Ginkgo Evaluation of Memory (GEM) Study Fails To Show Benefit in Preventing Dementia in the Elderly

The dietary supplement Ginkgo biloba was found to be ineffective in reducing the development of dementia and Alzheimer's disease in older people, according to a study published in the Journal of the American Medical Association1. Researchers led by Steven T. DeKosky, M.D., formerly of the University of Pittsburgh, vice president and dean of the School of Medicine at the University of Virginia in Charlottesville, conducted the trial known as the Ginkgo Evaluation of Memory (GEM) study at four clinical sites over the course of 8 years. GEM is the largest clinical trial ever to evaluate ginkgo's effect on the occurrence of dementia.

This research was co-funded by five components of the National Institutes of Health (NIH): National Center for Complementary and Alternative Medicine (NCCAM); National Institute on Aging (NIA); National Heart, Lung, and Blood Institute; National Institute of Neurological Disorders and Stroke, and the Office of Dietary Supplements.

"We have made enormous progress in understanding the basic mechanisms involved in Alzheimer's disease, and we continue to pursue a vigorous program to translate what we know into the development and testing of new potential therapies for this devastating disease," said Richard Hodes, M.D., director of the NIA. "However, it is disappointing that the dietary supplement tested in this study had no effect in preventing Alzheimer's disease."

GEM enrolled 3,069 participants age 75 or older with normal cognition or mild cognitive impairment. Those with dementia were excluded from participation. After extensive medical and neuropsychological screening, participants were randomly assigned to receive twice-daily doses of either 120 milligrams of ginkgo extract or an identical-appearing placebo. The 240 milligrams daily dose of ginkgo was selected based on current dosage recommendations and prior clinical studies indicating possible effectiveness at this dose. The products used in the study were supplied by Schwabe Pharmaceuticals, a German company.

"According to the 2007 National Health Interview Survey, ginkgo is one of the top 10 natural products used by Americans," said Richard L. Nahin, Ph.D., M.P.H., acting director of the Division of Extramural Research at NCCAM. "It is important to conduct studies and build the scientific evidence base regarding botanical supplements through rigorous research, such as the GEM trial."

The study was conducted primarily to determine if ginkgo would decrease the incidence of all types of dementia and, more specifically, reduce the incidence of Alzheimer's disease. Secondarily, the study evaluated ginkgo for its effects on overall cognitive decline, functional disability, incidence of cardiovascular disease and stroke, and total mortality. The primary endpoint was the diagnosis of dementia as determined by an expert panel of clinicians using standard criteria for diagnosis. The patients with a diagnosis of dementia underwent magnetic resonance imaging scans to determine their dementia type.

"The results of this study confirm the importance of randomized trials in the development of new therapies for dementia and Alzheimer's disease and in determining therapeutic benefit not only for conventional therapies but also complementary therapies like ginkgo," said Dr. DeKosky, principal investigator on the GEM study. "If older patients are considering using ginkgo for preventing dementia, I urge them to speak with their health care providers about the results of this study and work together to create the best treatment plan."

Study participants were followed for an average of approximately 6 years (maximum of just over 7 years). During the study, 523 participants were diagnosed with dementia, 246 in the placebo group and 277 in the ginkgo group. Thus, ginkgo showed no overall effect for reducing all types of dementia or Alzheimer's disease. In addition, in analyzing safety data, the GEM study did not find significant adverse effects from ginkgo, in particular there was no evidence for increased bleeding risk in persons taking ginkgo.

Cognitive status was known for more than 93 percent of all participants at the end of the trial and 60 percent of active participants were taking their assigned study medication. There was no difference in adherence to taking medication between the ginkgo group and the placebo group.

"While this study revealed that ginkgo does not have an effect on reducing dementia in the study population, it does provide us with important information about how to design and conduct large dementia prevention trials in older adults" said Dr. Jeff Williamson, a geriatrician and principal investigator of the GEM Clinical Coordinating Center at Wake Forest University. "Future analyses will provide us with additional information on ginkgo's possible effects on cardiovascular disease, cancer, depression and other age-related conditions. We are especially grateful to the more than 3,000 older adults who dedicated many hours to helping us answer the important questions addressed by GEMS."

The GEM results will prove useful in determining how many participants are needed in future trials to provide clinically significant measures on outcomes such as occurrence of dementia. Future analysis of this study may also identify subgroups of these participants who may be at greater risk for developing dementia.

Data analysis for the trial was overseen by the University of Washington, Seattle and the four GEM institutions that participated in this study were

University of Pittsburgh
Wake Forest University, Winston-Salem, N.C.
Johns Hopkins University, Baltimore, Md.
University of California, Davis


DeKosky ST, Williamson JD, Fitzpatrick AL, et al. Ginkgo biloba for Prevention of Dementia. Journal of the American Medical Association. 2008 300(19): 2253–2262.

source: NCCAM

Pregnancy pounds predict kids' weight as teens

Women who gain too much weight during pregnancy may not only have bigger babies, but bigger teenagers as well, a study suggests.

Researchers at Harvard Medical School found that among nearly 12,000 children and teenagers they studied, those whose mothers gained more than the recommended amount of weight during pregnancy were 42 percent more likely to be obese.

The risk was independent of other factors the researchers examined, including mothers' pre-pregnancy weight, family income and parents' education.

Some past studies have linked excessive weight gain during pregnancy to a higher risk of obesity in childhood. These latest findings add to evidence that the fetal environment may have a "sustained effect" on children's weight regulation, Dr. Emily Oken and colleagues report in the journal Obstetrics & Gynecology.

For women, they say, the study underscores the importance of going into pregnancy at a healthy weight, and then gaining only the recommended amount.

In the U.S., the Institute of Medicine (IOM) suggests that normal-weight women gain 25 to 35 pounds during pregnancy. Women who were overweight before becoming pregnant are encouraged to gain a little less -- 15 to 25 pounds -- while underweight women should put on 28 to 40 pounds.

The current study included 11,994 children between 9 and 14-years olds whose mothers were part of the Nurses Health Study II, a long-range health study of female nurses from across the U.S. The researchers found that 6.5 percent of the children were obese.

Oken's team found that when mothers exceeded the IOM guidelines for pregnancy weight gain, their children's weight also tended to climb.

Compared with their peers whose mothers followed the IOM guidelines, those whose mothers gained too much weight were 42 percent more likely to be obese by the time they were 9-to-14 years old.

Researchers suspect that excess pregnancy pounds may affect fetal development in a way that makes children more susceptible to excessive weight gain.

Animal research has found that overeating during pregnancy alters the expression of genes involved in fat regulation in offspring, and seems to affect the appetite-control centers of their brains as well.

SOURCE: Obstetrics & Gynecology, November 2008.

Gaga for Organic

Demand for organic commercial baby food is on the rise—and for good reason. Many experts believe that choosing organic foods is especially important for infants because they are much smaller than adults and often eat more food per pound.

As a result, any pesticide residue remaining on conventional foods may have a more significant effect on an infant or child than on an adult. And because they are experiencing rapid growth and development, everything you put in your infant’s body has the potential to affect them more significantly than at later stages in life.

Infants also lack the same defenses as adults and even older children, such as established blood-brain barriers, immune systems or liver detoxification enzymes. This makes them more vulnerable when it comes to potentially toxic compounds.

These concerns have led many parents to favor organic foods whenever possible. Our shelves offer many organic choices for baby. Options include: fresh frozen purées, baby food in jars, cereals, crackers, teething biscuits and other snacks for infants and toddlers. Whole Foods Market is also the ideal place to shop for ingredients to make your own baby food because we offer more fresh, organic produce than any other store.


Ref: Whole foods

How High Cholesterol Leads to Atherosclerosis

For decades, news stories and TV ads have hammered it into our heads: Cholesterol is bad for you. (Got the message yet?)

High cholesterol levels lead to clogged arteries in a process called atherosclerosis. Lowering cholesterol lowers the risk of diseases caused by atherosclerosis, like heart attacks and strokes.

What makes cholesterol so bad for your arteries? And isn't there a "good" cholesterol? How does treating high cholesterol help?

Cholesterol and Atherosclerosis: The Bad, the Good, and the Ugly
In cholesterol and atherosclerosis, there are good guys and bad guys:

"Bad" cholesterol, also called low-density lipoprotein (LDL), has chemical properties that can damage arteries. Damaged areas allow more LDL to penetrate artery walls. The LDL gets stuck and accumulates in the artery's wall.

(Warning: chemistry lesson ahead!) Inside the artery wall, free radicals transform LDL from something bad to something worse: oxidized LDL. The cholesterol chemical spill attracts white blood cells and other cells to try to clean up the mess. The cells chew up and digest oxidized LDL.

Once begun, this whole process tends to continue. Over years, the deposit of "bad" cholesterol, cells, and debris grows larger, and it's called a plaque.

"Good" cholesterol, known as high-density lipoprotein (HDL), is the yin to LDL's yang. HDL is on your side: it circulates through your body, acting like a cholesterol magnet. HDL diverts and delivers cholesterol away from your arteries. Much of the cholesterol is either eliminated from the body, delivered to tissues such as the liver, or used to make hormones.

As cholesterol plaques form and grow inside arteries, they eventually can begin to block off blood flow. Here's where atherosclerosis gets ugly.

The LDL-rich center of the plaque can be stable, meaning it grows in a slow, controlled way. The plaque may eventually cause symptoms, but generally speaking, the body adapts. These blockages seldom cause heart attacks.

