By Jessica Snyder Sachs

If you're religious about what really matters, you can take shortcuts with the rest. Check out our guide to being a sensible slacker.

1. Work Out 5 Days a Week?

It's not your imagination: Our bodies simply become higher maintenance after 40. Indulgences of food or drink are quicker to take revenge. Muscles require more maintenance. Screening tests become more important. So there's a lot to remember -- and yet the wellness precautions keep coming, with new dos and don'ts every passing year. Can anyone do it all?

Actually, no. And if you try, say experts, you may end up throwing in the towel on some of the essentials, as well as what's helpful but optional. So find out where you can settle for good enough and still enjoy great health.

Rule 1: Work out 30 to 60 minutes a day, five days a week. 
The Midlife Shortcut: Catch up when you miss workouts.

To reduce the risk of heart disease, cancer, and osteoporosis -- all big concerns for women over 40 -- experts urge us to exercise at least 30 minutes a day, five days a week (and for maximum health benefits, make that an hour rather than half an hour). But daily workouts can be difficult to fit into a life crammed with work and family responsibilities. Then there's the knee and joint pain that many women experience after years of pounding their way through "healthful" exercise.

Why there's wiggle room: The cumulative hours -- the total time you clock each week -- is what really counts. In fact, the weekend warrior has gotten a bad rap, says exercise physiologist Jane Roy, PhD, of the University of Alabama at Birmingham. If you're too busy Monday through Friday, weekends are a great time for getting in two or more hours of enjoyable exercise a day. You can catch up by spending a weekend morning or afternoon playing tennis with girlfriends, taking back-to-back aerobic and Pilates classes, or going for a long walk or run.

Then, during the week, concentrate on interspersing sedentary activities such as computer work with small but frequent movement breaks, Roy adds.

2. Get a Pap Smear Yearly?

Rule 2: Get a Pap smear every year.
The Midlife Shortcut: Get tested every two to three years.

Sexually active women under 40 should be tested every year, but women over 40 can stretch it out to once every two to three years once they've had three or more normal results in a row, as long as they're in a long-term, mutually monogamous relationship or are not sexually active, and they're still getting annual pelvic exams.

Why there's wiggle room: When a woman is either not having sex or always has it with the same person (and that person is not having it with anyone else), she's not being exposed to new strains of the human papillomavirus, explains gynecologist Stacy Tessler Lindau, MD, of the University of Chicago Medical Center.

The majority of people who have ever been sexually active have been exposed to one or more strains of HPV. Most women clear the symptoms of the virus within a few months. But in a small minority, the infection causes cells to become precancerous over the course of several years. These are the abnormalities that show up on Pap tests.

What that means is the risk of precancerous changes (and ultimately cervical cancer) becomes very low once women pass through this latency period without being exposed anew by having sex with someone different. Even if you don't have a new partner, says Lindau, "You can be exposed to new sexual partners through your own sexual partner." That's why your relationship has to be mutually monogamous; if you're not sure it is, continue to be tested every year.

3. Eat 5 Servings of Veggies a Day?

Rule 3: Eat your veggies: five servings a day.
The Midlife Shortcut: Aim to include veggies in most meals.

Five servings a day add up to a heck of a lot of vegetables. Using USDA food guide serving sizes, you'd need to swallow up to 17 cups of salad or solid veggies a week to meet that goal -- that on top of the four daily servings of fruit you're supposed to get.

Admittedly, as the over-40 metabolism slows, substituting produce for higher-calorie foods and snacks can help with weight control. But as our lives grow exponentially busier, getting down all those veggies can become overwhelming.

"Five servings a day remains an admirable goal," says registered dietitian Christine Gerbstadt, MD, of the American Dietetic Association. And she argues that meeting it can be a lot easier than you think. "Potatoes count," she notes. "Just don't make it french fries every day." You can also add salsa, tomato sauce, or any kind of bean to the list.

But she's also willing to compromise. "A decent daily plan is to include some vegetables in most meals, then concentrate on rounding out the rest of your diet by pumping up the fibrous whole grains and healthy fats."

Why there's wiggle room: If you look at the big nutrition picture and aim for moderate goals, success may encourage you to surpass your quota. But if you don't hit the mark every single day, Gerbstadt says, you can get by with a daily multivitamin -- that will ensure you get the vitamins and minerals that are naturally abundant in fresh vegetables.

4. Brush After Every Meal?

Rule 4: Brush after every meal. 
The Midlife Shortcut: Put down the toothbrush and grab some gum.

Or a toothpick. Or gum. Or a glass of water. It's not necessary to brush your teeth after every meal if you do something else to remove the food debris.

Why there's wiggle room: Brushing when you get up and before you go to bed is just fine, according to Edmond Hewlett, DDS, of the UCLA School of Dentistry. In fact, Hewlett says it's a bad idea to brush right after consuming acidic foods or beverages such as wine, orange juice, and most soft drinks. "The acidity slightly softens tooth enamel," he explains. So habitually brushing right after eating these foods can contribute to tooth sensitivity and cavities.

Chewing sugarless gum has other benefits besides removing food residue. It also increases saliva, which contains minerals that help replace the enamel lost to acidic food and acid-producing mouth bacteria. That's particularly important after age 40, when your natural saliva production starts to decrease. And if the gum contains xylitol, you'll get an added bonus: This sugar substitute inhibits the growth of cavity-causing tooth bacteria.

5. Sleep for 8 Hours?

Rule 5: Eight hours of sleep every night -- no sleeping in. 
The Midlife Shortcut: Sleep late on weekends.

Yes, the human body does need eight hours of sound sleep each night, says Joanne Getsy, MD, of Drexel University College of Medicine, in Philadelphia. "It's a fallacy that you need less sleep as you get older," she says. "You don't need less; you simply get less." Anyone dealing with hot flashes and sleep disturbances knows this too well. But whereas many experts insist that "catch-up sleep" isn't as good as the real thing, Getsy says there's room for deviating from your normal wakeup and going-to-bed times.

Why there's wiggle room: "The aim should be to pay back your sleep debt as soon as you can," Getsy says. Specifically, she recommends scheduling twice-a-week catch-up nights. "Pick one weeknight and one weekend night, and don't plan anything on those evenings," she advises. "Let them be your nights to recover." Daytime napping is okay too, she adds: "Just keep it under an hour so it doesn't interfere with a solid night's sleep."

As for sleep-bingeing on weekends, Getsy advises staying in bed as late as you like on Saturday. Then on Sunday, split the difference between when you'd like to get up and when you have to get up on Monday. That will help ease you back into your weekday schedule.

Even better news: Getsy says that when it comes to sleep debt, it's okay to pay back less than you borrowed. Usually one full night's sleep is enough to make up for a couple of shortchanged ones, she says. "If you feel better in the morning, you've slept enough."

6. Lift Weights 3 Times a Week?

Rule 6: Lift weights three times a week.
The Midlife Shortcut: Try for one or two sessions a week.

On top of encouraging us to meet aerobic exercise quotas, the health gurus tell us to get to the gym and pump iron at least three days a week. Strength training is especially important after menopause, at which point a woman's body tends to lose both muscle mass and bone strength.

"When you make the muscle grow, you strengthen the bone that's attached to it," explains Felicia Cosman, MD, of the National Osteoporosis Foundation. Aerobic exercise such as jogging works only about 20 percent of muscle fibers, she says, while strength training with weights engages up to 90 percent.

Why there's wiggle room: There's no magic number as to how often you need to strength train. Aim for regularity, Cosman says, even if it's just twice a week. Nor do you have to schlep to a gym. "Weight machines and free weights are good," Cosman says, "but so are equipment-free Pilates and yoga moves, and push-ups."

7. Do a Breast Self-Exam?

Rule 7: Do a breast self-exam every month.
The Midlife Shortcut: Do it often enough to notice changes.

We came of age being trained to search for lumps every month. The mandate feels even more compelling now, given how greatly the incidence of breast cancer increases after 40.

As it turns out, however, there's little evidence that obsessively examining yourself really helps women catch more life-threatening lumps.

Why there's wiggle room: After years of urging women to perform monthly self-exams, the American Cancer Society recently deemed them optional. But what's still important, says ACS spokesperson Debbie Saslow, PhD, is that women become familiar with how their breasts feel and what's normal for them. "For a lot of women, that's still a monthly exam. For others, it's the occasional self-exam or simply paying attention when getting dressed or showering."

