Sugar and Skin

Is there a link between sweets and wrinkles?

It’s no secret that your 3 o’clock Peanut M&M’s habit can affect your waistline. And now some experts are suggesting it could also make your skin age faster—which, in turn, is spawning a new crop of antiaging beauty products. Are they worth it? Some dermatologists believe eating more sugar than you need will speed up your body’s natural process of glycation—that’s when sugar and protein molecules gang up and get hostile toward collagen. And collagen damage can make your skin less elastic, more easily wrinkled, and more vulnerable to sun damage, according to Paul J. Beisswenger, MD, a diabetes researcher and Dartmouth Medical School professor of medicine.

Not all experts are convinced, though. “There’s probably some connection between too much sugar and your skin; we just don’t have enough data to show us what that is,” says Ranella Hirsch, MD, vice president of the American Society of Cosmetic Dermatology and Aesthetic Surgery. “Most research has been small, commercially sponsored, or done on cells in a lab.” So it’s hard to know if results translate to your skin.

That said, a few cosmetics companies are confident enough about the sugar-wrinkle connection to create products designed to combat it. These are among the first on the market:

• Estée Lauder Resilience Lift Extreme ($70; esteelauder.com). The line includes firming creams and a lotion, all with SPF 15, as well as a night cream and an eye cream.

• Dr. Brandt Lineless Cream ($100; sephora.com) works for normal to dry skin and can be used in the morning or at night after cleansing.

• Prescriptives Anti-AGE Advanced Protection Lotion ($60; prescriptives.com) is a lightweight daily moisturizer with SPF 25 that helps guard against the effects of sun, pollution, and stress.

How beneficial these topical sugar-busters are may still be in question, but one thing’s for certain: They’re all good moisturizers, and two fight skin aging with sunscreen.

Give Your Eyes a Boost

Makeup application tips to brighten your eyes.

Play up top lashes.
Droopy top lashes can make your whole eye look like it's sagging. Give the lid a lift by first blending a dark eyeliner along the top lashes (start at the inner corner of your eye and follow the lash line to the outer corner, concentrating the color on the outer third of the lid) and then curling and coating lashes with mascara. Leave your lower lashes bare: Lining them only draws attention to dark circles and makes the eye look smaller.

Use concealer strategically.
If puffy eyes or dark circles make you look like you pulled an all-nighter—even when you've had eight hours' sleep—cover them up with a swipe of concealer in just the right place. Some people are naturally more prone to puffiness (which is caused by fluid retention in the tissue around the eyes) than others, and as the skin ages and loses elasticity the problem can seem more pronounced. The best tactic: Blend a liquid concealer only on the line created by the bag—the swollen area itself doesn't need coverage, says Alison Raffaele, a makeup artist who specializes in cover-up (Skin Alison Raffaele). If dark circles are your nemesis, erase them by blending concealer over the entire eye area—including circles and from lashes to brows—to even out your skin tone and give you a well-rested look. Always use your fingers to apply concealer around the eye; this allows you to achieve a flawless finish.

Brighten up with an eye pencil.
Line the inner rim of your lower lashes with an eye pencil (in white or flesh tones for light skin; in golden tones for dark skin) to erase any redness around your eyes and make whites look brighter and larger. We like Chanel's Line Perfector Face Pencil and Three Custom Color Specialists' Clarifier Pencil. Be sure to blend well so that people will notice your eyes, not the liner.

Pick the right eye cream–and put it on ice.
Creams containing anti-inflammatory ingredients can help reduce puffiness, says Dennis Gross, MD, a New York City-based dermatologist. Cucumber extract, caffeine, and vitamin K have been shown to constrict blood vessels and cut down on fluid retention. Refrigerating your eye cream can also help, since the chilled cream works like a cold compress, reducing swelling.

Not Tonight Dear, I'm Shopping

Which would you rather give up—sex or smoking?

Hard to believe, but a recent British poll found that most European smokers would rather go without sex for a month than cigarettes. That got us wondering what Health's non-nicotine-addicted, mostly female readers prize more than sex. The answers, according to a Health.com survey: a full night's sleep, shopping, and exercise. We can understand how sleep got the top vote—we know American women are tired. But shopping and workouts? Come on.

However, at least one expert believes these responses make perfect sense. Sandra Leiblum, PhD, director of the Center for Sexual and Marital Health at Robert Wood Johnson Medical School and co-author of Getting the Sex You Want, says many women feel they can count on having more fun at the mall than in bed. "Every time you go shopping, there's a different adventure," Leiblum says. "For a lot of women, sex has become boring and predictable." Point taken—but jogging? "Exercise produces a rush of endorphins, and afterward women feel good about their bodies," Leiblum explains. "With sex, they may feel more self-conscious."

Overall, Leiblum says your answers reflect many women's attitudes toward sex. "There's a notion that people are having a ton of sex, and they feel deprived if they don't have it." In reality, she says, "giving sex up might be a relief for some women." (A recent survey by the Kinsey Institute found that 24 percent of the women surveyed felt "worried" or "distressed" about sex.) Luckily, you don't have to go that far. If medical concerns aren't causing your bedroom boredom, the old advice still holds true: Take stock of your needs, and start talking. Hopefully, you'll end up like Health reader Maureen, who wrote, "There's nothing I'd give up sex for."

Fit Advice: Workout Warning Signals

The old adage "No pain, no gain" isn't necessarily true. Take note of these symptoms that signal it's time to stop your workout and seek medical attention.

