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New breast cancer screening recommendations from an expert panel are turning conventional wisdom on its head. Rather than starting mammograms at age 40, as the panel previously recommended, women are now advised to begin at 50--and then to be tested every other year, rather than annually. The recommendations do not apply to those at increased risk of breast cancer, who may need to be tested at younger ages and more frequently.

Internet chat rooms, message boards, and Facebook postings from my friends reflect the widespread confusion, consternation, and even anger that the new guidelines have unleashed. The decision about whether and when to test can be tricky, and the scientific data are open to different interpretations. Other groups, such as the American Cancer Society, are still suggesting yearly mammograms, beginning at 40, at least for now.

Because there are no black and white answers when it comes to this issue, it's important for each woman to talk to her doctor and decide what makes sense for her. That requires being armed with accurate information, but unfortunately, there are a number of falsehoods floating around about the new recommendations. Here are five that seem to be especially popular:

• This is all about saving money. In fact, it's about science. The group issuing the recommendations, the U.S. Preventive Services Task Force (USPSTF), is an independent panel of experts in prevention and primary care. Its job is to objectively analyze the scientific evidence for a wide array of clinical preventive measures--ranging from testing newborns' hearing to taking aspirin to prevent heart disease--and determine whether, on balance, they improve public health. The USPSTF's mission is not about money. In fact, one of the other steps that the group now recommends against, teaching breast self-exams, is very inexpensive, while others it embraces, such as routine screening for colon cancer, are relatively costly.


• This is about rationing.The new recommendations are just that--recommendations--and if a woman prefers to get screened earlier or more often, she can and should do so. Insurers have said they will continue to cover the cost for annual mammograms beginning at 40. The idea behind guidelines like this is not to withhold life-saving tests and treatments; it's to help us figure out what works--and therefore make more rational decisions--by looking at outcomes. Guidelines that we take as gospel, whether starting mammograms at 40 or colonoscopies at 50, always involve subjective judgments. Why not start mammograms at 35, for example, or colonoscopies at 40? It's because scientists have determined that the drawbacks outweigh the benefits for the population as a whole. The latest mammography guidelines are simply one panel's attempt to re-draw that line, based on new information.


• Early detection saves lives. Not always. For some conditions, such as cervical or colon cancer, early detection and treatment are unquestionably beneficial. But for others, it's not so clear-cut. With breast cancer, it depends on the type of tumor. Some breast cancers are so slow-growing that they don't spread or cause harm. In such cases, a woman will live just as long whether the tumor is found earlier or later. At the other end of the spectrum are aggressive cancers that spread quickly and kill, no matter how early they're detected. Mammography saves lives most often when it finds tumors between these extremes, but it's impossible to predict how an individual tumor will behave. One concern is that too many of the cancers that are found through mammography may be those for which it doesn't change the outcome.


• The fact that I or someone I know was saved by a mammogram proves that more testing is better. There are two problems with this logic. First, while an individual who was diagnosed with a cancer in her 40s may believe that early detection saved her life, there's often no way to know for certain. As discussed above, depending on the type of tumor, the ultimate outcome may have been the same had the cancer been found later. Second, anecdotes aren't the same as evidence. Just because certain individuals have benefited from mammography in their 40s doesn't necessarily mean that it's warranted for all 40-somethings. Public health recommendations are based on aggregate data, which in this case show that starting screening at age 40 has only modest benefits over beginning at 50. Plus there's an increased risk of potential harms, such as unnecessary follow-up tests and biopsies.


• The shifting recommendations prove that scientists are clueless. Science is about accumulating knowledge and getting smarter so that we get closer and closer to the truth. In this case, new research prompted the panel to change its recommendations. While flip-flops like this can certainly be frustrating, we want researchers to continue learning and sharing their findings so that we can make the best possible decisions about our health. And we should be grateful that there are groups like USPSTF that synthesize the science without an agenda. What we do with the information is up to us.

Are nuts really as healthful as they're cracked up to be? Our healthy skeptic investigates.

Halloween is one of my favorite holidays, so I don't take kindly to the killjoys who try to scare us about all the calories and fat in candy. After all, it's just one day a year.

But now comes the post-Halloween candy glut, and we need to heed their warnings. It's that time when people take their leftover candy (and perhaps part of their kids' loot too) to the office to unload on, er share with, co-workers.

For many of us, that big bowl of candy by the water cooler can be impossible to resist. If you're like me, every time you walk by it, you grab a piece or two, thinking "These are tiny. What's the harm?"

