Mesothelioma Diagnosis

Diagnosing mesothelioma is often difficult, because the symptoms are similar to those of a number of other conditions. Diagnosis begins with a review of the patient's medical history. A history of exposure to asbestos may increase clinical suspicion for mesothelioma. A physical examination is performed, followed by chest X-ray and often lung function tests. The X-ray may reveal pleural thickening commonly seen after asbestos exposure and increases suspicion of mesothelioma. A CT (or CAT) scan or an MRI is usually performed. If a large amount of fluid is present, abnormal cells may be detected by cytology if this fluid is aspirated with a syringe. For pleural fluid this is done by a pleural tap or chest drain, in ascites with an paracentesis or ascitic drain and in a pericardial effusion with pericardiocentesis. While absence of malignant cells on cytology does not completely exclude mesothelioma, it makes it much more unlikely, especially if an alternative diagnosis can be made (e.g. tuberculosis, heart failure).

If cytology is positive or a plaque is regarded as suspicious, a biopsy is needed to confirm a diagnosis of mesothelioma. A doctor removes a sample of tissue for examination under a microscope by a pathologist. A biopsy may be done in different ways, depending on where the abnormal area is located. If the cancer is in the chest, the doctor may perform a thoracoscopy. In this procedure, the doctor makes a small cut through the chest wall and puts a thin, lighted tube called a thoracoscope into the chest between two ribs. Thoracoscopy allows the doctor to look inside the chest and obtain tissue samples.

If the cancer is in the abdomen, the doctor may perform a laparoscopy. To obtain tissue for examination, the doctor makes a small opening in the abdomen and inserts a special instrument into the abdominal cavity. If these procedures do not yield enough tissue, more extensive diagnostic surgery may be necessary.

Doctors have begun testing the Mesomark assay which measures levels of soluble mesothelin-related proteins (SMRPs) released by diseased mesothelioma cells. The procedure could diagnose mesothelioma earlier than conventional methods thus improving the survival prospects for patients.^[3]

Typical immunohistochemistry results

Positive	Negative
EMA (epithelial membrane antigen) in a membranous distribution	CEA (carcinoembryonic antigen)
WT1 (Wilms' tumour 1)	B72.3
Calretinin	MOC-3 1
Mesothelin-1	CD15
Cytokeratin 5/6	Ber-EP4
HBME-1 (human mesothelial cell 1)	TTF-1 (thyroid transcription factor-1)

Mesothelioma Signs and symptoms

Signs and symptoms of mesothelioma vary depending on where the cancer occurs.

Pleural mesothelioma signs and symptoms may include:

* Shortness of breath
* Painful breathing
* Chest pain under the rib cage
* Unusual lumps of tissue under the skin on your chest
* Unexplained weight loss
* Dry (nonproductive) cough

Peritoneal mesothelioma signs and symptoms may include:

* Abdominal pain
* Abdominal swelling
* A change in your bowel habits, such as more frequent diarrhea or constipation
* Lumps of tissue in the abdomen
* Unexplained weight loss

Signs and symptoms of pericardial mesothelioma and mesothelioma of the tunica vaginalis are unclear. These forms are so rare that not much information is available. Mesothelioma of the tunica vaginalis may be first detected as a mass on a testicle. Pericardial mesothelioma signs and symptoms may include difficulty breathing and fever.

Signs and symptoms of mesothelioma that has spread to other parts of the body include:

* Pain in the area where cancer has spread
* Difficulty swallowing
* Swelling in the neck and face

Mesothelioma (Causes)

What are the main causes of mesothelioma?

Mesothelioma is most predominantly caused by asbestos exposure. Asbestos fibers that are inhaled through the mouth and nose may eventually become embedded in the lining of the lungs, causing damage and resulting in lung cancer or asbestosis (scar tissue formation in the lungs). It has also been found that swallowing asbestos fibers could contribute to a form of mesothelioma originating in the abdomen called peritoneal mesothelioma.

Mesothelioma generally results from occupational exposure but there are instances of environmental exposure to asbestos that can cause the disease. Oftentimes second hand exposure of a family member to an asbestos workers dirty work clothes can result in that family member developing mesothelioma.

Asbestos insulation workers appear to have the highest death rate. One study reports that almost six percent of asbestos workers fall victim to mesothelioma and asbestos insulation workers are over 300 times more likely to die from mesothelioma than the general public.

Mesothelioma (Risk Factors)

What are the risk factors for malignant mesothelioma?

There are several risk factors that increase the likelihood that a person will develop mesothelioma. The primary risk factor is asbestos exposure. Exposure to this very harmful substance can significantly enhance the chances of contracting the disease. Other secondary factors include exposure to radiation, zeolite, simian virus 40 (SV40) and tobacco. We discuss each of these risk factors in more detail below.

Asbestos

Exposure to asbestos is the leading risk factor associated with mesothelioma. Asbestos is an insulating material comprised of magnesium-silicate mineral fibers. It was favored by builders and contractors for many years for its low heat conductivity and resistance to melting and burning. Since researchers have identified more and more links between mesothelioma and exposure to asbestos, the material is now less widely used. Prior to this discovery, however, millions of Americans have experienced serious exposure to this harmful substance.

Over 700,000 schools and buildings in the United States today contain asbestos insulation as reported by the US Environmental Protection Agency. Asbestos exposure doesn’t stop there, however. Asbestos is often found in ship yards, manufacturing facilities, railway facilities and construction sites. Blue collar workers are at the highest risk for developing mesothelioma due to occupational exposure and include those who work in mines, factories, shipyards, construction sites, railroads and for insulation manufacturers and gas mask manufacturers. The occupations most widely affected are miners, factory workers, railroad workers, ship builders and construction workers - especially those who install asbestos containing insulation. Sometimes family members related to the workers receive second hand exposure to asbestos from the dust and fibers that were brought home on the workers clothes and also become at risk for contracting mesothelioma.

Serpentine fibers and amphiboles are the 2 primary types of asbestos used. Chrysotile is a form of serpentine fiber and the most frequently used. These fibers tend to be curly and flexible. Amphibole fibers, however, are generally straight and thin and usually comprise one of five types: crocidolite, amosite, anthrophylite, tremolite, and actinolyte. The crocidolite type of Amphiboles is thought to be the leading contributor to cancer caused by asbestos. Serpentine fibers are dangerous as well, however, and have also been linked to mesothelioma.

