Wednesday, November 11, 2009

H1N1 flu (swine flu): Can you catch it twice?

H1N1 flu (swine flu) can't reinfect you, but it's not the only flu in town.

From MayoClinic.com


No name / No state givenQ:
My children are just getting over the swine flu (H1N1), and I may have picked it up. If I get sick, is there a chance the kids will catch swine flu a second time, from me?

After being infected with the 2009 swine flu virus, your children can't catch the same virus again — not from you, not from anyone else. All flu viruses are that way. Once you're exposed to a flu virus, your immune system develops antibodies and memory cells unique to that virus. Your body can then defend itself if you're exposed to the virus again. This system of defense is known as acquired immunity. You also acquire immunity to flu viruses when you get a flu shot or take the nasal flu vaccine.

If having the flu or getting vaccinated gives you immunity, why is the 2009 swine flu (H1N1) virus such a problem? And why get a seasonal flu shot every year?

The short answer: Flu viruses rearrange their DNA all the time; it's how they survive. So, while your children are now immune to influenza caused by the 2009 swine flu virus, other flu viruses can still make them sick, as can many noninfluenza viruses, including those that cause colds and pneumonia.

What you're coming down with is most likely an infection with the same virus your kids had, and most flu-like illness these days is caused by the H1N1 virus. But on the off chance that you have a viral infection your children aren't immune to, it's still wise for everyone in your home to wash their hands often and cover their coughs and sneezes. You don't have to isolate yourself from the rest of the family, but give them some distance until you're well again.


Sunday, November 8, 2009

Flu Shots While Pregnant?

Protecting yourself and your fetus from viruses.

By Howard LeWine, M.D., Harvard Health Publications

Pregnant women and those who expect to become pregnant are being urged to get flu shots, especially the vaccine for H1N1 (swine) flu. But that’s not always a simple decision for a woman once she knows she is pregnant. For most, protecting the health of the fetus is their No. 1 concern. This means many of them won't take a medicine or have a medical procedure unless they know that it is absolutely safe for the baby.

A vaccine against the novel H1N1 flu virus is being shipped and has arrived in many states. Its rapid development and production is a terrific achievement. The vaccine will help to protect against the virus commonly called swine flu.

The U.S. Centers for Disease Control and Prevention says that pregnant women should get the vaccine. In fact, they are on the priority list to get the vaccine first.

Pregnancy puts women at increased risk of getting serious health problems if they get seasonal flu. We don't completely understand why this happens. The risk is even higher if they get infected with the H1N1 flu virus. It can even be life-threatening.

This risk probably is higher than usual because most pregnant women have not been exposed to flu strains similar to the new H1N1 virus. So they don't have any natural immunity. Older people, especially those over age 60, do seem to have some natural immunity. This is one of the reasons younger people have a higher priority to get the vaccine.

It is understandable that pregnant women are anxious about choosing to get the swine flu vaccine. The vaccine is too new to give pregnant women assurance that it is 100 percent safe. But the safety of the H1N1 flu shot should be equal to the well established safety of previous flu shots. The swine flu shot, similar to the seasonal flu shot, is made from purified killed virus. There is no chance that you or your baby can get an infection from the vaccine.

Pregnant women should get the H1N1 flu shot and the seasonal flu shot for several reasons:

  • They can protect infants who cannot receive vaccination. The mother can pass protective antibodies to her fetus. They may help protect the baby after it's born.
  • If you do get the flu, you have a higher than average risk of getting pneumonia. Pneumonia lowers your blood oxygen level. This means your fetus may not receive the oxygen needed for normal development.
  • Having the flu in pregnancy increases your risk of a miscarriage or giving birth too early.
  • Women who have a fever during early pregnancy are more likely to deliver a baby with a neural tube defect, such as spina bifida.

Some people are concerned about thimerosal, a preservative used in many vaccines. The safety of thimerosal has been extensively studied. There is no scientific evidence of any bad effects on babies when mothers get shots containing this preservative.

