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TWENTY-SIX-YEAR-OLD Stephen Leak lives with the constant dread of death. He does not mention drunken drivers or a lunatic's fury among his worries. He's no hoodlum or wanna-be-gangster wondering if he'll catch a bullet for living on the edge. Instead, the young entrepreneur speaks of his lifelong struggle with asthma, a respiratory ailment that affects nearly 15 million Americans. With the innocence of boyhood still fresh on his face, Leak says he fears that his next labored breath could be his last.

The Chicago man still remembers his first major asthma attack at age 15.

"I never felt anything like it before," says the local party promoter. "I sounded like a dog crying. I started wheezing and I couldn't breathe. My mother had to help me out to the car."

He describes the sensation as similar to having just run a 100-yard dash and then having someone bind your mouth and nose with a scarf.

"You try to gasp for air, but you can't," he says. "You just stay out of breath."

More African-Americans are living with asthma, a chronic lung disease that inflames and swells the linings of the airways, than ever before. According to the American Lung Association, the number of people of all races who have been diagnosed with asthma soared 61 percent between 1982 to 1994, reaching what some experts are calling an epidemic. African-Americans are among the hardest hit: Blacks are three times as likely to be hospitalized for asthma as Whites. We are four times more likely to be rushed to the emergency room for care.

"I've seen about a 10 to 15 percent increase of patients with asthma over recent years," says Dr. Frank J. Cook, assistant professor in the Morehouse School of Medicine's division of pulmonary diseases who was in private practice for 17 years. "In the last two months, I've seen three deaths from asthma. [The illness] seems to be affecting our people more often from the oldest to the youngest."

Asthma is the most common chronic illness of childhood, according to American Lung Association statistics. But for young African-Americans, who are diagnosed with asthma twice as often as Whites, the consequences can be particularly devastating.

More than 5,000 people died from asthma in 1995, nearly double what the toll was two decades ago. The grave situation facing Blacks becomes apparent when you consider the disproportionate number of Blacks dying from the disease. While African-Americans make up just one in eight of the population, we compose one of every five of asthma-related deaths.

In recent years, more Blacks have felt the ache of losing loved ones to asthma, including author Terry McMillan whose mother died of asthma in the early '90s and Chicago political leader John H. Stroger Jr. whose 22-year-old son Hans died from an asthma attack in 1982, just seven months after graduating from Xavier University.

"My son had been an asthmatic all his life," says the first Black president of the Cook County Board of Commissioners. "The severity of asthma in this country seems to be getting worse at a time when we have advanced so much in medical technology."

What's behind the new asthma epidemic and why is it targeting Blacks? Answers to those questions depend on whom you ask.

"We have a disproportionately large number of people who are poor and who don't have the access to health care systems, medications and the specialists that can help them manage this disease," says Dr. Floyd J. Malveaux, dean of Howard University's College of Medicine and vice president of health affairs. "If you look at the numbers where deaths occur, you'll see they often happen in areas with large concentrations of the poor. It's the same thing when you look at emergency-room visits."

Malveaux, a leading asthma expert, says poor Blacks may face graver threats from asthma because of lack of money and education. Those who work part-time or lack insurance coverage can be left with the difficult choice of paying for costly medicine that can range between $100-$200 a month and rent or food.

"If you are poor, you can spend up to one-third of your income managing a sick, asthmatic child," Dr. Malveaux says.

Other experts say patients forget to take their medicine or neglect to continue the doses when they feel fine. Some follow the untested advice of friends who tell them they can become addicted to their inhalers -- devices that deliver a mist of medicine to clear the airways. Still others underestimate the seriousness of asthma, or mislabel asthma as a "children's disease," thinking they cannot get the respiratory illness because they are old.

Dr. Malveaux, Dr. Cook and others agree that a complex web of triggers like stress, environmental pollution, cigarette smoke, dust mites, mold, cockroaches, and constant exposure to animal dander contribute to the devastating trend.

While the cause of the surge is still debated, the dynamic of asthma is no mystery. The suffocating effects of asthma occur when the lung's bronchial tubes become hypersensitive to a trigger or allergen like dust, pollen or smoke, causing the body's immune system to spew inflammatory chemicals into the airways. These chemicals cause the air passages to swell and fill with thick, sticky mucus, leaving the asthma sufferer gasping for air.

# posted by Medical Information : 3:43 AM  0 Comments

Ever wonder why you feel cranky, stressed, and sleepy? times, the cause is physical inactivity. Don't worry if you are marathon runner or aerobics isn't your thing. The slightest movements--even simple stretching--and applying variety, balance, and moderation to your food choices and physical activity habits help increase your stamina for your overall long-term good health.

"Regular physical activity is a powerful tool for weight management," indicates registered dietitian, nutrition education counselor, and American Dietetic Association spokesperson Roxanne Moore. "A physically active lifestyle offers many rewards--from heart health to strong bones to stress relief--plus many other benefits."

The American Dietetic Association offers a number of ways to improve and maintain your lifestyle for a lifetime:

* Get up 30 minutes earlier in the morning and take a brisk walk to start your day. Bring a neighbor or friend to make it more pleasant.

* Forget the drive-through car wash. Wash your car yourself. You will save money at the same time.

