Short pieces from a column called Health Briefs that I produced for Newsweek magazinefor six years:

LOSING WEIGHT It's All in the Snacks 

Most people see losing weight as a 24/7 battle against fat, calories and overeating--in other words, a battle they're sure to lose. But a new survey by Nutricise, an online weight-loss program (nutricise.com), suggests that skirmishes may work better than all-out war. Nearly all the 400 people surveyed said they usually overate at the same time every day. Just under a third tended to wolf down goodies in the afternoon; more than a third gorged during prime-time television hours. Candies, cookies and doughnuts were the main temptations, providing many noshers with 300 to 500 calories per snack.

With a target that fat, you don't have to change your whole diet to lose weight. Suppose you could shave just 100 calories out of the daily indulgence--by forgoing a cookie or a third of a candy bar, or by substituting frozen yogurt for premium ice cream. If you persevered, you would lose approximately 10 pounds over the course of a year, even while leaving the rest of your diet alone. Small sacrifice, big return.

SURGERY How to Ensure Your Transplant Is Safe

Last December a 23-year-old Minnesota man died from an infection he contracted during a routine knee operation. It seems the cartilage grafted onto his knee came from a rotten corpse. Since then federal health officials have uncovered 25 similar infections, including another fatal one. Are tissue grafts inherently risky? Dr. Gary Friedlaender, a surgeon at Yale and a spokes-man for the American Academy of Orthopaedic Surgeons, notes that 800,000 grafts are performed each year, with very few problems. If you're receiving a tissue graft, ask your surgeon to confirm that the supplier is accredited by the American Association of Tissue Banks. A list of safe companies is posted at aatb.org.

AGING Can Low Cholesterol Salvage Your Brain?

We know how to ward off heart disease, but what about dementia? Early evidence suggests that aspirin, estrogen and mental exercise can help. Now comes a hint that lowering your cholesterol is yet another way to preserve your wits. In a four-year study involving 1,037 postmenopausal women, University of California, San Francisco, researchers found that cognitive problems were twice as likely in those with the highest cholesterol levels as in those with the lowest levels. There are many ways to interpret such a finding, but for anyone hoping to preserve mental clarity, the simplest take is probably the safest: better low than slow.

CYBERKIDS How to Save Their Eyes

Too much software may lead to eye wear. That's the conclusion of a new study from the University of California, Berkeley, which examined whether children develop eye problems from staring for hours at computer screens. The study found that one in four keyboard kids suffers from "computer vision syndrome" serious enough to benefit from an eye exam. The syndrome causes blurry vision and dry eyes, says Pia Hoenig, the optometrist who led the study, and may hasten the onset of nearsightedness. To avoid problems, kids should keep their screens slightly lower than eye level and sit at least 18 inches away (the farther the better). If needed, a child can get glasses designed to reduce computer eye strain. Just don't say the word "nerd."



Health: Tricking Knee Pain: A new study questions effectiveness of arthroscopic surgery.

You sign up for a clinical trial of arthroscopic surgery used to relieve knee pain caused by arthritis. You're sedated and wake up with tiny incisions. Soon your bum knee feels better. Two years later you find out you had "placebo" surgery. In a study at the Houston VA Medical Center, researchers divided 180 patients into three groups: two groups had damaged cartilage removed, while the third got simulated surgery. Yet an equal number of patients in all groups felt better after two years. Some 650,000 people have the surgery annually, but they're wasting their money, says Dr. Nelda P. Wray, who led the study. And the patients who got fake surgery? "They aren't angry at us," she says. "They still report feeling better."

Briefcase: Updates on the latest medical treatments.


HERBAL REMEDIES Depressing Results

Last year Americans bought about 165 million doses of St. John's wort, an herb commonly used to treat depression. A double-blind trial of 340 people run by Duke University Medical Center might cut into those sales. Researchers compared the effects of St. John's wort (900 to 1,500 milligrams daily) with the antidepressant Zoloft (50 to 100mg daily) and a placebo in people with major depression (other studies suggest the herb alleviates minor depression). While Zoloft had a slight positive effect, St. John's wort was even less effective than the placebo, according to the study in last week's Journal of the American Medical Association. Studies have also found that St. John's wort can have bad interactions with drugs used to treat HIV/AIDS and some heart conditions, as well as drugs that prevent organ-transplant rejection.