Plaques can instead be unstable. Remember the cells inside the plaque, digesting all the LDL? As they work, these cells release enzymes that dissolve some of the biological "duct tape" (collagen) holding the plaque together.

Unstable plaques are prone to tearing. If they rupture, they release material that causes a blood clot to form inside the artery. Within minutes, blood flow is cut off. The result: a heart attack or stroke.

Cholesterol Treatment: Down With the Bad, Up With the Good
The link between cholesterol and atherosclerosis led to treatments to improve cholesterol levels. Numerous medications, and changes in lifestyle, can improve cholesterol and reduce atherosclerosis.

Exercise with or without weight loss increases "good" HDL cholesterol and reduces the risk of heart attacks and strokes.

A diet high in fiber and reduced fats can lower "bad" LDL cholesterol. Plant-derived stanols used as fat substitutes also help lower cholesterol.

Statins are the most-often prescribed medicines for high cholesterol. Statins can dramatically lower "bad" LDL cholesterol, by up to 60% or more. They can also increase HDL modestly. In studies, statins reduce the rates of heart attacks, strokes, and death from atherosclerosis.

Avocado- Green Gold for Skin and Hair care

Many of us enjoy avocados in a bowl of guacamole now and then, but they have more going for them than just delicious taste. For centuries, ancient Mayan, Aztec, and Incan beauties knew the avocado is also a wonderful beauty aid, rich in beneficial oils that rejuvenate the skin, reduce eye puffiness, heal frazzled hair, and much, much more.

Find out the secrets of avocado here. It’s known as “green gold” for some very good reasons!
Avocados are perishable, so be sure to use these formulas as soon as you make them. When buying avocados, look for organically-grown firm fruit with a slight “give” to the flesh. To use, cut the avocado in half lengthwise and remove the pit. Cover the unused half with plastic wrap and refrigerate.

Aztec Miracle for Puffy Eyes
This works so well it’s almost scary. Just slice a peeled avocado half into quarter-inch crescent-shapes. Lie down with a few slices under each eye and rest for around 20 minutes. You’ll love the results!

Easiest Facial Mask Ever
Just mash half an avocado and spread evenly on your clean face. Allow to remain for 15 minutes, then rinse off with warm water. This is best for dry skin types.

Shiny Soft Hair Treatment
In a small bowl, mash and combine:
1 avocado (1/2 for shorter hair)
1 egg yolk
1/2 teaspoon olive oil

Apply to hair and allow to remain 30 minutes or longer, then shampoo and condition as usual. Amazingly silky, shiny, soft hair!

Soft, Smooth Hand Trick
This gently exfoliating scrub will make your hands noticeably softer and smoother.

In a small bowl, mash:
1/4 of a peeled avocado
1 egg white
2 tablespoons oatmeal
1 teaspoon lemon juice

Combine well and apply to your hands. Leave the mixture on for 20 minutes, then rinse in warm water and pat dry.

Appealing Moisturizer
Turns out we’ve been throwing away (or composting) a valuable part of the avocado!! You can use the inside of the peel as a fabulous humectant and oil-rich moisturizer. Just lightly apply the inside of the peel to your clean face, using gentle upward strokes. You can leave the oil on your face all night or rinse after 15 minutes. Makes a great foundation for your foundation or powder!

Oily-Skin Masque
In a small bowl, thoroughly mash and combine:
1/2 avocado
1 teaspoon lemon juice
1 egg white

Apply evenly to a clean face and allow to remain 20 minutes, then rinse with warm water and a cloth. Follow with an astringent, if you like.

Soothe your skin- Can borage oil help keep skin healthy?

Borage (Borago officinalis L.), also known as "starflower" (گل گاوزبان in Persian) is an annual herb originating in Syria, but naturalized throughout the Mediterranean region, as well as Asia Minor, Europe, North Africa, and South America. It grows to a height of 60-100 cm (2-3 feet), and is bristly or hairy all over the stems and leaves; the leaves are alternate, simple, and 5-15 cm (2-6 in) long. The flowers are complete, perfect with with five narrow, triangular-pointed petals. Flowers are most often blue in color, although pink flowers are sometime observed. White flowered types are also cultivated. The flowers arise along scorpiod cymes to form large floral displays with multiple flowers blooming simultaneously, suggesting that borage has a high degree of geitomogamy. It has an indeterminate growth habit which may lead to prolific spreading. In milder climates, borage will bloom continuously for most of the year.

Traditionally borage was cultivated for culinary and medicinal uses, although today commercial cultivation is mainly as an oilseed. The seed oil is desired as source of gamma-linolenic acid (GLA, 18:3, cis 6,9,12-octadecatrienoic acid), for which borage is the highest known plant-based source (17-28%). The seed oil content is between 26-38% and in addition to GLA contains the fatty acid palmitic (10-11%), stearic (3.5-4.5%), oleic (16-20%), linoleic (35-38%), eicosenoic (3.5-5.5%), erucic (1.5-3.5%), and nervonic (1.5%). The oil is often marketed as "starflower oil" or "borage oil" for uses as a GLA supplement, although healthy adults will typically produce ample GLA through dietary linoleic acid.

Borage production does include use as either a fresh vegetable or a dried herb. As a fresh vegetable, borage, with a cucumber like taste, is often used in salads or as a garnish. The flower, which contains the non-toxic pyrrolizidine alkaloid thesinine, has a sweet honey-like taste and is one of the few truly blue-colored edible things, is often used to decorate dessert. It is notable that the leaves have been found to contain small amounts (10 ppm of dried herb) of the liver-toxic pyrrolizidine alkaloids: intermedine, lycopsamine, amabiline and supinine.

Vegetable use of borage is common in Germany and the Spanish regions of Aragón and Navarra. Although often used in soups, one of the better known German borage recipes is the Green Sauce (Grüne Sauce) made in Frankfurt. The leaves and flowers were orginally used in Pimms before it was replaced by mint.

Naturopathic practitioners uses of borage for regulation of metabolism and the hormonal system, and consider it to be a good remedy for PMS and menopause symptoms such as the hot flash. Borage is sometimes indicated to alleviate and heal colds, bronchitis, and respiratory infections in general for its anti-inflammatory and balsamic properties. The flowers can be prepared in infusion to take advantage of its medicinal properties. The oleic and palmitic acid of borage may also confera hypocholesterolemic effect.

Tea made from the dried flowers is a traditional calming drink in Iran. It has a rich purple color that turns bright pink by adding a few drops of lemon juice
Studies show that topically applied borageoil can deliver GLA directlr to cells, where it can provide both immediate and long term improvement for those who suffer
from skin problems resulting from a deficiency of this omega-6 fatty acid.

Biological clock may shut down long-term memory at night

If you crammed for tests by pulling ‘all nighters’ in school, ever wonder why your memory is now a bit foggy on what you learned? A University of Houston professor may have the answer with his research on the role of circadian rhythms in long-term learning and memory.

Arnold Eskin, the John and Rebecca Moores Professor of Biology and Biochemistry at UH, was recently awarded two grants totaling $2,472,528 from the National Institutes of Health (NIH) to continue pursuing his investigations of memory formation and the impact of the biological clock on learning and memory.

Scientists have known for a while that the brain’s biological (or circadian) clock influences natural body cycles, such as sleep and wakefulness, metabolic rate and body temperature. New research from Eskin suggests the circadian clock also may regulate the formation of memory at night. This new research focuses on “Circadian Modulation of Long-term Memory Formation” and “Long-term Regulation of Glutamate Uptake in Aplysia,” with NIH funding to be disbursed over four years.

“There is a lot of research going on in memory,” Eskin said. “How do we remember things given that we don’t have a camera in our brain to record events? What changes take place in our brains that allow us to remember? These grants are about fundamental learning and memory and about modulation of memory.”

For the grant on circadian modulation of long-term memory formation, Eskin will continue studies based on his data that reveal the circadian clock modulates several forms of long-term memory in the marine snail Aplysia.

These studies involved experiments on the defensive reflexes and feeding responses of Aplysia. Eskin’s results showed that Aplysia form long-term memory when they are trained during the day but not when they are trained at night. However, short-term memory of the same behaviors is formed equally well during the day and night, which might explain why all-night cram sessions may have helped you get through certain classes in school, but did not leave you with enough of a lasting impression to become part of your long-term store of knowledge.

“Somewhere in the molecular circuit, in the neural circuit in the brain, the biological clock is shutting that circuit off at a particular time of night. It’s shutting molecules down so that long-term memory can’t happen,” Eskin said.

Lisa Lyons, a research assistant professor at UH, is the primary investigator on this grant and is already investigating molecules involved in memory formation that might be activated during the day but not at night. NIH funding will help advance the pursuit of this line of research.

For the grant on long-term regulation of glutamate uptake in Aplysia, Eskin will focus on the transmitter substance glutamate, which is involved in memory formation.

“The formation of memory happens at places in the brain called synapses, where cells ‘talk’ to one another through the release of chemicals called transmitter substances,” Eskin said. “In order for transmitters to work, once they are released they have got to be cleared away so that others can subsequently act. So, there are not only important mechanisms to release the transmitters, but also mechanisms to get rid of them, and these are called reuptake systems.”

Eskin is studying glutamate reuptake and glutamate transport to understand the mechanism or change that takes place at the synapses of nerve cells (or neurons) that enables people to remember. In previous research, Eskin found that glutamate transport molecules, which act as the brain’s cleaning crew during learning and memory formation, actually increase once the long-term memory-forming process begins. Deficiencies in these glutamate transporters that affect the strength of connections among the neurons associated with memory may explain why memory lapses such as forgetting where you last set down your keys occur.