* Take the stairs instead of the elevator or escalator. Walking up stairs is a great heart exerciser and calorie burner.

* Park at the far end of a parking lot for a longer walk. Get off the bus a stop ahead then walk the rest of the way to your destination.

* If you are a computer user move your body at least five minutes for every hour of computer time.

* Walk around your building--outside or inside--during your coffee break. You'll burn energy rather than being tempted to nibble or snack,

* Before and after dinner walk--and talk--with your family. To burn more energy if you are a parent or caregiver of an infant, use a baby carrier on your back rather than pushing a stroller.

* Do some backyard gardening. In the fall, rake leaves

* Ride your bike to work or to a friend's home. Walk to do errands that are just a few blocks away.

* While you watch television, do household chores or projects, such as mopping the kitchen floor or refinishing a piece of furniture.

* Catch up with your around-the-house work. Wash the windows; vacuum or shampoo the carpet; clean the garage or basement; and/or sweep the sidewalk.

* Use the exercise equipment you already own. Ride your stationary bicycle while you read or watch the news while you work out on rowing machine to make exercising more interesting.

* Push your lawn mower instead of using the power-assisted Skip the snow blower and shovel the snow by hand if you're fit.

* Make homemade bread, kneading the dough by hand, not with bread machine or food processor.

* Use a restroom or pay phone at the other end of the building.

* Plan an active family vacation or weekend outing. Rather than sitting on a beach, go canoeing, hiking, or skiing.

* "Walk your talk!" If you like to chat on the phone, buy a one so you don't need to sit still.

* Rent an exercise video rather than a movie, and work out with the video as a leisure-time activity.

# posted by Medical Information : 3:42 AM  0 Comments

TODAY IS A GOOD DAY FOR PRINCIPAL dancer Muriel Maffre. Her lower back isn't giving her too much trouble. She's able to move with good range of motion and extension during her classes and rehearsals with the San Francisco Ballet. That isn't always the case, though. On the bad days, her muscles spasm and the pain kicks in.

Next to the foot and ankle, the back is the sore spot for dancers. Back injuries "are a human condition," says physical therapist Michael Leslie of the San Francisco Ballet.

Getting educated is the critical first step. The spine is divided into the cervical, thoracic, and lumbar areas. Discs are pads of cartilage between vertebrae that act like cushions. Dancers typically have problems in the lower (lumbar) back, though sometimes the middle (thoracic) back can get into trouble.

Which back injuries sideline dancers often turns on age. Strains and sprains in the ligaments of the lower back often plague dancers in their early to mid-20s, Leslie says. In their mid- to late 20s their discs may start to degenerate. That can continue into their mid-30s, when their joints may start to go. Overuse contributes to many lower back problems. But body wear and tear also has to do with the demands of different styles of dance. In the United States, ballet companies offer a mix of styles that require different motor patterns. Dancing a variety of styles all in one night may put more strain on the lower back, Leslie says.

Other rimes, dancers push their bodies beyond what they are prepared to do, says Boyd Bender, physical therapist for the Pacific Northwest Ballet in Seattle. Experienced dancers, he notes, can often spot subtle problems, like the feeling of being off balance. Certain red flags--like stiffness on only one side--can tip physical therapists to trouble in a dancer's lower back, Leslie says.

Bender says dancers tend to be hypermobile in certain parts of the lower back. (Proper training and awareness of body position helps minimize stresses dancers put on their lower backs, especially from movements like arabesque.) But think of an ankle that has been sprained; over time, it becomes looser. Similarly, discs, ligaments, and the tissues surrounding the joints can become irritated and very painful. That, in turn, can affect the tone of the muscles and cause pain. Sometimes if a dancer has stiff hips, the body will compensate for that by using the back more.

Some injuries (like disc protrusions) are severe enough to require surgery. If not, physical therapists work closely with dancers to get them healthy again. Their treatments include stretching exercises, massage, and active release techniques to work the soft tissue and joints, and the familiar ice, heat, electrical stimulation, ultrasound, and taping.

Stretching is a mainstay. When Leslie works with dancers with low back problems, he often has them do the "swastika" stretch: sitting upright on the floor, in fourth position, with knees bent at ninety degrees. This move stretches the groin, or the "turn-in" muscles, which often get short shrift. To stretch the "turn-out" muscles in the hip joints, he has dancers lie on their backs with knees bent and feet on the floor, then place one ankle on the opposite thigh, reach under the supporting leg, and pull forward.

Another therapeutic stretch is the cobra pose, a fundamental yoga stretch. Leslie has dancers lie on their stomachs and gradually push up on their hands, working to extend their elbows while keeping the pelvis on the floor.

Strong abdominal muscles are critical to a strong lower back. Bender often instructs dancers to do modified curl-ups to work the deeper abdominal muscles. Other times, he puts them on a balance ball or wobble boards, which work their core muscles and promote balance and coordination.

Maffre, who was born with scoliosis, is no stranger to injury and cross-training. The 5' 10" dancer has always been extremely limber, which she says may have made her more susceptible to back injuries. Five years ago she had problems with hypermobility in the sacroiliac joint at the base of her spine. She received sugar-based injections, which created scar tissue to stabilize the joint.

