Artificial sweeteners: A safe alternative to sugar

More than ever, people are consuming large amounts of sugar as part of their daily diet. But in excess, sugar can take its toll. Eating large amounts of sugar adds extra calories, which can cause weight gain. Hence many people opt for artificial sweeteners — also referred to as sugar substitutes or low-calorie sweeteners — as a way to enjoy their favorite foods without as many calories.

What are artificial sweeteners?

Artificial sweeteners are chemicals that offer the sweetness of sugar without the calories. Because the substitutes are much sweeter than sugar, it takes a much smaller quantity of them to create the same sweetness. Therefore, products made with artificial sweeteners have a much lower calorie count than do those made with sugar. Artificial sweeteners are often used as part of a weight-loss plan or as a means to control weight gain.

People with diabetes may use artificial sweeteners because they make food taste sweet without raising blood sugar levels. But keep in mind that if you do have diabetes, some foods containing artificial sweeteners, such as sugar-free yogurt, can still affect your blood sugar level due to other carbohydrates or protein in the food. In addition, some foods labeled "sugar-free" — such as sugar-free cookies and chocolates — may contain sweeteners such as sorbitol or mannitol that contain calories and can affect your blood sugar level. Some sugar-free products may also contain flour, which will raise blood sugar levels.

Sweet choices

The Food and Drug Administration (FDA) has approved five low-calorie sweeteners for use in a variety of foods. The FDA has established an "acceptable daily intake" (ADI) for each sweetener. This is the maximum amount considered safe to consume each day over a lifetime. ADIs are intended to be about 100 times less than the smallest amount that might cause health concerns.

Artificial sweetener	ADI*	Estimated ADI equivalent**	OK for cooking?
Aspartame (NutraSweet, Equal)	50 milligrams (mg) per kilogram (kg)	18 to 19 cans of diet cola	No
Saccharin (Sweet'N Low, SugarTwin)	5 mg per kg	9 to 12 packets of sweetener	Yes
Acesulfame K (Sunett, Sweet One)	15 mg per kg	30 to 32 cans of diet lemon-lime soda***	Yes
Sucralose (Splenda)	5 mg per kg	6 cans of diet cola***	Yes
Neotame	18 mg a day	No consumer products available yet in the U.S.	Yes

*FDA-established acceptable daily intake (ADI) limit per kilogram (2.2 pounds) of body weight.
**Product-consumption equivalent for a 150-pound person.
***These products usually contain more than one type of sweetener.

Safety of artificial sweeteners

Artificial sweeteners are often the subject of stories in the popular press and on the Internet, claiming that they cause a variety of health problems, including cancer. According to the National Cancer Institute, however, there's no scientific evidence that any of the artificial sweeteners approved for use in the United States cause cancer. And numerous studies confirm that artificial sweeteners are safe for the general population.

Aspartame does carry a cautionary note, however. It isn't safe for people who have the rare hereditary disease phenylketonuria (PKU). Products that contain aspartame must carry a PKU warning on the label.

Still empty calories

Just removing sugar from cookies and chocolates doesn't make them low-calorie, low-fat foods. If you eat too many, you'll still get more calories than you need, and you may not get enough nutritious foods. Unlike fruits, vegetables and whole grains, sugar-free soft drinks, candy and desserts often provide few — if any — beneficial nutrients.

Use artificial sweeteners sensibly. It's OK to substitute a diet soda for a regular soda, for example, but diet soda shouldn't be the only beverage you drink.

By Mayo Clinic Staff
July 3, 2007

20 ways to revive your healthy-eating plan

Make healthy eating interesting and enjoyable. These quick tips are certain to invigorate your healthy-eating efforts.

Whether you're just starting or have been following a healthy diet for years, sticking to the plan can be challenging. But healthy eating doesn't need to be boring or tiresome. Flavorful food combinations, new cooking ideas and an inventive spirit can enliven your meals and snacks.

Here are 20 ideas to keep you on course.

