Watch the caffeine if you're pregnant

Whether it's a short, bitter shot of espresso or a comforting, milky latte, there's no denying that, when most people think of caffeine, they think of coffee. But it turns out that women who are pregnant or thinking of having a baby may be better off cutting back on coffee, along with other foods and drinks that contain caffeine.

In a new study, researchers looked at more than 2,000 pregnant women in Britain. They found that women who were getting more than 200 milligrams (mg) of caffeine a day (equivalent to two small cups of coffee) were more likely to give birth to an underweight baby.

Some doctors already advise women to go easy on the coffee while pregnant. But in this study, most of the caffeine women consumed came from other sources. About 62 percent was from tea, with 14 percent coming from coffee, and 12 percent from cola. Chocolate accounted for 8 percent of women's caffeine intake, with smaller amounts coming from hot chocolate and energy drinks.

The British are famously fond of tea, so American women's diets are likely to be different. Even so, the results show that keeping a lid on your caffeine intake means being careful about more than just coffee. It's made more difficult by the fact that not all products that contain caffeine will say so on the label.

Tip of the day: Make sure your goose...err, turkey is cooked

It's turkey time and it goes without saying that an undercooked bird could put a damper on your holiday—and make you and your family sick. Use a meat thermometer to make sure your turkey gets hot enough to kill harmful bacteria: It should read 165°F for the innermost part of the thigh and for stuffing cooked in the turkey. Two top picks from our recent tests are the Polder THM-360 and the Taylor Weekend Warrior 806.

Read more on how to avoid food poisoning, and check out our interview with Food Network host Robin Miller on holiday eating without the guilt.

Tip of the day: Flu shot fears

Thinking of skipping the flu shot because you're worried about the side effects? Flu-shot side effects are uncommon and usually mild, including soreness or redness at the injection site, aches, and mild fever. A small number of people do have a more serious allergic reaction to the shot. And research suggests that roughly 1 out of every 1 million people vaccinated might develop Guillain-Barre syndrome, a neurological disorder. But the shot's protection against illness, hospitalization, and death far outweighs the risk. Still, if you've had Guillain-Barre syndrome, avoid the spray vaccine and discuss with your doctor whether to get a shot. Finally, there is no convincing evidence linking the mercury-containing preservative thimerosal with autism or other health problems. However, if you're concerned, ask for a preservative-free vaccine, such as Fluzone.

Read the top excuses for skipping the flu shot, take our quiz to test your flu smarts, and take a look at our Treatment Ratings (subscribers only) for flu remedies. 

Handle contact lenses with care

If, like me, you're a contact lens wearer, you'll know how hard it can be to comply with all the advice from your optometrist. If you remove your lenses when you go swimming, you can't see the end of the pool. When you run out of saline solution—well, how bad can it be to use tap water to rinse your lenses instead?

Actually, it can be pretty bad. You risk a painful eye infection called amoebic keratitis, which can damage your sight if it isn't picked up and treated quickly. Cases of amoebic keratitis are increasing worldwide, probably because of the increase in people wearing contact lenses. It's caused by a microscopic bug called Acanthamoeba, which lives in soil and water, including swimming pools and tap water. Usually, it causes no problems. But if it contaminates your contact lens, it can infect your eyes.

A new study looked at the contact lens cases of 153 people in Tenerife, a Spanish island. Disturbingly, 66 in every 100 cases were contaminated with types of Acanthamoeba that can cause infection. The people most at risk were those wearing lenses designed to be worn for a month or longer. Daily disposable lenses were not a problem.

Consumer Reports food-labeling poll reveals safety concerns

While the majority of Americans regard the overall food supply as safe, nearly half say their confidence in the safety of the nation’s food supply has decreased, and many are concerned with the safety of imported food, according to a Consumer Reports poll released today.

The loopholes in “country of origin labeling” (COOL) is among the safety concerns. An overwhelming majority of Americans want specialty meat and fish stores to label their products by country of origin. Meat and poultry sold in butcher shops and fish sold in fish markets—some 11% percent of all meat and fish—are currently exempt from COOL. Ninety-five percent of consumers polled believe that processed or packaged food should be labeled by their country of origin and that COOL for products should always be available at point of purchase.

Read our recent blog and advice on COOL, and for more on the national food safety and labeling poll results (PDF), visit GreenerChoices.org.

