5 Drinks That Help You Calm Down

Stressful day? Don't reach for a candy bar. Try one of these soothing liquids instead.




1. Drink a glass of milk. It contains tryptophan, which as it is metabolized is converted to mood-boosting serotonin. Plus, its calcium, magnesium and potassium content may help keep blood pressure down.






2. Drink hot cocoa. Warm drinks raise your body temperature—a feeling we associate with comfort, so it triggers a similar response in our brains.






3. Order black tea instead of coffee. A study by University College London shows that drinking black tea four times a day for six weeks lowered the stress hormone cortisol after a stressful event.






4. Drink green tea—packed with theanine, which increases the brain’s output of relaxation-inducing alpha waves and reduces the output of tension-making beta waves.






5. Drink a glass of cold water, then go for a walk outside. The water gets your blood moving and the air invigorates by stimulating the endorphins that de-stress you.


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Bone Health Tips for Every Decade

It may seem like osteoporosis is just a part of aging, but it doesn't have to be. While it's true you lose bone strength and mass as you get older, there are many things you can do to lower your chances of getting osteoporosis. We've spoken with experts and gotten tips for keeping your bones strong during your 20s, 30s, 40s, 50s and 60s.

Though this information is arranged by decade, and some advice—like that on estrogen replacement and bone density tests—definitely applies to that age group, tips on nutrition and exercise are important no matter what your age, and should be followed throughout your life.

In Your 20s

Hip fractures and loss of bone density are likely not on the minds of most 20-somethings, but this is when women need to start working on maintaining the bone strength they have. Marjorie Luckey, MD, medical director at Saint Barnabas Osteoporosis Center in Livingston, New Jersey, says women reach their peak bone mass by their early 20s. This means you have to start working on maintaining what bone strength you have during this decade of your life. Women in their 20s should:

1. Avoid smoking. Smoking cigarettes hampers the work of bone-building cells and increases your risk of developing osteoporosis.

2. Exercise properly. Weight-bearing exercise (this can include simple activities like walking) is strongly recommended throughout your life in order to keep up bone strength. But, as with most things, moderation is key. Nathan Wei, MD, clinical director of the Arthritis and Osteoporosis Center of Maryland, says woman who have extreme exercise habits—to the point where they develop amenorrhea (loss of menstrual cycle)—trick their bodies into thinking they are going into menopause, a major risk factor for osteoporosis.

3. Watch your weight. During your 20s, you may only be concerned with keeping your figure trim, but a healthy body weight should be the goal instead. Being underweight is a high risk factor for osteoporosis. (Underweight is defined as a body mass index (BMI) of less than 18.5 kg/m2.) To find out your BMI, go to WomansDay.com/BMI.

4. Consider a vitamin D supplement. Vitamin D is important for every stage of life because it helps your body absorb calcium, which is very important for bone health. "There is an epidemic of vitamin D deficiency in the U.S.," says Dr. Luckey. "We get a lot less vitamin D than past generations because we are out in the sun less." She advises that women, especially those living in the Northeast, who don't receive as much sunlight as their Southern counterparts, take a vitamin D supplement to reach the recommended 600 to 800 IU per day. Foods such as fatty fish and milk as well as some juices contain vitamin D, but not in large enough doses to get as much as the body needs.

In Your 30s

For many women this is the decade when their focus is on building a career and starting a family. Both of these can have an effect on overall bone health. Women in their 30s should:

1. Keep salt and caffeine in check. Too much of either can promote calcium loss. Lanah J. Brenna, a registered dietician at Reactive Nutrition in Lafayette, Louisiana, advises women to limit their sodium intake to 1,300 mg a day and caffeine to 200 to 300 mg a day to help reduce bone loss.

2. Limit drinking. Excessive alcohol consumption (more than two drinks a day) has been linked to increased risk of hip and other osteoporotic fractures.

3. Consider a calcium supplement. Adult women should get about 1,000 mg of calcium a day. If you're pregnant or nursing, you should bump up your intake to 1,200 mg a day. Dr. Luckey says that most people naturally consume about 300 mg of calcium a day. Adding yogurt or lowfat cheese to your diet will help increase your numbers. "Calcium is listed on nutritional labels as a percentage; to convert that to milligrams, just add a zero," advises Dr. Luckey. If you calculate how much calcium you're getting and you still come up short, add a supplement—most contain between 200 to 600 mg.

4. Learn your family history. Find out if your mother, grandmother, aunts or sisters have (or had) osteoporosis, fractures or any other related health issues. Heredity plays a big part in assessing your risk. If you know you have a family history of osteoporosis, then you can talk to your doctor about what measures (such as earlier bone density testing) you may need to take.

In Your 40s

Hopefully you've established healthy habits during your 20s and 30s. If not, don't underestimate how important this time of your life is. Kick your fight against bone loss up a notch before you reach your high-risk 50s. Women in their 40s should:

1. Add weight training to your exercise routine. You should already be doing at least 30 minutes of physical activity a day, like walking, gardening, golfing, swimming, tennis or dancing. But now's the time to add strength training to your workout routine. Staying active throughout your life helps your bone health by increasing muscle mass, strength, balance and coordination.

2. Consider other health risks. Talk to your doctor about how other health problems such as diabetes, depression and intestinal disorders affect bone health. Also discuss how some medications as well as more intense medical treatments, like chemotherapy, can alter your body's ability to absorb calcium.

3. Figure out your fracture risk. The World Heath Organization has a tool called FRAX that helps you figure out your risk for getting a fracture over the next 10 years. Simply enter your age, height and weight, then answer a few questions about your family history and lifestyle to get recommendations for treatment.

In Your 50s

Your 50s are a time of change—the most important of which is the beginning of menopause. Dr. Luckey says that the 3 to 5 years after menopause are the most important in terms of bone density loss. "Osteoporosis can occur at any age, and for a variety of reasons," says Elizabeth Ricanati, MD, staff physician in the Department of Disease Reversal at Cleveland Clinic. However, she points out that according to the National Osteoporosis Foundation (NOF), over half of the U.S. population develops osteoporosis after the age of 50. Women in their 50s should:

1. Up your vitamin intake. The NOF recommends that adults age 50 and over get 1,200 mg of calcium daily. If you are postmenopausal and not taking hormones, the dosage increases to 1,500 mg a day. It's also recommended that adults 50 and over get more vitamin D (1,000 to 2,000 IU daily).

2. Consider estrogen replacement. Once you go though menopause, your body loses estrogen. Dr. Luckey says that women with high risk factors or signs of osteoporosis often benefit from a low-dose estrogen patch. She sometimes recommends the drug Evista, which "mimics the effect of estrogen" in the bone.

In Your 60s

The decrease of estrogen in your body during your postmenopausal years is a major cause of bone density loss. While some bone loss after menopause may be inevitable, other factors, such as breaking a bone, can put some women at higher risk than others. Women in their 60s should:

1. Get a bone density test. According to Dr. Luckey, all women over 65 should get routine bone density tests. If you're under 65, postmenopausal and have high risk factors, such as a family history of osteoporosis or a broken bone after age 40, it's also recommended that you have regular bone density tests.

2. Protect yourself against falls. Wear shoes with nonslip soles, clear things from the floors that could be easily tripped over, keep hallways and corners well lit, use a stepstool with handrails and be careful with medications that affect your balance or make you drowsy.

