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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.

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

Statins, those wonder drugs that reduce cholesterol, have proven to be a lifesaver for people at high risk of having a heart attack. Among those who have already suffered one heart attack, statins have shown to cut the risk of another event by more than 30%, making them indispensable for the 8 million people in the U.S. who fall into this category.

What has been trickier to show is whether statins can also help healthy people avoid a first heart attack. But a new 10-year study of nearly 230,000 patients by researchers in Israel hints that the drugs may be up to the challenge.

In the trial, published Feb. 10 in the Archives of Internal Medicine, scientists at Tel Aviv University found that patients taking statins for up to five years reduced their risk of death from any cause by 45%, compared with those not taking statins. Granted, most of the people who benefited had high levels of LDL cholesterol, the "bad" cholesterol, to start, so they were more likely than others to be helped by the drugs' ability to prevent plaque build-up in artery walls. But many patients also had never had a heart attack or other heart event. That means statins may have helped stave off such an event altogether, a hopeful finding given that heart disease still kills more Americans than any other medical condition each year.

"We now have some growing evidence that indeed when statins are prescribed in the right indication in the right amounts, they can reduce heart attack and stroke and reduce death from cardiovascular disease," says Dr. Robert Bonow, chief of cardiology of Northwestern University and past president of the American Heart Association.

While the bulk of prevented deaths in statin-takers were attributable to heart-related factors, the authors note that mortality from other illnesses, such as cancer, also declined. That leads the authors to hypothesize that statins may benefit the body in many different ways. "The benefit cannot be explained by a reduction in cardiac death alone," said the study's lead author, Dr. Anthony Heymann, in an email. "It must mean that there are a large number of additional factors involved in preventing death that are influenced by taking statin medication."

If that's the case, it would add to the growing list of statins' unexpected benefits. Initially the drugs were designed to inhibit the liver's ability to make cholesterol, but it turned out that they not only lowered LDL, but raised levels of HDL, or good cholesterol, in the blood as well. In the early 2000s, researchers reported that statins also reduced inflammation, a process that appears to contribute to the rupture of unstable plaques in the heart vessels, which triggers heart attack.

The drugs have not been without problems, however. Statins have been linked to a rare but serious muscle weakening, and no studies have fully explored the effects of statins in patients who take them long term, perhaps for decades — today, the first generation of American heart patients to be prescribed statins have been taking the drugs for some 15 years.

Still, the new study offers further evidence that statins may help prevent heart attack in a much broader population than previously thought. Last fall, a large trial of middle-aged people who had not had a heart attack but showed signs of inflammation suggested that statins could reduce their risk of having a first heart attack by 45% to 47%. If more studies like these confirm the drugs' beneficial role in reducing cholesterol, inflammation and heart disease, doctors may someday consider advising otherwise healthy people to lower their levels of cholesterol and inflammatory protein markers below currently accepted limits — whether they make lifestyle changes or use medications such as statins.

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Let me get this straight. When the McCaughey septuplets were born in 1997, President Clinton called to congratulate the parents, who were given a free 12-passenger van, Pampers for life, furniture, food and a custom-built house. Last spring, when Michelle and Jim Bob Duggar got pregnant with their 18th child, they announced it on the Today show, and their reality-TV show launched that fall. When Nadya Suleman, 33, gave birth to octuplets on Jan. 26, she got revulsion, ridicule and death threats. A talk-radio host who called her a freak said his listeners were prepared to boycott any company that helped out mother or babies. Jimmy Kimmel declared that "golden retrievers do not have that many kids."

We now have a face and a voice to go with the object of our wrath: Suleman, who bears an ironic passing resemblance to celebrity multimom Angelina Jolie, sat down with NBC's Ann Curry to start to tell her story; the full interviews will air today and Tuesday. Suleman said plenty that will make people squirm even more. But she also exposes how publicly divided and personally judgmental we are about decisions that are, under any normal circumstances, none of our business. (See pictures of the annual Twins' Day festival.)

