Recurrence of Stage III Colon Cancer Traced to High-Fat Diets

After curative surgery and adjuvant chemotherapy for stage III colon cancer, patients who ate a high-fat diet were more likely to have a recurrence than those who ate a so-called prudent diet, found researchers here.

Those with a higher recurrence risk ate more meat, fat, French fries, refined grains, and desserts. Jeffrey A. Meyerhardt, M.D., M.P.H., of the Dana-Farber Cancer Institute, and colleagues, reported in the Aug. 15 issue of the Journal of the American Medical Association.

By contrast, a "prudent diet," high in fruits, vegetables, poultry, and fish, had no effect on cancer recurrence or death.
The findings came from a prospective observational study of 1,009 patients with stage III disease enrolled in a randomized adjuvant chemotherapy trial from April 1999 through May 2001. The NCI-sponsored Cancer and Leukemia Group B (CALGB) trial compared with weekly fluorouracil and leucovorin with weekly irinotecan, fluorouracil, and leucovorin.
Previous epidemiological studies have indicated that dietary factors are associated with the risk of developing colon cancer, the researchers wrote. "However, the influence of diet and other lifestyle factors on the outcome of patients with established colon cancer is largely unknown," they added.
It is possible, they said, that after resection of stage III colon cancer, increasing intake of the high-fat and processed foods in the Western diet may facilitate a milieu that allows residual microscopic disease to proliferate and spread.
Also, they said, patients rated high for consumption of foods in the Western diet after diagnosis may have had a similar diet before diagnosis and consequently may have had more biologically aggressive tumors. Nonetheless, there was no significant association between dietary pattern and tumor-related characteristics, the researchers said.
Patients filled out a semiquantitative food frequency questionnaire during and six months after adjuvant chemotherapy. Using factor analysis, the researchers identified two major dietary patterns, the fat-heavy Western diet and the prudent diet. Patients were then followed up for cancer recurrence or death.
During a median follow-up of 5.3 years for the overall cohort, 324 patients had a cancer recurrence, 223 died as a result, and 28 died without documented cancer recurrence.
Compared with patients in the lowest quintile of the Western pattern, those in the highest quintile had a more than three-fold higher risk of cancer recurrence or death (adjusted hazard ratio hazard ratio for disease-free survival, 3.25, 95% confidence interval 2.04-5.19; P for trend <0.001).
Patients in the highest quintile were also 2.9 times more likely to have a recurrence than those in the lowest quintile (adjusted HR, 2.85; CI, 1.75-4.63, P for trend <0.001).
Similarly, a significantly higher overall risk of death was observed compared with the lowest quintile (adjusted HR, 2.32; CI, 1.36-3.96, P for trend <0.001).
The reduction in disease-free survival with the Western diet was not significantly modified by sex, age, nodal stage, body mass index, physical activity level, baseline performance status, or treatment group.
No relationship was seen for recurrence-free survival (P for trend =0.84) or overall survival (P for trend =0.54) across various intakes of the prudent dietary pattern.
The adjusted hazard ratio comparing the highest and lowest quintiles of the prudent diet was 1.20 (CI, 0.83 -1.75) for disease-free survival (P for trend 0.78).
Similarly, no relationship was seen for recurrence-free or overall survival across the various intakes for those who ate a prudent diet.
Higher prudent diet scores were found for patients who were physically active, had a lower BMI six months after adjuvant therapy, and were less likely to be smokers.
Higher undesirable Western scores were seen among men, whites, and past or current smokers.
In contrast, other characteristics, particularly tumor types known to predict prognosis, did not vary significantly among the quintiles of either dietary pattern, the researchers reported.
The researchers pointed out that they could not completely exclude the possibility that a higher intake of the Western pattern may have reflected other predictors of poor prognosis.
Nevertheless no significant association between diet and predictors associated with cancer recurrence (extent of invasion into bowel wall, number of positive lymph nodes) was observed.
Because the study was observational, causality cannot and should not be drawn from these data, Dr. Meyerhardt wrote. Nonetheless, the data suggest that eating more red and processed meat, sweets and desserts, French fries, and refined grains increases the risk of recurrence and decreases survival.
"Further analyses are under way to better delineate specific nutrients or food groupings that may have the strongest association," the authors concluded.
Eric Jacobs, Ph.D., a senior epidemiologist at the American Cancer Society, called the study by Dr. Meyerhardt and colleagues well-designed and addressing "an important question that has not been studied so far."
He pointed out that diet and the risk of colon cancer studies have not been consistent, but there has been almost nothing about the risk of recurrence. "The effect of diet on recurrence may be biologically different from the original risk," he noted. "Other studies will have to attempt to duplicate the results and then see where it leads."
As to why the prudent diet showed no benefit beyond not stimulating recurrence is an important question, he added. "Stay tuned," Dr. Jacobs said. "It's a really important question and needs more research."

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Chinese Seafoods to The United States Contain Antibiotics and Antifungal

The FDA said sampling of Chinese imported fish between October and May repeatedly found traces of the antibiotics nitrofuran and fluoroquinolone, as well as the antifungals malachite green and gentian violet. Of particular concern are the fluoroquinolones, a family of widely used human antibiotics that the FDA forbids in seafood in part to prevent bacteria from developing resistance to these important drugs. The best-known example is ciprofloxacin, sold as Cipro, which made headlines as a treatment during the 2001 anthrax attacks.

The chemicals are used to help shrimp and fish survive in squalid, overcrowded fisheries along the coast of China, and many European countries have long-banned the chemical-laced fish.

The FDA announced a broader import control of farm-raised catfish, basa, shrimp, dace (related to carp), and eel from China. FDA will start to detain these products at the border until the shipments are proven to be free of residues from drugs that are not approved in the United States for use in farm-raised aquatic animals.

FDA officials said the levels of the drugs in the seafood was low and the FDA isn't asking for stores or consumers to toss any of the suspect seafood.
Evidently consumers are left to protect themselves – if you are in a supermarket and needs some Catfish, Shrimp, Dace, Eel or Basa, find out if they are from china before you buy. Note also they may still deceive you to make you buy since they are yet recalled.

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Bariatric Surgeries - A Ray Of Hope For The Morbidly Obese

