Men’s Grooming Habits That Turn Women Off (BLOG)

Ladies, tell me you agree. There is a horrific beauty double standard going on that we have to do something about. Now that it's summer, we've all been upping our beauty game— more shaving and waxing, keeping toenails in check— so the terrible grooming habits of our guys have become all the more glaring. Why is stomach-turning neglect (or in certain cases, too much attention) the norm? We're not asking guys to do anything we don't do ourselves. If you're feeling extremely grossed out by what you're seeing thanks to flip-flops and bathing suits, take comfort in this: You are not alone.

We asked our Facebook friends (affectionately known as "Threaders") to share the grooming issues that irk them the most, and the answers were awfully familiar. One Threader asked if we could please paste the comments "on a huge billboard that all men can see." Well, here's our billboard equivalent! See the top ten offenses below and add more by posting on our Facebook wall.

1. Long, dirty toe nails. Or, as one Threader called it, "Hobbit feet." I love that. It's true. Guys, you don't have to sit for a pedicure, but there's no excuse for claws filled with dirt.

2. Hair where it shouldn't be. Nose hair was the number-one complaint with ear hair a close second. "Why is it so hard to buy a trimmer and a mirror?" asked a completely reasonable Threader. We don't have the answer.

3. Mouth madness. This is just basics. We're brushing, flossing, and whitening, but certain guys seem to think they can get away with "yuck mouth," as a Threader called it. Not true.

4. Unattractive smells. This can mean not showering often enough or not embracing deodorant. This is also related to #3 (see above).

5. Eyebrow issues. Either overgrown or over plucked. We don't want unruly, caveman hairs, but we also don't want you to look more sculpted than we do.

6. Too much cologne. If everything you touch starts to smell like your medicine cabinet, that's not good.

7. Too much waxing. There's grooming and then there's grooming. No one wants to feel like they're with a newborn.

8. Dry, cracked heels. You can put lotion on them, you know.

9. Hair that never moves. If your hair is as hard as a car door, you've got to rethink your products.

10. Letting your blackheads live on. Everyone has zits, especially in the hot and sweaty summer. But, jeez, if you have blackheads on your face, deal with them or book a facial where someone else will.

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7 Fresh Tips to Prevent Bad Breath (BLOG)

In papyrus scrolls dating back from 1550 BC, Hippocrates, the Greek physician famed as the father of medicine, offered a formula for sweet-smelling breath: rinsing with a mouthwash made of red wine, anise and dill. Toothpaste is even older than that, with an ancient Egyptian medical text called the Ebers Papyrus containing recipes dating back some 6,000 years, while toothbrushes to apply it were only invented about 500 years ago, most likely by the Chinese, reports Dr. Harold Katz, director of the California Breath Clinics and author of The Bad Breath Bible.

Today, 93 million Americans suffer from chronically bad breath (halitosis), which can sometimes signal other health problems. If you or someone you smooch with regularly is one of them, these tactics can help restore fresh breath, according to Margaret Mitchell, DDS and other experts.

1. Clean your tongue. Along with brushing and flossing twice a day, also use a tongue scraper, available at most drugstores, or brush your tongue. “Your tongue, especially the top back, is a serious source of halitosis,” says Dr. Mitchell. That’s because your tongue has millions of filaments that can trap food particles and bacteria, leading to oral odor.

2. Chew sugarless gum. Surprising as it sounds, saliva is the best defense against bad breath. A common cause of halitosis is dry mouth, which can be triggered by certain medications and health problems. If you’re wondering why morning breath can be smelly, that’s because saliva flow is lower during sleep. Chewing gum counteracts these problems by stimulating salivation. What’s more, gum containing the sugar substitute xylitol may help reduce cavity-causing bacteria, a recent study suggests.

3. Scent your breath with cinnamon. Unlike other flavorings, such as mint, which only mask bad breath, cinnamon appears to have odor-combating compounds, with a study presented at the annual meeting of International Association for Dental Research reporting that the cinnamon-flavored gum, Big Red, seems to reduce odor-causing bacteria. In the study, people who chewed the gum had a more than 50 percent drop in bacteria levels.

4. Keep your mouth moist. Drinking more water also helps wash away bad-smelling bacteria. There’s also research indicating that drinking tea may be helpful, since it contains polypehnols, a plant chemical that may help curb bacterial growth.

5. Pay attention to your diet. An unfortunate side effect of a low-carb diet, such as the Atkins plan, can be “dragon breath” due to ketosis (the fat-burning state that is one of the goals of this type of diet). The only cure is increasing carbs, though chewing mint leaves or parsley can temporarily mask the problem. Also watch out for other foods that can trigger mouth odor, such as coffee, alcohol, and such obvious culprits as onions and garlic.

6. Choose the right mouthwash. Antibacterial mouthwashes help combat oral infections, thus improving breath. An analysis of five studies involving 293 participants by the Cochrane Database of Systematic Reviews found that such ingredients as chlorhexidine and cetylpyridinium chloride, chlorine dioxide and zinc are all helpful for reducing mouth odor. However, chlorhexidine mouthwash, available by prescription from dentists, can temporarily stain teeth and your tongue. If your dentist advises it to clear up an oral infection, you may be told to dip a Q-tip into the mouthwash and apply it to the backs of your teeth and gums, or only to the infected area.

7. Rule out medical problems. 90 percent of the time, halitosis is triggered by microbes in the mouth. Common dental causes include cavities, gum disease (which may not cause any obvious symptoms other than bad breath), and faulty tooth restorations that have become a breeding ground for bacteria. However, if you have good oral health—and persistent halitosis—check with your doctor, since such illnesses as respiratory tract infections, diabetes, acid reflux disease, liver disease and even cancer, in rare cases, can also cause mouth odor, cautions Dr. Mitchell. One of the best ways to protect your oral health—and keep your breath fresh—is to avoid tobacco use, which greatly increases risk for gum disease and oral cancer.

yahoo

Do You Have Burning Mouth Syndrome? (BLOG)

If you are suffering from a burning or tingling sensation in your mouth that has no obvious cause, your doctor may diagnose you as having burning mouth syndrome. This is a relatively common problem. It affects more than one million people in the United States, mostly women of middle age and older. In fact, in postmenopausal women, the prevalence may be as high as 33 percent.

Current treatments for burning mouth syndrome focus on finding the reason that a person's mouth is burning so the source of the pain can be eliminated. For many people, mouth pain seems to be linked with affective disorders such as anxiety and depression, and treating those problems can be the fastest route to improving their symptoms. In other patients, burning mouth syndrome seems to be linked to medication side effects or food allergies, and looking at when symptoms started can give doctors a clue about how to make them go away. What if you're one of the many people whose burning mouth syndrome remains unexplained? Some scientists think nerve or circulatory problems may be causing your pain. But even without an explanation, there are still treatments available, such as clonazepam, that may help.

Find relief at last with the Your New Pain Prescription

Is It Burning Mouth Syndrome?

The one symptom all patients with burning mouth syndrome have in common is, as the name of the disorder implies, a burning sensation in their mouths. While most burning mouth syndrome symptoms occur on the tongue, they can also affect the lips and the palate. People's experience of the timing of burning mouth pain also varies; sometimes it's constant, sometimes it's intermittent, and sometimes it increases in severity throughout the day.

Burning mouth syndrome usually isn't diagnosed until you have experienced pain for several months. In part, this is because doctors primarily diagnose burning mouth syndrome by looking for underlying causes of your pain. If there's no good reason for your mouth to be burning, you may end up being diagnosed with the condition by default.

