Health-and-Fitness online information.

FROM the concert stage to the big screen, some celebrities get rave reviews for the figures they flaunt in movies and on the red carpet. But they aren't born with washboard abs, Tina Turner legs and sculptured backsides.

To get and to keep fabulous figures, many hire personal trainers who specialize in training the stars and keeping them fit. Among the leading celebrity trainers are Darrell Foster, who trains Will Smith and Jada Pinkett Smith, and Orlando Brown, who supervises Kirk Franklin's workouts. All say that training stars is more demanding than training non-celebrities because the celebrities' time is at a premium and everybody can see and comment on the results.

Darrell Foster (Will Smith & Jada Pinkett Smith)

Celebrity trainer and fitness consultant Darrell Foster, who has been involved in boxing since he first entered the ring as a fighter in 1972, uses his extensive knowledge of the sport to train celebrities like Will Smith, Jada Pinkett Smith, Antonio Banderas and Woody Harrelson.

Although he also works with people who are not celebrities, Foster takes his responsibilities as a celebrity fitness trainer seriously. He teaches the actors how to fight, not how to fake it. "They have to learn the basics and how to take a punch," he says. A licensed boxing and fitness trainer and emergency medical technician, Foster is the owner of Omega Bodies, Inc., a fitness and fighting outlet based in California. He not only works with celebrities on coordinating their fight scenes, but also on their lifestyle and weight management, because, he says, "a lot of diseases are lifestyle-related."

Actor Will Smith says Foster is an asset to his business team. "I first started training with Darrell to prepare for my role as Muhammad Ali for the film Ali," he says. He has continued to use Foster for his other roles in Men in Black II, Bad Boys II and I, Robot. "I train with Darrell because he is simply the best."

The actor's transformation into a young Muhammad Ali for the film even impressed the champ himself. Muhammad Ali says Foster is extremely talented and an exceptional trainer. "He was able to train Will to fight as I did, to dance around the ring and be light on his toes. Will's transformation into Muhammad All the boxer was total and complete" he adds.

Foster also trained Smith's wife, Jada, for her strenuous fight scenes in The Matrix sequels and in the film Collateral. He says when training Jada for The Matrix, he had to consider her post-partum condition, because she had recently given birth to her daughter Willow. "We had to take the training a little slower," he says. But in her recent film, Collateral, he almost had to do a reverse training for her, encouraging her to "consume a few more carbs" and incorporating more cardiovascular fitness into her training regimen.

McDonald's USA has redesigned its cooking oil to lower the amounts of heart-harming fats in its fried food without changing the taste. For example, the revised recipe will reduce trans fatty acids by 48 percent and saturated fat by 16 percent in the firm's french fries, while upping levels of healthier polyunsaturated fat by 167 percent.

The new oil, which will also be used for Chicken McNuggets, Filet-O-Fish, hash browns and crispy chicken sandwiches, is expected to be available in all 13,000 of the megachain's American restaurants by February. McDonald's Europe has already attained comparable reductions.

"This is going to have a major and immediate impact," says Dean Ornish, M.D., founder of the Preventive Medicine Research Institute. "McDonald's will be [improving] the nutritional value of meals eaten by millions of consumers every day."

Though the redo gives the company's offerings a better nutritional profile, they're hardly diet food: Total fat content in the french fries--22 grams per medium serving--will remain unchanged.

"However, there is no question that reducing TFAs and saturated fat and increasing polyunsaturates delivers health dividends," says Ann Rusniak, R.D., chief nutritionist for McDonald's.

In a related story, the nonprofit Center for Science in the Public Interest has found that the following items on several new-and-improved fast-food menus will please your taste buds without sabotaging your nutrition plan. (For our own choices, see "The Best Fast Food for You," page 90.)

* Wendy's Mandarin Chicken Salad: 620 calories, or 420 if you lose the noodles and half the dressing.

* Burger King Chicken Whopper Jr.: A kid's meal? No, it's "the only way to get a normal-sized sandwich" at 350 calories.

