Health-and-Fitness online information.

Q For a few years now I have had to deal with abdominal pain, gas, bloating, diarrhea and/or constipation. I'm 45 years old, and I've had this condition for the past two years. I really don't know if certain foods aggravate the condition because the discomfort just seems to occur without warning. What could be my problem? A.W., Phoenix

A Abdominal problems could result because of a variety of reasons, but your description appears to indicate irritable bowel syndrome (IBS), which is a chronic condition that's characterized by abdominal pain or cramping and changes in bowel function.

Doctors say IBS is a functional disorder of the intestines that currently affects 40 million Americans. It affects nearly two times as many women as men and typically begins in late adolescence, but can affect people of any age.

In IBS sufferers, the intestines squeeze too hard or not hard enough, causing slow or accelerated movement of waste through the intestines. It isn't a life-threatening condition, and it can be controlled by eating a healthy diet that includes enough fiber and by avoiding foods that aggravate the condition--fatty and spicy foods, milk products, alcohol, caffeine, chocolate.

The notion that diet causes acne--discredited, it was believed, more than 30 years ago--may be credible after all. Until 1970, when a German researcher supposedly showed that adolescents who ate chocolate had the same rate of acne as those who did not, mothers routinely told their teenaged children to avoid fudge, french fries and other rich, fatty foods as a way to avoid blemishes. A new study reported in the December 2002 issue of the Archives of Dermatology has revived the seemingly discredited diet-acne link by comparing diets of South Pacific Kitava Islanders to those of American teenagers. No acne was discovered among the Kitavans, whose diet consists of roots, fruits and vegetables; in the United States, where sweet and fatty foods are popular, 79 to 95 percent of adolescents have acne. While much research remains to be done--factors other than diet may explain the differences between the skin conditions of the two groups--researcher Loren Cordain, a health and exercise professor at Colorado State University, thinks the case is closed. "I'm not a dermatologist," says Cordain, who gained fame in 2001 with his caveman diet, "yet I cracked one of the greatest mysteries by solving this acne problem."

`I'm pregnant ... and my husband is going through morning sickness.'

MALE `SYMPATHETIC PREGNANCY'

Q My husband and I will have our first child next month. Since this is my first pregnancy, there are a lot of things that have surprised me, especially the reaction of my husband. Like me, his personality has changed and he has gone through something similar to morning sickness. I thought it was a myth, but is it normal for men to "experience" what women go through during pregnancy? H.L., Detroit

A It is not a myth and is probably more normal than you would expect. Commonly known as "sympathetic pregnancy," in medical circles it is known as Couvade Syndrome, a condition associated with a woman's partner who could begin to vomit, gain weight and experience hormonal fluctuations during her pregnancy.

The syndrome generally begins at the end of the first trimester and increases in severity until the third trimester. Doctors say the only cure appears to be the birth of the child.

In a recent study, researchers cited the expectant fathers' hormonal changes as a central component of Couvade Syndrome. They found that the fathers' levels of estradiol (or estrogen), the female sex hormone, rose significantly as the birth approached and continued to rise after the birth. They also found that prolactin, which plays a significant role in breastfeeding, increased in both parents before birth. Researchers think prolactin may help expectant fathers become more nurturing.

The study indicated that men who exhibited signs of "sympathetic pregnancy" had more prolactin and sharper drops in testosterone than those who didn't have such symptoms.

NEW `PAINLESS' DIABETES MONITOR

Q I was diagnosed with diabetes four years ago and I have done everything my doctor has recommended, proper diet, exercise, etc. My problem is that I hate to have to prick my finger to get a blood sample to check my glucose level. Is there another less-painful way to monitor my condition? K.B., Camden, N.J.

A The FDA recently approved the Freestyle Blood Glucose Monitoring System, which represents a breakthrough in blood-monitoring technology. The device allows those with diabetes to get blood samples (about the size of a pinhead) from their forearms, which is much less painful than samples that are normally extracted from the fingertips.

In clinical studies, 9 out of 10 people said the new system was less painful than their current monitoring system, and it eliminated squeezing or "milking" the site.

