April 7, 2011 -- DNA may play a large role in determining how much caffeine people consume in beverages such as coffee, tea, and soda and food such as chocolate, new research indicates.
Scientists from the Harvard School of Public Health, the National Cancer Institute, and other institutions say they have discovered two genetic variations that influence the metabolism of caffeine and are associated with how much caffeine people consume. People with particular variations of two specific genes are more likely to consume caffeine, and to drink more of it when they do, study leader Marilyn C. Cornelis, PhD, of the Harvard School of Public Health, tells WebMD.

Genes and Coffee

The genes are identified as CYP1A2, long known to play some role in caffeine metabolism, and another called AHR, which affects regulation of CYP1A2.
All people have both genes, but the study, involving more than 47,000 middle-aged Americans of European descent, finds that people with the highest-consumption variant for either gene consumed about 40 milligrams more caffeine than people with the lowest-consumption gene varieties. Forty milligrams is the equivalent of 1/3 cup of caffeinated coffee or one can of soda.
Cornelis says her own father may carry the variations that correspond to higher caffeine consumption because he drinks “at least 10 cups” daily.
“He’s not trying to achieve pleasurable effects,” she tells WebMD. “Rather, he’s trying to maintain levels as a means to avoid the withdrawal symptoms. Without a cup he’d wake up in the middle of the night with a headache.”
That suggests he “could possibly have the genetic profile of a fast caffeine metabolizer,” she says in an email.
The researchers say it’s likely that genetics plays a major role in other behaviors, such as alcohol consumption and smoking.

Coffee Consumption

The researchers say in a news release that their conclusions are based on an analysis of five studies conducted between 1984 and 2001. Average caffeine consumption via coffee, tea, caffeinated sodas, or chocolate was recorded.
About 80% of the caffeine intake among participants involved in the analysis was from coffee, similar to the adult caffeine consumption in the U.S. “We propose that those with the genotype corresponding to ‘higher caffeine consumption’ are metabolizing caffeine at a different rate vs. those with the ‘lower caffeine consumption’ genotype, and so require a different level of intake to maintain or achieve physiological caffeine levels that produce pleasurable effects,” Cornelis tells WebMD.
So what does this mean?
“Clearly these genetic variants are affecting how our body processes caffeine,” she tells WebMD.
Caffeine is implicated in a number of medical and physiological conditions. Caffeine affects mood, sleep patterns, energy levels, and mental and physical performance.
“Caffeinated products, particularly coffee, have long been implicated in various health conditions.”
She says that “studying the effects of caffeine, say, on the cardiovascular system, would be challenging if the group of subjects we’re studying process caffeine differently.”

More ‘Caffeine Genes’ May Be Identified

This genetic knowledge could be used “to advance caffeine research and potentially identify subgroups, defined by genotype, of the population most susceptible to the effects of caffeine,” Cornelis tells WebMD. “More research on the precise function of these variants is needed, however, and there are likely more ‘caffeine genes’ to be identified.”
She tells WebMD that her team’s findings “demonstrate that our search approach -- scanning the entire human genome -- works.”
Also, it shows for the first time that genetics may be responsible for inherited differences in how people drink coffee.
The study is published in the April issue of PLoS Genetics.

WebMD Answers Your Health Questions About Government Shutdown

Which health services will continue? Which won't?

Most government health services are administered by the Department of Health and Human Services. During the government shutdown, 62% of HHS employees will not be allowed to work.
The remaining 38% of HHS employees will continue to administer programs that involve the safety of human life and protection of property, as well as programs that pay for themselves.
HHS shutdown plans remain sketchy, but here's a rundown of how the shutdown affects HHS services:

