Urinary Tract Infection

Reviewed by Louise Chang, MD on January 31, 2011
Sources: © 2011 WebMD

What Is a Urinary Tract Infection?
About half of women will get a urinary tract infection or UTI at some point in life. It happens when germs infect the system that carries urine out of your body -- the kidneys, bladder, and the tubes that connect them. Bladder infections are common and usually not serious if treated promptly. But if the infection spreads to the kidneys, it can cause more serious illness.

UTI Symptoms: Bladder Infection
Most UTIs are bladder infections. Symptoms include:
Pain or burning during urination
The urge to urinate often
Pain in the lower abdomen
Urine that is cloudy or foul-smelling
Some people may have no symptoms

UTI Symptoms: Kidney Infection
An untreated bladder infection can spread to the kidneys. Signs of this include:
Pain on either side of the lower back
Fever and chills
Nausea and vomiting

When to See Your Doctor
See your doctor right away if you have signs of a urinary tract infection. A bladder infection is generally not a medical emergency – but some people have a higher risk for complications. This includes pregnant women, the elderly, and men, as well as people with diabetes, kidney problems, or a weakened immune system.

UTI or Something Else?
Although burning during urination is a telltale sign of a UTI, it can  also be a symptom of certain sexually transmitted diseases (STDs.) These  include chlamydia, gonorrhea, and trichomoniasis. Simple lab tests are  available to distinguish a UTI from an STD.

Honeymoon Cystitis
Few things can ruin a honeymoon like a UTI. But this is so common, it has its own name – "honeymoon cystitis." The reason is that sexual activity can push bacteria into the urethra. Of course, the problem is not confined to honeymoons. Some women get a bladder infection almost every time they have sex. Women who use a diaphragm for birth control are especially vulnerable.

Stealth UTI
Occasionally, UTIs occur without the classic symptoms. A person may have no symptoms at all. Yet, a urine test shows the presence of bacteria. This is known as asymptomatic bacteriuria. In many cases, no treatment is needed. But pregnant women, some children, and recipients of kidney transplants should be treated to avoid a kidney infection.

UTI Complications
The main danger associated with untreated UTIs is that the infection may  spread from the bladder to one or both kidneys. When bacteria attack the  kidneys, they can cause damage that will permanently reduce kidney function. In  people who already have kidney problems, this can raise the risk of kidney  failure. There’s also a small chance that the infection may enter the  bloodstream and spread to other organs.

How Do UTIs Begin?
Many types of bacteria live in the intestines and the genital area, but this is not true of the urinary system. In fact, urine is sterile. So when errant bacteria, such as the E. coli shown here, is accidentally introduced into the urinary system, it can start a UTI. Typically, bacteria travel up the urethra to the bladder, where an infection can take hold. Women are more susceptible than men, probably because they have shorter urethras.

What Boosts Your Risk?

UTIs are most common in sexually active women. Other factors that may increase your risk include:
Not drinking enough fluids
Taking frequent baths
Holding your urine
Kidney stones

Urinary Tract Infections in Men
Men are much less likely than women to get UTIs. When it does happen, it's often related to another underlying medical condition, such as a kidney stone or an enlarged prostate.

Diagnosing UTIs
The first step in diagnosing a UTI is usually a simple urine test called a urinalysis. It looks for bacteria, as well as abnormal counts of white and red blood cells. The dipstick test provides quick results. Your doctor may also send your urine to a lab for culture to confirm the type of bacteria. At-home test kits can help detect a UTI, but are not 100% accurate. Be sure to go over the results and your symptoms with your doctor.

Treating UTIs
Prescription antibiotics will almost always cure a UTI. Your health care provider may recommend drinking lots of fluids and emptying your bladder frequently to help flush out the bacteria. Kidney infections can often be treated with oral antibiotics, too. But severe kidney infections may require hospital care, including a course of intravenous antibiotics.

Treating Recurrent UTIs
Some women are prone to getting UTIs over and over again. If you have three or more a year, talk to your doctor about how to prevent or minimize these infections. Your options may include:
Taking a low dose of antibiotics long-term
Taking a single antibiotic dose after sex
Taking antibiotics promptly as self-treatment when symptoms appear

UTIs and Diabetes

People with diabetes are more vulnerable to UTIs for several reasons. First, their immune systems tend to be weaker. Second, high blood sugar can spill into the urine and encourage the growth of bacteria. Also, nerve damage related to diabetes can prevent the bladder from fully emptying. People with diabetes should talk with their doctor at the first sign of a UTI.

