but Pittler and Ernst reported that "the case of pyruvate as an aid to body-composition changes and weight loss is weak."

Buyer Beware

The clinical evidence was scant for other supplements sold as weight-loss aids, including the evergreen tree-derived herbals Yerba mate and Yohimbe and the fiber psyllium, but the researchers concluded that "none of the reviewed dietary supplements can be recommended for over-the-counter use."

Weight loss specialist Madelyn Fernstrom, PhD, says it is not surprising that the evidence does not support the claims that dietary supplements lead to quick and easy weight loss. Fernstrom is director of the weight management center at the University of Pittsburgh Medical Center.

"There is no magic pill," she tells WebMD. "If you are looking to try and moderate your weight loss with the help of a pharmacologic agent, get a prescription medication."

She adds that it is important for people to understand that a supplement isn't necessarily safe because it is unregulated. She cites the products now being sold as "ephedra free," which may be just as dangerous as those containing ephedra.

"There is already a supplement out there that is just as dangerous taking ephedra's place in these products, and it is called bitter orange," she says. "People have to be careful. Just because it comes from the food supply doesn't mean it's safe."

June 7, 2005 -- Skipping exercise for a week or two may cramp your mood, says a study that turned regular exercisers into couch potatoes.

"We were able to measure negative results from withdrawal of exercise in just two weeks," says researcher Ali Berlin, MS, in a news release. Berlin works at the military's Uniformed Services University of the Health Sciences. She presented her findings in Nashville, Tenn., at the American College of Sports Medicine's annual meeting.

Stick to It

The take-home message: Once you start exercising, keep it up. That doesn't mean becoming a slave to the Stairmaster or a fanatic about any particular workout. Adjustments may be necessary from time to time.

For example, "if someone is a regular jogger or bicyclist and find they cannot do the activity for a short time, they need to do something else like walking until they can resume their preferred activity," says Berlin.

Forced to Take a Break

Berlin's study included 40 regular exercisers. "We were not looking at elite athletes; the study participants were people who are regularly active at a moderate level," says Berlin.

First, the participants took mood and fitness tests. Next, half were forbidden from exercising for two weeks. The others were told to follow their normal fitness routine.

The tests were repeated one and two weeks later. The results showed that the forced exercise "vacation" didn't recharge anyone's batteries. Instead, it left the former exercisers feeling worse than before.

It's one of those strange-but-true health facts: The more active you are, the more energy you have. That is, as long as you're not ill or engaging in ridiculous amounts of exercise that push the body too hard.

The CDC recommends that adults get at least 30 minutes of moderate-intensity physical activity five or more days per week.

No Exercise, Crummy Mood

"After one week we began to see changes," says Berlin. After two weeks, those changes had deepened. Two weeks of slothfulness had pushed the former exercisers into a grim state.

By then, they were significantly more tense, tired, and less vigorous. The more out of shape they became, the more their mood and energy level worsened. "What this tells us is that any interruption in a regular fitness routine can have a negative [impact]," says Berlin.

So what's a person to do when the weather is miserable or time seems scarcer than usual? Get creative. Tweak your routine, choosing other activities to stay physically and mentally fit, Berlin suggests.

Health care workers may also want to keep an eye out for depression symptoms in exercisers who get sidelined by injury or illness, she says.

Whether you're eyeing a 5K, 10K, half marathon, or even a marathon, one thing is for sure -- your next race promises to be your farthest and your fastest.

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Nervous? Excited? Don't know where to start? Don't fret, we are here to help. Follow our expert-approved, 10-step plan to train for your next long-run.

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Good luck!

Step 1. Pick a race, any race.

"The first step is to pick the race that you want to enter," says fitness trainer Kathy Kaehler of Hidden Hills, Calif. "This way you have a date in mind, a time frame to train within and a goal," she tells WebMD. Find out about local races by visiting your local roadrunner's club. Not sure if you have one? Visit the Road Runner's Club of America website at http://www.rrca.org for a list of local clubs. Click on your state for a list of local races.

Step 2. Get a physical before you get physical.

"Before you begin, it's a good idea to see your doctor and get a thorough physical examination -- particularly if you have not had one in several years or if until now you have been fairly sedentary," says Lewis G, Maharam, MD, medical director of the New York City Marathon and NYC Triathlon, among others. "This exam should include an exercise stress test (preferably done on a treadmill) to try and make sure that you have no obvious heart problems that might surface if you exercise too hard."