Where Not to Cheat

Here's where our health gurus draw the line. Follow these three rules, they say, as scrupulously as you can.

Keep Moving 
Yes, you get brownie points for working out on weekends, but you lose out on lots of benefits if you just sit in a chair the rest of the week, says Jane Roy, PhD, of the University of Alabama at Birmingham. So get up for a stretch break at least once an hour at work (you could walk down the hall to talk to a colleague instead of sending an e-mail), and a few times a day, catch some fresh air with a quick five-minute stroll outside.

If you need extra motivation, consider this: Five one-minute stretch breaks over the course of a day burn just 15 to 20 calories. But over the course of a year, that adds up to over two pounds of fat.

Get a Mammogram Every Year 
When cancer strikes women in their 40s, the tumors tend to be aggressive, which means fast-growing -- so the early detection offered by mammograms is crucial, says the American Cancer Society's Debbie Saslow. After menopause, women tend to have slower-growing cancers, she adds, but the incidence increases. "So going longer than a year just isn't worth the risk," she says.

Maintain a Healthy Weight 
Overweight women are more likely to develop heart disease, diabetes, and many types of cancer than normal-weight women are.

In fact, a recent analysis estimates that 20 percent of all cancer deaths in American women are linked to excess weight. In general, cancer rates increase when a woman's body mass index exceeds 25, says Colleen Doyle of the American Cancer Society. The risk rises more dramatically when the BMI passes 30. Abdominal fat appears to be closely associated with postmenopausal breast cancer and cancers of the colon and pancreas. And some experts say that the risk increases when a woman's waistline exceeds 32 inches.

Originally published in MORE magazine, February 2009.

 

Unbridled development and pollution threaten the Chattahoochee's ability to be all things to the millions who use and abuse the fabled river

Copyright Jessica Snyder Sachs, as originally appeared in National Wildlife magazine

GRIDLOCK seizes metro Atlanta by 8:00 am most weekdays, as traffic grinds to a halt along hundreds of miles of urban highway. Ironically, it's from this road-rage-inducing vantage point that millions have fallen under the spell of the river the Creek Indians called Chattahoochee--"the river of painted rocks." For as the waterway dips and weaves beneath dozens of the city's thoroughfares, an ethereal mist rises from its waters, broken only by the herons and kingfishers that dive from its wooded banks. Look long enough and you can imagine an ancient hunter in a dugout canoe slipping through the billowing vapor. Look again and imagine it's you, disappearing downriver, far away from the exhaust and blaring horns.

Ask anyone who lives in this sprawling metropolis of 3.5 million and you'll be hard pressed to hear a negative word about their beloved 'Hooch. They boat and fish in its waters, picnic and play on its banks, draw power from its dams and drink from its spigots. Even as the river passes through the most industrialized sections of this city, its banks remain cloaked in the river birch, sycamore and tulip poplar that inspired southern author Pat Conroy to describe Atlanta as "where they built a city and left the forest."

But despite its serene appearance, this same river also flushes metro Atlanta's toilets and silently accepts the equivalent of a major oil spill in polluted runoff each year. As a result, the 70-mile section of river south of Atlanta ranks among the five most polluted waterways in the nation. Meanwhile, the metro area's breakneck growth continues to devour the Chattahoochee's watershed--the smallest to supply a major American city--at the unprecedented rate of 50 acres a day.

Not that Atlantans stand alone in loving the Chattahoochee to death. Over the last decade, the state governments of Georgia, Alabama and Florida have remained locked in a water war over their competing rights to use the river as both water source and sewer. So great are the demands that not only water quality but water quantity--an issue more often associated with the arid West--has become a severe regional problem. So much water is being drawn from the Chattahoochee along its 540-mile journey to sea that its declining volume threatens one of the world's most productive estuaries: Apalachicola Bay in the Gulf of Mexico.

"We are at the crossroads," says Sally Bethea, director of the Upper Chattahoochee Riverkeeper, a river advocacy group founded in 1994 by Laura and Rutherford Seydel, daughter and son-in-law of Atlanta media mogul Ted Turner. "We have already changed this river forever, with 15 dams from one end to the other," adds Bethea. "But it still supports an immense diversity of wildlife. The crucial issue now is whether our leaders will insist the river be protected as a healthy ecosystem or whether we continue using it as a toilet and dump."

This workhorse of a river begins as a weeping-rock spring in the Blue Ridge Mountains, 80 miles north of Atlanta and a stone's throw from the Appalachian Trail. Surrounding the headwaters is the lush, 750,000-acre Chattahoochee National Forest, home to some 500 species of animals.

Several miles downstream, after the river tumbles out of federal land, it flows south through poultry farms and fertilized fields, picking up a heavy load of agricultural runoff. This section of the upper Chattahoochee is a magnet for construction of new, luxurious retirement communities. The development increases downstream as the river widens to form the aquatic playground of Lake Lanier, created with the completion of Buford Dam in 1956. By releasing water from the chilly bottom of its reservoir, the dam transformed the section of river below its turbines into the nation's southernmost cold-water trout stream.

Lanier itself has become the country's most-visited federal reservoir. As a result, the 38,000-acre lake is now visibly filling with tons of silt. Add to this mix the discharge of high-phosphorus wastewater from poorly regulated treatment plants and the tainted runoff from oil-slicked roads and chemically pampered lawns.

Concluding that the lake can cope with the onslaught, Georgia's Environmental Protection Division last year signaled a willingness to permit the rapidly growing counties bordering the lake to increase their wastewater discharges, contingent on enforcement of water-treatment standards. "That the state is finally setting water-quality standards for the lake is a step in the right direction," says Russ England, assistant chief of fisheries with the Georgia Department of Natural Resources. But the environmental pressures on Lanier won't abate as long as the region's unbridled growth continues, he cautions. "If they halfway try, a lot of upstream communities can learn from Atlanta's mistakes," adds England. "But their interests remain with rapid growth and against anything that would drive up the cost of that growth."

Existing regulations include a prohibition on disrupting a 25- to 50-foot buffer zone along the riverbank and requirements for erosion-control barriers on construction sites within the watershed. But enforcement is lax, claims Bethea. Part of the problem is lack of manpower. Though Georgia is the largest state east of the Mississippi River, its Environmental Protection Division staff is disproportionately small.

Between Lake Lanier and Atlanta, the Chattahoochee winds for 48 miles through the metro area's affluent suburbs. The riverfront here lies protected from further development by dozens of municipal parks and the 4,000-acre Chattahoochee River National Recreation Area, a string of 13 riverfront units. Even private homes on this stretch of the river remain largely hidden by the resilient vegetation that typifies Georgia's Piedmont region.

But just 50 feet back from the river begins a sea of impervious pavement and brick. During rainstorms, runoff that would naturally filter through vegetation-bound soil instead collects on hot surfaces and slaloms down streets to pour into the river and its tributary creeks. The unnatural wallop of sediment and heated water has already exterminated the Chattahoochee's native shellfish and now endangers temperature- and sight-sensitive fish such as trout, says naturalist Henning von Schmeling of the Chattahoochee Nature Center, a 130-acre riverfront educational facility north of Atlanta.

 

Over the next ten miles, as the river flows through Atlanta proper, it absorbs more than 250 million gallons of treated sewage and nearly a billion gallons of heated power-plant discharge a day. Even worse are the millions of gallons of raw sewage that spill into the river when rainstorms swamp the city's overburdened treatment plant.

From 1995 to 1997, the Riverkeeper spearheaded a lawsuit against the city for its sewer system's long-standing violations of the federal Clean Water Act. As a result, Atlanta was forced to pay $2.5 million in fines and comply with a strict eight-year timetable for improving water quality that included spending $360 million to upgrade its main sewage plant and committing another $25 million for watershed restoration.

A greater problem remains in polluted runoff from roads, construction sites and other nonpoint sources. The longstanding provisions of the federal Clean Water Act require the state of Georgia to reduce such pollution to a level that the river can absorb without threatening wildlife. "But the state has yet to determine the level of pollutants going into the river, let alone what it can safely handle," says biologist Andrew Schock, director of NWF's Southeastern Natural Resources Center. NWF has become particularly involved in training community activists in Atlanta's poorer neighborhoods to lobby for the restoration of the heavily polluted waters where their children fish, swim and play.