Carolyn Sayre

Losing weight is an uphill battle — especially for the morbidly obese. Diet and exercise often fail. Drugs are not very effective. And in the end, many people suffer for years only to be left with one last and very expensive resort: surgery. That was certainly the case with Shawn Tarman, a 42-year-old woman from Willow Grove, Penn., who says she'd tried absolutely everything to lose weight. She finally resorted to gastric bypass surgery, a procedure that shrinks the stomach, and lost over 100 pounds.
In the last decade, bariatric surgeries like gastric bypass have become an acceptable method for treating the 15 million people in the U.S. who suffer from morbid obesity. "Obesity can be life threatening," says Dr. Philip Schauer, president of the American Society for Bariatric Surgery (ASBS). "And surgery is the next best step." Despite this, only 1% of patients who are eligible for surgery (those with a BMI over 40 or a BMI of 35 or more in conjunction with an obesity-related disease) actually get it. Sometimes, people just don't want to undergo a surgical procedure, but more often than not, obese patients are dissuaded by difficult insurance companies and are sometimes discouraged by doctors who feel they may not be the right age for the procedure.
But two new studies presented the annual meeting of the ASBS in San Diego, Calif., from June 11 to 16 show that adolescents and seniors, two age groups that have traditionally been urged to shy away from bariatric procedures, can actually benefit from surgical intervention. Another study shows that insurance companies could wind up spending less by approving bariatric surgery when compared to the life-long cost of obesity. And the latest piece of science shows that even though patients lose weight, they still need to be careful around certain indulgences — substances like alcohol have been found to have an even greater effect after surgery.
Researchers from the University of Texas Southwestern Medical Center in Dallas have found that teenagers handle bariatric surgery even better than adults. The study of 309 adolescents and 55,192 adults found that only 5.5% of teenagers had complications after surgery compared with 9.8% in adults. "There has always been a lot of concern that doing surgery in a young person, however extreme the case is, will carry a lot of complications," says Dr. Esteban Varela, lead author of the study and director of Minimally Invasive Surgery at VA North Texas Health Care System. "But it is even safer." Between 2000 and 2003, the number of teenagers who had bariatric surgery tripled. While the number is growing, with 771 adolescents signing up in 2003, teenagers still represent less than 1% of all bariatric surgeries — a number that will begin to increase as more doctors view the practice as safe.
From the same center, a similar study of the elderly population showed that seniors do not experience significantly more complications than young adults. In fact, only 13% of patients, age 65 and older, who had laparoscopic adjustable gastric banding (LAGB) — a surgical procedure that inserts a hollow band around the stomach to limit food intake — had complications. Even more compelling, nearly two-thirds of patients lost their excess weight and significantly improved their obesity-related conditions like diabetes. "No one questions whether we should offer knee or hip replacements to people over age 65," says David A. Provost, an associate professor at the University of Texas Southwestern Medical Center, who authored the study. "Weight loss surgery can provide similar quality of life improvements with less risk."
Even though Medicare and Medicare began covering bariatric surgery last year, many private insurance companies still do not want to pay for such an expensive procedure, which can cost anywhere from $10,000 to $40,000. However, a small preliminary study presented at the conference could change some of this thinking. Researchers found that the average cost of bariatric surgery is often completely recouped by the patient after three years, after which time the medical expenses of patients who did not have surgery are twice as high. "Patients who come in for surgery have a lot of medical problems," says Dr. Anita Courcoulas, lead author of the study. "It makes sense that it would end up costing less." A larger study still needs to be done, but this new research shows that surgery may actually be the cheaper option in the long term.
Most insurance companies will make patients jump through hoops before they will actually pick up the tab for bariatric surgery. Providers often require that patients lose a specified amount of weight by staying on a medically enforced diet plan. However, a new study from Duke University Medical Center found that 62% of bariatric surgery patients trimmed the excess fat regardless of whether they lost or gained 10 pounds before surgery. "There is no value in policies like this," says Dr. Eric DeMaria, the study's lead author. "If there is no value, we shouldn't use it as a requirement."
Bariatric surgery isn't a cure-all. There are still significant diet and lifestyle changes that need to be enforced. For example, a new study from Stanford University shows that patients who have gastric bypass are more susceptible to the effects of alcohol. Inspired by an episode of Oprah Winfrey in which most individuals who had undergone gastric bypass said they got drunk faster on less alcohol, the researchers decided to test this theory. The study found that for people who had the surgery, drinking 5 ounces of wine would give them an average blood alcohol level of 0.08, while the level of non-patients was only at 0.05. People who had the surgery also took 108 minutes to sober up, while non-patients only needed 72 minutes. Since the stomach is smaller after bypass, alcohol is absorbed faster and takes longer to clear the system.
It may be an uphill battle, but the evidence at this year's conference shows that gastric bypass surgery is more effective and safer that originally thought, and can significantly improve the quality of life for all ages. It certainly did for Shawn Tarman. "Eating used to be my life," Tarman says. "And surgery helped me get that life back."

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5 Ways To Identify The Best Diet

“Saying there’s one best diet for everyone is a little like saying there’s one best type of music for everyone,” Michael Dansinger, M.D., director of obesity research at the Atherosclerosis Research Laboratory at Tufts-New England Medical Center, says. People should consider a broad spectrum of options.

1) Cut The Easiest Calories First.

Eliminating the nonnutritive foods that are least important to you can have a major effect. Avoiding sugared soft drinks and juices and outsized baked goods, such as mega-bagels, alone could eliminate 500 to 1,000 calories a day from your body.

2) Choose A Safe Dietary Plan.

If you have any kind of medical condition, check with your doctor before starting a weight loss attempt, especially if you’re drawn to one of the more nutritionally extreme diets such as Atkins. Don’t strive for rapid weight loss. Losing more than 1 to 2 pounds a week can cause undesirable health effects, with the Medifast weight loss plan being the exception. Increase fiber intake gradually and drink a lot of water to avoid digestive upsets. Also, consider taking a multivitamin pill while you’re cutting the calories.

3) Consider Personal Preferences.

Someone who doesn’t like red meat will find Atkins very difficult to follow, and someone who does will probably find the vegetarian Ornish diet intolerable. Those who like variety may tire of the limited menu of a meal replacement diet.

4) Follow the Rules.

If the diet says to eat one half cup of rice, be sure to measure it in a measuring cup. If you’re supposed to eat a snack at 3 p.m. then eat it. The more faithfully people adhere to a diet, the more successful they will be.

5) Be Ready To Switch.

”You have to ‘date’ the diets and be ready to fail a few times before you find the right one that you can stick with. If after three weeks, you find a diet too difficult or unpleasant to follow or you are not losing weight then try another.

Whatever option you choose it’s very wise to seek personal support and encouragement. Surveys show that a counselor was second in effectiveness only to devising their own personal diet and exercise plan. Whether support is one-on-one or in group support behavioral support can help people lose weight. One of the largest diet studies ever conducted, involving more than 3,200 overweight people at high risk for diabetes, found that intensive counseling to support diet and exercise changes worked better than a drug to prevent diabetes and induce consistent weight loss.

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10 Slimming-Down Tactics You Cant Ignore

Rebecca Webber

The devil is in the details -- and nowhere is the cliché truer than with weight loss. It's the small decisions that add up to change, and that's a good thing, says William Dietz, MD, PhD, at the CDC: "If you can count it, you can change it." The 10 countable steps that follow will add up to victory over unwanted pounds. But don't try them all at once. "It's like renovating a house; most people do better taking one room at a time," says John Jakicic, PhD, director of weight management at the University of Pittsburgh. "Start with the easiest tactic. Once you master it, move on."

1. Weigh yourself one time per day
Why It Works
Weekly weigh-ins are a staple of many popular diet programs, but studies now show that daily weighing is the key to lasting loss. When researchers at the University of Minnesota monitored the scale habits of 1,800 dieting adults, they found that those who stepped on every day lost an average of 12 pounds over 2 years (weekly scale watchers lost only 6) and were less likely to regain lost weight. The reason: "The more often you monitor your results, the quicker you can catch the behavioral slip that causes weight gain," says Jakicic.

Who It Helped
Heidi Hurtz, 29, of Los Angeles: "I was in denial about my size, so I never used a scale. When I started weighing daily, I lost 7 pounds in 2 weeks. I loved the immediate gratification, and eventually lost 77 pounds."

Add It In
Step on the scale first thing every morning, when you weigh the least. Expect small day-to-day fluctuations because of bloating or dehydration, but if your weight creeps up by 2 percent (that's just 3 pounds if you weigh 150), it's time to pass up the bread.

2. Watch no more than 2 hours of TV a day
Why It Works
TV junkies miss out on calorie-burning activities like backyard tag with the kids; instead, they become sitting ducks for junk-food ads. One recent study found that adults who watch more than 2 hours of TV per day take in 7 percent more calories and consume more sugary snacks than those who watch less than an hour a day.

