Health-and-Fitness online information.

Urban Sprawl and Public Health: Designing, Planning, and Building for Healthy Communities, by Howard Frumkin, Lawrence Frank, and Richard Jackson, Washington, D.C.: Island Press, 338 pages, $30

DURING THE SUMMER, we often pack up our kids for a little sun and fun at the local pool, nestled in our low-density, sprawling suburb in the Midwest. My kids eat a balanced diet, are physically fit, and are certainly not overweight. The pool is one of our tactics for moderating their time in front of video games and the television. It also ensures that they get a little exercise.

Each year we're surprised to find that other parents don't see things the same way, at least to judge by their children's girth. As our kids frolic, we sit amazed that other parents let their overweight children walk up to the snack bar to consume ice cream, hot dogs, and other high-calorie snacks. We know American kids face an obesity problem--we see it every summer in the jiggling rolls of sunburned fat at our local pool.

So I welcome any book that wants to inform the public about ways to keep us and our children fit. That's what the authors of Urban Sprawl and Public Health seem to promise. Unfortunately, the book doesn't deliver, partly because authors Howard Frumkin, Lawrence Frank, and Richard Jackson can't solve the problems we see every summer.

Although the fitness category sees its share of trendy products which at times can cause sales to be erratic, the category overall is an anchor to the hardlines side of the sporting goods business and one that grows more firmly established every year.

That looks to be the case again this year with sales in the category projected to grow at the 4% rate seen in 2004 or perhaps slightly faster, according to the Sporting Goods Manufacturers Association. Manufacturer sales of equipment were estimated to be $4 billion last year.

The growth is being driven by a variety of factors, but in general more Americans are working out more often and they stand ready to purchase fitness and related products that allow them to pursue an active lifestyle. While this would appear to stand in contrast to reports about rising obesity rates and the sedentary lifestyle of the nation's youth, information from SGMA's annual study of sports participation indicates that participation in virtually all fitness activities increased last year. The lone exception among the top 10 activities was stair climbing and the industry has seen that shift coming for several years as the overall trend in the category is toward lower-impact forms of exercise.

The other good news for the category is that the number of health clubs--and membership in them--continues to increase. In fact, last year the health club industry set a record for expansion as the number of units increased 14% to 26,830 facilities, according to the International Health, Racquet & Sportsclub Association. The group also tracks membership and those figures have more than doubled since 1990 and last year surged past 40 million.

Logic might suggest those trends would be bad for the home fitness market, yet products for home use accounted for 80% of the approximately $4 billion worth of equipment manufacturers sold last year. That's due largely to the fact that the more people work out in clubs, the more likely they are to purchase equipment for home use. For example consumers were turned on to elliptical trainers at health clubs more than five years ago and have since made them a fixture in their homes.

While the overall market grew last year and is projected to do so again this year, there have been some shifts. Market leader Icon Health & Fitness has noticed slower sales of informercial-driven items.

"Our commercial business is running a 32% sales increase and that is comparable to what you would find with our competitors. It is our normal channels of distribution that we had a soft year with," said Icon Health & Fitness chairman and ceo Scott Watterson.

Icon's results suffered in part due to a strategic shift at the The Sports Authority that saw the company attempt to replace Icon's well-known brands with direct imports. The strategy did not work well and Scott indicated Icon was meeting monthly with the chain to restore the flow of its brands onto the sales floor of The Sports Authority's roughly 350 locations.

"We are very encouraged by the progress we are making with The Sports Authority," Scott said.

Another interesting development that will influence the fitness category this year and next is the recent merger of Sears and Kmart. Sears is already the nation's largest seller of big-ticket fitness products such as treadmills and ellipticals, whereas Kmart had become a non-factor in the category, selling declining volume of low-end goods. However, with 400 Kmart locations slated for conversion to a Sears format this year and next that will include an improved presentation and assortment of fitness products, there is certain to be an impact to full-line sporting good chains, discounters and warehouse clubs.

This summer AFAA attended the Can-Fit-Pro Convention, held at the Metro Toronto Convention Centre in Toronto, Ontario, from August 23rd to 25th, for the first time. The convention, supported by a tradeshow of over 200 health and fitness vendors, hosted over 5,000 fitness professionals. The AFAA booth received a high volume of visitors, some from as far away as Japan, who were pleased to see AFAA at the convention.