Step 3. Find a running partner or group

Once your doctor has given you the 'all-clear,' the next step is to find someone to train with. "Partners and groups are motivating because you are accountable to a group and pushed by people -- some of whom are better than you," Kaehler says. "If you can't find a club, then try to find a running partner who is equivalent to your fitness level." Local running stores and your local runner's club can help you find groups. Many major road races, particularly marathons, also have classes for the benefit of runners training for their event. The park and recreation departments in many cities often provide jogging programs for interested parties. In addition, many charity organizations, notably The Leukemia & Lymphoma Society's Team In Training, offer training programs and help runners raise money for the cause.

Step 4. Dress for success

Though clothes do not make the runner, there is no substitute for the right running shoe, Maharam tells WebMD. "There should be about a thumbnail's length between the longest toe and the end of the shoe. Without this much space, you can lose your toe nails," he cautions. Your best bet is to go to a specialty shop to buy running-specific shoes because the staff will better trained at fitting them. Replace your running shoes every 350 to 500 miles because they lose shock absorption and other protective qualities with use. What's more, "make sure you choose synthetic socks," Maharam says. "Unlike cotton, synthetic material wicks away moisture and fluid; preventing blisters and the wearing away of your feet."

Step 5. Train to train

"Most people start running with a health or fitness goal in mind such as losing weight or being healthier rather than a specific race," says master's champion runner and coach Gordon Bakoulis, author of How to Train for and Run Your Best Marathon. "You should really be doing a base of 10 to 20 miles a week before you start training for your first long run." Once you have established a baseline, then training can begin. Remember that the amount of time it takes to train for a race depends on the distance as well as your fitness level, she says. In general, marathon training can take anywhere from six months to a year.

Sallie Elizabeth has always had large breasts and a big bottom, and she has accepted them as part of her genetic makeup. But when cellulite appeared in the back of her upper leg, she "freaked out" and resolved to do something about it.

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A friend recommended endermologie, a deep massage treatment using a motorized device with two adjustable rollers and controlled suction. The device is said to improve the look of cellulite by gently folding and unfolding the skin for smooth and regulated deep-tissue movement.

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The cellulite is "less visible," she says, noting her smoother, softer skin. "I feel healthier. My circulation has improved ... and I feel more relaxed."

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To keep up the effects, the 20-something model visits Smooth Synergy, a cosmedical spa in Manhattan, once or twice a week for 35-minute sessions with the endermologie machine and a technician.

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Elizabeth may be enjoying her cellulite-busting experience, but experts raise eyebrows at many tools or treatments purported to reduce the appearance of cellulite, trim fat in specific areas, shed pounds, or build muscle -- particularly if they claim to replace exercise and good nutrition.

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"They're a waste of money," says Richard Cotton, a spokesman for the American Council on Exercise and chief exercise physiologist for myexerciseplan.com.

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If that is the case, then a sizeable chunk of currency could be going down the drain. According to a Federal Trade Commission (FTC) weight loss advertising trend report, in the year 2000 alone, consumers spent an estimated $34.7 billion on weight-loss products and programs.

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While it is not known how much of that accounts for sales of unproven or fraudulent merchandise, an FTC study of weight loss ads from different media shows that nearly 40% of ads make at least one false claim, and an additional 15% make at least one claim that is very likely false, or lacks proof.

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To add to the number soup: Results from a national health survey conducted between 1999 and 2000 indicate that more than six out of every 10 Americans are overweight or obese, a figure that has increased dramatically in recent years.

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Another recent survey that looked at the attitudes of Americans adults toward their own weight found that despite the fact that two-thirds of men were considered overweight, only about half (51%) said they wanted to lose weight versus 68% of women who said they wanted to lose weight.

Put it all together and there are arguably more people wanting to use weight loss products, and according to the government's trend report, the "marketplace has responded with a proliferating array of products and services, many promising miraculous, quick-fix remedies."

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There are, indeed, numerous therapies, including weight loss programs and dietary supplements. Then there are the popular treadmills, bun and ab rollers, the body bow, and bun and thigh max.

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For this piece, however, WebMD looked only into passive exercise devices such as electrical muscle stimulators and toning tables, cellulite reduction therapies, and gels, creams, eyeglasses, earrings and similar doodads marketed for weight loss, and muscle-building.

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Granted, not all remedies may be the same, but health professionals say far too many of them can't be trusted.

