Miracle Tax Diet

Op-Ed Columnist
By NICHOLAS D. KRISTOF
Published: December 18, 2008
The new soda tax proposed by Gov. David Paterson of New York is a breakthrough. It could raise $400 million a year but could also help make us healthier

http://www.nytimes.com/2008/12/18/opinion/18kristof.html?partner=permalink&exprod=permalink

Now on the Menu, Full Disclosure, and It’s Not Appetizing

By JIM DWYER
Published: December 20, 2008
Look closely at those seven-digit numbers posted next to items on the menu.

http://www.nytimes.com/2008/12/20/nyregion/20about.html?partner=permalink&exprod=permalink

About 1 in 9 US kids use alternative medicine

By MIKE STOBBE
ATLANTA – More than one in nine children and teens use herbal supplements or some other form of alternative medicine, the government said Wednesday, citing a new national survey. It's the first time children's use of such remedies, including acupuncture, meditation, and chiropractic care, has been measured. Adult use of alternative treatments remains about the same as it was in 2002 — more than one in three.

Herbal remedies were the top type of alternative medicine for both adults and those under 18. Leading the list for children were echinacea, used for colds, and fish oil, sometimes given for attention deficit hyperactivity disorder.

Such therapies were most often given for head or neck pain, colds and anxiety. Body aches and insomnia were other top reasons kids got alternative therapies, the study found.

Given that children are generally pretty healthy, the finding that one in nine uses alternative medicine is "pretty amazing," said one of the study's authors, Richard Nahin of the National Center for Complementary and Alternative Medicine.

However, it's difficult to say if that level of use is harmful or beneficial because many therapies have not undergone rigorous scientific testing to gauge their effectiveness, Nahin added.

The study by the U.S. Centers for Disease Control and Prevention is based on a 2007 survey of more than 23,000 adults who were speaking about themselves and more than 9,000 adults who were speaking on behalf of a child in their household.

Vitamin and mineral supplements were not counted as alternative medicine, nor were folk medicine practices or religious healing.

The adults most likely to report using alternative medicine include women, those with advanced college degrees and those who live in the West. Among non-elderly adults, it was used about equally by those with private insurance and those with no health insurance at all.

Kids were five times more likely to use alternative therapies if a parent or other relative did. And those covered by private health insurance were more likely to use it than children who were uninsured or covered by public programs, the government study found.

It's a bit surprising adult use didn't rise more, given other trends, said Michael Cohen, a lawyer who teaches health policy and management at the Harvard School of Public Health. Adult use was 36 percent in 2002, compared to 38 percent last year.

U.S. supplement sales grew about 6 percent from 1998 to 2007, totaling $23.7 billion last year, according to industry data.

Also, in this decade, many academic medical centers and other mainstream health care providers have integrated alternative medicine into their research and patient services. Acupuncturists now work with anesthesiologists, and chiropractors can be found in general hospitals. Insurance coverage and licensing of alternative therapies also is rising, experts said.

"I definitely see a trend," said Cohen, who in his legal work represents doctors who provide complementary and alternative medicine.

There were some differences in how the 2002 and 2007 surveys were done. On the topic of herbal remedies, the 2007 study asked people whether they'd used such a product in the previous 30 days, while the 2002 study asked if they'd taken it in the past year.

In both studies, herbal remedies were the most popular form of alternative medicine in adults; in the latest survey, nearly one in five adults said they had taken a supplement in the previous month.

Among the most common were glucosamine, used for joint pain, and fish oil, often taken by adults to reduce the risk of heart disease.

For adults, pain was by far the main reason adults tried massage, chiropractic care and other alternative therapies.

Many adults say they had trouble getting back pain relief from mainstream medicine. "Some facet of conventional care is not satisfying and they're looking at other options," he said.

The CDC report: http://www.cdc.gov/nchs

A Call for Caution in the Rush to Statins

By TARA PARKER-POPE

Is it time to put cholesterol-lowering statin drugs in every medicine cabinet?

http://www.nytimes.com/2008/11/18/health/18well.html?partner=permalink&exprod=permalink

Scientists Find Clues to Aging in a Red Wine Ingredient’s Role in Activating a Protein

By NICHOLAS WADE
Published: November 27, 2008
Researchers have discovered that a compound in red wine may reverse the chromosomal aging process.

http://www.nytimes.com/2008/11/27/health/27aging.html?partner=permalink&exprod=permalink

Bulging Waist Carries Risk

A bulging waistline may be a stronger predictor of premature death than a person's overall weight, according to a large-scale European study that bolsters the findings of earlier research.
For the study, published in this week's New England Journal of Medicine, researchers tracked nearly 360,000 men and women in nine European countries for about a decade. Study participants ranged in age from 25 to 70.

At the outset, researchers calculated participants' so-called body-mass index. The BMI has been the standard formula for assessing weight. It uses a person's height and weight to come up with a score. A person with a BMI of between 25 and 29.9 points is considered overweight; those with higher scores are deemed obese.
The researchers also measured the circumference of participants' waists as well as the ratio of their waist and hip measurements. In recent years, various studies have shown that the location of body fat -- particularly if it is in the waist area -- can be an important factor in assessing the risk of various diseases and death. Men with waists measuring over 40 inches are considered at a higher-risk; for women, the figure is 35 inches.

A big waist may predict premature death better than overall weight.
Current treatment guidelines call for physicians to measure patients' waists but usually only when their BMI indicates they are overweight, said Tobias Pischon, the study's lead author and a researcher at the German Institute of Human Nutrition, in Potsdam-Rehbruecke, Germany.
For the study, patients were divided into groups according to their BMI, waist circumference and waist-to-hips ratio. During the course of the research, more than 14,723 of them died from various causes.

Researchers found that even patients who would be considered at normal weight, according to their BMI, faced increased risk of death if they had a large waist.
Normal-weight male participants with waists measuring 102.7 centimeters (about 40 inches) or more were twice as likely to die as those with waists measuring 86 centimeters (34 inches) or less. Women who weighed in the normal BMI range but had waists that were 89 centimeters (35 inches) or more were 79% more likely to die than those with waists measuring 70.1 centimeters (28 inches) or less.
The researchers also calculated that, for a five-centimeter, or about two-inch, increase in waist size for patients with any given BMI score, the risk of death increased by 17% for men and by 13% for women. The researchers found similar trends when they compared waist-to-hips ratios.

Rob M. van Dam, a Harvard Medical School professor not involved with the research, said that while the European study doesn't break new ground, its size and breadth make it a "very important" contribution to the field. "They really put it on the table in a very convincing way," said Mr. van Dam, who has been involved in similar research.

Dr. Pischon, the study's lead author, said in an email that the research didn't focus on why larger waists mean a higher death rate, but added that the fat in the abdomen tends to be so-called visceral fat, which builds up around the organs and secretes certain hormones that contribute to the onset of various diseases.
He said future research should focus on whether treatment for weight problems should focus on preventing increases in waist size rather than holding down weight overall.
NOVEMBER 13, 2008
WSJ ROBERT TOMSHO

Some Patients Are Saying ‘Om,’ Not ‘Ah’

In One Section of Beth Israel Hospital, Some Patients Are Saying ‘Om,’ Not ‘Ah’
By ANEMONA HARTOCOLLIS
Published: October 30, 2008
A foundation run by Donna Karan has donated $850,000 for a yearlong experiment combining Eastern and Western healing methods at Beth Israel Medical Center.

http://www.nytimes.com/2008/10/30/nyregion/30yoga.html?partner=permalink&exprod=permalink

Calories Do Count

By KIM SEVERSON
Published: October 29, 2008
Complex diet regimens are starting to look like exotic mortgages and, just like a reliable savings account, good old calorie counting is coming back into fashion.

http://www.nytimes.com/2008/10/29/dining/29calories.html?partner=permalink&exprod=permalink

Applying Science to Alternative Medicine

By WILLIAM J. BROAD
Published: September 30, 2008
While sweeping claims are often made for alternative medicine treatments, the scientific evidence for them often lags behind.

http://www.nytimes.com/2008/09/30/health/research/30tria.html?partner=permalink&exprod=permalink

Searching for Clarity: A Primer on Medical Studies

By GINA KOLATA
Published: September 30, 2008
There are three basic principles that underlie the search for medical truth and the use of clinical trials to obtain it.

http://www.nytimes.com/2008/09/30/health/30stud.html?partner=permalink&exprod=permalink

The Claim: Grape Juice Has the Same Benefits as Red Wine

By ANAHAD O’CONNOR
Published: September 23, 2008
Many teetotalers wonder whether they can reap the cardiovascular benefits from wine’s unfermented sibling.

http://www.nytimes.com/2008/09/23/health/23real.html?partner=permalink&exprod=permalink

Ancient, but How Safe?

By ABBY ELLIN
Published: September 18, 2008
The health industry has questions about metals like lead, mercury or arsenic being found in ayurvedic supplements.

http://www.nytimes.com/2008/09/18/fashion/18skin.html?ex=1379476800&en=36c1686dd7a20cee&ei=5124&partner=permalink&exprod=permalink

Superfood or Monster From the Deep?

By JULIA MOSKIN
Published: September 17, 2008
Major food companies are competing for health-conscious consumers by plugging one food into another and claiming the health benefits of both.

http://www.nytimes.com/2008/09/17/dining/17nutrients.html?ex=1379390400&en=7d65c39db5854908&ei=5124&partner=permalink&exprod=permalink

Instead of Eating to Diet, They’re Eating to Enjoy

By TARA PARKER-POPE
Published: September 17, 2008
Many dieters are shunning deprivation diets and instead focusing on adding seasonal vegetables, nuts, berries and other healthful foods to their plates.

http://www.nytimes.com/2008/09/17/dining/17diet.html?ex=1379476800&en=26bd5ae7bb74c794&ei=5124&partner=permalink&exprod=permalink

6 Food Mistakes Parents Make

By TARA PARKER-POPE
Published: September 15, 2008
Most parents can relate to the daily challenge of finding foods that children will eat.

http://www.nytimes.com/2008/09/15/health/healthspecial2/15eat.html?ex=1379304000&en=916e6480bc36f917&ei=5124&partner=permalink&exprod=permalink

Living Longer, in Good Health to the End

Personal Health
By JANE E. BRODY
Published: August 26, 2008

Getting older doesn’t have to mean getting frailer.

http://www.nytimes.com/2008/08/26/health/26brod.html?ex=1377403200&en=620cea7b9dacd456&ei=5124&partner=permalink&exprod=permalink

Vitamin D Deficiency May Lurk in Babies

By RONI CARYN RABIN
Published: August 26, 2008
Exclusive breast-feeding may be associated with vitamin D deficiency and rickets, recent research suggests.

http://www.nytimes.com/2008/08/26/health/research/26rick.html?ex=1377403200&en=5c6cdd79b5062238&ei=5124&partner=permalink&exprod=permalink

What's Coming From Your Tap?