Lisa Hamlin, AFAA Professional Affiliate Coordinator (PAC) of Southern California, met numerous program directors and fitness professionals. This face-to-face contact was highly successful in promoting APEX Conventions and acquainting Canadian professionals with AFAA's certifications and workshops. Many AFAA certified professionals stated they look forward to future AFAA events hosted there.

AFAA also hosted an APEX Convention in Toronto from September 20th to 22nd. The Personal Trainer Certification was held at Ryerson University, while the Primary Aerobics Certification took place at The Adelaide Club. Debra David Kavluk, group exercise director for the club, said hosting APEX was an exciting opportunity to offer professional development for her staff as well as other fitness professionals.

While having strong genes is certainly a plus, the real secret to staying youthful and healthy is living with passion and joy. It's mainly about your attitude--loving yourself and the gift of life enough to adopt the resolutions and rituals that keep mind and body strong and emotions in balance.

Learning how to live your best life at any age is an art the fit and fine women on the preceding pages have obviously mastered. You, too, can enter the prime of your life in peak form. Here's how:

STAY FIT

* Commit to exercise. While everyone ages differently, geriatricians agree that nothing ages us faster than illness. It wears down our body, depleting its vitality. Although no regimen we follow will guarantee that we'll never face a serious health challenge, committing to a regular exercise program is one of the most important life-preserving steps we can take. Working out consistently reduces the incidence of heart attack, stroke, diabetes and high blood pressure, the leading causes of illness and death for Black women. A 30-to-60-minute aerobic workout--running, walking, biking, playing tennis--four to five times a week goes a long way toward increasing your life span, and the best news is that it's never too late to get started. Of course, before beginning any exercise regimen, it's best to check with your doctor first, especially if you haven't worked out in a while.

* Pump iron. We begin losing muscle mass around age 35, so as we get older, weight-bearing exercises become even more critical. They help build bone density and strength, both of which are essential to preventing osteoporosis. (And yes, Black women are vulnerable to this disease.) An added benefit: Lean muscle is metabolically more active, meaning that it burns more calories--even at rest.

Having breakfast increases your chances of achieving and maintaining weight loss, according to a new study presented at a conference of the American Society for Clinical Nutrition.

Analyzing data on nearly 3,000 adults who lost a minimum of 30 pounds and kept the weight off for at least one year, researchers found that 78 percent ate breakfast daily, 10 percent skipped an early meal either once or twice a week, and 4 percent blew it off entirely. The average diet was high in carbohydrates, with about 22 percent of calories derived from fat.

"Eating breakfast helps you spread out your hunger and manage your food intake better throughout the day," says study author James Hill, M.D., director of the Center for Human Nutrition at the University of Colorado Health Sciences Center in Denver. "If you start out the day by eating something, you don't get this burning hunger later that causes you to overeat."

The importance of physical activity in childhood and adolescence cannot be overstated. Since adequate amounts of physical activity provide multiple health benefits and will improve or maintain physical fitness, it should be an integral component of children's lives. However, children and adolescents are much less active than in previous decades. The causes of this phenomenon are numerous, including social and environmental factors, and practices in schools. Physical therapists should consider these factors and the unique response to exercise by the pediatric population when prescribing exercise. Physical therapists can intervene to increase regular physical activity in children and adolescents at a variety of levels. At the Individual Level, we can support physical activity in the treatment of children with disabilities and for wellness. At the School Level, we can become active volunteers or consultants to enhance physical activity in the school environment. At the Policy Level, we can support policies that increase opportunities for physical activity in the schools, communities, and society. We need to change the way physical activity is perceived as not only an individual behavior choice, but also the result of many choices made for us in our environment. As physical therapists, we are uniquely positioned to advocate and provide guidance for increased physical activity among children and adolescents, their families, and the society as a whole.