“This research will provide significant information toward understanding memory and thus diseases that affect memory,” Eskin said.

With the potential to shed light upon neurodegenerative diseases such as Alzheimer’s - marked by a loss of brain function due to the deterioration of neurons - studying these nerve cells could one day take this research from helping you be better able to find your glasses to providing relief from a debilitating illness.

“At the end of the day, we can’t make memory better or improve it unless we understand how memory works and is modulated,” he said. “That’s what this research is all about.”

He is currently completing the last year of another NIH-funded grant on “Glutamate Transport Regulation and Synaptic Plasticity” that complements these two new grants, but investigates the role of glutamate uptake in associative learning in mammals. This research project on mammals represents a great example of traslational research in which basic findings in a simple system (i.e. Aplysia) were quickly applied to a higher organism (i.e. mammals). They found that glutamate transport increased in the brains of mammals during learning as also found in Aplysia. (See related release at http://www.uh.edu/admin/media/nr/2002/032002/eskinlearning.html.)

Coming to UH more than 25 years ago, Eskin guided the merger of two departments into what is now the Department of Biology and Biochemistry in the College of Natural Sciences and Mathematics. As department chair from 1994 to 2000, Eskin tripled research grants to approximately $6 million per year and developed the department’s research foci of neuroscience, the biological clocks and infectious disease. The author or co-author of more than 150 publications, he has received numerous honors, including the Esther Farfel Award, the university’s highest faculty honor. He is the only faculty member to receive both the Farfel Award and the Moores Professorship in the same year. Eskin earned his bachelor’s degree in physics from Vanderbilt University and his doctorate in zoology from the University of Texas.

UH’s Biological Clocks Program is one of the world’s leading centers for circadian rhythms research, with five laboratories and a team of more than 30 scholars. In addition to Eskin, the group is led by four other tenured faculty members in the biology and biochemistry department - Associate Professor Gregory M. Cahill, Professor Stuart Dryer, Professor Paul Hardin and Professor Michael Rea. For more information on the biological clocks program at UH, visit http://www.bchs.uh.edu/research_clocks.htm

23 Ways to Reduce Wrinkles

Whether you're 35 and just beginning to see the first signs of aging, or 55 with skin that isn't exactly keeping your birthday a secret, seeking ways to reduce wrinkles is probably on your agenda.

At the same time, experts say, many of us are losing the wrinkle battle, watching helplessly as the glow of youth goes on the dimmer switch.

"Many women as well as men believe that aging skin is inevitable, but with the information and technologies we have today, you really can look as young as you feel," says Robin Ashinoff, MD, a dermatologist at the Hackensack University Medical Center in New Jersey.

What follows are 23 ways experts say you can make a difference. While some require a visit to the dermatologist, many are things you can do on your own.

How to Reduce Wrinkles: What You Can Do
1.Avoid the sun. It's the No. 1 cause of wrinkles, with dozens of studies documenting the impact. In one study that looked at identical twins, New York plastic surgeon Darrick Antell, MD, found sun exposure was even more important than heredity. Siblings who limited sun time had fewer wrinkles and looked younger overall than their sun-worshiping twins.

2.Wear sunscreen. If you must go out in the sun, the American Academy of Dermatology says, wear sunscreen! It will protect you from skin cancer, and help prevent wrinkles at the same time.

3. Don't smoke. Some of the research is still controversial, but more and more studies are confirming that cigarette smoke ages skin -- mostly by releasing an enzyme that breaks down collagen and elastin, important components of the skin. Sibling studies done at the Twin Research Unit at St. Thomas Hospital in London found the brother or sister who smoked tended to have skin that was more wrinkled and up to 40% thinner than the non-smoker.

4. Get adequate sleep. Yale dermatologist Nicholas Perricone, MD, says that when you don't get enough sleep, the body produces excess cortisol, a hormone that breaks down skin cells. Get enough rest, Perricone says, and you'll produce more HGH (human growth hormone), which helps skin remain thick, more "elastic," and less likely to wrinkle.

5. Sleep on your back. The American Academy of Dermatology (AAD) cautions that sleeping in certain positions night after night leads to "sleep lines -- wrinkles that become etched into the surface of the skin and don't disappear once you're up. Sleeping on your side increases wrinkles on cheeks and chin, while sleeping face-down gives you a furrowed brow. To reduce wrinkle formation, the AAD says, sleep on your back.

6. Don't squint -- get reading glasses! The AAD says any repetitive facial movement -- like squinting -- overworks facial muscles, forming a groove beneath the skin's surface. This groove eventually becomes a wrinkle. Also important: Wear sunglasses. It will protect skin around the eyes from sun damage -- and further keep you from squinting.
7. Eat more fish -- particularly salmon. Not only is salmon (along with other cold-water fish) a great source of protein -- one of the building blocks of great skin -- it's also an awesome source of an essential fatty acid known as omega-3. Perricone tells WebMD that essential fatty acids help nourish skin and keep it plump and youthful, helping to reduce wrinkles.

8. Eat more soy -- So far, most of the proof has come from animal studies, but research does show certain properties of soy may help protect or heal some of the sun's photoaging damage. In one recent human study, published in the European Journal of Nutrition, researchers reported that a soy-based supplement (other ingredients included fish protein and extracts from white tea, grapeseed, and tomato, as well as several vitamins) improved skin's structure and firmness after just six months of use.

9. Trade coffee for cocoa. In a study published in the Journal of Nutrition in 2006, researchers found cocoa containing high levels of two dietary flavanols (epicatchin and catechin) protected skin from sun damage, improved circulation to skin cells, affected hydration, and made the skin look and feel smoother.

10. Eat more fruits and vegetables. The key, says Kraus, are their antioxidant compounds. These compounds fight damage caused by free radicals (unstable molecules that can damage cells), which in turn helps skin look younger and more radiant, and protects against some effects of photoaging.

11. Use moisturizer. "Women, especially, are so concerned with antiaging products they often overlook the power of a simple moisturizer. Skin that is moist simply looks better, so lines and creases are far less noticeable," says Ashinoff.

12. Don't over-wash your face. According to dermatologists at the University of Maryland Medical Center, tap water strips skin of its natural barrier oils and moisture that protect against wrinkles. Wash them off too often, and you wash away protection. Moreover, unless your soap contains moisturizers, you should use a cleanser instead.

Topical Treatments That Reduce Wrinkles
Studies show the following ingredients can reduce wrinkles. Most are found in a variety of skin-care treatments, both prescription and over-the-counter.

13. Alpha-hydroxy acids (AHAs). These natural fruit acids lift away the top layer of dead skin cells, reducing the appearance of fine lines and wrinkles, particularly around the eyes. New evidence shows that in higher concentrations, AHAs may help stimulate collagen production.

14. Retinoids (including Retin A). The only FDA-approved topical treatment for wrinkles is tretinoin, known commercially as Retin A. Ashinoff says this prescription cream reduces fine lines and large wrinkles, and repairs sun damage. Retinol is a natural form of vitamin A found in many over-the-counter products. Studies show that in a stabilized formula, in high concentrations, it may be as effective as Retin A, without the side effects, such as skin burning and sensitivity.
15. Topical vitamin C. Studies at Tulane University, among others, have found it can increase collagen production, protect against damage from UVA and UVB rays, correct pigmentation problems, and improve inflammatory skin conditions. The key, however, may be the type of vitamin C used. To date, most of the research points to the L-ascorbic acid form as the most potent for wrinkle relief.

16. Idebenone. This chemical cousin to the nutrient coenzyme Q10 (CoQ10)is a super-powerful antioxidant. In one study published recently in the Journal of Dermatology, doctors found that with just 6 weeks of topical use, there was a 26% reduction in skin roughness and dryness, a 37% increase in hydration, a 29% decrease in lines and wrinkles, and a 33% overall improvement in sun-damaged skin. Other studies have found similar results.

17. Growth factors. Part of the body's natural wound-healing response, these compounds, when applied topically, may reduce sun damage and decrease lines and wrinkles, while rejuvenating collagen production, studies have shown.

18. Pentapeptides. The results of a study supported by the National Institutes of Health suggested pentapeptides can increase collagen production in sun-damaged skin. Several subsequent studies (including one presented at a recent national dermatology conference) showed that when topically applied, pentapeptides stimulated collagen production and diminished lines and wrinkles.

Medical/Spa Treatments That Reduce Wrinkles
19. Botox. An injection of this purified version of the Botulinum toxin A relaxes the muscle just underneath the wrinkle, allowing the skin on top to lie smooth and crease-free.

20. Wrinkle fillers. Doctors fill wrinkles with a variety of substances, including collagen, hyaluronic acid, and other synthetic compounds. Popular treatments include Restylane, Juvederm, and ArteFill, among others.

21. Laser/light resurfacing. Here, energy from a light source -- either a laser or a pulsed diode light -- removes the top layer of skin, causing a slight but unnoticeable skin "wounding." This kicks the skin's natural collagen-production system into high gear, resulting in smoother, more wrinkle-free skin.

22. Chemical peels. In this treatment, one of a variety of different chemicals is used to "burn" away the top layer of skin, creating damage that causes the body to respond by making more collagen. You end up with younger-looking, smoother skin.

23. Dermabrasion. A vacuum suction device used in tandem with a mild chemical crystal, dermabrasion helps remove the top layer of skin cells and bring new, more evenly textured skin to the surface. In the process, fine lines and wrinkles seem to disappear.

