The Calorie-Restriction Experiment

By JON GERTNER

Published: October 11, 2009

Eating much, much less helped rats live longer. Will it work on humans?

http://www.nytimes.com/2009/10/11/magazine/11Calories-t.html

Can Meditation Curb Heart Attacks?

By RONI CARYN RABIN
Published: November 20, 2009

Transcendental meditation may help lower blood pressure and lower the risk of heart attacks, a new study suggests.

http://well.blogs.nytimes.com/2009/11/20/can-meditation-curb-heart-attacks/

Popcorn’s Dark Secret

By KAREN BARROW

Published: November 19, 2009

A review of the nutritional contents of movie-theater popcorn reveals an alarming amount of fat, salt and calories in even the smallest sizes.

http://well.blogs.nytimes.com/2009/11/19/popcorn/

Phys Ed: Why Doesn’t Exercise Lead to Weight Loss?

By By GRETCHEN REYNOLDS

Published: November 4, 2009

Few people, an overwhelming body of research shows, achieve significant weight loss through exercise alone, without changing their eating habits.

http://well.blogs.nytimes.com/2009/11/04/phys-ed-why-doesnt-exercise-lead-to-weight-loss/

Path to Alternative Therapies Is Littered With Obstacles

By WALECIA KONRAD

Published: November 14, 2009

Trying unconventional remedies is a bold move, let alone trying to get an insurer to cover the expense and knowing what pills to buy.

http://www.nytimes.com/2009/11/14/health/14patient.html

Vitamin D Shows Heart Benefits in Study

RONI CARYN RABIN

Published: November 16, 2009

Many adults are deficient in vitamin D, a study found, and may be at increased risk of heart disease and stroke.

http://well.blogs.nytimes.com/2009/11/16/vitamin-d-shows-heart-benefits-in-study/

New York study says menu labeling affects behavior

By David Morgan Mon Oct 26, 3:57 pm ET

WASHINGTON (Reuters) – New York's mandate that fast-food restaurants post calorie information on their menus has changed consumer habits, the city said on Monday, contradicting a recent independent study showing no effect.

The city's Department of Health and Mental Hygiene released preliminary data showing evidence that people bought food with fewer calories at nine of the 13 fast-food and coffee chains included in a study on the effects of menu-labeling laws that went into effect in 2008.

Researchers surveyed more than 10,000 customers at 275 locations in early 2007 and another 12,000 this year.

They found statistically significant decreases at four chains -- McDonald's, Au Bon Pain, KFC and Starbucks -- and said diners who saw and acted on calorie information bought food containing 106 fewer calories on average than those who did not notice the postings.

All told, 56 percent of fast-food customers reported seeing the calorie information, researchers told the annual meeting of the Obesity Society in Washington.

The earlier study by researchers at New York University and Yale University, which included 1,156 adults who ate at Burger King, KFC, McDonald's and Wendy's immediately before and after the rule went into effect, found no change to consumer habits in low-income neighborhoods.

The city's researchers said their study was more representative of dining habits because it included more people over a longer period of time and not limited to outlets in low-income neighborhoods.

In July 2008, New York became the first U.S. city to require fast food restaurants to post calorie counts in large type on menu boards.

The system has since become a model for similar rules intended to combat obesity and promote good nutrition in California, other parts of New York state, the cities of Seattle and Portland, and elsewhere.

Health advocates see menu labeling as a tool for fighting obesity. About one-third of U.S. adults are obese, a condition that increases the risk of heart disease, diabetes, cancer and other medical problems, and another one-third are overweight.

Both the city and New York University studies were funded by the nonprofit Robert Wood Johnson Foundation.

Lynn Silver, assistant commissioner for New York's Bureau of Chronic Disease Prevention and Control, said government findings show diners are noticing and acting on the labels.

"Dietary change is likely to come gradually; it will start with consumers interested in making informed, healthy eating decisions and we hope industry will respond by offering more healthier choices and appropriate portion sizes," she said in a statement.

But city researchers also found that the labeling laws' influence can be overcome by restaurant marketing.

The privately held Subway restaurant chain, which has promoted its menu as a vehicle for weight loss and healthy eating, posted calorie information on some of its menus before the labeling laws went into effect in 2008.

The number of calories purchased at Subway more than doubled during the study period, which coincided with an advertising campaign to promote larger 12-inch sandwiches. The calorie gain at Subway was roughly the same as losses at seven other food chains, researchers said.

Scientists say curry compound kills cancer cells

Wed Oct 28, 12:15 pm ET

LONDON (Reuters) – A molecule found in a curry ingredient can kill esophageal cancer cells in the laboratory, suggesting it might be developed as an anti-cancer treatment, scientists said on Wednesday.

Researchers at the Cork Cancer Research Center in Ireland treated esophageal cancer cells with curcumin -- a chemical found in the spice turmeric, which gives curries a distinctive yellow color -- and found it started to kill cancer cells within 24 hours.

The cells also began to digest themselves, they said in a study published in the British Journal of Cancer.

Previous scientific studies have suggested curcumin can suppress tumors and that people who eat lots of curry may be less prone to the disease, although curcumin loses its anti-cancer attributes quickly when ingested.

But Sharon McKenna, lead author of the Irish study, said her study suggested a potential for scientists to develop curcumin as an anti-cancer drug to treat esophageal cancer.

Cancers of the esophagus kill more than 500,000 people across the world each year. The tumors are especially deadly, with five-year survival rates of just 12 to 31 percent.

McKenna said the study showed curcumin caused the cancer cells to die "using an unexpected system of cell messages."

Normally, faulty cells die by committing programed suicide, or apoptosis, which occurs when proteins called caspases are 'switched on' in cells, the researchers said.

But these cells showed no evidence of suicide, and the addition of a molecule that inhibits caspases and stops this "switch being flicked' made no difference to the number of cells that died, suggesting curcumin attacked the cancer cells using an alternative cell signaling system.

U.S. researchers said in 2007 they had found curcumin may help stimulate immune system cells in the Alzheimer's disease.

F.D.A. to Clarify Standards for the Front of Food Labels

By WILLIAM NEUMAN

Published: October 21, 2009

The government said it wants nutrition labels to be more frank, and that could be a challenge for the Smart Choices program.

http://www.nytimes.com/2009/10/21/business/21food.html

Rules to Eat By

The Food Issue

BY MICHAEL POLLAN

Published: October 11, 2009

For all the authority we grant to science on nutrition, culture has a lot to teach us.

http://www.nytimes.com/2009/10/11/magazine/11food-rules-t.html

Calorie Postings Don’t Change Habits, Study Finds

By ANEMONA HARTOCOLLIS

Published: October 6, 2009

A study of New York City’s pioneering law suggests that people’s stomachs are more powerful than their brains.

http://www.nytimes.com/2009/10/06/nyregion/06calories.html

In Schools, New Rules on Snacks for Sale

By JENNIFER MEDINA

Published: October 7, 2009

The new snacks and drinks will be more nutritious — but probably less popular, as the estimate of future income for schools from vending machines is revised downward.

http://www.nytimes.com/2009/10/07/nyregion/07contract.html

Kids Eat Few Fruits, Veggies .

Fewer than 10% of U.S. high-school students are eating the combined recommended daily amount of fruits and vegetables, a finding that the Centers for Disease Control and Prevention called "poor" in a report.

The report, based on 2007 data, found that 13% of U.S. high-school students get at least three servings of vegetables a day and just 32% get two servings of fruit. Fewer than one in 10 get enough of both combined.

Some states—including Arkansas and North Carolina—were significantly below those averages. But some New England states, particularly Vermont, were notably better.

The CDC said the report was the first to give such detailed information on adolescents' fruit and vegetable consumption. The data come from a national survey of about 100,000 high-school students.

CDC officials said the findings indicate a disheartening gap between how people should be eating and what they are actually consuming in an era of rampant obesity.

Federal nutrition goals for 2010 call for at least 75% of Americans to eat two servings of fruit each day and at least 50% to eat three vegetable servings.