For eight years, Maffre, 35, has coped with the degeneration of the joints in her lower back. The moment she arches her back, she's in pain. She works with a physical therapist twice a week, but she won't take painkillers. "I would rather feel my body and the pain as it is and deal with that," she says.

To cope, Maffre has changed how she trains and dances. She dances six days a week and on the seventh day, she goes to the gym or does some nonballet activity, like power-walking. She stretches for half an hour before classes, rehearsals, and on her days off. She'll start with the cat stretch, followed by lunges and hip stretches. When she does arabesque, she lifts and lengthens her torso to create room for her vertebrae and relieve pressure on her spine. She's learned to use her abdominal muscles more instead of relying solely on the flexibility of her spine.

# posted by Medical Information : 3:41 AM  0 Comments

A new study finds work quality and quantity both show significant improvement when workers are more active and physically fit.

The study, led by Minneapolis-based Health Partners researcher Nicolaas Pronk, was published in the January Journal of Occupational and Environmental Medicine. It analyzed health and lifestyle factors in 683 workers in various occupations. Researchers compared levels of physical activity, fitness and obesity with indicators of job performance rated by the workers themselves. Not only did physical activity and fitness have a significant impact on work performance, but workers who were more physically fit needed to put out less effort to do their work. Obesity had a negative impact, and about a fifth of workers in the study fit that description. They reported having more difficulty getting along with co-workers, and those who were "severely obese" (4.5%) missed many more days of work. Concluded the researchers, "Lifestyle-related, modifiable health risk factors significantly impact employee work performance."

# posted by Medical Information : 3:06 AM  0 Comments

You've probably seen them from your car window during your daily commute: Spandex sporting, Walkman blasting, water-bottle toting warriors, walking their way to fitness. You may not know where they're coming from, but you do know where they're headed -- down the path to a healthy lifestyle. Every day millions of Americans step into their walking shoes and strut their stuff through cityscapes and countrysides across the nation.

Walking is the most popular exercise in America, and with good reason. "It's very easy, it's convenient and it's natural," says Dr. Deborah L. Bernal, the American Academy of Physical Medicine and Rehabilitation's liaison counselor to the National Medical Association. "The main benefit is convenience. It's an easy [fitness] program to initiate because most people walk a certain distance anyway to get somewhere." Physicians and fitness experts say that walking has the edge over aerobic exercises like running because it's a safe, low-impact activity that doesn't put a huge pounding on the body. That makes walking an excellent exercise for beginners, the obese and the elderly because the risk of injury to muscles and joints is minimal.

Medical experts say that people who can't even walk under normal conditions can water-walk in a swimming pool using flotation devices to strengthen their muscles. Walking also is part of the rehabilitation program for many heart attack and stroke sufferers. Even better, walking probably is the cheapest exercise around. All you need is a pair of comfortable shoes and you're good to go. But perhaps the greatest advantage walking has over other exercises is convenience. You can walk around your block, through your neighborhood or up and down the stairs at work or home.

Walking 20-30 minutes a day just three times every week can yield enormous benefits for your body, especially when combined with healthy eating. Walking lowers blood pressure and cholesterol levels, stimulates circulation and reduces the risk of heart attack, heart disease and stroke. It boosts your immune system, your metabolism and your endurance. Walking also strengthens bones, tones muscle, fosters weight loss, and helps you sleep better. In addition to its physiological benefits, walking has important psychological effects. It decreases stress and tension, relieves depression, and improves both your mood and your self-image.

GETTING STARTED

Before you start any fitness routine, it's a good idea to visit your physician for a checkup, just in case you have any underlying health conditions that need monitoring. Once you get the go-ahead, wear comfortable clothing and shoes to make your walk as pleasant as possible and to avoid serious injuries. "I saw a lady walking to work in three-inch high heels and a skirt so tight, that if she hit a crack, I'd have another patient," Dr. Bernal chuckles. Yet foot problems and injuries caused by walking in improper shoes are no laughing matter.

"Walking in high heels causes stress to the balls of the feet, ankles, knees, back, shoulders and neck," says Dr. Bernal, who also is a member of the Board of Medicine for Washington, D.C. "Lose the heels while you're walking. The lower the heel and the greater the arch support, the better." Along with well-cushioned shoes, heavy socks are a must-have to prevent blisters.

Once you get your gear ready, gear yourself up for success. Use the step approach. Start slowly, doing only what feels comfortable, and build from there. You only need to exercise 20-30 minutes a day, three times a week to see results, so make that your initial goal. Don't go for broke on your first few attempts, and make sure you enjoy what you do. Otherwise, you will soon have your feet off the pavement and back on the coffee table.

WALKING WISELY

Once you have the right attire and the right attitude, approach walking wisely to get an effective workout. Stretch before and after your walk to prevent muscle cramps. Start slow, walking with your back straight, toes pointed forward and chin up. With each step, plant your heel down first and push off with your toes. Move your arms to give yourself more momentum and to tone those arm muscles. You can even carry a couple of dumbbells and do arm curls while you walk. Work up to a comfortable pace. Experts say you can us, the "talk test" to determine if you're exercising at the proper pace. You should be able to carry on a conversation without gasping for air. Wrap up your workout by slowing down to a casual stroll and ending with a stretch.