April 15, 2005 -- Diets that lower carbohydrates may not get any extra advantage from boosting protein.

When diets substitute proteins for carbohydrates, studies show greater fat loss in women. But it's not known whether the effect is due to the increased protein content of the diets or the reduction in carbohydrates, write the researchers.

However, Australian researchers find that when they put a small group of obese men and women on two different low-carb diets -- high and low protein -- weight loss results did not differ.

The study appears in the April 1 edition of The American Journal of Clinical Nutrition.

"In previous studies, we have shown differences between high-protein diets and lower-protein diets when we substituted protein for carbohydrate and kept fat constant," says Peter M. Clifton, FRACP, PhD, of the University of Adelaide's medicine department.

"The question: Was it protein or the carbohydrates? This study suggested that perhaps it was the decrease in carbohydrates, rather than the increase in protein that made the difference we saw previously," Clifton tells WebMD in an email.

Do Carbs Count More Than Protein?

Participants were 73 obese men and women; none had type 2 diabetes. They were divided into two groups for a 12-week diet.

Both diets cut carbs to the same level: no more than 30% of total daily calories. One diet featured low-fat (29% total calories), high-protein (24% total calories) items. It was based on lean meat, poultry, and low-fat dairy foods, says Clifton's study.

The other low-carb diet had a standard amount of protein (8% total calories) and a higher amount of monounsaturated fat (45% total calories). Those menus included lean meat, poultry, higher-fat milk, and oil and nuts high in monounsaturated fat.

After 12 weeks of the calorie-restricted diet -- followed by four weeks of a maintenance diet -- the two groups had no differences in weight loss, fat or lean-mass loss, insulin resistance (a risk factor signaling heart disease and type 2 diabetes), or fasting cholesterol and triglyceride levels.

On average, the low-fat, high-protein group lost about 21 pounds. The average weight lost by the high-fat, standard-protein group was 22.5 pounds.

Both diets were well tolerated; no negative side effects were seen. Neither plan hurt bone mass or kidney function, says the study.

Participants said they were less hungry after the low-fat, high-protein meal, both at the beginning and end of the study. However, "having a lower desire to eat did not translate into a lower intake," Clifton tells WebMD.

The diets' long-term effects aren't known. Neither are the results for people who aren't obese (body mass index of 30 or higher).

Which Diet Is Best?

Calories count on any diet, and sticking to the diet is important. "Most studies have shown that energy intake and not macronutrient composition is the key determinant of total weight loss," says Clifton's study. Macronutrients include fats, carbohydrates, and proteins.

Researcher's Perspective

"I don't think low-carbohydrate diets are quite as popular here [in Australia] as in the U.S.A.," says Clifton.

When asked what he would tell obese people considering either diet, he says, "For a short-term -- say, 12-week weight loss -- I would not say anything. But long term, I would recommend at least 100 grams of carbohydrates from bran cereals, fruit, and vegetables to keep micronutrient intake normal and bowel function normal."

Other studies have recommended favoring complex carbohydrates (in fruits, vegetables, whole grains, and legumes) over simple carbohydrates, which include sugary foods and refined grains.

Don't forget that exercise is the other half of effective weight loss. Check with a doctor about changing your food or fitness habits.

July 30, 2003 - An employee's waistline can greatly affect a company's bottom line on health-care spending, according to a new study. It shows that overweight staffers are more absent and have higher health-care costs than leaner employees.

The study appears in the July/August issue of the American Journal of Health Behavior.

The research shows the body mass index (BMI), a measure of weight in proportion to height, predicted higher health-care costs and greater absenteeism among workers. The average medical costs for city employees got larger as the employees got bigger. In this analysis done on almost 500 municipal workers in the city of Dallas:

• Normal-weight employees (BMI <25) cost $114.00 per year.
• Overweight employees (BMI 25-30) cost $513.00 per year.
• Obese employees (BMI >30) cost $620.00 per year.

Overweight and obese employees were more likely to have more hours absent than normal-weight employees. A normal-weight employee averaged 27 hours of missed work, while overweight and obese employees missed 30 and 35 hours, respectively. An obese person was also more than four times likely to be assigned to a group that had higher health-care costs than the normal-weight employee.

"In order to decrease health-care costs, efforts to prevent overweight and obesity and to transform the overweight and obese to normal weight should be taken," researcher Timothy Bungum, PhD, suggested in a news release.

