Saturday, October 31, 2009

How Nurses Can Help Patients Manage Chronic Fatigue Syndrome

By Debra Wood, RN, contributor

Oct. 29. 2009 - More than a million Americans suffer from chronic fatigue syndrome ― dealing with sleep, cognitive and physical symptoms that are often difficult to manage. While misperceptions have surrounded the disease, more health care professionals are beginning to recognize that they can help patients cope with the condition, manage symptoms and improve function and quality of life.

“Perceptions are changing,” said K. Kimberly McCleary, president and chief executive officer of the CFIDS Association of America, headquartered in Charlotte, N.C. “We’ve seen dismissal and disbelief give way to the need for tools. Health care professionals in the past said it was not real: a collection of symptoms or a name for something until we find what is really causing the problems. Now there seems to be recognition the patient is really sick.”
K. Kimberly McCleary
K. Kimberly McCleary indicates there are many ways nurses can help chronic fatigue patients cope with their illness.

Chronic fatigue syndrome (CFS), also known as chronic fatigue and immune deficiency syndrome (CFIDS), was first recognized about 25 years ago. Experts still do not know the cause. As recently as 2006, the Centers for Disease Control and Prevention (CDC) estimated that less than 20 percent of Americans with CFS have been diagnosed.

Profound exhaustion, poor stamina with post-exertional relapse, and difficulty with concentration, processing thoughts and short-term memory characterize the condition. Joint and muscle pain, unrefreshing sleep, tender lymph nodes, sore throat and headache may accompany the core symptoms, which can vary in severity.

“The most disabling symptoms are usually those that, if treated, can improve the whole symptom complex and function,” McCleary said.

Treatment often entails correcting sleep abnormalities, with behavioral management strategies and medications, such as amitriptyline or antihistamines.

“Most nurses understand if there is poor sleep, pain is worse, cognitive problems are worse,” McCleary said. “That becomes a cycle that is difficult for the patient to break.”

Some providers will prescribe Provigil or Ritalin to boost energy levels. Prescribers, typically, start with the lowest possible dose. But in addition to medications, patients must adjust their lifestyles and learn to pace activities. They also need emotional support, even professional counseling.

“Nurses play an important role in the care of patients, in the inpatient and outpatient settings,” McCleary said. “Nurses have a mindset oriented to patients’ needs, beyond the prescriptions that need to be written, and they can be important links in a health care system that doesn’t always serve chronically ill patients as well as it should.”

Three forms of chronic fatigue exist: a sudden-onset, post-viral condition; a remitting-relapsing form; and a severely ill or progressive type. About one-quarter of patients receive disability benefits, and others may work part time in less-demanding positions than they once held.
Suzanne D. Vernon, Ph.D.
Suzanne D. Vernon, Ph.D., said nurses can help patients receive an earlier diagnosis, which might improve outcomes.

“It’s important to get people diagnosed earlier,” said Suzanne D. Vernon, Ph.D., scientific director of the CFIDS Association of America. “Data shows if a person with CFS is diagnosed early, once they meet the case definition, which is six months or longer, the likelihood of recovering from the illness is greater than if it goes beyond two to five years.”

Current Research, Tools and Awareness Efforts

The CFIDS Association of America, together with the CDC, created a national public health education campaign called Spark! to increase understanding of CFS among individuals experiencing symptoms of the illness, the general public and health care professionals. The campaign includes a national traveling photo exhibit called The Faces of Chronic Fatigue Syndrome.

Along with the campaign, the CFIDS Association has developed several free resources for nurses and other health care professionals, including a 12-page CFS Toolkit, a two-hour self-study course, a quick-reference brochure and several CFS-related articles, all available for download from the CFIDS web site.

Research continues in an attempt to find a cause for CFS, a test to help diagnose the disease, and better approaches to treating the illness.

In October 2009, a team from the Whittemore Peterson Institute at the University of Nevada, Reno; the National Cancer Institute, part of the National Institutes of Health; and the Cleveland Clinic in Ohio announced a potential retroviral link to chronic fatigue syndrome, after discovering the xenotropic murine-related retrovirus was present in 67 percent of a specific group of long-term CFS patients with cognitive deficits but in only 8 percent of the healthy controls.

Vernon describes this as a possibly “game-changing scientific event,” if the data can be replicated, since it could help as a diagnostic tool.

“It clearly shows an indisputable biologic basis for describing the immune dysfunction in CFS,” Vernon said.

In addition, the CFIDS Association is funding research to better understand the association between CFS and Epstein-Barr virus. The viral infection may possibly be a triggering event. Another study is researching a marker present after CFS patients exercise.

“There is hope,” McCleary said. “There are things that help to give patients a foothold in trying to get their function and daily life improved, while the science continues looking for better answers.”

Changing Behavior Helps Patients Take Medication As Prescribed

Taking medication as the doctor prescribes is crucial to improving health. However, 26 to 59 percent of older adults do not adhere to instructions, according to a 2003 study published in Drugs and Aging. In a new study, researchers at the University of Missouri found that applying behavior changing strategies, such as using pill boxes or reducing the number of daily doses, can improve patients' abilities to take their medications as required.

"It is very important for physicians and nurses to move past educating patients about the need for medication and focus on teaching behavior strategies," said Vicki Conn, associate dean of research and Potter-Brinton professor in the MU Sinclair School of Nursing. "Implementing these strategies can help older adults take their medications, resulting in better health and well-being."

The Mizzou researchers found that behavior-changing strategies have a greater impact on medication adherence than reinforcing the importance of taking medication to patients. Effective strategies include reducing the number of doses taken daily, prescribing medications so they can be taken at the same time as other medications, and encouraging the use of pill boxes. Giving patients clear, easy to read instructions for the medications also proved to be effective.

There are many reasons older adults have difficulties with medications, Conn said. Vision changes can interfere with reading medication bottles, and arthritis can make it difficult to handle pills and containers. However, the majority of adherence problems are not related to physical health. For example, many people simply forget to take their medications.

"There are approaches to overcome almost all problems," said David Mehr, co-author of the study and director of research in the MU Department of Family and Community Medicine. "It makes a huge difference in patients' adherence and health if they have some type of organized system for taking medication."

Failure to take prescribed medications can result in costly health interventions, including expensive tests and unnecessary additional prescriptions, Conn said. An interest in medication adherence research has grown recently due to its low rates among the adult population. In this study, the researchers conducted an analysis of 33 trials to combine and relate the findings of previous research.

The study "Interventions to Improve Medication Adherence Among Older Adults: Meta-Analysis of Adherence Outcomes Among Randomized Controlled Trials" was published in the August issue of The Gerontologist.

