Monday, January 01, 2007

New Year's Resolutions

Op-Ed Contributor

Another Last Chance to Change Your Life

Published: January 1, 2007

Paris

IN one of his last books, Romain Gary tells how, as a lover at 59 of a Russian woman of 20, he decided to end the relationship because of the age difference. But, deeply in love, he hesitated. In the cafe where he went to write a letter breaking off the liaison, the server asked him what he wanted. “Je prendrai une décision,” he said, I will have a decision. As the server, philosophically, waited for him to place his proper order, he corrected himself. “Je prendrai une infusion,” I will have an herbal tea.

The practice of making New Year’s resolutions is growing rare in France, perhaps because we spread them out from January to December, a demonstration of a delicate balance between good will and willpower. Descendants of the spiritual exercises of the ancients, resolutions are both educational and therapeutic.

In declaring resolutions, if possible before witnesses, we nourish the illusion that changing our lifestyles will change our lives: “This year, I will read Proust.” “This year, I will not invade Iraq.” “This year, I will be faithful to my wife.” “This year, I will reduce unemployment in France.” Or, more prosaically, “I will exercise three times a week, I will finally try to stop smoking, I will cut back on sugar,” etc. It’s a sort of collective drunkenness for people to make vows that nobody expects to keep.

Westerners are athletes of introspection — we never stop analyzing ourselves. “It is never too late or too early to care for the well-being of the soul,” Epicurus said, and so we make our lives a study of ourselves. We need a moment in the year when we look at ourselves, weigh our good and bad habits, evaluate our conduct as a doctor evaluates our health during an annual examination, so we can strive for a way of life that is wiser and more responsible.

There are two types of resolutions: those that are reasonable, and those that are not. The day I took communion, when I was an adolescent and still believed in God, I would decide to be good to everyone, to smile at my family, to spread charity and goodwill. This love for my neighbors, even the ones who annoyed me, lasted two days, and then I returned to being an ordinary human, neither good nor bad, with my moods and my preferences. I could not make myself someone I was not.

Similarly, to declare that in 2007 we resolve to be happy is unreasonable. We can’t determine to be happy: it is in our power to avoid certain evils, to stay away from conflict, to not bankrupt ourselves, to not throw ourselves out the window or under a train, but we can’t order up happiness as we order a dish in a restaurant or command a dog to come at our call. Happiness eludes the rendezvous we fix, arrives when we least expect it, disappears when we think we have it in hand.

In other words, those people who are unhappy about not being happy forget that happiness has a knack for indirection, coming in the middle of the most ordinary day or disappearing at the height of one’s career. It is a matter of luck, almost of grace, a visitor who enters the house unexpectedly and vanishes on tiptoe. “I recognize happiness by the sound it makes when it leaves,” said the poet Jacques Prévert.

In contrast, let’s imagine someone who sets out on Dec. 31 to ruin his life. It’s not certain that ruin will arrive easily: it is no less difficult to destroy one’s life than to improve it. Catastrophe is a delicate art that also requires chance. Hell is just as hard to get into as heaven.

If the end of the year brings a flood of resolutions to change, it is because we are faced with an existence that is invaded by the routine, by the rush of demands. We can’t bear it. We know that another life exists, more beautiful, more passionate, one that laziness and apathy keeps us from attaining.

I have to break with time to overcome my obstacles, to rediscover myself, to be myself in all innocence. I can change my life, at least in some small way. Making resolutions demonstrates optimism, the desire to make oneself better, a faith, naïve and beautiful at once, that declarations can spontaneously become actions, that saying means doing.

Oh, the glorious day of making a resolution, the belief that starting tomorrow I will be the pilot of my existence, that I will stop being the plaything of external circumstances, that I will govern myself. I’m better than I seem to be — a person obsessed by little irritants, addicted to talking nonsense — and I’m going to prove it to the world. The certainty that soon, thanks to my willpower, I will no longer be someone who is habitually late, a slave to my cellphone, a glutton, a distracted driver... that can galvanize me, prompt me to change, tear away my imperfect personality. Real life starts now; I can immediately free myself of my neuroses, correct myself. I can rid myself of the fear of failure and of the specter of the failures of the past.