3. Talk to your doctor about prescription medication. Depending on how advanced your bone loss is, your doctor may suggest you take medication to prevent further bone loss. Dr. Ricanati explains, "There are different classes of medications to treat osteoporosis, such as the bisphosphonates (Fosamax, Boniva, Actonel and Reclast), SERMs (selective estrogen receptor modulators), estrogen/progestin, parathyroid hormone and others." Dr. Wei also points to a new treatment, denosumab, which is recommended for women who experience side effects from bisphosphonates. As with any prescription drug treatment, there are risks associated with most medications, and the best avenue is always prevention.

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Top 6 Skinny Foods for 2010!!!

If you're looking for creative (and delicious!) ways to enhance your weight loss efforts, here's a fresh collection of six slimming foods you should add to your repertoire. I'm a firm believer that dieting and losing weight doesn't mean you have to subsist on bland, boring cardboard. With that in mind, I've put together a list of strategic skinny eats, each of which has its own unique way of satisfying your taste buds while blunting your appetite. I encourage you to peruse my list and use these tasty bites to your advantage!

1. Pumpkin Pudding: Decadent, creamy pudding for less than 150 calories--and it helps you lose weight! Just combine a 6-ounce container of nonfat vanilla yogurt with ½ cup canned 100% pure pumpkin puree and a dash of cinnamon. The pumpkin bulks up the yogurt--already a protein-rich, nutrient-packed food--and adds a hefty dose of fiber. This winning combo of protein and fiber expands in your stomach, keeping you full long after you finish, so you're not looking for more munchies an hour later.

2. Vegetable Soup: Studies have shown that just by starting a meal with a fiber-rich bowl of broth-based veggie soup, you can reduce your total calorie intake by 20 percent. That's because this "veggie first course" helps to fill you up, so you wind up eating less at the main meal.

3. Cucumber Tomato Salad: Thanks to their high percentage of water (95%!), cucumbers are low-calorie, high volume, and top-notch for weight loss! Slice up one whole cucumber plus a medium tomato, then toss with light vinaigrette or unlimited vinegar (balsamic or red wine is delish) plus 1 teaspoon olive oil. The entire salad has only 125 calories!

4. Ginger Green Tea: Nursing a warm mug of tea is a calorie-free way to de-stress after a long day without falling prey to emotional eating. As an added bonus, research suggests that regularly drinking green tea may give you a slight calorie-burning advantage. Steep your tea with a thin slice of ginger root for an extra punch of flavor.

5. Fiery Chicken Salad: Adding a few dashes of fiery hot sauce to your food slows down your eating big time so you're less likely to eat past the point of fullness. For a simple lunch, whip up a chicken salad with diced chicken breast, 1 tablespoon reduced-fat mayo, hot sauce to taste, and any diced veggies on hand. Serve over a bed of lettuce (and have a glass of water handy!).

6. Shrimp Cocktail: At around 8 calories a piece, shrimp are a fabulous source of lean protein, which helps rev your metabolism and keeps you feeling full for hours. Next time you dine out, start your meal with a shrimp cocktail appetizer. When you're eating at home, dunk your shrimp in this could-not-be-easier cocktail sauce recipe: simply combine 1 tablespoon ketchup with 1 teaspoon bottled horseradish.

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10 Secrets of Happy Women..

No one is as happy as a clam all day, every day. But experts say learning to find joy in little moments is the real trick to feeling content.

1. Spread your happy thoughts Let your daughter know how great it feels to spend the day shopping with her. Brag to your spouse about the unexpected compliment your boss paid you.

E-mail your best friend to tell her how fondly you remember the camping trip you took last year, and include a hilarious picture of your attempt to pitch a tent. Sharing happy memories and experiences with others—or even simply anticipating doing so—is one of the most powerful and effective ways to prolong and magnify joy, Bryant's research shows. "It helps sustain emotions that would otherwise fade," he says. Affirming connections with others, he adds, is "the glue that holds people together."

2. Build memories you can savor Take mental snapshots of memorable moments that you can draw on later.

Recall vivid, specific events, and pinpoint what brought you joy. Do you love your red wool scarf because it's chic and cozy, or because its smell reminds you of your childhood romps in the snow? Interjecting mystery into happy moments—reflecting on what's surprising or hard to understand about them, for example—can strengthen their power. Just be careful not to overanalyze and lose the wonder of the moment. What you want, says University of Virginia social psychologist Timothy D. Wilson, PhD, is to dissect your experiences just enough to appreciate how they've helped form you and then get back to simply living them.

3. Pat yourself on the back Take pride in a hard-won accomplishment—it’s not something that many people do.

If you spent a year sweating at the gym to reach a fitness goal, bask in your new jeans size—and share your success with others. Self-congratulation doesn't come easily to everyone. "A lot of people have trouble basking in an accomplishment because they feel that they shouldn't toot their own horns or rest on their laurels," Bryant says. It's a fine line between joyous self-congratulation and shameless self-promotion, but don't worry: You'll know if you're crossing it.

4. Fine tune your senses Here’s an easy trick to hone your tastebuds or follow your nose.

Close your eyes while you roll a square of dark chocolate over your tongue or fill your lungs with salty sea air or eavesdrop on your grandchildren's play and laughter. Shutting out some sensory stimuli while concentrating on others can heighten your enjoyment of positive experiences—particularly those that are short-lived.

5. Compare downward Comparing upward makes us feel deprived, but comparing downward can heighten enjoyment.

Think about how things could be worse—or how things used to be worse. Keep it light—you don't have to relive a scary health diagnosis or revel in a neighbor's job loss. Simply take note: Is today sunnier than the weather report predicted? Did you finish off that work project more quickly than you thought you would?

6. Get absorbed Some joyful moments seem to call for conscious reflection and dissection.

At other times, we savor best when we simply immerse ourselves in the present moment, without deliberate analysis or judgment. Listen to your favorite music with headphones in a dark room. Lose yourself in a novel you just can’t put down. Set aside enough time on the weekend for your favorite hobby so you can attain a level of absorption known as the "flow" state.

7. Fake it till you make it Putting on a happy face—even if you don't feel like it—actually induces greater happiness, says Bryant.

So be exuberant. Don't just eat the best peach of the season; luxuriate in every lip-smacking mouthful. Laugh out loud at a funny movie. Smile at yourself when you pass by a mirror. After all, he says, "a surefire way to kill joy is to suppress it."

8. Seize meaningful moments Some positive events come and go quickly—a surprise toast to your accomplishments at work, your daughter's sweet 16 party.

It seems obvious that the more quickly a positive experience evaporates, the more difficult it is to savor. Yet paradoxically, Bryant has found, reminding ourselves that time is fleeting and joy transitory prompts us to seize positive moments while they last.

9. Avoid glass-half-empty thinking The world has enough pessimists.

Short circuit negative thoughts that can only dampen enjoyment, such as self recriminations or worries about others' perceptions. When you find yourself awash in happiness, give it space to grow—don't ruminate about why you don't deserve this good thing, what could go wrong, how things could be better. Consciously make the decision to embrace joy.

10. Say thanks more often Cultivate an "attitude of gratitude," Bryant says.

Pinpoint what you're happy about—a party invitation from a new pal, a seat on a crowded subway—and acknowledge its source. It's not always necessary to outwardly express gratitude, Bryant notes, but saying "thank you" to a friend, a stranger, or the universe deepens our happiness by making us more aware of it.

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Recharging..

I had a good sleep. I just woke up. I feel like I really needed it. I am recharge now. I always see my skin glowing every time I wake up from a good sleep. I feel beautiful too. It's been a busy week for me. I go home late. I sleep late. And I have to wake up early everyday because I have work. It's kinda exhausting. It's my routine. I have no complaints. I am grateful that I have a job.

I believe that having enough rest is a big help to my body system. My brain is functioning well after a good rest. I am full of life and energy. I can do my task to the best of my abilities. I am more alive and happy. I can entertain people with a smile on my face. And it's good so I can build a good relationship with them.