Doctors say the new device should make a dramatic impact because pain is perhaps the main barrier that prevents diabetics from testing more frequently. Studies have shown that more frequent monitoring and control of blood glucose levels could significantly reduce the effects of diabetes, which can contribute to such conditions as strokes, heart disease and blindness.

TREATMENT FOR BUNIONS

Q My best friend and I are dedicated runners, who run about 30 miles a week. However, in recent weeks I have noticed swelling and almost continuous pain in the joint of my left big toe. The pain is making it much more difficult to run. I've never had foot problems, but could this be a bunion? R.J., New York City

A You should make an appointment to see a podiatrist as soon as possible because you could be experiencing the beginning stages of a bunion, which is a misaligned big-toe joint that becomes swollen, causes the first joint of the toe to slant outward and the second joint to angle toward other toes.

Bunions are believed to be hereditary and routinely victimize women more often than men, doctors say. Wearing improper shoes can make the condition worse, many times requiring surgery to correct alignment and eliminate pain.

NEW INFORMATION ON THE BENEFITS OF FIBER

Q For years we have heard about how important it is to add fiber to the diet to promote a healthy colon. Now there seems to be some confusion about how fiber actually contributes to your health. What's the latest information about fiber? C.B, Cleveland

A Two new studies indicate that, contrary to what we've been told for years, a fiber-rich diet may not protect against colon cancer. Even if continued research rules out a connection between fiber and colon cancer prevention, doctors say there already is indisputable evidence that eating a high-fiber diet--including grains, fruits and vegetables--can help in other ways. It decreases cholesterol, lowers blood pressure and lessens the possibility of developing adult-onset diabetes.

You've finally made the commitment to exercise regularly and switch to a low-fat diet. And as a truly health-conscious sister, you may have even taken steps to combat stress through daily meditation or deep breathing. There's just one thing missing from your holistic health picture: your mate.

Like many women, you may have a partner who opts for fried chicken over fresh vegetables, and for lounging on the couch over a brisk walk in the park. How can you motivate him to adopt healthy habits that will benefit both of you?

To help solve this dilemma, Essence turned to Victoria Johnson, an internationally known fitness expert, author, speaker, consultant and trainer based in Lake Oswego, Oregon. Her motivational advice will help you and your partner forge a more healthy union. Most important, you must keep the commitment to yourself. As you become more fit and balanced, you'll become more loving, and your partner will want to support you - and even join you - in developing a powerful new lifestyle. Essence: What role does our partner play in our efforts to stay healthy? Johnson: An important one. It can be very difficult to make healthy lifestyle changes over the long term if your partner is not supportive, or even worse, if he sabotages your efforts. In motivational seminars I encourage courage couples to discuss their nutrition and fitness goals. Essence: What can we do to get a reluctant mate to try a healthier lifestyle? Johnson: Become a master salesperson. Use encouraging language and speak in the context of "we" For example, - your might say "I was just thinking about how which I love being with you. Let's discuss the possibility of our starting a nutrition-and-exercise program together." Emphasize the fact that it mill give you the opportunity to spend more time together, increase your energy and have fun.

Q For as long as I can remember, I have been getting cold sores and fever blisters for some unexplained reason. I've been told that they are caused by herpes. Please tell me what causes these little, uncomfortable bumps that appear on my lips. I also need to know what, if anything, can be done to treat these frequent outbreaks. K.J., Kansas City

A Fever blisters or cold sores usually are tiny, clear, fluid-filled blisters, which occur on mucous membranes, and doctors say, are caused by the herpes simplex virus--a common viral infection.

Typically, cold sores and fever blisters rarely lead to medical complications and usually disappear in seven to 12 days. Doctors say the frequency with which they appear depends on the person. Some people may experience a cold sore only once in their lifetime, while many others may be affected with frequent recurrences.

Before cold sores and fever blisters appear, the skin may itch or become very sensitive. Ice applied directly to the affected area can reduce the discomfort. Recently developed antiviral drugs, such as acyclovir and famcyclovir, lessen the symptoms and frequency of recurrences for some patients.

