Brazilian Police vs Drug Traffickers

Brazilian police has invaded and taken under control several criminal slums in Rio de Janeiro.

New discovery in the fight against Huntington’s disease

Scientists have made a novel discovery in the fight against Huntington’s disease (HD).

HD is an incurable progressive neurodegenerative genetic disorder which affects motor coordination and leads to cognitive decline and dementia.

The disease pathology stems from a mutation in the huntingtin (Htt) gene, which results in the accumulation of toxic proteins leading to neuronal cell death.

Previous studies have clearly implicated caspases – enzymes that break down cells – as key players in the cascade of events involved in HD neuronal death.

Now scientists have identified three small molecules that inhibit the activity of those caspases, suppressing toxicity and rescuing neurons from cell death in cell culture.

The research was led by both Buck Institute faculty member Lisa Ellerby, and Yale University faculty member Jonathan Ellman. Dr. Ellerby is doing follow up studies in a mouse model of the disease.

Dr. Ellerby said a substrate based screening method was used to identify compounds that reacted with caspases. Based on those reactions, Jonathan Ellman, from the Yale University Department of Chemistry, converted the compounds to caspase inhibitors.

Dr. Ellerby said that the inhibitors are based on properties of a drug, which had entered Phase I clinical trials for the treatment of human liver preservation injury.

“These molecules shows particular promise. They cross the blood-brain barrier and acts selectively to block the processes involved in HD,” said Ellerby.

Dr. Ellerby said the caspase inhibitors both suppressed the proteolysis of Htt and rescued HD neurons that have begun to undergo cell death.

“We believe this is going to help us move the field forward because now we can test these compounds in live animals. Up until this point we have not identified a caspase inhibitor that has acted selectively against the toxic effects of the Htt mutation,” said Dr. Ellerby.

Schizophrenic Brains Not Fooled by Optical Illusion

Schizophrenia sufferers aren’t fooled by an optical illusion known as the “hollow mask” that the rest of us fall for because connections between the sensory and conceptual areas of their brains might be on the fritz.

In the hollow mask illusion, viewers perceive a concave face (like the back side of a hollow mask) as a normal convex face. The illusion exploits our brain’s strategy for making sense of the visual world: uniting what it actually sees — known as bottom-up processing — with what it expects to see based on prior experience — known as top-down processing.

"Our top-down processing holds memories, like stock models," explains Danai Dima of Hannover Medical University, in Germany, co-author of a study in NeuroImage. "All the models in our head have a face coming out, so whenever we see a face, of course if has to come out."

This powerful expectation overrides visual cues, like shadows and depth information, that indicate anything to the contrary.

But patients with schizophrenia are undeterred by implausibility: They see the hollow face for what it is. About seven out of 1000 Americans suffer from the disease, which is characterized by hallucinations, delusions, and poor planning. Some psychologists believe this dissociation from reality may result from an imbalance between bottom-up and top-down processing — a hypothesis ripe for testing using the hollow mask illusion.

In healthy viewers, the illusion is so powerful that even when aware of the illusion (see video below), they are unable to see the concave face — the mind just flips it back. Though the illusion is strong for faces, it doesn’t work well with other objects, or even with upside-down faces. This bias is likely due to the special relationship we humans have with faces. Many neuroscientists believe we have brain regions dedicated to processing faces, and some brain injuries can leave patients unable to recognize faces, even though their vision and other memories remain intact.

Dima and Jonathan Roiser of University College London wanted to understand why people with schizophrenia aren’t fooled. They put 13 schizophrenia patients and 16 healthy control subjects in an fMRI scanner that measures brain activity, and showed them 3D images of concave or convex faces. As expected, all of the schizophrenic patients reported seeing the concave faces, while none of the control subjects did.

Dima and Roiser analyzed the fMRI data using a relatively new technique called dynamic causal modeling, which allowed them to measure how different brain regions were interacting during the task. When healthy subjects looked at the concave faces, connections strengthened between the frontoparietal network, which is involved in top-down processing, and the visual areas of the brain that receive information from the eyes. In patients with schizophrenia, no such strengthening occurred.

Dima thinks when healthy subjects see the illusion, which is somewhat ambiguous, their brains strengthen this connection such that what they expect — a normal face — becomes more influential, overpowering the actual, though unlikely, visual information. Schizophrenia patients, meanwhile, may be unable to modulate this pathway, accepting the concave face as reality.

Schizophrenics aren’t the only ones who see the concave face — people who are drunk or high can also ‘beat’ the illusion. A similar disconnect between what the brain sees and what it expects to see may be occurring during these drug-induced states.

The Daily Consequences of Having Evolved

From hiccups to wisdom teeth, the evolution of homo sapiens has left behind some glaring, yet innately human, imperfections

Natural selection acts by winnowing the individuals of each generation, sometimes clumsily, as old parts and genes are co-opted for new roles. As a result, all species inhabit bodies imperfect for the lives they live. Our own bodies are worse off than most simply because of the many differences between the wilderness in which we evolved and the modern world in which we live. We feel the consequences every day. Here are nine.



1. Our cells are weird chimeras


Perhaps a billion years ago, a single-celled organism arose that would ultimately give rise to all of the plants and animals on Earth, including us. This ancestor was the result of a merging: one cell swallowed, imperfectly, another cell. The predator provided the outsides, the nucleus and most of the rest of the chimera. The prey became the mitochondrion, the cellular organ that produces energy. Most of the time, this ancient symbiosis proceeds amicably. But every so often, our mitochondria and their surrounding cells fight. The result is diseases, such as mitochondrial myopathies (a range of muscle diseases) or Leigh’s disease (which affects the central nervous system).


2. Hiccups


The first air-breathing fish and amphibians extracted oxygen using gills when in the water and primitive lungs when on land—and to do so, they had to be able to close the glottis, or entryway to the lungs, when underwater. Importantly, the entryway (or glottis) to the lungs could be closed. When underwater, the animals pushed water past their gills while simultaneously pushing the glottis down. We descendants of these animals were left with vestiges of their history, including the hiccup. In hiccupping, we use ancient muscles to quickly close the glottis while sucking in (albeit air, not water). Hiccups no longer serve a function, but they persist without causing us harm—aside from frustration and occasional embarrassment. One of the reasons it is so difficult to stop hiccupping is that the entire process is controlled by a part of our brain that evolved long before consciousness, and so try as you might, you cannot think hiccups away.