That's one of my secrets. Just give me a time to recharge and a time to sleep for at least an hour, then I'll be back to you with a whole me. I will be ready for the next fun and adventure you could ever think of. Let's go!

Fatty Foods Affect Memory and Exercise

Eating fatty food appears to take an almost immediate toll on both short-term memory and exercise performance, according to new research on rats and people.

Other studies have suggested that long-term consumption of a high-fat diet is associated with weight gain, heart disease and declines in cognitive function. But the new research shows how indulging in fatty foods over the course of a few days can affect the brain and body long before the extra pounds show up.

To determine the effect of a fatty diet on memory and muscle performance, researchers studied 32 rats that were fed low-fat rat chow and trained for two months to complete a challenging maze. The maze included eight different paths that ended with a treat of sweetened condensed milk. The goal was for the rat to find each treat without doubling back into a corridor where it had already been. The maze was wiped down with alcohol, so the rat had to rely on memory rather than sense of smell.

All of the rats studied had mastered the maze, finding at least six or seven of the eight treats before making a mistake. Some rats even found all eight on the first try.

Then half the rats were switched to high-fat rat chow (comprised of 55 percent fat), while the remaining rats stayed on their regular chow (which had 7.5 percent fat). After four days, the rats eating the fatty chow began to falter on the maze test — all of them did worse than when they were on their regular chow. On average, the rats on the fatty diet found only five treats before making a mistake. The rats who stayed with their regular food continued the same high level of performance on the maze, finding six or more treats before making a mistake.

Half of the rats had also been trained to run on a treadmill. After only a few days on the high-fat diet, the rats performed 30 percent worse on the treadmill. After five days of testing, the treadmill performance of the rats eating fatty foods had declined by half. The study results appear in The Faseb Journal, which is the journal of the Federation of American Societies for Experimental Biology.

“We expected to see changes, but maybe not so dramatic and not in such a short space of time,’’ said Andrew Murray, the study’s lead author and a lecturer in physiology at Cambridge University in Britain. “It was really striking how quickly these effects happened.’’

Although the human data aren’t yet published, the researchers have also performed similar studies of high-fat diets in healthy young men who then performed exercise and cognitive tests. Dr. Murray said he is still reviewing the data, but the short-term effect of a fatty diet on humans appears to be similar to that found in the rat studies.

It’s not clear why fatty foods would cause a short-term decline in cognitive function. One theory is that a high-fat diet can trigger insulin resistance, which means the body becomes less efficient at using the glucose, or blood sugar, so important to brain function.

Fatty foods appear to have a short-term effect on exercise performance because the body reacts to high fat content in the blood by releasing certain proteins that essentially make the metabolism less efficient. “It’s thought to be a protective mechanism to get rid of excess fat,’’ Dr. Murray said. “But it was making muscles less efficient at using oxygen and fuel to make the energy needed to run.’’

The findings are particularly relevant to people who may not worry about binging on fatty foods because they exercise regularly.

“Exercise is a good way of burning it off, because you’re burning the calories off,’’ Dr. Murray said. “But in terms of actually trying to put in a good time if you’re running, it will limit your performance.’’

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8 Best Foods for Fitness

Fitness foods that help burn fat, build muscle and boost your cardiovascular health.

It's true: Spinach is muscle fuel. But not because it instantly turns you lean and sexy. Researchers from Rutgers University found that a compound in the leafy green increases protein synthesis by 120 percent, helping your muscle tissue to repair itself faster after you work out. The problem, however, is that you’d have to eat Popeye-sized quantities to experiences dramatic results (we’re talking almost 2 pounds of the iron-packed veggies a day). The good news is that spinach isn’t the only food that can help you to look and feel better than ever—even when you're not exercising.

The right fitness foods help burn fat, build muscle, and even boost your cardiovascular health. Ready to eat your way to better results? These 8 great foods and drinks are guaranteed to make any type of exercise you do more effective—long after you’ve broken a sweat.

EAT THIS!

Pineapple and papaya

Good for: Muscle recovery

Both of these tropical fruits are loaded with bromelain and papain, enzymes that not only help break down proteins for digestion but also have anti-inflammatory properties to speed up your post-workout recovery.

Salmon

Good for: Cardiovascular fitness

Australian researchers found that cyclists who took fish oil for 8 weeks had lower heart rates and consumed less oxygen during intense bicycling than a control group did. The fatty acids in fish oil need to become incorporated into muscle and heart cells to have an effect, and that takes weeks of consumption—so either take fish oil pills each day, or try to eat fish rich in fatty acids multiple times a week to see similar results.

PB&J or pasta with meat sauce

Good for: Muscle building and repair

The perfect post-weight training repast has about 400 calories, with 20 to 30 grams of protein (to build new muscle) and 50 to 65 grams of carbohydrates (to repair old muscle). Peanut butter and jelly sandwiches or a small bowl of pasta with meat sauce fits that formula.

Pork tenderloin

Good for: Waist-trimming

Lean meats are a great low-calorie source of protein, and scientists at McMaster University in Hamilton, Ontario, found that eating more protein may reduce the fat around your midsection. People who ate 20 more grams of protein every day than the group average had 6 percent lower waist-to-hip ratios.

DRINK THAT!

Coffee

Good for: Pain relief

University of Georgia scientists revealed that taking a caffeine supplement (equal to two cups of coffee) after exercise reduces muscle soreness more than pain relievers can. Caffeine blocks a chemical that activates pain receptors.

Cold water

Good for: Endurance

Drinking cold water before and during exercise can help improve your endurance. In a British study, cyclists who drank about 30 ounces of a chilled drink in the half hour before riding in a hot, humid environment—and smaller amounts as they rode—were able to bike 23 percent longer than riders who downed lukewarm liquids. Drinking cold water may be the most direct way to reduce core body temperature, so it takes you longer to heat up and slow down.

8 ounces of chocolate milk

Good for: Hydration

The best sports drink may come from a cow. British researchers found that milk does a better job than water or sports drinks at rehydrating the body after exercise. Why? To begin with, milk has more electrolytes and potassium. The addition of chocolate gives milk the perfect balance of carbs, protein, and fat for speedy muscle recovery.

Green tea

Good for: Muscle recovery

Brazilian scientists found that participants who consumed three cups of green tea every day for a week had fewer markers of the cell damage caused by resistance to exercise. So drinking a few cups every day may help your muscles recover faster after an intense workout.


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"HEALTHY HEART"

A friend of mine just sent me a forwarded message this morning. I want to share it with you. It is about "Healthy Heart". It means HEAL-THY-HEART. Allow God to heal our hearts from past wounds, insults, pains and grudges. Isn't it wonderful? Only God can heal us physically and emotionally. We should remember that God is good all the time. He is the great healer. He comforts us all the time. He is always in control.

As individuals, we have to have a forgiving heart. It is only when we forgive that we set ourselves free from heartaches and pain. And makes us feel better. Whoever hurts us will not be able to hurt us again. If we continue to keep grudges and pains in our heart, the person who said bad things on us will continue to affect us. It is not good for our health especially to our heart.

Life is short. We should live it well and be happy. Forgive and forget! Let go and let God!

How To Avoid Hidden Prescription Drug Risks

by Rebecca Ruiz

These simple steps will help prevent complications from drug use.

To many patients, the notion of doing more harm than good with a prescription drug is a passing thought. After all, medication is dispensed by doctors and pharmacists who are well-versed in treating conditions with drugs. Keeping up with the latest research on risks and benefits of the use of prescription drugs--a $291 billion industry--also seems like a task best left to the professionals.