1. Experiment with new foods and combinations. Try mango or peach slices on whole-wheat toast with a little peanut butter and honey. Toss some mandarin orange and peach slices into a salad.
2. Add chickpeas, black beans or garbanzos to your lunch or dinner salad. If you typically buy a salad at work and no beans are available, bring beans from home in a small container.
3. Try something new for breakfast. Munch on leftover vegetable pizza or make a smoothie blended from exotic fruits, low-fat yogurt and a spoonful of wheat germ.
4. Stir-fry extra-firm or firm tofu rather than meat in oriental dishes. Freezing and then thawing tofu before use gives it a firmer, chewier texture.
5. Make a nutritious snack rather than a full meal when time is tight. For example, spread a brown rice cake with ricotta cheese and fresh strawberries or low-sugar, spreadable fruit. Or try corn muffins with apple and cheese slices, or fat-free refried beans mixed with salsa, a small amount of low-fat sour cream and baked tortilla chips.
6. Add crushed bran cereal or unprocessed wheat bran to baked products, such as meatloaf, breads, muffins, casseroles, cakes and cookies. Also, use bran products as a crunchy topping for casseroles, salads or cooked vegetables.
7. Grill fresh vegetables for a quick and healthy side dish. Cut vegetables into 1/2-inch slices or large chunks and baste with a light salad dressing or brush them with canola or olive oil. Grill until tender, turning only once.
8. Take advantage of ready-to-use foods. Fresh bagged salads, frozen vegetables, low-fat deli meats, whole-wheat pasta, whole-grain breads, and fresh and canned unsweetened fruits take only minutes to prepare.
9. Vary your salad greens and enjoy the multitude of flavors and textures. Choices include arugula, chicory, collard greens, dandelion greens, kale, mustard greens, spinach or watercress. Purchase a different variety each week.
10. For breakfast on the go, munch dry, ready-to-eat cereal with a banana and drink a small carton of low-fat or skim milk.
11. Choose a dish that serves as a full meal for quick and simple cooking. Healthy examples include beef, barley and vegetable stew; chicken, vegetable and rice casserole; turkey and bean casserole (made with turkey breast, white beans and tomatoes); or vegetarian chili with diced vegetables.
12. Take advantage of healthy side dishes offered at fast-food restaurants. Instead of french fries, choose a side salad with low-fat dressing or a baked potato. Or add a fruit bowl or a fruit and yogurt option to your meal.
13. Stock your shelves with good-for-you snacks. Low-fat pudding cups, dry roasted soy nuts, low-fat popcorn and whole-grain crispbread crackers are good choices.
14. Decrease the meat portion on your plate and increase the serving size of vegetables. Use three times as many vegetables on pizzas or in casseroles, soups and stews.
15. Plan meals so that you can use the extra food in other dishes. For example, bake chicken breasts for a meal and use what's left in sandwiches, soup or a stir-fry.
16. Use salsa for more than just chips. Whether it's mild, fruity, scorching, smooth or chunky, salsa is a great companion for potatoes, vegetables, fish, chicken or meats.
17. Marinate meat, chicken, fish before cooking to tenderize and add flavor to foods. Try mixtures of herbs or spices with wine, olive oil, soy sauce, cider vinegar or lemon juice.
18. Expand your grain repertoire with whole-grain complements, such as kasha, brown rice, wild rice, barley or whole-wheat tortillas.
19. Use herbs and spices to add color, savory taste and sensational aroma. Add cilantro to rice or bean dishes. Sprinkle rosemary on roasted potatoes or grilled meats. Add freshly chopped chives to omelets or pasta salads.
20. Explore world cuisines. Discover and enjoy foods from around the world: Mexican, Latin American, Indian, Greek, French and Asian cuisines, just to name a few. Some of the world's most intriguing ingredients — quinoa, edamame, bok choy, bulgur — are as healthy as they are delicious.

Fast food: 6 ways to healthier meals

These six tips can help you make wise meal choices when going to a fast-food restaurant.

Can fast food be part of a weight-loss or healthy diet plan? You might not think so. In fact, you might even think that you can't have a meal that's both quick and healthy.

But this isn't necessarily so. An occasional stop at a fast-food restaurant can fit into a healthy diet plan. The key is to choose wisely.

1. Keep portion sizes small. If the fast-food restaurant offers several sandwich sizes, pick the smallest or order half a sandwich, if available. Bypass hamburgers with two or three beef patties, which can pack more than 1,000 calories and 70 grams of fat. Instead, choose a regular- or children's-sized hamburger, which has about 250 to 300 calories. Also, skip the large serving of french fries or onion rings and ask for a small serving instead. This switch alone saves 200 to 300 calories. Or better yet, select a lower calorie option.
2. Choose a healthier side dish. Take advantage of healthy side dishes offered at many fast-food restaurants. For example, instead of french fries choose a side salad with low-fat dressing or a baked potato. Or add a fruit bowl or a fruit and yogurt option to your meal. Other healthy choices include apple or orange slices, corn on the cob, steamed rice, or baked potato chips.
3. Go for the greens. Choose a large entree salad with grilled chicken, shrimp or garden vegetables with fat-free or low-fat dressing on the side, rather than regular salad dressing, which can have 100 to 200 calories per packet. Watch out for high-calorie salads, such as those with deep-fried shells or those topped with breaded chicken or other fried toppings. Also skip salad extras, such as cheese, bacon bits, croutons and fried chips, which quickly increase your calorie count.
4. Opt for grilled items. Fried and breaded foods, such as crispy chicken sandwiches and breaded fish fillets, are high in fat and calories. Select grilled or roasted lean meats — such as turkey or chicken breast, lean ham, or lean roast beef.
5. Have it your way. Don't settle for what comes with your sandwich or meal. Ask for healthier options and substitutions. For example, ask for reduced-fat mayonnaise or mustard on your sandwich. Or at a fast-food Mexican restaurant, request salsa with your meal instead of shredded cheese and nacho cheese sauce. Try to avoid special dressings, tartar sauce, sour cream and other high-calorie condiments.
6. Watch what you drink. Many beverages contain a large number of calories. For example, a large regular soda (32 ounces) has about 300 calories. Instead, order diet soda, water, unsweetened iced tea, sparkling water or mineral water. Also, skip the shakes and other ice-cream drinks. Large shakes can contain more than 800 calories and all of your saturated fat allotment for the day.