Safety Alert: Infant gas relief drops recalled

If you use Mylicon anti-gas drops for your baby, Johnson and Johnson--Merck Consumer Pharmaceuticals Company is urging you to stop using the product because of a recall. The company, in consultation with the U.S. Food and Drug Administration, has announced a voluntary recall of approximately 12,000 units of Infants' Mylicon Gas Relief Dye Free (simethicone-antigas) non-staining sold in 1 oz. plastic bottles that were distributed nationwide after October 5, 2008 in retail stores and pharmacies. The recall involves two lot numbers: SMF007 and SMF008. You can find the lot numbers on the bottom of the box containing the product and also on the lower left side of the sticker on the product bottle.

Although the potential for serious injury is low, the company is implementing this recall after determining that some bottles could include metal fragments that were generated during the manufacturing process. If any medical events were to occur, most are expected to be temporary and resolved without medical treatment. Parents who have given the product to their infant and are concerned should contact their health care provider immediately.

For more on this recall and for what to do if you suspect you have the recalled drops, please see the FDA notice. Read more on child safety on our Babies & Kids blog.

Vitamin E and selenium: No magic bullet against prostate cancer

The National Cancer Institute has halted the testing of vitamin E and selenium for preventing prostate cancer after early trial results showed that the supplements not only didn’t help but might actually cause harm. An independent review suggested that men in the study who took only vitamin E were slightly more likely to develop prostate cancer than those taking just selenium, a combination of the supplements, or placebos. The study also suggested that those who took only selenium developed more cases of type-2 diabetes. While the NCI said both findings could be due to chance, the study clearly showed that neither mineral, alone or in combination, had the hoped for effect of warding off prostate cancer.

Those findings continue the long run of disappointing results for antioxidant supplements. As we recently noted, 67 previous trials of various antioxidant pills produced only one positive result—a reduced risk of mortality that was cited in some, but not all, of the selenium trials. Vitamin C trials showed no benefits, while beta-carotene, vitamin A, and vitamin E supplements were actually linked to an increased risk of death.

Vitamin E pills have had a particularly bad run. A series of three other vitamin E studies published in recent years found that moderate to large doses did not reduce the risk of Alzheimer's disease, cancer, or cardiovascular disease. And one of those studies linked the supplement to an increased risk of heart failure in people with clogged arteries or diabetes. Another suggested that people being treated for head or neck cancers who take supplemental doses of vitamin E could triple their risk of developing a new cancer.

Too sick to work?

I kind of like staying home sick from work. It reminds me of snow days, when I was a kid. My wife, on the other hand, hasn't missed a day for as long as I can remember (unless you count maternity leave, which I don't.) In that way, we're atypical, at least according to a flu survey conducted in October by the Consumer Reports National Research Center. It found that men, in general, are far more willing than women to head off to work with a cough, a cold, a fever, or even diarrhea. Seventy-one percent of women said that last complaint would keep them home, while only 56 percent of men said the same. Overall, more than twice as many men as women say that none of the maladies we listed in our survey would keep them from their appointed rounds (right).

Deciding when and whether to stay home from work because you're sick is a complicated dance that requires balancing professional responsibilities and expectations with health concerns. For example, as an editor I can often stay home and still get my work done, especially now that so much is done by e-mail. But my wife delivers babies for a living, and last I checked that still requires hands-on care. Of course, as a healthcare professional my wife also has to be particularly concerned about passing on germs to people when they're most vulnerable. But when I get to work, I could quarantine myself behind my office door and no one would care. In fact, they might thank me.

All of which prompts the question, how do you know when you should stay home from work? In answering that question, Consumer Reports chief medical adviser Marvin Lipman, M.D., recommends asking yourself these questions:

Tip of the day: Got a cold? Skip the multi-symptom remedies

Drugs that combine cold and flu remedies might seem like a sure-fire way to get relief, but those combo medications have multiple ingredients and can raise the risk of side effects and overdoses if you mix them with other drugs. Instead, choose over-the-counter medications by their active ingredients and buy single-symptom formulas.

For more on the best drugstore products to buy, read our report "Medicine cabinet dos and don'ts" (free). And check out our Treatment Ratings (subscribers only) for the common cold.

Safety Alert: ReliOn diabetes syringes recalled

If you have diabetes, the U.S. Food and Drug Administration urges you to check the packaging of your hypodermic needles because of a new recall. Tyco Healthcare Group LP (Covidien) is recalling 4,710 boxes of ReliOn sterile, single-use, disposable, hypodermic syringes with permanently affixed hypodermic needles due to possible mislabeling. The use of these syringes may lead to an overdose of as much as 2.5 times the intended dose, which may lead to hypoglycemia, serious health consequences, and even death.