Studies also show that incorporating moderate- to high-intensity spurts into your workout not only helps you burn fat four times faster, but also brings new life to an old routine, and keeps your body from plateauing -- getting so accustomed to a particular workout that it loses its effectiveness. To interval train, walk three minutes at your regular pace (brisk, yet comfortable), then walk faster for a full minute by lengthening your stride and swinging your arms harder. Return to your regular pace for three minutes, then walk fast for one minute. Do this 3-1-3-1 combination throughout your workout.

# posted by Medical Information : 3:05 AM  0 Comments

You've heard it before: If you have heart disease, or never want to get it, exercise is one of your best allies. But hitting the gym three times a week may not be good enough anymore.

As researchers gather more data--and as Americans grow more sedentary--the recommendations for physical activity are changing. Even if you need to step up your routine, staying in shape is a goal within almost everyone's reach. It's more about consistent effort than Herculean exertion.

Like any muscle, the heart is conditioned by regular sessions of physical activity. A fit heart pumps a higher volume of blood per beat than one that's out of shape, giving you the stamina for bursts of activity, such as sprinting up five flights of stairs. But exercise also single-handedly reduces many potential threats to cardiac health by lowering cholesterol levels and blood pressure, as well as fighting obesity and relieving stress.

Perhaps the last time you heard, heart health authorities were advising 60 minutes of moderate exercise three times a week. But since 1996, recommendations for both prevention and treatment of heart disease have become more comprehensive. Just 10 years ago, doctors prescribed rest rather than exercise after a heart attack. But now they say a weakened heart must be built up again. The bottom line is that a sedentary lifestyle is dangerous, whether your heart is healthy or not.

According to the Centers for Disease Control, the Surgeon General's Office and American Heart Association (AHA), the current consensus for heart health and exercise is aerobic exercise (walking, jogging, cycling, swimming or racquet sports) at least five days a week for 20 to 60 minutes, along with at least two 30-minute weight-lifting sessions weekly. The latest studies also show that breaking up physical activity into 10- to 15-minute segments throughout the day is just as beneficial as one long session. The results of such a routine are dramatic. Researchers at Brigham and Women's Hospital in Boston found that men who exercised at least five times a week had 46 percent fewer heart attacks than those who worked out once a week or less.

While activities like vacuuming or gardening are good ways to burn calories, they are not enough in the way of aerobic activity because they don't work the ticker hard or long enough. You need to exert yourself at 60 to 90 percent of your maximum heart rate, says Shirley Moore, R.N., Ph.D., a nursing professor at Case Western Reserve University in Cleveland. The general rule for determining maximum heart rate is to subtract your age from 220, but that formula doesn't allow for individual differences in fitness levels. (The maximum heart rate for a sedentary younger person might be too low for a fit older person.) After you determine the rate, take your pulse for a minute while exercising to see if you're on target. It's also helpful to judge exertion by how hard you're breathing, points out Gerald Fletcher, M.D., a cardiologist at the Mayo Clinic in Jacksonville, Fla. When exercising at the proper intensity, he says, you should be short of breath but still able to talk.

Whether your jogging shoes are in mothballs or you've been diagnosed with a heart disorder, it's still possible to exercise safely and maintain fitness goals similar to those of healthy people, says Terry Bazzarre, Ph.D., an AHA staff scientist. After consulting with your doctor to devise an appropriate exercise routine, start off slowly. As you gain strength, gradually increase the intensity, frequency and duration of workouts.

Adding two to three weight-training sessions to a weekly exercise regimen can reduce blood pressure and body fat levels, according to a 1999 study conducted at the William Beaumont Hospital in Royal Oak, Mich. Experts advise getting professional training to learn how to pump iron safely and protect yourself from injuries. After you get the basics down, aim for 8 to 15 repetitions each of 8 to 10 exercises that condition major muscles, such as the biceps, triceps, quadriceps, deltoids and trapezius.

If there's one thing that scientists seem certain of, it's that frequent physical exertion is an essential component to your heart's strength and longevity. The best strategy is to find a physical activity you enjoy so workouts don't seem like a chore. Even if you're comfortable going to the gym, breaking your routine occasionally to, say, Rollerblade through the park is good for your outlook and your heart.

# posted by Medical Information : 3:05 AM  0 Comments

Incorporating a physical regimen into your everyday lifestyle is something that everyone should strive for, including people with diabetes. When your body is in good physical condition, you have the endurance, flexibility and strength needed to perform daily activities with ease. If you've spent most of this year more stationary than active, but would like to take steps toward a healthier you, then don't wait any longer. The first step begins by making a conscious decision to get moving. Before you sign up to compete in the next triathlon, the American Diabetes Association (ADA) recommends that people with diabetes first follow a few helpful tips:

visit your doctor

* Schedule a visit with your physician before beginning any form of exercise. Your health provider's advice will depend on the condition of your heart, blood vessels, eyes, kidneys, feet and nervous system. They may also recommend an exercise stress test to see how your heart reacts to physical activity. If the tests show signs of disease, ask what exercises will help you without making your conditions worse.