The truth behind 13 physical quirks

That's why it's a good idea to keep a diary of your pain symptoms to discuss with your doctor or dentist. Be sure to record where the pain appears in your mouth, what times during the day you experience it, if anything improves your symptoms, and when the pain first appeared. The more information your doctor has about your burning mouth symptoms, the better chance she has of finding an effective way to treat them. In fact, if your pain is intermittent, you might even want to keep track of the food you eat and the medications you take to see if there is a correlation between the timing of your symptoms and something you're putting in your mouth. The Pain Diary in Part Three may help you zero in on the cause of your pain.

Fast Pain Relief

If you’ve been suffering from burning mouth syndrome for long enough to get a diagnosis, you know that there’s no quick fix for your pain. Still, there are a few tricks you can try that may reduce the toll that burning mouth syndrome takes on your mind and body.

1. Keep your mouth moist.

When your mouth is dry, the sensations of burning and pain can increase. Drinking water or sucking on a hard candy can help; but if dry mouth is a frequent problem for you, it’s worth asking your doctor to prescribe a lubricating solution.

2. Work on your oral habits.

If you tend to clench your teeth, chew on your lips, bite your tongue, or otherwise play with your mouth, make a real effort to stop. These activities can dry out your mouth and irritate or damage your skin, increasing your pain rather than making you feel better.

3. Find new ways to deal with depression and stress.

Anxiety, stress, and depression are closely linked to many people’s experiences with burning mouth pain, both because these conditions affect the way that sensations are processed in the brain and because people have reduced saliva production when they’re stressed.91 If you can improve your mental health through therapy, medication, or a combination of both, it may also have the pleasant side effect of relieving your physical pain.

The best natural remedies for pain

Your New Pain Prescription

The best thing you can do to relieve your burning mouth pain is to identify its underlying cause. Although your doctor is an excellent resource, there is also some research and experimentation you can do on your own.

Step 1:Try to figure out what’s causing your pain. Check your prescriptions in a Physicians’ Desk Reference to see if any of them has the side effect of mouth pain. See if your mouth is sensitive to the food you’re putting into it by selectively eliminating foods from your diet for 2 weeks. Eliminate mouthwash from your regimen since it can dry you out. Switch to a new toothpaste to make certain that it isn’t the source of irritation.

Step 2: Reduce your stress. Stress can make burning mouth pain worse, so finding ways to reduce your stress can also help you treat your pain. Whether this means taking time to go for a walk each day, adjusting your workload, or seeing a doctor for professional help, anxiety reduction can both reduce your pain and make it easier to cope with.

Step 3: Try supplementation. Experimenting with zinc supplementation is a relatively low-cost and low-risk technique for treating burning mouth at home. Zinc supplements are available over-the-counter and as a component of multivitamins. Just don’t take more than the recommended dose.

Pain Prevention Strategies

Food and Supplements

Zinc

Zinc is the second most abundant mineral in the body after iron. Several studies have suggested that zinc deficiency may play a role in burning mouth syndrome for a subset of patients.

The evidence: A study of 276 patients with burning mouth syndrome found that approximately 25 percent of them had low blood zinc levels. When they were treated with 14.1 milligrams a day of zinc and a steroid gargle, 72 percent of the patients experienced partial or complete pain relief compared to 52 percent of the controls, who received only the gargle.

How it works: Zinc plays a role in the function of the nervous, immune, and reproductive systems. It is also associated with good mental health. In people with zinc deficiency, dietary supplementation can help raise levels to normal and improve overall health. Zinc may also improve taste perception, which is a problem common in individuals with burning mouth syndrome.

What you need to know: Follow-up studies are definitely indicated to see how well zinc replacement works in larger populations of individuals with burning mouth syndrome, including those who are not noticeably zinc deficient. However, adding a zinc-containing multivitamin to your diet if you are not already taking one poses minimal risk to your health as long as you stay below the tolerable upper limit, which for adults is 40 milligrams a day.

Capsaicin

Capsaicin is the substance that makes hot peppers burn your mouth. That’s why it’s slightly ironic that it may also be an effective treatment for burning mouth syndrome.

The evidence: A small, placebo-controlled trial involving 50 patients with burning mouth syndrome found that swallowing capsaicin caplets significantly reduced mouth pain. Another small study of 14 patients found that a thrice daily mouth rinse with 250 milligrams of red pepper emulsion in 50 milliliters of water could also be effective.

How it works: Capsaicin causes a burning sensation in the mouth, but that sensation can desensitize the nerves of the mouth to pain by overloading their response cycle.

What you need to know: Capsaicin pills can cause serious stomach upset when used too often. Although topical capsaicin treatments such as “hot” candies and Tabasco sauce have been shown to be useful for the treatment of other oral pain syndromes, there have been few studies of their efficacy in treating burning mouth.

Mind-Body Therapies

Psychotherapy

There is some evidence that certain types of oral habits—including pressing the tongue against the teeth, clenching or grinding the teeth, and biting the tongue or lips—may predispose individuals to burning mouth syndrome. In addition, burning mouth syndrome has been linked to anxiety, depression, and other affective disorders.

The evidence: A study comparing group psychotherapy to the use of a placebo pill found that pain scores improved in 70 percent of the patients in the psychotherapy group but only 40 percent of patients in the placebo group.

How it works: Different types of psychotherapy can be a useful way not only of adjusting problematic habits but also of improving people’s ability to deal with their pain. In addition, since burning mouth syndrome is linked to affective disorders such as anxiety and depression, for many patients treating those disorders may also improve symptoms by eliminating their underlying cause.

What you need to know: Both individualized cognitive-behavioral therapy and group psychotherapy have been shown to improve the pain that people experience from burning mouth syndrome. It may, however, take several months for therapy to have an effect.

8 mistakes that make pain worse

Pain Medications and Medical Treatments

Clonazepam

Clonazepam (Klonopin) is an antiseizure drug that is also used for the treatment of panic attacks. It is one of a class of medications known as benzodiazepines.

The evidence: A randomized controlled trial of 48 patients with burning mouth syndrome found that sucking on a 1-milligram tablet of clonazepam reduced pain scores by four times as much as sucking on a placebo tablet.

How it works: It is thought that clonazepam might reduce burning mouth syndrome pain by altering the reactivity of GABA nerve receptors in the mouth; however, its mechanism of action is still poorly understood.

What you need to know: Clonazepam is probably the most widely accepted medical treatment for burning mouth syndrome; however, it can also cause burning mouth syndrome when used in some patients. In addition, there is a risk that clonazepam can be habit forming with prolonged use, which means that it should not necessarily be your first choice for treatment.

Other Strategies

Watch what you put in your mouth: Sometimes burning mouth syndrome is caused by underlying health problems, but other times it seems that the pain is caused by the things that go into your mouth.

The evidence: Although allergy does not seem to be responsible for most cases of burning mouth syndrome, it may play a role in some people’s pain. In addition, some foods and products may cause irritation without an allergic reaction. Therefore, changing your diet and the oral care products you use may be an effective way to deal with your pain.

How it works: Low-level allergies and contact hypersensitivity can make your mouth feel like it’s starting to burn. Figuring out what products irritate your mouth and keeping them far away is a good way to stop your pain and keep it from coming back.

What you need to know: The American Dental Association recommends that people with burning mouth syndrome try eliminating gum, tobacco, and acidic foods (soft drinks, coffee, some fruit juices) from their diets for at least 2 weeks to see if their symptoms improve. It also suggests removing mouthwash entirely from your oral care routine, since it can dry out your mouth, and switching toothpaste brands in case additives are responsible for your symptoms.

Want to Eat Less? Try a Bigger Fork (BLOG)

(HealthDay News) -- One way to avoid overeating at your favorite restaurant may be to order bigger cutlery, a new study suggests.