• Medicare and Medicaid: If the shutdown last only a few weeks, Medicare and Medicaid coverage of medical care and prescription drugs will continue. However, funds could run out before the end of the summer if there is a continued shutdown. And it's not clear whether doctors would get paid during a shutdown, so some doctors may decide to stop taking Medicare/Medicaid patients. The Medicare hotline would continue, but staffing cutbacks will mean longer wait times. Health care fraud and abuse teams will not work.
• National Institutes of Health: The NIH Clinical Center will continue to direct patient care and clinical trials, but only for current patients and studies already under way. It will serve about 90% of its normal patient load. No new patients will be accepted; new clinical trials will not start. No new medical research will be funded. The NIH will continue to feed and protect all animals in its care.
• FDA: The FDA will continue to review imports offered for entry into the U.S.
• Indian Health Service: The IHS will continue to provide direct clinical services and referrals for contracted services.
• Health Resources and Services Administration: Health Centers will continue to pay grantees for services. HRSA grants provide health care to uninsured people, people living with HIV/AIDS, and pregnant women, mothers, and children. It also supports rural health care and oversees blood and organ donation.
• The Administration for Children and Families: Many ACF programs will continue for the time being. These include support to states for foster care, adoption assistance, and child support enforcement.
• Substance Abuse and Mental Health Services Administration: SAMHSA would continue the national Suicide Prevention Hotline.
• CDC: The CDC will continue global health programs abroad, such as Haiti cholera relief, that are funded by prior-year appropriations. Epidemic intelligence officers will continue surveillance for disease outbreaks, but a wide range of CDC-supported activities will not continue.

The Veterans Administration is a major source of government supported health care. Here's how the shutdown affects the VA:

• All VA clinics and medical facilities will remain open, including prescription services.
• No new Educational and Vocational Rehabilitation benefit claims will be accepted.
• The Board of Veterans Appeals will be closed.
• There will be no new VA hiring, staffing, or training.
• The National Cemetery Administration will slow down military burials and will not process applications for Presidential Memorial Certificates.

How to Make Your Home a Skinny House

From Health magazine
When you think about what causes pounds to creep on, an immediate list of usual suspects comes to mind: junk food, skipped workouts, supersize portions. But you might want to add your house to that fat list. “Everything from the lighting in your dining room to the size of your dinnerware could be making you gain weight,” says food psychologist Brian Wansink, PhD, author of Mindless Eating: Why We Eat More Than We Think. You can think of it this way, though: If your home can make you gain, it can help you lose, too.

Here, Health’s natural-foods chef and columnist Bethenny Frankel shows you the best ways to slim down your space—from the moment you walk in the door until you hop into bed. Use these expert tricks to make your home way more diet-friendly.

7 Essentials for the Dieter's Kitchen

Stock your kitchen cabinets with these seven calorie savers, and you'll see the scale start to move in no time.

Immersion blender
Dieters still want comfort foods—just not the calories that come with them. A handheld blender lets you whip up thick soups and hearty stews with minimal ingredients (and very little cleanup). I like to blend zucchini, butternut squash, or broccoli with either chicken broth or skim milk for a quick soup dinner. Or, use the immersion blender to make dressings and marinades, like in this recipe for Grapefruit-Avocado Salad.

Ramekins
I'm sure you've heard of the Small Plate Movement. I use one of these guys every single day to portion out trail mix, nuts, chips, ice cream—you name it!

Istockphoto


Microplane grater
Sprinkling a dish with grated Parmesan is a great way to get a lot of flavor—but not a lot of fat. Skip the jarred variety, and splurge on a small wedge of fresh cheese for a more intense taste.

Ice-cream scooper
Do you have a hard time visualizing proper serving sizes? Here's an easy way to cheat: Use ice-cream scoopers to serve up sides like rice. I also like to use one to portion ground turkey meat into burgers.

Mini-muffin tin
These are another great way to keep portions in check—and you shouldn't limit these tins to just muffins. I like to whip up individual frittatas, quiche, stuffing, or souffles.

Parchment paper and aluminum foil
Chances are you already have a roll of each lying around, so put them to good use. I fill a parchment pouch with fish and a few veggies, then pop it in the oven or on the grill. And I use aluminum foil to make flavorful roasted veggies. Not only does it make for easy cleanup, but also using this method lets you cook with less oil, so you wind up saving calories.

Mustard
Most of my favorite dips call for at least a cup of mayonnaise, but any good dieter knows that's one big fat trap. Instead I opt to add a tablespoon or two of mayo, then I supplement the rest with mustard. You wind up with a tangier dish that's better for your figure.

Party This Summer Without Putting on the Pounds

Want to enjoy that block party or backyard barbecue but don't want to stretch the waistline of your capris? Naturally Thin author Bethenny Frankel shares her tips for partying without putting on the pounds:

Eat in slow-mo. "Everyone thinks I eat like a horse, because I'm still eating when everyone else is done," says Bethenny. "But I just eat really slowly, which means I'm eating a lot less and enjoying it more."

