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DoesDrinkingWaterBeforeMealsHelpYouLoseWeight?TwoglassesbeforemealsmayhelpyoushedpoundspermanentlyByHANNADUBANSKYPosted:November24,2010Drinkingtwo8-ounceglassesofwaterbeforebreakfast,lunch,anddinnermaybejustthebackstopyourwillpowerneedstohelpyoushedpoundspermanentlyin2011,accordingtoarecentstudypublishedinObesity.Researchersinstructedtwogroupsofoverweightorobesemenandwomentofollowalow-caloriediet,askingonegrouptoalsodrinktwocupsofwaterbeforemeals.After12weeks,thewaterdrinkershadlostanaverageof15%pounds,comparedwith11poundsforthecontrolgroup.ThosewhocontinuedthehabitforayearlostanadditionalWipoundsonaverage."Iwouldneverpromotethisasaget-slim-quickscheme,"saysseniorstudyauthorBrendaDavy,anassociateprofessorinthedepartmentofhumannutrition,foods,andexerciseatVirginiaTechUniversity,whonotesthatthepracticeslowstheemptyingofthestomach."Thisissimplyanadditionalstrategythatcouldhelppeoplemanagetheirhunger."Thestudyexaminedtheeffectonlyonmiddle-ageandolderadults,butLiweiChen,anassistantprofessorofepidemiologyatLouisianaStateUniversityHealthScienceCenterSchoolofPublicHealth,thinksit'sasmartstrategyforeverybody,particularlyifitcausesthemtocutbackonsoda.Americanadultsaverage28ouncesofsugar-sweetenedbeveragesperday,saysChen,wholedastudypublishedinMaythatfoundevenasmallreductioninsugarintakesignificantlyloweredbloodpressure."Aimtoavoidsugar-sweetenedbeveragesaltogether,"sheadvises.Thatway,youbattletworiskfactorsatonce.U.S.DietaryGuidelinesAbouttoChange—GetReadyforaSeriousFoodFightNewfederaldietaryguidelinescouldgobeyondhowweeattoattackthewayfoodismarketedByHANNADUBANSKYPosted:November24,2010AfewmorethantheusualnumberofNewYear'spledgestoeatbetter,exercisediligently,andshedflabjustmightbekeptin2011,pendingthefederalgovernment'sabout-to-be-unveiledrevampingofthe2005DietaryGuidelinesforAmericans.UpdatedbylaweveryfiveyearsbytheDepartmentofAgricultureandDepartmentofHealthandHumanServices,theguidelinesdirectfederalnutritionalpolicyfromthecontentsofan8-year-old'scafeteriatraytothenumbersdisplayedonthenutritionallabelofacanoftomatosoup.FewAmericansareleftuntouchedbytheirrecommendations.Thethrustanddetailsofthe2010guidelineswon'tbeknownuntiltheyarereleased,achangefrombefore,whenthegovernmentsimplyadoptedtherecommendationsofanadvisorypanel.ThistimeDOAandHHSarehammeringoutthefinalversionbehindthecurtains,witha13-memberadvisorypanelprovidinginputratherthandictatingthecontent.ButthereportandrecommendationsreleasedbythepanelinJuneareboundtocarryheavyweight.Ifthepanel'sinputforeshadowstheshapeandscopeoftheguidelinesthegovernmentwillissue,thepublicwillseeathoroughoverhaul,andonethatreflectsasenseofurgency.Thereportmarksthefirsttimeproposedguidelineshaveconfrontedobesitydirectly.Itnotesthatnearlythree-fourthsofwomenandtwo-thirdsofmenarenowconsideredoverweightorobese,anditcallsforquickandfar-reachingchanges—notonlyinpersonaldietandlifestylebutalsointhemarketplace,toreversethetrend."Theobesityepidemichasonlygottenworsesince2005,"saysLindaVanHorn,chairoftheadvisorycommitteeandprofessorofpreventivemedicineatNorthwesternUniversity.TheadvisorsalsoobservedthatAmericanseatnotonlytoomuchbutnotenoughofwhattheyshould.The2005guidelinesurgedgreaterconsumptionoffruitandvegetables,forinstance,butarecentreportfromtheCentersforDiseaseControlandPreventionfoundthatin2009onlyaboutoneinthreeadultshadmorethanasingleservingoffruitadayandoneinfourhadmorethantwohelpingsofvegetables—farshortoftherecommendedtwoandthreedailyservingsrespectively.Thequestioniswhatwilltakesomeoftheairoutoftheballooningobesityrate—atrendthatWalterWillett,professorofepidemiologyandnutritionattheHarvardSchoolofPublicHealth,partlyblamesontheexistingguidelines.Byvilifyingfatsandoverpromotingcarbohydrates,hesays,"thecurrentguidelinesmayhaveindirectlycontributedtotheobesityepidemic."Willettisamongachorusofcriticseagerforchange.MyPyramid,theiconicvisualsummaryofthe2005guidelines,iswidelyviewedashardtodecipher(whatdothosecoloredstripesmean?)andtheguidelinesareseenaslaggingbehindcurrentthinkingbothondesirableamountsofnutrientssuchasproteins,carbohydrates,andtransfatsandinfocusingtoospecificallyonsuchnutrients.Advisingthepublicto"avoidtoomuchfat,saturatedfat,andcholesterol,"andto"eatfoodswithadequatestarchandfiber,"forexample,isseenbytheadvisorypanelasgivinginsufficientattentiontootherattributesoffoodquality.Atfirstglance,theadvisorsseemtofollowthewell-wornpathofageneralattackonfat,sugar,andsalt(proposinga35percentdecreaseinthedailysaltallowance,forexample),exhortationtoconsumemorevegetablesandwholegrains,andpraiseforseafood,leanmeats,poultry,eggs,andfat-freeandlow-fatmilkasopposedtofattiersourcesofprotein.Buttwonewchaptersinthereportsignalaclearchangeindirection.Oneblendsthepanel'sfindingsintoapracticalapproachtoeating.Theotherdiscusseswhatitcalls"powerfulinfluencesthatcurrentlypromoteunhealthyconsumerchoices,behaviorsandlifestyles"—thebillionsofdollarsspentonmarketingjunkfood,forone—andlaysoutwaystosidestepbarrierstoahealthierlifestyle.Fruitsandveggiescouldbemorewidelyavailablebyencouragingthegrowthoffarmers'markets,forexample.Andallofthepanel'sproposalsrelyonsolidfindings—theyare"evidence-based,"inscience-speak—thatutilizetheNutritionEvidenceLibraryestablishedbytheUSDAin2009."Tremendouseffortwasputforthtonotstopatpointingtoproblems,butmakingspecificrecommendationsonhowtoaddressthem,"saysVanHorn."It'sonethingtoreviewtheevidence;it'sanothertotakethosefindingsandcreateimplementablestrategiesthatwork,"Andinfants,children,andpregnantwomen,vulnerablesubgroupsignoredinpreviousreports,eachgetindividualattention.Industryoppositionandlobbyinginresponsetothereporthavebeenintense.Themeatlobbyopposestherecommendedshifttowardamore"plant-based"diet.TheSaltInstitutehasaggressivelybattledtheproposedreductioninthedailyceilingonsodium.Thedairyindustryiswaryofrecommendationsforreducedsugar,lestflavoredmilkfallsoutoffavor.Butiftheyaretohaverealimpact,thenewguidelinesmustbeaggressive,saysVanHorn,whonotesthatpriorguidelinesmostlyaddressednutrientdeficienciesandothernutritionalmainstaysandgenerallyavoidedtakingcontroversialstands."Weneedtoprioritizeobesity,"shesays."Todonothingmorethanwehavemeansthatfiveyearsfromnowwe'llbeinanevenworsesituation."BestandWorstFastFoodKids'MealsAnewreportsuggestsfastfoodisstillunhealthy,addingtoconcernsaboutchildhoodobesityByANGELAHAUPTPosted:November9,2010AHappyMealatMcDonald'sEvenifyoudon'twantfrieswiththatkids'meal,chancesareyourfastfoodrestaurantwantstogiveyousome.ChainslikeMcDonald's,TacoBell,andBurgerKingofferunhealthysidesanddrinks84percentofthetime