JOINTS Replacing Knee Replacement Surgery?

As many middle-aged joggers know, the knees can be a very weak link. Each year more than 2 million Americans damage the cartilage that keeps the two main knee bones from rubbing. While there are various ways to repair the joint, major surgery to install an artificial knee is often the best choice. But a new kidney-shaped disc made of a composite called cobalt chrome might help people postpone that surgery for years, while allowing them to continue running and jumping. The UniSpacer Knee System is designed to replace damaged cartilage. In an hourlong surgery, the spacer is set between the knee bones, where friction holds it in place. About 400 spacers have been installed so far, with no unusual complications.

CHOLESTEROL The Statin Supplement

Statin drugs like Lipitor and Mecavor are the standard treatment for high cholesterol. But noted cardiologist and nutritionist Dr. Stephen Sinatra has new and controversial advice on dealing with their dark side. Last year the widely cited, largest-ever study of cholesterol-lowering drugs called statins "safer than aspirin." While Sinatra agrees that the drugs can significantly lower the risk of heart problems, he's concerned they can interfere with a coenzyme called Q10 that's essential to the heart muscle.

Sinatra gives statins to people who've had heart surgery or a heart attack and can't lower their cholesterol naturally. He also prescribes statins to reduce high C-reactive-protein levels, which are a newly recognized marker for heart disease. Sinatra tells his statin patients to take coenzyme Q10 to offset any loss from the statins, but he advises people at less risk to lower their cholesterol with nutrition and exercise. The American Heart Association says more research is needed to determine coenzyme Q10's safety or usefulness.

Does the popular herb echinacea really fight colds? Researchers at the Medical University of South Carolina recently assayed a common brand of echinacea to be sure it contained cichoric acid, considered one of the herb's main healing components. Fifty people took the herb for two weeks, and 42 took a placebo. The researchers then dripped active cold virus into everyone's nostrils. Both groups suffered equally fierce colds, confirming earlier studies that deemed the herb ineffective. While the researchers hope to test other chemicals in the herb, they are skeptical. Best to leave this plant, also called coneflower, to the butterflies.

 

Can aspirin help ward off heart attacks? Yes, if you already have heart problems. But for other people, the popular regimen may do more harm than good. In a recent study, British researchers followed 5,500 men with no known heart ailments. Regular doses of aspirin may have reduced the risk of heart attack in people with systolic blood pressure of less than 130--but those with higher pressure clearly didn't benefit. Since chronic aspirin use can lead to internal bleeding and hemorrhagic stroke, experts say people with no history of heart disease should not use it prophylactically in any case. Exercising, quitting smoking and lowering your blood pressure and cholesterol are surer ways to keep your heart going strong.

MIGRAINES Beautiful Pain Relief

Here's a painless way to look good. Many dermatologists have found that the Botox they use to erase wrinkles also prevents migraines. Botox is a purified derivative of the same toxin that causes botulism, and it's been used safely for several years to paralyze the facial muscles that cause forehead wrinkles and frown lines around the mouth. Dr. Richard Glogau, a dermatologist in San Francisco, says that 75 percent of his migraine-prone patients enjoy roughly three months of headache relief whenever Botox is injected into their foreheads. Other physicians are reporting similar experiences. Though the mechanism of action is unknown, preliminary studies have achieved success rates of 50 to 60 percent. No one is yet recommending that all migraneurs visit their dermatologists, and more studies are underway. But people whose skull-splitting headaches don't respond to other treatments may want to give this one a shot.

WARTS Microbe vs. Microbe: Candida Can Do It 

Most warts are harmless viral eruptions that disappear within two years. But since many people hate to see brown cauliflower sprouting from their skin, doctors often burn or freeze the growths away. Unfortunately, these treatments cause pain and scarring, and the warts often return. A new report in the Archives of Dermatology suggests another approach. Researchers led by Dr. Terry Ruhl of Altoona, Pa., followed 149 people whose warts were injected up to three times with dead candida, the fungus that causes yeast infections. The candida triggers an immune response that seems to destroy warts for good, leaving no scars. No wonder 76 percent of the patients were "very happy" with the results.