"This is a call for states, communities, schools and families to support increased fruit and vegetable consumption," said Heidi Blanck, a CDC senior scientist who worked on the report.

The CDC also released data on a survey of adults. It found fruit and vegetable consumption was basically unchanged from when a similar survey was done in 2005: About 27% got at least three servings of vegetables a day, and 33% got two servings of fruit.

People who participated in the survey were asked, essentially, how many times a day they had fruits or vegetables.

Vermont and other states that had higher rates of fruit and vegetable consumption were also more likely to have fruit available in school vending machines or at snack shops, Ms. Blanck said.

—Copyright © 2009 Associated Press

Congress, Concerned About Steroids, Reviews Law on Dietary Supplements

By NATASHA SINGER and MICHAEL S. SCHMIDT

Published: September 30, 2009

Congress is investigating whether laws, health agency resources and manufacturing guidelines are adequate to protect the public from products that illegally contain steroids but masquerade as dietary supplements.

http://www.nytimes.com/2009/09/30/business/30supplement.html

Melanoma on the Rise, or Is It Just Diagnoses?

By NICHOLAS BAKALAR

Published: September 29, 2009

A study found evidence that an epidemic of malignant melanoma might be due in part to a growing tendency to identify and treat benign lesions as malignant cancers.

....“Squamous and basal cell carcinomas are no doubt caused by sunlight,” he said, “and those increases are concentrated on the face and neck.” But the diagnoses of melanoma in the registry were mostly on the back, trunk and limbs, areas not consistently exposed to the sun. This means that exposure to sunlight cannot explain the increased number of lesions reported as malignant, he said."

http://www.nytimes.com/2009/09/29/health/29mela.html

Probiotics: Looking Underneath the Yogurt Label

By TARA PARKER-POPE

Published: September 29, 2009

Health-food claims about a type of live micro-organisms may, or may not, outstrip the science.

http://www.nytimes.com/2009/09/29/health/29well.html

Quest for a Long Life Gains Scientific Respect

By NICHOLAS WADE

Published: September 29, 2009

Who would have thought it? The quest for eternal life, or at least prolonged youthfulness, has now migrated from the outer fringes of alternative medicine to the halls of Harvard Medical School.

http://www.nytimes.com/2009/09/29/science/29aging.html

How Safe Are Osteoporosis Drugs?

HEALTH MAILBOX
SEPTEMBER 21, 2009

Columnist Melinda Beck answers readers' questions

Q: I read your article on osteoporosis ("Saving Your Bones: Hard Choices," Sept. 15) with great interest. My older sister and I both have osteoporosis, and I've been reluctant to go on bisphosphonates for the very reasons you mention. My sister, who lives in France, is taking strontium ranelate. How is it different from a bisphosphonate, and is it safe?

—J.R.

A: Strontium is a natural element similar to calcium. A compound called strontium ralenate has shown promise in both delaying the resorption of old bone and stimulating growth of new bone. A study in the New England Journal of Medicine in 2004 found that strontium ranelate reduced vertebral fractures by 41% and hip fractures 36% compared with placebos in elderly women with osteoporosis, with no more gastrointestinal effects. And unlike bisphosphonates, strontium ralenate generally comes in a powder form that can be dissolved in water and taken at bedtime, with no need to stand or sit upright for 30 minutes afterward.

A prescription version made by the French company Seriver with the brand name Protelos has been approved for use in 27 European countries, but not yet in the U.S.

Prescriptions: Partisan Politics, Bipartisan Holistics

September 24, 2009

By David M. Herszenhorn

In a debate over an amendment that would have extracted billions of dollars from major drug manufacturers, Senator Charles E. Schumer, Democrat of New York, decided Thursday to share his personal experience in fighting high cholesterol.

Mr. Schumer said his doctor had directed him to take Lipitor, which is manufactured by Pfizer, and then, after his cholesterol levels had dropped, suggested that he try a less expensive, generic medication instead. But he switched back after his cholesterol levels went back up. “I’m taking Lipitor even though it’s more expensive,” Mr. Schumer said.

Mr. Schumer also hastened to add that Pfizer has its headquarters in New York -– a local shop, in other words.

That prompted Senator Charles E. Grassley, Republican of Iowa, to suggest that Mr. Schumer try a more natural remedy: red yeast rice. “I’ll bring the pills for you tomorrow,” he told Mr. Schumer.

Red yeast rice contains cholesterol-lowering compounds, called monacolins, and has been a dietary staple in China for more than 1,000 years. It is made from yeast, grown on rice, and is the ingredient used to give the popular dish Peking duck its trademark red tint.

Presumably, Mr. Grassley who hails from a state famous for corn, had no geographic interest in promoting a rice product. (The federal Food and Drug Administration has also banned some versions of red yeast rice supplements because of concerns that they can cause kidney and muscle problems).

The exchange between Mr. Schumer and Mr. Grassley inspired Senator Bill Nelson, Democrat of Florida, who was the sponsor of the amendment under debate, to make a pitch for his own locally grown remedy for high cholesterol. “Grapefruit might do the same thing for you,” Mr. Nelson said.

“How about a pastrami sandwich?” Mr.Schumer replied. “How would that do?”

It’s unclear if any senators will be changing their breakfast habits, but Mr. Nelson’s other pitch, for his amendment, failed by a vote of 13 to 10.

In One Study, a Heart Benefit for Chocolate

By NICHOLAS BAKALAR

Published: September 15, 2009

People who eat chocolate have increased survival rates after a heart attack, researchers in Sweden found in an observational study.

http://www.nytimes.com/2009/09/15/health/15choc.html

A Doctor for Disease, a Shaman for the Soul

By PATRICIA LEIGH BROWN

Published: September 20, 2009

A California hospital’s attempts to cater to its immigrant patients resulted in a policy allowing for Hmong shamans to practice within their walls.

http://www.nytimes.com/2009/09/20/us/20shaman.html

Saving Your Bones: Hard Choices

Osteoporosis Drugs Prevent Fractures, but Patients Worry About Side Effects; Weighing the Risks

MELINDA BECK WSJ Sept 15, 2009

Osteoporosis has haunted my family for generations, as it has many other families.

My great-grandmother was bent nearly horizontal from collapsed vertebrae. My grandmother lost a foot in height as her spine deteriorated, and broke her hip just pushing a grocery cart. I made her a new backbone out of papier-mâché when I was 4.

My mother did everything she could to avoid the family curse, but she also suffered painful collapsed vertebrae. All three women died, directly or indirectly, as a result of osteoporosis.

Osteoporosis has expanded the gaps in the spongy tissue within a spinal vertebra, increasing the bone’s brittleness and probability of fracture.

That was before the bone-building drugs called bisphosphonates became widely available in the mid-1990s. Thanks in part to them, the number of hip fractures has dropped significantly in the U.S. and Canada in recent years.

Osteoporosis remains a serious health problem for the 10 million Americans who have it and the 34 million who are at risk due to low bone mass; 80% of sufferers are women. It's estimated that one half of women and one-quarter of men over age 50 will suffer an osteoporosis-related fracture.

But reports of scary side effects from bisphosphonates including Fosamax, Actonel and Boniva are circulating on the Internet and in medical journals. Hundreds of lawsuits allege that the drugs cause a rare condition in which part of the jaw bone dies. The first case to be tried against Merck & Co.'s Fosamax ended in a hung jury last week in federal court in New York City. And some critics say the drugs with sales of $8.3 billion a year in the U.S. are being oversold to women who may never need them.

All that leaves women facing a difficult dilemma: Powerful osteoporosis drugs known to prevent future debilitating injuries are also suspected of increasing the risk for other terrible conditions. Balancing the risks and benefits is different for every woman, and depends on factors such as genetic history, diet and lifestyle. Figuring out how to proceed also requires having a very careful discussion with a qualified physician.

A good place to start is with your family tree. Having a parent with osteoporosis raises your own risk significantly. Caucasians, Asians and Hispanics also have higher rates of osteoporosis than African-Americans. So far, scientists have identified 15 related genes but there isn't likely to be a predictive genetic test anytime soon.