Pregnant women have an understandable reluctance to getting a shot that has not had thorough testing. Certainly more testing would make all of us feel more secure about its safety. But in balance, I believe the risks of not having the shot are greater than the unlikely, but remotely possible, side effects that have not been seen so far.

From: MSN Health

Thursday, November 5, 2009

Your Swine Flu To-Do (and Don’t Do) List

Health.com

Swine flu vaccines are rolling out this month—finally. Health-care workers in Indiana and Tennessee were the first to get the nose-spray version, while New Yorkers clamoring for the H1N1 vaccine finally had their chance too.

However, the onslaught of information about H1N1—be it playground rumors, employer signs telling you to cover your cough, memos from your kids’ school, or scary-sounding news reports—is making it pretty hard to figure out what you should be doing right now.

Although some people have already been vaccinated, it could be weeks—depending on your age and risk factors—before you even get a chance at the shot (or spray). So now what?

Sometimes it feels like you have two choices:

  • Wring your hands endlessly about something over which you have no control.
  • Tune out the static and pretend this is all just a horrible dream. (Call it the ignore-the-whole-sorry-mess-until-my-neighbor-is-sick approach.)
  • Well, guess what? There are a few things you should—and should not—be doing at the moment. Here’s your guide.

    Look up local flu outbreaks

    If you’re getting most of your news from the Internet—and about 40% of people say they do—you may not be up on H1N1 activity in your community. Take the time to check local flu activity on the online version of your local newspaper (remember those?) or health department. Try FluTrends, which is produced by Rhiza Labs, and includes past cases and current activity, or the Centers for Disease Control and Prevention’s (CDC) weekly flu update.

    If your city or state is a bit of a hot spot, you may need to focus on some of these to-do points sooner than others. The good news is that some of the hardest hit areas in spring—like New York—don’t seem to have that many H1N1 cases at the moment. (Experts estimate that up to 1 million New Yorkers may have had H1N1 in the spring, which would protect against subsequent infections.)

    Don’t panic

    For most people, an H1N1 infection is generally mild and can be cured with time, bed rest, and fluids. The virus is serious, though—particularly for those in high-risk groups. So far this year, 28 pregnant women have died of H1N1, as have 76 children. “At least two-thirds of [the children] had underlying conditions, which we recognize as putting them at increased risk for complications,” says Nathan Litman, MD, the chief of pediatric infectious diseases at the Children’s Hospital at Montefiore, in New York City. High-risk people, whether adults or children, tend to have chronic heart or lung conditions (including asthma), weakened immune systems due to disease or chemotherapy treatment, or diabetes.

    That said, H1N1 will feel like seasonal flu for most people. “I’d say at the present time the swine flu looks no more serious than the routine seasonal influenza,” says Dr. Litman.

    Stay home

    Are you sick right now? Say, with flu-like symptoms such as fever, aches, stuffy nose, and chills? Sorry, but it’s quite possible you already have swine flu. Experts say that flu activity is higher-than-normal for this time of year and almost all of it is due to H1N1. If you (or your child) are not in a high-risk group, it’s best to stay put.

    If a child is 2 or older "and has no risk factors for complications and has fever, runny nose, or cough, the best thing to do is to stay home,” says Dr. Litman. “Plenty of fluids, Tylenol, Motrin, or Advil for fever, and it should run its course on its own.”

    If a child has difficulty breathing, is unable to take fluids, or starts to be less responsive, or after appearing to recover from the influenza develops a fever and starts coughing again, then see a doctor.

    If you are pregnant and have flu symptoms, it might be best to call your doctor before going in to see him or her, says Dr. Litman.

    “They may want to set up a separate location to be seen or separate times to see sick patients,” he says. “You don’t want the pregnant woman with influenza who is coughing and sneezing to go into the room with pregnant women who are well and just there to get routine prenatal care.”

    Understand the risks

    While the symptoms of H1N1 may be no different from seasonal flu, there are some key differences. H1NI may be easier to catch than regular flu, and younger people may be more likely to come down with it than older people. “From what I’ve seen, I actually believe it to be more contagious,” says Dr. Litman. Often with the seasonal flu that’s circulating, a percentage of the population has some immunity to it. With H1N1, it looks like most people—other than the elderly—have no immunity to it, and that may be why it appears more contagious, he says.