be rational

* When beginning your regimen, think about what activities are realistic for you to do. Make sure your activity of choice is somewhat challenging but not overly difficult.

start slow

* Allow yourself time to get into a routine. Start off by working out for 30 minutes for two days a week and gradually increase your days up to four. Don't get discouraged. Set a goal for yourself each week and once you reach it find a rewarding way to treat yourself.

check your blood glucose

* Everyone's blood glucose response to exercise will vary. Checking your blood glucose before and after exercising can show you the benefits of activity.

wear your ID

* In case an emergency occurs during your workout, a medical identification bracelet, necklace or even a medical ID tag should be worn to inform others of your condition.

avoid low blood glucose

* During activity, check your blood glucose if you notice symptoms such as hunger, nervousness, shakiness or sweating. If low blood glucose is interfering with your exercise routine, try eating a snack before your workout or adjusting your medication. Talk to your physician about what's best for you.

bring a snack

# posted by Medical Information : 3:25 AM  1 Comments

Before leaving home to attend college, Tina Beauvais carried a healthy 135 pounds on her 5-foot-8-inch frame. "I ate properly since my mom cooked healthful meals every night," Tina remembers. "But when I went to college, unhealthy dorm food and my active social life caused me to gain weight." Then during Tina's sophomore year of college, her mother died suddenly. That sent Tina into a deep depression, and she turned to food for comfort. Soon, Tina's weight rose to 165 pounds. "I figured life was too short to diet and ate to my heart's content," she says.

HER TURNING POINT

A year and a half after her mother's death, Tina saw herself in a photograph and did a double take. "I thought, 'Is that really what I look like?'" she recalls. "I was huge and out of shape. I didn't look like myself."

HER WEIGHT-LOSS & EXERCISE PLAN

Tina went to a Weight Watchers meeting the very next day. "My mom had lost weight on their program, so I decided to check it out," she says. At the meeting, Tina learned that she needed to stick to 1,800 calories a day to lose weight. Tina also committed herself to exercising 2-3 times a week, doing 30 minutes of cardio on the bike or walking on the treadmill, and 20 minutes of weight training at the campus fitness center.

MAKING SUCCESS HAPPEN

Tina was out of the dorm and living on her own, so it was easier for her to bring home nutritious foods. "I added lowfat, high-fiber foods like fruits and vegetables to my diet so I could fill up on fewer calories," she says. Tina occasionally treated herself to her favorite foods, such as chocolate, so she wouldn't feel deprived.

With these improvements to her eating habits, Tina lost about 2 pounds a week. "It was exciting to see the changes in my body, and my depression slowly started to lift," she says. Tina was 30 pounds lighter when she married her fiance a year later.

Tina maintained her weight loss for three years, until her first pregnancy. After her daughter was born, Tina wanted to lose 20 pounds to return to her pre-pregnancy weight. "I only lost 5 of them by the time my daughter turned 3 months old," she says. "The last 15 pounds were the hardest to lose--I was exercising and watching what I ate, yet the needle on the scale didn't budge." Concerned, she went to her doctor and was diagnosed with hypothyroidism. Tina was prescribed medication to regulate her thyroid and improve her metabolism. "I lost the last 15 pounds in six months," she says.

Tina has since had another baby, and four months postpartum she was back at 135 pounds, thanks to her exercise and healthy eating habits. These days, eating right and working out have a new purpose, Tina says. "I have the energy I need to keep up with my kids, which is the best reward of all."

WORKOUT SCHEDULE

Weight training: 30 minutes/3 times a week

Walking, yoga videos or kickboxing: 45 minutes/4-5 times a week

RELATED ARTICLE: TINA BEAUVAIS, 28, MICHIGAN

* Height: 5'8"

* Pounds lost: 30

TINA ON ...

* FAMILY FITNESS "My 3-year-old daughter and I love to do a children's yoga video together. I get a kick out of hearing my daughter say 'namaste.'"

* RECIPE MAKEOVERS "Almost every recipe can be prepared more healthfully. I've trimmed the fat from my favorite zucchini bread recipe, and no one knows it's lowfat because it's so delicious."

* TRYING SOMETHING NEW "I've taken classes like figure skating, water aerobics and martial arts. I learn something new to get out of a fitness rut."

# posted by Medical Information : 3:25 AM  0 Comments

You hear a lot about pre- and post-workout nutrition, but what do you do when the hunger pangs strike right in the middle of a hard session? Don't just reach for whatever. Depending on your type of exercise and your fitness goal, different types of supplements can best serve your needs--without sending you to the bathroom minutes later.

RESISTANCE-TRAINING MEAL REPLACEMENTS

If you're lifting weights to get huge, you need high protein and even higher carbs. Go for a serving of Muscletech Mass-Tech mixed in water (45 g protein, 150 g carbs per serving).

If you're lifting to gain lean mass, you need a whey protein isolate with about twice as many carbs from maltodextrin as protein. Down a bottle of ABB Mass Recovery (35 g protein, 60 g carbs).

If you're aiming to drop fat, you need a whey isolate that's low in carbs. Reach for a bottle of Nature's Best Zero Carb IsoPure (40 g protein, 0 g carbs).