When eating out, people who used a large fork for bigger bites ate less than those who used a smaller utensil, according to findings released online in advance of publication in an upcoming print edition of the Journal of Consumer Research.

In conducting the field study in an Italian restaurant, Arul Mishra, Himanshu Mishra and Tamara M. Masters, all of the University of Utah in Salt Lake City, provided two sizes of forks to modify customers' bite sizes. The researchers found that diners who used large forks ate less than those who were given small forks.

The reason for the discrepancy, the study authors suggested, is that people who eat out have a well-defined goal of satisfying their hunger. This makes them more willing to invest energy and resources to meet that goal, such as making menu selections, eating and paying the check.

"The fork size provided the diners with a means to observe their goal progress," the investigators explained in a journal news release. "The physiological feedback of feeling full, or the satiation signal, comes with a time lag. In its absence, diners focus on the visual cue of whether they are making any dent on the food on their plate to assess goal progress."

The research team put their conclusion to the test by varying the portions of food. They found that when served larger portions, diners with small forks ate significantly more than those with larger forks. In contrast, when customers were served smaller portions, the size of their fork did not affect the amount of food they ate.

The study authors pointed out that their findings apply to restaurant customers only -- not people eating at home who may not have the same goals of satiating their hunger as restaurant customers.

To avoid overeating, the researchers suggested that people learn to better recognize and understand their hunger cues and how much food they should eat.

State should take obese kids from parents: US doctors (BLOG)

The government should have the right to remove severely obese children from their parents' home and place them in foster care, two US doctors argued in a controversial editorial.

"State intervention may serve the best interests of many children with life-threatening obesity, comprising the only realistic way to control harmful behaviors," wrote Lindsey Murtagh of the Harvard School of Public Health and David Ludwig of Children's Hospital in Boston.

"In severe instances of childhood obesity, removal from the home may be justifiable from a legal standpoint because of imminenthealth risks and the parents' chronic failure to address medical problems."

Some two million children in the United States are considered severely obese with a body mass index at or above the 99th percentile, the doctors wrote.

"Obesity of this magnitude can cause immediate and potentially irreversible consequences, most notably type 2 diabetes," they said.

Child abuse laws have long addressed situations in which children are starved or neglected, but "only a handful of states, including California, Indiana, Iowa, New Mexico, New York, Pennsylvania, and Texas, have legal precedent for applying this framework to overnourishment and severe obesity."

Murtagh, who is also a lawyer by training, and Ludwig said that while it may be an undesirable option, placing a child in temporary foster care could allow better habits to take root and avoid the risks of weight loss surgery.

"Although removal of the child from the home can cause families great emotional pain, this option lacks the physical risks of bariatric surgery."

The opinion piece in the Journal of the American Medical Association made waves in the medical community and US media, and JAMA issued a statement pointing out that the piece did not reflect the institution's view.

"This commentary does not reflect policy or opinion of the American Medical Association (AMA) or JAMA. The content of this commentary is solely the responsibility of the authors," it said.

New wristband tracks your every move in the name of health (BLOG)

Personal trainers are great, especially robotic ones, but what happens after you leave the gym and hit the couch can be another story altogether. Jawbone, traditionally a manufacturer of bluetooth headsets, is branching out with the Up, a lightweight bracelet that will track your daily physical activity (or lack thereof) with the use of built-in motion and vibration sensors.



The small piece of health-conscious wristwear, due out later this year, will tie into a clever smartphone app. On the app you'll be able to log your eating habits by snapping shots of your food (just like the app Meal Snap, we presume). The Up app crunches the numbers, giving you a data-rich portrait of your lifestyle, complete with motivational nudges to improve upon your existing health habits.

In the vast realm of technology, consumer health tech remains largely unexplored. With the advent of the Wii, exercise and gaming suddenly made sense in combination, and Microsoft's Kinect has improved on the formula since. Jawbone's Up also takes its cues from devices like the Nike+, a small exercise sensor with a companion app. But rather than just focusing on the kind of stats runners care about, the Up wants to paint a comprehensive portrait of health, from what we eat to how we sleep.

Both devices employ sensors to passively monitor our activities, zapping a wealth of personal data to the web where we can analyze and make sense of it. While we're arguably not quite cyborgs yet, more feedback technology on and in our bodies is just over the horizon.

Jawbone via Engadget

The Meaning of Addiction: Is Eating Addictive? (BLOG)

(Huffington Post)That idea that addiction has a "meaning" seems strange -- haven't they discovered "addiction" in a PET scan in a laboratory at the National Institute on Drug Abuse (NIDA)? It's either there or it's not, right?

Not actually. Here's why.

A brief world history of addiction. Addiction's meaning has changed substantially over time. And here's the funniest thing: its meaning is changing more rapidly now, when it is popularly believed that addiction has been scientifically specified in terms of the brain's neurochemistry.

For most of world history, addiction was applied as a general term, meaning people had a habit or really liked something -- as in, "He's addicted to his plum brandy." Only late into the 19th century, after the development of a modern hypodermic syringe and the synthesis of heroin from morphine, did a medical conception of addiction emerge. Oddly, in the 19th century, opiates were distributed and used indiscriminately, and it was with alcohol that the temperance movement developed the first pre-modern disease theory of addiction -- essentially the same disease theory that exists today.

This is how things stood through the 1980s. Heroin and alcohol stood alone as addictive drugs capable of creating "physical dependence." What shook the term out of its three-quarters of a century of lethargy was the large-scale misuse of cocaine, which pharmacologists had specifically decided was not addictive. They (collectively) changed their minds. And when they did, the image of addiction changed. It was no longer the stupor-inducing state associated with heroin and marked by intense withdrawal. Addiction changed shape to incorporate the experience of heightened sensations and intense energy levels of stimulant highs to which people regularly returned.

Which is where smoking comes in. The Department of Health and Human Services officially labelednicotine addictive only in 1988. The storied 1964 Surgeon General's Report, Smoking and Health, specifically rejected the claim that smoking was addictive -- it devoted a chapter to the matter. The leading pharmacologists of the time saw things this way because smoking (a) was not intoxicating, (b) did not involve street-dealing, psychopathic -- as they were seen -- users, and (c) was not thought to create severe, life-threatening withdrawal, as narcotics were imagined to do. That these reservations were reversed shows us just how much subjective and cultural interpretation are involved in the addiction-defining process.

The recent history of addiction. Once the lid was off of that box -- the one in which they kept the official definition of addiction at Greenwich -- all barriers were broken. Next to be classified as addictive was marijuana.

But why stop with drugs? The new volume of the American Psychiatric Association's diagnostic manual, DSM-V, scheduled for release in May 2013, recognizes gambling addiction but punts on video games, eating and sex addictions.

However, the current issue of the prestigious journal Addiction takes as its theme the matter of food addiction. In 1985, I wrote for what was then called the British Journal of Addiction, "How can addiction occur with other than drug involvements?" I'm happy to see that, a quarter of a century later, the issue is being actively debated in this distinguished journal.

The lead article is titled, "Can food be addictive?", by Ashley Gearhardt et al. Unfortunately, it comes to this very muddled conclusion: "Although there exist important differences between foods and addictive drugs, ignoring analogous neural and behavioral effects of foods and drugs of abuse may result in increased food-related disease and associated social and economic burdens."

Was that a yes, or a no?