The recall applies only to lot number 813900 syringes. This number can be found on the back panel of the 100 count syringe carton, or on the white paper backing of each individual syringe "peel-pack." These syringes are sold only by Walmart or Sam's Club pharmacies under the ReliOn name, and were distributed from Aug. 1, 2008, until Oct. 8, 2008. Walmart has posted recall announcements in stores and on its Web site.

For more on this recall and for what to do if you suspect you have the recalled syringes, please see the FDA notice. And for more on diabetes, see our Treatment Ratings, and our free Best Buy Drugs report on cost-effective drugs for diabetes.

The early warning sign all men should heed

Most men have problems getting an erection from time to time. It's not something many men feel comfortable talking about. But if your partner has trouble with erections a lot of the time, they really need to talk to their doctor.

Erection problems can cause heartache and distress for a couple. But they can also be a warning sign of physical problems. About 8 in 10 men who regularly have difficulty getting an erection have a physical cause for their symptoms, like diabetes or early heart disease.

In fact, regular erection problems can be seen as an early warning sign that your partner may have a heart attack in the next two to three years, doctors have warned. The risk that an erection may be a warning sign of heart disease is especially relevant to older men.

Canada pushes forward with BPA ban; will U.S. follow suit?

Canada recently announced plans to immediately proceed with drafting regulations to prohibit the importation, sale, and advertising of polycarbonate baby bottles containing bisphenol A (BPA). The U.S. Food and Drug Administration maintains in a draft report that products containing the chemical are safe at current levels of exposure. But an FDA Science Board subcommittee that peer-reviewed this draft report said last week said that the FDA assessment had "important limitations." The report concluded that "the Margins of Safety defined by FDA as 'adequate' are, in fact, inadequate."

BPA is commonly found in polycarbonate baby bottles and sport bottles as well as in the lining of canned foods, including liquid infant formula. Studies suggest that the chemical can mimic estrogen and may be linked to cancer, cardiovascular disease, diabetes, reproductive abnormalities, and other health problems in children and adults. Canada announced a proposal last April to ban some items containing BPA and to take action to keep BPA out of the environment. Those regulations are expected to take effect in 2009.

In the U.S., the FDA stated in a draft report in August that an "adequate margin of safety exists for BPA at current levels of exposure from food contact uses for infants and adults." The agency says it looks forward to reviewing the new subcommittee report and will respond before the next scheduled meeting of the Science Board in February 2009. Consumers Union testified at an FDA hearing in September that the agency should use its full authority to reduce consumers exposure to BPA by eliminating the chemical from any packaging that comes in contact with food or beverages.

Q&A: Severe cough syrup side effects?

I was recently prescribed a hydrocodone cough syrup, which cured my cough but left me with severe nausea. Is this typical?—L.F., Valhalla, N.Y.

Prescription cough syrups containing the narcotic hydrocodone can cause nausea as well as other side effects, such as constipation, dizziness, drowsiness, fatigue, vomiting, and psychological dependence. That's one reason that syrups containing hydrocodone—or the related ingredient codeine—should be used only for especially persistent and wrenching coughs, and only for adults.

Try milder measures first, such as humidifying the air to moisten dry airways, drinking hot liquids, and sucking on non-medicated lozenges. Most coughs actually stem from postnasal drip associated with the common cold. In those cases, using an over-the-counter antihistamine or nasal spray can help resolve the symptoms that cause dripping. Note that no cough product, either prescription or over-the-counter, is recommended for young children.

Find out more on home remedies for colds and coughs, and read our advice on treating your child's cold.

ADHD drug promotions don't tell you the whole story

Have you seen the recent ads and promotions for ADHD drugs? The ones that claim the drugs can help counter drug or alcohol abuse or help kids who have attention deficit hyperactivity disorder perform better in school?  Some of the promotions even fail to make it clear the drugs can cause dangerous side effects, like sudden death in those with heart abnormalities.

The Food and Drug Administration wants the ads and promotions out of the public eye. In late September the FDA sent warning letters to five drug companies to stop their campaigns: Shire for Adderall XR, Johnson & Johnson for Concerta, Novartis for Focalin XR, Mallinckrodt for Methylin, and Eli Lilly for Strattera.

An estimated 5 to 8 percent of school-aged kids in the US have ADHD. While the drugs used to treat the condition are generally effective and safe, they can in rare cases cause serious side effects, such as death and psychiatric disturbances. But in terms of how effective the drugs are, the ads in question go too far by claiming they can reduce problems that could arise from untreated ADHD, like poor school and job performance, social problems, and drug and alcohol abuse, the FDA said in its letters.

Are parents too pessimistic about kids' asthma control?