Q I am so excited because I'm pregnant with our first child, which is due in a couple of months. During my pregnancy, I have gained a lot of weight and some of my friends say I should be concerned about the onset of diabetes. Before getting pregnant, I did a lot of research, but I didn't come across anything about diabetes being associated with pregnancy. Can I be in some serious trouble with this pregnancy? What should I know about diabetes as it relates to pregnancy? D.W., Oakland, Calif.

A Doctors say about 3 to 6 percent of all pregnant women are affected by gestational diabetes, which occurs in non-diabetic women. It usually begins 24 to 28 weeks into the pregnancy and usually disappears shortly after the birth of the baby.

The main problem in this form of the disease is insulin resistance. In gestational diabetes, the mother-to-be produces the proper amount of insulin, but its effects are lessened by a variety of other hormones (including estrogen, progesterone, prolactin and human placental lactogen) made in the placenta. As the placenta grows, more of these hormones are produced and the insulin resistance becomes greater. Doctors say when the pancreas produces all the insulin it can and still can't overcome the effect of those hormones, gestational diabetes results.

Pregnant women who are over 30, obese, have a family history of diabetes and have previously given birth to a very large child are among those who are most at risk to develop the condition. Once the condition is identified, treatment includes exercise, weight-watching and eating a carefully planned diet that will help the blood sugar level stay within the normal range (60 to 120mg/dl).

HERE'S A POP QUIZ: WHO HAS TO BE able to lift 100 pounds, sometimes repeatedly, doing it beautifully, gracefully, and musically, with perfect form--and no grimacing allowed? You guessed it: It's a male dancer, especially in ballet. Sure, there are plenty of athletes out there who can heft more than their body weight--but they get to focus on only the lifting. Doing such movement within the context of an art form is a challenge unique to dancers.

Lifting a living, moving being is far more difficult than hoisting a barbell with a constant weight. Dancers have to lift partners of varying sizes, often within one ballet--partners whose costumes and sweaty, bare skin can make it harder to lift them properly. Then, too, barbells don't coming hurtling at you from across the stage, expecting you to toss them in the air. The variables are daunting. What's required are strength, second-nature response, and proper training.

Prevailing thinking long held that dancers only had to dance more to correct problems, says Peter Marshall, company physical therapist for American Ballet Theatre. Dancers everywhere did few activities outside of ballet, worrying that gym workouts would make them look like the Incredible Hulk. Yet their injuries persisted, with the lower back especially vulnerable. Without sufficient power in his shoulders and arms to do overhead lifts, a dancer might jerk his partner overhead, straining his lower back.

By the mid-1990s, dance medicine began to take cues from sports medicine, according to Marshall. Alternate forms of training became more acceptable, physical therapists started working with dancers at an earlier age, and dancers became more knowledgeable.

Jock Soto, principal dancer at the New York City Ballet, has seen the mind-set toward preventative therapy change, as companies began to use chiropractors, physical therapists, massage therapists, and athletic trainers. "People got more health conscious and wanted ways of getting stronger," Soto says. "So many dancers were getting injured. To prevent this, you had to join the club."

Therapists realize that preserving the long, lean "look" of a male dancer will figure into treatment. They work with dancers over the long haul in order to bring them back with maximum range of motion, Marshall says.

Q I get conflicting advice on how to train my arms for a shapely, sexy look. One person tells me that if I train them like guys do, my arms will end up looking like a dude's. Someone else says the same training approach works for both sexes; that the genetic differences between us will produce different looks no matter what. Who's right?

B.D.

Vero Beach, Florida

A Saryn Muldrow, 1996 Fitness Olympia winner, responds: "It depends on your individual genetics for arm development, but as a general rule, women don't need to train arms any differently than men do. Try doing barbell curls, hammer curls and one-arm cable curls for biceps; and dumbbell kickbacks, one-arm overhead cable extensions and bar pressdowns for triceps. I recommend doing no more than three exercises for bi's and three for tri's per arm workout. Choose a weight that produces a real bum -- where you feel like you can't press or squeeze out one more rep -- at 10-15 reps, then increase the weight once you can exceed 15. Rest 30-45 seconds between sets and only slighter longer between exercises to allow for a change of weights or apparatus."