Related

• Health Blog: Updates on Potential New Drugs

That's because environmental factors also play a big role. The more bone you build up during the peak building years before age 30, the more reserves you'll have when net bone loss sets in. For women, that happens very rapidly after menopause when estrogen levels decline. Men lose bone far more slowly, although hormone-deprivation drugs for prostate cancer can also set them up for osteoporosis, as can a very strong hereditary load.

A diet rich in calcium (from dairy products and vegetables), plenty of exposure to vitamin D and weight-bearing exercise all help to build strong bones. Too little of those can weaken them, as can smoking, drinking alcohol, and a taking a variety of medications, including corticosteroids, anticonvulsants and antidepressants. Excessive dieting and exercising and being very thin with a body-mass index of less than 20 can also leave your bones with little reserve. Being obese actually lowers your risk, though it can overstress your joints.

But some people can do everything right and still develop osteoporosis if they have a strong genetic predisposition.

A bone-mineral-density test can give you one indication of how strong your bones are. Women with several risk factors should have one at menopause; or at least at age 65. The most common such test, called a DEXA (for dual-energy X-ray absorptiometry) is quick and painless and measures the amount of bone in your hip, spine or wrist. Results, called T-scores, compare that density with an average peak at age 30.

A T-score of minus 2.5 or below indicates osteoporosis. A T-score between minus 1 and minus 2.4 is considered osteopenia meaning low bone density but not full-blown osteoporosis.

You and your doctor can also assess your risk by using an online tool developed by the World Health Organization called FRAX, for Fracture Assessment Risk Tool. (See www.shef.ac.uk/FRAX.) It asks your sex, age, weight, height, hip-bone density and factors such as smoking, drinking, and parental hip fractures. It computes your chances of suffering a major bone fracture in the next 10 years.

What to do with that information is still somewhat controversial. "If you already have severe osteoporosis, you don't need a FRAX score to tell you you need treatment," says Bess Dawson-Hughes, director of the Bone Metabolism Lab at Tufts University, who has advised many of the drug makers. "Where we have struggled is what to do with that large group of healthy people who have low bone mass."

The National Osteoporosis Foundation's latest guidelines say that women who have a 3% risk of developing a hip fracture or 20% risk of other major fracture in the next 10 years are candidates for treatment, on cost-effectiveness grounds. In studies of older women with osteoporosis, Fosamax has been found to reduce the chance of hip and spine fractures as much as 50% . But it's less clear to what extent such drugs can prevent osteopenia from becoming osteoporosis.

Experts say that individual patients should never be treated based on T-scores or FRAX probabilities alone. Many other considerations apply.

Are You at Risk?

The more "yes" answers, the greater your risk for developing osteoporosis:

• Do you have a small, thin frame and/or are you Caucasian or Asian?
• Have you or a member of your immediate family broken a bone as an adult?
• Are you a postmenopausal woman?
• Have you had an early or surgically-induced menopause?
• Have you taken high doses of thyroid medication or used glucocorticoids 5 mg a day (for example, prednisone) for three or more months?
• Have you taken, or are you taking, immunosuppressive medications or chemotherapy to treat cancer?
• Is your diet low in dairy products and other sources of calcium?
• Are you physically inactive?
• Do you smoke cigarettes or drink alcohol in excess?

The National Osteoporosis Foundation

"You need to consider the unique characteristics of this lady in front of you," says Ethel Siris, director of the Toni Stabile Osteoporosis Center at Columbia Presbyterian Medical Center, who has also consulted for the drug makers. For example, a 50-year-old woman with osteopenia may not be a candidate for treatment based on her FRAX alone. But if she falls a lot and her mother suffered spinal fractures, which the FRAX doesn't ask about, it may make sense to treat her for a few years and see how her bone density does, Dr. Siris says. Meanwhile, a 70-year-old who has the same T-score probably started out with better bone density, but she has had 20 more years for her bone architecture to erode, so her bones are more fragile, even though they weigh the same.

The official guidelines also don't take into account potential side effects of the bisphosphonates, which are also highly individual. Gastrointestinal upsets are the most common; the oral medications aren't recommended for patients who can't sit upright for at least a half-hour because these drugs can irritate the esophagus. Gastro-esophageal reflux disease (GERD) can make such discomfort worse. A woman with severe GERD might fare better on Reclast, a once-a-year injection of bisphosphonate.

Some patients have also reported severe bone and muscle pain while taking bisphosphonates. The Food and Drug Administration alerted doctors last year that they might see this and consider discontinuing the drugs at least temporarily. Who is most affected and how long it lasts seems unpredictable. "I treat a gazillion patients and I see this rarely," says Dr. Siris. "When I do, we stop and re-evaluate."

Cases of osteonecrosis of the jaw (ONJ) in which parts of bone become exposed during dental work and don't heal are more serious but very rare. No one knows the exact incidence. Estimates range from 1 in 1,000 to 1 in 100,000 patients taking bisphosphonates for osteoporosis. (It's far more common in cancer patients on much higher doses.) Merck and other manufacturers say there is no evidence that the drugs cause ONJ at doses used for osteoporosis, but some dentists have become wary of doing invasive dental work on women taking bisphosphonates.

"We often advise patients who need extensive, invasive dental work to get that done first, then start the drugs and the issue disappears," says Ian Reid, a professor at the University of Auckland in New Zealand who has written on biosphosphonate safety.

A few doctors have reported unusual fractures of the thigh bone in women taking bisphosphonates for many years. One theory is that because the drugs inhibit the breakdown of old bone, they may be maintaining bone that is unusually brittle. Here too, the incidence seems extremely rare and the link remains unproven. But experts agree that it warrants further study and that patients and doctors should investigate any unusual thigh pain which has preceded several of the fractures.

On balance, most experts say that women with confirmed osteoporosis face a much higher risk of fractures if they don't treat their condition than if they do. "These horrible cases are incredibly rare, whereas hip fractures are not rare in the aging population and they can kill you," says Dr. Siris. She notes that there are still many unknowns about drugs, including how long it is safe for women to stay on them. Many doctors are using them with patients only about five years at a time and then re-evaluating.

Other osteoporosis drugs on the market work differently and carry different risks. Evista (raloxifene) acts on estrogen receptors and can cut the risk of breast cancer as well as spinal fractures in some women, although it doesn't prevent hip fractures. Forteo (teriparatide) is a daily injection for women with severe osteoporosis, but has been linked with bone malignancies in rats. Last month an advisory panel recommended that the FDA approve denosumab, a biological agent that blocks the production of osteoclasts that break down bone. It would be a twice-yearly injection.

Estrogen-replacement therapy can also help women postpone the rapid loss of bone mass that occurs after menopause. It's no longer recommended for bone protection alone in part because of the added risk of heart disease and breast cancer found in older women in the Women's Health Initiative studies. But the risk-benefit profile seems more favorable for younger women who want relief from menopausal symptoms like hot flashes. "If you hate your life without estrogen, you can go back on it and that's your bone-loss drug as well," says Dr. Siris.

Some clinics urge women to fight osteoporosis with lifestyle changes rather than pharmaceuticals. Many experts agree that sufficient calcium (at least 1,200 mg per day from food or supplements) and vitamin D (800 to 1,000 IUs per day) and weight-bearing exercise (at least 30 minutes, three times a week) are critical for building and maintaining strong bones, but they may not be sufficient for reversing serious bone loss once it's set in.

All camps agree that the very best way to strong bones is to build them well to begin with. Nearly 90% of bone mass in females is built by age 18, yet few adolescent girls are getting the recommended amounts of calcium and vitamin D.

Beyond the Heart, What Else Can Omega 3s Do?

By JEANNE WHALEN

WSJ Sept. 15, 2009

Many a carton of milk or yogurt now brags of its fortification with omega 3s, a trend that has made the dietary additive seem like just the latest marketing gimmick for health-minded consumers.