It's no surprise then that Americans seem to be dangerously undereducated about the risks of prescription medicine, particularly when combined with over-the-counter drugs and supplements. A study published in December 2008 in the Journal of the American Medical Association found that one in 25 adults surveyed, who were between the ages of 57 and 85, were at risk for a major potential drug-drug interaction.

"Patients need to ask questions about their therapies," says Cynthia Reilly, director of the practice development division at the American Society of Health-System Pharmacists, a professional association. This common sense approach can be supplemented with other strategies, like scaling back on unnecessary medications, consulting reputable online resources and treating minor issues with lifestyle changes instead of another prescription.

In Depth: How To Avoid Hidden Prescription Drug Risks

What Causes Complications?
Patients often struggle to identify adverse drug interactions or side effects, Reilly says, because there may be no physical symptoms.

For example, hypertension patients who take medication to control blood pressure may render the drug less effective when simultaneously treating a common cold with a nasal decongestant, which increases the heart rate with stimulants. The effect subsides when the patient stops taking the decongestant, but it's possible to not even realize the interaction occurred unless one monitored blood pressure levels daily.

In more serious cases, an adverse interaction can cause life-threatening complications. Combining the anti-coagulant Warfarin with aspirin, for example, can lead to an increased risk of bleeding, which is particularly hazardous for patients recovering from surgery. Each individual has a unique response to an adverse interaction, but Reilly says patients should contact a pharmacist or physician if they experience a rash or difficulty breathing.

Research has also shown that risk increases with the number of prescriptions, over-the-counter drugs and supplements used. The JAMA study found that 68% of the 3,000 older adults surveyed were using all three concurrently; previous studies have shown that the use of five medicines or more at once has increased in recent years.

Reilly traces the trend to at least three factors: More people are living longer with chronic diseases, patients have many more over-the-counter options for treatment, and studies have shown evidence for the effectiveness of combined prescription drug therapies.

How to Avoid the Risks

While these developments have been beneficial to patients, some experts argue that patients and doctors need to be more discriminating.

Dr. Gordon Schiff, associate director of the Boston-based Center for Patient Safety Research and Practice, co-authored an article last month in JAMA urging physicians to reconsider the use of prescription drugs. Patients can easily incorporate some of his suggestions, including using just a few drugs well and pursuing alternative approaches like diet changes, exercise and physical therapy.

Salina Wong, director of clinical pharmacy programs for Blue Shield of California, says that while patients should always discuss medication with a pharmacist or physician, those who have new questions or feel uncomfortable in the public setting of a pharmacy, can take advantage of online resources.

Blue Shield offers members a free chat service with pharmacists who answer questions within two days of receiving an inquiry. Health Net ( HNT - news - people ), a pharmacy benefits manager, created a similar program last year.

If your insurance provider doesn't offer this resource, there are reputable Web sites that give consumers information about potential drug interactions. Medscape is a free peer-reviewed Web site that contains information on uses, dosage and potential interactions. Blue Shield of California also maintains a Web site accessible to anyone, not just insurance members.

It's essential to know the risks, says Wong, but she also urges patients to adopt a new mindset about prescription drugs that may not be necessary.

"When you add drugs, you're adding more complications," she says. "It's important to try to resolve issues without a pill."

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Health Tip: What Causes Sore Breasts?

(HealthDay News) -- Breast soreness is common in young women, but it becomes less common as they get older.

Breast pain may be constant, or come and go over time. Pain that won't go away or frequently comes back should be discussed with a doctor.

The American Academy of Family Physicians lists these common causes of breast soreness:

• Hormonal changes associated with the menstrual cycle.
• Retaining water, which often happens during the menstrual cycle.
• An injury or damage to the breast.
• Pregnancy or breast-feeding.
• An infection in the breast.
• Breast cancer, although this is a rare cause of breast pain.

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What You Should Know About Generic Drugs

by Rebecca Ruiz

These cheaper substitutes are just as effective as brand-name versions, but some consumers don't realize it.Generic drugs--cheaper forms of name-brand medicines--account for most of the pills dispensed by pharmacies in the U.S. Using these alternatives saved American consumers $121 billion last year, according to Generic Pharmaceutical Association, a trade group.

Yet many people doubt that the less expensive pills are as effective as the brand-name drugs they replace. Thirty percent of 1,000 adults polled in May by Prescription Solutions, a pharmacy benefit manager, either didn't believe generics were as good as their brand-name counterparts or were unsure. People tend to associate cost with quality, says Jacqueline B. Kosecoff, Prescription Solutions' chief executive. "Generic often connotes something different."

In Depth: Facts About Generic Drugs

That's one reason some consumers hesitate to trust generic drugs. They also read about patients' accounts of their troubling experiences online and even occasionally hear about drug manufacturing companies that violate standards and are forced to issue product recalls.

Yet Gary J. Buehler, director of the office of generic drugs in the Food and Drug Administrations' Center for Drug Evaluation and Research, sees little cause for concern. The FDA, he says, is confident that generics perform as well as brand-name medicines. The agency says rigorous quality and safety measures show that generics are of identical strength, purity and quality as the original brand-name drug.

"I don't think consumers should be worried," he says. "There's a lot of anecdotes out there, but we haven't seen any real scientific evidence."

Why the Concern?
While there is no evidence to support the claim that generics are inferior, patients often cite their own experiences as proof--and the Internet is home to countless testimonials.

Joe Graedon, a pharmacologist who runs People's Pharmacy, a Web site clearinghouse for drug-based medical advice, says he has received "hundreds and hundreds" of patient complaints about dozens of drugs. One of the most frequently discussed drugs has been the generic antidepressant Bupropion (brand names Wellbutrin and Zyban). Patients have cited a lack of efficacy or intolerable side effects such as severe depression and fatigue.

The FDA is investigating these claims, and while Buehler cannot comment on the case, he does note that "hundreds of thousands of people take this drug successfully."

Dr. Harry Lever, a cardiologist at the Cleveland Clinic, shares Graedon's concerns about the number of patient complaints. In particular, in the past he has been puzzled by occasional reports from patients that they fared better on the brand-name beta-blocker Toprol XL--which is used to treat cardiac conditions such as high blood pressure--than they did when taking the generic version. Since the time-release formula of the generic Toprol is not identical to the brand name, he says, it may not be as effective.

His suspicion was heightened earlier this year after two companies, Sandoz and Ethex, a subsidiary of KV Pharmaceutical Company, stopped producing the generic version. FDA inspections found that both companies weren't following manufacturing guidelines.

Buehler says the FDA is meticulous in studying the effect of different time-release formulas. If clinicians observe a significant difference between the two, they will not permit pharmacists to substitute the generic for the brand-name drug. Patients on Coumadin, for example, are not advised to alternate between the brand-name blood thinner and the generic warfarin. Torprol XL does not fall into this category.

But Lever's concerns go beyond patient experiences. He has counted 150 recalls of both generic and brand-name drugs in the past several years, a figure that makes him wonder if the manufacturing process needs further regulatory scrutiny.

Indeed, in late June the FDA ordered U.S. Marshals to seize 33 generic drugs manufactured in Michigan by Caraco Pharmaceutical Laboratories. The company had been warned last October that it had violated manufacturing standards by, among other things, failing to investigate inconsistent batches and distributing products whose ingredients may have been compromised.

Buehler characterizes this incident as an exception instead of the rule and proof that the FDA is closely regulating the production process. Manufacturing problems, he says, aren't exclusive to generic-drug makers either. Brand-name producers, for example, have been forced to recall several asthma drugs, including Advair and Pulmicort. In one case, Schering-Plough ( SGP - news - people ) shipped asthma inhalers without any medicines in them.