Who It Helped
Christy Taylor, 27, of Sylacauga, Ala: "TV was one reason I weighed 220 pounds. I watched it constantly. My blood pressure skyrocketed during pregnancy, and when it didn't come down after my son was born, I decided to try to limit myself to one show a day. That was 10 months ago, and I've since lost 32 pounds."

Add It In
Wean yourself off the tube by introducing other activities into your life. Eliminate the temptation to watch between-show filler by recording your must-see programs so you can fast-forward through the ads. Or subscribe to a mail order DVD service like Netflix, and make a movie the only thing you watch all day.

3. Contact a friend three times per week
Why It Works
"Long-term weight loss requires support," says Marion Franz, RD, a nutrition consultant in Minneapolis. Her study review found that people who met regularly with a dietitian or attended groups like Weight Watchers were more likely to maintain their losses than those who didn't.

Who It Helped
Maggie Ramos, 39, of Houston: "When I plateaued for months, my friend Nancy stepped in and cheered me on until I lost it all."

Add It In
If you can't attend group meetings, announce your weight loss intentions so friends can support you, says Franz. And add a dieter pal to your regular call or e-mail list, too.

4. Eat four grams of fiber in every meal or snack
Why It Works
A high-fiber diet can lower your caloric intake without making you feel deprived. In a recent Tufts University study, women who ate 13 g of fiber or less per day were five times as likely to be overweight as those who ate more fiber. Experts see a number of mechanisms through which fiber promotes weight loss: It may slow down eating because it requires more chewing, speed the passage of food through the digestive tract, and boost satiety hormones.

Who It Helped
Monique Hester, 41, of North Richland Hills, Texas. "I started a diet that had me consuming more than 25 grams of fiber daily, and before I knew it, I'd lost 23 pounds. I don't even like white bread anymore. I want something I can crunch and chew."

Add It In
To get 25 grams of fiber a day, make sure you eat six meals or snacks, each of which contains about 4 grams of fiber. For instance, Hester started her day with grapes (1 cup = 1.4 grams of fiber) and cracked wheat toast (two slices = 6 grams) or oatmeal (1 cup = 4 grams). She often had a cup of black bean soup for lunch (4.4 grams) with a slice of cracked wheat bread. One good trick: For to-go snacks, buy fruit; it's handier than vegetables, so it's an easy way to up your fiber intake. For instance, one large apple has just as much fiber (5 grams) as a cup of raw broccoli.

5. Take five (thousand) extra steps a day
Why It Works
A typical person takes about 5,000 steps per day between going to work, running errands, and doing chores around the house. Doubling that number can have significant health benefits: higher "good" HDL cholesterol levels, lower blood pressure, improved glucose control, and yes, a lower number on the scale. Walking more steps per day also leads to a lower percentage of body fat and slimmer waists and hips, reports a recent University of Tennessee study of 80 women. An earlier University of South Carolina study of 109 people showed that those who took fewer than 5,000 steps per day were, on average, heavier than people who took more than 9,000.

Who It Helped
Joanna Webb, 34, of Queen Creek, Ariz.: "I started walking when my daughter was 2 months old. I couldn't even make it around the block without stopping. I kept at it until I could walk 6 nights a week with my husband, our 5-year-old, and the baby. Now I've lost 35 pounds."

Add It In
Wear a pedometer to make sure you log your 5,000 extra steps, or aim for about 50 minutes of extra walking (2 1/2 miles) per day. In the Tennessee study, "Some of the women walked with friends; others increased their steps by taking the stairs and parking farther away," says lead researcher Dixie Thompson, PhD.

6. Log it six times per week Why It Works
"Monitoring your eating and exercise every day will let you know if you're reaching the 500-calorie daily deficit you need to lose about a pound a week," says Robert Carels, PhD, a psychology professor at Bowling Green State University. His study of 40 obese adults found that those who recorded their food and exercise over 6 months lost more than 20 pounds. That was nearly twice the amount shed by less consistent notetakers.

Who It Helped
Julie Fugett, 29, of Lawrence, Kan.: "Journaling was an important part of my program. I chronicled food intake using the Weight Watchers Points system and also printed out a monthly calendar to schedule workouts in advance. I'd mark each successful day of exercise with a purple smiley face, and eventually those stick-on grins added up to a 25-pound weight loss that I've maintained for over 2 years."

Add It In
Carry a small notebook or PDA to record what you eat and use a pedometer to estimate the calories you burn. Although you should try to keep a daily log, it's realistic to give yourself a break one day a week and allow time off for holidays and houseguests. "Then get back on track," says Carels.

7. Sleep seven hours a night
Why It Works
A University of Chicago study found that people deprived of Zzzs had lower levels of the hormones that control appetite. "The research suggested that short sleep durations could be a risk factor for obesity," says James Gangwisch, PhD, an epidemiologist from Columbia University Medical Center. Sure enough, his follow-up study of 9,588 Americans found that women who slept 4 hours or less per night were 234 percent more likely to be obese.

Who It Helped
Julia Havey, 44, of St. Louis: "I used to stay up late watching movies and eating ice cream. I'd have to wake up at 6AM, so I always felt exhausted and bloated. Now I make it a point to be in bed by 11PM. The extra sleep makes it easier for me to stick to my diet and exercise routine because I have more energy and fewer cravings."

Add It In
The key number for most people is 7 hours or more a night, says Gangwisch, so set an early bedtime and stick to it.

8. Drink eight glasses of water per day
Why It Works
Water is not just a thirst quencher --it actually speeds the body's metabolism. Researchers in Germany found that drinking two 8-ounce glasses of cold water increased their subjects' metabolic rate by 30 percent, and the effect persisted for 90 minutes. One-third of the boost came from the body's efforts to warm the water, but the rest was due to the work the body did to absorb it. "When drinking water, no calories are ingested but calories are used, unlike when drinking sodas, where additional calories are ingested and possibly stored," explains the lead researcher, Michael Boschmann, MD, of University Medicine Berlin.

Who It Helped
Paige Tomas, 25, of Corpus Christi, Texas: "I used to have a five-can-a-day Dr Pepper addiction. To stop, I'd make myself drink a whole glass of water before allowing myself a soda, and now I'm down to just two Diet Dr Peppers a day."

Add It In
Increasing water consumption to eight glasses per day may help you lose about 8 pounds in a year, says Boschmann, so try drinking a glass before meals and snacks and before consuming sweetened drinks or juices.

9. After a nine hour day (lunch included!), go home
Why It Works
A University of Helsinki study of 7,000 adults found that those who'd packed on pounds in the previous year were more likely to have logged overtime hours. Lack of time for diet and exercise is most likely the cause, but it's also possible that work stress has a direct effect on weight gain through changes in hormones like cortisol.

Who It Helped
Nicole Bruni, 36, of Milwaukee: "I gained about 35 pounds in my first year at my law firm, so I started making it a point to wrap up the day in time for a 6PM spinning class, and I've since lost 40 pounds."

Add It In
Set firm limits on your workday so that when you're done, you still have the oomph to take a bike ride and broil fish for dinner. To help you stay productive enough to finish on time, set an hourly alarm; when it goes off, deal with your most pressing duties.

10. Shave 10 points off your glycemic load
Why It Works
Foods high on the glycemic index --including sugars and refined carbohydrates -- cause blood sugar to spike. "The body uses insulin to bring down blood sugar," says Yunsheng Ma, MD, PhD, an assistant professor of medicine at the University of Massachusetts Medical School. The body stores the excess sugar as fat. But that leaves blood sugar levels low, so we feel hungry again and eat more -- an unhealthy cycle. Ma studied the eating patterns of 572 people and found that those who ate foods high on the glycemic index weighed significantly more than those who did not. "There's about a 10-pound body weight decrease for every 10-point drop in the glycemic index of all the food a person eats each day," he says.