Some research points to the fact that inhaled asbestos fibers cause a physical irritation resulting in cancer rather than the cancer being caused by a reaction that is more chemical in nature. As fibers are inhaled through the mouth and nose they are cleared from the body by adhering to mucus in the nose, throat and airways and then get expelled by coughing or swallowing. The Amphibole fibers (long and thin) do not clear as easily and it is therefore thought that they can embed into the lining of the lungs and chest and result in mesothelioma.

Asbestosis (scar tissue in the lungs) or lung cancer can also be caused by the inhalation of asbestos fibers. In fact, people exposed to asbestos are seven times more likely to develop lung cancer over the general public. Workers who sustain high levels of asbestos exposure are more likely to die from asbestosis, lung cancer or mesothelioma than any other disease. It is also believed that the action of coughing up and swallowing asbestos could contribute to a form of mesothelioma originating in the abdomen called peritoneal mesothelioma. Mesothelioma has been found to exist in other organs of the body as well such as the larynx, pancreas and colon, but those instances are extremely limited compared to lung cancer incidents.

The chance of developing mesothelioma is in direct proportion to the duration and amount of asbestos exposure that an individual sustains. Those who are exposed to high levels of asbestos at a young age, for long periods of time have a greater risk of being diagnosed with mesothelioma than those who have short, low level exposure. Another important consideration is that Mesothelioma can take a long time to manifest. Often, twenty to forty years can elapse from the time of exposure to diagnosis. Genetic factors can also play a role which explains why not everyone exposed to asbestos develops and asbestos related disease.

Radiation
Thorium dioxide (Thorotrast), a substance used in x-ray tests in the past has reported links to pleural mesothelioma and peritoneal mesothelioma. The use of Thorotrast has been discontinued for many years due to this discovery.

Zeolite
Some mesothelioma cases in the Anatoli region within Turkey have been linked to Zeolite, a silica based mineral with chemical properties similar to asbestos found in the soil there.

Simian Virus 40 (SV40)
Some scientists have found the simian virus 40 (SV30) in mesothelioma cells from humans and have been able to create mesothelioma in animals with the virus. The relationship between this virus and mesothelioma is still unclear, however, and further research is being conducted to gain clarity on this potential link.

Tobacco
Smoking alone is not linked to mesothelioma, but smokers who are exposed to asbestos have a much higher chance of developing lung cancer (as much as fifty to ninety percent higher). Research indicates that lung cancer is the leading cause of death among asbestos workers.

Mesothelioma

What are the different types of mesothelioma?

Malignant Mesothelioma

Malignant mesothelioma is an uncommon form of cancer and of all asbestos related diseases, the most serious. The symptoms associated with the disease make it difficult for doctors to diagnose. Often, by the time that a proper diagnosis is made, the disease has progressed to a point where patients do not respond well to treatment therapy. Malignant mesothelioma is caused almost exclusively by the inhalation of airborne asbestos particles. Another unique factor associated with the disease is that there can be a long latency period between the time an individual is exposed to asbestos and the actual manifestation of the disease in the form of malignant mesothelioma.

Pleural Mesothelioma – affects the chest and lungs

Malignant pleural mesothelioma often originates within the chest cavity and can, at times, involve the lung. This particular form of mesothelioma can metastasize to numerous organs in the body – even the brain - and tends to do so more frequently than not.

Pleural mesothelioma is not always easily detectable. Frequently, in the early stages of the disease, symptoms may be mild. Patients usually report pain in one area of the chest that never seems to go away, weight loss and fever. Occasionally, other symptoms are more severe and include problems with breathing due to fluid build up in the chest. A CT Scan of the chest area has proven to be the best test for identifying how far along the disease has progressed.

Frequently serum markers are used to diagnose of various forms of cancer. Mesothelioma cannot be diagnosed using this method as no serum markers currently exist. If high levels of hyaluronic acid are present it may be possible to distinguish mesothelioma from other types of cancer or to determine the effectiveness of a treatment protocol.

The survival rate for patients diagnosed with pleural mesothelioma typically is not high. Patients typically do not live beyond seventeen months from the onset of symptoms. Only 8% of those diagnosed with mesothelioma will live three to five years from the onset of symptoms.

Peritoneal Mesothelioma – affects the abdomen

Peritoneal mesothelioma originates in the abdomen and will frequently spread to other organs in area including the liver, spleen or bowel. Severe abdominal pain is the most common complaint that patients present to their doctor. There may also be a discomfort level with fluid build up in the abdomen as well. Other symptoms of peritoneal mesothelioma may include difficult bowel movements, nausea and vomiting, fever and swollen feet.

The survival rate is even worse for those diagnosed with peritoneal mesothelioma will patients typically surviving only ten months from time that they first started experiencing the symptoms noted above.

Pericardial Mesothelioma – affects the heart

Pericardial mesothelioma is the least common form of mesothelioma. Pericardial mesothelioma, as the name suggests, involves the heart. This rare type of mesothelioma invades the pericardium, the sac that surrounds the heart. As the cancer progresses, the heart is not able to deliver oxygen as efficiently to the body causing further decline in health at an increasingly rapid rate. The symptoms most commonly associated with pericardial mesothelioma mimic those of a heart attack: nausea, pain in the chest and shortness of breath.

Benign Mesothelioma – affects the peritoneum

Cystic mesothelioma primarily affects women of younger age and affects the peritoneum. This type of mesothelioma is not frequently diagnosed and is also not a malignant form of the disease. It is, however, extremely difficult to identify and requires specialized microscopes and immunologic techniques to aid in diagnosis.

Mesothelioma in Uncommon Sites

A form of cardiac cancer that is rarely seen involves the pericardium. Tumors associated with this type of mesothelioma are not easily detectable and patients presented with this diagnosis tend to have a very low survival rate. There have also been reports of mesothelioma involving ovaries in women and the scrotum in men. Treatment for all of these rare forms of mesothelioma will vary depending on what stage a patient has progressed to but in most all cases the projected outcome is not favorable.

Sodium: Are you getting too much?

You've been trying to eat less sodium — just a pinch of table salt on your baked potato and a dash to your scrambled eggs.

But a pinch and a dash can quickly add up to unhealthy levels of sodium, especially when many foods already contain more than enough sodium. About 11 percent of the sodium in the average U.S. diet comes from adding salt or other sodium-containing condiments to foods while cooking or eating. But the majority of the sodium — 77 percent — comes from eating prepared or processed foods that contain the mineral. So even though you may limit the amount of salt you add to food, the food itself may already be high in sodium.

Are you getting too much? Here's where sodium sneaks into your diet and ways you can shake the habit.