By ANJALI ATHAVALEY
August 19, 2008; Page D1

America's latest drinking problem isn't about alcohol.

Many pharmaceuticals taken by humans are excreted into urine, or are flushed intentionally down the toilet. Even though wastewater is treated, trace amounts of the drugs are often not eliminated. Also, drugs found in the waste of animals treated with hormones and antibiotics can eventually end up in groundwater.

http://online.wsj.com/article/SB121910526011851511.html

Vitamin D May Play Larger Role in Health

August 19, 2008
Vital Signs
By ERIC NAGOURNEY

A lack of vitamin D has been found in some studies to play an unrecognized role in death among people suffering from a variety of medical problems, including heart disease and cancer.

Now researchers say they have evidence that even in the general population, having too little of the vitamin appears to be associated with a higher risk of death.

Writing in The Archives of Internal Medicine, researchers say they looked at the vitamin D levels and death rates of more than 13,000 people over a period of more than six years.

Those who fell in the lowest quarter of vitamin D levels had a 26 percent higher risk of death from all causes than those in the top quarter, found the study, which was led by Dr. Michal L. Melamed of the Albert Einstein College of Medicine.

About 41 percent of men and 53 percent of women in the United States have levels of the vitamin that are considered too low.

The researchers pointed to other studies looking at the role in disease of vitamin D, which can be found in milk and also comes from exposure to the sun. Researchers have found, for example, that deaths from cardiovascular disease are higher in the winter, when less sun leads to lower levels of vitamin D.

The question now, the study says, is whether taking supplements to raise levels of the vitamin would lower the risk of death.

On the Table: the Calories Lurking in Restaurant Food

HEALTH JOURNAL
By MELINDA BECK
July 29, 2008; Page D1

Studies have shown that even dietitians often underestimate how many calories dishes contain, and no wonder. Applebee's Fiesta Lime Chicken packs 1,290 calories. Pizzeria Uno's Individual Chicago Classic (serves one) has 2,310. Who could eat another bite after an appetizer like T.G.I. Friday's Jack Daniel's Sampler at 2,330? Bear in mind that to maintain their present weight, most men should consume from 2,000 to 2,500 calories a day; most women from 1,500 to 1,800, depending on activity level and size.

See the rest of the story:

http://online.wsj.com/wsjgate?subURI=%2Farticle%2FSB121728720696791385-email.html&nonsubURI=%2Farticle_email%2FSB121728720696791385-lMyQjAxMDI4MTE3OTIxODk3Wj.html

Honey, I Plumped the Kids

By OLIVIA JUDSON
Published: August 10, 2008
Reversing the obesity epidemic may rest on helping women lose weight before they conceive and helping them eat a balanced diet while they are pregnant.

http://www.nytimes.com/2008/08/10/opinion/10Judson.html?ex=1376107200&en=794205adf4f3510a&ei=5124&partner=permalink&exprod=permalink

Does Fructose Make You Fatter?

Tara Parker-Pope
NYT July 24, 2008

High-fructose corn syrup is a sweetener used in many processed foods ranging from sodas to baked goods. While the ingredient is cheaper and sweeter than regular sugar, new research suggests that it can also make you fatter.
In a small study, Texas researchers showed that the body converts fructose to body fat with “surprising speed,'’ said Elizabeth Parks, associate professor of clinical nutrition at the University of Texas Southwestern Medical Center in Dallas. The study, which appears in The Journal of Nutrition, shows how glucose and fructose, which are forms of sugar, are metabolized differently.
In humans, triglycerides, which are a type of fat in the blood, are mostly formed in the liver. Dr. Parks said the liver acts like “a traffic cop” who coordinates how the body uses dietary sugars. When the liver encounters glucose, it decides whether the body needs to store it, burn it for energy or turn it into triglycerides.
But when fructose enters the body, it bypasses the process and ends up being quickly converted to body fat.
“It’s basically sneaking into the rock concert through the fence,” Dr. Parks said. “It’s a less-controlled movement of fructose through these pathways that causes it to contribute to greater triglyceride synthesis. The bottom line of this study is that fructose very quickly gets made into fat in the body.”
For the study, six people were given three different drinks. In one test, the breakfast drink was 100 percent glucose. In the second test, they drank half glucose and half fructose; and in the third, they drank 25 percent glucose and 75 percent fructose. The drinks were given at random, and neither the study subjects nor the evaluators were aware who was drinking what. The subjects ate a regular lunch about four hours later.
The researchers found that lipogenesis, the process by which sugars are turned into body fat, increased significantly when the study subjects drank the drinks with fructose. When fructose was given at breakfast, the body was more likely to store the fats eaten at lunch.
Dr. Parks noted that the study likely underestimates the fat-building effect of fructose because the study subjects were lean and healthy. In overweight people, the effect may be amplified.
Although fruit contains fructose, it also contains many beneficial nutrients, so dieters shouldn’t eliminate fruit from their diets. But limiting processed foods containing high-fructose corn syrup as well as curbing calories is a good idea, Dr. Parks said.
“There are lots of people out there who want to demonize fructose as the cause of the obesity epidemic,” she said. “I think it may be a contributor, but it’s not the only problem. Americans are eating too many calories for their activity level. We’re overeating fat, we’re overeating protein and we’re overeating all sugars.”

Defending Against Disease With Vitamin D

New Studies Suggest It Isn't Just Bones That Might Benefit
July 15, 2008; Page D1

Sunlight, as a source of vitamin D, is free and abundant, at least in most of the world. Supplements are almost as cheap. Yet a growing number of experts think that many people aren't getting enough vitamin D -- particularly those who work and play indoors and slather on sunscreen. And the more experts learn about what D does, the more worrisome a deficiency seems.

It's long been known that D is crucial for strong bones. But new research suggests that it also protects against a wide variety of diseases. A study in the Archives of Internal Medicine last month found that men with low D had a higher risk for heart attacks. Other studies have linked low D with cancer of the breast, ovary, prostate, stomach, bladder, esophagus, kidney and lung. Low levels of D also have been associated with high blood pressure, stroke, diabetes, periodontal disease, rheumatoid arthritis, multiple sclerosis, macular degeneration, mental illness and chronic pain.

"It sounds crazy -- until you realize that vitamin D turns into a steroid hormone that's involved in the maintenance of over 200 human genes," says John J. Cannell, founder of the nonprofit Vitamin D Council in Atascadero, Calif.

The strongest source, by far, is ultraviolet B rays from the sun, which convert a form of cholesterol into vitamin D in the skin. A person sitting outside in a bathing suit in New York City gets more vitamin D in 20 minutes than from drinking 200 glasses of milk. But UVB rays vary greatly depending on latitude, cloud cover, time of year and time of day. Above 42 degrees north latitude (a line from the northern California border to Boston), the sun's rays don't provide sufficient D from November through February. Researchers looking at latitude and disease rates have found some intriguing patterns. Type 1 diabetes, for example, is much rarer in countries like Cuba than in either New Zealand and Sweden.

Dark-skinned and elderly people don't process vitamin D from the sun as efficiently as younger, fair-skinned people. UVB rays also don't penetrate glass or sunscreen with a factor of 8 or more.

It's difficult to get much D through diet. Few foods contain it naturally -- mainly fatty fish like salmon, mackerel and tuna, as well as liver and egg yolks. Since the 1930s, most milk in the U.S. has been fortified with D to prevent rickets, a bone-softening disease.

It's widely accepted that most people need some supplemental D -- the question is, how much? Current U.S. guidelines, issued in 1997, call for 200 international units from birth through age 50; 400 IUs from 51 through age 70 and 600 IUs from 71 on. But many experts and the American Medical Association are urging the government to revisit those numbers in light of the latest research, and the Institute of Medicine is in discussions to do so.

Some groups aren't waiting. The American Academy of Pediatrics says breast-fed infants should get 400 IUs of supplemental D daily. The National Osteoporosis Foundation urges adults over age 50 to get at least 800 to 1,000 IUs to prevent fractures. Look for D3, which is more potent than D2.

You can learn your vitamin D level with a blood test, which costs about $100. It should measure 25-hydroxyvitamin D, not 1,25-dihydroxyvitamin D. A concentration of less than 20 nanograms per milliliter is considered deficient. Many cancer-prevention benefits have been seen at levels of 30 ng/ml or more. Alan Pocinki, an internist in Washington, D.C., has been testing his patients -- mostly white-collar workers with indoor jobs -- and found about half are below 20 ng/ml.

It's not possible to overdose on vitamin D from the sun; it degrades in the skin at high levels. For supplements, the Institute of Medicine set an upper limit of 2,000 IUs per day, but some experts think that's too low. Vitamin D toxicity can involve kidney stones and heart arrhythmias, but cases are very rare.

Does all this D-iscussion leave you D-izzy? "Many people are confused by the conflicting messages," says Len Lichtenfeld, deputy chief medical officer for the American Cancer Society, which suggests getting D from supplements, not the sun. "We need to know more about what the health benefits are, and what the right level is. We're a country of different ethnicities and locations and sensitivities. We probably can't make a one-size-fits-all recommendation."

GETTING YOUR D

Sunlight:
• 20 minutes of noontime sun in New York City in July: 20,000
Foods:
• Cod Liver Oil, 1 Tbs: 1,360
• Salmon, 3.5 oz: 360
• Tuna, canned, 3 oz: 200
• Milk, D-fortified, 1 cup: 98
• Egg yolk, 1: 20
• Liver, 3.5 oz: 15
Supplements:
• Most multivitamins: 400
• Others: 200 to 10,000
Note: In international units

Source: National Institutes of Health, Office of Dietary SupplementsIt's difficult to get much D through diet. Few foods contain it naturally -- mainly fatty fish like salmon, mackerel and tuna, as well as liver and egg yolks. Since the 1930s, most milk in the U.S. has been fortified with D to prevent rickets, a bone-softening disease.

Drugs to Build Bones May Weaken Them

By TARA PARKER-POPE
Published: July 15, 2008

A series of case reports indicates that a rare type of leg fracture is linked to osteoporosis treatment.

http://www.nytimes.com/2008/07/15/health/15well.html?ex=1373774400&en=ed0426a8f9721c44&ei=5124&partner=permalink&exprod=permalink

Resveratrol May Prevent Breast Cancer

In Test Tube, Red Wine Supplement Blocks Estrogen Toxicity
By Daniel J. DeNoon
WebMD Health
July 7, 2008 --

Resveratrol, a nutrient found in red wine, keeps estrogen from causing breast cancer in test-tube studies.

Prolonged exposure to estrogen is a major risk factor for breast cancer. Most research has focused on the interactions between estrogen and estrogen receptors on breast cancer cells.

But when the body's system for processing estrogen gets out of balance, dangerous estrogen metabolites appear. These toxic compounds react with DNA in breast cells and jump-start the growth of tumors.