Use the sandwich technique. This tip is from Susan B. Roberts, Ph.D., director of the Human Nutrition Research Center on Aging at Tufts University and author of The Instinct Diet: Use Your Five Food Instincts to Lose Weight and Keep It Off: Sandwich high-calorie foods between two high-fiber, lower-calorie foods, to trick your body into feeling fuller without gorging on the high-calorie treat. So start with something bulky and filling like a green salad with beans, then have an entree (like a small burger or BBQ chicken) and a small portion of a rich dessert, then end with something low-cal like fresh fruit.

Don’t be a light-food martyr. If you love ribs and know you're not going to be happy with a skinless chicken breast, says Bethenny, then have the ribs! It's better to have a small portion of something you really love than to make yourself miserable with the supposedly virtuous option—and end up noshing later when you don’t feel satisfied. "Skinny is a mindset," says Bethenny. "It's about enjoying yourself instead of obsessing about food.

5 Fabulous Cocktails Under 220 Calories

Skinny sips

Liquid calories are a dieter's worst nightmare, but it's hard to pass up a cool cocktail at a fancy fete. Bethenny Frankel's new book, The Skinnygirl Dish: Easy Recipes for Your Naturally Thin Life, is full of fabulously light, flavorful drink ideas. Check out these three sips from her book, plus two bonus recipes.

How to Healthy Up Cookies

Use these simple tips from celebrity natural-foods chef Bethenny Frankel to add a healthy boost to your favorite cookie recipes.

Add ground flaxseeds (try 1 tablespoon) to batter for more fiber and omega-3 fatty acids.

Experiment with different natural, healthy sweeteners, like honey and agave syrup instead of the sugar. You can also try this in other recipes that call for plain granulated sugar.

Use this cookie base (minus the last 3 ingredients) as a blank canvas for other flavor variations. So instead of using bananas, walnuts, and chocolate chips, try one of the following:
• raisins and a pinch of cinnamon
• dried blueberries with raw sugar sprinkled on cookies
• dried cranberries and 1/2 teaspoon orange extract
• slivered almonds and 1/2 teaspoon almond extract

Bethenny Frankel's Citrus Shrimp Cocktail

2 large shrimp +
1/4 of a cucumber, peeled and chopped +
1/4 of an avocado, cubed +
1/4 of a pink grapefruit, segmented +
1/4 of a lime, segmented =
Citrus Shrimp Cocktail

I love when a super-simple recipe comes off looking like a dish that took major time and effort to prepare. Just boil and peel shrimp, then split each in half. In a bowl, combine the remaining ingredients. Serve in a chilled martini glass topped with the shrimp

10 Small Diet and Exercise Tricks That Get Big Results

Small goals make a big difference

By Eric Metcalf

When it comes to type 2 diabetes, you need diet and exercise goals that encourage you to succeed—not ones that set you up to fail, says Ann Goebel-Fabbri, PhD, a psychologist and investigator at the Joslin Diabetes Center, in Boston.

"I think goals have to be small and well spelled out for people. Everyone has the experience of going to a health practitioner and being told something vague: 'You know, you really ought to lose weight.' What does that mean? Goals need to be broken down into small nuts and bolts," she says.

Next: First step: See where you stand now

Credit: Getty Images

26 Fresh & Juicy Strawberry Desserts

Strawberry-Buttermilk Sherbet

Blend buttermilk with your choice of fresh or frozen strawberries to create this creamy springtime treat. This simple recipe only takes 15 minutes to prep before going into the ice cream maker.

5 Surprising Things You Don’t Have to Buy Organic

Avocados

By Sara Reistad-Long

You’re pretty safe with fruits and vegetables like avocados, which have a thick skin that you don’t eat. Just remember to wash the peel before cutting into them to get rid of any residue.

Addiction to Food, Drugs Similar in the Brain

MONDAY, April 4, 2011 (Health.com) — Ice cream and other tasty, high-calorie foods would seem to have little in common with cocaine, but in some people’s brains they can elicit cravings and trigger responses similar to those caused by addictive drugs, a new study suggests.

Women whose relationship to food resembles dependence or addiction—those who often lose control and eat more than they’d planned, for example—appear to anticipate food in much the same way that drug addicts anticipate a fix, according to the study, which used functional magnetic resonance imaging (fMRI) brain scans.