Ways to Encourage Positive Emotions

Visualize yourself at a time when you were happy, relaxed, and full of energy-try to recall your emotions and reexperience how you felt.

Develop your sense of humour.

Practice looking on your bright side.

Work on closeness.If you are glad to see someone,or grateful for an act of kindness, say so enthusiastically.

Let those who are dear to you know how much you love them.

Learn yoga,qigong, or meditation to help still the mind and focus thoughts.

Altruism is healthy. Do somethng to help pther people, whether voluntary work or visiting a sick neighbour.

Link up your thoughts with feelings. Try writing an account of unpleasant or traumatic events, describing your emotions.

Summer Skin Care

Summertime, and the living is easy -- that is, until you notice the havoc all that fun in the sun has wrought on your body. Fortunately, summer also brings an abundance of tasty and nutritious foods, including berries (loaded with antioxidants), tomatoes, sweet bell peppers (good vitamin C source), and protein-filled grilled fish and burgers. And by simply choosing the right ones to add to your daily diet, you can help prevent or alleviate the following common hot-weather woes:

Dry or Damaged Skin

What causes it: You sweat more in the summer, so skin is less supple; plus, saltwater and chlorine have a drying effect. Sunburns and bug bites are also saboteurs of healthy skin.

What to eat: Help heal weathered skin with foods like raspberries, blueberries, and strawberries, which are rich in antioxidants and vitamin C. Protein, in the form of lean meats, beans, nuts, and seeds, is also key. Keep dryness at bay by drinking lots of water, which Lona Sandon, RD, calls "the forgotten nutrient." Sandon is a spokeswoman for the American Dietetic Association. She recommends that women drink 92 ounces (8-10 cups) of water in the summer and men 125 ounces to prevent dehydration. Since calcium can also be lost through sweating, it's a good idea to replace it by eating low-fat dairy products like skim milk, yogurt, and cottage cheese.

Yeast Infections

What causes them: Sitting around in a wet bathing suit provides a perfect environment for yeast overgrowth.

What to eat: To make conditions less hospitable for yeast to take hold in the first place, cut back on sugary foods, advises Leanne Ely, CNC, author of Saving Dinner: The Menus, Recipes, and Shopping Lists to Bring Your Family Back to the Table.

Parched Hair

What causes it: Overexposure to sun, saltwater, and chlorine.

What to eat: Toss some burgers or shrimp kabobs on the grill, or make a three-bean salad or other protein-rich meal because hair consists of protein fibers called keratin. Eating foods rich in vitamin B-5 (found in yogurt and California avocadoes), vitamin B-8 (in liver and cooked eggs), folic acid (in fortified cereals and beans), calcium (in milk and yogurt), and zinc (in meat and fish) can reduce hair loss and replace dull hair with shiny hair. Theses nutrients also play a role in maintaining healthy skin.

Muscle Cramps

What causes them Too many games of beach volleyball (or other outdoor exercise). Muscle cramps result from overexertion and dehydration. When you don't have enough fluid in your system, it leads to an electrolyte imbalance that causes your muscles to cramp up. Sodium, calcium, and potassium are the main electrolytes lost through sweating during exercise.

What to eat: Replenish electrolytes with a sports drink that contains them and drink water. Potassium-rich foods include bananas, raisins, potatoes, and spinach.

Eye Damage

What causes it: Age-related macular degeneration is the most common cause of vision loss and blindness in people over the age of 55. This occurs when the central part of the retina (macula) becomes damaged.

What to eat: The retina is actually made up of vitamin A, Ely tells WebMD. Thus, foods rich in this vitamin -- along with beta-carotene, zinc, and Vitamins C and E -- are beneficial to the eyes. Good sources are dark green vegetables like kale, chard, and mustard greens, plus bell peppers, carrots, and blueberries. Eat eggs for their high dose of lutein, an important antioxidant that also helps prevent eye damage.

Cold Sores

What causes them: Sun exposure can trigger cold sores in people who are prone to them.

What to eat: The amino acid L-lysine has been shown in some small studies to help, but larger studies are needed to confirm these findings. Sandon says a deficiency in B vitamins and riboflavin can make you usceptible to cold sores. She recommends eating fortified cereals and bread or taking a B-complex vitamin.

Wrong and Ideal combinations of food

According to Ayurveda few things are forbidden to be combined with each other and eaten.Given are the below combinations which are forbidden according to Ayurveda.

Wrong Combination:

Milk and curd with banana
Milk or curd with radish
Milk and curd
Honey with hot water or any other hot substance
Honey and radish
Khichdi and Kheer
Milk with musk melon(kharbooza)/watermelon/cucumber/sanke gourd(kakadi)
Bengal gram (Urad) and radish
Curd and blackberry(jamun)
Curd and musk melon(kharbooza)
Curd and paneer
Fruits with vegetables
Radish or curd at night
Curd after heating
Ghee kept in a copper pot for more than 10 or more days
Pulses with sweet potato/potato/kachalu
Musk melon(kharbooza)/watermelon with any other food item
Pulses and rice or pulses and chapati
Milk or curd with chapati
Chapati and tamarind


According to Ayurveda these are the Ideal Combinations of food.

Mango and cow's milk
Milk and dates
Rice and coconut
Guava with fennel seed(saunf)
Watermelon with radish leaves
Asparagus(bathua) and curd raita
Curd and pulses
Mix vegetable of carrot and methi
Banana and cardamom(small)
Curd and amla powder
Swetsaar with vegetables
Dry fruits with citrus fruits
Pulses and vegetables
Vegetables and rice khichdi
Fruits and small quantity dry fruits with vegetables
Chapati with green leafy vegetables
Sprouts with fresh coconut

39 Flower Remedies for Every Emotion

If you are living too much in the past, maybe honeysuckle will help? Gloomy? Try some mustard flower! Flower remedies represent a combination of herbalism and homeopathy. Their main therapeutic effects are found on the emotional level.

The best known flower remedies are the Bach flower remedies originated in the l930s by Dr. Edward Bach, an English physician. In recent times, Australian wildflower remedies and Californian flower essences have also become available; these are sold mainly in health food stores and by various practitioners.

The usual dosage of a Bach remedy is two to four drops of the composite preparation in a teaspoonful (plastic) of water at least four times daily, taken before meals and especially as the first and last thing daily. Hold this solution in your mouth and under the tongue for some time; store remedies in a cool place.

Reference guide for the selection of Bach flower remedies:
• Agrimony: Suffering or worry hidden by smiling face.
• Aspen: Apprehension, vague fears of unknown origin.
• Beech: Intolerance, arrogance, tendency to be overcritical.
• Centaury: Susceptibility to influence and exploitation, weak will, timidity.
• Cerato: Lack of confidence, doubt, constant requests for advice.
• Cherry Plum: Uncontrolled temper, desperation, fear of loss of mind.
• Chestnut Bud: Slowness to learn, lack of observation, repetition of mistakes.
• Chicor: Possessiveness, self-love, self-pity, attention seeking.
• Clematis: Indifference, dreaminess, lack of interest.
• Crab Apple: Feeling of being unclean, shame, self-dislike; the cleanser.
• Elm: Occasional feelings of inadequacy, too much responsibility.
• Gentian: Discouragement, self-doubt, negative attitudes, depression.
• Gorse: Hopelessness, despair, despondency.
• Heather: Self-centeredness, love of talking, inability to listen.
• Holly: Envy, suspicion, revenge, hatred, jealousy.
• Honeysuckle: Living too much in the past, homesickness.
• Hornbeam: Mental and physical weariness.
• Impatiens: Impatience, irritability, mental tension.
• Larch: Lack of confidence, expectation of failure, feeling of inferiority.
• Mimulus: Fear of known things, shyness, timidity.
• Mustard: Deep gloom or depression of unknown cause.
• Oak: Onward struggle despite despondency/despair.
• Olive: Mental and physical exhaustion or weariness.
• Pine: Self-blame, self-reproach, guilt, false humility.
• Red Chestnut: Fear and anxiety for others.
• Rock Rose: Terror, panic, extreme fear.
• Rock Water: Self-criticism, rigidity, self-denial.
• Scleranthus: Uncertainty, indecision, hesitation, lack of balance.
• Star of Bethlehem: After-effects of shock and trauma.
• Sweet Chestnut: Extreme anguish, hopeless despair, loss of faith.
• Vervain: Overenthusiasm, fanaticism, nervous tension, strain.
• Vine: Dominance, leadership, craving for power, ambition, inflexibility.
• Walnut: Helps in changes, link breaking, protects.
• Water Violet: Aloofness, reserve, pride.
• White Chestnut: Unwanted persistent thoughts, worry, inner mental arguments.
• Wild Oat: Dissatisfaction at not having found goal, uncertainty.
• Wild Rose: Resignation, lack of interest, apathy.
• Willow: Resentment, bitterness, “not-fair” attitude.

• Rescue Remedy (a composite of Cherry Plum, Clematis, Impatiens, Rock Rose, and Star of Bethlehem): Use for shock, terror, upsets, fright, accidents; give frequently in all emergencies; apply externally on wounds.

The Doctrine of Signatures

Every whole food has a pattern that resembles a body organ or physiological function and that this pattern acts as a signal or sign as to the benefit the food provides the eater. Here is just a short list of examples of Whole Food Signatures.