Now Eleanor G. Rogan, PhD, and colleagues at the University of Nebraska show that resveratrol decreases the processing of estrogen into these dangerous compounds. Perhaps more importantly, it also blocks interactions between estrogen metabolites and cellular DNA.

And that's not all. Rogan's team finds that resveratrol increases production of an enzyme that destroys dangerous estrogen metabolites.

"Resveratrol has the ability to prevent the first step that occurs when estrogen starts the process that leads to cancer," Rogan says in a news release. "We believe that this could stop the whole progression that leads to breast cancer down the road."

The Rogan team's findings come from studies of human breast cells grown in the laboratory. It's a long way from showing that resveratrol can actually prevent cancer in women.

Even so, there's a hopeful sign: Resveratrol had anticancer effects at very low doses.

"This is dramatic because it was able to be done with fairly low concentrations of resveratrol," Rogan says.

A resveratrol concentration of 10 micromoles per liter was able to keep estrogen metabolites from interacting with DNA. A glass of red wine has a resveratrol concentration between 9 and 28 micromoles per liter.

However, a 2007 study in the U.K. suggested that even very high doses of resveratrol do not achieve blood concentrations as high as those needed for anticancer effects.

Resveratrol is a naturally occurring antioxidant found in the skins of red grapes, red wine, red or purple grape juice, peanuts, blueberries, and cranberries. It's also available in dietary supplements.

Although many health claims have been made for resveratrol, the risks and benefits of taking this supplement have not been formally tested in definitive clinical trials.

Rogan and colleagues report their findings in the July issue of Cancer Prevention Research.

Higher vitamin D levels linked to reduced telomere shortening

The November, 2007 issue of the American Journal of Clinical Nutrition published an article describing the discovery of British and American researchers of an association between longer telomeres and increased levels of vitamin D. Telomeres are caps on the ends of chromosomes which have been found to shorten with age, as well as with increased oxidative stress and inflammation. The finding suggests that vitamin D may play a role in slowing the onset of age-related diseases.

Dr J. Brent Richards at King's College, London School of Medicine and colleagues studied 2,160 female twins aged 19 to 79 for the current research. Blood samples were analyzed for serum vitamin D levels, C-reactive protein (CRP, a marker of inflammation) and additional factors, and telomere length was measured in the DNA of peripheral white blood cells (leukocytes).

As expected, older participants had shorter telomeres; however, leukocyte telomere length (LTL) was greater among subjects whose levels of vitamin D were high compared to those with low concentrations, a finding which persisted after adjustment for age and other factors. Participants in the top one-third of serum vitamin D levels had telomeres that averaged 107 base pairs longer than those in the lowest third, equivalent to a five year difference in chronologic aging.

Telomere length was also greater in those with lower C-reactive protein levels than in subjects with higher concentrations. When participants who had the highest CRP and lowest vitamin D concentrations were compared with those who had the lowest CRP and highest vitamin D levels, the difference in telomere length was equivalent to 7.6 years of aging.

In a subset analysis of vitamin D supplement users, those who supplemented were also found to have longer telomeres than those who did not supplement with the vitamin.

In their discussion concerning mechanisms of action, the authors note that inflammation and oxidative stress are key determinants in the biology of aging, and that vitamin D decreases mediators of systemic inflammation such as interleukin-2 and tumor necrosis factor-alpha. While habits that increase oxidative stress and inflammation may be difficult to change, they observe that “vitamin D concentrations are easily modifiable through nutritional supplementation or sunshine exposure.”

“Although both LTL and serum vitamin D concentrations decrease with age and are thus possible markers of aging in general, we have shown that the positive association between LTL and vitamin D concentrations is independent of age and many other covariates,” the authors conclude. “Longitudinal studies or randomized controlled trials of supplementation exploring the effect of vitamin D on LTL will be necessary to unequivocally establish the relation between vitamin D and leukocyte telomere dynamics; but for the moment, our data suggest another potential benefit of vitamin D—on the aging process and age-related disease.”

Using food diaries doubles weight loss, study shows

USA TODAY
07-08-08

Dieters who write down everything they eat each day lose twice as much weight as those who don't, according to one of the largest weight-loss studies ever conducted.

This confirms the importance of keeping a food diary -- advice that nutritionists and weight-loss programs have pushed for years.

Scientists at four clinical research centers recruited 1,685 overweight or obese adults who weighed an average 212 pounds. Forty-four percent were African Americans.

The participants were offered 20 weekly group sessions led by nutritionists and behavior counselors and encouraged to try to lose at least 9 pounds in six months. They were told to consume about 500 fewer calories a day, eat plenty of fruits and vegetables, do about 180 minutes of moderate-intensity physical activity a week, and keep daily food and exercise records.

The findings reported in the August issue of the American Journal of Preventive Medicine:

*Dieters who kept their food diary six or more days a week lost an average of about 18 pounds in six months, compared with about 9 pounds for those who didn't keep food diaries.

*The biggest losers also attended most of the group meetings and did more exercise. Some did 300 minutes or more of physical activity a week, but the average participant in the study did about 117 minutes a week.

*69% of the participants lost 9 pounds or more, which is enough to improve some health measures such as blood pressure, joint pain and pre-diabetes.

*69% of black men and 59% of black women lost at least 9 pounds.

"There is a misconception that nobody can lose weight, but in this study, two-thirds of them lost enough weight to make a difference to their health," says Victor Stevens, senior investigator at the Kaiser Permanente Center for Health Research in Portland, Ore. The National Heart, Lung, and Blood Institute sponsored the study.

These weight-loss techniques work well with everybody, including African Americans, who are often underrepresented in studies and yet suffer from a high rate of obesity and weight-related illnesses, he says.

Food diaries are a "powerful self-management technique. They help you figure out where the extra calories are coming from," he says. It works best if someone else looks over your food record. "When you put yourself in a position where you are accountable for your behavior, it changes behavior."

Many people are getting lots of extra calories by eating large portions at restaurants, Stevens says. He is currently working with a client who was consuming 1,500 calories of fast food at lunch. The dieter is now bringing a 500-calorie lunch to work, saving 1,000 calories a day.

Dawn Jackson Blatner, a registered dietitian in Chicago, tells people that a food diary "is the best way to monitor every crumb, morsel, nibble, sip, swallow and bite you take."

The 11 Best Foods You Aren’t Eating

By Tara Parker-Pope
Published: June 30, 2008
An unusual list of foods that probably aren't in your shopping cart.

http://well.blogs.nytimes.com/2008/06/30/the-11-best-foods-you-arent-eating/

Lying About Your Vegetables

By Tara Parker-Pope
Published: July 1, 2008
Many people overstate their fruit and vegetable consumption, a new study suggests.

http://well.blogs.nytimes.com/2008/07/01/lying-about-your-vegetables/

Real Thought for Food for Long Workouts

By GINA KOLATA
Published: June 5, 2008
How much truth is there to the myth that athletes should have a protein and carbohydrates mix within a certain time frame after workouts or else they risk slowing their recovery?

http://www.nytimes.com/2008/06/05/health/nutrition/05Best.html?ex=1370404800&en=b18a01a83c755d7f&ei=5124&partner=permalink&exprod=permalink

Mediterranean Diet May Cut Diabetes Risk

By NICHOLAS BAKALAR
Published: June 10, 2008

Sticking to the Mediterranean diet — rich in olive oil, grains, fruits, nuts, vegetables and fish, and low in meats and dairy — may lower the risk for diabetes.

Scientists followed 13,380 healthy Spanish university graduates for an average of four and a half years, tracking their dietary habits and confirming new cases of diabetes through medical records. The study was published online May 29 in The British Medical Journal.

The researchers ranked the strictness of adherence to the diet on a 10-point scale, and found that those with the highest scores reduced their relative risk of diabetes by 83 percent compared with those with the lowest.

The authors acknowledge that the number of cases of diabetes they found was small, which limits the statistical power of the finding, and that the nutritional information is based on self-reporting, which is not always reliable.

Still, the large sample and the finding of a dose-response relationship between stricter adherence to the diet and lowered risk of diabetes give the study strength.

“There are good fats, like those in olive oil, that are quite healthful,” said Miguel A. Martínez-González, the lead author and a professor of epidemiology at the University of Navarra. “We have to change this belief that a low-fat diet is the key to good health.”

Experts Revive Debate Over Cellphones and Cancer

By TARA PARKER-POPE
Published: June 3, 2008
What do brain surgeons know about cellphone safety that the rest of us don’t?

http://www.nytimes.com/2008/06/03/health/03well.html?ex=1370232000&en=67e663973d172d0d&ei=5124&partner=permalink&exprod=permalink

New Hints Seen That Red Wine May Slow Aging

By NICHOLAS WADE
Published: June 4, 2008
Red wine may be much more potent than was thought in extending human life span, a new report suggests.
http://www.nytimes.com/2008/06/04/health/research/04aging.html?ex=1370318400&en=76bfeae177c1db5a&ei=5124&partner=permalink&exprod=permalink

A Low Dose of Dietary Resveratrol Partially Mimics Caloric Restriction and Retards Aging Parameters in Mice(PLoS One)
http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0002264

Lotus Therapy

By BENEDICT CAREY
Published: May 27, 2008
Mindfulness meditation has become perhaps the most popular new psychotherapy technique of the past decade.

http://www.nytimes.com/2008/05/27/health/research/27budd.html?ex=1369627200&en=243cf577038c27b1&ei=5124&partner=permalink&exprod=permalink

Eating Your Way to a Sturdy Heart

By TARA PARKER-POPE
Published: May 13, 2008

When it comes to improving heart health, it’s important to look beyond the medicine cabinet and to the kitchen.

http://www.nytimes.com/2008/05/13/health/13heart.html?ex=1368417600&en=3139bdc2b103ad98&ei=5124&partner=permalink&exprod=permalink

Finding the Best Way to Cook All Those Vegetables

By TARA PARKER-POPE
Published: May 20, 2008
By now, most people know they should be eating more vegetables. But are there ways to get more from the vegetables you already eat? A growing body of research shows that when it comes to vegetables, its not only how much we eat, but how we prepare them, that influences the amount of phytochemicals, vitamins and other nutrients that enter our body.

http://query.nytimes.com/gst/fullpage.html?res=9C01E5DF1239F933A15756C0A96E9C8B63&sec=&spon=&partner=permalink&exprod=permalink

Breast-Feeding Tied to Intelligence

By NICHOLAS BAKALAR
Published: May 13, 2008
In a large randomized trial of human lactation, researchers have found evidence that prolonged breast-feeding is associated with improved scores on some intelligence tests in childhood. The results, published in the May issue of The Archives of General Psychiatry, appear to confirm those of previous observational studies.

http://query.nytimes.com/gst/fullpage.html?res=9907E0DA1739F930A25756C0A96E9C8B63&sec=&spon=&partner=permalink&exprod=permalink

Evidence a High-Fat Diet Works to Treat Epilepsy

By ALIYAH BARUCHIN
Published: May 6, 2008
A formerly controversial high-fat diet has proved highly effective in reducing seizures in children whose epilepsy does not respond to medication, British researchers are reporting. As the first randomized trial of the diet, the new study lends legitimacy to a treatment that has been used since the 1920s but has until recently been dismissed by many doctors as a marginal alternative therapy.

http://query.nytimes.com/gst/fullpage.html?res=9C01E6DA143FF935A35756C0A96E9C8B63&sec=&spon=&partner=permalink&exprod=permalink

EU urged to ban food additives over child hyperactivity fears

BRUSSELS (AFP) - Europe's main consumer watchdog called Thursday for an EU-wide ban on six food colourings which a scientific study has linked to hyperactivity in children.

