5 Ways to Boost Your Metabolism and Lose Weight

Magnesium, interval training, and other tricks to burn more calories
by Ross Weale

Health magazine contributor Samantha Heller shows how to burn more calories, during an interview on the Today show, March 10.



SAMANTHA HELLER

Samantha Heller, RD, is the nutrition coordinator at the Fairfield Connecticut YMCA. A certified dietitian/nutritionist and exercise physiologist, Heller earned her master's degree in nutrition and applied physiology from Teachers’ College, Columbia University. She served as the senior clinical nutritionist and exercise physiologist at NYU Medical center in New York City for almost a decade and created and ran the outpatient nutrition program for the NYU Cardiac Rehabilitation Program. She has also been a fitness instructor for 15 years. Heller specializes in nutrition, wellness, stress management, and fitness for people who are fighting heart disease, diabetes, cancer, and obesity.

A contributing editor to Health magazine, her writing has also appeared in numerous other magazines, including Men’s Fitness, Men’s Health, and Glamour, as well as sites such as Fitness.com.

Born to Be Obese?

(HealthDay News) -- The brain circuitry that controls appetite might be wired differently in some people, and that could predispose them to obesity, California researchers suggest.

The study was conducted in rats, not humans, and yet it could ultimately lead to novel obesity treatments, said Philip Smith, director of the Office of Obesity Research at the National Institute of Diabetes and Digestive and Kidney Diseases.

"It is not just about drugs that modify short-term appetite," he said, "there may be drugs that stimulate development of the appropriate neural pathways. So, it is an exciting, but very early, time in this field."

The study was published in the February issue of Cell Metabolism.

Sebastien Bouret, an assistant professor of neuroscience at the University of Southern California, and his colleagues examined neural circuits emanating from the appetite, hunger and body-weight control center of the brain -- the so-called arcuate nucleus of the hypothalamus (ARH) -- in a series of rats bred to be either prone to, or resistant to, obesity.

The team found fewer neural connections projecting from the ARH in obesity-prone animals than in their leaner counterparts. Surprisingly, Bouret said, this deficiency developed very early in life, before the animals became obese, and appeared to extend into adulthood.

"Somehow, these animals are programmed to become obese," Bouret said. "The obesity is hard-wired into the brain."

When the researchers then looked at why the brains of obese rats differed from their normal-weight counterparts, they found that the neurons from obesity-prone animals were less responsive to leptin, a hormone that controls the development of these circuits, and which also signals the body's energy status and controls metabolic rate.

"This paper presumes to say, these animals must be leptin-resistant, and that is why the pathways are not developing," said Smith.

But that doesn't mean they are doomed to a life of severe obesity, said Dr. Barbara Kahn, chief of the Division of Endocrinology, Diabetes and Metabolism at Beth Israel Deaconess Medical Center, in Boston. How they live their lives also matters.

"It is important not to 'blame' the obese person or imply that he/she is responsible for being obese," Kahn noted. "Having said that, reasonable, healthy caloric restriction and a safe and sustainable program of physical activity can help limit weight gain and often bring about some degree of weight loss. In addition, healthy eating and regular exercise can reduce the complications of obesity such as type 2 diabetes and cardiovascular disease."

At the same time, she added, not everyone can wear a size 4.

"There is a certain aspect of genetics that sets somebody in a certain range of possible body weights, and then how that person lives his or her life will determine whether they are at the bottom or top of the range," she explained.

Human obesity has both genetic and environmental roots. The rats used in this study, like most humans, developed obesity when fed a high-energy diet. On a normal diet, they were heavier than normal rats, but not yet obese.

"This is quite an exciting paper," said Smith, "because it links more closely to human behavior than most rodent models we have seen."

The findings also suggest a possible therapeutic approach to combating human obesity. If drugs could be designed to influence the formation of neural circuits during development and targeted to at-risk pregnancies, Smith said, "there is a good likelihood we could have successful interventions that improve the health of the mother, and which have a major impact on disease risk for the infant, during pregnancy."

A related study from Boston University researchers in the same journal found that bulking up muscle mass can lead to a general metabolic improvement in obese individuals. "Interventions designed to increase skeletal muscle mass in at-risk human populations may prove to be critical weapons in the fight against obesity and obesity-related comorbidities, including diabetes, heart disease, stroke, hypertension and cancer," an accompanying editorial stated.

More information
For more on obesity, visit the National Institute of Diabetes and Digestive and Kidney Diseases.

Realistic Expectations Help Ward Off Holiday Depression

(HealthDay News) -- For many people, heightened expectations, financial and social stress, and memories of lost loved ones can cause tension, anxiety and sadness.

All of that can lead to seasonal blues during the holidays, says an expert at Cedars-Sinai Medical Center.

For example, people who expect difficult relationships to improve just because it's Christmas are likely to be disappointed.

"In terms of relationships, nothing magical 'just happens' during the holidays," Dr. Mark H. Rapaport, chair of the department of psychiatry and behavioral neurosciences at Cedars-Sinai, said in a prepared statement.

"If you don't get along with your in-laws during the year, you're probably not going to get along with them during the holiday season, either. Understanding that before you go to visit them can improve how you'll handle your feelings while you're there," he said.

Planning ahead can help people cope with many sources of holiday-related stress and anxiety.
"If you plan ahead and focus on what you really enjoy about the season, you can spend more time 'living in the moment,' which is the key to getting the most out of each holiday experience," Rapaport said.

He offered some tips for coping with the holidays:

• Have realistic expectations about interactions with family and friends.
• Make a list and prioritize activities that you feel are most important.
• Limit your drinking. Too much alcohol can lead to bad behavior, hangovers, and remorse which, in turn, can lead to depression.
• Share holiday responsibilities such as shopping, cooking, party planning, and activities.
• Get regular exercise. Walking for just 30 minutes three times a week can give you a big boost.
• Keep your holiday spending under control.
• Eat well, get enough rest, and make time for yourself.
• Spend time with caring and supportive people and reach out to those who may benefit from your support.
• Don't worry too much about details. Live in the moment as much as possible and look for meaningful moments throughout the season.

More information
Mental Health America has more about holiday depression and stress.

more discussion: Forum
· Addiction Forum · Ask the Doctors Forum · Ayurveda Forum · Ayurvedic & Thai Herbs Forum · Colon Cleansing Forum · Dental Forum · Diabetes Forum · Diet Forum · General Cleansing Forum · Hepatitis A, B. C Forum · Integrated Medicine Forum · Live Blood Analysis Forum · Ozone-Oxygen-Forum · pH - Alkaline - Acidity Forum · Weight Loss Forum

Health Tip: What's Plantar Fasciitis?

(HealthDay News) - Plantar fasciitis is a common condition -- caused by overuse -- and characterized by often severe pain in the heel.