When these women saw pictures of a chocolate milk shake, they displayed increased activity in the same regions of the brain that fire when people who are dependent on drugs or alcohol experience cravings. When presented with the same milk shake, women who don’t feel addicted to food showed comparatively less activity in those regions.

Once the women actually tasted the milk shakes, however, those who scored high on a food-addiction scale showed dramatically less activity in the “reward circuitry” of their brains than the other women—a phenomenon, also seen in substance dependence, that could lead to chronic overeating and other problematic eating behaviors, researchers say.

“It’s a one-two punch,” says the lead author of the study, Ashley Gearhardt, a PhD candidate in psychology at Yale University. “First, you have a strong anticipation, but when you get what you are after, there’s less of an oomph than you expected, so you consume more in order to reach those expectations.”

The study, which appears in the Archives of General Psychiatry, included 48 young women with a wide range of body sizes who had signed up for a program aimed at helping them control their weight and develop better eating habits.

Each of the women filled out a 25-item questionnaire, adapted from assessments for drug and alcohol dependence, in which they were asked how strongly they agreed with statements such as “I find myself continuing to consume certain foods even though I am no longer hungry” and “When certain foods are not available, I will go out of my way to obtain them.” They were also asked to identify any foods—from a list including ice cream, chocolate, chips, pasta, cheeseburgers, and pizza—that gave them “problems.”

Then the researchers brought on the milk shakes, made with four scoops of vanilla ice cream and chocolate syrup. While their brains were being scanned, the women were shown a picture of the milk shake to whet their appetite; five seconds later, they got to taste it. (As a comparison, each of the women was also shown a picture of a glass of water followed by a tasteless beverage.)

In addition to exhibiting patterns of craving and tolerance similar to those seen in drug addiction, the brains of women who scored high on the food-addiction scale showed less activity in areas responsible for self-control, which suggests that their brain chemistry may prime them to overindulge, Gearhardt says.

“It’s a combination of intense wanting coupled with disinhibition,” she says. “The ability to use willpower goes offline.”

Emotional Eating: The Trick to Staying Slim

Love to eat? No worries!

By Kimberly Goad

Your idea of a good time after a bad day is a scoop of dulce de leche ice cream piled high atop a fudge brownie. You’re digging in because each creamy mouthful makes you feel inexplicably happy. Is that really so bad?

Surprisingly, emotional eating doesn’t have to be a problem, says Michelle May, MD, author of Eat What You Love, Love What You Eat. "Trying to talk yourself out of getting a mood boost from food only sets you up for a bigger overeating problem—like bingeing," she says. You can comfort yourself with food and stay thin with these simple ground rules.

10 Myths and Facts About COPD

What is COPD?

By Tammy Worth

Everyone has heard of heart disease and cancer, and it’s well-known they’re the top causes of death in the U.S. But what about chronic obstructive pulmonary disease, or COPD?

All too often, people have never heard of this lung disease, or they think it is rare or not serious. Nothing could be further from the truth.

Still, the more you learn about COPD, the greater your chances of preventing it. In past generations, education and prevention efforts led to a drop in heart attacks—thank you, oatmeal for breakfast! In the same way, experts hope that as more people learn about COPD, fewer will actually get it.

Next: COPD is rare

Credit: Corbis

10 Household Tools for People in Pain

Products that ease the pain

By Anne Harding

For people with rheumatoid arthritis, painful flare-ups can make opening a door or getting dressed a daunting struggle.

"The number-one tool that one needs during a flare, by far, is this word called autonomy," says Nortin Hadler, MD, a professor of medicine and microbiology/immunology at the University of North Carolina at Chapel Hill. "It means the ability to pace the day and choose activities."

Next on the list, Dr. Hadler says: assistive equipment to help you accomplish daily tasks. Here are 10 household tools to make life easier when pain strikes.

Long Hours at Work May Boost Heart-Attack Risk

MONDAY, April 4, 2011 (Health.com) — While you may consider yourself lucky to be working long hours—or working at all—in the current economy, your diligence may be undermining your health in the long run.

People who work an average of 11 or more hours per day have a 67% higher risk of suffering a heart attack or dying from heart disease than people who work a standard seven- to eight-hour day, according to a new study in the Annals of Internal Medicine. Those who work between 10 and 11 hours per day have a 45% higher risk.

Work schedules may be an overlooked and underutilized early warning sign for heart disease, the researchers say.