 

"Success," adds Schock, "means having the people who live in those neighborhoods involved in the decisions that affect their daily lives."

South of the city, the Chattahoochee opens up for a slow, 40-mile meander through floodplain farmland to West Point Lake on the Georgia-Alabama border. West Point's quiet waters--a stark contrast to Lanier's buzz of activity--have become a settling pond for Atlanta's tainted runoff. But even as pollution levels dampen the lake's popularity for swimming, the high load of nitrogen and phosphorous has made West Point one of the nation's most fertile bass hatcheries. Bald eagles, osprey, and heron share the world-class fishing with sports anglers, though the humans know better than to eat what they catch.

After West Point, the Chattahoochee continues south along the state border and over the fall line, where the hard rock and red clay of Piedmont Plateau give way to the soft sandstone of the coastal plain. Wildlife becomes even more abundant as the river fills its last reservoir, the shallow and reedy Lake Seminole. There, the waters of the Chattahoochee mingle with those of the Flint River before entering the Florida Panhandle under a new name: the Apalachicola. Over its final 100 miles, the meandering stream nourishes millions of acres of hardwood swamp, including the world's largest stands of tupelo trees.

The river's final act is to deliver some 16 billion gallons of fresh water a day into Apalachicola Bay, a protected estuary where fresh and salt water mix slowly to produce a world-class harvest of oysters, shrimp and fish valued at more than $100 million a year. Imperative to the health of this breeding ground is the massive influx of fresh water that keeps deep-ocean predators at bay. Declining volume and pollution have already begun to take their tolls.

"A lot of hip Atlantans love to eat Apalachicola oysters at the city's finest restaurants," comments von Schmeling. "They need to realize that the road grease from their commutes and the chemicals from their over-fertilized yards are ending up on their plates." In many ways, Atlanta's appreciation of fine Apalachicola oysters epitomizes the larger issues facing the Chattahoochee. The millions of Southeasterners who benefit from this river must now face the cost of ensuring its long-term welfare.

"The answers must come from a sense of wise stewardship," says Lindsay Thomas, the federal commissioner appointed to oversee the ongoing negotiations between the three states for the Chattahoochee-Flint-Apalachicola River Basin. But solutions have not come easily. Over the last three years, state negotiators have failed to meet four deadlines for a mutually satisfactory water-management plan. Georgia and Alabama want enough water to sustain another 50 years of booming development, without sacrificing irrigation for agriculture or river levels for commercial navigation. Florida remains desperate to stem the dwindling flow that threatens Apalachicola Bay and 90 percent of its oyster harvest.

Fighting to be heard above the fray is the 17-member TriState Conservation Coalition, which includes the Riverkeeper and two NWF affiliates, the Georgia Wildlife Federation and Florida Wildlife Federation. Lobbying for negotiators to go beyond sheer quantity, the coalition is raising complex "flow" issues that directly impact the wildlife that make southeastern rivers among the most biologically diverse on Earth. Many of the Chattahoochee's 170 species of fish, for example, rely on spring floods to reach their spawning grounds in surrounding wetlands. As withdrawals lower the river's flow, the careful timing of dam releases becomes crucial to these natural cycles. Cyclic flooding is even more pivotal to the Apalachicola Bay system, with its vast fishery nurseries.

The coalition's demands are bolstered by such federal laws as the U.S. Fish and Wildlife Coordination Act, which requires federal negotiators to consider ecological impacts; and the Clean Water Act, which mandates that waterways be kept clean enough to maintain wildlife.

Meanwhile, water-quality issues remain largely in the control of local communities, particularly metro Atlanta and its northern neighbors. Sensing the shift in mood, some of the region's developers have begun to go beyond the letter of the law to protect the Chattahoochee. "More developers are approaching us with a sincere attitude of wanting what's best for the community," says Bethea. "Other times, they're forced to work with us."

A recent case involved construction of the massive Mall of Georgia, the centerpiece of a sprawling retail complex that laid bare some 500 acres of red Georgia clay south of Lake Lanier. "The developers needed a variance to build within stream buffers and knew we could raise holy hell about it," explains Bethea. "As result we got a seat at the planning table." Specifically, the mall's developers consulted closely with Riverkeeper engineers to keep construction runoff from rolling into bordering creeks.

On the public side, Georgia Governor Roy Barnes recently budgeted 60 new positions in the state's Environmental Protection Division, primarily in programs focusing on water quality, with a promise of 140 more over five years. Barnes also vetoed a bill that would have allowed the state legislature to strike down environmental regulations set forth by the agency. Perhaps the most exciting opportunity on the horizon is the creation of a 180-mile greenway protecting riverbank from Helen to Columbus. Though it would leapfrog privately held land, the proposed Chattahoochee Riverway would become the longest river park in the nation--a project that will require $180 million to complete.

Clearly, the momentum for saving the Chattahoochee has never been greater. "What makes this river so remarkable is the fact that there are so many people who love it and depend on it," concludes England. "But the same environmental issues are being faced by great rivers across the nation." What happens here in the next few years, environmentalists agree, will largely determine whether the Chattahoochee becomes a national paradigm or a legacy lost.

Writer Jessica Snyder Sachs is the author of Good Germs, Bad Germs: Health & Survival in a Bacterial World (Hill&Wang/FSG) and Corpse: Nature, Forensics, and the Struggle to Pinpoint Time of Death (Perseus/Basic Books).

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A fragile linkage exists between the nation's water supplies, the wild places where they come from, and the life that the two support together

copyright Jessica Snyder Sachs, as first appeared in National Wildlife

FOR TENS OF MILLIONS of years, a corps of natural hydrologists ensured the continuous cleansing of our continent's water supplies. In woodlands across North America, some 200 million beavers slowed rivers and streams to a silt-dropping crawl with their semiporous dams. Moreover their relentless logging created an elaborate network of wetland meadows that absorbed and cleansed surface runoff.

Beyond the forests, tens of millions of bison and elk worked in tandem with wildfires to sustain the short-grass and tallgrass prairies that soaked up the torrential downpours of seasonal thunderstorms. Beneath these same grasslands, hundreds of thousands of prairie dogs dug vast networks of tunnels that channeled groundwater deeper, to feed and refresh underground rivers that, in turn, continually recharged the continent's lakes and above-ground streams.

In these ways, a network of keystone species helped maintain a clean supply of the continent's most vital, life-sustaining substance. For while many forms of life can survive without oxygen, none can do so without water. Indeed, 60 to 80 percent of every living cell consists of water, and all vital biological processes begin or end with this simple molecule.

So far as science can discern, life on this planet began in a watery cradle. And when astronomers scan other planets for the potential to support life, they look first for signs of the molecule H20.

As seen from space, the sparkling blue ball that is Earth reveals itself to be a paradise of wetness. Above the oceans and lakes that cover more than 70 percent of the planet's surface drifts an ever-shifting lace of water-vapor clouds. Water pours from our skies, courses down our mountains and flows across every continent, back to the seas where the warming sun sends it skyward again. In this manner, our planet continually recycles an estimated 370 quintillion gallons (18 zeros), most of it older than the oldest fossils.

As life in North America and elsewhere evolved around water's unique properties, elaborate ecosystems developed to ensure continual recycling and purification. In Water: A Natural History, environmental engineer Alice Outwater describes the consequences of disrupting these ecosystems, particularly the large-scale decimation of North America's pre-Columbian populations of beaver, bison, elk and prairie dogs. "By tampering with and in some cases eliminating the ecological niches where water cleans itself," she says, "we have simplified the pathways that water takes through the American landscape, and we have ended up with dirty water."

Without wetlands and prairie grasslands to absorb rainfall, water slaloms across the landscape, picking up and dumping sediment into streams and lakes. Without beaver dams to brake their flow, streams frequently deepen into brown-water gulleys, continually eating away at their own banks. In an even more dramatic manner, development that clears natural vegetation speeds sediment-laden runoff during rainstorms, while adding a potentially toxic load of pesticides and other chemicals. The U.S. Geological Survey's recently completed ten-year assessment of the nation's water resources found multiple pesticides and unnaturally elevated levels of phosphorus and nitrogen in virtually all streams and groundwater sampled outside undeveloped wilderness. The majority of these streams contained pesticides at levels that exceeded--and often far exceeded--federal guidelines for the protection of aquatic life. These same chemicals can likewise endanger humans if they enter the drinking water supply.