But omega 3s, a family of unsaturated fatty acids, have been shown to reduce the risk of coronary heart disease. And now, the compounds are being studied by scientists around the world as potential treatments for a wide range of other serious conditions, ranging from Alzheimer's disease to epilepsy and rheumatoid arthritis. Further research also is being done on omega 3s' role in preventing heart disease to determine the full range of potential benefits.

University of Birmingham

In an experiment, omega 3s block white blood cells from moving out of a blood vessel (left). Without omega 3s (right), the cells move readily.

Omega 3s are found naturally in fatty fish such as salmon, mackerel and sardines, and in some botanical sources such as flaxseed and kiwi fruit. A variety of firms also sell omega 3s as dietary supplements. Scientists say the benefit to the body should be the same whether they are consumed through food or capsules. Many scientists believe omega 3s provide health benefits in part by reducing inflammation, which can contribute to heart disease, arthritis and other ailments. But researchers are still attempting to understand how exactly omega 3s interact with the body. And studies for a number of medical conditions aren't far enough along to know whether the fatty acids could be beneficial.

One research team in the U.K. recently experimented on human cells in artificial blood vessels to try to understand what role omega 3s play in inflammation. The researchers used a glass tube to mimic a blood vessel. Normally, inflammation occurs when white blood cells migrate from the blood, through the blood-vessel wall and into surrounding tissue. The researchers coated their glass tube with endothelial cells, which normally line the interior walls of blood vessels. Then they added omega 3s to the endothelial cells.

Later, when the researchers pumped white blood cells into the tube, they saw under a microscope that the cells couldn't get across the endothelial barrier—the omega 3s were blocking them, according to a paper published in online journal PLoS Biology last month. When they performed the same experiment without the added omega 3s, the white blood cells easily penetrated the endothelial barrier.

More Research Needed

More research is needed to determine if the omega-3 blockade similarly occurs in actual blood vessels. But Ed Rainger, a cellular immunologist at the University of Birmingham Medical School, who led the research, says the experiment shed light on how inflammation works in the body and how tweaking the diet might affect it. He added that the discovery could eventually help scientists develop new medicines that block inflammation, which could be useful in treating diseases such as rheumatoid arthritis and psoriasis.

Inflammation plays a role in many areas of heart disease, which is probably at least partly why clinical trials have shown that omega 3s can reduce rates of heart attacks and strokes and slow the buildup of harmful plaque in the arteries, says Stephen Nicholls, a cardiologist at the Cleveland Clinic in Ohio.

Omega 3s appear to have benefits beyond reducing inflammation. They also lower levels of potentially harmful blood fats called triglycerides, which are unrelated to inflammation but can increase risk for heart disease, Dr. Nicholls adds. A prescription-strength pill called Lovaza, made from omega 3-containing fish oil, is approved for sale in the U.S. for reducing triglycerides.

Many scientists also believe that omega 3s might help stabilize cells and prevent them from generating erratic electrical signals in the heart and brain, which can cause irregular heartbeats, seizures and other problems.

Christopher DeGiorgio, professor of neurology at University of California, Los Angeles, has been testing this theory in epilepsy, with mixed success. In past studies, omega 3s haven't helped much to reduce seizures, he says. In a new study of 30 epileptics, he hopes to show that omega 3s reduce rates of sudden death. Sudden death—when an epileptic dies suddenly with no clear cause—accounts for about 20% of all deaths among epileptics, and irregular heartbeat can contribute to it, Dr. DeGiorgio says. He wants to test whether omega 3s help stabilize the heart and thus reduce cases of sudden death.

Some experiments on animals have suggested that omega-3 consumption can reduce brain levels of the amyloid proteins associated with Alzheimer's disease. These findings have helped drive researchers to study omega 3s in Alzheimer's patients, too.

One study involving 400 Alzheimer's patients, presented at the International Conference on Alzheimer's Disease in Vienna this summer, showed mixed results. A daily dose of two grams of DHA, one type of omega 3 fatty acid, for 18 months did not help patients perform better than those taking a placebo on standard tests used to assess the disease.

But in an interesting twist, patients taking DHA who didn't have a gene variant called ApoE4 did experience a slower rate of decline on one test of mental function compared with patients taking a placebo. Joseph Quinn, associate professor of neurology at Oregon Health & Science University and the leader of the study, cautions against making too much of this finding for now. But he says it's "encouraging and intriguing" that at least some patients seemed to benefit from omega 3s and says he hopes to conduct new studies to "look at that genotype more carefully." At least one-third of people with Alzheimer's disease lack this gene variant, according to the National Institutes of Health.

Dietary supplements usually contain about 200 milligrams of omega 3s per capsule, while a fatty salmon steak can contain up to one gram, according to Maria Makrides, an expert on omega 3s at Women's and Children's Health Research Institute in Australia.

Dietary Advice

The American Heart Association recommends that people without coronary heart disease eat a variety of fish at least twice a week, and include other foods such as flaxseed and walnuts in the diet. It says people with documented heart disease should eat about one gram of omega 3s a day. The AHA says that while omega 3s are generally safe, some side effects can include a fishy aftertaste, gastrointestinal disturbances and nausea. It says that while most omega-3 supplements are "essentially" free of mercury, the toxic metal sometimes found in fish, some poorly made supplements can contain "appreciable amounts."

Regulators and Physicians Raise Alarms About Dangerous Ingredients in Many Herbal Remedies

By ANNA WILDE MATHEWS

Mark Matcho

When Dan Gerkey was trying to get into better shape a few years ago, he tried out a dietary supplement from a local store that promised to help build his strength. At first, the stuff worked. But after several weeks the police officer, who lives in Fraser, Mich., started feeling exhausted, and his wife noticed a yellowish tinge in his eyes.

http://online.wsj.com/article/SB10001424052970204731804574390840811949538.html#

Jury Deadlock Ends a Trial Over Merck’s Bone Drug

By NATASHA SINGER

Published: September 12, 2009

Jurors sent the judge desperate hand-scrawled notes saying they were deadlocked over a verdict in the trial, which had been monitored as a bellwether for hundreds of other similar lawsuits against Merck.

In the case in United States District Court in Manhattan, a 71-year-old retired deputy sheriff from Fort Walton Beach, Fla., Shirley Boles, contended that taking Fosamax from 1997 to 2006 cause her jawbone tissue to die.

Millions of women have taken Fosamax, made by Merck, to offset bone loss associated with menopause.

During the trial, lawyers for Mrs. Boles used expert witnesses, reports in medical journals and internal company documents to bolster their argument that Merck knew or should have known that Fosamax can cause osteonecrosis of the jaw, or jawbone death.

http://www.nytimes.com/2009/09/12/business/12drug.html

The Claim: Cinnamon Oil Kills Bacteria.

By ANAHAD O’CONNOR

Published: September 7, 2009

THE FACTS

In a country obsessed with germs and sickness, antibacterial soaps and sanitizers are becoming more and more common. But because such products contribute to the growing problem of antibiotic-resistant bacteria, some researchers recommend sanitizers made with cinnamon oil, which has been shown in many studies to have powerful antimicrobial properties.

A recent study by a team of surgeons, for example, found that a solution made with cinnamon oil killed a number of common and hospital-acquired infections, like streptococcus and methicillin-resistant Staphylococcus aureus, or MRSA. The study found it was just as effective as several antiseptics widely used in hospitals. Another study by French researchers in 2008 had similar results, showing that at concentrations of 10 percent or less, cinnamon oil was effective against Staphylococcus, E. coli and several antibiotic-resistant strains of bacteria.

Dr. Lawrence D. Rosen, a pediatrician in New Jersey who dispenses natural health advice on his blog, wholechildcenter.org, recommends a tried-and-true recipe for homemade hand sanitizer called thieves oil. “I add cinnamon bark, lemon oil and eucalyptus,” he said, adding, “The recipe goes back to the Middle Ages, where it was used by these thieves who would go around stealing jewelry from dead bodies, and they never got sick.”

Cinnamon oil, when applied topically, is generally safe. But in some people it can cause an allergic reaction.