Knowing that you can change your behavior, even by an iota, is essential for holding yourself in esteem. We’re often cynical about how resolutions are never kept, but we shouldn’t be. Resolutions are perhaps lies, but they’re lies of good faith, necessary illusions. As long as we can make them, we are saved, we can control the chaos of destiny; it doesn’t matter that we break them and that others view us with skepticism. Every resolution is good simply because it is declared. It is a comedy, perhaps, but it keeps us sane.

Pascal Bruckner is the author of “The Temptation of Innocence: Living in the Age of Entitlement.” This article was translated by The Times from the French.



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Soldier's Journal for Son

An Appreciation

From Father to Son, Last Words to Live By

Published: January 1, 2007

He drew pictures of himself with angel wings. He left a set of his dog tags on a nightstand in my Manhattan apartment. He bought a tiny blue sweat suit for our baby to wear home from the hospital.

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Dana Canedy

“Follow your heart,” Charles M. King wrote in a 200-page journal for his son, Jordan, whom he first held this fall just weeks before he died in Iraq.

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One of the drawings First Sgt. Charles Monroe King left for his son in a journal.

Then he began to write what would become a 200-page journal for our son, in case he did not make it back from the desert in Iraq.

For months before my fiancé, First Sgt. Charles Monroe King, kissed my swollen stomach and said goodbye, he had been preparing for the beginning of the life we had created and for the end of his own.

He boarded a plane in December 2005 with two missions, really — to lead his young soldiers in combat and to prepare our boy for a life without him.

Dear son, Charles wrote on the last page of the journal, “I hope this book is somewhat helpful to you. Please forgive me for the poor handwriting and grammar. I tried to finish this book before I was deployed to Iraq. It has to be something special to you. I’ve been writing it in the states, Kuwait and Iraq.

The journal will have to speak for Charles now. He was killed Oct. 14 when an improvised explosive device detonated near his armored vehicle in Baghdad. Charles, 48, had been assigned to the Army’s First Battalion, 67th Armored Regiment, Fourth Infantry Division, based in Fort Hood, Tex. He was a month from completing his tour of duty.

For our son’s first Christmas, Charles had hoped to take him on a carriage ride through Central Park. Instead, Jordan, now 9 months old, and I snuggled under a blanket in a horse-drawn buggy. The driver seemed puzzled about why I was riding alone with a baby and crying on Christmas Day. I told him.

“No charge,” he said at the end of the ride, an act of kindness in a city that can magnify loneliness.

On paper, Charles revealed himself in a way he rarely did in person. He thought hard about what to say to a son who would have no memory of him. Even if Jordan will never hear the cadence of his father’s voice, he will know the wisdom of his words.

Never be ashamed to cry. No man is too good to get on his knee and humble himself to God. Follow your heart and look for the strength of a woman.

Charles tried to anticipate questions in the years to come. Favorite team? I am a diehard Cleveland Browns fan. Favorite meal? Chicken, fried or baked, candied yams, collard greens and cornbread. Childhood chores? Shoveling snow and cutting grass. First kiss? Eighth grade.

In neat block letters, he wrote about faith and failure, heartache and hope. He offered tips on how to behave on a date and where to hide money on vacation. Rainy days have their pleasures, he noted: Every now and then you get lucky and catch a rainbow.

Charles mailed the book to me in July, after one of his soldiers was killed and he had recovered the body from a tank. The journal was incomplete, but the horror of the young man’s death shook Charles so deeply that he wanted to send it even though he had more to say. He finished it when he came home on a two-week leave in August to meet Jordan, then 5 months old. He was so intoxicated by love for his son that he barely slept, instead keeping vigil over the baby.