Moms and dads often have sky-high expectations for their children in the classroom and on the playing field. But when it comes to controlling their child's asthma, many parents' expectations are unnecessarily low, according to a new study. And this may mean kids have too many days with asthma symptoms.

Research shows that around 4 in 10 children with asthma don't have adequate control of their condition, and a similar number don't use daily controller medications, which can prevent wheezing, coughing, and asthma attacks. In the new study, researchers explored whether parents' expectations and beliefs about asthma and its treatments might be partly responsible.

Researchers surveyed more than 700 parents of children ages 2 to 12 who had persistent asthma. They asked about each child's symptoms and how well parents believed these symptoms could be controlled. Specific questions covered whether they thought their child could be symptom-free, participate fully in gym class and other physical activities, and avoid emergency room visits. Researchers found that children were more likely to have frequent symptoms if their parents had low expectations for how well their asthma could be controlled.

Drug Alert: Treat your child’s cold and cough, but skip the drugs

If you have a child under age 4, what are you supposed to do now that the makers of children's cough and cold medicines are warning parents not to use their products? Actually, all children under age 6 shouldn't be given these medicines. And these drugs should only be used with caution, if at all, for children up to the age of 12, according to our team of medical advisers.

During any given week in the U.S., parents are still doling out these ineffective products to millions of children. Clinical trials so far have shown no benefit to giving children cough and cold products, except to sedate them. At the same time, these drugs pose a high health risk. Particularly dangerous are combination cough and cold medicines (for example, Benadryl Allergy & Cold Fastmelt Children's or Tylenol Cold Multi-Symptom Children's), on which kids can more easily overdose.

Instead, you can do what moms and dads have been doing for generations—using good old home remedies like these:

• Keep your child warm and dry in inclement weather, which can actually cut the chance of catching a cold in the first place.
• Give your child hot chicken soup, which can help with his or her congestion and sore throat, plus lessen the feeling of being sick.
• Ask your child to cough or sneeze into tissues, and dispose of them after using.
• Dole out honey (one-half teaspoon to children ages 2 to 5, 1 teaspoon to children 6 to 11, and 2 teaspoons to those ages 12 to 18), or give your child hard (sugarless) candy to suck on to help reduce coughing.
• Show your child how to gargle with warm, salty water, which can ease a painful throat.
• Remind your child to wash his or her hands often, which can reduce the likelihood of transmitting infections.

Could using a fan reduce the risk of sudden infant death syndrome?

Most parents of young babies know the feeling. You wake suddenly in the middle of the night with a sense of panic, and tiptoe to the crib to make sure your baby is still breathing. Losing a baby to sudden infant death syndrome (SIDS) is a very real fear for parents. It happens when a baby under 12 months old dies suddenly while sleeping, for no apparent reason. Although not common (it happens to around 1 in every 2,000 infants), SIDS is still the leading cause of death for babies age 1 month to 1 year.

Research shows that simple steps, such as putting a baby to sleep on his or her back, can greatly reduce the risk of SIDS. Now a new study suggests that having a fan on while a baby sleeps might help as well.

Researchers interviewed 185 mothers who had lost babies to SIDS. They asked several questions about the infant's last sleep, including whether a fan was on, if a window was open, what bedding and covers the infant had, what the room temperature was and whether the infant used a pacifier. They also asked 312 mothers of healthy babies the same questions, but about their infant's most recent sleep. The two groups of moms were matched for race, age and the area where they lived.

The study found that 11.7 percent of healthy babies had slept with a fan on, compared with 3.6 percent of babies who had died. After taking into account other things that might have affected the babies' risk of SIDS, researchers found that fan use was associated with a 72 percent drop in risk. Having a window open also seemed to help, but the difference in risk was small and might have been due to chance.

Got a serious illness? Think about moving to Vermont

U.S. hospitals often lead the world in providing innovative, life-prolonging treatments for cancer and other serious illnesses. But when it comes to adequately caring for the individual behind the illness, many hospitals aren't making the grade. According to a new report (links to PDF), U.S. hospitals get a C overall for how they care for the sickest patients.

The report provides the first state-by-state look at the availability of palliative care programs within hospitals. Palliative care focuses on improving the quality of life of seriously ill patients and their families. It typically involves a team of doctors, nurses and social workers who strive to improve patients' comfort, coordinate their care, and provide counseling and support for patients and their families. Identifying each patient's goals and wishes is also key, as this can help prevent overly aggressive treatment that may not improve the patient's lifespan or quality of life. Palliative care programs are open to anyone with a serious illness, regardless of their age or prognosis. Unlike hospice programs, they do not focus just on end-of-life care.