Patients, of course, should discuss complications related to generic or brand-name prescriptions with a physician or pharmacist. If a generic drug seems less effective and is meant to control a condition that can be measured, such as high blood pressure or cholesterol, Graedon recommends keeping a diary of laboratory tests to evaluate the results.

What the Research Shows
Patients do themselves a disservice, however, when they correlate an emergent symptom with a new drug regimen without further investigation. The connection could be coincidence, or it could stem from the perception that generics are inferior.

Researchers have compared generic and brand-name drugs in one conclusive study published last December in the Journal of the American Medical Association and found no difference between such drugs used to treat cardiovascular conditions. The study reviewed 47 previously published articles in which researchers compared several drugs, including statins and beta-blockers.

Despite the lack of convincing evidence to show that generics are harmful, the study's co-author Dr. William Shrank wrote that among the 43 editorials he reviewed, more than half "expressed a negative view of generic-drug substitution."

Shrank can't explain why some physicians discourage generic drugs, but the American Medical Association has discredited this position, noting that the scientific evidence is too weak to support such concerns.

Buehler agrees. "If there was a problem with generics," he says, "we'd be hearing much more than we hear now."

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Men With Angina Do Worse Than Women

Doubled rate of heart attack, tripled rate of death seen in study

By Ed Edelson
HealthDay Reporter

THURSDAY, Aug. 6 (HealthDay News) -- New research shows that men diagnosed with the chest pain called angina did much worse than women, and neither artery-opening angioplasty nor coronary-bypass surgery reduced long-term mortality for either gender.

The study of 1,785 people newly diagnosed with angina at 40 primary-care practices in Scotland confirmed a previously reported difference between men and women that is something of a medical mystery, said Dr. Brian Buckley, a research fellow in the National University of Ireland department of general practice, and lead author of an Aug. 7 online report in BMJ.

The study, done in collaboration with physicians at the University of Aberdeen in Scotland, found that in the five years following the diagnosis, men were twice as likely to have a heart attack and three times more likely to die of a heart-related condition.

"A lot of practicing doctors would have a hunch that would be the case," Buckley said. "Reports of that difference actually go back about 10 years. We pretty well demonstrate that it is a reality."

Asked if he knew the reason for the difference, Buckley said, "I wish I did. We can't tell people why it is so. We need further research to get into the details of why men are doing worse than women."

Lifestyle factors clearly made a difference in outcome. Smoking doubled the risk of a heart attack and death from all causes, as did obesity, the study authors noted.

Men were more likely than women to have angioplasty or bypass surgery, but the study found no difference in survival for those who had either intervention.

"Bypass surgery does work for many people, there is no doubt about that," Buckley said. "Maybe people who have it should be chosen more carefully than they are. Angina is an early stage of heart disease. At that stage, maybe it doesn't have the effect that might help at a later stage."

The study does indicate the need for emphasizing "lifestyle risk factors and optimal medical [drug] treatment" after a diagnosis of angina, Buckley said.

"For many people, the important thing when they are diagnosed with angina is to look at their lifestyle and do what can be done about it," he said. "Medications to reduce blood pressure and cholesterol are good. If you could do that without drugs, so much the better. There are a lot of risk factors that can be managed, and when you do that you are avoiding heart attacks and deaths."

The findings should be interpreted cautiously, said Dr. Gregg C. Fonarow, a professor of medicine at the University of California, Los Angeles, and director of the Ahmanson-UCLA Cardiomyopathy Center. One reason is that a diagnosis of angina does not pinpoint the cause of the chest pain, he said.

"Angina is a lot of challenges," Fonarow said. "It can mean a lot of different things to a lot of different people."

And the study was observational, meaning that it dealt with all the people seen at the medical practices rather than being a controlled trial in which participants are carefully matched, he said. "Treatment was decided upon not by randomization but just by defining the condition," Fonarow said. "You need a randomized clinical trial to get definitive results."

But the difference in outcome between men and women appears real, although the reasons for it remain unknown, Fonarow said. "That simply hasn't been established," he said.

More information

Angina and its treatment are described by the American Heart Association.

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Fast Headache Relief

When your head is pounding, you want headache relief – and fast. Get the facts about effective headache treatment, including medications and quick-acting coping tips.

By Diana Rodriguez

Medically reviewed by Niya Jones, MD, MPH

The splitting pain of a headache — especially a migraine — can make it difficult to drive, work, and even carry on a conversation. Instead of crawling into bed and pulling the covers over your head, find out about effective headache treatments, including tips that will help you find quick headache relief.

Headache Treatment: Medications

Just about any over-the-counter (OTC) pain reliever can offer headache relief for non-migraine headaches, also known as tension headaches, says Jack M. Rozental, MD, PhD, a migraine specialist at Northwestern Memorial Hospital in Chicago. Medications that contain only one drug (acetaminophen, ibuprofen, naproxen, or aspirin) are an effective headache treatment, he says, as are those that include a combination of aspirin, acetaminophen, and caffeine.

For those who suffer from frequent or recurring headaches, doctors sometimes recommend prescription-strength doses of non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen. Indomethacin, an NSAID that is available only by prescription, is "usually used for arthritis, but can also be very useful as a headache treatment," Dr, Rozental says. "Indomethacin's downside is that it is among the drugs most likely to cause gastric irritation," including stomach ulcers and bleeding.

These prescription drugs are sometimes used to treat migraine headaches:

• Butalbital, a barbiturate often used in combination with acetaminophen, caffeine, aspirin, and/or codeine
• Narcotics, such as oxycodone, hydrocodone, hydromorphone, or codeine
• Butorphanol, a narcotic nasal spray
• Tramadol

Unfortunately, the risk with many of these prescription drugs is that they can lead to substance abuse and dependence, Rozental says. Butorphanol, in particular, "should be avoided because of its very high propensity to cause dependence after even minimal use," he explains.

Frequent use of any pain reliever, including OTC drugs, can also cause what are known as rebound or medication-overuse headaches, says Rozental. To treat this type of headache, all pain-relieving medications must be stopped for at least three months. If you're consistently taking large doses of OTC medications to treat recurrent headaches, talk to your doctor about your symptoms.

Headache Treatment: Tips to Cope

Fortunately, many headaches can be at least partially alleviated without medication, which will help minimize your need for pain relievers and reduce your risk of rebound headaches. Here are some tips for headache relief:

• Close your eyes and rest. This is an effective headache treatment for a migraine headache, and can help ease a tension headache as well. Sit in a quiet, dark room with your eyes closed and just relax for a bit. "Patients with migraine instinctively seek out a dark, quiet environment in which they can go to sleep for at least a few hours,” Rozental says. “Sleep frequently diminishes or eliminates the pain."
• Massage your neck and temples. Rubbing your neck and temples can improve blood flow and soothe tension headaches.
• Warm up your neck Try putting a heating pad or a warm cloth around your neck and the base of your skull to ease tension headaches. If that doesn't help, you can apply an ice pack instead to see if that brings you headache relief.
• Relax. Meditate, breathe deeply, and try to visualize a peaceful image. "Various relaxation techniques can significantly help patients who suffer from 'muscle contraction' headaches," says Rozental.
• Minimize stress. If you have a bad headache, try to step away from stress, literally. Avoid noisy environments, leave work a little early if you can, or ask your partner to take care of chores or the kids.
• Watch what you eat and drink. What you put into your body can have a big impact on your headaches. Rozental advises limiting caffeine and alcohol and avoiding cigarettes. He also says regular meals are important, especially for people who get headaches from low blood sugar. "Do not skip meals, particularly breakfast," he urges.