UTIs and Pregnancy
During pregnancy, there are several factors that boost the risk of UTIs, especially a kidney infection. Hormones cause changes in the urinary tract, and the uterus may put pressure on the ureters or bladder or both -- making it more difficult for urine to pass from the kidneys to the bladder and out.  Untreated UTIs can contribute to preterm labor, so be sure to alert your doctor if you suspect you have an infection.

UTIs and Menopause
Estrogen has a protective effect in the urinary tract, but levels of this hormone drop off significantly during menopause. Low estrogen levels can make it easier for bacteria to thrive in the vagina or urethra. For this reason, women may be more susceptible to UTIs after menopause.

UTIs and Hospital Stays
A hospital stay can put you at risk for a UTI, particularly if you need to use a catheter. This is a thin tube that's inserted through the urethra to carry urine out of the body. Bacteria can enter through the catheter and reach the bladder. This is more often a problem for older adults who require prolonged hospital stays or who live in long-term care facilities.

UTIs in the Elderly
UTIs are among the most common infections in the elderly. But the symptoms may not follow the classic pattern. Agitation, delirium, or other behavioral changes may be the only sign of a UTI in elderly men and women. This age group is also more likely to develop serious complications as a result of UTIs.

UTIs in Infants
Babies occasionally develop UTIs, but they can’t tell you what they feel. Here are some signs to watch for:
An unexplained fever
Strange-smelling urine
Poor appetite or vomiting
Fussy behavior
 It’s vital to treat a baby’s UTI quickly to prevent kidney damage. Promptly changing a dirty diaper can help prevent bladder infections. And of course, wipe from front to back whenever changing a baby's diaper.

UTIs in Children
About 1% of boys and 3% of girls develop UTIs by age 11. This includes some children who repeatedly delay a bathroom trip. Their muscles may not relax enough later to fully empty the bladder and flush away any bacteria. More regular bathroom trips and drinking plenty of liquids may help. A small number of children have a structural problem that obstructs urine flow or lets urine flow back from the bladder to the kidneys, triggering chronic kidney infections. This can lead to kidney damage.

UTI or Potty Training Problem?
Accidents are par for the course during toilet training. Even kids who have mastered the art of the potty may sometimes have a relapse. Other children may scream or cry when taken to the potty, as a way of rebelling against the process. These are generally not signs of a UTI.

Preventing UTIs
Here are several strategies to reduce your risk of UTIs:
Drink plenty of water.
Visit the toilet before and after sex.
Wipe from front to back.
Avoid feminine hygiene sprays.
Take showers instead of baths.

The Cranberry Connection
Maybe Mom told you that cranberry juice cures a UTI. She’s close. Some studies suggest it can prevent, but not treat an infection, and is more effective in young and middle-aged women. Cranberries contain a substance that prevents E. coli bacteria from sticking to the walls of the bladder. If you don’t like the taste of cranberry juice, capsules or tablets may work, too. People with a history of kidney stones should check with a doctor, first.

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Cervical Cancer

Reviewed by Louise Chang, MD on September 21, 2011
Sources: © 2011 WebMD

What Is Cervical Cancer?
Cervical cancer occurs when abnormal cells develop and spread in the cervix, the lower part of the uterus. More than 12,000 new cases are diagnosed each year in the U.S. A unique fact about cervical cancer is that most cases are triggered by a type of virus. When found early, cervical cancer is highly curable.

Symptoms of Cervical Cancer
When cervical cells first become abnormal, there are rarely any warning signs. As the cancer progresses, symptoms may include:
Unusual vaginal discharge
Vaginal bleeding between periods
Bleeding after menopause
Bleeding or pain during sex

Top Cause of Cervical Cancer: HPV
The human papillomavirus (HPV) is a large group of viruses. About 40 types can infect the genital areas, and some have high risk for cervical cancer. Genital HPV infections usually clear up on their own. If one becomes chronic, it can cause changes in the cells of the cervix. And it's these changes that may lead to cancer. Worldwide, over 90% of cervical cancers are caused by an HPV infection.

Symptoms of HPV
HPV infections usually have no symptoms and go away on their own. Some types of the HPV virus may cause genital warts, but these are not the same strains linked to cervical cancer. It's important to note that genital warts will not turn into cancer, even if they are not treated. The dangerous types of HPV can stay in the body for years without causing any symptoms.