,inlieuoftheirmorenutritiousofferingslikeappleslices,yogurt,andjuice.That'samongthefindingsofanewanalysisreleasedMondaybyresearchersatYaleUniversity'sRuddCenterforFoodPolicyandObesity,whichexaminedfastfoodmarketingandnutritiontrends.Thefastfoodindustryhassteppedupitseffortstoreachchildrenandteens,theresearcherssay:Lastyear,preschoolerssaw56percentmoreadsforSubway,21percentmoreadsforMcDonald's,and9percentmoreadsforBurgerKingthantheydidin2007.Andoften,they'rebombardedwithimagesofsnacksanddesserts-childrenseemorethantwoadvertisementseachdaypromotingunhealthymenuitems.Thereportaddsweighttoconcernsaboutthechildhoodobesityepidemic.Asfastfoodmarketingcampaignsbecomemoreaggressive,childrenaremorelikelytochowdownongreasyfriesandburgers,RuddCenterresearcherssay,whichcouldtakeatollontheirwaistlines.Andchildhoodobesityisn'tjustashort-termproblem:Obeseteensare16timesmorelikelythantheirpeerstobecomeseverelyobesebyage30,accordingtoastudypublishedtodayintheJournaloftheAmericanMedicalAssociation.(Severeobesitywasdefinedasabodymassindexof40orgreater;obesitywasdefinedasaBMIofmorethan25.)Severeobesitycanleadtodiabetes,hypertension,asthma,arthritis,andashorterlife,saysseniorauthorPennyGordon-Larsen,anutritionresearcherattheUniversityofNorthCarolina-ChapelHill."It'sveryeasytoeatahigh-calorie,high-fatdiet,"shesays."Wehavesomuchfoodaround-high-fat,high-sugar,tastyfoodthatweneedtobeverycarefulof.Thosefoodsaremarketedwelltopeople,andmakinghealthierchoicestakesalotmorework."That'swhyCaliforniaistakingstepstoblunttheinfluencefast-foodmarketingcanhavebybanningtoysthatcomewithkids'mealsloadedwithcalories,fat,andsugar.Lastweek,SanFrancisco'sBoardofSupervisorsapprovedanordinancethatwouldpreventfastfoodchainsfromofferingtoyswithkids'meals,unlesstheycontainlessthan600calories—nomorethan35percentfromfat—and640milligramsofsodium.Allmealswouldalsoberequiredtoincludefruitsandvegetables.ThelegislationcouldbecomelawinDecember.Industryofficialscitesomechains'increasingemphasisonhealthyoptions:"Therecanbenodisputethattherestaurantindustryhasbeencommittedtoprovidingagrowingarrayofnutritiousofferingsforchildren,"JoyDubost,directorofnutritionandhealthylivingattheNationalRestaurantAssociation,saidinastatementtoreporters."Numeroussurveysshowtheincreasingnumberofhealthfuloptionsinkids'meals.Andnutritiousofferingsinchildrens'mealsisthenumberonefoodtrendin[fastfood]restaurants."TheRuddCenterresearchersanalyzedthecalories,fat,sugar,andsodiuminmorethan3,000possiblecombinationsthatchainsmarketaskids'meals.Themealswerethenrankedas"best"and"worst"basedonguidelinessetin2009bytheInstituteofMedicine,anindependentadvisorypaneltotheU.S.government.Preschoolchildrenshouldconsumenomorethan410caloriesand544milligramsofsodiumpermeal,accordingtotheIOM,comparedto650caloriesand636milligramsofsodiumforelementaryschoolchildren,and700caloriesand720milligramsofsodiumforolderchildren.Only12kids'mealcombosmettheIOM'snutritioncriteriaforpreschoolers,while15metthecriteriaforelementarykids.Another20combosmetkids'caloriegoals,butweretoohighinatleastonearea,likesodium,theRuddresearchersfound.Just36—orapproximately1percent—ofthekids'mealcombostheyexaminedqualifiedas"best,"whichtheresearchersranked.Thevastmajority,however,wereplacedinthe"worst"categoryandweren'tranked,sincetheywereall"equallybad,"saysstudyleaderJenniferHarris,directorofmarketinginitiativesattheRuddCenter.Instead,researchersdescribedtheworstthreekids'mealsateachrestaurant.Butifparentsareturningtoafastfoodrestaurantfordinner,anyofthe"best"optionsareallreasonable,shesays:"Wefeelcomfortablerecommendingthosemealstochildren."These,accordingtotheresearchers,aresomeofthebestandworstkids'mealcombinationsateightpopularfastfoodchains:SubwayBest:VeggieDelitesandwich(wheatbread,nocheese);appleslices;100percentjuice.