You can eat healthy away from home, even at fast-food restaurants. The bottom line: Be choosy. Make wise menu choices and focus on portion control.

By Mayo Clinic Staff
May 30, 2008

Red wine and resveratrol: Good for your heart?

Red wine and something in red wine called resveratrol might be heart healthy. Learn the facts, and hype, regarding red wine and its impact on your heart.

Red wine has long been touted as heart healthy. Some have suggested that the apparent health benefits of red wine, namely reducing your risk of heart disease, are behind the so-called French paradox. The French are regular drinkers of red wine and have relatively high amounts of saturated fat in their diet. Despite this fat intake, the French have lower rates of heart disease.

While the news about red wine might sound great if you enjoy a glass of red wine with your evening meal, doctors are wary of encouraging anyone to drink alcohol because too much alcohol can have a host of harmful effects on your body.

But despite the caution, doctors do agree that something in red wine appears to help your heart, though it's unclear just exactly what that "something" is. Recent research has indicated a substance called resveratrol, which is found in the skin and seeds of grapes used to make wine, has promising heart-healthy benefits.

Resveratrol isn't the only substance in red wine that looks promising. The alcohol in red wine also appears to be heart healthy. Understand what's known — and not known — about red wine and its possible heart-health benefits.

How does alcohol help the heart?

Various studies have indicated that moderate amounts of all types of alcohol benefit your heart, not just alcohol found in red wine. Some heart-healthy benefits of alcohol include:

• Raises high-density lipoprotein (HDL) cholesterol, the "good" cholesterol
• Inhibits the formation of blood clots
• Helps prevent artery damage caused by high levels of low-density lipoprotein (LDL) cholesterol, the "bad" cholesterol

Is red wine better?

Red wine in particular seems to have even more heart-health benefits than other types of alcohol, according to a large Danish study from 2000. The study, known as the Copenhagen City Heart Study, found that those who drank red wine had about half the risk of dying of heart disease as those who didn't.

Additional studies have given mixed results — some confirming the Danish finding, others showing red wine isn't any better than beer, white wine or liquor for heart health. As a result, the American Heart Association says there's no clear evidence yet that red wine is superior to other forms of alcohol when it comes to possible heart-health benefits.

The pro-red wine studies suggest antioxidants in red wine called polyphenols help protect the lining of blood vessels in your heart. These antioxidants come in two main forms: flavonoids and nonflavonoids.

• Flavonoids. These antioxidants are found in a variety of foods, including oranges, apples, onions, tea and cocoa. Other types of alcohol, such as white wine and beer, contain small amounts, too, but red wine has higher levels.
• Nonflavonoids. These antioxidants found in red wine have recently been of particular interest because they appear to help prevent arteries from becoming clogged with fatty blockages. However, these studies mostly involved mice — not humans. Resveratrol is the nonflavonoid that researchers are most interested in.

Resveratrol in red wine

Some researchers believe that resveratrol might be the key ingredient in red wine that helps prevent damage to blood vessels, reduces "bad" cholesterol and prevents blood clots.

Research in mice given resveratrol has indicated that the antioxidant might also help protect them from obesity and diabetes, both of which are strong risk factors for heart disease. However, those findings were reported only in mice, not in people. In addition, to achieve the dose of resveratrol used in the mice studies, a person would have to consume 100 to 1,000 bottles of red wine a day.

Some companies sell supplements containing resveratrol. However, doctors caution that not enough is known about resveratrol's effects to endorse resveratrol supplements. Research into the potential heart-health benefits of resveratrol is continuing.

Resveratrol in grapes and other foods

The resveratrol in red wine comes from the skin of grapes used to make wine. Because red wine is fermented with grape skins longer than is white wine, red wine contains more resveratrol. Simply eating grapes, or drinking grape juice, has been suggested as one way to get resveratrol without drinking alcohol. Some studies have suggested that red and purple grape juices have some of the same heart-healthy benefits of red wine.

Other foods that contain some resveratrol include peanuts, blueberries and cranberries. It's not yet known how beneficial eating grapes or other foods might be compared with drinking red wine when it comes to promoting heart health. The amount of resveratrol in food and red wine can vary widely.

Drink in moderation — or not at all

Red wine's potential heart-health benefits look promising. Those who drink moderate amounts of alcohol, including red wine, seem to have a lower risk of heart disease. However, more research is needed before we know whether red wine is better for your heart than are other forms of alcohol, such as beer or spirits.

The American Heart Association doesn't recommend that you start drinking alcohol just to prevent heart disease. Alcohol can be addictive. Too much increases your risk of high blood pressure, high triglycerides, liver damage, obesity, certain types of cancer, accidents and other problems. In addition, even small amounts of alcohol can cause cardiomyopathy — weakened heart muscle — and heart failure in some people. If you have heart failure or a weak heart you should avoid alcohol completely.

If you already drink red wine, do so in moderation. Moderate drinking is defined as an average of two drinks a day for men and one drink a day for women.

• A drink is defined as 12 ounces (oz.) of beer, 5 oz. of wine or 1.5 oz. of 80-proof distilled spirits.

The limit for men is higher because men generally weigh more and have more of an enzyme that metabolizes alcohol than women do.