It's one thing to breathe (and sweat) a little more heavily than usual during an intense workout, but it's another thing entirely to find yourself gasping for air during a leisurely after-dinner walk. While occasional exercise aches and pains are rarely cause for alarm, certain symptoms that pop up out of the blue when you exercise could sometimes signal something serious, says Martha Gulati, MD, assistant professor of preventive medicine at Rush University Medical Center in Chicago. If you're otherwise healthy and in good shape but experience any of the warning signs listed below during a workout, stop what you're doing and see your doctor right away.

What You Feel: Chest pain, pressure, or tightness
What It Could Mean: Heartburn, muscle strain, or something more serious, like heart disease

What You Feel: Unusually rapid heartbeat
What It Could Mean: Heart disease, arrhythmia, anemia, thyroid disease, or even just too much caffeine

What You Feel: Difficulty breathing
What It Could Mean: Heart disease or asthma

What You Feel: Fainting
What It Could Mean: Heart disease, arrhythmia, a glitch in your nervous system, dehydration, or low blood sugar

What You Feel: Severe headache
What It Could Mean: Dehydration, stroke, cerebral aneurysm, or high blood pressure

The New Skinny on Cellulite

Cutting-edge treatments are taking on this perplexing problem—with beautiful results.

For years, you’ve heard that the only way to improve cellulite is with diet and exercise. That’s pretty frustrating advice, considering that about 90 percent of women—including those who exercise like Olympians—are walking around with unwanted dimples.

All that’s about to change, though. Research is spurring new treatments that are producing visible improvements in a majority of women. We wish we could tell you that these procedures will magically make all of your cellulite disappear, but that would be stretching the truth. We can say that these are your best bets for making a dent—or fewer of them—in those dimpled thighs.

Lasers that relocate fat
They’re the latest high-tech take on cellulite removal: painless lasers that smooth the fatty layer for a less-puckered appearance. One, called the TriActive (a laser surrounded by suctioning rollers), recently won approval from the U.S. Food and Drug Administration (FDA) as an effective cellulite treatment. A similar, newer laser is the VelaSmooth—which combines radio waves, infrared light, rolling massage heads, and suction—is awaiting FDA review and generating early buzz. Both of these lasers theoretically firm your skin by boosting collagen while melting and rearranging the fatty tissue.
The process: As you lie on a table, a technician passes the device over your target areas. Far from being painful, the sensation is pleasurable—like getting a slightly vigorous massage for half an hour or so. You’ll see your best results after 2 months of weekly treatments. (Dermatologists recommend that you get maintenance treatments at 2-month intervals.)
The proof: In FDA clinical trials done by Mitchel Goldman, MD, a cosmetic dermatologic surgeon and medical director of La Jolla Spa MD in California, the TriActive achieved visible results in 100 percent of patients; 75 percent of them saw their dimples reduced by 50 percent or more. VelaSmooth also seems somewhat successful in studies. “We measured an average thigh circumference reduction of 3.3 millimeters (about 1/8 inch) after eight treatments,” Sadick says.
The payout: $150 to $200 for each of the eight to 14 sessions. Go to syneron.com for locations.

Dream creams for firmer skin
Plenty of creams promise to cure cellulite. But the only ones with years of clinical data behind them are those containing retinoids, vitamin-A derivatives proven to boost collagen production. You can find retinoids in over-the-counter body lotions (listed on the label as “retinol”), but the most potent are the prescription versions sold under brand names like Renova and Retin-A. “Retinoids create a firmer, thicker skin cover that can help camouflage cellulite,” says Paul T. Rose, MD, who served until recently as professor of clinical dermatology at the University of South Florida.

Newsier, but not-so-proven, are fat-busting creams with ingredients like caffeine, black tea, and theophylline (a form of caffeine). The theory is that these stimulants work to reduce thigh circumference by breaking down fat-cell stores more rapidly.
The process: No matter which formula you use, you’ll need a good dose of patience. “Cellulite creams should be applied daily for about 8 weeks in order to see results,” Goldman says.
The proof: A study in the American Journal of Clinical Dermatology reported that testers who used retinol creams for 6 months saw an improvement in skin firmness—from 11 to 15 percent on average. Early research on fat-burners looks encouraging, too. In a recent Goldman study in the Journal of Cosmetic Dermatology, some 76 percent of those using a fat-burning cream (containing caffeine and green tea) lost an average of ½ inch in their thigh circumference.
The payout: From $12 for drugstore brands to more than $60 for department-store or spa versions (you tend to get a higher percentage of active ingredients in pricier lines). Among your best over-the-counter options: Neutrogena’s Anti-Cellulite Treatment, L’Oréal’s Sublime Slim Anti-Cellulite + Skin Sculpting Body Firming Gel, Shiseido’s Body Creator Aromatic Firming Cream, and Avon’s Cellu-Sculpt Anti-Cellulite Slimming Treatment.

Devices that roll away ripples
It was big news in the mid-1990s when Endermologie became the first FDA-approved method for the reduction of cellulite. It’s now one of the top cellulite procedures at doctors’ offices and spas.
The process: During any Endermologie session, you squeeze yourself into a skintight nylon/spandex bodysuit. Then a technician runs a device (basically, a vacuuming head surrounded by rollers) over your trouble spots—suctioning, pulling, and squeezing them for 20 to 30 minutes. The newer machines use less suction power and smaller, independently moving rollers, making for a session that’s less like torture and more like a massage. You’ll get some swelling and redness with either method, but the newer one tends to work much faster—in 10 rather than 14 to 20 visits (doctors usually recommend two treatments per week).
The proof: Endermologie originally received FDA clearance after a clinical study found it to be both safe and effective. “We checked the subjects at 10 and 20 weeks,” says study co-author Lillian Nanney, PhD, director of plastic surgery at Vanderbilt University School of Medicine. “And we found that while their fat did not disappear, the connective tissue in the treated area became thicker, giving the appearance of firmer skin. These results improved with each new treatment.”
The payout: Endermologie can get pricey, running between $80 and $150 per session. Go to aad.org to find a doctor near you.