    People who are older than 60 may have been exposed to a swine-flu-like virus in the distant past, which is giving them an edge with this pandemic. That’s not to say they can’t get sick, but “many of them appear to have immunity from a prior infection with a similar virus or cross reactions with a similar virus that help protect them against the swine flu,” says Dr. Litman.

    Get a seasonal flu shot

    The regular seasonal flu shots are available now, and it makes sense to “get the jab” (as the Brits say). While most flu cases happening right now are caused by H1N1, “in two months or three months it may be the regular seasonal flu and we should be prepared for that,” says Dr. Litman. “Since that vaccine is currently available, I recommend that everyone considered a risk group receive the seasonal flu vaccine.” Seasonal flu can be just as dangerous as H1N1; about 36,000 people die, including about 80 children, of seasonal flu every year.

    Get a pneumonia vaccine

    What, another shot? For the vaccine wary, this might just feel like one too many pinpricks. However, the pneumonia vaccine, a shot that can help prevent any illness caused by certain types of pneumococcus bacteria, including meningitis and ear infections, may be a good idea too.

    The CDC has analyzed H1N1-related deaths and found many people who died had dual infections, including some with pneumococcus. The good news is that if you’re up-to-date on your child’s vaccines, they probably already have it. Approved in 2001 and called Prevnar, it’s routinely given to children.

    Another vaccine, Pneumovax, is available for adults, and is recommended for the elderly and those at high risk of infections.

    Wash your hands

    Just about every expert is chanting a “wash your hands” mantra. And, in fact, washing your hands with soap and water or using an alcohol rub can help. However, when it comes to flu, just keep in mind that hand-washing may fall into the “can’t hurt and may help” category.

    Because flu virus can hitch a ride on airborne water droplets, you can inhale the virus and get sick even if you wear gloves 24-7 or scrub-in like a brain surgeon. But again, flu viruses can live on surfaces for up to 48 hours. So, yes, wash up. Plus, good hygiene can protect you from other germs, like pneumococcus, which could make a simple case of flu much worse when added into the mix.

    Don’t stock up on face masks or Tamiflu. If you’re the type of person who hoarded cans of soup and bottled water in 1999 just in case the world ended in 2000, it can be tempting to grab a box of surgical masks “just in case.” The CDC and most experts say that’s not a recommended—or a proven way—to prevent infection, although some studies suggest that they can be helpful in homes with a flu-infected family member or when used by hospital workers in place of a N95 respirator.

    And while it may seem perfectly harmless to stockpile antiviral drugs, it isn’t. If Tamiflu is gathering dust in your medicine cabinet, then people who truly need it may find the pharmacies are fresh out. And the surest route to a drug-resistant flu virus is having people taking it “just in case” or for symptoms that would go away on their own.

    Get a swine flu vaccine—really

    Or at least seriously consider it. Lots of people are not crazy about vaccines in general, and fully one-third of parents say they’re going to skip them for their child, according to an AP poll. Understandable. Taking something that could cause side effects, when you feel (or your child feels) perfectly healthy is tough. But keep in mind that if you’re thinking about waiting until swine flu is in full force in your community, it may be too late. It can take several weeks after vaccination before your immune system ramps up to full-protection mode.

    If you or your child is perfectly healthy, you can get the nose-spray version, which contains a weakened, but not killed, virus. Unfortunately, if you’re in a high-risk group, you may have to wait a bit for the version with killed virus, which is given in shot form. Those should be available in mid- to late-October.

    While mulling over your options, try not to think of large federal agencies as faceless giants trying to impose vaccines on you. In fact, such agencies are staffed by scientists and doctors who are trying to protect the public.

    “Each year approximately 30% to 40% of children between 5 and 19 years of age get influenza, that not only keeps them out of school for a few days, but they are also the epicenter of the epidemic—they spread it to household contacts, other school contacts, and high-risk people in the community, like the elderly—their grandparents,” says Dr. Litman. “For their benefit and for the benefit of others, it’s wise to get both the seasonal flu vaccine and swine flu vaccine.”