* Subway's Low-fat Subs: three options ranging from 310 to 370 calories, all with six grams of fat or less.

* McDonald's Fruit 'n Yogurt Parfait: 380 calories--less 100 if you skip the granola--and two grams saturated fat.

* Burger King BK Veggie Burger: 330 calories, two grams saturated fat.

On the other side of the blood flow, the health advocacy group issued its choices for the worst of the worst. Burger King swept this category with its milk shakes (the medium size has 760 calories and 42 grams of fat, 29 of which are saturated plus trans fat); King-sized fries (600 calories and 30 grams of fat, 16 saturated plus trans); large hash browns (390 calories and 25 grams of fat, 15 saturated plus trans); Double Whopper With Cheese (1,150 calories and 76 grams of fat, 33 saturated plus trans--not to mention 1,530 milligrams of sodium); and the Value Meals (1,300 to 2,100 calories, depending on the size).

About this time every year, many of our self-improvement resolutions center around changing our lifestyle habits. Yet even when we have the best intentions, our resolutions are often circling the drain by about Feb. 15, as we revert to ingrained behavior patterns.

Sure, we'd all be fit, healthy and energetic if we could just get into the habits of exercising regularly and eating nutritious foods, and break the habit of downing a pint of Rocky Road in front of the TV instead of taking an after-inner walk. But why is it so difficult to cultivate good new patterns and break bad old ones? "Humans were designed to habituate," says Roger Walsh, M.D., Ph.D., a professor of psychiatry and human behavior at the University of California, Irvine. "Our brains are wired that way." It's habitual behaviors like eating and sleeping, after all, that keep humans surviving as a species.

While these two behaviors are instinctual, most of our habits are learned, often in childhood and from repetition. It's been said that a habit is like.a sheet of paper: Once it has been creased, it tends to fall into the same fold. But even if your habits are as plentiful as folds in a triple A map, you can learn new ones.

Just don't attempt to change them all at once. A grand scheme to quit smoking, drinking, eating junk food and being a couch potato simultaneously is likely doomed to failure. Pick one habit and focus on it. Decide which will be most encouraging to you: to master the hardest or the easiest one first. When that habit is entrenched, tackle the next one.

Also, be specific, Instead of vowing to "eat better," for example, determine to eat more fruits and vegetables daily for a month, then to have well-balanced breakfasts and then to make menu plans.

Set yourself up to succeed

First, arrange your environment to support your desired new habit, and remove sources of temptation that perpetuate the old one. If you're trying to quit eating so much ice cream, for example, don't keep any in the freezer. Ask your friends and family for their support. Or, if you suspect they might not bolster your efforts or even sabotage them, keep your plans to yourself. You might want to "bribe" yourself by setting up a system of rewards. Do whatever it takes to stack the odds in your favor.

You'll also have to be staunchly resolute until you've established your new habit. "Make no exceptions for the first month," Walsh says. It's easy to convince yourself that just one cookie, just one missed workout, doesn't count. Psychologists say it's like dropping a ball of yarn you're trying to wind: It quickly unravels. Only when you've broken your habit of eating a pint of ice cream every night is it safe to enjoy an occasional serving.

Spring is here at last! This season of rebirth is the perfect time to make a fresh start with fitness. Maybe it's been a few months since your last workout. Maybe a lifetime. No matter. Make today the first day of your new healthy life.

And it doesn't take much. Health experts say you only need to get your body moving only 20 to 30 minutes a day, three times a week to look and feel good. A brisk walk here, some stair climbing there, a bike ride or roller lade in the park, and you're done. Ready to change for the better? The following tips will keep you psyched for fitness this spring and forever:

* Start Slow. If you haven't exercised in a long time, the worst thing you can do to your body is to work out too hard, too soon. Overzealous exercising increases the likelihood of strains, sprains and other injuries that can derail you for days, weeks or months and discourage you from fitness. Do what your body can handle, no more. A good workout should leave you a little sore the next day, not writhing in agony. Slow and steady wins this race.