"Scientific studies have repeatedly shown that our ability to protect our water sources from pollutants--and there are many of them--relates closely to our ability to safeguard our own health, especially that of our children, with their growing bodies," observes Monty Fischer, National Wildlife Federation policy director of water resources. "As conservationists, we're also keenly aware of the crucial role an untainted and abundant water supply plays in sustaining wildlife."

Certainly, Fischer points out, part of the solution is increased water efficiency--from turning off the faucet when we brush our teeth to making sure that our municipalities repair leaky water mains and otherwise invest in efficient water-delivery systems. But more important, he says, "is a public understanding of the linkage between the water flowing out of your tap and the wild places where it comes from, both in terms of the quantity and quality of that water, and the commitment it takes to protect those water sources."

Outwater agrees, adding: "An undeniable symbiosis exists between our country's water, the land from which it springs and the life that the two support together. Safeguarding that symbiosis is a responsibility all of us must share."

New Jersey journalist Jessica Snyder Sachs wrote about the effects of pesticides on endangered species in the December/January issue.

SIDEBAR:

H₂O: The Incredible Molecule

What is it that makes H₂O the liquid of life itself?

In chemical structure, the water molecule could hardly be simpler: two hydrogen atoms stuck like Mickey Mouse ears onto a single atom of oxygen. But in that simplicity can be found water's unique properties.

In essence, every water molecule is a tiny magnet, and its strong polar nature gives it the ability to dissolve an unparalleled range of substances, including a wide range of salts. In addition to the familiar sodium-chloride molecule we know as table salt, these include scores of biologically important substances such as potassium chloride, magnesium chloride and calcium sulfate. Indeed, all living beings--from plants to humans--depend on water to release the life-sustaining minerals contained in these salts.

Water's remarkable solvent powers provide the perfect medium for virtually every biological reaction that occurs inside a living cell--from energy-storing photosynthesis to energy-consuming respiration. And water has the remarkable ability to dissolve gases--most importantly, oxygen and carbon dioxide. It is water's oxygen-carrying capacity that sustains aquatic animal life.

A water molecule's mini-magnet configuration generates a host of other queer qualities, as well. Given its simple structure and small size, it should fly apart into gaseous form at extremely low temperatures. But water molecules cluster into tight groups, with each molecule's negatively charged oxygen atom lining up with the positively charged hydrogen on its neighbors. The considerable amount of energy needed to break these "hydrogen bonds" gives water the unusually high boiling point of 212 degrees F (100 degrees C). As a result, the planet's surface water never completely evaporates under the beating sun. Instead, oceans and lakes act as impressive energy sinks for storing and slowly releasing solar energy to temper seasons, and smooth out temperature differences between day and night.

As temperatures drop toward freezing, the hydrogen bonds between water molecules perform another impressive trick. They preassemble into the open-lattice structure that gives snowflakes their beautiful patterns and makes ice lighter than water. This bizarre quality of water being lighter as a solid than as a liquid has a huge consequence: It is the reason that lakes and oceans don't freeze from the bottom up, solidifying into a global ice block that even the hottest summer would never melt.--Jessica Snyder Sachs

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Copyright Jessica Snyder Sachs, as first appeared in National Wildlife

THE EARLY MORNING SUN glints off the amber, "swamp tea" waters of Okefenokee National Wildlife Refuge, as an eager group of Sunday birders clamber up its wetland observation tower. For the last half mile of boardwalk, they've heard the croak of sandhill cranes above the rustling sound of the sawgrass blocking their view. "They'll be lifting off any day now," says refuge ranger Maggie O'Connell of the swamp's winter population of several thousand greater sandhill cranes. Though only mid-February, winter is already loosening its halfhearted grip on southern Georgia's Great Okefenokee, one of the largest intact freshwater ecosystems in the world.

Atop the 50-foot tower, O'Connell surveys her domain. "Seventeen miles to the horizon without a stitch of solid ground," she marvels. Indeed, the dense vegetation of this landscape grows atop floating peat-bog islands, the largest crowned by bald cypress draped in ghostly green Spanish moss. For good reason, the Creek Indians dubbed this Oguafenogua, the "land of the trembling earth." Stomp hard enough and even the trees shake.

Like the majority of the 539 units in America's National Wildlife Refuge System, the Okefenokee was protected to serve as sanctuary for migratory waterfowl such as the cranes, teals, mergansers, herons and egrets seen feeding across its open, wet "prairie." But the Georgia reserve has evolved far beyond its "duck factory" genesis.

This refuge's expanded purpose becomes clear as the sun rises high enough to banish the morning chill, and boaters begin paddling and motoring up the swamp's 120 miles of canals and slow-moving streams. Blinking back at them from the shore or half-submerged in the shimmering blackwater are the sleek American alligators that are among the Okefenokee's star attractions. Many of the visitors will linger after returning to dock--lunching on the refuge's grassy picnic grounds, touring its new million-dollar environmental education exhibit, and shopping for souvenirs in the gift shop. Some will spend the night, either in the state park easement on the refuge's west side or deep in the swamp, on one of seven overnight canoeing platforms.

In addition to playing host to more than 400,000 visitors a year, the staff of this national wildlife refuge have launched an ambitious long-term project to restore and expand the area's upland stands of rare longleaf pine and wiregrass habitat--home to endangered red-cockaded woodpeckers and threatened gopher tortoises, indigo snakes and Florida black bears. To this end, nearly half the refuge staff work on the fire crews that conduct prescribed burns to beat back the saw palmetto and slash pine that once were kept in check by seasonal wildfires. "We figure it'll take about 300 years of active management to restore the area," says O'Connell.

Now, as it prepares to celebrate its centennial year beginning in March, the National Wildlife Refuge System as a whole is experiencing an equally radical deepening and expansion of its purpose. Administered by the U.S. Fish and Wildlife Service, it is the world's only national network of public lands set aside specifically for wildlife. And for years, it struggled without any sense of unifying mission. Beginning with President Theodore Roosevelt's founding of the first refuge--Florida's Pelican Island in 1903--one unit after another has flickered into being with its own narrowly defined mission. Before Roosevelt left office in 1909, these included 56 big game preserves and bird reservations such as Idaho's Mindoka refuge for ducks and geese, Oklahoma's Wichita Mountains for bison and elk, and Alaska's Fire Island for moose.

In addition to playing host to more than 400,000 visitors a year, the staff of this national wildlife refuge have launched an ambitious long-term project to restore and expand the area's upland stands of rare longleaf pine and wiregrass habitat--home to endangered red-cockaded woodpeckers and threatened gopher tortoises, indigo snakes and Florida black bears. To this end, nearly half the refuge staff work on the fire crews that conduct prescribed burns to beat back the saw palmetto and slash pine that once were kept in check by seasonal wildfires. "We figure it'll take about 300 years of active management to restore the area," says O'Connell.

Now, as it prepares to celebrate its centennial year beginning in March, the National Wildlife Refuge System as a whole is experiencing an equally radical deepening and expansion of its purpose. Administered by the U.S. Fish and Wildlife Service, it is the world's only national network of public lands set aside specifically for wildlife. And for years, it struggled without any sense of unifying mission. Beginning with President Theodore Roosevelt's founding of the first refuge--Florida's Pelican Island in 1903--one unit after another has flickered into being with its own narrowly defined mission. Before Roosevelt left office in 1909, these included 56 big game preserves and bird reservations such as Idaho's Mindoka refuge for ducks and geese, Oklahoma's Wichita Mountains for bison and elk, and Alaska's Fire Island for moose.

Since 1934, the Migratory Bird Hunting and Conservation Stamp Act has funded the acquisition of millions of acres of additional waterfowl habitat, concentrated up and down North America's four major migratory flyways. Among the first, Montana's Red Rock Lakes refuge became the last-chance sanctuary for the highly endangered trumpeter swan in 1935.

In 1966, Congress passed the National Wildlife Refuge Administration Act, enlarging the refuge system further with several thousand small prairie pothole wetlands designated as "Waterfowl Production Areas." And in 1980, the Alaska National Interest Lands Conservation Act nearly tripled the refuge system's holdings with some 54 million acres of pristine arctic and subarctic habitat.