Who Is at Risk for HPV?
HPV is so common that most people who have ever had sex -- both women and men -- will get the virus at some point in life. Because HPV can linger quietly, it's possible to carry the infection even if it has been years since you had sex. Condoms can lower your risk of getting HPV, but they do not fully protect against the virus. HPV is also linked to cancers of the vulva, vagina, penis, and to anal and oral cancers in both sexes.

How HPV Causes Cervical Cancer
If one of the high-risk strains of HPV lingers in the body, it can cause abnormal cells to develop in the cervix. These precancerous changes do not mean that you have cervical cancer.  But over time, the abnormal cells may give way to cancer cells. Once cancer appears, it tends to spread in the cervix and surrounding areas.

What Else Raises Your Risk?

Hispanic and African-American women have higher rates of cervical cancer than white women. The risk is also higher in infected women who:
Smoke
Have many children
Use birth control pills for a long time
Are HIV positive or have a weakened immune system

Early Detection: Pap Test
The Pap test is one of the great success stories in early detection. A painless swab of the cervix can reveal abnormalities, often before cancer appears. Women should start having Pap tests three years after becoming sexually active and no later than age 21. How often tests are done depends on the type of test, your personal risk factors, and your medical history.  Skipping Pap tests raises your risk for invasive cervical cancer.
Of note: You'll still need Pap tests after getting the HPV vaccine because it doesn't prevent all cervical cancers.

What If Your Pap Test Is Abnormal?
If test results show a minor abnormality, you may need a repeat Pap test. Your doctor may schedule a colposcopy -- an exam with a lighted magnifying device -- or biopsy to get a better look at any changes in the cervical tissue. If abnormal cells are precancerous, they can then be removed or destroyed. Treatments are highly successful in preventing precancerous cells from developing into cancer.

Early Detection: HPV DNA Test
In some cases, doctors may offer the option of the HPV DNA test in addition to a Pap test. This test checks for the presence of high-risk forms of HPV. It may be used in combination with a Pap test to screen for cervical cancer in women over 30. It may also be recommended for a woman of any age after an abnormal Pap test result.

Diagnosing Cervical Cancer: Biopsy
A biopsy involves the removal of cervical tissue for examination in a lab. A pathologist will check the tissue sample for abnormal changes, precancerous cells, and cancer cells. In most cases, a biopsy takes place in a doctor's office with local anesthesia. A cone biopsy allows the pathologist to check for abnormal cells beneath the surface of the cervix, but this test may require general anesthesia.

Stages of Cervical Cancer
Stage 0 describes cancer cells found only on the surface of the cervix.  More invasive cancers are separated into four stages. Stage I is when the cancer has not spread beyond the cervix. Stage II means the tumor has spread to the upper part of the vagina. A Stage III tumor extends to the lower part of the vagina and may block urine flow. In Stage IV, the tumor has reached the bladder or rectum, or cancer cells have spread to other parts of the body and formed new tumors.

Treatment: Surgery
If the cancer has not progressed past Stage II, surgery is usually recommended to remove any tissue that might contain cancer. Typically this involves a hysterectomy, the removal of the cervix and uterus as well as some of the surrounding tissue. The surgeon may also remove the fallopian tubes, ovaries, and lymph nodes near the tumor.

Treatment: Radiation
External radiation therapy uses high-energy X-rays to kill cancer cells in a targeted area. It can also help destroy any remaining cancer cells after surgery. Internal radiation, or brachytherapy, uses radioactive material that is inserted into the tumor. Women with cervical cancer are often treated with a combination of radiation and chemotherapy. Side effects can include low blood cell counts, feeling tired, upset stomach, nausea, vomiting, and loose stools.

Treatment: Chemotherapy
Chemotherapy uses drugs to reach cancer wherever it is in the body. When cervical cancer has spread to distant organs, chemotherapy may be the main treatment option. Depending on the specific drugs and dosages, side effects may include fatigue, bruising easily, hair loss, nausea, vomiting, and loss of appetite.

Coping With Cancer Treatments
Cancer treatments may make you tired or uninterested in food. But it's important to take in enough calories to maintain a healthy weight. Check with a dietitian for tips on eating well during cancer treatment. Staying active is also important. Gentle exercise can increase your energy while reducing nausea and stress. Check with your doctor to find out which activities are appropriate for you.

Cervical Cancer and Fertility
Treatment for cervical cancer often involves removing the uterus and may also involve removing the ovaries, ruling out a future pregnancy. However, if the cancer is caught very early, you still may be able to have children after surgical treatment. A procedure called a radical trachelectomy can remove the cervix and part of the vagina while leaving the majority of the uterus intact.