The American Academy of Orthopaedic Surgeons offers additional information about the condition, including its risk factors:

• Women and people who are overweight are more likely than others to develop plantar fasciitis.
• Frequent running or walking for exercise may increase your risk of developing the condition.
• People with flat feet or very high arches are at greater risk.
• Standing or walking on hard surfaces for long periods also may increase your risk.
• The injury usually doesn't hurt during exercise, but pain begins to develop afterward.
• Pain may be most severe when waking up in the morning, or after rest.
• Plantar fasciitis requires treatment to prevent it from becoming chronic.

more discussion: Forum
· Addiction Forum · Ask the Doctors Forum · Ayurveda Forum · Ayurvedic & Thai Herbs Forum · Colon Cleansing Forum · Dental Forum · Diabetes Forum · Diet Forum · General Cleansing Forum · Hepatitis A, B. C Forum · Integrated Medicine Forum · Live Blood Analysis Forum · Ozone-Oxygen-Forum · pH - Alkaline - Acidity Forum · Weight Loss Forum

Health Tip: Female Infertility

(HealthDay News) - About 7.3 million females in the United States aged 15 to 44 had difficulty becoming pregnant or carrying a baby to term in 2002, according to the U.S. Centers for Disease Control and Prevention.




The U.S. Department of Health and Human Services lists these factors that may contribute to female infertility:

• Age.
• Stress.
• Unhealthy diet.
• Being overweight or obese, or significantly underweight.
• Strenuous exercise.
• Smoking or drinking alcohol.
• Sexually transmitted disease.
• Health conditions that affect hormone production.

more discussion: Forum
· Addiction Forum · Ask the Doctors Forum · Ayurveda Forum · Ayurvedic & Thai Herbs Forum · Colon Cleansing Forum · Dental Forum · Diabetes Forum · Diet Forum · General Cleansing Forum · Hepatitis A, B. C Forum · Integrated Medicine Forum · Live Blood Analysis Forum · Ozone-Oxygen-Forum · pH - Alkaline - Acidity Forum · Weight Loss Forum

Oxy-Powder® Complete Cleansing System $147.75 [ learn more ] Complete Cleansing System with Livatrex™, Oxy-Powder®, Latero-Flora™, and two bottles of ParaTrex®.

Teen Boys at Growing Risk for Eating Disorders

(HealthDay News) -- Eating disorders rose significantly among American boys between 1995 and 2005, according to a study that examined weight control behaviors among high school students.

The study, based on an analysis of national data from the U.S. Centers for Disease Control and Prevention Youth Risk Behavior Surveillance System, identified a large increase in all forms of weight control behaviors among males, including dieting, diet product use, purging, exercise and vigorous exercise.

Hispanic males were most likely to practice weight control, while white males were least likely, said the study authors, led by Y. May Chao of Wesleyan University in Middletown, Conn.

They also found a significant overall increase in dieting and diet product use among female adolescents. White females were most likely practice weight control while black females were least likely, the researchers said.

The increased weight control behavior noted in males suggests growing social pressure for males to achieve unrealistic body expectations, thus increasing the risk of body dissatisfaction and eating disorders, the study authors said.

"Considering that males have negative attitudes toward treatment-seeking and are less likely than females to seek treatment, efforts should be made to increase awareness of eating disorder symptomatology in male adolescents, and future prevention efforts should target male as well as female adolescents," the researchers wrote.

The study was published online in the International Journal of Eating Disorders.

More information
The Nemours Foundation has more about teen body image and self-esteem.

Health Tip: Risk Factors for Type 2 Diabetes

(HealthDay News) - Type 2 diabetes is a disease in which the body doesn't properly process the hormone insulin, which regulates blood sugar. This form of diabetes is controlled with medication, proper diet and exercise, and maintaining a healthy body weight, and normal blood pressure and cholesterol levels.

The National Diabetes Information Clearinghouse lists common risk factors for type 2 diabetes:

• Being overweight.
• Being over age 45.
• Having a family history of type 2 diabetes.
• Giving birth to a large baby (more than 9 pounds).
• Having high blood pressure or high cholesterol.
• Having a history of heart disease.
• Maintaining a sedentary lifestyle and getting little or no exercise.

Oxy-Powder® Complete Cleansing System $147.75 [ learn more ] Complete Cleansing System with Livatrex™, Oxy-Powder®, Latero-Flora™, and two bottles of ParaTrex®.

Preseason Warm-Ups Cut Soccer Groin Injuries

(HealthDay News) -- A special 20-minute warm up done two to three times a week during preseason can cut soccer players' groin injuries by nearly a third, researchers report.

Groin injuries, which include injuries ranging from minor strains to hernias that need surgery, make up five percent of all sports injuries.

"Our 28 percent injury reduction rate is highly significant," principal investigator Dr. Michael B. Gerhardt, director of the Center for Athletic Hip and Groin Disorders in Santa Monica, Calif., said in a prepared statement.

Gerhardt is also team physician for US Soccer and Chivas USA, a major league soccer team. "We were anticipating a five to 10 percent reduction rate, so we were pleasantly surprised that the injury reduction number was so high," he said.

The exercises included warm-up, dynamic stretching and strengthening moves. The researchers enrolled 315 major league soccer players in the prevention program.

Athletes in the program had a groin injury incidence of 0.44 injuries per 1,000 hours, compared to 0.61 injuries per 1,000 hours among players who did not participate in the preseason prevention program.

"While we were able to prevent the total number of groin injuries, we were unable to significantly reduce the number of surgeries," Gerhardt noted. "Once an injury reaches the chronic stage, it is hard to manage with any treatment regimen, including ours. These players typically go on to require surgery."

Groin injury is a leading cause of lost playing time among professional athletes. Gerhardt and his study team argue that a simple, cost-effective preseason training program could benefit teams worldwide.

The data was expected to be presented Thursday at the 2007 Annual Meeting of the American Orthopaedic Society for Sports Medicine, in Calgary, Alberta, Canada.

More information
For information about groin injuries, visit the American Academy of Family Physicians.

Simple Workout Urged for Pregnant Women on Bed Rest

(HealthDay News) -- Pregnant women restricted to bed rest can and should do safe, specially-designed physical activity, say experts at the American Physical Therapy Association (APTA).
Each year in the United States, an estimated 700,000 women with high-risk pregnancies (including nearly all those carrying triplets or more) are put on bed rest, the APTA said. But, in many cases, the incapacitating effects of total bed rest are not being addressed, leaving some expectant mothers ill-prepared for pre- and post-partum physical and psychological challenges.

"As a result of prolonged bed rest, pregnant women experience an array of symptoms ranging from cardiovascular deconditioning, musculoskeletal discomforts, stressful postures and positions, skin breakdown, muscle weakness, as well as psychological issues such as guilt, stress, and depression," Jean Irion, a professor of physical therapy at the University of South Alabama in Mobile, said in a prepared statement.

Irion teaches physical therapists across the United States to develop safe physical activity programs for pregnant women on bed rest.