Well, the answer is that the calories in those mini candies can quickly add up. My pal Hungry Girl has done a little digging and compiled some scary stats. Eat just eight Hershey's Kisses, three Nestle Crunch Fun Size Bars, or a couple of Reese's Snack Size Peanut Butter Cups, and you'll instantly get 200 calories. Do that a few times a day, and you'll soon be packing on pounds. Check here for the complete list.

Research shows that, not surprisingly, we consume more if the candy is in a clear container that allows us to see the goodies. As this video segment reveals, the candy's location can also make a difference. The easier it is to reach, the more we tend to eat.

Unfortunately, if it's candy I like--meaning pretty much anything chocolate--putting it out of reach still doesn't seem to deter me much. My only hope is that my co-workers will come in with treats that don't tempt me. Bring on the Skittles and Sweetarts!

I am part of a small (and perhaps strange) minority of people who actually enjoy running. When non-runners learn about my passion, they sometimes seem slightly apologetic--as though they have this nagging feeling that they too should be hitting the trails but for whatever reason aren't.

If you fall into that category, here's some good news: Other activities may be even better for you--and easier to stick with.

Researchers at the University of Copenhagen divided 65 subjects--all of them women ages 19 to 47--into three groups: One learned to play soccer for two hours a week; the second ran for two hours a week; and the third did neither. After 16 weeks, the soccer players had greater improvements than the runners in measures of fitness such as maximum oxygen uptake, muscle mass of the legs, and sprinting speed.

Perhaps most important, the soccer players were more likely than the runners to continue their activity after the study was over. The reason is motivation: Runners cited health benefits as the impetus for their exercise, while the soccer players were motivated by the opportunity to join others in the group and have fun.

The research offers two lessons (and no, one of them is not that everyone needs to run out and join a soccer league). First, running is by no means the only way, or necessarily the best way, to stay fit. If you like it, then great. But if not, don't feel you're a slacker. And second, exercise has to be enjoyable. If you're doing it only because you feel you must, you're far less likely to continue over the long term.

There are all kinds of ways to be physically active and have fun. Watch these videos to learn about just a few: waltzing, tai chi, kickball, belly dancing, sword fighting, and self defense.

So if you're discouraged because you can't bring yourself to pound the pavement or hit the gym, don't fret. Instead, just find something you enjoy--and get moving.

As H1N1 flu marches across college campuses this fall, students are hearing a simple message about how to protect themselves: Wash your hands. But getting them to comply may be far more complicated.

During an infectious disease outbreak at a Canadian university in 2006, researchers found that students frequently failed to clean their hands before going into the cafeteria--even though there was a hand sanitizer and poster by the door instructing them not to enter unless they washed up. According to the study, which appears in the current issue of the Journal of Environmental Health, 83% of the students said they practiced proper hand hygiene. Yet they actually did so less than 20% of the time.

The researchers say one problem is that the "wash your hands" messages posted on campus weren't compelling enough. So how do you get students' attention? Gross them out. At least that's what another study on hand-washing found. As this video shows, when messages such as, "You just peed, wash your hands," were posted in bathrooms at the University of Denver, hand-washing rates went up.

This kind of in-your-face approach isn't limited to hygiene messages. It's also being used in Great Britain to warn kids about the dangers of texting while driving. Police in Wales have produced a gory video, which has become a YouTube sensation, showing a deadly accident caused by a teen texter.

Health officials in New York City are also trying to shock people--
in this case adults -- with posters on subways. A picture shows disgusting globs of fat pouring from a soda bottle, along with the message "Don't drink yourself fat." The campaign, which will run through the fall, aims to get people to cut back on soda and other sugary beverages.

Not all health educators agree that provoking shock and disgust is an effective way to change behavior. But if the result is that even a few more students wash their hands or put away their cell phones in the car, it's worth the effort. At the very least, it makes those health messages a lot more entertaining.

As summer draws to a close, many of us will be hitting the beach for one last hurrah. If, like some members of my family, you prefer building sandcastles over swimming because the ocean seems dirty and disgusting, I have some unsettling news: The sand is even worse.

Scientists have found that levels of E. coli bacteria in sand tend to be higher than those in the water. The result, according to a recently-published study in the American Journal of Epidemiology, is that people who dig in the sand are more likely to get sick than those who take a dip in the ocean or walk on the beach.

The scientists interviewed more than 27,000 visitors at seven U.S. beaches and asked about the beachgoers' activities. Ten to 12 days later, participants were contacted by phone and asked about any illnesses they had experienced since their trip to the beach.

Those who had dug in the sand were slightly more likely to develop stomach illnesses and diarrhea than those who had not dug in the sand. The risk was further increased among people who had been buried in the sand. As you might expect, kids were especially vulnerable.