A sliced Carrot looks like the human eye. The pupil, iris and radiating lines look just like the human eye...and science shows that carrots greatly enhance blood flow to and function of the eyes.
A Tomato has four chambers and is red. The heart is red and has four chambers. All of the research shows tomatoes are indeed pure heart and blood food.
Grapes hang in a cluster that has the shape of the heart. Each grape looks like a blood cell and all of the research today shows that grapes are also profound heart and blood vitalizing food.
A Walnut looks like a little brain, a left and right hemisphere, upper cerebrums and lower cerebellums. Even the wrinkles or folds are on the nut just like the neo-cortex. We now know that walnuts help develop over 3 dozen neuron-transmitters for brain function.
Kidney Beans actually heal and help maintain kidney function and yes, they look exactly like the human kidneys.
Celery, Bok Choy, Rhubarb and more look just like bones. These foods specifically target bone strength. Bones are 23% sodium and these foods are 23% sodium. If you don't have enough sodium in your diet the body pulls it from the bones, making them weak. These foods replenish the skeletal needs of the body.
Eggplant, Avocadoes and Pears target the health and function of the womb and cervix of the female - they look just like these organs. Today's research shows that when a woman eats 1 avocado a week, it balances hormones, sheds unwanted birth weight and prevents cervical cancers. And how profound is this? .... It takes exactly 9 months to grow an avocado from blossom to ripened fruit. There are over 14,000 photolytic chemical constituents of nutrition in each one of these foods (modern science has only studied and named about 141 of them).
Figs are full of seeds and hang in twos when they grow. Figs increase the motility of male sperm and increase the numbers of sperm as well to overcome male sterility.
Sweet Potatoes look like the pancreas and actually balance the glycemic index of diabetics.
Olives assist the health and function of the ovaries.
Grapefruits, Oranges, and other citrus fruits look just like the mammary glands of the female and actually assist the health of the breasts and the movement of lymph in and out of the breasts.
Onions look like body cells. Today's research shows that onions help clear waste materials from all of the body cells They even produce tears which was h the epithelial layers of the eyes.

"The news isn't that fruits and vegetables are good for you, it's that they are so good for you, they can save your life."

David Bjerklie, TIME Magazine, Oct. 2003

Mindfulness meditation slows progression of HIV

Reducing stress can bolster immune system in HIV-positive adults, others, says eurekalert press release

CD4+ T lymphocytes, or simply CD4 T cells, are the "brains" of the immune system, coordinating its activity when the body comes under attack. They are also the cells that are attacked by HIV, the devastating virus that causes AIDS and has infected roughly 40 million people worldwide. The virus slowly eats away at CD4 T cells, weakening the immune system.

But the immune systems of HIV/AIDS patients face another enemy as well — stress, which can accelerate CD4 T cell declines. Now, researchers at UCLA report that the practice of mindfulness meditation stopped the decline of CD4 T cells in HIV-positive patients suffering from stress, slowing the progression of the disease. The study was just released in the online edition of the journal Brain, Behavior, and Immunity.

Mindfulness meditation is the practice of bringing an open and receptive awareness of the present moment to experiences, avoiding thinking of the past or worrying about the future. It is thought to reduce stress and improve health outcomes in a variety of patient populations.

"This study provides the first indication that mindfulness meditation stress-management training can have a direct impact on slowing HIV disease progression," said lead study author David Creswell, a research scientist at the Cousins Center for Psychoneuroimmunology at UCLA. "The mindfulness program is a group-based and low-cost treatment, and if this initial finding is replicated in larger samples, it's possible that such training can be used as a powerful complementary treatment for HIV disease, alongside medications."

Creswell and his colleagues ran an eight-week mindfulness-based stress-reduction (MBSR) meditation program and compared it to a one-day MBSR control seminar, using a stressed and ethnically diverse sample of 48 HIV-positive adults in Los Angeles. Participants in the eight-week group showed no loss of CD4 T cells, indicating that mindfulness meditation training can buffer declines. In contrast, the control group showed significant declines in CD4 T cells from pre-study to post-study. Such declines are a characteristic hallmark of HIV progression.

Creswell also noted that researchers found a "dose-response" relationship between MBSR class attendance and CD4 T cells, meaning, said Creswell, "the more mindfulness meditation classes people attended, the higher the CD4 T cells at the study's conclusion."

The researchers were also encouraged because the overall CD4 T cell effects remained even after controlling for a number of factors that could have skewed the study results. Most notably, they found equivalent protective effects for participants whether or not they were on antiretroviral medications for HIV. Even participants taking HIV medications showed the CD4 T cell buffering effect after the mindfulness meditation class, Creswell said.

There is emerging evidence from other studies that shows that behavioral stress-management programs can buffer HIV declines in HIV-positive people, Creswell noted. And while there has been an exponential increase of interest in and practice of mindfulness meditation in the West over the past 10 years, this study, he said, is the first to show an HIV disease protective effect with mindfulness meditation training.

In order to understand the health benefits of mindfulness meditation, Creswell and his colleagues at UCLA are now examining the underlying pathways through which mindfulness meditation reduces stress, using brain imaging, genetics and immune system measurements.

"Given the stress-reduction benefits of mindfulness meditation training, these findings indicate there can be health protective effects not just in people with HIV but in folks who suffer from daily stress," Creswell said.

Home Made Facials

To be beautiful is always a big deal. And the secret to being beautiful is to have smooth, moisturized and flawless skin. There are many moisturizers available specially formulated to suit every skin type. Most of them guarantee beautiful, clear skin with continuous use. Oftentimes, though, they come with chemical ingredients that may not be very friendly for very sensitive skin. Because of this, a lot of people are now turning to healthier alternatives, using products that you may already have in your garden or in your kitchen.


For instance, lemon juice, vinegar, blackberries, grapes, oranges, tomatoes, and apple juice are great facial cleansers.

For an overnight facial, dab some apple cider vinegar on your face before retiring to bed. This will rid your face of blemishes and impurities overnight. When you wake up in the morning, you will have softer, smoother skin.

You can also make your own moisturizer mask. Just add two tablespoons of honey to two teaspoons of milk. Then smooth the solution over your face and throat. Leave on for about 10 minutes before rinsing it off with warm water.

The following tip is an excellent remedy for dry skin. If you have a piece of egg, a tablespoon of oil and half a teaspoon of freshly squeezed lemon juice, you may be well on your way to have moisturized, smooth skin. Here is what you must do: beat the egg and add oil and lemon juice. Mix them well. Apply a bit of the mixture on your wrist, then refrigerate the rest of it. After an hour, your wrist should look and feel okay. This is an indication that the mixture may now be applied to your face. Wash your face and carefully massage the mixture on your face. Leave on for 15 minutes, then rinse well.

5 Little-Known Ways to Reduce Arthritis Pain

If you have arthritis, you've probably tried painkillers and heating pads. You may have even tried drugs like Celebrex® or supplements like glucosamine. But here are 5 little-known remedies that you probably haven't tried. They're safe... they're inexpensive... and they can dramatically curb your symptoms.

Drink Tea. Yes, tea. Research shows that green tea is rich in polyphenols -- compounds that suppress the expression of a key gene involved in arthritis inflammation. Black tea is made from the same leaves and may be as beneficial, even though it is processed differently. Drink one or 2 cups of hot or cold tea daily.
Boost Your C and D. Vitamin C is believed to slow the loss of cartilage due to osteoarthritis, while a diet low in vitamin D has been shown to actually speed the progression of osteoarthritis. In a recent high-profile study, doctors discovered that patients who ate a diet high in vitamin D (or who took vitamin D supplements) reduced their risk for worsening their arthritis by 75%. Another study of over 25,000 people concluded that a low intake of vitamin C may increase the risk of developing arthritis. Take daily supplements that provide 500 to 1,000 mg of vitamin C, and 400 IUs of vitamin D.

Try Willow Bark and Boswellia. Willow bark is where aspirin comes from. And boswellia has been used for centuries to reduce inflammation and maintain healthy joints. A study showed that taking these 2 herbs is just as effective as taking a drug like Motrin®. Take 240 mg of willow bark and 1,000 mg of boswellia per day.

Eat Grapes. Grape skin contains resveratrol, a natural compound known to act as a COX-2 inhibitor. Resveratrol both suppresses the COX-2 gene and deactivates the COX-2 enzyme, which produces inflammation at the site of injury or pain. A study published in the Journal of Biological Chemistry confirmed that resveratrol acts as an antioxidant and a COX-2 inhibitor. Eat one cup of white or red grapes daily. Good news: Purple grape juice and wine contain resveratrol, too.

Therapeutic Taping. Wrapping tape around a joint to realign, support, and take pressure off it has great benefits for arthritis sufferers. In an Australian study, 73% of patients with osteoarthritis experienced substantially reduced symptoms after just 3 weeks of therapeutic taping. The benefits were comparable with those achieved by standard drug treatments and lasted even after taping was stopped! Important: Taping must be done properly to be effective. Consult a physician or physical therapist who can show you or a family member the proper technique

Homeopathy for Infant Colic

The following information gives a brief description of some of the more commonly used remedies for colic:

Bryonia alba
(Bryonia) is for the infant who is irritable and does not want to be carried. He is worse from movement and touch with a tendency toward constipation.

Chamomilla
Chamomilla is for the "impossible cranky irritable" baby who moves about in agony. She cries one minute for something and then pushes it away the next. Both baby and parents are miserable. Baby is better from being carried. One notable feature is that one cheek is red and the other is pale.

Colocynthis
Colocynthis should be considered for severe colic. The baby screams with gas pains and is doubled over. The pain is better with firm pressure on the tummy.

Magnesia phosphorica
(Mag phos) is used when relief is brought on by gentle abdominal pressure. The baby also feels better with warmth on the belly.