Overweight Employees Cost Companies Billions

Researchers say health-care spending on American employees and dependents exceeds $900 billion and counting each year. Direct and indirect absenteeism costs are believed to be as high as $25 billion per year. Researchers aimed to target the source of some of these rising costs.

Bungum's team surveyed 500 municipal employees in Dallas, which was ranked the "fifth fattest city in America" by Men's Fitness magazine in 2002. Questionnaires asked about certain variables including age and education. Respondents were 61% men, 55% white, 31% black, and 11% Hispanic. The average age was 43, and the average BMI was 28. Normal BMI is under 25, according to government standards.

"Age, gender, race, educational attainment, and smoking all failed to predict obesity-related health-care costs. The lone significant predictor of health-care costs was BMI," Bungum says.

Though researchers say their findings show that the relationship between obesity and company health-care costs needs addressing, they also say that more research needs to be done before cause-and-effect inferences can be drawn.

April 2, 2004 -- "Burn Fat While You Sleep." "Lose 10 Pounds in 10 Days." We all know the ads are too good to be true, but Americans still spend billions each year on unregulated pills and potions promising weight loss.

While we may want to believe the hype, is there any scientific evidence to back it up? According to findings from a newly published analysis, the answer is a qualified no.

Two researchers from England's Universities of Exeter and Plymouth reviewed studies evaluating weight loss among people taking a dozen supplements commonly found in unregulated weight control preparations. They concluded that there was "little convincing evidence that any specific dietary supplement is effective in reducing body weight."

Study co-author Max H. Pittler, MD, would not go so far as to say that people are wasting their money when they buy unregulated diet drugs, but he did tell WebMD that there is "not much concrete evidence showing them to be effective."

Modestly Effective

Of the 12 dietary supplements included in the review, only two -- ephedra and chromium picolinate -- proved to be more effective than placebo.

According to Pittler, the most rigorous review showed ephedra use to be associated with modest, short-term weight loss. But the supplement is also known to speed the heart rate and constrict blood vessels, and heart palpitations were common among the participants in the ephedra studies.

Earlier this year, the FDA issued a ruling prohibiting the sale of dietary supplements containing ephedra because it presents an unreasonable risk of illness or injury.

The ruling, which requires ephedra to be removed from all unregulated products sold in the U.S., will become effective by the end of this month. It is the first time the agency has banned a dietary supplement.

The other supplement shown to be modestly effective for weight loss was the trace mineral chromium picolinate, which is touted as enhancing insulin's activity and reducing body fat. But the researchers concluded that the weight loss effect of the supplement was minimal.

The review was published in the April issue of the American Journal of Clinical Nutrition.

Other Supplements

Other supplements found to have little or no effect on weight loss included:

• Chitosan -- A marine-derived starch found in the skeletons of shrimp, crab, and other shellfish. The supplement is used in products promising to keep dietary fats from being absorbed by the body. But the researchers concluded that "the evidence available in the literature indicates that there is considerable doubt that chitosan is effective for reducing body weight."
• Garcinia cambogia -- One of the main ingredients in one of the best-selling supplemental weight loss aids, Hydroxycut. The researchers concluded that "the evidence for G. cambogia is not compelling."
• Pyruvate -- Formed by the body during breakdown of carbohydrates, it's touted as a booster of metabolism and an appetite suppressant, but Pittler and Ernst reported that "the case of pyruvate as an aid to body-composition changes and weight loss is weak."

Buyer Beware

The clinical evidence was scant for other supplements sold as weight-loss aids, including the evergreen tree-derived herbals Yerba mate and Yohimbe and the fiber psyllium, but the researchers concluded that "none of the reviewed dietary supplements can be recommended for over-the-counter use."

Weight loss specialist Madelyn Fernstrom, PhD, says it is not surprising that the evidence does not support the claims that dietary supplements lead to quick and easy weight loss. Fernstrom is director of the weight management center at the University of Pittsburgh Medical Center.

"There is no magic pill," she tells WebMD. "If you are looking to try and moderate your weight loss with the help of a pharmacologic agent, get a prescription medication."

She adds that it is important for people to understand that a supplement isn't necessarily safe because it is unregulated. She cites the products now being sold as "ephedra free," which may be just as dangerous as those containing ephedra.

"There is already a supplement out there that is just as dangerous taking ephedra's place in these products, and it is called bitter orange," she says. "People have to be careful. Just because it comes from the food supply doesn't mean it's safe."