"It is unacceptable to leave on the market substances strongly suspected to increase hyperactivity in children while having no added value at all except colouring food," said Monique Goyens, head of the BEUC consumers association.

"The European Union must place the health of its most vulnerable consumers before any other interest," she said in a statement backed by 41 interest groups.

A study published in September in the British science review, The Lancet, found that a cocktail of artificial colours and the commonly-used preservative sodium benzoate are linked to hyperactivity in children.

In the past decade, hyperactivity has -- apparently -- ballooned into serious proportions in some countries, stirring controversy along the way.

US doctors commonly see it as a medical condition (attention-deficit hyperactivity disorder, ADHD) and prescribe a potent drug, ritalin, to treat it.

Other experts speculate that hyperactivity has social causes such as home instability and poor education, and say use of powerful, mind-altering drugs is dangerous.

The study, conducted by researchers at Southampton University in southern England, recruited 153 local three-year-olds and 144 children aged eight or nine.

The six food colourings in question are Tartrazine (EU reference E102), Quinoline Yellow (E104), Sunset Yellow (E110), Carmoisine (E122), Ponceau 4R (E124) and Allura Red (E129).


http://news.yahoo.com/s/afp/20080410/hl_afp/euhealthchildrenfoodadditiveshyperactivity_080410185439

Review raises questions over aspartame and brain health

Excessive intake of aspartame may inhibit the ability of enzymes in the brain to function normally, suggests a new review that could fan the flames of controversy over the sweetener.

The review, published recently in the European Journal of Clinical Nutrition, indicated that high consumption of the sweetener may lead to neurodegeneration.

http://www.foodnavigator.com/news/ng.asp?n=84424-aspartame-sweetener

Can we delay aging?

Increased exercise can increase telomere length and longer telomeres has been associated with longer life (see July 2007 post on meditation and telomere length).
Telomeres are found on the tips of chromosomes and they shorten as people age. In this study published in Archives of Internal Medicine (Jan 28, 2008) those subjects who exercised the most had the longest telomeres.


http://www.ncbi.nlm.nih.gov/pubmed/18227361

Some With MS Put Their Hopes in a Diet

Gluten free/ casein free, rich in essential fatty acids particularly omega 3, and let's not forget to check Vitamin D levels...

By JANE E. BRODY
Published: March 11, 2008
What you are about to read is not an endorsement of any particular diet as a therapy for multiple sclerosis.

http://www.nytimes.com/2008/03/11/health/11brod.html?ex=1362974400&en=8a7f446917534132&ei=5124&partner=permalink&exprod=permalink

Drugs found in drinking water

A vast array of pharmaceuticals — including antibiotics, anti-convulsants, mood stabilizers and sex hormones — have been found in the drinking water supplies of at least 41 million Americans, an Associated Press investigation shows.

There's growing concern in the scientific community, meanwhile, that certain drugs — or combinations of drugs — may harm humans over decades because water, unlike most specific foods, is consumed in sizable amounts every day.

Our bodies may shrug off a relatively big one-time dose, yet suffer from a smaller amount delivered continuously over a half century, perhaps subtly stirring allergies or nerve damage. Pregnant women, the elderly and the very ill might be more sensitive.

Many concerns about chronic low-level exposure focus on certain drug classes: chemotherapy that can act as a powerful poison; hormones that can hamper reproduction or development; medicines for depression and epilepsy that can damage the brain or change behavior; antibiotics that can allow human germs to mutate into more dangerous forms; pain relievers and blood-pressure diuretics.

For several decades, federal environmental officials and nonprofit watchdog environmental groups have focused on regulated contaminants — pesticides, lead, PCBs — which are present in higher concentrations and clearly pose a health risk.

However, some experts say medications may pose a unique danger because, unlike most pollutants, they were crafted to act on the human body.

"These are chemicals that are designed to have very specific effects at very low concentrations. That's what pharmaceuticals do. So when they get out to the environment, it should not be a shock to people that they have effects," says zoologist John Sumpter at Brunel University in London, who has studied trace hormones, heart medicine and other drugs.

http://news.yahoo.com/s/ap/20080310/ap_on_re_us/pharmawater_i

NYC: Traces of sedatives in NYC water - Yahoo! News
http://news.yahoo.com/s/ap/20080310/ap_on_re_us/pharmawater_nyc_water

VIDEO: Pharmaceuticals found in drinking water
http://cosmos.bcst.yahoo.com/ver/256.0/popup/index.php?cl=6888171

Concern in Europe on Cellphone Ads for Children

Technology
Concern in Europe on Cellphone Ads for Children
By DOREEN CARVAJAL
Published: March 8, 2008

Driven in part by a lack of knowledge over the long-term health effects of mobile phone use, parent groups in Europe have called for a ban on marketing to children.

While there is no specific evidence that mobile telephones pose a health threat to young users, researchers worry that there is still only scanty scientific information about the long-term impact of radio frequency electromagnetic fields emitted by mobile telephones on the developing brains and tissues of children.

http://www.nytimes.com/2008/03/08/technology/08mobile.html?ex=1362718800&en=14ff8a0964418120&ei=5124&partner=permalink&exprod=permalink

I Need a Virtual Break. No, Really.

By MARK BITTMAN
Published: March 2, 2008
The author tries taking a real day off by fully disconnecting himself from his cellphone, land line and computer. A "day of rest" gives him his life back.

http://www.nytimes.com/2008/03/02/fashion/02sabbath.html?ex=1362114000&en=74ad7f9264b36784&ei=5124&partner=permalink&exprod=permalink

Cholesterol Myth

Does lowering cholesterol really reduce CVD mortality? Listen to Dr. Hyman's videoblog.

http://www.ultrawellness.com/blog/medical-industrial-complex

Consumption of Meat, Fried Foods, and Diet Soda May Increase the Risk of Developing the Metabolic Syndrome

In a prospective study involving 9,514 subjects between the ages of 45 and 64 years, consumption of a "Western" dietary pattern, including meat, fried foods, and diet soda, was found to be associated with the development of the Metabolic Syndrome (MetSyn). Food-frequency questionnaires were used to assess subjects' dietary intakes, from which "Western" and "prudent" dietary patterns were derived. 3,782 cases of MetSyn were reported over the course of a 9 year follow-up. After adjusting for various potentially confounding factors, adherence to a Western dietary pattern was found to be associated with development of MetSyn. Further analysis of individual food groups found that meat, fried foods, and diet soda were each independently associated with the MetSyn. Dairy consumption, on the other hand, was found to have a beneficial effect. The authors conclude, "These prospective findings suggest that consumption of a Western dietary pattern, meat, and fried foods promotes the incidence of MetSyn, whereas dairy consumption provides some protection. The diet soda association was not hypothesized and deserves further study."

Lutsey, P.L., Steffen, L.M., Stevens, J. (2008). Dietary intake and the development of the metabolic syndrome: The Atherosclerosis Risk in Communities Study. Circulation, 117 (6): 754-61.

An Oldie Vies for Nutrient of the Decade

NYT February 19, 2008

Researchers are trying to understand how much vitamin D is necessary for optimal health. Are you taking enough?

http://www.nytimes.com/2008/02/19/health/19brod.html?ex=1361163600&en=abade0993ceae829&ei=5124&partner=permalink&exprod=permalink

Gentlemen, 5 Easy Steps to Living Long and Well

By NICHOLAS BAKALAR
Published: NYT February 19, 2008
Five behaviors in elderly men are associated not only with living into extreme old age, a new study has found, but also with good health and independent functioning.

http://www.nytimes.com/2008/02/19/health/19agin.html?ex=1361163600&en=5db0c3d4c165532e&ei=5124&partner=permalink&exprod=permalink

Good Question: Do Cellphones Affect Fertility?

By Tara Parker-Pope
Published: February 19, 2008

A reader asks about the links between cell phone use and fertility.
http://well.blogs.nytimes.com/2008/02/19/the-inbox-cell-phones-and-sperm/

Can a Drug That Helps Hearts Be Harmful to the Brain?

More good news for statin drugs...

WSJ- February 12, 2008

Cognitive side effects like memory loss and fuzzy thinking aren't listed on the patient information sheet for Lipitor, the popular cholesterol-lowering drug. But some doctors are voicing concerns that in a small portion of patients, statins like Lipitor may be helping hearts but hurting minds.

"This drug makes women stupid," Orli Etingin, vice chairman of medicine at New York Presbyterian Hospital, declared at a recent luncheon discussion sponsored by Project A.L.S. to raise awareness of gender issues and the brain. Dr. Etingin, who is also founder and director of the Iris Cantor Women's Health Center in New York, told of a typical patient in her 40s, unable to concentrate or recall words. Tests found nothing amiss, but when the woman stopped taking Lipitor, the symptoms vanished. When she resumed taking Lipitor, they returned.

Pfizer Inc.'s Lipitor is the world's best-selling medicine, with revenues of $12.6 billion in 2007. The company says that its safety and efficacy have been demonstrated in more than 400 clinical trials and 145 million patient years of experience, and that the extensive data "do not establish a causal link between Lipitor and memory loss." Pfizer also says it draws conclusions about adverse events from a variety of sources "as opposed to anecdotal inferences by individual providers with a limited data pool."

World-wide, some 25 million people take statins, including Zocor, Mevacor, Crestor, Pravachol and Vytorin. As a group, they are widely credited with reducing heart attacks and strokes in people at high risk, though the benefits are less clear in people who are not at high risk, particularly women and the elderly. Some 15% of patients complain of side effects; muscle aches and liver toxicity are the most recognized to date. But anecdotes linking statins to memory problems have been rampant for years.

On balance, most cardiologists see little cause for concern. "The benefits far outweigh the risks," says Antonio Gotto, dean of the Weill-Cornell Medical School and past president of the American Heart Association. Dr. Gotto, who has consulted for most of the statin makers and been involved in many of the trials, says "I would hate to see people frightened off taking statins because they think it's going to cause memory loss."

Thinking and memory problems are difficult to quantify, and easy for doctors to dismiss. Many people who take statins are elderly and have other conditions and medications that could have cognitive side effects.