Other articles take opposing positions: One that argues "yes" states:
Preclinical studies, beginning in Bart Hoebel's laboratory at Princeton University, have shown that rats overeating a sugar solution develop many behaviors and changes in the brain that are similar to the effects of some drugs of abuse [5,6], including naloxone-precipitated withdrawal [7], and others have shown complementary findings that suggest reward dysfunction associated with addiction in rats that overeat highly palatable foods [8]. These studies are supported by clinical research showing similarities in the effects of increased body weight or obesity and abused drugs on brain dopamine systems, as well as the manifestation of behaviors indicative of addiction [9-12].

Here is the countervailing viewpoint:
Over-consumption of food is one example of a more widespread acquisition of material objects well beyond any limits defined by personal need. People in industrial societies are encouraged to purchase more clothes, shoes, TVs, motor cars, refrigerators, furniture and palatable foods ... However, the acquisition of possessions beyond need extends well beyond the food repertoire. The prevailing socio-economic system encourages a philosophy of materialistic self-interest and unnecessary consumption (and purchasing) which is required in order to drive economic growth. Therefore, over-consumption takes place in a climate of abundance, aggressive advertising and easy accessibility in which food consumption is promoted strongly by the socio-economic market.

But the question is being framed poorly because of our attachment to disproved assumptions about addiction. The idea used to be that heroin is addictive, therefore people become addicted to it. It isn't true that some things are purely addictive, which is obvious in the case of alcohol. Addiction is a specific connection some people form to specific objects. As I described in The Meaning of Addiction , in 1985, which formed the basis for my piece in the journal:


People become addicted to experiences. The addictive experience is the totality of effect produced by an involvement; it stems from pharmacological and physiological sources but takes its ultimate form from cultural and individual constructions of experience. The most recognizable form of an addiction is an extreme, dysfunctional attachment to an experience that is acutely harmful to a person, but that is an essential part of the person's ecology and that the person cannot relinquish. This state is the result of a dynamic social-learning process in which the person finds an experience rewarding because it ameliorates urgently felt needs, while in the long run it damages the person's capacity to cope and ability to generate stable sources of environmental gratification.

Because addiction is finally a human phenomenon, it engages every aspect of a person's functioning, starting with the rewards (as interpreted by the individual) that an involvement provides and the individual's need for these rewards. The motivation to pursue the involvement, as compared with other involvements, is a function of an additional layer of social, situational, and personality variables. All of these elements are in flux as an individual grows up, changes environments, develops more mature coping mechanisms, loses and gains new opportunities for satisfaction, and is supported or undermined in forming new outlooks and self-conceptions.



There are indeterminate elements -- for example those activated by the person's value commitments -- affecting whether the person will continue to return to an experience that is progressively more damaging to the rest of the person's life. Even after the person has developed an addictive attachment, he or she can suddenly (as well as gradually) rearrange the values that maintain the addiction. This process is the remarkable one of maturing out, or natural remission in addiction.



To put this into common sense terms, people form addictions to intense experiences to which they regularly return to seek essential gratifications. There is nothing inherently addictive about any one thing -- people take long courses of narcotics all the time without becoming addicted. It is how the experience of that involvement -- pharmacological or otherwise -- fits into their personal ecology, and how dependent they grow on it, that determines addiction. Addiction is not a list of different objects, and eventually DSM and other respected organs will tire of asking whether this or that thing is addictive. Instead, as I wrote for Psychology Today,
The problem with the DSM-V approach is in viewing the nature of addiction as a characteristic of specific substances (now with the addition of a single activity). But think about obsessive-compulsive disorder (OCD): People are not diagnosed based on the specific habit they repeat -- be it hand-washing or checking locked doors. They are diagnosed with OCD because of how life-disruptive and compulsive the habit is. Similarly, addictive disorders are about how badly a habit harms a person's life. Whether people use OxyContin or alcohol, people aren't addicted unless they experience a range of disruptive problems -- no matter how addictive the same drug may be for others.

So, if food serves an intense emotional or other life need for people (beyond enjoyment or survival), and people grow to depend on that gratification as essential to their daily lives, whether they steadily overeat to create serious life-disturbing consequences or binge eat in ways that they regret and despise themselves for (this steady vs. binge variety of addiction occurs with alcohol as well), then they will fulfill more or less closely the criteria for addiction.

So, yes, food is addictive for some people. And to reckon that food can be addictive for some tells us how ubiquitous addiction is around us, only reaching pathological extremes in some alarming cases. At the same time this awareness informs us that addiction does not result from strange, or foreign, or chemically alien substances. Addiction attaches to experiences that are emotionally gratifying, often all-consuming, but essentially unfulfilling and negative, and ultimately dangerous. Only when we comprehend the experiential nature of the process can we define addiction and addictive objects appropriately.

But all of this is not to say that how we think about and define addiction is trivial. Such conceptions have life-affecting consequences for us as individuals and as a society, a process I detail in the next post in this series, "The Meaning of Addiction, II: Why Meaning Matters."

Stanton Peele

Superbug of Gonorrhea, STD's Just got scarier (BLOG)

Superbug — the term is scary for a reason! In fact, there’s a “superbug” strain of gonorrhea discovered in Japan that is immune to known forms of treatment for the sexually transmitted disease. This new superbug, dubbed H041, has actually evolved to a point where previous forms of antibiotics have no effect on it whatsoever. Each generation of gonorrhea gets gradually stronger and develops a resistance to antibiotics. Since this latest strain is immune to all previous forms, it gets labeled a superbug, and if an antibiotic that can treat it cannot be found, it may pose a serious health threat.

According to The Centers for Disease Control and Prevention, gonorrhea is “caused by Neisseria gonorrhoeae, a bacterium that can grow and multiply easily in the warm, moist areas of the reproductive tract, including the cervix (opening to the womb), uterus (womb), and fallopian tubes (egg canals) in women, and in the urethra (urine canal) in women and men. The bacterium can also grow in the mouth, throat, eyes and anus.” In short, anyone who is sexually active is at risk for contracting this STD; those who have the highest risk are sexually active teenagers, young adults and African Americans, who have the highest reports of gonorrhea in the United States.

Since there is no cure immediately available, should the superbug make its way to America, your best bet is to practice safe sex. This might mean asking a partner about his sexual background, even if you think you know him very well. In fact, friends with benefits might inadvertently steer you wrong since you are less likely to be vigilant about wearing a condom with a friend or asking if a friend has been tested, leading to the potential spread of sexually transmitted diseases. Regular checkups are also another smart way to avoid trouble with STDs. If you are unsure where there is a health center in your area, this webpage will help you find one.

How to Stay Hydrated in Hot Weather (BLOG)

SATURDAY, July 2 (HealthDay News) -- Staying hydrated is critical if you're physically active in hot weather.

But individuals have different hydration needs, so you need to assess your personal sweat rate, according to Brendon McDermott at the University of Tennessee at Chattanooga.

"Sweat rate is very simple to calculate: weigh yourself before exercise, with as little clothing as possible; exercise for half an hour and don't drink or use the bathroom for that half hour; weigh yourself again, wearing the same amount of clothing to see how much you've lost," he explained in auniversity news release.

If you've lost a pound, for example, that translates to about 16 ounces of fluid that you'll need to replace. Sports organizations suggest dividing your total by four to see how much water you need to drink every fifteen minutes while exercising to replace your lost fluids.

When exercising in hot weather, you should be well-hydrated when you begin your exercise and fluids should be readily accessible during your activity. Don't wait until you feel parched before you drink, because the thirst mechanism isn't triggered until you're two percent dehydrated, said McDermott, assistant professor, clinical coordinator for graduate athletic training program and co-director of the applied physiology laboratory.

Having cool fluids on hand may encourage your to drink during activity in hot weather. If you're playing sports or exercising for longer than an hour, you may require sports drinks.