Suzanne Somers. Marilu Henner. Dr. Phil. Sylvester Stallone. You name the celebrity and odds are they've got a diet program complete with a book, a DVD, infomercial, and maybe even a line of supplements. And those that don't have their own diet, yet, may be outspoken advocates of the latest and greatest in fad diets from South Beach and Atkins to the new Hamptons diet.

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But just because they can act, sing, and look glamorous and buff as they stroll down a red carpet, doesn't necessarily mean they have a PhD in nutrition.

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"Just because someone is a celebrity doesn't mean they know what they are talking about in terms of diet and health," says Samantha Heller, MS, RD, senior clinical nutritionist and exercise physiologist at the New York University Medical Center in New York City. Acting advice can certainly come from celebrities, but nutrition advice should come from a health care professional such as a registered dietician.

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When browsing the book store or otherwise choosing a diet, look for the author's credentials like an MD (medical doctor) or RD (registered dietitian), or if it's someone with a PhD, find out what its in, it could be in history -- not anything pertaining to health or nutrition, Heller says.

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Read the author biography to see if this person has clinical experience. "Where did he or she work? Did he or she ever have real world experience with real patients?" Heller suggests.

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"Celebrity plans have a tendency to promote a very quick fix, are hard to stick by and are touting all types of products and when the author doesn't have a degree in health, it can be very scary," agrees Rachel Beller, director of the Brander Nutritional Oncology Counseling and Research Program at the John Wayne Cancer Institute in Santa Monica, Calif.

Red Flags Abound

Regardless, these books and diets are often tempting and tantalizing to consumers. Being on the lookout for certain red flags can help separate the wheat from the chafe.

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"A red flag is when they are selling food products and supplements that go with the program," Heller explains. "A red flag can be a personal red flag because sometimes these diets can be very expensive and not everyone can afford these foods or are these foods available in every neighborhood," she says.

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In other words, watch Dr. Phil on his talk show or Suzanne Sommers on Three's Company reruns, but when looking for a healthy eating plan, look for one that includes foods you can afford and are readily available.

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"A lot of the celebrities look fabulous," Heller says, "but they are being paid a lot of money to look that good and they can afford to have a personal chef and meals delivered.

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"For the rest of us who are not getting paid that much money and don't have that incentive, we need to find healthy ways of eating that we can incorporate into our lives on a daily basis," Heller states.

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Victoria Shanta-Retelny, RD, at Northwestern Memorial Hospital's Wellness Institute, in Chicago, weighs in with this comment: "Are they making promises that sound too good to be true such as 'lose 10 pounds in a week'? If the claim sounds too good to be true, it usually is."

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Any plan that hawks one specific nutrient whether protein, carbohydrate, or fat as a savior or remedy for weight loss, is a red flag. "There is no miracle food," she says.

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So why are we so attracted to these diets?

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"The draw is celebrity status," she says. "Suzanne Somers is an older woman and to look as good as she looks is appealing," she says. "It's not the diet. It's how these people look that is the draw."

April 2, 2004 -- "Burn Fat While You Sleep." "Lose 10 Pounds in 10 Days." We all know the ads are too good to be true, but Americans still spend billions each year on unregulated pills and potions promising weight loss.

While we may want to believe the hype, is there any scientific evidence to back it up? According to findings from a newly published analysis, the answer is a qualified no.

Two researchers from England's Universities of Exeter and Plymouth reviewed studies evaluating weight loss among people taking a dozen supplements commonly found in unregulated weight control preparations. They concluded that there was "little convincing evidence that any specific dietary supplement is effective in reducing body weight."

Study co-author Max H. Pittler, MD, would not go so far as to say that people are wasting their money when they buy unregulated diet drugs, but he did tell WebMD that there is "not much concrete evidence showing them to be effective."

Modestly Effective

Of the 12 dietary supplements included in the review, only two -- ephedra and chromium picolinate -- proved to be more effective than placebo.

According to Pittler, the most rigorous review showed ephedra use to be associated with modest, short-term weight loss. But the supplement is also known to speed the heart rate and constrict blood vessels, and heart palpitations were common among the participants in the ephedra studies.

Earlier this year, the FDA issued a ruling prohibiting the sale of dietary supplements containing ephedra because it presents an unreasonable risk of illness or injury.

The ruling, which requires ephedra to be removed from all unregulated products sold in the U.S., will become effective by the end of this month. It is the first time the agency has banned a dietary supplement.

