Years ago, a friend of mine, repeatedly frustrated by failing to get her 4-year-old out of diapers, was told by him that he just wasn’t interested and that he “would never go to the potty.” That kid today is a professor at an Ivy League college.

His example may not reassure parents who struggle with what seems like such a straight-forward task: Helping a child to become more independent while saying goodbye to wet, poopy, smelly diapers.

Toilet training is anything but a no-brainer and bookstores and the Internet are full of guides and kits promising to graduate children from wet diapers to washrooms. While these vary in their training methods, they all attempt one thing: To calm a parent’s fear of their child being in diapers until his first date.

Questions about toilet training are among the most common questions asked of pediatricians, says Dr. Darcie Kiddoo, a pediatric urologist from Edmonton who last fall wrote an article on the subject for the Canadian Medical Association Journal.

“Toilet training is felt to be a natural process that occurs with development,” she says, “but very little published science is available for doctors who care for children.”

Toilet training is quite complex, Kiddoo told me. “Most people think of the bladder as a simple storage organ and so they assume toilet training is easy, but it is highly complicated.”

So many different factors play a role in toilet training readiness: There’s the basic physiological development of the bladder, but there’s also a neurological dimension. All these coming together at the right time equals toilet-readiness.

In her research and literature review, Kiddoo found there was no evidence to show that one method worked better than another. But she says that for toilet training to have a chance, both parents and children have to be in sync.

“If you have an interested child but a parent who can’t take him to the bathroom on a regular basis, then it’s not going to succeed. On the other hand, where there’s a motivated family but a child with no interest, toilet training will be tricky.”

Training methods have swung like a pendulum since 1900, alternating between strict control (putting an infant on a toilet after every meal) to punishment-oriented (introducing timeouts or withholding treats) to permissiveness (at age 4, my friend’s son decided he was ready).

Today’s working parents may have an imposed timeline in that some childcare centres don’t accept children in diapers. Whenever you choose to begin the process, the Canadian Pediatric Society recommends a child-oriented approach, says Kiddoo.

“While there is no perfect time, they advise starting when a child is 18 months of age and that the child must be interested in the process.”

Training a very young child (usually by placing them hourly on the toilet, or after they eat) is not widely endorsed today.

“I would rather they focus on the baby’s development, making sure they reach all their milestones,” Kiddoo says. “Having a child is difficult enough. A very young child is not really toilet trained. It is the parents who are.”

Check out toilet readiness and best how-to method at cps.ca.

What works for you?

· Child-oriented, relaxed: Both child and parent are interested and committed

· Parent-oriented, structured: Increased fluid intake, scheduled toileting, positive reinforcement and overcorrection of accidents

· Infant toilet-training: Infant placed on toilet after a meal

· Operant conditioning: Dryness rewarded with affection, toys or candy; accidents are dealt with through punishment or lack of positive attention

Harmful habits

Kids who hold their urine can get infections, says Kiddoo, whose patients are older children who were toilet trained but get infections and have accidents. Generally speaking, these are kids whose parents forgot to follow through after they seemed trained. “I would much prefer parents be more aware of what happens after they toilet train than worrying about a specific age or method for toilet training.”

Did you know: Training basics

Take a child-centred approach for long-standing success. Look for signs your child is ready: Does he have an interest in the toilet, can he stay dry for two hours at a time, is he interested in underwear, can he follow simple instructions, is he interested in doing things himself, can he walk to the toilet.

NEW YORK – Almost half of women who said they’d been struggling to get pregnant for at least a year ended up having a baby despite not getting fertility treatment, in a new study from Australia.

That success rate was only slightly lower than in women who also reported trouble conceiving and opted for treatment with fertility hormones or in vitro fertilization (IVF).

“Many women aged up to 36 years with a history of infertility can achieve spontaneous conception and live birth without using fertility treatment indicating (they) are sub-fertile rather than infertile,” study researcher Danielle Herbert of the University of Queensland School of Population Health in Brisbane told Reuters Health in an email.

That means that if nothing is clearly wrong — men make enough sperm, and women are ovulating regularly — couples who have had trouble conceiving should still be optimistic they can get pregnant on their own, researchers said.

“I’m not surprised that women who were not treated still get pregnant — we know that,” said Dr. Courtney Lynch, head of reproductive epidemiology at The Ohio State University in Columbus, who wasn’t involved in the new research.