By the time the 500th refuge--West Virginia's Canaan Valley--was established in 1994, the system encompassed more units than the National Forest Service and more land (90 million acres) than the National Park Service's holdings. Yet much of the refuge system continued to be managed under a mishmash of policies and regulations that left its lands vulnerable to such strangely incompatible uses as jet skiing, dune-buggy racing, livestock grazing, oil drilling, even military war games and bombing runs. Refuge managers opposing such uses stood on shaky legal ground unless they could show that the activities directly threatened the specific purpose for which their refuges had been established.

A case in point: In 1990, the manager of Aransas National Wildlife Refuge on the Texas Gulf Coast tried to remove privately owned cattle from the preserve's wildlife-rich Matagorda Island. Biologists had determined that overgrazing had already degraded the island's otherwise pristine habitat, including nesting sites for endangered sea turtles and underbrush vital to wintering songbirds. The problem was that Congress had established the refuge in 1937 specifically as a sanctuary for the world's last wild population of whooping cranes.

"We could show that the cattle were definitely degrading the overall ecosystem of Matagorda Island," explains National Wildlife Refuge System Director Dan Ashe. "But technically, in order to deny the grazing permit, we had to show that it was incompatible with the refuge's original purpose." In the end, federal administrators stood behind the refuge manager's claim that cattle grazing constituted an incompatible use. "But a lot of people, including our own attorneys, thought we were stretching things," admits Ashe.

Such legalistic hand-tying came to an end in 1996, with an executive order by President Clinton, followed the next year by the bipartisan passage of the National Wildlife Refuge System Improvement Act. These two legal directives set forth "conservation" as the refuge system's singular and all-encompassing purpose--a purpose against which any proposed use had to be judged. The groundbreaking Improvement Act also required the staff at every refuge to create a 15-year comprehensive conservation plan--guided, in large part, by public input. Indeed, by placing an emphasis on "wildlife-compatible" uses such as observation, photography and limited hunting, the law acknowledged that refuges are for people too.

Specifically, some 2 million hunters and 6 million anglers visit the refuge system each year. Twice that number--some 16 million visitors--come solely to watch wildlife or soak in the beauty and serenity of the nation's wildest places. Add busloads of students and tour groups taking advantage of environmental education programs and the tally swells to at least 35 million visitors a year. The importance of their input in setting the system's agenda for its second century can hardly be underestimated, says Jamie Rappaport Clark, former director of the U.S. Fish and Wildlife Service during the Clinton administration and now NWF senior vice president for conservation programs. "The pressures on the refuge system have grown tremendously in recent years," she explains. "We have more threatened and endangered species, more demands for human activity on the landscape, and more development and encroachment from the outside. As a result, the job of safeguarding these wild places and passing them on to new generations demands a high level of public engagement."

In fact, the most serious threats to refuge wildlife and habitat--urban sprawl, water depletion, pollution and invasive species--originate outside refuge borders and, therefore beyond the system's authority. Consequently, progress depends on activism on the part of local citizens and allied conservation organizations.

In recent years, for example, the Okefenokee National Wildlife Refuge has depended on a large coalition of conservation groups, including NWF and its affiliate, the Georgia Wildlife Federation, to stave off plans by the chemical giant DuPont to excavate a 30-mile-long, 50-foot-deep titanium strip mine a few feet from the refuge's eastern border. The proposed mining operations would generate a 24-hour-a-day onslaught of dust, smoke, exhaust, noise and light directly alongside the refuge's main wildlife observation drive. Worse, scientific studies indicate the mine could irrevocably alter the Okefenokee's delicate hydrology and ecology. With no authority to stop operations off refuge grounds, refuge managers continue to rely on sustained and vocal public opposition to keep DuPont's plans at bay.

Public opposition has, at least for the time being, helped play an even larger role in confronting what many people view as the greatest single threat to the refuge system in its 100-year history: the proposed opening of the coastal plain section of Alaska's 19.6 million-acre Arctic National Wildlife Refuge to oil drilling--a plan that the U.S. Senate voted down last year. Scientific studies by government wildlife biologists had confirmed that petroleum operations on the Arctic refuge would disrupt its vast caribou calving grounds and irreparably harm the region's delicate tundra ecosystem. More importantly, says Clark, "opening Arctic to drilling would totally blow apart the purpose of the entire refuge system. For if there's the will to violate a refuge as spectacular and ecologically unique as Arctic, what would stop the same from happening at the system's 75 million other acres?"

At the least, adds Clark, the 1997 Refuge Improvement Act makes doing so extremely difficult. "As there's no possible way to open up the heart of this refuge to drilling and call it 'compatible' with conservation," she says, "it would require Congressional legislation to literally set the Refuge Improvement Act aside."

More insidious threats to the system include a widening budget shortfall for staffing and maintenance, says Evan Hirsche, president of the National Wildlife Refuge Association, the umbrella organization for more than 200 local refuge volunteer "friends" groups. "Wildlife refuges have long been the black sheep of federal land holdings in terms of monetary support," he says. Specifically, the system must manage more than 94 million acres--and the welfare of more than 200 threatened or endangered species--with an annual budget of $370 million, or less than $4 an acre.

"As a result," says Hirsche, "a great deal of conservation objectives are not being met." Primary among these has been the refuge system's losing battle with invasive species such as the Australian pine and Brazilian pepper trees supplanting native habitat at Florida's Pelican Island National Wildlife Refuge; the zebra mussels and purple loosestrife crowding out native mollusks and wetland plant species in the Upper Mississippi National Fish and Wildlife Refuge; and nutria, a beaver-like Central American rodent, tearing up tidal marshes in Maryland's Blackwater National Wildlife Refuge. Also showing the strain of underfunding is the refuge system's aging infrastructure of access roads, buildings, water-management facilities and other assets.

The severe underfunding for maintenance and staff has also slowed the system's opening of new refuges, despite the annual influx of "Duck Stamp" money for land acquisition. "Before we acquire new areas, we have to ask ourselves whether we'll have the funds to manage them," explains Ashe. "Too often, I hear the argument, 'You don't have to do anything, just buy the land and protect it.' But 'protect' is an active verb."

Indeed, though much of the refuge system consists of wilderness where humans seldom tread, at a minimum, these places must be posted and patrolled. "In this day and age, even our most remote areas are no longer insulated from such illegal activities as drug trafficking, poaching and garbage dumping," says Ashe. "If we just left these places alone, I don't think anyone would be happy with what we'd find when we came back five years later." Moreover, a large percentage of the refuge system requires intensive management such as controlled burning to maintain ecosystem balance and active farming to provide grain for migratory waterfowl. "We need more maintenance workers, more equipment operators, more law-enforcement officers," says Ashe.

In particular, Ashe and conservation activists agree, the system needs more wildlife biologists. "The lack of biological expertise undermines any effort at strategic planning and wise management," says Clark. "Many of our refuges need extensive habitat restoration that can't be carried out because of this lack of biological expertise." At the very least, she explains, the system needs enough biologists to conduct wildlife surveys, monitor wildlife threats and prioritize spending at individual refuges.

For all these reasons, a coalition of 20 conservation groups, including the National Wildlife Federation, recently called on President Bush and Congress to nearly double the refuge system's budget. "Because of their strategic locations and acreage, our refuges provide safe havens for hundreds of threatened and endangered species, provide migratory stopover for millions of birds, while at the same time provide terrific areas for solace and enjoyment for people who want to experience nature," argues Clark. "But it's a system that desperately requires increased funding if it's going to address the needs of both wildlife and people."

The good news is that authorities in Washington, D.C., are finally getting the message. "We've seen sustained budget increases over recent years, including Secretary of the Interior Gale Norton's endorsement of a nearly $57 million increase for maintenance and operations in 2003," says Ashe, who credits conservation groups for their persistent lobbying on behalf of the refuge system. "Constituent organizations like the National Wildlife Federation have in the past five to six years rallied to our defense. It's in large part thanks to them that government leaders have been able to set aside political differences and support us."

Admittedly, recent federal funding increases fall far short of the refuge system's staggering maintenance backlog--currently estimated at more than $526 million, with another $700 million needed for high-priority projects such as restoring degraded habitats and promoting the recovery of endangered species.

Increasingly, refuges have come to rely on volunteers to pick up the slack. Every year some 30,000 volunteers donate more than a million hours of their time to driving heavy equipment, conducting habitat surveys, building boardwalks, running bookstores and nature programs, and lobbying for increased local, state and federal support. "That translates to about $13 million worth of services a year," notes Hirsche.