The other supplement shown to be modestly effective for weight loss was the trace mineral chromium picolinate, which is touted as enhancing insulin's activity and reducing body fat. But the researchers concluded that the weight loss effect of the supplement was minimal.

The review was published in the April issue of the American Journal of Clinical Nutrition.

Other Supplements

Other supplements found to have little or no effect on weight loss included:

• Chitosan -- A marine-derived starch found in the skeletons of shrimp, crab, and other shellfish. The supplement is used in products promising to keep dietary fats from being absorbed by the body. But the researchers concluded that "the evidence available in the literature indicates that there is considerable doubt that chitosan is effective for reducing body weight."
• Garcinia cambogia -- One of the main ingredients in one of the best-selling supplemental weight loss aids, Hydroxycut. The researchers concluded that "the evidence for G. cambogia is not compelling."
• Pyruvate -- Formed by the body during breakdown of carbohydrates, it's touted as a booster of metabolism and an appetite suppressant, but Pittler and Ernst reported that "the case of pyruvate as an aid to body-composition changes and weight loss is weak."

Buyer Beware

The clinical evidence was scant for other supplements sold as weight-loss aids, including the evergreen tree-derived herbals Yerba mate and Yohimbe and the fiber psyllium, but the researchers concluded that "none of the reviewed dietary supplements can be recommended for over-the-counter use."

Weight loss specialist Madelyn Fernstrom, PhD, says it is not surprising that the evidence does not support the claims that dietary supplements lead to quick and easy weight loss. Fernstrom is director of the weight management center at the University of Pittsburgh Medical Center.

"There is no magic pill," she tells WebMD. "If you are looking to try and moderate your weight loss with the help of a pharmacologic agent, get a prescription medication."

She adds that it is important for people to understand that a supplement isn't necessarily safe because it is unregulated. She cites the products now being sold as "ephedra free," which may be just as dangerous as those containing ephedra.

"There is already a supplement out there that is just as dangerous taking ephedra's place in these products, and it is called bitter orange," she says. "People have to be careful. Just because it comes from the food supply doesn't mean it's safe."

Dec. 8, 2003 -- Television may be killing children's eating habits. A new study shows that the more television children watch, the fewer healthy fruits and vegetables they eat.

The results indicate that watching TV not only contributes to children's bulging waistlines by making them less physically active, but it also negatively affects their food choices.

Researchers say that children spend more time watching television than engaging in any other activity except sleep. On average, children between 2 and 17 watch an average of 22 hours of television a week.

Although prior studies have linked TV viewing to childhood obesity, researchers say that until now little was known about how television affects children's eating choices

TV Kills Kids' Fruits and Veggies

The study, published in the December issue of Pediatrics, tracked the TV viewing and fruit and vegetable consumption of 548 seventh grade public school students for 19 months from 1995 to 1997.

At the start of the study, the children reported eating an average of 4.23 servings of fruits and vegetables per day, which is below the recommended five servings per day. The children also reported watching an average of more than three hours of television per day.

Researchers found that after adjusting for other factors, such as frequency of sit-down dinners and physical activity, the number of fruit and vegetables servings the children ate per day decreased by 0.16 with every additional hour of television viewing reported at the start of the study. That translates to one less serving every six days.

In addition, the number of fruits and vegetable servings decreased by another 0.14 servings per day for each hour increase in TV watching reported at the end of the study.

Researchers say that means the average child who watched three hours per day of television at the start of the study and increased his or her television viewing by one hour per day over the course of the study had 2.25 fewer servings of fruits and vegetables per week or up to 110 fewer servings per year than those who did not watch television.

How TV Affects Children's Eating Habits

Researchers say the commercials children are exposed to may be to blame for the negative impact of TV on their eating habits. Children 2 to 11 years old are exposed to an average of 150 to 200 hours of commercial messages or 20,000 commercials a year.

Previous studies have shown that more than half of those commercials are for food, and little of this marketing is aimed at fruits and vegetables. Many of the commercials targeted at kids also contain misleading messages of about the nutritional value of the foods advertised.

For example, one study showed that more than 90% of cereal advertisements asserted that the food was part of a "balanced" or "complete" breakfast.

Researchers say that kids may also be turned off by food commercials that tout the nutritional content of the food and are encouraged to replace fruits and vegetables with other products that are marketed as "nutritious" but are in fact of little nutritional value.