Still, the chronology can be very telling, says Gayatri Devi, an associate professor of neurology and psychiatry at New York University School of Medicine, who says she's seen at least six patients whose memory problems were traceable to statins in 12 years of practice. "The changes started to occur within six weeks of starting the statin, and the cognitive abilities returned very quickly when they went off," says Dr. Devi. "It's just a handful of patients, but for them, it made a huge difference."

Researchers at the University of California at San Diego are nearing completion of a randomized controlled trial examining the effects of statins on thinking, mood, behavior, and quality of life. Separately, the UCSD researchers are collecting anecdotal experiences of patients, good and bad, on statins; memory problems are the second most common side effect, after muscle aches, in about 5,000 reports to date.

Still, the chronology can be very telling, says Gayatri Devi, an associate professor of neurology and psychiatry at New York University School of Medicine, who says she's seen at least six patients whose memory problems were traceable to statins in 12 years of practice. "The changes started to occur within six weeks of starting the statin, and the cognitive abilities returned very quickly when they went off," says Dr. Devi. "It's just a handful of patients, but for them, it made a huge difference."

Researchers at the University of California at San Diego are nearing completion of a randomized controlled trial examining the effects of statins on thinking, mood, behavior, and quality of life. Separately, the UCSD researchers are collecting anecdotal experiences of patients, good and bad, on statins; memory problems are the second most common side effect, after muscle aches, in about 5,000 reports to date.

"We have some compelling cases," says Beatrice Golomb, the study's lead researcher. In one of them, a San Diego woman, Jane Brunzie, was so forgetful that her daughter was investigating Alzheimer's care for her and refused to let her babysit for her 9-year-old granddaughter. Then the mother stopped taking a statin. "Literally, within eight days, I was back to normal -- it was that dramatic," says Mrs. Brunzie, 69 years old.

Doctors put her on different statins three more times. "They'd say, 'Here, try these samples.' Doctors don't want to give up on it," she says. "Within a few days of starting another one, I'd start losing my words again," says Mrs. Brunzie, who has gone back to volunteering at the local elementary school she loves and is trying to bring her cholesterol down with dietary changes instead.

"I feel very blessed -- I got about 99% of my memory back," she adds. "But I worry about people like me who are starting to lose their words who may think they have just normal aging and it may not be."

Of course, not every case of mental decline can be reversed by stopping statins. In fact, there's some evidence that statins may ward off Alzheimer's by reducing plaque and inflammation in the brain.

On the other hand, the brain is largely cholesterol, much of it in the myelin sheaths that insulate nerve cells and in the synapses that transmit nerve impulses. Lowering cholesterol could slow the connections that facilitate thought and memory. Statins may also lead to the formation of abnormal proteins seen in the brains of Alzheimer's patients.

The cognitive changes can affect men as well as women. But women on statins are often simultaneously losing estrogen due to menopause, which can also cause cognitive changes. "Women are getting hit with a double whammy," says Elizabeth Lee Vliet, a women's health physician in Tucson, Ariz., who has a background in neuroendochronology.

Side effects are always highly individual. Most patients tolerate statins very well, and heart disease remains the leading cause of death in the U.S. for men and women.

But it pays to think hard about whether you really need to be on a statin -- or if you could accomplish your goals with diet and exercise instead. "Some people want to take a pill and think they can eat whatever they want," says Nieca Goldberg, a cardiologist and medical director of the Women's Heart Program at the New York University School of Medicine. She says she typically prescribes statins for women who have elevated cholesterol and have already had a heart attack. But for younger women with high cholesterol and no other risk factors, she encourages lifestyle changes.

"I try to initiate diet modifications and physical activity in all my patients -- even if they still need medication, I can give them a lower dose," says Dr. Goldberg. "I try to make the point that we are all in this together."

If you do need to be on cholesterol-lowering medication, pay close attention to any side effects and talk with your doctor. You may have a different experience with a different dose or different statin. Also remember that the doctor taking care of your heart condition may not be as experienced in other body parts. "You really need a balanced approach," says Dr. Vliet. But "each physician may be looking at only one part of the elephant -- that's the way medicine is practiced in the U.S.

As Jane Brunzie says, "I learned through this experience that you have to use your own brain, as well as your doctor's brain, when it comes to your health."

http://online.wsj.com/article_email/SB120277403869360595-lMyQjAxMDI4MDEyNjcxNzY0Wj.html#CX

Cell phone linked to salivary gland tumors

TEL AVIV, Israel, Feb. 14 (UPI) -- An Israeli scientist is investigating a possible link between heavy cell phone use and tumors of the salivary gland.

Dr. Siegal Sadetzki of Tel Aviv University investigated nearly 500 people who had been diagnosed with benign and malignant tumors of the salivary gland and found that frequent cell phone users had a higher risk of developing tumors, the university said Thursday in a release.

Patients who used a cell phone heavily on the side of the head where the tumor developed were found to have a 50 percent greater risk of developing a tumor of the parotid salivary gland, compared to those who did not use cell phones.

The report was published in the American Journal of Epidemiology.

"Unlike people in other countries, Israelis were quick to adopt cell phone technology and have continued to be exceptionally heavy users," Sadetzki said in a statement. "Therefore, the amount of exposure to radio frequency radiation found in this study has been higher than in previous cell phone studies."

Sadetzki recommends that people use hands-free devices at all times, hold the phones away from the body while talking and make fewer and shorter phone calls.

Lights at Night Are Linked to Breast Cancer

washingtonpost.com

02-20-08

Women who live in neighborhoods with large amounts of nighttime illumination are more likely to get breast cancer than those who live in areas where nocturnal darkness prevails, according to an unusual study that overlaid satellite images of Earth onto cancer registries.

The finding adds credence to the hypothesis that exposure to too much light at night can raise the risk of breast cancer by interfering with the brain's production of a tumor-suppressing hormone.

"By no means are we saying that light at night is the only or the major risk factor for breast cancer," said Itai Kloog, of the University of Haifa in Israel, who led the new work. "But we found a clear and strong correlation that should be taken into consideration."

Scientists have known for years that rats raised in cages where lights are left on for much of the night have higher cancer rates than those allowed to sleep in darkness. And epidemiological studies of nurses, flight attendants and others who work at night have found breast cancer rates 60 percent above normal, even when other factors such as differences in diet are accounted for.

On the basis of such studies, an arm of the World Health Organization announced in December its decision to classify shift work as a "probable carcinogen." That put the night shift in the same health-risk category as exposure to such toxic chemicals as trichloroethylene, vinyl chloride and polychlorinated biphenyls (PCBs).

The mechanism of such a link, if real, remains mysterious, but many scientists suspect that melatonin is key. Secreted by the pineal gland in the brain, the hormone helps prevent tumor formation. The body produces melatonin primarily at night, and levels drop precipitously in the presence of light, especially light in the blue part of the spectrum produced in quantity by computer screens and fluorescent bulbs.

In keeping with the melatonin hypothesis, mice in cages with night lighting have normal cancer rates if they get shots of the hormone. And blind women, whose eyes cannot detect light and so have robust production of melatonin, have lower-than-average breast cancer rates.

Kloog and his colleagues took a previously untried approach to testing the link. They obtained satellite data from NASA that showed in great detail how much light was emitted spaceward from neighborhoods throughout Israel.

Although the light levels that reached the satellite were about one-tenth their intensity on Earth, the approach provides an accurate measure of which areas are brighter or darker than others and by how much.

The team then overlaid that map with local statistics on cases of breast cancer and, for comparison, lung cancer, which is caused mostly by smoking and so would not be expected to be linked to light.

After using neighborhood data to correct for other factors that can affect cancer rates, including wealth, ethnicity and the average number of children in families living in those localities, the researchers found no link between night lighting and lung cancer, they report in this week's online issue of the journal Chronobiology International.

But the researchers found the breast cancer rate in localities with average night lighting to be 37 percent higher than in communities with the lowest amount of light; and they noted that the rate was higher by an additional 27 percent in areas with the highest amount of light.

Abraham Haim, a University of Haifa chronobiologist involved in the study, said the findings raise questions about the recent push to switch to energy-efficient fluorescent bulbs, which suppress melatonin production more than conventional incandescent bulbs. "This may be a disaster in another 20 years," Haim said, "and you won't be able to reverse what we did by mistake." He called for more research before policies favoring fluorescent lights are implemented, and for more emphasis on using less light at night.

Jim Burch, a University of South Carolina epidemiologist and biostatistician familiar with the study, called the approach and findings "fascinating."

"The study has limitations," including not measuring levels of indoor lighting, "but it supports the overall idea," Burch said. "I think there is enough evidence to suggest we ought to be thinking about this more carefully."

For more news, or to subscribe to the newspaper, please visit http://www.washingtonpost.com

Artificial Sweeteners Linked to Weight Gain

New research indicates that saccharin and other sugar substitutes may not be such a sweet deal for weight watchers
By Lisa Stein

You know those no-guilt diet drinks you chug by the gallon, and the fake sugar you dump in your coffee to stay trim? Bad news: a new study suggests that artificial sweeteners may actually make it harder to control your weight.

Psychologists at Purdue University's Ingestive Behavior Research Center report that nine rats given yogurt sweetened with no-cal saccharin ended up eating more and gaining more weight and body fat than eight fellow rodents given yogurt containing plain old glucose (a simple sugar with about 15 calories per teaspoon, the same as table sugar).

Study authors Susan Swithers and Terry Davidson speculate the reason is that the faux sweetener messes with the brain, fooling it into revving up the body's metabolism in anticipation of a never-to-come calorie load.

Typically, they say, the taste buds, sensing something sweet, signal the brain to prep the digestive system to gear up for a caloric onslaught; when the expected sugar jolt (extra calories) fails to materialize, the body gets rattled and has trouble bouncing back and regulating appetite when other food is available. As a result, rats eat more or expend less energy than they would have had they had the real thing.

"The data clearly indicate that consuming a food sweetened with no-calorie saccharin can lead to greater body-weight gain and adiposity [fat] than would consuming the same food sweetened with a higher-calorie sugar," the authors write in the journal Behavioral Neuroscience. They say that other artificial sweeteners—aspartame, sucralose and acesulfame—could have a similar effect.

The researchers note that the findings jive with other emerging evidence—including a study published last month in the American Heart Association's journal, Circulation—that shows people who down diet drinks are at a higher risk for obesity and metabolic syndrome (a medley of medical problems such as abdominal fat, high blood pressure and insulin resistance that puts people at risk for heart disease and diabetes).

They acknowledge, however, that more research is needed. After all, just because this counterintuitive effect may occur in rats does not necessarily mean it also happens in humans. Still, let it serve as a warning to anyone who may have a false sense of security that artificial sweeteners are all it takes to be fit and healthy.