“We know we can get women pregnant quicker if we have them go into IVF, but if we give women time, (many of them) can still get pregnant,” she told Reuters Health.

The research is part of a long-term study of more than 7,000 women living in Australia. Starting in 1996, participants filled out health surveys every few years, which included questions on pregnancy and childbirth.

The current data is from about 1,400 women age 28 to 36 who reported on the most recent questionnaires that they’d tried unsuccessfully to get pregnant for at least a year at a time.

Close to 600 of those women said they’d received infertility treatment using IVF or fertility hormones, including Clomid.

Through the latest survey in 2009, 53% of those women said they had a baby following fertility treatment, compared to 44% of women who’d had trouble conceiving but didn’t seek treatment, the researchers reported in the journal Fertility and Sterility.

For women who did have a baby, there was no difference in pregnancy complications — including stillbirths or premature births — between those who did and didn’t get fertility treatment.

AFTER A YEAR, GET CHECKED OUT

Herbert and her colleagues pointed out some limitations of the report, including that they didn’t know if women changed male partners at any point during the study period, which could have affected their chances of becoming pregnant.

And one fertility researcher not involved in the new study said it’s impossible to know whether women who didn’t get treatment lost or gained weight, or changed their diet and lifestyle to improve their chances of becoming pregnant.

Alice Domar, of Boston IVF, said that the number of women who got pregnant without treatment after a year of infertility is higher than previous studies have suggested.

“What a lot of physicians feel is if you’re not pregnant within a year, it usually means there’s something going on,” she told Reuters Health.

Domar said that she’d still recommend a woman who’s been trying to get pregnant for that long get checked out to see if there’s anything preventing her from conceiving. If not, she can keep trying. But if, for example, her tubes are blocked, any extra waiting is “time out the window,” she said.

Lynch said that about 15% of women won’t get pregnant after a year of trying, but only three to five percent of them are truly infertile. The rest will likely conceive on their own after another year or two.

“There are a lot of patients that don’t want to wait another year, especially if you’re an older patient,” Lynch said — and they might want fertility treatment, even if pregnancy without it may be possible.

“But if you’re 28, I think waiting another year makes sense potentially before going on a treatment.”

According to Domar, most women who can’t get pregnant will only need treatment with fertility hormones, which cost about a dollar a day, to get ovulation back to normal. IVF, on the other hand, runs for about $15,000 a cycle, and may or may not be covered by insurance.

‘WOMEN SHOULD STILL BE HOPEFUL’

The findings can be seen as encouraging for some women, Domar said.

“It means if you’ve been trying for a year and you’re young and you have unexplained infertility, according to this data you have a decent chance of spontaneously conceiving,” Domar said.

Dr. Sacha Krieg, an ob-gyn who studies recurrent pregnancy loss at the University of Kansas Medical Center in Kansas City, agreed.

“Women should still be hopeful that they’re going to get pregnant, even if they’ve been trying for an entire year,” she said.

Still, Krieg told Reuters Health, “I wouldn’t want this to (dissuade) women from seeing a fertility specialist and being evaluated.”

Take a daily aspirin, not a daily vitamin. Trade the heels for sensible shoes. Throw away the juicer and buy frozen vegetables. And take complete charge of your health. Doing these and other simple things like moving around more and getting a flu shot will help you to live longer.

Or so says Dr. David Agus, whose new book The End of Illness offers a different twist on the prevention message. It argues that although medicine has failed in the battle against illnesses like cancer, we have at our disposal the tools, tests and know-how to delay our demise – if we challenge long-held wisdoms of what health means. The book is already a bestseller for Agus, who heads the University of Southern California Westside Cancer Center.

While not a cancer book, it’s his view that cancer is “a metaphor for the basket of the world’s illnesses.” Cancer isn’t something that happens outside of you, he writes. You don’t “get” cancer, you “do” cancer.

“It’s self-generated in the sense that it’s our own cells gone awry.” That’s why he uses cancer as a verb, as in “the patient is cancering.”

Medicine has won the war against infectious diseases, he writes, but the germ theory doesn’t apply to today’s chronic diseases. For them we need a new strategy, one that focuses on the body as a complex whole system. Argus, who co-founded two health care technology companies and received the 2009 GQ Magazine Rock Star of Science Award, says that when the body is stressed through drugs, supplements, poor schedules, or excessive exercising, eating and drinking, we interrupt the body’s homeostasis – its inclination to seek balance. When our system is thrown off balance, we’re vulnerable to illness.