Introducing the Airport Spa

Delayed flights and missed connections can leave you stressed and bored, with hours to kill. To make the wait less painful, many airports are bringing in full-service spas.

Here are a few airport spas we like:

Long-layover reviver. At the Oasis Day Spa in New York’s JFK Inter-national Airport, you’ll find a full menu of manicure, pedicure, and facial treatments, including The Classic Facial ($80 for 45 minutes) that uses papaya and pineapple enzymes and a cream mask to hydrate tired skin.

The screaming-kids de-stresser. Doze in a plush massage lounger at XpresSpa in the Pittsburgh International Airport while up to three attendants work on your face, feet, and hands to restore full-body circulation ($35 for 30 minutes).

The missed-flight calmer. A 15-minute oxygen mask at OraOxygen Spa in the Detroit International Airport helps reduce fatigue and intensify mental alertness ($18).

Live Your Dreams

Life lists help you set and achieve important goals. Are you ready to start living your dreams?

The act of writing down a year’s worth of goals helped me move from “What if I did this?” to “When will I do this?” That’s also the idea behind life lists, which have become the power tools for helping people like me reshape their lives. They can’t be viewed as simple to-do lists, though. “A life list helps you focus on finally doing things you’ve imagined will make your life better,” says Molly Barker, founder of Girls on the Run International, a North Carolina–based running and character-building program for preteen girls.

That’s why “good lists start with a lot of soul-searching,” says Phil Keoghan, host of CBS TV’s popular reality show The Amazing Race who’s kept a list for 19 years. He believes so fervently in the transforming power of life lists that he’s written a book on the topic—No Opportunity Wasted: 8 Ways to Create a List for Life (due out in paperback in May). He’s also launched a TV show of the same name on the Discovery Channel.

Major events like a serious illness, the death of a loved one, or the loss of a job may cause you to reevaluate your life. For Keoghan, it was a near-death experience while filming an underwater shipwreck. Soon after his rescue, Keoghan grabbed a crumpled brown bag and shakily scribbled a list of all the things he wanted to do before he died. Topping the list of mostly daredevil stunts: Do another dive on that dangerous shipwreck.

Over the years, the man and his list have matured. Recently, he drove across America with his father. “I asked him every question that I would have regretted not knowing the answer if he died,” Keoghan says.

As for me, my life lists are certainly still working. I’ve performed in The Vagina Monologues (before an audience that included my shocked in-laws), for instance, and driven 100 mph on the German autobahn.

Life lists can work for you, too. And these tips from the experts can help you get started.

Tap into your passions.
Before starting a list, consider this: If I were to take my last breath at 3 p.m. tomorrow, what will I regret not having done? “Many of us never take the time to identify our dreams and passions to make the shoulda, woulda, couldas happen,” Keoghan says.

Set a special day to make your list.
Each year, create your life list on a day that’s meaningful for you. Start by reviewing your previous year’s successes, accomplishments, and challenges. Then consider what you still want to have, to be, and to do, advises Jatrine Bentsi-Enchill, CEO of North Carolina–based InSite Corporate Coaching and Training.

Test your limits.
Don’t stick to ordinary tasks that you have never made time for or have avoided doing. Include challenges that take you into unfamiliar, even scary, territory. “Facing your fears will transform your life,” Keoghan says.

Revisit and revise—often.
Your life changes over time, so should your list. “Put it in a place where you see it every day. But don’t get stuck on the details,” advises clinical therapist Judith DiPerna, who says lists help her depressed and anxious patients feel more in control of their lives. Being flexible allows you to take advantage of any opportunity that comes your way

Reflecting on You

Build stronger, happier relationships—by taking a closer look at the part you play.

After years of counseling couples in transition, Denise Mosher knew a bad relationship when she saw one. And while her own 18-year marriage was not one of them, she still had the nagging feeling that it could be better. Increasingly, she was bugged by the little things: the fanny pack her husband left on the counter, the feet he didn’t wipe on the way into the house.

Then Mosher read about Naikan (pronounced NYE-kon), a little-known practice of self-reflection rooted in Zen Buddhism and developed in Japan in the 1940s. It looked like something that could help her decode her feelings and figure out what to do about them quickly, easily, and effectively. So the 40-year-old minister in Monmouth, Oregon, decided to give it a try.

Using Naikan, Mosher asked herself three questions about her relationship: What did I receive from this person? What did I give this person? And what troubles did I cause this person? Each day she repeated the exercise, and recorded her answers in a journal.

Naikan’s power lies in the details—the good, the bad, and the ugly truths that make up the mosaic of any relationship. But your focus is on the role you play, your actions and choices, and on what you received from the other person. What you uncover can be surprising. “People are often in denial about their ability to cause trouble in the world,” says New York psychologist Wylie Goodman, PhD, a traditional therapist who uses Naikan in her practice.

Couples who practice Naikan regularly don’t usually have to wait long to experience the positive results, Goodman says. “They quickly start acting differently toward each other,” she explains.

Mosher agrees. Once she started asking the three questions, she was able to stop letting her husband’s minor transgressions get to her. Instead, she began noticing all the things he does for her, like fixing her office computers after a busy day at work. And she started fessing up to her own annoying habits, like her chronic tardiness. “I’ve kept him waiting constantly, for over 20 years—every party, every appointment,” she admits.