3. Backaches


The backs of vertebrates evolved as a kind of horizontal pole under which guts were slung. It was arched in the way a bridge might be arched, to support weight. Then, for reasons anthropologists debate long into the night, our hominid ancestors stood upright, which was the bodily equivalent of tipping a bridge on end. Standing on hind legs offered advantages—seeing long distances, for one, or freeing the hands to do other things—but it also turned our backs from an arched bridge to an S shape. The letter S, for all its beauty, is not meant to support weight and so our backs fail, consistently and painfully.



4. Unsupported intestines


Once we stood upright, our intestines hung down instead of being cradled by our stomach muscles. In this new position, our innards were not as well supported as they had been in our quadrupedal ancestors. The guts sat atop a hodgepodge of internal parts, including, in men, the cavities in the body wall through which the scrotum and its nerves descend during the first year of life. Every so often, our intestines find their way through these holes—in the way that noodles sneak out of a sieve—forming an inguinal hernia.



5. Choking


In most animals, the trachea (the passage for air) and the esophagus (the passage for food) are oriented such that the esophagus is below the trachea. In a cat's throat, for example, the two tubes run roughly horizontal and parallel to each other before heading on to the stomach and lung, respectively. In this configuration, gravity tends to push food down toward the lower esophagus. Not so in humans. Modifications of the trachea to allow speech pushed the trachea and esophagus further down the throat to make way. Simultaneously, our upright posture put the trachea and esophagus in a near-vertical orientation. Together these changes leave falling food or water about a 50-50 chance of falling in the “wrong tube.” As a consequence, in those moments in which the epiglottis does not have time to cover the trachea, we choke. We might be said to choke on our success. Monkeys suffer the same fate only rarely, but then again they can’t sing or dance.



6. We're awfully cold in winter


Fur is a warm hug on a cold day, useful and nearly ubiquitous among mammals. But we and a few other species, such as naked mole rats, lost it when we lived in tropical environments. Debate remains as to why this happened, but the most plausible explanation is that when modern humans began to live in larger groups, our hair filled with more and more ticks and lice. Individuals with less hair were perhaps less likely to get parasite-borne diseases. Being hairless in Africa was not so bad, but once we moved into Arctic lands, it had real drawbacks. Evolution has no foresight, no sense of where its work will go.



7. Goosebumps don't really help


When our ancestors were covered in fur, muscles in their skin called “arrector pili” contracted when they were upset or cold, making their fur stand on end. When an angry or frightened dog barks at you, these are the muscles that raise its bristling hair. The same muscles puff up the feathers of birds and the fur of mammals on cold days to help keep them warm. Although we no longer have fur, we still have fur muscles just beneath our skin. They flex each time we are scared by a bristling dog or chilled by a wind, and in doing so give us goose bumps that make our thin hair stand uselessly on end.



8. Our brains squeeze our teeth


A genetic mutation in our recent ancestors caused their descendants to have roomy skulls that accommodated larger brains. This may seem like pure success—brilliance, or its antecedent anyway. But the gene that made way for a larger brain did so by diverting bone away from our jaws, which caused them to become thinner and smaller. With smaller jaws, we could not eat tough food as easily as our thicker-jawed ancestors, but we could think our way out of that problem with the use of fire and stone tools. Yet because our teeth are roughly the same size as they have long been, our shrinking jaws don’t leave enough room for them in our mouths. Our wisdom teeth need to be pulled because our brains are too big.



9. Obesity


Many of the ways in which our bodies fail have to do with very recent changes, changes in how we use our bodies and structure our societies. Hunger evolved as a trigger to drive us to search out food. Our taste buds evolved to encourage us to choose foods that benefited our bodies (such as sugar, salt and fat) and avoid those that might be poisonous. In much of the modern world, we have more food than we require, but our hunger and cravings continue. They are a bodily GPS unit that insists on taking us where we no longer need to go. Our taste buds ask for more sugar, salt and fat, and we obey.

Amazon Tree Houses, Beautiful

8 Things Your Hair Says About Your Health

When it comes to our hair, most of us worry most about what to do with it: how short to cut it, how to style it, whether to color it once it begins to go gray. But experts say that our hair says a lot more about us than how closely we follow the latest styles. In fact, the health of our hair and scalp can be a major tip-off to a wide variety of health conditions.

“We used to think hair was just dead protein, but now we understand that a whole host of internal conditions affect the health of our hair,” says dermatologist Victoria Barbosa, MD, who runs Millennium Park Dermatology in Chicago. “Our hair responds to stress, both the physical stressors of disease and underlying health issues, and psychological stress.” Here, eight red flags that tell you it’s time to pay more attention to the health of your hair — and to your overall health in general.

Red flag #1: Dry, limp, thin-feeling hair

What it means: Many factors can lead to over-dry hair, including hair dyes, hair blowers, and swimming in chlorinated water. But a significant change in texture that leaves hair feeling finer, with less body, can be an indicator of an underactive thyroid, known as hypothyroidism. Some people conclude that their hair is thinning because it feels as if there’s less of it, but the thinning is due more to the texture of the hair itself becoming finer and weaker than to individual hairs falling out (though that happens too).

More clues: Other signs of hypothyroidism include fatigue, weight gain, slow heart rate, and feeling cold all the time, says Raphael Darvish, a dermatologist in Brentwood, California. In some cases, the
eyebrows also thin and fall out. A telltale sign: when the outermost third of the eyebrow thins or disappears.

What to do: Report your concerns to your doctor and ask him or her to check your levels of thyroid hormone. The most common blood tests measure the levels of thyroid-stimulating hormone (TSH) and T4. It’s also important to keep a list of your symptoms — all of them.
“A doctor’s visit is best to work up this problem; he or she may choose to do a thyroid ultrasound and a blood test in addition to an examination,” says Darvish.

Red flag #2: Scaly or crusty patches on the scalp, often starting at the hairline

What it means: When a thick crust forms on the scalp, this usually indicates psoriasis, which can be distinguished from other dandruff-like skin conditions by the presence of a thickening, scab-like surface, says Lawrence Greene, MD, a spokesperson for the National Psoriasis Foundation. Psoriasis is the most common of all the autoimmune diseases and occurs when the skin goes into overdrive, sending out faulty signals that speed up the turnover and growth of skin cells.

More clues: Psoriasis, which affects nearly 7.5 million Americans, often occurs in concert with other autoimmune diseases such as Crohn’s disease, lupus, and rheumatoid arthritis. If you have another autoimmune disorder, it’s that much more likely you’ll develop psoriasis. In turn, the discovery that you have psoriasis should put you on the alert for more serious conditions. Up to 30 percent of people with psoriasis develop a condition called psoriatic arthritis, which causes painful swelling of the joints.