    Don’t let the past haunt you

    Although the 2009 virus has been tagged with the unfortunate moniker swine flu (just like the 1976 version), there is a world of difference between the two. For one, they are different viruses. And if you were alive in 1976, you were probably digging the bicentennial, groovy pants, and platform shoes, but your chances of getting swine flu were pretty much nil. (There were roughly 200 cases in Fort Dix, N.J., and the virus never spread.)

    Fast forward to 2009, which is truly a pandemic—there have been more than 340,000 confirmed cases worldwide and nearly 44,000 confirmed and probable cases in the U.S. alone. (The CDC estimates that more than 1 million people have contracted swine flu, but that their cases weren’t recorded because they didn’t seek treatment.) And the ’76 version did have a problem with side effects, including Guillain-BarrĂ© syndrome (GBS), a rare condition in which the immune system attacks nerves, resulting in weakness and even paralysis (although most people eventually recover).

    However, the vaccine production used in the 1970s now looks as outdated as your striped bell-bottoms and rockin’ sideburns.

    “Over the years there have been several improvements in vaccine manufacturing,” says Claudia Vellozzi, MD, the assistant director of the CDC’s Immunization Safety Office. “That certainly plays a role in improved vaccine safety now, compared to 1976.”

    Of the 30 to 40 million people vaccinated for swine flu in 1976, about 1 in 100,000 did develop GBS. However, current research suggests there is little to no GBS risk associated with seasonal flu vaccine.

    "There have been one or two studies that showed that if there is a risk, it’s very small, or about one in 1,000,000 additional cases of GBS would be attributable to the flu vaccine—but most studies have not supported any association,” she says. (There are 2,000 to 3,000 GBS cases in the U.S. every year, unrelated to vaccines, says Dr. Vellozzi. The cause is unknown, but it can be triggered by infections.)

    “In terms of our current vaccine, we expect to have a similar safety profile as our seasonal flu vaccine, which has a good track record,” she says.

    Be prepared

    If you do want to get an H1N1 flu shot, it’s best to be patient. It may take weeks before everyone who wants one can get it. In the meantime, think about what you will do if you or a family member does get sick.

    “Get immunized, wash your hands, cover your mouth and nose if you’re sneezing or coughing, stay home if you’re sick, and if any warning signs come up—difficulty breathing, not responsive as usual, unable to take fluids, or after a day or two of the fever coming down and having more fever and cough again—see the doctor,” says Dr. Litman.

    Mushrooms and Green Tea May Lower Breast-Cancer Risk

    By Margaret Furtado


    A recent study reported in the International Journal of Cancer suggests that women who eat large amounts of mushrooms and drink a lot of green tea may be at lower risk for developing breast cancer.

    The research trial included more than 2,000 Chinese women, with 1,009 breast-cancer patients (aged 20-87) and an equal number of healthy women matched for age. Each woman completed a detailed dietary questionnaire citing specific foods consumed.


    Do mushrooms and green tea affect breast-cancer rates?

    The researchers found that the greater the mushroom consumption (both fresh and dried), the lower the breast-cancer risk. Those who ate the greatest amounts of fresh mushrooms (10 grams or more per day) were about 2/3 less likely than those who ate none at all to develop breast cancer. Subjects who ate 4 grams per day saw their breast-cancer risk fall by half.

    Interestingly, the women decreased their risk even more if they also drank green tea daily. The breast-cancer risk of women who consumed both mushrooms and green tea was 11 percent, compared to 18 percent for women who didn't consume either food. The study used green tea, which is a "younger" tea but which still has caffeine.

    No proof yet

    While the researchers eliminated possible confounding factors, this study does not prove that mushrooms and green tea actually reduce a woman's chances of getting breast cancer.

    Epidemiological studies, however, do show that in places where the Chinese people are still eating the traditional diet, breast-cancer rates are 4-to-5 times lower than those of most developed countries. (All bets are off if a Chinese woman has switched to eating a westernized diet.)