Survival Rates for Cervical Cancer
The odds of surviving cervical cancer are tied to how early it's found. Depending on the stage, between 93% and 15% of women will survive for at least five years after diagnosis. Keep in mind that these numbers are based on women treated between 2000 and 2002. The treatments and outlook may be better for those diagnosed today. And statistics don't predict how well any one individual will respond to treatment.

Vaccine to Help Prevent Cervical Cancer
Vaccines are now available to ward off the two types of HPV most strongly linked to cervical cancer. Both Cervarix and Gardasil require three doses over a six-month period. Studies suggest the vaccines are effective at preventing chronic infections with the two types of HPV that cause 70% of cervical cancers.  Gardasil also protects against two types of HPV that cause genital warts.

Who Should Get the HPV Vaccine?
The vaccines are only used to prevent, not treat, HPV infection. They are most effective if administered before an individual becomes sexually active. The CDC recommends girls get an HPV vaccine series when they are 11 or 12.  It can also be given as a catch-up vaccine for girls and women from ages 13 to 26.

Read More

Cervical Cancer

Reviewed by Louise Chang, MD on September 21, 2011
Sources: © 2011 WebMD

What Is Cervical Cancer?
Cervical cancer occurs when abnormal cells develop and spread in the cervix, the lower part of the uterus. More than 12,000 new cases are diagnosed each year in the U.S. A unique fact about cervical cancer is that most cases are triggered by a type of virus. When found early, cervical cancer is highly curable.

Symptoms of Cervical Cancer
When cervical cells first become abnormal, there are rarely any warning signs. As the cancer progresses, symptoms may include:
Unusual vaginal discharge
Vaginal bleeding between periods
Bleeding after menopause
Bleeding or pain during sex

Top Cause of Cervical Cancer: HPV
The human papillomavirus (HPV) is a large group of viruses. About 40 types can infect the genital areas, and some have high risk for cervical cancer. Genital HPV infections usually clear up on their own. If one becomes chronic, it can cause changes in the cells of the cervix. And it's these changes that may lead to cancer. Worldwide, over 90% of cervical cancers are caused by an HPV infection.

Symptoms of HPV
HPV infections usually have no symptoms and go away on their own. Some types of the HPV virus may cause genital warts, but these are not the same strains linked to cervical cancer. It's important to note that genital warts will not turn into cancer, even if they are not treated. The dangerous types of HPV can stay in the body for years without causing any symptoms.

Who Is at Risk for HPV?
HPV is so common that most people who have ever had sex -- both women and men -- will get the virus at some point in life. Because HPV can linger quietly, it's possible to carry the infection even if it has been years since you had sex. Condoms can lower your risk of getting HPV, but they do not fully protect against the virus. HPV is also linked to cancers of the vulva, vagina, penis, and to anal and oral cancers in both sexes.

How HPV Causes Cervical Cancer
If one of the high-risk strains of HPV lingers in the body, it can cause abnormal cells to develop in the cervix. These precancerous changes do not mean that you have cervical cancer.  But over time, the abnormal cells may give way to cancer cells. Once cancer appears, it tends to spread in the cervix and surrounding areas.

What Else Raises Your Risk?

Hispanic and African-American women have higher rates of cervical cancer than white women. The risk is also higher in infected women who:
Smoke
Have many children
Use birth control pills for a long time
Are HIV positive or have a weakened immune system

Early Detection: Pap Test
The Pap test is one of the great success stories in early detection. A painless swab of the cervix can reveal abnormalities, often before cancer appears. Women should start having Pap tests three years after becoming sexually active and no later than age 21. How often tests are done depends on the type of test, your personal risk factors, and your medical history.  Skipping Pap tests raises your risk for invasive cervical cancer.
Of note: You'll still need Pap tests after getting the HPV vaccine because it doesn't prevent all cervical cancers.

What If Your Pap Test Is Abnormal?
If test results show a minor abnormality, you may need a repeat Pap test. Your doctor may schedule a colposcopy -- an exam with a lighted magnifying device -- or biopsy to get a better look at any changes in the cervical tissue. If abnormal cells are precancerous, they can then be removed or destroyed. Treatments are highly successful in preventing precancerous cells from developing into cancer.

Early Detection: HPV DNA Test
In some cases, doctors may offer the option of the HPV DNA test in addition to a Pap test. This test checks for the presence of high-risk forms of HPV. It may be used in combination with a Pap test to screen for cervical cancer in women over 30. It may also be recommended for a woman of any age after an abnormal Pap test result.