Who It Helped
Jessica Seaberg, 28, of Minneapolis: "I eradicated most refined sugars from my diet and lost 65 pounds. I stick to whole grain bread, slow-cooking brown rice, and whole wheat pasta."

Add It In
Read labels to avoid added sugars, or better yet, eat fresh produce. Healthy swaps include a baked sweet potato (48 on the glycemic index) instead of a russet potato (94); grapes (49) instead of dates (103); pasta (45) instead of pizza (60); and Nutella (30) instead of jelly beans (80). And skip the liquid glucose known as juice.

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10 Slimming-Down Tactics You Cant Ignore

Rebecca Webber

The devil is in the details -- and nowhere is the cliché truer than with weight loss. It's the small decisions that add up to change, and that's a good thing, says William Dietz, MD, PhD, at the CDC: "If you can count it, you can change it." The 10 countable steps that follow will add up to victory over unwanted pounds. But don't try them all at once. "It's like renovating a house; most people do better taking one room at a time," says John Jakicic, PhD, director of weight management at the University of Pittsburgh. "Start with the easiest tactic. Once you master it, move on."

1. Weigh yourself one time per day
Why It Works
Weekly weigh-ins are a staple of many popular diet programs, but studies now show that daily weighing is the key to lasting loss. When researchers at the University of Minnesota monitored the scale habits of 1,800 dieting adults, they found that those who stepped on every day lost an average of 12 pounds over 2 years (weekly scale watchers lost only 6) and were less likely to regain lost weight. The reason: "The more often you monitor your results, the quicker you can catch the behavioral slip that causes weight gain," says Jakicic.

Who It Helped
Heidi Hurtz, 29, of Los Angeles: "I was in denial about my size, so I never used a scale. When I started weighing daily, I lost 7 pounds in 2 weeks. I loved the immediate gratification, and eventually lost 77 pounds."

Add It In
Step on the scale first thing every morning, when you weigh the least. Expect small day-to-day fluctuations because of bloating or dehydration, but if your weight creeps up by 2 percent (that's just 3 pounds if you weigh 150), it's time to pass up the bread.

2. Watch no more than 2 hours of TV a day
Why It Works
TV junkies miss out on calorie-burning activities like backyard tag with the kids; instead, they become sitting ducks for junk-food ads. One recent study found that adults who watch more than 2 hours of TV per day take in 7 percent more calories and consume more sugary snacks than those who watch less than an hour a day.

Who It Helped
Christy Taylor, 27, of Sylacauga, Ala: "TV was one reason I weighed 220 pounds. I watched it constantly. My blood pressure skyrocketed during pregnancy, and when it didn't come down after my son was born, I decided to try to limit myself to one show a day. That was 10 months ago, and I've since lost 32 pounds."

Add It In
Wean yourself off the tube by introducing other activities into your life. Eliminate the temptation to watch between-show filler by recording your must-see programs so you can fast-forward through the ads. Or subscribe to a mail order DVD service like Netflix, and make a movie the only thing you watch all day.

3. Contact a friend three times per week
Why It Works
"Long-term weight loss requires support," says Marion Franz, RD, a nutrition consultant in Minneapolis. Her study review found that people who met regularly with a dietitian or attended groups like Weight Watchers were more likely to maintain their losses than those who didn't.

Who It Helped
Maggie Ramos, 39, of Houston: "When I plateaued for months, my friend Nancy stepped in and cheered me on until I lost it all."

Add It In
If you can't attend group meetings, announce your weight loss intentions so friends can support you, says Franz. And add a dieter pal to your regular call or e-mail list, too.

4. Eat four grams of fiber in every meal or snack
Why It Works
A high-fiber diet can lower your caloric intake without making you feel deprived. In a recent Tufts University study, women who ate 13 g of fiber or less per day were five times as likely to be overweight as those who ate more fiber. Experts see a number of mechanisms through which fiber promotes weight loss: It may slow down eating because it requires more chewing, speed the passage of food through the digestive tract, and boost satiety hormones.

Who It Helped
Monique Hester, 41, of North Richland Hills, Texas. "I started a diet that had me consuming more than 25 grams of fiber daily, and before I knew it, I'd lost 23 pounds. I don't even like white bread anymore. I want something I can crunch and chew."

Add It In
To get 25 grams of fiber a day, make sure you eat six meals or snacks, each of which contains about 4 grams of fiber. For instance, Hester started her day with grapes (1 cup = 1.4 grams of fiber) and cracked wheat toast (two slices = 6 grams) or oatmeal (1 cup = 4 grams). She often had a cup of black bean soup for lunch (4.4 grams) with a slice of cracked wheat bread. One good trick: For to-go snacks, buy fruit; it's handier than vegetables, so it's an easy way to up your fiber intake. For instance, one large apple has just as much fiber (5 grams) as a cup of raw broccoli.

5. Take five (thousand) extra steps a day
Why It Works
A typical person takes about 5,000 steps per day between going to work, running errands, and doing chores around the house. Doubling that number can have significant health benefits: higher "good" HDL cholesterol levels, lower blood pressure, improved glucose control, and yes, a lower number on the scale. Walking more steps per day also leads to a lower percentage of body fat and slimmer waists and hips, reports a recent University of Tennessee study of 80 women. An earlier University of South Carolina study of 109 people showed that those who took fewer than 5,000 steps per day were, on average, heavier than people who took more than 9,000.

Who It Helped
Joanna Webb, 34, of Queen Creek, Ariz.: "I started walking when my daughter was 2 months old. I couldn't even make it around the block without stopping. I kept at it until I could walk 6 nights a week with my husband, our 5-year-old, and the baby. Now I've lost 35 pounds."

Add It In
Wear a pedometer to make sure you log your 5,000 extra steps, or aim for about 50 minutes of extra walking (2 1/2 miles) per day. In the Tennessee study, "Some of the women walked with friends; others increased their steps by taking the stairs and parking farther away," says lead researcher Dixie Thompson, PhD.

6. Log it six times per week Why It Works
"Monitoring your eating and exercise every day will let you know if you're reaching the 500-calorie daily deficit you need to lose about a pound a week," says Robert Carels, PhD, a psychology professor at Bowling Green State University. His study of 40 obese adults found that those who recorded their food and exercise over 6 months lost more than 20 pounds. That was nearly twice the amount shed by less consistent notetakers.

Who It Helped
Julie Fugett, 29, of Lawrence, Kan.: "Journaling was an important part of my program. I chronicled food intake using the Weight Watchers Points system and also printed out a monthly calendar to schedule workouts in advance. I'd mark each successful day of exercise with a purple smiley face, and eventually those stick-on grins added up to a 25-pound weight loss that I've maintained for over 2 years."

Add It In
Carry a small notebook or PDA to record what you eat and use a pedometer to estimate the calories you burn. Although you should try to keep a daily log, it's realistic to give yourself a break one day a week and allow time off for holidays and houseguests. "Then get back on track," says Carels.

7. Sleep seven hours a night
Why It Works
A University of Chicago study found that people deprived of Zzzs had lower levels of the hormones that control appetite. "The research suggested that short sleep durations could be a risk factor for obesity," says James Gangwisch, PhD, an epidemiologist from Columbia University Medical Center. Sure enough, his follow-up study of 9,588 Americans found that women who slept 4 hours or less per night were 234 percent more likely to be obese.