Water: How much should you drink every day?

Water is essential to good health, yet needs vary by individual. These guidelines can help ensure you drink enough fluids.

How much water should you drink each day? A simple question with no easy answers. Studies have produced varying recommendations over the years, but in truth, your water needs depend on many factors, including your health, how active you are and where you live.

Though no single formula fits everyone, knowing more about your body's need for fluids will help you estimate how much water to drink each day.

Health benefits of water

Water is your body's principal chemical component, making up, on average, 60 percent of your body weight. Every system in your body depends on water. For example, water flushes toxins out of vital organs, carries nutrients to your cells and provides a moist environment for ear, nose and throat tissues.

Lack of water can lead to dehydration, a condition that occurs when you don't have enough water in your body to carry out normal functions. Even mild dehydration can drain your energy and make you tired.

How much water do you need?

Every day you lose water through your breath, perspiration, urine and bowel movements. For your body to function properly, you must replenish its water supply by consuming beverages and foods that contain water.

Several approaches attempt to approximate water needs for the average, healthy adult living in a temperate climate.

• Replacement approach. The average urine output for adults is about 1.5 liters (6.3 cups) a day. You lose close to an additional liter of water a day through breathing, sweating and bowel movements. Food usually accounts for 20 percent of your total fluid intake, so if you consume 2 liters of water or other beverages a day (a little more than 8 cups) along with your normal diet, you will typically replace the lost fluids.
• Eight 8-ounce glasses of water a day. Another approach to water intake is the "8 x 8 rule" — drink eight 8-ounce glasses of water a day (about 1.9 liters). The rule could also be stated, "drink eight 8-ounce glasses of fluid a day," as all fluids count toward the daily total. Though the approach isn't supported by scientific evidence, many people use this basic rule as a guideline for how much water and other fluids to drink.
• Dietary recommendations. The Institute of Medicine advises that men consume roughly 3 liters (about 13 cups) of total beverages a day and women consume 2.2 liters (about 9 cups) of total beverages a day.

Even apart from the above approaches, if you drink enough fluid so that you rarely feel thirsty and produce 1.5 liters (6.3 cups) or more of colorless or slightly yellow urine a day, your fluid intake is probably adequate.

Factors that influence water needs

You may need to modify your total fluid intake depending on how active you are, the climate you live in, your health status, and if you're pregnant or breast-feeding.

• Exercise. If you exercise or engage in any activity that makes you sweat, you need to drink extra water to compensate for the fluid loss. An extra 400 to 600 milliliters (about 1.5 to 2.5 cups) of water should suffice for short bouts of exercise, but intense exercise lasting more than an hour (for example, running a marathon) requires more fluid intake. How much additional fluid you need depends on how much you sweat during exercise, the duration of your exercise and the type of activity you're engaged in.

  During long bouts of intense exercise, it's best to use a sports drink that contains sodium, as this will help replace sodium lost in sweat and reduce the chances of developing hyponatremia, which can be life-threatening. Also, continue to replace fluids after you're finished exercising.

• Environment. Hot or humid weather can make you sweat and requires additional intake of fluid. Heated indoor air also can cause your skin to lose moisture during wintertime. Further, altitudes greater than 8,200 feet (2,500 meters) may trigger increased urination and more rapid breathing, which use up more of your fluid reserves.
• Illnesses or health conditions. Signs of illnesses, such as fever, vomiting and diarrhea, cause your body to lose additional fluids. In these cases you should drink more water and may even need oral rehydration solutions, such as Gatorade, Powerade or CeraLyte. Also, you may need increased fluid intake if you develop certain conditions, including bladder infections or urinary tract stones. On the other hand, some conditions such as heart failure and some types of kidney, liver and adrenal diseases may impair excretion of water and even require that you limit your fluid intake.
• Pregnancy or breast-feeding. Women who are expecting or breast-feeding need additional fluids to stay hydrated. Large amounts of fluid are used especially when nursing. The Institute of Medicine recommends that pregnant women drink 2.3 liters (about 10 cups) of fluids daily and women who breast-feed consume 3.1 liters (about 13 cups) of fluids a day.

Beyond the tap: Other sources of water

Although it's a great idea to keep water within reach at all times, you don't need to rely only on what you drink to satisfy your fluid needs. What you eat also provides a significant portion of your fluid needs. On average, food provides about 20 percent of total water intake, while the remaining 80 percent comes from water and beverages of all kinds.

For example, many fruits and vegetables, such as watermelon and tomatoes, are 90 percent to 100 percent water by weight. Beverages such as milk and juice also are composed mostly of water. Even beer, wine and caffeinated beverages — such as coffee, tea or soda — can contribute, but these should not be a major portion of your daily total fluid intake. Water is one of your best bets because it's calorie-free, inexpensive and readily available.

Staying safely hydrated

It's generally not a good idea to use thirst alone as a guide for when to drink. By the time you become thirsty, it's possible to already be slightly dehydrated. Further, be aware that as you get older your body is less able to sense dehydration and send your brain signals of thirst. Excessive thirst and increased urination can be signs of a more serious medical condition. Talk to your doctor if you experience either.