What to do: There’s a long list of ingredients that help relieve psoriasis, and treatment is often a process of trial and error. Topical treatments include shampoos containing coal tar or salicylic acid, and creams or ointments containing zinc and aloe vera. Hydrocortisone cream works to relieve inflammation. Prescription creams include vitamin D, vitamin A, and anthralin. Many patients also have great success treating the scalp with UV light therapy, and systemic medications such as cyclosporine work better for some people than topical medications.

It’s a good idea to see a dermatologist for help sorting out the various treatments, rather than trying to do it on your own. One thing to keep in mind: Psoriasis puts you at increased risk of diabetes, heart disease, hypertension, certain types of cancer, metabolic syndrome, obesity, and depression. So if your psoriasis becomes severe, bring it to your doctor’s attention as part of a discussion of your overall health.

Thinning hair and hair loss

Red flag #3: Thinning hair over the whole head

What it means: It’s normal to shed approximately 100 to 150 hairs a day, the result of the body’s natural turnover. It’s when you notice considerably more hairs in your brush or on the towel after you
shampoo — or when hair appears to be coming out in clumps — that it’s time for concern. One common cause: a sudden psychological or physical stressor, such as a divorce or job loss. Another: having a high fever from the flu or an infection. Diabetes can also cause hair to thin or start to fall out suddenly; some diabetes experts say sudden hair thinning or hair loss should be considered an early warning sign that diabetes is affecting hormone levels.

A number of medications also cause hair loss as a side effect. These include birth control pills, along with lithium and Depakote, two of the most common treatments for bipolar disorder. More rarely, tricyclic antidepressants such as Prozac, and levothyroid — used to treat hypothyroidism — cause thinning hair. Hormonal changes can also cause hair to thin, which is why both pregnancy and perimenopause are well known for causing hair to fall out, while polycystic ovary disease can cause both hair loss and overgrowth of hair, depending on how the hormones go out of balance. Thyroid disease, especially hypothyroidism, is one of the most common causes of hair loss.

More clues: Check for tiny white bumps at the roots of the hair; their presence suggests that this is temporary hair loss rather than male/female pattern baldness, says Chicago dermatologist Victoria Barbosa. Any medication that interferes with hormones can cause this type of hair loss; the list includes birth control pills, Accutane for acne, and prednisone and anabolic steroids. Physical stressors that can lead to temporary hair loss include iron deficiency anemia and protein deficiency; these are particularly common in those who’ve suffered from eating disorders.

What to do: If you have what experts call temporary hair loss — to distinguish from hereditary hair loss, which is likely to be permanent — you’ll need to discontinue the medication or treat the underlying condition that’s causing the problem. It can also help to take supplemental biotin, which has been shown to strengthen and thicken hair and fingernails, says Barbosa.

And while vitamin D deficiency hasn’t been pinpointed as a cause of hair loss, research has demonstrated that taking vitamin D helps grow the hair back. “We don’t know how vitamin D contributes to hair loss, but we do know the hair follicles need good levels of vitamin D to recover,” Barbosa says. Recommended dose: 2000 IUs of vitamin D3 daily. In addition, talk to your doctor about getting your blood levels of iron checked for anemia, and take iron if needed.

Red flag #4: Overall hair loss that appears permanent, often following traditional pattern baldness

What it means: Both women and men are subject to what’s formally known as androgenetic and androgenic alopecia. It’s usually caused by a change in the pattern of the sex hormones, but diseases and other underlying conditions can cause this type of hair loss by affecting the hormones. In women, a derivative of testosterone is often the culprit, shrinking and eventually killing off hair follicles. Traditionally known as “male pattern baldness,” this type of hair loss is often hereditary and is typically permanent if not treated with medication, says Larry Shapiro, a dermatologist and hair surgeon in Palm Beach, Florida.

Men’s hair loss nearly always follows a pattern of thinning along the hairline, at the temples, and in the back of the scalp. Some women’s hair loss also follows this pattern, but more typically women experience thinning over the entire head.

Diabetes also can cause or contribute to hair loss. Over time, diabetes often leads to circulatory problems; as a result, the hair follicles don’t get adequate nutrients and can’t produce new hairs. Hair follicles can eventually die from lack of nutrition, causing permanent hair loss.

More clues: Certain underlying conditions can cause this type of hair loss by altering hormones; these include thyroid disease (both overactive and underactive thyroid) and autoimmune disease, Shapiro says. Many drugs taken long-term to control chronic conditions can have a side effect, in some people, of causing or contributing to hair loss. They include beta blockers such as propranolol and atenolol, anticoagulants like warfarin, and many drugs used to control arthritis, Parkinson’s disease, and other conditions.

What to do: If you suspect a medication is causing or exacerbating your hair loss, talk to your doctor about whether an alternative is available that’s less likely to have that side effect. (But don’t just stop taking your medicine.) Minoxidil, the generic name for the drug marketed as Rogaine, is the primary proven method of treating androgenic hair loss. It works by blocking the action of the hormones at the hair follicle. It’s now available over the counter, so you don’t have to have a prescription, and it’s sold in male and female versions.

Another drug, finasteride, requires a prescription. Some women find that taking estrogen helps with hormonally triggered hair loss.

Dry and patchy hair

Red flag #5: Dry, brittle hair that breaks off easily

What it means: When individual hairs litter your pillow in the morning, this typically indicates breakage rather than hair falling out from the follicle, says Chicago dermatologist Victoria Barbosa. Breakage is most frequently the result of hair becoming over-brittle from chemical processing or dyeing. “Bleaching, straightening, and other chemical processing techniques strip the cuticle to let the chemicals in, which makes the hair shaft more fragile,” Barbosa explains.

However, certain health conditions also lead to brittle, fragile hair. Among them: Cushing’s syndrome, a disorder of the adrenal glands that causes excess production of the hormone cortisol. A condition called hypoparathyroidism, usually either hereditary or the result of injury to the parathyroid glands during head and neck surgery, can also cause dry, brittle hair. Overly low levels of parathyroid hormone cause blood levels of calcium to fall and phosphorus to rise, leading to fragile dry hair, scaly skin, and more serious symptoms such as muscle cramps and even seizures.

More clues: If the cause of your dry, brittle hair is an underlying health condition, you’ll likely notice additional symptoms, such as dry, flaky skin. Overly dry hair also can signify that your diet is lacking in omega-3 fatty acids, which are found in salmon and fish oil, as well as many nuts and seeds, particularly flaxseed.