"All I wanted was children," Suleman told Curry. "That's all I ever wanted in my life."

So what is it about her choices — the how, the who and the why — that gets people so riled up? Remember that for an instant, there was celebration and wonder at the news of healthy octuplets. But it vanished quickly once we learned that the mother was already the single parent of six, living with her own mother, who had to file for bankruptcy last year. First, she seemed to have violated some unspoken rule we have about fertility treatments, the miracle technologies that nuzzle up against so many ethical lines. We can create embryos in a dish, pick out the best ones, hire surrogates to carry them, freeze and discard the extras, all processes that make at least some people somewhat uncomfortable but that we accept because of our understanding of the deep desire to be a parent — a need that for many ranks somewhere with food and sleep, only it lives less in the body than in the soul. Even the pro-life movement hasn't tried to outlaw fertility treatment: anyone who has ever watched someone they care about run the fertility gauntlet thinks twice before getting in the way. (Read "A Brief History of Multiple Births.")

But Suleman was already a mom, six times over. So the first wave of anger was aimed at her doctor, for implanting so many embryos in a woman who was already anything but childless. She says she used the same doctor, but in an interview Sunday with RadarOnline.com, Suleman's mother Angela, a retired teacher, said she and her husband pleaded with Nadya's doctor not to help her get pregnant again — so Nadya went and found a new one, who implanted six more embryos (two split and became twins). The California Medical Board is reportly investigating whether there was a "violation of the standard of care."

The next wave of anger hit her, as though she should have been content with her first one or two or three miracle babies rather than going on to mass-manufacture them. Maybe this is why she is vilified for having 14 children, while the Duggars, members of an Evangelical movement called Quiverful that views children as God's special blessing, are celebrated for having 18 the old-fashioned way.

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

But Suleman points out another difference: she suggested to Curry that the hostility reflected the fact that she was unmarried and had chosen this unconventional and overwhelming variety of single motherhood. (A male friend is father to all 14; she's hoping that once he's no longer in shock, he'll want to be involved in their lives in some way. Suleman's mother said he wanted to marry her, but she wanted to have children on her own.) Count it as another measure of recessionary stress, but at a time when everything is constricting and contracting and downsizing, her choices don't match the moment. Who will be left paying for the vast expense associated with caring for eight low-birth-weight babies (estimated at more than $1.3 million for delivery and hospitalization) or raising 14 of them? "The truth is, Nadya's not capable of raising 14 children," her mother says.

Suleman rejects the charge that she is reckless or irresponsible to have so many children without the means to support them. She said she has never gone on welfare; once she finishes her education, she told Curry, she'll be able to support her family. "If I was just sitting down watching TV and not being as determined as I am to succeed and provide a better future for my children, I believe that would be considered, to a certain degree, selfish." But the first to make the charge was her mother, who has had to support her. "Nadya promised to help me with the bills, but she never has," she told RadarOnline. "I lost a house because of it, and now I'm struggling to look after her six. We had to put in bunk beds, feed them in shifts, and there's children's clothing piled all over the house."

At the very least, Nadya can leverage our cultural hypocrisy; even as talk-show hosts flay her and bloggers blast her, she has hired a p.r. firm to weigh the offers: "She's the most sought-after mom in the world right now," said one of her publicists, Joann Killeen. Is she crazy to imagine there's a reality-TV show in her future as well? Or that her extravagant approach to mothering could turn out to be a shrewd career move?

Finally, there's the question of her motives, already a matter of much speculation ever since her mother told the Los Angeles Times that she "is not evil, but she is obsessed with children ... obviously, she overdid herself." Suleman told Curry that it was "always a dream of mine to have a large family, a huge family, and I just longed for certain connections and attachments with another person that I really lacked, I believe, growing up."

What did she lack? "Feeling of self and identity," Suleman said. "I didn't feel as though, when I was a child, I had much control of my environment. I felt powerless ... [My childhood] was pretty dysfunctional, and whose isn't?"