CARDIO-TRAINING MEAL REPLACEMENTS

If you're on the treadmill for endurance, you need high carbs and a little bit of protein. Bite into a good old-fashioned Power Bar (10 g protein, 45 g carbs).

If you're sweating to get ripped, you need plenty of amino acids and no carbs. Try Optimum Nutrition Superior Amino 2222 Tabs. For shredded results, take 3-6 tablets with at least 8 ounces of water.

If you want to maintain mass, you need an equal mix of protein and carbs. Grab a serving of VPX Nitronx mixed with water (47 g protein, 38 g carbs).

# posted by Medical Information : 3:24 AM  0 Comments

While there were several booths with commercial cardio equipment including Sports Art, Vision Fitness and The Nautilus Group - which debuted two new Schwinn Evolution Indoor Cycling bikes, the Schwinn Evolution and Schwinn Evolution-SR - perhaps the strongest innovation is coming from strength manufacturers.

Tuff Stuff, based in Pomona, CA, was attracting a great deal of traffic to its booth with its newest offering, the Power Spot.

Made of 2-inch ?3-inch 11-gauge tubular steel, the Power Spot looks like a Smith machine, until you take a closer look. The Power Spot is a self-spotting dumbbell machine that allows the user the freedom to work out with heavy dumbbells without the need of a partner or spotter. This is achieved by locking dumbbells into two separate rotating handles that glide horizontally up and down on linear bearing shafts and bearings on each side of the machine. A secondary two-foot linear shaft also attached to each dumbbell handle will allow the dumbbell vertical movement altogether giving the user the same 360-degree free-floating movement as if the dumbbell were unattached.

For those looking for a little more freedom with their strength workouts, Impact2 Fitness Systems previewed two pieces of club-level items.

The item attracting the most attention was the B250 3-Way smart rack bench. It is a flat-incline-decline bench that "delivers" the uprights to the lifter by sliding a carriage to the appropriate position. The uprights are made to allow a lifter to grab a dumbbell from a racked position, which eliminates the need to have the weights handed to them - or jerking dumbbells into place.

Also strengthening out its line was Hoist Fitness, which added to its HD product line with the HD-1900 personal pulley system. The HD-1900 has a unique L-shaped corner design and small footprint and offers two independent proprietary Silent Steel graduated weight stacks, totaling 135 pounds each.

"I'm very excited about this latest addition to the Hoist HD product line. The HD-1900 fits nicely into our existing product offering and is superior to similar pulley gyms on the market today," Hoist Vice President Randy Webber says. "The Hoist design team has worked to develop a piece of fitness equipment that satisfies our consumers' requests, but also enhances the overall work-out experience through fluid motion and design."

So while you are gearing up for Club Industry 2002 next month keep in mind that these and other vendors will have plenty of products to see and try out throughout the year.

# posted by Medical Information : 3:11 AM  1 Comments

If you're like most MUSCLE & FITNESS readers, you don't exercise just to look good. Your gym time also transfers over into your other activities, such as pickup basketball, flag football, softball or mountain biking. It's likely that you notice the edge you have over your buddies who participate in the same activities as you but don't hit the gym regularly. And while routine strength training gives you a distinct advantage, throwing in some exercises you don't usually see performed in your local gym can up that advantage even more. New research from the U.S. Olympic Training Center (Colorado Springs, Colorado) shows that while typical strength moves like the squat are associated with better athletic performance measures, Olympic weightlifting movements--the clean and jerk and the snatch--have an even higher correlation.

Gold-Medal Science | The U.S. Olympic scientists tested 64 national-level Olympic weightlifters for their ability to jump vertically. The higher an athlete can jump, the better his or her athletic performance tends to be in most sports. The researchers then compared the athletes' jumping ability to their maximal strength in the squat, the clean and jerk and the snatch. The study found that while the athletes' squat strength was closely related to their jumping ability, their strength in the snatch and the clean and jerk--two explosive movements--reflected their jumping ability even more accurately.

JUMP STREET

THIS GRAPH SHOWS the correlation between vertical jump height and maximal strength on the squat, clean and jerk, and snatch. A value of 1.00 indicates a direct relationship, while a value greater than 0.50 indicates a good relationship that gets stronger as it approaches 1.00. By these standards, the snatch is best for transference to athletic performance.

# posted by Medical Information : 3:09 AM  1 Comments

Maura is like a lot of kids who study dance and join their school's dance team. While she was thrilled about making the team, her dance teacher wasn't happy about her decision, and Maura, a 13-year-old from Fairfax, Virginia, said she feels torn between her teacher's concerns and her own desire to be on her school's dance team. The subject is so touchy, in fact, that she asked that her real name and that of her dance teacher not be used in this story.

"I mainly joined the team because I wanted to dance in front of my school. I wanted to make new friends. I wanted to have a good, fun, exciting time," Maura said. "My ballet teacher was happy that I made it, but I think she was hoping that I would not make the team so there wouldn't be any complications. It's a touchy subject with my ballet teacher. I feel as though I am being pulled in two different directions, and it gets a little bit stressful at times."