Pulsatilla
Pulsatilla is for the affectionate baby who is irritable and desires sympathy and attention.Naturally, homeopathy offers relief and cure to countless other challenges that await new parents. Homeopathic remedies are growing in popularity as people are becoming more familiar with all it has to offer.

Girls and Women Vulnerable to Knee Injuries

There are many physiological and anatomical differences between men and women beyond the obvious ones -- including, as it turns out, vulnerability to orthopedic injuries. It appears that how women are built leaves us -- and our daughters, like my two soccer players -- four times more likely to suffer knee injuries, especially to the anterior cruciate ligament (ACL) in the knee joint. Although the ACL is the smallest ligament in the knee, the fact that it is part of the connective structure between the femur (thigh bone) and tibia (shin bone) makes it critical to stability. A torn ACL can be painful and often requires surgery, followed by four to six months of physical therapy to regain proper functioning and return to sports. New research provides an improved understanding of how to protect yourself from the risk of injury -- not to mention the resulting pain and cost for treatment.

RESEARCH TO DATE

Research a few years ago revealed one major cause of ACL injury in women -- after a jump, as in basketball or volleyball, females tend to land with straighter legs than males do, which puts more pressure on the ACL. Research also has shown that females often have an imbalance between the strength in their quadriceps muscles in the front of the thighs and the hamstring muscles in the back of the thighs. This alters knee functioning and may affect stability.

The newest study on female knees comes from the University of Michigan, Division of Kinesiology, adding a subtle but important additional clue to the ACL/female injury issue. Researchers found that many women athletes maintain a knock-kneed position when landing after a jump. When I called orthopedic surgeon Jo A. Hannafin, MD, PhD, at the Hospital for Special Surgery in New York City to learn more, she told me that knock-knees come about for several reasons. Some people (both male and female) are simply born this way -- it is the anatomic alignment they were given. But often it is due to yet another muscle imbalance, this one between the inner (medial) and outer (lateral) thigh muscles. In this study, researchers determined that females -- even those who are not knock-kneed -- tend to activate the stronger outer thigh muscles in preparation for a landing. Without equally strong inner thigh muscles to provide balance, the knees rotate even further inward, increasing the risk to the ACL. Playing primarily one sport year-round or repeating the same exercise routines makes injury even more likely -- repetition of one activity builds only the muscles the particular sport requires, and may create a strength imbalance, says Dr. Hannafin. Cross training helps avoid this problem.

Not only jumping sports but any that involve torquing the knees -- the twisting that is inherent in skiing, tennis or even ballroom dancing -- puts pressure on the knee and increases risk of injury, says Dr. Hannafin. This makes it important for all active women to pay special attention to their knee positioning and muscle strength balance.

To find out if your inner and outer thigh muscles are balanced, Dr. Hannafin suggests doing a mini-squat on one leg (described below) -- if the bent knee goes toward the other knee rather than remaining pointed out straight, it shows weakness of the inner thigh muscles and the muscles of the hip and buttock that rotate the knee outward.

PROTECT YOURSELF

Strengthening and balance training exercises to build up the muscles and paying close attention to how you jump, land and pivot can help you avoid such injury. For example, focusing on trying to land with knees that are slightly bent, or decelerating before switching directions when you're moving quickly (as in tennis) may help, according to a report by the Journal of Athletic Training. Here are some suggestions from Dr. Hannafin:

Wear the right shoes. Key: Supportive shoes with a good, strong sole. Avoid flip-flops, sandals and fashion flats as these can aggravate problems in people who are flat-footed or who pronate excessively. Look for sandals with a built-in arch or use an arch support in your shoes.
Stand straight. Pay attention to how you position your hips during all activities, including standing. You can get some sense of this by doing your exercises in front of a mirror, but if you are serious about sports, consider an assessment by a sports physical therapist.

Strengthen hips. Strengthening hips also helps prevent injury. One way to do this is with hip abductions, says Francesco Gallaro, MSPT, CSCS, a certified strength and conditioning coach and physical therapist in Norwalk, Connecticut. These also serve to strengthen gluteus muscles. Do two or three sets of eight to 12 reps of standing resisted hip abductions, using a rubber band. Kick one leg from the midline of your body to the side in a backward diagonal direction. Note: Kick should be a smooth continuous motion. Try to complete the entire set without the foot touching the ground. Good hip strength prevents the knee from rolling inward into a knock-kneed position.

Balance thigh muscles. To strengthen and balance the thigh muscles, Dr. Hannafin advises making a routine of the one-sided mini-squat mentioned earlier. Keep the gluteus (the muscles of your buttocks) tight and pay close attention to activating muscles on both sides of the leg. To perform this exercise correctly, stand on one leg. Bending from the knee, lower your body down until your knee is bent to 45 degrees (you don't have to go all the way to a sitting position for it to be effective). Raise yourself back up. Do two or three sets of 10 repetitions, each leg.

Strengthen the hamstring (for the quad-hamstring imbalances mentioned earlier). Gallaro suggests the deadlift. Stand on one leg, bend your body forward at the waist so you are at a 90-degree angle. Raise yourself back up -- do three sets of eight to 12 reps. The leg not in contact with the floor should be straight and in proper alignment with your trunk. Try performing a set without letting your foot make contact with the ground. As you get stronger, you can do this exercise while holding weights.

Perform leg strengtheners. Leg presses at the gym are also helpful -- but with a strong caveat, says Dr. Hannafin. It's important to maintain proper form, keeping your knees over your feet. Women tend to squeeze their knees together as they push against the platform -- this further strengthens and trains the outside of the quad to do the work, leaving the inner thigh muscles getting weaker. Try placing a small ball between your knees when you are on the leg press.
Don't ignore your core. Finally, Dr. Hannafin recommends core strengthening exercises. Having strong pelvic and lower abdominal muscles, interestingly, helps to protect your knees. Pilates is good for this, of course, as are assorted core-exercise programs that employ large exercise balls.

Source(s):
Jo A. Hannafin, MD, PhD, orthopaedic director, Women's Sports Medicine Center, Hospital for Special Surgery, New York City.

Francesco Gallaro, MSPT, CSCS, a certified strength and conditioning coach and physical therapist in Norwalk, Connecticut.

Acupressure

Acupressure is often called acupuncture without the needles. Instead of needles, acupressure involves the application of manual pressure (usually with the fingertips) to specific points on the body.

According to the principles of traditional Chinese medicine, the body has vital energy called "chi" or "qi" that flows along invisible lines of energy flow called meridians. There are thought to be at least 14 meridians connecting our organs with other parts of our body. Acupuncture and acupressure points lie on those meridians. If the flow of qi is blocked at any point on a meridian, it's thought to be the cause of ailments and lead to disease anywhere along the meridian. That's why a practitioner may apply pressure to an acupressure point in the foot to relieve a headache.

There is no scientific consensus on how acupressure might work. Some theorize that the pressure may promote the release of natural pain-relieving chemicals in the body, called endorphins. Another theory is that the pressure may somehow influence the autonomic nervous system.

Why Do People Try Acupressure
Most people try acupressure for a specific ailment. Some of the more common ailments are:

nausea and vomiting during pregnancy/ morning sickness

motion sickness

nausea after surgery

nausea due to chemotherapy

cancer-related fatigue

headache

menstrual cramps

muscle tension and pain

Although more research is needed, studies examining the use of acupressure for nausea have generally found that it's effective at relieving nausea. All studies have used a particular point on the inside of the wrist called P6 for nausea.

Some of the advantages of acupressure to P6 for nausea are that it can be self-administered and it is believed to safe for pregnant women and those with cancer or other illnesses.

How is Acupressure Done?
Acupressure is often administered by an acupuncturist with the person receiving the acupressure lying on a massage table.

Acupressure can also be self-administered. Although it's best to consult an acupuncturist for proper instruction, acupressure is generally done by using the thumb, finger or knuckle to apply gentle but firm pressure to a point. The pressure is often increased for about 30 seconds, held steadily for 30 seconds to two minutes and then gradually decreased for 30 seconds. It's often repeated three to five times.

The point P6 can be found by turning the arm so that the palm is facing up. Place the thumb at the center of the crease of the wrist (where the hand meets the wrist) and then position it two finger widths away from the crease towards the elbow. The point is between the two large tendons. See an illustration of the point.

Precautions
Acupressure should never be painful. If you experience any pain, discontinue the session.

Pressure should be gentle over fragile or sensitive areas, such as the face.

People with osteoporosis, recent fracture or injury, easy bruising, bleeding disorders, circulatory problems from diabetes, and those using anticoagulant or antiplatelet medications such as Coumadin (warfarin) that "thin" the blood should avoid acupressure unless under the supervision of a qualified therapist.

Pregnant women should consult their doctor before using acupressure. Acupressure shouldn't be done on the abdominal area or to certain points on the leg if pregnant.

Acupressure shouldn't be done over open wounds, bruises, varicose veins, or any area that is bruised or swollen.

Side Effects
After an acupressure session, some people may feel soreness at the points. People may also feel temporarily lightheaded.

Source:

Ezzo J, Streitberger K, Schneider A. Cochrane systematic reviews examine P6 acupuncture-point stimulation for nausea and vomiting. J Altern Complement Med. (2006) 12.5: 489-495.

Power Foods for Pregnant and Nursing Women

Berries
Why? These colorful fruits top the charts with their antioxidant content and have been shown to help with brain, eye and vascular health. Antioxidants are compounds that protect cells from free radical damage. Free radicals are highly reactive particles - induced by such things as cigarette smoking, sunlight and excessive exercise - that damage cells throughout the body by triggering oxidative reactions. Berries also provide fiber, which is beneficial for pregnant women.