I can fill in some of the blanks left for Jordan about his father. When we met in my hometown of Radcliff, Ky., near Fort Knox, I did not consider Charles my type at first. He was bashful, a homebody and got his news from television rather than newspapers (heresy, since I’m a New York Times editor).

But he won me over. One day a couple of years ago, I pulled out a list of the traits I wanted in a husband and realized that Charles had almost all of them. He rose early to begin each day with prayers and a list of goals that he ticked off as he accomplished them. He was meticulous, even insisting on doing my ironing because he deemed my wrinkle-removing skills deficient. His rock-hard warrior’s body made him appear tough, but he had a tender heart.

He doted on Christina, now 16, his daughter from a marriage that ended in divorce. He made her blush when he showed her a tattoo with her name on his arm. Toward women, he displayed an old-fashioned chivalry, something he expected of our son. Remember who taught you to speak, to walk and to be a gentleman, he wrote to Jordan in his journal. These are your first teachers, my little prince. Protect them, embrace them and always treat them like a queen.

Though as a black man he sometimes felt the sting of discrimination, Charles betrayed no bitterness. It’s not fair to judge someone by the color of their skin, where they’re raised or their religious beliefs, he wrote. Appreciate people for who they are and learn from their differences.

He had his faults, of course. Charles could be moody, easily wounded and infuriatingly quiet, especially during an argument. And at times, I felt, he put the military ahead of family.

He had enlisted in 1987, drawn by the discipline and challenges. Charles had other options — he was a gifted artist who had trained at the Art Institute of Chicago — but felt fulfilled as a soldier, something I respected but never really understood. He had a chest full of medals and a fierce devotion to his men.

He taught the youngest, barely out of high school, to balance their checkbooks, counseled them about girlfriends and sometimes bailed them out of jail. When he was home in August, I had a baby shower for him. One guest recently reminded me that he had spent much of the evening worrying about his troops back in Iraq.

Charles knew the perils of war. During the months before he went away and the days he returned on leave, we talked often about what might happen. In his journal, he wrote about the loss of fellow soldiers. Still, I could not bear to answer when Charles turned to me one day and asked, “You don’t think I’m coming back, do you?” We never said aloud that the fear that he might not return was why we decided to have a child before we planned a wedding, rather than risk never having the chance.

But Charles missed Jordan’s birth because he refused to take a leave from Iraq until all of his soldiers had gone home first, a decision that hurt me at first. And he volunteered for the mission on which he died, a military official told his sister, Gail T. King. Although he was not required to join the resupply convoy in Baghdad, he believed that his soldiers needed someone experienced with them. “He would say, ‘My boys are out there, I’ve got to go check on my boys,’ ” said First Sgt. Arenteanis A. Jenkins, Charles’s roommate in Iraq.

In my grief, that decision haunts me. Charles’s father faults himself for not begging his son to avoid taking unnecessary risks. But he acknowledges that it would not have made a difference. “He was a born leader,” said his father, Charlie J. King. “And he believed what he was doing was right.”

Back in April, after a roadside bombing remarkably similar to that which would claim him, Charles wrote about death and duty.

The 18th was a long, solemn night, he wrote in Jordan’s journal. We had a memorial for two soldiers who were killed by an improvised explosive device. None of my soldiers went to the memorial. Their excuse was that they didn’t want to go because it was depressing. I told them it was selfish of them not to pay their respects to two men who were selfless in giving their lives for their country.

Things may not always be easy or pleasant for you, that’s life, but always pay your respects for the way people lived and what they stood for. It’s the honorable thing to do.

When Jordan is old enough to ask how his father died, I will tell him of Charles’s courage and assure him of Charles’s love. And I will try to comfort him with his father’s words.

God blessed me above all I could imagine, Charles wrote in the journal. I have no regrets, serving your country is great.

He had tucked a message to me in the front of Jordan’s journal. This is the letter every soldier should write, he said. For us, life will move on through Jordan. He will be an extension of us and hopefully everything that we stand for. ... I would like to see him grow up to be a man, but only God knows what the future holds.