What to do: No matter what the cause of your dry, brittle hair, minimizing heat and chemical treatment are necessary for it to get healthy again. If an underlying condition is throwing your
hormones out of whack and in turn affecting your hair, talk to your doctor. The symptoms of hypoparathyroidism, for example, are often reduced or eliminated with supplemental vitamin D and calcium.

Next, deep condition your hair to restore it to health. Hair oils can help restore flexibility to the hair shaft, Barbosa says; look for products made with natural oils such as coconut and avocado oil, which penetrate the cuticle, rather than synthetic oils made from petrolatum, which merely coat the hair. Take fish oil supplements to renourish your hair. And minimize breakage while you sleep by replacing cotton pillowcases, which tend to catch and pull at hair, with satin pillowcases, which are smoother.

Red Flag #6: Hair falling out in small, circular patches

What it means: The body’s immune response turns on the hair follicles themselves, shrinking them and causing hair to fall out entirely in small, typically round patches. This kind of hair loss — which experts call alopecia areata — can also occur at the temples or at the part line. Diabetes can trigger the onset of such hair loss in some people. And it can continue to spread; in extreme cases, sufferers lose all their hair or lose hair over their entire body.

More clues:Alopecia areata can also cause the eyebrows or eyelashes to fall out, which in addition to the circular pattern can distinguish it from other types of hair loss. Alopecia areata is an autoimmune condition and has been shown to be more common in families with a tendency toward other autoimmune diseases, such as rheumatoid arthritis, early-onset diabetes, and thyroid disease.

What to do: The treatment most proven to work against alopecia areata is cortisone shots delivered directly into the scalp in the spots where the hair is falling out. “If you don’t get steroid injections, the circular patches will get larger and more cosmetically noticeable,” says California dermatologist Raphael Darvish.

Oral forms of cortisone and topical cortisone creams are also available, but topical cortisone is less likely to be successful unless it’s a mild case. Many doctors will also suggest using minoxidil (brand name Rogaine) to speed the rate of regrowth. Treatment may need to be repeated a number of times over a period of months.

Flaky scalp and gray hair

Red flag #7: Yellowish flakes on the hair and scaly, itchy patches on the scalp

What it means: What most of us grew up calling dandruff is now understood to be a complicated interaction of health issues that deserve to be taken seriously. Seborrheic dermatitis is a chronic inflammatory condition of the scalp that causes skin to develop scaly patches, often in the areas where the scalp is oiliest. When the flaky skin loosens, it leaves the telltale “dandruff” flakes.

Seborrheic dermatitis coexists in a “chicken-and-egg” relationship with a fungal infection caused by an overgrowth of a yeast that’s normally present on our scalps and skin. The yeast organism, Pityrosporum ovale, takes advantage of skin already irritated by dermatitis and inflames it still more. Some experts now believe that the yeast overgrowth may occur first, setting off the inflammatory reaction of the dermatitis, but that hasn’t been proven.

More clues: One way to differentiate seborrheic dermatitis from plain dry skin: When skin is dry,
you’ll typically also see dry, scaly skin between the eyebro[1]ws and by the sides of the nose, says California dermatologist Raphael Darvish. Also, seborrheic dermatitis tends to be seasonal, flaring up during the winter and disappearing in the summertime. It may be triggered by stress as well.

What to do: See a dermatologist to make sure it’s seborrheic dermatitis. If so, “there are great prescription shampoos and creams that can correct this,” says Darvish. The most effective treatment for yeast overgrowth is ketoconazole, a newer drug that works by damaging the fungal cell wall, killing the fungus. It comes in the form of pills, creams, or shampoo under the brand name Nizoral.

However, as an oral medication it has many side effects, so if you and your doctor decide on an oral treatment, an alternative antifungal, fluconazole, is preferable.

To calm flare-ups as quickly as possible, Darvish recommends using a prescription steroid cream. However, long-term use of these creams can thin the skin, particularly on the face, Darvish warns, so
doctors recommend using them in short-term doses known as “pulse therapy.”

To prevent recurrence, it’s necessary to get the skin back in balance, and many experts recommend garlic for this purpose. You can either eat lots of fresh garlic, which might annoy those in close proximity to you, or take a garlic supplement.

Red flag #8: Gray hair

What it means: Many people perceive gray hair as a red flag, worrying that it’s an indication of stress or trauma. And history abounds with stories like that of Marie Antoinette, whose hair was said to have gone snow white the night before she faced the guillotine.

Experts tend to dismiss such fears and stories, explaining that how our hair goes gray or white is primarily influenced by our genetics. However, in recent years research scientists have reopened the debate. While they can’t yet prove or explain it, many researchers now believe that stress may trigger a chain reaction that interferes with how well the hair follicle transmits melanin, the pigment that colors hair. Researchers are looking at the role of free radicals, which are hormones we produce when under stress, and studies seem to show that they can block the signal that tells the hair follicle to absorb the melanin pigment.

Other experts argue that a trauma or stressful event causes the hair to stop growing temporarily and go into a resting phase. Then when the hair follicles “wake up” and begin turning over again, a lot of new hair grows in all at once, making it appear that a great deal of gray has come in all at the same time.

More clues: The schedule and pattern by which you go gray will most likely follow your parents’ experience. However, if you suspect stress is graying you prematurely, keep careful track of stressful events. People who experienced a traumatic event that they believe caused them to go gray have reported that their hair eventually returned to its former color.

What to do: If you believe that stress or trauma is causing your hair to go gray, boost your coping strategies by working on your reactions to stressful situations. Yoga and meditation, for example, are effective stress-management tools.

If you see results, you’ll know you’re on the right track. In the meantime, you might want to talk to your parents about how their hair color changed over time, and learn what you can expect. After all, if Great-Aunt Eliza first developed her dramatic white skunk streak in her mid-30s, that might be something you want prepare yourself for.

14 Things Your Eyes Say About Your Health

Looking someone straight in the eye may or may not reveal their honesty — but the eyes can tell you about cholesterol, liver disease, or diabetes, if you know what to look for.

“The eye is a unique window into health,” says ophthalmologist Andrew Iwach, spokesperson for the American Academy of Ophthalmology (AAO) and executive director of the Glaucoma Center of San Francisco. “It’s the only place in the body where, without surgery, we can look in and see veins, arteries, and a nerve (the optic nerve).”