Behavioral Neuroscience

http://www.apa.org/journals/releases/bne-feb08-swithers.pdf

Even More Bad News for Diet Soda

Vital Signs
Symptoms: Metabolic Syndrome Is Tied to Diet Soda
By NICHOLAS BAKALAR
Published: February 5, 2008
Researchers have found a correlation between drinking diet soda and metabolic syndrome and elevated blood pressure.

http://circ.ahajournals.org/cgi/content/abstract/CIRCULATIONAHA.107.716159v1

Hawthorn Berry Eases Symptoms of Heart Failure

Vital Signs
Regimens: An Herbal Extract Eases Symptoms of Heart Failure
By NICHOLAS BAKALAR
Published: February 5, 2008
The herbal supplement hawthorn extract is effective in treating symptoms of chronic heart failure, new research suggests.

http://www.cochrane.org/reviews/en/ab005312.html

Outcomes: Heeding Familiar Advice May Add Years to Your Life

Vital Signs
Outcomes: Heeding Familiar Advice May Add Years to Your Life
By NICHOLAS BAKALAR
Published: January 22, 2008
Researchers have calculated just how many years you can add to your life by adopting healthy habits.

http://www.nytimes.com/2008/01/22/health/research/22outc.html?ex=1358658000&en=b32a513751e20341&ei=5124&partner=permalink&exprod=permalink

http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371/journal.pmed.0050012

More bad news about cola beverages

Really?
The Claim: Too Much Cola Can Cause Kidney Problems
By ANAHAD O’CONNOR
Published: January 22, 2008
When it comes to kidney problems, is there a difference between colas and other kinds of soda?

http://www.nytimes.com/2008/01/22/health/nutrition/22real.html?ex=1358658000&en=bfaaf54ba7f71c7a&ei=5124&partner=permalink&exprod=permalink

What’s Cholesterol Got to Do With It?

Driven by the fervor of the pharmaceutical industry relentlessly promoting the use of cholesterol lowering medications, doctors are advocating bringing down total cholesterol and LDL cholesterol to unaturally low levels. It is finally about time to reevaluate the key risk factors for heart disease.


Op-Ed Contributor
What’s Cholesterol Got to Do With It?
By GARY TAUBES
Published: January 27, 2008
The truth is, we’ve always had reason to question the idea that cholesterol is an agent of disease.

http://www.nytimes.com/2008/01/27/opinion/27taubes.html?ex=1359090000&en=8b0a1260ba521c07&ei=5124&partner=permalink&exprod=permalink

High Mercury Levels Are Found in Tuna Sushi

By MARIAN BURROS
Published: January 23, 2008
Tests on sushi bought in Manhattan revealed mercury levels that exceed accepted safety standards.

http://www.nytimes.com/2008/01/23/dining/23sushi.html?ex=1358830800&en=48af12845334336a&ei=5124&partner=permalink&exprod=permalink

FDA Opens "Pandora's Box" by Approving Food from Clones for Sale

(January 15, 2008) Washington, DC - Today, the Center for Food Safety (CFS) condemned the Food and Drug Administration's (FDA) irresponsible determination that milk and meat from cloned animals are safe for sale to the public. In addition, the FDA is requiring no tracking system for clones or labeling of products produced from clones or their offspring. This action comes at a time when the U.S. Senate has voted twice to delay FDA's decision on cloned animals until additional safety and economic studies can be completed by the National Academy of Sciences and the United States Department of Agriculture (USDA).

"The FDA's bullheaded action today disregards the will of the public and the Senate - and opens a literal Pandora's Box," said Andrew Kimbrell, CFS Executive Director. "FDA based their decision on an incomplete and flawed review that relies on studies supplied by cloning companies that want to force cloning technology on American consumers. FDA's action has placed the interests of a handful of biotech firms above those of the public they are charged with protecting."

With FDA's release of their controversial risk assessment today, CFS joins dozens of other food industry, consumer, and animal welfare groups, as well as federal lawmakers in calling for swift action on the part of Congress to pass the 2007 Farm Bill containing provisions delaying FDA's release of clones into the food supply. The Farm Bill currently contains an amendment, advanced by Senator Barbara A. Mikulski (D-MD.) and co-sponsored by Senator Arlen Specter (R-PA), requiring a rigorous and careful review of the human health and economic impacts of allowing cloned food into America's food supply. The Senate overwhelmingly passed the bill by a vote of 79 to 14.

"The passage of this bill with the Mikulski-Specter amendment sends a strong message that the FDA has failed the public again by taking an inadequate and half-baked look at the safety of food products from cloned animals and their offspring," said Joseph Mendelson, CFS Legal Director. "The FDA's cavalier approach to cloned food and its potential impacts calls for the remedy of a truly rigorous scientific assessment, and Congress has now repeatedly called for such action."

The Farm Bill amendment addresses the gaps and inadequacies of the FDAs current risk assessment, and would go into effect before any food products from clones are marketed. The Farm Bill also directs the USDA to examine consumer acceptance of cloned foods and the likely impacts they could have on domestic and international markets. (Click here for more information on this amendment).

Additionally, the FDA is today issuing a guidance document for food producers; It fails to require any special procedures for tracking or handling food products from clones. It also fails to require labeling of any kind on food products from clones or their offspring, which deprives consumers of their right to know about the origins of their food.

Recently, two cloning companies - Viagen and Trans Ova, proposed the creation of a voluntary cloning registry program. While they advanced claims that the registry would provide consumer protection and transparency without regulation, clones and their progeny will still be dispersed through the food system without any tracking or labeling.

"The cloning industry's proposal is simply another attempt to force cloned milk and meat on consumers and the dairy industry by giving the public phony assurances," said Mendelson. "The proposal neither provides new studies on the safety of clones nor protects the consumers' right to know whether their food or dairy contains products from clones. Once clones are released into America's food supply without any traceability requirements, it will be difficult, if not impossible, to recall them."

Recent opinion polls show the majority of Americans do not want milk or meat from cloned animals in their food. A December 2006 poll by the Pew Initiative on Food and Biotechnology found that nearly two-thirds of U.S. consumers were uncomfortable with animal cloning. A national survey conducted this year by Consumers Union found that 89 percent of Americans want to see cloned foods labeled, while 69 percent said that they have concerns about cloned meat and dairy products in the food supply. A recent Gallup Poll reported that more than 60 percent of Americans believe that it is immoral to clone animals, while the Pew Initiative on Food and Biotechnology found that a similar percentage say that, despite FDA approval, they won't buy milk from cloned animals.

In its risk assessment of cloned food, the FDA claims to have evaluated extensive peer reviewed safety studies to support its conclusion, yet a recent report issued by CFS, Not Ready for Prime Time, shows the assessment only references three peer-reviewed food safety studies, all of which focus on the narrow issue of milk from cloned cows. What is even more disturbing is that these studies were partially funded by the same biotech firms that produce clones for profit.

New studies, different outcomes on caffeine, pregnancy

One study found that consuming 200 milligrams or more of caffeine per day doubled the risk of miscarriage.

USA TODAY
Most women know they shouldn't smoke or drink alcohol while pregnant. But what about caffeine?

Two new studies reach somewhat different conclusions about the connection between drinking caffeine and miscarriage risk, an inconsistency that dates back to the 1980s, when scientists began investigating the subject.

It's plausible that caffeine could trigger a miscarriage, a pregnancy loss before 20 weeks gestation. Caffeine crosses the placenta, but a fetus is not able to metabolize it. Caffeine might adversely affect cell development in the fetus and decrease blood flow in the placenta.

But some scientists have speculated that caffeine only appears to increase miscarriage risk because women with morning sickness, who are more likely to carry a pregnancy to term, avoid coffee and other drinks that contain it.

In both of the new studies, the authors say they took morning sickness into account, so their findings relate to caffeine and not to other characteristics of pregnant women who drink it.

In one study, in the American Journal of Obstetrics & Gynecology, Kaiser Permanente researchers analyzed information about caffeine drinking by 1,063 women early in their pregnancies.

Women who reported drinking less than 200 milligrams of caffeine per day (about two cups of regular coffee or five cans of caffeinated soda) were 40% more likely to miscarry than women who said they drank no caffeinated beverages. Those who drank 200 milligrams or more of caffeine per day had about twice the miscarriage risk as women who drank none.

"My suggestion is women who are pregnant and women who are trying to become pregnant should consider stopping caffeine entirely," co-author De-Kun Li says. If you must have that morning cup of coffee, he says, let it be your only one of the day.

Not so fast, says David Savitz, lead author of the other new study on the subject, in the January issue of Epidemiology. Savitz, a professor in community and preventive medicine at New York's Mount Sinai School of Medicine, found no link between miscarriage and caffeine consumption in the 2,407 pregnant women he studied.

Compared with women in other studies, though, Savitz says, his subjects were pretty light caffeine drinkers. The biggest consumers drank the equivalent of only about two cups of coffee a day, he says.

"It's really hard as a physician to translate this into clinical practice," says OB-GYN Tracy Flanagan, women's health director at Kaiser Permanente Northern California, who wasn't involved with Li's study. Flanagan advises pregnant women in their first trimester to limit their caffeine to two cups of coffee or five cans of soda a day. Better yet, she says, switch to decaffeinated beverages.

"Here is something that women can actively do" to reduce their miscarriage risk, Flanagan says.

After her first pregnancy ended in a miscarriage, self-described caffeine addict Tammy Plotkin-Oren of El Cerrito, Calif., swore off the stuff. Her sister, an OB-GYN, told her: "Is it going to ensure that you're not going to have another miscarriage? No." Coincidence or not, Plotkin-Oren, 35, went on to deliver three healthy daughters.

Study Reveals Doubt on Drug for Cholesterol

By ALEX BERENSON
Published: January 15, 2008
A clinical trial of Zetia, a widely used cholesterol drug, has raised questions about its effectiveness and the behavior of pharmaceutical companies that conducted the study.

http://www.nytimes.com/2008/01/15/business/15drug.html?ex=1358226000&en=dba4b9b6fb66e970&ei=5124&partner=permalink&exprod=permalink

Blueberries rate low on pesticide

By Shea Rarback
Concerns about pesticides can make the ''eat more fruit'' recommendation hard to swallow. I learned this from a reader who stopped eating blueberries when told they were high in pesticides. Here are the facts. In 2003 the Environmental Working Group tested and ranked 46 common fruits and vegetables for pesticide contamination. According to their findings, the produce with the highest amount of contamination, coined the dirty dozen, are peaches, strawberries, apples, spinach, nectarines, celery, pears, cherries, potatoes, bell peppers, raspberries and imported grapes. These would be the best choices for organic. Blueberries ranked No. 31.
Fruits and vegetables are great sources of naturally occurring disease-fighting compounds. They are low in fat and high in fiber. There might be small amounts of residue on produce but the benefits outweigh the risk and I encourage all to bring back the berries and at least four other servings of fruits and veggies daily.

A cloned cheeseburger? Don't fire up the coals yet

It's going to take years for ranchers to raise the animals. And consumers may not have a taste for them.

http://www.latimes.com/features/health/la-fi-clonedmeat16jan16,1,6648168.story?track=crosspromo&coll=la-headlines-health&ctrack=1&cset=true

Genetically Modified Foods: Just Say No!