On their own, these little details are, well, little. But Mosher says looking at them through Naikan’s lens has had a profound effect. Does she still want her husband to wipe his feet before stepping over the threshold? Sure. But reflecting on the three questions helps her keep those feelings in perspective. “They train the emotional muscles to move from complaining to gratitude,” Mosher says. “I’m aware of how lucky I am to have my husband in my life. Now, when we have a tough conversation, instead of complaining or nagging, I’m less shrill. I no longer feel like a shrew. Naikan is one of the most powerful, easily accessible things you can do for a relationship.”

For more information about Naikan, contact The Todo Institute, 802-453-4440, or todoinstitute.org.

To try Naikan for yourself, see page 134 of Health's May 2006 issue (on newsstands now).

Supplement Watch: What Works When Workouts Hurt

A little glucosamine may ease all kinds of aches and pains.

The popular pill got mixed reviews in a recent study sponsored by the National Institutes of Health (NIH). But some experts say it’s smart therapy for knee pain that drives you nuts or a cranky joint somewhere else. Here’s the lowdown:

How it works: Glucosamine is a natural compound found in humans and animals; the supplement is made from shellfish skeletons. And chondroitin, a related supplement, comes from cow and shark cartilage.

While anti-inflammatory drugs relieve pain by reducing inflammation, these supplements are thought to restore worn-down connective tissue (cartilage) that cushions bones. That’s important if you have joint pain, because it might be a result of osteoarthritis (OA), a common breakdown of cartilage. Roughly 20 million Americans have OA. And both glucosamine and chondroitin may help make a protein that builds and repairs cartilage.

What to expect: In the NIH study, 79 percent of people with moderate to severe osteoarthritis pain in their knees found that glucosamine and chondroitin reduced discomfort by 20 percent or more; 54 percent using a placebo got the same results. (People with mild pain got no relief.)

Brent A. Bauer, MD, director of the Complementary and Integrative Medicine Program at the Mayo Clinic, says the finding is reason enough for a patient with regular joint pain to consider several months of glucosamine-chondroitin therapy ($100 to $200 for three months). Both supplements seem to require two to three months to be effective, and Bauer recommends the combination (1,500 mg of glucosamine and 1,200 mg of chondroitin, three times daily) because it’s not clear if one works better. Side effects are mild (gas, soft stools).

To find a reliable brand, check with watchdogs like the U.S. Pharmacopeia or ConsumerLab.com. And don’t dump your ibuprofen or naproxen right away. Take them if you’re hurting, Bauer says, and see if you can cut back as the supplements go to work.

Stand Up to Back Pain

Poor posture can make you achy. Here are the 5 fixes you need.

Are you sitting up straight? Super—because if you slump, slouch, or hunch through the day, you may join the 80 percent of Americans who will suffer from back pain at some point in their lives. Recent research confirms that what you do every day can trigger soreness or spasms. So whether you’re at home Googling for a great deal on Jimmy Choos or sashaying down the street in those heels, you can save yourself some discomfort by babying your back. Here’s how.

1. Forget the salute
“Good posture is not standing like a soldier at attention,” says Arthur White, MD, a renowned back surgeon and author of The Posture Prescription. That General Patton stance puts pressure on the spine. Instead, White recommends standing in a relaxed, balanced manner. And you should check your stance throughout the day—when you’re waiting for a latté, say, or an elevator—and adjust as needed.

That’s what Jean Schatz of Wrentham, Massachusetts, started doing after severe back pain threatened to end her dental-hygienist career. “When I reposition myself, it always feels better,” she says. “I’ve actually had people tell me that I look taller.”

2. Put your feet first
High arches, flat feet: These foot problems, among others, can sabotage your posture and lead to an aching back. Women are particularly vulnerable; they suffer from four times as many foot ailments as men. And narrow, ill-fitting high heels are enemy number one. But doctors agree that custom-made corrective shoe inserts (orthotics) can improve most of these troubles. There are even “dress” orthotics for your pumps. “Orthotics can tilt the alignment into balance and relieve back stress,” says Robert Shmerling, MD, a Harvard Medical School associate professor.

They can be expensive, though—$250 to $400—and generally aren’t covered by insurance. But moderation can help, too. Wear those Choos for meetings and parties, but for extensive walking, slip on comfortable shoes (heels no higher than 1 ½ inches, or 2 inches for wedges).

3. Walk this way
Studies show that walking relieves back pain. But if your posture is poor, you may be taking a step backward instead. Bearing weight on one side or hunching as you walk may cause you pain over time.

Sherry Brourman, a Los Angeles–based physical therapist who specializes in “gait training,” healed her back problems by making a habit of walking the right way. Her advice: Unlock your knees and concentrate on keeping both your ribs and your pelvis “stacked.” Relax your buttocks and pull your stomach muscles into a “soft hold” (no clenching). Your feet should roll from heel to ball. Think balanced, not rigid, and don’t put too much pressure on your heels. Brourman recommends practicing four times a day for 5 minutes until the stance feels natural.

4. Lighten your load
Chances are one side of your body does double duty, from carrying a toddler around to schlepping your laptop home. And playing favorites throws off your posture, which can really strain your muscles, says Daniel Mazanec, MD, head of spine medicine at the Cleveland Clinic Spine Institute.

The best solution: Switch shoulders or hips periodically. Duh, right? But breaking this habit is not always that easy. Try resting your purse on your left shoulder on the way to work, then shifting it to your right shoulder on the way home. Also, whatever you’re carrying, be sure that you keep it as close to your body as possible.