THE BOTTOM LINE
Cinnamon oil has antiseptic properties.

Late Night Eating Linked to Weight Gain

By By Tara Parker-Pope

Published: September 3, 2009

A new study in mice suggests that it's not just how much you eat, but when you eat it, that influences weight gain.

Researchers at Northwestern University wanted to test whether the timing of meals could influence body weight. Many diet books advise would-be weight losers to stop eating after 6 or 7 p.m. However, it’s never been clear if the strategy works as a behavioral change — we tend to overeat in the evenings in front of the television and the computer. Or is there some physiological reason late-night eating adds extra pounds?

To test whether time of feeding alone can affect body weight, the researchers studied two groups of mice who were fed identical diets of food that contained 60 percent fat. Mice are nocturnal, and they typically consume the vast majority of their calories at night and sleep during the day. For the study, half the mice were fed the diet during the daylight hours when they would normally be sleeping — simulating late-night eating in humans. The other half were given the same food on their regular eating schedule.

At the end of the six week study period, mice in both groups had consumed about the same amount of calories and performed the same amount of exercise. However, the mice who ate when they normally would have been sleeping hours posted an average 48 percent increase in body weight. The mice who ate on a regular schedule had an average increase of 20 percent of body weight. The findings will be published in the October issue of the journal Obesity.

Fred Turek, director of the Center for Sleep and Circadian Biology at Northwestern and the study’s senior author, said that human studies are needed to determine if timing of food intake influences body weight, but the study suggests that late-night eating may be worse, in terms of weight gain, than eating during normal waking hours. The findings would be particularly important for shift workers, who are known to be at higher risk for obesity, diabetes and other health problems. But he notes that it’s not just shift workers who are eating late. Most people eat a large percentage of their calories in the evening and continue eating late into the night.

Dr. Turek notes that humans evolved from a situation where they ate and foraged between sunrise and sunset. “After sunset, there were no refrigerators, no food just hanging around,” he said. “You didn’t eat. But today, people eat most of their calories after sunset.”

Letters

Putting America on a Healthier Diet

Published: September 12, 2009

To the Editor:.

http://www.nytimes.com/2009/09/12/opinion/l12pollan.html

By MICHAEL POLLAN

Published: September 10, 2009

The American way of eating has become the elephant in the room in the debate over health care.

http://www.nytimes.com/2009/09/10/opinion/10pollan.html

For Your Health, Froot Loops

Published: September 5, 2009

A seal meant to flag healthier food has been granted to the likes of Froot Loops and full-fat mayonnaise, alarming nutritionists.

http://www.nytimes.com/2009/09/05/business/05smart.html

Food Contest Helps Hospital Chefs Move Beyond 'First, Do No Harm'

No Jell-O or Broth for Winner Daniel Skay: Machaca Steak With Sauce, Minus Some Butter

http://online.wsj.com/article/SB125192498549680871.html

New Targets in the Fat Fight: Soda and Juice

By SEWELL CHAN

Published: September 1, 2009

Officials believe an ad’s graphic, in-your-face approach will make New Yorkers think twice before drinking a soda.

http://www.nytimes.com/2009/09/01/nyregion/01fat.html

Sweet Surrender: Sugar Curbs Urged

By RON WINSLOW and SHIRLEY S. WANG

Sergio Capursi/The Wall Street Journal

Most women should limit sugar intake to 100 calories, or six teaspoons, a day. Men should limit their consumption to 150 calories. That won’t be easy. A 12-ounce can of cola has 130 calories, or eight teaspoons.

The American Heart Association is taking aim at the nation's sweet tooth, urging consumers to significantly cut back on the amount of sugar they get from such foods as soft drinks, cookies and ice cream.

In a scientific statement issued Monday, the organization says most women should limit their sugar intake to 100 calories, or about six teaspoons, a day; for men, the recommendation is 150 calories, or nine teaspoons.

The recommendations are likely to prove challenging for many consumers to meet. Just one 12-ounce can of cola has about 130 calories, or eight teaspoons of sugar.

Data gathered during a national nutrition survey between 2001 and 2004 suggest that Americans consume on average 355 calories, or more than 22 teaspoons, of sugar a day.

"We're trying to make reasonable recommendations around the amount of sugar in a diet that enables people to achieve or maintain a healthy weight," said Rachel Johnson, associate provost and professor of nutrition at the University of Vermont in Burlington and lead author of the statement.

As the heart association's statement acknowledges, the science directly linking added sugar consumption to obesity is inconsistent. This in part reflects, the impact of such things as genetics, physical activity and diet have on weight.

The heart association has encouraged consumers to moderate sugar consumption, but the new statement is the first time it has suggested specific limits. The recommendations apply only to what are known as added sugars—those that are added to foods during manufacturing, or by consumers. They don't include sugar that occurs naturally in fruits, vegetables, dairy products and other foods.

Marion Nestle, a professor of nutrition and food studies at New York University who wasn't involved with the document, said it was a significant departure from previous recommendations, in part because "nobody has ever said it quite so forcefully."

The statement heightens the battle against foods that many public-health officials say contribute to the higher risk of such problems as diabetes and cardiovascular disease among the nation's overweight and obese consumers. A recent unrelated study by the U.S. Centers for Disease Control and Prevention said the medical costs associated with treating obesity-related conditions may have reached $147 billion last year, up from $74 billion a decade ago.

Major Sources

The chief sources of added sugar in the diet include soft drinks, candy, desserts such as cakes and cookies, fruit drinks and sweetened dairy products, including ice cream and yogurt, the statement says. Sugar in alcoholic beverages also counts as added sugar, Dr. Johnson said.

Added sugars "offer no nutritional value other than calories to the diet," Dr. Johnson said. "The majority of Americans could reduce their risk of heart disease by achieving healthy weight and the evidence is fairly clear that reducing the amount of sugars can help with that."

While many studies associate increased consumption of soft drinks with higher calorie intake, weight gain and obesity, others have failed to support the connection. Similarly, research investigating added sugar's impact on blood pressure, heightened inflammation and on changes in blood fats called triglycerides is inconclusive. And there are no studies linking the recommended limits to preventing weight gain or promoting weight loss.

Instead, Dr. Johnson and her colleagues on the heart association's nutrition committee based the suggestions on the concept of discretionary calories that are part of the U.S. Department of Agriculture's dietary guidelines called Mypyramid. Discretionary calories are those allotted to a person beyond what are necessary to consume nutrients essential to a healthy diet while still maintaining a proper weight.

Under the Mypyramid guidelines, people on a 2,000-calorie-per-day diet have 267 discretionary calories. Active young people on a 3,000-calorie-a-day-diet have 512 discretionary calories.

Related

• Health Blog: How to Figure Out How Much Sugar Is Added to Foods

Dr. Johnson said the committee decided that allocating half of the discretionary calories for added sugar was a proper course. More than that risks displacing necessary nutrients with calories from added sugar, she said.

For a moderately active middle-aged woman on a 1,800 calorie-a-day diet, the recommendations translate to about 100 calories for added sugar. For a sedentary middle-aged man consuming 2,200 calories a day, the allotment is about 150 calories.

Dr. Johnson said the statement doesn't tell people to eliminate sugar from their diets. She does recommend using the allotment to make healthier foods more tasty, such as adding sugar to whole-grain cereal, instead of using it on candy. People who get regular exercise, she said, can consume higher quantities of added sugar.

William Dietz, director of the division of nutrition, physical activity and obesity at the CDC, said the guidelines are reasonable, but he said it may be difficult for the public to understand the recommendation in terms of grams of sugar intake.

'Sugar Burden'

Instead, "I think it's easier to talk to people about what types of foods are likely to contribute to the sugar burden," with sugar-sweetened beverages like soft drinks and fruit juices at the top of the list, he said.

Consuming added sugar in drinks is particularly problematic, he said, because it doesn't make you feel as full as when you eat solid food.

Quillian Haralson, 38, of Waldorf, Md., says he would try to adhere to the recommendations and pay special attention to the sugar intake of his two children.