Did you know? One way to ensure you are eating the recommended servings and variety of fruits and vegetables is to eat a colorful diet. Most experts agree that the colors in foods, also known as phytochemicals, impart numerous health benefits. As a general rule, have at least three natural colors on your plate at each meal. For added antioxidant content, experiment with fruits and vegetables in new varieties of colors. Look for purple cauliflower, red or yellow carrots, purple potatoes, pink radishes, red cabbage, blood oranges, purple beans and more.

How? Berries are delicious when fresh, but frozen berries are available all year round and are a nice addition to smoothies, muffins, pancakes or salads. They also make a wonderful sauce when cooked with a little maple syrup and water. Try also all-fruit berry jam or berry juice (great mixed with some sparkling water).

Sweet Potatoes
Why? Sweet potatoes have a stellar nutrition profile. They are an excellent source of vitamin A (as colorful beta carotene) and a good source of vitamin E.

Did you know? By eating sweet potatoes with a little fat, you will increase the absorption of nutrients, including beta carotene.

How? The easiest way to prepare sweet potatoes is by simply baking them in the oven at 400°F for one hour. You can bake several at a time, then store in the refrigerator for a few days until needed. Baking brings out the natural sugars in sweet potatoes, and will make your kitchen smell wonderful. Due to their skin (be sure to eat the skin for added nutritional benefits), they are easily portable. Eat as a side dish to a main meal, as a snack, or for breakfast, with hard-boiled eggs.


Avocado
Why? Enjoyed by many due to their smooth texture and mild flavor, avocadoes are an excellent source of potassium, folic acid, and vitamin C. Nutrient-dense avocados also contain healthy monounsaturated fats.

Did you know? Avocadoes contain significant quantities of the antioxidant lutein, which has been shown to be beneficial for eye health.

How? Avocadoes are great eaten plain or on salads, but can also be used as the base for a guacamole-type dip, perfect for snacking raw with veggies.


Legumes
Why? Legumes, or dried beans, are a vegetarian source of protein and are fiber-rich. Many varieties are an excellent source of iron, folate and magnesium. These are an important source of minerals and nutrients for vegetarians.

Did you know? In a recent study, certain colored beans — including kidney beans, pinto bean, and black beans — were found to contain high levels of health-promoting antioxidants.

How? Serve legumes in wraps and tortillas, in soups, or as a spread or dip. For ease and convenience, use canned beans or ready-prepared bean spreads, like hummus. Beans cook exceptionally well in a crock pot. Crock pots are great time saving devices — perfect for stews with lots of vegetables and beans. Make extras to freeze for easy meals on busy weeknights.


Nuts
Why? A satisfying, versatile and nutritious food, nuts provide fiber, vitamin E and magnesium. Specific types of nuts have their own nutrition specialty; for example, walnuts have omega-3 fatty acids and almonds provide calcium.

Did you know? Although nuts are high in fat, they contain primarily monounsaturated and polyunsaturated fat, and have not been shown to promote weight gain when eaten in moderation — about a small handful five times a week.
How? Nuts are wonderful on their own, but a trail mix with nuts, seeds, dried fruit, or dried coconut makes a delicious treat. Be sure to explore the bulk aisle for an abundant variety of nuts and trail mixes that you may not have considered previously. Roasted nuts make a tasty addition to salads and vegetable dishes. You can also try a variety of nut butters like almond butter and cashew butter - an easy snack when spread on crackers or raw vegetables. For a special treat, mix a little honey or maple syrup with the nut butter of your choice and enjoy on sliced apples or pears.

Power Foods for Pregnant and Nursing Women

These foods are great for pregnant and lactating women, along with their families. When it's important to make every bite count, depend on these nutritional powerhouses. In case any of these don't suit your taste buds or your dietary choices, we've included alternative sources of key nutrients as well.

Yogurt

Why? Calcium needs increase during pregnancy and yogurt is an excellent calcium source. The need for calcium increases to approximately 1300 milligrams a day during pregnancy. If you are not obtaining this quantity from your diet or vitamin supplement, your body will meet your baby's calcium needs by pulling from your own supply, which makes calcium-rich foods like yogurt, dark leafy greens, sardines with bones, and calcium-fortified orange juice important at this time.

Did you know? In addition to calcium, yogurt is a beneficial fermented food that provides probiotic bacteria, which promotes intestinal and immune health for baby and mom. Probiotic bacteria are cultures of beneficial bacteria found in healthy gut microflora. Yogurt, probiotics and fermented foods help us to keep our intestinal ecosystems healthy.

How? There are many varieties of yogurt and fermented dairy. Yogurt can be eaten as a convenient snack or meal, as an ingredient in smoothies or dips, or as a healthy dessert. If presweetened yogurt is too sweet, mix together half plain and half sweetened, or sweeten plain yogurt with berries and a little sweetener of choice. Probiotic supplements are also available.


Dark Leafy Greens

Why? Dark leafy greens, such as kale and collards, are nutrient powerhouses, containing calcium, fiber, and vitamins A and C, and also rate high on the antioxidant scale. Dark leafy greens are also an important source of folic acid. The U.S. Food and Drug Administration (FDA) recommends that all women in their childbearing years consume 400 micrograms (or 0.4 mg) of folic acid every day to help prevent neural tube defects in their children. Other foods high in folic acid include oranges, beans, asparagus, avocado, and berries. Many vitamin supplements contain folic acid as well.

Did you know? Dark leafy greens are an easy-to-absorb source of non-dairy calcium. This is because they contain the optimal phosphorus to calcium ratio to enhance calcium absorption. Important exceptions to note are spinach and Swiss chard, which contain compounds called oxalates that interfere with calcium absorption. Although spinach and Swiss chard are nourishing foods, do not think of them as a significant source of minerals.

How? Eat with a little fat for better absorption of nutrients. Add a little vinegar for optimum availability of minerals. Dark leafy greens are easily added to other dishes including soup, meatloaf or quiche, adding nutrients without excessive flavor.

Other Non-Dairy Sources of Calcium: Fortified orange juice, sesame seeds, almonds, dried fruit, corn tortillas, tofu, sardines with bones, legumes, fortified foods and supplements.


Eggs

Why? When it comes to value and high quality nutrition, eggs are a good choice since they contain important nutrients for pregnant women, including vitamin A, iron, and protein. Protein needs increase by 10 grams daily for pregnant women, and an adequate protein intake often helps to temper sugar cravings. Note that most of the nutrition in eggs is found in the yolk.

Did you know? For extra nutrition, look for DHA-enriched eggs. DHA is an omega-3 fatty acid important for brain development. The chickens that produce these eggs have been given a special fed containing marine algae, which increases DHA levels in the egg.

How? The simplest way to prepare eggs is hard-boiled. Other easy dishes include omelets and quiches.


Fatty Fish

Why? Fatty fish, such as salmon, sardines, black cod, anchovies, herring and trout, provide omega-3 fatty acids, which are the primary components of brain tissue and are vital for brain and visual development. Studies have shown women who eat fish during pregnancy have children with better visual acuity, higher IQ, better in language and communication skills, and decreased rates of allergies and asthma.

Did you know? The FDA recommends that pregnant and lactating women have no more than 12 ounces (2 servings) of low mercury fish a week. Pregnant and nursing mothers are also advised to avoid larger, long-lived fish with more dark meat - particularly tuna, shark, swordfish, king mackerel and tilefish - as they contain high mercury levels which may harm a baby's developing nervous system. As an alternative to eating fatty fish, fish oil supplements that have been processed to remove contaminants are available. See our Methylmercury Fact Sheet for additional information.

How? Look to our seafood department for a source of fresh fish as well as for frozen fish and soups to have on hand for busy evenings. For a quick meal or snack, top a green salad with canned salmon or heat up a frozen salmon burger or fish cakes. Vegetarian Sources of DHA: Microalgae DHA supplements, DHA-enriched eggs.

Lamb

Why? An excellent source of vitamin B12 and a good source of highly accessible iron and zinc, lamb provides important nutrients for pregnant women. Zinc, in particular, is vitally important for growth and development, because it is required for cell division, DNA/RNA synthesis, and protein synthesis. Adequate zinc levels also ensure optimal bone growth in developing babies and are necessary for immunity. Because zinc is difficult to absorb from plant foods, you may consider supplementing if following a vegetarian or vegan diet.

Did you know? Minerals compete with each other for absorption in the small intestine. It is best to eat calcium-rich foods and zinc-rich foods at different times for optimal absorption of these important nutrients.

How? A tender, flavorful and nourishing meat, lamb is easily prepared on the grill or in the crock-pot.

Vegetarian sources of zinc: legumes (especially adzuki, navy beans, and split peas), nuts and seeds (especially pumpkin seeds, sunflower seeds and cashews), whole grains (fortified cereal and wheat germ), fortified soy foods, supplements.
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Stretch Marks

Stretch Marks are a form of scarring which occurs as a result of rapid stretching of the skin. They initially appear as red or purple lines, and then eventually fade to a light pink or white hue. The affected area is usually very soft to the touch.

While stretch marks can appear anywhere on the body, they usually appear in locations where the body stores more fat. Common places therefore include the stomach area, breasts, arms and armpits, thighs, hips, and buttocks. In most cases, stretch marks do not pose any health risk and are mainly an annoyance.

Stretch marks are caused by rapid stretching and tearing of the skin, usually as a result of rapid growth. Common reasons include:
Puberty
Pregnancy
Rapid weight gain or obesity
Fast muscle growth due to exercise.