The need for volunteer support will only increase in the refuge system's second century. "These precious places are mere islands in the landscape, and we can't hope to ever acquire all the land we need," he explains. "As a result, the success of the system's conservation mission will depend on local volunteers becoming envoys to neighboring landowners and local governments, and in this way extending each refuge's wildlife objectives beyond its borders."

In the future that Hirsche envisions, "refuges will become shining examples for private landowners, state land managers and other federal land agencies of how they can all develop management policies consistent with species conservation."

New Jersey-based journalist Jessica Snyder Sachs visited the Okefenokee and Pelican Island National Wildlife Refuges while reporting for this article.

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Copyright Jessica Snyder Sachs, as first appeared in National Wildlife

FROM A DISTANCE, the oddly stunted mangrove trees of Florida's Pelican Island look dusted in snow. Approach closer, however, and the snowfall turns out to be hundreds of nesting egrets, herons, ibises, wood storks and downy young pelicans. The mangrove's dwarfed greenery likewise results from the birds, whose continual pruning for nesting material has produced an island-wide bonsai effect. Scientists estimate that this tiny islet, a stone's throw from the East Florida mainland on one side and barrier islands on the other, has provided the birds and their nestlings safe haven from predators for thousands of years.

Yet in the closing years of the 19th century, this ancient rookery came within a hair's breadth of extirpation. First came the winter tourists, shooting clouds of island birds for idle entertainment. Plume hunters followed, systematically raking the island for both nestlings and adults to feed the insatiable demand for fashionable feathered hats. Naturalists and scientists only added to the massacre in the late 1800s with their wholesale collection of eggs and specimens for display.

Watching it all from the mainland, boat builder Paul Kroegel cursed the mindless slaughter. In 1881, Kroegel established his boat shop across from Pelican Island in order to enjoy the sight of reeling birds. But by 1898, the herons, egrets, roseate spoonbills and white ibises were gone, the pelicans severely reduced. Over the next five years, Kroegel and pioneering wildlife conservationists William Dutcher and Theodore Palmer lobbied officials in Washington, D.C., for protection. In 1903, they finally convinced President Theodore Roosevelt to declare Pelican Island a wildlife sanctuary--the country's first national wildlife refuge.

Hired as the sanctuary's first manager, Kroegel earned $1 a month to keep his eye on the island rookery. He kept a ten-gauge shotgun in his dockside skiff to help persuade trespassers to move on. The mild-mannered conservationist started the island on its slow recovery.

A century later, refuge manager Paul Tritaik continues the fight to protect Pelican Island and its spectacular diversity of nesting birds. Instead of a gun, Tritaik faces the island's modern-day threats with an impressive array of bureaucratic wrangling and artfully harnessed public activism. "I try every angle I can," says Tritaik of his ten years managing a refuge that until recently didn't so much as provide him with his own budget, let alone a wildlife biologist or other full-time help.

When he arrived at the refuge in 1993, Tritaik realized that Pelican Island was literally disappearing. "I noticed it when I was looking at old aerial photos of the island," he explains. "The shape of the island was dramatically different than it is today." A survey confirmed Tritaik's worst fears: Over the course of the 20th century, the island had eroded from a 5.5-acre triangle to a 2.2-acre comma.

Part of the problem, Tritaik realized, was the island's location--dead center in Florida's busy Intracoastal Waterway. The wakes generated by the heavy boat traffic had been pounding on the fragile islet for decades. "At some point, I knew the island would simply be too small to support a viable rookery," he says. But Tritaik remained powerless to stop or even slow the traffic.

Though the refuge had acquired some 4,700 acres of surrounding water from the state of Florida in 1963, the additional territory came with the precondition that no restrictions be placed on fishing or boating. Tritaik first turned to volunteer labor to try to stabilize the islet's battered shore. When that made little headway, he finagled Pelican Island's designation as a National Historic Landmark into getting money for hiring a helicopter to dump 250 tons of oyster shell.

Similarly, Tritaik has wrangled Environmental Protection Agency funds to help clean and restore the surrounding Indian River Lagoon, even as he gleaned other restoration money based on its status as a National Wilderness Area. Most importantly, perhaps, Tritaik continues to network with Pelican Island's many passionate local supporters, who stand ready to wield their lobbying clout as well as their physical labor.

A sea change in government support arrived in 1999, says Tritaik, when U.S. Fish and Wildlife Service Director Jamie Rappaport Clark committed her agency to transforming this, the nation's first wildlife refuge, into a showcase for the system's upcoming centennial. Within three years, the refuge had acquired more than 150 acres of neighboring barrier island. The newly acquired acreage will allow the refuge to welcome the public for the first time with hiking trails, boardwalk, rookery observation tower and visitors' center. "Pelican Island today," says Tritaik, "stands as a monument to the National Wildlife Refuge System that it spawned."

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Are you doing what you can to protect your child from sexual abuse? The standard advice is wrong: Here's what you need to know.

 copyright Jessica Snyder Sachs, as first published in PARENTING magazine

When I was 11, I kept a terrible secret from my parents. I feared their reaction if they found out what a neighbor and family friend had done in his home after turning off the lights and saying he loved me. Besides, it took me months to figure it out myself. Even then, I doubt that the term "molestation" had become part of my vocabulary.

My story wouldn't bear mentioning except that it continues to be horribly common. Although studies show a small but steady decline in substantiated child molestations over the past decade, conservative estimates still place the number of children who are sexually abused each year at around 200,000. Only about half of cases are reported, experts believe. And the problem extends into younger age groups than most people realize. In a national survey of adults molested as children, the median age of first abuse was 9 years, with one-fourth being violated before age 8 and nearly 15 percent before age 6.

Scarier still, conventional notions on how to protect kids is wrong. We rush to teach them about "stranger danger," but more than 80 percent of molesters know their victims, according to a study by the University of New Hampshire's Crimes Against Children Research Center. We instruct our children to "Yell and Tell," but such simplistic advice can backfire when youngsters face the typical offender  -- the outwardly caring teacher, coach, friend, or relative who's worked hard to win your child's trust  -- not to mention yours.

"In no other area do we give children the responsibility to stop or change the behavior of the adults in their life," says Elizabeth Ralston, Ph.D., executive director of Dee Norton Lowcountry Children's Advocacy Center, in Charleston, South Carolina. "The result is that often, kids who've been molested feel guilty for not having prevented the abuse and ashamed to tell anyone about what's happened to them."

Even lessons on "good touch/bad touch" can backfire because molestation doesn't always start out feeling "yucky." Nor does it necessarily involve physical contact, as is the case when adults expose children to sexually explicit pictures, talk, and behavior, or when they get them to expose themselves for photographs.

You're probably cringing right about now, but that discomfort is a part of the problem. "It's natural for parents to cling to the myth of the child molester as the dirty old man in the wrinkled raincoat," says Anna Salter, Ph.D., author of Predators: Pedophiles, Rapists, and Other Sex Offenders. "It's disturbing to think that people we know, or even love, could harm our children."

Your first line of defense, then, is to minimize the situations in which your child is left alone with an adult you don't thoroughly know and wholly trust  -- even if it's Grandpa. "This isn't about being paranoid," says Anne Lee, founder of the national child-protection campaign Darkness to Light and a survivor of sexual abuse herself. "Just as we're not being paranoid about the risk of an accident, so we buckle our kids into their car seats or hold their hands crossing the street, it's not paranoid to eliminate one-on-one situations that may put them at risk of abuse." These age-specific guidelines can help you keep your child safe.

Protecting Infants and Toddlers

It was the grandma who noticed. While diapering her 14-month-old granddaughter, she felt a roughened area between the baby's buttocks. The pediatrician said it was too calloused to be diaper rash and concluded it had been caused by chronic rubbing over a long period of time. It turned out, says Ralston, that the teenage boy who babysat the child had been masturbating against her.

Yes, babies get abused. A molester may masturbate against an infant or toddler, stimulate the child for self-gratification, or even attempt penetration. Red flags for possible abuse include abrasions, swelling, and skin tears around the genitals, anus, or mouth. If you notice such an injury, see your doctor immediately.

Ralston urges parents to screen any adult they're considering as a regular caregiver for criminal offenses through local law-enforcement agencies and the FBI. You'll need the person's birth date, social security number, and a list of the counties and states in which she's lived.

