Other articles by Andrew Weil:

Ask Dr. Weil : Growing method doesn't determine nutrition value Ask Dr. Weil : Monitor toxins that body burden tests measure Ask Dr. Weil : Nasal-spray flu vaccine is safe for kids over 2 Supersweet, natural stevia appears to be safe Olive oil adulteration is a tough problem to solve Registered dietitians and certified nutritionists No reason to buy supplemental bovine colostrum No clear evidence on cell phone's long-term risks Soy eaten in whole, unrefined forms is preferable Chemical used for sterilizing almonds a concern

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Q. I've just read that obese men with heart disease do better overall than men of normal weight. If so, what's the point of all this emphasis on weight control?

A. I understand your frustration and puzzlement. In fact, results of a study published in the June 2007 issue of the American Journal of Medicine do suggest that obese men with heart disease symptoms tend to live longer than men whose weight is normal.

For more than seven years, California researchers followed 6,876 men who went to Veterans Administration hospitals for stress tests because they had symptoms consistent with heart disease. Initially, the men's heart disease risks were assessed via exercise stress tests, their blood pressure was checked, and they had blood tests to determine if they had diabetes. Over the years, the researchers found that obese men were 35 percent less likely to die than normal-weight men.

This isn't the first study to yield such perplexing results. Obesity also has been linked to longer survival among patients with congestive heart failure, and there's evidence that obese patients do better after heart bypass surgery. In addition, a study published in the June 20, 2007, issue of the European Heart Journal found that obese patients treated for one type of heart attack (with minimal damage to the heart muscle) were less than half as likely to die in the following three years as those with a normal body mass index who had the same procedure.

For this study, researchers in Germany and Switzerland followed nearly 1,700 patients who had been admitted to hospitals between 1996 and 1999 with a narrowing of the arteries upon minimal physical exertion. The researchers reported that adjustments made when analyzing their data ruled out the possibilities that the survival effect could be a result of the obese patients' being younger or more likely to be on drugs to lower cholesterol and blood pressure.

Some evidence suggests that doctors may treat obese patients more aggressively, thus accounting for the so-called "obesity paradox," but clearly, we need more research to see what's going on here. In the meantime, if you're trying to lose weight to improve your heart health, I would encourage you to keep at it. Mystifying as the results of these studies are, keeping your weight under control with healthy eating and exercise is still the key to avoiding a heart attack in the first place.

Q. I am so confused about echinacea. I know you recommend it for colds, but in the past I've read that it really doesn't help. Now a new study says it does work. What do you make of the contradictory findings?

A. Echinacea is a traditional herbal remedy prepared from the root and leaves of the purple coneflower, Echinacea purpurea, and related species. It stimulates the immune system and is used traditionally to prevent and treat common colds and other minor infections.

The latest word on echinacea, from a review of 14 earlier studies, concluded that the herbal remedy reduces the risk of catching a cold by 58 percent and shortens the duration of colds by 1.4 days. Researchers at the University of Connecticut and Hartford Hospital found that adults who took echinacea contracted only one to two colds per year instead of the usual two to four. Among those who took echinacea after catching cold, symptoms lasted four to six days instead of the more common five to seven days. The investigators also reported, however, that echinacea was less effective against rhinoviruses (the most common type of cold virus) than it was against other cold viruses.

Most of the research on echinacea has been done in Germany and has confirmed the herb's antiviral, antibacterial and immunity-enhancing properties. However, until the publication of the Connecticut study, much of the U.S. research yielded mixed results, especially on its use as a preventive measure. The last well-publicized study, from the University of Virginia School of Medicine, found that echinacea neither prevented colds nor decreased symptoms.

Although this was a well-designed study, the doses used may have been too low to have a beneficial effect. Other problems with past research have been failure to control for the species of echinacea used (purpurea vs. angustifolia), the part(s) of the plant used (whole plant vs. root or leaves), the method of extraction, and the method of delivery (capsules, tinctures, extracts, etc.).

I doubt that either the Virginia or Connecticut findings will be the last word on the subject. We need more well-designed studies testing different species of echinacea, different doses and different preparations to determine how effective this traditional remedy really is.

In the meantime, echinacea is a worthwhile first line of treatment for the common cold, sore throats and episodes of low resistance. The recommended adult dose is two capsules of freeze-dried extract, or one teaspoon of the tincture in a little warm water four times a day. Half this dose is enough when you're taking echinacea to enhance immunity in the absence of infection.