STOP! Put down the leftovers and back away from the fridge. If you're like the millions of other Black Americans who gave up fitness for food during the holidays, then it's past time to get back on track.

Whether you've been committed to living a healthy life for years or have just started to commit to better health, the holidays are often a time when people tend to forget their fitness plan, make poor choices and gain weight.

"There's so much going on, and the workout gets pushed to the back burner," says Linden Mathurin, president of Total Wellness Systems Inc., a private personal training studio in Chicago. "People are a lot more social and they basically put too much into their system."

But experts say it's never too late to get going again. Even though the best strategy would have been to stay with it and stay focused during the holidays, that's all in the past. The New Year is for starting fresh, making changes and getting back on the right track. It's time to make the right exercise and food choices to jump-start your way back into the get-fit game.

EXERCISE

Depending on your fitness level and routine before the holidays, it's important, experts say, to begin slightly behind where you once were. If you were doing 45 minutes of cardio three times a week and haven't exercised for a few months, start with a lower dose of cardio and work back up to 45 minutes. Instead of doing three sets of crunches, try doing one or two sets of crunches at first and gradually increase the sets. Instead of lifting and cardio on the same day, choose one or the other and alternate days.

It will take time and patience to restore your fitness level but that's to be expected. Once your body gets used to eating poorly and being less active, it takes more time to burn fat and get in shape.

FOOD

To get your metabolism burning fat again, eat breakfast every day, fitness experts say. Try eating your first meal within a couple of hours of waking up and then have three more meals spaced throughout day, generally every three to four waking hours--ending before 7 p.m.

It may be a good idea to limit certain foods at the beginning of jump-starting your fitness plan. Consult your physician about foods that may help or hinder your specific fitness plan. Then you can gradually add those foods again.

Q I am an African-American male who has endured a medical condition commonly known but often ignored by countless thousands--razor bumps. It is painful and often results in discoloration and swelling, and can leave permanent scarring. Many of us just grin and bear it in silence, but what can I do to get relief from this age-old problem? A.M., Landsdowne, Pa.

A As you said, you are experiencing one of the most troubling and uncomfortable conditions that many Black men have to endure. Razor bumps (pseudofolliculitis barbae) results when curved hairs grow back into the skin, causing inflammation, hard bumps and keloid scarring.

Dermatologists say the most effective treatment is to allow the beard to grow because once the hairs reach a certain length they won't grow back into the skin. The use of an electric razor will help the condition because it does not cut as closely as blades.

There are several products on the market that can alleviate the condition, but the most frequent recommendations for daily care include massaging the beard area gently in a circular motion with a warm, moist, soft washcloth; shaving every other day, rather than daily; not pulling the skin taut when blade shaving; and if you must use a blade, wash your face with a mild cleanser before shaving.

Q I am a 37-year-old female who has sensitive skin and is concerned about my facial moles. More and more have appeared as I have gotten older, and they first appeared when I was a youth. After constantly trying to deal with them with several facial treatments, nothing seems to work. What should I do about the moles on my face, and are they life-threatening? Should I follow my mother's advice and have them removed? W.A., Crystal Springs, Miss.

A Moles are small, usually dark, skin growths that develop from pigment-producing cells in the skin. They are common and can appear on most parts of the body, but they tend to get more attention when they appear on the face.

Doctors say practically everyone has about 10 moles, which are usually dark brown or black, but they can be flesh-colored or yellow-brown. They commonly develop during childhood or adolescence, and like all cells, pigment cells respond to changes to hormone levels, so moles may appear, enlarge or darken during pregnancy.

Most moles are harmless and don't have to be removed, but noncancerous moles can develop into malignant melanomas. Fortunately, researchers say the risk of any mole developing into melanoma is small--about one case in 200,000. Last year, the American Cancer Society reported that only about 7,400 deaths were due to melanomas.

