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Yet another study is confirming that adolescents who skip breakfast have a higher risk of being overweight.

"There's a pretty significant inverse association between how frequently kids report eating breakfast and how much weight they gain over time, and we took into account other dietary factors and physical activity," said Mark Pereira, co-author of the study, published in the March issue of Pediatrics.

"It's interesting to note that the kids who eat breakfast on a daily basis overall have a much better diet and are more physically active," Pereira said.

Added Dr. Peter Richel, chief of pediatrics at Northern Westchester Hospital Center in Mount Kisco, N.Y.: "Grandma and Mom are right. When we skip breakfast, especially in the teenage years, then kids tend to snack and graze."

More than one-third of teens aged 12 to 19 are now overweight or at risk of becoming overweight. And over the past two decades, the proportion of children who are overweight has doubled; among teens, the proportion has tripled, according to background information with the study.

An estimated 12 percent to 34 percent of children and adolescents skip breakfast on a regular basis, a number that increases with age. Previous studies have linked breakfast skipping with a greater tendency to gain weight.

"There has been quite a lot of published scientific literature already on the relationship between breakfast habits in both children as well as adults and obesity risk," said Pereira, an associate professor of epidemiology and community health at the University of Minnesota School of Public Health. "It's pretty darn consistent in the literature that people who eat breakfast are at lower risk for obesity, but most of those studies have some methodological limitations."

The new study was both cross-sectional and prospective — moving forward in time. More than 2,000 adolescents were followed for five years. Participants completed detailed surveys on their eating patterns and also provided information on their height, weight, body-mass index and physical activity.

The more often a person ate breakfast, the less likely he or she was to be overweight or obese.

"We can't make definitive statements about cause and effect," said Pereira. But the evidence seems to point that way, he added.

"What happens is that total fat and saturated fat as a percentage of total daily energy were lower in the breakfast eaters compared with breakfast skippers," Richel explained. "This really shows that we have the potential to improve energy balance and weight control with healthy breakfast consumption. We're not talking pop-tarts."

In another Pediatrics article, researchers reported that an Internet-based program helped keep teens' weight in check over the short term and also reduced binge eating. Those who participated in the program also had less concern about their weight and shape, compared with teens who did not participate, suggesting that the program may lower the risk for eating disorders.

The 16-week program included education, behavioral modification, journaling, discussion and motivational messages.

WASHINGTON (AP) — An outbreak of hepatitis C at a Nevada clinic may represent "the tip of an iceberg" of safety problems at clinics around the country, according to the head of the Centers for Disease Control and Prevention.

The city of Las Vegas shut down the Endoscopy Center of Southern Nevada last Friday after state health officials determined that six patients had contracted hepatitis C because of unsafe practices including clinic staff reusing syringes and vials. Nevada health officials are trying to contact about 40,000 patients who received anesthesia by injection at the clinic between March 2004 and Jan. 11 to urge them to get tested for hepatitis C, hepatitis B and HIV.

Senate Majority Leader Harry Reid, D-Nev., met Monday with CDC head Dr. Julie Gerberding, and on a media conference call after their meeting both strongly condemned practices at the clinic.

Health care accreditors "would consider this a patient safety error that falls into the category of a 'never event,' meaning this should never happen in contemporary health care organizations," said Gerberding.

"This is the largest number of patients that have ever been contacted for a blood exposure in a health-care setting. But unfortunately we have seen other large-scale situations where similar practices have led to patient exposures," Gerberding said.

"Our concern is that this could represent the tip of an iceberg and we need to be much more aggressive about alerting clinicians about how improper this practice is," she said, "but also continuing to invest in our ability to detect these needles in a haystack at the state level so we recognize when there has been a bad practice and patients can be alerted and tested."

Reid said he would work with Gerberding to try to get the CDC more resources in an emergency spending bill Congress is to take up in April.

State health officials said they weren't sure how many of the 40,000 patients they'd been able to contact since making the risk public last Wednesday. At least initially they didn't have correct addresses for 1,400, officials said.

The head of the clinic, Dr. Dipak Desai, purchased space for an open letter in the Las Vegas Review-Journal on Sunday in which he expressed "my deepest sympathy to all our patients and their families for the fear and uncertainty that naturally arises from this situation."

Desai offered no apology but said a foundation was being set up to cover testing costs. He also defended practices at his clinic, which performs colonoscopies.

"The evidence does not support that syringes or needles were ever reused from patient to patient at the center," Desai wrote.

A spokeswoman, Nancy Katz, declined Monday to comment further.

The Clark County district attorney is investigating, as are various health agencies, including the Nevada State Board of Nursing. Several lawsuits already have been filed and a hearing is scheduled for Thursday before a Nevada legislative committee.

It may never be known how many people contracted hepatitis C because of unsafe practices at the endoscopy center, state health officials said. Brian Labus, head epidemiologist of the Southern Nevada Health District, said that because 4 percent of the population has hepatitis C, he expects to get numerous positive results after the at-risk clinic patients are tested and it may be impossible to determine which of those were infected at the clinic.

Of the six cases that health officials did trace to the clinic, five of them happened on the same day and genetic testing was used to make the connection, Labus said.

Hepatitis C can cause fatal liver disease as well jaundice and fatigue, but 80 percent of people infected show no symptoms. Hepatitis B is a more rare and serious disease that attacks the liver.

Meanwhile, state health officials are still looking at a second clinic with connections to the first, called Desert Shadow Endoscopy Center. At Desert Shadow, officials had been found to reuse anesthetic vials but not syringes and so far no patients have been notified of potential risk. That determination could still be made, said Lisa Jones, head of the Nevada State Health Division's bureau of licensure and certification.