Who It Helped
Julia Havey, 44, of St. Louis: "I used to stay up late watching movies and eating ice cream. I'd have to wake up at 6AM, so I always felt exhausted and bloated. Now I make it a point to be in bed by 11PM. The extra sleep makes it easier for me to stick to my diet and exercise routine because I have more energy and fewer cravings."

Add It In
The key number for most people is 7 hours or more a night, says Gangwisch, so set an early bedtime and stick to it.

8. Drink eight glasses of water per day
Why It Works
Water is not just a thirst quencher --it actually speeds the body's metabolism. Researchers in Germany found that drinking two 8-ounce glasses of cold water increased their subjects' metabolic rate by 30 percent, and the effect persisted for 90 minutes. One-third of the boost came from the body's efforts to warm the water, but the rest was due to the work the body did to absorb it. "When drinking water, no calories are ingested but calories are used, unlike when drinking sodas, where additional calories are ingested and possibly stored," explains the lead researcher, Michael Boschmann, MD, of University Medicine Berlin.

Who It Helped
Paige Tomas, 25, of Corpus Christi, Texas: "I used to have a five-can-a-day Dr Pepper addiction. To stop, I'd make myself drink a whole glass of water before allowing myself a soda, and now I'm down to just two Diet Dr Peppers a day."

Add It In
Increasing water consumption to eight glasses per day may help you lose about 8 pounds in a year, says Boschmann, so try drinking a glass before meals and snacks and before consuming sweetened drinks or juices.

9. After a nine hour day (lunch included!), go home
Why It Works
A University of Helsinki study of 7,000 adults found that those who'd packed on pounds in the previous year were more likely to have logged overtime hours. Lack of time for diet and exercise is most likely the cause, but it's also possible that work stress has a direct effect on weight gain through changes in hormones like cortisol.

Who It Helped
Nicole Bruni, 36, of Milwaukee: "I gained about 35 pounds in my first year at my law firm, so I started making it a point to wrap up the day in time for a 6PM spinning class, and I've since lost 40 pounds."

Add It In
Set firm limits on your workday so that when you're done, you still have the oomph to take a bike ride and broil fish for dinner. To help you stay productive enough to finish on time, set an hourly alarm; when it goes off, deal with your most pressing duties.

10. Shave 10 points off your glycemic load
Why It Works
Foods high on the glycemic index --including sugars and refined carbohydrates -- cause blood sugar to spike. "The body uses insulin to bring down blood sugar," says Yunsheng Ma, MD, PhD, an assistant professor of medicine at the University of Massachusetts Medical School. The body stores the excess sugar as fat. But that leaves blood sugar levels low, so we feel hungry again and eat more -- an unhealthy cycle. Ma studied the eating patterns of 572 people and found that those who ate foods high on the glycemic index weighed significantly more than those who did not. "There's about a 10-pound body weight decrease for every 10-point drop in the glycemic index of all the food a person eats each day," he says.

Who It Helped
Jessica Seaberg, 28, of Minneapolis: "I eradicated most refined sugars from my diet and lost 65 pounds. I stick to whole grain bread, slow-cooking brown rice, and whole wheat pasta."

Add It In
Read labels to avoid added sugars, or better yet, eat fresh produce. Healthy swaps include a baked sweet potato (48 on the glycemic index) instead of a russet potato (94); grapes (49) instead of dates (103); pasta (45) instead of pizza (60); and Nutella (30) instead of jelly beans (80). And skip the liquid glucose known as juice.

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6 Reasons Why You Should Eat Sea Foods

Although the link between seafood consumption and improved health has been known for decades, a number of recent studies are shedding new light on the many health benefits of the omega-3 fatty acids found in fish. Considered essential nutrients because the body does not make them, omega-3 fatty acids are fundamental molecules in the structure and activity of cell membranes, especially in the brain and retina of the eye.

The following summarizes some important research findings that show the omega-3 fatty acids in fish play a major health role at every stage of life, from healthy infant development through the prevention and management of certain diseases and chronic conditions that may appear later on.

1. Benefits for the Developing Infant

New Findings from Harvard Medical School

When it comes to the developing fetus, extensive research shows that one of the essential omega-3 fatty acids in fish - DHA (docosahexaenoic acid) - is a critical component for building brain tissue, for nerve growth, and for the retina. In fact, research finds that when babies are developing during the last third of pregnancy, the brain and nervous system rapidly accumulate DHA. Before birth, babies get the DHA they need from their mother. After birth they obtain it mainly from breast milk.

However, a new study by researchers at Harvard Medical School now finds that the importance of DHA to the developing brain is significant during the second trimester of pregnancy. According to a research article - Maternal Fish Consumption, Hair Mercury, and Infant Cognition in a U.S. Cohort - published in the October 2005 issue of Environmental Health Perspectives, the study of 135 mothers and their infants reported that the greater a woman's fish intake during the second trimester, the better her 6-month-old performed on a standard test of mental development. Overall, babies' scores on the test climbed by 4 points for each weekly serving of fish their mothers had during the second trimester, after findings were adjusted for maternal hair mercury and other confounding factors. Examining the impact of mercury, the study found that elevated maternal mercury levels were associated with deficits in infant cognition, but in spite of that, greater fish consumption was associated with better cognition. These results suggest that higher consumption of fish low in mercury is beneficial for infant cognition.

New Data from the National Institute of Environmental Health Sciences (NIEHS)

In July 2004, researchers with the National Institute of Environmental Health Sciences (NIEHS) published a research article in the Journal of Epidemiology based on assessing the fish intake of more than 7,400 mothers in the United Kingdom and found that those who ate fish regularly during pregnancy had children with better language and communication skills by the age of 18 months. Using standard tests of language, comprehension, motor and social skills to assess childhood development at 15 and 18 months, the study found a subtle but consistent link between eating fish during pregnancy and a child's early cognitive development, even after adjusting for factors such as the age and education of the mother, whether she breastfed, and the quality of the home environment. Moreover, the study revealed that the amount of fish associated with these cognitive benefits was one to three servings a week, which is consistent with the advice of the Food and Drug Administration (FDA) and the Environmental Protection Agency (EPA) that pregnant women should eat up to 12 ounces a week of fish low in mercury.

2. Benefits for Young Children

Findings from Child Asthma Prevention Study

Recent study findings from the Childhood Asthma Prevention Study in Australia also reported that the consumption of omega-3 fatty acids was linked to a reduction in asthma symptoms in children. Published in the October 2004 issue of the Journal of Allergy & Clinical Immunology and conducted by researchers at the University of Sydney, the study examined 616 children at high risk for developing asthma and found that those children whose diets were high in omega-3 fatty acids were much less likely to develop a cough, one of the major triggers for asthma attacks. Moreover, the study concluded that increasing the proportion of omega-3 fatty acids in the diet significantly reduced airway inflammation in children as young as age 3. Other research has found omega-3 fatty acids to be beneficial in other lung diseases such as cystic fibrosis.

3. Omega-3 Fatty Acids and Women's Health

Lower Prevalence of Postpartum Depression

Because the omega-3 fatty acids in fish enhance the ability of brain-receptors to comprehend mood-related signals from the brain, some researchers have observed that the likelihood of having depressive symptoms is significantly higher among infrequent fish consumers than among habitual fish eaters. This includes postpartum depression, where a 1998 study published in the Lancet, found that women in 23 countries whose breast milk was rich in omega-3 fatty acids because they had consumed fatty fish were less likely to suffer from this condition. Researchers noted that there was an inverse relationship between the consumption of fatty fish and the occurrence of postpartum depression. That means that women eating fatty fish were less likely to develop post partum depression.