* Buddy Up. When the initial excitement of starting a new fitness plan wears thin, it can be a real challenge to stay motivated, especially if you hate exercising in the first place. A good way to stay on track is to find a workout buddy. A partner can give you the push you need when you start slacking, and you can push back when your buddy needs it. And you have the satisfaction of sharing your success. Need to recruit someone? Chances are good there's a friend, co-worker or soul mate eager to join you. Or consider investing in a personal trainer, if only for a few workout sessions.

Now that you've gotten yourself in shape by meeting your fitness goals and maintained physical activity throughout the fall, you can stay in shape this winter with cold-weather workouts.

Prepare yourself for outdoor exercise by checking the radio, TV, or newspaper for weather conditions. When the temperature starts to hover close to freezing, follow these tips, and outdoor cold weather exercises will be a fun and safe experience.

Protect your skin by using a thin layer of petroleum jelly on exposed areas. This acts as insulation against the cold and wind.

Pay careful attention to slick surfaces and reduced visibility caused by rain and snow. Since your footing won't be as stable, be more attentive, slow your pace, and wear proper footwear.

Hypothermia is your biggest concern. As you exercise in a cold environment, you must consider how much heat your body will lose during exercise.

Air temperature and wind chill factor should always be checked prior to exercising in the cold. Data from the National Safety Council suggest little danger to individuals with properly clothed skin exposed at 20 degrees Fahrenheit, even with a 30 mph wind. A danger does exist for individuals with exposed skin when the wind chill factor exceeds minus 20 degrees Fahrenheit. If you are exercising near the danger zone for skin exposure, it's advisable to wear a scarf or mask over your nose and mouth.

Fat is the body's natural insulation. Clothing adds an insulation barrier and is clearly the most important element in performance and comfort while exercising in the cold. If the air trapped by clothing doesn't take heat away from the body, a comfortable temperature will be maintained. With this in mind you want to choose clothing that can trap air but allow sweat to pass through.

By wearing clothing in layers, you'll have the ability to change the amount of insulation that is needed. However, it's important to avoid heavy cotton sweats or tightly woven material that absorbs and maintains water. Carefully choose your clothing to provide the best protection against the elements. Shoes that are water-repellent nylon or water repellent leather are good choices.

Keeping the hands and feet warm is a common concern when exercising in the cold. Lower temperatures cause blood to be routed away from the hands and feet to the center of the body to keep the internal organs warm and protected. Gloves or mittens and warm socks are a must. One pair of socks of moderate insulation and thickness if a good choice. Wearing two or more pair of socks can cause too much friction between your foot and shoe and result in blisters.

Too often, the fitness and health club industry is viewed strictly by the bottom line or interpreted from company or industrywide trends. But there are plenty of other stories and trends to be found inside the four walls of almost any type of fitness club.

What better way to find those stories than to take a tip from the late John Belushi and the rest of his Delta House brothers and go on a road trip?

The editorial staff of Club Industry traveled by planes, trains and automobiles to visit various clubs from different regions around the country. Occasionally, they got lost along the way or found an empty club waiting for them and maybe found a toga party or two as well.

Those visits - without the toga party stories - continues, ripped out of each staff member's own travel log.

This month, managing editor Dawn Hightower, begins Part 2 of the journey with her travels from the Midwest.

Day One

Touching down at the Minneapolis airport ends my short and uneventful flight from Kansas City as I begin the first leg of my Midwest club visits. Collecting my bags I head to the Hertz pickup counter where the clerk hands me the car keys and directions to the hotel.

After checking in at the hotel I decide to drive downtown to scope out the location of my first visit. (I have never been to the Twin Cities.) Feeling confident about where I'm supposed to go in the morning, I meet a friend for a walk around one of the lakes and then enjoy a leisurely dinner before heading back to the hotel. As I settle into bed, I realize I am excited about tomorrow and the first of what I hope to be enlightening club visits.