    While this study has not nailed down a cause-and-effect relationship, it is the first to link high dietary consumption of mushrooms and green tea to reduced breast-cancer risk. In addition, those participants who ate at least 10 grams of mushrooms per day saw the greatest reductions in their risk.

    So eat some!

    Half a cup of raw mushrooms weighs roughly 35 grams, so a little more than 1/8 cup of raw mushrooms a day (about 8 or 9 grams' worth) might just help reduce your breast-cancer risk. Even an 8-ounce cup of raw mushrooms would add up to only 10 calories; therefore, a big helping of these tasty fungi might also help you feel fuller and lose weight. Adding green tea may be a good idea, too.

    If you're a mushroom-lover or willing to try them, here are some tips:

    • Look for mushrooms that are firm, unblemished, and free of mold or surface moisture (but not dry).
    • Store pre-packed containers of mushrooms in airtight plastic bags in the fridge, so they'll hold on to their moisture and won't spoil so rapidly.
    • Place loose mushrooms in a paper bag and then in your fridge.
    • Squeeze some lemon or lime juice onto raw mushrooms to help them retain their color.


      from: Yahoo Health

    Friday, June 5, 2009

    diet weight loss tips

    1. Add just one fruit or veggie serving daily. Get comfortable with that, then add an extra serving until you reach 8 to 10 a day.

    2. Eat at least two servings of a fruit or veggie at every meal.

    3. Resolve never to supersize your food portions—unless you want to supersize your clothes.

    4. Make eating purposeful, not mindless. Whenever you put food in your mouth, peel it, unwrap it, plate it, and sit. Engage all of the senses in the pleasure of nourishing your body.

    5. Start eating a big breakfast. It helps you eat fewer total calories throughout the day.

    6. Make sure your plate is half veggies and/or fruit at both lunch and dinner.

    Are there Any Easy Tricks to Help Me Cut Calories?

    cut calories diet weight loss

    7. Eating out? Halve it, and bag the rest. A typical restaurant entree has 1,000 to 2,000 calories, not even counting the bread, appetizer, beverage, and dessert.

    8. When dining out, make it automatic: Order one dessert to share.

    9. Use a salad plate instead of a dinner plate.

    10. See what you eat. Plate your food instead of eating out of the jar or bag.

    11. Eat the low-cal items on your plate first, then graduate. Start with salads, veggies, and broth soups, and eat meats and starches last. By the time you get to them, you’ll be full enough to be content with smaller portions of the high-calorie choices.

    12.
    Instead of whole milk, switch to 1 percent. If you drink one 8-oz glass a day, you’ll lose 5 lb in a year.

    13. Juice has as many calories, ounce for ounce, as soda. Set a limit of one 8-oz glass of fruit juice a day.

    14. Get calories from foods you chew, not beverages. Have fresh fruit instead of fruit juice.

    15. Keep a food journal. It really works wonders.

    16. Follow the Chinese saying: “Eat until you are eight-tenths full.”

    17. Use mustard instead of mayo.

    18. Eat more soup. The noncreamy ones are filling but low-cal.

    19. Cut back on or cut out caloric drinks such as soda, sweet tea, lemonade, etc. People have lost weight by making just this one change. If you have a 20-oz bottle of Coca-Cola every day, switch to Diet Coke. You should lose 25 lb in a year.

    20. Take your lunch to work.

    21. Sit when you eat.

    22. Dilute juice with water.

    23. Have mostly veggies for lunch.

    24. Eat at home.

    25. Limit alcohol to weekends.

    How Can I Eat More Veggies?

    fruits weight loss diets

    26. Have a V8 or tomato juice instead of a Diet Coke at 3 pm.

    27. Doctor your veggies to make them delicious: Dribble maple syrup over carrots, and sprinkle chopped nuts on green beans.