Are chemicals in your cosmetics putting you at risk?

If you've ever tried to decode the ingredients list on a cosmetic product, you know it can be difficult to decipher. But since some of those products contain ingredients that might not be so good for you, knowing what to steer clear of can help.

WHAT ARE THE RISKS? The U.S. Food and Drug Administration is not required to review cosmetics for safety before they appear on store shelves. Aside from certain color additives and a handful of prohibited ingredients manufacturers can use any ingredient they deem safe, and safety testing is voluntary.

Some ingredients you'll come across are linked to known hazards at certain doses. One example is formaldehyde, a known carcinogen that has been used in small quantities as a hardener in nail treatments. Lead acetate is another example. It's a probable carcinogen that can be used as a color additive in some progressive hair dye products, provided it's only used on hair on the scalp in limited quantities.

Q&A: Less exercise for seniors?

For years I've exercised fairly intensely six days a week, but now that I'm in my 60s I'm developing more muscle aches and minor injuries. Should I exercise less often, or just less intensely? —J.C.R., Fullerton, Calif.

Both. As you age, your body needs more rest between strengthening sessions and slightly lower-impact activities. At the same time, flexibility training, which helps maintain balance and mobility, becomes more important. Aim to strength-train twice a week, using somewhat lighter weights and more repetitions (10 to 15, rather than the 8 to 12 recommended for younger adults). Rest muscles for two days between sessions. Stretch each muscle group at least two to three times a week, or consider an activity like Pilates, tai chi, or yoga, which combine strengthening, stretching, and balance. And aim for at least four aerobic-style workouts a week, such as brisk walking, cycling, or water exercise.

Read more on exercise for every age group, and check out our interview with "Godfather of Fitness" Jack La Lanne.

Poisoned products: Is melamine in your milk?

No doubt you've heard about the contaminated milk that's sickened more than 50,000 children in China, hospitalized 13,000, and caused fatal kidney damage in at least three. Some 60 countries have now banned or recalled certain Chinese dairy products, including baby formulas and chocolates, because of contamination with melamine. That chemical can produce crystals that block tiny tubes in the kidneys, interfering with the production of urine and damaging the organ.

Melamine is the same chemical that contaminated pet food last year and killed many cats and dog. As we warned then, the appearance of a problem in pet food could signal a looming problem for our food supply too. (Marion Nestle, Ph.D., a New York University food expert who has an informative blog that's covered melamine, recently wrote a book called "The Chihuahua in the Coal Mine" about just that.)

The Food and Drug Administration and other organizations are now trying to determine how widespread and severe the problem really is. In the meantime, here are answers to three common questions about melamine.

Raking leaves: A cautionary tale

My patient, a 54-year-old dentist, was mowing the lawn one recent September when he ran over a nest of yellow jackets, causing them to swarm. He ran to escape but slipped on wet leaves. He fell with his arm outstretched, dislocated his shoulder, and suffered nerve damage. Although it took a year and a half, he ultimately recovered.

While winter may be the season most people consider risky for slips and falls, autumn can be equally dangerous.  Accidents sustained in autumn clean-up work keeps emergency rooms hopping and orthopedists busy until spring. If you're not careful, injuries can occur from cleaning the gutters, operating lawn mowers, raking leaves, and hoisting them into bags.  Falls off ladders, foot injuries from mowers, and low back pain from strenuous twisting and lifting can happen to just about anyone. Fortunately, the majority of these can be prevented by taking some simple preventive measures. The American Academy of Orthopaedic Surgeons recommends the following tips.

Q&A: Raw fish risk?

I love ceviche—raw fish marinated in citrus juice. Does the dish pose a threat from bacteria and parasites? —J.K., New Paltz, N.Y.

It could, but proper preparation can minimize the risk. Ceviche is made with raw fish or shellfish and lime or other citrus juice. Over time, the citrus "cooks" the fish by changing its molecular structure, similar to the effect of heat. But the acidity of citrus does not kill bacteria as effectively as heat, especially if you don't marinate the dish long enough. And to kill parasites without heat you have to freeze fish. If you're making ceviche, buy frozen fish or freeze fish at -4º F (-20º C) or lower for seven days. Keep fish cold until you use it, cut it into small pieces so the juice can penetrate the flesh better, and let it marinate in the refrigerator for the amount of time recommended in your recipe. When you eat out, ask your server whether the fish used in the ceviche was frozen appropriately. Children, seniors, pregnant women, and people with compromised immunity should avoid ceviche entirely.

Read more about fish risks and learn how to protect yourself from foodborne illness.

What nationality is your ground beef?