Sodium: Essential in small amounts

Your body needs some sodium to function properly. Sodium:

• Helps maintain the right balance of fluids in your body
• Helps transmit nerve impulses
• Influences the contraction and relaxation of muscles

Your kidneys regulate the amount of sodium kept in your body. When sodium levels are low, your kidneys conserve sodium. When levels are high, they excrete the excess amount in urine.

If your kidneys can't eliminate enough sodium, the sodium starts to accumulate in your blood. Because sodium attracts and holds water, your blood volume increases. Increased blood volume, in turn, makes your heart work harder to move more blood through your blood vessels, increasing pressure in your arteries. Certain diseases such as congestive heart failure, cirrhosis and chronic kidney disease can lead to an inability to regulate sodium.

Some people are more sensitive to the effects of sodium than are others. People who are sodium sensitive retain sodium more easily, leading to excess fluid retention and increased blood pressure. If you're in that group, extra sodium in your diet increases your chance of developing high blood pressure, a condition that can lead to cardiovascular and kidney diseases.

How much sodium do you need?

Various organizations, including the National Academy of Sciences' Institute of Medicine, have published recommendations for daily sodium intake. Most recommend between 1,500 and 2,400 milligrams (mg) a day for healthy adults. A lower sodium intake has a more beneficial effect on blood pressure.

If you are older than 50, are black or have a health condition such as high blood pressure, chronic kidney disease or diabetes, you may be more sensitive to the blood pressure raising effects of sodium. As a result, aim for a sodium intake at the low end of the range recommended for healthy adults. Talk to your doctor about the sodium limit that's best for you.

Three main sources of sodium

The average U.S. diet has three main sources of sodium:

• Processed and prepared foods. Most sodium in a person's diet comes from eating processed and prepared foods, such as canned vegetables, soups, luncheon meats and frozen foods. Food manufacturers use salt or other sodium-containing compounds to preserve food and to improve the taste and texture of food.
• Sodium-containing condiments. One teaspoon of table salt has 2,325 mg of sodium, and 1 tablespoon of soy sauce has 1,005 mg of sodium. Adding these or other sodium-laden condiments to your meals — either while cooking or at the table — raises the sodium count of food.
• Natural sources of sodium. Sodium naturally occurs in some foods, such as meat, poultry, dairy products and vegetables. For example, 1 cup of low-fat milk has about 110 mg of sodium.

Whether food comes by its sodium naturally or not, your daily intake can add up quickly when you tally the sodium from all of your meals and snacks. Here's an example of how easily sodium adds up:

Food	Amount of sodium
Breakfast
Scrambled eggs, 2 large	342 mg
Bacon, 1 slice	192 mg
Whole-wheat bread, 1 slice	148 mg
Butter, 2 teaspoons	54 mg
Total sodium for meal	736 mg
Lunch
Whole-wheat bread, 2 slices	296 mg
Ham, luncheon meat, 1 slice	350 mg
Mayonnaise, 1 tablespoon	105 mg
Dill pickle, 1 spear	385 mg
Pretzels, 1 ounce	486 mg
Orange, 1 large	0 mg
Total sodium for meal	1,622 mg
Dinner
Spaghetti noodles, 1 cup	179 mg
Spaghetti sauce, 1/2 cup	601 mg
Parmesan cheese, 1 tablespoon	76 mg
Green beans, canned, 1/2 cup	177 mg
Garlic bread, 1 slice	200 mg
Total sodium for meal	1,233 mg
Total sodium for the day	3,591 mg

Source: Department of Agriculture, Nutrient Data Laboratory, 2005

Be a savvy shopper: Find the sodium

Taste alone may not tell you which foods are high in sodium. For example, you may not think a bagel tastes salty, but a 4-inch oat-bran bagel has 451 mg of sodium.

So how do you identify foods high in sodium? The best way to determine sodium content is to read food labels. The Nutrition Facts label tells you how much sodium is in each serving. It also lists whether salt or sodium-containing compounds are ingredients. Examples of these compounds include:

• Monosodium glutamate (MSG)
• Baking soda
• Baking powder
• Disodium phosphate
• Sodium alginate
• Sodium nitrate or nitrite

How to cut your sodium intake

You may or may not be particularly sensitive to the effects of sodium. And because there's no way to know who might develop high blood pressure as a result of a high-sodium diet, choose and prepare foods with less sodium.

You can control your sodium intake several ways:

• Eat more fresh foods and fewer processed foods. Most fresh fruits and vegetables are naturally low in sodium. Also, fresh meat is lower in sodium than luncheon meat, bacon, hot dogs, sausage and ham are.
• Opt for low-sodium products. If you do buy processed foods, select those that have reduced sodium.
• Remove salt from recipes whenever possible. You can leave out the salt in many recipes, including casseroles, stews and other main dishes. Baked goods are an exception. Leaving out the salt could affect the quality as well as the taste of the food.
• Limit your use of sodium-laden condiments. Salad dressings, sauces, dips, ketchup, mustard and relish all contain sodium.
• Use herbs, spices and other flavorings to enhance foods. Learn how to use fresh or dried herbs, spices, zest from citrus fruit and fruit juices to jazz up your meals.
• Use salt substitutes wisely. Some salt substitutes or light salts contain a mixture of table salt (sodium chloride) and other compounds. To achieve that familiar salty taste, you may use too much of the substitute and actually not reduce your sodium intake. In addition, many salt substitutes contain potassium chloride. Though dietary potassium can lessen some of the harm of excess sodium, too much supplemental potassium can be harmful if you have kidney problems or if you're taking medications for congestive heart failure or high blood pressure that cause potassium retention.

Your taste for salt is acquired, so it's reversible. To unlearn this salty savoring, decrease your use of salt gradually and your taste buds will adjust. Most people find that after a few weeks of cutting their salt intake, they no longer miss it. Start by using no more than 1/4 teaspoon of added salt daily, then gradually reduce to no salt add-ons. As you use less salt, your preference for it lessens, allowing you to enjoy the taste of food itself.

© 1998-2007 Mayo Foundation for Medical Education and Research (MFMER).

Muscle Building Supplements - How To Choose The Right Ones

By : Mike Singh

If you just walked into the health store to purchase muscle building supplements, you are probably lost, confused and being pushed a dozen products by the salesman. But, how do you know which supplements are the right products for your goals? There are various levels of muscle building supplements and some may not be right for you. But, there are a handful that are excellent choices for anyone looking to build muscle.

Remember, you don't always need these supplements to build muscle, but these will definitely accelerate you towards your goals. They work as a tool to help you increase your potential for muscular development. They help in muscle growth, and quicker recovery times. Some important ingredients of muscle building supplements are:

Protein: The protein supplements are full of amino acids which are the building blocks for your muscles. Make sure that you include a supplement that takes into account proteins. You can take up to one to two grams of protein per pound of your weight. If you don't want to take them in a pill form, get the protein through shakes or even bars. Also, look for those that contain eggs, whey, soy or casein.