Source:
Emily (Smith) Martin
University of Missouri-Columbia

Unemployed nurses are switching to RN health coach careers

Although the contagious economic epidemic is killing off nursing jobs, the thriving RN health coach sector appears to be immune. Many underpaid or unemployed nurses are transitioning into the booming health coach field with help from L.I.T.E. Therapeutics -- a leading provider of health coaches with nursing backgrounds. The company operates two web sites, HealthCoachNursingJobs.com and RNHealthCoach.com, where nurses can discover exciting RN health coach careers that are personally, professionally, and financially rewarding.

Unemployment remains historically high, even within the nursing profession. But the recession is also inspiring consumers to take more responsibility for their own health and well-being in order to avoid costly visits to the doctor, especially since many Americans have lost their health insurance due to recent layoffs. That unique trend is creating a greater reliance upon professional health coaches as an alternative to doctors, clinics, and hospitals -- but has also created a shortage of qualified health coaches. Because nurses offer specialized health care knowledge, experience, and credentials that other coaches do not have, RN health coaches are suddenly in high demand.

Nursing jobs have historically been resilient during economic downturns. But as the Wall Street Journal, Forbes, and other business news sources have reported, this recession is different. Less health insurance money is in the system and cash-strapped Americans are having fewer elective medical procedures, which translates into dramatically lower health care industry revenues. A recent feature in USA Today, for instance, described how hospitals are delaying expansion projects and implementing hiring freezes. The American Hospital Association reports that nearly half of the hospitals it surveyed have postponed the expansion of medical wards, diagnostic equipment purchases, and planned staff increases in emergency departments. Meanwhile agencies have slashed student loan relief to recent nursing school graduates, leaving new nurses with fewer job prospects, lower pay, and bigger debt.

But RNs can become health coaches to easily avoid the problems facing their profession, says Dwayne Adams, RN, MS. The company he started, L.I.T.E. Therapeutics, offers an integrated health coaching system that was designed by nurses and for nurses. As Adams explains, "Our turn-key approach provides nurses with all the tools necessary to effectively manage both their patients and their businesses, to successfully transition into this growing field even during the nursing industry recession."

Coaches typically lack the medical training necessary to guide clients toward sustainable weight loss or improved health, for instance, but RNs are the best possible weight loss partners and personal trainers. Not only do they have advanced knowledge about diet, nutrition, and the accurate diagnosis of health challenges, but they also know how to keep clients safe, motivated, and effectively focused on essential health issues.

That makes them perfect candidates to excel within the burgeoning RN health coaching arena, where they can enjoy successful careers that are truly recession resistant.

Sunday, October 4, 2009

Obese and Overweight Women Have a Higher Risk of Giving Birth to Baby with Heart Defects

The largest study of obesity during pregnancy and babies with heart defects in the United States finds that women who were overweight or obese before they became pregnant had an approximately 18 percent increased risk of having a baby with certain heart defects compared with women who were of normal body mass index (BMI) before they became pregnant. Severely obese women had approximately a 30 percent increased risk, according to a study by the Centers for Disease Control and Prevention.

The study, “Association Between Prepregnancy Body Mass Index and Congenital Heart Defects,” published in the American Journal of Obstetrics and Gynecology, found a significant increase in several types of heart defects in babies born to overweight and obese women, compared to babies born to normal weight women.

These included obstructive defects on the right side of the heart, and defects in the tissue that separates the two upper chambers of the heart.

Obesity and overweight were determined based on the study’s participants’ BMIs. A BMI is a measure of weight in relation to height. Overweight is defined as a BMI of 25-29.9, moderate obesity is defined as a BMI 30-34.9, and severe obesity is defined as a BMI of 35 or higher. For example, a woman who is 5 feet, 5 inches tall and weighs 190 pounds has a BMI of 31.6 which places her in the moderate obesity category; a woman of that same height who weighs 160 pounds has a BMI of 26.6 which places her in the overweight category.

“Congenital heart defects are the most common types of birth defect, and among all birth defects, they are a leading cause of illness, death, and medical expenditures,” said Dr. Edwin Trevathan, director of the CDC’s National Center on Birth Defects and Developmental Disabilities. “Women who are obese and who are planning a pregnancy could benefit by working with their physicians to achieve a healthy weight before pregnancy.”

The study looked at 25 types of heart defects and found associations with obesity for 10 of them. Five of these 10 types were also associated with being overweight before pregnancy. Women who were overweight but not obese had approximately a 15 percent increased risk of delivering a baby with certain heart defects.

The study accounted for several important factors such as maternal age and race-ethnicity. Mothers with type 1 or 2 diabetes before they got pregnant, a strong risk factor for heart defects, were excluded from the study.

“These results support previous studies, as well as provide additional evidence, that there is an association between a woman being overweight or obese before pregnancy and certain types of heart defects,” said Suzanne Gilboa, epidemiologist at CDC’s National Center on Birth Defects and Developmental Disabilities, and primary author of the study. “This provides another reason for women to maintain a healthy weight. In addition to the impact on a woman’s own health and the known pregnancy complications associated with maternal obesity, the baby’s health could be at risk.”

One important limitation of the study is that BMI is calculated based on self-reported weight and height, and weight may be underreported by women during the study interview. Although the study found an association between overweight and obesity and the risk of certain birth defects, further study is needed to determine whether body weight is the direct cause of these birth defects.

The analysis included 6,440 infants with congenital heart defects and 5,673 infants without birth defects whose mothers were interviewed as part of the National Birth Defects Prevention Study (NBDPS). The NBDPS is funded by the CDC to collect information from mothers of children with and without birth defects in Arkansas, California, Georgia, Iowa, Massachusetts, New York, North Carolina, Texas, and Utah. This study is the largest effort ever undertaken in the United States to identify risk factors for birth defects.

For more information about heart and other birth defects please call toll free 1-800-CDC-INFO or visit http://www.cdc.gov/ncbddd.

Source: CDC


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Goal-setting helps smooth way to smoke-free future

By Jennifer A. Kern, M.S., C.T.T.S.

When planning to stop smoking, applying goal-setting strategies can help you create doable steps while preparing for your smoke-free date.

Effective goal-setting involves not just saying what you want to accomplish, but actually planning what to do, how much of it and by when. Your goals should be achievable for you and realistic within your normal routine. By setting measurable goals, you can tell whether or not you achieved them.

Vague goals, which neglect the planning stage, can leave your ambitions hanging somewhere out in the future, without your moving closer to them. The image that comes to my mind is of a donkey following a carrot on a stick that is dangled in front of it. No matter how much or how far the donkey walks, it never gets any closer to the carrot. By setting goals and effectively planning, you create strategies to "reach the carrot."