Dance team coaches say kids shouldn't feel they have to make a choice between dance team and taking dance classes. "I don't think of them as separate. I think of them as part of the same thing. Kids who do dance team should also be taking dance classes like jazz and ballet for strength and flexibility," said Jeanine Sabo, a judge and coach who teaches at training camps sponsored by the Universal Dance Association, an organization that oversees many major dance team training camps and competitions, including the championships televised on ESPN.

Cathy Cook, executive coordinator and a past president of Dance/Drill Team Directors of America, Inc., agreed. "If you are already doing dance training, you need to keep that up if you're doing dance team," she said. "The more training you have, the better for your stamina, for your flexibility, for your placement and posture and for avoiding injuries."

Cook added that some top coaches even use part of their practice time for dance technique classes. But the concerns of Maura's teacher mirror those of many dance teachers. Not only does dance team tend to pull their students away from class and rehearsals, but some also say the strong, punchy moves of dance team routines tend to overstress muscles and change a dancer's "look."

"Dance team routines tend to do a lot of pounding to the body. You're punching into jumps. You're punching the arms," said Nancy King, director of the King Centre for the Performing Arts in Wanaque, New Jersey. King has current and former members of her student company who also were on their school's dance team. King said she encourages her students who do dance team to continue coming to ballet class, especially. "You have to still do something else training-wise, like ballet, rope-stretching exercises, Pilates," King said.

Mikal Casalino, a retired dance teacher in Salt Lake City, Utah, said another concern is that teams in her area rely on student members to put together and teach routines. "This makes for an exciting goal for the students," she said. "But this can cause many students to do pieces which are beyond their abilities, which injure them and for which they have no time to warm up properly."

Here are some tips from dance teachers and dance team coaches for dancers who do dance team:

1. Be up-front from the beginning with your dance teacher. Talk face-to-face with your teacher about your dance team schedule.

2. Continue to go to dance class.

3. Listen to your body when doing dance team moves. Prolonged, excruciating pain means you are doing something wrong.

4. Warm up properly before doing dance team routines--start with basic stretches and move gradually into more aerobic movement requiring increasing levels of strength and agility. Some dance teams provide class before events. Skipping a warmup can increase your chances of injuring yourself.

5. Wear proper shoes when doing dance team routines--athletic shoes with firm support or jazz shoes, depending on the type of surface you're dancing on, the level of impact and the type of routine.

6. Be realistic. Don't expect a lead role in The Nutcracker if you're missing classes or rehearsals during the fall because of your dance team commitment.

# posted by Medical Information : 3:07 AM  0 Comments

If you thought Arnold Schwarzenneger was all muscle and movies, this will be further proof that you are wrong. Concerned for the fitness and health of our youth, he travels the country to wake up the kids as well as school administrators to the sad fact that our youth are out of shape. He's a dynamite chairman for a very motivated President's Council on Physical Fitness and Sports. "Our chief task is to facilitate a working relationship among many health and exercise programs so that they complement one another in the communities they service," says Arnold.

Thus he comes to Indianapolis to give awards in a series of relays at the Fitness Farm of the Children's Better Health Institute.

Beginning at one o'clock on April 11, the Farm will come alive as children and their grandparents start pounding the 200-meter track in a fun relationship that may well become a precedent for future good times in joint exercising adventures.

There will be Time Prediction Races, cleverly contrived to get participants to practice ahead of time. They must announce their predicted time for mastering the mile, choosing to walk, fast walk, or run. The person or family that comes in closest to their predicted time is the Grand-Time winner.

Grandparents and children can walk it together, or parents with children, children alone, or the whole family. Each contender or family is given a number, and a computer keeps track of the time.

Dr. John Cates of the University of California, a long-time member of AAHPERD and a special advisor to the President's Council on Physical Fitness and Sports, will be on hand to officiate at the Family Time Prediction Races on April 11. He was an early developer of Time Prediction Races.

Thanks to Arnold's personal daily fitness regimen, he will still have the stamina to participate in the gala Saturday Evening Ball. After all, his mother, Aurelia, is coming all the way from Graz, Austria, to be his partner. We expect there will also be some relays on the dance floor, as Arnold is a pretty popular fellow.

# posted by Medical Information : 4:04 AM  0 Comments

Muscle.

The word once struck fear in the hearts of women worldwide, women afraid of "getting too big" and "looking bulky." But those of us who have been training for any significant amount of time know just how difficult it is to develop lean, quality muscle tissue, that moldable material that protects us as we age, increases our metabolism and makes us look terrific in shorts and tank tops

But just what is the elusive recipe for muscle-building success? Unfortunately the answer is as simple as quantum physics, and pretty much anything and everything could have an effect on how we gain--and don't gain--muscle. Our nutritional regimens, lifting routines, cardio programs, stress levels, genetics and feminine hormones all play a role in whether we're successful at building muscle.

Yet despite all these formidable influences, it can be done! Our lineup of four fitness pros proves it. Each of these women has had trouble gaining lean muscle in the past, and they share some winning strategies they used to break out of their problematic plateaus and set a course for sizable change.

be a heavy hitter with lisa lowe

Former IFBB pro fitness competitor Lisa Lowe has always had trouble gaining weight. "I was a dancer, so I was a total stick figure before I got into weight training," she laughs. "Lifting finally gave me some shape and curves, especially in my lower body. But it was a fight to add that muscle, and what worked for me was using really, really heavy weights."