Creatine: The next important ingredient in the supplement you choose should be creatine. It will help to increase muscle mass by decreasing muscle fatigue and improving muscle recovery. It helps to increase something called ATP which is an energy source that will allow you to do more reps of higher weight. It is recommended that this should be taken in cycles e.g. four weeks on it then two weeks off of it.

Micro-nutrients - multivitamins and multiminerals: Many people mistakenly assume that they are getting enough vitamins and minerals through their normal diet. Unfortunately, this is not the case. We would have to consume extremely large quantities of food to get the recommended daily intake. An easier approach would be to supplement our diet with a good quality multi-vitamin/multi-mineral supplement. If you do not have one specific mineral in your diet, this can slow down your ability to develop muscles or improve your health.

Author Resource:- Mike Singh is the publisher of http://www.1-stop-fitness.com/ On his website he provides articles about womens health and fitness and adjustable weight benches.

How to Count Calories With Your Eyes

By : Marc David

Embarking on a serious fitness quest or even a journey to just be healthy can sometimes be a daunting task. And at some point, you've been told or heard that eating 5-6 frequent small meals a day is the way to go for weight gain or weight loss.

After running a fitness site and bodybuilding forum, I see a lot of confused individuals who ask this very question below about the 5-6 meal deal. They have heard about it and want to do it but when it comes to counting calories, they are not willing to measure each grain of rice.

And can you blame them?

Many times people will ask, "I know all that stuff like I need to eat 5-6 meal a day, eat less than your daily maintenance caloric and stuff like that... But what I do not know is how big the meal has to be?"

Despite what you may have heard... eating 5-6 times a day it's not that hard. It takes some discipline but it's not all that difficult and you certainly do not eat 5-6 large, American style meals. These are small, frequent meals that comprise what is termed a complete meal (protein, carb, sometimes healthy fat).

But let me go back to the beginning to continue the story...

Here's what you do:

1- Figure out how many calories per day you need to
gain/maintain/lose weight

2- Start tracking with any online nutritional tracking program.

3- Eye ball your portions. You know you had some brown rice
right? Get out a cup. Look at it. If you practice this,
you'll soon be able to eat, look at your place and just know.. that is about a cup of brown rice.

You don't have to physically measure your foods. I suppose you could but that wouldn't work so well when you eat out, go to a friends out and such. Who wants to carry around a complete set of measuring cups and spoons?

So you will need to look at measurement devices like a cup, a quarter cup and such and be able to eye ball things. Once you do this a few times at home, you will be able to visually look at a plate of food and roughly guess the portions. Once you know the portions...

Then you know how much you should enter into a calorie calculator tracking program.

And at the end of the day any good program will show what you ate in calories, protein, carbs and fats. And you'll be able to see this displayed in a graph so you know if your ratios are correct (assuming you are into or have any interested in ratios).

I personally don't carry around a cup or any type of measuring devices. But I know if I go out to eat that the chicken on my place is about the size of the palm of my hand.. times two...

.. the palm of my hand is roughly 3 ounces.

I can eye ball that chicken breast and guess it's about 6 maybe 7 ounces of chicken.

Are you getting my point?

Follow those steps above. Once you know how much you need to eat in terms of calories, you will be able to do whatever you want.

Then eat, and eye ball your portions. Quickly you will learn that in order to hit your daily calories, maybe you don't want to eat 2 cups of brown rice as it's too much. Or maybe not enough. But you can judge this and track it and that is how you will know.

Then track it. If you don't track what you eat, then you are only guessing. And those who guess get frustrated because those who guess do not know. That is why it's called guessing. So if you simply cannot or won't track, you'll always be frustrated and confused. Unless of course, you track it for the first day and forever on, eat the same portions and foods. Yuck!

The biggest mistake I see people making is:

1- They have not ever figured out the math to calculate their calories
2- They do not track what they eat
3- So they just do whatever and get whatever

If you follow the above three steps, you are almost guaranteed not to make the same mistakes that most other people make when it comes to reaching their fitness goals.

The Key to Building Muscle and Burning Fat at the Same Time

By : Marc David

Doesn't weight training build muscle and increase your metabolic rate and therefore the increase in your metabolic rate reduces fat? And if so, then doesn't this mean that you have gained muscle and lost fat at the same time?

I can understand how you might be confused because it's true that the more muscle you have, the higher your metabolic rate will be and the more fat you will burn as a result of having more muscle.

My point was not that building muscle and losing fat at the same time is impossible, but that attempting to build muscle and lose fat at the same time is not as efficient because you are chasing after two conflicting goals.

Let me explain...

If you want to put on the most muscle possible, you would engage in what's called a 'bulking' diet. That is where you eat 10-15% over your maintenance level calories. The rate of muscle growth can be quite rapid at this level of caloric intake, but the rate of fat gain can often be as high as the rate of muscle gain (a 1:1 ratio).

So why would you ever want to gain fat along with the muscle? Simply because you will gain the maximum amount of muscle possible only if you stay in a caloric surplus. People who want to gain muscle and lose fat at the same time have to alternate periods of caloric surplus with periods of caloric deficit and therefore will gain muscle much more slowly.

Let's talk about cutting diets.

The goal on a cutting diet is to eat 10-20% below your maintenance calories in order to burn as much fat as possible without sacrificing muscle. On any cutting diet, some muscle loss is almost inevitable, but your goal is to maintain as much lean body mass as possible.

A beginner is much more likely to build muscle and burn fat at the same time. (That's why being a beginner is pretty cool). For a beginner, almost anything works because your body isn't used to the stress of training, so great "beginner gains"can be made with virtually any training program.

But after about 6 months, the gains slow down, then nearly stops as you become more advanced and get closer to the limits of your genetic potential.

At this point, You have to work harder and smarter in order to keep your body progressing and changing. Not counting the initial "beginners gains" growth spurt, the only ways I know of to date that you can do both (build muscle and lose fat quickly) is thru anabolic steroids or to be extremely genetically gifted.

You see, testosterone promotes leanness and it builds muscle. Having super high levels will allow you to chase both goals and do it well. Of course, that isn't a risk free path and in the U.S. it is illegal. And there are a slew of other problems with that. I just wanted to insert that point.

Is it impossible to build muscle and lose fat at the same time? Nope. It's possible. It's simply more difficult and not the most efficient approach.