The eyes’ transparency explains why common eye diseases such as glaucoma, cataracts, and macular degeneration can be detected early with regular eye exams.

“Unfortunately, people get busy and delay not only eye exams but regular physicals. That’s why eye doctors sometimes discover other issues, like diabetes or high blood pressure,” Iwach says.
Especially vulnerable, he says: People like caregivers, who worry about others around them while neglecting care for themselves.

The Top 3 Red Flags

1. Red flag: Disappearing eyebrows

What it means: Shaved eyebrows are a fad (or fashion, if you will) in some circles. But when the outer third of the brows (the part closest to the ears) starts to disappear on its own, this is a common sign of thyroid disease — either hyperthyroidism (overactive thyroid gland) or hypothyroidism (underactive thyroid gland). The thyroid is a small but critical gland that helps regulate metabolism, and thyroid hormones are among those critical to hair production.

More clues: Brows tend to thin with age naturally. But with thyroid disease, the brow-hair loss isn’t evenly distributed; it’s a selective dropout on the ends. There’s usually a loss of hair elsewhere on the body, too, but the brows are so prominent, it’s often noticed here first. Early graying is a related sign of a thyroid problem. Women are more often affected than men, and hyperthyroidism especially strikes women in their 20s and 30s.

What to do: Mention this symptom to a dermatologist or your regular doctor. Most other symptoms of both hyper- and hypothyroidism are notoriously broad and general. Before you see a doctor, make note of any other changes you’ve noticed, possibly concerning weight, energy levels, bowel or menstrual regularity, mood, or skin changes.

2. Red flag: A stye that won’t go away

What it means: The vast majority of the time, a small, raised, often reddish bump along the inner or outer eyelid margin is just an unsightly but innocuous stye (also called a “chalazion”). But if the spot doesn’t clear up in three months, or seems to keep recurring in the same location, it can also be a rare cancer (sebaceous gland carcinoma).

More clues: Actual styes are plugged-up oil glands at the eyelash follicle. Fairly common, they tend to clear up within a month. A cancerous cyst that mimics a stye, on the other hand, doesn’t go away.
(Or it may seem to go away but return in the same spot.) Another eyelid cancer warning sign: Loss of some of the eyelashes around the stye.

What to do: Point out a persistent stye to an ophthalmologist (a medical doctor who specializes in the eye). A biopsy can confirm the diagnosis. The stye is usually removed surgically.

3. Red flag: Bumpy yellowish patches on the eyelid

What it means: Xanthelasma palpebra, the medical name for these tiny yellow bumps, are usually a warning you that you may have high cholesterol. They’re also called “cholesterol bumps” — they’re basically fatty deposits.

More clues: Sometimes people mistake these bumps for a stye, but with xanthelasma, there tends to be more than one bump and they’re quite small.

What to do: See your doctor or a skin or eye specialist. A diagnosis can usually be made by sight. An ophthalmologist can also examine the eye and see deposits; for this reason, in fact, sometimes high cholesterol is first diagnosed during a routine eye exam. The problem usually isn’t serious and doesn’t cause pain or vision problems. A physician will also evaluate you for other signs of coronary artery disease.

Red Flags 4 – 6

4. Red flag: Burning eyes, blurry vision while using a computer

What it means: You might be a workaholic, and you definitely have “computer vision syndrome” (CVS). The eyestrain is partly caused by the lack of contrast on a computer screen (compared with ink on paper) and the extra work involved in focusing on pixels of light. What’s more, by midlife the eyes lose some of their ability to produce lubricating tears. Irritation sets in, adding to blurriness and discomfort.

More clues: Does the problem worsen in the afternoon (when the eyes tend to become drier)? Is it
worse when you’re reading fine print (more eyestrain)? People who wear glasses or contacts tend to be bothered more by CVS. “Sometimes the problem is made worse by a fan positioned so it blows right in the face,” the AAO’s Iwach adds, noting that the air further dries tired eyes.

What to do: Reduce glare by closing window shades, investing in a computer hood, or checking out antireflective coating for your glasses (if you wear them). Simply tinkering with the contrast of your screen can help, too. White areas should neither glow brightly like a light source nor appear gray. Flat-panel LCD display screens (like those on laptops) cause less eyestrain than older models. Keep reference material close to the same height as your monitor, giving your eyes a break from having to refocus so much.

5. Red flag: Increasing gunk in the eye

What it means: Blepharitis — inflammation of the eyelids, especially at the edges — can have several causes. Two of them, surprisingly, are conditions better associated with other body parts: scalp dandruff and acne rosacea (which causes flushed red skin, usually in the faces of fair-skinned women at midlife).

More clues: The eyes may also feel irritated, as if specks have gotten in them. They may burn, tear, or feel dry. The crusty debris tends to gather in the lashes or the inner corners of the eyes, or even on the lids.

What to do: With clean hands, apply a warm, damp washcloth to the eyes for about five minutes at a time to loosen debris and soothe the skin. See a doctor, who may prescribe an antibiotic ointment or oral antibiotics, as well as artificial tears.

6. Red flag: A small blind spot in your vision, with shimmering lights or a wavy line

What it means: An ocular migraine (also called an “ophthalmic migraine,” “optical migraine,” or “migraine aura”) produces this disturbed vision, with or without an accompanying headache. Changes in blood flow to the brain are thought to be the cause.

More clues: The visual distortion starts in the center of the field of vision. It might appear as a bright dot, dots, or a line that can seem to move and disrupt your ability to see properly, as if you were looking through a pocked or cracked window. It’s painless and causes no lasting damage. Individuals seem to have different triggers (ranging from chocolate, caffeine, and alcohol to stress). A headache, possibly severe enough to cause nausea, sometimes follows.

What to do: If you’re driving, pull over until the phenomenon passes (usually within an hour). Do have an eye specialist check it out if vision impairment lasts more than an hour or so, to rule out serious problems such as a retinal tear; or if you also experience other symptoms elsewhere that could indicate stroke or seizure (such as fever, loss of muscle strength, or speech impairment).

The Final 7 Red Flags

7. Red flag: Red, itchy eyes

What it means: Many things can irritate eyes, but itchiness accompanied by sneezing, coughing, sinus congestion, and/or a runny nose, usually screams “I’m allergic!” When the eyes are involved, the trigger is usually airborne, like pollen, dust, or animal dander.

More clues: An eye allergy can also be caused by certain cosmetics or ointments. Some people, for example, are allergic to the preservative in eye drops used to treat dry eyes.