Diagnosing Cervical Cancer: Biopsy
A biopsy involves the removal of cervical tissue for examination in a lab. A pathologist will check the tissue sample for abnormal changes, precancerous cells, and cancer cells. In most cases, a biopsy takes place in a doctor's office with local anesthesia. A cone biopsy allows the pathologist to check for abnormal cells beneath the surface of the cervix, but this test may require general anesthesia.

Stages of Cervical Cancer
Stage 0 describes cancer cells found only on the surface of the cervix.  More invasive cancers are separated into four stages. Stage I is when the cancer has not spread beyond the cervix. Stage II means the tumor has spread to the upper part of the vagina. A Stage III tumor extends to the lower part of the vagina and may block urine flow. In Stage IV, the tumor has reached the bladder or rectum, or cancer cells have spread to other parts of the body and formed new tumors.

Treatment: Surgery
If the cancer has not progressed past Stage II, surgery is usually recommended to remove any tissue that might contain cancer. Typically this involves a hysterectomy, the removal of the cervix and uterus as well as some of the surrounding tissue. The surgeon may also remove the fallopian tubes, ovaries, and lymph nodes near the tumor.

Treatment: Radiation
External radiation therapy uses high-energy X-rays to kill cancer cells in a targeted area. It can also help destroy any remaining cancer cells after surgery. Internal radiation, or brachytherapy, uses radioactive material that is inserted into the tumor. Women with cervical cancer are often treated with a combination of radiation and chemotherapy. Side effects can include low blood cell counts, feeling tired, upset stomach, nausea, vomiting, and loose stools.

Treatment: Chemotherapy
Chemotherapy uses drugs to reach cancer wherever it is in the body. When cervical cancer has spread to distant organs, chemotherapy may be the main treatment option. Depending on the specific drugs and dosages, side effects may include fatigue, bruising easily, hair loss, nausea, vomiting, and loss of appetite.

Coping With Cancer Treatments
Cancer treatments may make you tired or uninterested in food. But it's important to take in enough calories to maintain a healthy weight. Check with a dietitian for tips on eating well during cancer treatment. Staying active is also important. Gentle exercise can increase your energy while reducing nausea and stress. Check with your doctor to find out which activities are appropriate for you.

Cervical Cancer and Fertility
Treatment for cervical cancer often involves removing the uterus and may also involve removing the ovaries, ruling out a future pregnancy. However, if the cancer is caught very early, you still may be able to have children after surgical treatment. A procedure called a radical trachelectomy can remove the cervix and part of the vagina while leaving the majority of the uterus intact.

Survival Rates for Cervical Cancer
The odds of surviving cervical cancer are tied to how early it's found. Depending on the stage, between 93% and 15% of women will survive for at least five years after diagnosis. Keep in mind that these numbers are based on women treated between 2000 and 2002. The treatments and outlook may be better for those diagnosed today. And statistics don't predict how well any one individual will respond to treatment.

Vaccine to Help Prevent Cervical Cancer
Vaccines are now available to ward off the two types of HPV most strongly linked to cervical cancer. Both Cervarix and Gardasil require three doses over a six-month period. Studies suggest the vaccines are effective at preventing chronic infections with the two types of HPV that cause 70% of cervical cancers.  Gardasil also protects against two types of HPV that cause genital warts.

Who Should Get the HPV Vaccine?
The vaccines are only used to prevent, not treat, HPV infection. They are most effective if administered before an individual becomes sexually active. The CDC recommends girls get an HPV vaccine series when they are 11 or 12.  It can also be given as a catch-up vaccine for girls and women from ages 13 to 26.

Read More

The Best and Worst Beverages for Weight Loss

Skinny Sipping: Drink Pounds Away
Many of us watch what we eat but not what we drink when on a diet. That’s a mistake. The average American gets a fifth of daily calories from beverages. Choosing the right drinks can tweak your metabolism, curb your appetite, and reduce your total calorie count. Which drinks are spoilers and which are helpers on the path to weight loss?

Spoiler: Soda
Every time you chug a bottle of soda, you’re consuming hundreds of empty calories. Switching to diet soft drinks is an obvious way to cut calories, but the research is mixed on whether this switch results in weight loss. Some studies show a short-term benefit. Others find diet soda drinkers gain weight. If your calorie intake exceeds what you burn off, just switching to diet soda may not do the trick.lpers on the path to weight loss?