5. Slump less, break more
Between work, Web surfing, and TV watching, you probably spend most of your day sitting, which is murder on your back. Throw poor posture into the equation, and look out. A landmark Swedish study shows that sitting upright increases the force on the spine by 140 percent, compared with standing; slump, and that number rises to 185 percent.

Rules to sit by: Line up head over shoulders and shoulders over hips, rest on your “sitz bones” (the two bones in your rear end), and place feet flat on the floor with legs at a 90-degree angle. And don’t just sit there; take breaks every 45 to 60 minutes to prevent strain, recommends Norman J. Kahan, MD, director of Sports and Occupational Medical Associates in Cupertino, California. He advises getting up and stretching. Neck rolls, chin tucks, and bending back with your hands on your hips can unkink muscles.

Pelvic Pain? Solve the Mystery

Use this checklist to explore the possible reasons—and remedies.

Remember New Year’s Day when you decided to jump-start your weight-loss program—by doing 500 sit-ups? That robo-routine could be the reason for the chronic ache in your pelvis. Then again, maybe not. One in seven women suffers from chronic pelvic pain, and the cause is often a mystery. To get relief, your first step (after the totally legit complaining) should be figuring out what’s wrong. Talk to your doctor about these possibilities, and to rule out ovarian cancer (which is rare):

It’s gynecological. Endometriosis—when uterine tissue grows outside the uterus—could be the culprit; roughly 10 percent of women have it. Also, prolonged pushing, a difficult forceps delivery, or certain types of incisions or lacerations during a vaginal delivery could lead to chronic pain. But don’t just assume it’s a female problem, cautions OB-GYN Andrea Rapkin, MD, director of the University of California, Los Angeles, Pelvic Pain Clinic.

It’s physical. Maybe it sounds odd, but a size mismatch between you and your partner could be to blame. If his penis is big, sex can bruise your cervix or tear the opening of your vagina. An injury from a fall could be responsible, too.

It’s intestinal or urological. Chronic constipation may trigger pain in the muscles of the pelvic floor, and malfunctions such as colitis, irritable bowel syndrome (IBS), and diverticulitis might feel like something more gyno than gastro. IBS is more common in women than men and often includes pain with constipation or diarrhea. Then there’s interstitial cystitis, a chronic inflammation in the bladder that can lead to pain, pressure, and tenderness.

And remember: It’s fixable. The pain may be chronic, but you don’t have to suffer. Experts say all of these underlying problems are treatable. Remedies may include hormonal therapy, antibiotics, pain relievers, antidepressants, counseling, relaxation exercises, physical therapy, or even surgery. And exhale now if fear of a disease like ovarian cancer is keeping you from seeing a doctor; pelvic pain is rarely a symptom. In fact, Rapkin says the chances of cancer being the problem are very low among premenopausal women.

Is That Stomach Pain All in Your Head?

Cut stress and that irritable bowel may disappear.

When bathroom issues put a cramp in your life, the most effective treatment may target both your gut and your mood. A Boston University study found that people with irritable bowel syndrome (IBS) were 40 percent more likely than those who didn’t have IBS to suffer from depression, too. IBS is a common disorder, especially among women. Depression doesn’t bring on IBS, experts say, and IBS doesn’t cause depression.

“But often the two conditions travel together,” says Olafur Palsson, PsyD, an associate professor of medicine at the University of North Carolina. Why? Nobody knows for sure—stress hormones may play a role—but the right remedy may address the connection. If you’ve got chronic gastrointestinal problems, experts suggest the following steps to get real relief:

Keep a daily mood and symptom diary for a week or two, noting any relationship between stressful events, mood swings, and your symptoms. “That way you can present a whole picture to your physician,” Palsson says.

Tell your doctor if you think you may be depressed. And speak up, too, if you’re experiencing headaches or puzzling pain and fatigue. The Boston University study found that irritable bowel also seems to be associated with migraine and fibromyalgia, a syndrome in which people feel overwhelmingly achy and tired.

Don’t be surprised if your doctor suggests a depression medication. Studies show that certain antidepressants actually relieve some symptoms of IBS, particularly abdominal pain. And that’s something to feel good about.

Help for Hurting Hands

Chances are, that achy feeling is nothing serious. Here’s how to find out—and get better fast.

Your hand and wrist ache after working at the computer all day, and they sometimes start feeling numb. Maybe the pain is centered on your forearms. Uh-oh: It’s carpal tunnel syndrome (CTS), and soon you’ll need a date with the surgeon, right?

Probably not. Research in recent years has found that things like typing and sewing rarely cause carpal tunnel, explains Barry Simmons, MD, Harvard Medical School’s chief of hand and arm surgery, who recently edited a special report on the topic. It’s more likely that you have a repetitive-strain injury, caused by overworking the muscles and nerves in your hands and forearms.

CTS happens when a nerve passing through your wrist gets pinched, usually because of arthritis, obesity, water retention due to pregnancy or PMS, or because you were born with a too-small passage, Simmons notes. (See “Car-pal Tunnel, or Just Over-use?” at right for some specific symptoms of both problems.)

The good news: For an overuse injury, you don’t need to go under the knife. Surgery won’t fix the problem, in fact. Try over-the-counter medicine to relieve the pain, and rest your hands regularly. Stay off the computer or limit your use to 20-minute sessions with 10-minute breaks, for example.

Wear splints while you work to keep your wrists from bending too high or low, and use a keyboard tray or adjust your chair so the keyboard and mouse are below your elbows and your wrists are level.