Day Two

Life Time Athletic Club, Minneapolis, MN

My first appointment is about an hour away. I leave the hotel in plenty of time to allow for rush hour traffic. As I navigate the city's one-way streets in my rental car, I find the parking garage and make my way to the Life Time Athletic Club in the historic Grand Hotel. Chris Fazi, the general manager, dressed in a suit, meets me outside his office where he begins to tell me more about this plush facility set in a turn-of-the-century hotel.

According to Fazi, this club is set apart from its suburban clubs because it is in the heart of the financial district and caters to people who live in the suburbs but work downtown. Members are in their mid-30s to mid-40s and are up and coming executives making about $80,000 a year.

Because Life Time Athletic Club is also a business club, it needs to be well rounded to suit members' business needs. "You need to have that business and social aspect along with the athletic programs and the group fitness," says Fazi.

On the fitness side, the club tries to stay a step ahead of other clubs. "I think our athletic programs are fantastic," says Fazi. "Our squash program is one of the best in the country - we have national and international tournaments on some of the best courts in the country." The Life Time Fitness triathlon is a big deal for the club and was broadcast on NBC in August.

In addition to the sports component, Fazi says members enjoy group exercise and its varying trends. Classes thatdevelop core muscles are popular. "Five to 10 years ago, nobody knew what core was," comments Fazi. "Once we get members in, I think we blow them away with our offerings."

As we walk around the busy workout floor, Fazi points out the arangement of the machines, what type of equipment is offered, and goes into detail about the remodeling. In the background a personal trainer is taking a woman through the paces on one of the Pilates Reformers.

Walking down the hall toward the locker rooms, we detour through the pool area, which looks like it was modeled after something at Caesars Palace in Las Vegas. Fazi waits outside while I check out the locker rooms, which are beautifully appointed and have all the amenities, as well as a separate sitting room with television, couches, phone and coffee tables. After members workout they can relax in the locker rooms (which are better equipped than my hotel bathroom!) or head to the LifeSpa for massages, pedicures and haircuts. Members can also wind down at the juice bar or sweat it out in the sauna and steam room or eat sushi at the swanky Martini Blu, where I had the opportunity to enjoy lunch.

Even though the club opened in 2000 after about 13 months of extensive renovation, the club has maintained the old world charm of the historic hotel through its cherry woodwork and updated art deco-style lighting, while offering the latest in equipment and top-of-the-line amenities and services.

For the more than 2,000 members that come to work out and do business at the club, service is number one, says Fazi. "Because if you come in all stressed out from a hard day's work, the last thing you want is somebody grumpy behind the sales desk."

To prevent your medications from taking a detour while you're on vacation, take note of these tips from the University of Pittsburgh School of Pharmacy:

Before your trip, make a list of all the medicine you'll need. Check with your pharmacist about possible drug interactions with medications for motion sickness. If you plan to travel out of the country, check online at cdc.gov to see what vaccinations are recommended and to view any public-health warnings.

Pack your medicine in a carrying case or purse that you'll keep in your possession. Keep an extra supply on hand at all times in case you have extended layovers. Pack medicine for common travel maladies such as diarrhea, headaches and allergies.

Store your medicine in a cool, dry place. Some medications can easily lose their potency if exposed to excessive heat, sunlight and humidity.

Have your pharmacist's and prescriber's phone numbers handy in case you lose your medicine. Know the generic name of the medicine you're taking in case you need to relay this information to an unfamiliar pharmacist.

Be aware of time changes. Keep a separate watch with you and have it set to your usual time so you can remember when to take your medication.

If your medication requires you to use a syringe, you may needs to carry your written prescription with you to ensure that you can pass through airport security.

Want to help a client or yourself go deeper into a stretch? If so, take a look at Facilitated Stretching (Human Kinetics; $19.95) by Robert E. McAtee and Jeff Charland. McAtee and Charland have developed an active, assisted stretching program based on proprioceptive neuromuscular facilitation (PNF)--active because the person stretching does most or all the work and assisted because a partner monitors and directs the movement. Designed to improve communication between the muscles and nervous system, facilitated stretching consists of three steps: actively lengthening the muscle, isometrically contracting it and actively lengthening it again. This increases flexibility and coordination.