There's an old proverb that says, "If you chase two rabbits, you will catch neither." Gaining muscle and losing fat require different eating methods to achieve. If you attempt to do both, you may end up in limbo going nowhere.

If you don't mind making much slower progress in muscle gains, you can put on muscle and trim down body fat. But many people want faster results, so they focus on a single goal and put all their effort and energy into that one goal.

Then when they reach a certain body fat percentage, they go the other way. Keep all the muscle they just built and lose the fat. In essence, you might start off at 200 lbs, 15% body fat but at the end, you might be 195 lbs, 9% body fat and have more muscle then you did at 200 lbs. Because you gained as much as possible, then cut away the fat. Now you are bigger but leaner.

My recommendation: Pick one goal and stick with it until you are satisfied. It's faster, easier and works better then trying to do both.

Author Resource:- Marc David is a bodybuilder and author of the, Beginner's Guide to Fitness and Bodybuilding. You can get info on Marc's e-book at: Beginning Bodybuilding. To get Marc's free e-zine, visit JustAskMarc.com

Nine Simple Ways to Increase the Intensity of Any Workout

By : Marc David

Beginners usually do not need such advanced concepts simply because as a beginner, pretty much anything will work as it's new to your body. You don't need to bump up the intensity because the workout itself is usually hard enough. But for those who have worked out for quite some time, doing a simple routine doesn't cut it. And for those who are entering a competition and may be on low card, sub-maintenance calories and doing cardio twice a day, adding more and more weight is easier said then done. Where's the energy?

That's where some advanced concepts come into play.

These are ways in which you can use the same routines, but thru some clever manipulation, you need not add any weight to make it the most intense routine you've ever experienced. This is especially a good toolset to use when you've worked out for many years and find it hard to make gains or you have a prior injury that makes it difficult to lift heavy weights. Working out heavier and heavier each time, trying to break your personal best can lead to injury and stagnation.

Using some of these advanced training concepts, you can take a simple bicep curl or bench press and maximize the intensity of the exercise without adding a single pound:

1. Repetition Speeds - Rather then 1 second up and 1 second down, there's a little know fact that you can take advantage of to double the effectiveness of any exercise. That secret is slowly lowering the weight on the negative part of the movement. By utilizing this alone, you will have increased the effectiveness of any single exercise by 100%. Not only will you be working on the upward movement but you will work the muscle on the downward rather then most people who just let gravity take over. Vary your repetition speeds for an increase in intensity.

2. Tempo Variations - Have you ever seen any programs listed as 4032? That just means 4 seconds on the down motion; 0 seconds at the bottom of the movement; 3 seconds up; 2 second hold at the top. You can do all types of tempo variations to just feel the muscle working and increase the intensity. For example, how about a set of machine bench presses where it's 8032? 8 seconds down? Not super-slow but very controlled. And with a nice 2 second squeeze at the top. You can take any exercise where you've done the same weight and instantly make it much harder and more intense. Without adjusting the weight in the slightest!

3. Tension Manipulation - If you think about it, some exercises like the dumbbell side lateral raise, when the weights are truly at your side (bottom of the movement) the tension is totally off the shoulder muscles. By using tension manipulation you can stop short of this occurring. Take the leg press for example. Rather then do a full rep where you might lock out and pause at the top, how about a slow 4 seconds down, 0 seconds at the bottom, 3 seconds up, and only go ¾ of the way to the lockout, no pause and repeat. This is called "continuous tension" and it will not only increase the intensity of any exercise but it's slow, controlled and the tension is never off the working muscle.

4. Stretch Exercises - With some exercises, there is a perfect opportunity to get a deep stretch with a weight load on the muscle. The calf press is a good example. How many people have you witnesses doing calf raises quickly using momentum? Several? Next time, take a 2 second pause at the bottom and feel the stretch before doing the next rep.

5. Contraction Exercises - Again, the calf raises can be slightly altered to make it feel like somebody has put a flame torch to the back of your legs. At the top of the movement, rather the lower the weight, hold the fully contracted position for 5 seconds and squeeze! This can be done with a set of Smith Machine squats too. At the top of the movement, squeeze like you are holding a flexed pose for 2+ seconds. It's one more way of taking the same old exercise and making it different.

6. Super-Sets - Ever heard that with super-sets you can get more done in less time? It's true. Rather then do a second of barbell bench presses, followed by a 3 minute rest, and then another. How about doing a set of barbell bench presses, immediately followed by a set of cable flyes? You can get more work done in the same time period. The more work you can do in a shorter time frame is a method of making the whole workout more intense.

7. Rest Periods - Take the example above but this time, after the cable flyes, you only rest 30 seconds and repeat. Not only have you done a super-set, but you've just shortened the rest period. The intensity bar is sure to show a spike now. By lowering the rest periods, you can effectively make the workout more intense, without adding more weight. Combine this with super-setting and you can do an amazing number of sets in 60 minutes. At one point, I was able to do 48 sets for my legs in 60 minutes! That is insane.

8. Split the Splits - This only applies to individuals that might have a lifestyle where this is possible in a given day. Take for example leg training. It's very difficult to train the quads, the hamstrings and calves in a single session for the advanced athlete. But if you are able to train quads in the AM and hams and calves in the PM, then you have just obtained an optimal workout. Both are short and intense. Both allow for fully recovery. And focus can be given to particular body parts. The most common type of split of splits is on a leg day where the front of the legs are training at one time and the back of the legs trained at another. Not only is this advanced but it really requires that you have a time period when you can do this. Possibly a weekend if you are disciplined enough to take up an entire Saturday or Sunday.

9. Ascending/Descending Sets - Nothing more then increasing or decreasing the weight in a given set but do not let this technique fool you. It's a wicked way to just blast a body part. Descending sets are commonly referred to as "drop sets." For example, if you were doing dumbbell curls, you could start with a weight and do 10 reps, the move down in weight for another 8 reps, and move again and again. Ascending is just the reverse. There's no set number of moves downward up upward you can do but the maximum that is efficient is no more then 4 either way. For an interesting twist on this move, use a combination of both. Start with a given weight, use the ascending technique and then immediately use the descending technique. This makes for a giant set using both principles. And is very difficult.

By using these nine simple steps individually or in combination, you are ensured to take yourself to the next level of intensity.

How New Acne Drugs Are Developed

The U.S. Food and Drug Administration (FDA) states its purpose in the following mission statement:

"The FDA is responsible for protecting the public health by assuring the safety, efficacy, and security of human and veterinary drugs, biological products, medical devices, our nation’s food supply, cosmetics, and products that emit radiation. The FDA is also responsible for advancing the public health by helping to speed innovations that make medicines and foods more effective, safer, and more affordable; and helping the public get the accurate, science-based information they need to use medicines and foods to improve their health."