    28. Mix three different cans of beans and some diet Italian dressing. Eat this three-bean salad all week.

    29. Don’t forget that vegetable soup counts as a vegetable.

    30. Rediscover the sweet potato.

    31. Use prebagged baby spinach everywhere: as “lettuce” in sandwiches, heated in soups, wilted in hot pasta, and added to salads.

    32. Spend the extra few dollars to buy vegetables that are already washed and cut up.

    33. Really hate veggies? Relax. If you love fruits, eat plenty of them; they are just as healthy (especially colorful ones such as oranges, mangoes, and melons).

    34. Keep seven bags of your favorite frozen vegetables on hand. Mix any combination, microwave, and top with your favorite low-fat dressing. Enjoy 3 to 4 cups a day. Makes a great quick dinner.

    Can You Give Me a Mantra that will Help Me Stick to My Diet?

    help stick to my diet

    35. “The best portion of high-calorie foods is the smallest one. The best portion of vegetables is the largest one. Period.”

    36. “I’ll ride the wave. My cravings will disappear after 10 minutes if I turn my attention elsewhere.”

    37. “I want to be around to see my grandchildren, so I can forgo a cookie now.”

    38. “I am a work in progress.”

    39. “It’s more stressful to continue being fat than to stop overeating.”

    I Eat Healthy, but I’m Overweight. What Mistakes Could I Be Making without Realizing It?

    diet mistakes

    40. Skipping meals. Many healthy eaters “diet by day and binge by night.”

    41. Don’t “graze” yourself fat. You can easily munch 600 calories of pretzels or cereal without realizing it.

    42. Eating pasta like crazy. A serving of pasta is 1 cup, but some people routinely eat 4 cups.43. Eating supersize bagels of 400 to 500 calories for snacks.

    44. Ignoring “Serving Size” on the Nutrition Facts panel.

    45. Snacking on bowls of nuts. Nuts are healthy but dense with calories. Put those bowls away, and use nuts as a garnish instead of a snack.

    46. Thinking all energy bars and fruit smoothies are low-cal.

    What Can I Eat for a Healthy Low-Cal Dinner if I Don’t Want to Cook?

    low calorie drinks meals tips

    47. A smoothie made with fat-free milk, frozen fruit, and wheat germ.

    48. The smallest fast-food burger (with mustard and ketchup, not mayo) and a no-cal beverage. Then at home, have an apple or baby carrots.

    49. A peanut butter sandwich on whole wheat bread with a glass of 1 percent milk and an apple.

    50. Precooked chicken strips and microwaved frozen broccoli topped with Parmesan cheese.

    51. A healthy frozen entree with a salad and a glass of 1 percent milk.

    52. Scramble eggs in a nonstick skillet. Pop some asparagus in the microwave, and add whole wheat toast. If your cholesterol levels are normal, you can have seven eggs a week!

    53. A bag of frozen vegetables heated in the microwave, topped with 2 tablespoons of Parmesan cheese and 2 tablespoons of chopped nuts.

    54. Prebagged salad topped with canned tuna, grape tomatoes, shredded reduced-fat cheese, and low-cal Italian dressing.

    55. Keep lean sandwich fixings on hand: whole wheat bread, sliced turkey, reduced-fat cheese, tomatoes, mustard with horseradish.

    56. Heat up a can of good soup.

    57. Cereal, fruit, and fat-free milk makes a good meal anytime.

    58. Try a veggie sandwich from Subway.

    59. Precut fruit for a salad and add yogurt.

    What’s Your Best Advice for Avoiding those Extra Holiday Pounds?

    holiday weight gain

    60. Don’t tell yourself, “It’s okay, it’s the holidays.” That opens the door to 6 weeks of splurging.

    61. Remember, EAT before you meet. Have this small meal before you go to any parties: a hardboiled Egg, Apple, and a Thirst quencher (water, seltzer, diet soda, tea).

    62. As obvious as it sounds, don’t stand near the food at parties. Make the effort, and you’ll find you eat less.

    63. At a buffet? Eating a little of everything guarantees high calories. Decide on three or four things, only one of which is high in calories. Save that for last so there’s less chance of overeating.