"Physical therapy is often equated with exercise, and many physicians equate exercise to a strong potential for exacerbating a given high-risk condition, so they don't suggest pregnant women restricted to bed rest see a physical therapist. This is a huge mistake," according to Irion.

She said physical therapists work to minimize loss of muscle tone and strength and to make the women as comfortable as possible.

"We're not training these women to compete in a triathlon following delivery. Our aim is for these women to maintain some strength, flexibility and range of motion in the upper and lower extremities, so they'll be prepared for the demands of lifting carrying, and holding their babies," Irion said.

More information
The Nemours Foundation has more about bed rest during pregnancy.

New Cholesterol Check Gauges Kids' Heart Risk

(HealthDay News) -- Whether America's fast-food-and-video-game culture, or some other confluence of factors is to blame, there's no denying that adolescents' health is at risk.

Little wonder, then, that one group of researchers has begun to take a serious look at the long-term health consequences of kids' inactivity. And they are using cholesterol levels as a window into these youngsters' futures.

Obesity, inactivity and cholesterol are closely linked, and data from the latest U.S. National Health and Nutrition Examination Survey (NHANES) finds that 17 percent of U.S. teens are overweight. Just one in four high school students packs enough physical activity into their day, and 12 percent get little or no daily exercise, reports the U.S. Centers for Disease Control and Prevention.

So, measuring kids' cholesterol in a really detailed way may make sense.
"There is growing scientific evidence indicating that cholesterol levels in childhood and adolescence have an effect on the development of plaque in the arteries, which is a clear indication of cardiovascular disease risk," explained study leader Ian Janssen, an assistant professor in the School of Kinesiology and Health Studies at Queens University in Ontario, Canada.

"There is also strong evidence indicating that children and youth with high cholesterol will continue to have high cholesterol in adulthood," he added. "Thus, it is important to start treatment and prevention efforts early."

Using data from the NHANES on more than 6,000 kids aged 12 to 20, Janssen and his colleagues developed age- and gender-specific reference points for total cholesterol, LDL ("bad") cholesterol, HDL ("good) cholesterol and triglyceride fat levels. The new tables, published last year in the journal Circulation, take into account fluctuations in cholesterol and fat that occur as a child matures.

The new reference data are meant to improve upon current guidelines, published by the U.S. National Cholesterol Education Program, which do not account for age-related fluctuations.
Still, Janssen admits that the guidelines have not yet been routinely adapted into clinical care settings in the United States. "These sorts of changes to clinical practice typically take years to manifest," he said.

Dr. Marc S. Jacobson, director of the Center for AtherosclerosisAtherosclerosis Prevention at Schneider Children's Hospital in New Hyde Park, N.Y., said it's unclear how the new tables will be received in the United States.

"It complicates lives of people like me who treat adolescents with lipid problems because instead of just having one number, you have to have four graphs and plot them out by age," he said.
"Instead of having one cut point," he continued, "you have a graph that you have to plot out a percentile. With each lipid profile, you have to decide which percentile this is for that individual's age. And when it goes up and when it goes down, did it go down because of treatment? Or did it go down because of advancing puberty?"

The challenge, then, is to make sense of that information, he explained. "It argues that you almost have to take it into account because you could say if the LDL changes, is it the treatment or is it a change in puberty?"

Currently, the federal government recommends cholesterol screening for children and teens with at least one parent with high cholesterol or a family history of early heart disease.
"Typically high-risk adolescents should be screened, and probably every year or two," Janssen said. "A high-risk adolescent would be one who's had a parent or grandparent with premature cardiovascular disease or high cholesterol, or a teen with other risk factors, such as obesity and high blood pressure."

Other risk factors, such as high blood pressure, obesity, diabetes or smoking, also would trigger cholesterol testing in doctors' offices, "and that covers a lot of kids now," Jacobson noted.
The issue is destined to garner greater attention when a U.S. National Heart, Lung, and Blood Institute (NHLBI) panel updates guidelines on cholesterol screening in children and teens. The new guidance is scheduled for release in April 2008, said Dr. Rae-Ellen Kavey, senior medical officer with the Pediatric Cardiovascular Risk Reduction Program in NHLBI's Office of Prevention, Education, and Control.

"Stay tuned," Kavey said, "because there really is going to be new information."

More information
Find out more about cholesterol at the U.S. National Heart, Lung, and Blood Institute.

Physical Activity Cuts Risk of Repetitive Strain Injury

(HealthDay News) -- Being physically active may reduce the risk of repetitive strain injuries at work, according to a new Canadian study.

Researchers at the University of British Columbia in Vancouver analyzed data from the 2003 Canadian Community Health Survey. They found that the overall prevalence of repetitive strain injury (RSI) was about 10.9 percent, and that the prevalence of work-related RSI was about 4.7 percent. Upper body injuries (most commonly wrist/hand, shoulder and elbow) accounted for 63 percent of RSI in full-time workers.

Physical work demands, work-related stress, obesity, and smoking were among the risk factors associated with upper-body work-related RSI, the study said. Women and people ages 30-49 were also at higher risk. Being physically active appeared to help reduce the risk of work-related RSI.

"This finding provides evidence for a hypothesis that an active lifestyle outside of work may protect against work-related RSI, adding another potential health benefit to leisure-time physical activity participation," the study authors wrote.

Physical activity may promote mechanical and metabolic processes in the musculoskeletal system that counter the repetitive or sedentary effects of many jobs, the researchers said. It may also improve upper body muscle strength and better balance of movement.

"Work-related RSI is a common problem that has significant costs in terms of lost wages and productivity, medical care and quality of life," the study authors wrote. "It is important to identify lifestyle factors that may protect against RSI in order to inform employers, compensation boards, and the working population. Identification of safe physical activities may reduce RSI and provide multiple other health benefits."

The findings are published in the April issue of the journal Arthritis Care & Research.

More information

The U.S. National Institute of Neurological Disorders and Stroke has more about repetitive motion disorders.

The Cardiovascular Cure: How to Strengthen Your Self-Defense Against Heart Attack and Stroke - Book Review

BY JOHN P. COOKE, M.D., PH.D., AND JUDITH ZIMMER; B
ROADWAY BOOKS; $25

SOME MAINSTREAM DOCTORS are bucking the system and suggesting that surgery or drugs may not be the best treatment for stroke, heart disease, and atherosclerosis (hardening of the arteries). One of these doctors, John P. Cooke, M.D., Ph.D., director of the vascular medicine section at Stanford University Medical School in Palo Alto, Calif., has written a book to help us trigger our body's remarkable capacity to heal itself.

Cooke and co-author medical journalist Judith Zimmer explain that a healthy endothelium, the innermost single-cell-thick lining of human blood vessels, releases a substance that packs benefits galore. Called nitric oxide (NO), this substance keeps blood vessels supple, prevents platelets from snagging on vessel walls, hinders the buildup of plaque, and even helps to reduce existing plaque deposits. Cooke says people with heart disease or the risk factors for it have elevated levels of an amino acid that impedes NO production.