In the process of preparing to stop smoking, I find some people have more success if they break it down and start by creating small goals along the way. Below is an example of how this might look:

Goal: Stop smoking in my car
Date (by when): Oct. 15
Planning (what to do):

* Buy substitutes: 1 bag of suckers, 10 packs of chewing gum, a stress ball and an audio book.
* Stock the car with substitutes on Oct. 14.
* Plan alternate routes to drive to regular destinations by Oct. 14.
* Buy air freshener and begin using on Oct. 15.
* Empty ashtrays and remove lighters on Oct. 15.

Once the first goal is accomplished (which you will know by Oct. 15), you can focus on the next aspect of moving toward your smoke-free date. Goal-setting and well-planned "baby steps" will support your transformation from smoker to non-smoker and make it more sustainable over the long haul.

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Scientists find path to fountain of youth

by Jean-Louis Santini Jean-louis Santini – Thu Oct 1, 11:10 pm ET

WASHINGTON (AFP) – The fountain of youth may exist after all, as a study showed that scientists have discovered means to extend the lifespan of mice and primates.

The key to eternal -- or at least prolonged -- youth lies in genetic manipulation that mimics the health benefits of reducing calorie intake, suggesting that aging and age-related diseases can be treated.

Scientists from the Institute of Healthy Ageing at University College London (UCL) extended the lifespan of mice by up to a fifth and reduced the number of age-related diseases affecting the animals after they genetically manipulated them to block production of the S6 Kinase 1 (S6K1) protein.

Scientists have shown since the 1930s that reducing the calorie intake by 30 percent for rats, mice and -- in a more recent finding -- primates can extend their lifespan by 40 percent and have health benefits.

By blocking S6K1, which is involved in the body's response to changes in food intake, similar benefits were obtained without reducing food intake, according to the study published in the US journal Science.

The results corroborated those of other recent studies.

"Blocking the action of the S6K1 protein helps prevent a number of age-related conditions in female mice," explained UCL professor Dominic Withers, the study's lead author.

"The mice lived longer and were leaner, more active and generally healthier than the control group. We added 'life to their years' as well as 'years to their lives.'"

The genetically altered female mice lived 20 percent longer -- living a total of 950 days -- or over 160 days more than their normal counterparts.

At age 600 days, the equivalent of middle age in humans, the altered female mice were leaner, had stronger bones, were protected from type 2 diabetes, performed better at motor tasks and demonstrated better senses and cognition, according to the study.

Their T-cells, a key component of the immune system also seemed more "youthful," the researchers said, which points to a slowing of the declining immunity that usually accompanies aging.

Male mice showed little difference in lifespan although they also demonstrated some of the health benefits, including less resistance to insulin and healthier T-cells. Researchers said reasons for the differences between the two sexes were unclear.

"We are suddenly much closer to treatments for aging than we thought," said David Gems of UCL's Institute of Healthy Aging, one of the authors of the study, which was primarily funded by the Wellcome Trust.

"We have moved from initial findings in worm models to having 'druggable' targets in mice. The next logical step is to see if drugs like metformin can slow the aging process in humans."

Other studies have also found that blocking S6K1 were channeled through increased activity of a second molecule, AMPK, which regulates energy levels within cells.

AMPK, also known as a master "fuel gauge," is activated when cellular energy levels fall, as takes place when calorie intake is reduced.

Drugs, such as the widely-used metformin, that activate AMPK are already being used in human patients to treat type 2 diabetes.

Recent studies by Russian scientists suggested that metformin can extend mice's lifespan.

Another drug, rapamycin, was found to extend the lifespan of mice, according to a study published in the British journal Nature.

As rapamycin is already used in humans as an immunosuppresant -- to prevent a patient from rejecting an organ after transplant -- it could not be administered as an anti-ageing drug in its current form.

But rapamycin blocks S6K1 activity and could thus extend lifespan through its impact on S6K1.

Seizing on the potential, US firm Sirtris Pharmaceuticals uses resveratrol, a powerful anti-oxidant found in red wine, as well as other fruits than raisin.

Sirtris scientists -- including co-founder David Sinclair, also a researcher at Harvard Medical School -- have found that resveratrol activates the production of sirtuin proteins, which also unleash the same physiological effects as reducing calorie intake.

Sirtris has produced highly concentrated doses of resveratrol and is currently leading clinical trials with diabetes patients and others suffering from liver and colon cancer.

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Saturday, September 5, 2009

Why Should I work with a Health Coach?

Why should you work with a health coach? What is a health coach and how do you use the services of one? Five years ago a health coach was an unknown profession except in the world of corporate executives or large corporations. Now it is a growing business with health coaches, wellness coaches and fitness coaches. In our age of growing baby boomers people are turning to coaches more and more for help with health or fitness related issues that they cannot resolve. We are in a movement of people acquiring more knowledge about health risks and wanting to make sound choices in their lives and prevent catastrophic problems. People are living longer each year and it is of utmost importance to keep ourselves healthy to live those extra years with a good quality of life.

A health coach is there for you to be your partner in taking charge of your health, recognizing bad choices and teaching you to make wise choices. Included in the job description of a health coach is the training that they incorporate into an action plan for you. They empower you, support you, motivate and inspire you, encourage you and challenge you.

A health coach gives you a new approach to your lifestyle in terms of getting fit, understanding what beneficial habits are and learning to stop non-beneficial habits. You and the coach focus on health changes you need to make and also on managing chronic health conditions enhancing your life.

There are some important points to consider when you are trying to stay healthy, reach a fitness or nutritional goal or manage a chronic health issue. Listed are some points to consider;

1. You need to have a goal to reach. That goal is specific for each individual. Examples would be a goal to lose 10 pounds, a goal to increase your endurance so you can go hiking for 5 miles with your kids, a goal to learn to eat nutritionally and decrease junk food, a goal of becoming more fit when you have severe arthritis. You can see what I mean, that goals are different for everyone. When you work with a health coach you and the coach decide what the goal should be, and put it in some concrete fashion. Concrete fashion could be a contract, written goals with specific time lines, you get the idea. Your coach works for you and with you to persevere towards that or those specific goals. Your coach should be able to motivate you, understand what needs you may have and continually promote progress. Your coach should also be able to listen to you and respect your concerns and issues that may be holding you back from reaching your goals.

2. Any wellness program has a fitness program. Your health coach works with you to research and plan for a specific program. The coach also motivates and inspires you to perform the program and push yourself.

3 A change in lifestyle is usually necessary to reach a goal of optimum health. A health coach has the knowledge to promote those changes in you and is your advocate when you are working against yourself.

4. Your health coach educates you about wellness, nutrition and fitness. Your coach should be knowledgeable about anatomy, physiology, disease processes and many other facets about health and disease. A health coach should provide you with informative articles, news, or places of value to you in bringing you to your optimum level of wellness.

5. Your health coach should have the knowledge base to understand your health and potential health issues and involve a medical professional when necessary.