PNF was first developed in the late 1940s and early 1950s for the rehabilitation of paralyzed polio patients. By the late 1970s, physical therapists and athletic trainers were using PNF techniques to facilitate flexibility in healthy people. McAtee and Charland have written Facilitated Stretching for athletic trainers, sports therapists, physicians, coaches and competitive athletes. They explain the neurophysiological mechanisms on which their stretching program is base& basic principles and different types of stretching, proper biomechanics and step-by-step instructions on how to stretch each major muscle in the body. The authors also explain how to do the stretches alone.

YOUR SHOULDERS ARE the crossroads of your upper body. Whether you're lifting luggage overhead on an airplane, bending down to pick up dumbbells, or reaching to pull some poor sap out of the drink, the 360-degree mobility of your shoulders makes it all possible. Without them, you'd wind up being as ineffective in your everyday life as most consultants are in theirs. Healthy shoulders not only have to be strong, they also must be flexible. Perform this stretch at the gym between exercises:

* Stand (or sit) straight while maintaining the natural arch in your lower back.

* Reach your right arm across your chest.

* Reach under your right arm with your left, and place your left hand on the right elbow.

* Gently pull your elbow in toward your chest. Hold for 30 seconds, then repeat on the other side.

Abstract: To examine relationships between health risk factors and sick leave usage, a retrospective design was used for analysis of a sample of university employees. Binary logistic regression identified variables characteristic of high sick leave usage compared to low. Predictive factors identified were." perceived stress, food choices, body mass index, systolic blood pressure, tobacco use, and cancer for females; and body mass index, physical activity, perceived stress, social support, and heart disease for males. While health risks were found to be related to amount of sick leave used, the analysis suggests that additional factors impact high rates of sick leave usage.

The causes of employee absenteeism are multiple and complex. In efforts to both understand and impact absenteeism, researchers and practitioners have focused attention on modifiable risk factors associated with employee illness expecting that changes in these risk factors would result in corresponding changes in absenteeism. Recent reviews suggest that health risks are associated with absenteeism (Aldana, 2001; Reidel, Lynch, Baase, Hymel, & Peterson, 2001). Aldana (2001) concludes that obesity, stress, and the presence of multiple risk factors are associated with increased rates of absenteeism. Aldana (2001) also indicates that the association between absenteeism and other health risks and behaviors such as seat belt use, cholesterol, physical activity, hypertension or alcohol abuse remains unclear. However, the body of literature upon which these conclusions are based is small. Additionally, few of the studies included in his review assess differences in extremely high and low rates of absenteeism. This is important since the vast majority of direct and indirect costs associated with poor health are attributable to 10-15% of a given population (Yen, Edington, & Witting, 1992).

Individual studies have identified a significant association between rates of absenteeism and obesity (Burton, Chen, Schultz, & Edington, 1998; Narbro et al., 1998; Thompson, Edelsberg, Kinsey, & Oster, 1998; Tucker & Friedman, 1998), tobacco use (Bertera, 1991), diabetes (Burton, Conti, Chen, Schultz, & Edington, 1999), seat belt use (Burton et al., 1999), physical inactivity (Steinhardt, Greenhow, & Stewart, 1991) and stress (Jacobson et al., 1996; Jamal, 1984; Neubauer, 1992; Tang & Hammontree, 1992; Woo, Yap, Oh, & Long, 1999). Additionally, hypertension has been associated with absenteeism (Burton et al., 1999), but this association does not appear to be consistent (Leigh, 1990). Finally, it has been suggested that one of the best predictors of absenteeism is past absenteeism (Yen et al., 1992) suggesting that absenteeism may be either related to chronic illness or simply be habitual.

It happens twice a year, no matter where you are stationed or what your rank may be. The Navy's physical fitness assessment, or PFA, will be around as long as there is a Navy. So I always wonder why it causes so much shock in our ranks every spring and fall.