After you hire someone, make it clear to her that you're vigilant about your child's safety and then check in unannounced periodically. "If she complains, find somebody else," says Ralston.

Protecting preschoolers and grade-schoolers

"See. You're a dirty little girl. You like it." That's what Anne Lee's great-uncle told her when he began fondling her during summers at the family's vacation house. She was 4 years old.

"The tragedy is, I believed him and felt too ashamed to tell my parents," says Lee, who's now the mom of a 10-year-old daughter. At the same time, Lee's behavior was a cry for help: "Here we had this wonderful place on a beautiful crystal lake, and I was begging not to go."

Although there are no numbers available regarding boys, the incidence of molestation and sexually motivated abductions of girls more than triples by the time children reach grade school. This isn't surprising, considering that as kids get older, they're out of their parents' sight more often. To protect them despite this change:

Reduce accessibility
There's no substitute for direct supervision. "Offenders look for ease of approach and ease of retreat," says Monique Boudreaux, Ph.D., a consultant with the Child Abduction and Serial Murder Investigative Resources Center, in Quantico, Virginia, and a mom of two. So plop down on a lawn chair when your kids play outside; take the phone along or let the voicemail pick up to avoid having your attention diverted.

Before your child visits a friend's home, get to know the parents or try to spend time there. If you're not comfortable, have them play at your house.

At your child's daycare or school, find out if there's an "open-door policy"  -- that is, an open door or unobstructed window should allow any classroom to be visible from the hallway at all times.

If you've chosen family daycare for your child, make it clear that she should never be left with anyone other than the primary caregiver without your prior approval. When babysitters come into your home, establish ground rules as to who else is allowed in the house while you're away.

Attend your child's practices, lessons, and other extracurricular activities, or send someone you trust. Relax on the sidelines, but be aware of how coaches and instructors interact with your child.

Never ignore the protests of a child who expresses reluctance or fear about spending time with a particular adult, even a relative or close family friend. Avoid leading questions, but assure your child that he won't get in trouble for telling you what's going on.

Reduce desirability
Advertising your child's name on the outside of backpacks and other personal items can draw unwanted attention. "We know that some offenders literally stalk children to gain information about them," says Boudreaux. "Knowing your child's name helps them." At the very least, it can make it easier for a molester to directly gain a child's trust.

In a more literal sense, reducing desirability means not dressing young children in alluring clothing, accessories, or makeup. Interviews with convicted child molesters suggest that a provocative appearance plays a significant role in the selection of victims.

Reduce vulnerability
Although it's important not to lay the responsibility of protecting themselves solely on the tiny shoulders of preschoolers, they are old enough to learn that their bodies are their own and that the parts normally covered by underwear or a swimsuit shouldn't be touched or seen by others, with the exception of a parent or trusted caregiver at bathtime or a doctor examining them with a parent or nurse present. They should understand that others should not be exposing or showing pictures of private parts to them. This sense of "owning one's body" begins with the child's privilege of saying no when he doesn't feel like hugging or kissing, even if that person happens to be Granddad  -- or you.

Similarly, don't tell your child to be a good boy (or girl) and do whatever his sitter (teacher/coach/neighbor) says. Boudreaux teaches her own kids reasonable and acceptable behavior while letting them know they have the right to politely but firmly say no if they're told to do something that doesn't seem right. It can help to playact nonscary scenarios in which your child should "talk back" to an adult.

Instead of teaching fear of strangers, Boudreaux also instructs her children to look for "a mommy with kids or a grandma" if they get separated from her in a store or elsewhere. (Recognizing a store clerk or security guard can be difficult for little ones.)

Reducing vulnerability means making sure your child feels safe coming to you about a disturbing or confusing situation or emotion. Tell her, in terms she can understand, that some adults  -- not very many, but some  -- try to touch or otherwise interact with children in inappropriate ways.

Protecting tweens and up

My daughter's now 11, the age at which I was molested  -- and I've gone through many a heart-clenching moment when she's been out of my sight. To protect maturing kids without smothering them:

Continue to get to know your preteen's friends, and if possible visit their homes.

Encourage supervised activities with kids her own age, explaining that while relationships with adults and older teens may be fun and exciting, she may find herself in a vulnerable position that can lead to abuse. Pay special attention to friendships involving older persons, even a 14-year-old palling around with your 10-year-old.

Kids approaching and passing through puberty also need help managing their own sexual feelings, setting boundaries with boy- and girlfriends, and handling peer pressure regarding pornography. Look for opportunities to talk about these issues and brainstorm ways for your child to avoid or get out of uncomfortable situations.

Finding a balance

Protecting kids from molestation requires being vigilant while giving them freedom to learn about their world, make friends, and become independent adults. For me, that's meant choosing a preschool with two teachers in every class; sitting in on music lessons; and having quite a few frank talks with my daughter about sexuality and molestation. Not as much fun as chatting about her interest in Shakespeare or horses, but vital to making sure she never has to experience the kind of shame and confusion that I did as a child.

Parenting contributing editor Jessica Snyder Sachs is the author of Good Germs, Bad Germs: Health & Survival in a Bacterial World (Hill&Wang/FSG) and Corpse: Nature, Forensics, and the Struggle to Pinpoint Time of Death (Perseus/Basic Books).

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Hospitals need to come clean about infections and what's causing them.

copyright Jessica Snyder Sachs, as originally appeared in The [Newark] Star-Ledger

Our neighborhoods are in a panic over news reports about MRSA, or methicillin resistant Staphylococcus aureus. There's no doubt that this nasty bug has moved into our communities and our schools. But the deadliest threat from MRSA--and an alphabet soup of other drug-resistant bacteria--remain behind the doors of our local hospitals. Eight-five percent of MRSA infections occur during or following a stay in a healthcare facility.

Illustration by Paul Lachine

The sad truth is that our hospitals have become dangerous places to be sick. Even routine surgical procedures bring the risk of potentially deadly infections involving hospital-bred bacteria. Infections picked up in health-care settings kill an estimated 99,000 Americans each year, more than twice as many as die in car crashes. It's a problem that has grown dramatically worse by the decade, as our antibiotic-infused medical centers became breeding grounds for drug-resistant bacteria.

In addition to MRSA,  other increasingly common hospital superbugs include a viciously toxic strain of Clostridium difficile, bred from the bacterium that commonly causes post-antibiotic diarrhea; vancomycin resistant enterococcus (VRE), a virtually untreatable bug bred from a harmless member of our intestinal microflora; and Actinobacter baumannii, another near-unstoppable microbe, this one recently introduced into our hospitals in the infected wounds of soldiers returning from Iraq, Afghanistan, and before that, Kuwait.

The good news is that a half century of dangerous secrecy is starting to come to an end. This year New Jersey joined New York and Connecticut in the ranks of at least 22 states with some sort of mandate for the reporting of hospitals infections. These laws represent a step in the right direction. But few ask hospitals to differentiate infections caused by "ordinary" bacteria and those caused by highly drug resistant superbugs. New Jersey is one of these exceptions, with a new law on the books requiring specific reporting of hospital MRSA.

The importance of such reporting laws goes beyond a consumer's desire to steer clear of a medical center plagued with abysmal infection control. Worse, fifty years of secrecy have left public health officials guessing as to the arrival and spread of deadly new strains of drug-resistant bacteria in our hospitals.

The current situation with C. difficile illustrates the problem. Since 2003, C. difficile deaths have dominated news in Canada and the United Kingdom. British tabloid headlines like "Toe Nail Surgery Nearly Killed Me" refer to the common scenario wherein someone checks into the hospital for a routine procedure, receives antibiotics, and promptly contracts this drug-resistant invader.

Public outcry in Canada and the UK produced tremendous political pressure to address the problem in those countries. Even today, British lawmakers are quick to call the government's health minister before Parliament for public castigation when quarterly hospital reports of either MRSA or C. difficile rates fail to show improvement.

Ironically, in 2005, medical detectives traced the origins of the toxic C. difficile strain wreaking havoc in Canada and the U.K. to the United States, where hospitals had been heedlessly experiencing deadly outbreaks for at least six years. "We had no idea what was going on," admitted the chief of infection control at the University of Pittsburgh Medical Center, which in 2005 belatedly reported that its own C. difficile death toll had begun a dramatic ascent in January 2000.