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Friday, December 29, 2006

Eldercare Costs

Elder-Care Costs Deplete Savings of a Generation

Published: December 30, 2006

To care for her ailing 97-year-old father over the past three years, Elizabeth Rodriguez, a vice president at the Federal Reserve Bank in New York, has borrowed against her 401(k) retirement plan, sold her house on Staten Island and depleted nearly 20 years of savings.

The money has gone to lawyers’ fees ($50,000) to win a contested guardianship. It has gone for home-care equipment like the mattress for his hospital bed (about $3,000 in all) and for a food service to deliver meals ($400 a month).

It has gone for a two-bedroom rental apartment big enough for herself, her dad and a home aide ($1,600 a month more than a one-bedroom apartment in the same building), and for a wheelchair-accessible van to get him to doctors’ appointments ($330 a trip).

Asked to tally the costs, Ms. Rodriguez, 58, said she had no idea how much she was spending. “A shower chair, body cream with no alcohol, new shoes,” she said. “You don’t stop and calculate. You just buy what you have to buy.”

Ms. Rodriguez is among the legion of adult children — more than 15 million, according to various calculations — who take care of their aging parents, a responsibility that often includes paying for all or part of their housing, medical supplies and incidental expenses. Many costs are out of pocket and largely unnoticed: clothing, home repair, a cellular telephone.

Adult children with the largest out-of-pocket expenses are those supervising care long distance, those who hire in-home help and those whose parents have too much money to qualify for government-subsidized Medicaid but not enough to pay for what could be a decade of frailty and dependence.

The burden is compounded by ignorance, according to a study by AARP, released in mid-December, which found that most Americans have no idea how much long-term care costs and believe that Medicare pays for it, when it does not.

Families have always looked after their elderly loved ones. But never has old age lasted so long or been so costly, compromising the retirement of baby boomers who were expecting inheritances rather than the shock of depleted savings.

“There is a myth out there that families abandon their frail elders,” said Dr. Robert L. Kane, a geriatrician at the University of Minnesota School of Public Health. “Instead, across the income spectrum, children are sacrificing to care for their parents to the limit of their means and sometimes beyond.”

Researchers have documented the time spent by adult children, and others, caring for ailing relatives. But data is woefully inadequate on how much they actually spend, health economists say, because most people do not keep itemized entries as they write checks, use their credit cards or pocket money to meet the demands of the day.

“When you’re in the middle of the forest, with so many things coming at you, you can’t really see the trees,” Ms. Rodriguez said. “But each one of those trees has actual dollars connected to it.”

Costs are astronomical for long-term, low-tech care, the sort most often needed by those who linger with Alzheimer’s disease or are too frail to get around on their own. Medicare is of almost no help, since it covers only acute episodes like a heart attack, cancer or repair of a broken hip.

That means the elderly and their families are left to pay for assisted living (which averages $35,000 a year), nursing homes ($74,000) or home health aides. Only the very poor receive Medicaid, which pays nursing-home bills nationwide but home care in only a few states (New York among them), and nothing toward assisted-living rent.

Nor does Medicare cover equipment like grab bars for the shower and incontinence supplies, which alone can run $2,000 a year, or travel expenses for an adult child responding to medical emergencies.

Marilyn de Leo, for instance, has made two trips from New York City to Los Angeles since September, when her mother fell in the bathroom and broke her neck and both ankles. Ms. de Leo, 62, an associate director in the development office of Mount Sinai Medical Center, spent $800 on airfare for the first frantic trip , plus $50 a day on taxis, since she had left her eyeglasses behind in a mad dash to the airport and therefore could not rent a car. Ms. de Leo has no savings left, and is $5,000 in debt. When asked about her own future, she said, “I’ll have to work till I drop.”

Only one authoritative survey, in 2004, has even asked adult children how much they contribute to their parents’ support. Half said they did, and the average monthly expenditure was $200. Respondents who looked after their parents at least 40 hours a week said they spent an average of $324 a month.