Until now, when I bought commodity ground beef, I had no clue where it came from. But as of Sept. 30, 2008, long awaited government regulations require most supermarkets and grocery stores to inform consumers about the nationality of their beef, veal, lamb, pork, chicken, and even goat. These retail stores must also identify where in the world their fresh and frozen fruits and vegetables, peanuts, pecans, ginseng, and macadamia nuts were grown.

Congress passed the so-called, "country of origin labeling" or "COOL" legislation back in 2002, but under pressure from industry, delayed its implementation—requiring only labeling of wild and farm-raised fish and shellfish—until now.

COOL's full implementation is a big step forward for food safety-conscious people. A Consumer Reports poll released last year found that 92 percent of Americans agree that imported foods should be labeled by their country of origin. Labeling allows consumers to choose to buy foods raised locally, domestically, and from countries they trust. Some people may like to buy only U.S. products, or certain imported products, such as New Zealand lamb or Holland tomatoes.

Should you consider a period-reducing birth-control pill?

You've probably seen the ads: An attractive young woman releases colorful balloons into the air bearing words like "acne," "bloating," "irritability"—the premenstrual symptoms she's ostensibly able to kiss goodbye now that she's taking the birth-control pill Yaz. In a print and Web spot for Lybrel, a similar-looking woman dances in a field, liberated from her period altogether, since Lybrel is taken every day, 365 days a year, with no placebos. And a TV ad for Seasonique features two versions of the same woman—Logical and Emotional—conversing with each other about having just four periods a year while taking that pill. The ads are so visible they've even spawned a Saturday Night Live parody for a fictional, one-period-a-year drug called Annuale. (Warning: Content is hilarious.)

Yaz, Lybrel, and Seasonique are all extended-cycle oral contraceptives, so named because they decrease (or in Lybrel's case, eliminate) the no-hormone "placebo days" that result in withdrawal bleeds, or periods. With a traditional birth-control pill, a woman takes 21 days of active (hormone) pills followed by 7 days of very low-dose or placebo pills, resulting in 13 withdrawal bleeds a year. With Yaz, you take 24 days of active pills followed by just 4 days of placebos; it's approved not just for contraception but also for treating acne and a severe form of PMS called premenstrual dysphoric disorder. Seasonique, like its precursor Seasonale, provides 84 days of active pills followed by 7 days of placebos, resulting in just 4 periods a year. In 2007, Lybrel became the first oral contraceptive approved by the Food and Drug Administration for continuous, year-round use—meaning no placebo days, and thus no periods.

Buzzword: Nanotechnology

What does it mean? Nanotechnology, or nanotech for short, refers to the creation of incredibly tiny materials and devices for a whole host of uses, from cancer treatments to food and cosmetics. "Nano" comes from the Greek word for "dwarf," and in the metric system a nanometer is equal to a billionth of a meter. How small is a nanometer? A black strand of human hair is between 50,000 and 180,000 nanometers in size or less, and a sheet of paper is about 100,000 nanometers thick. Nanotechnologists typically work on materials and devices at the molecular or atomic scale of 100 nanometers in size or less. The principles of quantum physics rule the land of nanotechnology, meaning materials can display characteristics that appear to come from science fiction: Carbon can be 100 times stronger than steel, gold can melt at room temperature, and aluminum can turn explosive. In addition, researchers can manipulate individual atoms and molecules to form microscopic tubes, spheres, wires, and films for specific tasks, such as generating electricity or transporting drugs in the body.

Why the buzz? Nanotechnology is making its way into products and materials at a breathtaking rate, with about $2.6 trillion worth of goods worldwide expected to use nanotechnology by 2014, a 5,200 percent increase from just $50 billion in 2006. But even though nanotech materials are pushing their way into products of every kind, size, and shape, the nanotech industry is barely regulated.

Study finds more cause for concern over bisphenol A in plastic bottles, containers

Like many parents, I've been schooled in the ABCs of BPA this year.

I've learned that bisphenol A (BPA for short) is found in many plastic baby bottles and sippy cups, as well as metal cans and hard-plastic food containers and water bottles. I've read about lab findings that BPA can leach out of plastic baby bottles into milk. And I've heard reports suggesting that this chemical, which mimics the hormone estrogen in the body, may be linked to higher rates of cancer, diabetes, reproductive abnormalities, and other health problems in adults and children. Some experts think that infants and unborn babies might be at particular risk because of their developing brains and bodies.

But much of the research on BPA so far has come from studies on animals and in the laboratory. Now the first major study has been published looking into possible health effects in people. Its results are far from reassuring.