You can also monitor your hydration status by a tried-and-true method: checking the color of your urine.

"It should have a light yellow tinge to it. Lemonade is much better than apple juice. And if you're delving into the ice tea realm, it's time to drink," said McDermott, who noted that it's normal to have darker urine in the morning.

After your activity, it's important to rehydrate as soon as possible within 30 minutes, he advised.

More information

The U.S. Centers for Disease Control and Prevention has more about water you need.

"Don't Get Surgery in July..." (BLOG)

A part from interfering with your beach vacation, there's another, more serious reason to steer clear of summer surgery if you can: a 10% spike in fatalities at teaching hospitals in July, confirmed by a new Journal of General Internal Medicine study. David Phillips, PhD, the study's lead author and professor of sociology at the University of California, San Diego, speculates that the "July effect" may occur because that's the month when new doctors-in-training begin their residencies.

The fatalities aren't the fault of poor knife skills botching operations, though—rather, they're due to mistakes made prescribing and administering patient medications, both surgery-related and not.

All told, as many as 98,000 deaths occur each year due to all kinds of medical mistakes—the equivalent of a fully packed 747 crashing every other day. According to a congressionally mandated study on Medicare recipients, during 2008, 1 in 7 hospital patients experienced at least one unintended harm that prolonged his or her stay, caused permanent injury, required life-sustaining treatment, or resulted in death.

The 14 worst hospital mistakes to avoid

So what can you do to make sure this doesn't happen to you or someone you love? Plenty, say doctors, nurses, and researchers. Here's where to start.

1. Choose Carefully

Infections that are acquired after checking into the hospital kill 31,000 patients a year, which nearly rivals the number of breast cancer deaths annually, says Peter Pronovost, MD, PhD, the author of Safe Patients, Smart Hospitals. What's more, most of these could easily have been prevented. If you have a choice of hospitals, ask if your doctor knows your options' infection rates, which are measured using "catheter days," meaning every 24 hours that a tube is inserted in a patient's blood vessels. "The best hospitals' rates have been zero in one thousand catheter days for a year or more," says Dr. Pronovost. "If it's risen above three, I'd be worried."

2. Practice Makes Perfect

The more often a doctor has performed a procedure, the more familiar she is with its variations and complications and the higher her success rate is likely to be. Confirm that your physician is board certified in her specialty (check the American Board of Medical Specialties at abms.org), but also ask her how many times she's treated your condition.

3. Timing is Everything

Weekends, nights, and holidays are not the optimal times for operations. Even the lead-up to the weekend can be problematic: "For elective surgery, avoid a Friday afternoon operation slot if possible," advises a surgeon in a busy Midwestern hospital who asked not to be named. "The operating room staff may be fatigued and less able to concentrate then."

It gets worse on the weekend. Stroke patients treated in hospitals on Saturday and Sunday were 16% more likely to die than those treated on weekdays, found a recent study from the University of Toronto. Staffing tends to be lighter then; getting lab results takes longer; and on-call docs have to drive in from home.

From drug-resistant superbugs to surgical mistakes, how to get out of the hospital alive

4. Go Digital

Often, in a busy hospital, complicated medication orders are dictated quickly to harried staffs, so they can frequently be a source of error. If possible, use a hospital with electronic records, which can reduce prescription slipups sevenfold, according to a recent Weill Cornell Medical College study. When information is entered, the computer alerts staff to potential problems by beeping, freezing, and/or flashing a warning message to prevent improper dosages, incorrectly filled prescriptions, and dangerous drug interactions. Only 17% of hospitals have such a system for medications, but it's worth checking for: After the Lucile Packard Children's Hospital at Stanford in Palo Alto, CA, adopted one, its death rates dropped by 20%.

5. A Question of Clotting

One in 100 patients admitted to a hospital dies of venous thromboembolism—a potentially deadly blood clot that forms in a vein—but half of those lives could have been saved with simple preventive measures available everywhere. When you're admitted to the hospital, you should be screened—particularly if you'll be recovering from cancer, heart disease, or any other major illness, says Frederick Anderson Jr., PhD, who wrote about the topic in the American Journal of Medicine. But half of at-risk patients don't get basic clot-prevention help, such as compression stockings or heparin therapy—so double-check with your doctor that your risk has been adequately assessed and the appropriate measures taken.

6. Enlist an Entourage

When you're a patient in the hospital, you're likely to be worried, stressed out, and under sedation at times, so it's helpful to have your relatives and friends with you to act as your advocates. "I love it when someone close to the patient is there," comments Ralph Brindis, MD, clinical professor of medicine at the University of California, San Francisco. "They can ask questions the patient hasn't thought of, and—because they know their loved one—they understand what she'd be anxious or unclear about." By acting as extra eyes and ears for you, this team can keep track of your treatment and may prevent errors that would otherwise go unnoticed.

How to make a mammogram, colonoscopy, endoscopy or MRI less scary and more comfortable

7. Mark the Spot

Your surgeon should call a time-out before your procedure so the operating team can make sure everyone knows who you are, why you're there, and the correct site of the procedure. Things can still go wrong, however, when a surgery requires multiple incision sites or if the team skips procedural steps during an emergency. To be safe, ask your surgeon to draw the proposed incisions right on the body part that will be operated on so you can see them while you're still awake, recommends Dr. Buchanan.

8. Be Shift-Savvy

The chance of medical mishaps shoots up during shift changes, says Arthur Aaron Levin, MPH, director of the Center for Medical Consumers. Before your current nurse leaves, request time to review your chart and what treatment you're supposed to get next. And meet with your new nurse, too, to ask any questions you have, advises Caitlin Brennan, RN, PhD, a postdoctoral fellow at Case Western Reserve University Frances Payne Bolton School of Nursing.

9. Give 'Em Gel

Potential for infection lurks everywhere in a hospital, so ask everyone to wash their hands before touching you. Sanitary gel dispensers should be available just outside or inside your room, but if you're not sure they've been used, keep your own gel by your bedside, rub some on before shaking hands, and offer it to visitors, says Lawrence C. Chao, MD, an ophthalmologist in Irvine, CA.

The 7 germiest public places you should should avoid

10. Call for a Cleanup Crew

Typically, a room is completely washed down between patients, but if you're there for a few days, ask that frequently touched areas be disinfected. It's not always done but should be, says Lisa McGiffert, director of Consumer Union's Safe Patient Project. "Everything in the room could potentially spread infection," she says.

11. Elevator Button = Panic Button

The elevator is a favorite shot on Grey's Anatomy—but ever notice how no one washes her hands before riding it? When you're up again, use a tissue when handling publicly pawed buttons and knobs.

12. Warm 'Em Up

No study proves that bringing treats to the nurses wins special privileges, but being pleasant does seem to make staff particularly attentive. Try to be friendly even when there's a problem: "I understand that it's busy, but my IV is beeping, and I'm worried." Manipulative? Insecure? Maybe—but it's your life that's at stake.

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Adult diabetes rate doubles: study (BLOG)

LONDON (AFP) – The number of adults with diabetes worldwide has more than doubled since 1980, with almost 350 million now affected, according to a new study published in The Lancet medical journal.

Scientists from Imperial College London and Harvard University analysed blood sugar date of 2.7 million people aged 25 and over across the world and used the results to estimate diabetes prevalence.

The number of adults with diabetes more than doubled from 153 million in 1980 to 347 million in 2008, according to the research published Saturday.

Diabetes is caused by poor blood sugar control and can lead to heart disease and stroke and can damage the kidneys, nerves and eyes.

High blood sugar levels and diabetes kill three million people across the world each year.

The researchers said two of the strongest factors in the rising diabetes rate were increasing life span and body weight, especially among women.