Fortunately, you don't need to forfeit that sandcastle-building contest to stay well. According to another new study, this one in the Journal of Water and Health, there's a simple solution: Wash your hands. The researchers found that subjects with sand-covered hands who rinsed in clean water removed 92% of E. coli that might otherwise have ended up in their mouths and led to illness. Rinsing four times removed virtually 100%.

Of course, it's best to use soap or an alcohol-based hand sanitizer. If you don't have access to either, though, rinsing your hands with clean water several times before you dig into your picnic basket or leave the beach can do the trick.

It's a reminder that even on vacation, Mom's advice to wash your hands still applies. To find out other surprising places where potentially harmful germs lurk and how to protect yourself, watch this video.

How mindful are you? Unless you're a Buddhist, it may sound like a strange question. But being more mindful could be an answer to two health issues high on many people's top-10 list: stress and weight.

Simply put, mindfulness means being aware of what you think and do in response to what's around you. It's the idea behind a technique known as mindfulness-based stress reduction (MBSR), which was developed by best-selling author Jon Kabat-Zinn, Ph.D. Research has shown that MBSR can help alleviate anxiety, depression, and pain.

MBSR, which is now offered by medical centers around the world, teaches people to live in the moment and become more aware of how they respond to their surroundings. As a result, they can change how they view whatever causes stress, pain, or other negative feelings and thereby achieve greater peace of mind. Typically, training is intensive, requiring eight weekly 2.5-hour classes plus 45 to 60 minutes a day of meditation. For some busy, stressed-out people, the time commitment is, well, too stressful.

A recent study, published in the journal Health Education & Behavior, has found that a scaled-down version of MBSR can be used successfully at workplaces. People who attended weekly one-hour MBSR meetings at lunch and practiced 20 minutes of yoga a day at their desks reported feeling less stress and sleeping better than those in a comparison group who did not participate.

On the heels of that research comes another new study, published in the Journal of the American Dietetic Association, suggesting that mindfulness may also play a role in weight control. Participants (80% of them women) filled out questionnaires asking how often they had reactions such as:

• When a restaurant portion is too large, I stop eating when I'm full.
• I taste every bite of food that I eat.
• I recognize when I'm eating and not hungry.
• When I'm sad, I eat to feel better.

Those who were more mindful about food and eating tended to weigh less. They were also more likely to practice yoga, which the researchers hypothesize may have taught them greater self-awareness.

Food scientist Brian Wansink has written a terrific book, called Mindless Eating, about our lack of mindfulness regarding food and what we can do about it. I highly recommend it. And for more on how greater self-awareness can help control stress, sit back, relax, and watch this video segment.

I attended a rock concert recently, and my ears did not enjoy it. They began to hurt as soon as the band started to play. Now, granted, I'm not exactly an avid concertgoer--you're about as likely to find me in a mosh pit as on an alien space ship--but my ears' aversion surprised me. This was, after all, an outdoor concert, and I was sitting relatively far from the stage. But as I learned, amphitheater speakers that are many hundreds of feet away may still produce noise levels that can be hazardous to your hearing.

Noise is one of those health threats that many of us don't take very seriously, but we should. Exposure to loud noise is thought to be a contributor to hearing loss in about half of the estimated 28 million Americans who have it. Damage can occur from short-term exposure, but typically it's due to the daily, chronic assault on our ears from multiple sources.

One of those sources is public transportation. A study in the August issue of the American Journal of Public Health finds that noise levels from New York City subways are high enough to cause hearing loss in people with regular exposure.

On average, subways had noise levels of about 80 decibels (dBA). The highest levels--up to 102 dBA--were found on platforms. That's about the same as the noise level from a chainsaw. By comparison, normal conversation is about 65 dBA and a whisper is 30. (Each increase of 10 dBA corresponds to a 10-fold increase in loudness.)

According to the researchers, exposure to 100 dBA for as briefly as two minutes a day could lead to hearing loss in some regular riders. Longer exposures to 90 or 95 dBA-- levels found on many of the subway trains--could have a similar effect.

If you're tempted to try to drown out the noise with your MP3 player, think again. Cranking the volume up to high on your favorite Metallica or Twisted Sister tune can produce noise levels of 100 dBA or higher. The result is that you've traded one potentially hazardous exposure for another.

A better solution when you're encountering the subway, concerts, or any other noisy environment is to wear protective earplugs. For more tips, watch this segment. And see what one former punk rocker is doing to raise awareness of noise-related hearing loss.

Tis the season for sunscreen - and for lots of advice in the media about how to use it properly. Among the often-repeated tips: Choose a product with an SPF of at least 15 that protects against both UVA and UVB rays; apply liberally to all exposed areas; and reapply every two hours.