A headache can certainly put your activities on hold until you're feeling better, but learning effective headache treatment can help you feel better, faster. Instead of trudging through your day with a headache, take time out to care for yourself. Medications can get your head to stop pounding, but a little relaxation and time for yourself can only help, too.

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Bad Breath: 5 Causes and 5 Cures

How to restore your fresh breath—and relationships

By Marin Gazzaniga for MSN Health & Fitness

Wondering why your loved ones are giving you more personal space than you’ve asked for? Suspicious about the Altoids left on your desk with dental floss bows? If you’re one of 90 million Americans suffering from chronic bad breath, here are some of the possible causes, as well as remedies to restore your fresh breath—and relationships.

Top 5 Causes of Bad Breath

1. A dirty mouth

“Ninety percent of mouth odors come from mouth itself—either from the food you eat or bacteria that’s already there,” says Dr. Richard H. Price spokesman for American Dental Association. “Mouth odor is like any other body odor—the result of microbes living in the body giving off byproducts.” In the mouth, this means bacteria that normally live in the mouth interact with food particles, blood, tissue, etc., to create volatile (i.e., stinky) sulfur compounds. If you don’t clean properly, the bacteria build up, and next thing you know—that’s not toothpaste on your tongue.

2. A mouth out of balance

Certain mouth conditions can exacerbate bacterial growth and odor, such as gum disease and dry mouth. Gum disease causes bloody gums, creating more elements for those pesky bacteria to putrefy. But it is a dry mouth that is the more common cause of bad breath. Saliva helps flush out the mouth, keeping bacteria moving so they don’t settle down and multiply, while drier mouth is a breeding ground for bacteria. In spring and summer, allergy medications can dry you out; in winter, dry heat tends to be the culprit.

3. Stinky foods

If it stinks going in, chances are it’s going to stink coming out. The obvious offenders are onions, garlic, alcohol and tobacco. And foods don’t only create a stench in the mouth. “Plant oils are absorbed and the byproducts enter your bloodstream so you are actually breathing the odors out via your lungs three to four hours later,” says Jeannie Moloo, a registered dietitian and spokeswoman for the American Dietetic Association. [Fulldisclosure: Moloo is the author’s cousin.]

4. Not enough carbs

You look great after four weeks on Atkins, so how come you still can’t get a date? High-protein, low-carb diets cause your body to burn stored fats for fuel instead of carbs and can lead to a condition called ketosis. “As fat burns, ketones build up in the body, and some are released through breath,”explains Moloo. “Unfortunately ketones don’t smell particularly good.” And bad breath trumps six-pack abs.

5. Illness

Occasionally, bad breath can be a sign of a more serious illness. The most common systemic causes of bad breath are diabetes or GERD (or gastro esophageal reflux disease). Diabetes can also cause ketosis, and the resulting bad breath is sometimes one of first symptoms that lead to diagnosis. GERD is a backflow of acid from the stomach to the esophagus. Less common but possible are liver or kidney disease—when toxins from these organs are excreted through the lungs, causing bad breath.

Top 5 Cures

1. Keep it clean

Gum, breath mints, mouthwash… these are all helpful stopgaps, but they won’t cure bad breath. The way to get rid of bad breath for most of us is to brush, floss and tongue scrape twice a day. Yes, for fresh breath, the key is tongue scraping. “You can brush and floss till the cows come home, but it won’t help unless you get way back,” says Price of the American Dental Association. A tongue scraper is available at most drugstores. Price swears it helped him when he was suffering from bad breath (not something you want in your dentist, he points out). “Now I smell like a petunia,” he says. “For most of us, brushing, flossing and tongue scraping twice a day will control bad breath.”

2. Keep it moist

The best way to keep the right saliva balance is to drink plenty of water or liquids. To prevent dry mouth in winter, use a humidifier. If you snore or suffer from postnasal drip, try saline nasal spray to keep nasal passages moist.

3. Watch what you eat

Avoiding the main offenders (onion, garlic, tobacco, coffee, etc.) is the best way to avoid food-related bad breath. Dietitian Moloo also cites research that suggests certain foods can help: “Two cups of tea a day can prevent bad breath for some. The polyphenols, a plant chemical in tea, may prevent growth of bacteria responsible for bad breath.” You can also chew parsley, which seems to curb offending smells from other foods and bacteria. And cranberries may eliminate offensive smells and make the bacteria less sticky, which makes plaque less likely to form. Price says sugarless gums that contain xylotol may kill some bacteria and help reduce plaque.

4. Eat some carbs

Apparently the only way to help the ketosis caused by low-carb diets is… to eat some carbs. Moloo recommends fruits, vegetables and whole grains over frosted doughnuts.

5. See your doctor

If tongue scraping and carbo-loading doesn’t do the trick, check with your doctor to see if he or she suspects a more serious cause. Diabetes, GERD or other diseases require specific diagnoses and treatments.

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7 Reasons Crying Can Be Healthy

By Therese Borchard

New York Times reporter Benedict Carey referred to tears in a recent piece as "emotional perspiration." Given that I sweat a lot and hate deodorant, I suppose it makes sense that I weep often. But I’m not going to apologize for that, because after a good cry, I always feel cleansed, like my heart and mind just rubbed each other’s backs in a warm bath.

In his intriguing article, "The Miracle of Tears" (answersingenesis.com), in which I found some of the research for this gallery, author Jerry Bergman writes: "Tears are just one of many miracles which work so well that we taken them for granted every day."

Here, then, are seven ways tears and the phenomenon we call "crying" heal us physiologically, psychologically, and spiritually.

Tears Help Us See

The most basic function of tears is that they enable us to see. Literally. Tears not only lubricate our eyeballs and eyelids, they also prevent dehydration of our various mucous membranes. No lubrication, no eyesight. Writes Jerry Bergman: "Without tears, life would be drastically different for humans—in the short run enormously uncomfortable, and in the long run eyesight would be blocked out altogether."

Tears Kill Bacteria

No need for Clorox wipes. We’ve got tears! Our own antibacterial and antiviral agent working for us, fighting off all the germs we pick up on community computers, shopping carts, public sinks, and all those places the nasty little guys make their homes and procreate.

Tears contain lysozyme, a fluid that the germ-a-phobe dreams about in her sleep, because it can kill 90 to 95 percent of all bacteria in just 5-10 minutes! This translates, I’m guessing, to three months’ worth of colds and stomach viruses.

Tears Remove Toxins

Biochemist William Frey, who has been researching tears for as long as I’ve been searching for sanity, found in one study that emotional tears —those formed in distress or grief—contained more toxic byproducts than tears of irritation (think onion peeling). Are tears toxic then?

No! They actually remove toxins from our body that build up courtesy of stress. They are like a natural therapy or massage session, but they cost a lot less!

Crying Can Elevate Mood

Do you know what your manganese level is? Neither do I. But chances are that you will feel better if it’s lower because overexposure to manganese can cause bad stuff: anxiety, nervousness, irritability, fatigue, aggression, emotional disturbance, and the rest of the feelings that live inside my head rent-free.

The act of crying can actually lower a person’s manganese level. And just like with the toxins I mentioned in my last point, emotional tears contain 24 percent higher albumin protein concentration--responsible for transporting small (toxic) molecules--than irritation tears.

Crying Lowers Stress

Tears really are like perspiration, in that exercising and crying both relieve stress. In his article, Bergman explains that tears remove some of the chemicals built up in the body from stress, like the endorphins leucine-enkaphalin and prolactin. The opposite is true too. Bergman writes, "Suppressing tears increases stress levels, and contributes to diseases aggravated by stress, such as high blood pressure, heart problems, and peptic ulcers.