What to do: Staying away from the allergic trigger is the usual treatment. Antihistamines can treat the itchiness; those in eye-drop or gel form deliver relief to the eyes faster. If the problem turns out to be an allergy to eye drops, look for a preservative-free brand.

8. Red flag: Whites of the eye turned yellowish

What it means: Two groups of people most often show this symptom, known as jaundice: Newborns with immature liver function and adults with problems of the liver, gallbladder, or bile ducts, including hepatitis and cirrhosis. The yellow in the white part of the eye (the sclera) is caused by a buildup of bilirubin, the by-product of old red blood cells the liver can’t process.

More clues: “Other tissues of the body would have the same look, but we can’t see it as clearly as in the whites of the eye,” says ophthalmologist Iwach. (Skin can also turn yellowish when a person consumes too much beta carotene — found in carrots — but in those cases the whites of the eyes remain white.)

What to do: Mention the symptom to a doctor if the person isn’t already under care for a liver-related disease, so the jaundice can be evaluated and the underlying cause treated.

9. Red flag: A bump or brown spot on the eyelid

What it means: Even people who are vigilant about checking their skin may overlook the eyelid as a spot where skin cancer can strike. Most malignant eyelid tumors are basal cell carcinoma. When such a tumor appears as a brown spot, then — as with any other form of skin cancer — it’s more likely to be malignant melanoma.

More clues: Elderly, fair-skinned people are at highest risk. Look especially at the lower eyelid. The bump may look pearly, with tiny blood vessels. If the bump is in the eyelash area, some eyelashes may be missing.

What to do: Always have any suspicious skin spots or sores checked out by a dermatologist, family physician, or eye doctor. Early detection is critical, before the problem spreads to nearby lymph nodes.

10. Red flag: Eyes that seem to bulge

What it means: The most common cause of protruding eyes is hyperthyroidism (overactivity of the thyroid gland), especially the form known as Graves’ disease. (First Lady Barbara Bush had it.)

More clues: One way to tell if an eye is bulging is to see whether there’s any visible white part between the top of the iris and the upper eyelid, because normally there shouldn’t be. (Some people inherit a tendency toward eyes that bulge, so if the appearance seems to run in a family, it probably isn’t hyperthyroidism.) The person may not blink often and may seem to be staring at you. Because the condition develops slowly, it’s sometimes first noticed in photos or by the occasional visitor rather than by someone who lives with the person every day.

What to do: Mention the symptom to a doctor, especially if it’s present in tandem with other signs of Graves’, including blurry vision, restlessness, fatigue, increase in appetite, weight loss, tremors, and palpitations. A blood test can measure thyroid levels. Treatment includes medication and surgery.

11. Red flag: Sudden double vision, dim vision, or loss of vision

What it means: These are the visual warning signs of stroke.

More clues: The other signs of stroke include sudden numbness or weakness of the arm or leg or face,
typically on just one side of the body; trouble walking because of dizziness or loss of balance or
coordination; slurred speech; or bad headache. In a large stroke (caused by a blood clot or bleeding in the brain), these symptoms happen all at once. In a smaller stroke caused by narrowed arteries, they can occur across a longer period of minutes or hours.

What to do: Seek immediate medical help by calling 911.

12. Red flag: Dry eyes that are sensitive to light

What it means: Sjogren’s (pronounced “show-grins”) syndrome is an immune system disorder. It impairs the glands in the eyes and mouth that keep them moist.

More clues: Sjogren’s usually affects women over age 40 with autoimmune disorders such as rheumatoid arthritis or lupus. Usually the eyes and mouth are affected together. The person may also have vaginal dryness, dry sinuses, and dry skin. Because of a lack of saliva, it can be difficult to chew and swallow.

What to do: A doctor can diagnose Sjogren’s through testing. Artificial lubricants (such as artificial tears) are usually necessary to protect the eyes, as well as to improve eating. Drinking plenty of water also helps.

13. Red flag: Sudden difficulty closing one eye, inability to control tears in it

What it means: Bell’s palsy is an impairment of the nerve that controls facial muscles (the seventh cranial nerve), causing temporary paralysis in half the face. It sometimes follows a viral infection (such as shingles, mono, or HIV) or a bacterial infection (such as Lyme disease). Diabetics and pregnant women are also at higher risk.

More clues: Half of the entire face, not just the eye, is affected. Effects vary from person to person, but the overall effect is for the face to appear droopy and be weak. The eyelid may droop and be difficult or impossible to close, and there will be either excessive tearing or an inability to produce tears. The effects tend to come on suddenly.

What to do: See a doctor. Most cases are temporary and the person recovers completely within weeks. Rarely, the condition can recur. Physical therapy helps restore speaking, smiling, and other tasks that require the facial muscles working in unison, and it also helps avoid an asymmetrical appearance. Professional eye care can keep the affected eye lubricated and undamaged.

14. Red flag: Blurred vision in a diabetic

What it means: Diabetics are at increased risk for several eye problems, including glaucoma and cataracts. But the most common threat to vision is diabetic retinopathy, in which the diabetes affects the circulatory system of the eye. It’s the leading cause of blindness in American adults.

More clues: The changes linked to diabetic retinopathy tend to show up in people who have had the disease for a long time, not those recently diagnosed. The person may also see “floaters,” tiny dark specks in the field of vision. Sometimes diabetes causes small hemorrhages (bleeding) that are visible in the eye. There’s no pain. People with poorly controlled blood sugar may have worse symptoms.

What to do: Someone with diabetes should have a dilated eye exam annually to catch and control the earliest stages of retinopathy, glaucoma, cataracts, or other changes — before they manifest as changes you’re aware of.

Best Tips For Cooking Beans

Beans are a member of the legume family, along with peas and lentils. They are a main staple for a vegetarian diet, and can be used by meat eaters as an alternative protein in recipes. However, because they are a starch-protein combination, they can be difficult for people to digest. One reason being that intestinal bacteria attacks the indigestible fiber that remains in the large intestine, causing gas to form. Another is a lack of proper enzymes needed to break down legumes trisaccharides into simple sugars. There are, however, a few things the home cook can do to help make beans easier to digest.

Why bother? Because according to Traditional Chinese medicine, beans strengthen the kidney-adrenal function, which governs balanced sexual activity and allows for proper growth of the physical body and brain. So, break out those dried beans that have been gathering dust on your shelf and cook up a batch for dinner. You can always freeze the leftovers for another day.

Tips For Preparing Beans:

Long Soak: Presoak the beans for five to eight hours, then change the water before cooking. Presoaking also reduces the cooking time by a good half hour or more.