But those figures were based on “quick, top-of-the-head estimates,” said Gail Hunt, president of the National Alliance for Caregiving, which conducted the survey.

Knowing the extent of these expenses might inform public policy, some experts say, calling attention to a gap in the government safety net for the elderly.

“Should this burden fall solely on the individual and the family?” asked Judy Feder, dean of the Public Policy Institute at Georgetown University. “And can we really expect this arrangement to keep doing the job as a larger and larger population comes to grips with it?”

Congress recently passed a poorly financed bill that would help family members who need a break to pay for substitute care of an ailing loved one. But the Bush administration, to date, has preferred a private sector solution, recommending long-term insurance and reverse mortgages.

For spouses, most expenses are tax-deductible if they exceed 7.5 percent of adjusted gross income. But children cannot claim parental expenses unless they pay more than half of a parent’s support, which is often not the case when the parents are on Medicaid, like Mrs. Rodriguez’s father, or have savings, like the Schoengood family.

The elder Schoengoods, both 86, own a home in Yonkers and a condominium in Florida and have assets enough for round-the-clock care, which can cost $100,000 a year. Still, their son, Matthew G. Schoengood, 49, vice president of student affairs at the Graduate Center at the City University of New York, has kicked in at least $1,000 a month since 2005, when his mother had the first of two strokes.

Mr. Schoengood flew his family nanny to Florida, for example, to look after his father. Now that his parents are permanently up north, Mr. Schoengood orders their groceries online along with his own. “As a child, it’s just something you do,” he said. “Mostly you don’t even think about it.”

His father makes a half-hearted effort to pay him back, but Mr. Schoengood always says, jokingly, “I’ll put it on your tab, Dad.” Typical of their generation, his parents fret about every penny. His father asks, incessantly, “Do we have enough?” Mr. Schoengood tells him not to worry.

For sure, he hopes his own children will do for him what he is doing for his parents, but he cringes at the prospect of burdening them — one reason long-term care insurance is becoming attractive.

Mr. Schoengood’s out-of-pocket spending is not sensible, elder-care experts say, but the result of the awkward minuet of preserving a parent’s pride.

If families behaved logically, said Steven Schurkman, an elder-care lawyer in White Plains, all expenses would be paid from the parents’ money, which if depleted would entitle them to Medicaid. “What most of us do isn’t sound financial planning,” Mr. Schurkman said. “But it’s healthy for the family dynamic.”

Carol Levine, director of the Families and Health Care Project at the United Hospital Fund in Manhattan, said that paying for her mother’s needs required delicacy, even subterfuge. When Ms. Levine went shopping, her mother would say, “Take $5 out of my purse.” Her daughter would return with 10 bags of groceries, and both would pretend that was all she had spent.

Both Mr. Schoengood and Ms. Rodriguez say their out-of-pocket expenses will not ruin them. Others are not so lucky.

Take Patrice B., 47, who returned to her childhood home in Jacksonville, Fla., seven years ago to move in with her mother, 84, who has Alzheimer’s disease, and her father, 86, who has congestive heart failure. (They requested that the family’s last name be omitted so neighbors would not know their plight.)

In their African-American culture, Ms. B. said, putting her parents in a nursing home would have been shameful. Plus, they could pay for some home care out of pensions as well as military disability checks. She, on the other hand, after years of sporadic part-time work and untallied out-of-pocket expenses, is broke.

She has catastrophic health insurance, but it will not pay for the hysterectomy she needs. She has lost her credit cards after accumulating $20,000 in debt. “Honestly,” Ms. B. said, “I’ve got nothing anymore. I go from very angry to very depressed.”

Kate Mesmer, a single mother in Northern California who had always worked for nonprofit organizations, was living paycheck to paycheck when her mother had a stroke in 2001. Ms. Mesmer took a tenant into her house so she could contribute to her mother’s $6,000-a-month rent at an assisted living center.