To ensure that your endothelium pumps out plenty of NO, Cooke recommends a modified Mediterranean-style diet supplying 1,800 calories a day. The evidence-based diet features whole grains, beans, nuts, legumes, fruits, and vegetables, and emphasizes foods rich in L-arginine, an amino acid used by the endothelium to make NO. His book includes a two-week eating plan with recipes, and detailed information on supplemental nutrients and phytochemicals.

The other component of Cooke's simple plan is aerobic exercise, which increases blood flow through your vessels. Increased blood flow stimulates the production of NO and keeps the endothelium smooth so plaque accumulation is less likely. He advocates at least 30 minutes of aerobic exercise four days a week.
This book manages to be both comprehensive and lively. Cooke presents just the right amount of detail about the scientific underpinnings of his conclusions, which are based on a Nobel-prize-winning theory. He claims you will have vascular improvement in just two weeks--and I believe him.
COPYRIGHT 2002 Weider Publications
COPYRIGHT 2002 Gale Group

The Cardiovascular Cure

The Cardiovascular Cure

Written by John P. Cooke, M.D., Ph.D. and Judith Zimmer
Category: Medical - Diet Therapy
Publisher: BroadwayFormat: Trade Paperback, 336 pagesPub Date: August 2003
Price: $15.95
ISBN: 978-0-7679-0882-5 (0-7679-0882-1)

ABOUT THIS BOOK
The Cardiovascular Cure offers a groundbreaking approach to preventing heart attack and stroke by enhancing your body’s own natural defenses. Dr. John Cooke, head of Stanford Medical School’s vascular unit, has devised a powerful new method for fighting cardiovascular disease without bypass surgery or angioplasty.

Drawing on his own investigations, as well as Nobel Prize-winning research from a team of American scientists, Dr. Cooke provides heart patients with a diet, supplement, and exercise program that will help them feel better in as little as two weeks.

His program also works to prevent heart disease in those at risk.

In 1998, the Nobel Prize in Physiology or Medicine was awarded for the discovery of EDRF (endothelium-derived relaxing factor), a chemical produced in the lining of the blood vessels, which keeps them free of plaque. Dr. Cooke and other investigators have found that specific nutrients can enhance EDRF production and improve blood flow in people with high cholesterol, high blood pressure, diabetes, or other risk factors for heart disease.

This potentially life-saving book shows how anyone can achieve healthier blood vessels (the key to preventing heart disease). A two-week menu plan contains recipes that emphasize EDRF-enhancing foods, and there is detailed information on supplemental nutrients and vitamins that are useful in strengthening the cardiovascular system. Recipes from breakfast (Banana Date-Nut Bread; Blueberry Oat Pancakes; Pineapple Ginger or Tropical Smoothies; Pumpkin Muffins) to dinner (Moroccan Red Snapper; Chicken Wrap with Refried Beans; Soy-Glazed Salmon; Turkey Meatloaf) feature healthy fats found in fish, nuts, and olive oil.

There is also welcome news that red wine and chocolate can be good for you (there are recipes for Double Chocolate Cake and Chocolate Raspberry Surprise). The exercise program consists of the same therapeutic plans Dr. Cooke has prescribed for even his most severely ill patients, many of whom begin to walk and even exercise more vigorously without pain after two weeks. In addition, there are aerobic workouts designed for more active patients.

Dr. Cooke also provides state-of-the-art information (pro and con) on conventional drugs–from aspirin to beta blockers–and medical tests and procedures to further combat cardiovascular disease. With an introduction by Sir John Vane, a Nobel Prize-winning cardiovascular scientist, this book will provide anyone concerned about his or her cardiovascular health with new hope for a pain-free, disease-free life.

From the Hardcover edition.PRAISE“In The Cardiovascular Cure, Dr. Cooke has translated the research of our field into life-saving information that we can all use. If you really care about your cardiovascular health, you must read this book!”--Louis J. Ignarro, Ph.D., 1998 Nobel Laureate in Physiology or Medicine for the discovery of Nitric Oxide“This authoritative book appropriately points out why everyone should worry about the health of their endothelium and, better still, do something to protect it if it shows signs of damage.

Early identification and treatment of reduced nitric oxide release should be the preventive agenda for the new millenium.”--Jay N. Cohn, M.D., Professor of Medicine, University of Minnesota Medical School“This book should be read by all patients with heart disease as well as anyone at increased risk for a heart attack or stroke.

The comprehensive risk reduction program recommended by Dr. Cooke uses the most advanced research to help everyone improve the health of their blood vessels.” --William L. Haskell, Ph.D., Stanford Center for Research in Disease Prevention“The Cardiovascular Cure is a lucidly written description of EDRF and endothelial dysfunction.

Treatment with exercise and a diet rich in arginine, vitamins, and anti-oxidants is important to the many patients prone to develop heart attacks or stroke.”--Dr. Ferid Murad, M.D., Ph.D., Director of the Institute of Molecular Medicine at the University of Texas, 1998 Nobel Laureate in Physiology or Medicine“Helping yourself prevent a heart attack means knowing more than your ‘cholesterol count.’

In this clearly written book, Dr. Cooke introduces you to the important role played by the endothelium (the lining of your blood vessels) in this process, and what you can do to keep this vital organ as healthy as possible.”--Gerald Reaven, Professor of Medicine, Stanford University School of MedicineFrom the Hardcover edition.

ABOUT THIS AUTHORJOHN P. COOKE, M.D., Ph.D., is Associate Professor of Medicine and Director of the Section of Vascular Medicine at Stanford University’s Medical School. He trained at the Mayo Clinic, earning a Ph.D. in physiology there, and he was on the faculty of Harvard Medical School before he was recruited to Stanford to spearhead the program in Vascular Biology and Medicine.

He is a sought-after consultant and has served on numerous national and international committees dealing with cardiovascular diseases, including those of the American Heart Association and the National Heart, Lung and Blood Institute. JUDITH ZIMMER has been a medical journalist for more than fifteen years.

She has contributed to such publications as the New York Times, and Self and Fitness magazines, and she currently writes for academic medical centers in New York City.
From the Hardcover edition.

Calculator Helps Users Gauge Heart Attack Risk

(HealthDay News) -- A new online heart disease risk calculator that can help you understand and gauge your heart attack risk is available from the Mayo Clinic.

The risk calculator on MayoClinic.com asks several questions about your lifestyle and health and then determines your 10-year risk of a heart attack. The risk score is based on a number of factors, such as age, gender, tobacco use, cholesterol levels, and blood pressure.

You can find the risk calculator by heading to MayoClinic.com and looking under "Heart Disease Risk Factors," in the Web site's Heart Disease Center.

About one in 10 people with a risk level of 12 percent will have a heart attack or die of heart disease within the next 10 years, experts say.