Typically, as we inch closer to the test, medical usually sees a mad dash of Sailors looking for a possible waiver, which rarely pans out. Those not hitting their local clinic hastily dive headfirst into their semi-annual crash diets, as they hope to shed those extra 10 to 15 pounds in two weeks.

Finally, the dreaded day arrives, and our commands quickly divide into "the three groups."

Group one is usually the command's serious athletes. They tend to breeze through the entire test like an assembly of Olympic champions. Group two is understandably the largest group. They are the Sailors who are able to squeeze in the occasional workout during their work week. For the test, they will definitely pass. But, the following day you will find them languishing in severe pain.

And then there is Group three. I like to think of this group as the "I know I'm going on remedial" group. To the Navy's credit, this group is almost always small, but why does it even have to exist at all?

We don't all have to be world-class athletes, but we shouldn't go into shock and freeze when faced with a one and-a-half mile run. Why not make fitness a part of our lives? Why not seriously approach PT as a command one hour a day, three times a week, no matter what? We shouldn't just have a group stretch before breaking off into the aforementioned "three groups." How about having one large group working together in an intense workout, helping one another to keep going?

If this idea were strictly enforced at every command, everyone would realize fitness training has its place in our daily routine--just like eating, drinking and brushing our teeth. The fact that the overall benefits from proper exercise can be life changing should be what counts, not physical appearance.

According to the National Institutes of Health, regular physical exercise can help people reduce anxiety levels, manage stress, alleviate depression and improve overall quality of life. It can also reduce the risks of heart disease, high cholesterol, diabetes, colon cancer and breast cancer.

There are so many reasons to exercise that entire books have been written on the topic. But if Sailors can find just one benefit, that should be enough to help them, start an exercise program and take steps to improve their health.

If every command throughout the Navy took this approach, then those two sometimes-dreaded days of the year would seem just like any other day in the Navy.

To test effects of water aerobics (WA) on weight and glucose. RESEARCH DESIGN: A one-group pre/post-test study assessed effects of WA 3 times/week for 12 weeks on weight, A1c, measurements, and extremity blood flow. SAMPLE: 34 Overweight Hispanic and African American males and females, 40-65 with Type 2 diabetes. FINDINGS: Data for 10 subjects show: Weight, M -1.85 lbs. (-12 to +5); A1c levels lowered M -0.4% (-1.9 to +0.4). Inches lost were: 1. neck = M -0.5 (-1.5 to +.5), 2. waist = M -1.85 (-6 to 0); 3. hips = M -1.35 (-2.25 to +1); 4. thighs = M +0.2 inches (-2 to +4). TCpO^sub 2^; M -2mmHg (-17 to +16); TCpCO^sub 2^, M 1.25mmHg (-11 to +15). Blood glucose was M -70 mg/dl/session (+22 to -111). RESULTS : WA effectively reduces A1c. A decrease of 1% of A1c reduces risk of stroke and heart attack by 40%.

Data show that 18.2 million Americans or 6.3% of the population have diabetes [U.S. Department of Health and Human Services (DHHS), 2002]. Type 2 diabetes (T2DM) accounts for about 90% of cases. Diabetes is the leading cause of blindness among people 20 to 74 years of age. Forty-four percent of cases of end-stage renal disease are related to diabetes. An estimated 82,000 non-traumatic lower-extremity amputations are performed annually due to peripheral vascular disease and peripheral neuropathy related to diabetes (DHHS, 2000). Treatment costs for diabetes amount to $132 billion annually (Mayer-Davis, D'Antonio, & Tudor-Locke, 2003). Each complication costs about $50,000 per case and adds to the escalating costs of Healthcare and human suffering. Means to reduce complications are greatly needed. A regular exercise program is one possible option.