I-forgot-to-soak-the-beans-soak: Cover the beans with water, bring to a boil, cover, remove from heat, and allow to sit for one hour. Change the water and continue cooking.

Salt: Add the salt and acidic ingredients such as tomatoes once the beans are soft.

Pressure-cooking: helps to reduce the gaseous qualities.

Lentils: Allow your digestive system to get used to beans by beginning with lentils, then adding small amounts of beans to your diet.

Begin: with beans that are easier to digest such as navy, great northern, aduki, or black beans.

Additions: Add a small piece of kombu seaweed when cooking beans, or season with ginger, fennel, cumin or bay leaf to help reduce the gaseous qualities.

Beano: Put a few drops of Beano in the first few bites of your meal. Beano is an enzyme product that works to digest the carbohydrates that would normally feed the intestinal bacteria.

Foam: When boiling beans skim the foam from the top and discard. Allow beans to simmer uncovered for first 20 minutes to help disperse the indigestible enzymes.

Vinegar: Add brown rice, apple cider or red wine vinegar to the beans in the final minutes of cooking.

Cooking with Beans:

The basic principle for cooking all beans is the same, no matter how you plan to use them in a recipe.

1. Before cooking, pick through the beans and remove any stones, broken beans, or other bits of debris.

2. Soak the beans and drain the soaking water and add fresh water before cooking.

3. Add kombu or herbs and bring water to a hard boil, reduce the heat, and let the beans simmer until tender, usually about forty-five to fifty minutes. Skim any foam that rises to the surface. At this point, you can add vegetables and seasonings such as potatoes, carrots, peppers, basil, and bay leaf.

4. About fifteen minutes before the beans are done, add the salt and any acidic ingredients like tomatoes. The salt helps to bring out the full flavor of the beans; but adding salt and acidic foods too early inhibits the water’s ability to penetrate the beans, leaving them hard and tough no matter how long you boil them.

5. When the beans are soft and tender, adjust the seasonings as needed.

Because beans and legumes have diuretic properties and can be drying to the body many cultures combine them with oil in order to stimulate the digestive process and enhance the flavor of the dish. For example, when the beans are almost tender add some oil to a skillet and saute chopped onions until slightly tender. Add ginger, garlic, tomatoes, and chopped parsley to the onions. Let simmer for five minutes then add to the beans along with a small amount of water used to wash out the flavors left behind in the skillet. Season with salt, miso or soy sauce for a deep, enriching flavor. Most importantly, chew your beans well.

10 Tips for Weight Loss After 40

Every year, it seems, the needle on the scale is a little harder to budge. You cut back on portion size; you say, “No, thank you,” to dessert; you sign up for an aerobics class — and yet your jeans size goes up and your energy level goes down. What’s going on?

Starting in our early 40s, our bodies go through a series of changes that affect the very core of our being. Thanks to hormonal and other changes, the very growth rate of our cells slows down. Some of these changes are the result of the natural aging process. It’s just something we have to learn to work around.

Sometimes, though, something’s gotten off track, metabolically speaking, and there’s an underlying medical issue that needs to be dealt with before the usual weight-loss measures will have any effect. Here’s a ten-step plan for understanding the challenges that prevent weight loss over 40, and for learning how to overcome them.

1. Get to know your body’s new biological rhythms — and adjust to them.

In long-ago times, older didn’t necessarily mean plumper. Think of those icons of the American prairie, the sinewy pitchfork-wielding farm couple pictured in American Gothic. But today, those of us over 40 face a twofold challenge: We’re living longer, and we’re no longer out there pitching hay to the cows at 5 a.m.

When it comes to burning calories, it’s a fairly simple equation. What goes in must be burned off, or it sticks to our ribs. Acquiring weight is absurdly easy — eating just 100 extra calories a day (100 more than what your body burns) will lead to a nine- to ten-pound weight gain over the course of a year, experts say. How much is 100 calories? Not a lot: A can of Coke contains 155 calories, a chocolate bar more than 200. Of course, that cola or chocolate chip cookie is no problem if we’re walking or running it off. But after 40, our activity level tends to decline, too. So the challenge is to bring the two into balance.

Look back over the past year, and think about when your weight seemed to be holding steady and when it seemed to be trending slowly upward. What were you doing during the good weeks? What sabotaged you the other times? Make a list of what works for you, and what throws you off. Your own healthy habits in the past are the ones most likely to work for you now.

2. Eliminate underlying metabolic conditions.

Would it surprise you to know that thyroid problems strike as many as one out of five adults over age 40? The most common of these is hypothyroidism — an underactive thyroid — and hypothyroidism is one of the primary reasons many people over 40 can’t lose weight. The thyroid is a tiny gland that produces hormones that regulate metabolism, and when it’s underactive, so is everything else. Think of low thyroid as having your internal thermostat set too low. Symptoms include feeling cold all the time, poor circulation in the hands and feet, clammy hands, tiredness and lethargy, hair loss (including eyebrows and eyelashes), and weight gain — despite real attempts to exercise and eat well.

If you suspect an underactive thyroid may be undermining your metabolism, the first step is to call the doctor and ask for a thyroid test. But beware: The first-line thyroid blood test, known as the TSH, is notoriously unreliable. And doctors are busy arguing about what’s “normal” anyway. As of 2003, the American Association of Clinical Endocrinologists began recommending that the cutoff for normal TSH should be 3.0 versus the older standard of 5.5, but this news hasn’t reached many labs or doctors. And lots of endocrinologists think having a TSH between 1 and 2 is ideal for maintaining normal body weight and function.

If your TSH result is above 3.0, make sure your doctor knows about the new recommendation. And ask for further testing; there a number of additional tests that many experts believe give more accurate readings of thyroid function.

3. Adjust your eating habits for maximum energy.

Your goal at this stage in your life is to keep yourself feeling full without succumbing to the temptation to eat like you could at age 20. One strategy recommended by internist Julie Taw, MD, of Englewood, New Jersey, is to eat more frequently but to consume less at each sitting. An added benefit of eating this way is that it’s easier to keep your blood sugar steady, so you don’t have the peaks and valleys that contribute to fatigue.

Here’s the rule: Try eating five to six small meals a day, and don’t go more than three or four hours without eating. For example, you might eat a healthy breakfast before you leave for work, then have a nonfat yogurt in the late morning. Then instead of eating a big pasta lunch and spending the afternoon in a stupor, eat a light lunch and spend the rest of your lunch break taking a brisk walk. An afternoon snack of trail mix and an apple keeps you from needing the 4 p.m. sweet treat and makes it easier to avoid overeating at dinner.