If you consider the moles on your face to be unattractive, you can have them removed, but according to statistics, they probably are not life-threatening. Talk with your doctor, especially if there are changes in a mole, including enlargement, darkening, bleeding, itching and pain.

`What can you tell me about the drug Ecstasy and its dangers?'

DANGERS OF THE DRUG ECSTASY

Q I have two sons, both of whom are away from home while they attend college--one in Washington, D.C., and the other in Atlanta. They are responsible, sensible young men, but I worry about them because I hear so much about the popularity of the drug Ecstasy and the dangers associated with it. What can you tell me about this drug and the effects it can have on one's body? D.M., Chicago

A Ecstasy (MDMA), one of several so-called party or club drugs, is among the most popular drugs being used by teenagers and young adults, and its abuse is being reported frequently in metropolitan areas like Chicago, Atlanta, Seattle and Miami, authorities say. Also called "Adam" and "XTC" on the street, Ecstasy is a synthetic, mind-altering drug with amphetamine-like and hallucinogenic properties.

Doctors say many of the risks users face with the drug are similar to those associated with amphetamines and cocaine--including depression, sleep problems, paranoia, muscle tension, nausea, blurred vision, and increases in heart rate and blood pressure, an especially dangerous risk for users with circulatory or heart disease.

Additionally, research links Ecstasy to longterm damage to those parts of the brain that are critical to thought and memory. The drug also could be an underlying cause of problems associated with Parkinson's disease and, doctors say, could eventually lead to a form of paralysis.

IMMUNIZATIONS FOR CHILDREN

Q My husband and I are the proud new parents of a 1-month-old boy, and since we want to do everything right to make sure that he remains healthy, when should we start to think about getting certain immunizations that will protect him from childhood illnesses? A. D., Miami

A You are right to begin thinking about having your baby vaccinated to prevent potentially deadly illnesses, but a discussion with your pediatrician is the best way to determine the immunization schedule for your child.

About 90 percent of all children in the United States are vaccinated, and all 50 states require certain vaccinations before children can be allowed to enter day-care centers.

(Q) If my goal is to burn calories, should I take a one-hour step class or a one-hour Spinning class?

(A) "They can be equal, or either one can burn more than the other, depending on several factors," says Dixie Stanforth, M.S., faculty member in the kinesiology department at The University of Texas at Austin. With step aerobics, the higher the platform and the more you weigh, the more calories you'll burn. The choreography also matters, although less than step height and weight. You're going to burn more calories with propulsive types of movements than with basic stepping," Stanforth says.

According to Stanforth, who has conducted research at various step heights, a 145-pound person doing basic stepping at a music speed of 120 beats per minute burns about 7 calories per minute on a 6-inch step, 8.5 calories per minute on an 8-inch step and 9.8 calories per minute on a 10-inch step. Add tougher choreography, and the same person burns more calories per minute: 9.3 calories on a 6-inch step, 10.3 calories on an 8-inch step and 11.1 calories on a 10-inch step. For one hour, the calorie expenditure typically ranges between 400 and 660. Upper-body movements add little to the calorie burn, Stanforth says.

Only a handful of studies have looked at the energy cost of indoor cycling classes, she says, and they have found a calorie expenditure between 300 and 600 for classes lasting 40-60 minutes.

With indoor cycling, your weight does not affect your calorie burn because in the seated position, you're not bearing the weight of your body. Instead, the key factor is your power output, a combination of how fast you pedal and against how much resistance. Pedaling fast with little resistance burns minimal calories, Stanforth says, because "the bike is doing the work -- not you." Pedaling at a slow cadence is also not an efficient way to burn calories. You'll maximize your calorie burn if you pedal at a faster cadence against a challenging resistance -- a pace that is hard to define, varies greatly from person to person and depends in part on your fitness level.

Many people think that, because they sweat so much in Spinning classes, they're burning more calories than they are in other classes. But that's generally not true, Stanforth says. The sweating is largely due to the lack of air movement in the room. "You tend to heat up a bit more unless there are fans," she says.

After last year's serious problem with the West Nile virus, I'm concerned about what we can expect this summer, since most of us want to spend time outside with our families. I have to tell you that I'm so scared my whole list of outside activities has been changed. What's the latest on this mosquito-related disease, and just how serious a problem is it?