In 2005 the FDA provided a public draft guidance document to the pharmaceutical industry on the development of drugs to treat acne vulgaris, or acne. The draft guidance document contains the FDA's current thinking on the development of acne drugs and the methods that should be used.

Some of the guidance document information is summarized below. At the time of this writing the FDA document had not been finalized.


Types of Acne Lesions

The two major types of acne lesions are classified as non-inflammatory and inflammatory. Non-inflammatory acne lesions are more commonly known as whiteheads and blackheads. Inflammatory acne lesions include papules and pustules and are more deeply seated in the skin than the non-inflammatory lesions.


How Acne Severity Is Rated

Currently there is no standardized method for rating the severity of acne outbreaks. Several methods have been proposed, but each has its difficulties. A sample scale for rating acne severity is summarized below, from least to most severe:

0 Clear skin with no inflammatory or non-inflammatory lesions

1 Almost clear; rare non-inflammatory lesions with no more than one small inflammatory lesion

2 Mild severity; greater than Grade 1; some non-inflammatory lesions with no more than a few inflammatory lesions (papules/pustules only, no nodular lesions)

3 Moderate severity; greater than Grade 2; up to many non-inflammatory lesions and may have some inflammatory lesions, but no more than one small nodular lesion

4* Severe; greater than Grade 3; up to many non-inflammatory and inflammatory lesions, but no more than a few nodular lesions

(* worsening beyond Grade 4 is possible).


Acne Drug Treatment Study Groups

Acne drug test groups should be large enough to be statistically significant so that any claims of success and safety can be supported. Test patients are usually recruited during their most severe acne breakouts.

Acne drug trials are recommended to be randomized, blinded, multicenter trials, and other requirements will also apply. A control or placebo group should be utilized.

Furthermore, those doing testing should recruit test populations that are representative of the age, race, gender, and geographic location of acne patients in the United States.


Determining The Success Of Acne Drug Treatments

Acne severity is rated at the beginning and end of every test. Photographic evidence and/or lesion counts may also be taken. It is proposed to measure the success of acne medications as either a success or a failure, based on one of these two methods of measuring success:

1. Success meaning a rating of clear skin or almost clear (severity rating 0 or 1) within the test period; or

2. Success meaning an improvement of 2 severity grades within the test period. Under this definition, a successful test subject would have a severity improvement from 4 to 2 within the test period, as an example.


The Final Decision On New Acne Drugs

Several phases of testing are recommended for proposed acne drugs. Studies must be designed to account for effects such as test dropouts. Rigorous data analysis must be performed in conformance with FDA regulations. Only acne drug test data that has been validated and undergone quality assurance testing should be submitted to the FDA for approval.

Only through a rigorous and tightly-controlled testing and analysis procedure, followed by FDA approval, can new acne drugs be made available to the public.

The resource link below contains free information on the best ways to utilize FDA-approved prescription and over the counter acne drugs and treatments.

Source: Guidance for Industry, Acne Vulgaris: Developing Drugs for Treatment, DRAFT GUIDANCE, U.S. Department of Health and Human Services, Food and Drug Administration Center for Drug Evaluation and Research (CDER), September 2005, Clinical/Medical.

Water: How much should you drink every day?

How much water should you drink each day? — a simple question with no easy answers. Studies have produced varying recommendations over the years, but in truth, your water needs depend on many factors, including your health, how active you are and where you live.

Though no single formula fits everyone, knowing more about your body's need for fluids will help you estimate how much water to drink each day.

Health benefits of water

Water is your body's principal chemical component, comprising, on average, 60 percent of your weight. Every system in your body depends on water. For example, water flushes toxins out of vital organs, carries nutrients to your cells and provides a moist environment for ear, nose and throat tissues.

Lack of water can lead to dehydration, a condition that occurs when you don't have enough water in your body to carry out normal functions.

Nearly all of the major systems in your body depend on water.

How much water do you need?

Every day you lose water through your breath, perspiration, urine and bowel movements. For your body to function properly, you must replenish its water supply by consuming beverages and foods that contain water.

A couple of approaches attempt to approximate water needs for the average, healthy adult living in a temperate climate.

• Replacement approach. The average urine output for adults is 1.5 liters a day. You lose close to an additional liter of water a day through breathing, sweating and bowel movements. Food usually accounts for 20 percent of your total fluid intake, so if you consume 2 liters of water or other beverages a day (a little more than 8 cups) along with your normal diet, you will typically replace the lost fluids.
• Dietary recommendations. The Institute of Medicine advises that men consume roughly 3.0 liters (about 13 cups) of total beverages a day and women consume 2.2 liters (about 9 cups) of total beverages a day.

Even apart from the above approaches, it is generally the case that if you drink enough fluid so that you rarely feel thirsty and produce between one and two liters of colorless or slightly yellow urine a day, your fluid intake is probably adequate.

Factors that influence water needs

You may need to modify your total fluid intake depending on how active you are, the climate you live in, your health status, and if you're pregnant or breast-feeding.

• Exercise. The more you exercise, the more fluid you'll need to keep your body hydrated. An extra 1 or 2 cups of water should suffice for short bouts of exercise, but intense exercise lasting more than an hour (for example, running a marathon) requires additional fluid. How much additional fluid is needed depends on how much you sweat during the exercise, but 13 to26 ounces (or about 2 to 3 cups) an hour will generally be adequate, unless the weather is exceptionally warm.

  During long bouts of intense exercise, it's best to use a sports drink that contains sodium, as this will help replace sodium lost in sweat and reduce the chances of developing hyponatremia, which can be life-threatening. Fluid also should be replaced after exercise. Drinking 16 ounces of fluid per pound of body weight lost during exercise is recommended.

• Environment. Hot or humid weather can make you sweat and requires additional intake of fluid. Heated indoor air also can cause your skin to lose moisture during wintertime. Further, altitudes greater than 2,500 meters (8,200 feet) may trigger increased urination and more rapid breathing, which use up more of your fluid reserves.
• Illnesses or health conditions. Signs of illnesses, such as fever, vomiting and diarrhea, cause your body to lose additional fluids. In these cases you should drink more water and may even need oral rehydration solutions, such as Gatorade, Powerade or Ceralyte. Certain conditions, including bladder infections or urinary tract stones, also require increased water intake. On the other hand, certain conditions such as heart failure and some types of kidney, liver and adrenal diseases may impair excretion of water and even require that you limit your fluid intake.
• Pregnancy or breast-feeding. Women who are expecting or breast-feeding need additional fluids to stay hydrated. Large amounts of fluid are lost especially when nursing. The Institute of Medicine recommends that pregnant women drink 2.4 liters (about 10 cups) of fluids daily and women who breast-feed consume 3.0 liters (about 12.5 cups) of fluids a day.