"Our study has shown that diabetes is becoming more common almost everywhere in the world," said Majid Ezzati, from Imperial College London, who co-led the study.

"This is in contrast to blood pressure and cholesterol, which have both fallen in many regions. Diabetes is much harder to prevent and treat than these other conditions."

Diabetes rates had risen most in Pacific island nations, where a greater proportion of people have the condition than anywhere else in the world, according to the study.

In the Marshall Islands, one in three women and one in four men have diabetes, it found.

Countries in western Europe had seen a relatively small increase in diabetes prevalence.

What Men are Most Likely to Die From (BLOG)

It was a sunny September day in the Pacific Northwest, and Jeff Hale had just closed a $1.5 million deal. To celebrate, he was taking the afternoon off, relaxing on his patio lounge, and playing ball with his dog. That's when he began feeling compression high in his chest, some pain in his left shoulder, and an unsettling sense of dread. At 44, he was in relatively good shape, although 15 pounds overweight and under a lot of stress from work. At first, he thought it was an asthma attack and took a hit off his inhaler. But when that didn't help, he remembered an article he’d read in Men's Health.

"There were two things from that article I recalled," he recounted to our reporter a few years ago. "One was that every heart attack is unique. My symptoms will be different from your symptoms. The other was, if you suspect you're having a heart attack, take an aspirin." Hale took two and drove himself to the hospital. He almost didn't make it. Doctors found blockages in three arteries and performed a triple bypass the next day. "They told me I'd saved my life," says Hale. "The aspirin thinned my blood, and the inhaler dilated my arteries."

Heart disease is the number one killer of men, claiming the lives of nearly 400,000 fathers, friends, brothers, and sons every year. Often, the difference between life and death is razor thin—remembering to pop an aspirin, not delaying your trip to the E.R.

This week is National Men's Health Week, which was created by Congress in 1994 to raise the awareness of the health threats uniquely facing men. To commemorate, we’ve put together a list of the most popular ways to die as a man in America. Collectively, these diseases kill nearly one million of us annually. And, chances are, your lifestyle or genetic profile puts you at risk for at least one of them.

But, as Jeff Hale learned, our fates are not sealed. If you understand your risks, and learn how to negate them, you can outrun the reaper. Here’s how:

#5 STROKE
Why you’re at risk: Each year, nearly 50,000 American men die of a stroke, according to the American Heart Association. I know what you’re thinking: But those are really old men. But you’re wrong. In fact, 1 in 14 stroke victims is younger than 45. As a neurologist I interviewed a few years ago told me: “If you did MRI scans on a hundred 40-year-olds, you’d see that a large number have already had a silent stroke.” And that’s scary because small, silent strokes often precede large, debilitating strokes.

What you can do about it: Keep your blood pressure at 120/80 or lower. Every 20-point increase in systolic BP (the top number) or every 10-point rise in diastolic BP doubles your risk of dying of a stroke, says Walter Kernan, M.D., an associate professor of medicine at Yale University. The good news: Simple lifestyle changes can dramatically reduce your risk. Assess your stroke risk right here, and learn how to turn the odds in your favor.

#4 CHRONIC OBSTRUCTIVE PULMONARY DISEASE
Why you’re at risk: Nearly 60,000 men died from COPD—which includes chronic bronchitis and emphysema—in 2006, according to the CDC. The chief cause: the Marlboro Man. In fact, smoking causes 80 percent of COPD deaths. Considering that tobacco use has also been directly linked to the other man killers on our Top 5 list—notably, heart disease (#1) and cancer (#2)—you have to ask: Why are people still smoking?

What you can do about it: It’s pretty simple, really. You need to figure out how to kick butts for good. Improve your odds by joining a gym—smokers who are trying to quit often fall off the wagon during stressful moments. Regular exercise lowers levels of cortisol, the stress hormone, in the brain. Warning: Going cold turkey is one of the least successful ways of quitting. Find out how to tilt the odds of success in your favor by checking out Will You Be Able to Quit Smoking?

#3 ACCIDENTS
Why you’re at risk: According to the CDC, 80,000 men die each year in unexpected tragedies, from sports injuries to fires to falls. But the most preventable accidental deaths are the 30,000 that occur on America’s roads every year.

What’s that? You’re a great driver? Not surprising that you think so. According to a study by the Insurance Institute for Highway Safety, 72 percent of drivers regard themselves as more skilled than everyone else. Researchers trace the bias to a fundamental information imbalance, namely that the poorest performers are also the least able to recognize skill (or lack of skill) in themselves or others.

But fine, let’s say it’s true. Then consider the guys you’re sharing the road with: Surveys indicate there's a nearly 80 percent chance they speed regularly, and a 53 percent likelihood they talk on the phone while driving. There's a 4 percent chance they run red lights—on purpose—and a 2 percent chance they have driven after drinking too much. These guys make Evel Knievel look like a defensive driver.

What you can do about it: If you do one thing today, make it this: Stop texting while driving. You’ve probably heard that texting behind the wheel is just as dangerous as drinking and driving. Not true. Texting is way more dangerous. In fact, texting increases your risk of a crash by 23 times (versus 11 times for driving under the influence), according to a Virginia Tech study. Step into the MH Driving Simulator and test how well you multitask behind the wheel.

#2 CANCER
Why you’re at risk: The Big C killed nearly 300,000 men in 2010, according to the American Cancer Society. Lung cancer tops the list, accounting for 29 percent of all cancer deaths, followed by prostate cancer (11 percent) and colon/rectum cancer (9 percent). We all know that smoking causes lung cancer, but the risk factors for prostate cancer are less well known. Yet, it’s one of the most common—1 in 6 men will get prostate cancer in their lifetimes—and least understood killers of men.

What you can do about it: Take our quiz to determine your risk. If you’re at high risk, put certain staples of the Mediterranean diet on your plate. A study published in the Journal of the National Cancer Institute shows that men who eat more than 10 grams of garlic or scallions (about three cloves of garlic or 2 tablespoons of scallions) daily have a 50 percent lower risk of prostate cancer than those who eat less than 2 grams. Sound like too much of a good thing? Other studies have linked the lycopene in cooked tomato products to lower prostate cancer risk; aim for at least two servings a week. And if you really like coffee . . . Harvard researchers found that drinking 6 cups a day reduces your risk of developing advanced prostate cancer by 59 percent.

#1 HEART DISEASE
Why you’re at risk: This is the deadliest disease known to man. More than 1 in 3 adult men have some sort of heart disease and more than 390,000 men died of the killer in 2007, according to the American Heart Association.

But you’re a fit, healthy guy, right? Why would you die of heart disease? Believe it or not, not every victim of the disease is overweight or inactive. Men’s Health Editor Peter Moore discovered this eight years ago. He was doing everything right: He was thin, exercised regularly, and ate a healthy diet. But none of that prevented one of the arteries in his heart from becoming 99 percent blocked. Still think you’re risk-free? You can find out your heart disease risk by clicking right here.

What you can do about it: Small lifestyle changes can yield big results when it comes to improving heart health. Here are four simple changes you can make today:

• Exercise for 30 minutes. Middle-aged men who exercise vigorously for two hours a week (aim for 30 minutes, four times a week) have a 60 percent lower risk of a heart attack than inactive men.

• Lose the spare tire. If you’re overweight, dropping 10 to 20 pounds lowers your risk of dying from a heart attack. In fact, a 10-year study found that overweight people had heart attacks 8.2 years earlier than normal-weight victims.

• Drink five glasses of water a day. Men who drink that many 8-ounce glasses are 54 percent less likely to have a fatal heart attack than those who drink two glasses or fewer. Researchers say the water dilutes the blood, making it less likely to clot.