Once forced to examine and deal with their superbug problems, hospitals can make great strides. This month, a once-chastened University of Pittsburgh Medical Center reported that it has brought its C. difficile rates down by more than 70 percent with an aggressive combination of tactics that include requiring doctors to get permission from an antimicrobial management team before prescribing the kind of powerful antibiotics known to raze the body's good bacteria and, so, leave a patient vulnerable to C. difficile and other drug-resistant bacteria.

Once their dirty secrets are out, other medical centers can likewise begin sharing and comparing infection control efforts. To that end, the first round state laws requiring hospitals to report infections in a general way do not go far enough. Our state legislators need to ride the current wave of public concern about supergerms to pass further legislation requiring hospitals to report on infection problems on a bug by bug basis--starting with their most dangerous and drug-resistant bacteria.

Jessica Snyder Sachs, a contributing editor to Popular Science and Parenting magazines, is the author of Good Germs, Bad Germs: Health and Survival in a Bacterial World.

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Many of us are in the danger zone, and we don't realize it. What to do right now.

by Jessica Snyder Sachs, as first appeared in HEALTH magazine

How's your cholesterol? Here's a guess: If you're healthy, you probably have no idea. New surveys show women tend to be clueless about their risks of heart disease, especially when it comes to managing their cholesterol.

But this kind of ignorance is anything but bliss. The reason: The artery clogging that makes heart disease the number-one killer of women late in life begins much earlier--in your 20s, 30s, and 40s--and that's when your cholesterol numbers may be sounding alarms. So, are you ready to start paying attention? Here, the things all women need to know now.

1. High cholesterol is surprisingly common in premenopausal women.
Researchers with the Framingham Heart Study recently delivered a nasty surprise: Nearly a quarter of women in the study who are in their early 30s have borderline-high levels of bad cholesterol, as do more than a third in their early 40s and more than half in their early 50s. A third of women in all three age groups have low levels of good cholesterol.

Bad cholesterol, also known as low-density lipoprotein (LDL), contributes to heart disease by laying down artery-clogging plaque; good cholesterol, or high-density lipoprotein (HDL), helps clear it away. "The double whammy of high LDL and low HDL is particularly dangerous," says Framingham researcher Vasan Ramachandran, MD, of the Boston University School of Medicine.

2. Your doctor may miss the problem.
Though women are better than men about seeing a doctor regularly, the care they receive isn't as good when it comes to preventing and treating cardiovascular disease, according to new studies. "Perhaps doctors still haven't gotten the message that women need to control cholesterol," says Chloe Bird, PhD, author of one of these studies and a senior sociologist at the nonprofit RAND Corporation. Bird found that doctors are less likely to monitor and control cholesterol in women than in men, even when the women are at superhigh risk of heart attack.

Part of the problem, she says, may be that many women see only a gynecologist. This isn't to say that OB-GYNs can't be good primary care doctors, but you have to make sure the doc is willing to monitor your heart health, especially if you already have diabetes or a heart issue. That means she should order cholesterol checks as part of your regular blood work and discuss the results with you. What does "regular" mean? See "How Often Do I Need a Checkup?"

3. Your numbers may trick you.
Many people misunderstand the roles of so-called good and bad cholesterols, according to cardiologist and lipidologist Pamela Morris, MD, of the Medical University of South Carolina in Charleston. "What we've learned is that HDL and LDL are independent predictors of a woman's heart attack risk," she explains. "We see women with high HDLs having heart attacks when their LDL is also high, and we also see heart attacks in women with very low LDL but also low HDL."

What that means to you: It's important to keep track of both. A woman wants to keep her HDL above 60 (the level at which HDL helps prevent disease) and her LDL below 100. If your HDL drops below 50 or LDL rises above 160, you need to take immediate action. That may include an LDL-lowering drug such as a statin, and it definitely includes a commitment to a heart-healthy diet and lifestyle.

4. You may need an "inflammation" test.
The math used to estimate your heart disease risk is a little misleading. If your LDL rises above the danger line of 160 or your HDL drops below 50, the math says you have an elevated risk of a heart attack within 10 years. But that warning may actually underestimate your risks beyond 10 years, Morris says. So when she has a female patient with cholesterol numbers in the intermediate range--LDL above 130 or HDL under 60--she often takes a close look at the woman's whole-body inflammation level.

You can't see this kind of inflammation, but it's actually an independent measure of heart attack risk. You measure it by adding a test for high-sensitivity C-reactive protein (hs-CRP) to the usual cholesterol blood work. CRP, essentially a body chemical, usually rises anytime your body becomes inflamed. And since artery clogging is associated with inflammation, high CRP is viewed as a marker for clogged arteries. That means your C-reactive protein levels may help you and your doctor decide how aggressively you need to control borderline-high-cholesterol levels with drugs, diet, and exercise.

5. These foods are your best friends.
Certain classes of food chemicals can actively and powerfully lower a person's bad cholesterol. Two--soluble fiber and phytosterols--have so much science behind them that they've become part of standard medical prescriptions for treating high cholesterol. But dietitian Janet Brill, PhD, RD, author of Cholesterol Down, also recommends regularly eating almonds, ground flaxseed, apples, soy protein, and olive oil. Preliminary research suggests they all have cholesterol-lowering powers. "Each one works in a slightly different way," Brill says. "So together, you get a synergy that can dramatically lower cholesterol."

Almonds and olive oil are high in monounsaturated fats, which are thought to blend with LDL molecules in a way that speeds LDL's clearance from the blood by the liver. Flax is high in both soluble fiber, which lowers LDL by absorbing cholesterol from both food and bile inside the intestines, and omega-3 fatty acids, which studies show have anti-inflammatory effects. Other foods especially high in soluble fiber include oat bran, oatmeal, and apples. (Soluble fiber is different from insoluble fiber, the kind found in whole-grain bread and bran cereal. That's good for you, too, but it won't affect your cholesterol.) Soy may mimic natural estrogens in their LDL-clearing effects. Phytosterols are the plant version of animal sterols (a.k.a. cholesterol) and lower LDL by competing with it for absorption into the body. They're found in supplements or phytosterol-enhanced margarine such as Benecol.

You don't need any of these foods if your LDL is low, but experts still recommend them for everyone. What about steak, eggs, and cheese? They sure won't help your cholesterol, because they all contain a lot of it. But it's more important to focus on foods that lower your numbers rather than simply avoiding the bad stuff, experts say.

6. Good cholesterol may have a bad side.
The higher your HDL, the better, right? That's been the current thinking, due to HDL's protective effect. But here's a surprise you may have read about in some news reports: Studies are showing that HDL may actually have harmful proteins capable of boosting heart disease risks. A test to determine if your HDL has the harmful proteins may be available in a few years. In the meantime, if your HDL is lower than 60, it's still OK to raise it a little as long as you don't go overboard. How? Try getting a lot of omega-3s from fish or fish oil, exercising regularly, controlling your weight, and avoiding smoking.

7. Your heart loves long walks.
Walking 10 miles a week brings lasting improvements in your heart health, according to researchers at Duke University Medical Center. The funny thing is, if you jog those 10 miles, you won't get quite as much benefit. "Duration appears to be key," says Duke's Cris Slentz, PhD, an exercise physiologist. "Jogging or walking 10 miles both burned around 1,200 calories, but in our studies, one took about two hours and the other, three."

Longer stints of exercise, even moderate exercise, may burn more belly fat--the little rolls of skin near your navel and the fat deep inside your abdomen. The latter is linked to metabolic syndrome, a condition associated with a host of cardiovascular risk factors including low HDL, high blood pressure, and high triglycerides (a kind of blood fat that contributes to heart disease).

Should you aim for weight loss as well as long walks? If you're overweight, absolutely. But understand that shedding a few pounds will make only a small dent in your cholesterol. Canadian researchers recently found that overweight women who lost about 25 pounds--no easy task--saw their LDL drop about 10 percent and their HDL rise by the same amount.

How Often Do I Need a Checkup?
Starting at age 19 and continuing until menopause, a cholesterol test once every five years is plenty--as long as your numbers fall in the healthy range:

HDL > 60
LDL < 100
Total cholesterol (HDL plus LDL) < 200.

But any time your numbers stray into unhealthy territory (and during and after menopause, when heart disease risk rises), get tested annually and work out an action plan with your doctor.

Writer Jessica Snyder Sachs is the author of Good Germs, Bad Germs, out in paperback this fall.

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