Why are GMO foods banned in Europe and not in the United States?

http://blogs.webmd.com/integrative-medicine-wellness/2007/11/genetically-modified-foods-just-say-no.html

Fish-Oil Doses Can Be Hard To Swallow

By DAVID STIPP
SPECIAL TO THE WSJ
January 8, 2008; Page D1

It's no wonder that more Americans are gulping fish oil. Hardly a month goes by without a study suggesting that the omega-3 fatty acids in fish oil can fend off disease -- including heart attacks, strokes, Alzheimer's disease, depression, rheumatoid arthritis, asthma, psoriasis and even attention-deficit hyperactivity disorder.

The problem is, to get the health benefits seen in clinical trials, you probably need to take fistfuls of capsules.

"The kind of benefits seen in most of the clinical trials with omega-3 generally have involved much higher doses than you see recommended on supplement labels," says Charles Serhan, a Harvard Medical School expert on omega-3's activity. "But although a large number of studies have used industrial-level doses," he adds, "we don't have rigorous scientific evidence about what the doses should be."

Regardless of the recommended dose, the need to stockpile bottles of supplements may diminish as more foods are fortified with omega-3 and as research shows ways of enhancing the benefits with other therapies.

While most of the scientific data on the health effects of fish oil aren't definitive, the federal National Institutes of Health concluded after a massive review three years ago that consuming omega-3 fatty acids cuts the risk of death from heart attacks and other cardiovascular causes, can reduce the joint pain of rheumatoid arthritis and "appears" important for proper brain development and function.

Because of news like that, the market for fish-oil supplements is booming. U.S. omega-3 supplement sales reached an estimated $600 million last year, up 20% from a year earlier, says the Global Organization for EPA and DHA Omega-3s, a Salt Lake City trade group. (The two key omega-3 fatty acids are called EPA and DHA.) Omega-3 fatty acids now rank as the fifth-best-selling dietary supplement, behind multivitamins, calcium and vitamins C and E.

In trials aimed at lowering high blood levels of triglycerides, a contributor to heart disease, patients took four particularly potent capsules that contained a total of more than three grams of EPA and DHA a day. You would have to pop a daily dozen of the typical omega-3 capsules on the market to get that much -- four to six times the suggested daily "serving" usually specified on their labels. That many capsules could cost you more than $2 a day, and it is a lot more than you are likely to get from consuming fish: You would need more than six servings a day of tuna, or about three of salmon, to get that much EPA and DHA.

FISHTAILING

Clinical trials suggest that fish oil can fend off a variety of ailments, but the omega-3 doses used in the studies have varied widely.
• Heart disease: one gram or more
• Rheumatoid arthritis: two grams or more
• Brain health: one-half gram or moreFish may good for you, but you can get risky doses of mercury and other toxins by consuming lots of it. That is one reason the American Heart Association recommends that people who need to lower triglycerides to ward off heart attacks take omega-3 capsules. The suggested dose is two to four grams of EPA and DHA a day, which supplements can provide toxin-free. For healthy adults seeking merely to cut cardiac risks, the heart association says eating fatty fish, such as salmon, at least twice a week is probably enough.

But how much omega-3 should you take if you are trying to ease the joint inflammation of rheumatoid arthritis? Or ward off Alzheimer's disease? Or alleviate depression?

Unfortunately, there aren't enough clinical data to give firm answers. But the omega-3 literature affords hints. Results in various rheumatoid-arthritis trials indicate that you need to take more than two grams, perhaps 10 typical capsules, of omega-3 fatty acids a day to significantly curtail joint inflammation and pain.

For maintaining brain health, the overall data on omega-3's potential are inconclusive, according to the NIH. But a recent Dutch study showed that about 400 milligrams of EPA and DHA a day -- which you can get from two typical omega-3 capsules -- helped elderly men maintain mental acuity. The study found that the more omega-3 ingested, the greater the benefit.

In the depression data, two things stand out: EPA appears more effective than DHA. And about one gram of EPA seems optimal -- more isn't better.

All this suggests that you may have to take a half dozen or more typical omega-3 pills a day to get the kind of benefits observed in clinical trials with fish oil. But soon it may get easier to get such hefty doses without taking so many pills. A growing number of foods are fortified with omega-3, everything from yogurt to orange juice, including more than 1,200 such products launched in 2006 alone, according to the London-based market researcher Datamonitor. Such foods typically don't contain much omega-3 -- a fortified egg might contain half as much as a typical capsule. But as more fortified foods come to market, it will be easier to get omega-3 in your diet.

There is another reason popping fish-oil capsules by the fistful may be overkill. Many scientists believe omega-3's benefits flow primarily from its ability to damp low-level inflammation, which is thought to be a key culprit in just about every major scourge of aging, from clogged arteries to Alzheimer's. Studies over the past few years suggest that taking small doses of aspirin daily, which many people do to prevent heart attacks, magnifies the anti-inflammatory effect of taking fish oil.

Indeed, some of the most dramatic evidence of fish oil's heart benefits came from a 1999 Italian study in which patients who had recently had heart attacks showed a 45% reduction in subsequent "sudden cardiac death" when given modest fish-oil doses (the amount in about three typical omega-3 capsules). The supplements' striking effectiveness may well have been magnified by the fact that many of the patients were also taking aspirin daily.

Aspirin's effect on omega-3 isn't clear yet, though. So for now, big doses of the supplement probably are necessary to get the health benefits.

Omega-3 appears to be safe, even at the high doses used in clinical trials. But large doses can have side effects. Perhaps the best source on that issue is the prescribing information for Lovaza. Sold by GlaxoSmithKline PLC unit Reliant Pharmaceuticals Inc., Lovaza is prescribed for "very high" triglycerides.

In Lovaza's clinical trials, patients took four capsules a day with a total of 3.4 grams of EPA and DHA. The most common "adverse event," reported by about 5% of patients, was belching. Some 4% reported infections, compared with 2% on a placebo, but it's not clear whether fish oil caused the difference. While some research suggests that taking fish oil prolongs bleeding time, no bleeding problems were reported in the Lovaza trials.

There's no evidence Lovaza works better or is purer than high-end omega-3 dietary supplements -- such as those made by Nordic Naturals Inc., of Watsonville, Calif. -- which cost less than half as much as Lovaza does per gram of EPA and DHA.

A 2004 analysis of 44 kinds of omega-3 supplements by ConsumerLab.com1, based in Scarsdale, N.Y., found that none had unsafe levels of mercury or PCBs. And Lovaza wasn't used in most of the promising clinical trials with omega-3.

URL for this article:
http://online.wsj.com/article/SB119975627038373627.html

On a Remote Path to Cures

By ANDREW DOWNIE
Published: January 1, 2008

Scouring remote regions for plants, oils and extracts can yield cures — and big profits — for pharmaceutical companies and indigenous tribes.

http://www.nytimes.com/2008/01/01/business/worldbusiness/01hunter.html?ex=1357016400&en=79f30970d7381269&ei=5124&partner=permalink&exprod=permalink

How dangerous are chemicals in ordinary products?

The (Possible) Perils of Being Thirsty While Being Green
By ALINA TUGEND
Published: January 5, 2008
I have the usual New Year’s resolutions — exercise more, lose weight, be a nicer person. I also hope to find out if I am inadvertently poisoning my children.

http://www.nytimes.com/2008/01/05/business/smallbusiness/05shortcuts.html?ex=1357448400&en=79df7579411f4b60&ei=5124&partner=permalink&exprod=permalink

Everyday Items, Complex Chemistry
By AMY SCHOENFELD
Published: December 22, 2007
Holiday shoppers may worry about whether the toys they buy contain lead, but some scientists are urging consumers to focus on the thousands of chemicals in everyday household items.

http://www.nytimes.com/2007/12/22/business/22chemicals.html?ex=1356066000&en=b42d1f7e4a74a77d&ei=5124&partner=permalink&exprod=permalink

Tame a Child's Cough With a Touch of Honey

By NICHOLAS BAKALAR
Published: December 11, 2007

A spoonful of honey might quiet a child's cough more effectively and safely than the most common over-the-counter cough medicine.

Researchers tested 105 children 2 to 18 with coughs from upper-respiratory infections, dividing them randomly into three groups. One received no treatment. The others received a remedy, but the researchers, parents and children did not know which it was: one or two teaspoons of buckwheat honey, depending on age, or an age-appropriate dose of honey-flavored dextromethorphan. The study was supported by a grant from the National Honey Board, an industry-backed agency of the Department of Agriculture.

Using questionnaires filled out by the parents, the scientists measured cough frequency and severity, and the effect on the children's and parents' sleep. By all measures, honey provided the greatest relief.

Honey, the authors wrote in the December issue of The Archives of Pediatric and Adolescent Medicine, has well-established antioxidant and antimicrobial effects, and it might be that sweet substances of any kind help dissolve mucus in the airways and soothe the back of the throat.

In October, a Food and Drug Administration advisory panel recommended a ban on over-the-counter cold medicine, including some brands containing dextromethorphan, intended for children under age 6.

Dr. Ian M. Paul, the lead author and an associate professor of pediatrics at Penn State, said that parents should consider honey ''as an alternative to cough medicine for children over age 1.'' In rare cases, honey can cause infantile botulism in children under 1.

Nursing Homes Struggle To Kick Drug Habit

New Therapies Sought For Dementia Sufferers; Music and Massages
By LUCETTE LAGNADO December 20, 2007 WSJ

BROOKLYN, N.Y. -- It is lunchtime at Cobble Hill Health Center and Elizabeth Johnson is busy helping patients in the Alzheimer's unit -- tying plastic aprons around their waists, passing out salt and pepper shakers, paper cups, straws and little containers of milk.

"You have to sit and eat," Mrs. Johnson tells one resident. "There is a spoon if you need a spoon," she says to another.

In her print dress and coral lipstick, Mrs. Johnson, 71 years old, can almost pass for a staffer on some days, or even the manager she used to be at a local city hospital. In fact, she is a patient here, stricken with an advanced form of dementia that sometimes renders her confused, fretful -- even combative. Not long ago, Cobble Hill's staff would respond to Mrs. Johnson's unruly episodes by putting her on a powerful antipsychotic drug.

Use of a new generation of antipsychotic drugs to control the behavior of dementia patients has surged in recent years, despite the Food and Drug Administration's "black box" warning labels that these drugs can increase the risk of death for elderly dementia sufferers. About 30% of nursing-home residents are on antipsychotic drugs, according to the Centers for Medicare & Medicaid Services, most of them on newer ones called atypical antipsychotics.

Mrs. Johnson, however, is now part of an experiment at the Cobble Hill nursing home to wean patients off antipsychotics. In her case, the staff has figured out that when she becomes distraught, the best way to calm her down is to have her do what she loved to do when she was well: work. Simple tasks such as setting the table, they say, give Mrs. Johnson a renewed sense of purpose and calm.