6. A health coach should be persistent, dedicated to you and patient with you.

A health coach is a motivating and inspiring force behind you. A health coach wants to bring you to your optimum level of health. Teaming up with a health coach can help you to achieve success, to emulate models of health and have an advisor who supports you and is a positive change agent in your life.

Kat is a RN and health coach. With over 20 years in practice she has an extensive knowledge base and is a motivating force. To read more visit her website and blog at http://www.goddessofchange.com



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Sunday, August 30, 2009

New Drug Fights Fat, Lowers Cholesterol and Reverses Diabetes - Nutrition | Physical - FOXNews.com

New Drug Fights Fat, Lowers Cholesterol and Reverses Diabetes - Nutrition | Physical - FOXNews.com

Researchers searching for a cure for obesity said on Thursday they have developed a drug that not only makes mice lose weight, but reverses diabetes and lowers their cholesterol, too.

The drug, which they have dubbed fatostatin, stops the body from making fat, instead releasing the energy from food. They hope it may lead to a pill that would fight obesity, diabetes and cholesterol, all at once.

Writing in the journal Chemistry and Biology, Salih Wakil of Baylor College of Medicine in Texas, Motonari Uesugi of Kyoto University in Japan and colleagues said the drug interferes with a suite of genes turned on by overeating.

"Here, we are tackling the basics," Wakil said in a telephone interview. "I think that is what excited us."

Scientists are painfully aware that drugs that can make mice thin do nothing of the sort in humans. A hormone called leptin can make rats and mice drop weight almost miraculously but does little or nothing for an obese person, for instance.

But Wakil, whose team has patented the drug and is looking for a drug company to partner with, hopes this drug may be different. "I am very, very optimistic," he said.

Fatostatin is a small molecule, meaning it has the potential to be absorbed in pill form.

It works on so-called sterol regulatory element binding proteins or SREBPs, which are transcription factors that activate genes involved in making cholesterol and fatty acids.

"Fatostatin blocked increases in body weight, blood glucose, and hepatic (liver) fat accumulation in (genetically) obese mice, even under uncontrolled food intake," the researchers wrote.

Genetic tests showed the drug affected 63 different genes.

The idea of interfering with SREBP is not new. GlaxSmithKline has been working on a new-generation cholesterol drug that uses this pathway.

After four weeks, mice injected with fatostatin weighed 12 percent less and had 70 percent lower blood sugar levels, the researchers wrote.

Now they plan to test rats and rabbits, Wakil said.

The drug also had effects on prostate cancer cells they said — something that may help explain links between prostate cancer and obesity.

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Saturday, August 29, 2009

7 Ways to Maintain Weight Loss

7 Ways to Maintain Weight Loss
by Melanie Thomassian

I've noticed recently some of the posters on Diet-Blog Share have been asking about how to maintain weight loss.

There's no doubt about it, despite the large amount of books and other resources available these days, the big problem most people seem to have isn't with losing weight, but maintaining weight loss.

However, it's also true to say there are plenty out there who have been successful at long-term weight loss.

So, what's their secret?

I'm sure you can add heaps to this post--please do I'd love to hear your ideas--these are a few of my suggestions...
How to Maintain Weight Loss

1. Start Small
Think about your current lifestyle, then decide on one or two healthier habits you could add into your life. Remember, they ought to be things you can maintain long-term.

Perhaps you could begin by simply having a healthy breakfast every day, or maybe you could determine that you will only eat when you're hungry and when sitting at the dinner table. Whatever you choose, keep your goals small initially, then add to them as you move forward.

2. Keep a Journal
This tip has probably been repeated so often that it washes straight over your heard, but it's a really important one. In fact, many people find it to be the single most important thing that helped them gain control of their weight.

If you haven't tried it, perhaps now would be a good time to give journalling a go. You'll want to note down everything you eat, including details of the time, place, cooking methods, and portion size, etc. You could also record your weight weekly in there, and perhaps make a note of any emotional eating, if this is a problem for you too.

3. Don't "Diet"
Don't you hate the word diet? I know I do! The very term itself has such negative connotations.

A fancy weight loss diet isn't necessary for weight loss. In fact, you'd probably do a lot better if you just stopped dieting, and instead focused on eating fresh, whole foods most of the time.

The problem with maintaining your weight loss on a "diet," is that most of them don't teach you what to do after you've lost the weight, they're all about the short-term weight loss.

Also, be realistic about what you want to achieve. This is something else I've noticed again and again in the recent Share posts--people want to lose too much weight too quickly. So, try not to set yourself up for a big fall by saying, "I want to lose 30 pounds in two weeks!" Disappointment will sabotage your weight loss efforts, set realistic goals instead.

4. Try a Portable Motivator
This could be an image of you at your heaviest/lightest/fittest--whatever works best for you.

The idea is that it will motivate you to continue. So, if you begin to notice your resolve slipping a little pull out your portable motivator, and remind yourself of what you're aiming for.

5. Stick With It
Successful losers will tell you it gets easier with time.

Studies show that people who have successfully maintained their weight loss for 2-5 years have a much better chance of longer-term success. I know 2-5 years seems like a long time, but weight loss is about change for life, so take it in small baby steps, and you'll get there.

According to the The National Weight Control Registry, successful losers have reported engaging in:


* High levels of physical activity (approximately 1 hour per day)

* Eating a low-calorie, low-fat diet

* Eating breakfast regularly

* Self-monitoring weight

* Maintaining a consistent eating pattern across weekdays and weekends

6. Address Weight Gain Early
How many times have you started dieting, been doing really well, then all of a sudden--BANG--you're back to square one. What on earth happened?

Usually, it's the result of not monitoring how you're doing consistently, so you don't notice things going off a little. To avoid this make sure you keep a consistent check on things, and put the brakes on any weight gain before it gets out of hand again.

7. Take Regular Exercise
Despite Time Magazine's recent bunk article, the fact remains that those who continue with some kind of exercise routine are much more likely to maintain their weight loss.

Check out Mike's article debunking "Why Exercise Won't Make You Thin," and also "How to Make Exercise Work for Your Fat Loss."

If you've successfully lost weight and maintained that loss, what tips would you share with the others on Diet-Blog who struggle with this issue?


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Thursday, August 27, 2009

The Milion $ Nurse




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Sunday, August 23, 2009

What Is The Fastest Way To Build Muscle?

I'm often asked by beginning bodybuilders, "What is the fastest way to build muscle?"
To which I always answer, "It depends."
What's fastest for me might not be optimal for you, and vice versa. We're all very different. However, there are some bodybuilding principles that we all could follow a little closer and learn more about muscle-building in general.
Getting a firm grasp of the following concepts will help you get to the "fastest way to build muscle" for the majority of muscle-building pupils.