Type 2 DM disproportionately affects ethnic populations, especially Hispanics, African Americans, American Indians, Alaska Natives, and Asian-Pacific Islanders. Additionally, these ethnic groups have more T2DM complications (DHHS, 2002). T2DM contributes to health disparities between minority groups and Caucasians (Rewers, Shetterly, & Hamman, 1995).

Studies show that obesity and a sedentary lifestyle are related to an increase in T2DM (Cary, Walters, Colditz, et al., 1997). Regular vigorous activity decreases the likelihood of T2DM and improves blood glucose control in people with T2DM (Hu, Sigal, Rich-Edwards, et al., 1999). The National Institute of Diabetes, Digestive, and Kidney disease called for research into diabetes and physical activity (Wing, Goldstein, Acton, et al., 2001).

Use a Stethoscope to Gauge Exercise Intensity

Keeping a stethoscope on hand makes it easy to check your pulse rate while exercising at home or in the gym. Counting your pulse at the wrist or neck is sometimes difficult. A stethoscope placed under the left breast clearly detects heartbeats, however.

Monitoring your pulse rate is Important for a safe and effective workout. To gauge exercise intensity, fitness experts recommend checking the pulse midway through an exercise session and comparing it to one's target heart rate--a figure based on age and fitness level,

To calculate your target heart rate, first subtract your age from 200. This is your maximum heart rate, or MHR. In general, the target heart rate is 65 percent of the MHR for those beginning an exercise program, 75 percent of the MHR for regular exercisers, and 85 percent of the MHR for those in advanced regimens.

A stethoscope, widely available for less than $20, is also a useful addition to home first-aid kits for detecting heart and lung sounds in an emergency.

Women's Health: Bladder Control

Women of all ages may have bladder control problems. The following self-care tips from National Institutes of Health experts can help:

* Daily exercises to strengthen pelvic muscles can maintain or improve bladder control (see sidebar above).

* Add fiber to your diet to help prevent constipation, a condition that stresses bladder control muscles.

* Caffeinated food and drinks may Increase urine excretion and should be avoided. Carbonated beverages may also irritate the bladder. ' Health professionals who treat incontinence include a gynecologist (a women's doctor), a urogynecologist (an expert in women's bladder problems), and a urologist (a specialist in bladder conditions). Dryness aids such as Serenity[R] pads provide absorbent, discreet protection to help people cope with bladder leakage. For a free sample and product information, visit www.serenity.com.

Keep Your Memory Sharp

Forgetting names and misplacing the car keys probably doesn't mean you're losing your memory, according to Mayo Clinic experts. Forgetfulness that people often report at midlife could be due to increased responsibilities or depression. Stress plays a role, too. Hormones produced by the body in times of stress can interfere with the ability to remember words. phone numbers and other details. action now can help

To help keep overcome forgetfulness your memory sharp, stay physically active, take a class or learn a new skill, and get periodic health exams. Left untreated, coronary artery disease and diabetes may lead to memory loss. For most healthy adults. there's very little change in thinking or memory before age 75. Even then, changes are minimal.

8 MAJOR FITNESS TRENDS OF THE 1990s:

In their recently published annual report, the Fitness Products Council identified eight major fitness trends in the 1990s.

1) An increase in the use of exercise machines--America especially embraced cardiovascular machines such as treadmills and stair climbers, but they also utilized strength training equipment.

2) A boom in the use of free weights, especially by women--In 1995, working out with free weights became the number one fitness activity in the nation.

3) An increase in treadmill popularity--In 1987, 4.4 million Americans reported exercising on a treadmill. By 1997, the number had grown by 720% to 31.7 million.

4) An increase in health club popularity--Health club memberships rose from 13.8 million in 1987 to 22.5 million in 1997--a 63% gain.

5) Increased usage of home equipment--The Fitness Products Council found exercise equipment is owned and used in nearly one-third of American households.

6) Enduring commitment--Baby boomers, the creators of the fitness movement, have not surrendered to middle age and settled into a sedentary life. Instead, they remain committed to working out.