The tie vote, with Chief Justice John G. Roberts Jr. not participating, will permit a lawsuit to proceed against the Warner-Lambert Company, the maker of a diabetes drug, Rezulin. The plaintiffs are 27 diabetes patients from Michigan who suffered liver damage while taking the drug. Rezulin was approved by the Food and Drug Administration in 1997 and withdrawn from the market three years later at the agency’s request.

A tie vote at the Supreme Court automatically affirms the lower court’s judgment. In this case, the federal appeals court in New York had rejected the company’s argument that the reasoning of a seven-year-old Supreme Court precedent barred individual damage suits that are based on the claim that a drug manufacturer obtained F.D.A. approval through fraud. Affirmance by a tie vote resolves only the particular dispute, without setting a precedent for other cases.

According to his financial disclosure form, Chief Justice Roberts owns $5,001 to $50,000 in stock in Pfizer Inc., Warner-Lambert’s corporate parent. When there is a tie vote, the court issues a one-sentence order that does not identify the positions of the justices who voted.

This case, Warner-Lambert Co. v. Kent, presented a narrow slice of the broad pre-emption issue that the court will take up in its next term. In that new case, Wyeth v. Levine, the question is whether the Food and Drug Administration’s approval of a drug’s label precludes individual damage suits based on the claim that the label failed to include sufficient information or adequate warnings.

In essence, if the answer is yes, most individual lawsuits for damages caused by approved drugs would be pre-empted. Last month, in Riegel v. Medtronic Inc., the court interpreted a federal law, the Medical Device Amendments, as barring most individual lawsuits against manufacturers of approved medical devices.

The Warner-Lambert case, by contrast, specifically questioned the status of lawsuits alleging that F.D.A. approval was obtained by withholding or misrepresenting crucial information — in other words, by fraud. A 2001 Supreme Court decision, Buckman v. Plaintiffs’ Legal Committee, barred general claims of fraud.

But the lawsuit by the Rezulin patients was brought under the specific provisions of a Michigan law that, while prohibiting product liability suits against makers of approved drugs, specifically permits claims that the manufacturer withheld or misrepresented information that was important to the approval process. The question was whether the existence of the state law placed the lawsuit on a different footing for the purpose of pre-emption analysis.

The Bush administration, which has embraced a broad theory of federal pre-emption of individual tort suits, entered the case on the manufacturer’s behalf. It argued that “permitting lay juries to second-guess” the adequacy of a drug application would interfere with the agency’s “exercise of its expert judgment.”

Cases in the US have doubled in recent decades and it seems fructose, a type of sugar, may be to blame, the British Medical Journal study reports.

You've heard the reason not to: You'll only eat more later on. But people don't automatically replace all the missed calories at their next meal, says David Levitsky, a professor of nutrition and psychology at Cornell University. His research team assigned one group of people small lunches of about 200 calories, while a second group dined on about 600 calories. Both ate as they wished the rest of the day. After two weeks, the small-lunch bunch lost weight; they were eating about 400 calories fewer than the all-you-can-eaters.

A variation that might not even feel like self-denial is to restrict calories every other day. In a small study published in March, researchers followed a group of 10 overweight people who were fed just 20 percent of their normal calorie intake on alternate days. The other days, they could eat what they wanted. After eight weeks, they'd lost an average of 8 percent of their body weight, says study co-author James Johnson, a clinical instructor in the department of surgery at Louisiana State University School of Medicine and author of a forthcoming book on alternate-day calorie restriction.

"I like the psychology of it," says Kenneth Webb, 37, a hedge fund trader from Walnut Creek, Calif., who's followed Johnson's program. "On the down days, you've got hope for tomorrow — who can't diet for one day? And on an up day, you've got no guilt about it."

Webb calculated his calorie needs based on his level of activity and eats just 30 percent of that one day; the next, he eats 130 percent. He's lost 30 pounds since July.

Healthy benefits?

Besides shrinking the waistline, skipping meals regularly might protect against disease. A study presented in November at an American Heart Association conference compared the rates of heart disease among Mormons, who are supposed to fast on the first Sunday of every month, with the habits and disease rates among a smaller number of non-Mormons.

Controlling for other behaviors that make a difference in the risk of heart disease, the researchers found that fasting seemed to be significant: If you fasted, you had a smaller chance of having heart disease.

"The thought from a biological perspective is that fasting rests the metabolism for a day and resensitizes the body's cells to glucose and insulin," says study author Benjamin Horne, who researches heart disease at Intermountain Medical Center and the University of Utah in Salt Lake City. That's only a theory, he notes, since most studies on calorie restriction have been done in rodents, roundworms and slugs.

Less is more

Still, there's plenty of evidence from the animal studies to suggest that some sort of calorie-restricted eating plan might be good for humans, too, says Mark Mattson, a neuroscientist at the National Institute on Aging who was also an author of the alternate-day study. (That study focused on asthma sufferers, whose symptoms improved more when they reduced their intake than seemed attributable to just losing weight.)

Eating less cuts down on the production of free radicals, which damage cells and can lead to disease, Mattson says. And there's a cellular response similar to what happens when we exercise. Like working out, going without calories is mildly stressful to the cells at the time but beneficial over the long run.

"Dietary restriction is about the best dietary advice I can give you," Levitsky says. "We don't know about living a longer life, but all the markers are in a favorable direction."

You may have noticed, though, that the bottom line of any of these techniques is cutting the overall number of calories you eat. Webb, for example, has effectively reduced his average daily caloric intake to 80 percent of what it used to be. Like Webb, many people may find that skipping a meal or two a week, or taking a day every month entirely away from food or eating a lot less during a given meal or every other day, is far more appealing than making the sacrifice all the time.