To ward off dehydration and make sure your body has the fluids it needs, make water your beverage of choice. Nearly every healthy adult can consider the following:

• Drink a glass of water with each meal and between each meal.
• Hydrate before, during and after exercise.
• Substitute sparkling water for alcoholic drinks at social gatherings.

If you drink water from a bottle, thoroughly clean or replace the bottle often.

Though uncommon, it is possible to drink too much water. When your kidneys are unable to excrete the excess water, the electrolyte (mineral) content of the blood is diluted, resulting in low sodium levels in the blood, a condition called hyponatremia. Endurance athletes, such as marathon runners, who drink large amounts of water are at higher risk of hyponatremia. In general, though, drinking too much water is rare in healthy adults who consume an average American diet.

If you're concerned about your fluid intake, check with your doctor or a registered dietitian. He or she can help you determine the amount of water that's best for you.

By Mayo Clinic Staff
April 19, 2008

High Blood Pressure

Every encounter you have with a health care professional likely involves getting your blood pressure checked. Why is blood pressure measurement such an important indicator of health? What does it mean if your blood pressure is high? High blood pressure, also known as hypertension, is the force applied against the wall of the arteries as the heart pumps. High blood pressure is a silent disease, one that may not have any symptoms for months or even years.

Blood pressure measurements are checked with a syphgmomanometer and a stethoscope. An inflatable cuff is placed around the arm and a stethoscope placed over the arteries in the crook of the elbow. As the cuff is deflated, a sound is heard as the blood courses through the artery. The first sound heard is measured and that is the systolic blood pressure. Normal systolic blood pressure is less than 120 (mm Hg). When the sound stops, the measurement is the diastolic blood pressure. Normal diastolic blood pressure is less than 80 (mm Hg).

Complications of high blood pressure are no joke. What happens is that the walls of the arteries lose their elasticity over time and the heart has to work harder to push the blood through them. Every organ and body system is therefore affected by high blood pressure. That is why treatment is so important. People sometimes want to stop taking their medications when they feel better. That is a dangerous practice with high blood pressure and can lead to life threatening problems such as heart attack or stroke.

Prevention of high blood pressure is a key to wellness. The High Blood Pressure Learning Center offers multimedia guides to preventing high blood pressure and its complications with very simple lifestyle adjustments. You may want to explore complementary and alternative therapies. The Learning Center provides talking points for discussions with your health care provider.

www.healthyline.com
September 03, 2008

Children and exercise-induced asthma: Playing sports safely

Children with asthma can benefit from participation in sports. To ensure your child's safety, control the condition, have an asthma action plan and communicate with your child's caregivers.

If your child has exercise-induced asthma, preventing flare-ups is a big concern. As with asthma triggered by other things, exercise-induced asthma occurs when the main air passages of the lungs, the bronchial tubes, become inflamed. The muscles of the bronchial walls tighten, and cells in the lungs produce extra mucus. This can cause signs and symptoms that range from minor wheezing to severe trouble breathing. But your child doesn't have to let asthma limit physical activity. In fact, regular exercise strengthens the lungs, making breathing easier for kids with exercise-induced asthma. Taking a few steps to ease symptoms can help your child avoid asthma flare-ups — and get off the sidelines and into the game.

Control asthma first

Before your child participates in sports, be sure that his or her asthma is under control. Controlled asthma means that regular symptoms and flare-ups are rare. If your child is on medication but continues to have symptoms or regular flare-ups, check with your child's doctor for possible changes to medications or dosages. Work with your doctor to create a detailed asthma action plan.

Treatment to control asthma varies from person to person and is based on symptoms and triggers. Along with avoiding triggers, a typical treatment plan involves a combination of long-acting medications to control the asthma over time and short-acting inhalers for quick relief of symptoms. Many children benefit from using a short-acting bronchodilator such as albuterol about 15 minutes before exercise.

Use an asthma action plan to stay on track

Work with your child's doctor to create an asthma action plan, a step-by-step guide for preventing, recognizing and treating an asthma attack. Every child with asthma should have an asthma action plan. Typical asthma action plans include a list of medications and dosages, symptoms and average peak flow readings, signs of an attack, when to seek emergency care, and contact numbers.

Choose activities wisely

Certain physical activities are more likely to cause asthma attacks, particularly those that require sustained effort with few breaks, such as:

• Basketball
• Cross-country skiing
• Cycling
• Ice hockey
• Long-distance running
• Rugby
• Soccer

If your child is especially sensitive to exercise as a trigger or has exercise-induced asthma, you may want to consider activities that are less likely to trigger asthma, such as:

• Baseball
• Golf
• Sprinting
• Swimming
• Weightlifting

While sprinting and swimming are strenuous activities, they're less likely to cause symptoms than are some other sports. Sprinting is high intensity, but doesn't require endurance. Swimming can be high intensity and high endurance, but the warm, humid environment associated with indoor pools usually protects those with asthma from having attacks. Golf usually requires less intense exercise; however, the outdoor exposure may trigger asthma for kids who also have allergies.

Although some activities are more likely to cause symptoms, your child may be able to participate in any sport he or she chooses with the right medications and asthma control. With good asthma control, most children with asthma can exercise as hard as they want.