Here are five heart disease prevention tips:

• Don't smoke or use tobacco products.
• Get exercise. Regular, moderately vigorous physical activity can reduce the risk of fatal heart disease by 25 percent. Combining physical activity with other positive lifestyle habits, such as maintaining a health weight, can provide even more heart health benefits.
• Eat a heart-healthy diet that includes plenty of fruits, vegetables, whole grains, and low-fat dairy products. Legumes, low-fat sources of protein and certain types of fish may also help reduce heart disease risk.
• Limit intake of saturated fats and trans fat.
• Watch your weight.
• Excess pounds can lead to conditions -- high blood pressure, high cholesterol and diabetes -- that increase the risk of heart disease.
• Get regular blood pressure and cholesterol screenings.
• High blood pressure and high cholesterol can damage your cardiovascular system, including your heart.

More information
There's more on reducing heart disease risk factors at the American Heart Association.

Researching Alternatives: A Talk With Donald Abrams

By Bob Huff
June 2003
You have a reputation as being a rigorous clinical researcher and tough advocate for making evidence-based treatment decisions.

Yet you've also been very open to studying a number of alternative and complementary therapies that have been used in the HIV patient community. How did all these concerns come together and what are you involved with these days?

I was training in oncology at UC San Francisco just as the first AIDS cases were reported. I helped found the AIDS program there and I've been participating in academic clinical research for over 20 years. More recently I've become an associate fellow of the Program in Integrative Medicine at the University of Arizona that was founded by Andrew Weil.

This is a two-year program, mostly online, that is increasing my training and background in integrative medicine, including things like botanical medicine, manual medicine, and spirituality. It's been a stimulating experience so far and I'm really enjoying it.

I've been interested in complementary medicine since the very beginning of my career, so one of the reasons I'm doing the fellowship is to learn more that I can integrate into my own healthcare discussions with my patients. Of course another impetus is to see what other things we might want to do clinical research on.

My intention is to continue to investigate the complementary and alternative approaches that our patients are using. We want to determine whether or not they may be beneficial, but also determine whether or not they may be harmful, particularly in how they interact with the conventional medications that patients are taking.

In the earliest days of AIDS we didn't have any treatment for this new disease; people were dying and everybody was frightened. Being here in San Francisco, we were near the Linus Pauling Research Institute in Palo Alto, so there were a number of people in the city who were proponents of high doses of Vitamin C.

One of the first responses we saw in the early '80s were storefront clinics opening up where people went to receive intravenous injections of very high doses of Vitamin C.

At that point in time we didn't even know that it was a virus causing the disease. So I used to go around on the lecture circuit with someone who would talk to audiences of concerned people who listened to him while hooked up to intravenous infusions of Vitamin C.

Then I would speak as the academician who cautioned people that we really don't know if this is beneficial and there may be some dangers to being hooked up to intravenous vitamin C, and so on. Ultimately, this led to me to write a grant proposal in collaboration with the Linus Pauling Institute.

It was right about the time we learned that HIV was the cause of AIDS so we wrote a proposal to the NIH to study the in vitro effects of Vitamin C on HIV. That grant didn't get funded.

In San Francisco at that time there were also a number of DNCB proponents. DNCB, dinitroclorobenzene, is actually a photographic chemical used for developing pictures, but it is also a skin sensitizer that had been used to test for delayed hypersensitivity reactions.

There were people who believed that somehow it might be useful in restoring some of the T-cell immunity that patients with this new disease were lacking. So there were people who would paint themselves weekly or so with DNCB until they developed these skin reactions, thinking that the skin reaction was some sort of improved T-cell immune response that would help combat the virus.

And again, seeing that people were using this and seeing that we really didn't have much else happening, I worked with some of the DNCB proponents, as well as some experts from the University of California -- I remember Jay Levy was involved, as was Marcus Conant and others -- and we wrote a protocol that we submitted to the FDA for funding. That also was rejected.

Around the time that AZT first became available in 1986, I went to a conference in Japan where I was introduced to some investigators from the Ueno Fine Chemicals company who told me that they had the cure for this disease. They said it was something that was very commonly used in Japan but they couldn't tell me about it until I signed a confidentiality agreement.

That turned out to be dextran sulfate. Not long after I was going through the process of filing the paperwork to get approval from the FDA to do a phase I study of dextran sulfate in the United States when evidently some people heard about it.

They realized that it was a product that was widely available in Japan -- I believe it was used for lowering cholesterol -- so they started an importation scheme similar to what had happened in earlier days with isoprinosine and ribavirin, which were brought across the Mexican border.

But people had now become more sophisticated in their methods and began to import dextran sulfate from Japan to sell in the underground AIDS therapy market.

I remember that activists stormed the offices of a Japanese drug distributor in New York for refusing to make dextran sulfate more widely available. Ultimately it became such a political issue that, even though my clinical trial here in San Francisco didn't show much benefit, Congress got involved and the AIDS Clinical Trial Group (ACTG) was asked to do a study of dextran sulfate through the NIH-funded mechanism. It turned out the drug was not even absorbed into the blood.

Another Japanese product I worked with was lentinin, which was an intravenously administered extract of shiitake mushroom. In Japan it was felt to be an immune booster for patients with cancer. Although it was being used by mainstream doctors in Japan, it was an alternative therapy here because it was not something that we had ever learned about or used in hospitals in the U.S. That's David Eisenberg's description of what an alternative therapy is -- that it's not taught about in medical schools or widely available in U.S. hospitals -- and certainly shiitake mushroom extracts qualified. Again, that's another study we did that had negative findings;

there was no benefit to the intravenous infusions of lentinin. Since I've learned more about botanicals, it would seem to me that if there were immune enhancing benefits to shiitake mushrooms then they are more likely to be obtained by eating them rather than by injecting an extract intravenously.

During that time I was also involved with studies of conventional therapies. Even in the days of early AZT monotherapy, which I was not a big supporter of, I was involved in trying to put some evidence behind the claims of the proponents for these various agents. And since that time, I've had a constant history of investigating conventional therapies through the federally-funded CPCRA (Community Programs for Clinical Research on AIDS), and more recently through the ESPRIT study of interleukin 2, as well as in other, sometimes pharmaceutical industry-sponsored trials. But always ongoing with those studies, I've been involved with clinical trials of complementary and alternative interventions.

When we first became aware of immune thrombocytopenic purpora (ITP) in AIDS, I worked with a nurse who was very interested in therapeutic touch and we studied men with low platelet counts to see if therapeutic touch could decrease their stress and increase their platelet counts. That was another study that turned out to be fairly negative.

I then became interested in traditional Chinese medicine (TCM) and, in fact, one of the colleges of TCM here in San Francisco sent me to China in 1989 just to learn about Qigong (Chi Kung) -- that exercise that's felt to improve the immune system -- to see if it was something that I wanted to study here. Although I never studied Qigong I collaborated with Misha Cohen from the Quan Yin Healing Arts Center here in San Francisco. We did three studies of traditional Chinese herbal interventions for, first, symptomatic HIV, then for patients with diarrhea without a pathogenic source, and then another study for patients with anemia.