• Count to 10. Keeping your cool under stress may keep you alive. Men who respond with anger are three times more likely to have heart disease and five times more likely to have a heart attack before turning 55.

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Big city got you down? Stress study may show why (BLOG)

NEW YORK – This may come as no surprise to residents of New York City and other big urban centers: Living there can be bad for your mental health.

Now researchers have found a possible reason why. Imaging scans show that in city dwellers or people who grew up in urban areas, certain areas of the brain react more vigorously to stress. That may help explain how city life can boost the risks of schizophrenia and other mental disorders, researchers said.

Previous research has found that growing up in a big city raises the risk of schizophrenia. And there's some evidence that city dwellers are at heightened risk for mood and anxiety disorders, although the evidence is mixed.

In any case, the volunteers scanned in the new study were healthy, and experts said that while the city-rural differences in brain activity were intriguing, the results fall short of establishing a firm tie to mental illness.

The study, done in Germany and published in Thursday's issue of the journal Nature, focused on how the brain reacts to stress caused by other people.

To do that, investigators had volunteers lie in a brain scanner and solve math problems. The volunteers expected easy problems, but they were in fact hard enough that each volunteer ended up getting most of them wrong.

While in the scanner, volunteers heard a researcher criticize their poor performance, saying it was surprisingly bad and disappointing, and telling the volunteers they might not be skilled enough to participate.

An initial study with 32 volunteers found city-urban differences in two brain areas. One was the amygdala, which reacts to threats in one's environment, and the other was circuitry that regulates the amygdala. Researchers found that volunteers from cities of more than 100,000 showed more activation of the amygdala than participants from towns of more than 10,000, and those in turn showed more activation than people from rural areas.

To assess any effect of where the volunteers grew up, the researchers assigned each an "urbanicity" score based on how many years they'd spent by age 15 in a city, town or rural area. The higher the score, the more urban their childhood life was, and the more activity showed up in the amygdala-regulating circuitry during the experiment.

A slightly different stress-producing test produced similar results with a different group of 23 volunteers.

But when a third group of 37 adults did mental tasks without being criticized for poor performance, they showed no urban-rural differences. That shows the effect comes from the criticism rather than just doing the mental task, the researchers said.

The study can't reveal why city life would boost the brain responses, but it could be because of the stress from dealing with other people, said Dr. Andreas Meyer-Lindenberg, director of the Central Institute of Mental Health in Mannheim, Germany, and senior author of the report. Animal studies suggest that early exposure to stress can cause lasting effects, he said.

Jens Pruessner, a study co-author from the Douglas Mental Health University Institute in Montreal, said the study illustrates a new avenue for understanding the risk factors for developing mental illness.

An expert in emotion and the brain who wasn't involved with the study, Elizabeth Phelps of New York University, said it's premature to draw conclusions about what the results mean for mental illness.

"These results are interesting but preliminary," she said. "This will raise a lot of interest in this idea. Whether or not it pans out in future research, who knows, but I think it's worth investigating."

Stopping A Migraine Before it Starts (BLOG)

A migraine is among the most debilitating conditions in medicine—a blinding, throbbing pain that typically lasts between four and 72 hours. There is no cure

Yet, a few hours or days before the dreaded headache sets in, subtle symptoms emerge: Some people feel unusually fatigued, cranky or anxious. Some have yawning jags. Others have food cravings or excessive thirst.

If migraine sufferers can learn to identify their particular warning signs, they may be able to head off the headache pain with medication or lifestyle changes before it begins, experts say.

"The holy grail of migraine treatment would be to have something you could take tonight to ward off an attack tomorrow," says neurologist Peter Goadsby, director of the headache program at the University of California-San Francisco. At a conference of the American Headache Society last week, he and other experts said these early symptoms may hold clues to what causes migraines in the first place.

Scientists have long known about this so-called premonitory phase, which occurs well before the better-known aura, the flashing lights and wavy lines that about 30% of migraine sufferers see shortly before the headache begins. Yet there have been only a handful of clinical trials treating patients in the premonitory stage—in part because the symptoms are so vague. Still, once patients know what to look for, many can identify some early warning signs.

"If you ask the average migraine sufferer, 'Do you have any symptoms a few hours before the headache starts?' about 30% will say yes," says Werner Becker, professor of neuroscience at the University of Calgary in Alberta. But given a list of 20 common signs, from changes in mood, appetite or energy to urinating frequently or yawning excessively, about 80% of patients will say, "Oh yes, I've noticed that," he says.

Dr. Becker says one of his patients frequently feels dizzy and loses her appetite about 6 p.m. and knows that an attack is imminent. She finds that taking the migraine drug rizatriptan—usually taken only after the headache starts—can ward it off. "If she doesn't take it, then the next morning, she wakes up with a full-blown migraine," Dr. Becker says.

Sheena Selvey, a 28-year old special-education teacher in Northbrook, Ill., says she knows a migraine is coming when co-workers say her neck muscles have tightened up. She rubs her neck with an essential peppermint oil until she can inject herself with Imitrex, another medication usually used to stop rather than prevent headache pain. She says such steps have helped reduce attacks to two or three times a month from three or four times a week.

Ben McKeeb, a 35-year-old nursing student in Bellingham, Wash., says his wife noticed that his forehead muscles tense up in the shape of a "V" a few hours before his headaches begin. "I can almost always catch that feeling, and if I do all the right things—stay hydrated, stay out of the sun, get plenty of sleep, don't work too hard—I probably won't get one," he says.

Nationwide, about 36 million Americans suffer from migraines. Although some people use the word very loosely, migraines are far more severe than a typical headache, last longer and tend to involve nausea, vomiting and sensitivity to light. Women are three times as likely as men to get migraines, and they've been diagnosed in children as young as 6 months. Migraines cost the country more than $20 billion a year in lost wages, disability payments and health-care bills, according to the American Headache Society, an organization of health-care professionals who specialize in headaches.

As many as half of all sufferers don't seek treatment, in part because they think there is little doctors can do for them. In fact, treatments are proliferating, including over-the-counter pain relievers for mild cases and a class of drugs called triptans typically used to stop migraine pain. For chronic migraines, doctors also prescribe beta blockers, antiseizure medications and antidepressants, but they have significant side effects and help only about 50% of patients about 50% of the time. More drugs are in clinical trials, and non-drug treatments such as acupuncture, massage, biofeedback and transcranial-magnetic stimulation are also showing some promise at alleviating migraine pain.

Doctors used to tell patients to wait until their headache pain was severe to moderate before taking medication. But that's changing. "Now we know the closer we can get to the beginning of the attack, the better the outcome will be," says David Dodick, president of the American Headache Society and neurologist at the Mayo Clinic in Phoenix.

Experts also think that they can learn a lot about the origin of migraines by studying how the body changes in the premonitory phase.

For example, "Many people tell us that they vomit yesterday's food," says Joel Saper, director of the Michigan Head-Pain and Neurological Institute in Ann Arbor. That's a sign, he notes, that their digestion slowed long before they knew a migraine was coming.

Some experts are also re-examining the role of common migraine triggers such as alcohol, chocolate, red wine, aged cheese and caffeine. It could be that physiological changes in the premonitory phase trigger a sensitivity to such foods, rather than the other way around.

"For years, patients would say they got a migraine because they ate chocolate or pizza or a hot dog," says Dr. Saper. "But when you ask why they ate those things, they say, 'I had this insatiable craving....' We need to understand where that craving came from."