Competition: Use a treatment plan to stay on track

A combination of high-endurance sports and competitiveness can be dangerous for children with asthma. Younger children tend to slow down their activity level when they feel discomfort. Older children are more likely to push themselves to perform even when having asthma symptoms. This is usually because they want recognition or find satisfaction in competing on the same level as their peers.

Following a treatment plan is the key to good asthma control. It's especially important if your child is competitive. Using a treatment plan will help you and your child monitor asthma symptoms and make adjustments as needed. Better control of asthma may result in better athletic performance — as well as fewer flare-ups and less danger of a serious asthma attack. Involving your child in the decision-making process makes it more likely that he or she will follow the plan.

Keep preventive tips in mind

In addition to controlling symptoms with medication, be sure your child follows these practical tips to avoid flare-ups:

• Always warm up and cool down. Help your child make it a habit to spend 15 minutes warming up before more intense physical activity, and to do another 15 minutes of cool-down after exercise. While it's a good recommendation for all athletes, warm-ups and cool-downs are especially important for those with asthma.
• Pay attention to environmental conditions. Cold temperatures, poor air quality and high concentrations of pollen in the air make conditions right for an asthma attack. If possible, encourage your child to stay indoors during these times. When the weather is cold, your child may be able to control symptoms by wearing a scarf or mask to warm the air before it enters the lungs.
• Exercise only when healthy. Asthma attacks are more likely during or immediately after a cold or other respiratory infection. Have your child wait a few days after cold symptoms subside before resuming physical activity.
• Use a peak flow meter to monitor airflow. A peak flow meter is a hand-held tool that monitors how well your child's lungs are working from day to day. With the help of your child's doctor, you first determine your child's average peak flow reading. A drop in the reading may indicate an increase in airway inflammation, even when your child feels fine. A low peak flow reading prompts you and your child to take extra precautions that day to prevent an attack.

Involve your child's school nurse, teachers and coaches

Because teachers, coaches and other caregivers may have different levels of education on asthma, it's important that they know exactly what to do if your child needs help. Make copies of your child's asthma action plan and give them to your child's caregivers, and be sure to regularly communicate the importance of knowing the plan and having it accessible in case of an attack. This important tool helps ensure that you, your child and other caregivers all follow the same plan if action needs to be taken. Talk to your child's coaches so that they're aware how serious asthma can be — and can better judge your child's needs and abilities.

With the help of your child's doctor, revise the plan regularly. Your child's symptoms or treatment needs may change based on different seasons, sports and age.

Asthma and sports can be a winning combination

Children with asthma can participate in sports. In fact, your child's condition may improve with regular physical activity. First, have an asthma action plan in place. Second, communicate regularly with your child's teachers and coaches. These and other practical steps allow your child to enjoy sports in an environment that keeps him or her safe.

By Mayo Clinic Staff
May 31, 2008

Allergies

Almost everyone has allergies but of course no one wants them. Allergies run the gamut from minor annoyances to life threatening emergencies. But allergies all have one thing in common - they are the body's immune system overreacting to allergens - things that aren't a problem to most people most of the time.

Our immune system detects irritants, toxins and potentially infectious agents and works to protect us from them. With allergies, something the body has been exposed to triggers an inflammatory response. What happens within the body when sensitivity to an allergen has developed is quite complex. The bone marrow releases eosinophils, and many other cell types from the immune system are thrown into overdrive, creating an inflammatory cascade. The treatment of allergies is geared toward the management of symptoms by mediating the inflammatory response triggered by exposure to an allergen. Scientific breakthroughs concerning the immune system and the inflammatory response have helped bring to market many new drugs, bringing relief to millions of people around the world.

Once the body has developed sensitivity to an allergen, an allergic response is initiated every time you're exposed to it again. Airborne allergens like pollen trigger responses such as hay fever or seasonal allergies. Mold, dust and pet dander can trigger asthma attacks. Irritants like poison ivy or chemicals can trigger skin allergies. Many people, especially kids, have food allergies which can create such a dangerous reaction - anaphylactic shock - a true medical emergency. Insect stings are another potentially life threatening allergy.

The prevention of symptoms is the key to allergy control, and that means controlling the environment through vigilance against whatever allergens trigger an allergic response for you. The Allergies Learning Center offers multimedia information - video, expert articles, quizzes and much more to help you understand and manage allergies. Scientific breakthroughs concerning the immune system and the inflammatory response have helped bring to market many new drugs, bringing relief to millions of people around the world.

www.healthline.com
September 02, 2008

Breast Cancer

Cancer is a scary word. But breast cancer is not a death sentence and every day there are more breast cancer survivors due to advances in treatments and drug therapy. Cancers are abnormal cells in the body which grow uncontrollably. Breast cancer is one of the most common cancers in women, although men get breast cancer too.

There are many known risk factors for breast cancer. Healthline's Breast Cancer Learning Center offers tools and expert articles to help you understand whether or not you are in a high risk group. It is now recommended that women in high risk groups have an MRI scan along with their annual mammogram. No matter what your risk of getting cancer, today we are armed with tremendous knowledge about how to prevent breast cancer.