The last two were hindered by the fact of being initiated about the time that HAART became available, so patients with diarrhea as well as anemia became scarce. There were also a lot of pills that needed to be taken in these Chinese herbal investigations and patients at that time were taking huge amounts of pills with their antiretroviral regimens, so the studies weren't very attractive. None of these studies had spectacular results and the anemia study was terminated for poor enrollment.

Have "soft endpoints" such as life satisfaction created a problem for designing and conducting credible studies?

The TCM herbal study that we published in 1996 investigated herbs versus placebo in symptomatic HIV infection. At the time of the study in 1993, we had patients with about 14 symptoms on average and we found that there was a significant decrease of symptoms in the herb-treated group -- they decreased from 14 to 12 -- whereas the other group still had 14 symptoms. We also found that they had improved "life satisfaction" which improved by a factor of +0.86 or thereabouts.

Yet, if you look at the rest of the results, the Chinese herbal patients actually lost weight over 12 weeks compared to the placebo group, and their CD4 counts also dropped -- not statistically significant, but it was a trend. So that was an example of where their symptoms improved and their life satisfaction increased, but the parameters that we would normally look at to see if a patient is doing well (i.e., weight and CD4 count) went in the wrong direction. So, although I was also first author on a study that showed that epoetin alfa improves quality of life in HIV patients who are anemic, I'd have to say that a study whose main endpoint is quality of life is something I would find difficult to interpret.

The CPCRA actually did a large study of acupuncture for patients with HIV-related peripheral neuropathy that was published in JAMA. That was a landmark, having the NIH support an acupuncture study, although, again, it turned out to have negative results; acupuncture didn't appear to be effective in treating peripheral neuropathy.

About this time I began trying to study another botanical, which has consumed my efforts for the past decade, and that would be cannabis, or marijuana. Starting in 1992 I began proposing and developing clinical trials to investigate first the effectiveness -- but then I realized that that wasn't going to happen -- so subsequently, the safety of smoked marijuana in patients with HIV.

We finally completed a study in the year 2000, that we hope will soon be published, that looked at the safety of marijuana in patients taking protease inhibitor regimens. And since that time we have obtained funding from the State of California that allows us now to conduct clinical trials to look at the potential effectiveness of smoked marijuana in patients with various syndromes. We have also just completed a pilot study in patients with HIV peripheral neuropathy, which allowed us to ascertain that there was some effectiveness of marijuana. But an open-label pilot study is not going to prove that, so we're now in the process of continuing on with a randomized, placebo controlled, double-blind trial in patients with HIV-related peripheral neuropathy. We're also doing marijuana studies in patients with cancer who have pain who are on opioid analgesics, and another study to look at the effect of smoked marijuana in patients who have delayed nausea and vomiting from breast cancer chemotherapy.

It was working with marijuana and all the problems that are inherent in studying a plant as a therapy that has led me to a broader interest in botanicals and the use of substances that come from nature as medicinal agents. Certainly, for thousands of years, people have depended primarily on these things. Whether or not they worked is unclear, but as an oncologist I know that many of my most potent chemotherapeutic agents were derived from plants. So right now we are waiting to hear if a protocol we submitted to the National Center for Complementary and Alternative Medicine (NCCAM) to investigate the lipid lowering effects of oyster mushrooms in patients on Kaletra is being funded. There's good evidence that mushrooms, including oyster mushrooms in particular, have some activity for lowering blood lipids and cholesterol.

We're also just finishing a three-year NCCAM grant studying the effects of DHEA, dehydroepiandrosterone, which is an over-the-counter adrenal steroid that people are taking for many reasons. We received a grant to investigate it as an antiviral and to see what impact it has on the immune system. Hopefully that data will be available by the end of the year and we will know if DHEA had any impact, positively or negatively, in our patients.

The goal, ultimately, would be to submit a center grant to the NCCAM, to allow us to establish a center here for the study of botanicals in HIV because there are still a number of herbal preparations and mushroom extracts that warrant further investigation for their potential benefit -- and to make sure that they're not harmful in our patients.

Safety keeps coming up again and again as one of the inarguable justifications for doing this research.

There's not a huge amount that we know about some of these botanical products and how they're metabolized, but there's probably more than people think. There are a number of textbooks available that talk about herb-drug interactions. That was the question in our marijuana study: is there an interaction between cannabinoids and protease inhibitors, which are both metabolized by cytochrome P450 enzymes in the liver, that may alter the activity of the protease inhibitors such that patients lose their viral suppression when they mix cannabis with their treatments?

And in fact, in our article that was already published in AIDS, we saw no such effect. We've all heard about garlic and St. John's Wort and their interactions, and I think there are many other agents that we would like to study to make sure that they are not having significant interactions with protease inhibitors. We don't want people to either lose control of their viremia (through underdosing) or experience toxicity (through overdosing) because of antiretroviral concentrations that have been affected by herb-drug interactions.

You had to be enormously persistent to accomplish your marijuana study. In the current political climate, is it going to be more difficult to do marijuana studies?

I think we're blessed to live in the State of California, which is somewhat of a freestanding republic in and of itself. In 1996, the people of California voted to allow physicians to talk to their patients about the medicinal use of cannabis. Then, through the work of Senator John Vasconcellos, one of our state senators, appropriations were made to the University of California that established the Center for Medicinal Cannabis Research (http://www.cmcr.ucsd.edu/). And that Center has had funds for the past three years that allows it to support clinical trials to investigate the use of marijuana for medicinal purposes.

Whereas the NIH and NIDA, via their congressional mandate, could only give marijuana to clinical trials that show that it was harmful (they are the National Institute on Drug Abuse, not for Drug Abuse, as NIDA's director Alan Leshner always reminded me), they were not really able to provide us with marijuana to study the benefits. But now, they have modified their system so they can provide marijuana for peer reviewed clinical trials that will look at its effectiveness as a therapeutic agent -- as long as they are not funding it. So they have now created this ability for us to obtain government marijuana.

Is there a need to increase provider knowledge about these issues?

I think a part of the problem is a lack of communication from both sides. Patients don't really perceive that these substances are something that they need to tell their doctor about -- in fact many studies show they don't want to tell their doctor because they're afraid they're going to be reprimanded or told that they're wasting their money. And many physicians never even think about asking about these things as potential confounders or as things that are causing clinical symptoms.

There also may be a variable of where in the country you are. I know many surveys show that we in the West have the highest percentage of people in the population who are using complementary and alternative interventions. So many of my colleagues here might be more familiar with how to ask the question and what to be looking for.

I remember once seeing a patient at our drop-in clinic who clearly had a drug rash. I looked through his chart -- this was when we had paper charts -- and he had a high CD4 count and a low viral load but he wasn't taking any medications.

So I said to the guy, "You're not taking any medications, huh?" And he said, "No."
"Are you taking any vitamins?" And he said, "Yeah."