That's good advice, but there's more to the story. Here are five facts about sunscreen that often go unreported:

Sunscreen has not been proven to protect against all forms of skin cancer.
While sunscreen has been shown to guard against squamous cell skin cancer, a less dangerous form of the disease, it has never been proven to protect against melanoma, the most deadly type. Nor is there definitive evidence that it guards against basal cell skin cancer, the most common form. It's possible that relying on sunscreen as a first line of defense, as we often do, may actually increase the risk of certain skin cancers by allowing us to spend more time in the sun and giving us a false sense of security. While sunscreen is an important tool for protecting skin against the sun's damaging rays, it's best used as a second line of defense, behind measures such as avoiding the sun, seeking shade, wearing a hat, and covering up. (Watch this to learn more about sun-protective clothing.)

Ultra-high SPF sunscreen offers very little extra protection.
Recently, manufacturers have been introducing sunscreens with SPFs as high as 85 or 100. In fact, these astronomical numbers are largely a marketing gimmick. While it may seem that SPF 90 provides three times the protection of SPF 30, the math doesn't work that way. SPF 30 blocks about 97% of UVB rays, while SPF 90 does only marginally better, blocking 99%. No sunscreen blocks 100% of rays. An SPF of 15 or 30 provides adequate protection for most people - assuming they use the sunscreen correctly.

Some products' claims about UVA protection are deceptive.
Increasingly, sunscreens claim to offer "broad spectrum" protection against both UVA and UVB rays - something that's important because both types contribute to skin cancer. But it turns out that many of these sunscreens have only limited effectiveness against UVA rays. Manufacturers are able to get away with this deception because there are no FDA regulations in place regarding UVA labeling. (After years of delay, such rules are expected to be finalized later this year.) To make sure you're getting a sunscreen that provides UVA protection, look for ingredients such as zinc oxide, titanium dioxide, avobenzone, or Mexoryl SX on the label.

There's no such thing as a 100% "waterproof" sunscreen.
Some products claim to be waterproof, implying that you can swim or sweat all day without having to worry about reapplying. While a sunscreen can be water resistant - meaning that its SPF protection remains intact after exposure to water for 40 minutes (and 80 minutes for sunscreens that are labeled "very water resistant") - no product is completely waterproof. To be safe, it's best to reapply sunscreen after you get in the water or sweat heavily. Oh, and by the way: In case you're wondering about those widely-circulated Internet rumors claiming that waterproof sunscreens cause blindness, they're false.

Products endorsed by health groups aren't necessarily better.
Some products carry seals of approval from respected health groups, implying that these sunscreens are superior to others. For example, you can find the logo of the American Cancer Society on certain Neutrogena sunscreens. It turns out, though, that only Neutrogena products are eligible for this recognition. It's part of a marketing deal between the two organizations, in which Neutrogena pays ACS for the right to use its logo. Likewise, the nonprofit Skin Cancer Foundation has a "seal of recommendation" program that it offers to qualified sunscreens and other sun protection products. But to be eligible, a manufacturer must be a member of the group's "Corporate Council." And how does one receive that honor? Contribute $10,000 to the organization. The bottom line is these stamps of approval are often more about money and marketing than solid science. They're best ignored.

Now that you're in the know, test your knowledge of sun safety with our video quiz.

Eighty-five year-old Gloria Vanderbilt has a new erotic novel out. Justice John Paul Stevens, 89, continues to crank out opinions from his perch on the Supreme Court of the United States. And journalist Daniel Schorr, who will soon be 93, is still providing incisive commentaries on NPR.

So why is it that they and others like them in their ninth or tenth decades of life manage to stay sharp, while many of their peers decline mentally and succumb to dementia?

It's a question that scientists continue to ponder and debate. A new study in the journal Neurology offers a few clues. For eight years, researchers followed 2500 people in their 70s, repeatedly testing the subjects' cognitive abilities. They found that over time, about half performed slightly worse on tests, and 16 percent showed major decline. But about one-third experienced no decline or even improved their test scores.

The scientists looked for characteristics that distinguished the non-decliners from everyone else. Some of the factors are things we can't do much about: Those who stayed sharp tended to have more social support, be more literate, and have at least a ninth grade education. But other, controllable factors also appeared to play a role: People who weighed less, got regular moderate or vigorous exercise, and didn't smoke were more likely to maintain their cognitive skills, as were those who still worked or volunteered.

If you listen to ads and claims on the Web, you may be led to believe that special brain-boosting puzzles, DVDs, and software are necessary for keeping your brain fit. For the truth about what measures are--and are not--proven, watch this Healthy Skeptic segment and listen to this interview with Dr. Sam Wang, co-author of Welcome to Your Brain.

Or, if you don't want to overload your brain, just remember this: Live a healthy lifestyle and stay active, both physically and mentally.