Training

  • Train with 5-8 reps for the upper body and 6-10 reps for the quadriceps (10-15 for calves).
  • Exclusively use compound movements. By definition, these exercises involve at least 2 joints. Leave the curls and crunches for putting the finishing touches on your newly-beefed body.
  • Train to failure, but don't go too far. Essentially, lift a weight until you cannot lift it any more (on the concentric portion).
  • High Intensity Training methods can be used, but only sparingly (use ONE method per bodypart). Drop sets, giant sets, negatives, etc. are all viable candidates.

Nutrition

  • Eat enough to fuel your muscle growth. Only you can know what this means, but you cannot expect to quickly build muscle while losing a good amount of body fat. It IS possible, but it's also very difficult to do. It's much simpler just to build the muscle mass quickly and then drop the weight.
  • Do NOT eliminate fats from your diet. In fact, you may want to add some in the form of fish oils and the like. If your body gets any indication that it's about to go hungry, it will go into "starvation mode" by burning muscle cells as fuel. Definitely not something you want to do.
  • Take your supplements! Double up, in fact. Your body needs more nutrition now than ever.

Recovery

  • Give your body enough time between workouts to build itself back up stronger and bigger. The ONLY way you can get bigger is to force your muscles to grow: Break them down with hard and heavy workouts and let them rebuild bigger and stronger. The body is all about self-preservation and if it thinks it can stave off another attack is by getting stronger, it will. It's just that simple.
  • You know how much sleep you need to maintain or grow moderately. But to grow a LOT, you need more rest. Cut out as much extra activity as possible. You can "get back in shape" later, once you've gained the size you want.
That's it really. If I can stress 3 things, it's that you need to keep your muscles constantly nourished with high-quality protein, you need to workout hard enough that the muscles break down, and you need to take enough time between workouts that your muscles have time to grow back stronger than before.
That's the ONLY way your muscles will ever grow.
http://www.muscle-build.com/fastest-way-to-build-muscle.html


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10 Tips for Bootstrapping Your Small Business

In today’s challenging economy you might think you really can’t afford to start a business. The reality is you can - and one smart way to do that is by bootstrapping your startup. This means starting on a shoestring and putting all the money you make back into the business. Bootstrapping will keep you out of debt as long as you remember that any profit you make goes toward growing the company. This has always been a smart way to start a business with less financial risk - and in today’s economic climate, it’s smarter than ever. Here are 10 tips for bootstrapping your business:

1. Start a low-cost business.

It might be nice to open the first of a chain of retail clothing boutiques or a hamburger joint, but most brick-and-mortar businesses require lots of cash. Service businesses or e-commerce businesses, on the other hand, are typically lower-investment. Find a middle ground between your entrepreneurial dreams and the reality of startup costs.

2. Count your cash.

Look around you for money you can tap into. Do you have savings or CDs you could cash in? Do you own any collectibles you could sell for quick cash? How about a “toy” like a motorcycle or sailboat?

3. Keep your day job.

If you want to bootstrap your business, you won’t be paying yourself a salary - at least, not for a while. So if at all possible, consider keeping your day job (or at least working part-time) so you have enough to live on while you build your business.

4. Live at home.

As a young person, maybe you can persuade Mom and Dad to let you live at home for a while so you can save even more money to put toward your business. (And the desire to get out of their house will probably motivate you even more to succeed!)

5. Don’t spend more than you need to.

Buy the bare minimum you need to get your business going. Strike a balance here: You don’t want to go so cheap that you buy a computer without the power you need. But you don’t need to waste money on unnecessary bells and whistles, either. Similarly, spend what you need to make a good impression on clients. But if clients will never see your office, does it matter if your desk is secondhand?

6. Save money on what you do need.

Register to get special offers from retailers you use often. For even more deals, check out Bank of America’s Add It Up, an online shopping portal which allows small business owners to earn up to 20 percent cash back from more than 270 retailers when they shop online with their Bank of America check card through the Add it Up Web site.” The program is free for Bank of America’s Online Banking customers; for more details, go to www.bankofamerica.com/additup.

7. Keep on top of cash flow.

A simple accounting program combined with online business banking can give you access to daily reports that show you exactly how much is coming in and going out.

8. Watch your receivables.

Today, many customers are going longer before paying. Don’t let them. If an invoice isn’t paid on time, follow up (politely) to see what’s going on. Often, a gentle reminder is all it takes to get your money. Or offer a discount if a client pays early.

9. Barter.

Bartering means trading your products and services for someone else’s instead of paying cash. For instance, your Web design company could design a marketing company’s site in exchange for their handling your ad campaign. You can join an official barter exchange (search for them online), or use informal barter with other business owners. Just be sure you put an agreement in writing so everyone knows what they’re getting.

10. Go for the low-hanging fruit.

Get more cash in your coffers by focusing first on the projects or products that are easiest (and least expensive) for you to handle. When you’ve got more money in the bank, you can tackle those longer-term projects that require a bigger investment.
This is a guest blog by Rieva Lesonsky, CEO, Journalist and Author.
Rieva Lesonsky is CEO of GrowBiz Media, a content and consulting company that helps entrepreneurs start and grow their businesses. She recently conducted an expert forum on Bank of America’s Small Business Online Community, where she answered questions about navigating a small business through the current economy. You can also ask her questions at www.askRieva.com or follow her on Twitter at http://twitter.com/rieva


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What Are Carbohydrates? What Is Glucose?

What Are Carbohydrates? What Is Glucose?

22 Aug 2009

There are four major classes of biomolecules - carbohydrates, proteins, nucleotides, and lipids. Carbohydrates, or saccharides, are the most abundant of the four. Carbohydrates have several roles in living organisms, including energy transportation, as well as being structural components of plants and arthropods. Carbohydrate derivates are actively involved in fertilization, immune systems, the development of disease, blood clotting and development.

Carbohydrates are called carbohydrates because the carbon, oxygen and hydrogen they contain are generally in proportion to form water with the general formula Cn (H2O)n.

The four major classes of biomolecules are:
  • Carbohydrates (saccharides) - Molecules consist of carbon, hydrogen and oxygen atoms. A major food source and a key form of energy for most organisms. When combined together to form polymers, carbohydrates can function as long term food storage molecules, as protective membranes for organisms and cells, and as the main structural support for plants and constituents of many cells and their contents.
  • Lipids (fats) - Molecules consist of carbon, hydrogen, and oxygen atoms. The main constituents of all membranes in all cells (cell walls), food storage molecules, intermediaries in signaling pathways, Vitamins A, D, E and K, cholesterol.
  • Proteins - Molecules contain nitrogen, carbon, hydrogen and oxygen. They act as biological catalysts (enzymes), form structural parts of organisms, participate in cell signal and recognition factors, and act as molecules of immunity. Proteins can also be a source of fuel.
  • Nucleic acids - DNA (deoxyribonucleic acid) and RNA (ribonucleic acid). These molecules are involved in genetic information, as well as forming structure within cells. They are involved in the storage of all heritable information of all organisms, as well as the conversion of this data into proteins.
Most organic matter on earth is made up of carbohydrates because they are involved in so many aspects of life, including:
  • Energy stores, fuels, and metabolic intermediaries.
  • Ribose and deoxyribose sugars are part of the structural framework of RNA and DNA.
  • The cell walls of bacteria are mainly made up of polysaccharides (types of carbohydrate).
  • Cellulose (a type of carbohydrate) makes up most of plant cell walls.
  • Carbohydrates are linked to many proteins and lipids (fats), where they are vitally involved in cell interactions.