Lower Risk of Breast Cancer

At a time when more than 40,000 American women die each year from breast cancer, the "Singapore Chinese Health Study" published in the May 2004 issue of the British Journal of Cancer found that postmenopausal women who ate more fish had a 26 percent lower risk of developing the disease. Conducted by researchers at the Keck School of Medicine at the University of Southern California and the National University of Singapore, the study examined the eating habits of 35,298 women aged 45 to 74 years over a five-year period and found that those who consumed an average of one and a half to 3 ounces of fish and shellfish daily were 30 percent less likely to develop breast cancer than women who ate less than one ounce of fish a day. Based on these observations, the study authors suggested that eating approximately 40 grams of seafood a day - about 10 ounces of fish a week - could reduce breast cancer risk by 25 percent. As a comparison, the average American consumes less than 5 ounces of seafood per week according to National Marine Fisheries data.

4. Reducing the Risk of Heart Disease and Stroke

Protection Against Heart Disease

The cardiovascular benefits of omega-3 fatty acids have been documented in many prospective studies and randomized clinical trials. For example, the findings of a small clinical trial published in the Annals of Internal Medicine found that patients who were given fish oil concentrate for two years had lower triglyceride levels and minimal artery blockage when compared to those receiving a placebo. Moreover, in a 1998 issue of Diabetes Care, a meta-analysis of studies on diabetes and fish oils found a 30 percent reduction in patient triglyceride levels, particularly among subjects with Type I diabetes who are at greatly increased risk of heart disease than people without the disease.

Along with these smaller studies, there have been a number of large trials reporting that omega-3 fatty acids in fish provide a protective mechanism of reducing the risk of irregular heartbeats. One major study called the GISSI-Prevenzione secondary prevention trial is particularly noteworthy. Reported in 2002 in the journal Circulation, this study of 11,323 subjects who survived their first heart attack demonstrated that even a small amount (about one gram a day) of the omega-3 fatty acids found in fish was effective in cutting the chance of cardiac death by 45 percent-nearly half.

Preventing Stroke

Although less is known about the relationship between the omega-3 fatty acids in fish and the prevention of stroke, findings from the Nurses Health Study, which were published in the January 23, 2001 issue of the Journal of the American Medical Association, found that women who ate fish more than once per month had a lower risk of stroke when compared with those who ate fish less than once a month. Moreover, women who ate fish two or more times per week had a significantly reduced risk of thrombotic infarction, the type of stroke most common in the U.S. Fish consumption is also linked to lower risk of stroke in men according to a major epidemiological study.

New Conclusions in 2005 Dietary Guidelines for Americans

Based in part on this body of evidence, the 2005 Dietary Guidelines for Americans recommend that Americans aged two and over get two eight-ounce servings a week of foods rich in the omega-3 fatty acids EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid). In making this recommendation, the 13-member 2005 Dietary Guidelines Advisory Committee whose scientific review formed the basis for updating the government's nutrition advice, concluded that higher levels of EPA and DHA are associated with the reduced risk of both sudden death and death from coronary heart disease in adults. Specifically, the Dietary Guidelines Advisory Committee estimates that there could be a 30 percent reduction in coronary deaths if people increased their intake of omega-3 fatty acids.

5. Improved Eye Function

Age-related macular degeneration (AMD) is a leading cause of loss of vision in older persons in developed countries. Although the exact causes of AMD are still unknown, many researchers believe that certain nutrients, such as the omega-3 fatty acids in fish, help lower the risk for AMD or slow down its progression. Towards this end, the August 2001 issue of Archives of Ophthalmology reported findings that consumption of omega-3 fatty acids had a protective effect against advanced macular degeneration. The Age-Related Eye Disease Study (AREDS) confirmed this finding in 2003. In this case-control study of 4,513 participants aged 60 to 80 years at enrollment, total fish consumption of more than two servings per week was associated with a decreased risk for AMD compared with no fish in the diet.

6. Improved Brain Function

Halting Mental Decline Later in Life

Growing scientific evidence now suggests that the omega-3 fatty acids found in seafood improve brain function in middle aged people and may actually lower the risk of mental impairment as people age. The latest research comes from researchers with Utrecht and Maastricht Universities in the Netherlands and was published in the journal Neurology in 2004. Tracking more than 1,600 Dutch men and women aged 45 to 70 over a six-year period, the researchers found that those who ate fish regularly scored higher on a battery of tests for memory, psychomotor speed, cognitive flexibility, and overall cognition. Moreover, the study concluded that the specific factors contributing to better brain function were fatty fish and the consumption of two essential omega-3 fatty acids found in canned tuna, EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid).

Slowing the Progression of Alzheimer's Disease

Reported in the September 2, 2005 issue of the journal Neuron, neuroscientists at UCLA showed for the first time, in animals with Alzheimer's disease, that a diet high in DHA helps protect the brain against the memory loss and cell damage caused by the condition, which now affects an estimated 4.5 million Americans. In the study, the researchers bred mice with genetic mutations that cause the brain lesions linked to advanced Alzheimer's disease. When the mice aged and showed brain lesions but displayed no major loss of brain-cell activity, the scientists then fed one group a diet high in omega-3 fatty acids and the other a diet depleted of these fatty acids. After five months, the researchers compared each set of mice to a control group without the disease and found extensive synaptic damage in the brain cells of the Alzheimer's mice that ate the DHA-depleted diet, but not in those consuming DHA.

Controlling Epilepsy

At a time when an estimated 2.5 million Americans have been diagnosed with epilepsy, new research from the Emory University School of Medicine finds that people with a common type of seizure (refractory complex partial seizures) often have significantly lower amounts of the omega-3 fatty acid DHA (docosahexaenoic acid) in their blood. Because this form of epilepsy is often resistant to drug treatment, the researchers suggest that an important way to control these seizures may be as simple as consuming more foods rich in DHA. These preliminary findings suggest another area of brain function that might be linked to omega-3 fatty acids that warrants additional investigation.

Therapeutic Effect on Depression

A growing body of research finds a connection between the intake of omega-3 fatty acids and a lower prevalence of depression. This is because the brain and central nervous system contain high levels of DHA and EPA to keep the pattern of thoughts, reactions, and reflexes running smoothly and efficiently. Although the precise mechanisms by which these omega-3 fatty acids regulate mood are unknown, a number of studies on omega-3 fatty acids and mood have reported positive outcomes. In a 2002 study published in the American Journal of Psychiatry, researchers showed that 2 grams of EPA could improve the symptoms of treatment-resistant depression. The researchers found that the EPA (versus placebo), when added to an ineffective antidepressant for one month, significantly improved depressive symptoms. A larger study published in Archives of General Psychiatry in 2002 confirmed these findings using a daily dose of 1 gram of EPA, and noted significant improvements in depressive symptoms, sleep, anxiety, lassitude, libido, and thoughts of suicide.

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Meeting Your Body's Daily Minerals And Vitamins Needs

Of course, you eat a balanced diet. That's why you're sure you get all the nutrients you need.

Just yesterday, for example, you had--oh, well, you skipped breakfast because you were in a hurry, then grabbed a fast-food lunch. For dinner--who has the energy to make dinner?--you zapped a frozen entrée and rewarded yourself with a cappuccino-mix coffee and mini chocolate chip cookies.