So I asked him what he took and he listed about four or five vitamin preparations. Then I asked, "Do you take any herbs?" And he said, "Sure."

And so I listed the three or four herbal substances th
at he took.
"Do you take any minerals?" And he said, "Yeah."
By the time I finished I had a list of 12 different things he was taking.
So I asked, "Well, how come everybody else wrote down that you don't take anything?" And he said, "Well, nobody ever asked me before."


more info at:
http://www.dreddyclinic.com/integrated_med/integrated_med.htm

The Mind as Medicine

(HealthDay News) -- What if your mind's eye could take you to a place so peaceful that the experience eased your pain or sped your recovery from surgery? It's not such a far-fetched concept.

"Guided imagery," a type of mind-body therapy that uses visualized images to communicate to the housekeeping systems of the body, is making its way into traditional medical settings.

"People are just now taking a very serious look at it," said David E. Bresler, co-founder of the Academy for Guided Imagery, in Malibu, Calif., and author of the book Free Yourself From Pain. "There are a handful of hospitals around the country and around the world that are starting to implement these programs," he said.

In one study, researchers at Harvard Medical School found that more than 30 percent of U.S. adults have used some form of mind-body medicine, a category that includes imagery, according to the National Center for Complementary and Alternative Medicine.

Bresler, a traditionally trained Ph.D. neuroscientist, first became intrigued with alternative methods of pain relief in the early 1970s, as founder and director of the University of California, Los Angeles, Pain Control Unit. Patients often used vivid images to describe their pain. It felt like an ice pick to one person, fire ants to another. One particular patient, a psychiatrist with a painful rectal carcinoma, suffered low back pain that he said "felt like a dog chewing on my spine."

Bresler knew that when patients used their imagination to go to a peaceful place, it helped them to relax, so he guided the agitated psychiatrist through a relaxation exercise. When the man's pain flared up, Bresler instructed him to speak to the dog. Would it let go of his spine? Then, an astonishing thing happened -- when the dog let go to talk, the man's pain subsided.

Today, guided imagery has numerous applications. Sports psychologists use it to enhance athletes' physical performance. Cancer centers often use it to relieve patients' pain and nausea.
In a 2004 study in the journal Pain, researchers at Cincinnati Children's Hospital Medical Center found that children who used guided-imagery tapes before and after routine surgery had significantly less pain and anxiety than a control group. More recently, researchers examined how children used these tapes, which suggested that they "go" to a park, at least in their mind. Many, though, put their own spin on the proposed image, allowing them to escape to places like a swimming pool, a lake or an amusement park.

Bresler said imagery is the language of the autonomic nervous system, the part of the nervous system that regulates many involuntary body functions, such as heart rate, blood pressure and digestion. "So, when you're working with images, it's really a set of instructions to the system," he said.

Victoria Menzies, an imagery researcher and professor at Florida International University's School of Nursing, in Miami, said the first step for a patient in any guided-imagery session is to develop a rapport with the guide who is asking you to close your eyes and relax. Once the patient is in a relaxed state, the guide will either offer an image or ask the person to come up with their own, someplace where he or she would feel calm and safe or joyful -- the mountains, the seacoast, a favorite room in their home, whatever.

Engaging the senses is the next step, she explained. The guide might ask where you are and what you see, hear, smell, feel and even taste.

Menzies led a 10-week guided imagery intervention for a small group of patients with fibromyalgia, a condition involving chronic pain and fatigue. In the study, published in January 2006 in the Journal of Alternative and Complementary Medicine, one group of patients received usual care and used a set of guided-imagery audiotapes. The other group received only usual care. Compared with the controls, the patients who participated in guided imagery were better able to perform activities of daily living and had a greater sense of being able to manage their pain and other symptoms, the study showed.

What's more, Menzies found, "The pain did not change, but the ability to cope with the pain was improved."

Bresler considers it shocking that medical colleagues would reach their hands into someone's body and remove organs before allowing a patient to go through an imaging exercise.
"It only takes a few moments to do these things and to really check on the wisdom from inside, because there is tremendous wisdom that's being generated if only we'd listen to it," he said.

More information
To learn more, visit the University of California, San Diego.

Health Tip: Breathe Right During Exercise

(HealthDay News) -- If you're just starting an exercise program, learning how to breathe properly can help you avoid shortness of breath.

Here are some tips on how to regulate your breathing while exercising, courtesy of the American Lung Association:

• Cough a few times to get rid of any mucus in your lungs.
• Relax and take a few deep breaths before you start your workout. Continue to breathe deeply as you exercise.
• Count as you breathe, and breathe out for twice as long as you breathe in. Count to two as you breathe in, and count to four as you breathe out.
• If you feel out of breath, try resting or slowing your pace for a few minutes, then continuing the exercise.

Aromatherapy: The Scent of Dispute

(HealthDay News) -- Aromatherapy is an affordable, accessible natural path to relief for a variety of health problems, ranging from arthritis pain to nausea to drowsiness, supporters insist.

But skeptics dismiss any claims that the use of essential oils from flowers, herbs and trees can promote health in any way.

And both sides are unlikely to relinquish their positions anytime soon.

Aromatherapy "works for so many different things, it is amazing," said Kelly Holland Azzaro, a registered aromatherapist in Banner Elk, N.C., and vice president of the National Association for Holistic Aromatherapy (NAHA), an industry trade group. "You can experience aromatherapy by inhalation by putting one drop of an essential oil on a tissue and inhaling," she said.

According to the NAHA, aromatherapy is the "art and science of utilizing naturally extracted aromatic essences from plants to balance, harmonize and promote the health of body, mind and spirit." These essences are then distilled into "essential oils" -- highly concentrated aromatic extracts -- that are derived from a "variety of aromatic plant material, including grasses, leaves, flowers, needles and twigs, peels of fruit, wood and roots."

Among the most popular essential oils, which are widely sold at health-food stores and over the Internet, are eucalyptus, geranium, lavender, lemon, peppermint, rosemary, and tea tree, and according to the NAHA.

"Uplifting scents such as citrus can keep you awake at work," Azarro said. "To help increase alertness, use rosemary and lemon." And to combat nausea, try essence of peppermint, ginger and orange, she added.

While research into aromatherapy's benefits is limited, there are some studies that suggest certain treatments can help ease some symptoms.

For instance, in a 2005 study published in the journal Chronobiology International, researchers reported that lavender aromatherapy helped all 31 men and women feel more "vigor" the next morning, compared to the night they breathed in distilled water, an exercise that served as the control setting.

A study in the March-April 2006 issue of the Journal of Midwifery & Women's Health said that aromatherapy, combined with massage, helped new mothers feel less "blue" and anxious, compared to mothers of newborns who didn't get the treatment.

And a review published in Holistic Nurse Practitioner found that patients with postoperative nausea and vomiting can be helped by aromatherapy as well as acupressure and acupuncture.
But critics find little of value with scent therapy -- or even label it as therapy.

