How Not to Look Old

It's a question surely as old as vanity itself: How can you look young forever? A forthcoming study in the journal Plastic and Reconstructive Surgery offers one surprising idea: as you age, don't be afraid to put on a few pounds. Fat, it turns out, can significantly smooth out wrinkles and give you a younger-looking face. (Read "Beth Teitell: On Not Looking Old.")

The authors of the new study, a team led by Dr. Bahman Guyuron of Case Western Reserve University in Cleveland, are plastic surgeons who study faces for a living. They analyzed photographs of the faces of 186 pairs of identical twins taken at the Twins Days Festival, a sort of twin-pride event held every summer in (naturally) Twinsburg, Ohio. Because the pairs had identical genetic material, differences in how old they looked could be attributed entirely to their behavioral choices and environment. Guyuron's team had the twins fill out extensive questionnaires about their lives - everything from how many times they had married to whether they regularly used sunscreen. Then a panel of four judges independently estimated the twins' ages by looking at photos taken in Twinsburg. (See pictures from the Annual Twins Days Festival.)

The Guyuron team's most interesting findings had to do with weight. Many of the twin pairs were of similar weight, but differences in how old they looked began to appear when one had a body mass index (BMI) at least four points higher than the twin sibling. For twin pairs under 40, the heavier one looked significantly older. But surprisingly, after 40, that same four-point difference in BMI made the heavier twin look significantly younger. (Read "Aging Gracefully.")

The study's authors theorize that "volume replacement" - that is, fat filling in wrinkles - accounts for the rejuvenated appearance of the over-40 twins. This theory was supported even more dramatically among twins older than 55. For them, having as much as an eight-point-higher BMI than their twin was associated with a younger appearance in the face. (Read "A Brief History of Multiple Births.")

Guyuron doesn't recommend that people gain weight just to look younger, and one limitation of his study is that the Twinsburg photos included only faces. If they had shown the whole body, the judges may have knocked a couple of years off the age estimates of those who had kept a youthful figure - and added a couple of years for those who were well fed in the middle.

The paper also makes clear that, weight aside, healthy living is crucial for keeping a youthful face. The siblings who smoked and didn't wear sunscreen looked significantly older than those who avoided cigarettes and tanning. Those twins who had been divorced also looked older (by about 1.7 years) than the twins who had not. (They also looked older than those who had stayed single, which reinforces a point I made in this article: you are better off staying single than getting into a bad relationship.)

Finally - and this was the cruelest finding - those who had taken antidepressants also looked older than their twins who hadn't. In other words, if the misery of your divorce doesn't age you, your attempt to treat it with Prozac might. Guyuron and his colleagues believe this unjust fact has something to do with the drooping relaxation of facial muscles that antidepressants can cause.

The bottom line is that if you care mostly about a young-looking face, don't smoke, don't spend time in the sun without protection, and try not to get into a bad relationship that will make you depressed. Instead, this summer at the beach, stay inside and have an ice cream. Make it a double scoop.

See pictures of the world's most celebrated senior citizens.

Read "The Year in Medicine 2008: From A to Z."

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• Facing Realities

Stimulus bill survives Senate test, moves ahead

WASHINGTON – An $838 billion economic stimulus bill backed by the White House survived a key test vote in the Senate Monday despite strong Republican opposition, and Democratic leaders vowed to deliver legislation for President Barack Obama's signature within a few days.

Monday's vote was 61-36, one more than the 60 needed to advance the measure toward Senate passage on Tuesday. That in turn, will set the stage for possibly contentious negotiations with the House on a final compromise on legislation the president says is desperately needed to tackle the worst economic crisis in more than a generation.

The Senate vote occurred as the Obama administration moved ahead on another key component of its economic recovery plan. Officials said Treasury Secretary Timothy Geithner would outline rules on Tuesday for $350 billion in bailout funds designed to help the financial industry as well as homeowners facing foreclosure.

Monday's vote was close but scarcely in doubt once the White House and Democratic leaders agreed to trim about $100 billion on Friday.

As a result, Republican Sens. Susan Collins and Olympia Snowe of Maine and Arlen Specter of Pennsylvania broke ranks to cast their votes to advance the bill.

Sen. Edward M. Kennedy, D-Mass., battling a brain tumor, made his first appearance in the Capitol since suffering a seizure on Inauguration Day, and he joined all other Democrats in support of the measure.

"There is no reason we can't do this by the end of the week," said Majority Leader Harry Reid of Nevada. He said he was prepared to hold the Senate in session into the Presidents Day weekend if necessary, and cautioned Republicans not to try and delay final progress.

He said passage would mark "the first step on the long road to recovery."

Moments before the vote, the Congressional Budget Office issued a new estimate that put the cost at $838 billion, an increase from the $827 billion figure from last week.

"This bill has the votes to pass. We know that," conceded Sen. John Thune, a South Dakota Republican who has spoken daily in the Senate against the legislation.

As if to underscore its prospects for passage, the U.S. Chamber of Commerce, a prominent and powerful business group, issued a statement calling on the Senate to advance the measure.

Even so, in the hours before Monday's vote, Republican opponents attacked it as too costly and unlikely to have the desired effect on the economy. "This is a spending bill, not a stimulus bill," said Sen. Lamar Alexander, R-Tenn.

All 36 votes in opposition were cast by Republicans.

The two remaining versions of the legislation are relatively close in size — $838 billion in the Senate and $819 billion in the House, and are similar in many respects.

Both include Obama's call for a tax cut for lower-income wage earners, as well as billions for unemployment benefits, food stamps, health care and other programs to help victims of the worst recession in decades. In a bow to the administration, they also include billions for development of new information technology for the health industry, and billions more to lay the groundwork for a new environmentally friendly industry that would help reduce the nation's dependence on foreign oil.

At the same time, the differences are considerable.

The measure nearing approval in the Senate calls for more tax cuts and less spending than the House bill, largely because it includes a $70 billion provision to protect middle-class taxpayers from falling victim to the alternative minimum tax, which was intended to make sure the very wealthy don't avoid paying taxes.

Both houses provide for tax breaks for home buyers, but the Senate's provision is far more generous. The Senate bill also gives a tax break to purchasers of new cars.

Both houses provide $87 billion in additional funds for the Medicaid program, which provides health care to the low income. But the House and Senate differ on the formula to be used in distributing the money, a dispute that pits states against one another rather than Republicans against Democrats.

There are dozens of differences on spending.

The Senate proposed $450 million for NASA for exploration, for example, $50 million less than the House. It also eliminated the House's call for money to combat a potential flu pandemic.

On the other hand, the Senate bill calls for several billion more in spending for research at the National Institutes of Health, the result of an amendment backed last week by Specter.

___

Associated Press Writer Andrew Taylor contributed to this story.

By DAVID ESPO, AP Special Correspondent