Prevention is key, of course, but early diagnosis can also save you. So the knowledge you carry into that doctor’s office is more essential than your doctor’s knowledge, he writes. Know your family medical history and be aware of everything from your loss of hair to the changing colour of your fingernails. Ask for medical records and digitize them so you can have them on hand, stored on a USB stick.

Agus says many patients ask him if they got sick because of a genetic predisposition. He says that while DNA governs possibilities, there is much you can do to shift your fate and live longer than what your DNA seemingly dictates.

As for Agus’s health tips, they’re unconventional, even controversial, and based on the idea that inflammation is the root of all evil. Yet in many ways, they’re reassuringly old-fashioned:

· Be regular – at mealtimes, at bedtimes, when you wake and when you exercise. Straying from your schedule, even on weekends, stresses your body. A regular schedule, he writes, is like a “wonder drug.”

· If you’re over the age of 40, ask your doctor to put you on a statin. These cholesterol-lowering drugs lower bad cholesterol, but maybe more importantly they impede inflammation – the cause of chronic diseases, including cancer – and are credited for reducing heart disease deaths by 60 percent since 1950.

· If you’re over 40, take a daily 81 mg “baby” aspirin. Doing so prevents blood clots which can cause heart attacks and strokes. The blood thinner is also a powerful anti-inflammatory that reduces the incidence of cancer by 20 percent.

· Ditch the supplements – including Vitamin D. Unless you have a diagnosed deficiency or are pregnant, it’s unlikely you need vitamins: Results of studies on them don’t live up to their hype; and they can disrupt the body’s ability to control what it needs. “Just as we cannot explain why some men taking selenium were at a higher risk of developing diabetes, we cannot expound on the complex network of how vitamins affect and alter our systems – for better or worse,” he writes.

· If vegetables aren’t market fresh, buy frozen. Fresh isn’t as fresh as you think, he writes. Food begins to degrade as soon as it falls from the tree or has been picked. Many fresh foods are nutrient-poor whereas freezing fruits and vegetables locks in their nutrients.

· Have a flu shot: The flu gives you more than aches and pains: It causes “an inflammatory storm” that can damage your body’s defences even 10 years hence.

· Move around more. Sitting all day is as bad as smoking! But when you move around, wear the right shoes as ill-fitting shoes cause chronic inflammation which can increase the risk of everything from Alzheimer’s disease to cancer.

Be your own doctor first

The End of Illness is, in part, about being your own personal health advocate. Go to your doctor primed with answers to Dr. David Agus’s personal health inventory questionnaire which includes questions on how you feel, how you walk, the colour of your nails, the triggers for headaches or pains, your sleep profile, your routine wellness check-ups and a list of OTC and prescription meds.

Did you know?

The body seeks simplicity.

Let the body find its own balance or homeostasis by being mindful of the body’s inputs and its preferred rhythms.

Whatever you think of the controversial new film The Iron Lady, it’s bound to raise awareness of a disease that threatens us all. In the film, award-winning actress Meryl Streep plays Britain’s former Prime Minister Margaret Thatcher, who currently struggles with dementia.

Critics of the film say that it was wrong to show Thatcher at her worst. But educator Mary Schulz can see the film’s value.

“If we are able, from books or movies, to help the public understand that people with dementia are people like you and me who can live meaningful lives and contribute then we would be very pleased.”

Schulz, education director of the Alzheimer Society of Canada, says the fact that the chronic, progressive brain disorder will affect 1.1 million Canadians in the next 25 years is partly what led to the Alzheimer Society launching Let’s Face it! (alzheimerletsfaceit.ca). The new campaign helps Canadians learn about dementia’s warning signs and offers a download of a doctor’s visit preparation checklist.

The movie and campaign raise the question of whether dementia is the same as Alzheimer’s. I asked Dr. Bill Dalziel, a physician who has treated countless people with dementia, for clarification.

“Alzheimer’s is the most common type of dementia,” says the founder and chief of the Regional Geriatric Program of Eastern Ontario at Ottawa Hospital. “Dementia is a large umbrella term that boils down to when someone is cognitively changed compared to themselves a year ago and when those changes have caused functional impairment compared to a year ago.”