If these steps don’t seem to help, make an appointment with your doctor, who can do specific tests to determine the real problem, and can refer you to a hand specialist if it’s necessary.

Carpal tunnel, or just overuse?

The two conditions can feel similar, but these subtle clues can help you tell them apart.

Carpal tunnel syndrome

–Numbness and tingling on the palm side of the fingers is common.
–Pain may shoot up the arm when you stretch your wrists.
–Pain may wake you up at night or be worse in the morning.
–You may have trouble making a fist, or lose coordination in your fingers.

Overuse injury

–Numbness and tingling appear over the back of the hand, if at all.
–Pain is dull, and usually in your forearms.
–It hurts the worst after the activity that caused the injury.
–You can’t lift heavy objects because your hands feel tired.

Take That! (for pain)

Here’s the latest on over-the-counter fixes.

Menstrual cramps again!? Before you grab another pain pill, check out the chart below. It reveals which of the most common nonprescription pain killers works best for cramps (and a host of other ailments). To get the skinny, Health talked to Richard Dart, MD, professor of surgery, pharmacy, and medicine at the University of Colorado Health Sciences Center, and Leland Lou, MD, associate professor of anesthesiology and pain management at University of Texas Southwestern Medical Center at Dallas. Caveat: You’ve probably heard about heart risks linked to ibuprofen (Advil, for instance) and naproxen (Aleve). Although the risks are decidedly small, recent studies show both may increase your odds of a heart attack if you take more than the recommended dose for four or more days. Still, they’re safe (and naproxen may be safest) when taken for just a day or two. In other words, follow the instructions on the label—please.

The Spa Doctor Will See You Now

An intrepid Health staffer tests a new trend: health care and pampering, all in one.

It’s 7:30 a.m., and through the window behind the receptionist, I can see “patients” pumping on treadmills, flat-screen TVs flashing above them. Down the hall to my right is a coffee-and-juice bar; to my left, a day spa. And waiting to escort me to my appointment for a physical I—no kidding—my personal concierge.

Clearly, this is not your basic HMO.

I’m at One Nineteen Health and Wellness, a center that could prove to be the next trend in health care: doctors and nutritionists, plus a gym, spa, even child care—all under one roof. Unlike posh places like Canyon Ranch, where you can spend entire vacations, centers like One Nineteen are one-day affairs. And unlike smaller medi-spas, which offer doctor consultations for Botox and facial peels, these places provide the same services as most medical offices, making it possible to have, for instance, a mammogram and a massage, or a urinalysis and a yoga class.

Is it worth it?
Almost makes a Pap smear sound fun, I think. The more I hear about these one-stop wonders (experts estimate there are a handful nationwide), the more I want to know. So I eagerly accept my assignment to try out the doctors, the gym, and, oh yes, the spa.

My main question: Is it worth the cost? At One Nineteen, a hospital-owned center located in Birmingham, Alabama (Health’s hometown), your bill can soar. A bone-density scan, which checks for signs of osteoporosis, costs $200. And the Executive Physical, which includes up to 12 tests, nutrition advice, and a visit to the spa or gym, will knock you back a whopping $2,500. Plus, most screening tests aren’t covered by insurance.

I’ve got personal questions, too. I’ve been drop-dead tired for weeks. And my jeans are too tight. I don’t know which bothers me more. I’d long been treated for hypothyroidism, a condition that’s known to cause fatigue and weight gain. The last time I’d seen my doctor, my thyroid levels were OK but my iron was low. Severe anemia, he said. Yet despite iron supplements, I’m still dragging my wagon—and judging by my jeans, my wagon’s getting bigger every day.

A workup, plus extras
So my quest at One Nineteen begins with a checkup. The first plus: There’s no wait (patients are scheduled far enough apart to avoid delays, my concierge says). I fill out the standard questionnaire and meet the doctor, who discusses my medical history, listens to my heart, and seems to take my tired-and-fat woes seriously.

We start with the basics (step on the scale, pee in a cup) and work our way up to a stress test (to see how hard my heart can work), carotid ultra-sound (to make sure the arteries in my neck aren’t blocked), and heart CT scan (to do the same for my heart). I haven’t been hooked up to so many machines in, well, ever. One nice touch: no embarrassing hospital gown. I stay in my sweats, undressing just once for an EKG.

After lunch—pasta salad, iced tea, and pound cake with strawberries—it’s on to the dietitian. She confirms what my clothes have been telling me: I could shed a few pounds from my size-4 frame without being considered underweight. She totals the daily calories I’d need to lose weight—and it’s a measly 1,243. Do I exercise? Not very much, I confess. (Yes, I work at Health, but we can’t all be fitness divas.) If I would exercise more, I could eat more and still drop those pounds, she hints.

Fortunately, there’s light ahead: yoga and the spa. By the time I’ve done some downward dogs and relaxed with a massage, facial, and sugar body scrub (the yummy moisturizer is scented with blood oranges), my cares seem far away. I leave feeling and smelling delicious, sort of like a Dreamsicle.

The results are in
A week later, the doctor calls. Internally speaking, I’m in fabulous shape, he says. My cholesterol is fantastic, and my blood pressure is something to be awed. Even my stress test, for a tired 45-year-old, is good.

And I’m not anemic. Instead, my thyroid levels are low, and he wants to up my meds. I’m elated. Soon I’ll have more energy and, with a little luck (and more exercise), better-fitting jeans. I make a note to follow up with my regular doc, to make sure he’s OK with this advice.