Beyond the tap: Other sources of water

Although it's a great idea to keep water within reach at all times, you don't need to rely only on what you drink to satisfy your fluid needs. What you eat also provides a significant portion of your fluid needs. On average, food provides about 20 percent of total water intake, while the remaining 80 percent comes from water and beverages of all kinds.

For example, many fruits and vegetables — such as watermelon and cucumbers — are nearly 100 percent water by weight. Beverages such as milk and juice are also comprised mostly of water. Even beer, wine and caffeinated beverages such as coffee, tea or soda can contribute, but these should not be a major portion of your daily total fluid intake. Water is one of your best bets because it's calorie-free, inexpensive and readily available.

Dehydration and complications

Failing to take in more water than your body uses can lead to dehydration. Even mild dehydration — as little as a 1 percent to 2 percent loss of your body weight — can sap your energy and make you tired. Common causes of dehydration include strenuous activity, excessive sweating, vomiting and diarrhea.

Signs and symptoms of dehydration include:

• Mild to excessive thirst
• Fatigue
• Headache
• Dry mouth
• Little or no urination
• Muscle weakness
• Dizziness
• Lightheadedness

Mild dehydration rarely results in complications — as long as the fluid is replaced quickly — but more-severe cases can be life-threatening, especially in the very young and the elderly. In extreme situations, fluids or electrolytes may need to be delivered intravenously.

Staying safely hydrated

It's generally not a good idea to use thirst alone as a guide for when to drink. By the time one becomes thirsty, it is possible to already be slightly dehydrated. Further, be aware that as you get older your body is less able to sense dehydration and send your brain signals of thirst. Excessive thirst and increased urination can be signs of a more serious medical condition. Talk to your doctor if you experience either.

To ward off dehydration and make sure your body has the fluids it needs, make water your beverage of choice. Nearly every healthy adult can consider the following:

• Drink a glass of water with each meal and between each meal.
• Hydrate before, during and after exercise.
• Substitute sparkling water for alcoholic drinks at social gatherings.

If you drink water from a bottle, thoroughly clean or replace the bottle often. Refill only bottles that are designed for reuse.

Though uncommon, it is possible to drink too much water. When your kidneys are unable to excrete the excess water, the electrolyte (mineral) content of the blood is diluted, resulting in a condition called hyponatremia (low sodium levels in the blood). Endurance athletes — such as marathon runners — who drink large amounts of water are at higher risk of hyponatremia. In general, though, drinking too much water is rare in healthy adults who consume an average American diet.

If you're concerned about your fluid intake, check with your doctor or a registered dietitian. He or she can help you determine the amount of water that's best for you.

© 1998-2007 Mayo Foundation for Medical Education and Research (MFMER).

Dietary Supplements

What are dietary supplements?

In the United States, dietary supplements are substances you eat or drink. They can be vitamins, minerals, herbs or other plants, amino acids (the individual building blocks of protein), or parts of these substances. They can be in pill, capsule, tablet, or liquid form. They supplement, or add to, the diet and should not be considered a substitute for food.

Dietary supplements are widely available in the United States in health food stores, grocery stores, pharmacies, and by mail. People commonly take them for health-related reasons. Common dietary supplements include vitamins and minerals (such as vitamin C or a multivitamin), botanicals (herbs and plant products, such as St. John's wort), and substances that come from a natural source (such as glucosamine).

Makers of dietary supplements cannot legally say that dietary supplements can diagnose, cure, treat, or prevent disease. However, they can say that they contribute to health maintenance and well-being.

People have used dietary supplements for thousands of years to help health and to treat illness. Sometimes those supplements are the basis for some of today's common medications. For example, people have used willow bark tea for centuries to control fever. Pharmaceutical companies eventually identified the chemical in willow bark that reduces fever and used that knowledge to produce aspirin.

The U.S. Food and Drug Administration (FDA) does not regulate dietary supplements in the same way it regulates medication. A dietary supplement can be sold without research on how well it works.
What are dietary supplements used for?

People use dietary supplements for many health conditions.

* People often use vitamins and minerals to supplement diet and treat disease. For example, many people believe that taking vitamin C may help prevent or reduce the length of a cold.
* Research on some herbs and plant products has shown that they may have some of the same effects that conventional medicines do, while others may have no effect or may be harmful. Historically, people have used herbal medicines to prevent illness, cure infection, reduce fever, and heal wounds. Herbal medicines can also treat constipation, ease pain, or act as relaxants or stimulants.
* Researchers have studied some natural products and have found them to be useful. Glucosamine, for example, is often used in the treatment of osteoarthritis.

Are dietary supplements safe?

Overall, experts consider dietary supplements to be safe.

Always tell your doctor if you are using a dietary supplement or if you are thinking about combining a dietary supplement with your conventional medical treatment. It may not be safe to forgo your conventional medical treatment and rely only on a dietary supplement. This is especially important for women who are pregnant or breast-feeding.

When using dietary supplements, keep in mind the following.

* Like conventional medicines, dietary supplements may cause side effects, trigger allergic reactions, or interact with prescription and nonprescription medications or other supplements you might be taking. A side effect or interaction with another medication or supplement may make other health conditions worse.
* Dietary supplements may not be standardized in their manufacturing. Because of this, how well they work or any side effects they cause may differ among brands or even within different lots of one brand. The form you buy in health food or grocery stores may not be the same as the form used in research.
* Other than in vitamins and minerals, the long-term effects of most dietary supplements are not known.

Instant Breakfast

By Elizabeth Ward, Men's Health

In the time you spend each morning calibrating your hair gel, you could be doing something more important, with a much better payoff: eating breakfast. Mom was right (and it's okay to admit it): Breakfast is the most important meal of the day.

It keeps you slim: Breakfast eaters are less likely to be overweight than breakfast skippers, and successful dieters are also more likely to be breakfast eaters.

It keeps you healthy: Eating breakfast may reduce your risk of serious illnesses like heart disease, stroke, diabetes, and cancer, and it strengthens your immune system so you're more resistant to common ailments like colds and the flu.

It keeps you sharp: Memory and concentration get a boost from breakfast. A study on children found that kids who eat breakfast score higher on tests and are less likely to suffer from depression, anxiety, and hyperactivity. It should help you at the office, too.