Functional-imaging studies of the brain have revealed another tantalizing clue: During the aura phase, a wave of electrical activity sweeps over the outer, furrowed layer of the brain known as the cortex, at a pace of 2 to 3 millimeters per minute. This wave—known as "cortical spreading depression"—activates nerve cells as it goes, and the symptoms sufferers report typically correspond to the area of the brain the wave is passing over. For example, the patient sees flashing lights and wavy lines when the wave is over the visual cortex, and tingling in the hands and feet when the wave is in the motor cortex. Once the wave passes by, the nerve cells become quiet and spent.

Dr. Goadsby and colleagues at UCSF are conducting more imaging studies to determine what brain activity occurs during the premonitory phase.

Experts say migraine sufferers can help themselves and their physicians by keeping a careful log of when their headaches occur, what they ate, drank and did several days in advance, as well as any early symptoms they experienced. They may notice patterns and find their own warning signs.

And even though there is no scientific evidence that taking medication at that early stage will stave off migraine headaches, some experts say it makes sense for patients to avoid their known triggers if a migraine seems imminent.

"If stress seems to be a trigger, cut back on your schedule, try a relaxation technique, don't plan a 12-hour day," says Dr. Becker. "You could potentially stop an attack."

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Viagra: The Thrill That Was (BLOG)

IT isn’t often that an article in AARP’s magazine gets the attention of People, the London tabloids, The Huffington Post and the celebrity blogosphere. But so it was last year when Michael Douglas, upon turning 65, sat down for an interview with the mass-circulation periodical for the over-50 set, and in the process uttered a word heard round the world: “Viagra.”

“Michael Douglas Takes Viagra” announced headlines in The New York Daily News and on sites like whyfame.com and hotfeeder.com, among others. “Michael Douglas Admits: I Have to Take Viagra” (The Daily Mail). “Michael Douglas: Thank Goodness for Viagra” (the Huffington Post).

And so on.

For the record, the exact quote was subtler (though the meaning seemed unmistakable), spoken during musings about his life with Catherine Zeta-Jones, the gorgeous (and quarter-century younger) actress he married in 2000: “God bless her that she likes older guys. And some wonderful enhancements have happened in the last few years — Viagra, Cialis — that can make us all feel younger.”

This was a man transformed, waxing poetic on the joys of fatherhood the second time around, that special feeling of knowing his was the “first face” his children see when they wake up and that sweet satisfaction from helping them get ready for school.

It could be argued that this new persona would never have existed but for the aforementioned little pill. At the very least, it seems to have played a role not only in fulfilling a marriage but also in the birth of the two children who turned the Hollywood playboy into a sentimental Mr. Mom.

With media images abounding these days of virile older men — Hugh Hefner, 85, and Crystal Harris, 25, announcing their engagement; 80-year-old Rupert Murdoch with his elementary-school-aged daughters; the 74-year-old Italian prime minister, Silvio Berlusconi, and that 18-year-old party girl — one has to wonder if Viagra has again worked its magic. (Do they or don’t they? Only their pharmacists know for sure.)

And now we have evidence that 54-year-old Osama bin Laden had what has been referred to as an “herbal version of Viagra” in his medicine chest at the compound where he was hiding out with multiple wives.

All of this raises the question of just what the far-reaching implications of Viagra (and similar drugs) are, beyond the specific medical achievement of providing a treatment, in the form of increased blood flow, for millions of men with erectile dysfunction.

More than any pill ever to be dispensed, Viagra has played to the yearnings of American culture: eternal youth, sexual prowess, not to mention the longing for an easy fix.

From the first announcement of the drug’s existence, fantasies went into overdrive; with the popping of a pill, lackluster marriages would be repaired. Or a generation of newly virile men would be on the make, hooking up with younger partners, maybe even getting a chance at righting any wrongs they had committed as fathers of young children years earlier. At the very least, everyone would be having great sex well into their twilight years.

It hasn’t worked out quite that way. Thirteen years after Viagra hit the market like a bolt of lightning (Dr. Jed Kaminetsky, a New York University urologist, said that at first he was so besieged with requests for prescriptions that he had to start seeing patients on weekends to keep up with the demand), we have not turned into a Viagra Nation.

Pfizer, the maker of Viagra, said that it has been prescribed to more than 35 million men worldwide. For many men, it has been a wonder drug, doctors like Dr. Kaminetsky agree.

But recently the market for Viagra-type drugs has stalled in the United States. Last year the total number of prescriptions for so-called ED drugs declined by 5 percent in the United States after growing just 1 percent annually the previous four years, according to IMS Health, a heath-care data and consulting firm. (Viagra prescriptions were off 7 percent; those for Levitra plummeted 18 percent.)

The drop seems all the more significant given that the population is aging, so there are surely more men who potentially need the drug.

There could be many reasons for the dip: effectiveness (it doesn’t work for everyone) or insurance payments, to name a few.

But another number is perhaps more telling: doctors widely observe that 40 to 50 percent of men who are given a first prescription do not end up refilling it. Perhaps the mentality is, as Dr. Kaminetsky suggested: “Having that blue pill is sort of like when they were kids but they walked around with a condom in their wallet: they may never have sex but they were ready.”

Abraham Morgentaler, the director of Men’s Health Boston and author of the book “The Viagra Myth,” said he was startled by the expectations that people initially poured into one little pill. It became, at least subconsciously, a panacea for all that was missing in their life. “Men look to these types of pills as a savior for other aspects of their lives where things are not going well,” he said.

But there’s only so much increased blood flow can do. Dr. Morgentaler cited two patients, one who stopped using Viagra shortly after he began and one who never used his prescription. The first man said that once he was able to perform again, he realized that the problems in his marriage went well beyond sex; soon after he began taking the drug, he and his wife separated. The second, a man in his 70s, said he and his wife realized the emotional connection was already there, so they decided not to use his prescription.

Neither has there been a boomlet of babies as a result of Viagra. In 2000, Ken Gronbach, a demographer, hailed the certain arrival of a “Viagra Generation,” a demographic of children who would never have been born but for the existence of the drug.

But population statistics suggest his predictions have not come to pass. Fatherhood rates among older men, always minuscule, have not risen since Viagra came on the market. According to the National Center for Health Statistics, they amounted to 0.3 live births per 1,000 men over age 55 from the mid 1990s through 2005 before dropping to 0.2 births per thousand in 2006, then rising to 0.4 in both 2007 and 2008, the latest year for which statistics are available. That puts birthrates of men over age 55 exactly where they were in the early ’80s.

The real effect of Viagra seems to be subtler. A 62-year-old man, who asked that his name not be disclosed, described in an interview how his experience helped change his attitudes about aging. The man, a widower who has been in a long-term relationship since 2004, said he initially looked to ED drugs as a savior. “This is going to give me back everything,” he said.

But that wasn’t the case. The man said he has ended up using the drugs on and off for the last 10 years. But he no longer believes they are necessary. “In some ways it’s a nice addition, but not so important that I need to have it every time,” he said. “We’ve sort of made an adjustment.”

Therapists and others who counsel people on relationships say that the very existence of pills like Viagra have heaped expectations on an age group that may have more concerns than just whether they can still have sex. (It’s stressful enough at 30. But 70?)

Leonore Tiefer, a clinical psychologist and sex therapist in New York, recalled two patients, a couple in their 70s, both widowed. Their experiment with Viagra had been unsuccessful. “They were eager for companionship but somehow they both felt they ought to be having sex,” she said. “I said you are supposed to be free of this kind of imperative at this point in your life. Why do you think you ought to be doing this?”

The ensuing dialogue, she said, went along the lines of the following:

“I thought you wanted to.”

“I thought you would have wanted to.”

It turned out neither one of them cared.

newyorktimes