What are saccharides?

Saccharides, or carbohydrates, are sugars or starches. Saccharides consist of two basic compounds:
    Aldehydes - composed of double-bonded carbon and oxygen atoms, plus a hydrogen atom. Keytones - composed of double-bonded carbon and oxygen atoms, plus two additional carbon atoms.
There are various types of saccharides:
  • Monosaccharide - this is the smallest possible sugar unit. Examples include glucose, galactose or fructose. When we talk about blood sugar we are referring to glucose in the blood; glucose is a major source of energy for a cell. In human nutrition, galactose can be found most readily in milk and dairy products, while fructose is found mostly in vegetables and fruit.

    When monosaccharides merge together in linked groups they are known as polysaccharides.
  • Disaccharide - two monosaccharide molecules bonded together. Disaccharides are polysaccharides - "poly…" specifies any number higher than one, while "di…" specifies exactly two. Examples of disaccharides include lactose, maltose, and sucrose. If you bond one glucose molecule with a fructose molecule you get a sucrose molecule.

    Sucrose is found in table sugar, and is often formed as a result of photosynthesis (sunlight absorbed by chlorophyll reacting with other compounds in plants). If you bond one glucose molecule with a galactose molecule you get lactose, which is commonly found in milk.
  • Polysaccharide - a chain of two or more monosaccharides. The chain may be branched (molecule is like a tree with branches and twigs) or unbranched (molecule is a straight line with no twigs). Polysaccharide molecule chains may be made up of hundreds or thousands of monosaccharides.

    Polysaccharides are polymers. A simple compound is a monomer, while a complex compound is a polymer which is made of two or more monomers. In biology, when we talk about building blocks, we are usually talking about monomers.

Three main types of polysaccharides - storage, structural and bacterial

Polysaccharides may act as food stores in plants in the form of starch, or food stores in humans and other animals in the form of glycogen. Polysaccharides also have structural roles in the plant cell wall in the form of cellulose or pectin, and the tough outer skeleton of insects in the form of chitin.
    Storage polysaccharides
  • Glycogen - a polysaccharide that humans and animals store in the liver and muscles.
  • Starch - these are glucose polymers made up of Amylose and Amylopectin. Amylose molecule chains are linear (long but no branches) while Amylopectin molecules are long and branch out - some Amylopectin molecules are made of several thousand glucose units. Starches are not water soluble. Humans and animals digest them by hydrolysis - our bodies have amylases which break them down. Rich sources of starches for humans include potatoes, rice and wheat.
  • Structural polysaccharides
  • Cellulose - the structural constituents of plants are made mainly from cellulose - a type of polysaccharide. Wood is mostly made of cellulose, while paper and cotton are almost pure cellulose. Lignin, derived from wood, is a key component in the secondary walls of plant cells. Some animals, such as termites, can digest cellulose because their gut has a type of bacteria that has an enzyme which breaks down cellulose - humans cannot digest cellulose.
  • Chitin - chitin, a polysaccharide, is one of the most abundant natural materials in the world. Microorganisms, such as bacteria and fungi secrete chitinases, which over time can break down chitin. These microorganisms also have receptors to the simple sugars that result from this breakdown (decomposition). The bacteria and fungi convert the decomposed chitin into simple sugars and ammonia.

    Chitin is the main component of fungi cell walls, the exoskeletons (hard outer shell/skin) of arthropods, such as crabs, lobsters, ants, beetles, and butterflies. Chitin is also the main component of the beaks of squid and octopuses. Chitin is useful for several industrial and medical purposes.
  • Bacterial polysaccharides These are polysaccharides that are found in bacteria, especially in bacterial capsules. Pathogenic (illness causing) bacteria often produce a thick layer of mucous-like polysaccharide which cloaks the bacteria from the host's immune system. In other words, if the bacteria were in a human, that human's immune system would less likely attack the bacteria because the polysaccharide layer masks its pathogenic properties. E. coli, which can sometimes cause disease, produces hundreds of different polysaccharides.

Carbohydrates and nutrition

Bread, pasta, beans, potatoes, bran, rice and cereals are carbohydrate-rich foods. Most carbohydrate rich foods have a high starch content. Proteins and fats require more water for digestion than carbohydrates. Carbohydrates are the most common source of energy for most organisms and animals, including humans.

Carbohydrates are not classed as essential nutrients for humans. We could get all our energy from fats and proteins if we had to. However, our brain requires carbohydrates, specifically glucose. Neurons cannot burn fat.
  • 1 gram of carbohydrate contains approximately 4 kilocalories (kcal)
  • 1 gram of protein contains approximately 4 kcal
  • 1 gram of fat contains approximately 9 kcal
However, proteins are used in both forms of metabolism - anabolism (building and maintaining tissue and cells) and catabolism (breaking molecules down and releasing/producing energy). So, the consumption of protein cannot be calculated in the same way as fats or carbohydrates when measuring our body's energy needs.

Not all carbohydrates are used as fuel (energy). A lot of dietary fiber is made of polysaccharides that our bodies do not digest.

Most health authorities around the world say that humans should obtain 40 to 65% of their energy needs from carbohydrates - and only 10% from simple carbohydrates (glucose and simple sugars).

Should I go for a high-carb or low-carb nutritional approach?

Every couple of decades some 'breakthrough' appears which tells people either to 'avoid all fats', 'avoid carbs', 'you can't go wrong with carbohydrates', etc. Carbohydrates have been and will continue to be an essential part of any human dietary requirement for hundreds of years, unless a fundamental mutation occurs.

The obesity explosion in most industrialized countries, and many developing countries, is a result of several contributory factors. One could easily argue for or against higher or lower carbohydrate intake, and give compelling examples, and convince most people either way. However, some factors have been present throughout the obesity explosion and should not be ignored:
  • Less physical activity.
  • Fewer hours sleep each night. (Short sleep and obesity link)
  • Higher consumption of junk food.
  • Higher consumption of food additives, coloring, taste enhancers, artificial emulsifiers, etc.
  • More abstract mental stress due to work, mortgages, and other modern lifestyle factors. (Stress and obesity link)
In rapidly developing countries, such as China, India, Brazil, Mexico, obesity is rising as people's standards of living are changing. However, for their leaner nationals of a few decades ago carbohydrates made up a much higher proportion of their diets. Those leaner people also consumed much less junk food, moved around more, tended to consume more natural foods, and slept more hours each night. Saying that a country's body weight problem is due to too much or too little of just one food component is too simplistic - it is a bit like saying that traffic problems in our cities are caused by badly synchronized traffic lights and nothing else.