The Perfect Meal
You say you eat breakfast? Good boy. Even so, it's likely you're doing it wrong. "Most men make the mistake of eating too little in the morning, and then get so hungry they go overboard and eat a giant meal later in the day," says Evelyn Tribole, M.S., R.D., a nutritionist in Irvine, California, and author of Stealth Health.

A typical breakfast is just a couple of hundred calories, mostly in the form of simple carbohydrates that spike blood-sugar levels and leave the body starving for energy a couple of hours later.

Even a classic fiber-rich breakfast — say a cup of raisin bran with blueberries and skim milk — provides less than 300 calories and only about 10 grams of protein. An ideal breakfast needs to be much larger — between 500 and 600 calories. And it needs to be packed with vitamins, minerals, and nutrients, including at least 20 grams of protein and at least 5 grams of fiber. That will give your body a high-quality, long-lasting, steady supply of energy to help you through the morning.

Here's how to hit those numbers. Each of the following meals tastes great and can be made in minutes.

Blueberry Smoothie With Toasted-Cheese Sandwich
Prep time: 4 minutes 2 slices whole-wheat bread 1/2 c Kashi Go Lean Crunch! cereal 1 c fat-free milk 1 c frozen blueberries 1 1-oz slice Cheddar cheese Pop the bread into the toaster. Dump the cereal, milk, and berries into a blender and liquefy. Stick a slice of Cheddar between the warm slices of toast and nuke the sandwich in a microwave for 15 seconds. It tastes grilled—but isn't.

Benefits: "The cheese and milk in this meal are essential for building and maintaining new muscle," says Christine Rosenbloom, Ph.D., R.D., a professor of nutrition at Georgia State University. "The whole grains in the bread and cereal will help lower cholesterol, and the minerals in the milk and cheese will help keep blood-pressure levels down." Per meal: 509 calories, 26 grams (g) protein, 75 g carbohydrates, 14 g total fat, 12 g fiber

Grab-and-Go Breakfast
Prep time: 1 minute 1 medium apple 1/2 pint fat-free milk 1 bran Vita muffin 1 pack Skippy Squeeze Stix peanut butter Slice the apple, grab the milk, muffin, and peanut butter, and go. Squeeze the peanut butter out of its pack onto your apple slices as you eat.

Benefits: Vita muffins (vitalicious. com) contain 100 percent of your recommended intake of several important nutrients, including vitamins A, B6, B12, C, D, and E. Foods high in monounsaturated fats — like peanut butter — may boost testosterone levels. This meal should help you burn energy more efficiently and lift more weight at the gym.
Per meal: 506 calories, 20 g protein, 87 g carbohydrates, 12 g total fat, 15 g fiber

Minute Omelette with Toast
Prep time: 2 minutes 1 egg 3/4 c frozen spinach, thawed 1 slice Canadian bacon, diced 2 slices whole-wheat bread 1 Tbsp almond butter 1 c Welch's grape juice Stir together the egg, spinach, and Canadian bacon and pour onto a plate coated with nonstick spray. Microwave for 1 minute or until the egg is fully cooked. Toast the bread and eat it with the almond butter. Chase everything with grape juice.

Benefits: Monounsaturated fat in the almond spread will help prevent spikes and drops in blood sugar, which can leave you feeling tired or crabby. Grape juice gives you an antioxidant, called resveratrol, that not only helps lower LDL (bad) cholesterol levels but also helps improve bloodflow to the heart.
Per meal: 540 calories, 25 g protein, 73 g carbohydrates, 19 g total fat, 8 g fiber

Two PB-and-Banana Wraps With Milk
Prep time: 2 minutes 2 Tbsp peanut butter 2 Eggo Special K waffles 1 medium banana 1/2 pint fat-free chocolate milk Spread a tablespoon of peanut butter over each (briefly microwaved) waffle. Divide the banana between them and roll each to make wraps. Wash down with chocolate milk.

Benefits: Eggo's Special K waffles supply complex carbohydrates, which break down slowly in the body and stimulate the production of serotonin, a calming brain chemical. The banana is packed with potassium — a heart protector.

Per meal: 570 calories, 23 g protein, 90 g carbohydrates, 16 g total fat, 7 g fiber

The Santa Fe Burrito
Prep time: 4 minutes 2 eggs 1 c Santa Fe frozen mixed vegetables (black beans, peppers, and corn) 1 flour tortilla 1/2 c low-fat shredded Cheddar cheese 1/4 c salsa Mix the eggs and vegetables and spread the mixture on a plate coated with nonstick spray. Cook in the microwave for 1 minute, stir with a fork, and microwave again until the eggs are cooked and the vegetables warm. Pile onto a flour tortilla, top with shredded Cheddar cheese and salsa, fold, and eat.

Benefits: "Without protein, guys can lose muscle mass quickly," says William J. Evans, Ph.D., a professor of geriatrics, physiology, and nutrition at the University of Arkansas. This meal is packed with it.
Per meal: 530 calories, 36 g protein, 53 g carbohydrates, 18 g total fat, 6 g fiber

Black-Cherry Smoothie and Peanut-Butter Oatmeal
Prep time: 4 minutes 1 c R.W. Knudsen black-cherry juice 1 c frozen strawberries 1 c frozen unsweetened cherries 2 Tbsp protein powder 2/3 c oatmeal 1 Tbsp peanut butter 1/2 c fat-free milk Blend the cherry juice, frozen fruit, and protein powder until smooth. Microwave the oatmeal according to the directions on the package. Stir in the peanut butter and milk.

Benefits: Men who ate at least one serving of whole-grain cereal (like oatmeal) a day had the lowest risk of dying of any cause, including heart disease, according to a 5-year study of 86,000 doctors. Cherries and strawberries are natural sources of salicylates — the active ingredient in aspirin — making them ideal for relieving stress-induced morning headaches.

Per meal: 600 calories, 27 g protein, 100 g carbohydrates, 11 g total fat, 10 g fiber

Almond-Butter-and-Raisin Sandwich With Smoothie
Prep time: 1 minute 2 Tbsp almond butter 2 Eggo Special K waffles 1 Tbsp raisins 1 Stonyfield Farm smoothie Spread the almond butter on the waffles. Sprinkle the raisins over one waffle and top with the other. Wash down with the smoothie.

Benefits: Whole-grain waffles help lower cholesterol and blood pressure, and improve your body's processing of insulin and glucose, a benefit that can reduce your risk of becoming diabetic.

Per meal: 600 calories, 21 g protein, 86 g carbohydrates, 22 g total fat, 7 g fiber