But, he said, it would be challenging to figure out how much added sugar is in different foods.

Mr. Haralson, a high-school teacher, said he is attentive to his three-year-old son's sugar intake, for instance, but he said he couldn't estimate how much the child is currently consuming.

"That's the sad part; I can't tell you," he said.

Current food labels don't list sugar content in calories or teaspoons and don't distinguish between natural and added sugars, Dr. Johnson said.

—Valerie Bauerlein contributed to this article.

Write to Ron Winslow at ron.winslow@wsj.com and Shirley S. Wang at shirley.wang@wsj.com

The Claim: Some Foods Can Ease Arthritis Pain

By ANAHAD O’CONNOR

Published: August 24, 2009

THE FACTS

Patients with arthritis are often encouraged to steer clear of all sorts of foods. But few of these diets are supported by any evidence.

In one of the largest analyses of diet and various types of arthritis, researchers looked at data on more than 800 patients from 15 studies. They examined several diets popular among arthritis patients and found that the one that had the greatest effect was a Mediterranean-type diet emphasizing foods like fruits, vegetables, grains, fish and olive oil, while limiting red meat. In 12 weeks, people on the diet reported about 15 percent less pain, but no improvement in physical function or morning stiffness. A vegetarian diet that allowed eggs and dairy products had a similar effect.

In other studies, patients who were given daily capsules of fish oil to take along with their antirheumatic medications saw greater benefits for swollen and tender joints than patients given a placebo, apparently because of the oil’s anti-inflammatory properties.

Meanwhile, vegetables in the nightshade family, like potatoes and tomatoes, have long been said to contribute to arthritis pain. Some researchers have speculated that a group of compounds in the vegetables called alkaloids might worsen inflammation in sensitive people. But so far no solid studies have demonstrated this. Experts say a diet in which suspect foods are gradually removed should help patients identify any problematic foods.

THE BOTTOM LINE

There is some evidence that certain diets may help with arthritis symptoms.

The Claim: Stress Can Make Allergies Worse

By ANAHAD O’CONNOR

Published: August 17, 2009

THE FACTS

Leif Parsons

This year’s allergy season has not been an easy one, with pollen counts at record highs in several major cities. But for many sufferers, a less stressful life may ease the allergy burden.

In recent years, studies have shown that psychological stress and anxiety — even at slight or moderate levels — can worsen allergy symptoms. Scientists suspect that it has something to do with the way stress affects the immune system, causing elevated levels of compounds that heighten the allergic response and remain unaffected by standard treatments for hay fever, like antihistamines.

One of the most recent and striking studies was published this year by scientists at Ohio State University. On two different days the scientists subjected hay fever sufferers to a series of skin prick tests to measure their responses to allergens, including the size of the wheals they developed. On one day the subjects gave speeches to a panel and then had to solve math questions in their heads. On the other day they had less stressful tasks, like reading magazines.

“Wheal diameters increased after the stressor,” the scientists wrote, “compared to a slight decrease following the control task.”

Even a day after the stressor, the most anxious subjects continued to show severe symptoms, suggesting a lingering response from the anxiety.

THE BOTTOM LINE

Studies show that psychological stress can heighten and possibly prolong allergic responses.

Brain Is a Co-Conspirator in a Vicious Stress Loop

Brain Is a Co-Conspirator in a Vicious Stress Loop

By NATALIE ANGIER

Published: August 18, 2009

Chronic stress changes the brain, but relaxation can change it back.

http://www.nytimes.com/2009/08/18/science/18angier.html

Tests Begin on Drugs That May Slow Aging

Science

Tests Begin on Drugs That May Slow Aging

By NICHOLAS WADE

Published: August 18, 2009

Excitement among some researchers has picked up with the apparent convergence of lines of inquiry involving genes and restricted diets.

http://www.nytimes.com/2009/08/18/science/18aging.html

Mercury Found in Every Fish Tested, Scientists Say

By CORNELIA DEAN

Published: August 19, 2009

When government scientists went looking for mercury contamination in fish in 291 streams around the nation, they found it in every fish they tested, the Interior Department said, even in isolated rural waterways. In a statement, the department said that some of the streams tested were affected by mining operations, which can be a source of mercury pollution, so the findings, by scientists at the United States Geological Survey, do not necessarily reflect contamination levels nationwide. But Interior Secretary Ken Salazar said the findings underlined the need to act against mercury pollution. Emissions from coal-fired power plants are the largest source of mercury contamination in the United States. A quarter of the fish studied had mercury levels above safety levels set by the Environmental Protection Agency for people who eat the fish regularly, the Interior Department said.

Tossing Out the Diet and Embracing the Fat

By MANDY KATZ

Published: July 16, 2009

A loose alliance of therapists, scientists and others explore whether ignoring dieting will make weight go away.

http://www.nytimes.com/2009/07/16/health/nutrition/16skin.html

To Eat Well, Be Instinctive

By MANDY KATZ

Published: July 16, 2009

We all knew how to eat intuitively once: Infants don’t binge or starve themselves, and presumably, cavemen didn’t either. But instincts become twisted in an environment where you can hold a Twinkie in one hand and the remote in the other, surrounded by images of skinny starlets.

http://www.nytimes.com/2009/07/16/health/nutrition/16skinside.html

Calorie Disclosures Fail to Weigh Whole Enchilada

Laws Requiring Restaurants to Post Nutritional Data Lean on Slim Research, Overlook 'Compensation' Meals

JULY 8, 2009
Joey Chestnut likely wasn't counting calories when he wolfed down a record 68 hot dogs at Saturday's annual eating contest in Nathan's Famous in Coney Island. But thanks to a new law requiring New York City restaurants to post nutritional information, it's easy to calculate that Mr. Chestnut's meal amounted to nearly 20,200 calories, or 297 per frankfurter.

http://online.wsj.com/article/SB124700756153408321.html#

Dieting Monkeys Offer Hope for Living Longer

By NICHOLAS WADE

Published: July 10, 2009

A study of monkeys suggests that people could in principle extend their life span by following a calorie-restricted diet.

http://www.nytimes.com/2009/07/10/science/10aging.html

Fortified Foods: How Healthy Are They?

Care for a dose of probiotics in your salsa? Or some omega-3 fatty acid -- derived from Peruvian sardines -- with your orange juice? In recent years there's been a boom in the number of foods enhanced to have health benefits, and consumers' appetite for the trend has been large.

http://online.wsj.com/article/SB124267976477131801.html

Skin Deep
A Slimmer You May Be a Whiff Away
By ABBY ELLIN
Published: June 18, 2009
Can the manipulation of smell really lead to weight loss? A handful of niche products would have you believe just that.

http://www.nytimes.com/2009/06/18/fashion/18skin.html

It's Salad Days for Weeds

http://online.wsj.com/article/SB124338226000356493.html

see video
http://online.wsj.com/video/gardener-advocates-eating-your-weedies/622FE67E-CD5A-41B2-97A0-771B0FB09D42.html

Navigating Health Food Claims

Many Americans assume they are on a healthy diet these days. But it's easy to be fooled. WSJ's Health Columnist Melinda Beck looks at whether some products are really as healthy as they say they are.

http://online.wsj.com/video/navigating-health-food-claims/37D74522-99B3-4A7F-9853-C4BBBFC92D4F.html

Mercury in corn syrup? Food made with ingredient may have traces of toxic metal

New study is bitter news for soda and candy lovers

A swig of soda or a bite of a candy bar might be sweet, but a new study suggests that food made with corn syrup also could be delivering tiny doses of toxic mercury.For the first time, researchers say they have detected traces of the silvery metal in samples of high-fructose corn syrup, a widely used sweetener that has replaced sugar in many processed foods.

The study was published Monday in the peer-reviewed journal Environmental Health. Eating high-mercury fish is the chief source of exposure for most people. The new study raises concerns about a previously unknown dietary source of mercury, which has been linked to learning disabilities in children and heart disease in adults. The source of the metal appears to be caustic soda and hydrochloric acid, which manufacturers of corn syrup use to help convert corn kernels into the food additive.A handful of plants across the nation still make the soda and acid by mixing a briny solution in electrified vats of mercury. Some of the toxic metal ends up in the final product, according to industry documents cited in the study.Corn syrup manufacturers insisted their products are mercury-free.