    64.
    For the duration of the holidays, wear your snuggest clothes that don’t allow much room for expansion. Wearing sweats is out until January.

    65. Give it away! After company leaves, give away leftover food to neighbors, doormen, or delivery people, or take it to work the next day.

    66. Walk around the mall three times before you start shopping.

    67. Make exercise a nonnegotiable priority.

    68. Dance to music with your family in your home. One dietitian reported that when she asks her patients to do this, initially they just smile, but once they’ve done it, they say it is one of the easiest ways to involve the whole family in exercise.

    How Can I Control a Raging Sweet Tooth?

    sweet tooth

    69. Once in a while, have a lean, mean salad for lunch or dinner, and save the meal’s calories for a full dessert.

    70. Are you the kind of person who does better if you make up your mind to do without sweets and just not have them around? Or are you going to do better if you have a limited amount of sweets every day? One RD reported that most of her clients pick the latter and find they can avoid bingeing after a few days.

    71. If your family thinks they need a very sweet treat every night, try to strike a balance between offering healthy choices but allowing them some “free will.” Compromise with low-fat ice cream and fruit, or sometimes just fruit with a dollop of whipped cream.

    72. Try 2 weeks without sweets. It’s amazing how your cravings vanish.

    73. Eat more fruit. A person who gets enough fruit in his diet doesn’t have a raging sweet tooth.

    74. Eat your sweets, just eat them smart! Carve out about 150 calories per day for your favorite sweet. That amounts to about an ounce of chocolate, half a modest slice of cake, or 1/2 cup of regular ice cream.

    75. Try these smart little sweets: sugar-free hot cocoa, frozen red grapes, fudgsicles, sugar-free gum, Nutri-Grain chocolate fudge twists, Tootsie Rolls, and hard candy.

    How Can I Conquer My Downfall: Bingeing at Night?

    eating late at night

    76. Eat breakfast, lunch, and dinner. The large majority of people who struggle with night eating are those who skip meals or don’t eat balanced meals during the day. This is a major setup for overeating at night.

    77. Eat your evening meal in the kitchen or dining room, sitting down at the table.

    78. Drink cold unsweetened raspberry tea. It tastes great and keeps your mouth busy.

    79. Change your nighttime schedule. It will take effort, but it will pay off. You need something that will occupy your mind and hands.

    80. If you’re eating at night due to emotions, you need to focus on getting in touch with what’s going on and taking care of yourself in a way that really works. Find a nonfood method of coping with your stress.

    81. Put a sign on the kitchen and refrigerator doors: “Closed after Dinner.”

    82. Brush your teeth right after dinner to remind you: No more food.

    83. Eat without engaging in any other simultaneous activity. No reading, watching TV, or sitting at the computer.

    84. Eating late at night won’t itself cause weight gain. It’s how many calories—not when you eat them—that counts.

    How Can I Reap Added Health Benefits from My Dieting?

    health benefits

    85. Fat-free isn’t always your best bet. Research has found that none of the lycopene or alpha- or beta-carotene that fight cancer and heart disease is absorbed from salads with fat-free dressing. Only slightly more is absorbed with reduced-fat dressing; the most is absorbed with full-fat dressing. But remember, use your dressing in moderate amounts.

    86. Skipping breakfast will leave you tired and craving naughty foods by midmorning. To fill up healthfully and tastefully, try this sweet, fruity breakfast full of antioxidants. In a blender, process 1 c nonfat plain or vanilla yogurt, 1 1/3 c frozen strawberries (no added sugar), 1 peeled kiwi, and 1 peeled banana. Pulse until mixture is milkshake consistency. Makes one 2-cup serving; 348 calories and 1.5 fat grams.

    87. If you’re famished by 4 p.m. and have no alternative but an office vending machine, reach for the nuts—. The same goes if your only choices are what’s available in the hotel minibar.

    88. Next time you’re feeling wiped out in late afternoon, forgo that cup of coffee and reach for a cup of yogurt instead. The combination of protein, carbohydrate, and fat in an 8-ounce serving of low-fat yogurt will give you a sense of fullness and well-being that coffee can’t match, as well as some vital nutrients. If you haven’t eaten in 3 to 4 hours, your blood glucose levels are probably dropping, so eating a small amount of nutrient-rich food will give your brain and your body a boost.