Want an eco-friendly yoga mat? Here's what you need to know

Each year consumers spend a whopping $5.7 billion on yoga classes and gear, according to a 2008 Yoga Journal survey. This popularity—and the big money—has sparked an array of so-called eco-friendly yoga mats. But are the claims they're rolled up with really true? Here are three examples of truly eco-friendly mats, plus how to choose one and keep it clean.

WHAT ARE THE CLAIMS?

Eco-claims are often made on the basis of what mats don't contain—particularly PVC (polyvinyl chloride) plastic, which can contain the heavy metals lead and cadmium, and phthalates, which have been linked to hormone disruption. While we haven't tested yoga mat for those substances, we would expect exposure to be limited. Concerns about PVC manufacturing, use, and disposal have led to bans and restrictions of the plastic in the U.S. and other countries.

Don't let a medical condition keep you grounded

My grandmother always said she had the energy to get ready for a trip or to go on a trip, but not both. Planning for a trip can be a hassle. But if you also have a health condition such as diabetes, epilepsy or a lung disease, it can take twice as much thought to make sure you stay healthy while you're away from home.

Here's a roundup of tips. Talk to your doctor for advice on your specific illness and travel needs.

Consult the experts. Discuss your itinerary with your doctor well before you travel. Your doctor can tell you how much medication to bring and how to adjust your dosing schedule if you're crossing time zones (for example, if you use insulin for diabetes or take medication to prevent epilepsy seizures). Your doctor may also have advice on how to pace yourself, whether you need any vaccinations and what other supplies you should bring. Foot care is important if you have diabetes, so comfortable walking shoes and antifungal cream should be on your packing list. Your doctor may also prescribe additional medication, such as antibiotics or treatments for nausea or diarrhea.

Consider telling your travel agent about your medical condition. He or she can request supplemental oxygen for your flight if you have a lung condition. You can also ask the agent to request special meals if, for example, you follow a low-salt diet for high blood pressure or a low-sugar diet for diabetes. If you have diabetes, be sure to pack plenty of snacks to keep your blood sugar from dropping too low.

Q&A: The safe way to trim toenails?

When clipping my toenails, should I cut straight across or in a rounded shape (and does it really matter)? —W.M., Gresham, Ore.

It does matter. You should cut them straight across and let them extend slightly beyond the tips of your toes. Rounding off a nail or cutting it too short can allow a corner to curve into the skin, causing a painful ingrown nail, a problem especially common with the big toe. If you get a mild ingrown nail, you can probably treat it yourself by soaking your foot in warm water, clipping off the ingrown portion, and placing a small piece of dry cotton ball under the nail's edge to keep it from turning back in as it grows. Nails that are very deeply imbedded or have become infected may require minor surgery. People with diabetes, poor circulation, or compromised immunity should seek professional care for even minor ingrown nails due to the heightened risk of infection, as should those with arthritic hands or poor eyesight.

This article first appeared in the September 2008 issue of Consumer Reports On Health.

Find out more about nail infections and what you can do to prevent them (free), and read our Treatment Ratings to find out what treatments work best (subscribers only).

Do infant seats leave too little "tummy time" for tots?

For the first six months of my daughter's life, there were three items I couldn't do without: a nursing pillow, a front carrier pack, and the all-important bouncy chair. Although I carried Maddy much of the time, I relied on the chair for a safe place to put her when my back needed a break, a meal needed cooking or my preschool son needed extra attention.

For many parents like me, chairs, swings and other strap-in seats are undeniably convenient. But they could be costing our babies developmentally important "tummy time," according to the American Physical Therapy Association (APTA).

The APTA says that many babies are spending too much of their waking time on their backs and not enough time on their stomachs. And a lack of tummy time can delay infants' muscle development and mobility. The APTA cites a recent survey of 400 physical and occupational therapists in which two-thirds had seen an increase in early motor delays among infants over the past six years. An early motor delay happens when a child isn't able to meet important physical milestones in the first months and years of life. More than 80 percent of therapists listed a lack of tummy time as the No. 1 reason for this increase.

Hospitals will have to pay for their mistakes

In 2004, the very hospitals where Dorothy Etheridge picked up infections and a bedsore were reimbursed by Medicare for the extra care she needed to recover from them. Etheridge, 73, a retired mental-health-care worker from New Hampshire, had a diagnosis of treatable lung cancer. The bed sore and infections added to her suffering and required significant hospital care in the last year of her life.

Consumers Union estimates that more than 2.4 million Americans suffer each year from an error or infection that occurs while they’re in the hospital for something else. Medicare, private insurers, or the patients are typically billed for the additional care they need to recover from hospital mistakes.