Know the symptoms of breast cancer. Most breast lumps are non-cancerous - so when should you be concerned? Learn about how breast cancer is diagnosed. Most women find lumps themselves during breast self-exams. Finding and treating breast cancer early greatly increases your chances of survival and of being completely cured.

If you are diagnosed with breast cancer, there are many resources to help you through it. Getting to the right medical team is crucial to good breast cancer care and increased survival rates. Breast cancer is complex. There are different stages of breast cancer and different types - invasive or non-invasive, hormone receptor positive or negative. The tumor size, shape and the rate of cell division all determine the prognosis. Once treated, breast cancer patients must be evaluated for recurrence.

The Breast Cancer Learning Center's multimedia offerings will help you anticipate your journey to healing. The Alternative Therapies section provides information you can discuss with your doctor if there are complementary practices you want to try.

www.healthline.com
September 02, 2008

Acupuncture: Can it help?

Acupuncture involves inserting hair-thin needles into your skin to relieve pain. Find out how acupuncture works and what conditions it can treat.

Acupuncture involves the insertion of extremely thin needles through your skin, to various depths at strategic points on your body. Acupuncture originated in China thousands of years ago, but over the past two decades its popularity has grown significantly within the United States. Although scientists don't fully understand how or why acupuncture works, some studies indicate that it may provide a number of medical benefits — from reducing pain to helping with chemotherapy-induced nausea.

What happens during an acupuncture session?

Acupuncture therapy usually involves a series of weekly or biweekly treatments in an outpatient setting. It's common to have up to 12 treatments in total. Although each acupuncture practitioner has his or her own unique style, each visit typically includes an exam and an assessment of your current condition, the insertion of needles, and a discussion about self-care tips. An acupuncture visit generally lasts about 30 minutes.

Before the needles are placed, you'll lie down on a comfortable surface. Depending on where the needles are to go, you will lie facedown, faceup or on your side. Make sure that your acupuncturist uses single-use sterile packaged needles. You may feel a brief, sharp sensation when the needle is inserted, but generally the procedure isn't painful.

It's common, however, to feel a deep aching sensation when the needle reaches the correct depth. After placement, the needles are sometimes moved gently or stimulated with electricity or heat. As many as a dozen needles may need to be placed for each treatment. Once the needles are inserted, they're usually left in place for five to 20 minutes.

How does acupuncture work?

The traditional Chinese theory behind acupuncture as medical treatment is very different from that of Western medicine. In traditional Chinese medicine, health results form a harmonious balance between the complementary extremes (yin and yang) of the life force known as qi or chi.

Qi is believed to flow through pathways (meridians) in your body. These meridians and the energy flow are accessible through more than 350 acupuncture points. Illness results from an imbalance of the forces. By inserting needles into these points in various combinations, acupuncture practitioners believe that your energy flow will rebalance.

In contrast, the Western explanation of acupuncture incorporates modern concepts of neuroscience. Many practitioners view the acupuncture points as places to stimulate nerves, muscles and connective tissue. This stimulation appears to boost the activity of your body's natural painkillers and increase blood flow.

Who is acupuncture for?

Acupuncture seems to be useful as a stand-alone treatment for some conditions, but it's also increasingly being used in conjunction with more conventional Western medical treatments. For example, doctors may combine acupuncture and drugs to control pain and nausea after surgery.

Scientific studies generally test treatments against placebos, such as sugar pills. It's difficult to conduct valid scientific studies of acupuncture, because it's difficult to devise sham versions of acupuncture. In fact, several studies have indicated that sham acupuncture works as well or almost as well as real acupuncture.

This makes it hard to create a definitive list of the conditions for which acupuncture might be helpful. However, preliminary studies indicate that acupuncture may offer symptomatic relief for a variety of diseases and conditions, including low back pain, headaches, fibromyalgia, migraines and osteoarthritis.

In addition, research shows acupuncture can help manage postoperative dental pain and alleviate chemotherapy-induced nausea and vomiting. It also appears to offer relief for chronic menstrual cramps and tennis elbow.

Pros and cons

As with most medical therapies, acupuncture has both benefits and risks. Consider the benefits:

• Acupuncture is safe when performed properly.
• It has few side effects.
• It can be useful as a complement to other treatment methods.
• It's becoming more available in conventional medical settings.
• It helps control certain types of pain.
• It may be an alternative if you don't respond to or don't want to take pain medications.

Acupuncture may not be safe if you have a bleeding disorder or if you're taking blood thinners. The most common side effects of acupuncture are soreness, bleeding or bruising at the needle sites. Rarely, a needle may break or an internal organ might be injured. If needles are reused, infectious diseases may be accidentally transmitted. However, these risks are low in the hands of a competent, certified acupuncture practitioner.

Choosing an acupuncture practitioner

If you're considering acupuncture, do the same things you would do if you were choosing a doctor:

• Ask people you trust for recommendations.
• Check the practitioner's training and credentials. Most states require that non-physician acupuncturists pass an exam conducted by the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM).
• Interview the practitioner. Ask what's involved in the treatment, how likely it is to help your condition and how much it will cost.
• Find out whether the expense is covered by your insurance.