Helper: Water

Replacing carbonated soft drinks with water will cut hundreds of calories per day, and the benefits don’t stop there. Drinking two glasses of water before a meal may encourage the stomach to feel full more quickly, so you don’t eat as much. In addition, new research suggests drinking plenty of water may have a positive effect on your metabolism.

Jury’s Out: Fruit Juice
Juice can have as many calories as soda, but it has far more to offer in the way of nutrients. This presents a dilemma -- you want the vitamins and antioxidants without all the extra sugar. The safest bet: Look for 100% fruit juice. Steer clear of juice drinks that have added sweeteners. Look for the percent of real juice, noted on the nutritional label. You can also slash calories by drinking water with a tiny bit of juice added.

Helper: Vegetable Juice

Vegetable juice is every bit as nutritious as fruit juice with about half the calories. One cup of tomato juice has 41 calories, compared to 122 calories for orange juice. Choosing juice with pulp provides some fiber, too, which can help control hunger.

Jury’s Out: Smoothies
Blend a banana, strawberries, and blueberries into a frothy smoothie, and you’ve got a delicious arsenal of disease-fighting vitamins and minerals. The homemade variety is best when you’re counting calories, because you can control the ingredients -- skim milk and fresh or frozen fruit are all you need. Restaurant smoothies may contain ice cream, honey, or other sweeteners that boost the calorie count sky-high.

Jury’s Out: Low-Fat Milk
Eating calcium-rich foods may do a body good, but calcium probably won't help you  lose weight, new research now reveals. Some earlier studies suggested calcium may prompt the body to burn more fat, but there’s little evidence to support these claims. To get the benefits of calcium without getting extra fat, stick to skim or low-fat milk, yogurt, and cheese.

Spoiler: Energy Drinks
Sports and energy drinks are calorie bombs like soda. They may have more added nutrients, but you can find the same vitamins and minerals in low-calorie foods. People who are serious about losing weight should stay hydrated with water rather than sports drinks.

Helper: Black Coffee
When you need a shot of caffeine, coffee is a better choice than soda or energy drinks. Black coffee is calorie-free and rich in antioxidants. Studies have shown that consuming moderate amounts of coffee (about 3 to 4 cups a day) may improve mood and concentration, and reduce the risk of type 2 diabetes and several types of cancer.

Spoiler: Fancy Coffee
Once you add heavy cream, flavored syrups, and/or a snowcap of whipped cream, that innocent mug of black coffee becomes a minefield of fat and sugar. Specialty coffees can contain up to 570 calories per cup -- possibly more than an entire meal! If you don’t like your coffee black, add a little skim milk and artificial sweetener to keep the calorie count low.

Helper: Green Tea
Green tea is another excellent choice when you’re looking for a little caffeine. Not only is it calorie-free, some research suggests green tea extract may stimulate weight loss.  It's not clear exactly how it aids weight loss, though caffeine and micronutrients called catechins may each play a role. The benefit appears to last only a few hours, so it may help to drink green tea at least twice a day.


Spoiler: Coolers
Coolers may sound light and airy, but they are heavy on calories. A 12-ounce cooler containing wine can have 190 calories and 22 grams of carbs. The same size hard lemonade or bottled alcoholic "ice" can have as much as 315 calories. Regular wine is not exactly a diet drink, with 100 calories in a 5-ounce glass. A low-calorie alternative is a wine spritzer: mix a dash of wine with some sparkling water.

Spoiler: Cocktails
A shot of hard liquor has fewer calories than wine or wine coolers, but once you mix in soda or cream, watch out… An 8-ounce white Russian made with light cream has 715 calories. A less fattening option is to mix rum or vodka with diet soda.

Helper: Light Beer
OK, beer is not really going to help you lose weight. But if you’re out with friends and want to share a pitcher, light beer is the way to go. A 12 oz serving has about 100 calories, compared to 150 calories for regular beer.

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Active Living with Osteoarthritis

Reviewed by Louise Chang, MD
Sources: © 2011 WebMD


Ride a Bike

Biking -- in a group or alone, outside or on a stationary bike -- builds stamina and balance with less impact on knees, hips, and other joints than walking or jogging. Recumbent and comfort bikes can provide relief for people who are uncomfortable on upright bikes. If you have a medical condition, check with your doctor before starting any new fitness program. Depending on your condition and health, some exercises may not be recommended.