But the study said at least one maker of caustic soda that has used the mercury-based technology listed the corn syrup industry as a client."This seems like an avoidable source of mercury that we didn't know was out there," said David Wallinga, one of the study's co-authors and a researcher at the Institute for Agriculture and Trade Policy, a Minnesota-based advocacy group.

The researchers cautioned that their study was limited. Only 20 samples were analyzed; mercury was detected in nine.Still, the impact of the findings could be significant. High-fructose corn syrup has become such a staple in processed foods that the average American consumes 12 teaspoons of it daily, according to federal estimates. Teenagers and children tend to eat more of it than adults.There is no established safe dose for elemental mercury, the type discovered in corn syrup. But the U.S. Environmental Protection Agency says an average-sized woman should limit her exposure to 5.5 micrograms a day of methylmercury, the kind found in fish. If that same woman regularly ate corn syrup contaminated at the highest level detected in the study—0.57 micrograms per gram—the researchers estimated that she could end up consuming an amount of mercury that is five times higher than the EPA's safe dose.

www.chicagotribune.com/features/lifestyle/health/chi-mercury-corn-syrupjan27,0,2801323.story

See our full article in Environmental Health:
http://www.ehjournal.net/content/8/1/2

America’s Diet: Too Sweet by the Spoonful

Personal Health
By JANE E. BRODY
Published: February 10, 2009
The average American has a daily intake of more than twice the recommended amount of sugar.

http://www.nytimes.com/2009/02/10/health/nutrition/10brod.html?partner=permalink&exprod=permalink

Bug Crazy: Assessing The Benefits of Probiotics

WSJ Jan 13, 2009

Bacteria are everywhere, and in the view of many people that's a good thing.

Many medical experts believe that consuming healthy bacteria, called probiotics, improves the body's overall balance of good versus bad micro-organisms, boosting general health. But nutritionists warn that not all the probiotic-containing products found on store shelves provide the health benefits they claim.

Companies have sought to attract health-conscious consumers in recent years by putting probiotics in products as diverse as yogurt, juices, muffins and even pizza, as well as in dietary supplements. Last year, 231 new probiotic-containing products hit grocery and pharmacy shelves, up from just 34 in 2005, according to market-research firm Datamonitor PLC.

Probiotics are found in products ranging from yogurt and ice cream to snacks and supplements.
To be sure, some regular foods contain healthy bacteria, from common yogurt to naturally fermented pickles. But pasteurization has eliminated much of the flora found in modern foods. The recent boom in probiotic products reflects an effort to re-introduce bacteria believed to promote good health. Probiotics are generally considered safe to eat, but scientists say people with immune deficiencies should consult their doctor first.

Companies that sell products with added probiotics claim they offer a range of health benefits, from helping with digestion to boosting the immune system and preventing cavities. Some of the claims are based on reputable scientific study. But others are unproved, and advertising pitches are sometimes exaggerated. The quality of probiotic supplements also varies widely. As a result, consumers might have a difficult time choosing among a host of products.

Of several hundred probiotic-product lines on the market in North America, "15 to 20 have clinical studies behind them," says Gregor Reid, a professor of microbiology at the University of Western Ontario's Lawson Research Institute.

Probiotics are defined as "live micro-organisms which when administered in adequate amounts confer a health benefit," according to 2002 guidelines developed by the World Health Organization and the United Nations. Exactly how this works isn't fully understood, but scientists believe that good types of bacteria have long lived in symbiosis with humans and that the positive health effects may have evolved over time.

In choosing a probiotic, consumers should look for products that list a specific strain of bacteria on their label or on a Web site. Look for three names -- in Lactobacillus rhamnosus GG, for example, the final two letters identify the strain. The GG strain has been well tested scientifically and has shown health benefits. A product that simply uses the first two names may include a similar, but not identical, bacterium that doesn't have the same science behind it.

The best evidence is when the actual product -- not just the bacterium -- has been tested in humans. Such studies are sometimes posted on manufacturers' Web sites. Otherwise, consumers can do an Internet search of the specific bacterial strain to see if there is credible evidence of a product's health claims. This can take some legwork.

Say, for example, you want information on the active bacteria in Activia, a probiotic-enhanced yogurt from Dannon Co. The product label identifies the strain as Bifidus Regularis, but this is only a marketing name. The Activia Web site, under the tab "for health-care professionals," links you to summaries of scientific papers that use the scientific name, Bifidobacterium animalis DN-173 010, which has been found to hasten digestion. For additional information, you can do an Internet search of that name and many of the scientific studies on the strain pop up.

Probiotic dietary supplements also may be confusing. In a 2006 study, ConsumerLab.com, which tests nutritional products, found that just eight of 13 probiotic supplements met its quality standards. While there's no guarantee, consumers stand a better chance of getting quality products from well known, reputable manufacturers, scientists say.

Some additional tips when buying probiotic foods: Look for the word "live" on the package, since organisms killed by processing won't be helpful, says Gary B. Huffnagle, a professor at the University of Michigan Medical Center in Ann Arbor. Respecting the expiration date is particularly important, because even if a product still tastes good the bacteria may no longer be alive. For maximum benefit, scientists say, try to consume a variety of different bacteria, as each may contribute something slightly different.

Here are some claims probiotic manufacturers make for their products:
Faster Digestion: Dannon's Activia yogurt and Yoplait Yo-Plus yogurt, made by General Mills Inc., contain bacteria that have been shown in scientific studies to reduce "transit time" of waste through the intestines. Slow digestion isn't necessarily bad but can cause discomfort, such as bloating or constipation.

Dannon points to four published studies testing a formulation similar to its product in humans. General Mills says a large body of scientific evidence backs up the efficacy of the bacteria in Yo-Plus. And the company says a recent study, presented at a conference of the American College of Gastroenterology, found that a dairy drink with the same active ingredients as a four-ounce container of Yo-Plus reduced transit time to 21 hours from 31 hours, compared with no change with a placebo. The study was funded by General Mills.

Irritable Bowel Syndrome: This disorder, including cramping, abdominal pain, bloating, constipation and diarrhea, can be disabling. A scientific task force, which published its findings in the American Journal of Gastroenterology this month, concluded that certain probiotic bacteria -- primarily bifidobacteria -- have shown "some efficacy" in treating the condition. One bacterium with solid science behind it is Bifidobacterium infantis 35624, the main ingredient in Procter & Gamble Co.'s Align dietary supplement. In a 2006 published study, partially funded by P&G, a daily dose of the product was shown to relieve a wide range of symptoms better than a placebo.

Colic: When babies scream or cry with no apparent reason, it's called colic. A study of 83 infants, published last year in the journal Pediatrics found that five drops a day of a probiotic supplement from Sweden's BioGaia AB reduced median crying time from 197 minutes a day to 51 minutes. A control group of babies was given a liquid medication commonly used to treat colic but not widely viewed as effective; this group's crying fell to a median of 145 minutes a day.

Immune Health: Studies have long found that probiotics help regulate the immune system on a biochemical level. A small but growing number of studies are showing concrete health benefits in humans. Among them is an Israeli study that looked at Lactobacillus reuteri 55730 and Bifidobacterium lactis Bb-12. Published in 2005 in Pediatrics, the three-month study of 201 infants found that babies fed with either of the two probiotic formulas had fewer episodes of fever and diarrhea than babies fed a control formula. Of the two bacteria, L. reuteri was more effective in preventing illness, the study found. B. lactis Bb-12 is available in Yo-Plus yogurt and Nestle SA's Good Start Natural Cultures infant formula. The L. reuteri strain is in BioGaia's dietary supplements, as well as in Nestle's Boost Kid Essentials boxed dairy drink. The bacteria are in the straw and are intended to be ingested with the juice. Other bacteria with scientifically demonstrated immune-health properties include Lactobacillus casei DN-114 001, the bacteria in Dannon's DanActive dairy drink, and L. rhamnosus GG, in Dannon's Danimals children's drink.