"It's not a therapy, it's a set of products with odors," said Dr. Stephen Barrett, board chairman of Quackwatch Inc., an Allentown, Pa.-based organization that says it fights health fraud and quackery.

"If people like the odors and want to pay for them, I would have no objection," Barrett said. However, he added, don't expect much. "There is no evidence that aromatherapy can alter the course of any disease. There is no logical reason to believe that any such evidence will ever be found," he said.

As for potential risks, Barrett said: "Some people find certain odors irritating. People who use aromatherapy with the hope that it will cure what ails them will waste money."
Azzaro said that, currently, aromatherapy is unregulated in the United States. "And that's part of the issue," she said. People don't understand exactly what it is, either. "People think it's potpourri or a smelly candle."

There's also no state licensing for aromatherapists in the United States. Most practitioners incorporate their training with another profession, such as licensed acupuncturist or registered nurse, according to the NAHA.

If you're interested in pursuing aromatherapy, Azzaro said it's best to ask a practitioner about his or her specific training. "And when you purchase oil, such as from a health-food store, hopefully some educational materials are with the product," she said.

Be aware, too, there can be the possibility of allergic reactions to some treatments.

More information
To learn more about aromatherapy, visit the National Association for Holistic Aromatherapy.

Banishing Balance Problems?

Q: Banishing Balance Problems?
You often suggest exercises to improve balance among seniors. How common are balance problems among older people and what is the cause?

A: Balance problems are very common among people over the age of 65 and are responsible for many serious injuries. It's estimated that this year one out of every four seniors living at home will fall.

Proper balance depends on the collaboration of three of your senses: your eyes, your sense of spatial orientation (the inner sense that tells you which way your feet or hands are pointing even with your eyes closed), and the vestibular system which encompasses the fluid-filled semicircular canals in the inner ear and informs the brain and eyes about the position of your head.

Each of these three senses diminishes with age, making balance more difficult.
Balance problems can also stem from the effects of alcohol, certain prescription drugs (ask your doctor if any of the drugs you take can have effects on balance), and such diseases as diabetes, which can cause numbness in the legs and feet, and arthritis, which can limit flexibility and range of motion.

Unfortunately, fear of falling often leads older people to become less active when, in fact, becoming moreactive can help reduce the risk. To improve balance, I recommend T'ai chi, which has been proven to reduce the odds of falling as well as the risk of injury if you do fall.

You can also learn balance exercises at the gym (have a trainer show you how to use balance boards or inflatable exercise balls). Physical therapy can further help you reduce the risk of falls with exercises tailored to whatever problem is impairing your balance.

You might also consider yoga, with its many balance poses, and Feldenkrais therapy to improve body awareness.

In addition, a new study from Indiana University at Bloomington has shown that exercises that speed up swaying may help forestall balance problems later in life.

We all sway when we stand on our feet but this happens so subtly that we're usually not aware of it.

Younger people generally sway backward and forward while older people tend to sway side to side, a less stable pattern. The Indiana researchers taught balance exercises to a group of adults between the ages of 55 and 60 who were in pretty good shape.

After doing three balance exercises four days a week for 15 minutes a day, all the participants improved their sway speed by an average of 16 percent, and, as a result, their stability.

One of the exercises required standing on one leg for 15 seconds with the other leg bent so the thigh was parallel to the floor; a second required balancing with one leg lifted to the side, and a third involved lifting one leg straight back while reaching forward with the opposite arm - all exercises that can be learned and practiced at home.

Andrew Weil, M.D.

Regular Exercise Helps Obese Teens' Hearts

(HealthDay News) -- Obese teens who start a regular exercise program can reverse or reduce early signs of heart disease, new research shows.

The finding suggests that continued exercise could decrease their risk of developing hardening of the arteries, heart attacks and strokes, said Dr. Andreas Alexander Meyer, of the University of Rostock in Germany.

"Obese young adults who were already obese in childhood have a high risk of developing serious cardiovascular events," Meyer said. "First events can occur between the age of 20 and 30 years."

Meyer's team studied 67 obese German teens with early signs of hardening of the arteries: decreased flexibility of their arteries and increased thickness in the linings of the carotid arteries of the neck.

"It was in the range we usually see in adults between the ages of 30 and 40," Meyer said. "This is clear evidence of vascular changes in obese children."

During the study, the researchers randomly assigned the teens, who averaged 15 years of age, to either a six-month exercise program or no change in their usual routine.

The exercise regimen included 60 minutes of swimming and water aerobics on Mondays, 90 minutes of team sports on Wednesdays and 60 minutes of walking on Fridays.

In the exercise group, the researchers saw an almost complete restoration of the arteries' flexibility, which resulted in improved blood flow. They also observed a significant reduction in the thickness of the linings of the youths' carotid arteries.

Because exercise also led to improvements in body-mass index (BMI), blood pressure, and cholesterol and triglyceride levels, the researchers concluded that it could significantly reduce the teens' risk of developing heart disease. "Even children who did not lose weight showed improvements in vascular status and obesity-related risk factors," Meyer said.

The study results are published in the Nov. 7 issue of the Journal of the American College of Cardiology.

Meyer cautioned that these benefits would quickly vanish if the teens did not maintain their healthy new lifestyle and strive to become even more physically active. "Generally, in children, we recommend moderate exercise of 45-90 minutes per day to keep cardiovascular risk low," he said.

Parental support is essential, Meyer said, but it can be difficult to convince parents -- who may themselves be obese and sedentary -- that their children's lives depend on eating right and exercising regularly.

"Most obese children don't get sufficient support in their efforts to reduce weight," Meyer said. "We have intensive talks with the parents about their children's medical and vascular status. We try to make clear that the whole family needs to change its risky behavior."

In recent years, childhood obesity has become a worldwide epidemic, affecting an estimated 22 million children under age 5. In the United States, one-third of children are either obese or at risk of becoming obese, according to a 2006 federal report, Progress in Preventing Childhood Obesity: How Do We Measure Up?.

Between 2002 and 2004, the obesity rate for American children and teens increased from 16 percent to 17.1 percent and is expected to reach 20 percent by 2010, according to the report.
"All children and adolescents should engage in at least 60 minutes of physical activity on most, preferably all, days of the week," said Karen A. Donato, coordinator of the National Heart, Lung and Blood Institute's Obesity Education Initiative. She was not part of the study.

"According to the U.S. dietary guidelines for Americans, regular physical activity has been shown to reduce the risk of certain chronic diseases, including high blood pressure, stroke, coronary artery disease and type 2 diabetes," Donato said. "The National Institutes of Health has begun a national education program entitled We Can! (Ways to Enhance Children's Activity and Nutrition) to provide parents and primary caregivers of children with important information and tips on ways to increase physical activity in children and youth, as well as to decrease screen time, and eat a nutritious diet."

More information
For more on childhood obesity, head to the U.S. Centers for Disease Control and Prevention.