Don't be afraid to tell your doctor you're considering acupuncture. He or she may be able to tell you about the success rate of using acupuncture for your condition or recommend an acupuncture practitioner for you to try.

By Mayo Clinic Staff
Dec. 13, 2007

Teething: Tips for soothing sore gums

Teething can be an ordeal for parents and babies alike. Learn how to soothe sore gums and care for your baby's new teeth.

Drooling, crankiness and tears can make teething an ordeal for parents and babies alike. Here's help easing the pain — for both of you.

What's typical?

Although timing varies widely, most babies begin teething by about age 6 months. The two bottom front teeth (lower central incisors) are usually the first to appear, followed by the two top front teeth (upper central incisors).

Classic signs and symptoms of teething often include:

• Drooling, which may begin about two months before the first tooth appears
• Irritability
• Swollen gums
• Chewing on solid objects
• Crankiness
• Trouble sleeping
• Loss of appetite

Of course, some of these signs and symptoms are simply part of a baby's normal development. By 4 months, most babies explore objects with their mouths — whether teeth are about to emerge or not.

What's the best way to soothe sore gums?

If your teething baby seems uncomfortable, consider these simple tips.

• Rub your baby's gums. Use a clean finger, moistened gauze pad or damp washcloth to massage your baby's gums. The pressure can ease your baby's discomfort.
• Offer a teething ring. Try one made of firm rubber. The liquid-filled variety may break under the pressure of your baby's chewing. If a bottle seems to do the trick, fill it with water. Prolonged contact with sugar from formula, milk or juice may cause tooth decay.
• Keep it cool. A cold washcloth or chilled teething ring can be soothing. Don't give your baby a frozen teething ring, however. Contact with extreme cold may hurt, doing your baby more harm than good. If your baby's eating solid foods, offer cold items such as applesauce or yogurt.
• Dry the drool. Excessive drooling is part of the teething process. To prevent skin irritation, keep a clean cloth handy to dry your baby's chin. You may want to lay a clean cloth under your baby's head while he or she sleeps to keep the sheet dry.
• Try an over-the-counter remedy. If your baby is having trouble sleeping or is especially cranky, acetaminophen or ibuprofen may help. Don't give your baby products that contain aspirin. Most doctors don't recommend teething medications that can be rubbed directly on a baby's gums. The medication may be washed away by your baby's drool before it has the chance to do any good — and too much of the medication may numb your baby's throat, which may interfere with his or her normal gag reflex.

Do I need to call the doctor?

Teething can usually be handled at home. Call the doctor if your baby develops a fever, seems particularly uncomfortable, or has other signs or symptoms of illness. Remember, teething doesn't cause fever, colds or diarrhea.

How do I care for my baby's new teeth?

Ideally, you've been running a clean, damp washcloth over your baby's gums every day. If not, now's a great time to start. The washcloth can keep bacteria from building up in your baby's mouth.

When your baby's teeth begin to appear, switch to a small, soft-bristled toothbrush or the fingertip variety specifically meant for infants. There's no need to use toothpaste. Until your child learns to spit — about age 2 or 3 — water is all you need.

It's also time to think about regular dental checkups. The American Dental Association recommends scheduling a child's first dental appointment by age 1. Because a baby's teeth and gums are examined at well-baby checkups, many doctors recommend scheduling the first dental appointment at about age 3 — or earlier if problems occur. Regular childhood dental care can set the stage for a lifetime of healthy teeth and gums.

By Mayo Clinic Staff
Dec. 19, 2007

Attention Deficit Hyperactivity Disorder (ADHD)

Parenting is exhausting and challenging, but parenting a child with ADHD presents unique challenges. Less than 10% of the population has ADHD, but ADHD is a family, school and community affair. A 2 year old child should be able to attend to a task for 6 minutes, and a child entering kindergarten should be able to concentrate for 15 minutes. People with ADHD are impulsive, hyperactive and have a limited attention span. If you or someone you know has these symptoms, consult Healthline's ADHD Learning Center for more information about the symptoms of ADHD.

It is important to remember that kids with ADHD aren't misbehaving on purpose. ADHD is a recognized neurobehavioral disorder. Diagnosis of ADHD requires careful investigation because there are no laboratory tests or brain imaging studies that provide a definitive diagnosis. The diagnosis depends upon careful analysis of a patient's history, symptoms and behavior. Some experts believe it is often a missed diagnosis, while others believe too many people are mistakenly labeled with the diagnosis. Minority ethnic groups are rarely diagnosed and treated for ADHD. The truth of the matter is that ADHD is rarely the only problem a person has. ADHD often manifests with other conditions such as bipolar disorder, conduct disorder, oppositional defiant disorder, pervasive developmental disorder, sleep disorders or anxiety disorders. The typical patient is a male child, but ADHD is also found in adults and females.

Drug treatments of ADHD are somewhat controversial. The ADHD Learning Center offers comprehensive information about medications to help you make informed choices. The treatment of ADHD must involve the family, teachers and school officials to be successful. Alternative therapies such as music therapy and massage have been found to be especially helpful in ADHD. Use the multimedia information from the ADHD Learning Center to learn more.

www.healthline.com
Septemeber 02, 2008