Current diet promoters of either high or low carb regimes in North America, Western Europe, and Australasia have not really addressed those obesity contributory factors properly. Most of them promote their branded nutritional bars, powders and wrapped products which have plenty of colorings, artificial sweeteners, emulsifiers, and other additives - basically, junk foods. If consumers are still physically inactive and not sleeping properly, they may gain some temporary weight loss, but will most likely be back to square one within three to four years. If you randomly selected 100 adults who have been lean for the last 7 to 10 years, and another 100 people who are obese today, and asked them this question "Have you been on a low fat or low carb diet during the last ten years?" the number of obese people who answered "Yes" to "low fat" and "Yes" to "low carb" would be dramatically higher.

It is true that many carbohydrates present in processed foods and drinks we consume tend to spike glucose and subsequently insulin production, and leave you hungry sooner than natural foods would. The Mediterranean diet of the people in Greece or the island of Corfu, with an abundance of carbohydrates from natural sources plus a normal amount of animal/fish protein, have a much lower impact on insulin requirements and subsequent health problems, compared to any other widespread western diet. Dramatically fluctuating insulin and blood glucose levels can have a long term effect on your eventual risk of developing obesity, diabetes type 2, heart disease, and other conditions. However, for good health we do require carbohydrates. Carbohydrates that come from natural unprocessed foods, such as fruit, vegetables, legumes, whole grains, and some cereals also contain essential vitamins, minerals, fiber and key phytonutrients.

What happens to sugar levels in the blood?

When we eat food with carbohydrates in them our digestive system breaks some of them down into glucose. This glucose enters the blood, raising blood sugar (glucose) levels. When blood glucose levels rise, beta cells in the pancreas release insulin. Insulin is a hormone that makes our cells absorb blood sugar for energy or storage. As the cells absorb the blood sugar, blood sugar levels start to drop.

When blood sugar levels drop below a certain point alpha cells in the pancreas release glucagon. Glucagon is a hormone that makes the liver release glycogen - a sugar stored in the liver.

In short - insulin and glucagon help maintain regular levels of blood glucose for our cells, especially our brain cells. Insulin brings excess blood glucose levels down, while glucagon brings levels back up when they are too low.

If blood glucose levels are rising too rapidly and too often the cells can eventually become faulty and not respond properly to insulin's "absorb blood energy and store" instruction; over time they require a higher level of insulin to react - we call this insulin resistance. Eventually, the beta cells in the pancreas wear out - because they have had to produce lots of insulin for many years - insulin production drops and eventually packs in altogether.

Insulin resistance leads to hypertension (high blood pressure), high blood fat levels (triglycerides), low levels of good cholesterol (HDL), weight gain and other diseases. All these illnesses, together with insulin resistance, is called metabolic syndrome. Metabolic syndrome leads to type 2 diabetes.

If over the long-term blood sugar levels can be controlled without large quantities of insulin being released, the chances of developing metabolic syndrome are considerably lower. Natural carbohydrates, such as those found in fruits and vegetables, legumes, whole grains, etc., tend to enter the bloodstream more slowly compared to the carbohydrates found in processed foods. Good sleep and regular exercise also help regulate blood sugar and the hormone control.

Carbohydrates which quickly raise blood sugar are said to have a high glycemic index, while those that have a gentler effect on blood sugar levels have a lower glycemic index.

The Glycemic Index

Carbohydrates enter the bloodstream as glucose at different rates - high glycemic index (GI) carbohydrates enter the bloodstream as glucose rapidly, while low GI carbohydrates enter slowly because they take longer to digest and break down.

A meal with lower GI carbohydrates will raise your blood glucose levels more slowly, and over a longer period - this is better for long-term health and body weight control.

People who are relatively physically inactive (sedentary), and don't sleep at least 7 hours every night are especially vulnerable to the long-term detrimental effects of regular consumption of high GI carbohydrates.

Low GI carbohydrates have the following benefits:
  • You are less likely to put on weight
  • You are more likely to lose weight if you are overweight
  • You will have better diabetes control
  • Your blood cholesterol levels will most likely remain healthy
  • Your risk of heart disease is lower
  • It will take longer for you to become hungry after a meal
  • Your physical endurance will improve

How can I switch to a low GI lifestyle?

  • If you eat cereals for breakfast, switch to oats, barley or bran. Make sure the oats are as natural as possible; milling or grinding can ramp up their GI dramatically.
  • If you eat bread, only consume wholegrain bread.
  • Eat plenty of fresh fruit and vegetables.
  • If you have a fruit juice make sure you eat all of the pulp (the meat of the fruit).
  • Eat rice with the husk still there (wild rice).
  • If you eat pasta go for whole grain ones.
  • Eat plenty of salads.
  • Cut out all junk foods, processed foods, foods with too many additives (flavorings, emulsifiers, etc).

How processing affects the Glycemic Index of carbohydrates

Milling and grinding of foods always raise their glycemic index. Unfortunately, the processes often eliminate other nutrients, such as minerals, vitamins, dietary fibers as well, leaving what is often no more than starchy endosperm (the inner part of the seed/grain, mainly starch).

What is the difference between the Glycemic Load and Glycemic Index of a food?

The GI refers just to how quickly a food's broken down glucose enters the bloodstream. This may be misleading sometimes. For example, a melon has a high GI, however most of it is water. The glycemic load (GL) takes into account the GI of the carbohydrate as well as how much carbohydrate that food has.

GL = (GI x amount of carbohydrate) divided by 100.

For example:
    An apple has a GI of 40 and contains 15 grams of carbohydrate. GL = (40 x 15) divided by 100 = 6g. A small baked potato has a GI of 80 and contains 15g of carbohydrate. GL (80 x 15) divided by 100 = 12g.
The GL is a better measure for calculating the metabolic effect of foods - but it may not always lead to best nutrition.

What is the disadvantage of using just the glycemic load?

Dietitians, nutritionists and endocrinologists say that GL is useful for scientists, but GI may be better for lay people, especially those with diabetes. Many low GL foods do not have the right nutrients, such as butter or fatty meats which have the wrong types of fats for good long-term health.

Experts from the University of Sydney's (Home of the Glycemic Index) suggest that lay people should use GI as a tool that allows you to "choose one food over another in the same food group - the best bread to choose, etc." and not to get bogged down with the figures.