That news alone makes the whole trip worthwhile. Since I’d already had my yearly thyroid check, I probably wouldn’t have seen my doctor for months. But this visit also makes me think: Even though I can’t afford such luxury care regularly, I can ask my doctors more questions. I can also stop living with warning signs and check them out instead. And every now and then, I can splurge on some Dreamsicle cream.

Can I find a lip gloss that's not sticky?

Question:

I love the look of lip gloss, but I can’t find one that’s not too sticky. I wind up peeling strands of hair off my lips all day. Any suggestions?



Answer:
We’re lip-gloss junkies, too. Luckily, we’ve found some that have little or no stick. Look for glosses with moisturizing ingredients like vitamin E, cocoa butter, or almond oil. “These will penetrate your lips rather than just sit on them, collecting hair,” says Jillian Jacobson, makeup artist and founder of Jillicious Cosmetics. Some packages even tout their non-tacky formulas, so look for that, too. A few of our favorites:

1. Palmer’s Cocoa Butter Formula Vitamin E Lip Gloss ($5.65) is plenty shiny. But with 100 percent pure cocoa butter, it’s glop-free.

2. American Beauty Pretty Glossy Luscious Lipshine ($12.50) has lycopene, which is both a conditioner and an antioxidant. Flavors like Cherry Soda and Strawberry Pop smell yummy, too.

3. H2O Plus Lip Satin ($14) has moisture-rich marine algae, orchid extract, and vitamin E. Plus, we like that it’s hypoallergenic and fragrance-free.

4. Too Faced Fat Kiss ($18.50) uses almond oil, grapeseed, and green tea to keep the formula smooth. And cinnamon and clove plump lips (you’ll feel it tingle).

How long should I keep my hairbrush?

Question:

I’ve used the same hairbrush for 5 years, and it still seems to be doing an OK job. Do you know of any rules on how long I should keep it?

Answer:

For the love of your hair, please trash that brush! “Old, out-of-shape bristles can break your hair by scraping against the follicle at the scalp,” explains Cristophe, stylist and owner of the Cristophe Salon in Beverly Hills. “It’s a good idea to buy a new one once a year.” Look for a brush with natural-boar bristles, which last longer than plastic or metal ones. Or go for a brush with ionic technology, which makes bristles heat-resistant and protects wet hair from breaking when you blow-dry. One of our favorites is Olivia Garden’s Turbo Vent 100% Boar Brush ($16.45–$24.25, depending on the size of the barrel), a combination of boar bristles and ionic technology.

To remove oil and bacteria from your brush, Cristophe advises cleaning it regularly. Once a week, run a comb through the bristles to remove excess hair; once a month, clean it with soapy water or shampoo, then rinse and air-dry.

Exfoliating 101

Make your skin look radiant and feel silky smooth with these exfoliating tips.

Q: I know exfoliating regularly can keep me soft all over, but how often should I do it and what's the best method?

A: With so many great exfoliating products on the market now, you can have fun choosing. But you're right to want to avoid overdoing it. Great results come when you find a method and schedule that suit your skin.

"The number one benefit is that skin seems smoother and silkier," confirms Harold Lancer, a dermatologist in Beverly Hills, California. "It also allows products to penetrate better." That's because exfoliating removes the surface layer of dead cells that can limit how much of your lotion gets through.

For most women, exfoliating twice a week is enough to ensure silky skin. To some degree, though, the frequency of your scrub-down depends on your age (older skin may be too dry and delicate for lots of scouring) and the climate you live in. Warm weather increases perspiration and oil production, leading to speedier accumulation of dead cells.

As for methods, a clean nubby washcloth will do the job. Don't use a sponge—they tend to stay damp and trap dead skin, creating a breeding ground for bacteria. Exfoliating gloves—available in fun colors—work great; pull them on and lather up with a moisturizing body wash. (Rinse the gloves well afterward, and let them air-dry.)

A scrub solution is another good way to go. We recommend Neutrogena’s Energizing Sugar Body Scrub, $9.99, and Apivita Aromatherapy Energy Body Scrub, $18.

Women with oily skin should exfoliate more often than their dry-skinned sisters. Oily skin makes it hard for complexion-dimming dead cells to make their exit. "Starting in your 30s, your skin can look dull and ashen because skin cells renew themselves more slowly than they did when you were younger," says Debra Jaliman, M.D., a clinical instructor at Mount Sinai School of Medicine.

Use grain products (we like Merle Norman's Luxiva Skin Refining Cleanser or Sonya Dakar's Triple-Action Organic Scrub). Or smooth skin chemically with items that have glycolic or salicylic acids (try DDF's Glycolic Exfoliating Wash or Cellex-C's Betaplex Gentle Cleansing Milk).

Can I Use Hot Makeup?

Question:

In the rush to get to work on time, I inadvertently left my cosmetic bag in the hot car all afternoon in the heat of the summer. Although everything looks OK, I'm wondering if it's safe to use my makeup now. Should I dispose of it?



Answer:
Official word from the makeup police: If this is your first offense, you’re OK. But if you repeatedly leave your cosmetic bag to fry in the car, you could be in trouble. “Most cosmetic and skin-care items are designed to be stored at room temperature,” says James Hammer, a cosmetic chemist and director of research at Shuster Labs, a consumer products research firm in Canton, Massachusetts. “Turn up the heat, and you can cause physical, chemical, and microbial changes in your products.”

Examples? Liquids such as foundations and cream blushes can dry out, or the water and oil may separate, making the products useless. Also, any vitamins in your liquid products can break down and become less potent. Makeup may develop a strange odor or change color so it doesn’t match your skin tone anymore. “Raising the temperature also encourages the growth of bacteria—particularly in products that you repeatedly dip into like lipstick or mascara,” Hammer adds. There’s an outside chance you could end up with an eye infection, sty, cold sore, or some other skin infection.