That's about to change for the more than 40 million Medicare enrollees. Congress passed a law requiring the Centers for Medicare & Medicaid Services to start identifying preventable "hospital-acquired conditions" for which Medicare would no longer pay. The idea is to push hospitals to improve care by making them foot the bill when they err.

Medicare has listed eight preventable conditions (above) for which it will not reimburse hospitals after Oct. 1, 2008, and is proposing nine more conditions to be added in 2009. The effects could widen as private insurers and state-funded health insurance programs begin to follow Medicare's lead.

Annual buzz about West Nile

As it seems to every summer, the buzzing of mosquitoes has turned to media buzz about West Nile virus. The Boston Globe recently reported that West Nile has been "established in Massachusetts for the summer." Last week a newspaper headline in Illinois read "West Nile cases now official in Illinois" announcing the first human case in the state for the year. And we could go on about other regions as well, but the fact is if you live in the continental United States, you should consider your mosquito season to be West Nile virus season. Every state except Alaska and Hawaii has had incidents of the virus reported in humans, or in birds, mosquitoes, or other animals over the past three years.

Take a look at this map of incidents to date this year from the Centers for Disease Control and Prevention (CDC). All but 10 states in the continental United States have already had either human, or avian, mosquito, or other animal cases reported. And mosquito season lasts until the first hard frost. On last year’s CDC map of the 48 contiguous states, only Maine remained free of the virus.

To understand the West Nile threat: The virus, which appeared in North America in 1999, is spread by mosquitoes. The CDC has estimated that there were approximately 175,000 West Nile virus infections last year, but fortunately most of them don’t cause any significant illnesses. About 20 percent of infections lead to West Nile fever, and fewer still cause more serious conditions including meningitis and encephalitis. The CDC reported that there were 124 fatalities from West Nile in 2007.

Epilepsy, drugs and pregnancy

If you're a woman with epilepsy, one of the challenges you may face is managing your condition if you want to get pregnant (subscribers only). It's important to avoid seizures during your pregnancy.

Happily, more than 9 in 10 women with epilepsy go on to have a healthy baby. But epilepsy drugs are linked to a higher chance of having a baby with birth defects.

Researchers are trying to find out which drugs, or combination of drugs, are safest for women and their babies. Older drugs like valproate (subscribers only) have a higher risk of certain birth defects. But there's been less research about newer drugs.

The latest research looked at a drug called topiramate (brand name: Topamax). The research found links between topiramate and some birth defects, but overall, topiramate didn't seem to be worse than other epilepsy drugs.

Makers of Airborne cough up $30M for false advertising claims

As part of a whopping $30 million settlement with the Federal Trade Commission, the makers of Airborne may have to grant refunds to millions of consumers who purchased their highly popular cold remedies. The settlement charges that Airborne did not have adequate evidence to support its advertising claims. "There is no credible evidence that Airborne products, taken as directed, will reduce the severity or duration of colds, or provide any tangible benefit for people who are exposed to germs in crowded places," said Lydia Parnes, Director of the FTC’s Bureau of Consumer Protection.

We've been skeptical of Airborne's claims since 2006. In a more recent blog about misleading packages, we advise consumers to leave over-the-counter products that are labeled homeopathic on the shelf.

Read more on what we say about homeopathic drugs, and to apply for a refund for Airborne product purchases, visit www.airbornehealthsettlement.com.

Q&A: X-rays and cancer risks?

In search of a diagnosis for my persistent low-back pain, my doctor recently ordered several X-rays of my spine. Do multiple X-rays increase my risk of developing cancer? —P.B., Clemson, S.C.

Yes. While nearly all X-rays expose you to radiation that increases your cancer risk, a low-back X-ray can expose you to relatively high doses. Moreover, those tests are often unnecessary, since nearly all low-back pain stems from muscles, ligaments, and nerves, which don't appear on X-rays. And most low-back pain eventually resolves on its own with simple self-help measures, including mild painkillers and cold packs.

In general, agree to imaging tests only if the pain doesn't respond to self-help methods or physical therapy and lasts for more than a month, or if you also have any of the following: leg weakness; pain radiating from the buttock to the thigh, knee, or lower leg; a history of osteoporosis, or a recent fall or accident; fever, night sweats, or unexplained weight loss; or a history of cancer or incontinence.

This article first appeared in the August 2008 issue of Consumer Reports on Health.

Find out when you should consider an X-ray for pain (free), see our whole-body guide on imaging tests (free), and take a look at our Treatment Ratings for back pain (subscribers only).

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