Like many of us, you probably have days when you eat more healthfully--having a salad with your meals and fresh fruit for snacks or dessert. But how regularly does your daily menu include the 1-1/2 cups of fruit, 2 to 2-1/2 cups of vegetables, 3 cups of fat-free or lowfat milk, 3 ounces of whole-grain foods and 5 ounces of meat or beans that the U. S. Department of Agriculture now recommends for most women?¹ (In April 2005, these new guidelines replaced the old food pyramid requirements. To see the new food pyramid and new dietary recommendations, visit www.mypyramid.gov .)

Our eating habits, aging, even how much sunlight we get, all affect how well we meet our bodies' daily nutrient needs. As a result, many women are deficient in one or more important micronutrients, such as vitamins A, B6, B12, C, D, E, folate (folic acid) and calcium. Having lower levels of these means greater risk for cardiovascular and other chronic diseases, certain cancers, bone fractures, and more.²

Getting the right balance

In middle age and beyond, it's important to give your body the vitamins and minerals that support good health.³ The best way to do that is by eating a balanced diet, with a variety of foods, minimal alcohol, and plenty of fruits, vegetables and fiber, says Marian Neuhouser, Ph.D., R.D., a nutritional epidemiologist and cancer prevention expert at the Fred Hutchinson Cancer Research Center in Seattle.

Yet that ideal is rarely achieved. "Almost all Americans are deficient in fruit and vegetable intake," Dr. Neuhouser says.

Indeed, research⁴ shows that most of us don't get all the vitamins we need through diet alone. Taking a daily multivitamin helps close that gap. "Even if you don't remember to take it every day, if you take it most days of the week, it's still a good investment in your health," says nutritionist Jo-Anne M. Rizzotto, M.Ed., R.D., L.D.N., C.D.E., Joslin Diabetes Center, Boston.

Change happens

As we age, our bodies may have difficulty absorbing and using certain nutrients that occur naturally in foods. However, very little is known about which individuals may be at nutritional risk from these changes. Because vitamin B12 absorption and utilization may be particularly problematic for some older individuals, the IOM has recommended that everyone over age 50 get their daily requirement by consuming foods specially fortified with vitamin B12, such as some cereals, or by taking a multivitamin supplement that includes B-12, notes Dr. Neuhouser.⁵

Similarly, levels of vitamin D--which the skin produces from ultraviolet light--often drop with age. This could be due to limited sun exposure, the skin's declining ability to make the vitamin, as well as low intake of foods containing vitamin D. "Increasing sun exposure and ensuring adequate vitamin D, whether by food or supplements, will optimize vitamin D status," Dr. Neuhouser says.

Calcium also shows an age-related decline in postmenopausal women, in addition to the drop that occurs at menopause.⁶

What you're not getting--or getting too much of--could hurt you

There's reason to be concerned about your vitamin and mineral intake. Here's a brief run-down on some key micronutrients:

• Vitamin A--helps immune function⁷, but a high intake (3,000 or more mcg. daily) may lead to hip fractures.⁸
  
• Vitamin B6-- may help manage depression and anxiety;⁹ in combination with folate, may reduce heart disease risk.¹⁰
  
• Vitamin B12--deficiency of B12 and folate may lead to development of Alzheimer's disease;¹¹ reduced B12 may cause anemias, neuropsychiatric disorders,¹² and lower bone mineral density;¹³ combined with folate, reduces coronary heart disease.¹⁴
  
• Vitamin C--potent antioxidant needed for body function, helps counteract some effects of smoking, but its role in lowering the risk of chronic disease is still unknown,¹⁵ as is whether it can help prevent the common cold.
  
• Vitamin D--deficiency may lead to osteoporosis, rheumatoid arthritis, multiple sclerosis, cancers and more;¹⁶ protects against fractures¹⁷ and falls;¹⁸ boosts absorption of calcium for protection against osteoporosis.¹⁹
  
• Vitamin E--inhibits cancer cell growth, may reduce risks of other chronic diseases;²⁰ controls cholesterol;²¹ despite high hopes, does not slow progression to Alzheimer's disease.²²
  
• Folate--low levels may increase risk for vascular disease, cancer and cognitive decline, while too much may mask B12 deficiency (so take multivitamin supplement that contains both);²³ may reduce breast cancer risk in women who are moderate drinkers²⁴
  
• Calcium--vital for preventing osteoporosis,²⁵ low intake may also contribute to risk of stroke in middle-aged women.²⁶

What's in your multivitamin?

The shelves of discount stores and drug chains are crammed with a dizzying number of multivitamin offerings. Your vitamin needs as a woman at midlife or later are different than for adolescents or men.

Rizzotto advises choosing multivitamins especially formulated for women over 50. Such supplements usually meet women's needs during all stages of menopause. Be sure to compare the vitamin amounts shown on the supplement label with these Dietary Reference Intake (DRI) recommendations from the IOM*:

	Women, 19-50	Women, 51-70	Women, 70 >
Vitamin A	700 mcg.	700 mcg.	700 mcg.
Vitamin B6	1.3 mg.	1.5 mg.	1.5 mg.
Vitamin B12	2.4 mcg.	2.4 mcg.**	2.4 mcg.**
Vitamin C	75 mg.	75 mg.	75 mg.
Vitamin D***	5 mcg. (200 IU)	10 mcg. (400 IU)	15 mcg. (600 IU)
Vitamin E	15 mg.	15 mg.	15 mg.
Folate (folic acid)	400 mcg.	400 mcg.	400 mcg.
Calcium	1,000 mg.	1,200 mg.	1,200 mg.
Iron	18 mg.	8 mg.	8 mg.

*The above amounts represent 100 percent of the daily value of each nutrient. Use this amount to compare with the daily value information on a supplement label.
**Due to age-related modest decreases in the ability to use the B12 from natural sources, fortified foods or supplements can help to meet the recommendation.
***In the absence of adequate exposure to sunlight.

To see the complete list of Dietary Reference Intake (DRI) levels for women, visit the IOM site at http://www.iom.edu/project.asp?id=4574 .

Tips on vitamin supplements

• Read the label carefully. All vitamin formulations are not the same.
  
• Make sure you understand what the "serving size" is. Some vitamin labels show a nutrient list for a "serving size" of two tablets or capsules. It's easy to mistakenly think that list shows the vitamin amounts in one tablet.
  
• Check the expiration date. Make sure you'll use the contents before you reach that date.
  
• Store supplements in a cool, dry place--not the bathroom.
  
• As with all medication, keep supplements away from children, in a locked or secure location.
  
• Supplements lose strength quickly in hot, humid climates. Air conditioning helps protect them.
  
• Your body can only absorb about 500 mg. of calcium at a time, Rizzotto says, so take it in separate doses, at different times, to get your full daily requirement. Avoid taking with iron-containing foods or supplements. She advises taking one dose at bedtime, when you're not eating anything that would interfere with absorption.
  
• More than 100% of a vitamin's daily DRI is not necessarily better. Avoid the dangers that megadoses may cause by consulting the recommended tolerable upper intake levels contained in the IOM Dietary Reference Intakes Table ( http://www.iom.edu).

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Women In The Habit Of Low Fat Diet Losses Chances Of Pregnancy

FIONA MacRAE

Women who keep to a low-fat diet when trying to conceive could be dramatically cutting their chances of pregnancy, according to a study.

Drinking a pint of semi-skimmed or skimmed milk or eating two pots of yoghurt a day almost doubles the risk of an increasingly common condition in which women stop ovulating.

Eating full-fat dairy products has the opposite effect. A bowl of ice cream a day was found to be enough to boost the chance of having a child.

The study carried out at the highlyrespected Harvard School of Public Health in Massachusetts involved nearly 19,000 women.