Tears Build Community

In her "Science Digest" article, writer Ashley Montagu argued that crying not only contributes to good health, but it also builds community. I know what you’re thinking: "Well, yeah, but not the right kind of community. I mean, I might ask the woman bawling her eyes out behind me in church what’s wrong or if I can help her, but I’m certainly not going to invite her to dinner."

I beg to differ. As a prolific crier, I always come away astounded by the resounding support of people I know, and the level of intimacy exchanged among them. Read for yourselves some of the comments on both my self-esteem file video my death and dying video and you’ll appreciate my point. Tears help communication and foster community.

Tears Release Feelings

Even if you haven’t just been through something traumatic or are severely depressed, the average Joe goes through his day accumulating little conflicts and resentments. Sometimes they gather inside the limbic system of the brain and in certain corners of the heart. Crying is cathartic. It lets the devils out before they wreak all kind of havoc with the nervous and cardiovascular systems. As John Bradshaw writes in his bestseller "Home Coming," "All these feelings need to be felt. We need to stomp and storm; to sob and cry; to perspire and tremble."

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Love Food to End Emotional Eating

The less you like food, the more likely it is that you'll overeat. So get ready to fall in love

By Geneen Roth

When my friend Ed wanted to stop smoking, a Zen master told him that he needed to love smoking first. "Create a ritual each time you smoke," the teacher said. "Take a cigarette and wrap it in a beautiful cloth. Go to a quiet place where you can be alone for a few minutes. Take your time unwrapping the cloth, removing the cigarette, smoking it. Notice how every inhale feels in your mouth and your throat. Notice if you like it. If you love it. If you want more of it. Only when you give it to yourself completely can you completely give it up."

"That's one smart dude," I told Ed, thinking of the parallels between smokers and emotional eaters. Of course, we can't give up eating altogether (and I never advocate depriving yourself of your favorite foods or even your non-favorite foods). But it's true that we can't stop emotional eating until we really love food. And in my experience, emotional eaters — those of us who eat for reasons besides hunger — don't actually like food.

I know I've just uttered a near blasphemy. And I know you're probably thinking, Wait just a moment, missy. My problem is not that I don't like food, but that I like it too much. That I think about it every moment. That I am willing to drive 10 miles out of my way for my favorite snack. That I hide the cookies where my kids won't find them. My problem is that I'm over the moon about food. I need to start enjoying it less, not more!

But think about it for a moment.

When you love something, you spend time with it. You pay attention to it. You enjoy it. And although most of us emotional eaters think incessantly about food, we consume meals as if they are stolen pleasures. As if we are not really allowed to have them, let alone have rollicking times eating them.

Last week I watched a 2-year-old eat a cracker. She took one, stared at it, then nibbled a corner of it just to see what happened to corners of crackers that are wet and soggy. After that, she tackled the salt issue. Licked it off. Took a bite, sucked on it for a bit. Her next step was to mush up the rest in her fist because now, she got to see (and taste!) an entirely new creation: a mushed-up, balled-up, saltless, wet, soggy cracker. In the time that it would have taken most of us to eat an entire row of crackers, she had not finished eating one — and she was positively gleeful.

In the days before I realized I was chubby (er, fat), ice cream was of great interest to me. Not only because of how it tasted, but because of what happened to it as it melted. I remember taking my spoon and running it around the edge of the bowl for the softest liquidy parts. I remember my brother and I making ice cream lakes, melting chocolate into vanilla and pretending we were forming rivers in our bowls.

Then I remember being told that I wasn't supposed to eat ice cream because I was too fat. Suddenly, ice cream became forbidden. Suddenly I wanted, needed, to have it. All of it. I was no longer interested in any aspect of ice cream but getting as much into my mouth as I could, as fast as possible. The hiding and sneaking started. The feeling that I was bad every time I ate it.

When the pleasure stops, the overeating begins.

For most of us, food isn't allowed to be itself: a source of pleasure, joy, nourishment. Instead, food is the middleman between feeling something we don't want to feel and numbing or distracting ourselves from feeling it. We don't eat for enjoyment, taste, or particular sensations, we eat for the effect the food will have on us. Food is our drug of choice.

But there is another way to live with food. It's called eating with gusto, joy, and pleasure.

A student of mine named Sunny tells this story: "Once a month I take myself out for a steak-and-mashed-potatoes dinner. I love steak — love, love, love it. But I don't think I am supposed to eat it. This doesn't stop me, of course, but it does stop me from enjoying it. So I eat my dinner in a hurry — as if someone I know is going to walk in the door, and I have to be quick before I am discovered. Then I pay for my meal, hurry home, and spend the rest of the night feeling ashamed of what I ate."

I ask Sunny what she thinks would happen if she allowed herself to eat with gusto. To taste every bite. To pay attention to what she finds pleasurable about it. I tell her the story about Ed and the Zen master. I ask her what she thinks her life would be like if she ate her once-a-month steak the way Ed was to smoke his cigarettes.

She laughs hard, and her eyes light up. "Eating is always a guilty pleasure," she says. "I feel as if I'm not supposed to enjoy food because I need to lose 10 pounds, and people who are supposed to lose 10 pounds should be ashamed of themselves. They should eat dry chicken without skin and salad without dressing — not steak and mashed potatoes."

Now we've gotten to the core belief: Emotional eaters and/or those of us who feel as if we are overweight are not supposed to enjoy food. We are supposed to skulk around, eating food that tastes like leather. Better yet, we should be eating astronaut food: freeze-dried pellets of desiccated vegetables.

Forget it.

After 30 years of working with emotional eaters, I can confidently say that I've never met anyone who has ever lost weight — and kept it off — by deprivation. We are sensory, pleasure-loving beings. It is not just calories that fill us up, but the joy we take from eating them.

We don't overeat because we take too much pleasure from food, but because we don't take enough. When pleasure ends, overeating begins.

Imagine what your life would be like if you let yourself eat with passion. If you felt entitled, no matter what you weighed, to eat with gusto. You may discover that foods you loved — as well as those you didn't — truly do give you pleasure, and there's no price tag attached. And that's how it should be. Why not be astonished by the crisp taste of an apple? Why not revel in the smooth texture of an olive? Since you need to eat to live, why let one moment of joy — even one — pass you by?

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How to Sleep with a Snorer

By Ellie McGrath

Love can be blind and, for a while, even deaf. I was somewhat aware that my husband-to-be had a snoring problem, but I didn't realize the extent until a friend he had traveled with presented us with an unusual wedding present: a black collar studded with little electrodes. Whenever my husband snored, he'd get a harmless electric shock that would wake him up — with the goal of conditioning him to stop snoring altogether. After a few nights, though, my husband called for an end to the torture, pointing out that a heart attack would permanently end the snoring. Like so many other couples, our bedtime rituals became reminiscent of Monday Night Football: swift kicks, sharp elbows, and time-outs. According to a National Sleep Foundation survey, twice as many men as women report that they snore every (or nearly every) night — 32 percent of men versus 16 percent of women. "The majority of people we see, study, and treat are men," says J. Catesby Ware, Ph.D., director of the Sleep Disorders Center at Sentara Norfolk General Hospital, and professor of medicine and psychiatry at Eastern Virgina Medical School. The majority of sufferers are women. Snoring can take a heavy toll on a relationship. A study by John Shepard, M.D., medical director of the Sleep Disorders Center at Mayo Clinic in Rochester, Minn., found that the bedmates of heavy snorers lose an average of one hour of sleep per night. Dr. Shepard calls the phenomenon of partners being awakened by snoring spousal arousal syndrome. Unfortunately, it's not the kind of arousal most people crave in bed. Another study released last year, from the National Naval Medical Center in Bethesda, Md., found that when heavy snorers with sleep apnea underwent treatment, they and their spouses reported better sex lives and a smoother relationship.