L W., Little Rock, Ark.

A Last year, there were 4,161 cases of West Nile reported in the U.S., and there were 277 deaths related to the disease.

The virus is one that is difficult for scientists to forecast exactly where it will appear this summer. It already has been identified in at least 30 states and the District of Columbia.

Doctors say the virus doesn't present a major risk for healthy individuals, but all residents where the virus has been identified are at varying degrees of risk, with persons having weakened immune systems facing the most serious threat--death.

Contact your doctor if you have symptoms of West Nile virus, including high fever, confusion, muscle weakness, swollen lymph glands, rash and severe headache. Officials say there is no specific treatment for the disease, but that severe cases require intensive supportive therapy.

THERE was no blood. No broken bones. No apparent cause for the excruciating pain in Anita Jones' lower back, knees, hands and neck. Yet the intensity of her pain was so unbearable that she could barely stand or walk. She lost the use of her hands at times and could no longer work her full-time job.

What was wrong with Anita Jones?

She was suffering from chronic pain, later identified as fibromyalgia, a condition that transformed her life into a prison of misery and suffering.

Anita Jones is one of millions of African-Americans, and people in general, of all ages, who suffer from painful medical conditions ranging from arthritis to back pain, cancer, diabetic neuropathy, HIV/AIDS, fibromyalgia, sickle-cell crisis, lupus and post-operative conditions. The latest studies indicate that chronic pain affects an alarming 44 million households and costs an estimated $100 billion per year in health care costs and lost productivity. The Partners Against Pain program reported that chronic pain is so severe and debilitating that one-third of all patients say that they cannot function normally and experience such agonizing pain that they often want to die.

To combat the rising problem, experts suggest that chronic pain be treated as a disease, not merely a symptom. "Pain is a growing problem for physicians and patients. When inadequately treated, pain can lead to depression, loss of function, increased time to heal and lost workdays" says Dr. Kathleen Foley, professor and neurrologist at Memorial Sloan-Kettering Cancer Center in New York.

But understanding the cause of pain, the patient's response to that pain, and then matching the appropriate pain management to the degree of pain can be difficult, says Dr. Gary C. Dennis, chief of neurosurgery at Howard University Hospital and former National Medical Association president. "However, using a pain scale ranging from 0 to 10, we ask the patient to assess their pain. If the pain is 10 out of 10, then that patient is in terrible pain," he says. "If a patient's pain is 10 out of 10 even with medication, then obviously, that medication is not working."

In 1998, the Royal Netherlands Army introduced a new examination system, which is based on the "workload-capability" model, to replace the old system, which focused on diagnosis and was solely based on the detection of diseases and infirmities. In a randomized controlled study, we found that soldiers recruited under the new system displayed a statistically significant higher number of days fit-for-duty and incurred lower medical costs than solders recruited under the old system. To gain a better understanding of the reasons for these differences, we studied the association between these results and information collected about the soldiers. In the course of the study, we collected various types of information about the study participants (e.g., education, deployment). During the study, soldiers were asked to complete a questionnaire twice a year, its content based in part on a periodic occupational health examination questionnaire commonly used in The Netherlands. We found that the following factors influenced fitness for duty and medical consumption: education, injuries, actual operational deployment, and the examination system itself. The superior performance of the new RNLA Basic Medical Requirements (BMEKL) system seems partly attributable to the assessment of the ability to meet the task-specific requirements. The primary mechanism is as yet undiscovered.

Introduction

In November 1998, the Royal Netherlands Army (RNLA) introduced a new medical examination system, the RNLA Basic Medical Requirements (BMEKL),1 to replace the previous system (PULHEEMS: all diseases and infirmities that lead to unfit declaration are subdivided into seven categories: physical capacity, upper limbs, locomotion, hearing, eyesight, emotional and mental state). The new system is based on the "workload-capability" model and focuses on the job requirements, whereas the old system was focused on diagnosis and assessed recruits on the basis of the detection of diseases and infirmities.