If doctors simply asked their patients “How many hours do you work?” during office visits, an additional 5 percent of the people who have heart attacks each year might be identified beforehand as being at risk, says the lead researcher, Mika Kivimäki, Ph.D., a professor of epidemiology and public health at University College London.

Routinely burning the candle at both ends may not increase heart risk by itself, but it may be an indicator of an unhealthy lifestyle in general, according to experts who weren’t involved in the research. The study didn’t show a cause-and-effect relationship between long hours and heart attacks, they point out, and the apparent link could be due to a number of complicated health factors, including stress, lack of exercise, and eating high-calorie takeout rather than healthy home-cooked meals.

“Somebody who works hard may eat fast food and not be very active, so it may not be the long hours that give them heart disease,” says Stephen Kopecky, M.D., a cardiologist and professor of medicine at the Mayo Clinic, in Rochester, Minn. “It’s eating fast food and being inactive.”

The study, a new analysis of a larger, long-running study known as Whitehall II, followed more than 7,000 healthy, middle-aged civil servants in the U.K. for an average of 12 years. More than half (54%) of the participants reported working seven to eight hours a day, while roughly 15% and 10% said they worked 10- and 11-hour days, respectively.

The new findings suggest that work hours should be added to the standard list of risk factors for heart disease, the authors say. These factors—which include age, sex, cholesterol levels, blood pressure, and history of smoking—are combined in what’s known as the Framingham risk score, a 10-year estimate of heart-disease risk named after a multigenerational study in Framingham, Mass.

Scott Shurmur, M.D., the director of preventive cardiology at the University of Nebraska Medical Center, in Omaha, notes that the study did not include information about the participants’ diets, activity levels, or family history of heart disease, and says that it may be premature to change current practice. “It makes sense,” he says, “but it’s hard for me to lay a specific cause and effect on working long hours when we know so little else about the patients.”

And the findings may not translate to all ethnic groups and nationalities, says Robert Scott III, M.D., an associate professor of internal medicine at Texas A&M Health Science Center College of Medicine, in Temple. “This looked at civil-servant workers in Britain who were largely white males and at low risk,” he says. “That limits the analysis.”

What’s more, the type of work, and how much you enjoy it, may make a big difference, Kopecky says. While sitting behind a desk for 11 hours may be unhealthy, farmers are notorious for working 12 or even 14 long, hard hours a day—and they tend to live longer than average, he says.

In Pain? Try Meditation

TUESDAY, April 5, 2011 (Health.com) — You don’t have to be a Buddhist monk to experience the health benefits of meditation. According to a new study, even a brief crash course in meditative techniques can sharply reduce a person’s sensitivity to pain.

In the study, researchers mildly burned 15 men and women in a lab on two separate occasions, before and after the volunteers attended four 20-minute meditation training sessions over the course of four days. During the second go-round, when the participants were instructed to meditate, they rated the exact same pain stimulus—a 120-degree heat on their calves—as being 57% less unpleasant and 40% less intense, on average.

“That’s pretty dramatic,” says Fadel Zeidan, PhD, the lead author of the study and a postdoctoral researcher at the Wake Forest University School of Medicine, in Winston-Salem, N.C. The reduction in pain ratings was substantially greater than those seen in similar studies involving placebo pills, hypnosis, and even morphine and other painkilling drugs, he adds.

The findings, which appear in the April 6 issue of the Journal of Neuroscience, aren’t entirely surprising. Past research has found that Buddhist-style meditation—also known as mindfulness meditation—can help people cope with pain, anxiety, and a number of other physical and mental health problems. But in most cases the training takes weeks, not days.

The fact that Zeidan and his colleagues achieved these results after just 80 minutes of training is “spectacular,” says Robert Bonakdar, MD, the director of pain management at the Scripps Center for Integrative Medicine, in San Diego.

“Although the full benefits of meditation can be realized after long-term training, our study suggests that some of the effects can be realized just for your average Joe,” Zeidan says.

The type of meditation used in the study is known as Shamatha, or “focused attention.” Like other forms of mindfulness meditation, it entails learning how to observe what’s going on in one’s mind and body without judging, and while maintaining focus on one’s breathing or a chanted mantra.

Brain scans conducted during the pain experiments showed that this technique appeared to cause a number of changes in how the participants’ brains responded to pain.