•Rank:#1Calories:285caloriesSalt:295milligramsSaturatedfat:0caloriesWorst:None."Theyonlyoffermilkand100percentjuice,andtheyhaveapplesandyogurtassides.Andtheirsandwichesareallprettylowinfot,"Harrissays.BurgerKingBest:Macaroniandcheese;apple"fries"(withoutcaramelsauce);fat-freemilk.Rank:#6Calories:285Salt:490milligramsSaturatedfat:14caloriesWorst:Cheeseburger;Frenchfries;Dr.PepperCalories:635Salt:1,106milligramsSaturatedfat:86caloriesKentuckyFriedChickenBest:Grilledchickendrumstick;cornonthecob;unsweetenedtea;stringcheese.Rank:#16Calories:270Salt:545milligramsSaturatedfat:23caloriesWorst:Extracrispychickendrumstick;potatowedges;MountainDew;stringcheeseCalories:680Salt:1,330milligramsSaturatedfat:54caloriesSonicBest:Jr.Burger;appleslices;unsweetenedtea.Rank:#20Calories:350Salt:620milligramsSaturatedfat:45caloriesWorst:Twochickenstripswithranchsauce;Frenchfries;greenappleslushCalories:708Salt:1,012milligramsSaturatedfat:51caloriesWendy'sBest:Crispychickensandwich;mandarinorangecup;low-fatmilk.Rank:#26Calories:520Salt:815milligramsSaturatedfat:41caloriesWorst:Fourchickennuggetswithsweetandsoursauce;Frenchfries;VanillaFrostyJr.Calories:610Salt:760milligramsSaturatedfat:68caloriesMcDonald'sBest:Hamburger;appledippers(withoutcarameldip);low-fatmilk.Rank:#30Calories:385Salt:645milligramsSaturatedfat:45caloriesWorst:Cheeseburger;Frenchfries;Hi-COrangeLavaburstCalories:650Salt:910milligramsSaturatedfat:68caloriesDairyQueenBest:Chickenstripswithketchup;applesauce;Sprite;vanillaice-creamcone.Rank:#33Calories:628Salt:1,000milligramsSaturatedfat:32caloriesWorst:Cheeseburger;Frenchfries;MountainDew;chocolateDillyBarCalories:973Salt:1,450milligramsSaturatedfat:171caloriesTacoBellBest:None.TacoBelldidnotmeettheresearchers'criteriaforhealthyoptions.Worst:Beanburrito;cinnamontwists;MountainDewBajaBlastCalories:760Salt:1,530milligramsSaturatedfat:32caloriesCancerPrevention:RethinkYourDietasWellasYourSmokingManycancerscouldbepreventedifAmericansquitsmokingandatedifferentlyByDEBORAHKOTZPosted:September8,2010Ifeveryoneweretoquitsmokingtoday,nearly450,000fewerAmericanswoulddieannuallyfromsmoking-relateddiseases.Yetevenwithallthesmokingbansacrossthecountry,oneinfiveAmericansstilllightsupregularly—aratethat'splateauedsince2005afterfourdecadesofdecline,accordingtoareportissuedTuesdaybytheCentersforDiseaseControlandPrevention.Whilethesmoking-lungcancerconnectionisanoldstory,everyweek,itseems,anotherheadlinetellsyouwhatyoushouldorshouldn'teattoavertthe"bigC".Eatacolorfularrayoffruitsandvegetablestowardofflungcancer,saysonerecentstudy;avoidsoftdrinksifyoudon'twanttodieofpancreaticcancer,warnsanother.Wineisgoodforyourheart,butmayincreaseyourriskofbreastcancer,otherssuggest.Andwhowouldn'tbewillingtogiveuptheDietCokeorchardonnaytosidestepthediseasewefearmost?ItyoutookactionbasedonresearchpublishedthisweekintheAnnalsofInternalMedicine,youmightfindyourselfforgoinghamburgersandchickenwingsandembracingsoyburgers,tofu,andpeanutbutterinstead.ThatstudyfoundthatanAtkins-styledietthatemphasizedvegetableproteinoveranimalproteinloweredtheriskofcancer.Butallthingsconsidered,howmuchdodietarychangesreallymatterintermsofcancerprevention?"Rightaftersmoking,dietranksrightupthereastheNo.2modifiableriskfactor,"saysDemetriusAlbanes,aseniorinvestigatorandmedicalepidemiologistattheNationalCancerInstitute."Twenty-fivepercentofcancerscanberelatedbacktoeatingpractices."Doesthatmeanwereallyneedtoavoidsoftdrinksifwedon'twanttogetpancreaticcancer,aswassuggestedbyarecentstudyinthejournalCancerEpidemiology,Biotnarkers&Prevention?"Idon'tthinkwecansaythat,"Albanessays."ThatparticularstudyfromSingaporedidn'tcontrolverywellforsmoking,whichisanimportantriskfactorforpancreaticcancer."Inotherwords,itcouldbethatthosewhodowndailysix-packsofFantaarealsomorelikelytolightup.Thereinliestherub.Unlikesmoking,whichisclearlycarcinogenic,nosinglefoodornutrientreallyimpactsyouroverallriskofgettingalungorbreasttumor,saysAlbanes,whohelpedconductthe1994clinicaltrialshowingthatsmokersrandomlyassignedtotakeeitherbetacaroteneorvitaminEsupplementsdidn'tgetanylesslungcancerthanthosewhoweregivenplacebos.It'sreallyaboutthecompositionofyouroveralldiet.What'sclear,hesays,isthatthevarietyofnutrientspackedintofoodslikegreenleafyproduce,orangesweetpotatoes,andbrightpinknectarinesallworkinsynergytohelpthebodyfendoffcancercells.Mostlikely,followingaMediterranean-styledietbasedonfruits,vegetables,fish,nuts,andwholegrainshelpsloweryourcancerrisk.Andthelatestresearchsuggeststhattweakingthisplantoincludelessbreadandpastaandmoreplantproteinlikesoycouldhaveaddedbenefits."Researchshowsthataplant-baseddietisideal,thelessprocessedthebetter,"saysAliceBender,anutritionistattheAmericanInstituteforCancerResearch,anonprofitresearchorganizationinWashington,D.C."Avoiddeep-friedfoodsandaddedsaltandsugar,thesortsoffoodsthataredenseincalories."Agoodruleofthumb:Twothirdsofyourplateshouldbefilledwithvegetablesandlegumes,whilejustonethirdshouldprovideanimalprotein.Thetypeofanimalproteinmatters.Trytominimizeyourintakeofdelimeats,hotdogs,andotherprocessedmeats—whichareprettystronglyassociatedwithcolorectalcancer—andlimityourconsumptionofredmeattonomorethan18ouncesperweeksincemorealsoincreasescancerrisk.Whatalsomattersishowmuchyouweighandhowmanycaloriesyouburn.Beingoverweightandinactiveappearstofostercelldivisionandproliferation,whichmaygiverisetotumors.Obesityalsogoeshandinhandwithhighinsulinlevelsandinflammation,twometabolicstatesthathelpcancersgrowandspread,"Itisjustnowbecomingapparentthatobesityisamajorriskfactorforseveralcancers,"sayscancerresearcherJuneStevens,chairofthedepartmentofnutritionattheUniversityofNorthCarolina."Physicalactivitytendstobeprotective.Sopeopleshouldthinkaboutlosingweightandbeingphysicallyactivetopreventcancer.Ofcourse,iftheyloseweightbybeingmorephysicallyactiveandeatingmorefruitsandvegetablesandlessredmeatandalcohol—somuchthebetter!"12ReasonstoReallyQuitSmokingNeverniindcancerorheartdiseaseforamoment.HerearesomenonobviousreasonstosnubcigarettesByLINDSAYLYONPosted:November14,2008We'llspareyouthelecture.