While the scarring is permanent, a stretch mark can diminish slightly over time. Some home remedies can also be used to reduce the visual appearance of affected skin areas.

Home Remedies and Natural Cures for Stretch Marks Treatment

While it is not known why, many people have found that massaging cocoa butter into skin areas affected by stretch marks can help reduce the appearance of the scars. This works particularly well for individuals with darker skin tones. A suggested remedy is to massage cocoa butter over the stretch marks once a day. The stretch marks should begin to appear lighter in about a month.

Researchers speculate that the massaging of scarred areas helps stimulate blood flow and distributes collagen evenly in the affected areas. Collagen is a protein responsible for skin strength and elasticity.



Vitamin E is an antioxidant that helps reduce scar tissue on both the inside and the outside of your body. Therefore, a simple home remedy is to massage Vitamin E oil onto the stretch marks each day after showering. Many women have found this treatment to work well on stretch marks after a pregnancy, although results vary significantly.

For Happiness, Seek Family, Not Fortune

Money might buy happiness for some, but for most people having strong family ties is a much bigger predictor of contentment than income, a new study shows.

When researchers analyzed data tracking married people over a decade, they found that while income did contribute to happiness up to a point, the quality of family relationships was much more important.

The study is one of the first to examine the impact of economic and family changes over time.

"Much of the research on money and happiness has shown a strong association up to the point where basic needs are met, and that is what we found," researcher Rebecca J. North tells WebMD. "But after this point income has a diminishing impact on happiness."

Money, Family, and Happiness
North and colleagues from the University of Texas at Austin analyzed data from a study involving 274 married adults living in the San Francisco Bay area who were followed from 1981 to 1991.

Each of the participants completed surveys at four different time periods over the decade-long study designed to measure changes in family income, family support, and happiness.

The surveys indicated that while happiness was strongly tied to changes in the quality of family relationships over time, it was much less strongly tied to changes in income.

"If you ask people about this, I think most would say that family relationships are more important than family income for happiness," North says. "But if you look at the way people allocate their time, you might get a different idea."

The findings may also have implications for how we measure our well-being at a national level, North and colleagues write in the June issue of the Journal of Family Psychology.

"Implicit in conventional policy making is an assumption that a strong economy can be equated with a society's well-being," they note. "Our findings underscore the importance of additional policy indicators that can tap the well-being of individuals and families at the psychosocial level to provide a more comprehensive understanding of a nation's well-being."

Different Perspective on Happiness and Money
The study adds to a growing body of happiness research, but it is far from the last word on the topic.

In a paper presented in April at the Brookings Institution in Washington, D.C., economists Betsey Stevenson, PhD, and Justin Wolfers, PhD, concluded that income does seem to be directly related to happiness, within societies and in personal terms.

Using polling data from both rich and poor countries, the researchers found personal satisfaction to be highest among people living in the richest countries. Within the countries, people with higher incomes tended to be happier than those with less money.

In the U.S., for example, 90% of people in households making at least $250,000 considered themselves "very happy," compared to just 42% of people in households with incomes below $30,000.
"We looked at 35 years' worth of data and found the relationship between income and happiness to be very strong," Stevenson tells WebMD.

The findings seem to contradict the idea that money is only related to happiness up to the point where basic needs are met.

The research by Stevenson and Wolfers shows that people living in households with annual incomes of $250,000 tended to report higher levels of personal satisfaction than people living in households with annual earnings of $120,000.

"We didn't look at the super-rich, so we can't really say if Bill Gates is that much happier than the rest of us," Stevenson says.

About 1% of American families have annual incomes of $250,000 or more, while just 5% earn $120,000 or more.

Massage

Massage therapy is the systematized manipulation of soft tissues for the purpose of normalizing them. Practitioners use a variety of physical methods including applying fixed or movable pressure, holding, or causing movement to the body. Therapists primarily use their hands, but may also use their forearms, elbows, or feet.
The basic goal of massage therapy is to help the body heal itself and to increase health and well-being.

Touch is the core ingredient of massage therapy and also combines science and art. Practitioners learn specific techniques for massage and use their sense of touch to determine the right amount of pressure to apply to each person and locate areas of tension and other soft-tissue problems. Touch also conveys a sense of caring, an important component in the healing relationship.

When muscles are overworked, waste products such as lactic acid can accumulate in the muscle, causing soreness, stiffness, and even muscle spasm.

Massage improves circulation, which increases blood flow, bringing fresh oxygen to body tissues. This can assist the elimination of waste products, speed healing after injury, and enhance recovery from disease.
Therapeutic massage can be used to promote general well-being and enhance self-esteem, while boosting the circulatory and immune systems to benefit blood pressure, circulation, muscle tone, digestion, and skin tone. It has been incorporated into many health systems, and different massage techniques have been developed and integrated into various complementary therapies.

Cochrane Review Shows Preventive Effects of Cranberry against Urinary Tract Infections

Reviewed: Jepson RG, Craig JC. Cranberries for preventing urinary tract infections (Review). Cochrane Database of Systematic Reviews. 2008;DOI:10.1002/14651858. CD001321.pub.4.
Urinary tract infections (UTIs) are diagnosed when a threshold of bacteria in the urine is exceeded (generally greater than 100,000 cells/mL). UTIs consist of cystitis (bacteria in the bladder), urethral syndrome, and polynephritis (infection of the kidney). Symptoms associated with UTIs include pain during urination, cloudy urine, blood in the urine, back pain, and fever. Infants, pregnant women, the elderly, patients with spinal cord injuries, and immunocompromised patients are at increased risk of UTIs. Although UTIs occur in both males and females, they are 50 times more common in females than in males, likely because females have a shorter urethra, which allows easier passage of bacteria into the bladder.

Generally, UTIs are easily treated with antibiotics. Cranberries (Vaccinium macrocarpum, Ericaceae) have been used widely for many years, usually in the form of cranberry juice, to prevent and treat UTIs. The preventive mechanism has not been definitively established; however, the functioning theory is that constituents of cranberries (fructose and proanthocyanidins) prevent bacteria (particularly Esch-erichia coli) from sticking to the uroepithelial cells that line the wall of the bladder. The objective of this review was to evaluate the effec-tiveness of cranberries in preventing UTIs in high-risk populations.

The following 2 hypotheses were tested: (1) cranberry juice and other cranberry-containing products are more effective than placebo or no treatment in preventing UTIs in susceptible populations, and (2) cranberry juice and other cranberry-containing products are more effective than other treatments in preventing UTIs in susceptible populations. A literature review of several databases (MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials) and the Internet was conducted. The purpose was to identify randomized clinical trials (RCTs) of studies that evaluated the effectiveness of cranberry products in preventing UTIs relative to placebo, no treatment, or other treatment. Studies of the treatment of asymptomatic or symptomatic UTIs and of UTIs not caused by bacterial infection were excluded. The primary outcome measure was the number of UTIs in each study group confirmed by a catheter or mid-stream specimen of urine or a "clean-catch" specimen. Secondary outcome measures were compliance with therapy and adverse side effects. The 2 authors of this review independently assessed the studies identified to determine eligibility for this review, and they inde-pendently extracted pertinent information (methods, participants, study design, interventions, and outcomes) from those studies that were deemed eligible. The quality of the studies was assessed on the basis of the Cochrane criteria.

Ten studies (n = 1049 subjects) were included in the review: 5 crossover studies and 5 parallel-group studies. Detailed tabular material is provided in this review for each of the 10 studies. In seven of the studies, cranberry or cranberry-lingonberry juice was compared with water, juice, or placebo. In the remaining studies, cranberry tablets were compared with placebo. Five of the studies were conducted in the United States, two in Canada, one in the Netherlands, one in Finland, and one in Scotland. Details of the studies follow:

1 study lasted 1 month (30 mL cranberry juice/day)

1 study lasted 9 weeks (400 mg cranberry in capsule form)

2 studies lasted 3 months (400 mg cranberry in capsule form or 300 mL cranberry juice/day)

5 studies lasted 6 months (300 mL cranberry juice/day, 50 mL cranberry-lingonberry juice 5 days/week, 2 g cranberry juice concen-trate, or 15 mL cranberry juice/kg/day)

1 study lasted 12 months (250 mL cranberry juice 3 times/day or one concentrated juice tablet 2 times/day).

The methodologic quality of all the trials was satisfactory. Four of the studies were included in a meta-analysis, and all of these studies showed that cranberry consumption significantly reduced the incidence of UTIs at 12 months (relative risk: 0.66; 95% CI: 0.47 to 0.92) compared with placebo or control. Only one of the 6 studies not included in the meta-analysis showed a significant effect of cranberry consumption on reducing the incidence of UTIs. Side effects (bad taste being the most common) were common in most of the studies, and the dropout rate was high in many of the studies. The authors of this review conclude that "evidence from four RCTs indicates that cranberry products can be effective in reducing UTIs. However, it may only be effective in certain sub-populations." Some evidence indi-cates that cranberry juice may be effective in women with symptomatic UTIs, but the evidence is inconclusive for the elderly. Moreover, the evidence is unclear as to the amount and concentration of cranberry that needs to be consumed and the duration of consumption for the intervention to be effective. A major challenge in comparison of these types of studies are the lack of measurements of the total proanthocyanidins (PAC) in the clinical materials used in each study, as these components are the presumed clinically active ingredients. Additional "properly designed studies" with PAC-standardized materials are needed to clarify these uncertainties.