How to Tell Him

An obstruction in the airway between the nose and lungs is usually the cause. It can be swollen nasal tissue, a too-relaxed tongue, fatty deposits in the throat, or a large uvula (that kidney-shaped object hanging at the back of the mouth). Snoring tends to get worse as people age because, like so many other body parts, tissues in and around the airway start to sag. The mid-40s and up is when snoring really becomes more prevalent, Ware says.

The first hurdle in dealing with snorers is to get them to acknowledge the problem. There's usually very little perception of snoring on the part of the snorer, says Victor Hoffstein, M.D., director of Toronto's Sleep, Nose, and Sinus Clinic at St. Michael's Hospital, and coauthor of No More Snoring. A man may not believe his wife, Ware says, but he'll believe his hunting buddies when they won't sleep in the same cabin with him. I personally discovered that a tape recorder did the trick. Tempting as it may be for a wife to withdraw to the guest room, Dr. Hoffstein says, that's focusing on the symptom, not the root of the problem.

Examine His Habits

If you live with a chronic snorer, take a hard look at his habits. Some simple changes could stop the problem for good. The vast majority of snorers can be treated with a lifestyle solution, Dr. Hoffstein says.Is he overweight? Being overweight is the most common cause of snoring, Dr. Hoffstein explains. A person who gains weight usually has excess fat deposits in the neck. The fat deposits increase the collapsibility of the throat tissue and can narrow the airway. Once men hit a shirt size of 17, they are candidates for weight-related snoring. Sometimes a weight loss of as little as 10 pounds can help.Does he drink alcohol before going to sleep? If your bedmate is having a couple of nightcaps, it may be relaxing the muscle tissue in his throat and causing the tongue to drop back more. Don't drink alcohol less than four hours before bedtime, recommends Daniel Loube, M.D., director of the Sleep Disorders Center at Virginia Mason Medical Center in Seattle. Some medications, such as sleeping pills and tranquilizers, produce the same relaxing effect.Does he sleep on his back? If he does, his jaw may open, causing the tongue to shift closer to the back wall of his throat, which narrows the airway. Elevating the head can help up to thirty percent of snorers, Dr. Hoffstein says. Another solution is to make him sleep on his side. One low-tech strategy: Sew a sock containing a tennis ball onto the back of his pajama top so that when he turns on his back, he'll wake up and change his position.Does he smoke? Cigarettes irritate and inflame the upper airways, making them narrow. Snoring is just one more reason to try to get him to quit.

Possible Causes of Snoring

Does he have a cold or allergy? If so, the snoring is probably originating in the nose. If he has a cold, he can use nasal decongestants on a short-term basis. But if he has an allergy, it needs to be diagnosed and treated.Is there an anatomical abnormality? These can range from a deviated septum to extra tissue in the neck. If you suspect such a problem, it's time to talk to your doctor about a sleep study or polysomnogram, which involves a one-night test at a sleep center (average cost: $1,200, usually covered by health insurance). During the sleep study, instruments measure heart, lung, and brain activity; breathing patterns; arm and leg movements; blood-oxygen levels; and how often the patient awakens during the night. The study can determine the origin and severity of the snoring. Depending on the cause, there are a number of surgical procedures that can be done. The downside of surgery is that it can be very painful — and there's no guarantee that it will work in all cases, says Ron Kuppersmith, M.D., a surgeon at Virginia Mason Medical Center. The various procedures, often done on an outpatient basis, tend to cost between $1,500 and $2,500, and are covered by insurance if there is an underlying medical problem. Another possible solution is a mouth device that moves the lower jaw forward, thereby opening up the airway. The device can be fitted by a specially trained dentist and costs about $1,000.

Could It Be Dangerous?

Does he snort and gasp in his sleep, then feel tired all day? When a person has loud-intensity snoring, it is an alarm signal, Dr. Loube says. It is important to distinguish between benign snoring and a dangerous condition called sleep apnea.

A person with sleep apnea stops breathing for 10 seconds or longer several times every hour, all night long. As respiration is cut off, and the level of oxygen in the blood drops, he wakes up briefly to reopen his airway, then resumes breathing with a snort. When you go from being fast asleep to suddenly awake, it's very stressful on the body, Dr. Kuppersmith says. According to the National Center on Sleep Disorders Research, up to half of all people with sleep apnea have high blood pressure, which raises the risk of stroke and heart failure. The majority also suffer from daytime drowsiness and are more likely to have car accidents than people without the condition. One explanation of why married men live longer than single men is that their wives discover the sleep apnea problem and get them care, Ware says.

Sleep apnea can be addressed with oral devices and surgery, but continuous positive airway pressure (CPAP) is usually the first medical treatment used. It involves wearing a mask or special mouthpiece while sleeping; a blower gently forces air through the nasal passages. If the snorer can tolerate sleeping with the apparatus, CPAP is highly effective. Because apnea is a medical condition, most insurers will pay the estimated $400 to $1,200 cost for CPAP.

Fortunately, I haven't yet had to sleep with a masked man. My husband's snoring has improved over the years without such dramatic measures. He stopped smoking and lost some weight. After he drinks red wine, he sleeps in another room. And I do have my own secret weapon: a little white-noise machine. When the snoring starts, I just submerge myself in the soothing sounds of a waterfall.

Sleep Apnea

Not everyone who snores has sleep apnea, but almost no one has sleep apnea without loud snoring. Data from the Wisconsin Sleep Cohort Study suggests that 12 million Americans suffer from sleep apnea, a potentially life-threatening condition that temporarily cuts off respiration. How do you tell the difference between benign snoring and apnea? Wake up and listen! If your partner snores, watch to see if he actually stops breathing, says Ron Kuppersmith, M.D., a surgeon at Seattle's Virginia Mason Medical Center. If he's totally quiet and the chest is not moving, count the seconds. The next morning, most people with sleep apnea can recall hearing themselves snore. Some feel short of breath for a brief period. Here are the symptoms:

Chronic, loud snoring

Gasping or choking episodes during sleep

Excessive daytime sleepiness

Car- or work-related accidents due to fatigue If you suspect that your mate is suffering from sleep apnea, have him see his primary physician, who may refer him to a sleep specialist. For more information, contact: American Sleep Apnea Association, 1424 K St. NW, Suite 302, Washington, DC 20005; (202) 293-3650; sleepapnea.org or The American Academy of Sleep Medicine, One Westbrook Corporate Center, Ste. 920, Westchester, IL 60154; 708-492-0930; aasmnet.org.

Finding Help

Breathe Right: Although it is marketed to relieve nighttime nasal congestion, it has become a popular over-the-counter snoring aid. Does it stop snoring? Statistically, no, says Dr. Victor Hoffman. Have I ever seen it work? Yes. It's harmless, so try it.

Nasal sprays: Decongestants such as Dristan shrink blood vessels and tissues to open up the airway. They can relieve snoring that is caused by a cold or allergy for two or three days, but continued use will make the condition worse.

Oral decongestants and antihistamines: If snoring is caused by nasal swelling from allergies, these medications can help, but they are unsuitable as a long-term solution.

Antisnoring pillows: These support the head at an angle that widens the airway. They help some people, but others complain of neck pain and headaches.

White-noise machines: For you, not him. These little machines make sounds that range from a waterfall to a windstorm, with the goal of blocking out ambient noise such as traffic or snoring. At about $100, they're cheaper than a divorce.

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