(Seriously,though.Stampoutthatbuttandflushthepack,already.)Tobaccouse,namelycigarettesmoking,isthechiefcauseofpreventabledeathintheUnitedStates.Leftunbridled,smokingcouldkillmorethanabillionpeoplethiscentury,accordingtotheWorldHealthOrganization.ThatequalsthenumberwhowoulddieifaTitanicsankevery24minutesforthenext100years,asformerU.S.SurgeonGeneralC.EverettKoopsostarklyputitataMarchpressconference.Still,itmaybeharderthanevertoquit:Threequartersoftoday'ssmokerstryingtoshedthehabitareheavilyhookedonnicotine,up32percentfromalmosttwodecadesago,accordingtoresearchpresentedattheAmericanCollegeofChestPhysicians'annualmeetinginOctober.Soquitting,formost,isnotmerelyamatterofwillpower.Nonetheless,thereasonstodosokeepamassing—andthey'renotallaboutheartdisease,lungcancer,orrespiratoryproblems.Here'safewdownsidesyoumightnothaveconsidered.Itfogsthemind.Smokingmaycloudthemind,accordingtoaccumulatingresearch.AJunestudyintheArchivesofInternalMedicinefoundthatsmokinginmiddleageislinkedtomemoryproblemsandtoaslideinreasoningabilities,thoughtheserisksappearedlessenedforthosewho'dlongquit;thisisimportant,theauthorswrote,becauseotherresearchhasshownthatpeoplewithmildcognitiveimpairmentinmidlifedevelopdementiaatanacceleratedrate.Theirreportpiggybacksonseveralfocusedontheolderset:A2007analysisof19priorstudiesconcludedthatelderlysmokersfaceaheightenedriskofdementiaandcognitivedecline,comparedwithlifelongnonsmokers.Andin2004,researchersreportedinNeurologythatsmokingappearedtohastencognitivedeclineindementia-freeelderlysmokers,bringingitonseveraltimesfasterthanintheirnonsmokingpeers.Itmaybringondiabetes.Asifweneedanymoreriskfactorsfordiabetes,ananalysispublishedintheJournaloftheAmericanMedicalAssociationlastyearfoundthatacross25priorstudies,currentsmokershavea44percentgreaterchanceofdevelopingtype2diabetesthannonsmokersdo,andtheriskwasstrongestforthosewiththeheaviesthabit,whoclocked20ormorecigarettesperday.Inanaccompanyingeditorial,researchersmadeastrikingestimation:Thatsome12percentofalltype2diabetescasesnationwidemightbeattributabletosmoking.Itinvitesinfections.InOctober,thefederalAdvisoryCommitteeonImmunizationPracticesmadeitsfirsteverrecommendationthatallsmokersages19to64beaddedtoashortlistofcandidatesforthepneumococcalvaccine.That'sbecausethereareverystrongdatashowingthattheriskofinfectionbypneumonia-causingbacteriaissubstantiallygreaterforsmokersthanfornonsmokers,saysPekkaNuorti,amedicalepidemiologistattheCentersforDiseaseControlandPrevention.Exactlywhyisunclear,thoughthere'sevidencethatsmokingmaydamagetherespiratorysystem'sprotectivemucousmembranes,makingiteasierforinfectiousorganismstolatchonandcausedisease,saysNuorti.Otherresearchsuggeststhatsmokingmayinterferewithimmunity,compromisingpeople'sabilitytofightinfections,headds.Heightenedsusceptibilitytoinfections,itappears,isn'tlimitedjusttothosewhodothesmoking:AMaystudyinTobaccoControlfoundthatchildrenexposedtosecondhandsmokeathomeduringearlyinfancy(especiallythosebornprematurelyorwithalowbirthweight)aremorepronetoathrongofsevereillnessesthatmaylandtheminthehospitalatsomepointduringchildhood.Thefindingswerebasedonananalysisofmorethan7,000Chinesechildrenfrom1997to2005.Itmaystultifyasexlife.IfmenwanttohopaboardtheViagrabandwagon,mountingevidencesuggeststhatpuffingcigarettesmightbejusttheirticket.Smokersaremoreapttoexperienceerectiledysfunctionthannonsmokersare,andthisriskclimbsasthenumberofcigarettessmokedincreases.AstudyintheAmericanJournalofEpidemiologyin2007trackedmorethan7,500Chinesemenwithlowriskforartherosclerosis,achiefunderlyingcauseoferectiledysfunction,andfoundthatsmokingcouldindependentlyhikeaman'schanceofwranglingwiththesexualcondition.Preventingsmokingisan"importantapproach"forcuttingtheriskofED,theresearchersconcluded.Itmayleadtowrinkles...everywhere.Notonlydoessmokingcontributetoprematurefacialwrinkles,buta2007studyintheArchivesofDermatologyfoundthatitmayalsoleadtowrinklingofskinthatrarelyseesthelightofday-inareassuchastheinnerarmandperhapsthebuttocks.Itmayhastenmenopause.Womenwhosmokefaceanincreasedriskofinfertility,andtheymayexperiencenaturalmenopauseatayoungeragethandononsmokers,accordingtothe2004andthe2001SurgeonGeneral'sReports,respectively.Furtherevidence:A2001animalstudyinNatureGeneticsfoundthatchemicalsincigarettesmokecanhurrymenopausebykillingoffeggcellsmadebyovaries,therebydwindlingtheeggcellreserve.Sincethetimingofmenopauseisdictatedbythesizeofawoman'seggcellreserve—whichisstockedwithaboutamillioneggsatbirthandvanishesbymenopause—anythingthatspeedsupitslosscouldlogicallyleadtoamuchearlieronsetoffertilitytroubles,notesJonathanTilly,oneofthestudy'sauthorsanddirectoroftheVincentCenterforReproductiveBiologyatMassachusettsGeneralHospital.Moreworrisome:Womenwhosmokeduringpregnancymaybecompromisingnotonlytheirownfuturefertilitybutthefertilityoftheirunborndaughters.Instudiestestingthatidea,miceexposedtochemicalsincigarettesmokeduringgestationwerebomwithshrunkeneggreserves."Evenunderthebest-chancescenario—you'reanonsmoker,you'rehealthy,you'reyoung,youeatwell,you'reinshape——humanfertilityisn't100percent,"saysTilly."Anythingyoucandotomakeitbetteriscertainlyworthyourwhile."Itmaydullvision.Severalstudieshavefoundarobustlinkbetweensmokingandeyedisease,specificallyage-relatedmaculardegeneration,whichcanpermanentlyblurvisionorcauseblindness.A2005reviewof17studiesinthejournalEyereportedthatactivesmokersmayfacetwotothreetimestheriskfordevelopingthediseaseexperiencedbythosewhohaveneversmoked.Ithurtsbones.Smokingweakensthebody'sscaffoldingandisaseriousriskfactorforosteoporosis,accordingtotheNationalInstituteofArthritisandMusculoskeletalandSkinDiseases.It'sbeenshowntofritterawaybonedensityinpostmenopausalwomenandtohiketheriskofhipfracturesinbothsexes,accordingtothe2004SurgeonGeneral'sReport.(Peoplewhoendurehipfracturesare12to20percentmorelikelytodiethanthosewhodon't,theReportnotes,thoughtherearewaysosteoporosissuffererscanprotectthemselves.)Smokersmayalsoexperienceslowerhealingofbrokenbonesandwoundedtissuesthandononsmokers.Itmayinjuretheinsides.Sure,cigarettesmaybesmoothtoinhale,buttheycanroughupthedigestivesystem,leadingtoheartbum,pepticulcers,andpossiblygallstones,accordingtotheNationalInstituteofDiabetesandDigestiveandKidneyDiseases.What'smore,currentandformersmokershaveanelevatedriskofdevelopingCrohn'sdisease,aconditioncharacterizedbyinflammationinthedigestivetractandcausingpainanddiarrhea,saysNIDDK.Itmaystiflesleep.Feelinggroggydespiteanight'sslumbermightbeaproblemforthosewholightup:AFebruarystudyinChestfoundthatsmokersarefourtimesmorelikelytogetnonrestorativesleepthanthosewhodon'tsmoke,andresearchersdeemednicotinethelikelyculprit.T