Oral Health: A small number of studies have found benefits for probiotics in preventing cavities and easing gum disease. A two-week, 42-patient study published last year found that daily chewing of gum with BioGaia's L. reuteri strains improved gum health compared with a placebo gum. The study was funded in part by BioGaia. The gum product is not available in the U.S. But the company sells lozenges that BioGaia says it believes will be as effective as the gum.
A seven-month Finnish study of 594 children, published in 2001 in the journal Caries Research, found that children who drank milk infused with L. rhamnosus GG had significantly fewer cavities than those who drank regular milk. The study received funding from Valio Ltd., a Helsinki company that supplies the bacteria to food and dietary supplement companies, including

Dannon for use in Danimals.
Antibiotic-associated diarrhea: Regular yogurt has long been used to stave off this unpleasant side effect of taking antibiotics. However, supplements and foods fortified with additional probiotics may provide further relief, scientists say. So far there is good scientific evidence for several strains, including L. rhamnosus GG and Saccharomyces boulardii lyo, a yeast sold by France's Laboratoires Biocodex SA as a dietary supplement under the brand name Florastor. Dannon's DanActive drink has also been shown effective.

New Thinking on How to Protect the Heart

Personal Health
By JANE E. BRODY
Published: January 13, 2009
Some newer suggestions for how to protect your heart may surprise you.

http://www.nytimes.com/2009/01/13/health/13brod.html?partner=permalink&exprod=permalink

Alternative' Medicine Is Mainstream

By DEEPAK CHOPRA , DEAN ORNISH , RUSTUM ROY and ANDREW WEIL

The evidence is mounting that diet and lifestyle are the best cures for our worst afflictions.

In mid-February, the Institute of Medicine of the National Academy of Sciences and the Bravewell Collaborative are convening a "Summit on Integrative Medicine and the Health of the Public." This is a watershed in the evolution of integrative medicine, a holistic approach to health care that uses the best of conventional and alternative therapies such as meditation, yoga, acupuncture and herbal remedies. Many of these therapies are now scientifically documented to be not only medically effective but also cost effective.

President-elect Barack Obama and former Sen. Tom Daschle (the nominee for Secretary of Health and Human Services) understand that if we want to make affordable health care available to the 45 million Americans who do not have health insurance, then we need to address the fundamental causes of health and illness, and provide incentives for healthy ways of living rather than reimbursing only drugs and surgery.

Heart disease, diabetes, prostate cancer, breast cancer and obesity account for 75% of health-care costs, and yet these are largely preventable and even reversible by changing diet and lifestyle. As Mr. Obama states in his health plan, unveiled during his campaign: "This nation is facing a true epidemic of chronic disease. An increasing number of Americans are suffering and dying needlessly from diseases such as obesity, diabetes, heart disease, asthma and HIV/AIDS, all of which can be delayed in onset if not prevented entirely."

The latest scientific studies show that our bodies have a remarkable capacity to begin healing, and much more quickly than we had once realized, if we address the lifestyle factors that often cause these chronic diseases. These studies show that integrative medicine can make a powerful difference in our health and well-being, how quickly these changes may occur, and how dynamic these mechanisms can be.

Many people tend to think of breakthroughs in medicine as a new drug, laser or high-tech surgical procedure. They often have a hard time believing that the simple choices that we make in our lifestyle -- what we eat, how we respond to stress, whether or not we smoke cigarettes, how much exercise we get, and the quality of our relationships and social support -- can be as powerful as drugs and surgery. But they often are. And in many instances, they're even more powerful.
The Opinion Journal Widget

Download Opinion Journal's widget and link to the most important editorials and op-eds of the day from your blog or Web page.

These studies often used high-tech, state-of-the-art measures to prove the power of simple, low-tech, and low-cost interventions. Integrative medicine approaches such as plant-based diets, yoga, meditation and psychosocial support may stop or even reverse the progression of coronary heart disease, diabetes, hypertension, prostate cancer, obesity, hypercholesterolemia and other chronic conditions.

A recent study published in the Proceedings of the National Academy of Sciences found that these approaches may even change gene expression in hundreds of genes in only a few months. Genes associated with cancer, heart disease and inflammation were downregulated or "turned off" whereas protective genes were upregulated or "turned on." A study published in The Lancet Oncology reported that these changes increase telomerase, the enzyme that lengthens telomeres, the ends of our chromosomes that control how long we live. Even drugs have not been shown to do this.

Our "health-care system" is primarily a disease-care system. Last year, $2.1 trillion was spent in the U.S. on medical care, or 16.5% of the gross national product. Of these trillions, 95 cents of every dollar was spent to treat disease after it had already occurred. At least 75% of these costs were spent on treating chronic diseases, such as heart disease and diabetes, that are preventable or even reversible.

The choices are especially clear in cardiology. In 2006, for example, according to data provided by the American Heart Association, 1.3 million coronary angioplasty procedures were performed at an average cost of $48,399 each, or more than $60 billion; and 448,000 coronary bypass operations were performed at a cost of $99,743 each, or more than $44 billion. In other words, Americans spent more than $100 billion in 2006 for these two procedures alone.

Despite these costs, a randomized controlled trial published in April 2007 in The New England Journal of Medicine found that angioplasties and stents do not prolong life or even prevent heart attacks in stable patients (i.e., 95% of those who receive them). Coronary bypass surgery prolongs life in less than 3% of patients who receive it. So, Medicare and other insurers and individuals pay billions for surgical procedures like angioplasty and bypass surgery that are usually dangerous, invasive, expensive and largely ineffective. Yet they pay very little -- if any money at all -- for integrative medicine approaches that have been proven to reverse and prevent most chronic diseases that account for at least 75% of health-care costs. The INTERHEART study, published in September 2004 in The Lancet, followed 30,000 men and women on six continents and found that changing lifestyle could prevent at least 90% of all heart disease.

That bears repeating: The disease that accounts for more premature deaths and costs Americans more than any other illness is almost completely preventable simply by changing diet and lifestyle. And the same lifestyle changes that can prevent or even reverse heart disease also help prevent or reverse many other chronic diseases as well. Chronic pain is one of the major sources of worker's compensation claims costs, yet studies show that it is often susceptible to acupuncture and Qi Gong. Herbs usually have far fewer side effects than pharmaceuticals.

Joy, pleasure and freedom are sustainable, deprivation and austerity are not. When you eat a healthier diet, quit smoking, exercise, meditate and have more love in your life, then your brain receives more blood and oxygen, so you think more clearly, have more energy, need less sleep. Your brain may grow so many new neurons that it could get measurably bigger in only a few months. Your face gets more blood flow, so your skin glows more and wrinkles less. Your heart gets more blood flow, so you have more stamina and can even begin to reverse heart disease. Your sexual organs receive more blood flow, so you may become more potent -- similar to the way that circulation-increasing drugs like Viagra work. For many people, these are choices worth making -- not just to live longer, but also to live better.

It's time to move past the debate of alternative medicine versus traditional medicine, and to focus on what works, what doesn't, for whom, and under which circumstances. It will take serious government funding to find out, but these findings may help reduce costs and increase health.

Integrative medicine approaches bring together those in red states and blue states, liberals and conservatives, Democrats and Republicans, because these are human issues. They are both medically effective and, important in our current economic climate, cost effective. These approaches emphasize both personal responsibility and the opportunity to make affordable, quality health care available to those who most need it. Mr. Obama should make them an integral part of his health plan as soon as possible.

Dr. Chopra, the author of more than 50 books on the mind, body and spirit, is guest faculty at Beth Israel Hospital/Harvard Medical School. Dr. Ornish is clinical professor of medicine at the University of California, San Francisco. Mr. Roy is professor emeritus of materials science at Pennsylvania State University. Dr. Weil is director of the University of Arizona Center for Integrative Medicine.