Alzheimer’s is the most common cause of dementia, but dementia is also caused by small or large strokes, he says.

Today, baby boomers’ parents are being hit with a double whammy of Alzheimer’s and strokes, adds Dalziel. “The most common cause of dementia over the age of 80 is a combination of both Alzheimer’s and little strokes. So we are now into an epidemic of dementia.” Other causes of dementia include Parkinson’s disease and Lewy body disease (the latter caused by abnormal deposits of protein).

In the public’s eye, awareness of dementia is where stroke was 20 years ago: A recent survey by the Alzheimer Society of Canada showed that close to 50 percent of Canadians lived a year or more with their symptoms before seeing a family doctor. The most common reason for the delay was the belief that symptoms were part of “old age” and would eventually go away.

But symptoms of dementia are not part of growing old.

“No one, except for a very few, has a perfect memory,” says Dalziel. “We all forget stuff, but they are sort of trivial non-important things.” Signs of deteriorating dementia include a progressive loss of memory and other mental abilities such as word-finding difficulty, forgetting names and appointments, trouble performing familiar tasks, and personality changes.

The difference between dementia and Alzheimer’s may be viewed like the difference between chest pain and a heart attack, explains Dalziel. Just as a heart attack is a cause of chest pain, so is Alzheimer’s one cause of dementia.

Early diagnosis and treatment can slow dementia and keep people out of nursing homes. Dalziel suggests a screening program for people of high risk (say, those with diabetes or hypertension) may be of benefit.

“We are currently diagnosing only 50 percent of people with dementia, and of those we are treating only half.”

Stigma plagues dementia

Denial and fear of dementia abound, says Mary Schulz, adding that progression of the disease can continue over a decade during which people, if properly diagnosed and treated, can live well. “Nobody wants to have this illness, but in essence they are the same people they have always been.”

Where are my keys?

Forgetting where you put your things is common to all of us, says Mary Schulz. “But forgetting how to cook a meal or balance a chequebook – these are not momentary lapses.” For personal stories, visit alzheimer.ca.

10 warning signs

1. Memory loss that affects day-to-day function

2. Difficulty performing familiar tasks

3. Problems with language

4. Disorientation of time and place

5. Poor or decreased judgment

6. Problems with abstract thinking

7. Misplacing things in inappropriate places

8. Changes in mood and behavior

9. Changes in personality

10. Loss of initiative

Did You Know: What is Alzheimer’s?

Alzheimer’s (which can only be diagnosed upon autopsy) is the result of neurodegenerative changes in the brain, says Dr. Bill Dalziel. Its amyloid plaques and tangles destroy brain connections and produce memory, function and behavioral changes. It is one cause of dementia.

Babies who are breastfed cry more than those who are formula-fed, a new study has found, but mother’s milk is still the healthiest option.

The Medical Research Council in Cambridge, U.K., studied 316 three-month-old infants, some breast-fed and others formula-fed. Mothers of the breastfeeding babies reported their children cry more and are more difficult to soothe.

“There is an overwhelming body of evidence supporting breastfeeding as the normal and most healthy form of infant nutrition and our findings do not contradict this. Bottle-fed babies may appear more content, but research suggests that these infants may be over-nourished and gain weight too quickly,” lead researcher Dr. Ken Ong said.

One theory is that babies prefer formula to breast milk in the same way many people prefer burgers to salad, even though the latter is much better for you.

“Our findings are essentially similar to other stages of life; people often find that eating is comforting,” Ong said.

Forget PJs, lingerie or sleeping in the buff.

Chady Dunmore admits that some nights she goes to bed in her workout clothes.

“So in the morning, there’s no excuse (not to exercise),” she says with a laugh in a phone interview from her home in Sacramento, Calif.

It’s just one example of how the busy 32-year-old fitness model and married mother of a 5-year-old girl commits to keeping fit.

Dunmore also typically treats her workouts — no matter what time she fits them into her hectic schedule — as appointments.

If she plans to work out at 3 p.m. one day, she’ll simply tell people she has an “appointment” at that time and nobody questions it.

“But I don’t say I have to work out at 3 because people are like, ‘Oh,’ and you feel bad and you’re like, ‘OK, I’ll just change it and we’ll have a coffee date,’” explains the two-time WBFF (World Bodybuilding and Fitness Federation) world bikini champ.