This is the part that makes you sad. People have always had children for all kinds of reasons, natural and noble and selfish and self-deluding, as though our offspring will make us feel better or younger or as if we'll live forever. But if anyone imagines that having children makes you powerful, well, that lasts for a little while maybe, when you're big and they're small and you're the only one with car keys and credit cards. But ultimately, being a parent may be the most humbling thing we ever do. No one ever feels they get it exactly right. And having 14 chances to try is not likely to improve the odds much.

So maybe we can call a truce here and let this woman work out her very challenging circumstances without our vitriol making it any harder. Listening to her and her mother in dueling interviews, working out a lifetime of needs and hopes and hurts, is just another reminder that the decisions we make about parenting are some of the most personal of our lives. These houses are all made of glass, and I'm not sure how many of us could withstand this level of incoming fire.

See the top 10 scientific discoveries of 2008.

See the top 10 medical breakthroughs of 2008.

Star Trek fans know it as the Prime Directive: that there should be no interference with the internal affairs of other civilizations. (Given the frequency with which captains Kirk, Picard, et. al., violate it, however, the Prime Directive seems more like a Prime Suggestion.) Since human beings have yet to explore very far beyond Earth, pondering an interplanetary noninterference policy of our own may seem a little premature — at least until we've mastered warp drives and phasers.

But in fact, such a directive already exists in some form — the international Outer Space Treaty of 1967, which governs the legal framework for activities in space. Best known for banning governments from putting nuclear weapons into orbit, the treaty also requires space-faring nations to avoid "harmful contamination" of other worlds while exploring the solar system. Human beings have yet to set foot on other planets, so the risk today comes from bacteria that can hitch a ride on unmanned spacecraft like NASA's Mars Phoenix Lander, which arrived on the red planet's surface last May. (See pictures of the Mars Rover's five years in space.)

Even though Phoenix was assembled in a special clean room to minimize bacterial contamination, and its arm, which would have direct contact with Martian ice, was heat-sterilized before launch, it's likely that dozens or more species of microbes hitched a ride on Phoenix's 10-month trip to Mars. Once on Mars, it's possible that bacteria shielded by the structure of the spacecraft from the harsh Martian UV radiation could stay alive, in dormancy, for hundreds of thousands of years. And if native microbes do exist on Mars — nothing has been found yet, but scientists hold out hope that the ice present on parts of the planet harbors life — there's a risk that foreign bacteria could contaminate or somehow change the development of their Martian counterparts. But beyond the broad language of the Outer Space Treaty, we don't really have set guidelines for how we should treat microbial life on another planet should we run across it.

That's why NASA planetary scientist Christopher McKay, in an article in this week's Science, suggests the need for a stronger policy that ensures all exploration of Mars be "biologically reversible" — meaning we would be required to effectively wipe away our footprints and remove any possibility of contamination, by leaving behind nothing that could foster alien microbial growth. Such a policy would be especially necessary if we discover that life on Mars has emerged independently of life on Earth — what McKay calls a "second genesis" — as opposed to Martian life that arose through the exchange of meteorites between Mars and a hospitable Earth, a condition in which the two planets would share a tree of life and contamination would be less of a concern. If there really were a second genesis on Mars, "contamination by even one Earth bacterium may be a serious issue of environmental ethics," McKay writes. We only have to look back at the damage that invasive species have inflicted on virgin territory on our planet, like the infamous cane toads that ravaged Australia, to know what Earth bacteria could do on an alien surface. (See pictures of Mars' surface patterns.)

For now, it's not difficult to make sure that we avoid squashing new life as we search it out — although doing so could add considerable cost to any space mission. Probes like Phoenix can be more fully sterilized before launch, and debris from any unmanned craft could eventually be recovered. The real challenge will occur if and when humans set foot on Mars or any other planet and begin establishing a more permanent presence, especially if we explore beneath the surface, out of the reach of the sterilizing solar UV radiation. When that day comes, we'll need to step carefully to make sure that native life on Mars — yes, I'm sorry, I have to say it — lives long and prospers.