Practice Yoga

Yoga is a gentle way to improve posture, balance, and coordination. Several early studies suggest yoga helps the physical functioning of people with arthritis and promotes relaxation. Look for a beginners' class and explain any physical limitations you have to the teacher. Once you're comfortable with the poses and breathing, you can also practice yoga at home.

Exercise in Water

Swimming, water walking, and other water-based exercises are ideal for relieving the pain and stiffness of arthritis. The resistance provided by water increases strength and range of motion, while its buoyancy supports the body's weight, reducing stress on joints. Water workouts can be as strenuous as swimming laps or as gentle as a game of tag in the shallow end.

Add Short Bursts of Activity

Physical activity in small amounts really adds up. Vacuuming or 10 minutes of pruning may be easier to incorporate into a busy day than an hour of exercise. Always try to use correct posture -- such as standing rather than stooping -- and let your larger joints handle as much of the work as possible. To track your activity, wear a pedometer and record how many steps you take each day.

Set a Goal

Commit to a greater level of training by signing up for a 5K walk, bike ride, or other organized event. Registering for an event increases your commitment and motivation to train. It may give you extra motivation to join events that support causes you may believe in, such as arthritis research. Be sure to give yourself enough time to train. Work backward from the event to set specific, realistic training goals.

Try Tai Chi

Studies suggest that tai chi, a traditional Chinese martial art, reduces pain and stiffness in many arthritis patients. Tai chi combines slow, gentle movements with a mental focus. It can be practiced in groups or alone. Participants in these studies also reported improved balance and lower levels of depression.

Maintain Sexual Intimacy

Pain from arthritis can affect every part of life, including sexuality. But a fulfilling sex life is possible. Plan for sexual activity during times when you feel rested, avoid cold temperatures, use pillows to support painful joints, and relax muscles and joints with massage. Communicate openly with your partner and strive for emotional and physical closeness.

Walk the Dog

Take your four-legged friend when you run errands on foot or head out for a lunchtime stroll. Walking the family pet around the block can deliver a low-impact, inexpensive workout. Walking can reduce stiffness, increase bone mass, increase energy, improve mood, and reduce anxiety.  Try to accumulate at least 150 minutes a week. This could include 30 minutes of walking or any other moderate-intensity "lifestyle" activity, three to five days a week.

Take a Hike

At home or on vacation, hiking is an active way to explore the outdoors. Vary the trails you use, from short and strenuous to long and gentle. Activities like hiking are essential to managing the physical symptoms of arthritis, but they have other benefits, too. Exercise improves sleep and helps combat the stress and depression that can accompany arthritis.

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Anger, Stress May Provoke Heart Attacks

Angry Heart Attack Survivors More Than Twice as Likely to Have Another Heart Attack, Study Finds
By Charlene Laino
WebMD Health News Reviewed by Laura J. Martin, MD

Aug. 31, 2011 (Paris) -- Heart attack survivors who anger easily or who are often stressed out may be setting themselves up for another, potentially fatal heart attack, a new study suggests.

Over a 10-year period, more than half of heart attack survivors who had high scores on psychological tests designed to identify people with anger problems had a fatal or non-fatal heart attack, compared with fewer than one-fourth of people who had low scores.

"People with a high score on the anger scale were 2.30 times more likely to have [another heart attack] in comparison with those with a low score on the same scale," says researcher Franco Bonaguidi, DPsych, of the Institute of Clinical Physiology in Pisa, Italy.

Similarly, heart attack survivors who scored high on the stress scale were 1.90 times more likely to have another heart attack, compared with those who had low scores, he tells WebMD.

The analysis took into account known risk factors for heart disease, such as age, gender, high blood pressure, and high cholesterol.

The study involved 228 people who had had a heart attack, 200 of whom were men. Over the 10-year course of the study, 51 people had another heart attack, 28 of whom died.

The findings were presented here at the European Society of Cardiology annual meeting.

Anger a Primitive Emotion

"Anger is a primitive emotion that cannot be switched off at will," Bonaguidi says. "It can have a constructive function when it comes to overcoming obstacles and reach certain objectives."

Beyond a certain point, however, or in people who are already vulnerable to heart disease, "anger can trigger unfavorable physiological changes and can contribute to self-destructive behaviors and food and alcoholic addiction," Bonaguidi says.

The good news: People can change their behavior, he says.

American College of Cardiology Vice President John Harold, MD, a heart specialist at the University of California, Los Angeles, says the findings reflect what he sees in his own practice.

"When a heart attack patient comes in and exhibits anger or turns beet red or is stressed out, I can almost predict [that they are not going to do well] if they don't change their behavior," he tells WebMD.