“The secret to my success is really setting your mind to it and committing. It’s like anything in life, if you don’t really want to do it, there’s no way it’s going to happen. You have to really, really want it.”

That level of commitment extends to Dunmore’s kitchen, where she prepares most meals ahead of time “so I’m eating really clean and I don’t have the urge to grab something that I shouldn’t.”

However, Dunmore, who weighs an uber-fit 135 pounds (and usually about 128 onstage) at 5-foot-8, hasn’t always been so committed to being buff.

During her pregnancy with her daughter, Dunmore ballooned to more than 200 pounds.

It was a high-risk pregnancy because Dunmore has a congenital kidney disease known as medullary sponge kidney. In layman’s terms, her kidneys don’t quite function the way they should and that can make her extremely sick.

It’s a disorder the New York native, who grew up in Miami, keeps in check by staying active and eating healthily.

But when doctors suggested that Dunmore’s baby was at risk for low birth weight, she began to eat like never before.

And when she gave birth in June 2006 to a healthy baby girl named Sofia, Dunmore found herself overweight for the first time in her life at 207 pounds.

With 70 extra pounds to lose, post-partum depression soon followed.

“My face got really round. And I had cankles,” she recalls. “I was so grossed out with myself.”

But Dunmore didn’t sit around and mope for long.

With a commitment to lose all her excess weight, the new mom cleaned up her diet and started exercising up to six days a week.

“I had a friend of mine who was a trainer who would come over to my house because I was so embarrassed to leave the house,” she says.

Within six months, Dunmore dropped 60 pounds.

But she wasn’t done yet.

She mustered up the courage to hit the gym and began sculpting her body with weights.

She loved the gym. And the gym loved her back.

Dunmore’s transformation was so amazing that friends eventually convinced her to step onstage in the bikini category of a 2008 fitness contest.

She climbed the competition ranks and earned the first of her two WBFF world bikini titles in 2010.

These days, Dunmore still pumps iron up to six days a week and takes a few weekly group fitness classes — usually spinning, Zumba or kickboxing.

And while she continues to follow a stringent eating regimen, she allows herself two “cheat meals” a week, including a weekly trip to IHOP for pancakes.

Meanwhile, her kidney disorder has never been more under control.

“I’ve been the best I’ve ever been. I take really good care of myself,” she says, noting it all comes down to commitment.

“If you want something that bad, you just make it happen.”

A 31-year-old Spanish woman is the first to become pregnant after having both ovaries removed, then receiving an ovarian tissue transplant.

The woman is currently eight to nine weeks pregnant, doctors reported in the British Medical Journal on Thursday.

The woman, from Barcelona, had both ovaries removed in 2001 because of tumours, Dr. Justo Callego of the Hospital Saint Joan de Deu said in the article. Part of one of her ovaries that was still considered viable was kept and frozen.

In July 2011, the woman told doctors she would like to have a baby, and so a graft of ovarian tissue was transplanted near her uterus.

Three months later, the woman had her first period in 10 years. Doctors then stimulated the patient’s ovarian tissue, which produced two mature eggs.

Those eggs were removed and doctors performed in vitro fertilization, where the eggs are fertilized in a lab setting, then transferred to a woman’s uterus.

“This is the first time in which (this procedure) is performed without (the patient) having any traces of ovarian tissue,” Callego wrote in the article.

The woman is due to give birth in July, Callego said.

Researchers in South Korea have developed a blood test that can determine a baby’s gender within the first trimester.

Parents usually have to wait until the second trimester for an ultrasound to tell them their baby’s sex because genitals are not fully formed before then. Other tests, such as chorionic villus sampling and amniocentesis, have a small risk of miscarriage, and also cannot be done until the eleventh week of pregnancy.

Dr. Hyun Mee Ryu of the KwanDong University School of Medicine in Seoul has discovered various ratios of two enzymes — DYS14 and GAPDH — which are found in the mother’s blood, can indicate if the baby will be a boy or a girl.

The study was published in the January edition of the Federation of the American Societies for Experimental Biology Journal.

The editor of the journal, Gerald Weissmann, said more work needs to be done, but the study is promising.