7) An evolution in exercise forms--New devices and routines have emerged to motivate and attract exercisers. Not only has new equipment such as stair climbers, abdominal trainers and elliptical motion machines been introduced to the gym, but step aerobics now shares the floor with yoga, ethnic-inspired dance movements, cycling, free weights and treadmills.

8) More personal trainers--Personal trainers who were once only employed by movie stars and sports heroes are now accessible to almost anyone. In 1993, the Aerobic and Fitness Association of America held 96 certification workshops for personal trainers. In 1998, the number of workshops will be nearly 300.

It already lowers your blood pressure, cholesterol, and risk of diabetes, stroke and heart disease, as well as boosting your sexual desirability and subsequent performance. Now it turns out that exercise may also keep cancer at bay, even if you're a smoker.

Researchers followed 25,892 men, ages 30 to 87, for an average of more than 10 years. During that period, there were 335 cancer deaths. The results were adjusted for age, examination year, smoking habits, alcohol intake, body mass index and diabetes.

"Moderate and high levels of cardio-respiratory fitness were associated with lower risk of smoking-related and nonsmoking-related cancer mortality when compared with low fitness in men," report lead authors Chong Do Lee of West Texas A&M University in Canyon, and Steven Blair of the Cooper Institute in Dallas. Thus, "fitness may provide protection against cancer mortality in men." Researchers at the University of Minnesota at Minneapolis also participated in the study, which was published in the journal Medicine & Science in Sports & Exercise.

The fittest subjects, considered "recreationally competitive," had a 55 percent reduction in overall cancer death. Moderate fitness, defined as the equivalent of running 20 to 40 minutes three to five days a week, was rewarded with a 38 percent risk drop.

The benefits widened to 66 percent and 43 percent, respectively, when assessing smoking-related cancers. About 10 percent of the fittest group smoked, compared to 20 percent of the moderately fit group and 33 percent of the sedentary group. If the sedentary subjects who smoked had become fit, the researchers calculated, they would have reduced their mortality risk by 13 percent.

Several theories were put forth to explain the benefits, the first being that cardiovascular exercise may help clear the lungs of cancer-causing chemicals. Fitness regimens could also improve the body's defenses against cancerous tumors, and/or help the body withstand the debilitating effects of cancer treatments. In addition, fit men are generally more health-conscious than sedentary men, and thus may seek medical treatment at earlier stages.

The study was less encouraging for light exercisers. Taking a walk may help your heart, but it appears you need to break a sweat to reduce your cancer risk.

This confirms an earlier study at the Royal Free and University College Medical School in London. After tracking 7,588 men for 18 years, investigators found that cancer protection only seemed to occur in those who pursued moderately vigorous or vigorous exercise. "Sporting activity was essential to achieve significant benefit," concluded the report, published last year in the British Journal of Cancer.

Pumping iron--a central component of bodybuilding and increasing muscle strength--is usually safe if an athlete is physically fit and supervised by a trainer. "Usually safe," are the key words. No matter how fit you are, it is important to listen to your body.

Take the 21-year-old football player, for example, who performed squat lifts as part of his off-season training program. For three years, he experienced knee pain when he did lifts with heavy loads, but experienced relief when he lifted lighter loads. One day, while lifting 227 pounds, he experienced a "pop" and acute pain in his left knee. Immediately, his knee filled with fluid, swelled and became tender to the touch.

At Pace University, an x-ray revealed he had a broken kneecap and the diagnosis was "stress fracture." The clinicians suggested that the heavier loads caused bone fatigue from repeated micro injuries, rather like bending a strip of metal back and forth until it snaps. The injury was treated promptly and the athlete recovered without complications.

A review of medical literature by the Pace Team produced reports of weight-lifting injuries of the limbs, chest and spine. They also found reports of kneecap fractures among basketball players and other jumping athletes, giving support to their theory that kneecap may break after repeated "minor" injuries.

Bone pain should alert athletes and their trainers of an impending stress fracture. A medical examination can indicate whether the athlete could benefit from lifting lighter weights or whether a re-evaluation of training goals is in order.