Your goal is the opposite of the starvation approach to dieting — you want to trick your body into feeling satisfied and well-fed at all times, though the total amount you’re eating is less.

4. Time your eating to take advantage of your body’s natural rhythms.

Experts are sure of one thing: Snack (or eat dinner) after 9 p.m., and whatever you eat goes straight to your hips and stomach. Happily, the opposite is also true — what you eat in the mornings, when your metabolism is revved up to its optimum operating speed, is much more likely to be expended efficiently.

Don’t like to eat breakfast? Sorry, but there’s no way around this one; eating a good breakfast is one of the key habits experts have identified that keeps thin people thin. When members of the National Weight Control Registry (people who have maintained a weight loss of 30 pounds for between one and six years) were surveyed, 78 percent reported eating breakfast every day and almost 90 percent reported eating breakfast at least five days a week. This was one of the only factors researchers identified that those in the registry had in common!

5. Trick your metabolism with fat-fighting foods.

I know you’ve heard it before, but it’s true: It’s really not just about how much you eat, but how much of which foods. There are plenty of healthy foods you can eat all you want of — and no, that doesn’t mean stuffing your fridge with celery sticks, 1970s-style. Instead, make a few simple tweaks to your diet, incorporating foods that actually fight fat instead of those that trigger it. Then eat other foods in moderation, and you should be OK.

6. Make muscles an ally in your weight-loss campaign.

There’s one thing the exercise gurus have gotten right: The more muscle mass you have, the more effectively your metabolism burns calories. But sad to say, a natural tendency of aging is to lose muscle, gradually replacing it with fat. So in order to enlist the calorie-burning abilities of muscle, we do have to work at it.

A common misconception, though, is to mix up muscle-building with aerobic exercise. Both are good, but the aerobic part — though it does burn calories — isn’t what we’re talking about here. What you really need to focus on for long-term benefit is basic strength training. Buy some hand weights, a bar, and some stretch bands, and channel your high school gym teacher. Make it as pleasant as possible; work out while you watch the evening news or your favorite sit-com. Slowly and gradually build up those biceps, abs, deltoids, and glutes, and you’ll have some key allies in your fight to prevent age-related weight gain.

7. Get more sleep to burn more calories.

As any perimenopausal woman or hardworking man over 35 can tell you, sleep gets ever more elusive as you age. It’s not just that we’re busier and more stressed. We also have multiple physical issues, from back pain to snoring to night sweats, any of which can interfere with getting a good night’s sleep.

Yet, paradoxically, getting a good night’s sleep is one of the keys to losing weight, says neurologist David Simon of the Chopra Center in Carlsbad, California. In recent years, significant research has shown that lack of sleep is directly connected to weight gain because of the actions of two hormones, leptin and ghrelin, that control hunger and satiety, or feeling full. When you’re sleep deprived, your ghrelin levels increase at the same time that your leptin levels decrease. The result is more craving, less feeling full. Add to that the fact that sleep-deprived people often crave “energy” foods, which tend to be sweet or salty, and you can see how small changes in your routine can add up to big weight gain.

Lastly, there are tantalizing new studies demonstrating that our bodies are most metabolically active while we sleep. So the longer we sleep, the more we rev up our inner fat-burning engines. (You still shouldn’t snack late at night, though. Researchers also believe that calories eaten late in the evening are processed less efficiently than those consumed during the day, no matter how active our nighttime metabolism.)

Add these all together and you can see a pattern emerging: The older we are, the harder it is to get a good night’s sleep — and the less we sleep, the more likely it is we’ll gain weight. What to do? Take steps to combat sleep problems and your waistline will benefit, too.

8. Strike up a healthy relationship with your sweet tooth.

If you’re dying for a sweet treat, give it to yourself, savoring it slowly so it registers fully with your brain’s pleasure sensors. A trick that many experts recommend: Cut the treat in half before you start eating, carefully wrapping the second half up to “save for later.” You may or may not want it — sometimes if you eat the first half slowly and consciously enough, you’ll feel satisfied. But knowing it’s there if you do plays a nice trick on your brain, which tends to crave things it perceives as being in short supply.

Also, don’t try to substitute artificially flavored sweets. Researchers have recently discovered that artificial sweeteners fail to trigger the body’s natural satisfaction response. So eating that 100-calorie artificially sweetened cookie only adds to your problems; you’ll keep on wanting the real cookie, so the 100 calories you just ate were in vain.

9. Forget dieting. Instead, focus on your fuel-to-energy ratio.

If, like most 40-somethings, you’re packing some extra pounds, you’ve probably made plenty of resolutions to go on a diet. You’ve also probably figured out by this point in your life that diets rarely work, and neither does suddenly embarking on a strenuous new exercise regimen. There’s a good reason that sudden, drastic changes don’t lead to long-term weight loss, and may even lead to a rebound.

Have you noticed that your weight tends to stay fairly constant week to week, even if one day you go on a junk food binge and the next day you’re fairly good? Nature designed us with optimum abilities to maintain a steady metabolic rate, because it helps us weather food shortages and sudden demands on our energies.

Unfortunately, this means that when you’ve gradually gained weight over time, your body has adapted to the new weight and now does its best to hold onto it. So here’s what you do: You make slow, gradual adjustments to each end of the equation. And you — and only you — decide which end of the fuel-in, energy-out equation to emphasize and when.

10. Make slow, realistic changes in tune with your lifestyle.

Let’s say you want to lose ten pounds. To do so right now, you’d have to eat nothing at all for about 2 weeks, or jog for 51 hours, or walk for 126 hours. Not only would it be impossible, attempts like those would send your body into starvation-mode metabolic slowdown, sabotaging your efforts.

But you could also, much more effectively, set out to lose one to two pounds a week for the next five to ten weeks. Remind yourself that you are the only one in charge of tuning up your metabolic engine. Decide whether you prefer to focus your energies on cutting down the number of calories you’re consuming, or on upping the number you’re burning. Most likely, you’ll strike a balance between the two that suits you.

If adding three half-hour walks a week is relatively painless for you, that’s a good choice. If going outdoors in ten-degree weather is singularly unappealing and you wouldn’t be caught dead in a gym, then focus on dietary changes instead.

Your primary goal should be making small, gradual lifestyle changes that you can incorporate into your daily routine and stick with over time. That’s the ultimate secret to combating over-40 weight gain.