Some women still fear lifting heavy, afraid of looking masculine, but our hormones work against us in that respect. Actually, women have to work much harder than men to add quality muscle to their frames. "When you say you want to 'tone up,' what you really want is to add muscle," says Lisa. "Remember: You can't tone fat. But you can shape your muscle, and if you're a hardgainer like me, using heavy weights is the only way to achieve that."

Choose a weight with which you can get only 8-10 reps per set, and perform 3-4 sets per exercise. Train only one or two bodyparts each day, always working a small part with a larger one, such as biceps with back and triceps with chest. If bodyfat isn't a problem for you, limit your cardio to 30 minutes four times a week at the most. "A lot of women tend to overtrain, and end up negating the gains they want to make," Lisa explains. "Limit your workouts to four days a week, and get plenty of rest on your days off. That downtime is when your body will recuperate and build your muscles, so total rest on those days is essential."

Implement a heavy training regimen for three months and see where it gets you. "If you're still not seeing results, something is off--maybe your diet is weak, or maybe you're doing too much cardio," Lisa states. "Keep a training and nutrition journal so you can go back and see where you need to tighten up or change your program.

lisa's trainign split

Day  Bodyparts Trained

1   Chest, triceps
2   Back, biceps
3   Off
4   Shoulders, abs
5   Legs
6   Off
7   Off

shock treatment with beth horn

Although you'd never know it to look at her today, IFBB pro fitness competitor Beth Horn used to be a skinny minnie. "I didn't know the first thing about gaining muscle or lifting for size when I first started out," she remembers. "But my trainer, Bob Dixon, put me on this shock program to kick-start my body, and it really worked! I noticed gains all over, especially in my back, hamstrings and shoulders."

Beth performed an overall-body workout twice a week using compound exercises (multijoint moves that require several muscle groups to work together, such as the squat) to encourage her body to add some muscle. "Work at about 75%-85% of your max for each lift," she suggests. "If you don't know your max, use a weight heavy enough so you can get only about 5-8 repetitions, and the eighth one is really hard." Beginners should try for three sets of each exercise, while more advanced trainees can bump it up to five. "Compound lifts are really taxing," warns Beth. "So rest 3-5 minutes between sets and recover completely before you continue."

Allow two full days off in between your shock sessions to recuperate. "You don't gain muscle while you're training, although it may seem that way because you get a 'pump,'" Beth explains. "Your body builds and repairs muscle tissue when you re resting, so the more rest you can get with this program, the better." And that includes sleep--eight hours or more per night if you can - and fueling your body properly "Muscle cannot be gained if you don't eat enough," says Beth. "You shouldn't be dieting or cutting your carbs while trying to gain muscle. After you gain some muscle, then you can manipulate your diet to get leaner"

Use this program for six weeks in combination with good nutrition, and cut way back on your cardio. "You're trying to change your body, and it's going to resist the change," Beth points out. "Give it every opportunity to add muscle by cutting down on your cardio. Even if you're jonesing to go running or take a kickboxing class, try not to [overdo it]. It's only six weeks--hang in there and see what happens."

# posted by Medical Information : 4:04 AM  0 Comments

Respondents to HFMA's on-line HIPAA readiness survey cite budgeting and staff constraints as two of the biggest challenges they face in the next six months in implementing HIPAA regulations. Respondents also saw difficulties ahead in conforming with other existing laws, focusing on the opportunities afforded by HIPAA, and involving the right people to ensure that HIPAA implementation is seen as an organizationwide priority.

The 143 survey respondents were healthcare providers, systems, or payers. Most survey respondents noted that they have a general understanding of HIPAA, but almost a third felt there was a lack of understanding of the law among others within their organization. Only 3 percent of respondents said that awareness and understanding of HIPAA existed organizationwide, and 18 percent said little or no awareness of HIPAA existed in their organization. To build awareness, respondents are holding in-house seminars or sending staff members to offsite seminars, distributing memos and newsletters internally, and fostering internal discussions with staff.

A total of 47 percent of those responding to the survey noted that they have some assigned structure in place to oversee HIPAA compliance activities. These structures include an individual, task force, or collaborative group designated to lead HIPAA efforts, or subgroups formed to address specific issues. Those organizations that have a defined structure in place are more likely than those that do not to have made progress toward HIPAA implementation in terms of beginning risk assessment; identifying existing policies, procedures, and systems; and performing a gap analysis (see Exhibit 1).

Health systems and hospitals differed in several areas with regard to readiness for HIPAA compliance. Health systems were more likely than hospitals to have begun to identify and address key gaps and risks associated with HIPAA implementation and to have made preliminary efforts toward implementation. More hospitals than health systems indicated a lack of understanding of the regulation (37 percent vs. 22 percent) and an uncertainty about what actions to take first (46 percent vs. 31 percent). However, a hospital or system with 301 to 500 beds was more likely to have begun to address gaps and risks than a hospital or system with either fewer than 301 beds or more than 500 beds. Small, rural hospitals were the least likely to have begun the implementation process.

# posted by Medical Information : 4:04 AM  0 Comments