SMOKING A Web Site That Will Get You Off Your Butts 

Some people say quitting cigarettes is harder than kicking heroin. A new Web site, , could help put the junkies back on top. This interactive site helps you define your goals (one pack a week? not a puff?) based on your reasons for wanting to quit (can't smoke at work? want to climb a mountain?). That done, you choose a withdrawal method that suits you, from drugs (for those who fear the distress of withdrawal) to going cold turkey (for the highly motivated). The site charts your progress and offers suggestions, based on your daily reports. Sure, you can light up while you're online filling out the questionnaires. But will you want to? As the site says, the very fact that you're considering this plan suggests you're ready to take control of your health.

SKIN CANCER Pigment in a Tube 

Melanin, the natural pigment that protects our skin from the sun's damaging rays, is now available at the cosmetics counter. Dermablend's Reflection cosmetics contain a synthetic melanin, called Melasyn, that not only conceals scars and other blemishes but may help guard against skin cancer. First synthesized from the aloe vera plant by John Pawelek, a Yale skin-cancer researcher, Melasyn reflects a person's natural skin color to create an even tone. Pollack says that Melasyn, like real melanin, also blocks UV rays and is a powerful antioxidant. No one has proved that it wards off tumors, but it does look nice.

 

DEPRESSION Sweating It Away 

Deep depression can make it hard to get off the couch, but preliminary evidence suggests that exercise may be a powerful remedy. Last year, in a study of 56 severely depressed people, Duke University scientists found that three 30-minute workouts each week brought as much relief as drug treatment. A follow-up study, published in this month's Psychosomatic Medicine, suggests exercise may also ward off recurrences. Nearly 40 percent of patients relying on drugs were stricken again within six months, versus 8 percent of those sticking to exercise. The researchers say exercise may work by improving one's sense of control. If you're on medication, don't assume you can toss it. Just don't take it sitting down.

NUTRITION Heartier Grains, 

Fewer Strokes From white rice to cake flour, Americans have a soft spot for highly processed cereal grains. We also have a weakness for strokes, which kill 160,000 of us each year and deprive thousands of speech and mobility. New research, published last week in The Journal of the American Medical Association, suggests there may be a connection. Researchers led by Dr. Simin Liu of Harvard Medical School analyzed stroke rates among 75,521 healthy U.S. women who were followed for 12 years as part of the ongoing Nurses' Health Study. Those who averaged even 2.7 servings of whole grains each day (the government recommends 3) were nearly 43 percent less likely to suffer a stroke, regardless of their other risk factors, than were those with the lowest consumption. Rye doughnut, anyone?

WEB WATCH Skin Flick

Skinema.com is the kind of site that can make you swoon (over Marilyn Monroe's mole) or gasp (at Mark Wahlberg's extra nipple). Never before have dermatology and movie trivia been combined with such clarity and vision. Hats off to Dr. Vail Reese, a dermatologist in San Francisco, for collecting enough movie stills to illuminate everything from hirsutism (Reese explains that laser therapy could help the hairy sorceress in "The Blair Witch Project") to pockmarks (even Elizabeth Hurley has a few) and other imperfections (what's that on Gwyneth Paltrow's forehead in "Duet"?). The site offers links to a number of medically useful resources. And you'll find some sobering examples of how too much time in the sun can spoil your Rodeo Drive looks.

CANCER TREATMENT A Better Beam 

Scientists at California's Lawrence Livermore National Laboratory are well versed in nuclear war. Now their knowledge is finding uses in the cancer ward. Each year about 120,000 Americans die from tumors that should be curable with radiation therapy. Because radiologists can't confine the damaging energy to cancerous cells, they're often unable to administer the needed doses. The Livermore system, known as Peregrine, allows radiologists to deliver higher doses to far more specific areas. The federal lab has licensed the design to a Pennsylvania firm called NOMOS, which will announce this week that it has won FDA approval to sell the technology to hospitals.

 

Stephen P. Williams