Harold says he often prescribes an ocean cruise for such patients. His point is relaxation may help their health.

Other advice: If a family argument or other stressful situation is getting out of hand, walk away, Harold says. "It's just not worth it."

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Sugary Drink Habit Is Widespread in U.S.

Survey Shows Teens and Young Adults Drink the Most Sugary Drinks
By Kathleen Doheny
WebMD Health News Reviewed by Laura J. Martin, MD

Aug. 31, 2011 -- Half of the U.S. population age 2 or older indulges in sugary drinks on any given day, new research finds.

"Men drink more than women, and teens and young adults drink the most," says Cynthia L. Ogden, PhD. Ogden is an epidemiologist at the CDC's National Center for Health Statistics.

The American Heart Association recommends drinking no more than 450 calories a week of sugar-sweetened drinks. That's less than three 12-ounce colas. In 2010, U.S. dietary guidelines recommended limiting the intake of both foods and beverages with added sugars.

Overall, men and boys drink an average of 175 calories from sugary drinks a day. That is more than one can of cola. Women and girls drank about 94 calories a day. That is less than one cola a day.

Sugary drink intake in the U.S. has increased over the last 30  years. Sugared beverages have been linked with weight gain, obesity, poor diet, and, in adults, type 2 diabetes.

The CDC report, "Consumption of Sugar Drinks in the United States, 2005-2008," was issued today.

Sugary Drink Intake: The Numbers

Ogden  looked at data from the 2005 to 2008 National Health and Nutrition Examination Survey (NHANES). This survey asks a sample representative of the U.S. population to tell what they ate and drank during a 24-hour period. It includes those who drink sugary drinks and those who do not.

Sugary drinks as defined for the analysis included fruit drinks, sodas, energy drinks, sports drinks, and sweetened bottled waters. Diet drinks, 100% fruit juice, sweetened teas, and flavored milks were not classified as sugary drinks in the study.

Among the other findings:

• Boys age 2 to 19 drink the most, with 70% drinking sugary drinks on any given day.


•  Adult women, overall, drank less, with 40% drinking sugary drinks on any given day.


• Teen boys averaged 273 calories a day from sugary drinks; teen girls, 171. Men 20 to 39 averaged 252 calories a day. Women in that age range averaged 138 calories.


• Five percent of the population drinks at least 567 calories from sugary drinks a day. That is more than four 12-ounce colas.

Low-income people take in more calories from sugary drinks as a percentage of daily calories than those with higher income. Non-Hispanic black and Mexican-American adults have a higher percentage of calories from sugary drinks than do white adults. One surprise, Ogden says, is that ''over half, 52%, of sugar drinks are consumed at home." She thought people would be more likely to drink them at restaurants.

She is not certain whether the intake of sugary drinks has declined since the 2010 guidelines were issued. There is new data from 2009 and 2010, she says, but it has not yet been evaluated.


Beverage Industry Reaction

Sugar-sweetened drinks ''are not driving health issues like obesity and diabetes," according to a statement issued in response to the report by Chris Gindlesperger of the American Beverage Association, an industry group.

The group points to a July 2011 study published in the American Journal of ClinicalNutrition. It showed that Americans took in nearly a quarter less added sugars in 2008 compared to 1999. That decline, according to the study, was mostly the result of people drinking less soda.

The new report did not look at these trends, but only at a snapshot in time, according to Ogden. There is not an identical NCHS report of sugared beverage intake on a given day from 2001 to 2004.

The statement by the industry group also says: "Moreover, the total number of calories from beverages that our member companies have brought to market decreased by 21 percent from 1998 to 2008, according to Beverage Marketing Corporation data."

This is due, the group says, to bringing more no-calorie and low-calorie options to market.

"Balancing calories from all foods and beverages with those burned through physical activity and exercise is essential to maintaining a balanced, active and healthy lifestyle," the group says.

Campaign to Reduce Sugar Drink Intake

A new campaign to help lovers of sugar drinks reduce their habit is being launched today by the Center for Science in the Public Interest.

It is called "Life's Sweeter with Fewer Sugary Drinks."  It will include city public health departments and organizations such as the American Heart Association and the American Diabetes Association, says Jeff Cronin, a spokesman.

The goal, he says, is to decrease intake of soda and sugary drinks down to the American Heart Association recommendation of fewer than three cans per person per week.

Among the cities signing on, he says, are Boston, Chicago, and Los Angeles. Some cities already have launched programs.

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