    89. Making just a few changes to your pantry shelves can get you a lot closer to your weight loss goals. Here’s what to do: If you use corn and peanut oil, replace it with olive oil. Same goes for breads—go for whole wheat. Trade in those fatty cold cuts like salami and bologna and replace them canned tuna, sliced turkey breast, and lean roast beef. Change from drinking whole milk to fat-free milk or low-fat soy milk. This is hard for a lot of people so try transitioning down to 2 percent and then 1 percent before you go fat-free.

    90. Nothing’s less appetizing than a crisper drawer full of mushy vegetables. Frozen vegetables store much better, plus they may have greater nutritional value than fresh. Food suppliers typically freeze veggies just a few hours after harvest, locking in the nutrients. Fresh veggies, on the other hand, often spend days in the back of a truck before they reach your supermarket.

    91. Worried about the trans-fat content in your peanut butter? Good news: In a test done on Skippy, JIF, Peter Pan, and a supermarket brand, the levels of trans fats per 2-tablespoon serving were far lower than 0.5 gram—low enough that under proposed laws, the brands can legally claim zero trans fats on the label. They also contained only 1 gram more sugar than natural brands—not a significant difference.

    Eating Less Isn’t Enough—What Exercising Tips Will Help Me Shed Pounds?

    Exercising Tips

    92. Overeating is not the result of exercise. Vigorous exercise won’t stimulate you to overeat. It’s just the opposite. Exercise at any level helps curb your appetite immediately following the workout.

    93. When you’re exercising, you shouldn’t wait for thirst to strike before you take a drink. By the time you feel thirsty, you’re already dehydrated. Try this: Drink at least 16 ounces of water, sports drinks, or juices two hours before you exercise. Then drink 8 ounces an hour before and another 4 to 8 ounces every 15 to 20 minutes during your workout. Finish with at least 16 ounces after you’re done exercising.

    94. Tune in to an audio book while you walk. It’ll keep you going longer and looking forward to the next walk—and the next chapter! Check your local library for a great selection. Look for a whodunit; you might walk so far you’ll need to take a cab home!

    95. Think yoga’s too serene to burn calories? Think again. You can burn 250 to 350 calories during an hour-long class (that’s as much as you’d burn from an hour of walking)! Plus, you’ll improve muscle strength, flexibility, and endurance.

    96. Drinking too few can hamper your weight loss efforts. That’s because dehydration can slow your metabolism by 3 percent, or about 45 fewer calories burned a day, which in a year could mean weighing 5 pounds more. The key to water isn’t how much you drink, it’s how frequently you drink it. Small amounts sipped often work better than 8 ounces gulped down at once.

    How Can I Manage My Emotional Eating and Get the Support I Need?

    weight loss support

    97. A registered dietitian (RD) can help you find healthy ways to manage your weight with food. To find one in your area who consults with private clients check out the ads at the top of the page, ask your friends or consult your yellow pages

    98. The best place to drop pounds may be your own house of worship. Researchers set up healthy eating and exercise programs in 16 Baltimore churches. More than 500 women participated and after a year the most successful lost an average of 20 lb. Weight loss programs based on faith are so successful because there’s a built-in community component that people can feel comfortable with.

    99. Here’s another reason to keep level-headed all the time: Pennsylvania State University research has found that women less able to cope with stress—shown by blood pressure and heart rate elevations—ate twice as many fatty snacks as stress-resistant women did, even after the stress stopped (in this case, 25 minutes of periodic jackhammer-level noise and an unsolvable maze).

    100. Sitting at a computer may help you slim down. When researchers at Brown University School of Medicine put 92 people on online weight loss programs for a year, those who received weekly e-mail counseling shed 5 1/2 more pounds than those who got none. Counselors provided weekly feedback on diet and exercise logs, answered questions, and cheered them on. Most major online diet programs offer many of these features

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