Then Ms. Mesmer lost her job and had to move her mother to a board-and-care home. A second stroke forced her mother into a nursing home, where she qualified for Medicaid. That is where she died last year, with nothing left but an $18,000 I.R.A. The State of California is seeking that, contending the $18,000 should have gone toward nursing-home fees.

Given what she learned in the final years of her mother’s life, Ms. Mesmer said: “I have a panic attack at least once a day. It’s frightening to think about our generation and what’s going to happen to us.”



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Thursday, December 28, 2006

Fitness : BMI

Fitness

Quick, Do You Know Your B.M.I.?

From left, Mario Anzuoni/Reuters; Danny Moloshok/Associated Press; Michael Stravato for The New York Times; Mike Segar/Reuters

RATING GAME The facts and figures for these examples of the Body Mass Index come from public records and interviews. (Mr. Stallone’s B.M.I. represents his fighting weight in “Rocky Balboa.”)

Published: December 28, 2006

IN the past, you could learn a lot about a person from a group of letters: Ph.D., D.D.S., V.F.W., D.W.I.

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Should one measure of body size fit all?

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Now another set looms ahead, and it affects everyone from teeny tiny models to adoptive parents to schoolchildren: B.M.I. or Body Mass Index.

But few people actually know what it means.

“I know that having a low B.M.I. is supposed to be a good thing, but I have no idea what it really is or how to figure it out,” said Hilary Black, 35, the editor of Tango, a magazine about relationships. “Keeping track of my weight is more important to me than keeping track of my B.M.I.”

Ms. Black is not interested in adopting a child from China. If she were, she might be very concerned with her index rating. Last week, the government-run China Center of Adoption Affairs mandated that prospective adoptive parents have, among financial, educational, marital and other health requirements, an index rating under 40.

Ms. Black does not have children. If she did, and if she lived in Arkansas or Tennessee, she would receive a report card noting her children’s index figures, in addition to their ability to play nice with others.

Ms. Black might also be worried about her index number if she were a model: In September, organizers in Madrid banned from its runways five models whose index rating was below 18.5. In Milan, fashion industry officials have also barred knife-thin models from its February shows.

The B.M.I. is a mathematical calculation of a person’s weight in kilograms divided by his or her height in meters squared. Since most Americans have no clue what their height is in meters (remember the failed attempt to go metric circa 1976?), it’s easiest to determine an index rating by visiting a Web site like that of the National Heart Lung and Blood Institute (www.nhlbisupport.com/bmi), where one can determine their index rating by entering their height in feet and weight in pounds.

And as the index, a measurement adopted by government health agencies, increasingly gains currency in many areas of life, you may wish to know yours. But how important is it? The number should not be the final word for measuring whether a person is under- or overweight to an unhealthy degree, some experts say.

“Our society is really fixated on numbers, and the problem is when it comes to weight distribution and the risk for heart disease, it’s not just one number — it’s the percentage of body fat, B.M.I. and waist size that matters,” said Dr. Nieca Goldberg, a cardiologist at Lenox Hill Hospital in Manhattan.

Dr. Peter D. Vash, the director of medical affairs at Lindora Medical Clinics, in Costa Mesa, Calif., compares the index to a speed limit. “It’s not always an absolute index in the individual case,” he said.

A Belgian statistician and astronomer, Adolphe Quetelet, invented the index formula in the 1830s. But it wasn’t until the 1980s that public health agencies adopted it as a way of identifying individuals at risk for heart attacks, hypertension, diabetes, stroke and some cancers.

In 1998, two branches of the National Institutes of Health created new guidelines which divided people into categories: You were “normal” if your index rating was between 18.5 and 24.9; “overweight’’ if it was 25 to 29.9; and “obese” if it was 30 or higher.

After the change, many doctors and lay people were up in arms. By the revised standards, nearly 55 percent of the American adult population in 1998, was considered overweight or obese, according to the N.I.H. (Today, 66.3 percent of adults are overweight or obese, according to the Centers for Disease Control and Prevention.)