Jorge Chavarro, the report's author, advised would-be mothers to eat up to two servings of full-fat dairy foods a day. One serving equates to half a pint of milk, an ounce of cheese or half a cup of ice cream.

Yoghurt, cottage cheese and skimmed or semi- skimmed milk are classed as low fat, while whole milk, cream, ice cream, cream cheese and other cheeses count as full fat.

Dr Chavarro warned women however not to increase their overall calorie intake, or their intake of dangerous saturated fat.

"Once they have become pregnant, then they should probably switch back to low-fat dairy foods, as it is easier to limit intake of saturated fat by consuming low-fat dairy foods," he added.

The study tracked the health and diet of 18,555 women for eight years.

During that period, 438 of the women, who were aged between 24 and 42, were diagnosed with anovulatory infertility.

The condition, in which ovulation stops, accounts for a third of female fertility problems.

Scrutiny of the women's diets revealed a clear link between dairy food and anovulatory infertility, with low-fat products appearing to exacerbate it.

Those women who ate two or more servings of low-fat dairy foods a day were 85 per cent more likely to suffer from it.

Women who ate at least one serving of full-fat milk dairy food a day were 27 per cent less likely to have the condition. Adding half a pint of whole milk to the diet cuts the risk of ovulation problems by 22 per cent.

Women who ate ice cream at least twice a week were almost 40 per cent less likely to suffer from anovulatory fertility than those who rarely ate it.

Writing in the journal Human Reproduction, the researchers said they could not explain the results.

It is possible that dairy fat or the sex hormones in cow's milk boost fertility by affecting the balance of hormones involved in ovulation.

Both the fat and the sex hormones are at their highest in whole-fat products.

It is also possible that removing fat from dairy products raises the levels of a hormone thought to be behind many cases of anovulatory infertility.

Professor Adam Balen, of the Royal College of Obstetricians and Gynaecologists, said: "It is an interesting finding but more research needs to be done. The main concern is obesity and the advice about not increasing calorie intake is key."

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Diets That Fight Cancer

Susan Burke MS, RD, LD/N, CDE
eDiets.com Chief Nutritionist

Cancer. It’s the diagnosis everyone dreads. But this is not a story about fear, it’s about hope. There’s hope for those diagnosed with cancer, because new techniques, treatments and medicines help people live longer. And although there’s no guarantee that lifestyle will prevent cancer, how you live, what you eat, and your daily habits can lower your risk for getting many types of cancer, even breast cancer.

Cancer is a disease that may be managed, though not usually completely cured. Although heart disease kills more Americans, cancer is a close second. The National Cancer Institute (NCI) reports that although cancer research has improved the outlook for people already diagnosed with cancer, it remains one of our most “urgent health concerns and the disease many fear most.” More than 1.3 million new cases will be diagnosed this year, and more than a half million people will die from cancer.

Breast cancer follows lung cancer as the second most common cancer in women. The American Cancer Society (ACS) estimates that one in every seven American women will develop breast cancer in their lifetime. More than 220,000 American women will develop breast cancer this year, more commonly in older (greater than age 60) women. Risk increases with a family history (grandmother, mother, sister, daughter or two other close relatives).

Overweight Increases Risk for Cancer

Let’s get down to brass tacks. If you’re having a hard time finding motivation to lose weight, then think about cancer, because the risk for cancer increases along with overweight and obesity. Overweight women have a higher risk for breast cancer, especially if they gained weight after menopause. According to the NCI, obesity and physical activity may account for up to 30 percent of postmenopausal breast cancer, as well as colon, endometrial, kidney and esophageal cancer.

From 11,000 to 18,000 deaths per year from breast cancer in American women over age 50 might be avoided if women could maintain a BMI under 25 throughout their adult lives. For example, a 5-foot-6 woman who weighs 165 pounds has a BMI of 26.6; losing 15 pounds makes the BMI about 24.2.

A study in Cancer Detection and Prevention (June 2003) reported that approximately 41,000 new cases of cancer in the U.S. were linked to obesity, and 20 percent of cancer deaths in women were due to overweight and obesity. Obesity may increase estrogen levels, which supports rapid growth of breast tumors. Before menopause, the ovaries are the primary producer of estrogen, but after menopause fat tissue becomes the primary estrogen source.

Obesity is linked to type 2 diabetes, a risk factor for gallbladder, ovarian and pancreatic cancer. The online journal Diabetes Today (September 26, 2006) reported those with type 2 diabetes were more likely to develop cancer, especially of certain organs, such as the pancreas and liver. Researchers hypothesize that type 2 diabetes produces excess insulin that may promote cancer-cell growth in the liver or pancreas.

According to the ACS, obesity is known to increase cervical, endometrial, ovary and gallbladder cancer risk in women, and colorectal and prostate cancer risk in men.

Losing weight after menopause decreases risk for breast cancer. The best advice is to avoid gaining weight to begin with, and staying at a healthy weight.

Prevention

The ACS notes that there are some risk factors you can control, some you cannot. Your age (over 50 increases risk), gender (women are 100 times more likely to get breast cancer than men), and genes (certain gene mutations increases risk by 80 percent) cannot be controlled. But other risk factors, including excess alcohol and obesity, increase risk for cancer. Your weight and your diet are two factors that are absolutely controllable. Take control.

The Best Diet

Managing your weight with healthy diet and exercise not only lowers your risk for breast cancer, but also can help prevent cancer reoccurrence.

Jennifer K. Nelson, Mayo Clinic’s director of clinical nutrition, says research supports including more fruits and vegetables in your diet daily to lower the risk for many serious diseases, including cancer. Rather than taking supplements, getting the health-providing compounds from foods means more phytonutrients, minute chemicals that are immunity-boosting and protective against cancer-causing free radicals.

“Eating a variety of plant foods -- fruits, vegetables, whole grains, legumes, nuts, seeds -- helps ensure that we get a variety of what Mother Nature intended for us to get," she said.

Jennifer also notes that managing your weight through diet and physical activity can "play a role in preventing breast cancer and keeping it from returning."

A study in the Journal of Clinical Oncology (September 20, 2005) found that women who increase their intake of vegetables and fruits following early-stage breast cancer diagnosis had a greater rate of recurrence-free survival.

Lower your risk for cancer by managing your weight. The Mayo Clinic Plan gives you virtually unlimited vegetables and fruits, plus a variety of healthy choices from all of the food groups. More variety increases your intake of beneficial phytonutrients in different fruits and vegetables. Lose weight and improve high blood pressure and cholesterol, as well as reduce your risk for heart disease, Type 2 diabetes and certain types of cancer.

The Mayo Clinic experts have developed this plan to help you live a longer, healthier life. Join eDiets.com and get a personalized approach to weight management, support and reliable information.

Physical Activity Lowers Cancer Risk

Moderate to vigorous regular activity reduces risk of developing colon and breast cancer, and since physical activity is a key factor in maintaining or achieving a healthy body weight, make it your business to stay active. Physical activity has beneficial effects against heart disease and diabetes too, so find something you like to do and get moving.

Your eDiets Fitness Plan is also personalized to your current level of fitness, and is modified to be more challenging as your strength and fitness increases.

Early Diagnosis

Early diagnosis means early treatment, perhaps even a cure. Monthly breast self-exams can save your life. Depending upon your individual risk factors, women should have a mammogram every year beginning at age 40. Prostate cancer will affect almost all men at some point in their life and staying at a healthy weight and activity lowers risk. Prostate is usually a slow-growing cancer, not as easily detected, and men also need a digital exam starting at age 40. Early detection means a better chance of survival. Find out more about early detection at http://www.nbcam.org/aboutBC_earlyDetection.cfm.

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