Fluoroquinolone resistance in Streptococcus pneumoniae is primarily mediated by point mutations in the quinolone resistance-determining regions of gyrA and pare. Antimicrobial resistance mutations in housekeeping genes often decrease fitness of microorganisms. To investigate the fitness of quinolone-resistant S. pneumoniae (QRSP), the relative growth efficiencies of 2 isogenic QRSP double mutants were compared with that of their fluoroquinolone-susceptible parent, EF3030, by using murine nasopharyngeal colonization and pneumonia models. Strains containing the GyrA: Ser81Phe, ParC: Ser79Phe double mutations, which are frequently seen in clinical QRSP, competed poorly with EF3030 in competitive colonization or competitive lung infections. However, they efficiently produced lung infection even in the absence of EF3030. The strain containing the GyrA: Ser81Phe, ParC: Ser79Tyr double mutations, which is seen more frequently in laboratory-derived QRSP than in clinical QRSP, demonstrated reduced nasal colonization in competitive or noncompetitive lung infections. However, the strain was equally able to cause competitive or noncompetitive lung infections as well as EF3030.
Streptococcus pneumoniae causes otitis media, baceremia, and meningitis and is a leading cause of community-acquired bacterial pneumonia worldwide. Pneumococcal infections are commonly treated with [beta]-lactams, macrolides, and, increasingly, fluoroquinolones. Pneumococcal resistance to each of these drug classes has increased in recent years (1,2). Initially, antimicrobial resistance in a pathogen may come at a cost: modifications that allow survival in the presence of antimicrobial drugs may render the pathogen less efficient at host infection, even in the absence of the antimicrobial agent (3). Little is known about the fitness of antimicrobial-resistant S. pneumoniae (4-8). The emergence of quinolone-resistant S. pneumoniae (QRSP) appears to be more dependent on fluoroquinolone selection of de novo spontaneous point mutations in the quinolone resistance-determining regions (QRDRs) of the topoisomerase genes gyrA and parC than on clonal dissemination (9-13). However, some studies reported occurrences of clonal relatedness among QRSP (11,14-16).

* Columbus, Ohio, may be the second stop of the 2005 IFBB professional season, but for many, it is the starting point of the year. The IFBB Ironman Pro Invitational and FitExpo, two weeks prior to the Arnold Fitness Weekend, draws fans primarily from the West Coast, and its pro bodybuilding contest is for men only. The Arnold weekend includes the IFBB Arnold Schwarzenegger Classic, as well as representing the distaff side with the IFBB Ms. International, Fitness International and Figure International. In addition, it features competitions and demonstrations in approximately 20 other sports, including several Olympic events.

* Of course, the biggest attraction is none other than the contest's namesake and current governor of California. That title brought the implementation of many changes to the event, staged this year over the March 4-6 weekend. Most notably, security at the venue was tighter than ever before, and certain areas that had been easily accessible in the past were off limits when Arnold Schwarzenegger was in close proximity. Also, it was evident that the Arnold Fitness Expo was bigger and more crowded than ever before. I don't know how that was possible, but trust me, it was an unbelievably busy weekend.

* In addition to Schwarzenegger, several other Mr. Olympias were present: Sergio Oliva, Franco Columbu, Frank Zane, Dorian Yates and reigning champion Ronnie Coleman. Coleman appeared to be causing a commotion at the BSN supplement booth, where it was reported that he signed the most lucrative endorsement contract in the history of the sport. It reportedly will keep him at BSN for at least two years.

PURPOSE: Without definitive intervention, individuals with an untreated pneumothorax should not participate in commercial flying. Whether this advice applies to patients with a long-standing pneumothotax is uncertain. We report two adults with persistent pneumothoraces who underwent further investigation to determine the safety of doing so.

METHODS: Following clinical assessment, both subjects had chest computerised tomographic (CT) imaging and underwent a hypoxic challenge test (breathing 15% oxygen). The individuals then proceeded to cabin altitude simulation in a hypobaric chamber.

RESULTS: Case 1--Chest CT showed a small left pneumothorax (estimated volume 110 millilitres). During a hypoxic challenge test, the oxygen saturation fell to 90%. During cabin altitude simulation, the patient remained asymptomatic and oxygen saturation fell to 90%. He was considered fit to fly and has completed over a dozen transatlantic flights without difficulty. Case 2--Chest CT showed a loculated right sided pneumothorax (estimated volume 250 millilitres) and during a hypoxic challenge test, the oxygen saturation fell to 93%. An altitude chamber test was tolerated without symptoms and the oxygen saturation fell to a minimum of 92%. She was therefore considered fit to fly in commercial aircraft.