The index also didn’t distinguish between body fat and muscle mass, so athletes and bodybuilders like Arnold Schwarzenegger, whose rating was 33 when he was Mr. Universe, were technically obese.

That struck some people as odd. Such discrepancies got experts wondering how accurately the index gauges health. Others questioned the reliability of the index because the figure doesn’t take fitness into account.

A low number can be deceptive. Sedentary men with a rating of less than 27 were at a greater risk for heart attacks, strokes, diabetes and certain cancers than fit men with a rating above 30, according to a study of 25,389 men conducted by the Cooper Aerobics Center in Dallas.

“In the past, it used to be felt that if you had a high B.M.I. you had a high mortality and all these risk factors,” said Dr. Michael D. Ozner, a cardiologist and medical director of wellness and prevention at Baptist Health South Florida in Miami. “We now know that exercise is extremely important.”

A study published in the August 19 issue of the medical journal Lancet combined data from 40 studies involving about 250,000 people with heart disease. The researchers found that patients with a low rating in the normal rating had a higher risk of death than others in the normal rating. Overweight patients had better survival rates and fewer heart problems than those with a normal index number.

“We concluded that B.M.I. might not be the best way to assess body fatness,” said Dr. Francisco Lopez-Jimenez, the lead author and a cardiologist at the Mayo Clinic in Rochester, Minn. “The issue is that people with ‘normal’ weight based on B.M.I. may have a lot of fat, and we’re labeling these people as completely healthy when they might not be.”

Yet, the index remains a widely accepted gauge of health, even though some tools are better predictors like say the hip-to-waist ratio in the case of heart attacks. Part of the reason is because it’s simple to calculate and cheap.

It is not the best way to test body fat, but the others are often time-consuming or unreliable. Many gyms use the skin-fold test: a caliper-wielding trainer pinches your body in three to seven places to determine your fat-to-muscle ratio. But the results vary depending on who’s administering the test, and what body parts they pinch.

The method that many doctors consider the gold standard is both tricky and inconvenient, since it requires a patient to be submerged in a water tank, to exhale, and then sit on an underwater scale. (Since fat is less dense than muscle, the more body fat you have, the less you’ll weigh in water.) But most doctors don’t have oversize cisterns in their offices, not everyone can hold their breath for an extended period and “Who wants to get all of their patients naked?” asked Dr. Amanda J. Dupont of the Austin Bariatric Clinic in Texas.

To assess her clients, Charla McMillian, a former Marine who runs FitBoot, a training program in Boston, says body fat is more crucial than the index. “It has nothing to do with how’s their heart, how’s their cardio, how’s their strength,” she said.

Maybe so, but that’s not much of a consolation for Lauri Owen, a lawyer in Bethel, Alaska, who is planning to adopt a 3-year-old boy from China, in March. Ms. Owen, 39, applied in July; her application was accepted a week before the China ruling. “If it had been a week later I wouldn’t have been able to adopt the boy,” said Ms. Owen, who is single and whose index rating hovers between 41 and 42. “It’s appalling. There are so many kids over there who desperately need homes. It was my hope to adopt him and then another child from China. Obviously, that’s not going to happen now.”

Paula Schwartz contributed reporting.



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Tuesday, December 26, 2006

Weight & Prostrate Cancer

Study: Weight Loss May Lower Cancer Risk

Published: December 26, 2006

Filed at 7:46 p.m. ET

ATLANTA (AP) -- Here's another reason for men to avoid packing on extra pounds over the holidays: A new study has found that losing weight reduces the risk of an aggressive form of prostate cancer.

After tracking the weight of nearly 70,000 men between 1982 and 1992, researchers from the American Cancer Society and the Duke University Prostate Center found that men who lost more than 11 pounds had a lower risk for aggressive prostate cancer than men whose weight remained the same over a decade.

Previous studies have found that obese men have a higher risk of developing aggressive prostate cancer. This study appears to be the first to indicate that recent weight loss can decrease that risk.