The challenge of caring for rising numbers of seniors who suffer from dementia and the behavior problems that can stem from it has provoked a wrenching debate among nursing-home operators, regulators and families. There are few effective medicines to manage the outbursts of Alzheimer's patients -- behavior that can overwhelm family members trying to care for a loved one at home, and strain the resources of those trying to maintain order in nursing facilities.

Federal law strongly discourages nursing homes from physically tying down unruly patients. But federal health-care programs such as Medicaid do pay for drugs that may help calm aggressive behavior and agitation associated with Alzheimer's.

Medicaid in 2005 spent $5.4 billion on atypical antipsychotic medicines -- more than it spent on any other class of drugs, including antibiotics, AIDS drugs or medicines to treat high blood pressure. Atypical antipsychotics are approved for schizophrenia and bipolar disorder. But in what is known as "off label" use, doctors often prescribe the drugs to elderly people with dementia.

The widespread use of antipsychotics among the elderly has begun to draw criticism from regulators, researchers, lawmakers and some in the nursing-home industry. Sen. Charles Grassley, the ranking Republican on the Senate Finance Committee, this month asked several drug manufacturers for records on how they may have marketed these drugs for use in geriatric patients. He also has asked the Inspector General of the Department of Health and Human Services to investigate use of the drugs in nursing homes.

The $122 billion nursing-home industry has evolved toward large, often understaffed institutions. A law signed by President Reagan in 1987 sought to limit physical and chemical restraints in nursing homes. But in the late 1990s, with the introduction of new medicines called atypical antipsychotics, use of psychotropic drugs among the elderly began to creep up.

According to CMS, nearly 21% of nursing-home patients who don't have a psychosis diagnosis are on antipsychotic drugs. A 2005 study, published in the Archives of Internal Medicine, found antipsychotics were prescribed not only for psychosis, but for depression, confusion, memory loss and feelings of isolation, says the study's author Becky Briesacher.

Last year, CMS instituted new guidelines to limit the use of antipsychotics. Even so, under federal rules, it's still easier for nursing homes to get reimbursed for giving patients extra pills than it is for hiring extra staff.

An elderly person with Alzheimer's often isn't able to refuse antipsychotic drugs, says Cynthia Rudder, of the Long-Term Care Community Coalition, a New York patient-advocacy group. "You are basically quieting them against their will, and it is absolutely horrendous," she says.

Family members can object to the use of such drugs. But they risk having the facility threaten to discharge their relative on grounds that they pose a danger to themselves or others.

At CMS, officials stress the need to shift to smaller, less-rigid facilities as a way to reduce antipsychotic usage. Dennis Smith, director of the Center for Medicaid and State Operations, says nursing homes should seek "a different model" of care, so that when dealing with patients in distress, the solution isn't only "unlocking the drug cabinet." His agency is pursuing a twofold approach, offering alternatives to nursing homes -- such as the option to live in the community -- and trying to improve nursing homes by letting them know "they will be open to scrutiny."

Some nursing-home-industry officials agree change is needed. "We cannot treat people by simply throwing psychotropic drugs at them for our convenience," says Larry Minnix, president of the American Association of Homes and Services for the Aging. While there are "really good places where physicians and nurses monitor this carefully, that is the exception not the rule," he says.

Yet replacing drugs with approaches that require a more human touch is easier said than done. Staffing remains an issue: According to CMS, nursing-home patients, on average, receive a half-hour of care per day from a registered nurse, plus 48 minutes from a licensed practical nurse and two hours and 18 minutes from an aide.

There are some Alzheimer's patients for whom nonpharmacological approaches simply don't work, says William Thies, a vice president at the Alzheimer's Association in Chicago, and in these cases antipsychotics may be warranted. But the drugs need to be used very carefully, at the lowest dose and after ruling out a medical problem, says Dr. Thies, who has a doctorate in pharmacology.

Still some nursing homes are trying alternatives. At Providence Rest Nursing Home in the Bronx, distraught Alzheimer's patients are given massages and aromatherapy. Providence, a facility with 200 patients run by an order of nuns, has brought its overall reliance on antipsychotics down to 2% over the last few years -- and down to zero among patients who are not psychotic. At Bishop Wicke Care Center, a 120-bed facility in Shelton, Conn., the emphasis is on giving patients consistent caregivers -- avoiding staff turnover that can make life trying for residents. The home has also undertaken a project to get to know what patients were like when they were young, as a key to dealing with their angst.

At Cobble Hill in Brooklyn, the effort to wean Mrs. Johnson off antipsychotics is part of a broader effort by the facility's Chief Executive Officer Olga Lipschitz to make the facility more "homelike." Mrs. Lipschitz, who at 74 is the age of some of her patients, took over Cobble Hill in the 1970s following a scandal over conditions in New York nursing homes. "I have been at this for 35 years," she says. "Reform is constantly needed."

Some patients are responding well to alternative approaches. Others still need drugs.

After she retired, Mrs. Johnson lived on her own in Brooklyn. But she began to wander from her house. "Strangers were bringing her home," recalls her daughter, Shirlyn Breeden.

One day, a bruised Mrs. Johnson showed up at her church, unable to explain what had happened.

She was taken from one medical facility to another and given antipsychotics, her daughter says. Mrs. Johnson was on antipsychotics when transferred to Cobble Hill in May 2005 and the staff kept her on the medication. She was "combative with other residents at times," say her case notes.

"My mother thought this was her apartment and these strangers were living there. She would tell them to get their feet off the bed," Ms. Breeden recalls. "I would tell her, 'You're being mean to them,' but she would say, 'They know that you are not supposed to put your feet on the bed.'"

Ms. Breeden worried about her mom. "Her eyes were weak, she was incoherent, she couldn't complete a full sentence," she says. "That wasn't my mother -- she was never like that." Her mother was the kind of woman, she says, who never left the house without putting on lipstick.

The medication didn't halt her outbursts. Her daughter recalls a terrifying day when Mrs. Johnson moved her bed to block the door of her room, convinced strangers wanted to come in.

In 2005, Louis Mudannayake, Cobble Hill's medical director, decided the facility had too many patients on antipsychotic drugs.

"They were chemically 'shlogged,'" he says. "A patient who had had some quality of life earlier, who was able to interact and smile at her relatives and put a fork to her tuna fish, was no longer able to do that."

He began a chart-by-chart review of every patient on any type of antipsychotic. He formed a team -- including a psychiatrist, pharmacy consultant, a nurse, social worker, recreational therapist and nurse's aide -- that met roughly once a month. They determined which patients could be taken off the drugs and which ones could have doses reduced.

Initially, there was skepticism from the staff. Some nurses warned patients would run amok if taken off the drugs. Doctors balked, persuaded the drugs worked.

Ravi Amin, a psychiatrist who works at Cobble Hill and other facilities, says he has given orders at some of the other nursing homes to have a patient taken off antipsychotics only to find them countermanded by the unit nurse and the facility's on-site internist. "Doctors would be called to restart the medicine so that by the time I made the second visit, some patients were back on it," he says.

Mrs. Johnson had been on an antipsychotic called Seroquel for about a year and a half. In May, the team concluded she was a candidate for "environmental redirection." This meant that if she became upset, the staff wasn't to automatically reach for Seroquel, but try other ways to calm her.

Within a month, she was taken off the antipsychotic entirely.

"We began to give her little tasks -- pre-packaged spoons to give out, aprons to put on other residents," says Liza Long, a nurse who is the unit's community director. "She still thinks she's at work."

To her daughter, a telling change in Mrs. Johnson's life since stopping the antipsychotics is cosmetic: These days, she says, Mrs. Johnson rarely leaves her room without her lipstick on.

A spokesman for AstraZeneca Pharmaceuticals LP, maker of Seroquel, says "decisions about medical treatment are made by physicians" and the company doesn't recommend the drug "for uses other than its approved indications in schizophrenia and bipolar disorder." He says the boxed warning "contained in all labels for this class of drugs states there is 'increased mortality in elderly patients with dementia-related psychosis.'" He adds that the labels also state the drugs aren't approved for treatment of patients with dementia-related psychosis.

Some caretakers say that antipsychotics can be effective in helping an elderly loved one at home.

Serena Ferguson, 56, a physician, took care of her mother at home for years. In the throes of dementia, her mother would pace and wander and try to leave the apartment, she recalls. It was hard to get her to fall asleep and Dr. Ferguson had to place herself by the door to make sure her mom wouldn't slip out.

Dr. Ferguson says atypical antipsychotics were the only way to keep her mother safe at home. "They would calm her down," she says. "Those medications will make you drowsy, and she would go to sleep, and that is good, because I would go to sleep," she says.

Last year, her mother was admitted to Cobble Hill, where she remained on the antipsychotic drug Seroquel. But when the nursing home told her they wanted to wean her mom off the drug, Dr. Ferguson agreed.

Her mother has been off antipsychotics for about 11 months. Instead, she has been getting stimulation, her daughter says, including music and dancing.

When her 92-year-old mother, Mae, was young, she loved to go dancing at the Savoy Ballroom in Harlem. Mrs. Ferguson worked as a presser at a dry cleaner's to support herself and her only child.

On a recent Friday, Mrs. Ferguson sat motionless at the dining room table. She wasn't smiling; she had not eaten much.

Then a staffer put on a CD of Nat King Cole singing "Almost Like Being in Love." Mrs. Ferguson's eyes widened and she started to smile. With help from an aide, she rose and began swaying to the music, snapping her fingers. "Dance with me," she said to Dr. Mudannayake, the medical director. "I'd like to dance with all of you," she said to the staff.

Not all cases work out. Some patients relapse. Some receive reduced doses of antipsychotics, but show signs of distress. Others are taken off drugs and still suffer from symptoms of their brain disorder.

In 2003, the rate of antipsychotic use among Cobble Hill patients who didn't have a psychotic disorder was nearly 24%. Earlier this year, it had fallen to about 12%. But lately, the rate has crept up again, showing the constant struggle.

Sometimes little seems to work. After Cobble Hill patient Mary Goldman, a former college professor, suffered yet another stroke this year, she was no longer able to speak clearly. She began to scream uncontrollably, tugging at nurses. In an effort to calm her, the staff administered 75 milligrams of Seroquel, twice a day.

But Mrs. Goldman screamed even more loudly, sometimes for as long as an hour and a half, the medical director says.

When her case was reviewed earlier this year, the team recommended trying to taper her off the antipsychotic.

Now, Mrs. Goldman is off the drug. She still screams and cries out, her husband says, though not for as long. When his wife becomes distraught, he tries to soothe her by speaking gently, holding her arm, and stroking her hand.

"Sometimes it works and sometimes it doesn't," he says. "It does not diminish agitation completely but it does diminish it."

Lately, Cobble Hill has tried bringing books and magazines to Mrs. Goldman's bedside. "She is not really reading," says Dr. Mudannayake, "but they seem to comfort her and she yells and screams less."

Often she will merely fling them to the ground. Her husband bends down and picks them up.