In 2002, WHO, the World Health Organization, initiated a global strategy on diet, physical activity and health. One of their first projects was to enlist the aid of doctors and medical researchers around the globe to assess the general health of world populations relative to local diets and levels of activity.

I became informed about WHO in 2004 during a class for caregivers at the Seattle Cancer Center where my oldest son was preparing for a stem cell transplant. The WHO report was not yet available to the general public but the entire cancer center seemed to be buzzing with this first ever evidence that our growing cancer epidemic might be stemmed just by eating better.

Among their findings: An unhealthy diet and physical inactivity

• are second to tobacco use as risks factors for chronic illnesses like heart disease, stroke and type 2 diabetes.
• stand third in line behind tobacco, environmental pollutants as risk for cancer.

I am a family caregiver. I have a healthy interest in maintaining good diet and improving my physical condition spurred more by the trauma and disease I have witnessed than by the ads and pithy web sites that abound. I have an unhealthy lifestyle borne more from necessity than from a lack of desire to change it. It seems impossible to make sweeping changes for my own betterment without making changes to the detriment of others I care for deeply.

As a family care giver, I can generally expect to be visiting any of several doctors a dozen times a month, a hospital, imaging center or lab service a dozen times a year, not to mention all those innumerable trips running errands. In order to manage all these activities and remain gainfully employed, I work nights. I work weekends. I work holidays. I get exposed to everything. I suffer from a chronic case of generally creeping crud. I sleep six hours or less on most days. Two hours in the morning after work and four hours in the evening before work.

Unlike nine to fivers, the end of my work day is usually not the end of my day, but the beginning of it. Most of the meals I eat are of the grab and go variety and not meals at all. The "real" meals that I eat are usually prepared and eaten just before bedtime. At least half my daily calories come from grains, mostly bread, that I eat between 8 and 10 am. Don't ask me why, but I crave bread in the morning and whatever my intentions, any other food I eat during that time of day, inevitably become calories in addition to instead of substitutions.

To make matters worse, my 76 year old mother lives with me. Smoking and daily baking are the two biggest cornerstones of her retirement.

My biggest problem is inactivity. My job keeps me chained to my desk. During the day, I'm on the go but all that going is filled with hours of driving, waiting and plodding along behind old ladies and their walkers, activities which hardly count as exercise. Last year, I made a conscientious decision to forego my regular television viewing to watch FIT TV in the hopes it would inspire me to exercise regularly. Key word here is "watch".

Like eating, I watch TV before going to bed, when I'm already tuckered out and I'm. . .uhmmm. . .eating.

Face it, I kissed my tight buns goodbye the day they ran off with my flat abs and I haven't seen anything in the mirror that resembles the athletic, 112 pound girl my husband married in almost three decades. I don't have that much time for mirror browsing anyway but when I do, I see prime real estate for future suffering.

In lieu of making sweeping changes that I would never be able to stick to, after that four month stint in Seattle and a constant exposure to the benefits of good nutrition, I decided to use my new years resolutions to make small changes that would hopefully have long term benefits.

That year, I started by taking supplements and vitamins. Well, I'd been taking some already, sort of, but I vowed to be more regular about it.

The next year was a bust. My son's cancer worsened. My mother-in-laws conditioned worsened. My brother-in-law who has Wegener's actually went into remission but he developed other problems. My own mother was in the hospital with pneumonia three times. My husband was diagnosed with type 2 diabetes. Hey, I was busy. And more than a little depressed.

Two years ago, with the advent of Splenda, I swore off added sugars. I was never one to add a lot of sugar to anything anyway. Chocolate. . .chocolate I can add to anything. Chocolate already comes laden with sugar, so my efforts, although sustainable, didn't have as much effect as I hoped for. I redoubled my efforts by switching to dark chocolate and using cocoa. Then I found an ice cream fudge bar with only thirty five calories per bar which as lowered my dependence of other chocolate sources, remarkably.

Last year, besides tuning to FIT TV, I decided that since my diet included so much bread, I could at least eat healthier breads. I now eat only lower calorie, multi grain breads. I can't say it made that much noticeable difference but I continue to take its benefit on faith.

This year, in having gained a new high on my scale, I swore off bread, altogether. And I made a discovery about myself, and I won't say it applies to anyone else. Bread bogs me down.

Without bread, I didn't sleep for three days. No kidding. I was so consumed with nervous energy, I was driving myself crazy along with everyone else. Then I finally broke down and made a sandwich. I had to use up the loaf, anyway. I slept like a baby for fourteen hours.

Bread is comfort food. When I'm in pain or sick or the weather grows unseasonably cold. . .cakes, cookies and donuts, I can do without. Non chocolate candy, I can ignore. Chips have never been on my diet anyway. But bread. . .bread just does it for me. I don't know what the bio-chemistry of the effect is. I don't know if it's physiological or conditioned. Bread instills within me those warm, fuzzy feelings that I associate with contentment and relaxation. Bread is good! So says my brain. Bread is bad! So says my big fat butt.

Life without bread has been a struggle. I have had to make some concessions. I haven't given up grains, altogether but I limit my cereals to meager portions. I try to stay away from sugar coated brands and I concentrate on premeasured packages of weight control oatmeal and grits. Grits, according to the label is a good source of iron and non dairy calcium. Who would guess? And I need that, because of my age and because without bread, I don't drink as much milk or eat as much cheese.

I'm not entirely breadless. I let myself eat sandwiches about three times a week.

The end result: In two months, I've lost fifteen pounds. And with diligence, I might not gain it all back in the next five or six days. Don't laugh! I have done it before.

If you need a laugh. Look through my picture window around seven thirty in the morning. Oh, please don't look. It's not a pretty sight. You might actually see me toe tapping and flapping my arms in front of my TV, somewhat like a disgraced albatross with indigestion, not so much as to actually be cardio, and not so consistently as to actually be a work out, but it burns off some of that nervous energy and helps me sleep.