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See pictures of Earth from space.

One could argue that some jobs — painting, writing, being a rock star — are better performed under the influence. But other jobs should clearly be given only to the perpetually sober: we don't want our railroad operators or nuclear-plant employees to be smoking up on the job. So it seems appropriate that U.S. employees in those high-risk positions are routinely subjected to random drug-testing.

But what about people who work in less perilous, if equally unpredictable, environments — say, with children in public schools? Should teachers be randomly drug-tested too? Yes, says Linda Lingle, the Republican governor of Hawaii, where the teachers' union agreed in 2007 to negotiate terms of a new drug-testing program in exchange for higher wages. Now some Hawaii teachers are resisting. (So far, no drug tests have been administered.) The contentious issue of teacher testing has also become the subject of recent court cases in North Carolina and West Virginia, where educators argue that the cost and time taken by random tests would be better spent in the classroom. (See pictures of the college dorm's evolution.)

But one important question hasn't been addressed so far in the legal proceedings: Does random drug-testing actually reduce drug use?

Probably not. No studies I found have looked at the specific issue of whether random drug tests affect substance use among teachers. But several studies have examined the impact of random testing in another school population — students. In the most comprehensive study on the subject to date, a 2003 University of Michigan study involving 894 middle and high schools found that random student drug-testing tends to reduce marijuana use slightly (about 5%) but actually increase the use of other drugs (about 3%). The authors theorize that drug-using kids may think that prescription and other drugs are harder to detect by urinalysis, so they switch from pot to something else. (This assumption is usually incorrect — most drug tests capture everything from heroin to Valium — although certain lesser-used drugs like the anesthetic ketamine aren't detected by the usual tests.)

Even after the University of Michigan authors controlled for socioeconomic differences among students and schools, they found no statistically meaningful difference in drug-use rates among students who attended schools that randomly drug-tested and those who didn't. In short, kids weren't deterred from using drugs even when they knew they might be surprised one day with an order to pee into a cup.

Still, the behavior of high school kids doesn't neatly correspond to that of their teachers — they may well change their behavior in response to random tests. Which leads to a more fundamental question: If we are serious about drug enforcement, why not require every American, or at least every American who comes into contact with children, to be tested randomly? (See pictures of a diverse group of American teens.)

One answer is cost. In the West Virginia drug-testing case, which is currently working its way through the federal court system, Judge Joseph Goodwin of the U.S. District Court noted that it costs about $44 a pop to do urine tests, which would cost the West Virginia school district in question about $37,000 a year. (Here's a PDF of Goodwin's preliminary injunction against drug-testing.) That same $37,000 could easily pay for a full-time teacher, meaning that drug-testing would have to be sufficiently valuable to displace an entire teaching position.

But the evidence suggests that drug use among teachers is not exactly a pressing problem. In 2007, the Department of Health and Human Services published a major study showing that people who work in education rank 18th out of 19 listed professions in the use of illicit drugs. (Those who work in food service, arts, retail and "information" services — like, um, journalists — were among the major offenders.) Only 4% of educators reported use of illegal drugs in the previous month, compared with 14% of construction workers, who work in a much more dangerous environment. The 4% figure for teachers is still too many, but it doesn't indicate an epidemic of intoxicated teachers that would justify a huge expenditure to curb.

What no one argues against — even attorney Michael Simpson of the National Education Association — is that teachers who are behaving erratically should be tested when their bosses suspect drug use. "If an administrator has a reason to believe a person is under the influence, the school should have the right to test," says Simpson. "But our members feel it's demeaning and unprofessional to make a teacher without suspicion go into a bathroom."

The matter won't be resolved without further studies on whether random drug-testing actually reduces drug use, and we may get them under an Administration less ideologically opposed to drug reform than President Bush's. But the data so far suggest that random drug-testing is a costly, ineffective solution to a non-problem.

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