In the study reported this month in Cancer Epidemiology, Biomarkers & Prevention, researchers analyzed the height and weight of the men in 1982 and 1992 and every three years after that until 2003. At that time, more than 5,200 of the men -- more than 7 percent -- had prostate cancer.

Among those cases, about one in eight had a form of cancer that was aggressive but had not spread to other areas of the body. The study's major finding focused on those aggressive cases, with researchers concluding that those who lost 11 or more pounds were 42 percent less likely to develop that form of prostate cancer than those whose weight remained the same.

''Whether it's exactly 40 percent, we don't know, but they lower their risk when they lose 11-plus pounds. We feel confident, at least in this population, that was real,'' said lead researcher Dr. Carmen Rodriguez.

More than seven times as many men whose weight remained the same developed aggressive prostate cancer compared to those who lost 11 or more pounds.

''No significant associations'' were found regarding the effect of weight gain or loss on the most severe forms of prostate cancer, those that spread throughout the body, the study said.

The number studied was small, the researchers acknowledged, because fewer than 15,000 men lost weight over the time period, and only 1,000 of those developed some form of prostate cancer.

The 69,991 participants were part of a bigger cancer society study of 1.2 million Americans that began in 1982.

Rodriguez said men should avoid putting on extra weight as they get older.

''The main message for men is to not get overweight. If they are overweight, that's another reason to try to lose weight, just to decrease the risk for prostate cancer,'' said Rodriguez, who works for the Atlanta-based cancer society.

Other than skin cancer, prostate cancer is the most commonly diagnosed cancer for men, and about one in six will get it during his lifetime. It is the second leading cause of cancer death for U.S. men.

The study is considered the first of its kind to examine the role of weight change in the development of prostate cancer, said Dr. Ronald Ennis, director of radiation oncology at St. Luke's-Roosevelt Hospital Center in New York, who was not involved in the study.

''This is one of the best studies'' examining the role of weight on prostate cancer, Ennis said. ''It does seem to be true that if you are overweight, you are at risk of getting more aggressive forms of prostate cancer and if you lose weight, you can decrease the risk.''

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On the Net:

Cancer study: http://cebp.aacrjournals.org/cgi/rapidpdf/1055-9965.EPI-06-0754v1.pd f




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Monday, December 25, 2006

The Christmas Spirit

Editorial

How We Say Christmas

Published: December 25, 2006

What would you say if you had to explain Christmas to someone who knew nothing about it? You might begin with the shepherds in the fields by night or Santa at the North Pole or even the druidic appeal of a winter festival that comes just when the sun seems most meager. Redemption and rejoicing, feasting and singing, humility and awe — these would all be parts of your answer, as would the perennial cast of characters who people this turning time of year. The personal explanations would come easiest: the rituals of Christmas Eve, the smell of fresh balsam, the stillness of a world cloaked in snow. You would probably have something to say about the importance of family and the force of a holiday whose strongest emotions center upon children, and upon our memories of being children.

And yet to really explain Christmas you would also have to try to answer the question that seems more pressing every year: how do those emotions and memories connect to the frenzied commercial machinery of the weeks that lead up to Christmas? What does all that retailing and wrapping paper have to do with peace on earth? There is no glossing over the problem — not to a puzzled stranger and not to ourselves. What matters is not just the disjunction between the majesty of those old hymns and the immodesty of this shopping season. It is that all those presents did not really catch the feeling we were looking for, did not say what we hoped to say.

A stranger might well wonder, don’t you always hope for peace on earth? Does good will really have a season? And if you genuinely love one another — truly hold one another in your hearts — wouldn’t simply saying it be far more eloquent than any other gift that you could give? These questions point to something most of us already know, that for all the push and pull of the Christmas rush, for all the sputtering of the commercial volcano that erupts at the end of every year, this is truly a holiday of modest spirit, a day of humble aspirations. What we want is to love and know we are loved and to imagine a world that lives up to the purity of that feeling.



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