“This paper does show it is possible to predict the sex of a child as early as the first few weeks after conception,” Weissmann said. “At present, parents are sometimes given the wrong information about the sex of their unborn child; this test should prove helpful in resolving any uncertainties of today’s ultrasound observations.”

A new study suggests 56 interventions doctors can do to prevent the death of women during pregnancy and childbirth.

The three-year study reviewed 50,000 medical papers on the effectiveness of interventions and the impact on the survival of both women and children.

The World Health Organization (WHO), Aga Khan University, and The Partnership for Maternal, Newborn & Child Health (PMNCH) released the study Thursday.

“A lot is not brand new,” an author of the study, Dr. Elizabeth Mason, said in a release.

“It has been more a question of putting together information in a different way and building consensus among physicians, scientists and professional organizations to lay out an evidenced-based path to help women before, during and after birth and their children. Everyone now agrees on the 56 essential interventions.”

Some of the interventions include managing a woman’s anemia with iron, immediate thermal care for newborns, and extra support for feeding small and preterm babies.

The report noted 358,000 women die in pregnancy and childbirth globally each year, and 7.6 million children die before the age of five. It’s a particular problem in developing nations. In Sub-Saharan Africa and South Asia, most maternal deaths occur during or immediately after childbirth due to bleeding, high blood pressure, prolonged or obstructed labour, and infections.

Just in time for the holiday season: Canada’s National Alcohol Strategy Advisory Committee has released new recommendations to help guide you in how much to consume ­– very much encouraging moderation. Recognizing that drinking is a personal choice, they suggest that if you do choose to drink, these guidelines can help you decide when, where, why and how much.

To reduce long-term health risks, they recommend no more than two drinks a day, five times a week or 10 drinks total a week for women and no more than three drinks a day, five times a week or 15 drinks total a week for men.

In the new guidelines, one drink means:

341 ml (12 oz.) bottle of 5% alcohol beer, cider or cooler.

142 ml (5 oz.) glass of 12% alcohol wine.

43 ml (1.5 oz.) serving of 40% distilled alcohol (rye, gin, rum, etc.)

They also recommend planning non-drinking days each week.

To reduce the risk of injury and harm, the group advise drinking no more than three drinks for women and four drinks for men on any single occasion.

If you are pregnant, planning to become pregnant, or before breastfeeding, the safest choice is to drink no alcohol at all, according to the document.

Now, we know there is some evidence that connects alcohol and good health. There have been studies showing that a drink a day could be helpful in lowering the risk of heart disease, stroke and even type 2 diabetes. However, while a drink a day can, in some instances and for some people, be beneficial this is definitely not a case of more being better. There are also many studies showing that alcohol can increase risk of certain cancers such as esophagus, throat, breast and colon as well as liver disease and other serious health issues.

The report also recommends that you drink slowly ( no more than 2 drinks in any 3 hours), that you eat before and while drinking and for every drink of alcohol, to have one non-alcoholic drink.

Now, I don’t want to be a complete scrooge and make you feel guilty about having holiday drinks, but, there are a few considerations to also think about when it comes to alcohol and the festive season.

Alcoholic drinks contain calories, plain and simple: One typical drink can have 100 to 200 calories. A 1.5 oz. (43 ml) serving of rye, gin. scotch etc has about 90 calories, a 5 oz. (142 ml) glass of wine has about 120 calories and a 12 oz. (341 ml) bottle of beer has about 150 calories.

Besides the alcohol, there are the mixers. Soda water for example has no calories but a typical can of tonic water has about 150 calories. Regular soft drinks are about 150 calories per can and diet pop has less than 10. A cup of juice also has about 100 calories. This time of year, eggnog is a popular drink. A cup of fancy eggnog can be 200 – 300 calories but now you can buy calorie reduced ones that will cut those calories by about half. Drinks that contain Irish cream, Kahlua or other cream-based liqueurs are higher as well – a 1.5 ounce serving having about 175 calories.

Besides the calories, having a few drinks can easily soften your resolve, making it easier to dive into that plate of nachos or chicken wings.

Check the sizes of your wine or drink glasses. If they are oversize goblets or tall 16-ounce glasses, you probably will drink more. Sip slowly and make whatever you’re drinking last longer.

As the guidelines suggest, alternate alcoholic drink with a non-alcoholic drink. Sip a glass of club soda with lemon, lime or a dash of juice or a “virgin” Caesar.