Remember

  • Slow carbs matter much more than low carbs. A well balanced diet consisting of good quality foods is as important as physical activity and good sleep.
  • Physical activity is a key factor in weight control and good long-term health. It is as important as a good diet and good sleep.
  • Sleeping at least 7 hours each night is as important as a well balanced diet and physical activity.
If you are overweight and you want to lose weight, focusing on slow carbs is useful. A well balanced and nutritional diet, such as the Mediterranean diet, plus good sleep and plenty of physical activity, is much more likely to lead to long-term success and good physical and mental health.

Written by Christian Nordqvist
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today


Article URL: http://www.medicalnewstoday.com/articles/161547.php
Main News Category: Nutrition / Diet
Also Appears In: Obesity / Weight Loss / Fitness, Endocrinology,


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5 medical tests that could save your life

5 medical tests that could save your life


Cardiac CT angiography, virtual colonoscopy are worth the time
By Justin Park
Mens Health
updated 9:57 a.m. PT, Sun., Aug 23, 2009
There are health tests we need, and those we don't. Pelvic ultrasound? Sounds ultrasuspicious. Occult blood test? Only if it comes with an exorcism. Urinalysis? Great, now I'll be kicked off the tour...
It's tough to know which of these are truly essential, especially when they're packaged with dozens of other tests and called an "executive health exam." And yet thousands of men sign up for these screenings — at an out-of-pocket cost of up to $10,000 apiece — based on the sales pitch that a test may uncover a hidden health condition.
Of course, 10 grand might be worth it if all that random screening actually did any good: But a seminal study by the Rand Corporation found that patients who had the most screenings over 5 years were no healthier than those given less medical attention. This isn't to say executive health exams are scams. They can be quite valuable — if you know which of the procedures are worthwhile. So we asked our experts to create an a la carte menu to bring to your GP. Think of these as the best tests for a recession.
Cardiac CT angiography
These colorful 3-D images allow radiologists to calculate one of your most important heart numbers: your coronary artery calcium score, a measure of how much plaque is piling up in your arteries. A 2007 study of over 10,000 people published in the journal Atherosclerosis reported that calcium scores alone can predict heart attacks, while a 2003 study found that a high calcium score is associated with a tenfold increase in heart-disease risk. This is compared with a less-than-twofold increase in risk from traditional risk factors such as diabetes and smoking. The test has one significant downside: The radiation exposure from your average cardiac CT is equal to 600 chest x-rays, according to a study in the Journal of the American Medical Association. This produces a 1-in-5,000 risk of cancer, another study reveals.

Who needs it: Men with some of the risk factors for heart disease whose physicians may be on the fence about starting treatment. "In these medium-risk cases, cardiac CT scans and calcium scoring can provide the extra level of information that we feel we need," says Gerald Fletcher, M.D., a professor of cardiology at the Mayo Clinic. The lower the calcium score, the lower the risk. If you reach 112, your physician might recommend aspirin or statins.

Cost: $350 to $900. Most insurance companies will reimburse you if you've previously had an abnormal stress test or chest pain.

Bone density scan
Think osteoporosis affects only old ladies? Fact is, men begin losing bone mass at age 30. That's why it's important to assess the state of your skeleton now with a dual energy X-ray absorptiometry (DEXA) scan, which uses low-radiation X-rays to gauge bone mineral density (it can also measure body fat percentage). "DEXA scans allow us to identify people at high risk for fracture so they can start treatment to strengthen their bones before a fracture occurs," says Murray J. Favus, M. D., director of the bone program at the University of Chicago medical center. Your doctor might suggest adding strengthening workouts to your exercise program and supplementing your daily diet with up to 1,000 milligrams of calcium and up to 400 IU of vitamin D.
Who needs it: Anyone with any osteoporosis risk factors: inactivity, smoking, a family history of the disease.
Cost: $250 to $300. To increase the odds of your insurance covering the scan, make sure your doctor notes any risk factors.
VO2 max test
With the VO 2 max test, you hop on a treadmill or stationary bike and give your maximum effort while wearing a mask that captures your every breath. By analyzing the amount of oxygen you consume, the test determines how efficiently your body extracts and uses oxygen from the air. This makes it the gold standard of fitness markers, as well as a strong indicator of your overall health. "Blood pressure, cholesterol — those are what we call 'remote markers.' The best predictor of your longevity is going to be your fitness," says Walter Bortz, M. D., a longevity researcher at Stanford University.

Who needs it: Anyone who wants their blood to pump. If your score is under 18 ml/kg/min, talk to your doctor about increasing the intensity of your workouts.

Cost: $110 to $160. The test is available at physical therapy, rehab, or cardiopulmonary centers. Insurance providers won't cover it.

Virtual colonoscopy
By definition, something "virtual" usually can't compare to the real thing. But with a virtual colonoscopy, you avoid the two downsides of a traditional colonoscopy — sedation and the risk of a perforated colon — while still benefiting from the one big upside: test results you can stake your life on. "Virtual colonoscopies have the same sensitivity for detecting large polyps, which are the precursor lesions of colon cancer," says Judy Yee, M. D., a professor of radiology at the University of California at San Francisco. Though the CT scanning technology of a virtual colonoscopy can miss some smaller polyps, a University of Wisconsin study found that these are usually benign anyway. And don't sweat the radiation; you'll receive about 5 to 8 millisieverts, an amount that isn't considered dangerous, says Dr. Yee.

Who needs it: People ages 50 and older, especially those on blood thinners, because an "oops" with a regular scope could cause dangerous internal bleeding. The exception: If your family has a history of colon cancer, you should be screened at least 10 years before the age your relative was when he or she was first diagnosed, Dr. Yee says. People who are overweight or inactive, drink or smoke heavily, or have an inflammatory bowel disease should also consider early screening.

Cost: $500 to $1,000. Many health care plans now recognize the effectiveness of virtual colonoscopies and increasingly cover them.

Nutritional evaluation
While it's not a test per se, putting your diet under the microscope could result in a leaner body and a longer life. "The benefits of meeting with a dietitian are accountability, moral support, and troubleshooting if your progress stalls," says Alan Aragon, M. S., the Men's Health Weight Loss Coach. In a 2008 Kaiser Permanente study, diabetic patients who received nutritional counseling were nearly twice as likely to lose weight as those who had no guidance. To find a registered dietitian who can see beyond the food pyramid, Aragon recommends going to the American Dietetic Association's Web site (eatright.org) and clicking on "Find a Nutrition Professional." Then call the R.D. and ask how he or she stays up on the latest research, which should include reading journals such as the American Journal of Clinical Nutrition or the Journal of Applied Physiology.
Who needs it: Anyone who should lose weight or simply wants to know how they can eat to beat disease.

Cost: $40 to $75 a session. Your insurance company may reimburse you if you have a condition that can be improved with diet changes. Ask your doctor for a referral.

URL: http://www.msnbc.msn.com/id/31892143/ns/health-mens_health/page/2/


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