Is it safe to test makeup at department stores?

Question:

Like a lot of women, I test makeup at department stores. My friends think that's a bad idea. Who's right?

Answer:
Sorry, but they are. Products sampled by hundreds, if not thousands, of other people become a breeding ground for bacteria—and we're not talking about the type that leads to a mere case of itchy eyes. Depending on who gave the item a try before you did, "you could develop a sty, cold sore, cold, even a staph or strep infection," says Shelley Sekula-Gibbs, MD, clinical assistant professor of dermatology at Baylor College of Medicine.

Keep these safety tips in mind:

# Ask for a sample to take home. If this is not an option, use the disposable tools offered at many counters, like mascara wands and makeup sponges. Also, don't double-dip, and don't use your fingers.

# Bring your own clean brush to test blush. Though many counters use brush cleaner between customers, it may not be strong enough to sterilize them adequately.

# To test lipstick, first wipe the tip clean with a tissue, then swipe a cotton swab over the product and apply. Stay away from store lip brushes, and never allow the tube to touch your lips directly.

# Have the salesperson sharpen eye or lip pencils before you use them. This helps remove any lingering germs.

A Medicure?

Our Beauty & Fashion Editor Colleen Sullivan puts it to the test.

Pedicures, for me, are the ultimate beauty treatment. Nothing takes you to another place like having your feet rubbed and scrubbed. What I'm not so keen on is leaving the salon after paying 30 bucks only to find heels that peel and flake within days. That's why I was so excited to try the new foot treatment called a medicure (a.k.a. medical pedicure), during which a manicurist (no special license is required) removes dead skin and calluses, and thoroughly cleans feet and toenails in a supersanitary way. Some are done in traditional salons, others in medical spas.

At the Sally Hershberger Face Place in New York, I met manicurist Erica Marton, whose all-white outfit set a serious (sanitary!) mood for what lay ahead. I put my bare feet in a basin of warm water, as Marton slipped on a pair of latex gloves and looked for fungal infections, corns, ingrown toenails, even signs of skin cancer. In all my years of pedicures, no manicurist has ever done that!

With a jar of barbicide for soaking instruments beside her, Marton clipped and filed my nails and pushed back my cuticles. Next, she donned a nose-and-mouth mask and pulled out a drill. Yes, a drill. It looked just like something you'd find at Home Depot, except it had a small sandpaper tip. She revved it up and spent 20 minutes meticulously sanding off every last callus. Then she followed up with a paddle exfoliator. After a fabulous foot massage, she buffed and polished my nails. Medicure complete! My feet hadn't been so baby-soft since, well, I was a baby.

The bottom line: Six weeks—and a saltwater-and-sand vacation—later, and my feet still felt incredible. In fact, the skin on my soles outlasted my nail polish. My medicure cost a reasonable $35. But prices can be as high as $125, so be sure to ask about cost before you book yours.

The pedicure checklist
– Follow these tips, and leave the salon with pretty, healthy feet.
– Drop by the nail salon before making an appointment to see how clean it's kept.
– Bring your own tools to prevent infections.
– Look for a salon that uses basins instead of whirlpool tubs; germs collect in jets.
– Alcohol should be kept nearby to treat nicks.
– Never let a manicurist use a razor on your feet (it's illegal in most states).

Editor's Picks: Self-Tanners

After covering up in faux glows from head to toe, our Health testers chose these favorites among the new self-tanners.

BeComing’s Glow It All Face Cream, $14, also has vitamins A and E to help ward off damage caused by free radicals.

Michael Kors Shimmering Self-Tanner, $30, is laced with the designer’s signature fragrance, a light citrus-floral scent. The creamy, golden body lotion instantly covers skin with a subtle sparkle.

Neutrogena MicroMist Tanning Sunless Spray, $11.99, is like a professional airbrush tan, at a fraction of the cost. Spray the fine mist all over, then give it 5 minutes to dry—no rubbing required.

After a few days of using Jergens Natural Glow Daily Moisturizer, $5.99, body lotion you’ll see a subtle change in your skin tone. The longer you use it, the darker you’ll get.

Thermal Water: Beauty Secret or Fad?

Here’s what you should know before you open your wallet.

The latest European beauty secret to find its way across the Atlantic: products made with thermal water. Naturally endowed with minerals like sulfur and selenium, and free of chemicals such as chlorine, the water comes from European thermal springs with longstanding reputations for therapeutic benefits. “Certain minerals can soothe skin and reduce redness and inflammation,” says Leslie Baumann, MD, director of the University of Miami Cosmetic Center, a cosmetic-research facility. “Some have even been shown to be effective in treating eczema.”

So should you stock up? That depends on the product. Mineral-water sprays and moisturizers are both good bets because they stay on your skin. Besides replenishing nutrients, sprays can combat sunburn and other skin irritations. In fact, doctors sometimes use them to heal a patient’s skin after a procedure like a chemical peel.

Lotions and creams with thermal water are good hydrators for women with sensitive skin or those who live in dry climates. But don’t waste your money on cleansers or bath soaks; both rinse off too quickly to have any noticeable effects. For a thermal facial treat, we like Vichy Thermal Spa Water Spray ($10; Vichy.com), with 15 minerals from sulfur and silica to calcium. Another winner: Rosaliac Hydratant Perfecteur Anti-Rougeurs by La Roche-Posay ($30; available only at doctors’ offices). This moisturizer has thermal water with a water-soluble form of vitamin B3, to soothe sensitive skin.